Monthly Archives: October 2016

The Wife's Tale

Let Me Overwhelm You

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x02a32If you’re like me, there are a lot of things that you’ve gone through life without studying. My knowledge of diabetes had come mostly from a couple peripheral acquaintances growing up who had type 1 diabetes (insulin shots, no candy), and an elderly cousin of my mother’s.

When Emerson came home with his diagnosis of prediabetes, I knew that as the chief cook and bottlewasher of this establishment I was going to quickly need to be much more knowledgeable, but oh, where to even start?

In retrospect, I was pretty lucky when we made the switch to low-fat eating almost two decades ago. Years earlier, my mother had researched and experimented during the nine years between my dad’s bypass surgery and his fatal heart attack, and she sent me her books. If I had questions, I called.

However, even getting started learning about prediabetes felt like studying oceanography – in the desert.

Our health-care provider offered a class with a Certified Diabetes Educator (CDE), which I immediately called to schedule. It’s an excellent idea, and I thank them very much, but at that time it was six weeks away and they didn’t understand why I would want to attend. I can’t imagine why I wouldn’t. Not only is eating a communal activity, but as I say, I’m the chief cook around here. I had to fight to be included in the session, but in the end I got a seat, too.

The real problem: that six-week time lag. Obviously, we’d need to do some eating before then, and it couldn’t be things like Emerson’s post-diagnosis lunch, which sent his blood glucose soaring above 180.

So, I started out with what I could do immediately, which was to begin reading.

quick_startMy first stop was Google, and my second was Amazon.com, where I ended up ordering two books: The Quick Start Guide to Pre-diabetes, a Kindle Single by Gretchen Scalpi that I ordered electronically for some immediate info, and Prediabetes for Dummies, by Dr. Alan L. Rubin, which I asked for in print form because I knew we’d need to share it.

The Scalpi book truly was a quick start on educating myself a little about pre-diabetes, and because I was so new to the whole thing – and more than a little freaked out by that point – I probably didn’t get as much from it as I might have. However, I felt truly ready to take on the world of low-carb eating – right until I stood in the pasta aisle at my supermarket trying to do a comparison between white and whole-wheat spaghetti pasta.

Truth be told, I am not a good shopper. However, in this case, I knew I was definitely in over my head. I folded my tent and headed home. I don’t remember what I made for dinner that night, but I’m sure I wasn’t happy about it.

Tech

A New Scale: Worth the Weight

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Prediabetes is life by the numbers, whether it’s A1C, glucose levels, body weight, nutrition or just about anything else you can measure in your daily routine. The quicker you deal with the data, the faster you’ll get at determining your progress with the condition.

If you have an aversion to numbers, I’ll be blunt: Get over it. Despite what you’ll often hear in health-plan commercials – usually with diet programs – you need to start counting from the first day you decided to tackle prediabetes.

People often see bad news in numbers, whether it’s in balancing the checkbook, figuring up tax returns, or estimating what’s needed to fund a full retirement (just don’t go there). If you avoid the totals, you avoid the negative.

Prediabetes goes by the numbers; the medical community will say, over and over, that there’s no almost or borderline with A1C. You’re prediabetic when you hit 5.7-6.5 on the scale.

You can work on that with two scales of your own. (You might even own one, although you might need an upgrade.) Neither measure your glucose levels – there are other devices for that – but both are key in changing those numbers for the better.

One is the standard body-weight scale, which is standard in most households for adorning the bathroom and often collecting dust.

The other is the kitchen scale, which is something you probably don’t have  … and will soon become the most-used appliance in your home. (I’m covering that in a separate blog.)

For decades, the bathroom scale was my tool of avoidance. My curiosity in my weight came up maybe once a year after the annual physical checkup; all I saw was bad news.

It’s not unusual behavior for anyone. Occasionally, there’ll be a New Year’s resolution on losing weight, or a scare when a like-aged friend or acquaintance drops dead of a heart attack or dies from a fast-moving cancer, and regular weigh-ins go for up to several months. Eventually, though, the scale goes into a corner or a cabinet and renews its dust-collection duties.

It’s one of the main points of this blog – and you’ll likely tire of it soon – is that losing weight is a byproduct, and not the goal, of treating prediabetes. Unfortunately, in our weight- and exercise-obsessed society, it’s the top item on the health scorecard, and you’ll be asked constantly by everyone you know (and that’s not an overstatement), so you’ll need to have some kind of answer.

My aversion to weight measurement kept me away from my own bathroom scale for the first three months of my prediabetes treatment. Clothes seemed to be loose-fitting and I didn’t grunt much when getting out of chairs, so I finally listened to my spouse and pulled out the scale.

In mid-August last year, I weighed 271 lbs. On Nov. 28, I weighed 242 lbs.

I suddenly got very interested in my weight.

Oddly enough, that massive (for me, anyway) change leads to my first recommendation on a body-weight scale: Unless you acquired your model in the past year or two, buy a new one. And make it digital.

After that first shocker in November, I started weighing in every Saturday morning. My analog scale proved to be a pain in trying to zero-out for each weigh, and the weekly weight loss made me suspicious of accuracy. A new digital scale confirmed the downward count, but seeing exact weights to the tenth-of-a-pound gave me a more-realistic view of my progress.

250_digital_scale
Weight Watchers WW401GD

I’ll admit that I took the easy route and bought my scale at Costco. The Weight Watchers WW401GD has performed flawlessly for the past six months and, outside of telling me the unfortunate truth about gaining a pound this summer, is a weekly source of good news.

Weight Watchers lists this for a $39.95 MSRP, and I got it for half of that at Costco. Amazon.com will sell it to you for $17.95.

To be honest, I don’t recommend this particular model; it’s certainly worked for me, but it’s not the easiest to find, and Amazon’s own stock is limited. For the budget-minded, there are dozens of models priced at $25 or less at Amazon, Walmart or your nearest low-priced outlet.

The price goes up for scales with more functions. You can pay $150 for units that connect to smartphones via Bluetooth, send data via wi-fi, and analyze all sorts of items, including bone density and water weight. There’s a detailed comparison this month in PC Magazine.

Even for a gadget geek like me, the scales often seem like technology gone amok. (My pick for strangest feature goes to the scale that doesn’t show weights to pregnant women, but sends data via the Internet to their doctors.) Many of the high-tech devices also use impedance measurement via electrical impulses, which is pain-free and healthy – except for pregnant women and people with pacemakers, where the results can be really heart-stopping in shock value.

And, for all the hookups with your mobile devices, you don’t get linking with diabetes-specific apps such as logbooks. (You’ll find this happens with a host of other devices, including glucose meters and fitness trackers.) You’ll still need to enter the numbers yourself, which brings you right back to a $25 model being good enough.

Again, weight’s not the main target in dealing with prediabetes, but dropping some pounds is better for your overall health and the one visible sign to others that you’re making progress. It’s worth the effort to give it an accurate value.

Medical

I Got Prediabetes from My Doctor’s Vacation

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It’s a great tabloid headline, mainly because it plays fast and loose with the truth. The kernel of fact in it, though, shows the danger of being prediabetic – and having no clue.

The vacation part is true; my physician (who’ll remain nameless, mainly to spare embarrassment) went away for a few weeks last August at the time I called in for an annual checkup. I asked the office if I could get blood work done in the meantime, so I’d be ready as soon as the doctor returned.

As noted in my Welcome, I wasn’t the picture of health at that point. Overweight? Yep. And, well, I was sure I could be better overall, but I wasn’t losing any other body functions. My main concern was the PSA screening, since both of my older brothers went through bouts of prostate cancer.

My family’s health history showed a few other warning signs – high blood pressure and colon cancer – but nothing pointing to diabetes. My doctor ran lipid panels on my blood, but nothing on glucose.

Last August, the test lineup changed as another physician in the office OK’d a full workup, including A1C and fasting glucose. I didn’t know that at the time; the only difference came with the nice lab attendant taking another vial of blood. (I only saw that as I left; I can’t stand the sight of the draw.)

Two weeks later, I went in for my office visit with my regular physician. After discussing my weight – a regular part of my annual visit – we got to the matter of the blood tests. The doc didn’t mince words; my numbers showed that I was prediabetic.

Looking back, I can see that the physician put it a bit too kindly. With a 6.6 A1C, I crossed the line into diabetes territory. My doc counseled that we could get that number down, depending on how I serious I wanted to get on treatment.

I don’t like anyone to get rosy about health, and mine in particular. I’ve always said that when it gets time to get the bad news, I wanted it straight, as in “how long have I got, doc?”

This wasn’t the ticket to the Big Adios, but diabetes didn’t seem like anything that needed a half-hearted approach. “Ok,” I said, “what’s serious?”

The light approach, according to the physician, would be to watch diet and weight and see if I could reduce the numbers. Going serious would mean daily glucose monitoring, daily medication and some hard work on diet and exercise. My medical plan also offered a class with a dietician to educate me on my diet.

“Then let’s go serious,” I said. “When do we start?”

“Today. I’ll send the orders to the pharmacy. And good luck.”

With that, I walked out of the office, a new entry in the growing crowd of millions nationwide suffering from a diabetic condition.  Outside of some literature, a scrip and a phone number for a dietician, I had little clue on how to proceed.

Actually, I didn’t feel like I was suffering anything … but that’s the problem with prediabetes. The only thing I could credit for the diagnosis was my doc choosing late August to get out of town.

The Wife's Tale

Prediabetes: The First Ton of Bricks

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dietaryLife is full of memorable days. And, if you’re reading this, you’ve probably experienced the same sort of memorable day my husband, Emerson, and I went through more than a year ago. My name is K. Schipper, and I certainly wasn’t thinking of anything quite as upending to our lives as prediabetes when he headed out the door for his annual checkup.

Sure, I’d had my concerns, especially in my more pragmatic moments when I’d think about the fact that the man I’ve been married to for more than 30 years, was not only obese, but much-less-prone to exercising than I am. The fact that his systolic blood pressure was sitting in the 130-140 range has also stirred that little nagging voice in the back of my mind.

We do know about blood pressure. Nineteen years ago, I had my own memorable day with my doctor. My systolic blood pressure was at 160, my total cholesterol almost 300. I was surprised then, too, and I’m not sure why, since heart disease killed my father at 50, and every woman in both sides of my family has medicated for high blood pressure starting around the age of 40.

Home I went, and we overhauled both the pantry and what we were eating. We lost weight. And, with the medication my numbers went back to where my doctor was much happier with me.

If anything, I was expecting Emerson to come home with a prescription for something to lower his blood pressure and a suggestion to exercise a bit more. So, when he gave me a brief call to say he was coming home with medication, and it wasn’t for blood pressure, I was concerned. However, I also needed him to pick up some vegetables for the salad I was making as our main entre of the day, so I knew he’d come home and explain – eventually.

When he did come through the door, groceries in one sack, a glucose meter and a bottle of Metformin in the other, and a diagnosis of prediabetes, I had only the smallest inkling of what was to come.

Probably the contents of the grocery sack epitomized our problem. Although my request had been for a large zucchini, a red pepper and an onion, the recipe I was planning to make also included spaghetti pasta – white, of course – and as always, I figured the two of us would split a bagel or I’d warm up some dinner rolls – white again – to go with it. And, he had also considerately brought home a package of day-old, reduced-price brownies from the store’s bakery.

Yes, while I can congratulate myself in taking a great deal of fat and cholesterol out of our diet, we had replaced it with carbohydrates, and now those were going to have to be changed, replaced, closely monitored and always with that meter to tell us how we were doing.

To say I was a little out of my comfort zone isn’t the half of it.

About

Welcome

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x02d24There’s not much to look at with this website, and I don’t know how you managed to get here, but thanks for turning up. Right now, this post is just about all you’ll see for a bit.

My name is Emerson Schwartzkopf. And the reason I’m here is because I’m prediabetic. If you’ve arrived here, changes are good that you’re prediabectic, too.

This isn’t a new 12-step program, or a pitch  for some whippy new diet or medicine or vitamin tablet. I’m here to share my journey — my prediabetic trek — in the past 14 months.

Since August 2015, my A1C dropped from 6.6 — past the line that moves you into full-blown diabetes — to 5.7, and almost out of the prediabetic range. My fasting glucose went from 109 mg/dl to 96 mg/dl.

In August 2015, my blood pressure rang in at 134/76, with a pulse rate of 64. A year later, my check-up showed a BP of 109/55 and a pulse rate of 54.

And, yeah, my weight. Fully clothed, I tipped 271 lbs on the clinic scale with a 5′ 8 1/2″frame and body mass index (BMI) of 40.6. A year later? Try 207 lbs with a BMI of 31. That’s still obese on all the health charts, but a  drop of 64 lbs in one year.

What I’ve probably picked up is your full attention, with the question of how did he do that? It’s a long story — it’s why I’m going to do this website — but I’ll tell you what I didn’t do:

I didn’t get bariatric surgery.
I didn’t go to a health spa.
I didn’t join a gym.
I didn’t hire a personal trainer.
I didn’t buy any exercise equipment.
I didn’t run 10 miles a day. I didn’t even jog 20 steps in one year.
I didn’t fast (except before blood tests at the clinic).
I didn’t go into induced comas and take all nutrition via IVs.
I didn’t go on Whole30, or Paleo, or gluten-free, or any publicized diet plan.
I didn’t join a weight-monitoring group.
I didn’t join a delivered-food plan.

There’s no miracle here. I did a bunch of very simple things that just about anyone, anywhere, anytime can try for themselves.  However, don’t mistake simple for easy. And don’t think all of it is a joy. (Oh, man, do I miss Red Velvet cake. Man, oh man, do I miss it.)

I’ll be writing blog posts in the coming weeks to flesh this out a bit, and then go into more detail. What I did may not work for you. Maybe you can adapt and improve. Maybe you’ll get going in a different direction and find success in dealing with prediabetes. Whatever works is OK.

The point of all this is that I don’t see a lot written on how an everday, ordinary person can deal with prediabetes, save for a lot of non-specific lists vetted to mundane deaths by lawyers.

I’ll be back. I hope you’ll return soon.