Diabetic Pain – Neuropathy

Neuropathy

DIABETIC NERVE DAMAGE (neuropathy) affects approximately 60-70 percent of patients with diabetes. Once again, the longer the duration and severity of diabetes, the greater the risk of neuropathy.

There are many different types of diabetic nerve damage. Commonly, diabetic neuropathy affects the peripheral nerves, first in the feet, and then progressively in the hands and arms as well, in a characteristic stocking-and-glove distribution. Damage to different types of nerves will result in different symptoms, including

• tingling,
• numbness,
• burning, and
• pain.

The incessant pain of severe diabetic neuropathy is debilitating, and the symptoms are commonly worse at night. Even powerful painkillers such as narcotic medications are often ineffective. Instead of pain, patients may sometimes experience complete numbness. Careful physical examination reveals decreased sensations of touch, vibration, and temperature, and a loss of reflexes in the affected parts of the body.

While a loss of sensation may seem innocuous, it is anything but. Pain protects us against damaging trauma. When we stub our toes or lie in the wrong position, pain lets us know that we should quickly adjust ourselves in order to prevent further tissue damage. If we are unable to feel pain, we may continue to experience repeated episodes of trauma. Over the years, the damage becomes progressive and sometimes deformative. A typical example is the foot. Significant nerve damage can lead to the complete destruction of the joint-a condition called Charcot foot-and may progress to the point where patients are unable to walk, and may even require amputation.

Dr. Jason Fung, The Diabetic Code p.28

Diabetic neuropathy has led directly to my willingness to undergo a radical lifestyle change, including intermittent fasting, and major changes to my overall dietary behavior. In particular, major pain to my hands and feet has increased exponentially in the last couple of years.

This type of pain is almost invisible to the people around a diabetic. They often wonder, I’m sure, what the hell is wrong with me, as I stumble from step to step, at times looking for all the world like a drunk after one too many.

Despite my best efforts to appear normal, it is sometimes impossible for me to avoid an outburst from a sudden onset of sharp pain in my hands or feet, without any advance warning that my chronic pain will suddenly become extreme, even if only for a few moments.

Dr. Fung mentions that it is worse at night while a diabetic sleeps or rests. Well, there are many times when neither is really possible, and my partner lays across from me worrying as I toss and turn in pain. And neuropathic pain is only one of the causes of pain in my body at night. Others are arthritis, bursitis, and severe muscle cramps.

Combine these with fibromyalgia and I guess that I have won the sweepstakes of pain, so far without winning the big prizes, premature death or paralysis. Even without the immediate threat of dying, chronic intense pain is exhausting, often leaving me so tired that days go by without being able to accomplish even the smallest things. Even I tend to feel like a lazy sonofabitch because my progress in so many things is fractional or even non-existent.

I wish I were faking it, of which I have been accused at times. If I could make it go away, I would indeed. The best thing my doctor ever told me about neuropathy is while I can still feel the pain, it is still at least possible that my nerve damage may partially recover as I reduce my diabetes and stop making it worse. Once the nerves are deadened to the point where my feet are simply numb, there would be no hope of ever recovering any of the la\ost sensitivity in my feet or hands.

This is one of the reasons why I am so determined to take any measure that has even a promise of helping me eliminate or radically reduce the effects of diabetes in the future.

My fasting journey has just begun.

Amazon Digital Services, Inc.

No matter how far we are going on a journey, each step is a new beginning. When I began intermittent fasting, back in July, I knew from the start that it is a long term project, and progress measured in weeks, months and even years. My incentives for giving it my best shot are huge – better health, a longer life and a more enjoyable and energetic present.

What I didn’t know, at least not in my heart, is that every day would require a new, fresh commitment to the plan. I sort of thought that my inertia would carry me along long enough to sustain me until I reach my goals, which are tangible, measurable and, hopefully, achievable.

Well, no such luck. Almost every day I fast I find myself feeling extremely positive about what I’m doing. Almost every day I’m not fasting I find myself haunted by doubts. I feel like I’m not losing weight fast enough, I’m not managing my insulin and medications well enough, and whatever I’m eating is working directly against my goals. I see a perfectly normal person walk by and I think to myself, “What a fat slob”. Because I’m afraid that somehow I’ll lose my commitment and indulge myself in foods that I don’t even really like or want anymore.

And I’m still less than a half the distance to my weight loss goal, and still unsure about how long it will take me to get to the point where I don’t need my diabetes medications and insulin any longer. I guess I’ll know when I get there, because both goals are measurable, and there is external evidence that I’m making good progress on both fronts. But in the meantime, I feel a little bit lost at sea, from time to time. The worst times are when I’m eating, and wondering if I can really afford this whatever.

I tried to pretend that I wasn’t obese. It didn’t work, and I still became more and more seriously ill with diabetes and its complications. Something had to change, or I would die of the disease and complications from the disease.

I also know that even when I reach my weight goal, and my ambition to defeat metabolic disorder, and eliminate my diabetes, that I will then have to undertake another journey. Maintaining my healthy body will require vigilance, and committing to a healthy low carb diet, not for a while, but for the rest of my life. So the change I am currently experiencing through intermittent fasting will only be sustainable if I commit fully to the change in lifestyle needed to maintain the results.

Intermittent fasting is a little like travelling through a very long tunnel, at the end of which is new territory I’ve never seen before. There’s also probably more intermittent fasting in the future, if I really intend to maintain my health gains and not go back to obesity and diabetes.

This doesn’t discourage me, but it does present me with a challenge in the present, which is that my level of commitment to a certain and achievable weight and health goals must be followed by an endless journey, if the effort being made now isn’t to be completely wasted.

At that’s just a little intimidating. Well, maybe not just a little. Maybe a lot.

Reversing Diabetes with Weight Loss: Stronger Evidence, Bigger Payoff

In an article I read today in Endocrine Web, by Kathleen Doheny

Every year, about 1.5 million Americans learn they have diabetes. However, there are more than 7 million adults who have diabetes but haven’t been diagnosed, according to the American Diabetes Association. This matters since we are learning that the best chance of reversing diabetes seems to occur very early in the onset of the disease. Finding from several recent studies indicate that the timing of diagnosis matters a lot.

If you have diabetes, your doctor may have encouraged you to consider making lifestyle changes; for many, that may include losing weight. While that same message has been discussed for years, recent evidence suggests that achieving about a 10% weight loss may be even more important than experts thought—with a payoff that is greater than previously imagined.

Endocrine Web, by Kathleen Doheny

So you don’t have to lose all your excess weight to get a benefit from weight loss. As noted above, even a weight loss of 10% has a powerful effect on your A1C levels. This should be a great incentive for diabetics who, like me, have been identified as obese, or even merely fat or overweight.

After nearly three months I can say that fasting is making my health a little better, including reductions in A1C but also including things like mobility. I can actually reach down and touch my toes for the first time in a long time. Fungal infections have been radically reduced already. And my sense of hope for the future is significantly better.

What some authors have written about is the profound effect that fasting and weight loss have on the emotional health of a person. This may be something I’m prepared to write about in the future, but right now I feel like I’m on a roller coaster emotionally, really happy with my results one moment, and anxious about further progress the next.

My wife was diagnosed with Type two diabetes about the same time as I started my fasting program. She tried fasting the same amount as did I, but found that she simply couldn’t sustain a fast for so many hours, so she reduced the fasting to 16 hours and also continued to cut carbs and sugar in the rest of the day. Barely two months into her lifestyle change, including the reductions in carbs and sugar, she managed to reduce her A1C from 11+ down to 7.4.

She also lost some weight but not really that much. The thing is that her BMI is a healthy 24 so she really didn’t need to lose weight, as much as she needed to reduce carbs. A ten pound weight loss translated into a radical change in her blood sugars, and indeed in her medication requirements after the test.

I’m really proud of her accomplishment is such a short time, and firmly believe that if she continues in this direction that she will effectively a “non-diabetic” by spring, if not sooner.

I still hover around 215 pounds, but my blood sugars came down to 7.0 from 8.1 two months ago. My family doctor was pretty surprised and pleased with my progress. The biggest thing I keep reminding myself is that Rome wasn’t built in a day. My obesity is the result of 25 or 30 years of overindulging carbs and sugars, and it’s taking me some time to get the weight off. So be it. I already notice and now so are some of friends and family.


Three Steps Forward…

For the first time since I started this new lifestyle and intermittent fast, I am feeling a little discouraged. My weight has been fluctuating up and down between 215 and 225 pounds for a week. I thought once it got down to 215 it would stay there, but no. So I looked back at the week, and realize that I haven’t actually done anything inconsistent with my program.

So what is going on? I also notice that my blood readings have been running much higher all week, on fasting days as well as on eating days. What’s with that? Maybe I reduced my insulin too much too soon…. I don’t know but it’s discouraging. A bit. From what I read in the literature about fasting, it is seldom a straight line downwards in weight, and adjusting my insulin every day and every night is a little hit and miss.

Necessarily so, since the body isn’t actually just a machine, but is indeed an organic whole system, which I’ve been messing with for the last three months.

Today was my first day of fasting for this week. And I’m sticking to it, even on the bad days. Tomorrow with be a better day. Maybe not. But a tomorrow will be a better day if I stick to my guns and follow the program.

Hang in there with me, folks. The ride’s a little bumpy!

FB SUPPORT INTERMITTENT FASTING

Aside

Low-Carb and Intermittent Fasting support group by Dr. Andy Phung

by Dr. Andy Phung of NC Medical Weight Loss & Direct Primary Care

If you download the TOFI chart from this blog you’ll see how many different conditions and diseases are a direct result of eating too much carbohydrate and sugar over a long period of time.

As described by the Canadian Dr. Fung undoing the damage is a little more complicated than just reducing your carbohydrate and sugar consumption, it includes some level of intermittent fasting for long enough to effective reset the liver functions to allow the proper processing of carbohydrate and sugar, and eliminate the negative consequences of prolonged Metabolic Disorder.

There is now a lot of scientific support for carb restricted diets and lifestyle changes, but as I go along it is useful to collect other Facebook pages, Instagram, and other resources online to support sticking to a difficult but important process.

Counting Carbs

Dietician working on diet plan for weight loss and right nutrition concept. Source: BS

Canada urgently needs a diabetes strategy – just not necessarily the one that Diabetes Canada would have us believe is the right path

The following information is from Diabetes Canada – Basic carbohydrate counting for diabetes management. The charts and recommendations are EXACTLY as outlined in their PDF file available from the Diabetes Canada website

Following the information provided by Diabetes Canada, I will discuss briefly my own take on what this actually means, in the context of intermittent fasting and the low carb lifestyles recommended by Dr. Fung in his Diabetes Code.

STEP 1 Make healthy food choices

  • Enjoy a variety of vegetables, fruits, whole grains, low fat milk products, and meat and alternatives at your meals. A variety of foods will help to keep you healthy.
  • Use added fats in small amounts. This helps to control your weight and blood cholesterol.
  • Choose portion sizes to help you to reach or maintain a healthy weight.

STEP 2 Focus on carbohydrate

  • Your body breaks down carbohydrate into sugar (glucose). This raises your blood sugar levels.
  • Carbohydrate is found in many foods including grains and starches, fruits, some vegetables, legumes, milk and milk alternatives, sugary foods and many prepared foods.
  • Meat and alternatives, most vegetables and fats contain little carbohydrate. Moderate servings will not have a big effect on blood sugar levels.

STEP 3 Set carbohydrate goals

  • Your dietitian will help you set a goal for grams of carbohydrate at each meal and snack. This may be the same from day to day or may be flexible, depending on your needs.
  • Aim to meet your target within 5 grams per meal or snack.

STEP 4 Determine carbohydrate content

  • Write down what you eat and drink throughout the day.
  • Be sure to note the portion sizes. You may need to use measuring cups and food scales to be accurate.
  • Record the grams of carbohydrate in these foods and drinks.
  • For carbohydrate content of foods, check the Beyond the Basics resources, food packages, food composition books, restaurant fact sheets and websites.

STEP 5 Monitor effect on blood sugar level

  • Work with your health-care team to correct blood sugar levels that are too high or too low.

My take on the information provided above by Diabetes Canada is that it is great information, as far as it goes… Which means that I think that there’s a lot more to it than meets the eye.

Trust is a dangerous game.
—via Quotes ‘nd Notes

VARIATION 1 Make healthy food choices – just not the ones implied

Enjoy a variety of vegetables, fruits, whole grains, low fat milk products, and meat and alternatives at your meals. A variety of foods will help to keep you healthy.

Diabetes Canada

This is only one point of view, and one that isn’t necessarily all that helpful, especially since built into the advice are prejudices about the virtues of vegetables, fruits, whole grains and low fat. From my reading in the recent past I am now vitally convinced that the international obsession with starch and sugar based foods (ie: vegetables, fruit, and whole grains) is the fundamental CAUSE of the current epidemic of diabetes. Included in this obsession is the unproven argument against fat and meat.

Recent articles and books on the subject suggest strongly that the prejudice against fat has directly led the world’s health practitioners and public health authorities to make recommendations that have strongly affected whole populations into wrong minded and dangerous eating habits.

So the first point is almost right. Just totally wrong about low fat, oh, and about having a healthy mixture of vegetables, fruits and whole grains. Generally one considers that the first items listed in a list of recommended items should be the items encouraged and supported as the primary source of dietary energy. And this would be WRONG! Sugars and starches should never constitute more than about 10%, maybe 15% of your daily calories. The rest should be made up of proteins and fats, as your primary source of dietary energy for life.

And portion sizes are really important – mostly to keep the amount of starches and sugars to the lowest possible levels, to allow the body to use fat as a primary sources of energy, leaving dietary sugar and starches to supplementary roles.

VARIATION 2 – Don’t trust traditional dieticians or doctors to give you good dietary or lifestyle advice.

Don’t trust you dietician to set goals for you, especially regarding carbs, sugars, fats and protein. Most dieticians today have been trained in a world where fat and protein (especially from red meat) have demonized and starches and sugars elevated to saintly status. Most cook books, dietician training materials, and schools are teaching the same poisoned information that has led us into the diabetic disaster that is underscoring modern lifestyles.

If you want to continue to fight with obesity and diabetes, then follow the Canada or US National Health Strategies, because doing so with take you down the same path as millions of us who are now suffering from severe diabetes, and other side effects of this advice and governmentally supported policy.

On the other hand, if you want to get off the Merry Go Round, and start to live a healthy, happy life, start to adopt what is considered to be a radically reduced diet of sugars and starches. Take your primary sustenance from meat, butter, eggs and fat, or even from vegetables rich in fat. Sugars and starches should be considered as purely luxury items, to be consumed sparsely, and in consideration of their potential for causing harm

Fast Changes

At the end of another week of three 36 hour fasts, I’m contemplating how much my life has already changed, and how much it may still change, as I continue my fasting and attack on diabetes.

Changing your lifestyle is the first key to beating diabetes

First of all, I currently weigh about 30 pounds less than when I started on the low carb high fat program. Fasting started about two weeks later, after I took the time to consult with my endocrinologist about how to manage my blood sugars during my fasting. We had already switched to two different types of insulin, long acting and fast acting, and I’m using the new meter that tests all day long, so he felt that the risk of a dangerous low could be managed.

Secondly, I now know that fasting isn’t really all that hard, for me. I suspect that motivation is a huge part of this, but fasting seems pretty straightforward to me now. Take care of my insulin and blood glucose levels, otherwise just don’t eat. Anything. Instead of it being hard, it’s been pretty easy, and the results so far are gratifying.

Weighing myself every day has become a lifetime habit. Getting my weight to a better levels is one of the keys to improving my diabetes, blood pressure, arthritis, and many other inflammatory problems and diseases.

I made the change to my lifestyle on July 10, and began fasting near the end of the month. It’s now the end of the first week of September so I’m approach two months into the program. My insulin levels are lower than ever as are my glucose readings. I take half of the prescribed dose of long acting insulin these days, and no fast acting insulin at all on my fasting days, and about three quarters of the previous prescibed dose on my non fasting days.

The biggest concern is keeping my blood sugars high enough not to end up in a coma from hypoglycemia from having too much insulin in my system and lowering my blood sugar too much. In more than 20 years of trying to manage my diabetes low blood sugar was never ever a remote possibility, even after being on insulin, as my blood sugars were always higher than desireable.

I recently made two new holes in my belt to keep my pants from falling down, after moving from the last belt hole at the other extreme. I didn’t measure my waist when I started because I was too embarrassed to admit how big I had become. Now I wish that I had because I’m shrinking fast.

When I started this fast, I told myself that I would stay the course for three months, and then re-evaluate where I’m at then, from a health perspective as well as general feeling perspective. I also said that I would be happy if I were to get my weight under 200 lbs or 90 KG by the end of the 90 days of fasting. Today I weigh 217 lbs, down from 244 lbs on July 10th. I believe that I will achieve both goals, at which time I will commit to the next phase of this program.

I wish I could say that there have been no negative effects of fasting. It’s a little early to make that statement. What I can say is that there haven’t been any, so far.