T Minus Two Type Two Diabetes and Other Passions


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.


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.


Makeover: Not a Post About Clothing or Hair

An allegory. Or a metaphor. Or a random neural firing. Or something.

Once upon a time there was a man who’d never paid much attention to how he dressed. He tried wear clothing appropriate to the situation, but mostly wanted things that were comfortable and easy to care for.

Then, a friend talked him into making some changes. The friend took him to a store where he replaced his business clothes with things that fit well, were made of quality materials, were fashionably cut and colored, and made him look like he earned a bit more than he currently did. Then, the friend took him to a different store for “having fun” clothes that were bright and pleasingly eye-catching.  Finally, the friend took him to a salon where he was taught to style his hair in a way that was very attractive but much different than he’d ever worn before.

Back alone at home, the man examined his new look in the mirror. The changes, he knew, were just beginning. Getting ready for work or a social event would take longer, and he’d have to spend more time caring for the new clothes. Further, he would have to regularly replace items in his new wardrobe to keep it fashionable and in good repair.

There were other things, too, maybe more important. The man suspected that the people around him would react to him a little differently, and new acquaintances would be meeting a somewhat different person.  And, he understood, he would even have to adjust how he perceived himself.

The man loved his new look. But, as he examined himself in the mirror, he asked himself:

“Am I still me?”

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.


What’s the Good Word?

For me, one of the difficult aspects of personal change is the necessity of altering my view of myself to accommodate the change. Otherwise, way too often, the old self-image wins.

In the early days of my walking program, when giving up seemed a very real danger, a friend gave me a great gift.  In response to a Facebook or Twitter message I'd made about that day's struggle, she expressed confidence, noting that I can be 'stubborn'. I knew right away that I'd been paid a compliment, and I knew almost right away that this was something I could use.

See, I know that I can be stubborn. I can pursue figuring out  how to use a software program in a particular way well past the point of it being worth the trouble. But I'd never thought of myself in that way in regards to healthy changes.

I can't tell you how helpful it's been. There have been many days when I really didn't want to go out and finish my steps. But, instead of thinking of myself as prone to easily giving up, I choose to think of myself as stubbornly pursuing this daily goal. There have been three or four days when I chose to have a light day, but I haven't yet missed a day do to a failure of purpose.

Not once. Because I'm stubborn.



Short and Hard

Long-term and flexible? Or short and hard?

For a long time, most of my health goals had a timeframe of, well, forever. On the surface, this would seem to make sense. When, exactly, should I stop eating healthily or checking my feet every day?

But forever goals have to have some flexibility, because most things can't happen absolutely all the time. But it's very difficult to define flexibility in a non-flexible way. But for me, these goals acquire so much flexibility as to disappear entirely.

So I'm experimenting with a different approach. Suppose I set a time-frame that's very short but does not have much flexibility. When the time's over, I can decide if the goal seems to be sustainable, if it needs adjustment, if I've accomplished what I needed to do, or if I just need to find another tree to bark up.

When I began my walking program, I picked the number of steps I wanted to walk a day and decided that I would do that every day for a week. I chose to do 8,000 steps a day. I've often heard 10,000 as a goal, but decided that the lower number was more likely to be achievable. And, I decided, I would accomplish this unless something really unforeseen came up - not for forever, but just for the week.

And I did it. Because I already walked to and from work each day, it wasn't overly daunting to get in my 8K. That first weekend was a big challenge, though, because it was much harder to get to my total than I expected. But I got there, and decided that I could keep it up, and I have kept it up. At the end of the week, I just kept going. I haven't yet found it essential to redefine my goal, though I think I will need to someday.

It's early days for the "short and hard" approach, though there have been a couple of smaller successes as well. But so far, so good.


The Journey is the Destination

Some steps are harder than others.

I find that getting my walking in is made much easier if I've got a destination. It's best if my destination is someplace where I need or want to do something, but it's okay if the destination is just theoretical, like a given intersection. Doing "laps" around a preplanned route is harder, and hardest of all is when I need to get the steps in by walking in place in my apartment. (I've had to do that twice.)

Why is this? For me, walking in place or doing "laps" requires more discipline than heading for a particular place. I can stop any time, and the part of me that would rather be comfy reminds me of that frequently.

I need to work past this, at least as far as doing "laps" go. Too many of my destinations involve food, one way or another. For example, my local grocery store is a great destination - it's about a mile and a half round trip, and I don't have to add much to that to get my steps in. But, this becomes less of a good thing if I pick up a pint of ice cream while at the store. Also, there are days when I prefer not to leave my immediate neighborhood.

One think I've thought about doing but haven't yet done is catching a bus to other parts of town to get a bit of variety. There are a lot of nice or interesting neighborhoods.

I'm hoping that doing 'laps' is something that becomes easier with practice. It's worth some effort.


Why Keep Doing It?

That guy can not be having any fun.

It's the 5th or 6th of July during almost any of the twenty years I've lived in this apartment building. In the park across the street, which in recent days has been the scene of many illegal fireworks, one man is setting off the last of his stash.

(Yes, the person could be a woman. But c'mon. It's a guy.)

Here is what it sounds like:






And so forth. And so on. And, sometimes, for an hour or more of so ons.

Maybe the guy feels that it's unwise to store fireworks, or maybe he's just stubborn about using the fireworks he's purchased. Whatever his motive, it's hard for me to imagine that he's enjoying himself.

After my diagnosis with Type 2 diabetes, one of the first changes I made was to quit ordering french fries and to not accept the dinner roll that comes with many meals at a sit-down restaurant. The reasoning was simple: I don't like french fries that much, and I don't especially like most dinner rolls, either. It was an easy change to make. I now order french fries only a few times a year, and take a dinner roll only if the rest of the meal is pretty low carb and I think I'm going to want it.{Of course, if you really like french fries or dinner rolls, it's not the same thing for you.)

Granted, it's a small thing, especially considering some of the foods I don't pass up. But I figure that there have been a lot of french fries over the years that I haven't eaten, and that's not meaningless. Perhaps there are other things that I eat mostly out of habit even though I don't especially enjoy them.

Why keep doing it if it isn't fun?



OK, No Matter What

Last week, I re-ran a post I wrote several years ago about the basis of self-esteem. In it, I concluded that the only reason I could find to feel good about myself is simply that I am. I have the worth that all people have.

For a couple of years, I've been avoiding major efforts in the area of weight loss. That had become such an emotionally complicated for me that I simply couldn't make any progress. But, the last few weeks, I've gotten back on the horse. I bought a bathroom scale, and I've been using it. I've even found a way of getting steady cardio in that has worked for me and feels like it will continue to do so. All of that feels good.

But, I believe it's important to remind myself that this doesn't make me better in a fundamental way.

I am okay. If I lose a bunch of weight, I will still be okay, but I won't be any more okay. My life will be better, but my basic worth will not have changed: it is inalienable. I could become so fit that triathletes will be jealous of my BMI, but I'll still be the same okay.

The reason is this is critical is that things may also go the other way. If my current efforts collapse – as so many such efforts have collapsed – I will be not be any less okay, any less worthwhile as a person, than I would be if I got skinny. Even if I gain a lot of weight, I will still be okay.

Additionally, keeping my essential worth in mind is helpful in this context because (possibly contrary to what one might think), I just find it easier to do if I'm only trying to get a bit healthier rather than trying to fix a flaw in my being. It's just so much less complicated.

I am okay. That is unchanging and unchangeable.

And you're okay too.

Switch to our mobile site