Wednesday, September 26, 2012

Diet Woes

One of the good things about getting the diabetes diagnosis is that I've got access to a dietician, and my insurance pays for it.  Both the dietician and the diabetes nurse (who I met before during the whole dexcom thing) are seriously interesting and awesome women, and I keep running my appointments overtime just out of enjoying talking with them.  But getting back to the dietician...  The other day I had my appointment with her to determine my resting metabolic rate and draft a meal plan.

A bit of recap.  I'm not happy with the amount of fat I've got on me.  It may not be a lot in terms of numbers or compared to other people, and it might well be more the result of socialisation by my constantly-dieting mother than the result of knowing what's healthy, but it's still more fat than I want.  I've got crappy self-control in terms of food (not a sweets fan, but I love to eat and drink), and the thought of counting my calories or macros makes me want to throw a tempter tantrum like a 3-year-old denied ice cream.  Since I've been on medication for my Graves' disease I have put on about 4 or 5 kg, and I've been feeling like a complete lard ass.

I know, in a logical way, that carbs are not inherently evil.  I also know that diabetics should be eating carbs, albeit those with a lower glycemic index and load (carbs are not evil, but bagels are the antichrist with a hole in the middle).  I know these things in a logical way, but my mind is not free from the influence of people who talk about how much weight their cutting by avoiding carbs, or how I have to watch out that I don't eat too much bread, or how grains are poison.

As the dietician was going through a meal plan and comparing it with the food log I gave her a few months ago, she was looking for ways to add more carbs:  "What about fruit? How about you have an apple or something here...  Let's put some beans into that salad, beans are great..."

"I could do that",  I say.  Meanwhile I'm thinking about how I was told not to eat fruit more than once a day at most because of all that terrible sugar by one diet advisor, and how all the paleo proponents I know are convinced that legumes contain "anti-nutrients".  I find myself immediately deciding that I'll just skip the fruit.  Also in the conversation I'm relieved to find out that Greek yogurt and milk are counted as carbs, so my latte will do as a carb serving, and I can have yogurt before bread rather than more fruit.

I feel ridiculous as I watch myself react and think this way, how I'm already balking at the meal plan for being too carb-heavy.  I'm also wondering where the hell I've been going wrong since this plan (minus all the wanton carbs) so closely resembles how I've been eating yet I'm still gaining weight.  Additionally, I'm noticing that I still feel panicked and trapped by this meal plan even though there's no massive difference between it and my recent diet.

I'm having a really hard time resolving all this or knowing what it is I should be doing or eating.  I'm also now hating myself for eating anything as I watch the numbers on the scale at my endocrinologist's office creep upward.

The worst part is my metabolic rate.  Apparently 1500 calories is my basal need.  How can I justify eating 1900 (which I argued down from 2100)?  Surely I'm not lifting or climbing that hard.

Saturday, September 22, 2012

Wherein I am Judgmental

I'm usually not the judgmental sort.  I'm not saying this as a boast or anything, I just notice that a lot of things don't phase me, and I've had other people (including my own sister, who I don't particularly get along well with) tell me they value my lack of judgement.

There, of course, some subjects in regards to which my neutrality goes right out the window.  These include the obvious such as bigotry, charlatans of all description (and often those who buy into them), folks who say "nucular", etc.  Another one of these subjects is willful ignorance.

The other day I'm in the pharmacy, waiting patiently to get my anti-leukotreines before the places closes.  There's a guy at the counter engaged with one of the pharmacists.  He looks to be in his 50s.  He's got the beer gut, and ball cap, and there's obviously some issue.  As near as I can tell, there's a big bag of pharmaceuticals with his name on them, but he's not actually prepared to buy all of them.  The pharmacist has actually resorted to tearing the bag open, and is going though the bottles and canisters one by one to determine what the guy is going to take.  It amuses me at first, because rather notably the pharmacist is speaking in normal volume about all this personal medical crap, except when she says the phrase "stool softener".  So apparently it's ok that we can piece together this guy's medical issues, but it's embarrassing that he's a little constipated?  It's this amusing thing that gets my attention so moments later I'm completely eavesdropping on the pharmacist's side of the conversation (I can't hear the dude talking).

The pharmacist is pulling bottles out of the torn bag and telling they guy what's in them: Tradjenta, Lipitor, Advair, Dylacor...  She's giving him simple descriptions of what the medications are for "It's to lower your cholesterol... It's an inhaler, for your lungs, to help you breathe..."  This is where the judgement starts.  I'm amazed that this guy is taking all these things, but doesn't actually know what they do or why he's taking them.  Doesn't he think?  Isn't he interested in his own health?  Then I start to notice how very full the bag is and how many of these drugs are for things such as cholesterol and blood sugar.  I look at the guy's big belly, and then the judgement really flies, "What the fuck, dude..." I'm thinking, "You know you could ditch half that stuff if you just got up off your ass every now and again."

I'm not really proud of this, but I'm not exactly ashamed of it either.  I know that health issue such as high blood pressure and type 2 diabetes are multifactorial problems and that those who suffer from them are not at fault.  I also know that for many people, these things can be mitigated by diet, exercise, and lifestyle.  Looking at this guy it's clear he's got not got much of a handle on these things.  Yes, cleaning up your health is damn hard (I certainly have issues with it), but can't you make some kind of effort?  Even just a little moderation and movement can make a difference.  I see people like this chowing on some greasy fast food with the extra-ginormous fries in their pick-up trucks (with the engine running), and I just wonder: How can they not know?  How is it they don't understand what they're doing to themselves?  Or more importantly, how is it they know, but they're doing nothing to change? Are they too lazy?  Are they too stubborn?  Have they given up?  Have they chosen not to care?

It's so very frustrating to me to see people who choose not to take an interest and become and active participant in their own health and well-being.  It is a form of willful ignorance to know that your lifestyle is having a detriment, but to continue living the same way.  I have no sympathy for such a lack of involvement.  Am I alone in this, or do other people get frustrated in seeing it as well?