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No tracking this week. Or next. Holiday time, and hosting time, and a few random stresses on top of that, and my weight's all over the place. It'll settle down once normal habits resume.

I do note that my blood pressure's definitely responding to medication. Down 40-odd points on the high end, 8-10 on the low end, and the pulse is coming down a bit too. Happy. :)
 
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I got my eyes examined this morning, and feel a lot of confidence in both the assistant and the doctor. They listened carefully, asked helpful questions to enable me to make useful distinctions, and did all their measurements with evident care and courtesy. Good stuff. I'm pretty severely nearsighted, as I knew, and have a prescription for new bifocals. Must see what Medicaid covers. But what really matters, what I was worried about, is that there's no sign at all of developing glaucoma nor of any retinal damage from diabetes. 

I am deeply relieved. 
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After several weeks of erratic dislocation, I find myself just where I'd like to be in my diet again, both in terms of Weight Watchers points and carbohydrates.
 
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Up 2.4 pounds, to 312.0. But this was my week of fighting a cold and being off some of my medication (turns out you shouldn't take metformin while fighting an infection), and I made a conscious decision not to worry about any of the metrics until I was well and truly mending. I resume point and carbohydrate tracking today, since I really do feel better, and expect that I'll be back where I want to be by the weekend.
 
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I worked out why I kept coming up short on carbohydrate counts: I was preparing my meals with carb counts suitable for having three meals a day, and three snacks with a carb count adding up to the same as one of those meals. But in fact I have two real meals a day, and four-five snacks with a carb count that adds up to a meal's worth. So what I will try this coming week is adding some carbs to each meal, and a bit to my snacks, and I think that'll get me where I want to be. Math will resume on Monday.

I am having much greater difficulty than I'd like keeping away from political-type blogs I know would just leave me pointlessly angry and miserable. So far I've resisted the urge to go back and edit my /etc/hosts file again, and shame keeps me away from it, but damn is it hard. I need to be reading and writing more, I really do.

In part to support the above, I'm also culling down my music collection. Like a lot of people online a lot, I have way, way more music than I can ever actually listen to, and I simply don't need most of it. I'm giving things a chance to win my favor again, and if they don't, they get archived and/or nuked. I have the packrat habits formed in pre-Internet days, when if you passed up a chance to get a rare album you might literally never get another chance at any price you could afford. But that's no longer the case. As with my bookshelves, I'm aiming for a condition where every track is a wanted track, something that makes me glad to play it when I'm in the mood for that kind of tune, that has good associations, that is an active asset to me.

Now that I'm over the hump on medical crisis—stuff remains to do, but it's all incremental now, I think—I'm beginning to think and (more importantly, perhaps) feel about where to go with gender identity. I'm still pretty clueless, but it's a more comfortable sort of lack of clue right now. I have time to work on it with Cassie, my counselor, and to get advice from fine folks like readers like yourselves, and read, and think and ponder, and I'm confident that by the time my next birthday rolls around early in October, I'll be moving somewhere on it.

More to come. :)

 
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I did speak with the nurse at last night's session about my running too low on daily carbs, and she also had some general advice. Since some of you are interested...

She and the endocrinologist emphasized the importance of feeling comfortable with what we're doing, because stress itself drives blood sugar production out of whack and is therefore a health risk all by itself. If you're under constant stress and frustration and feel like your life of diabetes management stinks, you're hurting yourself. So they talked about the value of enjoying treats on special occasions and of treating target numbers like carbs per day as goals to approximate rather than ones that must be hit precisely every time.

In my particular case, since I have both a shorfall in carbs eaten and some favorite foods I miss, the right thing to do is indeed to just add some of them back in and see how my blood sugar goes.
 
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 Last night I went to the third of three training sessions for new diabetics, postponed a month because of July heat problems. Ironically, yesterday was the hottest day of this month, but it wasn't quite as bad and I figured I'd better go than keep postponing it in perpetuity. It turns out to be a very good thing indeed that I did!

The focus of this last session was long-term care—what the complications that can arise from diabetes are. This is not an innately cheery subject, to put it mildly, but I came out of it substantially encouraged, because of the approach. For each topic, our speakers explained what the threat is, and then what we can do right now to decrease our risks of getting it (with some hard data: doing X reduces your risk N% over Y years, doing Z reduces it so much, and so on) and what we can do to contain and live with it if we develop it anyway. A whole lot of scattered things came together during this time, including some insights into symptoms I've always associated with my immune troubles; it looks like maybe I've had hypoglycemic troubles go undiagnosed for 20-odd years.

That was really awesomely worthwhile. I have a lengthy list of things to discuss with Medicaid and find how frequently they'll cover costs of repeating this and that test and examination, and I need to schedule some things with my doctor, but there's nothing huge now looming on the horizon. Time to settle in and live with what I've learned.

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This has been the way of it: I keep a daily log of what I eat in Weight Watchers' online log so that I know the points value of what I'm eating, and do a loose daily tally in my head to get a sense of how many carbohydrates I've eaten so far, and leave the detailed math on carbs to writing up notes on training day. That's today, so I'm going through my August food log to do the math.

I've been off on my carb counts. Way, way, way off.

How off? I'll tell you. The goal for someone in my condition is about 180g of carbs per day. What did I eat the first seven days of this month? 112g, 176g, 94g, 120g, 158g, 103g, 154g. Which is to say that on average I was about 50g short, and that adds up to some good generous servings of things I've been avoiding, including fruit and rice.

I'm deeply embarrassed by the magnitude of my error, but glad to know about it, and very glad indeed that it's a matter of having fallen short rather than overeating that much. And I think I'm going to do the math daily for a while.



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I've been really blah a lot lately, and want to write down my thoughts so far about what's up with it. Cut tag in place for those who just don't need the extra blah-talk.

Read more... )

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Tandoor Chef's kofta curry entree is 5 Weight Watchers points and has 6 grams of carbohydrates. Which means that with a glass of nonfat milk to soothe my intermittently burning mouth and some veggies on the side, the whole thing comes in at under 20g of carbs, or maybe 25g if I indulge and grate some cheese on top of the veggies.

Some reading this will be glad to know.
 
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They started me off on 500 mg of metformin once a day, and it made my poor tummy sick for a couple of weeks. But that settled down, and I went to 500 mg twice a day with close to no trouble at all. Now I'm going to 1000 mg twice a day, and it's sick time again. Sing we now the praises of Tums, and I stay out of net arguments to avoid dumping really irrelevant, er, bile. 
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So what have I learned about myself, with a week of glucose level testing and carbohydrate counting? That I kinda suck, but in addressable ways.

The basic goal in diabetic eating is to keep the grams of carbohydrates per meal low: 45-60g in general, 30-45g if you're looking to lose weight. Likewise, snacks should have no more than 15g or so of carbs, and less is better.

The problem for me is that Weight Watchers doesn't track carbs, so I've been looking at things that are genuinely good in other ways—overall calories, fat, and fiber—but sometimes very bad in carbs. So I ended up with daily totals well over 200g, dragged down to 175g or so with a few initial substitutions. I've got to make some more, swapping out high-carb products (in particular, crackers and bread) for lower-carb ones.

Emotionally, this is terribly draining. I have moments of deep discouragement, particularly at the thought of harm done to myself unintentionally and ignorantly. Sometimes the challenges seem manageable. Sometimes I just want to crawl in a hole and forget it all.  I've been here before, which is both a blessing and a curse. I've been here before, and I'm weary of it, but on the other hand, I'd sure rather know what needs to be fixed and start fixing than die of some stupid thing.
 
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Upped my metformin dosage today and didn't start feeling my guts ripped again. Very welcome. I was able to sit and enjoy a lot of good World of Warcraft time and resume thinking seriously about Project N, and ponder some collateral research for it next week.

I'm also sitting here with a big goofy grin, having heard out of the blue from a net friend I lost track of back around 2001 or so.
 
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 Glucose Buddy is an iPhone/iPod Touch app for recording data of concern to diabetics: blood glucose test results, meals eaten and their carbohydrate counts, exercise engaged in, and medication taken. I'm liking it a lot. It's simple to use, and it syncs up data to a web site, where it can create graphs and e-mail reports to me and my doctor. I don't think I'm going to use that last feature out of security concerns, but having a pleasing report printed out is very handy, too, particularly if your doctor isn't as e-mail-enthusiastic as mine. 

Highly recommended.

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Ceri B.

April 2010

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