Diabetes Lottery

To Drink Or Not To Drink? THAT Is The Question!

After last week's post, I was asked a VERY important question, and I think it should be addressed immediately.  The question posed was:  What about alcohol?

It's funny that I was asked that question, because (of course) I asked the same thing.  Here is what I was told.

Carbohydrate contents:

12 oz. Beer - 15 grams

12 oz. Light Beer - ~ 7.5 grams

1 oz. Liqueur - 15 grams

3 1/2 oz. Dessert Wine (Sherry) - ~15 grams

5 oz. Dry Red or White Wine - negligible

1 1/2 oz. Distilled Spirits - 0 grams.

WHAT???!!!  Did I hear that right?  Beer has carbs.  Light beer has carbs. Liqueur has carbs. Dessert wines have carbs.  Red and white wine have a little bit.  But whiskey?  Bourbon, gin, vodka, rum - ZERO????   YEEEHAAAA!  Booker's Manhattan here I come!

Not quite so fast cowboy.  It is true that distilled spirits have zero carbs, and we all know that carbs are the enemy.  The problem is - distilled spirits actually LOWER your blood sugar.

At this point in the discussion, my brain was going so fast I was hoping no one would notice the wisps of smoke coming from my ears.  

Wow - I think she just said that I can cure my high blood sugar by drinking bourbon!  My blood sugar will be 0 by Saturday afternoon!

Here's the deal.  If you are a diabetic (hyperglycemic), you need to lower and control your blood sugar.  But not TOO low (less than 70 mg/dL).  If your sugar goes too low, (hypoglycemic) you run the risk of passing out, going into a seizure, a coma, or even death.  Drinking too much alcohol could cause your blood sugar to go too low.

I know what you're thinking.  Drinking too much can cause me to pass out?  Thanks for the tip Sherlock!  I thought that was the goal.

I can deal with the passing out part.  Been there, done that. It's the seizures, coma and death part that worries me.  Are diabetics more susceptible to the more negative outcomes of over-imbibing  than non-diabetics?  The teacher didn't say.  But let's just use our heads here.  If you are taking meds to help lower your blood sugar, and drinking alcohol in excess, I think it's safe to assume your risk is greater.  And please notice I said 'in excess'.  Over the last eleven months I have certainly not been a saint.  I have had cocktails on more than one occasion.  Just not in excess.  

The other thing you need to know are the warning signs of low blood sugar.  Diabetics know the signs of high blood sugar all too well.  But I can assure you, I've never been the low blood sugar type, and had no idea what the symptoms were.  When our teacher told us the symptoms, I realized that I have a lot of them on a daily basis.

The symptoms of low blood sugar are:

Sweaty or clammy

Irritability

Weak, lightheaded or shaky

Confusion and Hunger

Well that pretty much sums up how I felt after every night of drinking I've ever had.  

If you are diabetic, you need to pay closer attention to what your body is telling you.  If you have any of these feelings, you should test your glucose.  That is, of course, assuming that you are weird enough to carry your meter and test strips out for a night on the town.  (I would love to tell you that I am, but that would be a lie.)  If you have any of these feelings, you need to treat yourself for hypoglycemia.  How do you do that Bob?  Glad you asked.

Remember the "Routine 15".  If you feel that your glucose is low, you should test your glucose, but whether you've tested or not, eat or drink 15 grams of carbs.  A half of a regular soda, a half cup of orange juice, a cup of milk, or two or three hard candies will do the trick.  In fifteen minutes, you should test again. If you are still low, take in another 15 grams.  If you do this three times, and you are still low, you should call your doctor or 911.  This is not the time to fool around.

Here's one of what I will refer to as 'Uncle Bob's Rules of Thumb':  

Don't be stupid.  

If I am invited to have cocktails, I'm in - every time.  There was a day when I could settle in with a nice bottle of bourbon and spend the evening.  As Stevie Ray Vaughn used to say, "livin' life by the drop."  But that was yesterday. Today it is much more important to me to be healthy.  A couple of cocktails  and then just sit around and laugh at the people who are way too intoxicated.  It's actually quite enjoyable.

So, kids...  What have we learned today?

The world has not ended.  You can still enjoy cocktails... just don't be stupid and you'll be fine.  

I'm tired of typing now.  Think I'll have a drink...  

Continuing Education...

Now that I had a better understanding of what diabetes is, I wanted to know how to treat it.  (And by treat it, I mean beat it into submission.)  

Understand this.  I was obese.  I didn't become obese because of a thyroid or other medical condition.  The two things that caused my obesity were food and lack of exercise.  Period.  Of course, at the time, I didn't really consider myself obese.  I knew I was overweight, I knew I wasn't chiseled from marble, but I certainly didn't consider myself obese.  When I look back at pictures from only a year ago, I could vomit.  I'm not sure obese is a strong enough word.  'Tub of lard' comes to mind.  I'm actually embarrassed that I was so fat, but thankful that I allowed myself (on rare occasions) to be photographed.  Quite the motivator.  I promise you now - I will NEVER look like that again!

I tell you this to show you my state of mind at the time.  Losing weight was not my top priority.  I just wanted to take care of this diabetes thing.

We were given a meal plan in class.  It is a very simple plan, and I have been following it for 11 months now.  Diabetic or not, you should follow it too. It was titled, "The 2000 Calorie Basic Meal Plan".  Here's the gist of it.  The plan (notice I didn't say diet) breaks your intake into three groups: carbs, protein, and fat. You are permitted 225 grams of carbs, 125 grams of protein, and 67 grams of fat per day.  Don't panic. There are no scales necessary.

I'll make it simple for you.  Cut and paste this.  This is the secret. 

Breakfast:  3 carb choices (45 grams),  2 servings of protein (2 ounces), and 1 serving of fat.

Lunch:  2-3 carb choices (30-45 grams), 3 servings of protein (3 ounces), and 1 serving of fat.

Dinner:  2-3 carb choices (30-45 grams), 3 servings protein (3 ounces), and 1 serving of fat.

Between breakfast and lunch, between lunch and dinner, and between dinner and bedtime, you should have a snack.  The snack should consist of 1 carb choice, and 1 protein.

Now - what does that mean? Examples:

A carb choice is 15 grams of carbohydrate.  To give you an idea, a slice of bread has ~15 grams of carbs. One-half of a hamburger bun has ~15 grams of carbs.  White, wheat, rye, whole grain - doesn't make a difference.  You should, of course, opt for whole grains as they are easier for your body to process, and better for your heart, but for carb purposes, they are all equal.

A protein serving is 1 ounce.  A slice of lunch meat, a slice of bacon, and a tablespoon of peanut butter are all 1 ounce.

A fat choice could be the oil on your salad, or the butter on your bread.

These are just examples.  Most all foods have nutritional labels.  You do have to read the labels, and believe me, you'll be a pro at this in no time.

For illustrative purposes, your closed fist is about 1 cup.  Your palm is about 3 ounces.  Your thumb is about 2 tablespoons.  Your thumb tip is about 1 teaspoon.  A handful is about 1/4 cup.

Now, here is a sample meal plan for a typical day:

Breakfast:    2 slices of toast (30 g carbs), 1 teaspoon of margarine (1 fat), 2 scrambled eggs (protein).

Snack:    4 Triscuits (30 g carbs), 1 tablespoon peanut butter (protein).

Lunch:    2 slices bread (30 g carbs), 3 slices lean lunch meat (protein), salad with vinaigrette.

Snack:      4 cups of popcorn (30 g carbs).

Dinner:    3/4 cup mashed white potatoes, 1 cup steamed carrots (30 g carbs) 3 ounces roast turkey                      (protein), 1 teaspoon margarine (fat).

Snack:    1 small apple (30 g carbs) and 2 tablespoons peanut butter (protein)

Are you kidding me?  That's more food than I ate, when I ate like it was my job!  

This is just a sample meal plan.  I'll get more in depth in the near future, but for now just use the guide and read the labels.  You'll be surprised how easy and interesting this can be.  And in two weeks, it'll be second nature.  If I can do it - ANYONE can do it!

P.S. - Did anyone watch 'The Event' on Monday night?  I'm not sure if I liked it or hated it.  I was on the edge of my seat until the last 15 seconds, and then...

What did you think?

Hi Ho, Hi Ho...

You know - it's funny.  

I like to educate myself.  I practically have my pre-med degree from WebMD U., I read everything printed about diabetes, and consider myself quite astute in the study of the human spirit, but I HATE school.  It's kind of like my doctor's office phobia.  Today was no different.

That nervous feeling in the pit of my stomach reminded me of so many first days of school.  The only difference was that today I would begin learning about how to control my diabetes.  "If this class includes algebra, there's no way I'll pass" I thought as I pulled into the parking lot twenty minutes early.  

As the classroom began to fill with 'students' I was amazed at the diversity.  I assumed that I would be in a class filled with what was (in my mind) the stereotypical diabetic.  First lesson learned.  There is no stereotypical diabetic.  My class looked more like NATO that a bunch of diabetics.  Fat, thin, short, tall, moms, dads, twenty-somethings, seventy-somethings, couch potatoes, athletes - we were all there. (I fit into at least four of the categories.)

Our instructor, Trish, was a pleasant young lady, probably in her early thirties, who was also a diabetic. She gave us all a name tag (ugh), and then called us up for the weigh-in (UGH).  Although she was slender now, I assume that she was obese at some point in her life as she knew how to properly execute the weigh-in.  We went to the back of the room, one at a time, and mounted the scale.  When she had obtained the correct weight she wrote it down on our chart.  She then turned the chart around so we could see the number.  No announcement, no fanfare, no bullhorn.  Cool.

I was never a bad student, but I always had a problem with school - I had this feeling that my time would be better spent somewhere else. The topic of today's class was 'What IS diabetes'.  "Here comes that feeling again.  I already know what diabetes is.  Can we please hurry this along?"

Thankfully, we didn't.  Here is how Trish explained things:

When you have diabetes, it means that your blood glucose (sugar) levels are too high.  Much of the food that we eat is turned into glucose when it is digested.  The glucose is carried by your bloodstream to your cells and it is used for energy.

Your pancreas makes insulin.  Insulin is like a doorman.  When the glucose tries to enter your cells, it can't get in by itself.  The doorman (insulin) has to open the door for it.

If you pancreas doesn't make enough insulin, or if your cells 'resist' the insulin, the glucose can't enter your cells.  The glucose just hangs around in your bloodstream.  This is when your blood glucose levels go up.

That is diabetes.

Hmmm.  So it is starting to sound like all my years of debauchery didn't bring this on.

There are three types of diabetes: Type I, Type II, and Gestational.  My experience is limited to type II, so that is what I am going to focus on here.

Type II diabetics can't properly use insulin.  Our bodies 'resist' insulin.  Our little pancreas's just work themselves to death producing insulin that our bodies then resist. 

Ingrates.

Anyway, our pancreas gets tired of doing all this work for nothing and slows down production.  That is why many type II diabetics need to take diabetes meds, and/or insulin injections - to help out the pancreas.

Wow!  I thought I knew what diabetes was.  After doing some work sheets, q&a, and discussion, class number one was over. That nervous feeling was gone.  I had learned a lot.  And believe it or not, I was looking forward to next week!

P.S. - Thanks to Dianne Salerni (Diannesalerni.blogspot.com) for the great interview!  If you haven't done so, please check it out.  Also, thanks to all of you who have left such wonderful comments.  I am truly humbled.   

Interview today with author Dianne Salerni (my cousin). Check it out at :www.diannesalerni.blogspot.com

Inspiration From The Strangest Places

Before we head off to diabetes education class, I think now would be a good time to let you inside my head. Please keep your hands inside the ride at all times.  And please - no flash photography. 

There are many different ways to approach a problem, and I'm sure everyone thinks that their way is the best. I am no exception.  

Fight or flight is the most basic instinct.  In my opinion, if you have even the slightest chance of winning, fight is the best option.  Don't get me wrong, if a 1200 pound grizzly bear is about to remove your face, you may want to run, but  type II diabetes is not a bear.  It's time to stand and fight.  You may not be able to win, but you can beat it into submission.

It's all about attitude.  You can most certainly put your head down and feel sorry for yourself.  Take the meds that your doctor has prescribed, inject a little insulin, wait and hope.  Wait for the tingling to start in your fingers and toes. Wait for your vision to get blurry.  Wait for your organs to start shutting down.  Wait for the diabetic coma, heart attack or stroke.  And hope it doesn't happen for a really long time.

Or you can adopt my attitude.

An old Italian saying is, "If you dance, you have to pay the band."  What increases your risk of developing type II diabetes?  Smoking, inactive lifestyles, and certain dietary patterns (read:donuts and gravy).  I have contacted the American Diabetes Association and asked them to name this 'Bob Syndrome'.  I danced for 45 years.  And I danced hard. Legendary stuff.  Now I have to pay the band.

Whatever it takes, I don't care.  I have two kids, a great wife, great family and friends.  I will do whatever needs to be done, because even though my life is far from perfect, I'm not done yet, I don't anticipate being done for a really long time, and there is no way in hell that I am going to let diabetes take away one minute.

It's hard getting started.  It's hard staying motivated.  It's hard to change your lifestyle.  No kidding.  Look at each part of each day as a new challenge.  The feeling of accomplishment after completing each challenge will motivate you to meet and accomplish the next one.  It's a snowball effect. Put on you big boy (or girl) pants and get after it.  Keeping things simple can make even the most daunting tasks seem manageable.

My youngest nephew, Charlie, is five years old.  Charlie was in our office the other day and my father said, "Charlie, I hear you are doing really well with your swimming lessons."  Charlie looked at my father, and with wisdom that could only be imparted by a five year old said, "Poppy, it's not that hard.  The more better you try, the more better you get gooder."

My little nephew has it figured out.  "The more better you try, the more better you get gooder."  I wrote it down immediately.  The secret of life from a pre-schooler, and now my personal mantra.

  

What To Do? What To Do?

At first, of course, learning that I was diabetic was disconcerting to say the least.  After meeting with Dr. Jim however, I honestly felt that I would be able to handle it.  Dr. Jim gave me a basic understanding of what I should start doing immediately - the exact opposite of what I had been doing for 45 years. 

Dr. Jim explained that I needed to start an exercise program, control what I eat (notice I didn't say diet), and check my blood sugar regularly.  He was kind enough to give me a glucose monitoring kit and showed me how to use it.  It is a pretty benign looking apparatus; a little spring loaded needle, and a handheld monitor.  Prick your finger, touch the ensuing drop of blood to the test strip, and in 5 seconds you have your results.  The snapping noise that the needle makes is a little nerve racking to this day, but it's no big deal.  Glucose monitoring - handled.

I wouldn't say I was ever a sedentary person.  I love being in the outdoors.  I live on 5 1/2 acres, so there is always yard work to be done.  I coached grade school football.  I coached lacrosse.  When I wasn't doing that I was playing football or lacrosse with my kids in the backyard.  Oh yeah - I have a job too.  But even with that schedule, I still found time to watch television.  Lots of television. 

Exercise for the sake of exercising was never my favorite thing to do.  My wife and my sister-in-law run together.  Five miles a day.  Four days a week minimum.  At 5:00 in the morning.  She has been kind enough over the years to invite me to join them.  YEAH, RIGHT.   If I were going to list all of the things I would be interested in doing at 5:00 in the morning, getting out of my warm bed to run 5 miles wouldn't make the top ten thousand.  So I decided to keep up my walking.

After thoroughly depressing myself by learning that I was only physically capable of walking five tenths of a mile in thirty two minutes, I decided to make it a competition.  I would walk for thirty minutes every day and try to go a little further each day.  Please note that I said every day.  Over the top as usual.  If it was raining, I walked in the rain.  If it was snowing, I walked in the snow.  One time the snow was too deep to walk, so I walked laps around my basement for thirty minutes.  Swear to God.  If anyone had seen me they would have had me committed.  Every day without fail.  I started to notice that I was able to walk faster and further on an almost daily basis.  Sometimes, if I was feeling particularly froggy, I would jog part of the way.  By making it a competition, I found I was actually starting to enjoy it.  Being physically able to push myself to go faster and further than yesterday motivated me.  I don't know how far I walked and I don't care.  As long as it was further that yesterday I was happy.

Then I got an i-pod.  Yeah, I know.  I walked for three months in silence.  I'm not very tech savvy.

My oldest son loaded it up with "motivational music".  Hard core rock and roll.  I tried to keep time to the music with my footsteps.  It got to the point that I was actually looking forward to walking.  Who AM I?   Exercise - handled. 

It probably didn't hurt that I was starting to notice that my clothes were getting baggy.  Quite baggy actually.  The number on the scale kept getting smaller and smaller.  And people were starting to notice.  It's really comical actually, to see someone you haven't seen for a while after losing a considerable amount of weight.  You can tell they notice, but they don't know if they should say anything or not.  People would ask my wife, "Is Bob O.K.?  He's lost so much weight!  Is he sick?" 

A word of advice here.  When this happens to you, (notice I didn't say if) DO NOT reply to this question by saying "(insert name here) was diagnosed with diabetes."  This always makes people's eyes glaze over, grasp your hand or shoulder, and say "I'm SOOOOO sorry to hear that."  Now you're diseased.  Probably going to die.  Water cooler conversations begin with, "Did you hear about Bob?"  And trust me, bad news (perceived or otherwise) travels fast.

"DIET AND EXERCISE."  This is the correct answer.  People will look at you with admiration as opposed to pity.  You're not really dieting, but that'll be our little secret.

I was most concerned with this 'controlling what you eat' thing.  I am not a meat and potatoes kind of guy.  I am a meat and carbohydrates kind of guy.  I always thought the food pyramid consisted of meat, bread, chocolate, bakery items, and gravy.  I am sad to report that it does not.

Dr. Jim summed it up for me. (Imagine that.)

Cut way back on the carbs, increase the veggies.  WAY more on this later, but that was a beginning.  He also told me to go to the local hospital for diabetes education classes.  I can't recommend this enough.  There is too much you need to know and understand about this disease that will make your life easier to ever try to figure out on your own.

Controlling what you eat - handled (kind of)...

P.S. Just in case you are as tech-challenged as I am, you can follow this blog on Facebook, (Bob Abernethy) Twitter, (SalsLaxDad) or by clicking the 'follow' link on the sidebar.  Who knew?