biting in

out for dinner

celebrate your thirty-third birthday three weeks after the birth of our son – a pulsing, :flooding gush of blood

a crowning head from your body torn open

by his entry into our lives

you are more beautiful to me than ever

nursing breasts swollen with milk nipples still sore, from suckling the baby

belly shrinking, distended with stretch marks,

red stencils of her passage into motherhood

I wonder if you notice

how much you have changed since this conception.

months of wondering if this baby might survive

unlike our first.

Anxiety combines with nausea bloating, cramps

intermingled bleeding

rub vitamin E oils over distended bellyskin massage your lower back

your  mind – some other place

parenting classes, breathing exercises

sit with pillows on the floor, mark moments on our watches count the time between contractions

what to do when the water breaks

a packed bag – toothbrush change of clothing hospital stuff

then the day of the birth race home from work

find you already gone by taxi your bag still in the closet

all our lessons together already abandoned with your frilly gown

and brand new toothbrush

arrive at the  hospital after a sixty mile an hour drive across the city beginnings of rush hour.

I am terrified

I am going to miss being with you

to share in the birth of our child

when I arrive you complain

I’m never around when you need me but before you land any real blows you clench back a howl

from the pain of a contraction .

I hold your hand while your eyes glaze over momentarily

before you return from your journey into pain to look up at me

from your seat in the shower in the maternity ward

the rest of the long night blur of nurses and midwives, friends come by to see you

some stay through the birth

others leave at the first real signs of birth – the final minutes

unable to face

the overpower physical reality of it

during the breathing counts your eyes are locked onto mine

it feels like our souls are glued to each other by going through this passage together

it is the only way we can face this pain

is if you can concentrate your focus on my eyes, counting

panting together

a counterpoint to intercourse a body passion to expel

what we have inspired in your womb

in the final moments

fully dilated, ready to push flushed, fearful, pressed angry, hopeful

you are enraged when a nurse

scratches your thigh with a protruding fingernail

swear like a trucker

during the final push when the baby’s head passes out of your body

the rest of his little torso

is expelled from you like sausage from a meatmaker

part of me is repulsed

by the whole damn thing, but I am also

drawn in

by its sheer immensity

afterward

in the visitors room the relatives

noisily visit mama and baby

I finally go home

too exhausted to notice when I say goodnight

and kiss you on the cheek

you barely nod in my direction our son sucks

on breasts newly sprung triggered by the baby’s need.

out for dinner

three weeks after the birth of the baby you sit back in your chair

suckling the baby

even more of a stranger to me now than before our first embrace

Pushing on

Past the pain

It is Friday afternoon, and I’m sitting at my desk thinking about the past week. Wow! What a week it has been, and despite everything I’ve kept to my Intermittent Fast.

It has been a struggle, not to keep up with my fast, but to keep my blood glucose in tight control. I try to maintain my readings in a range between 4 and 7.8 mml, from my Free Libra meter. Twice in the past week my readings have been wayyyyy too high, up as high as 15 mml for a few hours after a meal, and even as high as 10mml all day long on my fasting days. Ouch! But I need to explain that in order to keep my levels in the right zone, it isn’t as simple as it seems.

I have to control not only my food intake, which I’m managing by eating low carb healthy meals on my eating days, without being obsessive about it, and fasting my three days a week, but also adjusting my insulin and other medications to balance off my fasting and feasting.

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This week, for the first time, I haven’t been taking my jentadueto which up until I’ve been taking twice a day, once in the morning and once at dinner time, even though I’ve been skipping on my fasting days. This week I’ve stopped taking them altogether, largely as a result of concerns about chronic pain, which seems to have become much worse since I switched from pure metformin a couple of years ago. My pain this week has been terrible, and I’ve thrashing about trying to figure out what’s triggering it.

Metformin itself can cause chronic pain, either as a standalone drug or as a component in Jentadueto.

I probably should have increased my insulin even more than I did, both on my fasting days and my eating days. As an adjustment for not taking the metformin I increased by long acting insulin to 35 g from 30 on my fasting night, and 40 to 45 g on my eating days. On both days my blood glucose levels were high all day, above 8mml but even higher, up to 15mml.

Tonight I’ll increase my insulin long acting to 50 units, and see if that does the trick, along with controlling my carbs. I’ll get it right, sooner or later.

Christopher Columbus – This week I played Christopher Columbus in a short movie.

However, what made me say “Wow” to my week is that this is the first time in my life I’ve actually been a paid actor in a documentary tv series. I don’t know if my scene will end up on the cutting room floor, although I hope not, but in some way it doesn’t matter. I’m now officially an “actor” because someone has paid me to appear in a movie or tv show.

One of the things I’m determined to do is to try new experiences, and to expand my capacities. Having shot one show suggests that I can do more, if I want. And I think I do. It’s important for me to make some money, of course, since I don’t think anybody can live on their Canada Pension Plan and Old Age Security checks. But I don’t need to make a lot of money, just enough to take the edge off, and be able to afford the luxuries of life, like food and housing.

Me as Christopher Columbus in a film shot in Vancouver, BC this week.

The fact that my acting debut happened the same week as my excruciating pain, and all my adjusting of my meds is perfect. Fasting doesn’t interfere with life, it is simply just another part of life. Pain interferes with life, for sure, but I won’t allow it to stop me from doing something fun and interesting.

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.

How to improve your health when your blood sugars are out of control.

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  • Healthy people are proactive about our health
  • Healthy people seek out more information
  • Healthy people consult professionals before implementing significant changes in our medications or lifestyle choices
  • Healthy people are patient and persistent in overcoming health or lifestyle challenges.
  • Healthy people accept total accountability for our own health, without taking on blame for things beyond our control.

What can you do to improve your AIC when you’re feeling terrible from a variety of symptoms and conditions, many of which are either a direct result of your diabetes, or at least are indirectly impacted by persistent high blood sugars.

There are any number of things you need to deal with in order to make real change. The most important of these things is probably NOT your diabetes. At least not directly.

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I’ve been a type two diabetic for many years. Diabetes probably started with me in my twenties although my first symptoms didn’t start to show up until I was nearly forty. I’m now in my sixties and I’ve been on insulin for more than fifteen years. That means I’ve been pricking my finger at least once a day since I was fifty years old, and injecting myself with insulin ever since.

The one thing I can say about my diabetes is that it has progressed in a predictable way, gradually causing negative effects to my body. All the way along the road various doctors have given me a lot of prescription medications, as well as a lot of advice. I’ve been to diabetic clinics where nurses and dieticians have attempted to teach me how to control my blood sugars through diet and exercise.

Why Me?

When I was first diagnosed with diabetes I even received counselling, to try to make sense of Why Me? I think everyone feels victimized by negative health conditions, whether it’s COPD, Heart Disease or Cancer. The answers to Why Me? are both existential and practical.

There are two parts to the answer. First, there is the part of Why Me? over which you have no control, never did, never will have and makes no difference anyway. Whether it’s fate, God, a cruel universe, DNA or the conditions of your life (including a bad diet, smoking, poor or no exercise, etc.) leading up to becoming diabetic none of them actually matter in coming to terms with the emotional fallout of Why Me?

Truthfully, there are many things I could have done differently in the past that might have made a huge difference in my experience of diabetes now and in the future. But for whatever reasons I had, or gave myself, I did what I thought was within my capacity to change in my habits and behaviors.

You can check your blood sugars regularly with you meter tests, get your AIC blood work done in the lab and consult with your doctor as often as she thinks is useful or necessary. You may make changes in your diet and exercise program, and do your best to lose weight and keep it within certain boundaries. And if you do all these things from the beginning, your diabetes will be stable and you will reduce the consequences of this disease.

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For most of us, however, no matter how much we say we care about our health, we’re not really willing to do whatever is necessary to fundamentally change our outcomes. We do some of it, maybe ever some of it every day with serious intentions.

This is the Second Part to Why Me?

This is the part of Why Me? you can control if you choose to do so. So how do you change what you do and how you act, to have a real impact on your own health? This goes back to me saying that it’s not actually about diabetes, or even about your physical health.

It’s really about becoming conscious about who and what you want to be in your own life. We’ve all been beat-up by life along the way. Parents, friends, lovers, partners and even strangers have both positive and negative impacts on our self esteem. Why is that? Why do we let anyone else impact how we feel about ourselves, and how we make positive or negative choices about our lives, including those choices about dealing with negative health outcomes resulting from poor choices.

I hate to say this but “Who cares?” It doesn’t matter what happened in the past, or how you allowed yourself to be negatively influenced regarding healthy living. It really doesn’t matter, but only if there is some way you can turn your life around and ultimately take control of those things that you can control.

How to take control and like it.

The first thing is to understand what it is you need to do to make things better. If you don’t know what you need to do, it’s pretty hard to decide what to do. So find out. See you doctors. Read everything you can find out about current treatment alternatives, and inquire from other people their experiences. Read blogs. Get new referrals to diabetic clinics and resources. Talk over alternatives with your specialist. Make a plan of action with on a few, specific steps, done regularly and persistently.

Don’t try to do everything all at once. Set limited goals with realistic objectives. For example: Don’t try to lose a lot of weight in a week or even a month. Lose weight in amounts that can actually be achieved. If you find it too hard to do by yourself, join a club or a weight loss program which comes with monitoring and emotional support. But don’t blame the program if your weight loss isn’t happening. Be totally honest with yourself, and reset your goals. Weight loss is fundamental to improved diabetic outcomes and lowering blood sugar.

Don’t hang around waiting for someone else to improve your health.

If it isn’t happening, then look elsewhere for support, but don’t give up on necessary change. Remember that whatever happened yesterday is no longer relevant unless it results in change today. Guilt is useless unless it is accompanies by a renewed sense of personal accountability.

When I graduated many years ago from UBC my school motto was TU UM EST. What I didn’t realize was how powerful an idea that really is.

TU UM EST!

New Insulin Monitoring, and new Insulin too!

My endocrinologist has been talking about getting me set up on a whole new system of monitoring my diabetes, in an effort to improve my blood sugar management. It turns out that my Blue Cross administration approved it last fall but nobody told me that they had done so. It was only when I submitted the application again late last month, and it was declined that I found out that it had already been approved, and it was expected that I would start to use, once the approval was provided. Just as a comment, this is a good example of how not to communicate about medical affairs. If I had thought to go to the Blue Cross members page and look, I would have seen that it was approved. However, I seldom, if ever, need to go onto the website and the members area. An email would have helped.

The next step is to return to my General Practitioner for the necessary prescriptions for the machine and the insulin, and whatever ever is required to use the system. Hopefully he will also provide me with instructions on how to do this.

Flash Glucose Monitoring System for Diabetes. … The FreeStyle Libre Pro is a glucose monitoring system intended to replace finger-stick tests; it uses a sensor implanted in the arm that a health care provider scans with a specialized reader for a record of glucose levels, trends, and patterns in people with diabetes.

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I am also hoping that with the new system of monitoring and delivering my insulin during the day, that I will need less of the other medications I have been taking for some time. My pharmacist thinks my doctor should eliminate the pills I take to control the diabetes, and use close management of insulin to control the blood sugars.

The reason for this recommendation is that it seems quite likely that a number of adverse symptoms I am experiencing are possibly related to my other diabetes medicines, and if I can stop taking them these side effects may, in fact, go away.

Any, this is a new start for in trying to better control my health and my diabetes, but only one of a number of steps I plan on taking in the next months and years.

I’m also hopeful that I will be able to use my iPhone 6+ as my monitoring device rather than the one from FreeStyle Libre.

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