Monday, April 26, 2010

The diabetic shoe dilemma

I bought a pair of girly shoes this weekend while shopping with my mom. Actually, I must confess; I bought two pairs. For years, I’ve been wearing clunky practical shoes – thinking of comfort and foot care first. And this week, I made a change.

I’ve always wanted to wear pretty clothes, accessorize with jewelry and scarves, and of course I’ve also always wanted to wear gorgeous shoes. I used to wear heels and sandals once upon a time until I developed so many blisters that it made the whole girly shoe thing impossible. I know, many of you are saying, you just wear the pretty girly shoes until your feet adapt. It’s not that simple for a diabetic though. We have to pay very special attention to foot care.

Yes, in addition to the shots, pumps, pricks, and sticks, diabetics have to take special care of their feet. Even ordinary problems such as blisters can develop into serious complications. If gone undetected or untreated, these foot problems can develop into infections, foot ulcers and even amputation.

So after developing multiple blisters and being in serious pain from wearing very pretty summer sandals – barefoot - I decided to go clunky. I mean comfortable. Yes, even during the summer. Socks at all times.

The clunky shoe became a way of life – which I have stayed true to. For the most part, no one really fussed about it – a few comments here and there. But my reliance on the clunky shoe to keep my feet safe became really evident one day at work around four years ago.

Four of us were sitting in a co-worker’s office meeting about saving the world by teaching kids how to read and write. M was there, a brown-haired Type 2 diabetic who often remained quietly observant, and T was there too, a friend of mine who has a serious girly shoe addiction and always dresses very smartly. J was also there, a very smart, loveable, and witty retired history teacher who started a second career in non-profit while in his mid-60’s.

We were all sitting around in a circle, no table between us, the women with legs crossed, while T was enthusiastically discussing her plans to help a school in need. J looked down at my feet and declared mid-conversation, “You have the same shoes as I do!”

I looked down. He was right. Were my clunky shoes so shocking that it stopped a conversation on saving children? We both had on black, clunky shoes with black socks. The difference is: He was a 65 year old man, and I was a 35 year old woman. I’m not sure, but I think his shoes may have been orthopedic too.

Had I taken clunky too far? I comforted myself, “Who says that I have to wear a certain kind of shoe to be a beautiful young woman? Beauty comes from within!”

I proclaimed my need to care for my feet as a diabetic. Everyone stopped in their tracks. Then J laughed a bit. Everyone else caught on to the laughter. And the topic went away. Back to kids in need.

As time went on, more and more people commented on my clunky shoes. And I continued to insist, “I have to care for my feet. I’m a diabetic. And that’s more important to me than wearing girly shoes.”

To be honest, that’s still true. Just because I bought a pair of pretty, girly shoes doesn’t mean that I’ve dismissed my diabetes.

“There are plenty of pretty and comfortable shoes out there today,” one of my doctors, a rheumatologist actually, said around the same time. At that point, my hip started to go arthritic – at age 35 - and so the conversation naturally unfolded into shoes and bags. I listened to her intently. I would do anything to take care of my health. And I still do.

“Why do you wear such shoes, Ophir? Look at how cute my shoes are!” another co-worker told me a few years ago.

I continued to insist: Health comes first. I love my feet, and I will always practice diabetic foot care.

So why the change? I still care about my health.

I don’t know if it’s the 6.5 A1C, the detox, writing this blog, or all of the meditation and yoga I’ve been doing. But for the first time in my life, I am starting to feel as though things that I never thought were possible suddenly are. Lately, I’ve been feeling like I want to make a change – to wear shoes that are feminine and pretty, shoes that complement an outfit and accentuate rather than clunkify. I’ve wanted to transform my ways from the old routines and modes of thought into ones where my dreams are possible, even down to the shoes I wear.

Diabetes will never hold me back from living the life I want to live. At least not again.

Yesterday, I found two beautiful, girly pairs of shoes that are also sensible from Anne Klein i-flex. No, they’re not Manolo Blahnik or whatever other fancy shoe designer is out there. But they’re cute and pretty - while being sensible too. They will go great with some new outfits, and they also accentuate the beauty within – because I’m not dismissing my diabetes. I’m merely finding the balance between me and my great diabetic shoe dilemma.

Monday, April 19, 2010

The 6.5 A1C

I was sitting on an examining table at Dr. W’s office, my endocrinologist, a couple of weeks ago waiting for him to get off the phone when I asked the nurse if she could make a copy for me of my quarterly lab test results, the results that would tell me my latest A1C - the test that gauges how well diabetics manage the disease. How well I’m managing my diabetes.

I was amazed at myself because I have been asking for those lab test copies the minute I walk in the office door for decades, and that day, it completely slipped my mind until I was sitting on the table waiting for Dr. W to tell me what latest thing I needed to change or do. That’s usually what happens at these doctor’s appointments.

I have been somewhat obsessed with the A1C number for the past decade or so. Why? I hate failing in general, but that one in particular is one that I loathe failing. The goal is a 6.5, and I had never gotten there before. I had been holding steady at 6.7 for five or six years, not quite making the 6.5, and before that I was holding at a 7 for about two or three years, and before that an 8.4 for I don’t know how long, and before that, I have no idea. For the past decade or so that I’ve been conscious of my A1C and actually trying to make it better, I have felt frustrated and less than adequate at the one job I work at the hardest - 24 hours a day, 7 days a week.

And then as I sat there in the doctor’s office, I realized that I hadn’t thought about the dream A1C in a long time, the 6.5. For the past three months, I had still been exercising, meditating, eating healthy, and monitoring my sugars in relation to all of these things, but I hadn’t really thought about the goal itself. I realized that I had let it go and began simply plodding along living my life in a balanced and healthy way.

The nurse returned, Dr. W still on the phone solving a crisis with another patient, and she handed me the pages. I thanked her and began scanning. Cholesterol – fantastic! Protein in urine – None to be found (protein spillage determines possible kidney disease which I had when I was 21 years old)!

But I was really searching for the A1C. I had to see the numbers, the results of all my hard work – the monitoring, pricking, bleeding, squeezing, tracking, evaluating, assessing, meal planning, weighing, exercising, and sugar inducing during the lows, and so on.

And as I continued scanning, I found it. There it was: A1C – 6.5. I reached my goal! Or at least the goal that endocrinologists have set for me since I started this diabetic journey in 1974. And it only took over 35 years to get here! But I’m here now!

The 6.5 A1C journey has been a long one. The first A1C I remember was an 8.4 which I learned about somewhere in the mid ‘90s. I guess that was the first A1C that I was half conscious for, which I assume was the case since I kept the document on file and still have it today. The next lab test document that I have in my file was taken a few months later, and the A1C read 8.2.

So what changed? How did my A1C path shift and start trending toward healthy levels?

That’s a big question. It’s a lot of things: patience, persistence, doctor-patient relationships, science, tracking, willingness to change routine, education, eating healthy, exercise.

It started with Dr. P back in the 8.4 days. Dr. P was considered an aggressive doctor, but quite frankly, she was exactly what I needed. Dr. P was incredibly persistent with me on monitoring and tracking my blood sugars. She also sent me to a nutritionist. I learned how to better plan my meals and eat healthy, well-balanced food. I started a regular exercise program and found myself becoming addicted to it! I read Diabetes Forecast monthly to learn about the latest information and stay informed. I had also started seeking support and talking about my diabetes for the first time in my life.

Types of insulins were advancing back then too, and Dr. P kept up to date. She switched me from pigs’ insulin to synthetic Humalog and Lantus, all injected through needles and back then considered the latest and greatest in insulin because they resemble human insulin more closely. I had made my way down to a 7.2.

I switched to the pump four years ago, after the Dr. P years but before Dr. W, and after reaching a 6.8. The pump has been the greatest blessing for diabetics as it attempts to mimic a fully-functioning, insulin producing pancreas. I had to basal test for a long time – which involves fasting and testing sugars every hour on the hour – until the docs found the right patterns for me. But I stayed persistent and tried to be patient (not always succeeding at that part), and eventually I found Dr. W who really understood how to set a basal pattern correctly. At that point, I had made my way down to a 6.7.

The big “ah ha” was when he told me that my basal patterns are fine, I need to focus on how much insulin to administer for different kinds of food. I had already learned carb counting, which is the typical lesson we diabetics learn when we go on the pump. We calculate how to bolus – or inject – insulin based on how many carbohydrates we are eating. But Dr. W claims that there’s more to it than that. Dr. W’s theory is that each food reacts differently in every person’s body, and so it’s up to us to look at each food and test how our bodies react to it. Then figure out the right bolus.

The more you are aware of your sugars in relation to the meals you eat, the dosages of insulin you administer, and the amount of physical activity you perform, the better your sugars will be. I find this all to be a royal pain in the neck. I hate tracking and testing it. I mean, I really hate it.

Dr. W would love to set up a study on this topic. I think that people first have to want to do it, to care that much about their health and bodies, to do all of the work involved in diabetes management.

And where does that desire come from? It comes from within.

Besides all of the stuff that diabetes doctors and educators have been talking about for years, all of those details I only glossed over above, there’s also the human side. Being a healthy diabetic requires living with the disease in an emotionally healthy way: Knowing who you are and accepting yourself fully. Listening and having compassion for yourself and others. And living your life’s passions to the fullest. It’s all connected.

Your state of mind - and dare I say connection to spirit - affects your state of body.

Dr. W got off the phone and started telling me the story behind the emergency call, apologizing for taking so long, “This guy just had his leg amputated. He’s on dialysis. I wish I had the ability to teach people how to live with the disease beyond what I can do in this office,” is more or less what he said.

He picked up my lab tests. “Look at these numbers,” Dr. W was scanning too, “We’ve been seeing each other for the past year, and I’ve seen you come a long way. 6.5 A1C. You’ve lost 5 pounds which is very good for a person at your weight. Perfect cholesterol. Not an ounce of protein. You’ve basically cured yourself of kidney disease.”

I left Dr. W's that day realizing that I’m in the best health I’ve ever been in my life, and I felt very proud. And I realized that the journey changed for the better the moment I became conscious. The moment I became conscious of self-love.

Monday, April 12, 2010

Changing habits with a detox: Part 2

I have always known that mind, body, and spirit are linked, but I never realized just how connected they really are until I did a detox this past week. Last week I wrote about my goals for doing the detox that I found in the March edition of Natural Health magazine. I wanted to change some habits: Stop snacking on unhealthy foods in the late afternoon and in front of the television after dinner.

Within the first few days of the detox, as my body began to clear itself of the toxins found in damaging foods, such as high fructose corn syrup, trans-fats, and all the other buzz words that nutritionists and fitness professionals talk about, I also found that I didn’t want to eat those foods either.

My mind became clearer as well. After a day or two, I suddenly realized that I wasn’t turning on the television first thing in the morning or checking e-mails every few hours. Actually, I didn’t check my e-mail even once all day yesterday! That’s miraculous for me! Without all of that television and e-mail, I had more time. I read more and had some personal revelations about who I am, my purpose became clearer, my blood sugars were simply fantastic, and I also found myself more present during the day. By Friday, after six days of detox, I suddenly realized that I hadn’t written one personal to-do list all week long! To-do lists have been one of the most consuming habits I have ever had. They have run my life, and I am thrilled that I didn’t write one all week. And I hadn’t even sought to change that habit!!!

I have finished the detox, and I can say that I rid myself of a lot of unhealthy habits. And although I have watched television, checked e-mail, and written a to-do list since, I have not eaten junk food, and I also believe I’m off lethal food additives like: high-fructose corn syrup and trans-fats. I also feel that I am still attuned to my purpose, and I plan to keep it that way!

The question is: Did I detoxify my life from unhealthy foods and habits because of what I ate? Or is it because I set an intention at the beginning of the week to change habits?

I believe it’s a combination of both.

Deepak Chopra wrote about the Law of Intention and Desire in the Seven Spiritual Laws of Success: “Inherent in every intention and desire is the mechanics for its fulfillment. And when we introduce an intention in our pure potentiality, we put this infinite organizing power to work for us”.

What this law is saying is that you can change your life for the better if you have the intention to do so, and the whole Universe will conspire to help you out. BUT, you have to also pay attention to the six other spiritual laws of success. Click here for a summary of all seven, and I strongly suggest reading the whole book.

But how is this possible? Okay, now we’re getting into quantum physics a bit, but let me try to explain. The law is based on the fact that energy and information exists everywhere in nature; a flower, a rainbow, a tree, and the human body – when broken down into its components – are all energy and information. The whole Universe is filled with interrelated energy and information. The only difference in the energy and information between humans and a tree or a flower is the content within our respective bodies. We can change the content of the energy and information of our bodies at the atomic level, and then it influences our external bodies, our environment and our world. The quality of the intention will cause things to manifest because it is linked to the energy and information in the entire Universe.

This is worth repeating: You can change your life for the better if you have the intention to do so, and the whole Universe will conspire to help you out as long as it is for the benefit of the entire world.

I chose to change bad habits with my detox, and it worked because I set a quality intention to change it. It cleared my mind, body, and spirit for greater things to enter my life. And, if you intend to detoxify your life from poisonous things, you can do so too. First choose: Do you find anything in your life to be toxic? What is it? Now set an intention to change it. You may want to detoxify from food too and/or make healthier food choices. You can also decide to clean out a cluttered closet, get rid of unhealthy relationships, or clean up your finances. (I am not a doctor or a therapist, simply a blogger who enjoys making my life better, and so I only ask that if you decide to do any detoxifying or decluttering, check with a professional in the chosen field first.)

You can change your life for the better by getting rid of whatever is holding you back. You just have to set the intention to do so, and the Universe will conspire to help you out. It works.

Here’s a list of resources that can help:
*Pema Chodron, Getting Unstuck CD
*Deepak Chopra, Seven Spiritual Laws of Success
*Natural Health, Detox you life (not the detox I did)
*Detox tips on

Monday, April 5, 2010

Changing habits with a detox: Part 1

I started a detox yesterday that I found in the March 2010 edition of Natural Health magazine. The typical and most obvious reason for doing a detox is to, as the name implies, detoxify the body from pollutants found in food and the atmosphere. You are advised to change the type of foods you eat, and in the detox that I’m doing, the reader is told to meditate, journal, practice light yoga and walking, and go to the sauna during the process.

I had always thought that a detox was not doable for me since I’m diabetic. To me, a detox meant drinking blended spinach drinks and eating grapes. I figured that I would be on the ground in a diabetic coma within one hour with a diet like that. The magazine’s program seems very doable though. As for the food, it advises to: “think fresh, whole, organic foods. Eat plenty of vegetables (choose sweet potatoes instead of white potatoes), fresh fruits, non-gluten grains, beans, legumes, small amounts of nuts, seeds, nut butters, lean, organic poultry and wild fish.” Alas, this detox does not mean starvation. (Disclaimer: I am in no way advising that you do a detox. If you do decide to do so, be sure to read the entire magazine article and check with a doctor first.)

I did not have any goals in mind when I decided to start the detox. It just seemed like a nice idea, a project. But then I slowly formed a goal: Use the detox as a needed push for changing some habits.

I eat healthy most of the time, but I have two weak points during the day: grazing around 4 or 5 pm and late night snacking, after dinner in front of the television. I eat healthy junk, and I weigh and measure it. I don’t feel the guilt inherent in late night snacking because of this. So why stop? Health: Weight loss and better blood sugars. I figured that this detox could train me to stop eating when I’m really not hungry.

Around the same time, I was also listening to a Pema Chodron CD workshop on getting unstuck. Pema Chodron is the first ever female, Western Tibetan Buddhist monk. Pema talks about a Tibetan Buddhist principle called shenpa during the workshop. Shenpa is a feeling which is very hard to define but is translated as attachment. It is like a hook, which you can sometimes feel in your body as tension, and usually occurs as a reaction to something or someone else. And you react to that hook, or attachment, either by going numb, getting aggressive, or having cravings.

Let me give you an example: Someone says something to you that touches a nerve. How do you react? For some, their body gets tense, and they keep their hurt feelings inside and then will talk about the person later, go out for happy hour, or watch television and eat lots of comfort food. Some people will answer with a quick comeback or yell or plead with a statement seeking approval. Some people will drink alcohol or do drugs or completely numb out. That feeling that hooks you is shenpa. Most people seek comfort from shenpa, as I wrote through numbness, aggressiveness, or cravings, but this only brings comfort in that moment. According to Pema, shenpa is the cause of addiction.

I’ve never really thought of myself as having an addictive personality. I hardly drink a whole glass of wine when I do drink. I don’t do drugs or smoke. But I do love watching television. And I love my morning coffee. And I love to snack! Do they bring me comfort? In that moment, they do. But then I’m sorry later. I wind up not losing those pounds that I’m working so hard most of the time to lose, and even worse, my blood sugars wind up being less than ideal.

Pema suggests that the way to get unstuck from shenpa is through the four R’s: recognize, refrain, relax, and resolve. First, become aware – recognize – when shenpa arises. Then, refrain from reacting and as I’m learning, reacting is really quick, momentary comfort seeking. Reacting can mean going numb or craving what you don't have, too, not only yelling or answering back aggressively. So in my case, that would mean refraining from snacking on comfort foods. Relax means to be with the shenpa, with the hook, rather than suppressing it through go-to comforts. Pema suggests breathing with the feeling. It doesn’t go away, but instead of suppressing the hook and possibly causing disease, pain, and anxiety, you are giving it space. Finally, resolve means to accept that shenpa is a part of life, and will continue to arise over and over again. Once you accept it, not pushing it away, you can live life more fully.

After hearing these teachings, I realized that I could use this detox to change some habits and hopefully live a healthier and thus happier life.

Here’s an update from the first day: I noticed that I didn’t feel the need to watch as much television, nor did I check e-mail or visit websites, nearly as much as I typically do. I am finding that I have more time, and so I went for a walk by the river yesterday and have been reading a book for the fun of it. I did watch some TV last night, and found that I began to crave chocolate after viewing a Hershey’s commercial. Otherwise, I hadn’t even thought of eating. I only miss coffee when I think about it.

I hope that by the end of this process I’ll figure out which habits I want to keep and which I will release from my repertoire for the long haul. Stay tuned for "Changing habits with a detox: Part 2" next Monday!

Have you ever done a detox? Tell me all about it! I'd love to hear about the program you did and how it affected you.