Entry Number Eight: Making an effort!
I'm going to try and write a coherent blog entry, but I have competition for my concentration right now. My wife is a few feet away, playing the Lego Movie video game. It's rather distracting (I've looked over three times while writing this sentence so far) but I'll give it my best shot!
So I left off last time saying I was ready to change my bad habits. I was under the impression that I could eat what I wanted, but I had to match my insulin to my meals. However, my wife and I decided that we both had to start eating more healthily. We had got into some habits which were bad for our finances as well as our health in general. We were succumbing to the dreaded Domino's pizza ordering. The weird thing was, it was not sating my hunger at all. I would get a medium pepperoni pizza, some potato wedges and a pot of Ben and Jerry's Ice cream. I would have the pizza, and we would split the wedges and ice cream (We got these as part of the deal Domino's were offering, it would be stupid to let them go to waste...right?). Afterwards, I would still be ravenous. Well, the first thing I needed to do was look at what was in my meals. I downloaded a MyFitnessPal app. I decided to input my details, and try and follow the recommendations for daily calorie intake. I also looked on the websites of my favourite foods, and I was horrifically shocked by the nutrition information of a lot of them. Even going down from a medium dominos pizza to a small, on its own that was about 100g of carbohydrate. Never mind the ice cream. So we stopped ordering from Domino's. First big step in the right direction.
I also started noting down my blood sugars. I needed to see what was happening. I noticed that my results were really not good. Peaks and valleys all the time. If my blood sugars were normal, they were just travelling through on their way to a high or low. I also noticed that my morning bowl of cheerios was spiking me massively. I tried limiting myself to their suggested serving (A really unsatisfying portion) but I was still going high. So I switched my breakfast. I started having Greek yoghurt, with blueberries and banana. I enjoyed the taste, but was not getting satisfied by it. I told myself I was being greedy, and that my hunger levels would settle down eventually. The frustrating thing was, I was still finding my blood sugars were suboptimal at best.
I found my resolve wavering a lot, so I decided I needed extra incentive. I started looking on www.diabetes.co.uk, both for success stories and for scare tactics. I looked in the complications section a lot. I already had the early signs of retinopathy. I scared myself witless. I started trying to go in the other way, so I looked for evidence of people who had dealt with their problems. And that's how I finally came across the writing of a Dr Richard Bernstein. I found a section of a book he had written, about looking after your feet, even if you already had neuropathy. I didn't have this (and to my knowledge I still don't), but I'm a hypochondriac. The information he was giving seemed to make a lot of sense. I looked into his book further. It was called 'Dr Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars'. That sounded like a bold claim. However, the book was not expensive as a Kindle download. I thought that I really didn't have anything to lose by checking it out. So I downloaded it, and I started to read.
In hindsight, I am really, really glad that the book contained testimonials from Dr Bernstein's patients. Because his methods were a difficult pill to swallow. He claimed that any result over 140mg/dl was unacceptable if one wanted to avoid diabetic complications. He also said that normal blood sugars were 83mg/dl. Now, these were american measurements. I was used to measuring in mmol/ls. I looked up the conversion, and I was both shocked and appalled. 83 translated to 4.8, and 140 to 7.8. I had always believed that up to 10 was fine, and even going to 11 or 12 was 'ok' if it didn't happen too often. I didn't think his claims were possible or credible. But I gritted my teeth and started to read on. How could he manage these numbers? I thought the man must just starve himself all the time. And then I came across his secret: A low carbohydrate diet.
I was distraught. It seemed that my choices were to either cut out every single food I loved, or continue down my path and die slowly. I closed down the kindle app on my iPad. it was stupid. It was ridiculous. Then I remembered, I had decided I would try anything to get good control. This promise could not just be lip service. I started to research low carbohydrate as a way of eating. I found out that this website had a section dedicated to it. I asked questions, and was reassured by the response. One overriding reply came through; It's great, but don't expect your health team to agree. Gradually, I came to grudgingly accept that this may be the only way for me to live. I decided I would try it. I was due my next diabetic clinic at the beginning of February 2014. That was two weeks away. Knowing what the community had said, I thought I needed some data to backup what I was going to try. For a week, I ate my high carbohydrate diet, and I meticulously noted everything down. And then I made the switch. I am not one to do anything by halves. I knew that if I was going to manage, It had to be completely or not at all. I talked about my plan with my wife. She was apprehensive, but cautiously gave her blessing to at least trying it. The last day before I started, I ceremoniously said goodbye to eating high carb. I finished that lifestyle with the last of our wedding cake, which we had frozen for the last few months.
Then I switched. I replaced my breakfast with bacon and eggs. I reduced my insulin and started to look at the results. I was astounded. My blood sugars started to be better. Much better. I missed my sandwiches and pizzas so, so much but I persevered. I stocked up on dextrose tablets in case I had a hypo. I decided that even if this didn't work, my love affair with fruit pastilles was at an end. They were just too nice to use as a way to treat a hypo. On the other hand, I didn't enjoy dextrose tablets. When I was a very young child, my rare bad hypos were treated with dextrose. I came round with their sickly sweet taste in my mouth. i would feel really unwell, with a headache and a clammy feeling. The taste of dextrose was tied in with that in my mind. This meant that they would be eaten only as a necessity, not a treat.
My diabetic appointment came round. My numbers were not great, but there was a really, really significant improvement. But, sure enough my doctor at diabetic clinic was skeptical. He told me I would have too many hypos on this new way of eating. I pointed out that I was having huge amounts of hypos on a high carbohydrate diet. I will never forget what he told me. He said that a low carbohydrate diet was completely unnecessary. He went on to say that I would be fine eating high carb, and that I would not get any complications in the next ten years. At the time of my appointment, I was 26. Now, I have a hope. This is going to sound ridiculous. You're all going to laugh at this, but here it is. I would quite like to get past 36 without complications. I know! Laughable, isn't it? Well, it seemed that it was in my doctor's eyes. The fact that I already had mild diabetic changes to my eyes, and that I was getting the hypos he was so worried about, that didn't matter. However, I pressed my case. For 45 minutes we went round and round. The light in his listening box switched off about 10 minutes into that. Finally, he grudgingly agreed to support my diet if I was not getting hypos. I said I wanted to see a dietician to discuss what foods to eat. He said 'Well I was going to suggest that, but I didn't think you would be concerned enough about your control to bother going.' Face palm face palm face palm face palm copy paste to infinity. I was finally making an effort, and he couldn't care less.
After all my appointments at diabetic clinic, the diabetes team sends a letter to my doctor's appointment, summarising what was discussed. I get sent a copy of this as well. Here is what my doctor had to say after my appointment:
'I reviewed my patient today in the diabetes clinic. He had made quite significant changes to his lifestyle generally since we last saw him; he has got married, changed his job now and is a bit more erratic in terms of his lifestyle and hours etc. but has also spent a lot of time concentrating on his diabetes. He had a letter through from the retinal screeners suggesting he had some background changes and has taken this on board and tackled his diabetes fairly aggressively. This has brought his HBA1C down to 37 and unfortunately he is doing this at the expense of regular hypos, at least one a day. He is also beginning to lose his awareness slightly of these hypoglycaemias though he is doing an awful lot of testing.
We talked about the pros and cons of this method of treating his diabetes is that there isn't any awful lot of benefit having an HBA1C of 37 opposed to the previous level of 50. I have said to him there is plenty of room to increase things up. He is noticing that he is tending to dip low and then have a rebound high again and it is the highs that worry him. Conversely it is the lows that worry me and I have asked him to try and concentrate on cutting these out so intake less and less insulin until these hypos stop.
He has also adopted a very low carbohydrate diet in the last week or so as he has got a book from America that rationalises this form of treatment. I am happy that he goes ahead with this as he is fairly insistent that he wants to try this diet as he feels a lot better on it. I just want him to do it in a balanced fashion if possible. I will therefore ask him to see on of our dieticians to see if we can help him through this; either way hypos are the key and if he needs to reduce his insulin down to very low levels then so be it.
I will see him again in four months' time to see how things are going.'
Reading in between the lines, he expected me to fail. The part about the book from America rationalising the treatment really made my blood boil. I decided that I would follow this low carbohydrate way of eating, just to throw it in his face if nothing else.
Next time, read about my new journey on a low carbohydrate diet! Did it work? Was I eaten by a bear at any point? All will be revealed!
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