Diabetes – Ken's Heart Wellness Blog

It’s been awhile…

…yes, indeed, it has. You’ve heard the old cliches… life gets busy, you feel better and start forgetting, yada yada yada. And all that’s true. I have been feeling better. Life has been busy. You forget things as mundane as keeping up a blog. All that stuff. And while things have been going in a generally positive direction, for which I am deeply grateful, all has not been perfect.

Back on December 18th I talked about water weight, sodium, and weight in general. My cardiologist and I got things worked out pretty quickly and things were going along well… until mid February of this year. Nothing had really changed, and I started gaining weight in leaps and bounds. Long story short I gained about 22 lbs in just over two months. I usually hover around 242-ish, give or take a pound, or two, on any given day. Now I’m hovering in the 260 to 265 lb range, the highest I have ever been. At least I seem to have plateaued, but it still feels defeating.

For about two months I didn’t think it was water weight, so I didn’t contact my cardiologist, which was a mistake. I wasn’t showing any of the other symptoms. I wasn’t bloated (heavy, uncomfortable, but not bloated), I wasn’t achy, I wasn’t short of breath, or any of that other stuff, just gaining weight rapidly.

Once I woke up and realized what was going on, to the doctor I went. We decided to change one of my medications, the ‘water pill’, and increase it and my potassium to twice a day, lower my sodium intake as much as possible, and go from there. I’m still hovering, which is kind of disappointing. I owe him a new blood test next week, and we will reassess then and move forward.

The moral of the story: Don’t be proud. Don’t be stubborn. Stubborn is dumb! Stubborn is dangerous. Stubborn could lead to congestive heart failure. That’s not a real fine option. Don’t be stubborn!

Upcoming: Rehab & glucose monitoring. (For my own reminders, more than anything.)

Reasonable Eating… Holiday and Otherwise

As a heart bypass surgery patient I have doctor instructions to consume less sodium, as little as possible, knowing that one’s body needs some sodium to survive and that some level of sodium is in virtually everything. This has been placed as an even higher priority than watching my carbohydrates (carbs) for my diabetes.

The key, of course, is to strike a sensible balance. Too many people freak out and try to do zero sodium, and that’s simply not realistic. On the flip side, many people completely ignore the advice and warnings and go back to what they’ve always done… go back to what got them where they are to begin with.

I’m trying to strike a reasonable balance, a happy medium, if you will. I want to be healthy, but I also want taste, and given that a person literally needs some sodium I think that’s a reasonable quest. Here’s my current plan of attack, as preliminary as it is…

Virtually eliminating adding salt when cooking.
Eliminating added table salt on most dishes where it really doesn’t make a difference and I was adding it for added flavor.
On a small handful of dishes where it does make a difference, I keep adding table salt, just not as much.
Seeking and trying various low-sodium recipes… which is a very hit-and-miss prospect.

This whole process doesn’t necessarily have to be rocket science. That’s why I’m thinking my approach above is reasonable… and realistic.

And be wary of various pre-packaged low/no-sodium and low/no-fat and low/no sugar. Read the labels. Read the ingredients. If they cut the fat, they might have increased the sodium. If they cut the sodium, they might have increased the sugar. You can’t win for losing. “Diet products”, I call them, generically. I prefer to eat the real thing and watch my portion control.

Here’s a recipe that I found that is quite tasty AND low in sodium, 150 mg per serving, Green Beans Amandine with Almonds and Garlic. The only modification I made was using regular fresh green beans instead of haricot verts. It was a nice edition to my Thanksgiving dinner.

For every yin there’s a yang. Another new recipe I tried was a low-sodium turkey gravy. Long story short, I’ll never do that one again. I’m going to guess that it is for people who have to aim for almost nothing in sodium because they’re in an even more dire health situation than I am. It literally had no taste, even after I added pan drippings to enhance the turkey flavor. My dressing and mashed potatoes actually tasted better without the gravy than with.

There’s going to be a lot of testing, triumphs and failures, as you work out your new diet. The primary point that I’m trying to convey here is to be reasonable and realistic. You will never find the ideal food or recipe, the one that combines perfect sodium, carbs, vitamins, and taste. Work out something you can live with… literally.

Note:  This is just what I am doing.  I am not a doctor, and this is not medical advice.  Please consult with your physician before making any changes.

Diet… Does Eating Suck Now?

Many people worry about this, and I’ll admit that I did, too. I mean, who doesn’t like good food, right? We can all breath a sigh of relief, it’s not quite as drastic as our fears led us to believe. A couple friends of mine told me that, for the first month or so after surgery, food tastes terrible. Not different or unrecognizable, per se, just bad. Lucky for me, my experience wasn’t like that. Food still tasted like it was supposed to, though maybe a little ‘dull’ for a short time. In my case, food tasted fine and I was able to eat almost immediately.

The first day in ICU I was restricted to a solely liquid diet, but that soon after surgery I really didn’t want to eat anyway, so that was fine with me. The first day and a half in the regular hospital room they fed me normal meals, but I wasn’t all that hungry so I ate only bits and portions. One meal I didn’t eat at all because I simply wasn’t hungry. After that I ate fine, and my appetite has been normal since.

And for what it’s worth the hospital food was actually pretty decent, even good at times… though the “pot roast” had the texture of something out of old Army C-rations. There’s a not too fond memory I’d rather push back into the deep dark recesses of my brain.

The big change in my diet kind of surprised me. Being diabetic and having everybody continually harp on me about blood sugar and carbs I was expecting a huge restriction there. Not so. Now don’t get me wrong, carb watching is still as important as ever. I still have to keep them in check and do the right thing. No, the big thing for me, at least for the foreseeable future, is sodium. I need to keep my salt intake down and well-managed. My hospital meals were specially designated as low-sodium, or possibly even no-sodium, I forget. They also made it a point to provide packets of Mrs Dash for seasoning to replace the salt. So the #1 dietary goal for me right now is reduce my sodium intake. I can do that.

About 15-ish years ago I eliminated added table salt on all foods, except french fries, corn on the cob, and popcorn. I did that for several years, but slowly backed away and started adding table salt to everything again. Well, now I’m determined to go back to that goal… and add french fries to the no salt rule. I even used Mrs Dash on some corn on the cob tonight and it was very good. I still can’t envision unsalted popcorn, though.

I’m also making an effort to make more foods either from scratch, or at least simpler. Packaged foods and mixes usually contain a bunch of sodium, for both taste and preservative purposes. And here’s a fun fact: Low-calorie, reduced-calorie, non-fat, and low-fat foods… basically anything packaged and marketed as an allegedly ‘healthier’ alternative… almost always have something increased to make up for what they took out, and very often that addition is a boatload of sodium. For a few years now my position has been to eat the real thing, just watch portion control.

So, here’s my ‘new’ dietary regimen…

Reduce sodium greatly.
Keep watching my carbs.
Watch my portions… not easy for me, but I’ve been good so far.
Eat real food, not bastardized concoctions, just watch portions (there’s that theme again).

See, it’s really not all that bad. Instead of ordering a meal and an appetizer, I pick one or the other, but not both. If I go to fast food, instead of a value meal and another burger as a side… yes, I do that… just the value meal. No more side burgers. And guess what… it’s really not that bad. I’m still satisfied when done.

Eat well, and bon appétit. 🙂

How Do I Feel?

How DO I feel? Since tomorrow is the one month anniversary of my surgery I realized that I haven’t given the simplest of updates… how I’m feeling as I progress in my recovery.

I wouldn’t go so far as to say that I am fully recovered. As I understand it, it can take up to roughly six month, on average, to be fully 100% (or better) yourself. I understand that, and can live with that. All things considered, though, I feel really good. I feel like my recovery is going quite well. Judging by comparing to others around me in rehab, and from what nurses tell me, I believe I am recovering faster and better than most people in the same situation. My breathing exercises have been lacking, and I still have a small issue with lung congestion, which I am working on. Even with that, I get the feeling that I was in better shape than most people going into a bypass surgery, which seems odd to me, but ok. I mean, I wasn’t exactly a pillar of physical strength and virility prior, if you know what I mean. I’m certainly younger than pretty much all of them, which isn’t something to brag about, either.

I have virtually no pain whatsoever from the surgery itself, meaning the inside stuff. I’m still short of breath and tire easier than pre-surgery, but that’s normal, and that and my stamina are steadily increasing with each day. The day after I got home I got wore out and had to take a long nap after just unloading the dishwasher… which Missy chastised me for doing too much too soon. Fast forward to today and I can do that and more, to the point that I feel like I’m actually accomplishing things.

My skin is… interesting. The two incisions on my left leg are pretty much fully healed. The two small incisions on my stomach from the drainage tubes are almost fully healed. I am amazed at how well the 7″ chest incision is doing. The scab portion is almost gone, only about an inch left. The 9″ incision the length of the inside of my left forearm is taking longer. It’s making progress, so I’m not worried, per se, but it is still about 80% scabbed with inflammation and redness. Just in the last week has it started healing enough in places for the scab to disappear. My skin on my forearm is forming some ‘pockets’ where the skin is pulling together unevenly.

Part of my left forearm and a portion of my left palm, in just the last 10 days or so, have developed some numbness and sensitivity. I was warned up front that this would be perfectly normal and not to worry about it. I have also since been told to ‘exercise’ it by stretching and working my hand and wrist from time to time.

My feet already had some very minor neuropathy from my diabetes prior to surgery, but now my feet and my upper chest, along with my left forearm, are all hyper-sensitive. Something as simple as wearing a shirt can be painful. My shirt will lightly brush against the incision areas and cause irritation, which turns to actual pain if it goes on for a few hours.

Part of my upper left chest will always be numb because they took out an artery that had some nerves attached for the bypass. And… this surprised me… I will never again have a legitimate pulse in my left wrist. The artery is gone from there, too, so there’s nothing to measure. Makes sense now that I think about it.

Mentally and emotionally I feel fine. I’ve been very open about this from Day One of being diagnosed. That’s been very therapeutic. I’ve been very stoic about it. It just is what it is, let’s deal with it. I feel like this blog has also been very helpful, keeping me in a good frame of mind. As I have mentioned before my sleep schedule has been upended, but I’m getting enough sleep and it has been good sleep. My appetite has been fine, though I’m consciously trying to eat smaller portions. I’ve pretty much cut out table salt, and have tried to make some better choices, though I haven’t gone total health nut whack job, and doubt that I will.

So that’s it. My health checklist, you might say. I’ll revisit this a couple more times before I’m done.

Stunted by Emotions

Ken asked me to contribute to this blog. I wanted to a few times. I would start, stop, start again. I could not find the words to describe how I was feeling and dealing with everything. I have decided to just lay it out and hope you can understand it all. I will start with my emotions leading up to the angioplasty and then what I felt after that.

As Ken explained, the nurse from the cardiologist’s office was trying hard to reach us. When he found out what was going on he called me and told me we were going to need to go in for the angioplasty. He explained why and what that was. I was sitting in the waiting room at the eye doctors waiting for his mom to be done with her appointment. All I could think of was that I didn’t want to lose it there. Then he asked me to talk to his mom about it. “Sigh!” Hold it together even longer. I can do this!

The day of the angioplasty comes. I was prepared to sit and do some work on my computer while they worked on him. I barely got set up and the nurse was coming for me. She took me to a little room with a computer in it. I was not sure what was going on, but I knew in my gut that it wasn’t good. The doctor came in and went to the computer to show me the pictures of Ken’s heart. He told me that they found many blockages and that there was no way a stent would do it. I was stunned. He informed me that it was from years of diabetes issues. However, the working part of his heart was strong. At least one thing was good!

Once I was away from the doctor the anxiety set in. I paced and started to feel out of breath. I knew I needed help to not have an anxiety attack. I called my mom. She is always my rock and I needed her on the prayer chain. She calmed me and was very helpful. One more call to a friend to fill the rest of the time before they came to get me and I was calm when I got in the room with Ken.

This is where we learned of the waiting game that would become our lives. I didn’t know what that meant at that moment, but I soon found out it meant anxiety, stress, and headaches. We are almost there and I, for one, can’t wait!

Missy ?

After the diagnosis

So, where were we?

Oh yeah, I’ve been diagnosed. As I mentioned the surgeon wants me to get my blood sugars down below an A1C of 8.0. It was 10.5. Not good, I know. (No lectures, please.) So that’s where my focus is going to be the next few weeks. I begin a stringent regimen of tracking my blood sugar numbers and eating less and better. In true nerd engineer-like geeky fashion I created a spreadsheet to help me. Those of you who remember Arlo Guthrie’s Alice’s Restaurant will remember the twenty seven eight-by-ten color glossy pictures “…with the circles and arrows and a paragraph on the back of each one explaining what each one was to be used as evidence against us.” Well, I created a spreadsheet with rows and columns and colors and a key chart to be used to keep me straight. Here’s an image of the actual spreadsheet, so far…

My endocrinologist today said that I have provided too much information. It’s overwhelming and hard to narrow anything down, but that’s jumping ahead a bit.

Anyway, with my meter and my chart I track myself morning, noon, and night. I have two appointments later in the month, the 28th with my endocrinologist, and the 30th with the surgeon where we will set the surgery date, providing my blood sugar numbers are down to being reasonable. Today, as I write this, it’s the 28th. Had my endocrinologist appointment this morning. Two days to the surgeon’s appointment. I’m just a little anxious, I want to get it scheduled and done, but I digress.

A couple days later my endocrinologist’s office calls and wants to see me for some diabetes education, so I set an appointment and we meet. Ends up being two appointments over two weeks and some good information is exchanged. The nurse marvels at my out-of-date glucose meter… she had to go look for the program to download it, it had been so long… so she gives me a new one. Then, we’re both perplexed because the new meter’s smart phone app to track for me won’t download onto my phone. Ya see, I have an Android v5.0.1 and the minimum version number is v5.1. Figures.

Long story short, things are going well and the next two and a half weeks go by fine without incident, until…