Sunday, March 02, 2008

Life By the Numbers

Saw my endo on Thursday for my every-three-months checkup.

My A1c is a respectable 6.2, which she was ecstatic about, but which I still found rather deflating. I'm aiming for 6.0 or less, cause 6 and under is a "normal" person's blood sugar. Yes, I'm being obstinate (the goal for diabetics is to have an A1c under 7.0. What can I say? I have high standards. I also had a 5.9 six months ago, so I know it's possible).

She found my reaction hilarious, because she'd just congratulated somebody for having an A1c of 8.6 (down two points from their previous one!).

Eh.

Anyway, we went over the bloodwork that I had done 3 months ago as a part of trying to get my pump. Everything looks lovely except... well, I knew this one was coming at some point.

My "good" cholesterol numbers are high (which is good), but my "bad" cholesterol numbers are borderline high (which is bad). If I wasn't diabetic, she said she wouldn't have been concerned about it, but I need to drop about 30 points to get to where I should be, optimally.

Horrific cholesterol runs in my family (I think I remember hearing I had an uncle with numbers in the 400s). She wants under 200. I'm at 219. She knows what my diet and exercise schedule is like, and once I told her about my family history she was like ahhhhh... you know, I know you'll hate to hear this, but I really think we should go with a low dose of Lipitor.

And yes, I do hate to hear it. I knew it was coming, of course. Bad cholesterol runs in the family, and it was only a matter of time before somebody did a blood test where mine showed up. Taking action now means fewer complications in the future. Diabetics die from complications - organ failure of one type or another, heartattacks in particular. So doing what I can to avoid placing undue burdens on my heart would be, you know, a good thing.

I asked her what I could do, dietwise, to help this along on my own. Ideally, I'd do the lipitor now, alter my diet, go off the lipitor for six weeks, and see if I'd managed to get it under 200 on my own. She gave me the name of a nutritionist that I can work with up in Centerville. Dropping 30 points through diet alone - after looking at what I eat already - probably isn't feasible. At best, she said I could likely drop about 10 points through diet alone. But let's be honest here, people: I eat a shit ton of full-fat dairy products and meat. Sure, I eat lots of vegetables, too, but meat and cheese and other dairy products are a mainstay of my life. These are foods I let myself eat as much as I want (and it likely the reason that, though I work out regularly, my weight stays the same).

Eliminating animal fat is going to be a big part of the diet change. That's going to hurt. I went ahead and took out butter, red meat, and took out all cheese but low-fat mozzarella on my own, and I'll be switching to egg whites over time. I'm using up the last of the whipped cream in the fridge, and will need to keep to my 0% fat yogurt religiously. This will also mean dumping sour cream.

I'll be replacing some of the meat I'm eating with beans and tofu and fish, which I don't mind. I already have turkey bacon on the weekends, and you know, there's some stuff I'm just not going to give up completely. Like bacon, yo.

So I'll be working on moving that over over the next few weeks and then seeing the dietician sometime in the next few weeks as well.

I need to make a habit of cutting out some of that animal fat on a regular basis. Cheese and steak should be treats, not everyday fair.

Ug.

And don't even get me started on the Chipotle burritos.

Blast.

Diabetes: not fun, people.

8 comments so far. What are your thoughts?

Cheryl said...

Sympathy. I've been through similar things myself. I don't have the diabetes complication, but the high cholesterol is genetic and enough of my close relatives have died of heart attacks for it to be rather worrying.

But do I want to live without cheese?

Yep, I just have to not eat a pile of it for lunch every day. I also tend to eat venison and buffalo in place of beef and pork. There are various natural cholesterol-lowing foods you can eat too: pomegranate, macadamia nuts. It all helps.

But I know that the first thing I'm going to want to eat when I get back to California is a Chipotle burrito.

Jackie M. said...

First of all: it seems like the good cholesterol/bad cholesterol thing is a false dichotomy anyway. Do you want me to find you the article? It's basically only a very specific lipoprotein that seems to be any real indicator--they just didn't have a proper test for it back in the day. And there's no good way to lower that lipoprotein via diet.

But cutting down on red meat, butter and cheese will very easily lower your overall "bad" cholesterol. Why not switch out guacamole for the cheese and/or sour cream, and switch chicken and the lean pork for the steak?

Kameron Hurley said...

But no more sour creeeeeam!!!

Yeah, I know. It'll be fajita burrito, black beans, mild salsa, lettuce and guac, prob'ly.

So I won't eliminate it, but I just don't think I'll be as addicted to it, either, without the cheese and sour cream... blessing in disguise, maybe? heh

Jackie M. said...

Why are you ditching the chicken, pinto beans and pork? Those are all fine.

And you're not in the 280's. Dumping either sour cream or cheese is probalby sufficient.

And did I mention lowering your LDL doesn't prevent cardiovascular problems? It's just the super-dense lipoproteins that matter. And you can't do fuck all about them.

Jackie M. said...

Sorry-- that should have bene "very low density" lipoproteins.

But seriously:

New York Times column on "bad" cholesterol.

New York Times column on statin usage in healthy/low-risk patients.

I'm doubtless overstating this. But given your actually-quite-low numbers and the all-or-nothing mantra advocated by your doctors, what the hell. The truth is probably somewhere in the middle.

Jackie M. said...

And as long as we're at it, you did see this study on super-low a1c numbers in Type 2 diabetics?

kristen said...

My mom swears by her "hooch" and phytosterol supplements to lower hers.

Hooch:
4 C. apple juice
3 C. white grape juice
1/2 C. apple cider (brown) vinegar

Mix it altogether and drink a juice glass full everyday.

Kameron Hurley said...

Ouch!

That would KILL my sugar numbers :)