The Angry Type 2 Diabetic: February 2012

Thursday, February 23, 2012

Go Forth... And Pursue

I love walking outdoors... in full Winter.

The cold, brisk air, cupping my cheeks; biting my lips... running it's fingers through my hair. A reminder that I need a warm embrace; a cup of hot Joe, or just... a new sweater. A reminder that I am made of flesh, and blood... of pulsing vessels: "I'm alive!" -- my body screams.

Winter is a painful lover I've come to cherish... and there are few things I love more than Winter.

You wouldn't know it by its beginning phases, though. Uncomfortable, and annoying. It often takes me great pains to get used to falling temperatures. The cumbersomeness of putting on so many clothes -- even remembering to do so. Keeping track of the &^%@! scarf and gloves; the hat. Never forget the silly hat. (I just NEVER looked good in hats. A big, fat, rounded head... hats have always been a difficult fit.) And if I had a choice, I'd just as soon avoid embracing Winter...

Oddly enough, this is how I feel about much of my life. There are just a lot of things which I hate the idea of them a lot more so than the actual, concrete form of them; the true reality of them. I'm not sure where this all began... perhaps in my father's off putting "We'll do it next week" remarks.

There were a lot of things which were always put off until "next week..." Oil painting lessons, photography lessons, writing lessons, flying lessons, trips to national parks, concerts, galleries, coupled with a few entire dismissals here and there, for volunteering to help others during national disasters, or the holidays... "We'll do it next week," he'd say. "This week, I'm busy."

But next week always came, and went; and in fact, the 'next week' never actually came at all. Thus, I missed an important lesson of sorts in my childhood, or perhaps, only learned it part-way.

"Courage," you see...

Some of us only see courage as people out there, running into burning buildings, dying in wars, or confronting the faces of evil.

But courage isn't always such a narrow thing. Courage isn't so cut and dried.

There is, a sort of, bolder kind of courage... waiting right here, in your messy living room. A courage that quietly asks "Do you want to be... who you were meant to be? Do you even want to find out? Will you even take the first step? Where are your scarf and mittens?"

As it is, I look around me, and it's a little deflating. Messy room, messy life. I've taken some of these steps before, but who am I (who are any of us, really?) to take them again? I don't just want to keep living in the hear and now, you know... as good and necessary as that is... but also... in the there, and the thereafter.

A Hero in Waiting... is What I am... 
Someone who doesn't just say "Just do it," but "Shut up, and just do it." Shuts out the insecurities, the stupid voices, the figures of the past who never bothered to build her confidence... perhaps because they had none to give. A scared... hero in waiting. Scared of big heights, and big changes, deep feelings, and challenges. Scared to express her big voice -- scared of even this very blog.

But I want to do it... Believe it, you are WORTH doing it.

You are worth...

  • the oil painting lessons;
  • the late blooming college degree;
  • the volunteering sessions at the soup kitchen or the hospice;
  • the trip to the big art gallery... 
  • that book, in your heart, wanting to get written;
  • the family, and the kids...
  • That big love affair NO ONE believed you could be.
You are IT. You are a lot more... than this stupid diabetes disease. You are MAGICAL. You are YOU ... And as the tears just stream down my face, perhaps thinking of my challenges ahead, or perhaps... just realizing I'm the only one to say these things -- to myself, or to you -- I say again... 

You are more than Diabetes; You are MAGICAL. You are YOU. You are worth the investment. And no one is more courageous than YOU. Go forth, and pursue. 

Wednesday, February 15, 2012

Not Quite a Wordless Wednesday: food IS love

I don't really care for Valentine's Day.

You know how it goes. The heavy pressure on that romantic aspect of our lives, that may or may not, live up to "Sense and Sensibility" expectations. The courting, the chocolates, the flowers, the glittery stuff. The "proposals" and declarations. Bah. Humbug. It was enough to make some of my dearest friends... 'joyfully' declare their mood of choice for the holiday, by getting creative on Facebook...

(I have to admit, since I also dislike romance novels,
I thoroughly enjoyed this little creation.)
So... though I do the usual, quiet penance at home with the husband, I can't say I focus very much on Valentine's Day. I certainly don't think of walking away with any sort of "wordless Wednesday lessons," if you would. What's to learn? Materialism? Impossible-to-live-to expectations? Yeah, so one would think. (I don't even have any kids, so I can't make this post about them! lol)

Often, though, life quietly speaks to us in it's own way... especially when our hearts are open, and not just open to diamonds, or chocolates, and other distractions and materialisms, but open to what's TRULY being expressed... by fate? God? The universe? Your own inner self? Perhaps. But, maybe... Just maybe... Valentine's Day needs to be a bit more "selfish" than it already is, you see. Valentine's Day should be about the one love that actually matters more than almost any love out there: self love. Yes, not the kind of self love that goes around expecting what can I get from others... but the kind of self love that goes around expecting what can I get from MYSELF. 

The little image, above... the heart made of wholesome food. That was IT. That was all Valentine's Day had to give me, yesterday. And it gave me a LOT; more than I could have imagined. A random posting of sorts, shared by a stranger, with entirely different intentions.

Food is love.

For me, food has always been love (even though I sort of dislike food). Just, perhaps, not the right kind of love.

Like any other person struggling with binge eating, and disordered eating, I tend to, unwittingly, look for love in food. I tend to want to FEEL things from the food I eat -- comfort, enjoyment, 'numbing' of bad feelings, friendship, avoidance of issues, appeasing of bad memories, etc, etc. Often, I've tried, again and again, to replace the love that others would not give me, or the missing attention from parents... with food, or bury whatever awful life traumas, underneath it.

Often, this is termed "When Food is Love."

Recently, though, I've been quietly asking myself... what if I can just change that definition around? What if food can still be love, but, from a different angle?

The image above gave me the answer. It almost literally screamed it:
"You can do more than just THINK you're getting emotional support from food... you can actually LOVE YOURSELF with food. Good food. Quality food... HEALTHY FOOD. To show yourself love with proper nourishment is the purest form of self love... Be very selfish with it. Do not abuse it, and do not entrust it to just any food. Treasure it."
When we thoroughly manage our health and give ourselves quality foods that make us FEEL healthy, able bodied, and able minded, capable of taking on the world, of thinking, and making proper decisions... When we give ourselves foods that don't just fuel our bodies, but make our hearts sing because they are wholesome and tasty, and FULFILLING, and in more than just temporary emotions we might feel... But also in HEALTHY emotions we may anticipate because we've put effort into making such meals, and invested in ourselves, as we would in our children... We are literally, feeding ourselves love. We ARE our children. We ARE our loved ones.

It's not a diet, it's not a "healthy lifestyle..." It is SELF LOVE. It is simply... Loving Yourself.  

Work on loving yourself, today. You'll be glad you did.

Friday, February 10, 2012

When Ostracizing Type 2 Diabetes Became an Accepted Lifestyle...

When it comes to Diabetes, and the messages being put out there in the media, it is really hard for myself and other folks not to become angry -- if not downright furious. I have to tell you, I generally look through articles, and skim through different headlines, and just tend to "cherry pick" what's going to be real news, and ignore and pass over the fluff. If I were to read it all, I might be en route to a heart attack in less time than you can say "duck fiabetes."

But on Wednesday, just having gotten home from a long, physically and mentally exhausting shift at work, I failed to listen to my own advise. A dear friend of mine shared a news article, in my "Living with Diabetes" Facebook group... and I just lost it. I don't think I have ever been so outraged by an article before. (Well, except maybe for Wendell Fowler's abusive tirade against little Type 1 Diabetic children having ice cream. OMG, how dare they! That's almost as dangerous as Paula Deen having a cheeseburger! *snark, snark*) I was seeing so many shades of red, and purple, I just could not think straight. I said a bunch of things, in my group, about the article, and to my husband... went and kicked a few things around... flipped off Dr Oz on the TV... and then I felt like my head was going to explode. It was just too much.

Having taken at least, a few days, to calm down... I can probably now tell you what I really think about this piece, with a little more perspective. The piece is called "Curing Diabetes: How Type 2 Became an Accepted Lifestyle" (Yes, you are reading right... That IS the headline for this article), and it was written for The Atlantic, by reporter John-Manuel Andriote, who has supposedly been specializing in HIV/AIDS reporting since 1986. I guess, I would like to think that being exposed to such a world would have given Mr. Andriote some perspective, and a keener sense of tact, and to an extent it has... but, apparently, not enough to have helped him rethink such a terrible headline.

The article itself makes a few key mistakes, which well, to an outsider would not be as self evident. And why would they? Our current government, medical advisory agencies, and medical industry want to do all they can to pass blame onto the Type 2 patient, entirely, and take on NO responsibility themselves. I've shared on this, before, many times. Especially, the deep denial of how multi-faceted the triggers are for Type 2 Diabetes, and the roles pollution and other medications, etc., have in the development of the disease. It is unfortunate that everyone in the industry quotes such poorly done research studies that do not take these complexities into account, or even consider to do so, to blanket claim that 80% of all Type 2 Diabetes is "largely preventable." These simplistic allegations lead to discrimination, misunderstanding of a very complex disease, denial of health management resources and tools by the insurance industry, and uneducated reporting that often leads to societal abuse, bullying, and further discrimination.

Still, there is some good, among the bad, to be found in this article. I do feel that, had the author taken some time to meet with members of the diabetic online community, this article could have really shed some light more adequately, on a lot of issues that affect our community, without contributing so much to the problems it so tries to 'address.'

The Good in this Article: 

  • Right off the bat, the article addresses the issue that the medical industry does not like to discuss with patients, or at least seldom does, the idea that they can manage their diabetes without medications, much less what Diabetes even IS. This is, indeed, a struggle we have right now. But it is a deep, and complex problem involving a lot of ethical concerns which affect almost every aspect of the health industry, including the American Diabetes Association itself (it's probably not an accident that they recommend diabetics keep their blood glucose levels at or below 180 mg/dL -- a very high, and potentially long term dangerous, blood glucose level), as well as other diabetes medical guideline agencies. The fact is, many medical professionals receive kick backs and incentives from the pharmaceutical industry -- large kickbacks and benefits -- and it's in their pocketbook's best interests to keep as many of their patients taking certain medications. This is not something exclusive to the diabetes industry, though. I am sure this is one of the prime reasons why there are now, commercials on mainstream media, for prescription only medications. It's BIG business, and there's no better salesman out there than your doctor. 
  • Andriote does some thinking outside the box, which is helpful: Chronic illness, particularly obesity and diabetes, are multi-faceted diseases which do not have just one contributing factor to them (though at times he seems to suggest they do) and thus, will need a multi-sector response. He speaks about our sedentary jobs, and a poor transit system, and the lure of the food industry, and how addicting high fat/high sugar/high salt/food combinations can be... and the supposed "myth" that healthy foods cost more than unhealthy foods. He even quotes an article from someone who supposedly "destroyed" this myth. What is perhaps not understood by people who claim that healthy food is cheaper than fast food is that most dedicated Type 2 diabetics don't consider healthy food what they consider healthy food, and they have to cut back on carbohydrates in order to control blood glucose, and not rely solely on their medications for control. I'd like to see Andriote actually trying to live a lower carbohydrate lifestyle, at a grocery store, with a maximum of $350 for 2 people, for a month worth of groceries, and not being able to eat as many starches, grains, and other foods which ARE the cheaper foods, for their value and how far they go. Living on lean proteins, and veggies, and cutting back on all those starches and breads, and grains is NOT cheap. Also, per the fast food cost example he uses, if one assumes poor people buy value meals at fast food joints to feed all of their family members, one might be very, very naive: there is such a thing as a dollar menu, or less, at these places... And people KNOW this. How can you beat $2 for two double cheeseburgers at McDonald's??? It costs me $2.88 a lb alone, for chicken! (And it's cheaper in Iowa, than in many places...) 
  • Andriote talks about the need for balance in media industry reporting (Surprisingly): On the one hand, you don't want people dismissing diabetes as 'not serious' enough, but on the other, you don't want to create a public backlash for patients. "When the media do focus on type 2 diabetes, said Sarah Gollust, assistant professor at the University of Minnesota School of Public Health, they give twice as much coverage to the behavioral risks for it than any of the other factors that contribute. But this over-emphasis on personal responsibility tends to blame and stigmatize people with type 2 diabetes or who are obese. Those living with the disease may feel it's their fault if they can't always maintain the ideal blood sugar level. Worst of all, said Gollust, public support could erode as people are expected to cover the costs, however they can, of a medical condition it's believed they brought on themselves ... Public support for addressing diabetes is imperative when you consider the tremendous amount of money it costs to manage the disease." This is a very important reality that we, as Type 2 Diabetes patients face as we strive to manage this disease. We NEED support, and we can't succeed without it. However, many of the undercutting remarks Andriote makes, including his headline, are FAR from being fair and balanced, and certainly not supportive! On page 2, Andriote has a "listing" of facts, and goes on to say that "Although there is a genetic predisposition for type 2 diabetes, the vast number of cases are the outcome of poor diet, obesity, and a sedentary lifestyle." Of course, this is contradictory... because ALL cases are of genetic predisposition. If not, then ALL obese persons would have diabetes -- and this is simply not the case. (I won't even go into his usage of the phrase "people of color" to talk about African-Americans, Latinos, and other minorities...) 
The Bad in this Article: 
  • Andriote, sort of, implies that most Type 2 Diabetics could manage their condition without the need for medications, if they just try a little hard, and then they would be cured. There is a BIG disconnect in here: 
    • For one -- he fails to realize that by the time the average person is diagnosed with Type 2 Diabetes, their disease is so advanced, they have lost nearly 40-80% of their beta cell function, making it extremely challenging to near impossible to control blood glucose levels without the assistance of oral medications, or insulin. Again, being the multi-faceted disease that it is, diabetes NEEDS a more aggressive and aware medical community, as well as increasing efforts in continuous education FOR the medical professionals, as well as patients. A medical professional who cannot think diabetes, and catch all the symptoms and markers of diabetes, in an age when it's being considered as an "epidemic," is a medical professional who will endanger lives, and contribute to the rising costs of the disease when it comes to complications that are not being caught on time. 
    • Secondly -- The kind of lifestyle changes to achieve true remission and euglycemia, are a lot more stringent than what the ADA might tout. You *cannot* reach euglycemia -- true euglycemia -- while thinking that blood glucose numbers below 180 mg/dL are normal. True euglycemia are levels that are below 140 mg/dL or lower, after 2 hours of eating, and in fact, rarely exceed that. In fact, some might even say below 120 mg/dL at 2 hours, or less. Not everyone can achieve those levels -- especially, if they struggle with hypoglycemia, or  have other health related dietary considerations to make that might not allow them to easily cut back on carbohydrates, or increase certain levels of exercise, etc. I, for example, have to consume 80-100 grams of carbohydrate a day, at a MAXIMUM, in order to maintain my euglycemia. This is unrealistic to many people... and it's not a character flaw! It is HARD, often unrealistic, work. 
    • Thirdly, he goes on to claim that if folks worked hard at it, they could "cure themselves," and he uses an opinion paper, mind you, to try to back up his assertions. He even goes as far as claiming that this is the opinion of the American Diabetes Association (ADA), by claiming that the ADA says that "maintaining normal blood sugar without medication for at least a year could be considered a "complete remission,"" when in fact, the ADA specifically highlights a the end of the second paragraph, in that same opinion paper that "The opinions and recommendations expressed herein are those of the authors and not the official position of the American Diabetes Association." Moreover, the panel of those expressing their opinions recognized that they had clear conflicts of interest in the matter, and also, found it difficult to reach consensus considering the wide arrange of questions to be considered. The group does, though, make a very telling distinction between a cure, and a remission... which the author of this article seems to gloss over, quite nicely, to what he could take out of context, and better fit into his piece: "Medically, cure may be defined as restoration to good health, while remission is defined as abatement or disappearance of the signs and symptoms of a disease (3). Implicit in the latter is the possibility of recurrence of the disease. Many clinicians consider true cure to be limited to acute diseases. Infectious diseases could be seen as a model: acute bacterial pneumonia can be cured with antibiotics, but HIV infection, currently, can at best be stated to be in remission or converted to a chronic disease. The consensus group considered the history of childhood acute lymphoblastic leukemia, which evolved from a uniformly fatal disease to one that could be put into remission to one that can now often be considered cured (4). Conversely, chronic myelocytic leukemia is now considered to be in prolonged remission, but not cured, with therapies such as imatinib ... For a chronic illness such as diabetes, it may be more accurate to use the term remission than cure. Current or potential future therapies for type 1 or type 2 diabetes will likely always leave patients at risk for relapse, given underlying pathophysiologic abnormalities and/or genetic predisposition. However, terminology such as “prolonged remission” is probably less satisfactory to patients than use of the more hopeful and definitive term “cure” after some period of time has elapsed. Additionally, if cure means remission that lasts for a lifetime, then by definition a patient could never be considered cured while still alive. Hence, it may make sense operationally to consider prolonged remission of diabetes essentially equivalent to cure. This is analogous to certain cancers, where cure is defined as complete remission of sufficient duration that the future risk of recurrence is felt to be very low."
You see, it is one thing to call something a "cure," because it is more hopeful, and more satisfactory to a patient... than for that to be, actually, a cure. The likelihood might be low, but it is, in fact, not a cure. As a comparison to HIV made above, for example, people like Magic Johnson have had their HIV infection in remission for years, but would would we say that he's cured? Not in a million years. Just because I can't "infect you" with diabetes does not mean I'm cured. This debate among colleagues does not equate to something actually being "officially" considered a cure. Obviously, operationally, we cannot treat presently uncontrolled diabetes in the same way as diabetes in tight control, or in remission... So DUH, it can be "operationally" a cure, but not in truth. Remission is remission. A cure, is a cure. This is truly, irresponsible journaling at it's best. 
I would add that the amount of mental focus that is required in maintaining diet, food carbohydrate counts, exercise, and meal planning often borders on obsessive and unhealthy, and ends in many an eating disorder for many diabetes patients. The psychological ramifications of attaining euglycemia, at all costs, for many... have NOT been assessed, and yet, they are just as much a part of the disease as hyperglycemia and other markers. Diabetes is NOT just a disease of high blood glucose!  

  • The author uses statistical scare tactics to put the fear of God in you: But he does not put them in perspective. It's one thing to discuss how the rate of diabetes will triple, or double, or whatever. It's quite another to not discuss the rate of population growth, right along with that. Obviously, people ARE reproducing, and diabetes isn't just happening in a vacuum where the rate is growing by leaps and bounds larger than what it is. It's hard to say, because what will the population be in 2050? Our population is EXPLODING to what are potentially unsustainable levels, and of course, that's going to make numbers for any disease seem scary high, without some perspective. What would the rate be in RELATION to total population at that time? THAT is what the question should truly be... In addition, the author wrongly states that the prevalence of obesity has been increasing, year after year, when the prevalence of obesity has remained STEADY for the last 12 years.  Could it change, tomorrow? Sure... but for now, I think we can say many folks are starting to be more conscious of obesity, and their health, even if they might not see themselves as 'overweight.' Andriote fails to keep balance in the picture he's trying to paint.
  • While Andriote wants to instill a sense of seriousness to diabetes, while claiming we need support, he attacks commercials with friendly faces and role models, claiming that persons who are fit, or joggers, or younger folks -- are not what most Type 2 Diabetics are like. Perhaps not (some) newly diagnosed Type 2 Diabetics, but is it wrong to have positive role models to aspire to? Is it wrong to see that some of us HAVE made changes, and CAN live a healthful life? Is it wrong for me to see another 35 year old I can relate to, on the tv? I fail to see just what he wants to accomplish, here. Does he want a fat, old Joe, sitting on a sofa, not able to move, and popping pills, or doing 'leg exercises' from a chair, because he can't move? Would THAT be more appropriate? Or perhaps, he wants people with their limbs amputated, like the city of New York's shocking diabetes ad campaign? I'm not sure what's the alternative he's looking for, here, and what's running through his mind. 
Of course, I can't end without discussing... that headline. "Curing Diabetes: How Type 2 Became an Accepted Lifestyle" ... I'm guessing he's trying to say most people just "accept" and take the diagnosis as a given, that they will need to live with this disease, forever... and take pills forever. But boy, is it an uneducated headline. Yes, people can live pill free, for a while... and depending WHEN they were diagnosed, if it was late in life -- maybe they might never have to take any meds, ever. But no, it's not a cure. Type 2 Diabetes IS a progressive illness, and the likelihood of a need for medications increases with the LENGTH of time we've had this disease -- and not exactly with how well we've taken care of it. Time goes by, and not in vain... our bodies DO age. Things break down. My father was in remission for years, yet he was never cured; diabetes still progressed, and still took his life. It happens.

Diabetes is not an "accepted lifestyle" anyone chose, anymore than people who got AIDS or HIV (by whatever method), CHOSE that as their lifestyle. I bet you $1,000,000 that this author would NEVER dream of writing "Curing HIV: How HIV Became an Accepted Lifestyle," merely because he read an opinion piece on how one can keep HIV in remission for YEARS. The headline even seems to sort of imply that we "coddle" people into being lazy about their care, and lazy about "curing themselves," so that we don't need to support them. It's not a disease, if you would, it's a "lifestyle." Yes, because Type 2 Diabetes is sooooooo glamorous. It's the lifestyle of the fat, and sloppy, and just give me my Metformin, over here. I'll take it with a side of that value meal, please. 

Sadly, Andriote could have done SO MUCH to advocate and help our community, but instead he chose the low road of blame, and veiled vitriol in between his lines. How someone who has written for the AIDS community can be so close minded about the needs of another equally ostracized community is BEYOND me. 

Tuesday, February 7, 2012

Laughing My Bottom Off, Perhaps Literally, at Diabetes...

It's been about a couple of weeks since I've ranted on anything, and I really apologize for that. The fact is... I've really been exhausted. I've been exhausted, and in a lot of pain. I'd call it chronic pain, but it's only chronic in the sense that other events keep happening, and happening, on top of one another, to not let the affected parts of my body just take some time to heal. It's like this stupid domino effect, of sorts, except, well... every time a stupid domino falls, it hurts, and I feel every bit of my 35 years of age.

Where do I start?

Well, let's see... About two weeks ago, while I was walking to our corner supermarket, I fell hard on some ice. And I mean, I fell REALLY hard. The kind of hard where you sit there, wondering if you broke anything, and unable to get back up after a few minutes. (The driver, passing by at about 20 mph, must have had a really good laugh at my expense.) The fall itself was painful, but then the pain didn't seem that bad after a few hours, and the next day, everything was fine.

Except for day 2, and day 3... which were utter hell. Then I felt 70, instead of 35... and in need of some kind of walker. (With apologies to 70 year-olds, who can probably run laps next to me, right now.) Leave it to me, to fall on some almost non-existent ice, on the mildest Winter we've had in at least 30 years. On the 4th day, I felt distinctly better, though not completely healed... But on the 5th day, I had to work -- and as some of you may know -- I work unloading trucks for a local department store, a few days of the week. Of course, I had to help unload a very atypical, large truck of merchandise, so that on day 6, I was back to feeling like I felt on day 2.

At work, I *also* hurt myself... by smashing my left shin against a flat of merchandise, which is still black and bruised, and throbbing, and overall, my joints just don't seem to be holding up so well. I'm having some pain in my left ankle, which actually began BEFORE I fell, the week before, from the constant stiffness of needing to walk on ice, and slippery sidewalks.

Many baths with Epsom Salt, and stretching exercises later, and I'm still one very achy feeling "old" lady. I also, still have to work tomorrow... It will be my third day in a row, when we usually have some off days in between.

Carpal Tunnel hasn't exactly been playing nice, either, with my poor wrists and elbows (at least on my left arm) not letting me get a good night's rest. I might yet consider some kind of joint support supplement, before this is all over. I mean, I feel like my warranty expired.  Are you tired of the whining yet??? I am. LOL And I have to live with me!

So... reading through one of my dear friends' blogs, I found a great, happy post... to sort of help focus some of my crappy attitude right now. My friend, A Diabetic Ballerina, wrote on adding a touch of "bling" to our diabetic tools. She gave me some inspiration to give it a little of my own twist... I may not be able to change a lot of my circumstances, but I can at least laugh while I'm doing some of the stuff I have to do.

So I've decided... that I can't freak out too much about having off diabetes days, from the pain, or whatever else comes my way... if my meter looks like this:

The supplies really didn't cost me that much: 49¢ for the googly eyes, and about a total of $4 for the gemstone cheeks, and foam with sticky backing, combined (with plenty of extras to spare, for the future). The foam came in the way of a bag of Valentine's Day hearts, in various colors, with sticky backing, and I just cut out the bottom to make one of them look like lips. 

It was all in all, an achy walk to JoAnne Fabrics, that was more than well worth it. Time to bling up the rest of my back up meters! *mwahahahahahahahahahahahaaaaaaaaaaaaaaaaaaaaa!!!!!*