T Minus Two Type Two Diabetes and Other Passions


State of the Bob Address


It's been over a year since I posted on this blog about how I'm doing. But I want to support #dblogcheck, and my friend Mary mentioned the other day that she likes to know how I'm really doing.

So here's the straight skinny. Or, more accurately, the straight not-so-skinny.

Two summers ago, I got things relatively in order in terms of eating, and I picked things up in terms of exercise, and I lost a chunk of weight, and I had a lot of hope.

That winter, I let it all go, except for the weight, which (mostly) came back. Or, if you prefer, it all (excepting, again, the weight) escaped. I feel a lot of shame, though I probably shouldn't. (You catching that? That I feel guilty about feeling guilty? I feel a bit guilty about that.)

Unsurprisingly, I don't feel as good as I did for a while. I've felt worse, but I've felt better. There are no signs of diabetes complications, but I get breathy too easily. (I did see my doctor recently, so there's nothing big I'm ignoring.) Though I am feeling my way back forward, my progress in that is slower than I'd like.

The same applies to the state of things between my head. I've been worse (much worse), but I've been better. The return of the longer days and warmer temperatures is a good thing for me.

I feel like this post is disproportionately negative, and that's not a full picture. There is a lot that's good in my life. I have a good job, and I find interesting things to spend my time on. I spent a number of months reading history in most of my spare time, and recently I've been scratching my creativity itch with a lot of sewing and crafting. (Oh, boy, am I starting from the ground level on that stuff!)  It's ALWAYS better for me to have an enthusiasm going.

So there's that. :)


Stride Forth! Or Not.

I couldn't figure out how best to introduce this post. Take your pick.

Introduction #1: A number of years ago, I went to the first appointment I'd ever made with a psychiatrist, an appointment at which I would (as it turned out) be diagnosed with clinical depression. I felt hopeful, but I also felt vulnerability and even shame. The receptionist's desk had a page-per-day calendar provided by a pharmaceutical company, and that day's page had a saying along the lines of "Stride confidently into your future!" The contrast between the saying and my situation struck me as both painful and hilarious. I showed it to the receptionist, saying "If I could do that, I wouldn't be here." She didn't see the joke.

Introduction #2: When I was teaching myself to cook, I was very conscious of one advantage I had over many kitchen novices: I had no one else I needed to please. I had no parents or siblings pretending to enjoy a mistake, no partner wishing we'd just ordered pizza, no children convinced that only a microwave could make food edible. I could carve my own way. As I did so, I also learned more about what I like to eat, and I learned how to cater to my own taste.

Introduction #3:
"Whatever gets you through the night 'salright, 'salright." – John Lennon


People respond in different ways to diabetes or other difficult situations in their lives. I've read posts on diabetes blogs that were optimistic, despairing, angry, loving, sad, and humorous, as well as many that were complex stews of emotion. One participant in an online chat claimed to have no trouble with diabetes whatsoever.

We're all different from each from each other, and each of us is different from moment to moment. We have different needs, and they change. I'm a big fan of each person finding what they need to get through the night (though I suspect that the protagonist of John Lennon's song was thinking of something other than emotional support). We all have to figure out what we need for dinner.

For myself, I'm not big on inspirational quotations or unmixed optimism. Many people love them, deriving motivation to do and be their best. Perhaps it's due to a loose screw, but I tend to see (and feel bad about) the gap between the sentiment expressed and what I do or feel.  I to be more into humor (the feebler the better, as far as I'm concerned). When I come across what's intended as hopeful, I may respond by feeling resentful or even angry. But you know what's great about social media? I don't have to like everything I read. Some days, I conclude

Social media is to me first about expressing the self. I don't want anyone to change how they deal with their situations to suit me if they've said what they want to say, that's the important thing. And if, secondarily, what they've said is part of what someone else needs, that's fabulous. The next person up to the reception counter I mentioned at the beginning may have found that the quote planted a seed of desperately-needed hope.

I don't feel like the Diabetes Online Community is responsible for making sure that everybody finds what they need, although we can certainly hope that they do. More than that, we can't hope that a person WON'T find what they DON'T need. Our best shot at meeting the needs of others is to be ourselves, and hope that people find the voices they need to hear.




In Sight

This post (not a repost!) is my response for today's prompt for Diabetes Blog Week: "Diabetes Life Hacks -- Share the (non-medical) tips and tricks that help you in the day-to-day management of diabetes ... Please remember to give non-medical advice only!"

I have griped a time or two (okay, maybe closer to 300 times) about how much I hate sitting down to count out my medications each week, because doing so seems to be a real symbol of my diseases.

But, I really don't mind -taking- the medications. However, it took me several years to figure out how to take them as consistently as I need to. For way too long, I relied on trying to remember the three times a day I have pills to swallow. That just didn't work. Eventually, I had the insight that I needed to keep my meds in sight. (See what I did there?)

The morning meds live on the desk where I used to sit at my computer every morning. (The computer now lives elsewhere, but seeing the desk is reminder enough.)  I have a phone-and-computer calendar reminder for the mid-afternoon, when I'm usually at work. And there's a little stand in my bathroom - which I'm sure to visit before I go to bed - that holds the sorter with the things I take at night.

I still manage to forget once in a while, but I'm pretty consistent.

It's simple, but it works for me.



Solo Flavors, Social Flavors

For my mouth, some flavors are solitary and some are more social.

Take sour/savory, such as a pickled vegetable that's not too sweet. I can spear a piece of pickled red pepper from a jar, and it's delicious, and it's enough: that flavor is content to be alone. Salty (not salty-fat) is the same way for me: just a few nice olives can be a nice little snack, and my mouth feels that it has been treated well and is content. (Pretzels are an exception for me.)

Fatty flavors are more social: they want more of their own kind around. I've barely got a bite of a good hamburger swallowed before my tongue wants the next bite. The call for "more!" doesn't go away until I feel full or the food is gone .. whichever is later.  Fatty/salty is even more so for many people - think potato chips or french fries. There are probably people who can eat one potato chip and fully enjoy it without reaching for the next one

Sweet is more social yet. A modestly-sized cookie wants to be joined by another, and another, and another. I have, on occasion, used mouthwash to try to stop the invitations from going out.

And fatty/sweet, like ice cream or milk chocolate? That's a flavor combo that wants to PAR-TAY, and how can it par-tay without mouthful after mouthful of the same flavor.  (Chocolate does not really trigger me like that, but it seems to for many people. Ice cream very much triggers me like that.)

This is just an observation. I don't know if it works like this for others.


Rising Against the Dragon

So, as you may know, I've been able to make some healthy changes in the last few months. There's quite a bit of exercise, both walking and things I do in my *ahem* home gym. (The "home gym" is a living room cluttered with dumbbells and exercise bands.) I'm eating right, and recording what I eat. Emotional eating hasn't been a problem. The home gym exercises can be a challenge some evenings, and some days bring other kinds of challenges Still, I've had a lot of initiative, and it hasn't been killer-hard to keep going.

And then, over the last week or so, ever so slowly, I've been slipping. The home gym sessions got skipped or foreshortened. I had a couple of days when I ate over my calorie goals … then a couple of days when I'm pretty darned sure I did, but I can't be absolutely sure because I didn't bother to record it. The eating was starting to feel out-of-control and intended to feed my heart rather than my body.

I came into the weekend feeling the hot breath of failure on the back of my neck, and I had no idea what to do about it. Then, as I was desperately trying to think of how to turn it around, I remembered the dragon.

See, as far back as the eighth grade, I've struggled with episodes of depression. These episodes can come at any time, but the midwinter months are usually hard, and those episodes have sometimes been deep.

You'd think that, since I know all this, I'd start watching for the signs. But, at least for me, depression tends to arrive pretty quietly. This morning, I realized that my healthy changes were being drug down by the challenges of emotional health. As I thought about it, I came to think of the depression as like a dragon. (You can blame a movie ad for the image.)

My initial thoughts for how to make accommodation for the dragon's presence were along the lines of partial surrender. Perhaps I shouldn't even try to do the gym exercises. Maybe I should raise my calorie limits. Maybe I should….

And then I got mad.

"Why," I asked myself, "should I give in to this? Why should I let it make me a failure?" I then talked aloud, perhaps just to myself, perhaps to make dragon, feeling all smaug over there on his gold. (See what I did there?) I would not, I said, give in. I would maintain my standards. I am not (I continued) the same person I used to be, and I will choose what I eat and how I exercise. There were other things I said as well.

Of course, telling a dragon off is not the same thing as defeating him. The dragon is still here, and he will remain here until he decides to go sit on his treasure someplace else for a while. I'm going to have to be careful, for example, to know exactly what my exercise plan is for the day. And, though I will be tempted, this will not be the time to make ambitious additions to my goals. And, I do think it's appropriate to restart the gym work a little slowly. But I will do these things because I CHOOSE to – not because I feel that choice has been taken from me.

And I must never forget that the dragon is there: he is most dangerous when I'm unaware of him.

Take that, you nasty overgrown lizard. And do something about that breath.

This post was edited on 11/25/13 to rearrange a tiny bit and to improve the post's resemblance to English.


Happy Birthday, Sir Frederick

This has become my annual World Diabetes Day post. It was first published two years ago.

Today would have been the 120th birthday of Frederick Banting, the man who (along with Dr. Charles Best) discovered insulin.

Perhaps you are an insulin-dependent diabetic, or love such a diabetic, and understand full well what you owe to Sir Frederick and why this day is celebrated as World Diabetes Day. Wish Sir Frederick a happy birthday.

Perhaps you are like me, a diabetic who is at this point still able to produce your own insulin, but realize that a time may come when insulin will be as important to you as oxygen. Wish Sir Frederick a happy birthday.

Perhaps you are not aware of knowing any insulin-dependent diabetics. But you almost certainly have. Spare a thought, today, for the acquaintance, whoever it might be, that you never would have known had it not not been for the work of these men. Wish Sir Frederick a happy birthday.

Please, take just a moment. Even though insulin is in no way a cure for diabetes, it has saved the lives of millions.

Please wish Sir Frederick a happy birthday.


A Small Matter

Years ago, I used to worry a fair amount about the psychology underlying my obesity and other things about myself that I wish I could change. Eventually, however, I decided that this whole approach (as least as self-directed) was fruitless and maybe counterproductive. I chose to focus more on coming up with strategies to help me make desired changes.

That's still pretty much my approach. However, as I've worked in a concentrated way to eat better and move more, I've found that it's necessary to think about "reframing", by which I mean how I think about who I am and the choices I make. Last week, for example, I had discovered that some challenges I'd encountered had me change from thinking myself as someone who was successfully making changes to someone who was slipping and would soon fail. That kind of thinking has all the markings of a self-fulfilling prophecy, and a pernicious one at that.
This morning, while walking to work, I was thinking about the success I'm having, when the word "small" popped into my mind, and I experienced a wrench of something like anxiety. As I worked to figure out what had just happened, I came to understand what I had reacted to. Something inside me is fearful that, since I'm quite short for a man, that losing my excess weight would make me not just a short man but a small man. And that whatever-it-is inside me found that a very uncomfortable prospect.
This seems ridiculous - I'm not aware of any conscious dislike of men that are both short and slender. I can name several that are fine men indeed. But, this reaction is worth paying attention to. Has this been an interior attitude of long standing? Has it maybe been a big part of what kept me so fat all these years? I don't know. It doesn't matter. What DOES matter, now that I know about this, is to watch for it in my own thinking so that I don't sabotage my progress.
After all, great things can come from "small" changes.

Of Tinkertoys, Perception of Self, and the Wee Small Hours

For many years, I have visualized the contents of our hearts and minds as an enormous, intricate and ever-changing network of nodes and rods. Each node represents a belief, a memory, an idea, a feeling, anything like that. The rods make up the billions of the connections between them. Do you ever travel around an area you've lived for a long time and noted all the building for which you have some kind of association? That house is where your friend's boss lived, so you've got nodes related to that house and your friend's boss, and those two nodes each have rods connecting to each other and the node for that friend, as well as to your memory of how badly that boss treated your friend and the sadness you feel about that.

(I often think of this structure, actually, as being made of the Tinkertoys I spent hours with as a child. Kiddies, come listen to Grandpa talk about how they were made of wood in those days.)

Everything that changes for us in however tiny a way requires at least a tweak to some part of that structure. Suppose you read an article about a musician you like. You learn that a forthcoming album is being done with a known producer. So, you add nodes for the new information and add rods of connection to the node for that producer. The article leads you to reevaluate your opinion of a particular album that you'd not liked, so you have to tear out the little bit of structure related to that musician and that album in order build in the new information AND the new opinions AND any new feelings.

(You –do- understand that I’m neither a neurologist nor a psychologist, right?)

When something big happens, in this metaphor, big chunks of the structure may require rebuilding, and I see that kind of work as requiring mental and emotional resources. In recent weeks, I have had trouble sleeping. No, that’s incorrect: I've had trouble choosing to sleep. Into the night, I play silly computer games and do the other things I do in period of stress. It’s my suspicion that my particular makeup uses the quiet of the late evening to do maintenance on my structure.

Why is so much work required right now? A couple of months ago, I started walking a certain amount every day. About a month ago, I started tracking what I eat and adjusting what I eat to meet the daily targets. Shortly after that, I started adding light calisthenics and dumbbell work. In short, I’m making changes. And, at this point, most of the changes feel sustainable: doing these things don’t require a triumph of will on most days.

(Do not read any of this as even a HINT that you should do ANY of this, too. I am not going to become one of those people who becomes convinced that what worked for them is The Answer. If I DO become that person, please shoot me.)

I have been seriously overweight for about four decades. For three and a half of those decades, I have made sporadic efforts to live in a way that might help with that, and I have ultimately failed in all of those efforts. I have felt bad about being fat, and I have felt bad about being unable to do anything about it. Since my diagnosis, when it became clear that healthy changes would be beneficial whether I lost any weight or not, my inability to make those changes has become deeply frustrating and deeply perplexing. More than anything else, this lack of success in moving forward has been what this blog has been about. All of this, I think, is a fairly big part of my structure of nodes and rods.

So, the change from Bob-as-I've-always-been to Bob-who-mostly-eats-well-and-exercises is a major one. I don’t know if it would be for anyone else, but it is for me. My last post was an attempt to begin to wrap my head around becoming a different-in-a-big-way person.There is, if my metaphor is valid, a great deal of rebuilding going on.

And that, I think, is what I’m doing late into the night when it seems like I’m just playing solitaire.


Not Guilty

"Your honor, we the jury find the defendant to be not guilty."

On Thursday morning, I had a checkup. Since this was my first time with a new doctor, I had worries about that in addition to the normal medical appointment jitters.

There was some good news. Most importantly, I like the doctor and believe he can help me. It was interesting to get a five minute lecture on patient empowerment, although he did not use that phrase.

Additionally, my cholesterol panel looked really good. The one number that is still out of range continues to improve.

I suppose it's good news of a sort that I was measured as being 5" 5' tall. I suspect there is some kind of error there, because I don't think I've ever been told that I'm that tall. But, maybe I'm having a growth spurt in my early 50s.

The not so good news was that my A1c jumped quite significantly and is now a little bit above the target range.

I've been puzzled about my reaction, or lack of reaction, to that last bit of news. I didn't seem to be feeling the things that I'd expect to feel, or even much of anything at all. Was I shocked into numbness?

But then I figured it out:

I don't feel guilty.

I simply don't find myself awash in the "should haves" and "could haves" I would have expected. I'm seeing my doctor again in a little over a month, and I'm going to be developing an action plan. For the moment, the doctor isn't changing my medication.

I'm sure that my good feelings about my walking program mostly explain the lack of guilt, despite my feeling lately that my eating is somewhat out of control. But, I think my heart is finally beginning to believe what my heart has known for five years: I have a disease, and a progressive disease at that. My choices are part of what determines the rate of progression, but only part. I know I have things I need to do, but I am able to see this clearly instead of through a fog of shame. I can explore options for improving the health of my body without feeling so much like my worth as a person is on the line.

I've been acquitted. Now I just wonder how I'm going to pay off my lawyer.


Walking Home

I grew up in Ames, Iowa, a community best known for being the site of Iowa State University and for appearing in many crossword puzzles. When I moved to Kansas City, after a couple of stops, my parents still lived in Ames. I used to wonder, in my odder moments, what it would be like to walk the 230 miles home. You know,  should there be a collapse of civilization or something. (You think about that, too, don't you? You don't? Um. Oh.)

So, when I began my walking program, I sort of kept an eye on the total distance I'd walked. And, last week, that total passed 230 miles. So, in a strange way, I'm home. That feels good.

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