Tuesday, July 29, 2008

Weekly weigh-in: -25 pounds!

Hurrah! I'm down to 240, only 5 pounds more than when I went back to being a desk jockey 3 years ago. I wish I'd taken measurements at the beginning, but I'm down about an inch all over in the past month. Average weight loss has been 2.8 pounds/week.

My long term goal? 143 pounds.
My medium-term goals? Break 200 by end of the year, be "overweight" instead of "obese" by 2/2/2009 (my 41st birthday).
My short-term goal? Survive our family trip without going crazy!!!

I'm a little worried about our Michigan trip. I know everyone will be supportive, there is always plenty to eat, but I'm worried more about (1) keeping up with my exercising and (2) getting quality food and (3) being without my food scale. (Heh, I guess I'm just worried about everything! ;-)

Here's the game plan:
  1. Be okay with maintaining rather than obsessed with losing. As long as I haven't gained, I'm ahead of all our other Michigan trips by at least 5 pounds.
  2. Pack and use the exercise tapes if it's too hot to exercise outdoors. Try to exercise before shower time. OK to skip Wednesday and Saturday, do not skip Monday if our flight leaves in the afternoon.
  3. Keep as active as possible. If there's a choice between sitting or standing, take standing, and add fidgeting.
  4. Insist on going to the grocery store for stocking up on food I need. Cottage cheese for breakfast will be fine, need "veggie tray" veggies at minimum (broccoli, carrots, celery), apples, and Triskets for when I need a whole grain alternative for starch.
  5. Pack the flax!
  6. Portion-wise, err on the side of smaller, except regarding veggies. I'm sure Mom P has some measuring cups.

Yanking the Sweet Tooth

I was the last person I'd thought could change my sugar-lovin' ways. But two months ago, I decided to clean up my eating habits: I eliminated refined sugars and sodas (I drank diet, but still, lots of chemicals), started eating whole grain products and more vegetables, and started weighing and measuring portion sizes. It was really, really hard for the first couple of weeks, I felt really headachey and crummy. I think it helped that I timed the beginning during menstruation, when I'd be feeling all bloated and crummy anyhow. But now I feel great. (It didn't take two whole months to feel great either; I was feeling much better at the end of the month.)

Tips for staying away from sugar? Hard to say, everyone differs in their cravings. I went totally without added sweeteners for those couple of weeks, just to break myself of the habit. I did have a bite of baklava on July 4th, but have otherwise stayed "clean." Here's what helps me:
  • Enjoy your fresh fruit. I did not cut fruit from my diet when cutting the added sugar, because of its other benefits. I did limit to two well-timed portions per day, fit in with my diabetes food plan. A good snack for me: chopped apples in plain yogurt (Greek style has less carbs), with toasted wheat germ, milled flax seed, and cinnamon mixed in with it. If you can tolerate oranges or pineapple, those add a bit of extra juice. (My mom and I enjoyed pineapple & plain yogurt a lot, so it wasn't a new thing for me. But back then, I'd put Cracklin' Oat Bran cereal on top...good, but a bit too sweet for me now.)
  • Use artificial sweeteners, but not too much. I enjoy a sugar free Popsicle now and then, and when drinking tea, I sweeten with splenda or stevia. But I try to limit those to one per day. I was delighted to find that Peet's has a no-sugar-added mocha now. Yeah, baby! I was worried that they might've mixed up my order and given me the regular, it was so good. I had to chuckle a little when the barrista asked me if I wanted whipped cream on it.
  • Find a sugar-free flavored tea that has some natural sweetness to the flavor. I have always loved Good Earth original tea, and they now have an organic version of their original flavor (the original has artificial flavoring).
  • Make your own hot cocoa. I used to be a total chocolate fiend. Every now & then I make my own hot cocoa with unsweetened cocoa powder (use good quality cocoa!) and with stevia sweetener. (Splenda works well, too.) I know mochas and no-sugar-added hot cocoa aren't exactly low carb choices due to the milk, but they're good if you're not on a total carb fast and are accounted for in your food plan.

Thursday, July 24, 2008

"Someday" is Now: Part of the Explanation

I saw a figure cited on the FAQ for alt.support.diabetes that blew me away. Was it true? I researched it and found the following quote in the document "Type 2 Diabetes Risk After Gestational Diabetes," produced by the National Diabetes Education Program:

"After pregnancy, 5 to 10 percent of women who had GDM are found to have type 2
diabetes. Women who have had GDM have a 20 to 50 percent chance of developing diabetes in
the next 5 to 10 years following pregnancy.(1, 2)"

1. National Institute of Diabetes and Digestive and Kidney Diseases: National diabetes statistics fact sheet: general information and national estimates on diabetes in the United States, 2005. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2005.
2. American Diabetes Association: Gestational diabetes mellitus (Position statement). Diabetes Care 2004; 27(Suppl. 1): S88-S90.

Whoa. Would it have made a difference in how I've lived the past four years? Hard to say, really. I think part of me wanted to deny diabetes. I got rid of all the paraphernalia once I was declared "in the clear." I should not only have gotten a post-breastfeeding food plan, but have monitored things now and then over the years.

Instead, I let myself climb up to 265 lbs. I was one of the unusual people who lost weight during pregnancy, and my post-second child weight was 210 lbs. I could kick myself for not trying harder to maintain that weight. Now I'm having to battle it down again. On the plus side, I'm down to 242 lbs (-23 lbs!). I still have a looooooong way to go, but it's a good start.

As I expected, the diabetes educator is recommending that I start a medication to help control my numbers. My post-meal numbers are within range, but my fasting are out of line. Looking at the average over the past month, my a1c numbers are going to be a lot better the next time I get that checked. Speaking of fasting, I tested my husband's fasting blood glucose this morning. 86! He's overweight, too, but does not have the family history. He's been on a low carb diet since his visit to the cardiologist a few months ago, the doctor said he's probably sensitive to carbs. We both started taking calcium supplements then, and with the extra vitamin D, I wonder if that was a catalyst in my "awakening" to the fact that I didn't want to be so friggin' huge anymore.

Friday, July 18, 2008

"Time spent laughing is time spent with the gods." -Japanese proverb

That cryptic post to my blog-that-fell-in-the-woods is the sig on my iPhone. I was testing emailing a post to this blog.

That quote is my all-time favorite. Two important things I'd like to ensure as I change: (1) Not becoming insufferable and annoying in my recasting as one of those healthy people, and (2) Keeping my sense of humor.

Hitting the wall? Already?!?

Okay, it's getting discouraging. I'm exercising daily, and more than I have since...probably high school, maybe college. Nah, probably high school. I'm eating to plan. I'm losing weight. But my darn blood glucose levels are not dropping. They're better than at diagnosis time (202, fasting, with a 9.5 A1C, so that wasn't a fluke), ranging between 137 and 170, generally, but today's shot up into the 180s. (181 fasting, 189 after exercise and breakfast...oh, and after some stressful work emails and nearly having a woman on the side of the road trying to help push a car stumble and nearly fall beneath the wheels of my faithful Civic. So yeah, maybe some stress there. And a pulled muscle in my leg, which I'm trying to be patient about, since the Pumpkin Run is only a few months away.)

So I'm betting that the CDE Rn will recommend medications on Monday. If I'm doing everything right and it's still not within the target ranges, what else is there to do? How long does lifestyle change typically take to make a difference? Guess it's "just put one foot in front of the other" time...

So, last time I thought I'd talk a little about how I'm going about this lifestyle change business without being overwhelmed by the "This is the Rest.Of.My.Life"-ness of it. How ironic! But here goes: I know it's happening when I start getting that little panicked feeling, when thinking about the future. Hmmm, why does it usually happen when I'm running? When it happens, I have to yank my thoughts back to the moment. Hakuna Matata. (That tune got stuck in my head after playing it for my daughter on my iPhone, and it's become my running chant, has a good cadence to it; appropriate on a number of levels...just hoping one of those levels is not that of poor Pumbaa when they put me on metformin!) All those Pema Chodron and Thich Nhat Hahn CDs I listened to during my commute sank in, I guess. *sigh*...I just hope I can get those numbers under better control before our Michigan trip, that's going to be a challenging time, all that tasty food....

Monday, July 14, 2008

Opposite Month #1

Well, it's been one month since I wandered out of Long's Drugstore with a Type 2 Diabetes diagnosis. Quite the eventful month:
  • Threw away the chocolate glazed donut I bought for breakfast that morning.
  • Felt anger, disgust, and shame. Why-oh-why had I let it come to this?
  • Clamped down on my food plan. I had dug out my old gestational diabetes food plan a couple of weeks ago--when I'd decided I'd had enough of being fat--but I wasn't following it precisely. I eliminated all refined sugar products and other forms of junk food; cut white rice, regular breads, and regular pasta; sodas (diet, rarely drank regular). Started eating only whole grain products. One serving of my starches is a combo of wheat germ and milled flax seeds in my plain Greek-style yogurt with a serving of fruit. I am becoming my mother...not a bad thing, in this case!
  • Celebrated our 11th wedding anniversary! (Splurged on sharing some tempura...oooooo. Bought used books instead of fancy desserts.)
  • Went to see the doctor on June 19. Yep, it's the big D, alright. We discussed--I told her I wanted to try diet and exercise first, since my previous years had been spent wallowing in sloth and gluttony. She wrote my Rx for a meter and strips, but she said to not fill it right away, because she thought our health group had some sort of contract with someone. (Word to the wiser-than-me: Be sure your doctor specifies the number of strips and lancets. Also, call your insurance company right away regarding how to get a meter! It's the *insurance company*, not the medical group, that determines which brands and models are covered. More on that later...)
  • Plodded along with my food plan and started exercising 3 days/week for 30 minutes. Decided to take up walking and--gasp!--jogging. I'd felt inspired by the Zen Habits blog article "How to Go From Sedentary to Running in 5 Steps," which describes how to get started with a running routine. (There's another good article I found on the Cool Running web site, "The Couch-to5K Running Plan, which is similar.) Yes, I guess aliens *have* taken up residence in my body.
  • Finally got the referral letter for the diabetes educator appointment. Called and made the appointment. I'm a little surprised that they let 2.5 weeks go by, but oh well.
  • July 1: At least I don't have breast cancer! I had my first mammogram today. The breast center at Mills Peninsula is soooo luxe! We had nice robes instead of paper ones, and the interior design was not sterile. Friendly, professional staff, too. I kept wondering when they'd call me for my facial and manicure.
  • Got overwhelmed by the conflicting info on the web. Low carb vs. low fat, Bernstein vs. ADA...oh my! My gestational diabetes food plan from 2001 seemed a bit high on the carbs, so I went with a modified version, "Low-Carb Diabetes Diet" from the prevention.com web site. I liked its inclusion of a "nut" portion, a *whole* ounce of nuts! Woo hoo! I made a modified version, though, to include 2 portions of milk and 2 portions of fruit and to total 1800 calories. My version has approx 131 grams of carbs, which is more than they recommended (they recommend 125 grams max).
  • Saw the diabetes educator and nutritionist on July 7. To my dismay, they were unable to issue me a blood glucose monitor, because they do not have the ones my insurance company covered. Got lots of good info: The nutritionist told me that my food plan looked good for now, I could probably eliminate some of the snacks if desired, but that research supported only dropping to 130 grams of carbs. She thought that the Bernstein diet was not practical and a bit extreme. (I had done a more restrictive plan during the end of my 2nd pregnancy, when seeing an endocrinologist, and I hated not being able to have fruit! Just lemme have a couple of apples, damn it!) Got some bad info: I wasn't exercising enough, according to the Rn: 30 minutes, 5 days a week is recommended for someone trying to control with diet and exercise. (And...when am I going to find the time? Oh, well, flight o' the bumblebee, right? Or, "when faced with the impossible, choose the improbable"...I think that's how the Sherlock Holmes quote goes.)
  • Went through the whole rigmarole of obtaining a meter. I was given the numbers to call to get either a One Touch or an Accucheck meter via the companies' free meter programs. I was unable to determine, even after two calls to the pharmaceutical part of the plan's info line, whether test strips for the Accucheck models they were offering were covered! Grrr...So I decided to geek out and get the One Touch UltraSmart, even though the Rn said she didn't care for the One Touch meters as well. OH well. Probably jacked up my blood glucose just getting the darn thing.
  • Received the meter on July 10 and started checking. Good news: my post-meal numbers are within range (137-158). Bad news: what IS UP with my fasting blood glucose? It's running between 160-170, even with all my good habits. I have a feeling I might be put on some meds. Ugh.
  • Started flossing again. Flossing is almost as irksome a chore as ironing clothes, but it must be done. *sigh*...
So, there you have it: the first one month of Opposite Life. Next time: How do I prevent myself from getting overwhelmed with the idea that this is The.Rest.Of.My.Life!

Tuesday, July 8, 2008

Today's Special: Plate o' Shrimp

...or, "Why Did Every News Web Site Have an Article About Food Diaries?"

In the movie Repo Man, the character Miller expounds upon synchronicity with his "Plate O' Shrimp" theory: "Suppose you're thinkin' about a plate o' shrimp. Suddenly someone'll say, like, plate, or shrimp, or plate o' shrimp out of the blue, no explanation. No point in lookin' for one, either. It's all part of a cosmic unconsciousness."

So the "cosmic unconsciousness" served up Food Diaries today. SF Gate and Yahoo News carried a nearly identical article about the effectiveness of food diaries. (The SF Gate article gave it an unintentionally amusing local touch, citing the example of a "Mr. Tacotaco" and his success with a food diary.)

Funny, my diabetes educator nutritionist just mentioned this to me the other day as a way to help my newly-developing good eating habits stick. I've been keeping a food diary for a couple of weeks now--mainly to track how closely I'm sticking to my food plan--and it's pretty effective. I've lost 17 pounds in the last couple of months by exercising more, cutting sugar and most refined foods, not eating the kids' leftovers, watching portion sizes, and eating more fruits & vegetables. (Yep, all the common sense stuff I should have been doing! ;-) I have a LONG way to go, but I feel a lot better already. I've found that weighing and measuring portions helps tremendously. It's too easy to overestimate a portion.

Another trick, if I'm somewhere where I can't easily measure, is the "Rate Your Plate" method of putting stuff on your plate: half of the plate gets a non-starchy vegetable, one quarter gets a protein serving, and one quarter gets a carb (bread/pasta/rice/starchy vegetable--in my case, whole grain bread or crackers or a starchy vegetable, I've been a little reluctant to let pasta and rice back on my plate). Sometimes I just fill it with more non-starchy vegetables, depending on what's available.

"Someday" is "Now"

Or, "About this blog":

I've always loved eating good food and (to quote the Sweet Potato Queens) "doing jack shit." My ideal life would be somewhere like this; getting served excellent, plentiful meals and tasty cocktails; snorkeling a little; laying around in the balmy air and reading books. It's a good thing I never won a Lotto jackpot.

I turned 40 this year. Foooooooooorty. Ooo. And I thought maybe I should get my act together. I am overweight, sedentary, married with two small kids. I had also had gestational diabetes during both pregnancies (you can see where this is going) and was therefore more likely to develop it someday. (Family history, too.) Ironically, I had started to make some changes for better health, and I went and got some screening done at Long's. Just to see where things were at.

"Someday" turned out to be "now": my fasting blood glucose was 202, a1c 9.5. Damn!

So now I'm living the "Opposite Life": opposite day, every day, when it comes to food and fitness. This blog records my journey, and maybe it will help others on the same path.