Mary, Mary, Quite Contrary

I graduated in 1984 with a Bachelor's in Dietetics. I majored in nutrition because I wanted to know why I was fat.  From the time I was 10, I had a weight problem, an energy problem and OH, I hated to exercise.  Right before I went to college, the first national Dietary Guidelines were issued in 1977 - the ones that Ancel Keys had so much influence over and published without any proof that what they were recommending was true. (See the following: Fat Head by Tom Naughton; Cereal Killers: The Movie, Statin Nation, Dr. Sarah Hallberg)  So began the obesity and Type 2 Diabetes epidemic.  We have been one big f&#$%ng science experiment and it FAILED. 

For the next 3 1/2 decades, I ate less fat, ate whole grains, fruit & veggies & moved more, got frustrated, gave up, felt like a personal failure, tried again: cut fat, cut calories, exercise like a madwoman, get frustrated, quit, etc.  Michele May calls this the Eat-Repent-Repeat cycle.  

There is nothing worse than an obedient little girl trying to be "good" and follow the rules and

    be met with failure,

    blame that it must be my fault,

    I must be "cheating",

    I'm not working out enough

    and finally just giving up. 

I ate whatever I wanted, and was happy for a few years, then became type 2 diabetic (T2). Now, having a degree in Dietetics, I knew more than the average Joe about standard diabetes care protocols.  This was my downfall. I knew better than some doctor who never studied a lick of nutrition, so I took what they told me and thought I was implementing it correctly.  Since high school, I had always been within 5-10 pounds of the same number on the scale.  Then I became T2 and was told to eat 5x/day, 45 - 60 g carb per meal and 2-3 20g carb snacks.  I was diabetic, they said and my body was resistant to insulin, so I was destined to just get sicker and fatter. Then I had to go on insulin.  All this time, my inner rebel insisted I knew better than the doctors trying to help me and I stubbornly didn't hear what a few of the docs tried to say - which was I was INSULIN RESISTANT. That's really what was wrong with me, but I had a mental block the size of Mt. Everest...but I can't go back.

Granted, there has been a lot more research on insulin resistance and optimal treatment for T2 in the past 10 years, but I ran an 8.2-8.7 A1c for far too long.  The more I tried to get serious, the more fat I cut out of my diet, the more whole grains I ate, the more beans, vegetables and fruit I ate and the fatter I got, the more insulin I needed and I experienced utter, complete failure.  In November of 2013, I was desperate. I felt like crap all the time, had no energy and could barely function at work, let alone at home. I didn't participate in my family life, I was too tired.  They grew up and went off to college and I feel like I missed their last years at home. It sucked.  My long-suffering husband was always there for me, he never said a word as I got fatter and fatter, more and more tired (I called it lazy, but I really just couldn't do anything).  On November 20, 2013, I said a prayer of desperation to my angels, guides and patron saints. I begged them to intercede for me and ask God to help me figure out something.  While surfing the net later that night for more updated treatments for T2 - which I assumed meant weight loss - I stumbled up on Michael Mosley's 5:2 Fast Diet. It was intermittent fasting - 2 days a week, you eat 500 calories, the rest of the week, you can eat whatever you want up to your TDEE (total daily energy expenditure - lots of online calculators can help you get this).  My TDEE was over 2200 calories, more than I had tried to eat for years, so I gave it a try and lost 30 pounds in about 6 months.  When I tried to hack my golden goose by going below my TDEE (which changes as you drop weight), it backfired on me.  Finally, people started noticing I was losing and it scared me off the plan. I regained all of it and more - the typical reason that diets fail 95% of the time.  Fast forward to 2015, my youngest had gone off to college and I was working long hours, not sleeping (4-5 hours if I was lucky), eating processed and restaurant food instead of cooking - a recipe for disaster. Even worse, since I "knew" about diabetes, I would adjust my insulin without my doctor's approval/recommendation. I gained and gained and gained. 

In December of 2015, I scared myself - I couldn't go up stairs without panting and getting dizzy, my blood pressure (as measured at home) was 150/110. I emailed (!) my doctor and asked what I should do (duh!!), she had me come in and really listened to me when I told her I just couldn't deal with feeling like this anymore and I was worried about the blood pressure. For the first time in my life, a doctor did NOT say "let me give you another prescription for blood pressure" - I think I was almost maxed out on the THREE I was already taking.  When I had been in during the summer, another doctor in the practice told me I had to cut carbs to 0, that was the only way to get better.  Pfft... said my inner 1984 dietetics graduate, everyone knows you have to have carbs if you're diabetic, so I ignored her (gained another 15# by December too).  I don't know what was different this time, but this doctor said if I didn't treat the insulin resistance with low carb and exercise, I was never going to get better.  Better? Diabetics don't get better, they were lucky if they could delay or prevent complications, but early horrible death was inevitable. That was the message I always perceived. You hear what you need to when you're ready, I guess.  This video - also linked above - is what put me firmly on the LCHF wagon. (TED)

This time, my doctor said she wanted to work with me. I had 5 weeks before I went back to work after the semester ended to work on learning about a low carb lifestyle - not diet - it has to be a forever commitment.  I am nothing if not a good little patient, so I took my 268 pound self off to do what I do best - read, cook and find out what this was about.  Of course this was two weeks before Christmas, but not a cookie or a cake passed my lips.  I didn't want them because I felt better.  Additionally, my son came home for the holidays after starting a new job in NYC and had lost 54 lbs since June. He looked amazing.  He had worked with his new company's nutritionist and cut carbs, ate a bit more protein and since he walked everywhere, it worked for him.  He and his fiance` joined a climbing gym too and climb twice a week, in addition to all the walking. Oh, and he doesnt' eat after 7 p.m. until breakfast the next day. I'm happy for him - his A1c in June was 6.9%. He had it tested while he was home (AFTER Christmas) and it was 4.8%. He worked really hard and is now going into maintenance, which he realized means not going back to the old way of being, but being smart while adding a bit more fruit & protein to his pattern.

Fast forward to today - two months later and I have completely switched my view of fat.  I learned about the LCHF (also called a ketogenic) eating pattern that can really help T2 and obese people.  Fat phobia was my biggest hurdle in learning about this. 1984 girl keeps screaming NO NO NO! But as I learn it and practice it, I feel like I might be onto something.  I'm sharing resources that are helping me, but I can tell you it took over two months for ketosis to really kick in and start lowering my blood sugars. I didn't lose an ounce, but I felt SO much better, I didn't care.  My main worry was my glucose numbers - they were so high, despite keeping to 20-30g of carb a day (down from 240+g/day prior to my doctor's appt in Dec).

The other kick in the pants for me was that I ended up in the doc's office again in January because I thought I had some kind of infection (sinus, UTI, ???) because my numbers were in the 250+ range again. She did find something, so I started on an antibiotic, but the numbers were still too high.  She handed me the beginner kit and a box of Victoza - a third injectable for diabetes.  She said to bring them back to my nutritionist appt in 3 weeks and if things weren't better, I'd need to start on it.  I cried. The LAST thing I wanted was ANOTHER  diabetes injectable drug. I was determined to figure this out and get OFF medicine, not add more.

At long last, being an insulin dependent diabetic means I have things that are being proven to be a better standard of care - a LCHF ketogenic diet and intermittent fasting. Turns out I was on to something last year, I just didn't have the right amounts of carb, protein and fat to make sustainable changes or glucose improvement.  The missing piece for me turned out to be exercise.  I can't get around it. When I added it to my week (3x/week, 15 minutes of HIIT), my sugars dropped like a rock. Adding two half-fasts a week had them coming down even lower. I had to cut my insulin for the first time.

In the interim, I also researched stress and cortisol levels, acupuncture and traditional chinese medicine and have found that a combination of MORE SLEEP, more exercise & a well-planned keto LCHF eating pattern feels like it is working for me.  I used a keto macro calculator for guidance - there are several out there, all come out about the same for me.  Nowhere near the 2200 recommended last year, btw!!  But, eating this way, I am finally not hungry all the time. I have more energy, my sleep is better, my focus is clearer, I'm having fun cooking again and I don't have to count calories - just carb grams (up to 20g per DAY), protein grams (up to 88g/day) and fat to satiety.  The reason I count protein is because protein can make your glucose rise if you have too much.  I'm actually looking forward to seeing the nutritionist - I'm confident I will NOT be starting a 3rd injectable and will be discussing some of the obesogenic  prescriptions I'm on to see if we can't stop or change them.

Here are the things that are helping me:

Dr. Andreas Eenfeldt: www.dietdoctor.com

and the book "Low Carb, High Fat Food Revolution"

Dr. Tim Noakes: Real Meal Revolution - http://realmealrevolution.com/ (don't forget, they call it "Banting" in South Africa)

Dr. Sarah Hallberg: www.fitteru.us
TED Talk that changed my life: 
http://tedxtalks.ted.com/video/Reversing-Type-2-Diabetes-Start

Butter Bob Briggs: buttermakesyourpantsfalloff.com

also check out his You Tube videos-they're great!

Jimmy Moore's livinlavidalowcarb.com

"Keto Clarity" by Jimmy Moore & Eric Westman, MD.

"The Art & Science of Low Carbohydrate Living" by Jeff Volek & Stephen Phinney

Finally, the practice of mindfulness (you knew I was going to get there sometime!) has been HUGE in making this work for me.  Cooking all these wonderful recipes has made everything taste so good, it's a shame to rush through it, so I've slowed down, enjoy every bite and when I feel that whole body sigh of satisfaction & satiety, I stop eating.  I still struggle a bit leaving food on the plate - some habits die hard - but I feel so much better, I'm learning to take smaller portions and let go of the guilt - which reduces my cortisol, which lowers my insulin resistance, which lowers my blood glucose.....

It's all good.

Pax