Safe House

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They couldn’t keep the homeless out of the old house. They weren’t really the homeless, but the hobos. Those who were homeless on purpose. They seemed to like to congregate in the old house for a night, a few days, a year. No one seemed to know why the hobos were determined to squat in the old house, but they knew they weren’t inclined to leave.

Her husband was selling the house and property. She wasn’t in favor of the sale. It was all she had of her family’s legacy to her. They argued about it, but he wanted to sell it to a buyer who would renovate it. She wanted to renovate it herself, but that seemed out of the question. He wasn’t having much luck.

The hobos wondered who left the food every morning. It was there when they awakened. A veritable feast. Why would they leave the old house when they had manna from heaven? A man kept bringing people to see the house and they had to scatter. They left the house in poor condition, hoping no one would buy it.

That was why she did it and it was working.

Photo Credit C.E. Ayr

 

Recipes for my Appalachian Readers: A Dilemma

I want to post a good recipe for all my Appalachian readers today. But, I have a dilemma and I guess I’m going to have to write a heartfelt blog post and make a confession before I can do anything. It’s hard for me to post the recipes handed down from my family from Appalachia right now..and probably in the future. Why? Twenty years ago, I was diagnosed with diabetes. I know many of you feel my pain as you are also diabetic. The prevalence of this disease is high, particularly in Appalachia. Don’t let anyone tell you it is just a function of your weight. I weighed 110 pounds. It is also a function of heredity. The Appalachia side of my family was riddled with it.

I am an insulin-dependent diabetic and have fought this disease one way or another for 20 years but until recently, I never fought it the right way. After my diagnosis and after beginning to take insulin, I gradually started to gain weight. I never gained an excessive amount of weight but it was excessive to me and it certainly did not help diabetes. The more weight I gained, the higher my blood sugar went and the higher my insulin requirements climbed. The higher my insulin requirements climbed, the hungrier I got.

In February of this year, I decided the madness had to stop. I had studied food and nutrition for diabetics. I essentially designed my own diet because the diets given to me by dietitians associated with my diabetes doctor were not working. On March 1, I started the diet I designed. I’m not going to discuss the details of the diet because each person is different and it might not work for you.

The diet did, however, work for me. I’ve lost almost 30 pounds and that is almost as much as I needed to lose. I no longer have to take any daytime insulin and my nighttime insulin has been cut by more than half. I don’t even crave the foods I used to eat.

Why am I telling you all this? Because most of the recipes from the old folks that I would post for you are terribly unhealthy. Delicious but not so healthy. I would like to help the people of Appalachia, not hurt them. So, I want to make a deal with you. Around the holidays, I will post the old recipes. Otherwise, I’m going to post a “lightened up” version of some of the old recipes that you may like just as well. If you are diabetic yourself, they are a lot more diabetes friendly. Deal?

My first “lightened up” recipe will be for cole slaw. #amwriting #blogging #diabetes #Appalachia

 

My Life with Diabetes

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There. I said it. Diabetes. Twenty years ago, I was diagnosed with diabetes. I have almost said it in a couple of blog posts, but never quite got up the nerve. I alluded to it in my posts on Healthy Eating and Orthorexia because I am always on a diet. Sometimes, a diabetic diet. Right now, both a diabetic and weight loss diet. Since I know many people can relate to this story, here goes.

When I was diagnosed with diabetes 20 years ago, I weighed 110 pounds. There is a misconception, I think, that you have to be overweight to develop diabetes. That is not true. I have diabetes on both sides of my family. Most of my aunts and uncles have diabetes and some of my cousins. The genetic cards were stacked against me. I remember coming home after the doctor gave me this news and announcing that diabetes was not going to change my life. I think back to that now and laugh. Maybe grimace is a better word.

I tried to control my blood sugar, at first, with diet and exercise. That is usually how doctors like to proceed. It very quickly became obvious that I needed more than diet and exercise. My elliptical and a strict diet just weren’t working. Diet for a diabetic, back then, meant no sweets and perhaps the old diabetic exchange system. Not much more. I went back to the doctor.

Next, we tried diet, exercise, and the drug metformin. The maximum dose. Metformin is a drug with a number of uses, but at this time, it was used primarily for lowering blood sugar in Type II diabetics. The beauty of metformin is that it also helps prevent negative cardiovascular events from occurring in Type II diabetics. We are at risk for heart events just by virtue of the fact we have Type II diabetes. Again, I stuck to my diet, rode the elliptical like a fiend, and took my metformin. My blood sugar did not come down. I felt like I would have to exercise on the elliptical for two hours after meals to make even a dent in my blood sugar.

Again, I returned to my primary care doctor. He decided that my particular case of diabetes was beyond his expertise and sent me to an endocrinologist. Endocrinologists specialize in diseases of the metabolic system such as diabetes and thyroid disorders. The endocrinologist was suspicious that maybe I did not have Type II diabetes after all. Maybe I had adult-onset juvenile diabetes or Type I diabetes. He did some tests for antibodies that indicate the presence of Type I diabetes, but they were negative. I had Type II diabetes, but I had very hard to control, brittle diabetes. The fear was that my high blood sugar was going to start causing damage to organs in my body so there was nothing to do but start on insulin, along with metformin and, of course, diet and exercise. By this time, most doctors were at least having their diabetic patients visit a dietician but except add “portion control” to the no sweets advice, not much had changed.

Type I diabetes occurs when the pancreas does not produce insulin and occurs primarily in children. It requires immediate insulin therapy. Type II diabetes is often seen in people who have insulin resistance. Their pancreas still produces insulin but, for whatever reason, their body cannot use it. In my case, I had been diagnosed as a Type II diabetic, which was the correct diagnosis, but I produced almost no insulin. It took several years before this was recognized by my doctors. When a Type II diabetic has to begin using insulin, they are then classified as a Type I diabetic.

Back in those days, insulin was still administered with a syringe and a vial of the drug. Those shots weren’t fun, but they did start to bring down my high blood sugar. My doctor specified the dose and it was very hard to get it right. Sometimes, the insulin was too little and my blood sugar would still go too high. The scarier times were nights, when my blood sugar went too low and I would wake in the middle of the night shaking, sweating, and have to stumble to the refrigerator to get a quick glass of orange juice to bring my blood sugar up. It often went too low at night.

I was still working during all those years. In fact, I worked for 15 more years as a college professor after I was diagnosed with diabetes. There were days when I felt good, like myself. There were other days where the fatigue, a side effect of diabetes, made going to the office almost more than I could do. I’m sure I would have taught longer had diabetes not struck. I am still working now as a writer, but I am retired from teaching.

Life got a little better regarding diabetes when the insulin delivery system changed from the traditional needle to a punch needle system. About the same time, carbohydrate counting became an option for controlling blood sugar and it seemed to suit my needs. You simply count the carbs you eat at each meal and take the appropriate amount of insulin for that amount of carbs, based on a formula supplied by your doctor. I was able to control my blood sugar better than ever as indicated by my A1c readings, around 7.0, along with my home monitor readings. Doctors were finally recognizing that “sweets” were just one carbohydrate and that all carbohydrates raised blood sugar. My endocrinologist was pleased.

Taking insulin is a mixed blessing. It saves a diabetic’s life. But, it makes you hungry. Diabetics have to watch what they eat, and how much, very carefully. Insulin, and the resulting hunger, cause weight gain and I gained some weight which caused poor blood sugar control once again. Taking insulin is a vicious circle. At this point in my life with diabetes, I was taking up to 90 units of Novolog insulin during the day and 60 units of Lantus insulin at night, along with a fairly new drug called Janumet. As any diabetic or doctor who is reading this knows, that is a lot of insulin. Janumet is a combination of metformin and sitagliptin. Sitagliptin is a bit more dangerous than metformin. It is more likely to cause low blood sugar and other side effects. It increases the amount of insulin a diabetic produces and decreases the amount of sugar produced by the liver. I knew I had to do something. I just wasn’t sure what and neither was my doctor. All that I knew was that I wanted to have a life. A normal, active life.

By this time, low carbohydrate diets had become popular. I did a lot of my own research, talked to my doctor, and decided to go on a low-carb diet to see if I could lose the extra weight I had gained and, as a result, lower my insulin requirements. That’s where you find this writer today. I am happy to report that it seems that a low-carb diet is working for me. My blood sugar control is the best it has been in 20 years. My weight is dropping and I am optimistic I can get to my goal. It isn’t far away now! I don’t even crave carbohydrate-rich foods any more. I live on lean protein and salad. I feel the best I have felt in many years and can, once again, have a normal life. When I reach my goal weight, I will allow myself some carbohydrates here and there, but not many. I have worked too hard for the success I’m enjoying. I’m not able to exercise much yet. Insulin makes that difficult, but since I take much less than I used to, I hope exercise is in my future.

The change in my insulin dose is remarkable. Most days, I take no daytime insulin at all. I don’t need it anymore. I still take 55 units of Lantus insulin at night. Since I don’t produce insulin myself, I will always need a maintenance dose at night. I also still take Janumet though that could change.

It wasn’t particularly easy to write this account of my struggle with diabetes. It’s very personal. I thought it would be cathartic for me and perhaps helpful to some of you. Helpful because you will know you aren’t alone. Helpful because maybe it gives you a place to start. But, don’t start anywhere until you talk to your doctor. Your mileage may vary though I would encourage you to do research on your own. Don’t be a victim of this terrible disease. Take charge of your diabetes. Don’t let it take charge of you. It works silently and will damage your heart, eyes, nerves, kidneys, blood vessels, and much more. Work with your doctor and find out what works for you. You will feel so much better and be able to live a long, happy life!

A great blog on Type II diabetes is Diabesity

I’ll keep you posted.

*Image by Stuart Miles FreeDigitalPhotos.net

 

 

Eating Disorders: Orthorexia

Eating disorders. This isn’t really about eating disorders but everything you read about something called “orthorexia” will make you think you are reading about an eating disorder. As I was doing some research for this article, I originally thought I really had a bone to pick with this guy by the name of Steven Bratman. OK, Dr. Steven Bratman, which doesn’t impress me all that much given that he coined the term orthorexia. I did more research, I decided that his original article had been taken completely out of context in most everything that has been written about orthorexia since so maybe he wasn’t such a bad guy after all.

After all, even though he is an American Medical Association (AMA) qualified physician, he practices some forms of alternative medicine and he lived in a commune in the 1970s. He can’t be all bad, can he?

Back to orthorexia. We have the legitimate eating disorders such as anorexia and bulimia and a handful of other full-fledged eating disorders. If our society keeps putting pressure on our young women, there surely may be new varieties of eating disorders spring up. Orthorexia, as defined by Dr. Bratman, refers to a fixation on eating the proper food. (I can envision all my friends standing up, pointing their fingers at me, but they have surely forgotten about my love for tequila.) To continue, Bratman actually called it orthorexia nervosa, similar to anorexia nervous.

Anorexia and bulimia both focus on the quantity of food a person eats. Orthorexia focuses on the quality of the food. Bratman originally defined this eating disorder as one where a person may avoid all preservatives, fat, meat, and processed food. Orthorexics are vegetarians in that they do not eat dairy, eggs, or even fish. When Bratman considered himself to be orthorexic, he said he looked down on all his friends in the commune who didn’t eat exactly as he did and felt they were lesser human beings for their sins of eating foods such as meat or dairy or foods that were processed. Perhaps the most disturbing thing is this. Part of Bratman’s diet was to never fill his stomach more than half full when he ate a meal. He was never satisfied after eating.

No wonder he decided this was an eating disorder. The way Bratman handled so-called “healthy eating” wasn’t very healthy.

To say Bratman went overboard with his so-called healthy eating is an understatement. It was definitely not healthy mentally for him and it probably was not healthy physically. There was no mention of Bratman’s weight in his article so we don’t know if his eating habits caused him to lose an excessive amount of weight.

Bratman believed in using food as medicine when he started out on his health food journey. Unfortunately, he took it too far. In the years since he wrote his article in 1997, the medical community has learned that there are illnesses that do respond to changes in the diet. The term “health food” is not really used anymore. It has probably been replaced by organic food along with just the knowledge that items like processed food and too much red meat are not particularly good for us.

AMA-qualified doctors seldom address nutrition with their patients unless it is in the context of illnesses like lowering cholesterol. Then, they might tell you to lower your consumption of red meat. If you have high triglycerides, they will tell you to lower your consumption of sweets or carbohydrates. For a disease like diabetes, diet is definitely addressed. For a normal, healthy adult, however, nutrition is not something you usually are lucky enough to discuss with your family doctor. You have to seek out a dietician or even a doctor who specializes in alternative medicine, perhaps a nutritionist.

I have read other articles that mention orthorexia. The examples they give of individuals that have this particular eating disorder are usually also suffering from some form of obsessive-compulsive behavior or other Risk factors. There is nothing wrong with healthy eating. But, there is something wrong with anything you do if you do it in excess. A wise saying that all of us has heard. Everything in moderation. Take a look at this helpful infographic.

Bratman, Steven. Health Food Junkie. Yoga Journal 1997; September/October:42-50.

 

 

 

Healthy Eating…..Eating to Live

Eating to live, not living to eat. That’s a tough one for the American people. We have access to so much good-tasting food. Good-tasting food that, for some, may be killing us. Before I start this article, let me say that I live in a glass house. I am as guilty of enjoying all that good tasting, but unhealthy, food as the next person. So I am not throwing stones. For health reasons, I have had to try to mend my ways. I have been partially, only partially, successful. But, I am learning a lot on this journey toward improved health that I would like to share with you.

I am what is called a flexitarian. Never heard of it? Neither had I. I eat vegetables, and lots of them, and fish. Mostly seafood but some fresh water fish. I occasionally eat a chicken breast and I am done with red meat entirely. I do eat eggs. This all apparently makes me…..well…..a flexitarian which is similar to a lacto-ovo-vegetarian. But who cares about the designation?

I eat to live and wish I could take a pill instead of eating food. It would be a whole lot easier. In order to remain healthy and see those good blood work results, I eat virtually no bread products. You know how whole grain is supposed to be so good for you? Ha! Not for me. Now, as for you, your mileage may vary. Remember that bread products include potato chips (how I love salt and vinegar chips, but I have to forget them!), crackers, croissants, and so many wonderful goodies. But, we aren’t hunter-gathers anymore, people. We don’t need all the bread.

Staying with the carbohydrate theme, I eat no potato products except a baked sweet potato about every three weeks. It is really GOOD when I eat one, but it is a rare treat. I think you see what I am getting at. No white carbs. None. That includes pasta. I don’t even eat whole grain pasta and, like the rest of the world, I think a good pasta salad is to die for.

All of my carbs come in the form of vegetables, mostly salad vegetables. I do eat fruit occasionally but only low-glycemic fruit — an apple, blueberries, melon, kiwi. That is pretty much the complete list. Beans are good for you with black beans being at the top of the list. They have too many carbs for me so they aren’t on my list.

As far as my very limited meat consumption is concerned, I eat lots of fish. Salmon, tuna, shrimp, just about all seafood. A chicken breast. Small servings. I try to eat meat full of Omega-3’s.

That pretty much sums up my diet. I feel very well, better than I have felt in years. I have lost weight. I’m starting to look like “me” again and feel like me. One thing I have learned is that heavy carbohydrates in my diet, white carbs, weigh me down and make me sluggish. They also make my doctor crazy as they make my blood tests crazy. You can keep some fat in your diet if you cut the carbs.

One thing I do is take vitamins and a whole host of supplements. But, that is fodder for another blog post. I have a friend who calls all the strange little supplements her “dirt” vitamins. They work.

Your mileage may vary depending on your health challenges. Check with your doctor before starting any diet. My doctor is extremely supportive and believes that we all eat far too many carbs, herself included.

This is a weight-loss diet. Extremely low carbohydrate and 1200 calories per day. When I reach my goal weight, I will add back in some foods but I will never be able to eat a diet high in carbohydrates again. On a maintenance diet, I can increase my calories a bit. I can’t wait until I can eat a bowl of spaghetti!

Is eating this type of diet boring? You bet it is. But maybe I will live long and prosper!