Saturday, March 14, 2009

sugar sugar?


Over two weeks ago, I informed you in thanks for the memories that I saw my doctor for a long-overdue physical. Now that I am about to enter the world of no health insurance, I thought I should have some idea if my tires needed to be replaced or if my carburetor needed to have the carbon blown out.


As a result of my examination, he informed me I had "metabolic syndrome" because of my weight and several other factors. His recommended treatment (1) lose weight, (2) get more exercise, and (3) eat a better diet.


What he did not have in front of him were my blood and urine test results. He does now. And he asked me to return to his office earlier in the week.


His diagnosis is that I have gone beyond "metabolic syndrome." I have diabetes. Based on my blood tests, my glucose level would not constitute a diabetes diagnosis several years ago. But it does now.


Fortunately, the treatment remains the same. Losing weight should help in several respects. To lose weight, I need to exercise, and I need to more carefully monitor what I eat.


If I were going to stay in Salem at my current job, I would almost throw up my hands. It just would not happen. I would then take him up on his offer to start taking another pill.


But the move south is going to give me an opportunity to start anew. It also gives me another good reason to buy the kayak.


For those of you seeking an update, I intended to look at one in Portland today, but the dealer did not have one in the shop. I may have to make a trip to the coast to see one.


But I did have lunch with two lawyer friends I have known since the early 1980s. One is retired. The other is plodding on loyally in his prosecutor job. The conversation was fantastic -- hitting all of my favorite points of law, politics, and courtroom drama.


But I will not get points from my doctor (who reads this blog occasionally) when I tell you that we ate at Lew's Dari Freeze -- best known for their foot-log coney island dogs. Not an auspicious beginning on my new diet.


I will do better.

22 comments:

Calypso said...

Ouch - sounds like something you should take seriously - see you do need a wife.

"Honey you better not eat that." "That's a lot of salt!" "you've already had two pieces of pie - that's enough!"

Get healthy amigo with or without the mujere.

1st Mate said...

Steve - You are starting out with a good attitude after getting this "heads up" from your doctor. And you're going to love kayaking in Melaque.

I have a friend here in Mexico, about the same age as you, who got the same diagnosis last year and has worked out a regimen that has his doctor amazed at his results. I will put you in touch with him, and maybe you can get some tips on adapting your diet in Mexico, not an easy thing with all the added sugar.

Anonymous said...

Steve, rather than self insuring you might consider an expatriates' health insurance policy. If you select a high deductible and use it for catastrophic health care, it can be a very inexpensive safeguard of your retirement monies. They generally cover you everywhere but in the US or Canada with the accumulation of some coverage there during the course of the year to accommodate visits to the States.

I have one but have not ever used it as I just pay out-of-pocket for health care as I need it; my deductible would not be met in any given year in any case. Kathe

Miguelito said...

"I will do better." Famous last words. I was amused at your doctor´s recommendations. If you do No. 2 and No. 3, No. 1 will automatically happen, so it´s a two-part plan, not three.

What you are facing here is one of the hardest things in the world. The fact that you went directly to Lew´s Dari Freeze illustrates this fact nicely.

Long-overdue physical indeed. You knew what the outcome would be.

This one of my favorite topics. I lost about 60 pounds in the early 80s, and I´ve never put them back on, which is the unusual part. But I have a steel will and iron determination. Few people do.

I recall, back in my newspaper days, a story we ran on some organization that wanted to do a study of folks who had lost a significant poundage and kept it off for a year. They ultimately could not do the study because they couldn´t find enough people who had kept it off for a year. Just a year!

Losing weight is one of the most difficult things in the world because it´s connected to emotions and firm habit. One is not overweight due to hunger.

The weight-loss industry (like Weight Watchers) is enormous, pun intended, a multimillion-dollar giant because people just keep on coming back to it, but it does not work. Neither do diet books, none of them.

What your doc recommended is the only thing that works: Eat better and exercise more. Both counter bad habits, very firm ones set in cement.

And don´t make this quest complicated, which is very common. Avoid the obvious: hamburgers, fries, cakes, pizzas, milkshakes, etc. You know what they are. And forget the freaking kayak. Walk briskly 30 minutes a day, five days a week. Chill out on weekends. And do it the rest of your life. When you stop that two-part plan, the weight returns. Invariably.

That´s it. It´s not hard. But hardly anybody does it.

Losing weight is both the easiest and the hardest thing you will ever do. Good luck, and don´t go back to the Dari Freeze. Ever.

But you will, won´t you?

Anonymous said...

i love your analogy of your body with a car. i'm sorry to hear you have diabetes, as you know, it can be very serious if not properly taken care of. it runs in my family and i am prediabetic. the one thing i have going for me is that i love to exercise. unfortunately, i love to eat and have yet to take off the weight i gained over the holidays. i'm doing a very strict diet right now, long story, but i can only eat protein, fruits and veggies, so let's not go out for italian while i'm there ;-) maybe we can diet together that night.

take good care of yourself steve.

have a great weekend!
teresa

Laurie said...

Steve, hang in there. Many people reverse the initial diagnosis through lifestyle changes. Just beware of sugar-laden attitudes in Mexico. If I recall from my time in Mexico, sugar is a big part of most people's diet. One trick I use to help me from consuming soft drinks is that I buy carbonated water, mixed with a bit of juice and green tea. If I have the time I squeeze a few limes, lemons or oranges into the mix. Just a tad of pomegranate or cranberry juice is enough.

Honduras has an epidemic of diabetes right now. I know of a woman who adds Pepsi to her spaghetti sauce. It's a bit runny, but it's sweet and dark, which is how she eats her pasta sauce.

Larry Lambert, Mazatlan said...

Steve - From your writing I take it your diabetes is Type 2, which can be controlled with diet and exercise. For sure a doable thing, and I know many people with it.

In fact, diabetes is the most common disease in Mexico. Even above heart disease. Medical folks here are well aware of it and are used to dealing with it. The ones that really suffer are the very poor through lack of education and the right food.

Larry

Babs said...

Okay my friend - you MUST take this eriously. My step-father lost both of his legs to diabetes. If THAT doesn't get your attention, I don'tknow what - He had been a highschhol football coach.
STOP eating junk. I find it easier in Mexico cause there isn't all the junk food AND you'll be walking, walking, walking. Trips to the mercado for fresh fruits and veggies is a treat each and every time. OR you can try my "cough drop diet". Just kidding, but it did work, out of necessity. TAKE CARE - we all care about you.

Steve said...

Calypso -- You have probably already figured out that I have the disposition of an 8-year old. If told not to do something, I will do the opposite. Nagging would get no results. This is something I need to decide is in my best interestes. And I will. I have. But it will be tough.

1st Mate -- Hook me up. I know what I need to do, but more information never hurts.

Anonymous -- I will actually have some reimbursement help through my military retirement. But it has its own complications in Mexico. I will look into a catastrophic policy.

Miguelito -- My weight has only been an issue for the past 10 years. While I was still associated with the military, I had to keep my weight down. I had a good exercise program and I watched portions of food. Then came September 1999 (my retirement date), and within months, I allowed myself to eat whatever I wanted. But I was getting exercise. The dog and I walked briskly late every night for well over an hour. Other than greeting the occasional prostitute and drug dealer, we kept going at a good clip. Then he got older and would saunter. The walks are merely symbolic now. And I started eating like a horse and growing like a hippopotamus.

My point is that I spent almost 50 years with good habits, and the past decade with terrible habits. I need to get back to those prior habits. But, you are correct, breaking the food habit will be the most difficult. I was able to lose 30 pounds in three months with weight watchers, but they came right back when I started eating cruise ship-style food again.

Thanks for the concern.

Teresa -- My downfall is portions. A portion of pasta is never enough. I will take two giant plate fulls. I have learned far too many of my eating habits from my dogs.

Laurie -- Thanks. I intend to hang in there. As several people have noted, though -- including me -- the trick is going to be the food for me. And that will be difficult in Mexico. I was going to print a map of the diabetes frequency throughout the world. Mexico and Central America have a significantly higher occurence of diabetes than Canada or the United States. Not surprising when the local diet is built on sugar and carbohydrates.

Larry -- You are correct. It is Type 2. Finding the correct foods in Mexico is going to be a bit of a challenge, but I cook from scratch (in most cases), so I will know what I add.

Babs -- Thanks for the kind words. Your stores in the Beverly Hills of Mexico must be a lot different than the stores in my little beach community. In Melaque, there are packets of junk food everywhere. Pork and sugar-laden tacos are served at every step, and can be avoided only by stopping at the lines of card tables larded with cakes and gelatin being served by little old ladies. I often wondered how a diabetic would survive in such a gauntlet. I guess I will find out. The result of all this, as Larry points out, is that Mexico has one of the highest rates of diabetes in the world. Another challenge for me.

Nancy said...

Steve,

I am no paragon of virtue, but I believe REGULAR exercise that you enjoy is the key. The kayak sounds like fun but it isn't something that you'll be able to do daily.

I'd suggest you buy a mountain bike for exploring your area. Even if the streets are bumpy you will use it a lot.

I was so sad to sell my Nordic Track when we moved south, but I just bought a used one and now can watch Destinos or listen to music and have a ski trip at home. Sometimes when it is hot I can see myself enjoying the inside workout. Or you can put it out on the deck and watch the view.

If you're in the mood to spend money, buy a Vitamix blender. It is so incredible, makes a regular blender seem like a toy. Fruit and yoghurt smoothies are good for you and can be a part of your new regime. Oh, and tomato-carrot-parsley juice, yum.

American Mommy in Mexico said...

This is a good time to start anew. You will do it. Looking fowardto the blog entry that you have odne it.

Larry Lambert, Mazatlan said...

Steve - Maybe a kick start will help. I used to weigh 220. At barely 6' that's a bunch. I now weigh 160 and have for 30 years. How'd I do it? Don't scoff, but I put myself on the Scarsdale diet for two weeks for a kick start. After the two weeks and 30 pounds I had modified my eating habits so much that the other 30 came off in the next five months.

And yes, you can eat well here. Sugar and fried foods are everywhere. I'm not a purist, and I watch what I eat, but I can still indulge once in a while. The fresh fruit and veggies are the best I've had anywhere. And you may be suprised how little fat is in the meat. Folks NOB like their beef "well marbled," but not here. Chicken is also readily available with the skin and outer layer of fat removed. And whole chickens are grilled over carbon so most of the fat cooks off. Just stay away from rotisserie chicken, which is also popular.

Plus, you will do soooo much walking here. Jiggs will be welcomed in most places except for grocery shopping. Use that time alone to get some kilometros under your feet. I make it a habit to walk to my favorite fruteria just about every day.

As for the kayak, are you sure you don't want to paddle a little bit? It's great exercise for the upper body and uses the stomach as well.

You'll discover that you can really do it, but I think you need to modify your mind-set a bit. Don't think "I can do it," tell yourself "I WILL do it."

Larry

maria luz said...

Lo siento mucho, mucho, Steve. You will overcome this. Even in Mexico. This is very serious.

My husband was diagnosed with Type 2 diabetes six years ago and it has been an uphill battle ever since. It runs on both sides of his family, as does hypercholesteremia. Thankfully he does not have that.

He had spent a lifetime in control of his weight and exercising regularly, plus he has spent the last 23 years at work on his feet, walking continuously, running stairs, in a hurry, for 8 to 10 hour shifts, four to five days a week. He still developed it.

Initially, he was able to control it with very strict diet and heavy exercise. But, that does not always keep it under control as you go through the years to come. It depends on where your numbers are right now, and how bad they are. And remember, even thin folks get diabetes. Diabetes does not always discriminate between thin or fat. There are many factors that can lead to this road.

Everyone has a different metabolic composition. We don't all have the tall, ectomorphic build, metabolism, or genetics of Senor Dickson. Steel will is not the only thing at work in his life. I promise you that. It is a very complicated disease that research is learning more about with every passing day.

Even with diet and exercise being monitored constantly, you may eventually need medication, either orally or in combination with twice daily injections of a newer drug called Byetta. This has done miracles for my husband. It is not insulin. You can remain on these meds for a very, very long time and you may never, ever need insulin, if you are careful about what you eat. This is where my husband is now.

You need to do everything possible to make sure you are leaning heavily on quality proteins and good carbs (ie, unrefined carbs) by staying away from processed food. The very fact that you were diagnosed with metabolic syndrome means that most likely you are carb sensitive and probably needed to be avoiding refined carbs all through your life. This is based on the newer research that has recently come out.

Be aware that diabetics are very prone to craving carbs, especially sweets, once they are in the trenches of the disease. Even, if like my husband, you never cared for sugars at all in the past, it can become your heroin. This is where must find you will. Bread, white rice, pasta can be the other thing hard to pass up. Avoid the the bad carbs.

Go buy that kayak and get back to your walking program. The key here is to be doing more than one thing that you enjoy to get fit and keep fit. Be thankful that you are physically healthy enough to do the exercise. Some at this age are not.

Contrary to what others say, I believe you can do this! You are being very honest about where you went wrong. And that, my friend, is 80% of the battle. If you fall off the wagon, get back on, and don't beat yourself up about it.

Maintain that honesty and you can win!!

maria luz

Ron said...

Steve,

I received the diagnosis 5 years ago.

Get referred to a Certified Diabetes Educator and get some classes in before you move to Mexico. As with many things, knowledge is important and there are a lot of misconceptions out there - even among the medical community.

I have done well on a very low carbohydrate, high protein relatively high fat diet, losing 30 pounds and keeping them off. My main form of exercise is walking. I started medication a couple of years after the initial diagnosis.

Feel free to contact me if you want to. I am about 30 miles up I-5 from you. There is an email link on most of my blog entries.

Best wishes

Ron

glorv1 said...

My doctor told me the same thing a couple of years ago. Well he said my sugar levels were a little high and to exercise, cut back on sugary things. I did okay last year and have recently been neglecting my duties to stay healthy. So tomorrow since today is almost over, I will and I say will cut out sweets and try to cut out starchy foods and greasy foods. Unfortunately today I made tortillas and of course I ate two, not one but two. I think everyone experiences shifts in sugar levels. Good luck Steve, try hard.

Alan said...

Steve, I did not realize that my leaving "the company" in September of 1999 had such a severe trauma attached to it for you. I apologize, but I know you well enough to know that if you want to, gotta have the wanna, then you not only can, but will, since your body is not your own!! Best. Alan

Anonymous said...

Steve, like some of the others I too am a diabetic. Maria Luz is correct about Carbs being a diabetic's heroin. Here is a web site you might be interested in; http://mendosa.com/index.html. Senor Dickson is also correct about the weight loss issue, but here's the kicker, you've already tried to loss weight at least once, so your body is going to fight you tooth and toenail. Every pound will be a struggle and the second you relax, you will balloon faster than the last time. My suggestion is go for fitness. Can you pass a stress test with flying colors? Hang in there, it can be done. Judy

Steve said...

Nancy -- Several people have mentioned taking a mountain bike to Melaque -- with the usual warning for any tourist town that I will need to keep it locked up. Melaque is also a good walking town. That will be my regular exercise. But I still want that kayak.

Juicers are a bad idea for me. I need to feel the crunch of vegetables in my mouth.

AMM -- I know I can do it. But I am a hedonist at heart. It will be an ongoing battle -- that I will win.

Larry -- The kayak has a paddle as well. I have never been very good at paddling, though. That is why the pedal option was intriguing. I had a dream last night that I simply floated off into the ocean.

As for food, it will be tough, but I will do it. I made a Greek salad tonight. And it left me feeling very hungry. But I need to get started and stick with it.

Maria -- Great to hear from you. I have enjoyed your comments on Michael's blog. I knew that something was going wrong about three months ago when I started craving Hot Tamales. I have enjoyed them in the past. But I CRAVED them. I ate a 5 pound bag in about three days. This from a guy who has not been prone to sweets. Salt and grease: yes. Sweets: no.

I live 20 minutes from work -- walking. I am going to start doing that again -- if only for the next two and half weeks, and then I will keep it up. Thanks for the encouragement.

Ron -- Walking has always been a good exercise for me. I allowed the dog's infirmity to become an excuse for not going out on my own. My neighbor has severe diabetes. He invited me to go to his support group meeting before I leave. I am going to do that.

Gloria -- Maybe we can offer support to each other to stay on our diets.

Al -- You are correct that my personal discipline alone will not make this work.

Judy -- Thanks for the site. When I had to make weight (a decade ago), I was younger, and every month was a struggle. But I was able to do it. When I gave into my eating passions, I suffered the consequences. That is what will be hard to reset. I doubt it can. It will simply be a daily struggle that I will need to win. One thing I may need to do is get away from this computer in the evening.

Islagringo said...

So sorry to hear about your diagnosis. But very impressed with your honesty in knowing yourself. Not sure why, but it upsets me to no end to hear you say you still want that damn kayak! And then dreaming you floated out to sea! Maybe that's a warning? I have no advice to give you about your health but I know you will ultimately do what is best for you. We want you to enjoy your "golden" years!

Brenda said...

Look after yourself, we are all rooting for you. It is tough to change our eating lifestyle but can be done, with a lot of perserverance. Good luck.

Anonymous said...

Steve,

This book is based on entirely new research from a psychologist at UC Berkeley. He has apparently discovered an entirely new mechanism of hunger. Here's the link: http://www.amazon.com/Shangri-Diet-Hunger-Anything-Weight-Loss/dp/B0013JHCVC/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1237520791&sr=8-1

I've always been slim, though since my 30's have had to work at it. I do occasionally find myself needing to slim down a bit more, and just try to eat less. One of the things that helps me is this. If I'm hungry, I tell myself that food is plentiful, in fact, all around me. I am not starving, and can eat any time I want. But I am choosing not to. For me, it's amazing how that helps the psychology of starvation. You may feel hungry, but by telling yourself that you could eat at any time seems to take away that primal fear of starvation.

Also, avoid all starches. Just eat vegetables, and a bit of meat. There's some interesting work out there about the glycemic index of food, i.e., how quickly it turns to sugar in your body. Slower is better. That's why vegetable carbs are better, because they're slower to digest.

Hope this helps.

Fond Regards,

Kim G
Boston, MA

Steve said...

Kim -- Thanks for the information. I know that most of my eating is based on the same idea of fearing drowning. I am convinced that the food is going to disappear. Around here that is not very likely. As an example, I took a pile of snacks out to the trash bin this evening -- out of sight, out of mind. I then got in the hot tub to read. Because I have made a habit of eating in the hot tub, I started feeling hungry. I went to the trash bin, dug out a bag that had a few stale tortilla chips in it -- and ate them. Of course, I was hungrier then. Getting into the flow of a diet is the hardest part for me. I am not there yet. But I have to be. It is that or more drugs.