I am really upset … 3 Poor self care and diabetes complications

Those of you following this blog will know the story about my friend T who works for a friend/client of mine. At Christmas time he scraped his foot while swimming and by March his foot had been amputated.  He is still getting around on crutches while he awaits a prosthetic foot.

I was upset once again yesterday when I was told that T was admitted to hospital last Thursday with deep vein thrombosis in the remaining ‘good’ leg. He remains hospitalised at this time and I will contact his son later this morning to get the latest update. The grave danger and possible consequences in this situation do not have to be spelled out.

What really, really gets to me is that this whole unfolding crisis could quite probably have been avoided completely. It need never have happened.

T really needs to supplement his pension income, his employer wants to accommodate this but also has to deal with T’s lengthy  absences from work. It has placed my client in a  difficult situation which will have to resolved one way or another.

When we blithely ignore the warning signs that our lifestyle is causing our bodies to deteriorate, we are literally toying with our  lives. There are thousands of medical conditions that can befall us over which we have no control whatsoever. Surely it makes sense to take charge of what we can control and influence? But we just don’t do it.

I am relentlessly driven by a number of things to continue on my odyssey back to optimal (optimum?!) wellness. I cannot just let it go. I cannot just let things slide – much as I am so often tempted to do. I deviate from the path – badly sometimes – and yet I cannot throw in the towel.

• I value my financial independence and the lifestyle that this affords me.
• I dread the day my children have to step up to the plate and provide for me financially.
• I fear being dependant on others to care for me physically. I cared for my dying mom-in-law for over a year before she died and it was a harrowing experience for both of us. Well do I remember the two of us crying bitterly in each other’s arms as I changed her filthy disposable nappy yet again. The anguish she suffered from the pain and loss of dignity is something that still lives with me  26 years later.
• I am angry at myself for the stupidity I exhibited over many years in not looking after my health and lifestyle.  I still exhibit this same stupidity ; work and stressful deadlines still predominate in my life.

One small consolation is that sanity has now prevailed long enough for me to appoint a temporary office assistant. After only 3 mornings with us, the ‘advent of Nicky’ is changing my office landscape and I will talk more about this in a later post.

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This and that …… 1

” This and that “
These words bring back memories and a smile to my face. My only sibling C, my husband W and my children will remember so well that my Dad used to get a rise out of my Mom at least three times a day. She would get all huffy for a couple of seconds and he would grin in a self-satisfied way and stroll off.

How did he do this?
Every single time he stood up after breakfast he would say, ” Thanks Gog, what’s for lunch? “; after lunch he would do the same damn thing and say, “Thanks Gog, what’s for supper? “, and after … but you get my drift… My Mom would answer in an infuriated tone, ” This and That! ” and my Dad would smugly wander off to think of something else to draw attention to himself….

I really must invest in some new dictionaries. The Readers Digest Complete Word Finder and the Oxford Illustrated Dictionary – not surprisingly – do not have the word gogga listed but it does feature in the ” Tweetalige Skool-Woordeboek ” 1988 edition! An Afrikaans word meaning ” insect “, my Dad used the abbreviation “gog” as a pet name for my Mom – unusual in that neither my Mom nor Dad had any Afrikaans connections.

This is getting entirely off the point of this post – fiddling again!
Back to the matter in hand.

Succumbing to sheer laziness, I have had the following for breakfast, so far:
2 x Ouma Nutri Rusks (Intermediate GI)
1 x mug coffee (Jacobs Cronat Gold), with skim milk and 2 sweeteners (Equi-Sweet Blue)
   I also use Equi-Sweet Green but the green dispensers always seem to get jammed up.
   My all time favourite granulated sweetener Sweet Pea is only used on porridge and then only very sparingly.

Not too good hey? BUT not anything that I am not ” allowed ” to have. My point is that W & I work hard to have only ” legal ” foodstuffs in our home. I actually dislike calling food ” legal ” and ” illegal ” – comes from the days when Jean Nidetch founded Weight Watchers in New York yonks ago.

Even with my health challenges including DM II, there is no foodstuff forbidden to me – just have to know how to incorporate the item with other far better choices. Thus diluting/lowering  the glycemic effect of the (usually High GI ) item. We both like Checkers Decaff coffee and will tootle out later (when I can bestir myself to get showered and dressed) to get more.

What we will also do this morning is boil up 6 (Canola) eggs and I will chomp a hard-boiled egg with a teeny sprinkle of Low Salt and some freshly ground black pepper just now. Thus having 2 x carb + 1 x protein for my breakfast.

We keep to a maximum of 4 eggs each per week. These are often hard boiled. Sometimes we also spray a small non-stick frying pan with olive oil spray and fry ourselves an egg to have on low GI toast for breakfast. Once again, sprinkled with S + P as above, together with a dash of Worcestershire sauce.   A dash of  Light All Gold Tomato Sauce or Sweet Chilli sauce would be nice as well.  Note, I said a dash! 🙂 Once again, protein + carb = cool! We also sometimes use 1 x tsp olive oil heated in the non-stick pan and fry the eggs in that; giving an additional 1/2 fat to the day’s total. And yes, we do measure the oil.

Talking about toast – which I love to eat and my spouse does not – I am very particular about bread.
The simple rule is: If the label/packaging of the bread does not include the actual words ” Low GI “, I do not buy it. It’s just that simple.

My personal eating plan allows about 5 complex (starch) carbs per day. I have tried – oh how I have tried over the years – to like coarse bread that tastes like chipboard. OK, OK, as I imagine chipboard would taste! I know all about the linseed and soy loaves, the rye breads and the like. Just cannot get past one slice at the most. If I make my Ultimate Sandwich on rye, I tend to end up eating the protein and salad sandwich filling and not the bread!

We have settled on the following breads in our house:
Albany Brown Seed low GI (Yellow)
Albany White low GI (Lime green-do not confuse with ‘ ordinary ‘ green label one)
Sasko Low GI True Whole Wheat brown loaf
We buy the loaves and freeze them, taking out only what we require. Experiment with thawing times in the microwave and you will have lovely fresh, soft bread for the Ultimate Sandwich or whatever!

I would say that by changing your bread selections to only those specifically labelled ‘low GI’ you can reduce spiking of your glucose levels considerably. It is important to note that curbing spikes in glucose levels – in my experience – is as important for non-diabetics as it is for diabetics/pre-diabetics.

Do you get the munchies mid-afternoon? That’s low blood sugar folks!
My W-L plan lists two afternoon snacks – early afternoon (2-4pm) as well as a late afternoon snack (4-6 pm). I also have a mid-morning snack – making 3 snacks per day in all. This totally in keeping with lowGI/low GL eating guidelines.

Mid-morning is 1 x fruit + 1 x milk.
     I have a fruit (mostly a small crisp apple from the fridge) and 175 ml fat free fruit yoghurt.
Early afternoon is usually another fruit.
I love pears, grapes, kiwi, orange, all the berries. The peaches have been to die for this year and we have eaten a lot of them.
Late afternoon is 1 x Complex (starchy) carb + 1/2 protein.
possibly 3 Finn Crisps with PnP low fat hummus or cottage cheese or lower fat cheese.

Try it, it works!
Talk later, E

Chicks rule!!!

Right! Now I’m really getting somewhere!

Broken a plateau which really frustrated me for the much of February and this month to date.
Hovering between 21 and 22kg loss was not a joke and unfortunately my life is so crazy at this time that I had not posted here about it.

Stand by…….. drumroll…… 23.1kg down this morning!!! Whew what a great feeling – I’m on the downward path again. Decisively so.

Let me encourage you not to give up if you also experience no or minimal losses over an extended period – a few weeks in my case. Our bodies are not engines that we fuel and can then expect to perform to specification. Each and every one of us is very, very different and as we pay more attention to our health and bodies, we get to know what works and what does not.

I can honestly state that I did not panic and I did not think even for one split second about throwing in the towel. That option did not cross my mind.

So, what lead to the breakthrough? Two things only – portion control and eating right. In my case, as you know, ‘ eating right’ is a combination of my W-L plan, my plan devised by a dietician well versed in low GI/GL principles, ongoing discussions and shared info with my doctor Anna Hall and last but honestly not least my own research into the kind of nutrition best suited to slay the Metabolic Syndrome dragons.

Very bad grammar in the above paragraph but I am posting this nonetheless!! Or should I say I am nonetheless posting this? Eileen – get back to the subject at hand – you are fiddling again!

Please comment on this post or write to me personally if you are having similiar problems. A problem shared is a problem halved – most of the time anyway.

Chicks rule??
A real biggie is that I now weigh less than my husband – quite something that – as he is also now on his own journey which is a new development which I have yet to write about. That was another huge breakthrough in our little family.

Have a great day and a safe weekend.

BMR .. Basal Metabolic Rate .. what is it?

I’ve never really been a calorie (or kilojoule) counter. Over the years I have become used to simply eating the portions as prescribed for me by dieticians or by following the formula selected for me at Weigh-Less. So much easier in my view!

However, I have recently become curious and have swotted up about the balance of macronutrients (carbohydrate, protein and fat) in eating plans suitable for those of us with Metabolic Syndrome (Insulin Resistance Syndrome.)

Remember that according to the IDF (International Diabetes Federation), for a person to be defined as having metabolic syndrome, they must experience the following metabolic abnormalities:
– abdominal obesity (defined as a waist circumference beyond ethnic specific values (see elsewhere on this blog),
Plus any two of the following factors:
– raised triglycerides (above 1.7mmol/l);
– reduced HDL (good) cholesterol (below 1.03mmol/l in men or 1.29mmol/l in women);
– raised blood pressure (systolic >130mmHG; diastolic >85mmHg); or
– raised fasting plasma glucose (above 5.6mmol/l).
Ria Catsicas – The Complete Nutritional Solution to Diabetes. Publisher: Struik Lifestyle 2009.

According to Anne Till, another leading South African dietician, the balance of macronutrients could look like this:

Proteins 15%
Carbs 45-55%
Fat 30-40%
The Ultimate Diet Solution. Anne Till. Published by Struik 2006

Through membership of the GI Club run by GIFSA (Glycemic Foundation of South Africa), I have direct access to Liesbet Delport and Gabi Steenkamp authors of the bestselling Eating for Sustained Energy books. The books published by these two dieticians are the gold standard on low/lower GI/GL, lower fat eating in South Africa.

Liesbet Delport has advised me not to have more than 20% protein and 30% fat in my eating regime so I have tweaked my Benutriwise software to reflect the following breakdown:
Protein: 20%
Carbs: 50%
Fats: 30%

“BMR / Calories Required Calculator

Basal Metabolic rate (BMR) is the amount of calories needed by your body at rest.

For the average sized body the BMR is extremely accurate. However, for larger bodies (both muscular and fat) it can be inaccurate in determining your caloric needs.

For the muscular body type, the BMR can underestimate the number of calories required, and for the
overweight body type it can overestimate the number of calories required.

What you eat and how much you exercise are both important for achieving health and the type of physique you want.

But, the basic equation remains the number of calories taken in minus the number of calories consumed equals what’s left over to be stored as fat.

The BMR is calculated according to the formula :
Women: BMR = 655 + ( 9.6 x weight in kilos ) + ( 1.8 x height in cm ) – (4.7 x age in years )
Men: BMR = 66 + ( 13.7 x weight in kilos ) + ( 5 x height in cm ) – ( 6.8 x age in years )

To calculate Calories Required, BMR is multiplied by a factor depending on your Activity Level:

Sedentary – 1.2
Lightly Active – 1.375
Moderately Active – 1.55
Very Active – 1.725
Extra Active – 1.9

Based on the above, a Lightly Active, 30 year old woman, 55 kgs, 155 centimetres will have a BMR of
BMR = 655 + (9.6 x 55) + (1.8 x 155) – (4.7 x 30) = 1 321
Calories Required = 1 321 x 1.375 = 1 816 (calories required to maintain weight)

Be in good health ”
http://www.benutriwise.co.za. Should you opt to download a trial version of this great nutrition software, please be good enough to quote agent code AG Hall. Thank you! More about how I use this resource in a future post.

I am really upset … 2

I have survived 2 weeks of hell over the dreaded Year End as well as the Year End PAYE/UIF recons and submissions to SARS by yesterday. The caps for Year End are deliberate – Year End looms large in my line of work! I feel like I have been mangled in a mixer!

Anyway enough on that, all now sorted and we’re back on track.

My friend T is out of hospital, scooting around in a wheelchair a day after discharge and walking with crutches while his wife hovers anxiously behind him with the wheelchair at the ready.
He stops every few meters and sits in the wheelchair to catch his breath; then he’s back up again and walking some more …

Bear in mind this is a diabetic of 72 who almost definitely did not take proper care of himself. He is very much a ‘no nonsense’ ‘no hocus pocus’ type!

He’s also already back at work in his wheelchair for an hour or so per day; much to my utter relief. He is admin assistant to the owner of one of the most popular butcheries in KZN! He is my ‘man on the ground’ who simplifies my life greatly.

I just trust that he will not overdue things but it is a fact that his ‘can do’ attitude is pulling him through this traumatic episode. I expect to see him striding around on a prosthetic foot in about three months time.

Hats off to you Tony!

I am really upset…..

Today I learned that a friend and business colleague of mine has had his right foot amputated this last week. No prizes for guessing that he is a diabetic.

T scraped his foot in the swimming pool of the retirement village where he resides at Christmas time. Little did he know that less than 2 months later he would have first his toes,then his foot, then a few more cms of his leg amputated. The scrape on his foot did not heal, gangrene was a problem, his medical advisors tried all they could to save the foot without success.

An angiogram further revealed little circulation in the right leg below the knee and two weeks of sustained exercise under supervision did not help. We are told that a stent has been inserted to improve circulation to the stump; apparently successfully. A prosthesis (sp?) will be made and he should recover in due course.

The whole distressing matter has, once again, brought home to me that diabetes is a deadly disease and those who tend to take it lightly are literally playing with their lives. There is no such thing as mild diabetes.
You either have it or you don’t. It is not ‘ better’ to have type 2 rather than type 1. I could go on about this for pages but I think I have made my point.

May I strongly recommend having your glucose levels checked immediately if you have never done so.
May I strongly recommend that if you are already pre-diabetic that you take the matter VERY seriously.
May I strongly recommend that you implement lifestyle and dietary changes as a matter of urgency.