Sunday, January 25, 2015

Progress, Not Perfection

Three months ago I remembered I have health insurance and could visit a doctor about a rash I had on my chest that needed attention, without it affecting my bank accounts or credit rating. So I found a physician through my health insurance referral who made up in efficiency what she lacked in bedside manner. (Seeing as how infrequent my doctor appointments were over the years, part of me embraced her bluntness.) This doctor prescribed me some antifungal medication to treat the rash, but was satisfied with my vitals as she sent me on my way to have blood work drawn.

Two days later my doctor called me with the results of my blood work. "You have Type II diabetes," she said, matter-of-factly.

Not, "you're at risk for Type II diabetes." "You have Type II diabetes."

She said my hemoglobin levels (my 120-day blood sugar measurement) for a man my age, height and weight should be near 7; mine were pushing 12. I took the news in stride, knowing my mother's side of the family struggles with it. (Mom had been Type II for years and recently worsened to Type I.) The doctor gave me prescriptions to keep my blood sugar levels in check and said she would send me some paperwork in the mail on how to manage my condition with proper diet and exercise.

"Don't go looking online for information. There's a lot of misinformation out there," she instructed me while I was already researching the American Diabetes Association's website for more information. Three days later I received 15 pages of printouts from what looked like an archived Geocities website, with a tasteful post-it note reminding me of my new reality.

By the time the doctor's reading material arrived I had already started changing my dietary habits.Gone were the twice daily snack breaks involving a 20-ounce bottle of Pepsi and a four-pack of Reese's peanut butter cups, chips, simple carbs and most of the processed food that were a part of my diet. Then I took inventory of the rest of my larder and pantry to assess the building blocks I had in stockplenty of dried fruits, nuts and legumes; whole  wheat flour; sweeteners such as honey and maple syrup; spices, hot sauces and salsas.

The silver lining with my diagnosis was my weight was lower than I expected at 225 pounds, my blood pressure was normal and my pulse rate was commensurate with someone who works out 2-3 times a week. That and my food inventory indicated some good habits were in place that could serve as a foundation for change.

Cutting out the soda and candy was easier than anticipated. (I once went two years without a Pepsi, so I knew I could do it again and, thanks to my Sodastream, I could drink juice/seltzer mixtures.) And I've never been a fan of white bread, so eating multigrain was OK. 

But I love pasta and white rice, and Italian bread with olive oil and Parmesan, and a thick hamburger and hot dog bun. The thing about diabetes is sugar isn't your only nemesis. An excessive intake of simple carbs can result in elevated blood sugar levels, since the body processes carbohydrates into sugar. So I've spent the past three months working to adapt my normal recipes requiring regular flour for whole wheat. Mom's biscuit recipe was simple to adapt. And I'm making rouxs and gravies now with masa harissa and potato flours. White rice has given way to brown and wild rice, and I've added quinoa and farro to the mix for variety and flavor.

I've become very familiar with kale, arugula, collard green and other dark, spicy greens rich in minerals. I've become re-acquainted with my love for leeks, mushrooms, carrots, celery, cauliflower and broccoli, all non-starchy vegetables which make great additions to salads and are outstanding for dips. As far as meats are concerned, I've been eating lean for years, ever since I stopped being exclusively a food writer. The major addition there is fish. Tuna and tilapia are versatile and I do love a good fish taco.

But the biggest change has been when I dine out. Before the diagnosis, I was the type of person who would look at a menu for a hot second before ordering something heavy in my ongoing quest to be a stunt eater. Now I have to take my time and consider portions and balance. It's been humbling, but it is doable.

And the results have been promising. I went to my doctor for a follow-up check-up a few weeks ago and my hemoglobin levels were down to 8.7. My triglycerides and LDL levels, which were also through the roof in October, were normal. My blood pressure remained normal and my pulse rate was lower by eight beats per minute.

Because of the holidays, I was worried about losing weight but I weighed in at 219. I'm still on the blood sugar medication but things are looking good, overall. I don't need more motivation than I already have but I started a weight loss wager with a friend where the loser has to do an exercise of the winner's choosing. We're looking to lose 10 percent of our initial weigh-in weight by the spring solstice, which means reaching 200 pounds by March for me. Neither of us plans to lose, but we're encouraging each other to stick with our plans.

I've never wanted to keep tabs on my weight, preferring to be healthy regardless of my waist size. My new reality has me seeing things a bit differently. Having to be vigilant about this diagnosis has me shooting for a target weight I haven't seen since I was a teenager. If it doesn't happen, no worries. These days it's enough to be content more often than happy. And when it comes to eating, I ask what would my spirit guide do?