The Honeymoon is Over?

When I was first diagnosed in December of 2011, I was warned that I would, for the next few weeks or months (or even a year) experience what is commonly called the "honeymoon period." This is a time before T cells have destroyed all insulin producing pancreatic tissue and so your sugar highs and lows, spikes and drops have a buffer zone produced by your failing organ. I was warned, I was. And yet when I experienced some early success with some dietary alterations and regular exercise regimens I allowed my budding hope to harvest within me, dreaming of some diabetic fairytale where I use positivity and vegetables to send this life long auto-immune disease into remission. I was even off the insulin for a little over a week!

But the time bomb that was my flailing pancreas kept ticking towards an inevitable downfall. And though there is still some trace of function in my pancreas I've been increasing insulin dosage almost daily for the past week.

So here are a lot of numbers since I went MIA. Pay careful attention to the meds/insulin I take and watch as they increase:

March 30, 2012
12:00 -> 98 Still too high for the morning. Took 2P w/ cereal 120c, orange 15c, 1/2 banana 12c, peanuts 4c.
4:52 -> 111 Took 3P w/ pb and 1/2 banana 43c, pea soup 100c, pepper 8c, grapefruit 24c, apple 25c, pumpkin seeds 7c.
11:56 -> 71 Took 2P w/ salad 40c and took 1 unit of Novolog w/ 2 yams 55c, tortilla chips 20c, brussels sprouts and fennel 45c.
2:42 -> 127 Took 4 units Lantus w/ 2 cookies 19c.

March 31, 2012
11:09 -> 86 Good, 80s! Took 2P w/cereal 120c, apple 35c. At 3:30 had 2 oranges 32c and pumpkin seeds 6c.
5:27 -> 64 Low Took 3P w/ Whole Foods: sprouts 4c, cauliflower 5c, beans 100c, potatoes 30c, mango 30c, rice 25c, seaweed 5c = 200c + cookes 26c, fake coffee 4c, grapefruit 25c, more pumpkin seeds 6c.
12:04 -> 59 Tortilla chips 10c then 2P w/salad 45c and yams 70c.
2:38 -> 157 That's exactly where I want to be. Took 4 units Lantus.


April 1, 2012
10:37 -> 84 Great! Took 2P w/cereal 120c, 4 mile run, apple 35c, pb toast 16c, cake 40c, orange 15c.
6:50 -> 80 Took 2P w/SOU-EN ramen 55c and cornbread 50c and 1/2 SUN IN BLOOM cookie sandwich 40c, chips and hummus 10c, strawberries 27c, fries 5c, 2 shots of Fernet Branca.
2:31 -> 58 Larabar 31c, 1 Prandin w/salad 50c.
4:06 -> 83 Took 4 units Lantus w/ pb banana 50c.

April 2, 2012
10:53 -> 113 High, the alcohol processes slowly, and the 4am sandwich was too much. Took 2 P w/cereal 120c, apple 40c, Larabar 27c.
8:43 -> 70 Took 2P w/16 oysters, 3 oz salmon, potatoes 100c, spinach 14c, salad 7c, tomatoes 8c, asparagus 4c, 1 glass of wine.
1:04 -> 150 Took 4 units of Lantus.

April 3, 2012
10:33 -> 96 Higher than I'd like. Took 2P w/cereal 120c.
2:19 -> 164 No good! Took 2P AND injected 2 units of Novolog w/quinoa 60c, chickpeas 35c, grapefruit 25c, squash and cabbage 50c, sweet potatoes 40c, seaweed 5c, cookie 9c.
4:35 -> 41 Woops, overdid the meds. Had 2 bananas 60c, cookies 20c, pumpkin seeds 5c, bread w/hummus 18c and orange 17c.
10:54 -> 111 Took 2P w/salad 45c, greens 5c, 2 kiwis 20c, apple 20c.
2:37 -> 167 Took 4 units of Lantus.

April 4, 2012
10:39 -> 111 Too high for fasting level. Took 2P and 1N w/cereal 120c, grapefruit 24c, apple 18c, pb bread 22c, kiwi 10c.
4:41 -> 105 Not bad. Took 3P w/salad 40c and soup 40c, apple 20c, pb banana 58c.
7:41 -> 113 A tad low for Pre-Joey. Had grape leaves 47c. At intermission had kiwi 10c and pumpkin seeds 5c.
11:52 -> 132 Overdid it earlier I guess. Took 1P and 2N w/(rice 105c, beans 67c, chorizo 13c, salsa 10c, avocado 15c, fake cheese 2c, kale 5c) x 2/3 =140c + salad 25c, chips 15c, more kale 10c.
2:36 -> 96 Had grapefruit 24c with 4L.

April 5, 2012
11:04 -> 65 A little low. Took 2P and 1N w/cereal 125c, apple 18c, apple 18c, kiwi 10c, grapefruit 24c, pumpkin seeds 4c, Larabar 31c.
5:00 -> 95 Apple 25c, 6.2 mile run (46 minutes) Gu 25c.
6:49 -> 94 Nice! Took 2P w/yams 50c, cabbage and squash 60c, pb and j 38c, 2 kiwis 20c, pumpkin seeds 5c. At intermission had a grapefruit 25c.
1:00 -> 83 Took 1P and 2N w/spring roll 20c, Momma made casserole 200c.
3:26 -> 187 Took 4L

April 6, 2012
11:44 -> 61 One more low day and I'm going to decrease the Lantus. Took 2P w/cereal 110c, apple 25c, Larabar 27c.
5:24 -> 95 Took 3P w/SOUEN rice 45c and pesto veg 30C, dessert 45c, apple 38c, p seeds/hummus/peanuts 12c. At intermission pb and j 38c.
11:58 -> 93 Took 1P and 2N w/salad 52c, casserol 150c.
2:30 -> 85 Had 2 kiwis 20c, soy ice cream 20c and 4L.

April 7, 2012
10:51 -> 88 Good! Took 3P w/cereal 125c, apple 30c, grapefruit 24c, pumpkin seeds 4c.
4:52 -> 91 Took 2P w/rice 70c, beans 25c, fake cheese 2c, salad 40c, apple 18c, potatoes 60c, salad 10c, horoset 45c.
7:46 -> 140 Good Pre-Joey number. At intermission had pb and j 38c.
11:52 -> 136 Had 1P and 1N w/ brussel sprouts 18c, lentil soup 38c, pepper 6c, fennel 14c.
2:44 -> 106 Took 4 units with Lantus w/ mango piece 10c.

April 8, 2012
12:05 -> 108 Too high again. Took 2P and 1N w/cereal 130c, grapefruit 25c, gluten free muffin 35c, apple 35c.
6:51 -> 66 Not bad, took 3P w/ MAOZ falafel salad 225c, chips and macaroon 20c.
12:02 -> 136 Took 2P and 1N w/salad 30c, apple 40c, 2 kiwis 20c, green beans 8c = 98c.
2:38 -> 156 Woah, why so high? That's a big number after 2P and 1N. Took 4L.

April 9, 2012
10:56 -> 101 Too dang high! Tonight I take 5L. Took 2P and 2N w/cereal 140c, 2 apples 36c, Larabar 31c.
5:59 -> 55 Cookie 9c, coconut juice 16c, collard greens 18c. Then took 1P and 3N w/kurobata squash 45c, roast carrots 70c, potatoes 50c, Black Eyed Peas 45c.
8:42 -> 52 Corrected with a cookie 9c, black eyed peas 20c and an apple 18c.
11:29 -> 195 Over-corrected much? Ugh! Took 2P and 2N w/brussel sprouts 18c, BEPs w/kale 80c, 2 pieces of toast 60c.
2:07 -> 117 I'm appreciative of this good number. I'll have a kiwi 10c and then take 5 units Lantus. I should be fine with that since I haven't been active all day.

So over the time I'm showing you I've gone from 5 units of insulin per day to 11 units per day, and my Prandin dosage has stayed about the same. I've had 2 highs and 7 lows. When the diabetes progresses I always jump to errors I might have made first. Is it that I've become lax with the veganism? Is it that I don't workout daily but instead to huge cardio workouts once or twice a week? Am I getting lazy with my carb counting? Or...

...is the Honeymoon coming to an end?

Tomorrow I see Dr. Thys. I have some questions for her.

Day 111

Hypothyroidism

The newest condition I've added to my collection. They came as part of a package deal. Get one, the other three are complimentary. Even though I haven't been officially diagnosed, my endocrinologist insinuated that there was little doubt when last we spoke on the phone. My TH levels were low, my thyroid was underproducing. The only thing keeping me from an official diagnosis is another set of blood tests and a $400 in person evaluation.

I have no doubt of my condition however, I've been feeling the symptoms daily for over a week. The symptoms in some ways are worse than the symptoms I experienced with diabetes... in some ways.

For over a week now my mood has been much like the weather in Hawaii. The morning starts perfectly, another day in paradise. The sun is bright, the water warm, people are outside, life is good. Then sometime around lunch usually, sometime a bit earlier, sometime a bit later, the clouds roll in consuming the whole archipelago in torrential rainfall, the sun disappears almost completely, and even though it only lasts an hour or less, and even though you know that the sun will return again, for that period in the darkness, you wonder how you've made it this far and how in hell you can possibly make it through to the other side of the storm.

And I know it's chemical. I can almost feel that it's chemical. I have no reasons to be in daily anguish. Frustrated from time to time, sure, maybe even bored, occasionally fatigued, angry at situations or peeved by circumstances, but weak and ill and despairing to the point of wanting to cry?? Nothing in my life adds up to those emotions, and yet they return almost daily, triggered by the most inconsequential of things.

I feel like a small business owner under the repressive finger of a mob run protection racket, harassed and assaulted daily, and spending the rest of the time living in fear of the next visit, haunted by the memory of the last. My will-power and body awareness serve like a broken shield and rusted armor against the attack. I'm reminded of what I long thought was the MacMillan crest, a man with broken sword fighting off his enemies (turns out the sword was only broken on our crest).

I've chosen to write from a place of happiness to be as fair as possible to my experience. Anything I write during my afflicted hour would sound more like a Sylvia Plath poem than an original of mine. But this shouldn't last. Later this week I'll have my second blood test and a week later I'll see the doctor for the inevitable results and will likely start medication that night or the following morning.

And a glorious side affect of the medication is increased energy! (or one of the symptoms it alleviates is lethargy) Which means that once I start taking thyroid hormones orally I'll also start running several times per week.

Dailies:

12:01 -> 105 Took 2 Prandin with cereal 120c (coconut yogurt is higher in carbs than soy), apple 35c, fake coffee 5c, peanuts and pumpkin seeds 6c. At 4:30 Larabar 27c. At 6:30 another 24c.
8:07 -> 71 Took 3 Prandin at 8:40 with dinner of brussel sprouts 20c, portabello mushroom 4c, celeriac 30c, cabbage 35c, quinoa 60c, yam 50c.
12:23 -> 245 Dang it! Waiting so long to eat made me super hungry although a mere 190 carbs shouldn't really be a problem for 3 pills. I decided to take 1 unit of Novolog so that i could finish the yam 50c and have a small salad 30c without going any higher. I also took 3 units of Lantus in anticipation of a weird day tomorrow. If I'm lower than 140 when next I check I'll have another mini snack. Feels good to be full, thank you bolus insulin.
2:21 -> 218 Well... still high, but going down a little. If this keeps up I may have to relearn my carb: insulin ratio. I guess I'll go to bed sans snack and trust that 3 units of Lantus will put me in the sweet spot come tomorrow early. Why early? Oh yeah... 'cause this playah is rollin' to the Hamptons tomorrow! Hollah!!! Although this idiot will rely solely on Prandin and fasting to keep my blood sugar in a good range until Tuesday night.


Day 96

Goal: Becoming a Diabetic Leader

I want to make this operation bigger. I've been looking on Craigslist, JDSU websites, meetup.com and I can't really find the type of thing I'm looking for. I know there are bad diabetics out there. I hear about them all the time. And this pains me more than a cold injection into muscle tissue... or at least it pains me equally.

I want to find a way to get in contact with them and convince/teach them how to be better. My diabetic nurse sort of does this, but she has the restrictions of having to say certain things for legal reasons (such as change your insulin after 28 days). Certain individuals have maintained rigid glucose control since the dawn of insulin in the 1920s. Why then are people still showing up to the hospital with A1Cs in the teens, months or years after their original diagnosis?



Dailies:

9:40 -> 121 Don't get used to this time of day, I was just meeting a friend for b-fast which I ate at 11:00. Took 2 Prandin with vegan/gluten free lasagne. Not bad, but it was certainly over priced for what you got. About 80c and an apple 15c.
2:06 -> 119 Took 1 Prandin with a glorious Cameo apple 30c and my leftover swiss chard with squash 60c.
6:22 -> 71 Took 2 Prandin with lentil soup with rice 110c, grapefruit 25c, pb and banana bagel 50c, apple 30c, salad 20c, bread with hummus 20c.
9:54 -> 89 I only checked because I assumed I'd be high after 255 carbs, but this is a great number. Had a cookie 17c.
1:05 -> 65 Dang, and they tell me I'm not producing insulin. Had a salad (rocket, cucumber, tomato, avocado, onion, balsamic, soy chorizo) 45c.


Got some Vitamin D the old fashioned way today, and have a lobster red patch the size of a bear paw on my left arm.

Day 93

A Wake Up Call

Literally, five minutes before my alarm was scheduled to go off I received a phone call from my Diabetic Nurse, Linda. Her motherly voice showed no signs of resentment after I absentmindedly stood her up last week. We had scheduled an appointment two months in advance, and life caught up with me. No hard feelings though.

She wanted to check in, and since she hadn't received the news of my most recent blood work I was able to witness her organic reactions. We hadn't talked in so long that it was the first she had heard about me giving up daily insulin injections. I explained the reasons surrounding my decision, the middle of the night crashes and she supported my decision. But then I gave her the news of my new C-Peptide levels* and she, like Dr. Thys, encouraged me to be prudent in watching my sugar levels, and if they started creeping up to start back on daily injections of Lantus but at very low doses (2 units probably).

I was sure she would be thrilled to find out my A1C was 6.1%, but was mistaken. She saw this number as evidence that i was experiencing too many lows (I was) and would rather see me at about 6.5% she said. Towards the end of the conversation she cracked a joke at how obsessive I was about my control and we both had a good laugh. At least she's starting to get to know me!

I didn't tell her about my cholesterol which I mistakenly quoted as having dropped from 170-136 in my last post. It actually dropped to 126. My triglycerides were 51. Those are some healthy arteries.

When I hung up I went to check my sugar levels fully expecting to be as high or higher than the day before. After all my C Peptide is back at .53 which is super low. Surely Prandin alone can't encourage enough insulin production for somebody with my appetite... or can it?

Dailies:

11:40 -> 83 Woah! Back in the money! Took 2 Prandin with c ereal 110c, apple 15c, orange 20c, pumpkin seeds 6c. At 3:30 had bread with hummus 18c, and a clementine 9c.
4:50 -> 95 Great! Took 2 Prandin with dinner of Black Eyed Peas with kale 105c, grapefruit 25c, orange 20c, bagel with peanut butter and banana 54c, grapefruit 25c, blueberries 19c.
11:36 -> 76 Took 2 Prandin with black bean pasta 64c, indian eggplant 26c, chard and squash 15c.
1:55 -> 98 Dang! That's a day of freakin' great numbers and I never felt hungry either. Had 30c more of the squash swiss chard mix to give me a little boost for the night.

With numbers like these I don't think I'll be back on the insulin soon. But my C Peptide is low. So how is this possible? Wanna hear my theory? Sure you do.

I am (very wishfully) thinking that perhaps due to my high level of activity and my very healthy and fiberful diet maybe I just don't need as much insulin as other people. There is a range after all, from about .8 to about 3.2. If you're >3.2 then that's pre-diabetic for Type 2 meaning that you produce tons of insulin but don't use it efficiently. Isn't it possible then that somebody who's low is actually just very efficient? I mean, I didn't test above 100 once today. And I ate almost 600 carbs today with only 3mg total of Prandin. What would more insulin do to me?

Anyway, I go in for more tests in a week. But in the meantime I'm very pleased with my most recent blood work numbers.

Day 92

Blood Work: Part 4

I got my blood results today. This is the fourth time I've had blood work done. The first time was with my initial visit to the doctor. The second time only a few weeks later. The third was six weeks after that, and the fourth (most recent) was last week, three months from my initial diagnosis. There's no point in building suspense, I have to take the numbers and the results as a quarterly check in, to see how I'm doing. As always seems to be the case there was some good news and some bad news. The good news was good, the bad news... well, you'll see. (I'm recording these from memory, when I get a copy of the blood work I'll copy edit to make sure all numbers are accurate.)

GOOD NEWS:
Hemoglobin A1C: 6.1% This is amazing news. If I can maintain this number for life it is unlikely that I'll ever experience diabetic complications. Other than a freak high or low, complications are the biggest fear/concern (or should be) of all diabetics. A 6.1% A1C means that my average blood sugar level is about a 126.

Total Cholesterol: 126 Also amazing news. Cholesterol levels are a great indicator of heart and artery health. Even a level of 150, though well below the acceptable level as stated by the American Heart Association of 210, has been shown to increase your chance of heart disease. When I first got tested I was a 170, which is a good number for an American, but a bad number for a diabetic who is determined to live a long healthy life. A 126 on the other hand is amazing! I have to attribute this to my new dietary choices.

BAD NEWS:
C-Peptide: .53 This number will continue to fluctuate, a symptom of type 1.5 diabetes, and one of the biggest challenges I'll face in the next few months/years. The number indicates how much insulin my own body is producing. As this number increases so does my natural insulin production making my blood sugar more stable. As this number goes down (.5 is low) I'll be prone to higher and higher blood sugar levels. In response to this number my doctor put the responsibility of treatment in my hands. In her own words she reminded me that I knew how the Lantus and Novolog and Prandin worked, and to search for a balance with any combination I felt appropriate.

TH: Low. I forget the actual number, but this represents the hormone produced by the Thyroid. Mine is hardly producing at all. I am now the proud new recipient of hypothyroidism (more on that later). She's going to give me two weeks and then have me repeat this blood test. If the results stay the same or get worse I'll have yet another pill...to take daily...for the rest of my life.

So the good news is after a mere 3 months, the things that are in my power to control have been controlled. I've virtually disease proofed myself against a host of complications, and proved to myself that I'm smart enough, willful enough and strong enough to do that.

The bad news is that for the unforeseen future I'm shooting at a moving target when it comes to blood sugar regulation. I'll have to be flexible and alert. And the next few weeks may be rough. Hypothyroidism can cause sluggishness, fatigue, depression, etc. I fear a weekend trip to the Hamptons is only a temporary fix.

Dailies:

11:30 -> 138 That's the highest fasting level I've had since February 4th, not a great sign. Took 2 Prandin with cereal 110c. Walked several miles.
2:44 -> 123 That's better, I guess I'm still producing some insulin. Took 3 Prandin with black eyed peas 100c, apple 30c, clementine 9c, grapefruit 26c, lentils 20c. At 6:00 had bagel with pb & banana 55c
6:50 -> 117 Woah! Awesome, that right after having a bagel too! Had a piece of bread with hummus 20c. Performing as Joey. At 8:30 I had a cupcake 12c, pumpkin seeds 6c, and bread with jam 16c. At 12:00 I had a shot of tequila and a Larabar 26c.
1:54 -> 105 Great! Took 2 Prandin with salad 30c and brussel sprouts with cabbage 30c. If I'm above 150 before bed I'll take 2 units of Lantus with a little snack.
3:21 -> 104 Wow! Looks like the Prandin is still working today. I'll have an orange 20c and some blueberries 16c and go to bed.

Day 91

Fraud Alert for People with Diabetes

I received this email today from a Diabetes organization. Copied in its entirety is a message to Diabetics warning them of criminal acts of fraud targeting diabetics.  I'm sure I don't have to tell you how upset this makes me. News like this leaves me wishing for a prehistoric justice system.  Here's the warning:

"Criminals who plot to defraud the Government and steal money from the American people have a new target: people with diabetes.
Although the precise method may vary, the scheme generally involves someone pretending to be from the Government, a diabetes association, or even Medicare, calling you. The caller offers "free" diabetic supplies, such as glucose meters, diabetic test strips, or lancets. The caller may also offer other supplies such as heating pads, lift seats, foot orthotics, or joint braces, in exchange for the beneficiaries' Medicare or financial information, or confirmation of this type of personal information. Additionally, you may receive items in the mail that you did not order.

The call is a scam.

If you receive such a call, OIG recommends the following actions:

1. Protect Your Medicare and Other Personal Information

Do not provide your Medicare number or other personal information. Be suspicious of anyone who offers free items or services and then asks for your Medicare or financial information. These calls are not coming from Medicare, diabetes associations, or other similar organizations. While the caller says the items are "free," the items are still billed to Medicare. Once your Medicare information is in the hands of a dishonest person or supplier, you are susceptible to further scams. Alert others about this scheme, and remind them not to provide strangers Medicare numbers or other personal information.

2. Report the Call to Law Enforcement

Report the call to the OIG Hotline at 1-800-HHS-TIPS or online at www.OIG.HHS.gov/fraud/hotline. As part of your report, provide the name of the company that called you, the company's telephone number and address, and a summary of your conversation with the caller.

3. Check Your Medicare Summary Notice and Medicare Bills

Check your Medicare Summary Notice and other medical information to see if you were charged for items you did not order or did not receive. Also, check for items that were billed multiple times, such as glucose meters, diabetes test strips and lancets, and other supplies. Report any irregular activity to your health care provider and the OIG Hotline at 1-800-HHS-TIPS or online at www.OIG.HHS.gov/fraud/hotline.

4. Do Not Accept Items That You Did Not Order

You are under no obligation to accept items that you did not order. Instead, you should refuse the delivery and/or return to the sender. Keep a record of the sender's name and the date you returned the item(s) to help OIG catch any future illegal billing.

The Department of Health and Human Services, Office of Inspector General (OIG) fights fraud in Government programs. As part of this effort, the OIG relies upon alert citizens to help them catch those who steal from American taxpayers."

 

Dailies:

11:11 -> 87 Took 3 Prandin with cereal 110c, then apple 25c, kiwi 10c, 1/2 grapefruit 13c, apple 25c, 2 cookies 25c and a pb&j 30c at 4:00. Boy it feels good to eat after yesterday's workout!
5:05 -> 92 Took 2 Prandin with TJs salad 53c, cabbage stew 15c and then took a third Prandin with lentil soup 140c and a grapefruit 22c.
8:33 -> 175 Still pretty hungry, but not going to eat with a number this high.
11:28 -> 87 Took 2 Prandin with dinner: salad 25c, brussel sprouts with kale and jalepenos 20c, bell pepper 7c, pumpkin seeds 15c.
3:18 -> 104 Cookie 9c, kiwi 10c.

This was the greatest number of Prandin I've taken in a single day: 8 and yet the numbers didn't seem that much better or worse than usual. Perhaps I got the dosage right finally, or perhaps it's something else. I have a hypothesis brewing.

Day 87

Becoming Vegan

If you read my blog diligently and have a savant like brain for picking up on details and patterns then this may come as no surprise to you. Last week I decided to cut meat and dairy out from my diet. I read some compelling literature on the subject after which I decided I owed it to myself to give it a try and see how it affected my body.

I waited a week to announce this new dietary plan publicly because I wanted to give my body a chance to adapt and I also wanted to see for myself if it was something I could do. Both of those stories now have an ending. Just a few days after cutting out meat and dairy from my diet I had enough daily lows to cut out insulin injections completely. I've posted thrice on the subject but it still boggles my mind. I am NOT taking any insulin and haven't for four days now. As for the question of my ability to be vegan I've found it easier than I thought.

If you are the type of person who becomes anxious or worried at this news can I ask you to focus your energies on researching the subject before expressing your concerns to me. I am a person who has done quite a bit of research over the years on nutrition, who takes care of himself, who knows how to cook, and who REALLY likes food. I am no bird-like girl turning vegan to lose weight. I'm becoming vegan so that my body becomes ultimately efficient, so that I reach my maximum physical potential. I want to get bigger and stronger, but I want to do that while eating loads of beans and legumes, leafy greens, vegetables, fruit and hearty whole grains and all metabolized by my own insulin! If you think I'm at risk of being nutrient deficient in one capacity or another check out the short hand of what I eat (included at the bottom of every post) and see if it's missing. If it is, feel free to inquire and I'll do my best to explain how/where I get this or that nutrient. And if it turns out that I AM deficient, I'll happily make adjustments to correct it.

Dailies:

11:40 -> 113 Took 2 Prandin with Cereal 110c, 2 apples 30c, 2 oranges 17c, a larabar 24c and a bit of chocolate 5c.
5:32 -> 70 Took 2 Prandin with dinner from the Whole Foods hot bar: mung beans, kidney beans, chickpeas, kale, spinach, seaweed salad, cabbage salad, wild rice, okra, approximately 110c, apple 25c, snap peas and pb 6c, cookie 10c, toast 10c, hummus 5c.
9:21 -> 103 I checked here because I really guessed the carbs of my dinner and didn't want to find myself low while on stage. 103's alright, but since the pills work slowly I played it safe and had another Larabar (my go to for raising my glucose) 31c.
11:26 -> 61 Good thing I had the Larabar. Took 2 Prandin with black beans 67c, quinoa 40c, chorizo 13c, kale 4c, apples 30c, orange 9c, shot of fernet branca.
2:56 -> 111 I'm tempted to go to bed, but really I'd feel safer if this number were a little higher. Had some AMAZING cabbage and squash 15c, I'll post the recipe later, and apple sauce 10c.

Gratitudes:
1. Free tickets to the Moma.
2. Gluten free and vegan foods that still feel "naughty".
3. Fellowship with a friend on their B-day.

Day 80

Insulin Free

Since this is my second day without insulin I figured I should let my doctor know. I called the office. She was on vacation. So I texted.


(Actual transcription of my text messages with my doctor.)

Me: "Hey Dr. Thys. I started waking up real low and even having midnight lows and so I stopped taking Lantus 2 days ago. Numbers have been pretty good. Is that okay?"

Her: "Yes"

Communication made easier by technology. I am very very excited at how good the numbers have been. And I figured something else out today. I take usually 6 pills per day. A pill takes care of roughly 100 carbohydrates. A carbohydrate provides 4 calories of energy. Therefore any day that I take 6 pills will be a day that I consume 6x100x4 = 2400 calories worth of carbohydrates. Protein probably makes up at least 10% of my diet or around 60 grams or 240 calories, and I imagine I have at least 30 grams of fat or 270 calories. Combined that is a minimum of 2910 calories per day, a pretty good amount for somebody my size. Although with all the workouts maybe I'll start taking 7 pills and eat an extra 400 calories around lunch. And now for further proof of my insulin-free success!

Dailies:

11:20 -> 93 Perfect morning number! Took 2 Prandin with cereal 110c then at 1:00 had 2 apples 30c an orange 11c and peanuts 8c.
5:31 -> 83 Something obviously working! Took 2 Prandin with dinner of lentil soup with quinoa 115c and salad with hummus and avocado 45c. Also had fake coffee 4c, apple 15c and orange 9c.
10:55 -> 52 Low alert! Apple 15c. Waited a few minutes and then had a yam 75c with 1 Prandin, an orange 9c and a Larabar 24c.
2:42 -> 69 Too low for bed. Had a carrot 11c, 4 celery w/pb 4c and brussels sprouts 20c, and a half cup of apple sauce 20c. Going to bed!

Gratitudes:
1. Got my personal days approved in May.
2. The temperature went over 60 degrees today.
3. A productive physical therapy session.

Day 79

No Insulin Experiment

"This is my quest, to follow that star, no matter how hopeless, no matter how far."
~ Don Quixote in Man of La Mancha

The results are in and I am pleased to say that I survived my first synthetic insulin free day since December 19, 2011. Does anybody else find this as insanely awesome as I do? What a freakin' journey. I went to the doctor with all the classic symptoms of diabetes. I had an A1C of 13, a blood sugar level of 569, a C Peptide level of .55. In common English that translates to "YOU HAVE DIABETES DUDE!" This to me was an unbeatable disease, that's what everybody said. But in those early days I forgot a very powerful truth.

Unbeatable is not the same as unfightable.

I am very very lucky right now. My doctor has said it before and I've realized it many times since. I'm lucky. I've reversed every number that I just listed. My A1C continues to drop, and if I continue on my current trajectory I hope to get back an A1C under 7 when I get blood work done next week. My blood glucose was 67 last I checked and my C Peptide is 1.65, back in the healthy range.

Now, just because I've stopped taking insulin doesn't mean my Diabetes is in remission or anything like that. I'm still on 6 pills a day. I suffer lows an highs on a daily basis. But remember this:

A diagnosis is not a death sentence.

There are two ways to deal with being diagnosed with any type of Diabetes. You can bend over and allow Western medicine and western doctors to make a statistic out of you, or you can do everything in your power to maintain as close to normal health as possible. Make changes. Be an outlier. And keep up the good fight!

Dailies:

10:43 -> 89 This is my first fasting sugar level after not taking basal insulin. Took 2 Prandin with cereal 110c. At 1:30 had strawberries 30c. At 2:00 had 2 mandarin oranges 17c. At 3:30 had blueberries and nuts 10c. At 4:30 had an apple 25c in anticipation of a workout. Ran with sprints, about 4 miles.
5:30 -> 75 Took 2 Prandin with dinner: lentil soup with rice 100c and salad 30c and 2 mandarin oranges 17c. At 8 had strawberries 30 and fake coffee 4c. At 9:30 had an apple 15c, a cookie 10c and my last orange 9c.
12:31 -> 67 Took 2 Prandin with supper: red cabbage and squash 100c (that's a LOT of cabbage) and beans 57c and quinoa 30c.
3:26 -> 182 I'm not unhappy with this number. A little high, sure, but not so high, and since it's three hours since my last pills I'd guess this number is heading down. Will be interesting to see my morning number on what will be Day 2 of the experiment!

Gratitudes:
1. I held my blood sugar under 200 on my first day off insulin.
2. I felt compelled to periodically sprint during my run today.
3. The sun was out and the sky was clear. Spring is almost here.

Doc told me last time I saw her that she wanted my body to "cool down" which was the reason for ditching the Gluten and for ramping up the vitamins. Well, I'd say my body's pretty cool right now.

Day 78

No Insulin Today

Okay, I've been keeping a close eye on myself the past week and am finding that I am trending lower and lower. The Prandin usually works pretty slowly on me which isn't such a problem during the day because I snack quite a bit. But at night, I've been taking it with meals two hours before going to bed. My sugar before going to bed is usually high, but then I've been waking up on the low side. My recent mid-sleep hypoglycemic spell pushed me over the edge. I haven't even been very rigorously active recently. I haven't ran or rowed in several days and still my blood sugar seems a bit on the low side all the time.

I no longer feel comfortable going to sleep with both insulin and Prandin working their slow black magic in the night. I also don't feel comfortable performing as the horse in the show for fear that I'll drop mid-show. Today was one such day. I was performing Topthorn, had a few mandarin oranges before beginning, then a piece of toast mid Act 1, then some more goodies at intermission. But then mid Act 2 I felt myself dropping. I quickly had two cookies and when next I checked my sugar nearly an hour later I was at 71.

I refuse to continue this way. I called my doctor today but was told she's on vacation. So, I'm going to use a bit of my own common sense and try a day without insulin. I was going to just lower my dosage from 5 to 3 or something, but that hardly seemed like enough. And to take only 2 or 1 units of basal seems like stabbing myself for nothing.

So to repeat myself: I am not going to take any basal insulin tonight and will see how that affects me tomorrow. If it's a disaster - which I doubt - I'll go right back tomorrow. But with two shows tomorrow, one of which is Joey, and with the promise of 60 degree weather, which my running shoes finds irresistible, I can't imagine my blood sugar being too high. We shall see.

Dailies:

11:42 -> 62 This is a very low morning number, especially considering I had 45 carbs right before going to bed. This is why I'm not taking Lantus tonight. Took 2 Prandin with cereal 110c. Around 1:30 I had a small apple 15c and then a big apple 28c. Walked the Brooklyn Botanical Gardens
3:48 -> 82 Took 2 Prandin with 3 cups lentil soup 90c with kale 6c and rice 35c. At 6:00 had 3 mandarin oranges 26c, nuts 2c and peas w/hummus 10c. At 7:20 had pb toast 14c. At 8:30 finished the snap peas 6c. At 9:15 felt low and had 2 cookies 21c.
11:14 -> 71 Had a salad 30c, then took 2 Prandin with bok choy (szechuan, ginger, lime, coconut oil) 18c, quinoa 24c and adzuki beans cooked in coconut milk with ginger 62c. Fake coffee 8c.
2:45 -> 147 Let the experiment begin!

Gratitudes:
1. Eric's coat.
2. Subway naps - really, they're the best.
3. The Brooklyn Botanical Garden

Day 77

Hypoglycemia Alert!

I was there on the streets of New York, walking briskly, everything looked gray. I think I was somewhere near Chinatown, although I do sorta remember passing a church that I thought was further north. My sister was walking with me and trying to explain to me about a revelation of sorts she had had. She was beginning to practice honing in on skills she had, interpersonal skills, or perhaps better explained as psychic skills. She would walk down the street without gloves and try to touch the skin of passerbys and see if she could absorb some element of them, pick up on their state or something like that.

Whatever it was I'm not entirely sure because I couldn't stop thinking about how dang slow she was walking. Here I was trying to get somewhere in a hurry and she was dawdling, always dawdling. I think I grabbed her hand at some point and walked faster, but it was as if we couldn't even get to the corner. No matter how fast I tried to walk we didn't get any closer to our destination. I was panicking and I could feel myself sweating, I looked down at my hands and couldn't even see them. I turned around and my sister had vanished, in fact, New York had vanished and was replaced with darkness. Darkness and warmth and sweat and panic.

I threw my covers off and sat up in bed. My pulse was racing. Just a bad dream? I put two fingers to my neck and tried controlling my breathing. It did nothing. I found my glucometer. Pricked my finger, squeezed out a bead of blood, watched as the strip sucked it into the computer and waited five seconds...

It wasn't the lowest I've ever had, but it was certainly the lowest I've ever had in the middle of the night. In fact, this was the first time I've had to wake up in the middle of the night to check my blood sugar. That in itself is a pretty frightening thought. I ran to the fridge trying to think of something to eat and then reassessed and decided to go with quick sugar and had a whole juice box 24c. Thirty minutes later I had raised 43 points to the safe level of 93. I had a mandarin orange 9c and went back to sleep.

Here's why this is peculiar/frustrating/confusing news. I took my last pills of the night at about 7:30pm. Five and a half hours later when I went to bed, my blood sugar was 208. And yet, three and a half hours later I had dropped to 50? What gives? What was still working? I had eaten a massive 230 carbs with two pills. It's hard to imagine that the Prandin was still persuading my pancreas to work overtime. What then? Was it the 5 units of nightly Lantus I've been taking every single night since mid-December?

More importantly what am I going to do about it? Well, for starters tonight I'm going to compensate for any possible late night lows by eating the equivalent of a juice box and mandarin orange right before bed, 33 carbs, you don't have to ask me twice. Then I'm going to check my morning number. If it's pretty low again I'm going to call my Dr. and ask her recommendation and see if I can't decrease my insulin dose.

Dailies:

4:47 am -> 50 Had a juice box 24c.
5:15 -> 93 Much better. Had a mandarin orange 9c.
(morning)
11:03 -> 86 Took 2 Prandin with V cereal 110c. At 1:24 had an apple 20c. At 2:30 had 3 oranges 27c. At 3:30 had 1/2 a VG donut 24c.
5:08 -> 111 Took 2 Prandin with SOUEN RESTAURANT bowl of white sesame ramen 55c and corn bread 45c (which I was possibly misinformed about its gluten content). At 8:00 I had snap peas 6c and 2 oranges 17c.
11:39 -> 69 Took 2 Prandin with salad 20c, fake coffee 6c, 1 cup wild rice 35c, 2 cups lentil soup 60c = 120c. Took 5 units of Lantus.
2:12 -> 131 Not a bad number, however, to avoid a nighttime low I'm going to have another cup of soup 30c with 1/4 cup rice, 9c = 39c. And Bedtime.

Gratitudes:
1. Katy Pfaffl's voice.
2. The existence of an amazingly delicious Gluten Free Ramen restaurant in New York City.
3. Benedict Cumberbatch and the BBC series Sherlock.

Day 76

China Study Review: Part 2

The China Study is nothing if not a vegan manifesto. The list of evidence is compelling. The science is sound. A whole foods plant based diet is the best way to prevent a whole host of diseases including cancers, coronary heart disease, diabetes, osteoporosis, Alhzeimer's disease, etc.

Don't compare what you read in The China Study to what you hear on the news. The China Study is the primary source. This is the book written by the project manager of the biggest most comprehensive study on nutrition ever conducted. A $5 million dollar study examining the dietary traditions of villages across China over decades and the correlation to disease.

Really and truly, the author repeatedly throws some light on fad diets, science of convenience, and agenda based policy and reveals them all for what they are. I've obviously been influenced. If you can find this book in a library, check it out, it is shocking.






And with that I move onto my next book: A Fighter's Heart

Dailies:

11:33 -> 71 Noticing a trend? This is the fifth day in a row I've woken up under 100. Took 2 Prandin with V cereal 110c. At 12:45 had a banana 27c. At 1:30 had two apples 40c.
2:49 -> 86 Pre Joey number. Not high enough. Had a pb sandwich 25c. Did 1st act then had a Larabar 26c. That's a total carb count of 216c for 2 pills.
7:22 -> 74 Wow, impressive how low that is. Took 2 Prandin with beans 67c, chorizo 13c, quinoa 30c, brussels sprouts 20c, chips 20c, blueberries 20c, yam 60c, squash w/ tahini 4c. 234c for 2 pills.
10:03 -> 244 Dang it, I let my appetite get the best of me. If 216 carbs over 8 hours kept me stable with two pills, what made me think that 234 carbs would balance out 2 pills in one sitting. I'm an idiot.
1:00 -> 208 At least I'm heading down (I hope I didn't peak higher between these two numbers, though I probably did). It will be very curious to see what number I wake up at.

Gratitudes:
1. Medical insurance sent me a check, paltry but helpful.
2. My sis arrived in town.
3. Despite some shoulder irritation I completed a very enjoyable performance of Joey.

Day 75

Identity Crisis - Part 2

Not Knowing Who I Am...

What kind of Diabetic am I?

I was lost in a book today - as I'm prone to be found these days - about health and nutrition in America and the causes of Western Diseases aka Diseases of Affluence (Coronary Heart Disease, Cancer, Diabetes) and I came across a statistic that I've seen many times in the last few months: between 85-90% of diabetics are type 2, the other 10-15% are type 1. Okay, simple enough, I'm diabetic so I must be type...

What are my choices again?

Type 1: Insulin dependent. Diagnosis depends on symptoms and a one time random blood glucose reading that is high. Well, I had symptoms polyurea (peeing), polydipsia (thirst), weight loss, etc. AND when I went in for blood work my blood glucose was 569. My A1C (average blood sugar level) was in the 13s and my C-Peptite was .5. Simple enough, I'm Type 1.

But wait a second. After switching to a gluten free diet and starting a vitamin supplementation program I've gone from 30 units of insulin per day down to 5. My C Peptide has popped back up to 1.6 and now I only need .5-1 mg of Prandin per meal to maintain glucose control. Prandin doesn't work on Type 1 Diabetics so I must be Type 2...

But wait a second. Type 2s usually are accompanied by weight gain, show gradual increases in blood sugar (not 569) and have abnormally high C Peptide numbers because they're insulin resistant. In other words they produce a lot of insulin but their body doesn't use it well. That's not me either, If I inject one unit of insulin it's going to eat up everything in my body and make me crash - hard.

So what type am I? Type 1.5? Come on, now I feel like you're just making it up. Try telling your friends, or even your doctor for that matter, that your a type 1.5 diabetic. They won't know what you're talking about. And what am I supposed to get on this medical bracelet that supposedly I should wear forever... type 1.5? People who find me passed out will think I'm part of a hidden camera show. I feel like "type 1.5" is a name they gave to diabetic anomalies to keep them from asking difficult questions. As if by giving it a name it's totally under control. "Oh that? That's just type 1.5 diabetes... nothing weird there!" Insert salesman smile as they hand you the bill for the "diagnosis."

And what's worse?

There is basically NO information about Type 1.5. Take this quote for example from Diabetes Forecast magazine: "As of now, there is still a lot of uncertainty over how exactly to define LADA (Type 1.5), how it develops, and how important it is for patients to know if they have it."

How important it is for patients to know if they have it? What the hell is that supposed to mean?

From everything I've read I feel like there's a window of opportunity here. That Type 1.5 is some sort of pre-Type 1. It's the first sign of an inevitable progression to being fully insulin dependent. It's like one of those narrow escape scenes from the movies. There's a door in the distance that is slowly closing. Most doctors say, "nah, forget it, just stay in here, once the doors are closed you'll get used to it quickly, you'll adapt, it's better that way." And there I am I'm sprinting towards the door, but I don't know what to do if I get there. Do I run through? Can I run through? Can I prop the door open? How? IS THERE ANYTHING I CAN DO??


Dailies:

11:11 -> 81 Took 2 Prandin w/ v cereal 110c. At 1:30 had vitamins and apple 20c. Banana 27c at 3:30. Total 157c
4:56 -> 78 Took 3 Prandin w/kidney beans and quinoa 83c, yam 75c, salad 30c, grapefruit 30c and fake coffee 5c. Total 223c.
10:40 -> 56 Felt low. Had a Larabar 26c.
11:55 -> 59 Geez! No bueno! Had quinoa 60c, peas 17c, indian eggplant 26c = 103c with 1 Prandin. Took 5 units of Lantus.
2:50 -> 132 Lower than I expected, and lower than I feel comfortable going to sleep. Had celery with peanut butter 15c and blueberries 20c.

Gratitudes:
1. A beautiful sunset.
2. The energy and desire to workout on the river at sunset.
3. Unsweetened Baker's chocolate.

Day 74

Identity Crisis - Part 1

Not Knowing Where I Come From...

Where does my diabetes come from?

"The Stork brings it" ~Mom
"When two people really love each other..." ~Dad
"Happy Meals" ~ Ronald McDonald
"Bad Luck" ~clueless people
"Genetics" ~some books
"America!" ~Stephen Colbert
"There's an inciting incident" ~Doc Thys
"Muhahahahaha!!!" ~Mr. G. Reaper

I find myself scampering through books for answers, driving back into my memory for clues, but it's like the picture above. No matter how closely I look at the picture, what's at the beginning of the tracks remains, and will forever remain a mystery. Searching for answers brings too many. Genetics likely plays some role in the development of diabetes. But then my doctor took me off Gluten and my condition improved, so maybe it's a gluten intolerance. Now I'm reading a book that provides evidence of a link between childhood dairy consumption and several autoimmune diseases, which seems to pretty accurately describe me.

It's like the Nature v. Nurture question of disease. Am I fully absolved of any responsibility or guilt for my condition and just pulled an unlucky straw, or have I spent the last 26 years making decision after bad decision that slowly polluted my body to the point of it attacking itself? Both have supporters with medical degrees, both present compelling arguments, both can throw a pile of statistics in the air with great vigor. But none of that gets me closer to the why, when or how of the matter.

I see myself walking along in the dark, whistling a tune, with a swagger to my step and all of the sudden the lights turn on and I realize I'm walking a wire no wider than a pencil. To either side of me is a steep plunge to a certain death. I look back to see where I took a wrong turn, where the signs were "narrow path ahead", or evidence of the road gradually narrowing, but behind me is only darkness. And now for the rest of my life the swagger is gone, my tread has to be light and calculated, gentle and patient, careful and intentional. And with every step I take, the darkness behind me is more and more impenetrable. I am closer right now to being able to find an incident or explanation in my past that triggered this whole series of events as I ever will be. And I can tell you next to nothing.

Where does my diabetes come from? This question will haunt me until the day I die.

Dailies:

11:09 -> 61 That's the lowest morning I've ever had. I blame the one beer last night, I guess I'll err even higher next time I enjoy my weekly beer. Took 2 Prandin with cereal 105c. Then at 1:00 had an apple 20c. At 2:30 had pb toast 14c.
5:15 -> 87 Hungry! 2 Prandin with lentil souup 56c, salad with beans and broccoli 30c, apple 20c and fake coffee (no cream) 5c = 111c.
9:20 -> 90 Tested because i was hungry. Had 2/3 grapefruit 20c.
12:25 -> 62 Woah! I was feeling low symptoms. Had an apple, waited, took 2 Prandin, waited, had dinner: b sprouts 20c, salad 30c, quinoa 48c, kidney beans 35c = 133c. Took 5 units of Lantus. Seeing as it's night (Lantus worn off), and I had more carbs than usual per pill, I'm expecting a high bedtime number. However, that was slightly intentional since I've had five 60s in the past three days.
3:13 -> 158 Perfect number. I feel comfortable going to bed.


Gratitudes:
1. Grateful for a seat on the subway in both directions.
2. Grateful I wasn't being scrutinized during rehearsal.
3. Grateful for my loving relationship with peanut butter.

Day 73

Making Metaphorical Lemonade

I came across this video today:

And even though it's pretty clear to me that the guy is not actually in need of crutches it still reminded me of the potential for people to overcome handicaps in truly remarkable ways.

Here's a more real example, this dancer goes by the name BBoy Junior:

He has polio in one of his legs. But look what he's done with the rest of his body!

Dailies:

11:53 -> 128 Took 2 Prandin w/cereal 110c. Did a 5x10 minute (mild, medium, 5xsprints, medium, mild) piece on the erg, about 12K. Then had a protein shake 6c.
3:31 -> 76 Back in action! After a day of rest and needing lots of Prandin I'm excited that a little workout knocks me down a bit again. Took 2 more Prandin with Broccoli 40c, quinoa 40c, split peas 60c. At 6:00 had fake coffee 6c and at 8:30 I had an apple 20c.
10:42 -> 97 Took 2 Prandin and had Supper: Salad 35c, split peas 50, quinoa 40c. Also took 5 units Lantus.
2:50 -> 225 Dang, you're high. I guess either not enough working out (meh). And I didn't even finish my meal. I have to remember that the Lantus stops working after my evening dinner so my late night supper needs to have fewer carbs than usual.

Also, I'd like to say to everybody who reads this (so that I'm held accountable) that ever since I've switched from bolus insulin to the pill Prandin I've become much more irresponsible when it comes to remembering to take my basal insulin (Lantus). I haven't missed a dose yet, but I don't do it at a set time, and when I'm about to sleep I find myself remembering in a panic and then rushing to take it. This is not a good trend. Suggestions? Maybe I'll try taking it earlier, closer to the end of the show so that I can habit link... you know what habit linking is, right? Sounds like an idea for a future post!

1. Grateful to be strong enough to push myself.
2. Grateful for my amazing apartment.
3. Grateful for the little inspiring emails and messages I get periodically from people about my diabetes.

Day 70

Listen to Your Body

You're body's smarter than you think. My body's way smarter than I knew. I can remember back to the months before I was diagnosed. I had started doing several new things that with further research turned out to be good for diabetics. My body knew and was searching for homeopathic remedies without me even knowing it. This is not unique to my body. Everybody is born with this knowledge, with the ability to understand the language your body is speaking. It's a language we unlearn from lack of use. But stop and listen. What is your body saying to you? Are you high? Are you low? How's your energy level? How does your stomach feel? your legs? your eyes? Are you tired?

Today mine was telling me to work out. I heard it, but unfortunately I had already committed to getting body work done. I had a massage and acupuncture scheduled (poor me, right?). Normally I would be thrilled to spend a day luxuriating myself, but today was 55 and sunny, and my body is getting so used to working out that taking a day off has two affects on me. First, it makes me antsy and more easily unhappy. Second, it makes my metabolism of glucose less productive.

BUT

Rather than stick to my normal pill to carb ratio, I listened to my body and was able to manipulate the medication accordingly. In doing so I ended up with fairly normal sugar levels throughout the day, although I did take more medication than usual.

Dailies:
11:55 -> 82 Took 2 Prandin w/cereal (no yogurt!) 95c and pb bagel 32c. At 2:00 had fake coffee 5c. At 3:00 had 1/2 Larabar 13c.
5:01 -> 127 Big slice of gluten free pizza 40c. Took 1 Prandin and had other 1/2 Larabar 13c.
7:06 -> 145 I'm averaging higher today it seems. Took 2 Prandin w/ Chipotle bowl 110c.
11:26 -> 158 Well, this is obviously the affect of not working out all day. I guess I'll have to hit it hard tomorrow. Took 2 Prandin w/ salad 30c and broccoli 40c, deliberately overmedicating to bring myself down a little. Took 5 units Lantus.
2:53 -> 111 I'm very pleased with this number, and am happy with the way I managed a drop in blood glucose. But I'd rather not take 7 Prandin in a day if I can avoid it.

Gratitudes:
1. I'm grateful for the free ticket to see William Shatner today which also featured a guest appearance by Brad Paisley.
2. I'm grateful for the ability to sit for a half hour in Riverside park while the sun broke through the clouds and struck me with its warmth.
3. I'm grateful for the privilege of complimentary massage and acupuncture, and practitioners who are very talented and also wonderful people.

Day 70

Three Gratitudes

I'd like to share a video I came across on the internet. It's a lecture given at the 2012 Ted Talks by Shawn Achor about happiness. It's pretty remarkable, but there are a few things in particular that I took from it.

1. Only 10% of your happiness is determined externally, as in affected by your surroundings. The other 90% has to do with you and the way you look at the world.
2. You can improve your 90% with a few simple daily exercises. He includes: 3 daily gratitudes, journaling, exercise, meditation, random acts of kindness.

This means that even though I'm a super happy guy generally I can be happier still. I take on his challenge. For the next week I'll list three things I'm grateful for each day. So here goes nothing!

Gratitudes:
1. I'm grateful today that I was able to put together a great show for a sold-out audience.
2. I'm grateful for the opportunity to see Spider Man: Turn Off the Dark.
3. I'm grateful I have friends willing to join me for a Sunday night of jazz guitar.

That was easy. There are tons more, but three for now.

Watch the video, get inspired.


Dailies:

10:37 -> 99 Took 2 Prandin w/cereal 110c. Apple 20c at 12:30, and another 20c at 2:00
2:47 -> 120 Good Pre-Joey number. Had fake coffee 7c. At intermission (4:30) I had pb toast 14c.
6:21 -> 70 Had a salad 35c. At 11:00 had a glass of red wine.
12:54 -> 89 Took 2 Prandin with dinner: beans 67c, salsa 12c, avocado 15c, chips 18c, brussels sprouts 18c, 2 eggs = 130c. Because it's late I'll probably end up a little high, but that feels like a safer option than going to sleep low, especially because that one glass of wine got me a little tipsy.
2:58 -> 102 Hmm... Because of the wine, and the fact that I took 2 Prandin, and the fact that it's so late I'm going to say that I wanted this number to be a little bit higher before going to bed. The Prandin usually hits me slowly so I don't think it's done working. To play it safe I had 2 cookies 18c that I dunked in peanut butter 4c. I'm such a fatty sometimes.

This video and this message are pertinent to diabetics because they have a twofold risk of becoming depressed compared to the rest of the population based on the National Institute of Mental Health. I don't know the ins and outs of why, but it doesn't take a doctoral degree to realize that newly diagnosed diabetics are vulnerable to feelings of futility and hopelessness that can quickly escalate into depression. Rather than allowing these problems to grow empower yourself with the knowledge necessary to objectively deal with each and ultimately get your life back in under control.

Day 69

The City of Unlimited Choices

Today was rough. Not diabetically, not physically, in fact for no reason related to my condition at all. I had a crappy day at work. It happens, we've all been there, I'll live to see another day.

But a bad work day coupled with more wind and rain than we've had in months gave me a positively negative demeanor. And then I passed this...

Choco Bolo

The sign in the window advertised Chocolate, Cake and Coffee.

Chocolate, Cake and Coffee!

CHOCOLATE, CAKE AND COFFEE!!??

I can't have chocolate because I'm Diabetic. I can't have Cake because I'm Gluten Free. And I can't have coffee, because I gave it up for Lent!! AAAHHhGGGGHHhhH!!!

Sometimes I feel as discriminated against as a black man in rural 1950s Alabama. They're all inside there looking so happy, eating away at their eclairs and viennese tortes, sipping their mocha lattes and macchiatos and mayan sipping chocolate, oblivious to the amount of carbohydrates in each, blind to how hard their pancreases are working, to the caffeine that's running through their bodies artificially spiking their heart rate and adrenal production. Oh I envy you coffee drinking chocolate cake eating affluent kept women of the upper west side with your double decker MacLaren strollers and your dogs with cute sweaters, and your Chanel bags and your precocious little children.

I hope you feel a particularly intense burn of lactic acid when you're at your group pilates class at David Barton's gym. I hope your gyrotonics instructor dropped his shot of wheat grass on his way to work and takes it out on you. So there!

Breath,

breath,

breath...

Phew...

Sometimes, you just need a good shouting session. A time and place to vent and the freedom to do so. It's not always easy, living in the city of a thousand choices with so many restriction on you. It's not easy getting the stink eye from cocktail waiters who, while collecting used beer bottles, realize the Gluten Free bottle didn't come from their bar. But what's not easy is hard (I swear. Look it up in the dictionary if you don't believe me). And doing things that are hard make you stronger.

I'll be strong if you will.

Dailies:

11:23 -> 78 Took 2 Prandin w/cereal 110c and an orange 17c. At 2:15 had toast w/pb 15c. At 3:15 had Larabar 15c.
6:00 -> 89 Took 2 Prandin with Chipotle 110c, apple 20c, peanuts 6c and face coffee 10c.
11:20 -> 102 Took 1 Prandin with dinner: brussels sprouts 18c, salad 20c, apple 20c. Took 5 units of Lantus at about 1:00.
2:15 -> 74 pbgft (peanut butter gluten free toast) 15c. Bed

Day 66

Hour of Power

I swear, sometimes I only workout because I know that at the end of the day I'll have something to write about. I dread a blank screen more than I dread a painful training session and so I give myself a minute to decide what sort of workout is best and then I just do it. I wonder if that's the best thing that comes of writing this blog. But if so, then this blog is successful indeed. They call that something, don't they? Doing something not of your own accord but for somebody or something else. They do - they call it accountability.

Who or what are you accountable to? We all have things we could do better. If you're a Type 1.5 diabetic like me, maybe your A1C lives near the 8% mark and you want to get it lower. Maybe you're a type 2 and your goal is weight loss. Or you've taken on the Gluten Free Challenge and find yourself faltering, standing in the aisles at the grocery store with a hand on a box of mac and cheese, or in line at a sandwich shop. Maybe you're training for a competition, or just working towards your own personal goal. Are you a creative type who keeps resolving to start that novel, or finish that screenplay?

Everywhere I look I see people with wonderful wonderful goals. One friend wants to learn Portuguese so he can go to Brazil for the world cup. Another wants to save enough money to buy a house. One has aspirations to be a great banjo player. But goals are cheap. They are. It's a beautiful word that belongs somewhere near maybe or could in the dictionary.

I wrote a bit about willpower yesterday. But today I want you to think about what role accountability can play in fortifying your willpower. And when you're done thinking about it, choose one of your goals (preferably one that is attainable in the near-term, say a month or two) and find a way to hold yourself accountable. Make a pledge to someone who will check in on you and monitor your progress.

So what's an hour of power anyway?

Well, it's a very unoriginal name for sitting on an ergometer...

...and pulling you're butt off...

...for an hour.

It hurts. It's long. It's boring. BUT...




When you finish you realize you've just rowed 9.5 miles, a solid hour, burned over 1000 calories and you know that you are stronger and healthier than you were before. And what's more, you've built your self-confidence and strengthened your resolve. Next time will be easier and easier still until you'll have to make the workout harder to keep up with your progress.

But for those of you who read this only for the fitness aspect, yes, I realize that I've done two epic cardio workouts in one week. I had to do it to prove to myself that I could. It was mental training. Did I have what it would take to push through a distance. I answered that question. My question for next week is, how much intense pain can I suffer in the short term. In other words, sprints, and things like sprints, and lots of them.

Dailies:

12:17 -> 120 Seems a peculiar number. had 2 Prandin w/cereal 110c. Rowed a POWER HOUR! Had an orange 16c and salad w/quinoa 45c and chicken.
5:37 -> 77 Took a Prandin with chicken, quinoa 40c, indian eggplant 26c, orange 16c. Did Joey. At 9:30 had pb toast 15c, protein shake 5c and fake coffee 8c. At 10:45 had a shot of tequila, beer and Larabar 26c. Took 5 units Lantus at 1:50
2:40 -> 74 Don't feel like taking meds and waiting, so I just had baby zucchini 12c w/ tahini 5c.

Day 65

Reading Labels for Dibetic and Gluten Free Living

Well don't I feel like a fool. I made one of the classic schoolboy errors. Here I am, a guy who grew up reading labels, searching for key words like sugar and high fructose corn syrup and monosodium glutamate and other various additives that aren't good for you my whole life. Since my diagnosis I've gotten even more anal, checking for any glutinous ingredients or any of the manifestations of refined sugar. And I've gotten good, really good. I eat more and more macrobiotic foods, whole plants, unprocessed meats, fresh fruits and unrefined grains. But despite my obsessiveness mistakes happen. Here's an example from yesterday which may explain why my post breakfast numbers have been a bit higher than I'd like.

As one of the components of my breakfast "cereal" I include 3/4 cup of yogurt - organic, nonfat, unsweetened yogurt. I go through it pretty quickly and so I'm always back at the store buying more. Trader Joe's has a few good choices, so does Whole Foods. Both of these stores however get crowded, especially at peak hours. And when I only have 15 minutes to grab what I need, sneak through the line and bolt back to work I rush, and get sloppy and make mistakes. When reaching between an asian couple with a child (in stroller) a man restocking shelves, and an indecisive middle-aged tree-hugging type for yogurt I grabbed what looked like the last of the nonfat yogurts.

Over the next few days I made my cereal concoction as usual, guessed it to be about 110 carbohydrates, ignored my taste buds complaints at how uncharacteristically saccharine it was, and then was surprised at post-breakfast highs. When am I ever above 180 after breakfast? Why don't two pills knock out the carbs from a breakfast of cereal and fresh fruit? What the devil is going on?

I had had it with all these inconsistencies and so this morning went back to the drawing board measuring all my portions and checking it against the food labels. Everything was lining up as it usually did and I was at 100carbohydrates with only yogurt left. Unsweetened plain yogurt should have popped me up to about 110, but the stuff I was shoveling into my mouth was 30 carbohydrates! I was 20c higher than i should have been. I had compromised my health for the sake of saving a few seconds. That explains all the wacky numbers. Luckily the fix is quite simple, use less yogurt until it's done and then go back to what you usually buy.

Later in the day (after I had come up with the idea for this post) I invited a friend of mine out to a Mexican restaurant for dinner. The conversation got serious before we managed to order so I quickly browsed the menu, ordered the enchiladas, haphazardly looked up the carbohydrate content, guestimated the total and threw down a few pills. Once again my health had taken a back seat, this time to save a heartfelt conversation from interruptions. As I was about to finish my meal something began nagging me, so I went back to the carb counter book, added them up again and got a higher number, so high in fact that I decided to take a third pill (that still only totals 1.5mg, max dosage per meal is 4mg so don't freak out about the quantity). But now I was left in a strange situation, I had taken two pills a minute before eating, and then a third pill with only a few minutes left of eating. And what's worse is the book's estimate of the carbohydrate value of enchiladas seemed wrong. After all, they're little more than a tortilla wrapped around chicken with a little sauce. How could that be 49c? I added up the components and got closer to 25. Which put me way under, and since I was still hungry anyway I had a piece of peanut butter covered toast. Now I was one big mess, pills dissolving at different rates, food breaking down at different rates, my Pancreas getting the green light, followed by a second green light. And I was doing Joey tonight!

(this is me unhappy about doing Joey when my body's raging a war inside!)

If you're not used to reading labels as a diabetic or celiac it's time you started. Counting carbs is an art not a science but a good degree of practice is required before you get comfortable. Sometimes the book is wrong. It's your body, use your own judgment. The same goes for recognizing gluten and derivatives of gluten in products. If you're not sure, why risk it. Similarly with diabetes and carbs if I'm not sure I round the carbs up. Better (in my opinion) to start to descend a bit earlier than usual and correct with an extra snack then end up in the stratosphere having to decide whether to take a prandin or shot of insulin on top of what you've already had.

Dailies:

11:00 -> 126 Good enough, wish it was a tad lower though. Took 2 Prandin with cereal (actually 110c) a banana 25c, and apple 20c = 155c. At 3:00 I had a piece of bread with peanut butter 17c.
5:21 ->84 Dinner. Took 2 Prandin with enchiladas 40c, beans 40c, rice 70c, chips with salsa 40c = 190c. But, the carb counter book mislabeled enchiladas as 49 each so I took a third Prandin on mis-information, figured out my mistake later and had an additional piece of bread w/pb 19c. Total carbs 209c with 3 Prandin (1.5mg)
8:17 -> 231 High. Damn it. Probably because my meal was so carb heavy and I didn't give myself anytime to digest the Prandin before I started eating. Performed in Joey and drank a lot of water.
11:00 -> 128 Well either the Prandin is still working or Joey really uses a lot of glucose. Took 5 units of Lantus. Went bowling. First game 115, second game 124. End of year goal 180.
2:20 -> 58 What the hell?? Is the Prandin still working? I mean, I took it 6 hours ago! Unless the Lantus just decided to work really quickly. How can I possibly regulate a medication that takes up to 6 hours to fully work but not at a constant speed at all. Ugh! At least I felt able to eat an apple without worrying about a spike 20c.
2:58 -> 89 Well, finally I catch a break with a decent number. Chances are my blood sugar's on the rise, but how high can an apple put it? Just to be safe I'll also have a bunch of snow peas 12c. And some herring 0c.

These numbers do not a happy GI Jon make. Especially because I was hungry most of the day. I was hungry after breakfast despite eating 155c, and hungry after dinner despite eating 209c. And I'm tired of feeling like I ALWAYS have to load up on protein now! I mean, I eat a lot of vegetables, maybe not today, but in general. I need to be eating probably in the range of 150 carbs per meal, and yet the annoyingly slow rate that Prandin metabolizes my sugar means that that many carbs will probably create a sine curve - first high, then low. The only way i can think to avoid that would be to eat medium sized meals followed by snacks similar to what I did this morning. I would hate to see what a continuous glucose monitor would say about me.

Mamma said they'll be days like this!

Tomorrow, despite rehearsal and a show in horse I'm going to workout. With temperatures projected in the mid-high 40s, I gotta take my bike out for a ride!! :)

Day 58