Saturday, July 30, 2005

New Yahoo Group! Diabetes Buddies

I have started a new Yahoo Group, Diabetes Buddies. The goal of the group is to provide a place for diabetics to link up with other diabetics -- to provide regular, email support for each other on a one-to-one basis, with the goal of improving control! In other words, people will go to Diabetes Buddies to find an email buddy.

I am the first and only member so far. I am an adult female looking for a buddy with type 1 diabetes, preferably an insulin pumper. (Now doesn't that sound like a dating ad?)

If you're interested in joining, go to the Diabetes Buddies website, tell me why you want to be a member, and I'll sign you up!

Thursday, July 28, 2005

Looking for a diabetes buddy

I decided I need a diabetes buddy -- someone to link up with over the internet. I want somebody to check in with about how I'm doing with my diabetes control, on a day-to-day basis. And in return, I would do the same for the other person. It seems relatively obvious. But when I went looking on the internet, I didn't find anything here in the US. There are diabetes buddy programs in Australia and the UK, but I don't think they are focused on the internet. Am I missing something, or is this kind of program just not available?

Yesterday I talked to my friend John in California about being my diabetes buddy. He said he could do it, but he's Type 2, and I'm Type 1. He doesn't take insulin and only has to check his blood sugars twice a week. He says he doesn't think he'd have much to offer. After some thought, I figured he was right.

I think it would be cool to start an internet diabetes buddy program. I wonder how that would work. There would need to be a central meeting point, like a Yahoo group for example, where people could post looking for a buddy. It would be a place where people could match themselves up. And a place for information about what it takes to be a good buddy. I don't think I have the time to achieve such a thing...but maybe somebody else does.

Tuesday, July 26, 2005

FitDay -- a public food log! (Yikes!)

Through ReneeGetsFit, I have discovered FitDay, an online food journal that can be made public. Actually, that there is my first FitDay record. More than 3000 calories and 160 grams of fat. Gotta do better than that. Okay, so I'm letting it all hang out here. Thanks again, Renee!

To Eat or to Smoke: That is the Question

I called LeAnn, my diabetes educator today. I got desperate. I can't seem to follow the diet. It's not because I don't know what I should be doing. I do. That part is easy. The complicated part is controlling the eating. I have been having trouble controlling my eating ever since I quit smoking.

It turns out that she is the one who has delayed my receiving the pump. Just because it was approved by the insurance company doesn't mean they are going to let me have it right now. She says she hasn't worked with me long enough. She is the one who needs to teach me to use it. So I am unhappy about this. At least I will get it eventually.

But back to the diet issues.

I told LeAnn that I don't know what to do. I am even considering starting smoking again, so I can control my eating and take off the weight I gained. Of course she doesn't want me to do that. What she wants me to do is to count the carbohydrates and cover them with insulin. The last thing I need is to go into ketoacidosis again. So the goal is to keep the blood sugars down even if I can't stop myself from eating.

This is a drag.

Renee's 5 lb Labor Day Challenge

I found Reneegetsfit through BlogExplosion. Truthfully, I haven't found many on that website that impress me, but Renee's did. She has actual polaroids of herself at stage one (in skimpy bathingsuit top, with fat hanging over waistband of jeans) and stage two (remarkable improvement, but more to go). Girl, does it take commitment and daring to put up those pictures! I can't even look at myself in the mirror since I quit smoking a few months ago.

So, anyway, Renee has posted a five-pounds-by-Labor-Day challenge. Since I'm supposed to be following an obcenely skimpy, disgustingly tasteless diabetic diet (which I am trying to transform into something tolerable), I figure I could use a little motivation from Renee. It will be interesting to see how many pounds the horrid diabetic diet will take off by Labor Day.

(See my earlier post, The Horrid Proposed Diet.)

I will get weighed on Wednesday, August 3, at my physical. Dread and loathing.

Thursday, July 21, 2005

Blogathon for Juvenile Diabetes Research Foundation!


I have signed up to participate in Blogathon! When I found Blogathon, I realized it would be a really cool thing to do: Blog for a charity. I chose the JDRF, of course. Nobody else on Blogathon was blogging for JDRF.

I would love if you would sponsor me! All you need to do is go to Blogathon and register, and then sign up to sponsor me. You can sponsor me here:

My JDRF sponsor link at Blogathon

If you choose to sponsor me, the link will take you DIRECTLY to the JDRF webpage, where you make your pledge. No money goes through me or through Blogathon. So you know your money is going straight to the charity. Isn't that cool?

Then, on August 6, starting at 9:00 eastern time, I'll be posting on this blog about every 30 minutes! And I'll be staying up all night to do it. Come in and see how I'm doing and what I'm writing! You don't need to stay up all night though, LOL!

My blog needs to bring in at least $5.00. All you need to do is pledge at least $1.00.

Hope you can participate!

Wednesday, July 20, 2005

My insulin pump is approved!

I got a call from Animas yesterday. My pump has been approved by United Healthcare, our insurance company! I will probably have it on Friday. I am so excited!

Monday, July 18, 2005

"Sugar": The first part of poem, "Diabetes," by James Dickey

One night I thirsted like a prince
Then like a king
Then like an empire like a world
On fire. I rose and flowed away and fell
Once more to sleep. In an hour I was back
In the kingdom staggering, my belly going round with self-
Made night-water, wondering what
The hell. Months of having a tongue
Of flame convinced me: I had better not go
On this way. The doctor was young

And nice. He said, I must tell you,
My friend, that it is needless moderation
And exercise. You don’t want to look forward
To gangrene and kidney

Failure boils blindness infection skin trouble falling
Teeth coma and death

O.K.

In sleep my mouth went dry
With my answer and in it burned the sands
Of time with new fury. Sleep could give me no water
But my own. Gangrene in white
Was in my wife’s hand at breakfast
Heaped like a mountain. Moderation, moderation,

My friend, and exercise. Each time the barbell
Rose each time a foot fell
Jogging, it counted itself
One death two death three death and resurrection
For a little while. Not bad! I always knew it would have to be
somewhere around

The house: the real
Symbol of Time I could eat
And live with, coming true when I opened my mouth:
True in the coffee and the child’s birthday
Cake helping sickness be fire-
tongued, sleepless and water-
logged but not bad, sweet sand
Of time, my friend, an everyday –
A livable death at least.

"Walking the Dog," a poem by John Wright

She weighed
three hundred pounds.
Fat and high sugars
were killing her
I thought.

So,
I thought.
So,

I gave her a puppy
with dark curly hair,
nothing else had worked.

Walking the dog
twice a day
I thought
might persuade,
might motivate.

She was pleased with my prescription,
she laughed,
she rocked
from side to side.

She lived
for twelve years
hugging
that little black dog
while her lean husband
walked it faithfully,
twice a day.

by James Wright (1927-1980)

Sunday, July 17, 2005

The Dietitian, Yogurt, and Yoplait Thick & Creamy

To me, good food is a quality of life issue. This also applies to yogurt. My favorite yogurt is Yoplait Thick and Creamy vanilla.

The dietitian had shown me cartons of nonfat yogurt with fruit on the bottom. I told her I eat Yoplait Thick and Creamy. She said these were high in fat, and I have a "fat tooth"! She also told me that I could eat two cartons of nonfat yogurt for one carton of the Thick and Creamy. I happen not to like yogurt with fruit on the bottom. I want to stay with my Yoplait.

As with everything else, I decided to do my own research on nonfat yogurt versus Yoplait Thick and Creamy. It turns out that the Yoplait is low fat yogurt with live or active cultures. Here are the facts for 8 ounce containers:

  • Nonfat yogurt has zero grams of fat. Yoplait yogurt has 3.5 grams of fat. Whole milk yogurts have 7-8 grams of fat. If I were to have a 1200 calorie diet, one carton of Yoplait Thick and Creamy would make up less than ten percent of my daily fat allowance. I wouldn't say Yoplait is high in fat.

  • Nonfat yogurt with fruit on the bottom has about 19 grams of carbohydrate per carton. Yoplait yogurt has 31 grams of carbohydrate. The dietitian told me I could eat two cartons of the nonfat yogurt for one carton of the Yoplait. That isn't exactly true. Even nonfat yogurt without fruit at the bottom has about 18 grams of carbohydrate.
Actually, the best yogurt is nonfat plain yogurt with active cultures. This I like, with my own fresh fruit or wheat germ mixed in. But the dietitian didn't offer me this choice. Her repertoire included mostly processed foods low on quality and flavor. I feel the dietitian mislead me about the fat content of my yogurt, making it seem as though I would be making poor choices going with lowfat yogurt.

I think what irks me the most is the dietitians's condenscencion toward me. It is true that I am more educated than the average patient, capable of doing my own research (after all, I am a social scientist). Why is it, though, that my doctors are not condescending and the dietitian is?

Finally, dietitians should consider the lifestyle and preferences of their patients in helping them plan a diet. For one person, packaged and processed foods (like packaged cheese), or foods low on flavor, are perfectly acceptable. For people like me, however, the thought of that kind of diet depresses me. I consider eating good food a quality of life issue, and I am going to find a way to do it within the limits of my diet.

Diabetes in Postage Stamps

In 2001, the U.S. Postal Service issued a diabetes awareness stamp. According to Diabetes Monitor, the stamp was designed by artist James Steinberg. That same year, Dr. Lee J. Sanders published The Philatelic History of Diabetes: In Search of a Cure, a book which tells the history of diabetes through 30 international postage stamps. The book is available at Amazon.com for $14.95.

There is a lecture by Dr. Standers on the internet called From Thebes to Toronto and the 21st Century: An Incredible Journey. It gives a nice overview of this topic, along with pictures of a lot of lovely stamps. Dr. Sanders is a podiatrist at the VA Medical Center in Lebanon, Pennsylvania.

My favorite stamp is a 1999 Canadian stamp of Frederick G. Banting and Charles H. Best, the discoverers of insulin. Shortly after I was diagnosed with diabetes, I read The Discovery of Insulin by Michael Bliss. I was in graduate school at the time, and deeply involved in research myself, so the book was an eye-opener in terms of medical ethics, animal research, the real "messiness" of research that can be made to appear neat and clean after the fact, and (last but not least) professional rivalry. I would love to have this stamp, put it in a frame with a wide white mat, and hang it in my office.

Saturday, July 16, 2005

The Eleven-Pound Baby: Pregnancy with Diabetes

If I'd had another child, I would have named her Isabella. I knew a little girl in Africa named Isabella, the daughter of a Kenyan doctor. She was called Bella for short. I think it is a beautiful name.

I had wanted four children. As it turned out, I had three. Diabetes made my third pregnancy difficult. Neither Daniel nor I were ready to go through it again.

Camille was born when I was 39. She weighed 11 pounds 3 ounces. There was extra amniotic fluid in my uterus, and I had braxton-hicks contractions for most of the pregnancy. My doctor didn't want me climbing stairs, but my office -- in an old building on the Lawrence University campus -- was on the third floor and the elevator only went to the second. I had to stop every so often as I climbed the stairs, because the contractions grew stronger.

My doctors were a high-risk neonatologist and an endocrinologist. I went to the hospital twice a week for a checkup, blood glucose monitoring, sonograms and whatever else they threw at me. This I had to do early in the morning so I could make it to my anthropology lectures on time. I drove back and forth between Appleton and Neenah at 7:00 am. It was very cold that winter.

The neonatologist was a sexist creep who told blonde jokes. He later lost his license. I think he was an alcoholic, because one of the nurses told me he had liver disease. He was often not there.

Labor was induced the day after Christmas in 1991. Nobody knew the baby was so big -- nor that she had such a large head that she would never drop down into my pelvis. I didn't even dilate. Daniel told the doctor that if he put me through labor and then did a c-section, he would have to buy us dinner. Camille was born they evening of the 27th, by c-section.

What I resent the most are the cracks the doctor made while delivering Camille, implying (while I was laying on the table in the operating room with my arms tied down) that I was dominating Daniel. That memory pollutes the experience of her birth. But he was the only game in town, as high-risk doctors went. Maybe I should be grateful he was there for me, but I have nothing but bad memories of him.

The worst was what he said after Camille was born. He said that because she weighed so much, the pregnancy had been "considered a failure." He said I must have cheated somehow. I tried to protest, but he walked away. My A1c's had been quite low, and my records were accurate. I met often with the endocrinologist, and (despite the fact that I claimed my morning blood sugars were too high) she felt I was doing great. The worst thing I did was eat muffins every once in a while. I was so good. I don't know why she weighed 11 pounds 3 ounces.

I held up my baby and said to him, "She is perfect. How can she be considered a failure?"

Sometimes I wonder what happened, why she was so big. I wonder why, because I had excellent control during my pregnancy. I wonder if there aren't factors we don't yet understand.

The best moments of my pregnancy were when I was in Kenya that summer. I was in my second trimester and just starting to show. I would walk all over Nairobi, and I felt so good and so healthy. The people out in the village told me that this one was going to be my daughter. One woman said, "We cursed you to have a girl." Some curse!

But it was a difficult pregnancy. And so there was going to be no Isabella.

What is appropriate fat consumption per day?

I found the following on a website called Ask the Dietitian. In this case, the dietitian argues that there is such a thing as too little fat. Given the following guidelines, fat consumption should make up 450 calories of an 1800 calorie diet.
If your diet has less than 1 teaspoon of soybean oil (linoleic and linolenic fatty acids) per day you could develop a fatty acid deficiency. Symptoms are red, irritated skin , infections and dehydration. Also, the liver processes food fat and may develop abnormalities if fatty acids are deficient.

Your body uses fat to synthesize hormones and regulate blood pressure as well. Dietary fat also carries fat soluble vitamins A, D, E and K which could also become deficient if fat is too restricted.

Diets of less than 25% fat tend to reduce feeling satisfied after a meal. Bulimics tend to binge on carbohydrates when fat falls below 20%. The current recommendations are 25 to 30% calories from fat.

On the same website, there is a "Healthy Body Calculator". Here are the results for me:

If I want to lose 2 pounds per week, I should eat a 1200 calorie diet which would be 360 calories from fat, a total of 40g of fat with 13g of that saturated fat. To lose one pound per week, total calories should be 1,760, with 530 calories from fat (59g of fat with saturated fat 19g).

How to argue with the dietitian about cheese!

Laurie, the dietitian, told me that cheese was cheese and it didn't matter what color it is. I recalled that white cheese had less fat than yellow cheese, but Laurie argued that it was because the yellow cheese was dyed. I said, "I don't eat that kind of cheese, I eat cheese from the deli counter." I tried to picture myself eating that horrible lowfat cheese in those packages. So I decided to find out for myself.

All cheese is not alike in terms of fat content. Fresh cheese, or curd style cheese, is lower in fat. That includes cottage cheese, feta cheese and mozarella. I knew mozarella was lower in fat than other cheeses, and I've been eating it for years. The quantity of cheese used in a dish is very important. A lot of low-fat cheese is worse than a small amount of higher fat cheese. That seems obvious, but at the moment it really hadn't occurred to me.

This information comes from the National Heart Foundation. See Fresh Cheeses.

Another source of information about cheeses comes from Dr. Christine Fenn. She writes:
All hard and cream cheeses are high-fat foods. Reduce the amount of cheese in sauces and dishes by using smaller amounts of strongly flavoured cheese or adding the cheese to the top of the dish instead of in the dish. Try lower-fat cheeses such as Edam, Gouda and Jarlsberg cheese as well as cottage cheese. They make great sandwich or baked potato fillings mixed with chopped spring onion, watercress, pickles or chutneys.

One UK website states that any cheese with 27g of fat per 100g can be offered as a "healthy choice," but warns to watch the quantities. Note: mozarella cheese has 18 g., feta has 16 g, and regular cottage cheese has 4 g.

Soy cheeses, by the way, have 7g fat.

Now I have the real information and am able to make cheese choices on my own. You know, I wish health care workers wouldn't try to simplify so much.

Lowfat salad dressings

Okay, I admit it. I went looking in my American Diabetes Association and American Heart Association cookbooks for lowfat salad dressings. There are actually some lowfat and nonfat dressings to make. The ADA dressings are lower in fat than the AHA dressings.

I wish the dietitian had given me a fat guideline of some sort -- how many fat exchanges per day for example. That would really have helped me.

Here's one from the internet:

Diabetic, Low-Fat Creamy Ranch Salad Dressing
1 cup low fat cottage cheese
2/3 cup low-fat plain yogurt
2 green onions, chopped
1 teaspoon Dijon mustard
1/2 teaspoon garlic powder
1/2 teaspoon dried basil
1/4 teaspoon dried oregano

In food processor or blender, process cottage cheese and yogurt until smooth. Pour into bowl and stir in onions and seasonings. Cover and refrigerate for at least 30 minutes so flavours develop. Store for up to one week. Stir before serving.

This has 3.8 g fat.

Okay, so a lowfat dressing is possible. Maybe I'm not going to suffer so much.

John Neale...

...has published all of the data on his diabetes since 1994. This is a fascinating website. Visit at: http://www.webshowcase.net/diabetes/archive/

Photographing food as an aid in improving control

I found an interesting thesis online: Visualizing Health: Imagery for data in changing personal practice by Jeana Frost. It appears to be from MIT Department of Media Arts and Sciences.

http://web.media.mit.edu/~frost/Thesis/FrostThesis.pdf


The thesis is about taking photographs as part of a diabetes care program, with the goal of improving how diabetics see their behavior. The author had diabetics take pictures of such things as their meals, inside their refridgerators, tables with food on it, food on the stove, etc. The photographs were then shown in front of other diabetics in a classroom situation, for feedback and critique. This helped the participants see their habits more honestly, and provided a tool to see what was actually happening with their diets.

Today, my photographs would consist of a series of Diet Pepsis, two cans of Slim Fast, and two oranges. Actually, I'm downright starving, and I'm thinking about a to-go order from the Korean restaurant of sashimi and rice, of course watching the quantities. I would have to think about the vegetable. I wonder if they have anything that's not fried. Hmmm. Should I take a picture of it?

The idea of taking pictures of diabetics' food is pretty brilliant. I would never have thought of that. I'm considering it as a supplement to my food records.

AFTERTHOUGHT: Here's how my head works. I pictured photographing everything I ate every day for a couple of weeks, and posting it on the web, along with my diet, for the dieticians to see. Or, alternatively, attaching the photographs to the charts where I'm supposed to keep track of my food. Then I realized that this could actually be performance art -- everything I put into my mouth photographed, and assembled into an installation or display of some kind. The ideal, though, would be to get hold of some of that plastic food, and actually show full size versions of everything I eat. Diabetic artwork, sort of. What do you think?

"Doing Fieldwork with Diabetes"

I just remembered something. I wrote an article for an anthropology research methods journal (Field Methods, formerly CAM: Cultural Anthropology Methods) entitled "Doing Fieldwork with Diabetes."* I need to retrieve that article from somewhere and post it so it can be read here. The article is rather long, so I would need to put it on a separate web page.

It's a good article. I considered publishing it in one of the diabetes magazines. I even queried the magazine editor at the American Diabetes Association about it, and he said he would want it. But I never did it. That's what I was like back then.

I think I could still rewrite the article for a diabetes magazine. It wouldn't focus on field methods. It would focus on getting by in Africa with type 1 diabetes.

(*Vol 9, Issue 2, 1997)

The horrid proposed diet: Visiting the nutritionist

This week I saw Laurie, the nutritionist. This is the first time I have seen a nutritionist or dietitian in years. I needed to go because my diabetes has been so out of control. I also gained wieght after I quit smoking. So I needed to look at my diet.

We did the usual -- looking at plastic slabs of meat and pizza and rubber glasses of juice. I remember the servings of meat and bread. Easy. Then she showed me the starches. How could I eat so little? I'm always hungry.

She went after my fat intake too. What the heck is lowfat salad dressing? I don't eat bottled dressing, I make my own! Bottled dressing tastes terrible. Or fat free yogurt with fruit at the bottom? I hate both fat free yogurt and fruit at the bottom! I like Yoplait Thick and Creamy. And she showed me slabs of lowfat cheeses! Yuck! I don't even buy package cheese. I buy it from the deli counter. I like real cheese, not processed cheese.

Quantities? Can I eat so little starch and fat?

I was almost in tears. Is it worth living longer if you can't eat decent food? Or of you have to be hungry all the time? I am so discouraged.

I now have sheets of paper I have to fill out with my food intake for all my meals and snacks every day. So far I haven't done it and I saw her on Tuesday. It's because I haven't eaten regular meals, so I don't know what to write down. I haven't even been to the grocery store.

What a hassle. What a hassle. I am so discouraged.

Thursday, July 14, 2005

I am getting an insulin pump

After 19 years with diabetes, I am getting an insulin pump. The paperwork has gone to the company for the pump I want, Animas, and supposedly they are clearing it with my insurance. It has been about three weeks; I expect to hear something soon. I chose the Animas IR 1250 insulin pump because of the software available, the lithium battery, and the fact that it doesn't lose all the data right away if the battery dies.

My doctor says programming an insulin pump is like programming a VCR.

I am looking forward to the day when the pump will measure your blood sugar in real time along with infusing insulin.

Why am I getting a pump? Because my diabetes has suddenly become very hard to control. In the last few months, I have had blood sugars ranging from 30 to 600. What I used to do no longer works. I was in the hospital three times with ketoacidosis. The doctor tried increasing my Lantus, but then my family ended up calling an ambulance on me because of severe hypoglycemia. I now know what ketoacidosis and severe hypoglycemia feel like, and I don't want to go there again.