I'm a retired advanced practice nurse who did most if not all of the diabetes education for the clinics where I worked before my retirement. I loved workin with my diabetic patients and even the non-compliant ones were a challenge for me and I loved getting that HA1C down. Even when the ADA said a HA1C of 7 was "good" I wanted my patients to do better and was always striving to get them to meet the goals we set.

The most challenging patient I ever had was a young man who was slightly "slow" and who had the highest HA1C I had ever seen, well above 14!!!! In six months--yes, six! His HA1C was down to 6! That is SIX! He was so faithful in following my teaching and never wavering that he accomplished what I thought was impossible. Yea for him, and yea for me!

My late husband was diagnosed with type II and he was another challenge for my motivational skills---because I never considered that I was anything but the Coach, and in fact, I used to tell my patients, "taking care of Diabetes is a do-it-yourself-care-plan, because the patient must be the one who does it and considers food, exercise and medication to all be "treatments" and the professional medical practitioner is simply the coach, teaching the team the rules. If you dont' know the rules you can't get on the field and play a good game, but the coach can't get out on the field and play the game. You are responsible for playing the game and treating your diabetes. The goal and reward is that you get to keep your eyesight, your legs and your heart working well!"

After my husband died suddenly in an aircraft crash here at our farm and airport six and a half years ago and I retired, I started gaining weight..."oh, it's only a pound or two, no big deal." That went on until recently I was feeling pretty bum and on a trip to my internist had her check my HA1C (I have a family history of Type II DM) and sure enough, it was "a tad high." My blood pressure, for years steady at a nice low 90/64 or there abouts, was starting to go up and my feet had begun to swell, so I knew "it was time" to get out of denial and get serious about takin care of myself and my health. To quit being the ultimate hypocrit and to get to work, taking care of myself.

I started checking my blood sugar four times a day for the first month. Yes, I know that isn't necessary to do it that frequently, but just to get a general ball-park-figure of what is going on, I did what I had advised my newly diagnosed patients to do. Plus, I wrote down every bite I ate and the time I ate it and saw how the blood glucose levels rose and fell accordingn to my intake and timing.

Instead of my usually poor timing of meals, I started eating three actual meals per day, with small snacks between meals and before bed. I measured every bite that went into my mouth, and literally became obscessive compulsive about the measurements. I also tracked my blood pressure as well.

I did daily weights and measured the circumfrence of my ankles and calves and checked for "pitting edema" (swelling that you can push on and leave a dent in the flesh after you remove your finger). I also set an exercise schedule and started to move my exercise up slowly from sedentary to more active, using my body and my blood sugars as a guide.

Within three months I had lost 21 pounds and my blood sugar had normalized and my blood pressure as well, and I only had to use the occasional lasix tablet when my sodium had been too high in order to control the edema (swelling) in my feet and legs.

Learning to cook again almost from scratch, since most foods that are processed or canned have added sodium in it, I had to plan ahead and shop more in order to cook a meal with lower sodium. I also learned to look for more frozen vegetables and fresh produce than processed foods. Unfortunately, I also learned that many low calorie items are also loaded with sodium and breads as well, so in addition to the decrease in calories in foods, I was having to eliminate or sharply curtail several of my favorite foods---low calorie salad dressings and cheeses are loaded with sodium. I also found that there was no room for cheating with the sodium, I could have an extra hundred or two of calories on a special day, but not increase the sodium without the edema going "waaaay up! "

Spices and herbs are wonderful substitutes for the high sodium that I had become addicted to from my youth. Sausage and ham, cheese and jerky, cornedbeef, hot dogs and bologna were all "no nos" now. After a while of decreasing the sodium content though, my tastebuds became accustomed to the lower sodium and more sensitive to the salt that was naturally in food.

Potassium Chloried in place of sodium chloride is acceptable to most diets in moderation. The key to just about anything, including diets is moderation. Not feeling deprived. I'm learning to be moderate in my habits and to get out on the field and play the game for myself now. Learning to quit being a hypocrit, and practicing what I preach to the best of my ability---and quit whining about it as well! Diabetes isn't the end of the world, but it will take control of my life if I don't take control of myself and take care of my health!

Views: 11

Tags: II, cooking, herbs, low, sodium, spices, type

Comment by Gerri on December 5, 2010 at 8:14pm
What an inspiring blog.
Comment by Ox Drover on December 5, 2010 at 9:06pm
Thanks, Gerri! I've been trying to "inspire" myself to live the life I know I should--and sometimes it is one of those things of "those who can do, and those who can't (or won't!) TEACH" I've seemed to always be a "great teacher" but have fallen down on the "doing" part, so now it is time for me to step up and stop being the hypocrit, and "do as I SAY." Laugh!
Comment by Gerri on December 5, 2010 at 10:51pm
Keep on doing it!
Comment by AngelaC on December 5, 2010 at 11:20pm
IMO, you're not a hypocrit -- just a human being who's learned "It ain't easy, bein' green"! It's a tough lesson for a lot of us to learn and you're not the first! Did you ever read June Biermann and Barbara Toohey's introductory books (for patients/consumers) on diabetes? I think the one I'm thinking of was published back in 1990 and goes under the title of (simply) "All Your Questions Answered". In it, they describe the results of an Australian study done back in the 1970, in which a group of nurses decided to act diabetic for 1 month. Just a mere 30 days, to see if they could do what they had told their patients to do. I think there were 30-some-odd participants. Guess how many finished the study? ONE. Yup, you read that right. ONLY ONE finished. Why? Because diabetes management is TOUGH. It takes a lot to manage this disease, more than people realize, and much more than many doctors encourage their patients to do. The only one who made it through that study had given up her life in order to finish the study -- no dates, no going out to dinner or ther movies, NOTHING. Just go to work, go home, go to bed. Eat the same meals every day. And they didn't have to worry about going low or going high, not to mention actually experiencing it. So, I wouldn't say you're a hypocrit. Not in the least!

BTW, welcome to this side of the fence :) The grass might not be greener over here, but at least it's not overly sweet!
Comment by Brian (bsc) on December 6, 2010 at 4:38am
One of the diabetes educators at my center spent a week last month on an MDI of saline, just so she would understand what it was like. I admire her for doing that. Your blog certainly gives us a view of your new found appreciation. I wish everyone could see so clearly.

Many of us approached our diagnosis with a vigor, that we were going to beat this thing. However over time, it can be a challenge to keep things up, lives are a marathon. Over the years, it can drag on you, burn you out, make you depressed. I envy your energy and hope you keep it up. I'd like to hear more of your journey. .
Comment by Frances on December 6, 2010 at 6:26am
Potassium chloride is potash. I've never heard of putting it on food.
Comment by Brian (bsc) on December 6, 2010 at 7:18am
Yes, potassium chloride is used a salt substitute like in NoSalt (http://www.amazon.com/gp/product/B000H185N6/).
Comment by Ox Drover on December 6, 2010 at 10:58am
I had a patient once I had to go from oral meds to insulin and he was terrified! He finally told me what he was terrified of, he thought the needle injection went through the skin on the belly into the intestines. I had to literally pull up my shirt and inject saline to show him it didn't hurt or piecre his abdomen!

The doing IS TOUGHER than the teaching LOL but at least I am not starting out totally having to learn everything from "scratch." Diabetes education is a big project and for patients especially those without a science background have to learn a lot and learn it fast! Unfortunately, many times the insurnace companies (or people without insurance) have a difficult time finding the information they need. With the internet which has come along since I started nursing is a wonderful resource.

What started me really getting interested in diabetes was years and years ago I worked as an advance practice nurse for a physician who chewed me out royally for spending so much time teaching patients, and told me I should just "they are too stupid to learn, give them more insulin and get them out of the office!" I was treating patients who had been his diabetic patients for years YEARS, and they knew nothing at all! Needless to say I left his employement and moved to another clinic, and a good many of the patients followed me to the new clinic.

What broke my heart though was one young woman who had been treated by him since age 14 and was so brittle, and ended up losing her eyesight and her kidneys, and though I lost touch with her now (I am sure she has probably passed away) that even though she and I were able to get her BG under control with frequent checks and insulin, the damage was already done. At age 30 after 16 years of this man's neglectful care it was too late to help much.

That lady was my reason for wanting to learn as much as I could about diabetes and to teach and coach my patients so that they would "know the rules" for taking care of their own health. It was up to them to do it, but it was up to me to make sure they knew how.

In my career I also found wonderful physicians who took time with their patients and taught them and worked with them, and there are some great new things out there for patients with Type I that help prevent some of the worst problems for the majority of patients. There are also great websites like this one to give knowledge and compassionate understanding to help motivate patients to do the best that they can.

With type II, I am well aware that the best "treatment" is my own compliance with a "healthy eating plan" and a "life style change." Not just to take care of the blood sugar problem, but the entire "Metabolic syndrome" situation, it is all connected.

BTW guys, thanks to everyone for the wonderful welcome! This is a great website!
Comment by DARGIRL on December 6, 2010 at 1:32pm
i am inspired by your story. I feel that diabetes educators are important people when trying to learn the crazieness of Diabetes. I congrulate you on your success. Great Job.
Comment by Ox Drover on December 6, 2010 at 9:18pm
Reading the blogs here has been an inspiration and has made me laugh and cry! Yesterday I was reading one where the woman had published a cook book called "I'm not a cook, but I know one" (or something on that order, I have CRS so have problems remembering things sometimes!) I'm having to learn to cook all over again and I feel like I no longer know how to cook! It's a challenge! Not only am I having to think about the portions of food, but the sodium content as well. I've cooked by "habit" for so long, quickly able to take something out of the cupboard or freezer and PRESTO! I have a great hearty and wonderfully flavorful southern meal on the table with a minimum of fuss or muss.

I quit frying a long time ago, so that wasn't a problem, but I have found that my favorite meals don't taste well without the salt so I am having to find new ways of preparing the foods, new recipies that work with a different kind of spice. I have to stop and think before I put a meal together---and half the time I don't have the right ingredients so have to put that on the grocery list. Since I live out of town, it is a "one trip to town a week" event. Plus, I have all these foods in the well stocked pantry that I'm too cheap to throw out but I can feed to my son and his friends, so have to separate them out from what I can eat! I feel like a stranger in my kitchen!

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