Monday, August 06, 2007


It’s been a year and a half since my Diabetes 2 was diagnosed (A blood glucose AVERAGE (ac1) of 300, which means it was over 300 half the time). My average now on the ac1 is 140 which I still don’t understand since I rarely get a reading on my little meter of more than 120, usually more like 87 or 91. Still, that ac1 translates to 6.4 which is under 7, the limit recommended by the American Diabetes Association. Some people think that’s too high. Others say it is the variation away from 100 that counts -- that an average of 100 does you no good if you are going high and then low -- so the goal should be keeping the numbers as close to 100 as possible.

This means constant monitoring which can be a pain in the -- um -- butt -- er -- fingertip if you’re using a blood-stick meter. Not that it hurts, but that it means remembering to do it, making a teeny mess. It’s the remembering that entangles me. I think I should get a timer/reminder pill box like the kind the AIDS people use. I was interested to read about a recent brain function experiment -- the kind that reads brain region activity with a big MRI -- that showed people can totally “space out” things even as important as their children left in a hot car. The results of that can be a murder charge. But forgetting to test blood means merely ambiguity.

I’m probably not going to commit suicide by absent-mindedness (though people do it all the time) but maybe a few cells die if I let my blood sugar get too high. If one’s score is over 140, the urine begins to pull sugar out of the blood. If urine becomes sugary, the same thing happens to the cells of the kidney and bladder as happens when you pour salt or sugar on a slug -- the cells plasmolize: water migrates out of the cells until they are dried out. That’s why, if you think your blood sugar is a little high, even if you’re going to take a quick walk to bring it down, you also ought to drink a tall glass of water to dilute the sugar in your urine.

Your doctor isn’t likely to tell you this stuff. I’m discovering that doctor after doctor has become so demoralized and fatalistic about people staying on diets and getting exercise that their attitude -- the DOCTOR’s, not the patients -- is either angry and punishing, or cynical and withdrawing. In this part of the world there are few diabetes counselors or supports and there are more than a few “sugar babies,” women who have self-rewarded their status or their hardships with sweeties. They are proud of their baking, used to snacking in the kitchen, and secretive about their private lives alone in the house while everyone is working or at school.

This is a different problem than the people Nomi Wolf must help. The most dedicated foe of diabetes for miles around and a long-time program director at the Browning Indian Health Service, she is absolutely relentless. Rez folks are far more likely to be out-of-work, low-income, stressed people with genetics meant to handle lean meat. This does not slow her down nor does she get cynical, partly because for her the work has a strong religious and political component.

One of my major problems is that I grew up in a time when war imposed rationing, my parents grew up in the Depression when getting enough to eat was a real problem, and I’ve always associated losing weight with cancer, having witnessed several cancer deaths in people close to me. When I lose weight, part of my mind says “great” and part of it says “you’re sick.” It does not help me to think of the poor starving children in Africa, but I do try to think of the local people on dialysis.

Underlying pluses (always try to balance negatives with positives, even if you have to really scrape to find them: it does get easier with practice) are that I’ve never smoked -- haven’t even lived with a smoker for a long time -- always ate the basic good things before I ate the empty-calorie bad things, and walked, walked, walked all through my young years, then spent another ten on horseback. Aside from the pure enjoyment of doing it, that lay down a bone and organ infrastructure that has served me well and is capable of rebounding with vigor.

Now I’m moving towards two things: another drop in weight and trying to remember to do a daily handweight routine to build up my withered arms. They WORRY me! On the other hand, I didn’t know my hands and feet would lose so much weight and that pleases me. I don’t even have as much of a fat head! I never thought about fat leaving me in a different pattern than it was acquired. My ribcage and back are still fat, but my cup-size is smaller than it’s been since I’ve needed a bra. Of course, now I REALLY need a bra.

My neighbors think my newly baggy clothes are disreputable, but I like them. Most of my thinner clothes are dress-up things I bought for work, so I’ll save them for book tours or something. What’s strange is that my work shirts and rough pants are getting longer as I get thinner. “I grow old, I grow old, I must wear the bottoms of my trousers rolled.” But I wear jaunty straw hats and wraparound sunglasses. (Take THAT, T.S. !)

My diet is a mash-up of Weight Watchers (esp. useful for portion control), low glycemic index, and nutrition advice (cinnamon in oatmeal with unsweetened frozen raspberries for breakfast). One of my secret weapons is the bran muffins off the All-Bran package which I “improve” with a package of walnuts and a cup or less of some kind of fruit, currently plums off my poor tree which the drought has about killed. (The previous muffin batches were full of rhubarb from the neighbor’s yard.) Maybe some people wouldn’t like them, but they make me feel like I’m an “earth muffin” myself. When one is eating much less and with less fat, one’s innards become inert without a good bit of roughage. This summer I’ve been taking them out of the freezer and eating them frozen -- sort of brancicles. If I weren’t trying to lose weight, I’d run them through the microwave with a bit of butter. But then, I’d run EVERYTHING through the microwave with a bit of butter and maybe some garlic. Even lettuce.

The theme that has developed here (I’m not always quite sure what it will be when I start) is that managing blood glucose is as much a matter of managing one’s mind as it is a matter of food.

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