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Monday, April 25, 2022

Checking In, Five Months After

Five months ago, I spent my Thanksgiving looking out the window from Good Samaritan Hospital while being treated for congestive heart failure. While this date may not be the traditional six months/half a year mark, I figured I ought to fill a few people in on what's been going on in my (non-MMO) life.*


Good ol' Ozzy. Still the Prince
of Darkness (since 1979).

  • My heart hasn't killed me yet.

    I mean, well... duh. I'm still here.

    I haven't exactly been raising hell or anything like Mr. Osbourne has, but after my little "adventure" my heart has settled back into it's typical non-existence.

    Last week I had an echo cardiogram as a follow up from my hospital stay, and the cardiologist was extremely pleased with the results. My heart, she informed me, is back to pumping at its proper capacity. There is a slight leak in one of the valves, but that is not a new event so she isn't concerned about it. That leak is more of a matter of "It might have always been there, so we'll just keep an eye on it and go from there."

    The way forward for me is to maintain my current drug cocktail and then after a six month follow up scheduled for October we might begin to wean myself off of some of the drugs. The cost isn't that problematic (yet), because my highest drug costs come from monitoring my diabetes as opposed to everything else.

  • I have more energy now than I did for most of 2021.

    This has taken some getting used to, because I wasn't expecting this.

    Yeah, my hospital stay had flushed out a lot of built up fluid from my congestive heart failure, so you'd think that on the face of it I'd have some improvement in my energy levels, but I didn't expect it to be quite like this. Part of the additional energy likely comes from managing my diet, because my blood glucose and blood pressure were definitely not in a safe zone, but I also think that there's more to it than that. I also believe that there's a direct impact from...

  • I've taken some steps toward getting back in shape.

    I'm not about to tell you that I've gone crazy or anything, because I've seen the Peloton memes. And thankfully I've not been bombarded by people trying to tell me how great spin classes and Peloton are, because even if I were interested in trying it out --I'm not-- the fervor of the True Believers is closer to what you'd see out of Twilight's Hammer than anything else.


    Yeah, this.

    Regardless, my reality consisted of two problems: my muscles atrophied during the course of my congestive heart failure in 2021, and I was in bad enough shape that I couldn't even put the outdoor Christmas decorations back on the shelf there they reside. I knew I had a long road to go to get this fixed.

    So I began walking.


    A view from Cincinnati Nature Center
    in early February.

    And walking.


    The pavilion seen through the trees at
    Ault Park.


    Until my knee --the one I'd injured back in 2020-- said "Fuck you!" and refused to behave.

    So while my knee has been recuperating, I began to lift weights. Not anything nutty, to be sure, but just some barbells to try to get some muscle back in my arms and shoulders. For people who haven't lifted weights before, one of the oddball things about exercising this way is that muscle weighs more than fat, so when you initially begin lifting, you actually gain a few pounds. That's because you're converting some fat to muscle, so it's quite common to see an initial bump in your weight before you start losing pounds.

    Well, I didn't have a bump in weight, but I didn't lose weight either. So I was a bit confused about all this until I spoke with the Diabetes team about it on a recent check-up, and they went through my diet and found quite a few hidden calories that I could cut out and maintain my current low-carb + low-salt diet. It's one of those scenarios where playing it smart adds up to some real results in the long run.

    But despite my not "losing weight", I have lost volume. I can now fit into clothes I was unable to back in 2021, and I've actually had to buy jeans two sizes smaller than where I was in 2021. To be fair, those jeans are starting to look large on me as well, so I get the feeling that I'll be getting these jeans replaced in a month or two.

    So at least there's that.


  • Dealing with a low salt diet is MUCH harder than dealing with a low carb diet.

    No, I'm not talking about the prevalence of Atkins and Keto dietary stuff lying around helping out, because those diets deal with things such as "net carbs". As a T2 Diabetic, I can't play around with numbers like that; I have to have a laser focus on total carbs, whether I like it or not. My current target is 60 grams of carbs per meal. No 'ifs', 'ands', or 'buts'. I can't trade carbs between meals like you can with total caloric intake, either. When a nutritionist visited me at the hospital on my first day there, she drew a circle on the paperwork in front of me.

    "This," she said, "is a plate of food for a meal. You have 60 grams of carbs to work with."

    She then portioned off 1/4 of the plate. "This is for meats and other proteins. Aim for about 15 grams of carbs from this section."

    Another 1/4 of the plate was portioned off. "This is for root or starchy vegetables. Aim for about 15 grams of carbs from these."

    Finally she circled the half of the plate that remained. "And this," she said with a tone of finality, "is for leafy greens. You can eat as many of those as you want. If you want to add something such as a roll or a slice of bread, fine, but you can't go over 60 grams total. And be wary of things such as salad dressings and other items in salads, because they'll add up fast."

    But I've discovered that handling 60 grams of carbs per meal is actually fairly easy when compared to a low salt diet.



    This is my life now. Look at
    the amount of sodium in
    a cup's worth of generic spaghetti
    sauce. The "low sodium" option
    isn't much better at probably
    66% of that, and I'm supposed to
    aim for around 1000 mg
    of salt per day.

    Things like this chart above show how hard it is to find truly low sodium options in a world where salt is freaking everywhere. For this example, I'm lucky in that I can find "no salt added" tomato sauce that I can work with and season the way that I prefer, but for many other items you simply can't avoid salt unless you have to take the bull by the horns and make it yourself.

    Once you've figured out how to manage a truly low salt diet, then you discover just how salty everything tastes. Much to my chagrin, a low salt diet has truly become a double edged sword.

  • I keep hearing how great I'm doing, but I certainly don't feel like I'm doing anything special.

    Okay, so this is gonna sound a lot like me discussing MMOs and whatnot, but I've had this conversation with both the Diabetes team and my cardiologist, who have all assured me that I'm doing very well.

    "But I'm doing what is being asked of me, and I haven't exactly been hitting my salt targets that well. It certainly doesn't feel like I'm doing a lot."

    "You have to understand," one of the Diabetes team members told me, "you doing just that means you're ahead of a lot of people who have Type 2 diabetes."

    "But--"

    "When just getting people to admit they have to change their diet is a chore, what you're doing is fantastic. You've never complained or bitched; you just went and did it. So just keep doing what you're doing, and you'll be fine."

    "Oookay...."

  • I'm really lucky in that I've got a good team in my corner.

    I simply can't sing the praises of the Diabetes Team loudly enough. The same goes for my cardiologist, whom I simply adore. I completely trust their judgement, and I've hopefully had it reciprocated by my trying to follow their instructions to the letter. That's not to say that there haven't been complications --there have been, and I'm not prepared to talk about those right now-- but they're a very good team and I know I'm in good hands.

I think the biggest take away that I have had over the past 5 months has been that this is a process. I'm not going to "solve" my health issues in a simple one-off solution. I could wake up tomorrow and discover I've become allergic to one of the medications I take, or that I could have a stroke while goofing around on WoW. None of this is easy, but in the end I hope to be kicking around here a bit longer.

Can't get rid of me yet....
From magicalquote.com.

 


 

*My life has, overall, taken a turn for the better by keeping my Facebook usage to an absolute minimum once the pandemic began. I think it says a lot about the state of Facebook when Reddit gives me less stress.

13 comments:

  1. Good stuff! Keep it up!

    Salt is a total pain to avoid. It's in everything and it doesn't need to be. As you found out, most things are already quite salty enough without any outside help. All adding salt does is raise your tolerance for the saltiness taste so you need more salt to notice it. Same applies to sugar, pretty much, although it's a lot easier to avoid sugar than salt.

    The great thing about reducing or giving up altogether on salt and sugar is that once your taste re-adjusts, everything tastes better. Things have more flavor, not less. Of course, that does mean when you do get a mouthfull of something with added sugar or salt it tastes disgusting.

    About the only way to really avoid salt is to do all your own cooking from raw ingredients but I can't say I have the patience for that. I do eat a lot of those leafy green vegetables these days - we have salads most days - and I don't eat salty snacks or add salt to anything at all but there's still way too much salt in my diet. There is in everyone's, sadly. Except yours now!

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    1. Yeah, sugar is much easier to avoid than salt, which is a shame. I mean, I understand why salt is in some items, such as bread: it's not a flavor enhancer, but it tempers the yeast to keep it from growing out of control. At the same time, if you make it yourself you can control a lot of the rise time of bread and/or rolls just by paying attention to the dough. But yeah, it's a crying shame that salt is in so much of the processed meats, and even roasted turkey.

      The raw ingredients' solution only works to an extent, as you already figured out the limitations of doing it all yourself. I'd love to cook more, but there's a practical limit to that, and while I'd use a crock pot/slow cooker like crazy, I'm afraid I'd be cooking only for myself if I were to go that route. My wife is NOT a big fan of eating stews/soups/whatnot out of a crock pot 4-5 days a week.

      But thanks for the encouragement! It's been quite an adventure, and I've also had the encouragement of my Questing Buddy as well, who had gestational diabetes when she was pregnant with her youngest kid, so she knows what it's like to have THAT dumped on you at the last second.

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  2. Thanks for the update!
    You are doing splendidly well! **fistbump**
    Hah, thanks for the diet description. I should apply it myself. I am woefully inadequate with those leafy greens... I have to admit that I did feel better when I was watching my carbs and therefore also cutting down my calories, as much as I disliked certain aspects of it.
    I like more salt than my husband does and don't have high blood pressure to worry about, but I have this one bread cookbook where I've learned that I have to halve the salt in any recipe that I make from it. The amount of salt in the recipes as printed is way too much even for my taste.

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    1. Well, I can totally understand if you're not interested in leafy greens that much, because I'm pretty sure I'll get sick of them after a while.

      My son is currently studying abroad in Lancaster, England, and at one of the overseas students events he was asked by a Brit if American foods are as salty as is claimed. His response was that if he'd been asked that last fall he'd have said no, but now that my dad has to have a low salt diet because of heart failure and diabetes, he's discovered that salt is in pretty much everything and he never knew.

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  3. Wow! You are doing great! I'm so glad!. That is fantastic about your heart function! I wish I was as happy about my cardiologist as my oncologist. My cardiologist described me as a car running on one cylinder but as my husband said I'm still alive so there's that!

    Lets see if we're speaking to Tome again.

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    1. I just hope that you get another cylinder up and running, so I can see you in game more often!

      It worked!! It worked!!

      For everybody else who is scratching their heads, I turned of the reCAPTCHA, since it seemed to be interfering with Apple devices (at the very least) and with certain other accounts, such as Ancient's. And now.... We have Ancient back!

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  4. Don't sell yourself short, Red, your doctors are right: Actually following through with all these lifestyle changes after a diagnosis is no mean feat. My father had diabetes too and didn't give a crap about changing his diet, which I'm sure played no small part in his early death due to multiple organ failures (well, that and the smoking and drinking...). My older brother was also diagnosed with diabetes recently and is struggling to adjust. I can only hope to take it as well as you when it's my turn one day (which seems quite inevitable given my family history).

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    1. Cincinnati is very much a German city in that a lot of the population is descended from Bavarian immigrants from the 1840s. So around here, like a lot of the American Midwest, you'll find tons of German sausages and other fare for sale, especially at sporting events. And what's been killing me is that I can't really have processed meats such as bratwurst (or ham or even turkey) because of the salt content. I wish I could say that it's easy, but damn I do love that stuff. I've tried hard to find sausages that I could actually insert into my diet, but the best I can do is one on an occasional basis.

      And knowing how hard it is when you're willing to change makes me realize just how much harder it is when the docs say you have to give up pretty much your entire lifestyle.

      I know that will be hard for you, and I really am sorry about your father and brother, but I do know that you can do it. I've ample evidence --through your blog-- that you have the willpower to change. I had external motivation --my youngest burst into tears when I talked to her from the hospital room because she knew that when my father went into the hospital he only left on his deathbed-- and that is motivation enough to make sure that I'm around for at least a few more years.

      That's what I keep telling myself: just a few more years. Don't make long term plans, just a few years at at time.

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  5. It sounds like you're doing great! I'm a salt fiend myself. Every once in awhile I'd give up "added salt" for Lent and it's amazing how salty everything tastes pretty quickly. Anything that can be helped by dietary changes is a doable problem. I also think, any time you are on a diet of any type, never say there's something "you can never have again". That just sets you up for failure. Change eating habits, but if there's that special something you want, have it, just don't have some giant pile of it.
    That said, I haven't diabetes, nor does anyone I know, so my grand theories likely go right out the window there. You seem to have things well in hand. Keep up the good work, stay with us for a long while.

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  6. Oops I thought I'd get a login prompt. That's my long babble above.

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    1. No worries! I do have to ration things quite a bit, but that doesn't mean that eating is a killjoy moment. I've got a big bag of those mini-ice cream cups, because they are exactly 15 grams of carbs each. If I can fit one in --and I've a hankering for it-- one of those will do. It does kind of suck that I can't get anything at my local soft serve ice cream place, however, but I make do.

      And thanks for the kind words, Aetheren!

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  7. We're living parallel lives here - other than I didn't suffer actual heart failure, though my cardio was amazed that I hadn't - something like 80% blockage or something. So in goes a stent and now I'm on blood thinners. The good news is that this actually helped with my hypertension and lowered my blood pressure.

    Glad to hear you're doing well(er). we like it when our friends don't die!

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    1. Oof...

      They were ready with stents when the went in and knocked me out to test my heart, but they found that everything in my arteries was fine. That doesn't mean that my trifecta --hypertension, diabetes, and high cholesterol-- were the culprit for my heart failure, but my cardiologist says that when everything else looks okay, they have to go with that diagnosis.

      Thanks again for the kind words, Grimmy! And I suppose I ought to post sometime about my other old man procedure I just had last week.

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