Satisfaction

So today I went for my yearly opthamologist appointment to check on the health of my eyes. For those of you longtime readers, you may remember that the way I found out about my diabetes was an eye doctor found the beginnings of blood vessel damage in my eyes which led to the diagnosis. A year and a half later and a whole lot of better numbers I go back to the eye doctor and he says..."Are you sure you're diabetic?"

SCORE!

Unlike a lot of chronic disease, I actually REVERSED the effects on my eyes and there's NO TRACE of damage to my eyes.

Well that makes the running, the food long, the carb counting and the classes worth it.

And interesting post on Pandagon

So I just read this post on Pandagon, a feminist, political website. It brings up two really good points.

1. BMI sucks and as an indicator of health. I have a cousin who is 6 feet and thin as a rail. I can run circles around him and my BMI is a zillion times more than his. My sister's boyfriend's BMI is a zillion times bigger than his - my sister's boyfriend IS A TRIATHELETE.

2. All of this fear on women "bulking up" is based on misogynist ideas that women should be frail and weak. My question for you readers of the female persuasion is - do you do weight training? Why or why not. I personally do the absolute minimum of weight training mainly because I find it boring and I cannot stare at the tv while I'm doing it.

Salt and Public Policy

The research and debates continue....

Health / Fitness & Nutrition
Big Benefits Are Seen From Eating Less Salt
By PAM BELLUCK
Published: January 21, 2010
Scientists writing in The New England Journal of Medicine conclude that lowering the amount of salt people eat by even a small amount could reduce cases of heart disease, stroke and heart attacks.

Media Literacy - Get Edumacated

Dealing with a chronic disease you get a lot of information throw at you. Most of it bad. With diabetes, I've certainly had to sift through a huge amount of misinformation. Or I should say misinformation about what works for me. For example, going to the American Diabetes Association message boards, you would think we were all confined to lives on the Atkins diet. That is effective for some people. Not good for me. I got plenty of bad misinformation from my primary care doctor who told me to reduce my morning blood sugar level, I should eat less carbs. As it turns out (and a piece of info I got from my dietician Aunt), my blood sugar level went down when I had a snack just before going to sleep.

It's particularly depressing when you try any journalism piece, whether written on televised, about health. They are, for the most part, utter crap. You see, the news media defines news and something that's new and different. That mostly means letting us know when things aren't working. It's not news when something that is designed to work actually does work. Let's look at sex. There's tons and tons of stories about teens going nuts on the oral sex and the sexting and the pregnancies. But the actual research shows that sex ed and contraception works and that teen pregnancy rates have gone down over the last 20 years. Check it http://www.guttmacher.org/pubs/fb_ATSRH.html. But hey, let's not let the facts get in the way of a good story.

In regards to reporting on health, it's suckers harder than a dyson vacuum. Seriously, a completely untested bra that purports to prevent breast cancer is news? As someone who is an avid media consumer (because I BLOG!), I got all happy inside to stumble on this site. They are a group of smarty mcsmartersons who review articles on health for accuracy and quality of reporting. I could spend all day on it if my work would let me. But reading through the reviews, you begin to get skills about what to look for in a health article. I'd highly recommend it.

For example, here's a list of seven words that shouldn't be used in medical news:

Years ago, the publisher of this site wrote an essay with the above title. The words were:
• Cure
• Miracle
• Breakthrough
• Promising
• Dramatic
• Hope
• Victim

BTW, they decided to stop reviewing television health stories because they blow.

Rocking the test results

Saturday, I got my blood drawn and my urine specimened to see what progress I've made dealing with diabetes. It was about 13 months since I was first diagnosed and five months since my last set of test results. In the intervening five months I went off all medication regulating my blood glucose so any result I had would be purely based on my diet and exercise. From the title of the post, you know how things turned out.

Here's the one year ago picture:

A1C level (measuring glucose) - 9.7 (standard is between 4.5 and 6.0)

ALBUMIN/CREATININE ratio (measuring how well my body able to retain protein in the bloodstream) - 122.5 (standard is below 29.9)

Overall cholestorol - 300 (standard is below 236)

HDL (the good cholesterol) - 40 (you should be above 40)

LDL (the bad cholestrol) - 137 (you should be less than 129)

Triglyceride (fat in your bloodstream) - 650 (should should be less than 199!)


So what are the numbers today?

A1C level (measuring glucose) - 5.1

ALBUMIN/CREATININE ratio (measuring how well my body able to retain protein in the bloodstream) - 14.5

Overall cholestorol - 151 (standard is below 236)

HDL (the good cholesterol) - 57 (you should be above 40)

LDL (the bad cholestrol) - 77 (you should be less than 129)

Triglyceride (fat in your bloodstream) - 83 (should should be less than 199!)


So there it is. I have to acknowledge that the Albumin/creatinine numbers and the cholesterol numbers are affected by the medication I'm taking but my doctor and nutritionist say those things don't mean bupkiss if I ain't living right. And the thing is, living right isn't a punishment. Last week I ate CHICKEN FRIED STEAK WITH BEER GRAVY! I made sure to forego the mashed potatoes and have a double order of roasted veggies but seriously folks - CHICKEN FRIED STEAK. What started out as one hellish month and a serious fear of Splenda has morphed into a lifestyle with a lot of Splenda desserts. Thanks y'all for giving me a space to think these things through. Let's keep on keeping on.

I DID Spend 15 years in DC - Health Care Reform

Has anyone been noticing the subtle (not!) fat hatred going on in the debate about health care reform? Over and over again, by both the right and the left, we hear the same message - you fatties are costing us money! Over and over again we hear how obesity is costing the country trillions of dollars. Yes folks, you fat ass and my fat ass is more costly than the fricking Iraq War. And if only we did more to shrink our fat asses our health care system would be magically fixed. You know the irony of this thinking? It's LAZY. The very thing that society accuses us fatties of. This research doesn't dig deeper to see about co-morbidity factors like lack of exercise. It doesn't look beyond what's on the scale. Because it would actually take EFFORT to look at measures of health like A1C, cholesterol, and incidence of stroke and heart disease.

Real health care reform isn't about numbers on a scale. It's about access. Because when you have access, the other stuff comes together. I spent a study abroad year in England under their "socialist" National Health Service. Because I didn't have to pay a goddamned dime to see the doctor, I went to the doctor every month. I got my teeth cleaned twice during that year and got a pair of contact lenses AND glasses. My doctor spent at least a half an hour talking to me about my health. It was EASY to stay healthy.

For real health care reform to take root, stop telling people to do more. STOP IT. Especially to us fatties. Because are you READING THIS FUCKING BLOG? Or Onyah's blog? Or Laure P's blog? We are working our asses off. We are thinking about this stuff every day. We're cooking healthier. We're getting up early to exercise. Don't tell me or anyone else that we need to work harder.

You want to spend less money on health care? Make this stuff easy. Make cooking easier. Instead of subsidizing Monsanto, why not subsidize CSA programs? Why not allow poor folks to get a box of organic produce the same why Onyah does? Why not spend a couple of million dollars (compared to the $300 million Monsanto gets) to start Farmer's Markets in Anacostia and West Oakland? Why not subsidize programs that get corner stores to replace cigarettes with fresh produce? By the way, this proposal IS BUDGET NEUTRAL. You aren't spending a dime more if you divert a teeny weeny portion of industrial agriculture subsidies to community food access programs.

Make going to the doctor cheap and easy. That means making sure we are guaranteed health insurance and it won't go away because we lose our jobs or because our jobs can't pay for them because the insurance company decided to jack up the premiums. You know what that means? The public option. Let me buy into Medicare. And make sure the insurance covers COST SAVING THINGS like gym membership and nutritionists. The thing is, these things aren't just luxuries for the young and affluent - they can be the determining factor between inexpensive prevention ($100 for a nutritionist appointment) and costly medical procedures ($100,000 surgery).

I find it hilarious that fatties are somehow the scourge of the earth and responsible for the health care crisis. As if the insurance companies don't spend $7 billion a year DENYING coverage. As if those same companies aren't spending hundreds of millions of dollars LOBBYING AGAINST the public option. That's pretty damn wasteful to me.

It must be my month to be right!

Check it. NPR's resident mathematician gives ten reasons why BMI is a big crock.

Graduation Day

So yesterday I had my last appointment with my nutritionist. Looking at the numbers (even slightly elevated) she said I had the diabetes in control. In fact she said that the higher numbers were within margin of error and it was a strong possibility that my numbers hadn't changed at all. The only thing that was holding me back from graduating was my blood pressure. The water pill I'm taking is doing the trick and my blood pressure is 78/116 below the 80/130 that is the goal. It's so funny how I cling to the structures that are keeping me healthy. My nutritionist happily told me that I could probably stop taking my blood sugar medication and could stop checking my blood sugar since as long as I was eating what I allow myself to eat my blood sugar is fine. I told her I would cut my blood sugar medication in half by the end of the summer and try to go off of it by the end of the year.

It's scary to think that I wouldn't need to take this stuff. It's a scary thought to think of myself as healthy. I wish the media would allow for such complexity. My nutritionist deemed me healthy. I have a chronic disease AND I'm healthy. In the same way that I can have severe allergies that I need to compensate for and still be healthy. Health is such a complex thing you know. It's not just what your body can and can't do (process sugar, keep its blood pressure reasonable) but what environment and support you create to address your body's strengths and weaknesses. Like the blog title says, it's a lifestyle.

P.S. This weekend I'm running Bay to Breakers. I've decided to change my costume and go as Aang the Avatar. I figured that had to be a benefit for being Asian and bald. Check it out:

Well this IS a Health Blog

So check it. Kate Michelman is broke. This isn't a story of how she blew it all on cocaine and faberge eggs (although how awesome would it be if there was an E true Hollywood Story on leaders in the feminist movement). She got screwed by this country's shitty, shitty health care system. This is someone who was making well into the six figures as the head of NARAL and probably got some lucrative consulting contracts post-NARAL. On top of that, her husband was a college professor. And then one paralyzed daughter and a husband with Parkinson's and goodbye savings, house, and retirement. Seriously, people, its FUCKING TIME FOR SINGLE PAYER HEALTH CARE. If the former head of NARAL and her college professor husband get wiped out by a catastrophic illness, what are the chances for the rest of us?

The Admonishment

So I had a call today from my substitute nutritionist. My regular nutritionist is in Australia for a month so her fill in called to check up on me. She doesn't have near the bedside manner as my regular nutritionist. She was very curt and short and pretty much went into full judgmental mode when she found out I hadn't filled my prescription for my blood pressure medication. For some reason, the pharmacy couldn't just mail it to me and I had to pick it up. On top of that, I was supposed to go to a drop in class for people with high blood pressure. I am delinquent on both counts. It was then she decided to go into full on scare tactic telling me that if I had continued high blood pressure I was at risk for kidney failure. My kidneys are particularly fragile being diabetic and high blood pressure was sure to fuck with them.

I'm trying to unravel my resistance to this new wrinkle in my health maintenance. It's not that hard, taking another pill and spending two hours in some useless class telling me to relax. But I haven't done it yet. I'm getting emotional writing this because I realize I am having a what the fuck reaction. Seriously, WHAT THE FUCK. I exercise all the freaking time. I've lost a ton of weight. I eat enough fruits and vegetables to bankrupt Whole Foods. My blood sugar levels are not just normal but AWESOME. And STILL my body says "hey I'm still fucked up in some way." The substitute nutritionist said that this was something that lifestyle changes weren't making a difference on and that I needed to take another pill and monitor my blood pressure the same way I monitor my blood sugar.

And I hate it. I fucking hate, hate, hate that my body still is fucking with me. I hate that THERE'S ONE MORE THING WRONG WITH ME. The ironic thing is that in this same conversation, the sub was telling me I graduated from seeing a nutritionist. I so had my diabetes under control I didn't need to see a nutritionist anymore. Since she was calling me at work, I couldn't say how much I needed the crutch of having a nutritionist. I couldn't say it scared me not to have someone to talk to once a month and to tell me I was kicking ass.

What all of this boils down to is how scared I am of change. I'm scared of having to do more more thing to keep myself healthy. I'm also scared to letting go of the things I do to keep myself healthy. I don't need to check my blood sugar every day. I probably don't need to keep a food log. I could probably back off the on the running. I do it because it scares me not to. And on the flip side, I am scared of doing more. I'm scared that doing more means there are insurmountable hurdles that affect my health and once I run past this one, there will be another. If it isn't my cholesterol, blood sugar or weight, it's my blood pressure.

The first step is that I got the sub to call the pharmacy and get them to mail the medication to me. I will then take my daily allotment of blood pressure medication. I will then take a fairly useless class on hypertension.

It's all about plugging on isn't it?

Phew

It took FOUR WEEKS for the stupid radiology office to send my results back to my doctor, and I kept calling and calling... but good news! My thyroid sonogram was NORMAL.

BIG Sigh of Relief

Okay, I've been freaking out for the last 12 hours or so. When I had my dr's appt on Wednesday, they did all the usual blood work, and my dr. said she would send a letter with all the results - which is the usual routine for this practice. So, I was very freaked out when I got out of meetings at work yesterday to have messages from my dr. on *both* my phones, saying she wanted to talk about my blood test results. I called back but had missed her for the day, so I needed to wait until this morning to learn what's up. PANIC ENSUES. (And a crazy email to my Dr. Friend at one point.)

Well, I just talked to her. And guess what? She called to tell me that my numbers were GREAT! That this blood test showed great improvements over my last round, which was about 18 months ago or so. My glucose was normal (a concern with Dad's diabetes) and all of the other usual stuff stayed normal. And here's all the really good news:

My cholesterol is good! I brought down my total cholesterol from 229 to 203, from high borderline to just above normal - and your good cholesterol (HDL) should be above 60, mine's 74, and the bad cholesterol (LDL) should be under 100, and I brought it down from 135 to 96! Holla! It wasn't very long ago that number was up in the 170's or more, back before I really started paying attention. (here's a handy link that lays out the optimal ranges)

My triglycerides - something to worry about with a family history of heart disease - are a little high - they should be 150 - but I brought them down from 171 to 163.

So -- I was very nervous about this call, but she actually just wanted to talk through these things before I get the letter so she could tell me I was doing a good job. She said "keep doing what you're doing." It's funny, I was thinking last night that if she called to say something was wrong with my numbers that it would almost feel like I'd failed a test, and I have always hated failing tests. Now, it feels like I got an A!

How 'bout that? Cooking works. Healthy ingredients work. Cutting out lots of snacking works. Ta dah! So, even though I'm still at my heaviest weight (blurgh) and need to drop those numbers in order to improve my blood pressure, overall I think this is the healthiest I've been as an adult. Proof that it is, indeed, a lifestyle, right?? :-)

Doctor's Orders

Timing is everything, right? As I'd mentioned, I finally had my physical check-up with my doctor this morning and I had a whole list of things to discuss with her. What I didn't plan for was that I'd get the nasty DC cold for the 3rd time this year 2 days ago -- so I did go to the appt, but mostly was a zombie with a runny nose, sneezing, with gross watery eyes and that "I habe a code" monotone. My lymph nodes are all swollen up, so I hope that combined with the cold in general didn't do too much to screw with my blood work and the appt as a whole.

I did go over the list, though, and here are the results...

1. I got a refill on the BP meds. It was up a little bit today, still in the normal range but at the upper limits - but I think that could be cuz of just feeling like crap and rushing to take a cab rather than the Metro this morning.

2. I did get a referral to a nutritionist, hooray! My doctor loves that I'm learning how to cook and was very encouraging about trying to find ways to make that work with my IBS.

3. As for my pain in the neck? She said it's probably muscle spasms, and may be related to the start of arthritis in my neck. My Dr. Dad had said that too but I thought he was just being gloomy - I don't want to think about arthritis already! But she said as a start I should do the things that make sense, lighten my purse, switch sides with it, stretch more, go back to doing yoga, etc. She said even in looking at me she could see that I scrunch my right shoulder up and out of alignment, so i need to work on all of that.

4. Here's the new thing - which I'm not going to stress about until I need to. She thought my thyroid seemed a little enlarged, just on the right side. This may be nothing, it may be enlarged, it may be hard to tell cuz my lymph nodes and glands were swollen already from this cold. But I'm going in for a thyroid sonogram next Monday just to figure it out. Not stressing.

In general, she reminded me that I need to get more exercise - but she actually never said the words "lose weight," and I appreciate that cuz obviously I *know* that's what I need to do. I really do love this doctor, and this was only my 2nd visit with her but I know she's got the best bedside manner of anyone I've been to. I had a *terrible* primary care doctor for years here in DC, who was just not friendly or encouraging or supportive at all, and i'm so glad I've found this new - literally -caregiver. Even as I was sick as a dog this morning and stressed about the stuff we were talking about, she kept things light - she asked about what books I've been reading (turns out we're both Malcolm Gladwell fans), she asked what I'd thought about the Oscars, she asked what the best thing was that happened to me so far in 2009 (I said the Inauguration). I love it, I love that she makes it a 2-person conversation and that she makes it seem like she's really interested in me as a person rather than just numbers on a chart. It makes all the rest of this stuff so much easier to handle.