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Location: Minneapolis, Minnesota, United States

Diagnosed with Type 1 diabetes in April of 1980. I recognize the incredible mental struggle of living with diabetes. I hope to share my struggles, my successes, and everything in between.

Friday, September 15, 2006

Fighting the Facts

There is a simple fact facing me.

This fact is, I believe, the root cause of many of the things I struggle with around my diabetes control.

I am fighting this fact tooth and nail. Even though I can clearly see this fact, I have, so far, not been able to change my behavior.

And my mind is really fighting hard to come up with some other answer, some other reason that is easier to deal with.

But it can't find anything that fits the puzzle so clearly.

So it turns up the volume on the depression. Because when I am depressed, it is harder to buck up and do the work.

Depression makes you want to stay stuck in the present - it makes you WANT to feel helpless against whatever may be bothering you.

What I am wrestling with is the fact that I eat way too many carbs.

Reading some of Dr. Bernstein's materials, which makes perfect logical sense, but seems very extreme (in the degree to which carbs are limited), scares the crap out of me.

So I reject it - saying things like "it's too extreme!!" and "who can live like that?!" But the man is living proof that his theories work wonders!

Then moving on to my latest series of books - which to my dismay, ventures into the lower carb lifestyle (although much more balanced) too! I found myself very disappointed! Why does everything that makes logical sense to me have to tell me to lower my carb intake?!

To see my favorite things, my staple meal items, to be blacklisted - forbidden , is hard for me to reconcile. And for the staple items in these "solutions" to be things that are so utterly gross and yucky to me - things I would never even consider eating, or for that matter even heard of before!

How does one with such incomplete nutritional information (me) come up with reasonable alternatives for all of this stuff?

My average daily carb intake tends to fall around 300 or 400 grams per day, unless I have a nighttime low when I can quickly add another 200 grams (in a heartbeat). Yes, I know - scary isn't it?

Is it any wonder why my A1C's aren't where they need to be?

I am addicted to carbs.

It's how I've always eaten, and don't know any different. I like the way I eat - except that I know it wreaks havoc on my body - which I cannot continue to endorse.

My parents tried their best to straighten me out when I was younger - but I didn't budge.

I have hope though - as I learn more about how to balance my meals and food choices, I know that I will be more satisfied with less food - that's one of the things balance does for you.

But it feels like such a big change - to work towards that goal. Partly because I'm terrible at taking things slow, and try to change it all overnight. Going from total carbohydratoholic to moderately low carbs all at once. No gradual change here.

My knowledge level of foods that comply with my wishes also seems so inadequate. I've never learned about such things - and to be my age feeling that almost complete lack of knowledge is very intimidating to me.

I feel completely stupefied when trying to find things I like when I'm out and about. Or even at the frickin' grocery store!! What am I even looking for?

Some of the recent posts from folks like Sarah and Beth help tremendously - giving me some concrete things to shop for and try. Brand names and things to ask for if I can't find them.

My mental side is not giving up easily though - throwing up tricks and traps at every turn.

It's very hard to (near impossible) to fight some of these physiological signals with willpower alone. The signals that our brains send coursing through every fiber, demanding that high carb rush to stimulate the endorphins and other "feel good" chemicals, they are almost unstoppable!

What can I use to combat such complex self destruction mechanism? What do I have that can possibly outmatch and outwit the minds drive for carby satisfaction?

Willpower is a good start - but it's not strong enough or consistent enough. Willpower is susceptible to sabotage. Willpower, while it can be so strong at times, is can also be manipulated like a kid being tempted with candy. Why else do you think they put on those crazy costumes on Halloween?

I also get frustrated when I make choices that better align with my wishes, and can't get my blood sugar figured out. When I have a low carb meal, but run super high hours later from all of the protein and fat - it's frustrating! To run so high after making what I thought were good decisions. It pisses me off, and makes me want to just forget it!

But I try to take a step back, and tell myself that it is a new thing - and new things take us time, experimentation, trial and error, and a good deal of perseverance to work through and figure out.

Some days though, the carbs win out, and I'll be programming a bolus for 180 grams of carbs in a single meal. I can't even believe I just typed that.

I'm working up the courage to do a series on Full Disclosure - where I document every minute of every day for a week or so, what I eat, what I drink, what I test and bolus, what I'm thinking, how I slept, any other thing that may influence things. And open that up to all of you - drawing on the vast collective knowledge and experience that the OC has.

I'm just not ready for that yet - as it scares the shit out of me. I am open and honest in my posts, but you really have no idea just how "out of whack" my dietary habits and resulting wild blood sugar swings really are.

It will take a lot for me to come clean and spill it all - but I almost feel that it's necessary. I will ask for compassion and gentle constructive solutions - and I'm not at all worried about that part of it.

The part I am worried about is being honest with myself, which is easier said than done.

20 Comments:

Blogger Scott K. Johnson said...

Here you go Kelsey! This one was worth following the link for right? :-)

hehe!

10:51 PM  
Anonymous In Search Of Balance said...

Have you ever seen the film Supersize Me? Where Morgan Spurlock eats only McDonalds for one month? By the end, he needed that food, felt sick when he didn't get it, and crashed a couple of hours after he ate. Sugar does have effects on the body that are beyond willpower, and make it so, so difficult to manage and to step away from. My mom's a biochemistry professor, and when I was little, we were a no-refined-sugars household because my brother had a lot of behavior problems, and the addition of sugar sent them through the roof. So please don't feel discouraged, your introspection and intention is a powerful foundation for any changes you want to make.

When I find myself eating too much sugar (mmmmm, sugar), I'll take one day, just one 24 hour period, in which I will eat only emergency sugar. Nothing else by way of carbs. For me, that seems to be like a reset button, where after that day, sugar in moderation is an easier (though never easy) thing to achieve.

If you're looking for lower-carb foods at the grocery store, a good rule of thumb is this: Shop only the perimeter of the store. Don't go down the aisles. That leaves produce, dairy, and meats.

Another thing I do to help out during the weekdays is preparing frozen food. Every now and then I'll spend a day cooking, and then store the foods in single servings in those Gladware things and stack them in the freezer, so when I need a quick snack I can choose to microwave some Mexican Chicken Parmesan (see next week's Recipe Thursday) instead of eating a peanut butter and jelly sandwich. And if you live near a Trader Joes, check out their frozen foods; they have awesome, healthyish, lower carb snacks.

That said, I'm no saint when it comes to the diabetic diet. It's HARD, and I fail again and again. And we all know that, and we've all been there. But it's wonderful to hear that right now, you are at a place where change is looking like a good thing to you. So congratulations on this first step, and best wishes on the continuing journey.

11:53 PM  
Anonymous In Search Of Balance said...

Wow, sorry that was so long. I got a little carried away :)

11:54 PM  
Blogger Lyrehca said...

Scott, that's a lot of daily carbs, but admitting it in public is the first step to change, isn't it (sounds like some kind of 12-step program for diabetics. Recovering carb addicts. But I digress.)

Have you ever met with a good nutritionist who knows type 1? Or is that too scary? And where do you stand on fruit and veggie intake? Fruit, I'm always surprised to find, has carbs but they're so much easier on my body than the white flour/sugar carbs. I mean, 15 grams of a fraction of a chocolate donut is far less predictable than 15 grams in an apple. Any way to slowly swap out, say, a bagel, for two apples? Or at least a bagel with for two slices of wheat toast with peanut butter?

I also think the switch from 400 carbs a day to the stuff Bernstein talks about is pretty drastic, although if it makes you feel immediately better, maybe it'll make you a convert.

Looking forward to seeing how it goes.

3:06 AM  
Blogger Lyrehca said...

meant to write "a bagel with cream cheese" above.

3:07 AM  
Blogger Bernard said...

Scott

Your post, and a post from Beth that I read shortly afterwards, made me write this blog entry.

Diabetes is a big burden that none of use asked for. I think you're doing a great job of always pushing yourself to do better.

How many years have you had diabetes? And how are you doing overall? If you don't have any major issues, you must be both blessed and doing some things right.

So give yourself permission to make some mistakes and work to get a little better at it all week by week.

6:17 AM  
Blogger Sarah said...

I followed Dr Bernstein's diet for awhile, back in 2003 (probably about 6 months). It was a HORRENDOUS first 2 weeks, but I stuck with it, and then I started feeling better then I had in, well I had NEVER felt that good.

I had an over-riding reason to try it though, even above being good to myself. I was DESPERATE to get pregnant and my PCOS was trashing me to itty bitty bits.

I'm trying to get back into it and it IS difficult. Like everything else though, baby steps are the way...And you are definitely working your way there!!

9:27 AM  
Anonymous Zazzy said...

I've been pondering this very issue lately. I came to the conclusion that the best plan for a person with diabetes is - the one he or she will stick to. Dr. Bernstein is too extreme for me. I know I won't stick to it. Other people I know do very well on the extremely low carb diets. In my opinion, it comes down to each of us balancing our medications, exercise and diet in a way that works for us.

Maybe I'm just rationalizing too, but I really hate cookie cutter plans and the notion that 'everyone' should do it a certain way. Everyone is different. What works for you may not work for me.

That said, I also know what works best for my body and keeping my sugars under control. I just don't do it. You're right, depression does a marvelous job of helping you stay stuck. My CDE showed me how to set up a plan using the foods I like and normally eat - and still be in balance. I just don't do it. I get frustrated at myself and then my focus is on how terrible I am instead of how to get back on track.

You've told me several times how important each small step is. You, too, need to give yourself credit for the steps you've taken to manage your diabetes. I'm totally impressed with your commitment to exercise since that has always been a real challenge area for me. I think we focus too much on feeling rotten about the things we don't do rather than feeling good about the things we do do. Don't you feel more positive about the next step if you feel good about this one?

9:28 AM  
Anonymous Chrissie in Belgium said...

Scott,

Each person is different - you are REALLY trying your best. Give yourself credit for that. No person should judge another by there own standards because we are all so different. What is hard as hell for one can be a piece of cake for another.

Another thing that you said really strikes a cord for me. You said:

"I also get frustrated when I make choices that better align with my wishes, and can't get my blood sugar figured out. When I have a low carb meal, but run super high hours later from all of the protein and fat - it's frustrating! To run so high after making what I thought were good decisions. It pisses me off, and makes me want to just forget it!"

What I want to point out here in relation to your above statement is that no doctor advices us on how to cope with the proteins and fats. We are NOT suppose to eat a lot of carbs and yet we do not have the instructions on how to cope with the other food sources that we are to eat instead! (Bernstein asks that we do not change the proteins and fat amounts from day to day, so that after much trial and error we can find something that will usually work.) All we are told is that we must test and try to find a pattern that will guide us in calculating a mealbolus that works for us. Well that is all fine and dandy if we do see a pattern, but what if a consistent pattern is NOT to be seen?! Is it so peculiar that we feel discouraged on doing all the dam tests and recordings? Pumps today are not adequately equipped to bolus for proteins and fats. THEY ARE MUCH BETYTER THAN INJECTIONS, but still. So we are just trying our best...... Give yourself credit for that! I get pissed at myself too, so who is talking here. Head says one thing and heart another! I do understand where you are coming from. Look all we can do is keep trying. As you know I am in my 45th year of this continual battle and I am doing fine. If I can do it, so can you. Don't give up, just chug along......

9:40 AM  
Blogger cHoCoMiLkRoCkS said...

I understand what it's like to be addicted to carbs. I have to have carbs with each meal. Plus carbs can give us a little lift when we're feeling so depressed.

I've been there, so depressed, the diabetes care is too hard. It's to tiring to care, too tiring to open a zip and put a strip in the machine put some blood on!

ahhh depression sucks.

I've lowered my carbs over the last few weeks, it's hard! very hard, although i still eat them at each meal. I've become addicted to pitta bread. But also having soya dippers. lots of protien and only 1.4g of carb!!!!

My TDD has shot down and I'm more sensitive to insulin.

Try work out a diet plan stick to it for a month if you can and see how better you feel!!!!????

Sorry if what i'm saying makes you more angry, it don't work for everyone.

All the best Scott,
Vicki x

2:46 PM  
Blogger Violet said...

Hey Scott--First, thank you so much for your kind comments on my blog. It's so great to hear from you.

I gotta echo Zazzy in admiration of your commitment to exercise. That's a really hard area for me, and I need to improve there.

There's a place between 300-400g of carbs and Bernstein, and I wonder if that place might be right for you. My daily goal, which was set by a dietician when I was dxed, is 180-200 grams. I don't keep to it all the time, but I do use it as the backbone of my meal decisions. I shoot for 50-60 per meal, plus a snack. But on special occasions I splurge. I have to have that freedom or I'd go insane.

I bet the same dietitian would give a big guy like you more than 200g, but less than what you're eating right now. And maybe you could live within that type of parameter as an experiment, to see if it helped. I often have trouble if I exceed my target for a few days in a row. It seems to throw everything out of whack.

If you'd like her name, you know where to find me :) It seems to me that your endo's office ought to be able to provide resources of this sort, and if they aren't, you deserve better.

Separately, I'm struggling a lot in my personal life these days with being honest with myself--being committed to reality. It's tough. I'm learning a lot from the process, though. Good for you for hanging in there.

Your openness on your blog is so helpful to so many. Thanks for your trust in us.

3:31 PM  
Blogger Minnesota Nice said...

Whoa..............judging by the number and length of commments, you and I are not the only ones with food issues.
After my favorable AlC three weeks ago, I decided to take a two day break and eat whatever I wanted and now I haven't stopped and I've been averaging 250-300 each day and feel rotten. It seems to have taken on a momentun of its own and I've probably gained 8-10 pounds. How distorted is that?
I called M. Hospital to ask them about their new binge eating program. The intake person said "how often do you purge"? Well, never. "How many calories are your binges?" Well, maybe 500-1000. "Oh, I'm sorry, you don't qualify because our criteria is for people who purge at least once per day and binge on at least 2000 calories worth at a time...........

And I know that diabetes is not to blame for this. If I were non-D, I'd still have the very same problems.

I really like all of the suggestions here - the "reset" day in particular.

Also, I go through a period every fall when my depression escalates and it's hard, very hard. But better days always do come - remember that.

3:32 PM  
Blogger Andrea said...

Scott~

I picked up Bernstein's book when I was first dx'ed... and then I quickly put it back down. I coud tell the diet was a little too restrictive for me. Frankly, I don't believe any food should be off limits. Yes, some foods are healthier than others, but food, in general is meant to be enjoyed... To cut something out that you derive a lot of enjoyment out of is taking something away from life... at least I feel that way.

I'm not a diet expert by any means, but I know that it is a struggle to eat healthy all the time. I've recently cut back on carbohydrates myself and as a result, I've cut down on my insulin total dose, & I've lost some weight (yay).

But, that said, I dont cut out any food group completely & I let myself have treats now and then too.

I know you were seeing that dietician not too long ago~ is this diet something she suggsted? I'd be surprised if it was.

Couple of suggestions ~ which you can take or leave as you please ;)...

Eat whole grains- generally these are healthier foods and are also higher in fiber.

Choose fruits and vegetables for your carbohydrate sources...

Drink plenty of water (got to do this one myself) instead of sugary beverages...

Protein- Lean proteins are very healthy and their was a study down that protein, not fat, is actually more responsible for satiety. Fish, Grilled Chicken, Turkey, etc are good choices...

Keep healthy snacks around between meals to prevent yourself from getting too hungry. Nuts, fruit, yogurt, and cereals are sensible choices.

Watch portins and serving sizes too..

Lastly, you may want to consider something I've heard about when planning your meal. Divide your plate into four sections... On half of it put your veggies, on one quarter put your protein, and on the remaining quarter put your carbs... I think this is a good way to eat :)

I think it's great that you are trying to keep healthy. Good luck and please keep us posted.

4:37 PM  
Blogger MileMasterSarah said...

Scott,
I can COMPLETELY relate with your food issues. Over the past year I have completely revamped my eating style, and I spent the entire year doing it, and I am STILL doing it. Im a HUGE carb addict. There are two MAJOR things I did to stop consuming huge amounts of carbs. The first thing was change my grocery store. Sounds silly, but when I go to Cub Foods or Cash Wise Im shopping American Diet and Im buying american diet because that is what I see. Now I shop at Byerly's and a local Coop, and what I see there is so different from what I see EVERYWHERE at the other chain grocery stores. The next thing I did was stop buying the crap that if I ate, I hated myself later for it. And if I wanted a high carb treat, I went to the store and bought a single serving. There is a big difference between buying 10 brownies and eating them all in 2 days and buying ONE brownie and eating all of IT (rather than ten. I will definitely be posting some more on some food Ive tried and some things that have helped ease this journey. I used to be the Little Debbie and Entemann's queen, and my idea of low carb used to be cut sugar and add splenda. Now it is totally different, and I know that anyone can find that balance if they really want it. Don't be hard on yourself, eating is an endless quandary of guilt and shame (at least it is for me) so give yourself a a good long time to change a lifetime of eating habits.....each thing that you choose to not buy and each thing that you choose to buy and stock your shelves with instead is a victory!

10:37 PM  
Anonymous soso said...

Hi Scott
I was very moved by your sincerity and predicament. Only a diabetic knows the crushing psychology of this disease and I congratulate you on your self knowledge...that is surely the first step to good health, of both mind and body.
Please do not fear Bernsteins methods so much. Even a partial commitment to his ideas will improve things for you...not everybody who follows him does so religiously. We all do what we can and I think the way you have sorted your exercise out shows what you are capable of. I hear you on the food shopping front and would like to send you some ideas...where can I do that, here in the comments section?
Another thing I wanted to mention is that on Bernsteins forum there is a T1 athelete called Adam who has a journal and somewhere there is a lot of stuff on bolusing for protein...My understanding (and experience) from reading Dr B is that fat has no effect on blood sugar, but protein does and needs to be bolused for.. if you want I will check it out for you and send you a link.
I think that is the biggest thing in doing low carb ala Bernstein is overcoming the fear of fat aspect...but after 2 yrs I can say, at least from my own experience, my fears were unfounded.
I wish all the best for you Scott, I think you are very brave and if I can help you in any way it will be my pleasure.. (I tempt my husband toward low carb every day, so know what men like..hahaha)
soso

6:57 PM  
Blogger Scott K. Johnson said...

Thanks everyone - you are all the best!!

I have met with a dietician in the past, and really clicked with her. Haven't seen her for about a year or so! Maybe it's time to schedule another appointment? That's been on my list for a while, just haven't actually done it yet.

I did watch "Supersize Me" - and it was profound. I am totally like Morgan near the end of the movie - where he's just a pile of unmotivated and miserable human. It helps to remember just how much he transformed - very powerful motivation indeed.

Many wonderful ideas her folks!

soso - yes, here in the comments are fine, or you can e-mail me privately if you prefer - it's up to you. My e-mail is in my blogger profile.

One more thing to complicate matters. I don't eat meat. Just don't like the feel of it, and have these crazy mental images of the process between living animal to dinner... el yucko.

Thanks again!

11:43 AM  
Anonymous soso said...

You are right scott, that not eating meat does make Low carb a bit harder, but if you eat nuts eggs and cheese and I am not sure what you think of fish?
Cans of Tuna or Salmon with ringpull lids are quite handy when you need to carry food, I often eat them with a few tomatoes or celery or whatever easy to transport veggie I fancy. Ditto boiled eggs..to make the cheese puffs, buy kraft extra chedder slices (others work, but may not puff up as much,,they are all good tho) take 2 slices and lay on a piece of parchment paper in the microwave zap for 2-2.5 mins till they are puffed up, let cool and you have a nice crispy snack...they should be a lovely chestnut colour inside when done. If you sqaush them down when still warm you can use them as the 'bread in a salad sandwich. I sometimes cut them up small before I start and then have a bag of cheesy wotsits to munch on..just be careful not to burn them..

an awesome cracker is 1 cup ground almonds (with skins..I use trader joes) one egg white, mix to a doughroll out very thinly (using saranwrap on top) on either a silicone baking sheet or a well oil sprayed bit of tinfoil...score lightly...cook at 250 for about 10 mins till firm but not burnt, cool snap and eat..these are legendary..even carb eaters snaffle them up....
I will send some more recipes by email...
ss

12:34 PM  
Blogger Kelsey said...

Definitely Scott! :)

I think you'll feel more encouraged as you start to see some progress. I relate to the "all or nothing" way of seeing things, but truly a slow and steady approach will work much better for you.

I know you've tried a lot of things, but my advice is to plan your food with the idea of "what should I fit into my diet?" instead of "what can't I eat?" This way you'll fill your meals with healthier options, without feeling so deprived. It's a subtle difference, but it helps.

Good luck and let us know how it's going!

Long or short updates are always appreciated :)

5:55 PM  
Blogger Johnboy said...

Scott, sorry to chime in late on this but I am really behind on my reading.

I think you really are addicted to carbs, my friend! I have been there too...and you know what? One "bad carb" seems to lead to another sometimes.

I have tried to shock my system out of it at times by being extreme about carb control, but in the end it's just not sustainable for me.

I think I would recommend both

1) a balanced in the types of foods you eat and

2) substituting good carbs (whole grains, fruits) for bad as moves that have worked for me in the long term.

Does this mean you can't ever have anything bad? Of course not! Just be very aware of the bad and limit it to an occassional treat so it doesn't spin you out of control.

Good luck, my friend.

- J.B.

9:25 AM  
Blogger Hannah said...

Oh gosh, I am so tired...dealing with my own stress this week...

I agree with what a lot of people have said here, and what you've said seems to echo some of my own problems right now.

Essentially, I just want to give you a big hug and tell you somehow you'll get everything figured out. I might have more to say later when it's not going on 3am. Haha.

12:14 AM  

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