I'm not going to develop diabetes. You know why? Because I'm going to die of a fucking a heart attack first, from being so stressed out over this. I never really think about food that much, aside from what I feel like cooking. All day today though I couldn't stop. Am I hungry? Should I eat now? How do I feeeeeel? How I felt was angry at myself and anxious all day long that I was screwing up. I wish somebody would just tell me exactly what to eat, how much of it, and at exactly what times. Figuring it out myself is too hard.
Breakfast: Grape Nuts, milk, sliced banana
Lunch: Chop't Creative Salad
Snack: watermelon
Dinner: pb&j with sliced apples on rye bread, string beans
Dessert: chocolate pudding
I don't like walking around having a disease I have to think about twenty times a day. When I was at the doctor, the truth was I was really tired and just wanted to go home as soon as possible. Maybe I didn't reallllllllly pay full attention, and didn't ask any questions. So I barely have any idea what it is that's supposed to happen. I looked up hypoglycemia on the web this morning, read about it for maaaaaybe ten minutes before I gave up. Now I am paranoid about what I've eaten. Maybe I should wake up in the middle of the night to eat? Maybe I ate wrong and should eat something else to counteract it. Maybe I should take lifesavers into the shower with me in case I don't feel good while I'm in there.
To the person who commented so much that it took two comments: wow, and thank you. Also, I am taking off a day from work at the end of the month to see my sister in her recital. Also also, you are right about the sleep thing and I try to go to bed at 11 every night but it never ever happens. More hours of sleep would help a lot, I think.
7 comments:
I had gestational diabetes (diabetes due to pregnancy) which is totally different from yours, but here are a few of the things I did. Track EVERYTHING you eat, and write down how you feel. See if you eat specific things on the days you feel tired or crappy and see if there's a correlation. Maybe you ate more carbs or less protein than usual those days. I was never allowed to eat carbs without protein, so they balanced each other. I know it's hard, but try not to stress too much. It's not serious at this point, and you'll get the hang of it. If you have questions, call the dr and just tell him you were freaked out and weren't paying attention and you would like to talk again. Maybe you can get a referral to a nutritionist who can help. Good luck!
Thank you for your kind words on the commenting. It's good to get the feedback, not just for the ego but to know what is helpful (and not helpful) to you. Hope this comment is helpful too; it might turn out to be similarly long.
Now, first, you know, it is totally normal to be freaked out. Of course you are stressed, upset about having another problem thrown at you, the creation of which you did not cause but the handling of which you must control.
That said, it isn't diabetes. Not to pull the crap where a person reeling from a big problem, a huge change for what is normal for him, is told that it isn't as bad as something else, an approach that usually just pisses the person off, but: this isn't diabetes, this isn't as bad as diabetes. Diabetes is really scary. Manageable, but really scary. Right now, you have hypoglycemia. This is much easier than diabetes. The diabetes you can work to avoid. This is new and overwhelming and a huge change for you and it stinks and you need another problem like you need a hole in the head, but it isn't as extreme as diabetes.
You might consider not reading too much about diabetes right now; you don't need to be scared about it and you don't need to be confused by it. This isn't to say "you shouldn't worry your pretty little head about it" or to indicate that you aren't smart enough to not be confused! Rather, you are already freaked out as it is, therefore limiting what you read about diabetes and sticking to the material about hypoglycemia can at least avoid some stress, and for any person feeling a lot of anxiety, having a lot of questions, and taking in a lot of new information fast, it is easy to confuse what is what, so it would be good to avoid reading scary information about diabetes and later misremembering it as about hypoglycemia.
You have the diagnosis now, but here's the thing: Things haven't really changed all that much since before. You never fainted before, right? So you probably aren't going to faint in the middle of taking a shower. What you are experiencing is not the same as hypoglycemic episodes for those who inject insulin. If you begin not to feel well during a shower, then you'll finish up and go take care of it, but have you yet experienced an episode that has come on that quickly? You probably do not need to wake up in the middle of the night to eat. If you do find that you get very sweaty while sleeping in a way that doesn't seem to be from the heat or from physical exertion, or if you get up in the middle of the night and find yourself shaky, then maybe you will want to keep a juice box by your bed.
It really would be great if the doctor would get you a glucometer. This way you could test in the middle of the night just to get some data if you happen to awake, and you could find out how your levels stand upon waking which would assist you in determining how quickly after waking you need to eat breakfast. Of course you need to be aware of your body, and you'll see what makes you feel better, but having the data can help. Like, let's say you feel oddly tired, and you check your blood sugar, and you find you are low. Well, now you've learned that that particular kind of tired -- perhaps it comes on suddenly, perhaps it doesn't feel like a normal tired or a normal sleepy, perhaps your head is swimming or you feel almost drunk -- now you know that is a symptom of hypoglycemia. The feedback from the data-giving machine helps you learn to read your body. And let's say you suddenly feel very sweaty, and you check and are within normal range, then you know you are simply overheated.
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Yes, figuring it out yourself is hard. Thank you for letting us help. Good for you for recognizing that when you received the diagnosis at the doctor you weren't able to focus well. What it is that's supposed to happen is obviously one of your questions for him. What can you do to be in a better place next time? Is your appointment earlier in the day, so you won't be as tired? Can you clear the hours before your appointment, so your mind won't be on what you were doing immediately prior to it? Can you schedule free time after the appointment, so you won't have to rush off to something else and can think instead? Will you take time to prepare by collecting and writing up all your questions, so that you can refer to your list during the appointment and have all your questions ready and get the answers to them and even write them down? Can you bring someone with you to the appointment, to help you pay attention and to collect the information with you?
Now, are you getting emotional support from your sisters and from Josh? You are close to your sisters, and you told us of how Danielle sat with you the other week when you weren't feeling well, but since you have been the de facto parent for so long the sense we get is that you don't really get taken care of by them. And Josh, how much are you sharing with him about how you are feeling, how this is hard for you emotionally? Can he comfort you?
When you were Danielle's age, you were responsible for both of your sisters and for running your aunt's household. Now Danielle is old enough to take on many of your responsibilities to run and support the household, and you have Josh to help instead of your aunt to cause trouble. Please delegate responsibilities to them.
You don't need to give up on getting to bed at an appointed bedtime just because it hasn't worked out in the past. You get to work on time, right? And to classes? You probably even leave extra time in case you get delayed. What do you do in order to make that happen? Can you apply that to getting to bed at your bedtime? Can you consider your bedtime something you schedule that is just as important to get to on time as the other appointments? What can your household do to help? How late do your sisters stay up?
If it doesn't happen because of things that need to be done around the house, delegate and find shortcuts. If it doesn't happen because you want to watch TV, record the programs. If it because your sisters want to talk with you, have them do so once you and they are completely ready for bed. If because you still need to write out a list, do it once you are in bed, so at least your body will be preparing to rest. And if it's because there's just too much to do, between work, household, school, well, something's got to give. If you agree more sleep will help, then that might have to take priority over something else, even if it means passing on some tutoring hours, being lax on some duties, and only doing the minimum in an easy, non-core class. This isn't about beauty sleep or being lazy; this is about your physical and emotional health.
Some other ideas: You have a crock-pot from Josh's parents, right? Using it to make some dinners could cut down on time, or using it to cook oatmeal (more on this later) overnight might be useful. Preparing a lot of dishes for the week on Sunday right after you go grocery shopping could save time on weeknights. Also, if your budget has the room, possibly create a cab budget, for the times when your day has run long into the evening and a cab home instead of public transportation could make the difference in getting to bed on time.
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Trying to make your room a place your body knows is for sleep could be helpful, too. Is the old television still in your bedroom? You might not want to use it, so your body will know when you are in bed it is time for rest, not to stay awake and be entertained. Keeping a pad of paper and a pen by your bedside table can help you avoid having to get up, and writing out a simple list is fine, as would be reading a novel for a literature class, but balancing your checkbook or looking over documents or actively studying or writing an outline probably would not be conducive to resting. Saving writing your end-of-the-day blog post for after you've gotten ready for bed and are in bed might be good, but then that should be it, keeping yourself from browsing and researching matters, whether you wrote about them in your blog post or not, that are just going to further your anxiety.
The day off for the recital will be good. What, though, about smaller bits of time for yourself each day? Go back over everyone's suggestions from a couple of weeks ago and see whether you can implement anything, even just committing to it on a trial basis.
Now, about your food yesterday. First, it is hard to say, as we don't yet have the directions from the doctor, and as well you don't indicate how you were feeling at each point. Fast sugars to correct a low, but slow carbohydrates to get you through?
That said, here's some feedback on yesterday's food:
Breakfast: Pretty fast. Good if you were low in the morning, but not much to tide you over. Not much fat or protein. Some fiber in the Grape Nuts, a more healthful option than some other cereals. Oatmeal is less expensive and better for you. Keep berries in the freezer and add a few while it cooks. You can mix in flax seed meal after you cook it for helpful Omega-6 fat and extra fiber. Have a hard-boiled egg too. A little milk is fine. A banana is a fairly fast fruit. If you had added a protein, as you often do, it would have been more okay.
Lunch: What was in your particular salad? Most vegetables are neutral. Olive oil and avocados are good fats. Chicken is protein and sometimes fat. Nuts, seeds, cheese are both fats and proteins.
Snack: Watermelon is like the sugariest of fruits. If you were trying to remedy a low, sure. But it wouldn't sustain you.
Dinner: Nicely balanced.
Dessert: Perfectly fine, if part of the nicely-balanced dinner.
Here's how things work: When one eats, the food becomes glucose, which travels through the blood to get to where it needs to go. Some foods do this faster, some not as quickly. Fiber, protein, and fat slows things down. White sugar, white flour, white rice, white potatoes are all very fast, as are some other sugars and starches and fruits and refined foods and such. Insulin is a key that allows the glucose to enter the cells. Without insulin, the glucose stays in the bloodstream, but with too much insulin, too much glucose leaves the bloodstream.
The body spends all day balancing, with the pancreas putting out insulin as necessary, and the liver releasing glucose when needed.
If one eats a bunch of fast sugar alone all at once, the pancreas releases an excess of insulin to cover it. One suddenly has an abundance of energy, from all the suddenly-available glucose. But then the insulin does more of a good job than it needs to, and one crashes, because the blood sugar is suddenly too low, too fast for the liver to correct it just as fast.
Normally, however, when one takes in food, some gets used for energy, some gets stored as fat, and some gets stored in the liver. If one doesn't eat more needed, one doesn't gain fat. In between meals, what the liver stores is released and helps things along.
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Now, if you go without eating for too long, if you get too many lows that the liver needs to correct, the stores in your liver get depleted. So, the fewer hypoglycemic lows you have, the more ready your liver will be for when you do are in danger of having one, while the more you have, the less able your liver will be to handle one.
Now this a question for the doctor, is the hypoglycemia caused not by an overabundance of insulin, but rather by the liver not being able to store glucose well? Seems less likely a cause for diabetes, but still worth asking.
Too much insulin can lead to Type 2 diabetes because the cells are like a lock that gets worn out from being unlocked so often by the key, the insulin. So the cells get less receptive to being opened, and it takes more insulin, like more tries with the key in a sticky lock, to open them, a vicious circle.
But we don't yet know the cause of your hypoglycemia; we are working with the idea of too much insulin because of the doctor saying it could lead to diabetes. He may have told you and you missed it, or he may not have told you, so you need to clarify.
If one eats a huge, fast-acting meal, then probably way more glucose than is needed to function in too short a period of time will get into the bloodstream. So, insulin will be released and the body will store this as fat, and then hunger will come quickly again, because the glucose has been stored as fat and is not as readily available for energy. If a meal that takes longer to digest is eaten instead, then energy will be made available continuously over a longer period of time and the person will be sustained.
So the idea Catherine and OTRgirl present of eating carbohydrates together with protein is good. You don't have to completely avoid the fast sugars, just use them both in moderation, which you already do a lot, and in combination with the slower foods. A meal with some fast and some slow works to get you energy both right away and for the next few hours. Where it's tricky is not having too much fast, which could lead to too much insulin and then a low blood sugar, but also having enough fast, for when you are already low. Again, a glucometer could provide hard data which along with your own observations could help you identify patterns.
It seems like you are quite good at only having a few of something, as your frequent mentions of a handful of almonds or the like indicate, as well as not eating food just because it is there, as evidenced by your making food and leftovers last.
Walnuts have protein and healthful Omega-6 fat. It is possible that just eating a few walnuts every hour in between meals would be sufficient. Or it could be that you need to have two snacks between meals of both something fast and something slower.
Some ideas for snacks to carry around with you: Walnuts, other nuts, sunflower seeds, snap peas, juice boxes, hard candies, glucose tabs.
Also, there are granola bars and power bars that are packed with carbohydrates, fiber, protein, and some fat. Those would be easily transportable. Or you could make your own! Use some of the following ingredients: oats, butter or oil, honey, flax seed meal, nuts, seeds, dried fruit, chocolate chips, psyllium fiber.
You've mentioned Danielle being very good with biology. Perhaps she'd be a good person to bring along to your appointment, so she can hear the information from the doctor too and support you in processing it all.
Again, it is completely normal for you to be overwhelmed and anxious. This is a lot. This is a change. You've had to control so much under difficult circumstances so of course you are upset about this. Emotionally, you'll feel this way for a bit. But recognizing some of the above intellectually might contribute to feeling better sooner emotionally.
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We all care about you. We all know that with the right help you can handle this and feel better.
This comment is embarrassingly long and somewhat rambly. It's taken a while to write it, so no more editing. Hope it's helpful and relatively clear.
(Phew!)
Gave all this some further thought overnight. Things seem simpler now. Here is the new thought:
Maybe you do not need to be worrying about this constantly throughout the day. Maybe you do not need to be asking yourself whether you are hungry and how you are feeling and do you need a snack all the time. Maybe you do not need a glucometer or even to actively determine any patterns.
Diabetics have to monitor constantly, especially those on insulin, because things can go up and down so fast for so many reasons. But that is not you.
You weren't in any imminent danger before, right? There's a risk of Type 2 diabetes for a reason we aren't clear about, but you weren't having blood sugars so low you were going to pass out. You've been tired a lot, your mood was affected too, but you were not going experience anything like diabetics do when they take more insulin than needed.
So.
So maybe OTRgirl's comment on the previous post is more of what you are supposed to do.
Maybe you just are supposed to make your meals, already pretty healthful, more healthful, more balanced with protein to get you through and with even less of the fast carbohydrates, and with the snack or two in between, too, all to make the day more consistently even.
Maybe you are just to avoid having watermelon, pretzels, candy, or the like for a snack without always pairing it with a protein, even just the ten almonds or whatever, or if you are feeling low, to have the sugary item first and then fifteen minutes later the protein.
Maybe you are just to be aware of what might be causing you to feel tired when it happens and know to take in some fast sugar to fix it.
Yeah, so maybe it's less detailed than we were thinking. Maybe you just are supposed to, one, make a few adjustments to what's in your meals and add in the snacks, mostly so as to avoid having lows, and, two, then when you do have lows, just be able to recognize and remedy them.
Even if that's not all there is to it, that's a good start. The whole thing is very overwhelming, so maybe just concentrate on that for now. You'll be better off than you were, and it won't be too much.
And Catherine's suggestion of presenting what information you need, starting by telling the doctor at your next appointment, or calling him on the phone if you want before then, and saying you were freaked out at the appointment and need him to go over the information with you from the beginning, that's a good approach. Still have your list of questions ready, but recognize that by understandably not paying attention you may have missed some basic information and so some of the questions might therefore be not based on the proper foundation. Starting from the beginning will clear up a lot, plus then you have your questions ready this time, would not have to think what questions to ask.
This really is going to be okay.
Sorry for not seeing things this way sooner.
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