Off I went to the doctor in Great Falls, confident that I was going to be praised for my good work, and for keeping my blood sugar and blood pressure stats diligently. I thought I had only one weak spot: not enough exercise, since it mostly consists of my two-block jaunt to the post office and back. I resisted all Christmas indulgences related to food, feasting on the Montana Nutcracker Ballet instead.
Instead of a happy visit, I walked into a buzzsaw. She began with my lack of exercise, went on to my terrible crime of eating beans for lunch (“most people do not eat baked beans for lunch and anyway they are high in sugar”) and when I began to argue about my decisions, she jumped me for “being defensive.” She didn't like having my file so fat with statistics, saying they were useless -- then criticized me for scores back in October when I blundered. It was as though she were provoking a fight. I’m never one unwilling to oblige, though --as usual -- I ended up in tears. “I’m just trying to keep you from going blind and having your feet sawed off,” she said. “Most people have blood sugars in the 130’s!” Mine have been close to 100, which is normal. I think she thought I was lying. I think she considers me arrogant and denying reality. (She’s not the first.)
Then she was on, asking me about “wheezing.” I don’t wheeze. “Retaining fluids in the lower limbs.” I don’t do that either, now that I don’t fly anymore. I tried to move her to discussion of this new discovery about mice cured when capsiacin was used to prune back the pain nerves knotted around their Isles of Langerhans. She didn’t know about it, pursed up her mouth, said, “You’ll always have diabetes and you’d better get used to taking meds.” (I don’t take any meds except for my blood pressure.) I was just stunned. She has NEVER been like this before.
This is a small community and everyone knows everyone else’s business. Distances are long so I had an hour-and-a-half drive to ponder on all this and try to get a handle on it. What it sounded like to my counseling ear, more than anything else, was a marital argument, with the old refrain of “you’re being defensive.” I might have reacted badly, but the battle was on from the minute the door opened.
I have at hand a pretty informed Internet community. My cousin: “Could you try to convert your outrage into compassion for whatever is the problem with her?” My NEW cousin, who was a medical librarian for years: “The last time I checked, doctors were human.” My Montana niece, “Yeah, I’m picking up rumors about marital troubles.” It’s a second marriage to an older man, also a doctor.
Nevertheless, it took me overnight to get back confidence in my ability to manage this Diabetes 2 stuff. This morning I stood paralyzed in front of my oatmeal saucepan, wondering whether I dared throw in the usual frozen unsweetened raspberries. I’d already figured out that the news about the mouse pancreas treatment was NOT that capciasin is a wonder drug I ought to run out to buy -- the important part was that they were able to prune back those knotted-up autonomic nerve cells that were throttling the insulin producers. And the important part of THAT was that it suggests a whole new way of of figuring out Diabetes 2, which is really a metabolic syndrome problem, probably with a strong emotional component. (I raised this with the doctor but she didn’t address my blood pressure or lipids -- just hammered away on diabetes. Has someone related to her or maybe even herself developed the problem?) Is it wrong to be hopeful, to try to understand what scientists and doctors do and why? I say, resoundingly, NO.
This punishing, threatening approach to motivation can only encourage lying. Also, it assumes a rather old-fashioned view of diabetes, the little sugar-pig theory. The more enlightened folks are talking about the glycemic index, stress as a fundamental cause (which ties right in with the autonomic nerve factor), and the synergy among protein/carbohydrate/fat mixes. The Australian counselors, who seem pretty advanced to me, will say, “If you have toast for breakfast, why not add a bit of low-sugar jelly and an egg?” I’m finding that it’s the unbalance of JUST the carb that’s not good. High fat alone will also make high sugar.
The Aussies say, “If you really love mashed potatoes (which converts almost direct to glucose), why not mix them with mashed lentils, which are high-glycemic, go well with potato, and slow down the need for insulin?” They encourage the learning of a list of foods in order of glycemic impact on the pancreas, always working to find the highest glycemic, slowest digesting, foods and include them in one’s diet. It’s not just that sugar is sugar, it’s that sugar demands insulin right away or else loads up the blood.
Even smaller portions of forbidden foods -- like REALLY small! -- might be all right. But I don’t even LOOK at them, for fear of eating too much: a tablespoon instead of a teaspoon might be too much. I’m looking back at my old Weight Watchers lessons and thinking about weighing portions. When one looks at a can or package for “serving size,” it’s often startlingly small. Especially for a single person who feels obliged to eat a whole canful of food once it’s open. Little bowls of saved stuff often turn into mold.
But -- live and learn. I’ll keep eating beans for lunch, but I’ll mix a serving size with the same amount of baby spinach. Or I might get out the old slow cooker to guarantee sugar-free beans. Why shouldn’t people eat beans for lunch anyway?
I'm not supposed to go back until July.