Blue Zones

If you ever catch me talking about what started me down my exploration of wellness then you've probably heard about the Blue Zones. I started working out around the age of 15 when I discovered crew. But it wasn't until five years later when I learned about the other aspects of wellness. You see, the recipe for living forever isn't just eating right and exercise. It's more comprehensive than that, it encompasses your entire lifestyle and includes things you may not expect. But don't take my word from it. These lessons were learned from centenarians around the world.

The idea of "Blue Zones" started when National Geographic writer Dan Buetner decided to write an article about a region of Sardinia with unnaturally high occurrences of longevity. After going there he was overwhelmed by just how true this claim was. Not only were people living longer, but they were living healthier. Many of the people he witnessed showed the mental and physical capacity of people 20 years their junior. After the article was published more and more of these "Blue Zones" (areas he circled on a map with a blue pen... the name stuck) started popping up. One in Okinawa, Japan; one in Ikaria, Greece; Another in Costa Rica; One surprisingly in Loma Linda, California.

I followed his progress and was equally awestruck. It changed the way i thought about health and wellness, and made me reexamine my life goals.

Since then I've wandered away from the study, found other books, discovered new philosophies, listened to people, experts, friends, etc. Then Diabetes and the rest hit me and I've been a bit lost in the midst of it all. But over dinner the other night the topic came up and I was happy to share what I remembered of this study. I wanted a visual example and went online to show the videos of their progress in Greece and found...

... there were now videos documenting some of their research in Japan and Costa Rica too!! I'll give you one guess how I spent the next hour. Just seeing the vitality in those centenarians thrills me to no end. I hope that others are as affected as I am by this fascinating exploration of lifestyle.

Dailies:

10:43 -> 78 Took 2 Prandin w/cereal 120c, apple 15c, pumpkin seeds 4c, cookie 18c.
1:54 -> 210 Too high... may be time to get back on Novolog. The Prandin just isn't working fast enough to avoid these highs. Had an orange 14c at 3:20.
4:53 -> 67 Well, at least it works. Took 3 P w/black eyed peas 115c, salad 30c, apple 23c, orange 14c, grapefruit 25c. At 9:30 had cookie 18c. At 11:30 had a glass of white wine.
12:56 -> 73 Had 1 Prandin with brussel sprouts 20c, chips w/salsa 20c, apple sauce 10c, and yellow pepper 7c.
3:03 -> 108 Took 3 units of Lantus with a piece of toast w/pb 15c.

Tomorrow I get more blood work done. If the C Peptide is lower I'll go back to insulin. If the Thyroid hormone is lower I'll start taking supplemental hormones. Either way knowledge is the path to balance.

Day 99

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

Habit Linking

Habit Linking - I googled this term and found nothing so I'm going to claim this as a GI Jon original. To best explain how I came up with this practice and this term I have to take you back to 2010.

In the summer of 2010 I had been touring the world for three years as a puppeteer in the show Walking with Dinosaurs. I had long since put aside my rigorous physical habits of the past in order to better absorb all aspects of the local cultures I was visiting. In other words, I hardly thought it a productive use of my time to be stretching and strengthening my body when I could spend the same time visiting an ancient temple or observing a tea ceremony.

I'm a pretty tough guy and pride myself on being able to power through most things, but after getting a particularly painful massage in Japan the masseuse told me that the root of most of my physical ailments was a lack of flexibility. I heard what she said, but it wasn't enough to get me to change my habits. It wasn't until a week later at a gym in Nagoya where I went to train with my co-workers that I realized I had the tightest hamstrings of all of them. Tell me I have tight hamstrings and I'll probably give you a chuckle. Tell me I have tighter hamstrings than somebody else and you've made it a competition. Now I felt motivated. But stretching is something that needs to be done daily, multiple times daily if you really want to improve. How would I ever remember to make this lifestyle adjustment especially when my life was so exciting and random all the time? I pondered this question for awhile and finally a light bulb went off.

Think of your typical week, for a moment, if such a thing even exists for you. Are there any things you do, every day? Well, you probably sleep every day, and eat every day, and more than likely use the restroom every day. But those are all things that your body tells you to do. There's no discipline in going to sleep or in deciding to eat, or relieving yourself, that's automatic. Okay, are there any things you do every day that you don't HAVE to do? There are dozens and they're different for different people - making your bed, brushing your teeth, journaling, reading the newspaper, who knows. The one I chose was brushing your teeth, and here's why.

I brush my teeth twice a day, every day, 365 days a year. It takes about 3 minutes when you include flossing. It only engages my hands and my mouth.

My goal was increased flexibility in my legs, specifically my hamstrings, adductors and my IT Band. That's three stretches on two legs - 6 stretches at 30 seconds each is 3 minutes. It was a perfect fit.

Now the first two weeks are crucial, you HAVE to remember to link the habits EVERY day. Every time I brushed my teeth I made sure to stretch, even if I was short on time and rushing a little, I made sure to go through the motions. The most important thing in the first two weeks is not to get more flexible but to train your body to associate the act of brushing your teeth with the act of stretching, linking a very new activity to a very well engrained habit. After two weeks the new habit is pretty well engrained and the pudding came a few months later. I had changed hotel rooms a half dozen times, switched countries thrice and was in a new timezone, and practically a new hemisphere, and I had just gotten back from an all night rave on the beach! I went into my room to brush my teeth before work, and it was all I could do not to pass out right there. But as I was brushing something felt weird. I felt anxious. Was it because this was my last week on tour? No.. that wasn't it. Maybe it was the day I had in front of me, two baby ts? Nah, that wasn't it either. While I tried to figure out why I felt so weird, I casually threw my leg up on the sink and leaned forward over it, I felt the burn of my muscle fibers stretching... and the anxiety went away.

Need a visual example? Watch this clip from The Office.

Workout today: 7x1000 meters at 1:48 with 6x500 meters at about 2:50 (rest).

1. I'm grateful for Thursday night bowling.
2. I'm grateful that I can afford to own a super awesome Concept 2 Model D ergometer.
3. I'm grateful that I live in an age where lots of information on health and nutrition is available for those with courage and a library card.

Dailies:

11:27 -> 88 Took 2 Prandin w/cereal 110c (walked to yoga, but it was cancelled) Did my rowing workout. At 2:30 had celery with tahini 15c.
4:00 -> 68 Nice! I love the slow downward creep post workout! Took 2 Prandin with a big yam 65c, broccoli w/homemade pesto 40c and a small cup of lentils & quinoa 40c.
7:45 -> 118 While this number is fine normally I want a higher Pre-Joey number. Had apple 20c and peanuts 5c. At intermission 9:30 I had 1/3 grapefruit 10c and peanuts 5c. After the show at 11:00 I had my pre-bowling beer. Took 5 units of Lantus at 1:00am.
2:23 -> 69 Happy with this number. Had a salad 30c with no medication and I'm going to bed now.

Day 72

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

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

Gluten Free Beers

I'm beat. A two show day and a mid-day workout of 10 quick sprints up a three story flight of stairs. So here's a quick round-up of a few beers I've had. All of them surprised me, in a good way. I'm also pleased to announce that there is some diversity between them so I'll start keeping them all on stock if such an opportunity arises.

GLUTEN FREE BEER!!!

Bard's Beer - Bards was a good place to start. I entered with very low expectations and yet it's cold crisp and pleasantly hoppy taste resurrected my faith in a benevolent God. This is beer, gluten free beer. There was a slight metalic taste and the aftertaste reminded me of my college red cup days, but it will suffice in a pinch and is worth the adolescent memories for the first few sweet sips. My life will not be beerless, just no more beers at bars. That's like going to the dentist expecting root canal and finding out it's just a cavity. It's a beer I'll drink if it's handed to me.

Greens - This is the closest I'll get to the Trappist Ales I've had to cut out of my diet. It is Belgian made which automatically makes it the best gluten free brewery in the world. It is the most expensive (to be expected) but has incredible depth, high alcohol content, and a robust sweetness that only comes from a Dubbel style beer. This is the cadillac of gluten free beers, best enjoyed cold, slowly, in a proper mug with a plate of strong cheese, gluten free bread, and a steaming pot of mussels.

New Grist - This beer was [very] light, crisp with a bit of a syrupy aftertaste. This will be the beer to fill those endless warm summer nights outside listening to the cicadas and crickets, or sailing down the coast of California, waves tickling my bare feet that hang over the deck, sun bleaching my saltwind swept hair. I guess what I'm trying to say is, though it's no wheat beer, it is similar enough in flavor quality to a Blue Moon to be my go to when I'm hankerin' for a fruity beer that is still masculine.

Redbridge - Of the four, Redbridge is the best all purpose beer. I'd be equally comfortable drinking this out of a tall and sexy glass at a Vegas club (although why would I be there?), or straight from the bottle at a monster truck rally. This is the beer for poker night, for drinking with a burger, for camping trips and tailgate parties, or for washing down the body aches of a long day working with your hands building a deck, or mending a fence or painting a house. It's gluten-free America in a bottle. Tastes like freedom.



Dailies:

12:00 -> 116 Took 2 Prandin with cereal 110c. At 1:00 apple 20c. At 2:00 had pb toast 15c and fake coffee 10c.
5:45 -> 68 After a few sprints up some stairs. Took 2 Prandin with 32 oz of chili 100-120c? At 8:00 had an apple 20c and quiche 35c. At 10:45 had half a beer.
12:01 -> 64 Based on this number I'd guess the chili was closer to 100c. Had a huge salad w/avocado 35c and chicken. Took my 5 units of Lantus.
2:45 -> 87 I'm going to sleep on this number. I'll keep sugar nearby, but honestly I imagine this to be slowly creeping up. I'll probably wake at 100.

Thoughts: I think the key to using Prandin successfully for me is understanding that it's affect on me is slow. Two of my pre-meal numbers were in the 60s and yet both times I didn't panic at all, felt no low affects and ate shortly afterwards. Those are not 60s that are dropping fast, but simply a reflection of a pancreas that is slowly ticking away and dealing with my obscene amount of food. One day soon I'll probably do a few 2-hour after my meal checks to make sure I'm not having any huge spikes as I was in the early days of Prandin.

Day 68

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

The Gluten Free Challenge

It was in Turkey back in September of 2009 that I really understood for the first time the purpose of giving something up for Lent. It does not feel so long ago that I was there, wandering the stalls of the Istanbul spice market, feasting on river fish, fresh figs, walnuts crushed with honey and cheese, sipping their dark and syrupy tea in a glass delicately held between my two fingers. A few days later I was on my own in the small seaside town of Amasrat, where I could sprawl on great sun baked rocks and watch the locals exchange village gossip or sit themselves in the shade of the cliffs. But it wasn't until I went to Bolu, a large but unimportant town in central Turkey that the meaning became clear.

Let me start by explaining that there is nothing in Bolu. It is a very dull place unless you are being hosted, which I suppose I was. He met me at the local park, spotting me easily, a tall blonde man made whiter by the goopy thick sunscreen I bought from the nearest convenient store. I've since forgotten his name but he was a slight man, short, dressed in a short sleeved collard button up one size to big tucked into his khaki shorts which were cinched tightly in an effort to give him the waist his God overlooked. When we met he was tired and irritable, nursing a headache and fatigue, but he put his physical troubles aside and took me to a local favorite spot of his for some food. I ordered two sandwiches and some exotic pastries before it dawned on me that he was a very religious man.

September of 2009 was Ramadan, a time of year when Muslims eat only when the sun is down. If you're thinking, "hey, I could just become nocturnal for the month" then you're just where I was two years ago. But even if you did choose to spend your Ramadan sleeping during the day and dining in the dark, which wouldn't be so fun after a few days, you'd be missing the point. As it was explained to me by my Turkish host, the point is to experience life, if only while the sun is up, as the poor and hungry do. He had been fasting since 5am, no food, no water and it was nearly sun down and still in the mid 80s. To feel, actually feel the hunger and the thirst is to understand better their lives. There is no better foundation for compassion than this shared experience.

That night when the sun finally went down he met with friends around a table sagging under the weight of the food. It was a buffet set for kings and as they filled themselves with all the bounty of the very generous Turkish land I saw them come to life again, enjoying food as you never can when it's always there. They had gained an appreciation for the gift of nourishment.

It's not Ramadan, and I'm not Muslim. But tomorrow is Ash Wednesday which means the beginning of Lent. I don't think I've successfully given something up for Lent in years, or even decades. Partially this was due to laziness (I couldn't think of anything big enough not to feel guilty but small enough not to really change my day to day life), partially this was due to a lack of motivation. I asked myself, "what's the point? Why should I give up chocolate... beer... ice cream? What will that teach me?" But those questions are selfish.

And so I come to my challenge for you.



I challenge you, the readers of this blog to learn what it is to be afflicted by gluten free living, to walk for a month in the footsteps of Celiacs and others with dietary restrictions around the world. Feel the small burden of our daily restrictions and sacrifices and know that no matter how annoying it may get, some day your inconvenience will end, but ours is for life.

I welcome you to share your experiences as comments on this post. What was the hardest thing to give up? What did you crave the most? What new foods did you learn to love? How did you find eating at restaurants? Would you be able to make the switch if you had to? I hope we all grow from the experience.

Dailies:

10:33 -> 116 Higher than I've been in the morning, I blame my late night. Took 2 Prandin w/Breakfast: Cereal 110c, banana 25c. At 1:00 had an orange 20c.
3:10 -> 108 Took 1 Prandin with Lunch: 1/2 rotisserie chicken, plantains 70c, salad 5c. At 5:00 had 1/4 protein bar 6c, peanuts 6c, 1/2 orange 10c and teeccino 7c. At 8:30 had peanuts 7c and 1/2 orange 10c.
10:48 -> 79 Took 2 Prandin with Dinner: Salad w/quinoa 60c, asparagus with onions 30c, bagel 26c, banana 26c, peanut butter 8c = 150c.
1:54 -> 256 Felt high, was high. The bagel was too much which is too bad. It was really really delicious. I'm sure I'll drop into range by tomorrow as the Lantus and Prandin continue to work.

Lessons:
1. Don't overshoot it late at night, it's easier to correct a low at night than a high.
2. If you aren't very active during the day expect your ratio to be smaller than usual. Afer the run I was almost 240c:2 pills. Today 150c:2 pills is too high.
3. If you don't sleep long enough you tend to run a little less efficient which can lead to highs.

As for me, since I'm already gluten free, I'm giving up caffeine.

Day 63

Learning about Prandin

Day two on the pill. After finally allowing myself to sleep I lay down and only woke a few times during the night because of sweating (it wasn't that warm) and stuffy nose (argh!). Without a doubt I'm fighting a little cold of some sort but I won't let it get me down.

Despite feeling congested I found the resolve to go outside and workout. I ran about 3 miles total and did a bunch of stairs and other exercises with Seth. If any diabetics (or anybody else for that matter) want to know exactly what I do for workouts message me at the bottom. If I get enough requests I'll make a post about it.

After working out I called my endocrinologist Dr. Susan Thys-Jones. I told her about the previous morning and afternoon. Naturally she got quite excited. After all I had several tests in the 70s pre-meal and all under 200 after meal... until the night. I then explained how my sugar level then went absolutely CRAZY!!! She agreed with me that those were crazy numbers. I told her my hypotheses: the carbs at dinner were too simple, I was feeling sick, I had the pill with dinner. She countered with a few ideas of her own.

Dr. Thys-Jones' advice for my new Prandin therapy:

1. Start counting carbs again. Your first two meals were about 120c and your last meal was closer to 190. Based on this information she'd like me to try to take one pill for that 120c range, and another pill if I'm in that higher range. She didn't give specific numbers, but I'm going to start experimenting and see how it goes.

2. Try to change your circadian rhythm to more closely align with the sun. In other words I go eat too late and go to bed too late and then wake up too late. Your hormones are most active in the early morning and least active late at night. She thinks I may be able to improve my late night numbers by eating earlier when my own hormones are more active. This will be a hard problem to solve, but perhaps I can modify my habits a little. I could try making my meals ahead of time, but I'd still be eating around or past midnight. The other option would be to decrease my night time carb:Prandin ratio. Maybe try 90:1 or 70:1 instead of the successful morning ratio of 110:1.

3. Take basal insulin at the same time every day, ideally between 11 and 12 at night.

So, her advice plus my observations and hopefully I'll start to learn the rules of this new game. And I was just starting to get the hang of bolus insulin injections. Oh well, gotta keep it exciting.

The Dailies:

11:53 -> 114 Wow, so after my crazy out of control high night, I woke up with a sweet number...sweeeet! Cereal 110c. Three mile run w/stair training and circuits w/Seth. 1/2 Larabar 13c.
4:41 -> 127 Good! At 5:16 I took Prandin, then at 5:30 I had Dinner: salad 18c + brussels sprouts 18c + yams 50c + shrimp 4c + orange 20c + chips with tahini 10c = 120c.
7:40 -> 114 A little more than two hours later and I'm at a sweet number again. Awesome!
10:33 -> 121 Rising a little, probably the previous day's Lantus has worn off. Took 2 Prandin at 10:35 with Dinner: rice 70c + salsa 21c + mung beans 41c + miso 2c + kale 5c + asparagus 14c + chips 30c = 183c. Ate at 10:49. Took 5 units Lantus at 12:20.
1:01 -> 218 Bad news is that I'm HIGH again. The good news is that compared to the same situation yesterday (2:20 after dinner last night I was at 380) I'm 160 points lower.

So what will I do differently tomorrow? For starters I'm not planning a crazy workout, just something light (yoga? finally?) so I'll probably aim for a lower ratio in the morning, or for that matter, maybe I'll try using lower ratios all day.

Day 55