I have not abandoned this blog, despite the lack of a new post since April. (Forthcoming case in point, no sooner did I write that one line on June 4th when I was distracted away and unable to get back.)
Now it’s July 6th and I believe I can finish a hasty missive.
2013 has left me with an overwhelming sense of loss. On top of reduced capabilities and an attrition of friends, over the time since the eye problems began, I started the year with poor feelings for having sold my car. I can accept the inability to drive more than no longer owning a vehicle.
As the year progressed, I had an eye procedure that brought complication and less result than anyone had hoped. My father passed away, I noticed that the Crow boot-bound leg is losing muscle mass and even routine things took more effort. Even further reduced exertion was more than I found I could handle. I’ve had to give up more, especially when "over" exertion inflamed the tendon in my leg, which re-triggered the Charcot Foot inflammation and ended up ulcerating the ankle. The hole was larger than a silver dollar. More than three months later, it’s about the size of a penny or nickel.
I suffered the worsened by moving prized possessions to a venue for their sale. Despite the pride in ownership, this stuff is heavy and bulky and useless to a blind guy. Removal became critical because the fact that my apartment–in a house I own–is no longer livable for me, even before the reduced eyesight and worsened leg. There’s 34 steps between the street and my apartment; 48 between the street and my bedroom. It’s hard enough getting in the house empty handed. Groceries are outright burdensome.
The eyesight, particularly effects of and adjustment to changes in light, is worse. This limits everything, including functional computer time. Work on fiction projects has stagnated as much as the blog while I try to close out responsibilities and roll with the changes.
Things are looking less bleak. My guardian angels may be masochists, but they are on the job!
Showing posts with label Diabetes. Show all posts
Showing posts with label Diabetes. Show all posts
Saturday, July 6, 2013
Friday, April 26, 2013
Circling Charcot
My resurgence of Charcot "Sharko" Foot makes it a good time to go over the condition, especially as one of the biggest threats of the condition is that it is rare enough that doctors can easily make it worse. To the cost of the patient’s limb.
Charcot Foot these days is almost an exclusive diabetic condition characterized by sudden and often "inexplicable" swelling of the foot. The foot will often "run a fever" and can be seven degrees Celsius warmer than the non-afflicted foot. The condition is most often painless to the patient.
Usually, the Charcot Foot is triggered by a break or fracture among the bones of the foot. With reduced circulation and/or nerve damage, the diabetic does not feel the break and continues to use the foot as normal. The swelling is the body’s way of protecting itself.
The unintentional risk posed by doctors is that the attending physician will not recognize or know of the condition. Often, the doctor will probe the swelling to test for bacterial or viral infection within the foot. In doing so, the doctor may introduce surface skin bacteria inside the foot and cause a sever infection that can jeopardize the limb. The patient should neither allow biopsy nor any type of mechanical reduction of the swelling. About half the patients who allow those thing quickly lose the foot.
Treatment for the Charcot relies on treatment for the underlying cause. X-rays and MRI’s are often necessary to determine the damage location and extent. Staying off the afflicted foot as much as possible will be necessary. The bones must heal properly. If they do not, they can separate further, mal-forming the foot permanently and risk ulceration of the foot. To be bluntly graphic, ulceration of the foot is when the bones poke through the skin from the inside out. The risk of infection during an ulceration is high, and the diabetic patient may not be able to feel it happening.
As usual with me, everything was slightly unusual. I developed Charcot Foot not because of a broken bone, but by tendon damage in my toe self inflicted by a hard kick. I had an inept foot doctor who prematurely declared the Charcot had passed Phase One and did not take into consideration that I was on eye-dropped prednisone for an eye surgery. The Charcot Foot renewed with a vengeance, and the swelling further reduced circulation. With further impeded circulation, nutrients including high levels of calcium and deficient Vitamin D could not reach the center of the ankle. The central bones collapsed, permanent damage that put me in a Crow Boot.
Overuse re-triggered the Charcot Foot recently by re-inflaming the tendon. When the foot swelled, the Crow Boot no longer fit correctly and the ankle bones that are twisted and misshapen ulcerated through the side of the ankle.
The tendon will ever be likely to re-inflame while a broken bone would likely have mended. The crushed ankle cannot mend. I have to be diligent, and my situation of not being able to feel much pain in the ankle combined with an inability to see things wrong with the foot makes that even more of an effort.
Charcot Foot these days is almost an exclusive diabetic condition characterized by sudden and often "inexplicable" swelling of the foot. The foot will often "run a fever" and can be seven degrees Celsius warmer than the non-afflicted foot. The condition is most often painless to the patient.
Usually, the Charcot Foot is triggered by a break or fracture among the bones of the foot. With reduced circulation and/or nerve damage, the diabetic does not feel the break and continues to use the foot as normal. The swelling is the body’s way of protecting itself.
The unintentional risk posed by doctors is that the attending physician will not recognize or know of the condition. Often, the doctor will probe the swelling to test for bacterial or viral infection within the foot. In doing so, the doctor may introduce surface skin bacteria inside the foot and cause a sever infection that can jeopardize the limb. The patient should neither allow biopsy nor any type of mechanical reduction of the swelling. About half the patients who allow those thing quickly lose the foot.
Treatment for the Charcot relies on treatment for the underlying cause. X-rays and MRI’s are often necessary to determine the damage location and extent. Staying off the afflicted foot as much as possible will be necessary. The bones must heal properly. If they do not, they can separate further, mal-forming the foot permanently and risk ulceration of the foot. To be bluntly graphic, ulceration of the foot is when the bones poke through the skin from the inside out. The risk of infection during an ulceration is high, and the diabetic patient may not be able to feel it happening.
As usual with me, everything was slightly unusual. I developed Charcot Foot not because of a broken bone, but by tendon damage in my toe self inflicted by a hard kick. I had an inept foot doctor who prematurely declared the Charcot had passed Phase One and did not take into consideration that I was on eye-dropped prednisone for an eye surgery. The Charcot Foot renewed with a vengeance, and the swelling further reduced circulation. With further impeded circulation, nutrients including high levels of calcium and deficient Vitamin D could not reach the center of the ankle. The central bones collapsed, permanent damage that put me in a Crow Boot.
Overuse re-triggered the Charcot Foot recently by re-inflaming the tendon. When the foot swelled, the Crow Boot no longer fit correctly and the ankle bones that are twisted and misshapen ulcerated through the side of the ankle.
The tendon will ever be likely to re-inflame while a broken bone would likely have mended. The crushed ankle cannot mend. I have to be diligent, and my situation of not being able to feel much pain in the ankle combined with an inability to see things wrong with the foot makes that even more of an effort.
Wednesday, April 24, 2013
Insensitive
Long story short on the latest malady:
I over-exerted from the third week of March through the first week of April, with a steady increase in activity. This caused no immediate strain, but inflamed the bad tendon, which inflamed the Charcot Foot, which caused the ulceration of my ankle. The open wound is typically encased in a Crow Boot, which is a tight, foam-lined brace that supports the permanently I have to wear the Crow Boot at all times or risk further ankle collapse whenever I put weight on the right leg. The Crow Boot can be very warm on the leg, and a symptom of Charcot Foot itself is temperature of the foot that can be seven degrees Celsius above the rest of the body.
This forms the ideal conditions for bacterial growth, dark and warm and moist. The problem getting so bad so fast is not a sign that I am a bad diabetic who does not take care of himself. It is a matter that I am a diabetic with nerve damage who could not feel the break in the skin on the foot. I am a blind diabetic who could not see the break in the foot, or blood on a dark sock.
Two things made me aware of the problem. The first was a lingering smell. I wondered what the bad smell was in the kitchen. I noticed it in another room. I thought the cat box in the bathroom had a funky odor. When I went to bed that night, the smell from the removed boot was overpowering. I happened to notice that the sock was wet, but not in a uniformly sweaty way. I touched what is normally a rough, dry area of skin and squished my finger in a wet hole.
I called a tenant who helps me out a lot. He came over and we cleaned things up. He found my emergency pack of antibiotics and I started those.
By specific criteria, he agreed with my decision not to go to an emergency room that night, but to get in contact with my regular foot doctor in the morning. This decision was not for financial reasons, but logistical ones. The truth is, Charcot Foot is not all that common and many doctors will not recognize it. Many, in the course of good and reasonable treatment, will do things that will increase the risk of Charcot Foot leading to amputation. I felt safer going to my doc–Thomas Mancini of North Providence–rather than to someone who I could only hope would not make things worse. I’ve been there and done that.
Dr. Mancini saw me that day. He cut away some dead tissue and was surprised by the amount of bleeding. Nerve damage is not the same thing as circulation problems. He prescribed Augmentin, a powerful antibiotic. I am making a concentrated effort to stay off the leg and keep the boot off when I can so the wound can breathe. I did catch the problem soon enough that the infection had not reached bone or flooded my system. The antibiotics knock me out a bit, but do not bother my stomach. I will be staying on them (and off the leg as much as possible) until the wound is healed up.
This may sound odd from a blind limpy guy, but I am lucky.
I over-exerted from the third week of March through the first week of April, with a steady increase in activity. This caused no immediate strain, but inflamed the bad tendon, which inflamed the Charcot Foot, which caused the ulceration of my ankle. The open wound is typically encased in a Crow Boot, which is a tight, foam-lined brace that supports the permanently I have to wear the Crow Boot at all times or risk further ankle collapse whenever I put weight on the right leg. The Crow Boot can be very warm on the leg, and a symptom of Charcot Foot itself is temperature of the foot that can be seven degrees Celsius above the rest of the body.
This forms the ideal conditions for bacterial growth, dark and warm and moist. The problem getting so bad so fast is not a sign that I am a bad diabetic who does not take care of himself. It is a matter that I am a diabetic with nerve damage who could not feel the break in the skin on the foot. I am a blind diabetic who could not see the break in the foot, or blood on a dark sock.
Two things made me aware of the problem. The first was a lingering smell. I wondered what the bad smell was in the kitchen. I noticed it in another room. I thought the cat box in the bathroom had a funky odor. When I went to bed that night, the smell from the removed boot was overpowering. I happened to notice that the sock was wet, but not in a uniformly sweaty way. I touched what is normally a rough, dry area of skin and squished my finger in a wet hole.
I called a tenant who helps me out a lot. He came over and we cleaned things up. He found my emergency pack of antibiotics and I started those.
By specific criteria, he agreed with my decision not to go to an emergency room that night, but to get in contact with my regular foot doctor in the morning. This decision was not for financial reasons, but logistical ones. The truth is, Charcot Foot is not all that common and many doctors will not recognize it. Many, in the course of good and reasonable treatment, will do things that will increase the risk of Charcot Foot leading to amputation. I felt safer going to my doc–Thomas Mancini of North Providence–rather than to someone who I could only hope would not make things worse. I’ve been there and done that.
Dr. Mancini saw me that day. He cut away some dead tissue and was surprised by the amount of bleeding. Nerve damage is not the same thing as circulation problems. He prescribed Augmentin, a powerful antibiotic. I am making a concentrated effort to stay off the leg and keep the boot off when I can so the wound can breathe. I did catch the problem soon enough that the infection had not reached bone or flooded my system. The antibiotics knock me out a bit, but do not bother my stomach. I will be staying on them (and off the leg as much as possible) until the wound is healed up.
This may sound odd from a blind limpy guy, but I am lucky.
Monday, April 22, 2013
Life and Limb
Yes, the blog’s been neglected this month. So has everything else. The new hole in my ankle is my excuse and my valid reason.
The Charcot Foot has relapsed with new complications. People who have read the older posts about the Charcot development may remember that I did not get Charcot Foot in a normal way. It is an esoteric diabetic thing, but normally stems from unfelt breaks or fractures in the foot. Mine resulted from tendon damage. During a "second" stage of Phase One, my circulation reduced During that time when nutrients could not find effective delivery to my swollen foot, the central bones of my ankle collapsed and a minor toe problem gangrened inside of three days. Luckily, somehow I did not have any part of the foot or toe amputated, although some meat was shaved off of the big toe. I’ve been in a Crow Boot since to reinforce the structural weakness of my ankle.
I am now a patient of podiatrist Thomas Mancini, who has offices in North Providence and East Greenwich Rhode Island. Doctor Mancini did great by me in every way. Instead of rehashing the bad things involved in last year’s mess, I’ll refer newer readers to the label for "Sturdy Hospital" and an old post titled "Doctor Dumbass."
So what went wrong this time? I over-exerted. I had to be a little more active with some things through the final weeks of March. That bothered the leg tendon in the thigh somewhat. Just having to walk to the adjoining building from my apartment is some 75 stairs each way. Having to make that walk so many times took more out of me than "it should."
April started with a project of moving things out of the house and setting up for sales in a booth at an antique co op. I arranged to hire an old friend ahead of time, a big brawny guy who can handle moving 40 boxes better than a limpy gimpy blind guy can. The fault in that plan was in hiring someone without a job. This friend has not outgrown his lazy streak since we’d had more exposure to each other. He called on the appointed day with supposed willingness but plenty of work-aversion ideas and theories. I went to the back up plans, which required more direct effort of me and did not get the entire project done in one day. It’s still not finished.
The efforts inflamed the tendon from toe to groin. This re-triggered the Charcot Foot. The foot swelled. Being trapped in a fitted brace that was now too tight, the collapsed ankle bone ulcerated the inside of the ankle against the boot. The Crow Boot is tight and warm, an ideal environment for bacterial growth.
My roommate was away that week. I can neither see nor really feel a problem on that lower leg. I realized it was infected by the smell.
Infection on that leg is literal risk to life and limb. Unchecked, an infection can flood my entire body pretty quickly, or it can root into local bones and necessitate removal of those bones and the part of the leg they form.
The Charcot Foot has relapsed with new complications. People who have read the older posts about the Charcot development may remember that I did not get Charcot Foot in a normal way. It is an esoteric diabetic thing, but normally stems from unfelt breaks or fractures in the foot. Mine resulted from tendon damage. During a "second" stage of Phase One, my circulation reduced During that time when nutrients could not find effective delivery to my swollen foot, the central bones of my ankle collapsed and a minor toe problem gangrened inside of three days. Luckily, somehow I did not have any part of the foot or toe amputated, although some meat was shaved off of the big toe. I’ve been in a Crow Boot since to reinforce the structural weakness of my ankle.
I am now a patient of podiatrist Thomas Mancini, who has offices in North Providence and East Greenwich Rhode Island. Doctor Mancini did great by me in every way. Instead of rehashing the bad things involved in last year’s mess, I’ll refer newer readers to the label for "Sturdy Hospital" and an old post titled "Doctor Dumbass."
So what went wrong this time? I over-exerted. I had to be a little more active with some things through the final weeks of March. That bothered the leg tendon in the thigh somewhat. Just having to walk to the adjoining building from my apartment is some 75 stairs each way. Having to make that walk so many times took more out of me than "it should."
April started with a project of moving things out of the house and setting up for sales in a booth at an antique co op. I arranged to hire an old friend ahead of time, a big brawny guy who can handle moving 40 boxes better than a limpy gimpy blind guy can. The fault in that plan was in hiring someone without a job. This friend has not outgrown his lazy streak since we’d had more exposure to each other. He called on the appointed day with supposed willingness but plenty of work-aversion ideas and theories. I went to the back up plans, which required more direct effort of me and did not get the entire project done in one day. It’s still not finished.
The efforts inflamed the tendon from toe to groin. This re-triggered the Charcot Foot. The foot swelled. Being trapped in a fitted brace that was now too tight, the collapsed ankle bone ulcerated the inside of the ankle against the boot. The Crow Boot is tight and warm, an ideal environment for bacterial growth.
My roommate was away that week. I can neither see nor really feel a problem on that lower leg. I realized it was infected by the smell.
Infection on that leg is literal risk to life and limb. Unchecked, an infection can flood my entire body pretty quickly, or it can root into local bones and necessitate removal of those bones and the part of the leg they form.
Wednesday, March 27, 2013
Freaky
While talking about caregivers and control freaks, I would be negligent to ignore opinions of some that I am a control freak myself.
Thursday, March 21, 2013
Adjusting the Dividing Lines
It’s been nearly three and a half years since the vitreous hemorrhage that started the permanent decline in vision and other diabetic related maladies. I’ve dealt with it OK, admirably, according to some people. I find irony that some of my personal strengths that have gotten me through these days and years are the same elements that did (and still do) grate on other people.
I’m not a warm and fuzzy guy. There’s a cold center beneath a warm midrange beneath a somewhat icy shell. Not everyone sees that. Cordial introductions can make people overestimate my social demeanor. Introductions made with a cool distance can lend opposite perceptions. Neither extreme is either wholly true nor untrue.
I’m cold and analytical. I judge no one but appraise everyone. Depending on where and how I know the other person, my appraisals often are twofold, personal and professional. Nobody’s all good or all bad, no one’s better than me and I’m not better than anyone else. I don’t force my way into others’ conversations with a driving need to express my opinion, yet have no fear of calling a spade a spade, or a diamond a diamond. I can come across as a wise ass, a know it all, a cold hard ass, a sympathetic shoulder, a passionate debater or a non-caring stone. They’re all legitimate parts of me, and different people tend to bring out different aspects under different circumstances. Under all circumstances, I stay true to myself. I don’t pander or jump through hoops for anyone, but compromise easily to find common ground with compromising people.
It’s those who don’t compromise from their own ways and desires who have had the greatest problems with me. Making friends by burying all my thoughts and needs for others never struck me as worth it. Those people can be very loyal, but only for as long as they are getting their own way. I’ve recognized since early adulthood that no one can be liked by everybody, and too often, the harder someone tries, the less they succeed.
That subtle and easily overlooked willingness to compromise and let others live as they would on their side of any dividing lines has also served me well, even when also being some of the greatest hardship to my adjustment. I have to learn to compromise on my own turf more, learn to accept help and adjust to things I can no longer do or control for myself.
That process of adjustment is still underway.
I’m not a warm and fuzzy guy. There’s a cold center beneath a warm midrange beneath a somewhat icy shell. Not everyone sees that. Cordial introductions can make people overestimate my social demeanor. Introductions made with a cool distance can lend opposite perceptions. Neither extreme is either wholly true nor untrue.
I’m cold and analytical. I judge no one but appraise everyone. Depending on where and how I know the other person, my appraisals often are twofold, personal and professional. Nobody’s all good or all bad, no one’s better than me and I’m not better than anyone else. I don’t force my way into others’ conversations with a driving need to express my opinion, yet have no fear of calling a spade a spade, or a diamond a diamond. I can come across as a wise ass, a know it all, a cold hard ass, a sympathetic shoulder, a passionate debater or a non-caring stone. They’re all legitimate parts of me, and different people tend to bring out different aspects under different circumstances. Under all circumstances, I stay true to myself. I don’t pander or jump through hoops for anyone, but compromise easily to find common ground with compromising people.
It’s those who don’t compromise from their own ways and desires who have had the greatest problems with me. Making friends by burying all my thoughts and needs for others never struck me as worth it. Those people can be very loyal, but only for as long as they are getting their own way. I’ve recognized since early adulthood that no one can be liked by everybody, and too often, the harder someone tries, the less they succeed.
That subtle and easily overlooked willingness to compromise and let others live as they would on their side of any dividing lines has also served me well, even when also being some of the greatest hardship to my adjustment. I have to learn to compromise on my own turf more, learn to accept help and adjust to things I can no longer do or control for myself.
That process of adjustment is still underway.
Friday, March 1, 2013
Charcot Revisited
The Charcot "sharko" Foot seems settled and healed. Perhaps I should do another visit with the good foot doctor, Thomas Mancini, before declaring that, bur I say so from observation of my own body.
The biggest "wild card" advantage I had during the Charcot cycle actually came from the retina reattachment. I was dropping prednisone into my eye, which regulated and reduced the swelling.
On the eye doctor’s advice, I ceased the prednisone. I did this with reluctance; when I tried getting off the prednisone in spring of 2012, the Charcot Foot, then erroneously declared "past Phase One according to Doctor Dumbass, flared worse than before.
This time, judging by the lack of a flare up, Phase One was truly over. The leg has not reswelled with discontinuation of the eye drop prednisone.
I had discussed the side effects of the prednisone with my eye doctor on previous occasions. She wrote off the stomach problems as a probable diabetic thing, perhaps bad kidneys. Maybe her opinion changed the morning she treated the post-victrectomy pressure build up. That was a bad morning altogether, even before she stuck a needle in my eye. Perhaps watching me retch acidic bile convinced her that the prednisone was having the stomach acid overproduction. Who knows? Maybe my puking in her trash barrel was the real reason she stuck a needle in my eye.
With the prior massive swelling of the left leg below the knee last fall, my already hindered diabetic circulation was further impaired. This had led to the gangrene infection on the toe, the problem that sent me to Sturdy Hospital in May. That all recovered nicely, without amputation but with a loss of some fleshy tissue from the big toe. More devastating, the swelling reduced circulation to the structure of the foot. I did not particularly stay off the foot, particularly with Dr. Dumbass telling me all was well. During this time, the bones could not get the nutrients they needed. Those nutrients were there; the semi-regular blood tests always show my calcium on the high end of the scale. While swelled, the center bone of the ankle and the inner portion of the hell bone weakened, rolled and collapsed. My right leg shortened about an inch, and it will never be safe for me to put weight directly on that ankle. The crow boot I wear everywhere except to bed and in the shower keeps the weight off and protects the leg with immobilization. I don’t complain about the Crow Boot. Without it, I would rely on crutches, and there’s not as much I could do with my hands otherwise occupied. The immobilization by the Crow Boot has had its own side effect. My calf muscle has diminished, to the point that it is noticeably smaller than the left calf. The Crow Boot is not a temporary cast or brace, but a permanent fixture.
It is what it is. I am accepting about it, even when I freely acknowledge that the combination of bad leg and blind eyes is a particularly difficult combination.
Difficult, but not insurmountable.
The biggest "wild card" advantage I had during the Charcot cycle actually came from the retina reattachment. I was dropping prednisone into my eye, which regulated and reduced the swelling.
On the eye doctor’s advice, I ceased the prednisone. I did this with reluctance; when I tried getting off the prednisone in spring of 2012, the Charcot Foot, then erroneously declared "past Phase One according to Doctor Dumbass, flared worse than before.
This time, judging by the lack of a flare up, Phase One was truly over. The leg has not reswelled with discontinuation of the eye drop prednisone.
I had discussed the side effects of the prednisone with my eye doctor on previous occasions. She wrote off the stomach problems as a probable diabetic thing, perhaps bad kidneys. Maybe her opinion changed the morning she treated the post-victrectomy pressure build up. That was a bad morning altogether, even before she stuck a needle in my eye. Perhaps watching me retch acidic bile convinced her that the prednisone was having the stomach acid overproduction. Who knows? Maybe my puking in her trash barrel was the real reason she stuck a needle in my eye.
With the prior massive swelling of the left leg below the knee last fall, my already hindered diabetic circulation was further impaired. This had led to the gangrene infection on the toe, the problem that sent me to Sturdy Hospital in May. That all recovered nicely, without amputation but with a loss of some fleshy tissue from the big toe. More devastating, the swelling reduced circulation to the structure of the foot. I did not particularly stay off the foot, particularly with Dr. Dumbass telling me all was well. During this time, the bones could not get the nutrients they needed. Those nutrients were there; the semi-regular blood tests always show my calcium on the high end of the scale. While swelled, the center bone of the ankle and the inner portion of the hell bone weakened, rolled and collapsed. My right leg shortened about an inch, and it will never be safe for me to put weight directly on that ankle. The crow boot I wear everywhere except to bed and in the shower keeps the weight off and protects the leg with immobilization. I don’t complain about the Crow Boot. Without it, I would rely on crutches, and there’s not as much I could do with my hands otherwise occupied. The immobilization by the Crow Boot has had its own side effect. My calf muscle has diminished, to the point that it is noticeably smaller than the left calf. The Crow Boot is not a temporary cast or brace, but a permanent fixture.
It is what it is. I am accepting about it, even when I freely acknowledge that the combination of bad leg and blind eyes is a particularly difficult combination.
Difficult, but not insurmountable.
Thursday, February 14, 2013
Eating Crow
I mentioned the orthopedic brace that is a permanent fixture, but neglected to ever cover what it was here. It’s called a Crow Boot. Pictures are readily available through any online search. I could post one here, but considering the blind angle, I decided early on that this would be a text site with no pictures.
The Crow Boot has two halves, upper and lower. It’s made of lightweight but highly durable black plastic and is lined with lightweight foam. When fitted for it originally, they took a cast mold of my leg. They have had to add foam as the Charcot swelling on the leg decreased. My foot goes into the lower half. The upper half then interlocks and is held in place with velcro.
The Crow Boot is needed because of the Charcot Foot. As it turned out, prednisone being dropped in my eye post retina reattachment went to work on the swelling of the Charcot Foot. When I had temporarily discontinued the prednisone, the foot swelled back up worse than before. My underlying injury seems to have been tendon damage rather than a broken bone, and the foot thickly swelled up to and even slightly beyond the knee. This swelling reduced circulation already naturally impeded by more than 35 years of diabetes. Oddly enough, as long as I kept exerting and moving I was fine. When I truly stayed off the foot–after last May’s development of a toes infection also triggered by the lack of circulation–the ankle collapsed. The central bone in the ankle, the one on which the tibia’s cupped end sits, and the inner part of the heel bone soften, collapsed and twisted. My right leg is now about a half inch shorter than the left.
The Crow Boot does nothing directly for any aspect of Charcot Foot. It compensates for the structural collapse and weakness that is a permanent disability.
The Crow boot immobilizes the ankle to make sure I cannot do further damage to myself. It also diverts weight from the ankle to the ball of the foot or the upper calf. It has a lifter to compensate for the different leg lengths.
I wear the Crow Boot when not in bed or in the shower. Even to get up in the middle of the night for a leak or a snack, I need to put the Crow Boot on. I’m still living in a place with way too many stairs for a blind guy with a bad leg.
Without the boot, I would need crutches. Times when I do "cheat" and use neither the boot nor the crutches leave me feeling the error for a few days.
I do not complain about the boot. I’d be able to marginally get around on crutches, but all these stairs would be a lot more difficult, and I would not be able to bowl. The Crow Boot is bulky, and on my right foot, so I probably would not be able to drive with it due to pedal spacing, but driving was lost a half year before due to the eyesight. The boot is inflexible at the ankle and sole, so even slight bumps or lumps in a smooth surface can make me feel like I am about to fall over.
When I say I am limping along, I mean that literally. Blind eyes and a bad leg is an especially bad combination.
The Crow Boot has two halves, upper and lower. It’s made of lightweight but highly durable black plastic and is lined with lightweight foam. When fitted for it originally, they took a cast mold of my leg. They have had to add foam as the Charcot swelling on the leg decreased. My foot goes into the lower half. The upper half then interlocks and is held in place with velcro.
The Crow Boot is needed because of the Charcot Foot. As it turned out, prednisone being dropped in my eye post retina reattachment went to work on the swelling of the Charcot Foot. When I had temporarily discontinued the prednisone, the foot swelled back up worse than before. My underlying injury seems to have been tendon damage rather than a broken bone, and the foot thickly swelled up to and even slightly beyond the knee. This swelling reduced circulation already naturally impeded by more than 35 years of diabetes. Oddly enough, as long as I kept exerting and moving I was fine. When I truly stayed off the foot–after last May’s development of a toes infection also triggered by the lack of circulation–the ankle collapsed. The central bone in the ankle, the one on which the tibia’s cupped end sits, and the inner part of the heel bone soften, collapsed and twisted. My right leg is now about a half inch shorter than the left.
The Crow Boot does nothing directly for any aspect of Charcot Foot. It compensates for the structural collapse and weakness that is a permanent disability.
The Crow boot immobilizes the ankle to make sure I cannot do further damage to myself. It also diverts weight from the ankle to the ball of the foot or the upper calf. It has a lifter to compensate for the different leg lengths.
I wear the Crow Boot when not in bed or in the shower. Even to get up in the middle of the night for a leak or a snack, I need to put the Crow Boot on. I’m still living in a place with way too many stairs for a blind guy with a bad leg.
Without the boot, I would need crutches. Times when I do "cheat" and use neither the boot nor the crutches leave me feeling the error for a few days.
I do not complain about the boot. I’d be able to marginally get around on crutches, but all these stairs would be a lot more difficult, and I would not be able to bowl. The Crow Boot is bulky, and on my right foot, so I probably would not be able to drive with it due to pedal spacing, but driving was lost a half year before due to the eyesight. The boot is inflexible at the ankle and sole, so even slight bumps or lumps in a smooth surface can make me feel like I am about to fall over.
When I say I am limping along, I mean that literally. Blind eyes and a bad leg is an especially bad combination.
Wednesday, February 13, 2013
Golden Starches
In December’s diet for/not for diabetic series, I did talk about the three basic things I never eat. There’s a fourth, in a broad category defined by brand. That is McDonald’s.
Maybe it was easier for me to stay away from McDonald’s than it would be for most people because I detest onions in all forms. That’s a plus for me as a diabetic.
My parents noticed since the onset of my diabetes that McDonald’s always triggered high sugar surges no matter what was eaten. Burger King, Burger Chef, and Dairy Queen did not have this effect even with directly comparable meals.
As an adult I noticed that a McDonald’s breakfast did not seem to trigger such high sugars, but I could never figure out the specifics. I thought maybe they added sugar to their frying oils or to the grills themselves. Maybe fries had a sugar coating that leaked into the fryers.
I learned more recently the direct cause. A former manager who was retired due to disabling complications of his Type 2 diabetes spilled the beans.
The sickness uniformly inflicted on diabetics by McDonald’s food is directly related to all the health problems caused by the chain’s food. The secret is not within the fries and oil or meat. It was fully compatible to why the Egg McMuffins never seemed to bother me.
McDonald’s sandwich bread is more this composite of sugar, old-time lard, sesame seeds and just enough wheat for the alien product to be classified as bread. There’s some exaggeration in the way I wrote that for attempted comic delivery, but the general content is accurate enough. The sandwiches may have the taste you want, but eating anything on the luncheon rolls is traitorous to the diabetic body.
The nature of McDonald’s bread-type products explains the sugar spiking tendencies, the calorie content and the cholesterol costs.
Neither Burger King nor Wendy’s ever had such severe effects on me. I state this as a diabetic who always managed his condition by feel, not by sugar numbers. McDonald’s always made me feel unwell while its competitors did not.
I’ve avoided most fast food whenever possible. I lean towards Subway whenever lunch on the run was something of a necessity. The alternatives are just healthier and the vegetables more diverse.
That does not mean I’ve been perfect, but that I choose healthy options whenever possible or productive. If I need a boost before bowling, I am inclined to snatch a couple Burger King cheeseburgers. The food itself does not overwhelm me as McDonald’s will, and Wendy’s burgers are usually dressed with mayonnaise rather than sugar-rich ketchup. When I stop for those burgers, I am eating for the sugar rather than enjoyment. Burger King burgers seem to have gotten smaller yet again.
I do not view McDonald’s as a viable choice under any circumstances.
Maybe it was easier for me to stay away from McDonald’s than it would be for most people because I detest onions in all forms. That’s a plus for me as a diabetic.
My parents noticed since the onset of my diabetes that McDonald’s always triggered high sugar surges no matter what was eaten. Burger King, Burger Chef, and Dairy Queen did not have this effect even with directly comparable meals.
As an adult I noticed that a McDonald’s breakfast did not seem to trigger such high sugars, but I could never figure out the specifics. I thought maybe they added sugar to their frying oils or to the grills themselves. Maybe fries had a sugar coating that leaked into the fryers.
I learned more recently the direct cause. A former manager who was retired due to disabling complications of his Type 2 diabetes spilled the beans.
The sickness uniformly inflicted on diabetics by McDonald’s food is directly related to all the health problems caused by the chain’s food. The secret is not within the fries and oil or meat. It was fully compatible to why the Egg McMuffins never seemed to bother me.
McDonald’s sandwich bread is more this composite of sugar, old-time lard, sesame seeds and just enough wheat for the alien product to be classified as bread. There’s some exaggeration in the way I wrote that for attempted comic delivery, but the general content is accurate enough. The sandwiches may have the taste you want, but eating anything on the luncheon rolls is traitorous to the diabetic body.
The nature of McDonald’s bread-type products explains the sugar spiking tendencies, the calorie content and the cholesterol costs.
Neither Burger King nor Wendy’s ever had such severe effects on me. I state this as a diabetic who always managed his condition by feel, not by sugar numbers. McDonald’s always made me feel unwell while its competitors did not.
I’ve avoided most fast food whenever possible. I lean towards Subway whenever lunch on the run was something of a necessity. The alternatives are just healthier and the vegetables more diverse.
That does not mean I’ve been perfect, but that I choose healthy options whenever possible or productive. If I need a boost before bowling, I am inclined to snatch a couple Burger King cheeseburgers. The food itself does not overwhelm me as McDonald’s will, and Wendy’s burgers are usually dressed with mayonnaise rather than sugar-rich ketchup. When I stop for those burgers, I am eating for the sugar rather than enjoyment. Burger King burgers seem to have gotten smaller yet again.
I do not view McDonald’s as a viable choice under any circumstances.
Sunday, December 16, 2012
Bamboozled!
I approach this topic reluctantly, but while discussing diet and food intake, I think I would be remiss not to discuss alcohol on some level. Several people who have passed through my life have been alcoholic, some recovered, some not, and some who have fallen down those twelve steps. A couple people in that last category are among those no longer in my life who I miss the most, so the subject can be somewhat loaded for me as I was not able to help people no matter how much I sincerely wanted to and tried.
I am not judgmental about alcohol use. I drink on occasion but can take it or leave it. I felt a certain propensity towards becoming an alcoholic that I have successfully resisted since that first bottle of blackberry brandy in the woods behind the house at age 15.
The diabetes itself, I think, can increase the propensity. Most diabetics are not consistent in temperament. We can be prone to depression and suffer hormonal changes to our biochemistry. This brings certain vulnerabilities to alcohol dependency or abuse that anyone can suffer. so diabetics who feel these daily desires may not be able to deny inappropriate use of alcohol as non-diabetics.
I do not think diabetics need to totally avoid alcohol or can never safely drink. Health benefits such as found in wine usually apply to diabetics. With wine, the diabetic must remain self aware as the grape source of wine can elevate sugar levels with fructose. Moderation with alcohol should always be followed.
A second hand concern was the core of my perceived need to address alcohol. Just as my experience with low fat milk elevating my sugar level more than whole milk, a diabetic friend tells me that light beers raise his sugar more than regular beers. I never acquired a taste for beer, so do not know how they achieve the reduced fat and/or calorie effects in lute beer. Strictly in a blood sugar effect, I say diabetics need to pay attention to their beer drinking.
Most of my drinking experience is with hard liquor. Basic straight alcohol–rum, gin, vodka, whiskey, etc–will lower blood sugar. But as most of the straight hard stuff is often mixed with fruit juices or liqueur varieties, this effect can be easily overridden or overlooked. Liqueurs contain sugar. contain sugar from their manufacturing and processing. Brandy and Schnapps will often have sucrose added on top of natural fructose.
The effect on sugar levels can be very inconsistent, depending on so many factors that diabetics need to be self analyzing. A shot of vodka will lower blood sugar. A screwdriver (vodka and orange juice) may have the two sugar influences cancel each other out over time, but from my experience he orange juice sugar will take effect first and be lowered by the sugar reducing alcohol. A Fuzzy Navel, which is made with orange juice, vodka and Peach Tree Schnapps, will raise the sugar. How much this effect happens depends on prior consumption sugar levels, and whether the last meal contained a lot of carbs or not, and the proportions in the drink consumed, and activity level.
There’s a lot of variables that are just harder to track with any temporary mental impairment brought by the alcohol consumed.
Diabetics are wise to avoid most alcohol, but drinking always pares down to personal choices and comfort levels, so give this opinion without judgment. The important thing, as with anyone, is to drink responsibly.
I am not judgmental about alcohol use. I drink on occasion but can take it or leave it. I felt a certain propensity towards becoming an alcoholic that I have successfully resisted since that first bottle of blackberry brandy in the woods behind the house at age 15.
The diabetes itself, I think, can increase the propensity. Most diabetics are not consistent in temperament. We can be prone to depression and suffer hormonal changes to our biochemistry. This brings certain vulnerabilities to alcohol dependency or abuse that anyone can suffer. so diabetics who feel these daily desires may not be able to deny inappropriate use of alcohol as non-diabetics.
I do not think diabetics need to totally avoid alcohol or can never safely drink. Health benefits such as found in wine usually apply to diabetics. With wine, the diabetic must remain self aware as the grape source of wine can elevate sugar levels with fructose. Moderation with alcohol should always be followed.
A second hand concern was the core of my perceived need to address alcohol. Just as my experience with low fat milk elevating my sugar level more than whole milk, a diabetic friend tells me that light beers raise his sugar more than regular beers. I never acquired a taste for beer, so do not know how they achieve the reduced fat and/or calorie effects in lute beer. Strictly in a blood sugar effect, I say diabetics need to pay attention to their beer drinking.
Most of my drinking experience is with hard liquor. Basic straight alcohol–rum, gin, vodka, whiskey, etc–will lower blood sugar. But as most of the straight hard stuff is often mixed with fruit juices or liqueur varieties, this effect can be easily overridden or overlooked. Liqueurs contain sugar. contain sugar from their manufacturing and processing. Brandy and Schnapps will often have sucrose added on top of natural fructose.
The effect on sugar levels can be very inconsistent, depending on so many factors that diabetics need to be self analyzing. A shot of vodka will lower blood sugar. A screwdriver (vodka and orange juice) may have the two sugar influences cancel each other out over time, but from my experience he orange juice sugar will take effect first and be lowered by the sugar reducing alcohol. A Fuzzy Navel, which is made with orange juice, vodka and Peach Tree Schnapps, will raise the sugar. How much this effect happens depends on prior consumption sugar levels, and whether the last meal contained a lot of carbs or not, and the proportions in the drink consumed, and activity level.
There’s a lot of variables that are just harder to track with any temporary mental impairment brought by the alcohol consumed.
Diabetics are wise to avoid most alcohol, but drinking always pares down to personal choices and comfort levels, so give this opinion without judgment. The important thing, as with anyone, is to drink responsibly.
Saturday, December 15, 2012
Milking the Diet
Cow’s milk has always been a major part of my diet, both as the base in which to eat cold cereal and on its own.
My body can be pretty primal. I don’t fight cravings, and any serious problems with bones or teeth or other problems such as a traumatic toenail injury will make me crave milk. During a time when a low level tooth infection went undiagnosed and treated, the milk craving was at an extreme. I would stop and buy two gallons at 7-11. I would swig from the gallon before driving the six blocks home. When parked, I would swig some more then walk up the two flights. I’d swig some more before putting the two new gallons in the fridge. The gallon I’d be drinking from could be more than half gone before it ever hit the fridge.
My doctor told me this was diabetic thirst. I know better. Milk doesn’t quench thirst; it usually coats the tongue and throat and increases thirst. Those times I have diabetic thirst, only water satisfies.
I never noticed any changes as the milk addictions came and went. About the time I gained a roommate, I switched from whole milk to the "healthier" 1% low fat milk. That was just easier than arguing for what I liked better. I also did not notice any change in my sugar during the time of the change. The 1% habit remained for years.
What has become apparent is that my body cannot metabolize the 1% as well. I’m not talking about lactose intolerance. Low fat milk raises my sugar more than whole milk does.
Shooting up extra insulin after a milk binge could not compensate when I indulged the cravings. When the ankle collapsed due to the Charcot Foot, my milk cravings were at a new high. The night I went into the hospital for the sudden toe infection had been a high milk night. I had eaten little throughout the day, a reasonable dinner, then about a half gallon of 1% before going into the hospital. Having become aware that milk was contributing to higher sugar levels, I had shot up before leaving.
My sugar was still in the 600’s when they tested in the hospital, and I could feel the insulin dose doing nothing.
I’ve since gone back to whole milk. The roommate mostly stays with 1%, but he has always been inconsistent about that and often eats cold cereal with ½ and ½ poured over it.
My sugars have felt better since I made the switch. 1%^ milk actually raises my sugar more than a glass of Kool-Aid will. Whole milk gets absorbed by my body in a more measured way, without absolute sugar surges.
I don’t claim to understand this. Low fat salad dressings definitely have added sugar. Low fat milks do not. Something about the low-fat process changes the milk’s biochemistry and how my diabetic body reacts to it.
This effect as observes in a "whole food" form reinforces my theories that "healthy" dietary changes can be beneficial to the normal dieter but catastrophic to diabetics. Our bodies metabolize changed foods in some fundamental and often unexpected ways. Diabetic diets are best in avoidance of pre-prepared and processed foods. As that can never be fully avoided in this day and age, we need to watch what we eat and what effects any change may bring.
The lower fat and reduced cholesterol benefits don’t amount to much if our blood sugar is always higher for the change.
My body can be pretty primal. I don’t fight cravings, and any serious problems with bones or teeth or other problems such as a traumatic toenail injury will make me crave milk. During a time when a low level tooth infection went undiagnosed and treated, the milk craving was at an extreme. I would stop and buy two gallons at 7-11. I would swig from the gallon before driving the six blocks home. When parked, I would swig some more then walk up the two flights. I’d swig some more before putting the two new gallons in the fridge. The gallon I’d be drinking from could be more than half gone before it ever hit the fridge.
My doctor told me this was diabetic thirst. I know better. Milk doesn’t quench thirst; it usually coats the tongue and throat and increases thirst. Those times I have diabetic thirst, only water satisfies.
I never noticed any changes as the milk addictions came and went. About the time I gained a roommate, I switched from whole milk to the "healthier" 1% low fat milk. That was just easier than arguing for what I liked better. I also did not notice any change in my sugar during the time of the change. The 1% habit remained for years.
What has become apparent is that my body cannot metabolize the 1% as well. I’m not talking about lactose intolerance. Low fat milk raises my sugar more than whole milk does.
Shooting up extra insulin after a milk binge could not compensate when I indulged the cravings. When the ankle collapsed due to the Charcot Foot, my milk cravings were at a new high. The night I went into the hospital for the sudden toe infection had been a high milk night. I had eaten little throughout the day, a reasonable dinner, then about a half gallon of 1% before going into the hospital. Having become aware that milk was contributing to higher sugar levels, I had shot up before leaving.
My sugar was still in the 600’s when they tested in the hospital, and I could feel the insulin dose doing nothing.
I’ve since gone back to whole milk. The roommate mostly stays with 1%, but he has always been inconsistent about that and often eats cold cereal with ½ and ½ poured over it.
My sugars have felt better since I made the switch. 1%^ milk actually raises my sugar more than a glass of Kool-Aid will. Whole milk gets absorbed by my body in a more measured way, without absolute sugar surges.
I don’t claim to understand this. Low fat salad dressings definitely have added sugar. Low fat milks do not. Something about the low-fat process changes the milk’s biochemistry and how my diabetic body reacts to it.
This effect as observes in a "whole food" form reinforces my theories that "healthy" dietary changes can be beneficial to the normal dieter but catastrophic to diabetics. Our bodies metabolize changed foods in some fundamental and often unexpected ways. Diabetic diets are best in avoidance of pre-prepared and processed foods. As that can never be fully avoided in this day and age, we need to watch what we eat and what effects any change may bring.
The lower fat and reduced cholesterol benefits don’t amount to much if our blood sugar is always higher for the change.
Friday, December 14, 2012
Splendid Equality
Here’s a natural bridge from the last post about sodas. I stated how I did not like the aftertaste of soda varieties sweetened with Splenda©. It tastes like sugar soda to me.
I don’t use Splenda, but have stuck with Nutrasweet as an artificial sweetener, in soda, coffee or any other things I feel the need to add an artificial sweetener. I like the taste and am used to it. If in a restaurant where the options are only Splenda or saccharine-based Sweet-n-Low, I will use Splenda.
But I would never allow myself to use Splenda regularly or habitually. This is a precaution based on the processes of my brain I call logic. I have not specifically researched this independently or for this post. My declining eyesight does not really allow me to research it now.
Here’s my precautionary logic:
Splenda is made from true sugar. It was modified to be a no- or low-calorie sweetener that tastes like real sugar. It did succeed in that, as my dislike of Diet Coke with Splenda demonstrated to me. I have no doubt that this is a great product for dieters.
I am not convinced it’s a good idea for diabetics, whether childhood or age advanced. Splenda, as a modified sugar, seems very likely to be processed by the body as sugar. Diabetics may benefit from the reduced calorie aspects, but could easily find that Splenda would raise their sugar as much as real unmodified sugar does.
I never tried Splenda to know if it would have such an effect on me. I saw no reason to risk this and still don’t.
You can call me paranoid, or cite studies that say Splenda is perfectly safe for diabetics. I will still stick with Equal.
Splenda is a new product, so may have effects not yet realized, or, worse, have effects that are being concealed. I do not know if it was ever specifically tested with diabetics. I would assume that any such tests were carried out by the manufacturer and spun to say what the manufacturer wanted without any outright lies.
This same logic, based on a general understanding of basic sciences, kept me from any temptation to try inhalable insulin, which was very shortly pulled from the market for causing lung cancer.
Just as I never thought inhaling a hormone was a good idea, I just don’t see any wisdom of diabetics habitually consuming modified sugar.
I don’t use Splenda, but have stuck with Nutrasweet as an artificial sweetener, in soda, coffee or any other things I feel the need to add an artificial sweetener. I like the taste and am used to it. If in a restaurant where the options are only Splenda or saccharine-based Sweet-n-Low, I will use Splenda.
But I would never allow myself to use Splenda regularly or habitually. This is a precaution based on the processes of my brain I call logic. I have not specifically researched this independently or for this post. My declining eyesight does not really allow me to research it now.
Here’s my precautionary logic:
Splenda is made from true sugar. It was modified to be a no- or low-calorie sweetener that tastes like real sugar. It did succeed in that, as my dislike of Diet Coke with Splenda demonstrated to me. I have no doubt that this is a great product for dieters.
I am not convinced it’s a good idea for diabetics, whether childhood or age advanced. Splenda, as a modified sugar, seems very likely to be processed by the body as sugar. Diabetics may benefit from the reduced calorie aspects, but could easily find that Splenda would raise their sugar as much as real unmodified sugar does.
I never tried Splenda to know if it would have such an effect on me. I saw no reason to risk this and still don’t.
You can call me paranoid, or cite studies that say Splenda is perfectly safe for diabetics. I will still stick with Equal.
Splenda is a new product, so may have effects not yet realized, or, worse, have effects that are being concealed. I do not know if it was ever specifically tested with diabetics. I would assume that any such tests were carried out by the manufacturer and spun to say what the manufacturer wanted without any outright lies.
This same logic, based on a general understanding of basic sciences, kept me from any temptation to try inhalable insulin, which was very shortly pulled from the market for causing lung cancer.
Just as I never thought inhaling a hormone was a good idea, I just don’t see any wisdom of diabetics habitually consuming modified sugar.
Tuesday, December 11, 2012
Diet at Fruition
The talk about the dangers of fruit pies to dieters and diabetics alike emphasizes one point of the "diet series" posts. Some things that are good for dieters are not so good for diabetics. Fruit. These are healthy foods with many benefits, but can easily be eaten into excess. Many menus or meal plans that diabetics receive from dieticians have the impractical inclusions of half a piece of fruit just for this reason. For all the health benefits, fruit contains a lot of natural sugars and can quickly throw diabetics out of whack. Diabetics are often advised to six to twelve servings of fruits and vegetable per day. The emphasis on such plans is to the vegetable, which should be roughly a ration of 2:1.
Diabetics should choose fresh fruit sources. As sweet as fruit is, most "prepared" forms have added sugar. The combination of sucrose and fructose can easily overload the system.
Canned fruits should always be checked and preference should be given to varieties with no sugar added. Apple sauce should always be analyzed for added sugar.
Jellies and jams are usually loaded with sugar and should be used sparingly, if at all.
Fruit juices, particularly "cocktails" also need close examination. Even without added sugar, juice can be high in sugar, particularly grape and orange. Properly made Tang actually has less sugar that whole and pure orange juice. Tang will provide Vitamin C, but not potassium and other benefits of orange juice.
The 100% "pure" Juicy Juice is typically one of the best alternatives, especially the varieties that mix lower natural sugar fruits with the higher. Cranberry juices almost always have sugar added.
As much as I would love to be more precise, my vision is no longer cable of label and ingredient comparison, even online. Fruit is an excellent option for dieter as the water based fructose generally pisses out of the system effectively, and an excess ill often trigger other bodily purges. Diabetics, however, need to limit and monitor consumption in the goal of keeping sugar levels down. This can be easy to forget when dealing with something so healthy.
Diabetics should choose fresh fruit sources. As sweet as fruit is, most "prepared" forms have added sugar. The combination of sucrose and fructose can easily overload the system.
Canned fruits should always be checked and preference should be given to varieties with no sugar added. Apple sauce should always be analyzed for added sugar.
Jellies and jams are usually loaded with sugar and should be used sparingly, if at all.
Fruit juices, particularly "cocktails" also need close examination. Even without added sugar, juice can be high in sugar, particularly grape and orange. Properly made Tang actually has less sugar that whole and pure orange juice. Tang will provide Vitamin C, but not potassium and other benefits of orange juice.
The 100% "pure" Juicy Juice is typically one of the best alternatives, especially the varieties that mix lower natural sugar fruits with the higher. Cranberry juices almost always have sugar added.
As much as I would love to be more precise, my vision is no longer cable of label and ingredient comparison, even online. Fruit is an excellent option for dieter as the water based fructose generally pisses out of the system effectively, and an excess ill often trigger other bodily purges. Diabetics, however, need to limit and monitor consumption in the goal of keeping sugar levels down. This can be easy to forget when dealing with something so healthy.
Wednesday, November 28, 2012
Getting Sauced
Ketchup is a source of high sugar that dieters and diabetics alike can easily overlook. Its healthier relatives of tomato sauces, whether for pizza or pasta, can also be another high sugar content source. Sauces, however, have more variance in sugar content from vendor to vendor.
I have little direct experience with jarred or canned sauce for home consumption. In addition to being leery of sugar content, many tomato sauces contain pieces of things I don’t like and won’t east, including onion in any form or pieces of peppers or tomatoes. I find it easier to make my own sauce from a tomato paste base and mixed with meats, vegetables and herbs. I do not add any sugar or salt to the pot, though I will salt it on the plate.
Tomatoes are acidic, so sugar is usually added to counter-effect the natural acids. Most grocery-bought sauces will contain some sugar. The FDA requires ingredients to be listed from most abundant to least, so it is best to choose brands by the most ingredients before sugar. Monitoring blood sugars after the meal is also advisable. Sauces sold in cans with tomato pastes, purees and pieces often are very straightforward and plain. These products, with makers such as Hunts, Contadina and store generics will usually have less or no sugar and can be seasoned to taste. Jarred sauces such as Prego, Ragu and Aunt Millie’s, sold as the "flavor" brands, will have more sugar.
Restaurants are harder to plan. Some chains may use basic foodservice packaged varieties of common brands, but these may also be labeled for specific chains so even the employees may not know. Many of the pizza chains have their own secret house recipes. These are also generally make offsite and shipped in gallon cans or five gallon bags. I worked for the New England chain Papa Gino’s and never felt as though my sugar was higher. I did notice when working in a mall that Pizzeria Regina lunches always shot my sugar higher than it should have been after a reasonable meal. As you cannot be sure of the accuracy of what most employees will tell you, it is best to avoid other sweets when eating Italian out and paying attention to your sugar levels afterwards. Avoid the places that raise your sugar and frequent those that do not.
You may find your prefer the higher sugar recipes . That’s okay, in my opinion. A successful diet is one you can maintain permanently, and avoiding all sugars all the time is not possible for most people. The important thing is to know what you are consuming and how it affects your body and knowing when you need to compensate. A carb-rich plate of pasta is an important thing to track as a sugary sauce will spike your sugar sooner and the pasta carbs will keep the levels elevated.
I have little direct experience with jarred or canned sauce for home consumption. In addition to being leery of sugar content, many tomato sauces contain pieces of things I don’t like and won’t east, including onion in any form or pieces of peppers or tomatoes. I find it easier to make my own sauce from a tomato paste base and mixed with meats, vegetables and herbs. I do not add any sugar or salt to the pot, though I will salt it on the plate.
Tomatoes are acidic, so sugar is usually added to counter-effect the natural acids. Most grocery-bought sauces will contain some sugar. The FDA requires ingredients to be listed from most abundant to least, so it is best to choose brands by the most ingredients before sugar. Monitoring blood sugars after the meal is also advisable. Sauces sold in cans with tomato pastes, purees and pieces often are very straightforward and plain. These products, with makers such as Hunts, Contadina and store generics will usually have less or no sugar and can be seasoned to taste. Jarred sauces such as Prego, Ragu and Aunt Millie’s, sold as the "flavor" brands, will have more sugar.
Restaurants are harder to plan. Some chains may use basic foodservice packaged varieties of common brands, but these may also be labeled for specific chains so even the employees may not know. Many of the pizza chains have their own secret house recipes. These are also generally make offsite and shipped in gallon cans or five gallon bags. I worked for the New England chain Papa Gino’s and never felt as though my sugar was higher. I did notice when working in a mall that Pizzeria Regina lunches always shot my sugar higher than it should have been after a reasonable meal. As you cannot be sure of the accuracy of what most employees will tell you, it is best to avoid other sweets when eating Italian out and paying attention to your sugar levels afterwards. Avoid the places that raise your sugar and frequent those that do not.
You may find your prefer the higher sugar recipes . That’s okay, in my opinion. A successful diet is one you can maintain permanently, and avoiding all sugars all the time is not possible for most people. The important thing is to know what you are consuming and how it affects your body and knowing when you need to compensate. A carb-rich plate of pasta is an important thing to track as a sugary sauce will spike your sugar sooner and the pasta carbs will keep the levels elevated.
Monday, November 19, 2012
Covering Condom’s...
Condiments, that is.
Like the low fat varieties of salad dressing or even the vinegarettes that can have major unrealized sugar content, condiments are typically the biggest source of unrealized sugar intake.
Ketchup/catsup is really one of the worst things a diabetic can casually eat. The sugar content exceeds orange juice, and, depending on the manufacturer, can contain multiple sources of sweetener such as both raw sugar and corn syrup. Manufacturers like mixing these two types of sweeteners in all sorts of products to make the taste sweeter without having to list a single sugar ingredient higher on the ingredient list. The United States Food and Drug Administration requires ingredient lists to be ordered from highest content to lowest, so dividing sweetener between multiple sources can be a deceptive way of "reducing" sugar content.
Barbeque sauces should also be reviewed before consumption. Typically, the spicier the condiment, the less sugar it will have, but particularly with barbeque sauces, the ingredient lists must be checked for sugar, brown sugar, corn syrup, honey, molasses and maple.
Mustards also follow this trend. A "mild" mustard will almost always have more sugar than a naturally hot mustard.
Restaurant "special" sauces should always be suspect, not just for sugar, but also for salt.
Steak sauces and marinades should also be checked before consumption.
I’m not advocating bland diets of plain food. By my experience, here in America, if something "needs flavor," chefs add sugar or salt or onions and think things much improved. I just hope to help diabetics and dieters be more informed in their choices and to think twice about their decisions. I don’t find catsup to be an enjoyable enough addition to anything to use it. I use barbeque as a more flavorful replacement, but have noticed that some push my sugars up higher than other.
All condiments from relish to basic salt should be checked for sugar. We are so familiar with these products that we may take them for granted and discount the things hidden within.
Like the low fat varieties of salad dressing or even the vinegarettes that can have major unrealized sugar content, condiments are typically the biggest source of unrealized sugar intake.
Ketchup/catsup is really one of the worst things a diabetic can casually eat. The sugar content exceeds orange juice, and, depending on the manufacturer, can contain multiple sources of sweetener such as both raw sugar and corn syrup. Manufacturers like mixing these two types of sweeteners in all sorts of products to make the taste sweeter without having to list a single sugar ingredient higher on the ingredient list. The United States Food and Drug Administration requires ingredient lists to be ordered from highest content to lowest, so dividing sweetener between multiple sources can be a deceptive way of "reducing" sugar content.
Barbeque sauces should also be reviewed before consumption. Typically, the spicier the condiment, the less sugar it will have, but particularly with barbeque sauces, the ingredient lists must be checked for sugar, brown sugar, corn syrup, honey, molasses and maple.
Mustards also follow this trend. A "mild" mustard will almost always have more sugar than a naturally hot mustard.
Restaurant "special" sauces should always be suspect, not just for sugar, but also for salt.
Steak sauces and marinades should also be checked before consumption.
I’m not advocating bland diets of plain food. By my experience, here in America, if something "needs flavor," chefs add sugar or salt or onions and think things much improved. I just hope to help diabetics and dieters be more informed in their choices and to think twice about their decisions. I don’t find catsup to be an enjoyable enough addition to anything to use it. I use barbeque as a more flavorful replacement, but have noticed that some push my sugars up higher than other.
All condiments from relish to basic salt should be checked for sugar. We are so familiar with these products that we may take them for granted and discount the things hidden within.
Thursday, November 15, 2012
Dressed for Unsuccess
Low fat diets can be dangerous to diabetics due to the addition of sugar to many low fat products. This does extend beyond foods labeled as low fat varieties. Last time out highlighted low fat dressings. The modern popularity of vinegarette dressings is another trail of the low fat craze, but many of these varieties are advertised as naturally low in fat but not as a "low fat" alternative.
The vinegarette dressings are lower in fat because they do not mis vinegars with oils as much as traditional Italian dressings do. Very often, they are high sugar options.
Raw sugar is often added to balance the bite of vinegar. Particularly in fruit flavors of vinegarettes, the sugar content can be particularly high. Diabetics and "healthy" dieters alike need to read salad dressing labels carefully. That salad that was chosen as a healthy alternative to an earnest diet can be an unrealized source of high sugar intake.
Sugar in salad dressings may be unavoidable, but careful label review can minimize the unwitting intake of excess sugars. The safest bet is plain old oil and vinegar, but that can get boring fast. The key to success is moderation. As diabetics are "supposed" to make each meal half fruit and vegetable, salads are an important staple to success, but extra attention is required to what is put on the salad.
If I was whole and capable, I would provide research and label comparisons. My eyesight has nowhere near enough capabilities for me to do that any more, so that extra effort has be put in by those truly interested in what they are consuming.
The vinegarette dressings are lower in fat because they do not mis vinegars with oils as much as traditional Italian dressings do. Very often, they are high sugar options.
Raw sugar is often added to balance the bite of vinegar. Particularly in fruit flavors of vinegarettes, the sugar content can be particularly high. Diabetics and "healthy" dieters alike need to read salad dressing labels carefully. That salad that was chosen as a healthy alternative to an earnest diet can be an unrealized source of high sugar intake.
Sugar in salad dressings may be unavoidable, but careful label review can minimize the unwitting intake of excess sugars. The safest bet is plain old oil and vinegar, but that can get boring fast. The key to success is moderation. As diabetics are "supposed" to make each meal half fruit and vegetable, salads are an important staple to success, but extra attention is required to what is put on the salad.
If I was whole and capable, I would provide research and label comparisons. My eyesight has nowhere near enough capabilities for me to do that any more, so that extra effort has be put in by those truly interested in what they are consuming.
Wednesday, November 14, 2012
Low Fat, High Sugar
In almost all cases, it is advisable for "healthy folk" to follow diabetic diets. Diabetic diets emphasize a balanced healthy diet. The reverse is not true. Diets for the general population typically are geared for weight loss, the quicker the better. Instead of emphasizing balanced, sustainable diets, they encourage the avoidance of certain foods or food classification, and this is seldom any healthier than bulemia.
One food diabetics need to avoid at all times is low fat or non fat versions of foods. In removing fat content, the manufacturers need to make the products taste good. The easiest and most frequent way they do this is by replacing the reduced fat with sugar.
One statistic I like to cite long after I have forgotten the source is that obese women consumer the most raw dietary sugar via low fat salad dressings. Obviously, diabetics and dieters alike should read labels carefully. What is being saved in low fat varieties may be providing excesses in other areas. Diabetics need to eat to avoid sharp and sudden rises and falls in their sugar levels, so obviously low fat but high sugar options are typically counterproductive to those goals.
Something seems to counteract most healthy choices as widening American population pursues lower fat diets in haphazardly convenient ways. E get information from people trying to sell us something. We embrace ground turkey as a low fat alternative to ground beef without realizing that turkey contains a much higher cholesterol content. They get you coming or going and prey on our choices for convenience.
The best diets are the ones you can consume for the rest of your life, not some fad that will be broken in a matter of weeks.
One food diabetics need to avoid at all times is low fat or non fat versions of foods. In removing fat content, the manufacturers need to make the products taste good. The easiest and most frequent way they do this is by replacing the reduced fat with sugar.
One statistic I like to cite long after I have forgotten the source is that obese women consumer the most raw dietary sugar via low fat salad dressings. Obviously, diabetics and dieters alike should read labels carefully. What is being saved in low fat varieties may be providing excesses in other areas. Diabetics need to eat to avoid sharp and sudden rises and falls in their sugar levels, so obviously low fat but high sugar options are typically counterproductive to those goals.
Something seems to counteract most healthy choices as widening American population pursues lower fat diets in haphazardly convenient ways. E get information from people trying to sell us something. We embrace ground turkey as a low fat alternative to ground beef without realizing that turkey contains a much higher cholesterol content. They get you coming or going and prey on our choices for convenience.
The best diets are the ones you can consume for the rest of your life, not some fad that will be broken in a matter of weeks.
Tuesday, November 13, 2012
Excuses...
The blog has been neglected lately for a few reasons that accumulate enough to come across as excuses.
First, and always best, is that my eyesight continues to deteriorate. Everything’s harder for me, including the computer, and I can spend less time on here before my eyes just burn out.
That burning out limitations works a few other ways too. I am, eleven months after the reattachment surgery, still on four different eye drops, and some recent events temporarily necessitated a fifth. The drops greatly reduce my vision for a few hours afterwards.
Despite the fact that I am really and truly disabled, I have not yet divested myself of all old responsibilities and some of those became quite taxing over the last couple weeks. Things seem to be under control again. I impressed even myself with some of the things I can do blind and am grateful for the lesson that I could still do some things. But the other side of that coin is that I know I don’t want to be doing most of those things. The effort just takes too much out of me.
The last excuse is my favorite. I submitted a shelved novel to a publisher and got a nibble. There’s promise and potential but far from any type of guarantee, but such a chance needed to be pursued. Again, my functional computer time is physically limited and the holdover responsibilities interfered even with the full writing goal, but I got "a more traditional synopsis" out tonight, so can eke out some time to resume posts.
I will be turning back to general diabetic issues of diet.
First, and always best, is that my eyesight continues to deteriorate. Everything’s harder for me, including the computer, and I can spend less time on here before my eyes just burn out.
That burning out limitations works a few other ways too. I am, eleven months after the reattachment surgery, still on four different eye drops, and some recent events temporarily necessitated a fifth. The drops greatly reduce my vision for a few hours afterwards.
Despite the fact that I am really and truly disabled, I have not yet divested myself of all old responsibilities and some of those became quite taxing over the last couple weeks. Things seem to be under control again. I impressed even myself with some of the things I can do blind and am grateful for the lesson that I could still do some things. But the other side of that coin is that I know I don’t want to be doing most of those things. The effort just takes too much out of me.
The last excuse is my favorite. I submitted a shelved novel to a publisher and got a nibble. There’s promise and potential but far from any type of guarantee, but such a chance needed to be pursued. Again, my functional computer time is physically limited and the holdover responsibilities interfered even with the full writing goal, but I got "a more traditional synopsis" out tonight, so can eke out some time to resume posts.
I will be turning back to general diabetic issues of diet.
Wednesday, November 7, 2012
Diet Differences
Popular or common use of the term "diet" does not fit exactly to "diabetic diet." The general term among non-diabetic populace carries an indication that the diet can be ended or suspended at any time. Diabetics just can’t do that. Every sugar spike, no matter how temporary, adds to the debilitating effects than can plague diabetics.
Diabetic diet must become a lifestyle change of healthy eating and exercise. The diabetic cannot take a week off from the diet. Upon diagnosis, the diabetic must cat back and cut out of their diets and routines. Forever.
That Boston Creme donut enjoyed once a week? Gone.
Diet soda is no longer an option, but the necessity of soda.
McDonald’s is a place that should never be entered again.
"Healthy" people wanting a diet routine could do well to look at diabetic allowances and routines. Diabetics cannot base their diets of fat cutting, calorie counting weight loss "tricks." Too many of those options just are not healthy.
Diabetic diet must become a lifestyle change of healthy eating and exercise. The diabetic cannot take a week off from the diet. Upon diagnosis, the diabetic must cat back and cut out of their diets and routines. Forever.
That Boston Creme donut enjoyed once a week? Gone.
Diet soda is no longer an option, but the necessity of soda.
McDonald’s is a place that should never be entered again.
"Healthy" people wanting a diet routine could do well to look at diabetic allowances and routines. Diabetics cannot base their diets of fat cutting, calorie counting weight loss "tricks." Too many of those options just are not healthy.
Saturday, October 27, 2012
Physical Low
When I don’t get frustrated or simply wake up with the buzz of low sugar level and insulin shock, certain physical conditions are evident. Keep in mind that this is not a comprehensive list of all symptoms that can occur, but the physical symptoms that usually hit me.
If I have eaten within a few hours of the sugar level dropping, one of the first physical symptoms is flatulence. I control this when I can, but that’s not always comfortably possible. What I ate makes no difference. This does not happen when my stomach is bare empty. This effect happens most often when the sugar drops due to increased physical activity rather than just not having eaten enough.
I will get tingly, especially in hands and feet, an itchy hot feeling.
I get hot and usually sweat. This is often the first symptom to subside with food as blood goes to the belly. I normally get cold after eating if it is under about 60 degrees F or less, and things have been that way since the 1990s.
I get weak and light headed. These days, this aspect will include vertigo. As some of the medications I am on and the eye problems themselves can cause vertigo, I am not sure to what extent the change in Wal-Mart’s ReliOn Insulin causes this specific problem.
Generalized shakiness will overcome me. More often than not, motor control diminishes.
There is a panic sense of urgency. When the sugar starts to fall I can put off resolution, but once a critical level is reached nothing can distract from the need. At advanced stages of low sugar, this does not become a short temper issue, but an exclusive focus on eating to ignorance of all other factors. I totally disconnect from anything else until the blood sugar levels rise.
Overall, it is a very weak and vulnerable feeling.
I have never had fainting spells or passed out due to the sugar being low. This may very well be because the sugar drop is typically a relative fall to where my sugar had been rather than a sheer drop to a home meter test number of 70 or less. While working on trying to get the numbers down last summer, I often let the low sugar feelings stretch out. That did not seem to work. Even as I felt everything was lower, the A1C remained high. There’s been considerable drug interaction in the past ten months, and my disabilities have had other effects that I should have anticipated....
If I have eaten within a few hours of the sugar level dropping, one of the first physical symptoms is flatulence. I control this when I can, but that’s not always comfortably possible. What I ate makes no difference. This does not happen when my stomach is bare empty. This effect happens most often when the sugar drops due to increased physical activity rather than just not having eaten enough.
I will get tingly, especially in hands and feet, an itchy hot feeling.
I get hot and usually sweat. This is often the first symptom to subside with food as blood goes to the belly. I normally get cold after eating if it is under about 60 degrees F or less, and things have been that way since the 1990s.
I get weak and light headed. These days, this aspect will include vertigo. As some of the medications I am on and the eye problems themselves can cause vertigo, I am not sure to what extent the change in Wal-Mart’s ReliOn Insulin causes this specific problem.
Generalized shakiness will overcome me. More often than not, motor control diminishes.
There is a panic sense of urgency. When the sugar starts to fall I can put off resolution, but once a critical level is reached nothing can distract from the need. At advanced stages of low sugar, this does not become a short temper issue, but an exclusive focus on eating to ignorance of all other factors. I totally disconnect from anything else until the blood sugar levels rise.
Overall, it is a very weak and vulnerable feeling.
I have never had fainting spells or passed out due to the sugar being low. This may very well be because the sugar drop is typically a relative fall to where my sugar had been rather than a sheer drop to a home meter test number of 70 or less. While working on trying to get the numbers down last summer, I often let the low sugar feelings stretch out. That did not seem to work. Even as I felt everything was lower, the A1C remained high. There’s been considerable drug interaction in the past ten months, and my disabilities have had other effects that I should have anticipated....
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