March.

Time Marches On.  March brings a few things.  It adds another year to both myself and Grete as we have birthdays.  And it brings a round of diabetic checkups (my yearly assessment).  As always, I’m expecting the worst from the blood glucose numbers, and assume I’ll be blind and missing limbs in a few months due to bad sugar control.  We’ll see what the numbers return.

I’m trying to remain upbeat about being almost 40, but with the all crap going on at work, that’s never easy.

5.8, which is really good. My GP is pleased, talked again about decreasing my metformin dose, but I’m loathe to jinx something that’s working. Maybe if I lose a stone or two I’ll change the dosage. He did say I could give up the aspirin if I wanted, since a) my sugar is under control and b) recent research suggests it’s not as useful in pre-heart-attack victims as it was once thought to be. I’ll see how it goes. Out of all of my medication it’s the one thing that has an obvious impact due to the blood thinning.

The other thing is that it’s HbA1c, not any other combination of those letters and numbers even though I can never get it right.  More than half my blog posts and tweets refer to it as Hb1Ac or something like that.  It’s HbA1c.  I’ll get it into my thick skull eventually.

5.8 – I’m chuffed!

When you’re overweight and diabetic, when you know you should be losing weight and controlling what you eat, ordering take-away food could be seen as failure.  It certainly feels like failing.  It doesn’t mean I don’t do it – and in fact, because I feel like it’s failing I usually end up ordering the worst possible thing (more calories than you can shake a stick at), because since I’m failing, fuck it, might as well fail in style.

But it’s not a good place to be mentally.  Food and emotions are already tied together too much (feeling good, why not eat to celebrate, feeling down, why not eat to cheer yourself up, eaten too much, better feel guilty, feeling guilty, why not eat to cheer yourself up.  repeat).  So feeling like a failure every time you order take-away food doesn’t help, it just drives the circle even faster.

So I decided to redefine success.

Now, the normal position is ordering take-away food.  That’s normal.  Success is not ordering take-away food.  There is no failure option.  Every day I don’t order take-away is a success.  I’ve achieved a goal.  I eat the chicken and veg or whatever other bloody meal I can pretend to enjoy and I succeed.  If I get take-away then that’s okay, it’s normal.  Tomorrow I have another chance at success.

It’s a much better head-space to be in.  Might feel like cheating, but I think that it doesn’t matter.  You have to be in control of how you feel to some extent, in order to manage what you eat and actually survive.  If I have to cheat by moving the goal posts to do that then I will.  It hasn’t (and won’t) lead to me eating more take-away food, but it’ll certainly lead to me not feeling so bad about it if I do (which in turn means I don’t eat even more crap), and every day I eat something boring and tedious and with the vague semblance of being healthy I’ll feel like I made progress rather than being stuck with the status quo.

I want to be sarcastic about the nurse appointment today, but the nurse was really nice and friendly so it wouldn’t be fair.  I knew I’d put weight on, she asked why, I said bacon cobs.  We had a discussion about grilling bacon, not frying it, and I tried to let her know I’m not stupid, I’m actually reasonably intelligent, and while I know what I’m doing wrong with food it doesn’t mean I can change it.  Finding food without any of the Unholy Trinity (fat, sugar, salt) that’s still worth eating isn’t that easy, so if I find something which keeps my sugars down, doesn’t put my blood pressure through the ceiling and has too much fat – well I’m sorry but I’m still going to eat it.  My feet are still there, my pulse is still present in my feet and I can still feel the little plastic stick thing they push into your toes to prove you still have nerve endings.  She was excited about revealing my blood sugar results until I pissed on her bonfire and told her I’d gotten them on Monday, she took it well.  And oddly, my blood pressure was really good.  ACE inhibitors do have a possitive effect on blood pressure but I’ve only taken two so it can’t be entirely down to those.  Maybe being on holiday helps, but I really thought after the last few weeks at work (which were some of the worst in the last 2 years) that my blood pressure would be somewhere around the height of Everest.  Just goes to show, you can never be totally sure how your body is behaving.

So, all-in-all an okay appointment, she really was nice even while she nagged me to eat less and lose weight.  Can’t really argue with her, and she couldn’t really argue with my sugar results so we were pretty much just shrugging a lot.

The wood pile in the garden is even smaller again – got a saw yesterday and had a go at some of the bigger branches and then snipped some more of the smaller ones.  Which means I’m getting perilously close to the worst bit – bagging it all up – I hate that bit.

And while I’m sure 99% of the world will think I’m being crazy – I’m really pleased at swapping out a dimmer light switch in the lounge for a regular old click on off switch, which means we can now use low energy bulbs in the lamp fitting, reducing electricity bills and bulb replacement costs.  The trip switch worked perfectly, letting me swap the light switch without having to power the whole house down and other than having to get my fat fingers into a tiny space to screw the wires in it was okay.  I’ll probably be fit to own a house by the time I’m 80 at this rate – so you know – we’re making progress.  The actual box on the wall is really ugly, and I may try and replace the whole thing with a more streamline fitting, now that I’ve seen the inside I’ve got a better idea how much space there is to work with (none!).

Car goes in for MOT tomorrow – if that goes not too badly it’s going to turn into a fantastic week.

So mixed bag today.  Once I realised I didn’t have any appointments today, I thought I’d try and get a phone appointment to get my blood results.  Rang the surgery and asked for one, and they told me my doctor was working out of a different location today and I should call there – after it took me about 20 minutes to get through.  Still, I called the other surgery, and after another 15 minutes asked for a phone appointment – they don’t do them – but he could see me at 10:30.  So, I ended up with a visit to the GP today anyway.

The good news, from the blood test my kidney and cholesterol results are fine.  My liver results are ‘off’ but they’re always off and this time they’re off by less than they ever have been before.  My HbA1c test was 5.8.  That’s pretty good, and the biggest indicator of diabetes related health.  It could stand being a little lower, more like 5% maybe and I still need to make sure day-to-day control is maintained.

The bad news is that my urine test showed protein, which means although my kidney blood tests are ok, my kidneys are allowing protein through.  Essentially this is caused either by diabetes, or by high blood pressure or by both.  The treatment is ACE inhibitors, which means another daily tablet.  Yay me – see the NHS did get me something new for my birthday – a surprise!  I get to take them for a week and then have more blood tests so now I have another appointment next week to give more blood and then I’ll need another GP appointment 3-4 weeks after that to review the results.

In other bad news – the car needs a new rear silencer (it sounded really bad today), and the MOT is due next week (which we’d kind of forgotten).  I guess I know where the money I’ve managed to save is going this month.

But in other good news, Wickes sell mini-trip switches which are the exact right size for our old fashioned fuse box.  I bought one 5amp one (after being caught out recently buying low energy light bulbs in bulk only to find out they didn’t fit, I thought I’d start with one thing this time and expand if it was the right option) and it fits perfectly.  So hopefully if the Annoying Hallogen Light Bulbs from Hell in the kitchen trip the fuse it’s a quick switch flick to get things back online and no need to power down the entire fricking house.

So tomorrow eye test, Wednesday nurse appointment, sometime between then and next week, car in for MOT.

Then I’ll probably need a holiday to get over all this stuff.

My birthday is in March, and the NHS gets me the same thing every year – a set of annual diabetic check-ups.  I get some retinopathy checks (they dilate your pupils and then photograph the back of your eyes).  I can’t see very well for a while after that because everything is too bright.  I get a visit to the nurse who checks my feet to make sure I can still feel them and that I didn’t cut a toe off without noticing, she tends to also nag me about not losing weight, having high blood pressure, and then asks me if I’m depressed.  Before all that I also have to have a blood test and provide a urine sample, did those today.  Bled pretty easily, was awkward last time but the nurse suggested it was because I hadn’t had a good breakfast.  This time I made sure I ate early and I sprayed the inside of the two tubes quite happily when she stuck the needle in.

Then I get to wait and see how my average blood sugar was over the last three months.  I’m not expecting a good result this time – I’ve had bouts of being ill on and off which messes with my control and emotionally I’ve not been strong enough to exert enough control either, so I suspect I’ll be having a talk with the doctor.  I’ll resist attempts to change my meds – I can control my sugar when I’m strong and I just need another kick up the arse.  I guess his concern will be that after too many kicks I’ll be blind and missing a foot.

Meat and two veg (one of which is McCain Microwave Chips) is pretty good for my diabetes (not for my heart, take it up with my GP).  To complete the lazy-ass setup I get the tesco microwave veg, it’s ok (it’s steamed).  My blood sugar is usually around 5 or 6 two hours after any combo of meat, veg and those chips.  However, it gets boring quick.  I quite like roast chicken, and steak and pork and all the other kinds of meat, but it still gets boring.

I can usually tolerate it for a couple of weeks before getting sick and wanting pizza and other high carb stuff.

Which means I understand why mustard and pepper are so important (and clearly, all the other spices).

Yesterday I had pork smothered in mustard before I cooked it, and today steak with crushed black pepper corns (fresh).  Nice change.

It amazes me what you can convince yourself is ‘nice’ in terms of food and drink.  I like beer (english bitter or stout).  But honestly, it actually tastes like bitter dish water until you ‘acquire the taste’, which essentially translates to, ‘until you convince yourself that you enjoy it and appreciate the differences in taste’.

I think a lot of food tastes are the same, the question is not ‘do you enjoy this’ it is ‘are you prepared to invest in the effort to learn to enjoy this’.  Like blue cheese.  The younger you are when you start learning to appreciate these tastes, the more natural they seem.

So, anyway this post is nothing to do with blue cheese or beer.  It’s about bread (yes, you guessed it).  I like hot buttered toast, sometimes I like a sandwich, I enjoy bacon cobs, I enjoy French bread.  But I’m diabetic which means I have to be careful with bread.  Eventually I found some tesco’s fresh baked bread (Finest Rustic Multigrain) which I actually liked (didn’t have to acquire a taste for it).  It’s nice when it’s fresh and it’s nice when it’s toasted.  I still wouldn’t do bacon sandwiches with it (white bread!) but I could picture myself eating ham and peas pudding sandwiches with it.  I ate it for a while, I’ve no idea what the GI is, but while eating it my blood checks were fine and my average (Hb1Ac) was excellent, so it was ok.

And then our local tesco changed the recipe, or something and it started tasting like cardboard.  Really, it was dry, fine grain inside (instead of fluffy) and just like ash when toasted.  I was gutted, so I stopped eating it.  I searched for something else which wasn’t bad for my blood sugar and found a couple of seeded loafs from various companies which were ok, I could tolerate them but my sugar wasn’t as good.  They were also stocked in pretty low numbers so I was never sure if they’d have any in.  Then I found the Bergen stuff (I’ve blogged about it a little bit, search for Bergen or Linseed).  It’s low GI, linseed and soya bread.

I ate it.  I tried it with sandwiches and I had it toasted.  I managed to acquire the taste so that it was ok toasted (if I let it cool).  Anything else and it was a bit nauseating to be fair, but I got used to it.  Was great for my blood sugar.   I liked it even maybe.

Well no I didn’t.  Because tesco have switched their Finest Rustic Multigrain back to the old recipe, or the old baker is back, or they changed supplier, or whatever and I got some the other day because I was feeling a bit tired of the Bergen.  And it’s delicious.  Nice, enjoyable.  And I realised I don’t like the Bergen, I was just prepared to tolerate it and had convinced myself the taste was ok.

It’s not really ok.  It’s really off-putting.

So I’m happy, the tesco bread is back, they usually have plenty in and as long as this recipe stays consistent I can enjoy fresh bread again.

I know white bread is bad.

I know that working from home usually means my sugar is generally higher than when I’m in the office.

Mixing the two is not good.

I need to be more careful.

Approaching two hours after finishing my breakfast, and my blood sugar is 6 mmol/L.  I had 3 hash browns and 4 slices of white bread (although they were half-loaf sized) and a lot of beans.  But I also had sausage, bacon and fried eggs, a solid mix of protein and fat.  That protein and fat ensures my body metabolises the carbohydrates more slowly.  If I’d had four slices a toast only with low fat spread, the ‘healthier’ option, or even some regular cereal, my blood sugar would be up in the high 8’s or 9’s at this point.

The irony doesn’t escape me.

Still, here’s to blood sugar levels of 6 mmol/L and a Merry Christmas ahead.