Miraculum's Journal, 21 January 2019

Good Monday to FS Friends, Met and Unmet!

I'm writing from my endocrinologist's exam room as I await a long-overdue follow-up. I postponed till I could report being back on track. I knew what I had to do and how to manage my insulin. Being knowledgeable, I'm confident doing so.

My weight (down from last visit by 14 pounds) reflects the last four weeks (minus two days) of super compliance with a truly ketogenic diet and all my medications.

My A1c, at 8.6%, reflects the last two months of 2018 when my average blood sugars were over 270 mg/dL and dailies regularly in the hi 200s to low 400s. This month as that average reading steadily dropped to 129 mg/dL.

I'm now taking a half to three-quarters of naproxen sodium, an kidney-burdening anti-inflammatory that my nephrologist hates, for severe arthritis in my knees and low back. that's the first reduction in 30 years!

The PA is vehemently against the LCHF/keto WOE and so documented my chart for the day I'm hospitalized for ketoacidosis. She and my M.D. base their anti-keto policy on outdated conventional medical practice.

The PA cut me off condescendingly when I mentioned online sources of "peer-reviewed studies and professional medical experience," saying almost indignantly: "Don't even *talk* to me about Google searches!"

She also cited the long-term unsustainability of keto and her experience with ill-informed fad-following patients, including a *type 1* diabetic who was hospitalized for ketoacidosis!

I love my MD at this office. He knows and respects my medical knowledge (general and particular to me) and opinions. That's why I haven't found a new endocrinologist.

His PA? I JUST TOOK THAT LADY TO SCHOOL!

LESSON ONE:
(1) I am not ignorant, irrational, uneducated, or uninformed.
(2) As a T2 diabetic, my metered serum glucose is *never* below 85 mg/dL, so lows are *never* an issue -- let alone ketoacidosis!
(3) I keep my insulin levels low by eating only two meals a day without snacks between meals.
(4) I drink at least 64 ounces of water daily as my beverage of choice.
(5) I test my *serum ketones* weekly *with a meter* and, this early in my keto life and have *never* had a reading over .8 mmol/L. (Ketoacidosis is in the 5+ range. Again, no danger of that for me!)
(6) I plan *every* meal *every* day, in writing, in advance, and stick to my plan.
(7) I consume 1200-1400 calories a day; I am not starving!
(8) I eat a variety of nutrient-rich, high-fiber, low-carb vegetables and low-carb berries in addition to quality protein -- all natural and unpackaged.
(9) My *net* carbs are under 20g but total carbs are usually around 40g. ("It's the fiber, stupid!)
(10) My nephrologist said I'm the rare patient whose kidney function numbers are actually *improving*, and he heartily endorses the LCHF/ketogenic dietary regimen. (So there!)

The truth is that most diabetes practitioners, instead of educating themselves and managing their patients to improve their health, prefer to leave dietary management to the ADA, dietary counselors, and the patients themselves. I get it. Theirs is often a thankless task, as they watch even their most compliant patients sicken and die.

I understand. Most T2 patients just eat what they want and settle for increasing doses of insulin that do nothing to prevent long-term complications, disability, and death. (I know. I was one of those.) They look for quick and easy glossy-magazine solutions and are unwilling to educate themselves and change, even if it would lengthen and even save their lives.

I'm now on track again and look forward to being at a "normal" BMI, *reversing* my T2 diabetes and hypertension, and eliminating my three diabetic meds (long- and short-acting insulin and Victoza) and most of my other medications.

And I've added another goal: TO PROVE MY DIABETES PRACTITIONERS WRONG!
221.0 lb Lost so far: 64.0 lb.    Still to go: 53.0 lb.    Diet followed reasonably well.

Diet Calendar Entries for 21 January 2019:
1207 kcal Fat: 107.44g | Prot: 45.79g | Carb: 30.99g.   Breakfast: Water, Coffee (Brewed From Grounds), Harris Teeter Whipping cream. Lunch: Trader Joe's Hass Avocado, Water, Nuttzo. Dinner: Water, Chicken Vegetable Teriaki. Snacks/Other: Water, Galbani String Cheese, Butter (Salted). more...
3884 kcal Activities & Exercise: Resting - 3 hours, Watching TV/Computer - 6 hours, Sleeping - 7 hours, Reading - 6 hours, Driving - 1 hour, Cooking - 1 hour. more...
on diet LCHF: Low carb, High fat / Ketogenic Diet   losing 3.5 lb a week

13 Supporters    Support   

Comments 
Wow, you're amazing. I love how you've educated yourself, and how you stand up for yourself. I also read the posts you put on someone else's page this morning and loved them, too. I'm seeing a new doctor this week and I'm a little nervous, both about my blood work and about how she'll react to the HFLC diet. We'll see. You inspire me. 
21 Jan 19 by member: PhillySue
YOU ROCK!  
21 Jan 19 by member: jeannieselby
@PhillySue, thank you so much! I suggest that, with a new doctor, let her tell you what her diet-and-nutrition "opinions" are. Then, diplomatically, tell her that you've "heard of this low-carb/high-fat/moderate protein ketogenic diet," ask if she's heard of it and what she thinks about it, and just listen. Then, if you prefer LCHF/keto to her suggestions, use LCHF as preparation for "full keto." Then, judge its results for yourself. If you lose some weight, you'll have a "positive leg to stand" on when you share the info with your doctor. I don't recommend complete secrecy from one's doctor. If you can't be honest, you need a different doctor. (P.S. - When I saw that you were "following" me, I looked you up and found that your entire profile info is "private." I encourage you to share some of your history and your ongoing journey to develop a FS support network, not just with me but with the many compassionate and friendly FS members who rely on each other.) 
21 Jan 19 by member: Miraculum
Thanks, Jeannieselby! 
21 Jan 19 by member: Miraculum
Way to go, Miraculum. 
21 Jan 19 by member: Draglist
Nice to hear M!! 
21 Jan 19 by member: Steven Lloyd
You are AWESOME! I am so glad to hear you say these things. My father was right up there with those previous numbers and only went higher every time he went to the doctor. He "cheated" and ate candy and drank soda...and I lost my dad. It just makes me so sad when I see someone say they are cheating like it's a one time thing but they really mean that soda and candy are actually the WOE for them. I want to read your posts for a good long time so keep up the good work and prove that doc W-R-O-N-G!!!  
21 Jan 19 by member: katies71
You have the right mindset! 7 out of 8 endos I've dealt with were shockingly incompetent. Every educator who was a T1 was awesome. When BG is over 250 try to flush with water and electrolytes if you can.  
22 Jan 19 by member: davet58
Hear Hear!!! Way to go! 
22 Jan 19 by member: FrankieBluEyes

     
 

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