Eat right. Live better.

How should we be assessing the risk for someone who has just developed diabetes? What causes beta cell failure?

There is no going back. Damage to your nerves by neuropathy is a one way street. Start treating your diabetes while you still can prevent the worst of it.

Check out Professor Shaheen.s Tutorials in Medicine for a better understand about the science of diabetes.

The journey into becoming a diabetic is one that most of us join without knowing the consequences of what we’re doing. There are a lot opinions out there, even among doctors, as to what actually “causes” diabetes, but pretty much everyone I read knows that diabetes is highly related to obesity and carbohydrate overconsumption. And when I was diagnosed, more than twenty years ago, the information I was given was faulty and at the very least incomplete.

Professor Shaheen’s Tutorials in Medicine https://internalmedicine.blog/

What no one ever said was that if I continued to eat what I thought of as a “normal” amount of carbohydrates and sugar every day, by the time I retired my life would be severely circumscribed, with many symptoms of diabetes and other metabolic syndrome related diseases causing continuing pain, physical exhaustion and emotional distress. I also suffer from chronic fatigue and despite having lost some weight, am still fighting the good fight doing intermittent fasting three days a week for 36 hours.

So what should I have been taught as a younger person, that might have protected me from getting full blown diabetes and other metabolic syndrome diseases.

Eat less carbohydrates. A lot less. On my current low carb high fat diet I keep my carbs below 150 grams a day. Eat even less added sugar. I try not to eat anything with added sugars, and when I do offend I eat very small portions of any sweet at all. Mind you, my appetite for sweet things has pretty much disappeared since I started avoiding them. Stay away from booze. Period. Lots of doctors and dieticians say that a one or two drinks a day is okay. I don’t believe them. Alcohol does similar things to the liver as carbohydrates, without the redeeming quality of providing me with any energy.

Always seek to reduce the amount of starch and sugar, and fill up on natural food if you are going to eat carbs. Eat fruit in season, in your area, and don’t overindulge even in fruit and vegetables.

Try not to get depressed because you can’t have any “real” food. Try to redefine what constitutes a meal, and understand that the meat and vegetables are really enough.

Pain Mastery Institute is shut down

The Pain Mastery Institute, which I’ve been blogging about for a couple of months, is shutting down due to financial considerations.

The Pain Mastery Institute, which I’ve been blogging about for a couple of months, is shutting down due to financial considerations. Their courses have been useful to me but not nearly as useful as if they had survived long enough for me to get through the whole program.

The main thing I learned from the courses is that much of what is available for mastering chronic pain is drawn by observed people as they take actions or make decisions which assist them in managing their pain, or ameliorating the amount and intensity of pain.

While the course is gone, and the Institute website shut down, this doesn’t mean that I’m abandoning my pursuit of effective pain management strategies. So keep watch for my blog because I will coming back with a new approach soon.

Update on Intermittent Fasting

Starting on Monday this week I began a five day fast, which so far has been a bit frustrating and challenging. The second day and the third day I found myself absolutely starving, which is odd because up until now, fasting for three days a week, 36 hours, I have never been really hungry.

It takes a bit of a different strategy for longer fasts, like a five days on, four days off, but I’m learning and will be putting together a new primer based on somewhat longer fasts.

Boing 737 crashed after being shot down near Tehran

This has been a really sad and horrific week for me, and for many Canadians. 147 Canadian residents and citizens were killed this week by an airline shot out of the sky by Iran, either by mistake or by design. Either way, we have all lost so much and I can’t really even begin to make any sense of it. I am just sick over it, and I didn’t know anyone personally on the plane, although I do know some family members.

The Prime Minister of Canada has been highly visible in his demands for accountability for this disaster, both from Iran and the United States governments, who put into play the violent altercation that led to these deaths, whether by misadventure or by malice.

I don’t know whether to rage or to cry, or both. I’m not expecting any closure any time soon. Iran is virtually certain to lie through their teeth on this, and Trump will do no better. This is a terrible tragedy for everyone involved in the flight, and all of their country mourns their loss.

Deviant Life #33 — Discerning Deviant

FIRST / PREVIOUS / NEXT For as long as I can remember, the Polyamory community has had a strangely sex negative segment that was largely born of the desire to distance themselves as much as possible from the widespread assumptions by people outside of the community that polyamory was all about fucking around indiscriminately. It’s […]

Deviant Life #33 — Discerning Deviant

Fit? OMG! Thriving or suffering in our bodies?

A couple of suggestions and questions.

  1. Don’t smoke
  2. If you smoke, quit!
  3. If you quit and still get COPD, what the hell do you do then?

Donald B Wilson 1959-60 a

I’m not exactly in the best physical condition, considering everything.  I’m a type two diabetic, dependent on insulin.  I’m way too heavy, as my lifelong personal physician put in my chart – obese! She was far too polite to say that out loud to me, so I found out only after she retired and sent me a copy of the charts for my next doctor to see.

Up until 12 years ago I was a heavy smoker, having nearly started in the cradle, with both parents chain smoking my whole childhood.  I stole my first smoke from my mom before going to elementary school!  By the time I was ten I was smoking pretty regularly, and spent high school pretty much hanging out in the smoke pit with the other addicts.  Both parents scolded me for smoking, but then doing what you do rather than what you say does not give parents a whole lot of credibility.  None, actually!

Still, although it might have been their fault that I started smoking, they didn’t hold the stick in my mouth, and force me to smoke for the next forty years.  That was my own doing, and there’s no getting around the fact that I smoked a lot! for a long time! and didn’t really think about the consequences much.

Actually that’s not true.  In my periodic journals and diaries over those years, I remember bitching and complaining about how much damage I was doing to myself by smoking, despite hating what it might doing to me long term, I still kept on smoking.  I was totally resistant to all efforts made to get me to quit.

I did try from time to time.  Once, in my forties I stopped smoking for almost a whole year, before giving in to the filthy habit. So I guess I did know how harmful it might be to me in the future.  And eventually I did quit.  Twelve years ago next January.  It wasn’t easy.  In truth I might still be smoking if I hadn’t ended up in hospital for near a month as a result of blocked colon surgery.

Part of quitting was about trying to be a better example of a human being to my grandchildren than I had been to my own children growing up.  Twelve years ago I didn’t have any grandchildren, yet, but I was encouraged by believing that it would be better if they never saw me smoking at all.

I really hoped that by quitting when I did that I would avoid the worst consequences of smoking, such as COPD or lung cancer.

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.

Well, I hate to say it, but so sad, too bad.  I have COPD, having pretty much avoided it until I caught pneumonia in August 2016 which triggered it, with severe breathlessness and a pretty severe and sudden restriction in my lifestyle.  The following list of things I could do comes from the Mayo Clinic website:

Lung therapies

Doctors often use these additional therapies for people with moderate or severe COPD:

  • Oxygen therapy. If there isn’t enough oxygen in your blood, you may need supplemental oxygen. There are several devices to deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town.

    Some people with COPD use oxygen only during activities or while sleeping. Others use oxygen all the time. Oxygen therapy can improve quality of life and is the only COPD therapy proven to extend life. Talk to your doctor about your needs and options.

  • Pulmonary rehabilitation program. These programs generally combine education, exercise training, nutrition advice and counseling. You’ll work with a variety of specialists, who can tailor your rehabilitation program to meet your needs.

    Pulmonary rehabilitation may shorten hospitalizations, increase your ability to participate in everyday activities and improve your quality of life. Talk to your doctor about referral to a program.

Lifestyle and home remedies

If you have COPD, you can take steps to feel better and slow the damage to your lungs:

  • Control your breathing. Talk to your doctor or respiratory therapist about techniques for breathing more efficiently throughout the day. Also be sure to discuss breathing positions and relaxation techniques that you can use when you’re short of breath.
  • Clear your airways. With COPD, mucus tends to collect in your air passages and can be difficult to clear. Controlled coughing, drinking plenty of water and using a humidifier may help.
  • Exercise regularly. It may seem difficult to exercise when you have trouble breathing, but regular exercise can improve your overall strength and endurance and strengthen your respiratory muscles. Discuss with your doctor which activities are appropriate for you.
  • Eat healthy foods. A healthy diet can help you maintain your strength. If you’re underweight, your doctor may recommend nutritional supplements. If you’re overweight, losing weight can significantly help your breathing, especially during times of exertion.
  • Avoid smoke and air pollution. In addition to quitting smoking, it’s important to avoid places where others smoke. Secondhand smoke may contribute to further lung damage. Other types of air pollution also can irritate your lungs.
  • See your doctor regularly. Stick to your appointment schedule, even if you’re feeling fine. It’s important to steadily monitor your lung function. And be sure to get your annual flu vaccine in the fall to help prevent infections that can worsen your COPD. Ask your doctor when you need the pneumococcal vaccine. Let your doctor know if you have worsening symptoms or you notice signs of infection.

https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685

It might seem obvious that I need to change my habits, if I’m going to improve the quality of the rest of my life.

Dr. Tsang, my pulmonary specialist, referred me to the Fraser Health Respiratory Rehabilitation and Education Program at the Physiotherapy Department at  Langley Memorial Hospital close to where I live.

It is a six week Pulmonary rehabilitation program pretty much as described in the Mayo Clinic Internet website.  A rehabilitation respiratory counselor provided lessons and counselling, and worked with a physiotherapist and dietitian to provide useful information.  The classes (my class had five COPD students) run for about three hours twice a week, and for me personally, were extremely useful.

There is really two different types of learning that goes on in the classes, both of which are useful but one of which is essential if a person really wants to get the benefits of the information provided in the handouts and lectures.

All the materials presented are readily available on the internet or at your Public Library.  You could find them yourself, read them, and then do what is recommended.  You’d think that as a adults we could do that, and save everybody a lot of money in providing these classes.  Hell no!  Because information without reinforcement and actual exercises is only a small part of the learning process.  In some ways the biggest thing I learned in the program was how to let go of my fears, anxieties and panic, when experiencing extreme shortness of breath.

It’s no party, not being able to breathe freely.  In fact, its terrifying when you discover yourself unable to catch your breath any time your do any exercise at all.  For me, even walking up a flight of stairs seemed beyond what I was able to do.  I thought I was going to die, and the more afraid I became, the more difficult I found it to catch my breath.

The doctor told me that it wouldn’t likely kill me to breath, no matter how short of breath I am.  Her advice was helpful, although I’m not sure I actually believed her when she told me.

What was more useful was sharing the experiences of the other students within the context of the classes, where we were encouraged to stretch ourselves and learn to manage our boundaries while improving our cardio vascular  health.  We walked, biked and did stretching exercise as a group, with the instructors monitoring our oxygen levels and pulse levels.

After six weeks I gained insight into better management of my health, and an improved sense of opportunity to control my future.

Before I started the class I had already begun to walk and do more exercise four or five days a week.  After completing the program I’m committed to walking and exercising more, as well as changing my diet to improve my weight.  I know that doing so will also improve my diabetes and blood sugar levels.

I no longer feel so dis-empowered by my COPD, and see it as somewhat similar to my diabetes, which I also resented like crazy when I was first diagnosed.  Just as I have learned to manage my blood sugar levels through a combination of medications, insulin, exercise and diet, over the past ten years I will get control of my cardio vascular health, and reduce to a minimum the impact of COPD on my life.

I have learned that just because it’s hard as hell to breath when I exercise is no reason to stop exercising.  In fact, the opposite is a fundamental truth.  Use it or lose it, as the old saw goes.

I now make real effort to get and walk every day, and to exceed the minimums recommended in the class.

Instead of taking the shortcut every time, I’m learning to take the longer road home