In a short while I’ll be flying across the strait to Vancouver for an appointment with an endocrinologist. It’s my first in-person meeting since coming under his care a couple years ago.
I’m trying to be chill, but my experience shows that doctors like to tell patients what to do and not have patients talk back. I don’t mean to be oppositional, but I DO know my body.
Let me tell you what’s been happening this month. I got so tired of chasing my glucose level with my long-term insulin. Often I’d have to adjust the dose up or down between night and day and day and night. My frustration with this, which I expressed during a phone appointment with the doctor, prompted him to have me “come over” for an in-person appointment.
After this last appointment, I tried to think of what I could do to change the glucose dynamic. I thought of fasting, which I’ve got some experience. So I decided to try a series of 48-hour fasts, my plan was to eat a dinner of protein every second evening. It was truly an experiment — I didn’t have any idea what would happen, and I was shocked at what DID happen: My glucose dropped precipitously. I went from using 60-70 units of long-term insulin to using 26 units, (13 units morning and night). This was the starting dose I used when diagnosed 20 years ago. I also lost 10-12 lbs over the first 10 days but that levelled off.
Over the past couple weeks my Dexcom sends me repeated messages that I’m falling in the target range. A nice change from the frantic chase of trying to dose a moving target.
About hunger, you ask. How can I go 48 hours and not die of hunger? I don’t feel hunger. I don’t know why. My job has me walking all day long, albeit slowly, but my mind stays busy. I drink coffee when I wake up and diet Coke until noon or so, or it affects my sleep. The bottom line on fasting is letting your body be boss. If I feel off, I eat something. The other rule is to keep my glucose as low as possible, otherwise I’ll be suddenly sick with the deadly illness of Diabetic Ketoacidosis, which I’ve had twice. DKA occurs when high glucose combines with high ketones, the product your body produces when burning fat. Two get up to trouble, and your body’s pH goes toward the acid end of things.
So I kept my glucose in single digits whenever possible. In fact, I often had to chew on jujubes to keep from bottoming out. Finally, my glucose has levelled off and I remain at this shockingly low level.
The weird thing is I found some protein dinners caused huge spikes. I had a bunch of pork chops in the freezer and started having them as my dinner. But they’d cause a huge spike. Just the pork chop, nothing with it. So I tried other proteins like egg and shrimp, and there was a flat-line response. Last night I had chicken cordon-bleu prepared at a local butcher. HUGE spike and I’m still wresting it down over 12 hours later. Sure, there’s a bit of breading that coats it, but I predosed with 8 units of fast-acting insulin. The meal blasted right past that preparatory dose and had me up in the night dumping in more insulin.
So I’m not sure what to expect from the appointment today. He’ll probably try sending me to a nutritionist, since doctors tend to defer issues they don’t understand.
But what I really want is to be heard, and to have him admit my experience is curious and interesting. I will try to remain hopeful.
PS. I got a high five!!!! The meat spike can be solved by smaller portions.
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