Out With The Old, In With The New

Once you are diagnosed diabetic, Type 1 or Type 2, there is no longer just a yearly checkup with your primary physician.  Instead, you must now add to that a visit to your endocrinologist about every 3 months for an A1c, as well as see a dietitian to ensure that you are managing your diabetes well. 

I am very fortunate to have insurance that allows me to see doctors within the Cedars Sinai group here in Los Angeles.  I saw doctors in this group before I was diabetic and I also gave birth to both of my children at Cedars Sinai Hospital.  They have always provided excellent service. 

I like my endocrinologist, who, lucky for me is also my primary physician.  I don’t think that is common.  I also like my dietitian.  Every time I see them for an appointment they are at a loss for words at how well I am managing my diabetes (I am guessing there is a vast majority that does not???).  I can see the shock on their faces.  I pretty much run my appointments.  My main purpose for seeing them is to make sure I get my prescriptions. 

I remember my appointment with my dietitian to discuss applying for the pump.  As usual she asked me a bunch of questions and how I was doing.  But when I got to the part where I told her I  don’t eat grains she promptly chimed in to say “Well you can have grains.  It is good to include whole grains as part of a healthy diet.”  Whoa.  I could have schooled her right there but I decided to save her dignity as a health professional.  Afterall, my goal was to see her so that I could get an insulin pump. 

My next visit with her was after I had received my pump and been using it for a couple weeks.  It is standard for you to come in to see how you are doing and to possibly make basal rate and/or carb ratio changes if necessary.  Because the pump was new to me I had a lot of questions for her.  My last question, however, was a complete curve ball.  I asked her what she thought of paleo.  (Most who are close to me know that I follow a primal way of eating and that I truly believe it has helped me immensely in dealing with my auto immune disease, Type 1 diabetes.)  Man did I have her stumped with my question.  She stumbled over her words saying “Well I haven’t really heard anything about that.  I’ll have to look into that.”

As much as I like her, I thought to myself how the heck can you be a “practicing” dietitian who is not keeping up with current health news and reports?  I must amdit thought I half expected this answer from her because she is older and I imagine has been doing this for more than a couple decades.  So I left and left it at that.

About a week ago, I recieved a letter in the mail from her.  It was announcing that she had made the decision to retire and would no longer be my dietitian.  This was a standard letter sent to all her clients.  She was very instrumental in getting me on my insulin pump in a quickly manner and I am very grateful for that, yet there is part of me that thinks this is a good thing.  This tells me that the generation is changing and with that the current health and diet paradigms too.  We need new health professionals that realize and put into practice a new way of thinking about diet and health.  Health professionals that know you DON’T need whole grains and starchy carbohydrates for proper bodily funtcion.  Not only that but health professionals who know what “paleo” is, ones who will take a more whole body approach to diagnosis and treatment and ones that don’t look at me wide-eyed in amazement at how well I am managing my diabetes because that should be the goal.  I am very excited to see how this change takes place and you can bet that I will have my own part in this upcoming health revolution.


Get Back On Track!

I admit it. I’ve been bad the past couple months. Bad with food that is. I kept making excuses for why it was ok to eat the chocolate chunk cookie every morning and the pound cake and other goodies they keep bringing into the work lunchroom. They tasted so good but that is so short-lived. Then the guilt sets in. And the rollercoaster of blood sugar levels doesn’t make me feel any better. So I feel down and then I eat some more. Talk about spiraling downward day after day. Living with diabetes I have found is a daily battle. It’s not just about maintaining my blood sugar. It’s also about maintaining my sanity in the process.

After all of this sugar debauchery, I put my foot down. I mean I have got to pull myself together! After my diagnosis I hardly put anything with sugar in my mouth and my A1c went from 8.3 down to 5.5! My last check up was not as good at 6.3. Where did I lose my way? So last week I made a change. For the last several days in a row I have eaten without needing to bolus. I havent had one single crash and my blood sugar hasn’t gone beyond 130! That, my friends, is the power of high-fat, low-carb eating. I am no scientist but the proof is right there. Sure there is always going to be that day when everything is totally wrong, including your blood sugar. Those just can’t be avoided sometimes, but I definitely want to be strong enough after having a bad day that I can wake up the next morning and get right back on track! How about you?

It Is Not Just “My” New Diabetic Life

When someone is newly diagnosed with a chronic illness it is often overlooked how immediate family members and close friends are affected.  I, for example, was very proactive about making the necessary lifestyle and dietary changes required to maintain my diabetes.  This was no easy task but especially harder because I was married with two very young children.  My life was turned upside down and in turn theirs was too.  Of course, there have been bumps along the way.  I suddenly went through the kitchen and tossed everything grain in the trash.  Yes that includes cereal, cookies and the most beloved staple in a Korean home, white rice.  I would watch my husband who is not diabetic walk into the kitchen scouring the fridge and the cupboards only to come out with a sad, defeated look on his face.  I mean I had to give the guy credit.  He was making the same changes I was making too but without the same reason.

It bothered me to think that I might become some sort of food nazi so I would watch him eat a hamburger on a lovely golden brown bun and eat all of the delicious panchan with soft sticky rice, while I on the other hand would eat my hamburger wrapped in iceberg lettuce and skip the rice completely.  I knew that when he went to work he would eat as he liked at lunchtime and of course whenever we would meet friends outside of the house it would certainly contain a fair amount of carbs.

All the while, I have tried to stay communicative with him.  Let him know what it feels like when I have a low or conversely when I am high.  I keep him informed when I research something and learn something new.  Sometimes I think to myself, “this is going in one ear and straight out the other.”  Surprisingly, I see changes.  There has been more than one occasion where he has skipped the rice not only on my behalf but because he now understands why it is not good for you.  We have a better kitchen routine down too.

So now the reason for this post.  I was going through the fridge today, as I usually do on the weekend.  Sometimes when I am feeling uninspired I will cheat and buy some of those low carb yogurt cups from the grocery store.  I know, I know, they are not ideal but I admit I cheat here and there.  Last time I picked some up I mistakenly chose a couple of the regular non low-carb version (35 grams of carbs!!!!).  I told my husband they were all his.  But to my surprise when I looked in the fridge today there is one of the two left.  It made it a whole week without being touched.  I’ve even suggested for him to eat it when he goes looking for a snack but no go.

Sure I guess it could be that he just hasn’t been in the mood for it but I’d like to think that my husband has really been there with me on this health journey.  And that maybe some things were not just going in one ear and out the other.  It is a silent sign and one that is encouraging and reminds me that I am not going through this alone.  Thank you honey for doing your best to understand and learn with me.  Thank you for not eating the yogurt cup in the fridge.

For those of you who are newly diagnosed remember that it is a big change for you and also for those close to you.  Just as it will take you some time to change your routine and sort things out it will be that way for others too because we are all in this together.

Sweat is Good

Sometimes I think to myself how far I’ve come to learn about my body in the past year.  There was a lot I didn’t know about it.  I feel like the body I knew for 28 years is not the same one I know now.  As I continue to research and read about physiology of the body (for personal interest, I am not a doctor), I come across new ideas about my body.  For example,  when I look back to when I was younger, I rarely sweat growing up.  I’d like to say I was very active but I don’t remember drenching t-shirts ever.  I was actually glad about this.  No nasty sweat stains for me!  Some will say that certain people genetically sweat more or less than others.  I used to think this was the case.  But now I don’t think that’s entirely true, at least for myself.

I’ve been bad the past few months: eating more carbs than I probably would like to and hardly exercising. Maybe because it has been winter? Anyway, last week I started walking on my treadmill again when the kids go to bed or I’ll ask hubs to give me 30 minutes time while he plays with them.  I walk just enough to get me sweating, (the incline setting helps), and I am in awe that my body is doing this.  My whole life it has been difficult to sweat and now I can get a nice sweat going after a good walk on the treadmill???? What gives right?  OK so maybe a portion of it is genetics, I’m still not sweating buckets but there has been a change.  I really think that the fact I wasn’t sweating previously was an indication something wasn’t right.  I now know it had something to do with my diabetes.

I am sure my inability to produce enough insulin at all times just sucked the life out of me, literally.  I’ve never been one to drink a lot of water either so inability to produce adequate insulin together with low water consumption equals serious dehydration.  I am pretty sure I was consistently dehydrated.  No wonder why I always had dry skin and never sweat!  When I found out I was diabetic the urgent care I went to put me on an IV.  They told me it would take about an hour to drain the bag.  Ummmm 30 minutes later that baby was empty!

Most people think of sweat and say “Ewww gross!” But for me it is so reassuring to feel beads of sweat running.  It tells me that my body is functioning differently than it used to and that’s a good thing.  Insulin, eating low carb and drinking 3-4 liters of water a day (I literally carry my liter water bottle everywhere I go, ask my husband) help me stay hydrated.  Can anyone diagnosed as diabetic later in life relate to my experience with sweating?  If so please share!

The Skinny Diabetic

Most people, when they learn I am diabetic, exclaim “But you are so skinny! You look great especially after having two children! I would never think you have diabetes!”  Typically when I hear this I know right away that their knowledge of diabetes is not the greatest.  First of all, I do not “have” diabetes.  I am diabetic.  My Type 1 Diabetes is an auto-immune condition that will stay with me for the rest of my life, not like “having” a cold.  Secondly, skinny does not always mean healthy!  In retrospect, I think I have been diabetic for a lot longer than a year.  I have always been fairly thin but now I see that I was not necessarily healthy:  “Because the pancreas produces no insulin, glucose cannot enter cells and remains in the bloodstream. To meet cellular energy needs, fat is broken down through lipolysis, releasing glycerol and free fatty acids. Glycerol is converted to glucose for cellular use.”  So basically I was running off of stored fat and not what I was consuming.  This is what happens to someone who becomes Type 1 diabetic.

However, I realize that when someone exclaims how skinny I am, they probably are thinking of Type 2 diabetes which “is characterized by the following three disorders: (1) peripheral resistance to insulin, especially in muscle cells; (2) increased production of glucose by the liver; and, (3) altered pancreatic insulin secretion.”  It is not the product of auto-immune beta-cell destruction like above.

But I can’t blame these people.  After learning I am diabetic I felt like everything advertised and talked about concerning diabetes was geared toward Type 2s.  Headlines like “lose weight now!” and “reverse your diabetes!”  Reverse?!?!? I guess in the minds of the general public if you are diabetic you are gray-haired and obese.  I was very lost right after being diagnosed because of this.  I kept thinking to myself “But I am a skinny diabetic! What about people like me?”  As the Type 1 community grows (because the reality is it is) I hope that more people come to understand the different types of diabetes.  I also look forward to seeing advertising that leads to misconceptions change.  It is looking like that is taking place as we speak.  For example, I recently joined a LinkedIn group called  JDRF.  The goal of this company is to research and find a cure for Type 1 diabetes.  There is currently a post talking about misleading advertising and in the comments people are mentioning that they take the time to write to companies to let them know what they are doing.  You can read here: http://www.linkedin.com/groupItem?view=&gid=129291&type=member&item=225408444&qid=e5df44ed-e0c5-4297-b83d-f9f060454296&trk=group_most_popular-0-b-ttl&goback=%2Egmp_129291

I was so happy to see this!  It means things are slowly changing.  Perhaps in the future the general public will understand that diabetics are not always overweight and that skinny is not always a sign of health.