Batman: A Metaphor for Diabetes

Good morning everybody. I thought I'd let you put faces to some of my doctors. So here is what things would look like if the story of batman were a metaphor for my diabetes.


First, Dr. Susan Thys-Jacobs the woman detective who refuses to let it be a simple case of "take insulin the rest of your life." Out of network, though she may be, she is relentlessly curious about the causes of diabetes and optimistic about more homeopathic treatments, including vitamin supplementation. She gets to be Morgan Freeman's character because she's the most specialized. I trust her and she trusts me but we don't see each other too often. She has the most specific knowledge to impart to me.



Second, Dr. Karen Thornton the woman responsible for the original diagnoses. She treats lots of people in the theatre industry. I had hard proof of this on my second visit when out walked the PSM of "On a Clear Day You Can See Forever" Lisa Iacucci. She gets to be Gary Oldman's character because I get the impression that though she wants to do good, she's a little over her head. Her and I need to work together to battle diabetes and we'll both be better for it.


Nurse Linda Haselman is the woman who sees me the most regularly. A diabetic nurse counselor, she tells me about the day to day of living with diabetes. She's helpful for showing me how to administer insulin injections, or a potentially lifesaving glucagon injection. She monitors my diet, making sure I eat enough carbs, protein, vegetables, etc. I always leave her office with some sort of goodie, either a few free lancets or maybe a diabetic cookbook. For those reasons, she gets to be Michael Caine's character.


Catwoman, tempting, provocative, so desirable - not bad for all people, but not good for me. I want it but I can't have it. It's not a stretch to see that she represents gluten.

Finally Diabetes itself:

There's no better personification of diabetes than the Joker. No rhyme, no reason, not really even funny (unless you have a very dark sense of humor). A product of civilization, that is willing to put humanity into life threatening situations. Remember the scene with the people on the two boats? He didn't actually explode either boat, but wanted the passengers to act out of fear and cowardice and do the deed themselves. But then diabetes doesn't really kill you either, it's not dealing with it responsibly that kills you.

... so what does that make me?






The dark knight! I fight the evil within and do my best to protect those who are less fortunate than me. In the words of the MacMillan crest "Miseris Succurrere disco" - which means: I learn to succor the innocent.

#s
12:12 -> 77 Bagel 42c, egg 1c, cheese 2c, soy chorizo 20c, cereal w/out yogurt which I poorly estimated to be 120c = 185c = 3 units. At 5:00 I had a small apple 14c, a handful of peanuts 4c, green tea and vitamins.
7:58 -> 151 Meh, Dinner: Sweet potatoes w/cinnamon & baker's chocolate 55c, peas 15c, quinoa 60c, curried spinach 14c, carrots 14c, apple 22c, salad 15c = 197c = 4 units.
11:20 -> 186 Hmm... may adjust to 50:1 tomorrow and see if that keeps me a little bit lower than I've been the past few days. Had a 7 oz skirt steak.
2:38 -> 180 Oh well, It's slowly going down, probably the work of my own beta cells. Thank you honeymoon period. Oh, and I just took my Lantus, shame on me for taking it late, maybe I should set an alarm?

Day 34

Top 10 Gluten Cravings

Here are the top 10 things I miss so far about being Gluten-free.


1. Sandwiches - From cubanos to tortas to paninis to grilled cheeses, bahn mis to burgers, it doesn't get much better than a good sandwich. Like this gouda grilled cheese with black bean spread, guava jam and dressed with jalepenos on a brioche served at the Kickshaw in Astoria. I've never had it, and now I never will.


2. Homemade cookies - When you work at a theatre with a cast of 37 and a company of almost double that, between the birthdays and the avid bakers there are ALWAYS little sugar, flour and butter based concoctions in the Green Room. Some days it's as simple as chocolate chip cookies, sometimes it's a ginger rosemary loaf, or maybe blueberry scones, or little cupcakes. Whatever it is, it's off limits to me.


3. Beer - I went to a bar the other night with over 100 beers. Only one was gluten free. It tasted terrible. Having been around the world and back again I've developed a taste for all beers. The good (Maredsous 8) the bad (Efes) and the necessary (PBR, Corona, Blue Moon). You can't play flip cup with red wine, and you can't chase shots of tequila with more shots of tequila. Plus, no more beer battered fish n chips, no beer can chicken, or beer braised ribs.


4. Dim Sum - This was the first thing I thought of when I was told to cut Gluten out of my diet, and two weeks later it continues to be the most devastating. There are no substitutes. Udi doesn't make gluten free pork buns, and no dumpling, no matter how good the company, ever tastes as good from a package as it does from a steam cart. Even the dim sum plates that I may be able to eat (pan fried taro cake, sweet bean curd, chicken feet, congee) are risky because any dim sum place that is worth anything is staffed by non english speakers. Miso sad!


5. Pizza - I live in New York. The top two reasons I decided to make the move were the following. 1. I got offered a job on Broadway. 2. New York Pizza. Come aaaaahhhn! It doesn't get any better than this. And to make matters worse, one of the best slices I've ever come across is served up at a deli a few blocks from where I live. It had become a once a week tradition, every Monday I'd get a few slices, a quart of their marinara, some homemade mozzarella and maybe a bag of dried mushrooms or something like that.


6. Magnolia Banana pudding - If you've never had it, I may recommend that you never do just in case you ever do end up with a disease where you're not allowed to eat it. There's no doubt in my mind that it is better and more addictive than crack. No matter how big the container, once I start eating it I can't stop until it's all gone. Banana Pudding, more than anything else I've experienced, has made me question the adage: "it is better to have loved and lost than never to have loved at all."


7. Bagels - Here's another example of an item that I didn't even eat that much when I could, but now that they're forbidden I see them everywhere. I sometimes wonder how I'll make it through the day. And there's no adequate substitute, just lots of mediocre ones. And sometimes that's even worse. It's easy to appreciate a Matisse if DaVinci is your favorite artist, but being asked to appreciate an art student's attempt at Mona Lisa? Forget about it.


8. Veggie sausage - This is the most umbrella category I'm including. Basically I miss being able to go into any Health food store and buy a prepackaged vegan something or other. Most vegan foods in such stores use wheat gluten as their protein source. It's a weird thing to miss, but sometimes I just want some veggie sausage in my salad, or a mock duck sandwich and now I can't.


9. Ramen noodles - I spent seven months in Asia, how can I not miss Ramen noodles now that they're on my forbidden list. Of all the foods on the list this seems the most cruel since I had only just started my love affair with asian noodle soups. It's a love cut off in its infancy. We were young and in love, but it was a love that could not endure. It's like a Shakespearean tragedy... told through food.


10. Clif Builder Bars - If you are what you eat, then last year I was approximately 15% Clif Builder Bars. I ate at least one a day, often two. They're freakin' delicious, chocolaty, minty, or else zesty with a sweet lemon creme. Probably the most delicious protein bars on the market.


For the Doctors:

pbpk weight: 179.8
12:15 -> 143 The fat at night kept me high. Gluten free bagel (meh) 42c, eggs 1c, cheese 2c, avocado 16c, soy chorizo 20c, cereal 40c = 120 = 2 units Novolog.
2:25 -> 90 Still hungry, had a gluten free Carrot Muffin 48c, two gluten free cookies 40c, a banana 27c, apple 12c = 127 = 2 units. Green tea and vitamins B12, B50, D, Cal and Mag.
7:28 -> 225 Well, shame on me for eating so much junk food earlier. Guess that caused the spike, too many high GI foods. Had 24 oz chili 75c, blueberries 20c, grapefruit 16c = 111 = 2 units insulin. Let's hope I creep down from the small carb deficit.
12:40 Had a glass or red wine.
1:40 -> 5 units of Lantus
3:18 -> 90 Had a pecan Lara bar 24c

Sigh, will I ever stop missing these foods? And what about the others I didn't mention? German pancakes, waffles, lobster ravioli, gnocchi, croissants...

Day 33

A Sleepy Diabetic

To say I'm burning the candle at both ends is an understatement. More like I put a candle on a table and then took a blow torch to it, reducing the candle, the table and half a city block to rubble and ash. I went to bed very late last night and did not sleep soundly. I woke up this morning at the butt crack of dawn to go to an appointment with my nurse where she said in about twice as many words: "You're doing very well."

Didn't weigh myself, too tired to step on the scale. I'll try again tomorrow.
8:49 -> 103 Another perfect morning number. Cereal 140c, 2 eggs with toast 16c, avocado 16c = 172 or 3 units of insulin.
11:32 -> 150 My traditional mid appointment blood check. Did pretty well, but it's just a bit higher than we've been seeing. At 1:30 I had a 12oz coffee with half and half. At 4:00 I had some peanuts and took my vitamins.
5:51 -> 128 Starving and so feasted on 2 Trader Joes cod dinners 58c, 3 cookies (gf) 36c, banana 30c, 5 oz blueberries 21c, grapefruit 26c = 171 = 3 units.
7:56 -> 146 Just checking pre-show because I'm doing Topthorn. I'm so freakin' tired I'm not as body aware as usual.
12:29 -> 108 Seems like I'm still creeping down between meals despite snacking. That suggests that my pancreas is still producing some insulin. Dinner: quinoa 60c, spinach dal 20c, salad 15c, 2 apples 40c, grapefruit 26c, toast 17c = 178c = 3 units Novolog and 5 units Lantus. At about 2:00am I also had three ducklegs. Lots of meat but lots of fat so hopefully much of my glucose had already been metabolized or else somebody's going to creep up in the night. :/ We'll see.
3:22 -> 178 Okay. So it seems like today I'm leaning a little higher post meals. I'm hoping this is just the affect of no sleep. If things settle a bit more tomorrow... great. If not, I may start adjusting to 55:1 or 50:1 carbs to insulin. Let's see what I wake up at.


But the numbers were good enough for now. Next week blood work. The week after that blood work results. I'm going for a 8% A1C (It'd be very improbable to be lower because the average would still include a few weeks of my prediagnosed levels). Two months from now I see the nurse again. In the meantime I need to see a dermatologist, buy a Type 1 identity bracelet, and start working out like a fiend. I can do it. But it all starts with sleep...

zzzzzzzzzz........

Day 32

I Met a Girl

In the War on Diabetes, yesterday was another victory for me! I gave them the one two combo of healthy eating and balanced injections. I Krav Maga'ed the numbers into a great range for the second day in a row.

Also I got a recommendation for a book called "Cheating Destiny: Living with Diabetes" Whaddya think? Should I pick it up? It was recommended by long time friend of my dad and sister Mark Zimmerman who has a recently diagnosed relative.

pbpk weight: 178.9
11:41 -> 121 Great! Woke up with perfect numbers. Had cereal 135c, apple 20c and 1 piece of toast with an egg 13c = 168 = 3 units Novolog. Later during the first show I had a handful of almonds 3c.
4:55 -> 136 Good! Had my gloriously delicious turkey chili 165c, chips 20c, salad 15c, a banana 25c and 1/3 grapefruit 9c = 238 = 4 units.
7:27 -> 79 Dang, just out of range, and a little low to be performing Joey. I finished the grapefruit 11c, and had another handful of almonds 3c.
12:40 -> Took 5 units of Lantus. Ate a Carrot Lara Bar 32c, had two vodka seltzers.
2:45 -> 139 Wow, not bad. With a number this good I didn't want to risk eating and then going to sleep so instead I had a 5c supper of smoked herring and celery stalks. I hope to wake up under 150.

Notice anything strange about what I consumed today? If you do, let me know and I'll give you the story.

Day 30

4 Weeks Before and After

This is what I looked like on December 20, 2011, on the first day of being diagnosed and weighing 161.







And this is what I looked like yesterday, January 16, 2012 four weeks later and weighing 181.



I'd like to dedicate today's numbers to my awesome team of medical personal. Dr. Thys and Dr. Thorton and Nurse Linda:

pbpk -> 178 Well looks like the weight has stabilized, now I'm going to have to earn those extra pounds. Time to add squats to my nightly push-ups.
11:40 -> 140 Good! Was rushed this morning so had a pb&j 33c, an apple 20c, and a protein shake 5 c = 58c = 1 unit. From here I went to acupuncture.
3:35 -> 110 Good! I didn't check two hours after breakfast because I felt really good and want to stop using so many test strips. But I think this number is proof that the Lantus dose is good. I had a Chipotle burrito bowl with a taco shell 9c, black beans 23c, rice 50c, chicen 1c, corn 12c, sauce 11c, s. cream 2c, tomato and lettuce 4c =112 = 2 units. Also had my vitamins D, Calcium, Magnesium, B12 and B50.
6:31 -> 128 Good! I got wicked hungry before the show and so I had another quick pb&j, 56 and some grapefruit 10c = 66c = 1 unit. Performed Joey.
12:05 -> 101 Good again! Salad 15c, Curried Spinach 14c, quinoa 60c, apple 20c, 2 sweet potatoes 50c, carrots 20c = 180c = 3 units of Novolog and 5 units of Lantus.
2:58 -> 132 And Good Night!


I have to be honest, I'm a bit diappointed in Diabetes. I expected a bit of a challenge, but a mere 4 weeks since my diagnosis I've got it all but licked. I'm big and strong and energized and can keep my numbers within a 39 point range. How do you like them apples??

Day 29

Best Day Ever!

Today was without a doubt the best day I've had all year and probably extending back into last year as well as far back as my trip to the Catskills, and spent with the same person.

Let's put aside the "diabetic" for today and talk about the "fittest" part.

Day started with a hearty breakfast and a quick rearrangement of my schedule and then the fun began. I went down to the Russian and Turkish bathhouse on the Lower East Side and accompanied by fellow actor Seth Numrich and his friends went from hot to cold then back to hot then back to cold. The Turkish room is kept at a little over 120 with mostly cedar wood and an ice shower up front. The Aroma Steam room is constantly pumping clouds of eucalyptus scented steam into the air until you are convinced your the only person there. The Russian room went to what felt like 180 degrees and makes your face feel like it's burning right off minutes into the experience. The only way to make it past five minutes is to dump buckets of the icy water that fills a well in the middle. Three hours later my pore had been opened and closed and drained so many times that when I finally dried off I felt newly born. I felt alive again, at peace, centered, baptized in the cleansing waters of the NYDWP.

From there I used my powers of persuasion to wrangle Seth into joining me for an introductory Krav Maga class at the Krav Maga institute. The first 10 minutes nearly made my heart explode out of my chest. Blood pumped so fast and so loudly around my body I felt like I had a subwoofer in my head, or that I myself was a subwoofer, thump thump thump. But then we stretched a bit and finally got to the nitty gritty of it, working strikes and blocks and kicks. It was a blast, a pretty good though not amazing workout, and armed me with a few skills to work on outside of class before returning. I finished the class aware that loads of little muscle fibers had torn and that I would be sore tomorrow and stronger next week. This is a very good feeling.

From there we took turns walking and sprinting to the Angelika Film Center on Houston St. where I paid a whopping $1 to see what is probably the best film since Amelie. "The Artist" is everything a film should be, transcendent, beautiful, provocative, hopeful. I left the theatre feeling alive, feeling filled with love for the world and love for my life. It is a testament to the creativity of man and a stunning realization of the value of life and the power of love. I couldn't go straight home after that and had to walk around Manhattan, snowflakes treading gently in the air.

When I finally made it back to Astoria I had a dinner of AMAZING turkey stew*, salad and two apples. Read a very exciting email from a dear friend in Maine and then I watched "The Descendants" with Cat on her new 40' flat screen. I can see why it's getting award nods. It tells a very good if highly predictable story of a man reconnecting with his family after tragedy befalls his wife juxtaposed with the paradise perfect backdrop of Hawaii. It's a great film, but falls very short of "The Artist."

Now for the doctors:

pbpk: I dunno, I felt like skipping this today.
11:42 -> 131 Good, popped up beautifully from my final evening snack last night. Had Cereal 135c and an apple 20c and 2 pieces of toast with an egg 24c and my vitamins = 179c = 2 units Novolog.
3:54 -> 215 Okay, okay, I know that's higher than I've been in awhile. Do I think I overshot breakfast? Not really. I actually just think this is the affect of three hours of super hot temperatures at the bath house. Cold makes you go down so it stands to reason that hot makes you go up. Right? I had 2 units Novolog with chicken and roasted veg 40c, potato salad 40c and beet salad 20c = 120.
5:15 -> 101 I could feel myself dropping, but since I quickly treated the symptoms with a Lara bar 24c and since I checked as soon as I felt the drop I don't know what the lowest I got was. What I do know is that I felt all the symptoms and that I dropped 114 points (or more) in about an hour. Because I ate the right amount of carbs per insulin, I can only imagine this is the result of finally "coming down" from the heat.
11:58 -> 121 Yes! Greek Salad 15c, Chili 165c, chips 24c, 2 apples 40c = 244 = 4 units of Novolog and 5 units of Lantus.
3:36 -> 134 And I am good to go to bed!! :)

Tomorrow I go to acupuncture, then another movie, some delicious food and then I get to perform the lead role in a hit Broadway show. LIG my friends, LIG.

*
I took a pound of turkey and browned it in a bit of olive oil in a 4 quart saucepan, then removed it from heat. I threw some minced garlic and half a chopped onion in a pan with more olive oil until the onions softened, then I added it to the turkey and returned the whole thing to heat. Next I added a 15 ounce can of tomato sauce, 30 oz of water and then 15 ounces of mixed legumes (lentils, peas, mung beans). I brought the whole mixture to a boil and then reduced it to a simmer. Now I added the spices, a ton of chili powder, a healthy amount of cumin, oregano, basil, thyme, garlic powder, salt, cinnamon and pepper. I also added a square (1/2 ounce) of baker's chocolate. Then I let it do it's thing and came back for the occasional taste. When I finished it was divine. The best chili I've ever made. I shredded a few ounces of english cheddar over the top and used tortilla chips in place of a spoon. I could eat this once a week forever.

Day 28.

Finding Balance

Today begins the most luxurious few days I'll have had in awhile. Starting with performing in a "rest" track for the show which already gave me a chance to regenerate, I punctuated the show with an hour massage session. Afterwards i enjoyed a delicious meal and watched what I thought was a perfectly arced film called "The Music Never Stopped." Starring the guy best known as the father in Juno or the newspaper editor in Spiderman, it's a film about a man fixing a broken relationship with his son who is amnesiac from a recent brain tumor. I'll go to sleep tonight before 2am (the earliest bedtime I've had in weeks). Tomorrow, if I stay as motivated as I'm feeling right now the plan is to wake a bit early and go to a Krav Maga (Israeli martial arts) class for an hour followed by as many hours as I can stand at the Russian Bath house on the lower east side. I'll have to watch my sugars closely since the class will be aerobic and the bath house will have temperature extremes. After that I'll use my SAG benefit to go see "The Artist" in a theatre and then it's home for leftovers of what I had today. Tuesday begins with an acupuncture session before taking in another SAG screener of "My Week With Marilyn." Did I mention that I don't have rehearsal Tuesday? That's a big deal, and my body and general mental state (which is actually probably an 8 out of 10 these days) will thank me.

I would consider today's numbers a great success. What I'm starting to see is stability between meals which suggests that the amount of slow release insulin in the form of a Lantus SoloStar pen is the right dose. Also, the 60:1 ratio seems to be very close to exact, especially when you consider many of my measurements are close approximations. The only thing that was unusual about today is my lack of activity. I had only one show in which I was "Crow" track, the slowest of the 4 tracks. I sandwiched work with very little activity.


pbpk: 180.4
9:53 -> 118 I did indeed wake up at this ungodly hour. Every since I got diagnosed with diabetes I seem to be forced into waking up before 11. Nowhere on the support groups do they list this under symptoms. The shakes, and sweats, and paranoia I can deal with, but waking up before the sun has reached it's high point seems cruel. Anyway, I had cereal 135c with 2 units of Novolog, and since that's 15c over my 60:1 ratio I might have been able to predict an increase of...
12:28 -> 165 Okay, I did do this check a bit early but since I'm still playing with numbers I check a bit too often sometimes. But the increase from the morning, and only 40 points seems to be a very good sign to me. Those are almost normal numbers. I took my vitamins at 3:00 with 3c worth of peanuts. At 6:45 I had a slice of grapefruit 3c.
9:56 -> 104 Hurrah! 9.5 hours after my last check I'm at 104, that should help out my next A1C. I had an epically delicious but very simple dinner: Greek salad with dandelion greens and a full avocado 30c, turkey chili (w/black lentils, peas, mung beans, tomato sauce and a bit of baker's chocolate) 165c, tortilla chips 24c, apple 20c = 239c.
10:20 -> Took 4 units.
12:27 -> 97 Yay!!! :) This is so close to perfect. I'm going to have the smallest little snack before bed, a half cup of milk 6c, but otherwise it's 5 units of Lantus and then sleep.

Total Insulin: 11 units
Total Carbs: 380


I wonder if there will come a time when I "get the hang of" diabetes. I mean, in some ways I feel like I'm already there, but I'm probably not. I remember back when I first arrived in NYC. I wanted to get my bearings so in the first few weeks I made a point of going all over the island and walking around until I had a pretty decent familiarity with the neighborhoods and could rattle off which subways went where. I had tried a few of the "best" pizza places, had made mental notes of where certain museums or concert halls or bars were. I could convince actual tourists that I was a native, but when people asked me where I was from I didn't hesitate in answering California. Now that I'm over a year in I modify my answer. "I'm from California," I'll tell them, "but I've been in New York for over a year." I see their disapproval partially fade away. I'd say right now the same is true of my disease. I know how to get to my apartment, but once I get there I'm not "home." Savvy?

Day 27