Apply Blood

Dealing with Type 2 Diabetes can be onerous. Even worse than the insulin shots (which I need to do four times daily) are the finger-stick glucose tests. I know I can always give myself an insulin shot anywhere without arousing too much attention, but finger sticks are a different matter entirely.

The problem arises when you have difficulty getting your blood to bead on your finger so that you can apply the test strip and get a glucose reading. Sometimes, I have to stick myself several times, usually painfully, on some of my fingers. My right forefinger is already nerve damaged, so that I have to be very careful about avoiding the nerves on it. On my thumbs and little fingers, I need a thicker lancet to draw blood, currently a 30 gauge. On my other fingers, a narrower 33 gauge lancet is sufficient.

Can you imagine me at a restaurant sticking myself several times with a needle, with a loud “Ouch” from time to time? So when I go out to eat, I don’t usually test myself.

My doctor wants me to test my glucose three times a day, before each meal. Just before each appointment with her, I produce a spreadsheet with the before-meal glucose readings for each day since my last appointment.

Type 2 Diabetes requires considerable attention to detail. This can be rough if you are going out to eat, busy cooking a dinner, or taking a trip. When Martine and I went to Las Vegas last month, for example, I skipped doing the tests

Living With Type 2 Diabetes

I Always Knew I Was Going to Become Diabetic

It seems that all the older people in my family were diabetic: my father, my mother, and even my great grandmother. Now even my younger brother is borderline.

Each day, I have to give myself three shots of Humalog (Lispro) and one shot of Lantus (Glargine). The Humalog shots all come before or immediately after meals, and the Lantus just before going to sleep. That’s not so bad, because both types of insulin use a KwikPen with an extremely skinny needle. I administer the insulin either in my gut or my thigh, with only occasionally a bad stick that hits a nerve.

What is worse are the finger sticks, which I have to do three times a day before meals. I have to poke a lancet into my fingertips and squeeze out a bead of blood so that I can tap it with a test strip connected to a device that reads the glucose level of my blood at that point. The problem is that I have trouble getting enough blood to give me a reading. Sometimes I have to poke the same fingertip as much as three times to draw enough blood.

As if that weren’t bad enough, some of my fingers (left thumb and right thumb) require a thicker lancet in order to get blood. My left forefinger has sustained some damage from all the finger sticking, so I usually skip it altogether. So I do a 9-finger rotation over a three-day period.

I don’t mind going with pen needle, nibs, and insulin to a restaurant, but I refuse to also prick my fingertips at the same meal. After all, the finger sticks are for measuring, whereas the insulin keeps my blood sugar low.

The good news is that what I’m doing is working for me. My last A1C reading was 6.5; and my finger stick readings tend to be in the low 100s.

Toenails and Teeth

My Own Toenails Don’t Look Anywhere Near So Good

I am happy to say that basically I am in good health, even though I have lived three quarters of a century. Of course, I still don’t have a pituitary gland (and never will), and my Type II Diabetes, though under control, doesn’t show signs of leaving.

Of late, my major complains have to do with my ingrown toenails and my teeth, both problems I inherited from my father. My father also had Diabetes, and suffered from the pain of excruciating neuropathy. Back in his day, though, I don’t think that his doctors really understood Diabetes. Neither did anyone in my family. The word for Diabetes in Hungarian is cukor (pronounced TSOO-khor), the same as the word for sugar. Naturally, people believed that if you switched from sugar to saccharin, everything would be A-OK.

This week I have been soaking my toes in warm water with Epsom Salts, applying triple antibiotic ointment to two ingrown nails, and bandaging them—with Martine’s help. Tomorrow, I see the podiatrist who will past judgment on how strictly I’m going to have to care for them.

I have bad teeth, but much of the problem is my own fault. I have generally avoided brushing my teeth; consequently, plaque ran wild, caused cavities, and in general undermined my crowns. Only recently, I bought an electric rotary toothbrush (Oral B) and began the long slow process of undoing a whole lot of negligence. Medicare takes care of my toes, but teeth are an entirely different matter. As things stand, I could easily spend $20,000 or more in the next two years on my teeth—and I can’t really afford that.



The Loose Juice Caboose

Why Do We Tend to Go Overboard with Beverages?

Why Do We Tend to Go Overboard with Beverages?

During my lunch hour, I visited the Westwood farmer’s market. What struck me funny was that the vendors of juices outnumbered the vendors of fruit and vegetables. Are so many people convinced that juices are the way to go that they tend to ignore whole fruits and vegetables.

The key word is “whole.” You know, of course, that the “whole” fruit or vegetable is more nutritious than the juice made from it. As a diabetic, I am very conscious that the process of making juice concentrates the sugars and usually leaves out the fiber. According to Harvard’s School of Public Health:

Fiber is a type of carbohydrate that the body can’t digest. Though most carbohydrates are broken down into sugar molecules, fiber cannot be broken down into sugar molecules, and instead it passes through the body undigested. Fiber helps regulate the body’s use of sugars, helping to keep hunger and blood sugar in check.

And since diabetes is probably one of the fastest growing diseases in America, we should re-evaluate our preference for juices. As for myself, I usually go for water, unsweetened iced tea, or mineral water. Tonight, I’m taking home three beautiful white peaches—and no juice.


Juice Wondering …

Are They Really As Healthy As People Think?

Are They Really As Healthy As People Think?

Omigosh, that photo caption is almost pure clickbait! The point I am trying to make is that fruit juices are one of those categories of foods that are almost universally thought to be good for you.

Except for one thing: They concentrate their one ingredient which is not so good for you, namely sugar, and throw out the fiber that your body needs far more. This goes back to that mantra of “quick energy” that used to be claimed for most sugary beverages going back to the 1960s.

To the youth of America, fiber is not only boring but decided unsexy. It seems to be associated exclusively with the old people’s bowel movements. Actually more important is that the fiber keeps the pancreas from being bombarded by an excess of sugar. According to Harvard’s T.H. Chan School of Public Health, they act to form complex carbohydrates:

These carbohydrates have more complex chemical structures, with three or more sugars linked together (known as oligosaccharides and polysaccharides).  Many complex carbohydrate foods contain fiber, vitamins and minerals, and they take longer to digest – which means they have less of an immediate impact on blood sugar, causing it to rise more slowly.

At a time when a whole generation seems to be headed into the maws of Type II Diabetes, it’s probably a good idea to minimize the impact of sugar on one’s diet—regardless of the promise of “quick energy.” So drink water, coffee, or tea instead.



Acres and Acres of Carbs

Most Supermarkets Are—To Me Anyhow—Carb-filled Minefields

Most Supermarkets Are—To Me Anyhow—Carb-Filled Minefields

Under my new way of life, after I learned that my pancreas was in the process of giving up the ghost, mealtimes are fraught with danger. This morning was all right: I ate a can of smoked trout from Trader Joe’s and a few stoned wheat crackers. I made it through lunch all right, too: A tasty spicy calamari salad at a local Thai restaurant. Tonight, Martine and I will eat some of my ham and lima bean casserole, which has not proven too destructive, along with, perhaps, some cherries and a white peach. As for my beverages, it’s always unsweetened hot or iced tea.

But God, how I miss the carbohydrates! There are times I would sell my soul for some white rice, potatoes, noodles, bread, or candy. As for pizza, it is a thing of the past, a fond memory of times gone by.

I wish I had something to replace rice. My doctor says that barley has too many carbs (though it has an acceptable glycemic index). In tonight’s casserole, the lima beans are filling in for the carbs, though again my endocrinologist says they have too high a carb count, but an acceptable glycemic index. Perhaps I could serve Styrofoam pellets with meat and vegetables?

Going to the supermarket is like crossing a dangerous border. Whole aisles of the market are loaded with stuff I can’t eat. I never realized before that our whole culture is based on carbohydrates, that Americans eat vast amounts of the stuff. Some of them become grossly obese, some of them develop diabetes sooner than they normally would otherwise.

Tonight I will go to the market, mostly for tomatoes (they’re OK) and sweet peppers and other stuff I can munch upon without sending my sugar levels into the red zone.

It used to be that my doctor told me that if I lost weight, I might overcome my diabetes. But how does one lose weight when one has to take Prednisone, a known appetite-enhancer, just in order to survive? Oh, I can lose weight all right; but I would have to be in a concentration camp.

But I have free will to choose anything I want at the market. Perhaps some tasty noodles, some sugar-laden breakfast cereal (like 99% of them) or a fruit smoothie. But no, I will try to be good. I lost both of my parents to Type II Diabetes. I want to survive, even at the cost of jettisoning virtually everything I like to eat and concentrating on salads, fish, fruits, vegetables, and tea.

If you see a sad guy in the supermarket line with a pile of stuff that’s good for you, it may well be me.


Opson and Situs

Seafood Mosaic from Pompeii

Seafood Mosaic from Pompeii

In 1997 classical scholar James Davidson published a fascinating little book about the ancient Greeks entitled Courtesans and Fishcakes. Discussing the eating habits of the ancient Athenians, Davidson makes a distinction between opson (ὄψον) and situs (σίτος).

Opson refers to what we would call meat entrées, particularly when they bare seafood. Beef and lamb were more associated with religious sacrifices, during which the meat was shared with participants and attendants at the sacrifice. But fish was the meat of choice at symposia such as the ones described so vividly by Plato and Xenophon.

Certain guests at a Greek symposium were known for what is called opsophagi, or “opson eaters.” It was considered rude for guests to ignore the situs, usually consisting of what we would call the side dish. (In our culture, it would include potatoes, rice, and bread; for the Greeks, wheat or barley was the usual side dish.)

One interest side to diabetes is that it is affected primarily by the dishes the Greeks would consider to be a part of situs (though barley is a special exception). People with Type II Diabetes, such as myself, have to concentrate on the opson, supplementing it with vegetables and fruit.

You can now consider me an opsophagos, though I wouldn’t call it to my face.


I Go on the Gulag Diet

Thanks, But No Thanks!

Thanks, But No Thanks!

Today, the doctor threw the book at me. My pancreas has become less able to process carbohydrates. The result: I will have to take even more insulin—two different types, even! And more seriously, I must root out and avoid carbohydrates to the maximum extent possible. I’ll be the person you see with a sour expression on his face discontentedly picking at a salad, moving the lettuce from side to side until I can stomach raising the fork to my mouth.

Effective today, I must reject all offers of food from friends. I may reach into my pocket and eat two or three peanuts when nobody’s looking my way.

What can I eat on the new Gulag Diet? Boots and belts are generally okay, but I must avoid all the carbs that lurk in the bootlaces and stitching.

Eventually, I will make some accommodation to what my doctor assures me is a dire need; but in the meantime, don’t expect me to jump for joy.



Watering the Forests of the Northeast

Forest in Maine

To return for a moment to my recent vacation, one thing I forgot to tell you was that I had forgotten to pack one of my diabetes medications, namely the Metformin HCL. One result was that, even taking insulin, my glucose reading was running rather high (in the 300s). Apparently, when that happens, I have to urinate frequently, about every thirty to forty-five minutes.

While Martine was driving toward the end of our vacation, I felt as if I had to stop by every other tree in the forests of New Brunswick and Maine to water it. That got particularly difficult when there was a chain-link fence separating me from the trees, making it difficult to disguise my actions from other motorists.

That last day from Bar Harbor, Maine, to Manchester, New Hampshire, was definitely the worst. Not only did I have to have Martine stop the car ten to twenty times, but there was a driving rainstorm once we passed Augusta.

Somehow I survived. As soon as we returned to Los Angeles, I started on the Metformin at once. Within a few days, the readings had declined to an acceptable level; and I no longer had to evaluate the cover possibilities of nearby trees.

I can tell you, I left a part of myself in the Northeast,