Blue Monday – But Only When It Comes To Sugar

If you read the Facebook page, you already know I received good news when I visited my primary care doctor, the ever educating Dr. H. Zhao of Deer Valley Family Practice here in Phoenix. The visit was for her to more carefully read the results of the blood tests than I am capable of since I’m not a doctor. I take these tests quarterly because I was prescribed Pravastatin which might have an effect on the liver.

By the way, pravastatin is used with hyperlipidemia (high cholesterol). Luckily for me, I have had no side effects from this drug.  As with every other patient taking the drug, it wasn’t even prescribed until after we had tried dietary changes, exercise and weight reduction.  My body seems to have a mind of its own (love the juxtaposition of body and mind), and paid no attention to any of my efforts; hence, the drug regimen.

That’s a pretty long involved explanation of why I was in Dr. Zhao’s office at all.  The good news is that with all my complaining – and there’s been plenty – about the exercise and renal diet, my eGFR (estimated glomerular filtration rate) went up to 60 from 50.  That is borderline between stage 1 or normal kidney function and stage 2 or mild chronic kidney disease. This, after three years of being at stage 3 or moderate ckd. I was so floored I was speechless, not at all usual for me.

Of course, along with the good came the bad.  Funny how it always works that way.  It seems my A1c, a blood test which measures how your body handles sugar over a three month period, had risen again.  This has been on a very slow incline for quite a while.  Now it’s 6.3.  At 6.4, I officially have type 2 diabetes.

What is that specifically?  Type 2 is the type that can be controlled by – surprise! – life style changes, while type 1 is insulin dependent or the kind that requires a daily injection.  But wait a minute!  I already limit the sweets (sugar) and make it a point to exercise, so how could this be?

When I asked Dr. Zhao to help me with this, she was able to print out material about diabetic exchanges for meals. I also made an appointment with Crystal Barrera, my nutritionist at Arizona Kidney Disease and Hypertension Center, so she could help me combine the renal, hyperlipidemia, diabetic, and hypertension diets I need to follow. But that’s later on this month. Meanwhile, let’s deal with the material I was given.

Lo and behold, sweets are only one aspect of the diet. I hadn’t realized carbohydrates had so much to do with diabetes. It seems they turn into sugar. Now that I know this, it makes perfect sense.  I just never made the connection. I learned that too many carbohydrates at the same time raise the blood sugar.

Well, I got myself another eye opener as I read.  I always thought of carbohydrates as starches – bread, cereal, starchy vegetables and the beans that I can’t eat anyway since they’re not on the renal diet. But I learned they are also milk and yoghurt (I have never been so thankful to be lactose intolerant), and fruit.

I wasn’t terribly upset since I’m already limited to six units of starches, three of vegetables (starchy or not), three of fruit and one of dairy.  Uh-oh, doesn’t that mean I was already being careful about my food intake? It was a struggle for this miller’s grand-daughter to keep within the bread limits.  What else was I going to have to struggle with?

It turns out the limits for each of the categories of food in the diabetic diet is more liberal than those on the renal diet.  For example, Sunday morning I make gluten free, organic blueberry pancakes. They’re simple, quick and tasty. Bear uses butter and syrup (got some terrific huckleberry syrup for him when I was in Portland, Oregon, for the Landmark Education Advanced Course in June, but I like them plain.) According to the diabetes exchange, one of these counts as a starch (1 4-inch pancake about ¼” thick) and ½ of a fruit exchange (one-half cup of canned or fresh fruit). Wait, there’s more.  I used 1 teaspoon of extra virgin olive oil which is a fat exchange. Hmmmm, this is simply not that different from counting units for the renal diet.

Ah, so the diabetic exchange meal is not that much of a problem for me, it’s combining the restrictions of the four diets I need to follow. I’ve already decided to follow the lowest allowable amount of anything.  For instance, the diabetic exchange allows 2,300 mg. of sodium per day while the renal diet only allows 2,000 mg.  I stay well under 2,000 mg.

I’m beginning to see that I can figure out how to do this myself, but I am so glad to have my nutritionist to verify my conclusions.  You know, the government pays for your nutritionist consultation once a year if you have chronic kidney disease.  It’s not a bad idea to make an appointment.  You may surprise yourself by not being aware of new dietary findings about the renal diet or discovering you’ve accidentally fallen into some bad dietary habit.

Also, as expected, exercise is also important if you (or I) have diabetes. It helps keep your blood sugar levels under control.  The recommendation is 30 minutes five times a week.  I’m already striving for 30 minutes a day every day and don’t want to let that go.  I’m hoping to make that a habit.

I am SUCH a writer!  One of my first thoughts after I was told about the A1c level was, “Maybe I should write a book about type 2 diabetes.”  As far as the ckd book, I was just informed I have blog readers in China who are ordering the book.  Let’s see if we can disseminate the information all over the world.  Here’s to no more terrified newly diagnosed patients!

Until next week,

Keep living your life!

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