More Bad News

Diseases & Conditions Diabetes
1
Hi, Gang....

(sigh) Looking for some encouragement here today. My doctor's appointment yesterday brought more bad news. My A1C went up again! I'm now at 10%! Had the best fasting number on a test ever, though - 8.0. Praise for small miracles, I guess.

The other bad news is my cholesterol. I've got a month before my next appointment and will be put on cholesterol meds if I can't get it under control. Here's the thing....I rarely eat cholesterol foods! The "culprit" foods I occasionally eat are peanut butter and eggs and the PB is always only 1TBSP/day and the eggs are 1 egg once or twice a week. I don't eat food with creamy sauces or are "rich", veggies (lots of them) are always steamed/boiled with nothing but enough Becel to coat and lemon and pepper, bread products are always whole grain and only 1-2 slices/day.......I could go on with examples but suffice it to say...I eat REALLY healthy. I do love chocolate and eat it in minute quantities a few times/week but always as a dessert and counted as part of my meal. I'm truly at a loss to find where I can cut back on the "bad" stuff. I know chips are bad and I do eat them a few times a week but never more than 10 chips at a time (yes, I count them or weigh them - ALWAYS).

The other thing is that I eat only 20-30 grams/carbs per meal. Even with the bedtime snack and sometimes a yogurt between meals, I'm not making my recommended 170 grams/carbs per day (my Dietician chastizes me every time). My daily caloric intake is less than 1200/day. Yada, yada, yada....I just don't know where to cut back? I'm 5'2", 110-112 lbs (can you believe my Dietician wants to see me at 115-120!?). Any suggestions?

Your thoughts, suggestions, kicks-in-the-butt, sympathy (I'll take that, too :-)

Thanks so much....

Cheers,
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"We do not see things as they are; we see things as we are." -- Talmud

2

Hey Phishbowl,

Well, here's a perfect example of genetic pre-disposition!  You sound like me.  No matter what I did, my sugars would not come down, and at the time I was diagnosed I had only 6% body fat! (chuckles, Im now at a normal body fat).  So what do you do?  Aside from trying to use the GI index to balance your carb intake, meds are a really good answer.  It will keep you from ballooning out of control on your sugars and doing all kinds of damage to yourself. 

Now, as to the Cholesterol !!  Sometimes you need a little chemical help.  My Endocrinologist is thin as a rail and he takes Lipitor because his cholesterol is elevated and he wants to nip it in the bud.  At least he practices what he preaches.  The point is, the high Cholesterol and the High BS are two significant risk factors for some sort of cardiac event that you don't need or want.  Better to get some medication help now and live longer for it!

scool Warren
 
PS - going on medication doesn't mean you've "lost the battle".  It simply is another tool you can use to stay healthy and live longer. We all need meds for something sooner or later, so maybe this is your time. As long as you live as healthy a lifestyle as you can, the meds you take will augment that to make sure your quality of life remains good for a long time to come.

It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.

Post Edited (Warren) : 5/24/2006 12:10:12 PM (GMT-6)

3
Phish,
Warren is right on with his answer. Look at your cholesterol meds as secret weapons against a stealth heart attack or stroke. They, along with correct diet, will work wonders for your numbers and the numbers are really what we are aiming for.

By the way, you may nosh away on peanut butter without guilt. It's full of monounsaturated fats and really quite good for your numbers. Olives, avacados, olive oil, peanut oil, nuts of all kinds.... these are your friends who will help you fight hunger, lift your HDL's and keep your skin and hair healthy.

Did a search on fats info and found two great links that might help you out:

New American Diabetic Assoc. Guidelines

Harvard School of Public Health: Fats and Cholesterol

Hope this helps.

~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross

4
Thanks for the replies, Guys. You always come through :-)

Like you, Warren, when I was diagnosed the Type 1 Jan'05, I had almost no fat (or muscle for that matter) and weighed 92lbs. The Dietician had me cooking with olive oil and adding peanut butter to my diet (actually can't stand the stuff but have just been following orders), drinking 2% milk, and a couple more things to get my body fat back up while, at the same time, starting insulin. If I would've kept on her recommended plan - 70-80 grams of carbs per meal and a 20 gram bedtime snack - I would be a balloon! I stopped following her diet when I hit 120 lbs, felt bloated and stuffed all the time and didn't see improvement in blood sugars. Why are all the Dietcians at the Edocrin/Diabetes Centre fat anyway? I don't mean to be mean but Holy Cow people! Do you not practice what you preach? Or all we all supposed to look overweight to be healthy? I'm not into the gotta be skinny thing, I just want to feel healthy.

My family doc told me to switch the peanut butter with almond butter and use egg substitutes or egg whites. My bedtime snack has been 8-10 almonds these past couple weeks since I started Levemir. I've done a lot of reading and searching on the Net and am truly having a hard time figuring where I can cut back.

Sigh, I just feel like everything is happening all at the same time again - new insulin, adjusting meal ratios, changing diet...and all when I don't have the medical support I need. My Endo defers EVERYTHING to his educators, of which I've been without since last fall and have had pump nurses and others "filling in the gaps" as a favor but not really giving me the time of day. A Dietician that goes by a textbook and IMHO, is frankly incapable of looking at me as an individual with extremely hard to control diabetes. This is the one who tells me to eat all the weight increasing food and then tells me I should cut back on protein and fat 3 months later. Ummmm...excuse me? This is the diet you put me on. Lost a lot of faith with that one. Besides, she's French and most them just hate English - that's why they're always trying to separate from the rest of us (Canada). I'm one of 147 on my Mom's side alone, all French speaking except our family and this French vs. English thing is everywhere, all the time, especially here in Ottawa. Anyway...I digress :-)

I will check out the sites you mention, Jeannie, and give the old 150% to change anything that might help my situation but...if next month shows no improvement, then I'll just go on the meds. I'm not afraid of taking anything that might help me but I also lost my insurance as of last Friday so, everything is out of pocket till I can find a new job, one with insurance. Man! Diabetes is an expensive disease, especially with going through 5-7 needle tips/day, 2 insulins 6-7 times/day, and test strips 6-10 times/day. Just feeling overwhelmed, frustrated, everything. Much appreciating the support from you, though. many thanks :-)

Cheers,
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"We do not see things as they are; we see things as we are." -- Talmud

5

Hey Phish,

I can really empathize with your frustration.  The difference between us is I'm MUCH more grumpy about it than you are! 

I think you need a new endo guy/gal.  The cookie cutter approach is not what you need right now.  Even if its to go to a clinic vs. an independant doctor, you need someone that will not just treat you by your chart.  I know thats hard to find now days when doctors are under pressure to see a set number of "cases" a day, but your present doctor is definately not working for you!  Im not going to steer you toward any specific recommendations for diet and meds at this time as you really need to get on a baseline program with a doctor you can communicate with.  THEN, we can probably help you with suggestions you can take to your doc to fine tune what you are doing.

Hang in there, and please feel free to yell at healthcare professionals that are treating you like a statistic.  It may not bother them in the least but I find its good for the soul!!!

scool Warren

It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.

6
Thanks again, Warren. Your approach makes me smile :-)

I think you are right about moving on and I think I'm starting to turn a new leaf with my current medical team. My frustration this past week alone is enough to have me start a list of things I will be "confronting" my Endo with when I see him June 23rd. I've been limping along for a year and a half because our medical system is not in the business of helping people, they're in the business of making money.

I will be asking him why if he thought I was a Type 1 (months before actually being diagnosed), he did not order tests to confirm it. Guess he figured if I was one, I'd eventually have his suspisions confirmed when I landed in the emergency room. Not the way I think things should be done. I also want to know why I even need him, other than to write scripts for whatever the educators think I should be on. Just what is he there for? I pay $14.00 to park at the clinic to see him and get not much more than agreement that I'm outta control. Gee, thanks (for nothin'). Writing some of these things is just confirming in my mind that I need to find someone who can work with me.

The educator nurse I had for a brief 5 months last year was the only one who REALLY tried to help me. She was even going to write a paper on me for the medical journals (as a special case - brittle). To be fair, my family has a well documented history of not responding to meds as anticipated/expected. We alwyas read the fine print that says what MAY happen in 1 in 100,000 because we know it will happen to us. Must be our blood and genes. Lucky us. So, I'm not too suprized to see what results I get insulin/diet regimens - or shouldn't be :-)

Sorry, Guys. I hate to be so bitter today - I've just reached my "had enough" point and need to vent. I just thank you for listening and letting me know that I shouldn't feel so bad for expecting more from my medical team or better medical care period. Tomorrow is another day - hopefully a better one.

And Warren......I'll be looking for some tips from you on how I can best get my message across before my Endo appointment :-)

Thanks to All!

Cheers,
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"We do not see things as they are; we see things as we are." -- Talmud

7
Phish,
My heart goes out to you... I know you must be ready to scream. I can help a little. I have no insurance and Warren helped me find a place to get meds inexpensively. I must say that with all I'm on, he's saved me a bundle. Please email me (jeannie at thecakery.com) and I'll give you the info. Right now I take generics of glucophage, levoxil, lipitor, prozac, avandia, celebrex and hydrochlorothyazide... and I'm getting all those scripts for under $100 a month on average. I buy my Lantus insulin at Sams Club because they are the least expensive in town.

Try to remember we will be your cheering section if nothing else... I'm even sending some prayers your way tonite.

~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross