Dancing with Carbs

Several nutritionists have tried to convince me to eat more bread/carbs than I thought was necessary.  The first just assumed that I should continue to eat a typical American diet with several portions of carbs at breakfast, several portions at lunch, even more at dinner and snacks with carbs as well.  When I finally found a nutritionist that listened to me and was willing to collaborate instead of lecture me with a party line, she hesitated when I suggested I could eat a lunch with just proteins and vegetables.  No fruit.  No bread.  No cookies or crackers. 

“How long could you possibly sustain that?” she asked, looking at me with skepticism and concern.  “Maybe for a little while you could, but eventually you wouldn’t be able to stick to that."

That’s crap.  That’s brainwashing.  That’s some freak adherence to a cultural standard while ignoring what my body is shouting at me and any medical practitioner who cares to listen.  My body wants less carb.  My pancreas wants a break.  My body is happy to process protein, low-glycemic vegetables and fats, but not so much with the carbs.  So I’m listening.  I can cut back.  For god’s sake – if I can have the self-control it takes to eat 1 square of chocolate and put the rest of the bar away because it’s too much for one meal, I can certainly pick and choose when to have carbs during my day.  I need a little at breakfast, but a half fruit portion is fine for me.  I don’t need any at lunch.  At dinner I need to be able to have a portion of some kind of starch and a small sweet treat, and a serving of fruit at night feels important as well.  That means I’m having half – or less- than the “standard” expectation/calculation of our medical protocols.

What they don’t really tell us is that we have choices.  Many choices every day.  We can eat more carb and take more insulin.  Or we can eat less carb and take less insulin.  There’s incredible power in that choice.  We can decide, we are in charge.  We can eat more carb and exercise more, or we can exercise more, maintain a lower carb level and reduce our insulin. 

It’s complicated to take in at first.  I expect that’s why they don’t spend a lot of time working with newly diagnosed patients on this self-monitoring, empowered dancing with the carbs.  Although I strongly, passionately disagree with NOT providing that kind of education immediately.  Because once we learn the basics, it's remarkable how having choices and control can inspire us to have an entirely new and wonderful relationship with our bodies.  

My entire life has been spent getting pronouncements, sentences, judgements, and punishments from doctors.  Shots, medications, admonitions, scary threats, test results and specific directions delivered with a wagging finger and stern expression designed to have me take whatever they were saying very, very seriously. 

I’ve left hundreds of doctors appointments with a mix of relief, shame, and fear.  Not just left…usually it feels like escape.  And I put off returning longer than I should.  I don’t even want to tell you the decades between pap smears, but trust me – I have avoided these testing, judgements and sentencing experiences with every excuse and denial and justification I could muster. 

But if we tweak the relationship just enough to question their authority and absolute rule…what happens?  IF we see them as expert consultants and advisers while WE are the CEO’s of our own bodies, what happens?  If we get multiple opinions, read on-line, talk to others about their experiences and pay attention to our bodies reactions to different choices/treatments/conditions…what happens? 

Make no mistake.  Refusing to be obedient and adhere to medical party lines is dangerous.  Doctors, nurses and nutritionists will confront and challenge you, consider you “non-compliant” (their word for you not obeying their every rule) and attempt to scare you and undermine your faith in yourself.  Until they see you being successful.

Diabetes is an unusual condition.  You’re not sick in the classic sense unless you ignore it.  You need to find ways – whatever they might be – to keep your blood glucose levels within the normal range.  But that’s the only “must” do.  How you do it varies like fingerprints.  Some people might exercise a lot, some less.  Some might need more carbs than others.  Some might eat more or less often than others.  If we pay attention, we’ll discover that all carbs are not processed the same way by our different bodies.

Each of our bodies reacts uniquely to foods.  Over time we’ve all learned about the foods that might upset our stomach.  Some people can’t eat really spicy food, or dairy, or nuts.  Some find that gluten makes them experience a whole host of negative symptoms.  These reactions can range from out and out dangerous allergic responses to milder responses which are not always even noted or considered. 

Since monitoring my blood glucose levels and tracking what I eat,I’ve learned so much about my body and food.  I’ve learned that white flour is something my body doesn’t react well to.  Even whole wheat flour isn’t processed easily.  My blood glucose rises more with flour even if I eat the exact same number of carbs as other complex carbs.  I seem to do very well with corn and sweet potatoes, but white potatoes raise my numbers noticeably more.  Happily for me, dark chocolate has no greater impact on my numbers than a comparable number of grams of most fruits.  These are not universal truths for people with diabetes…they are unique to me.  We can each learn what foods our bodies handle with ease and which present a challenge. 

Learning these lessons hasn’t meant that I never eat bread.  Once in a while I thoroughly enjoy a warm roll with butter at a restaurant or a blt sandwich for a special treat dinner.  For me, no food can be forbidden.  But by learning what I have, and by knowing that I need to make choices about insulin and carbs and exercise to maintain a healthy balance of numbers, I make some choices less frequently than others. 

Now that I’ve been losing weight, exercising and getting stronger, showing low A1C test results, lowering my blood sugar etc., medical providers approve of me.  I get lots of attention and congratulations and praise for my outcomes.  But it all happened despite their one-size-fits all approach.  It breaks my heart to remember how vulnerable I was when I was first diagnosed.  I want to make deals with anyone in authority who would speak to me so that I’d live.  I listened carefully to their directions and wanted to be a good patient. 

But some things just sounded wrong…discordant.  Like when you hear a singer hit a wrong note.  I couldn’t understand why they were telling me to just check my blood sugar a few times a day.  How was I to really learn how it rises and falls unless I tested before and after every meal, at wake up and before bed?  (I’ve even tested during the night at times to make sure I’m on track and aware of how I process sugar during the overnights).  I might not test like that all the time, but until I learned about my body it was absolutely essential.  And while I am losing weight and exercising, my body’s needs are changing and that requires paying close attention.  A cold or hormonal flare or significant stress can absolutely affect my numbers.  In those situations I need to pay close attention.

The other alternative is to pay no attention, dose myself at a higher level with insulin and just eat more to keep me at a higher average.  That’s what most doctors say they want.  Stay at a higher level because it’s safer that way.  Safer in terms of not having the risk of hypoglycemic lows.  But is it safer in terms of long-term risk of complications?  Of course not.  This is my body and my life and I will make the choice to reduce my risk of blindness, amputation and kidney failure thank you very much.

Of course test strips are pricey and insurance companies don’t want to pay for more than a few a day.  Stupid beyond belief.  How on earth can they ignore the obvious result of infrequent testing and lack of control?  Is it truly cheaper to just provide increasing medication, and deal with the complications of such a dangerous disease?  Just how are the pharmaceutical companies factored into the medical protocols we are told to consider our “bibles”?

If there’s one message I’d wish to share with other people being diagnosed, it’s to listen fully and read everything, but take it in with a degree of skepticism and never forget that you are the expert on your own body.   It will take some time and study to develop the kind of expertise that you’ll need, but it’s not hard.  It’s a few more tests a day, it’s paying attention to how you feel, it’s making choices and experimenting with the results.  And the result of all that is not just health and admiration from doctors.  It’s mind-blowing, exhilarating, freedom and power and trust in yourself.