Stay Hungry

Bit of catching up is in order.

First off, the boy’s leg is cast-free. He’s limping around on a leg that doctors assure us is doing fine – but I’m still waiting to see him run around like the wild little boy he deserves to be. He needs to do more and being cooped up with his family isn’t doing him a lot of good. He comes from an indoor-kid family, so I suppose it’s a bit much to expect him to turn into an extreme athlete – but I want him outside and throwing things. Soon.

Following December’s developments, I’ve necessarily plunged into the habits of a person with type II diabetes. I test my blood sugar with a meter that is astoundingly easy to use (the Freestyle Freedom Lite).

As a UI snob, I can attest to the quality of its workflow:

1. Add needle
2. Insert test strip
3. Stick finger
4. Apply blood to test strip
5. Pitch needle and test strip

Everything else is done by the machine.

Notice there were no steps to turn on and turn off the machine. Someone was thinking.

Not that I think this meter is particularly special, mainly I’m just impressed at how not an issue this process is.

The quibbles I have are fairly minor. The needle tool resembles a vending machine toy in quality of manufacture. The side seams look as if they are about to separate at any moment. The depth setting changes each time I get it out of the kit – so it’s always a double check to make sure it hasn’t dialed up to 4 (maximum needle depth) when 1 or 2 is sufficient for my office worker hands.

I don’t expect they put a lot of work into the needle tool – after all, they give these things away – and the bulk of their work goes into the meter. You break the needle tool and they’ll give you another for free. Everyone knows they make their money on the test strips.

The test strips are about 1 to 2 bucks a pop (pre-insurance). As you’ll be using them multiple times a day for the rest of your life, the meter manufacturers figure they can spot you the start up gear for free - many times over.

The strips degrade in open air so you get them in a sealed container. A single, sealed container – which would be another quibble I have. You buy a month’s worth of strips at a time. If you biff it when you pop the lid open - you could dump over a hundred bucks worth of product all over the floor of whatever public bathroom you happen to be in.

They should have a better dispenser – one that spits out one at a time – or (more simply) provide them in multiple containers so you put less of them at risk at any one time.

But overall, the easiest adjustment I’ve had to make – by far.

The more dramatic changes have obviously been with food. Quality and quantity.

Quantity I view as the easier of the two. At least at first. It would be very hard to continue eating the amounts I had been eating before. Breakfast amounted to two meals. Lunch was at least a meal and a half. Dinner was two meals, plus something afterwards before bed.

Laughable, all of it - but only in hindsight. At the time it was like, I feel like eating - I'll eat. Diabetes is particularly insidious as it has a number of effects that make you hungry. Your food becomes fuel, but your body isn't delivering the fuel efficiently. So your muscles and other cells tell your body they need more fuel.

So you feel hungry. And eat more. Which makes your body store the extra fuel as fat. More body fat makes your body's insulin function less effectively - leading to poorer use of the fuel you eat.  Poor use of fuel leads to cells demanding more energy, so you feel hungry, and off we go again.

Diabetes can lead to depression and fatigue, all of which play into doing less and eating more. Which is exactly the opposite of what a person with diabetes should be doing.

Any wonder why there are over 20 million cases in the US alone? Cripes, who designed this damn disease anyway?

So, I'm cutting back on portions. They are visible and tangible. I like to think I'm doing a lot better on this.

Food quality is a bit more mercurial. I need to know what's in the food I eat. Sometimes you have no idea - somebody else made it, I can't find an equivalent breakdown online.

So you go to classes where they break down what food is made of what.  

Carbohydrates, gotta watch the carbs.

I'm given a guideline on how much of them I should have over the course of the day.

Then you have to read serving sizes and count grams. Naturally cereal has different serving sizes because they vary by weight. One cereal is 1 cup per serving, the next is 3/4 a cup, the next 1/2 cup. Apples to apples requires math and then you have to set and remember a visual benchmark about how big a cup looks in a given container.

3oz is a standard serving size they want you to track on. About the size of a pack of playing cards. Depending on density. Blah, blah, blah...

I've opted to start with the basics. Half my plate should be veg, 1/4 carbs, 1/4 protein. Easier to remember, easier to visualize.

So long as I keep myself to a single plate. I'm sure to be better off than I was. I'll refine with math once I can sustain a sane eating pattern.

Plus, I get meds. Metformin once a day. I've had to renew a pill perscription for the first time in my life. Bleah.

Over and above that is activity level. I've fallen off the running wagon, but have every intention of getting back out there. In the meantime, I spend about a half an hour each weekday legging it around the concourse like a speedwalking senior.

I'm walking in a circle so I can live longer.

But that's the honest truth. Life expectancies for the average Type II diabetic are well short of where I want to be. Being diagnosed at my age means I will have to behave myself for decades. Have to start now and keep it up - there is no other option.

I am not losing limbs to this bullsh!t.

Early results have been encouraging. But I would think they would be at my age. My blood sugar's averaging around 118 these days, and I'm down more than a few pounds. It is depressing in the extreme to think I will have to become a scale addict. "What do I weigh?" But the reality is I need to know that I'm trending in the right direction. My dietician gave me numbers to hit and I need to believe I can hit them.

Insulin is produced by beta cells in the pancreas - and they always degrade over time. What I have now is the most I will ever have - and I can't afford to burn them up like I've been doing.

Which leads to a total rewrite of how I've looked at food. I've of course known what eating healthy required - but I've never regarded food with fear before.

A coworker of mine offered me a peanut butter bar the other day and I reflexively accepted it. Then I took it home and threw it away. Pre-diagnosis, I would have eaten it before I left their desk, and perhaps asked for another.

Now, I find myself glaring at the frustrating omnipresence of baked goods at work. Chocolates and snacks, everywhere. Every business sells food these days - and none of it is on the happy list.

My sister in law told me once that you never forget the first time your body lets you down - and sometime in the future my pancreas and I are going to have some serious words. But for now I've got to baby it, every day, for the rest of my damn life.

Jen tells me plenty of people find themselves living healthier with diabetes than they ever did without it. I suppose that makes a bit of sense. The feedback on a day of pre-diagnosis overindulgence would take years. At that rate, you'd never connect the dots.

Post diagnosis, I find out within hours when I've strayed from the true faith. We had a baking contest at work and I had two small slices of pie. My blood sugar was stratospheric three hours later. What's bad for me hasn't changed - but now I get graded one or two times a day.

Feedback on that timetable can occupy a conscious thought. A thought you can draw on when you're staring at a coffin-sized display of snacks at the gas station. 

And until my body magically adjusts to the new regime, I will have to get used to wanting things I can't have- or wanting more and not getting it.