End of May

Today ends five (5) months on a serious low-carb high-fat lifestyle. My weight continues to flucuate up and down, but the overall trend is still down. I'm not going to set new goals for next month. It seems that every time I set a new low for carb intake, I have a rash of migraines—10 to 17 consecutive days—until my body adjust to the new carb goal. So I'm keeping my calories and macronutrients the same as last month: 1200 calories, fat 100 g, carbs 30 g, protein 45 g, and fiber 20 g. My average blood glucose did not decrease significantly, staying at about 125. What I need to focus on in June—and probably for the rest of the summer—is exercise. I'm doing better! Taking Barley out for walks more and making an effort to ride my trike. It's just so discouraging lately with all the cold, overcast weather we've been having!

I had a diabetic retinal screening last week, and received this standard-answer report the following day: We are pleased to inform you that review of the screening images taken in the Diabetic Screening Clinic did not demonstrate any diabetic eye disease. We recommend that you continue to work with your primary care physician to obtain optimal blood sugar, cholesterol and blood pressure control. Please remember that optimizing blood sugar, cholesterol and blood pressure will help you minimize the chance of losing vision from diabetic retinopathy. I recommend repeating the diabetic retinopathy screening photos in two years.

I should be going in for bloodwork in a couple of weeks. Last week I got an email message from my Kaiser practitioner (a Pharm.D. who my primary care physician assigned to me several years ago when my blood glucose was running high). I'd like to include our entire conversation:

Dr. P: It looks like you are due to get some nonfasting blood test. Please get them done at your earliest convenience. Also, are you still taking your cholesterol medication, simvastatin? It looks like you last refilled 9/2014. Did you have any problem with it? Do we need to switch to another better cholesterol medication for you?

Me: Yes, it has been over a year since I had an A1C. I also need to have a fasting complete lipid panel, thyroid test, and kidney and liver function tests. I have not had a fructosamine test since 2011, and tests for calcium, magnesium, and potassium since 2009 (when I was hospitalized 5 days for kidney failure). I stopped taking simvastatin a few months ago when I realized that I have not had a high cholesterol test since 2001. I'm more concerned about triglycerides, though, and am still taking Slo-Niacin as prescribed for that. I would like to get the blood work done during the second week in June as I have a very heavy workload during the first week. Please let me know if I can get all these tests at that time.

Dr. P: Thank you for your update. Your doctor has already ordered all your blood tests below except calcium and magnesium. Unfortunately, I am not authorized to order these two items. Please follow up with Dr. Chan to add that to your blood test. I would encourage you to resume simvastatin as recommended. Studies have shown that simvastatin can prevent heart attacks and strokes even if your bad cholesterol (LDL) looks good. We are putting all patients on statins now. Do I need to order that for you? Please let me know.

Me: Thank you for the update regarding the order for my blood tests. I will contact Dr. Chan for the ones you are not authorized to order. I do not wish to resume statins at this time. My main concern is that it will make my diabetes worse and is not good for my liver and kidneys.

Dr. P: Your blood sugars were good being on simvastatin. I doubt simvastatin will increase your blood sugars. However, I am more concern of putting yourself at higher risk of heart attack and strokes. Slo-niacin may affect your liver as well but it does not protect your heart. I highly recommend you reconsider resuming simvastatin or switch to atorvastatin that can protect your heart and lower your triglycerides.

I did not respond to Dr. P's last message, but I did email Dr. Chan with: Dr. Poon recently contacted me that I am due for bloodwork. I responded to her: "Yes, it has been over a year since I had an A1C. I also need to have a fasting complete lipid panel, thyroid test, and kidney and liver function tests. I have not had a fructosamine test since 2011, and tests for calcium, magnesium, and potassium since 2009 (when I was hospitalized 5 days for kidney failure)." She responded back to me: "Your doctor has already ordered all your blood tests except calcium and magnesium. Unfortunately, I am not authorized to order these two items. Please follow up with Dr. Chan to add that to your blood test." So I am contacting you to verify which blood tests have been ordered for me. If possible, I would like A1C, complete fasting lipid panel, thyroid tests, liver and kidney function, Fructosamine, Calcium, Magnesium, and Potassium. I would like to get the blood work done during the second week in June. Please let me know if I can get all these tests at that time.

I did not mention Dr. P's insistence on statins. I shall wait to hear from Dr. Chan this coming week.

May Conference Call

What follows are notes that I took in real time during the NEWSTART® conference call today. I'm presenting my notes pretty much as I took them, except for making two observations: First, it is totally erroneous to describe low-carb approach as "low-carb, high-fat, high-protein." Dr. Atkins may have been high-protein in the beginning, but a true LCHF (low-carb, high-fat) recommends moderate protein. The second thing is that Dr. Bivens lumps saturated fat and trans fat together--again, a serious error! LCHF are just as against trans fats and hydrogenated fats as NEWSTART®, but recommend butter (especially grass-fed) and coconut oil, as well as olive oil. NEWSTART® prohibits all processed oils, allowing only avocados, olives, and nuts.

Real-time NOTES:

This is the third conference call that NEWSTART® Insights has initiated. I don't know if it would have happened if I had not urged Spencer and Tom and Ron to promote it more. Ron even gave me permission to create an event in the discussion group. It's 5 o'clock and the call is beginning.

Dr. Bivens is talking about a "success story" from a current NEWSTART® program. A 64-year-old who has spent two and a half weeks in the program. Said if you get your cholesterol under 150, you are at 0 risk for heart attack. His blood glucose is 101.

Now he's going to give a half-hour lecture on "Carb Fraud." Starting with Dr. Robert Atkins, describing it as low-carb, high-fat, high-protein. Talking about paleo diet (2002), the "caveman" diet. Said Dr. Atkins died of a heart attack. Not true! He died from a fall on an icy street in New York.

No diet works. Diets are counter-productive. Must be a lifestyle. Relating a study that examined a low-carb diet vs. plant-based diet (does not call it "vegan"). Claims low-carb diet "will kill you."

Type 1 and Type 2 diabetes are two separate diseases. Type 1 diabetics have a pancreas that does not product insulin.

Now he's explaining how blood glucose gets into the cells. In Type 1, there is not enough insulin to assist the blood glucose in getting into the cells. Type 2 diabetics have high insulin. But the insulin does not work well to let blood glucose into the cell. Called insulin resistance. Claims that when fat, especially trans fat, is reduced, patients will become hypoglycemic if they are taking blood-lowering medications. Recommends 8-20 servings of fruit a day.

Emphasizing that a low-carb "diet" is a fraud and will kill you. T. Colin Campbell authored a book called The Low-Carb Fraud. Claims low-carb allows only 30% of calories as carbs. Not true. Very low-carb is 30 grams carbs/day, not 30%. Claims low-carb diet mandates too much protein. Again, not true! He says vegans do not need to worry about getting enough protein.

How much protein is needed? He said 26-45 grams/day. Says meat analogs are not much better than flesh foods. Says many contain trans fat.

Talking about trans fats and saturated fats as if they are the same thing. Talking about coconut oil being a saturated fat. Says saturated fats are made by adding hydrogen to unsaturated fats. Does say that partially hydrogenated oils are trans fats. That part is true.

Goal is to get fat down to 20% to be low-fat. Dr. Bivens' definition of low-fat diet is 10%. Recommends 70% of diet be what he calls "complex carbohydrates."

Talking about their summit in June. One guest is Neal Barnard (another high-carb no-fat proponent).

Now it's Q&A time:

Rachel: Could you talk about gall bladder disease and fat?

Dr. B: Strong genetic component. Gall bladder stores bile, 97% cholesterol. Bile used to digest mainly fats. Gall bladder disease caused by diet high in fat, stimulates liver to make more bile. Gall stones made of cholesterol. When gall bladder is taken out, you don't have enough bile to digest fat. Thus must eat a low-fat diet.

Cherline: I'm on Dr. Esselstyn's diet. I eat 1 T. of ground flaxseed a day. How much fat am I getting? Is it too much oil?

Dr. B: You are doing the right thing. That much flax should not be detrimental. Walnuts are cardiac-protective, most heart-healthy.

Brenda: What about celiac?

Dr. B: There truly is an actual gluten sensitivity. Gluten makes them really sick, but that's a very small portion of the population. Farmers hit fields with Round-Up before harvesting. People who claim gluten sensitivity have been taken off gluten for 3 months then re-introduced to organic non-GMO wheat and have no problem. True celiacs will not respond this way.

Cherline: Would Ezekiel bread be safe? Is it organic?

Dr. B: I don't know the answer, because we make all our bread ourselves. I don't think Ezekiel bread is organic, but I don't know.

Carla: What if you are deficient in everything--vitamin B-12, vitamin D, iron, magnesium, etc.?

Dr. B: John McDougall says he can't identify any reason why anyone should take vitamin B/D? If you are eating organic whole foods, there's not much reason to worry. Especially if eating right, getting enough sunshine, etc.

Ron: What about someone who is deficient in iron?

Dr. B: Uterine fibroids cause a lot of blood loss. Have uterus out! Also, girls start menses at age 13.2, whereas a century ago it was age 17. This all would not happen if children were vegans.

Unnamed: Said she took blackstrap molasses and was able to drop iron supplement.

Next month third Wednesday will be the next conference call.

Keto Flu

I felt really yukky on Sunday. I did not want to eat or drink. I had to force myself to get out and take a walk before it got too dark. My blood sugar was elevated in the late afternoon and evening in spite of eating almost nothing. And I couldn't stay out of the bathroom. I felt better on Monday and even better today. Now that I look back, I'm wondering if I had "keto flu." I haven't yet used the Ketostix so I have no idea if I'm in ketosis or not, except that I'm experiencing a lot of what the others say it's like. I have no desire for sweets or starches any more. Not even the dark chocolate that's been in my desk drawer for a couple of months. I have more energy and feel more upbeat in general. I'm sleeping better, and I haven't had a migraine for four and half days. Yea, me!

Migraine Returns

After 19 consecutive days without a head-splitting migraine requiring medication, I had a migraine in the middle of the night (about 4 a.m., I think). Well, that was 19 days that were gifts. Fortunately, I've had enough time to accrue another month's supply of sumatriptan.

The only thing I ate yesterday that was unusual (for me) was tuna in olive oil, mixed with full-fat mayonnaise and dill pickle relish. Oh, also I had only 10 grams of carbs yesterday but I was "within budget" for fats and protein. Could have had more fiber, maybe, which would have added carbs. And I ended up, amazingly, with under 1100 calories. But I was never hungry. I ate until I was full, and I ate what I loved (including zucchini and a buttered almond bun).

It was just one of those days.

May Day

April was a hard month in many ways. I started out on Easter Sunday with a horrific cold that lasted a week. I had 11 days of migraines for the first 15 days of the month. I felt under increasing pressure to get the tax returns done in time. And of course I had all the usual web client work, including three email newsletters that I had to get out during the week that I was so sick! Then Linda had her oral surgery on the 15th and I needed to be available for her as needed.

My daily average glucose readings fluctuated a lot but did not essentially change from the first of the month to the last. My fasting blood glucose also remained pretty much the same. I stayed within my goals for calories, carbs, fat, protein, and fiber. My macronutrient percentages held steady. I've been able to increase my daily walking time for the last two months. The only thing that has changed significantly is that I've lost 5 lbs. over the past four weeks! And I'm really jazzed about that.
Still, I'm adjusting my goals for May to 1200 calories a day, 100 grams of fat, 30 grams of carbs, 45 grams of protein, and 20 grams of fiber, for fat-carb-protein ratio of 75%-10%-15%. Sounds reasonable to me.

Another significant occurrence was that, after some suggestion and research, I began taking herb capsules of butterbur on April 16 and, to date (16 days later) have been migraine-pain-free. Keeping my fingers crossed.

I've done a lot of thinking and reading and researching this past month and more work on my Adventist Vegetarian Diabetics blog, to supplement the Adventist Vegetarian Diabetics Facebook group. I'll go into more details about that on said blog.

I've also kept up with the other Facebook groups: NEWSTART Insights, Reversing Diabetes, The Vegetarian Low Carb Diabetic Healthy Diet Society, The Vegan Diabetic, and a few others which I check infrequently.

Last but not least, I've become better friends with Judie Lee Fizer who I "met" in the NEWSTART Insights group in February. And this is all part of my diabetes journey, my Year Without Carbs.