Very Old, Very Healthy Diabetic

...or die trying.
I was diagnosed in 1998 at the age of 33 with NIDDM or Type 2 diabetes. I come from a diabetic clan. I even married a diabetic. Are you on the diabetes road, too?
This is my goal: to become a very old, very healthy diabetic by day to day choices regarding eating, exercise and medical management. Walk along with me...

Friday, February 23, 2007

Trust and the Diabetic Partner

I've been reading this book called 21Ways to Defuse Anger and Calm People Down by Michael Staver.

Confession: I actually read few books. I listen to many many books while driving around in my car, and one of my favorite features about my new car is that it can handle both cassette tape and CD.

So, you may ask, what has this to do with diabetes?

Not much, not directly, except for this one little tidbit. He has this equation: Consistent Behavior over Time equals Trust.

I've been thinking about this in the context of diabetes and the relationships we have, especially in terms of the partners of PWDs. The Diabetes Partner Follies over at Diabetes Mine, always a favorite. And the blog Wife of a Diabetic, although it is not for the faint of heart.

Since I am a diabetic, and the wife of a diabetic, both of us type 2s, I know both roles. I'm also the daughter of two diabetics, the niece of several diabetics, and the granddaughter of two. (Diabetic cousins, please sign in now.)

Do you remember the equation? Consistent Behavior over Time equals Trust.

SOME persons in my family have at some times in the past accused me of being the Diabetes Police. Hmmm, we won't name names.

So, I was venting with a different, non-related, diabetic friend. D-friend shared the opinion that I couldn't possibly be part of the Diabetes Police, because I am a diabetic. Therefore, I do know a little bit about diabetes, and it's not like I'm a non-diabetic imposing my false and out-dated ideas about how a diabetic person should live.

Beggin your pardon, but my non-specific family member might beg to differ with you.

My grandparents eat at the same time, take meds at the same time, test at the same time, share their numbers, and discuss how much insulin to take for a particular meal.

My husband and I do not test together and are fortunate if we eat one meal together a day. We rarely discuss diabetes or diabetes-related topics.

Sometimes, it's along the lines of "Your doctor's office left a message on the machine about your appointment tomorrow. You should listen to it."

"Oh really, what did they say?"

Hard look. "You should listen to it yourself."

I always quiz my folks when I think I can get away with it. "So Dad, how's your diabetes? Did you see that podiatrist you were talking about?"

Let's go back to the equation. If Consistent Behavior over Time equals Trust, is it then true that Consistent Bad Behavior over Time equals Mistrust? Perhaps so.

So, if (relative)thinks my behavior towards (relative) regarding diabetes is bad, and if I do that same (bad) behavior over time, it only builds mistrust. And that's not good for close family relationships.

And the equation might be true for your relationship with your physician, or with your CDE. Consistent Behavior over Time = Trust (or Mistrust).

After several years with my physician, for the most part, she trusts that I know what I'm doing with my diabetes management, because my consistent behavior, as measured by my HbA1cs, over years, has produced trust. This doesn't mean that she doesn't ask questions. She does. She makes herself available for help or adjustments if needed.

But I'm not giving up my family just because they may handle their diabetes differently than I do mine. Sometimes, you just have to trust. And sometimes, you have to be the one to trust first.

It feels sort of like walking out on a frozen pond. It's likely to be OK. It has been OK in the past. But I don't want it to break this time.

[I know, it's rambling and not as funny as the last post. I promise, I'll post any joke I can think of soon. Besides, some of you should write some diabetes jokes, too!]

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Wednesday, February 21, 2007

One D Joke

Lori and Allison are walking through the city. The pass a chocolate shop and Allison's handbag starts beeps loudly five times.

"What's that noise?" asks Lori.

"It's my new meter,"Allison replies. "You know how I am about gadgets. I just had to get the latest meter. It has a proximity alarm for things that are dangerous to PWDs. So it beeps when I'm too near high concentrations of sugar, fats, things like that."

They continue on down the street and pass a bakery. The meter beeps loudly 10 times. Lori is starting to get a little embarrassed by all this. The pass a fast food joint and the meter beeps loudly 10 times and adds a shrill siren at the end.

Finally they turn into the office building. The alarm goes crazy, super-loud beeps and sirens and klaxons, and verbal warnings to leave immediately. Allison nearly drops her bag. She looks around. "Gosh, I don't know what's wrong with it. There's not even a coffee shop or a newsstand selling mints in here."

Lori says, "Oh, didn't you notice the listings? This building has some new tenants: your health insurance company, a brand new pharmaceutical company, and the state republican party headquarters. "

(Okay, so it's bad, really really bad. I'm not George, what can I say?)

Monday, February 19, 2007

Diabetes Joke Challenge

Sometimes I have stereotypical ideas about the genders. I admit it. I do.

I think that women don't tell jokes, the traditional joke-joke, as well as men do. I think it's something about the way the brains are wired. Mine is wired for matching colors; his is wired for puns.

I can't even remember jokes. You know, all those why-did-the-chicken-cross-the-road jokes and semi-matching punchlines you've heard over your lifetime. I can't even repeat them, and most men I know could probably list off at least five on demand.

Still, when I come up with a great opener like "two diabetics walk into a bakery on a saturday night" I can't leave it alone.

I'm going to be working on at least five jokes along that theme.

I think the basic pattern goes like this:

Two PWDs walk into Piece of Cake on a Saturday night. George says, "Hey, Scott, we should probably test, so we can decide whether to get the sugar free cake or the real stuff."

[Insert punchline here.]


Scott and George walk into a bakery on a Saturday night. The gal behind the counter sees them and shakes her head. She points to the door and says, "You'll have to leave. We don't serve your kind in here."

Scott and George glance at each other and say, "It's okay, [insert punchline here]."

See, I'm so un-funny when it comes to jokes. Dr. Parts says we might have to hire a real writer.

But I think that George and Scott are funny dudes. They can probably come up with something. It might require editing the photos though.

So, George and Scott and any other funny writers, I want to see some "Two Diabetics Walk Into A Bakery" jokes. Please. Post 'em on your weblog. Email them to me and I can post them here, if they're nice and clean.

In the meantime, if you need some funnies, you can go here.

Sunday, February 18, 2007

I wish it were a joke.

Have you heard this one? Two diabetics walk into the bakery department on a saturday night....

Well, there goes all my credibility for advocating good health for persons with diabetes.
As I keep telling my Uncle Pesky, I do think that the central question of the disease and the lifestyle treatment for Type 2s is CHANGE. How do you change the habits of eating and activity that got you here? Perhaps, earlier in life, this Saturday night photo might have included an entire cake, rather than four pieces. Perhaps, earlier in life, this photo might have included a gallon of ice cream and some cookies, too.
Is it an improvement? Maybe.
Is it ideal? Gosh no. No way.
Is it real? Very real.
You should have seen Dr. Parts when I whipped out the camera and took the photo.
Maybe we should have a weekly check-out shot for the blog. Hmmmm. I might have to think about that one.

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Friday, February 16, 2007

The Central Question of Diabetes (type 2)

A letter from Uncle Pesky to me:
When we have a Dependency, or When we need to change something, or When we need some will-power.....I've been dwelling on that lately.

Re: Food. If it's around, I will usually sample. Once I start a meal, it's difficult for me to stop at the 'full' level. I love it, and I just keep on eating as long as I have some to eat.

OK, so we are programmed as "wee small chirren".It's generally accepted that we wont ever change what we are.That's what I've been dewlling on. Changing something really deep.

When I quit smoking, I quit cold Turkey.It took some time to think it out.I figured I had at least three Dependencies.The Emotional habit.The Psychological need.The Physical need.The Reach...a sort of a crossectional between Psychological need and Psychological Habit.The "Reward" feeling that calls for a smoke.The feeling that wants a smoke whenever nothing else is happening.Probably more that all that too.Those things can all be 'ignored' and a person eventually will no longer 'need' the Cigarettes.But all of those things are the surface symptoms of something deeper.

Food is different. Since we must have food everyday, we cannot ignore Food and just never touch it again, like we can Cigarettes.

So in order to beat the urge to eat, we need to reach way back into our Psyche.Somewhere back in those early days is the 'Program Bit' that calls for Food, whether we need it or not, and convinces us that we will just do it, and ignore all the warnings.Our 'evil twin' tells us it's OK.That 'evil twin' is a name we give to something we cannot understand and cannot seem to control.It's that 'thing' we cant see but it can sure reach out and control us, that I'm trying to locate.Moving away from food for a minute.Whatever this 'thing' is, it contributes to lazyness, fear, lack of interest, Depression and probably some Hyper activities as well.I tried to reach it with the 'quiet room' technique. (Pogo called it his Ponderin stump)It's amazing what that activity will help out with. But I never got far enough back in time with it.

When I got up from thinking (this happend once) I had a headache from the effort.I went to the medicine cabinet for some Asprin. When I looked in the mirror, my forhead, ears and cheeks were bright red. Flushed with blood.I guessed thinking was a lot rougher on me than I first thought it would be.
So what do you think about this, Lori?
Can we ever reach back into our early childhood and change that program bit?

A reply to Uncle Pesky:

I think you've hit on what is, in my opinion, one of the central issues of living with type 2 diabetes. I kinda call it the question of change.

Can we change? If so, what method is the best method for producing a change?

I view a diabetes diagnosis as a call to health, a call to change our habits of life to produce the greatest health we can in our physical bodies.

Part of that involves changing our eating habits: changing what foods we choose to eat and changing the amounts of food we choose to eat. There may also be some change of the timing of eating foods.

There are many people who advocate the cold turkey technique. Make a BIG change and make it at a specific time. No turning back.

There are many people who advocate the gradual implementation technique. Make several small changes at specific intervals. Give yourself time to adjust before moving on to the next necessary change.

I do think that it's possible to change that deeply programmed stuff, but I don't think it's easy. My mother's treats (mayonnaise cupcakes, thin pancakes, and waffles) will always call to me. (Oh, and the choco-nugget cookies. So good!)

I think different people use different methods to change that early childhood programming. Some call it re-parenting, where you imagine that you're your own parent, a loving, perfect, wise parent, with all of the life-lessons that the adult knows (instead of those well-meaning idiots who actually got to raise you and made all those mistakes). And you can tell your younger self some different things about eating, and satisfaction and love and worthiness.

Some might use hypnosis or subliminal techniques. Some would use adversion therapy, where you snap a rubber band on your wrist whenever you make a poor eating choice.

Something I sometimes try, especially at church picnics or giant buffets, is to take a sample or small portion of a few things I want to try. I don't heap the plate. I give myself permission to go back through the line several times, but I don't take large portions of any one thing. That's good for those of us who were taught to eat all of the food that we put on our own plate.

Other behavioral technigues might include eating more slowly. Putting the fork down on the table between bites is one example. I believe this is meant to retrain the brain-stomach connection, to let you feel when your stomach and appetite are full, rather than just continue eating automatically.

Hang in there. Keep on treating yourself well.

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Thursday, February 15, 2007


I went back to Pod #1 on Tuesday. Pod #1 doesn't necessarily agree with Pod #2 that I have Joplin's neuroma. I think he doesn't agree because my pain presents differently, without shooting pains down to the toe. (Did you know that bilateral foot pain is characteristic of diabetic neuropathy?) So, he shot me up with cortisone, in one foot only, just to see what happens.

Gosh. You know what steroids mean for a diabetic. Elevated BG levels. The day before V-day. Thanks, hot shot!

The foot doesn't really hurt, as some predicted when they heard I got a cortisone shot. It doesn't feel significantly better. It does feel...different.

Went to see the acupuncturist tonight. He's disdainful of the other (allopathic) pratitioners, although he tries to hide it with a veneer of politeness, sometimes. The feet feel pretty good right now.

Course, I had to read this article when the title included "eases foot pain". That is one approach I haven't tried, ever.

So, I'm testing every few hours, but the sugar levels seem about the same as usual for me. Hmm. Do you think Pod #1 might have slipped me a placebo? I don't really care if he did or didn't; it may be good for a diagnosis. But he better not bill for drugs if he gave me saline!

I know, the pain meds are making me a leeetle paranoid. No, no, I'm not trying the new approach.

I hope your Valentine's Day was very good. Dr. Parts took me out to dinner. It's a lovely local bar, all decked out in dusty rose velvet. One room is the bar & Oregon Lottery poker lounge. It is always full and always smoky. The other room is the dining room, with boothes and the pool table. It is nonsmoking and has been empty, save for us, both times earlier we ate there. On Valentine's day, we thought there'd be 4 or 6 other couples. No, only one other table was occupied.

I'm discouraged about the foot pain, but Acupuncturist is encouraging that his treatment is working to break down the scar tissue that may be affecting the nerves.

Talked with a woman today whose 16-y-o daughter has diabetes, bipolar, and, apparently, a nasty rash of teenage rebellion. Daughter has, apparently, Type 2. These kinds of talks make me glad that I have my own diabetes, and not that kid's diabetes & other stuff. I pray that kiddo gets a handle on her life and her disease.

On to the next holiday...

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Sunday, February 11, 2007

Saturday Excursion down the Gorge

Dr. Parts had itchy feet, which meant that we needed a day trip.

We took the new spiffy red car and drove to the Dalles. We ate at Cousin's Restaurant, sort of a brunch meal. We were driving to the Maryhill Museum, which I thought I had researched thoroughly at this site. I've lived in the northwest for many, many years and never visited it yet.

We thought we'd stop at the Stonehenge replica first. It was built as a memorial to the war dead of WW1, and they've continued with memorials for those who gave their lives in other wars. Here's the photo I got:

We walked down to Sam Hill's gravesite. Yes, we believe our Sam Hill, is the Sam Hill memorialized in the saying "what in the sam hill is going on?" and its variants.

We drove up to the museum and realized the critical piece of information that I had failed to glean from their website. They are closed until March 15. Curses.

We decided to travel the 10 miles north to Goldendale, since Dr. Parts and I had never been there. Along the way, we stopped at this scenic viewpoint:

Okay, I found it very amusing. The photo is of good solid Washington winter fog. (I was born in Washington state. I believe I can say this.) Nothing was visible beyond the trees there. As we drove on I-84, Dr. Parts spotted the herd of wild bighorn sheep which can sometimes be seen in the Gorge. He pulled over and got photos. We also spotted four or five bald eagles sitting in the trees along the water. (Four or five, because we think #5 was one that we had probably seen earlier in the day.)

We drove back to the Dalles, stopped at Celilo Falls, which for centuries was a traditional gathering spot for native peoples. They fished for salmon at the falls there and it was the center of a trading network. It's not the same since the dams.

We ate dinner/late lunch at Baldwin's Saloon in the Dalles. That was fabulous. I'm definitely going back there. Great fresh food. Quiet and beautiful atmosphere. Terrific servers. Yum, yum. We did not even look at the dessert menu. Good for us.

We stopped at the Gorge Discovery center at about 5:20 pm. The worker, noting that we only had about 40 minutes left, let us in without the standard admission fee, encouraging us to come back when we had more time. We did a walk-through. They've got a great museum. I loved the wild flower displays. Dr. Parts always goes for the geology. This museum also does a great job at having plenty of hands-on stuff for the kids to try and read and play with. It draws them in and helps them believe that museums are fun places. How cool.

We came home and slept. It was a good day. My feet were not terrible, although I was dismayed at how sore I was from the little amount of walking that I did.

Tuesday, February 06, 2007

Terrible Tuesday

I got to work, only ten minutes late, only to realize that I had taken none, yes, that's right, none of my meds. What a brilliant diabetic am I!

I had to call the acupuncturist to find out whether we had set our appointment on Wednesday or Thursday night. I had forgotten to record it. Silly me.

I'm developing a boil or something on my [unidentified body part]. I get these from time to time. They're bigger than a pimple, but seem smaller than a boil. I use the ointment called BoilEase, but they often get infected because I want to express them before they're ready. It's already infected, I believe, another great move for a person with diabetes. I recently learned, if I'm correct, that the technical term for this is cellulitis. ( I think Dr. Parts would send me to the doc to ask for antibiotics if he saw it. Don't tell him.) I'll keep an eye on it. It will likely heal in the next week or so.

Is that too much information to post in a blog? Too personal? Too much? Really? Well, you can be grateful that I have not posted a photograph for your review.

I left work a few hours early because Dr. Parts wanted me to meet him in Posh Suburb for Happy Hour to meet a coworker he thought I would like. Coworker was late. We ate too much food and drank waaay to much (expensive) booze. We talked about how foolish their (non-present) co-workers were in their political beliefs, which differ from ours.

We were meeting in Posh Suburb, because I had a knitting class to attend. I am learning to knit socks (see my other blog but don't stay there because it's about knitting, which among diabetics, may only be interesting to me and Monika, aka Monika). We were at the crucial technical aspect of the class, turning the heel, a portion of knitting that requires good vision, excellent counting skills, and paying attention. Did I mention that this is class number three of four, with several persons who I like and/or admire? And I show up rather tipsy. Terrific.

Well, I turned the heel, without having to tear anything out, and I picked up the several stitches that I dropped. They don't count if you pick them up again. Really.

Good thing that tomorrow is another day.

Dr. Parts got home safely. I got home safely. 'Course, after knitting class, I was much less tipsy. I went home and took my meds. And confessed all here.

And, although this post relates more to my personal foolishness and poor choices today, I exchanged emails with my diabetic uncle, which I thought would be a nice blogpost, that actually is diabetes-relevant and might be encouraging to others. Perhaps tomorrow. Second chances are a wonderful thing.

Tomorrow is another day.

Sunday, February 04, 2007

Allison & Joplin

I hate Allison. Well, not true. I don't hate Allison. I hate Allison's idea for the OC New Me challenge. Because I am waaay up on my weight numbers. I think they swapped out my diuretic (really, it's for the blood pressure, not for weight loss) and put in a fake one. My number this evening was 183.2 lbs. Curses.

However, I believe that Pod #2 has given us the correct diagnosis for the foot issue.

Apparently, I have Joplin's Neuroma. Or, as the scientists put it, perineural fibrosis of the proper digital nerve to the hallux. And I have it in both feet. So put 'bilateral' in front of that big long latin sounding phrase, and you have it. Also, you can substitute 'compression neuropathy' or 'entrapment neuropathy' for the phrase 'perinural fibrosis', and still be correct, I think.

Pod #2 injected lidocaine solution into each foot, specifically into the nerve she believed involved. She then had my try and trigger the foot pain. I squatted, resting all my weight and balancing on the balls and toes of my feet. (Hyper-extended? I don't know the correct term.) This would normally trigger severe pain within two or three minutes, which would then last for days.

The good news is: I think Pod #2 has nailed the diagnosis. Pod #2 also spoke very highly about Pod #1, so I can go back to Pod #1 for treatment options. Also, correct diagnosis allowed the acupuncturist to adjust his treatment, and the feet feel much better.

The bad news is: damage like this to the nerves is, apparently, very difficult to actually heal. Also the delay in correct diagnosis, may have allowed the fibrosis to progress. The fibrosis, scar tissue, can almost strangle the nerve. Also, there is very little information on this particular location of neuroma on the web; most information is about Morton's neuroma, which is further in between the toes. (And yes, I found this article, and this site, too. Great site, I must say, but not specific information about the Joplin's neuroma.)

So, treatment options: surgical removal of the neuroma. Also, alcohol injections to damage/calm/cauterize the nerve. (Couldn't they use Botox for this, I wonder?) They may adjust the orthotics further. I'll also ask if the medications should have any adjustment, now that we know the nature of the source of the pain.

I'm troubled by surgery and by the injections to damage the nerve. Although I'm very attracted to life without pain, and to regaining at least a normal activity level for a person my age (41), I'm deeply troubled by the idea of deliberately creating numbness in a diabetic foot. Wouldn't that just set me up for trouble in future years (hopefully 20 or so)? We shall see. We shall see.

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