Healing

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Healing

I like to keep my body parts. I figure each one is there for a reason. But, when all other options have been exercised & surgery is the only option….well, reluctantly, I know when it’s time to fold ’em.

I am not new to surgery. I have had 4 surgeries between the ages of 21 – 32. I’m proud to say, I’ve had success with all surgeries & recoveries. It’s a challenge to walk away healthy without infection or complications, especially when living with diabetes.

It’s been 10 years since my last surgery. It’s been almost 20 years since my last major surgery.

When I found out a few months ago I would be under the knife once again, having major surgery with a 6 week recovery time, I decided to be proactive in preparing so my recovery would be uneventful.

I am only 4 days post op so I may be putting the cart before the horse with this surgery but I want to post some considerations about how to prepare before, during & after.

Before Surgery:

1. Gather a reliable support team that can be there for you before, during & after surgery. Make sure your team knows their responsibilities throughout this process. If someone offers to help, this is one time you can’t afford to say no. Don’t try to be a hero. I never heard anyone talking about the time “so and so had surgery & what a champ he or she was going solo, doing it all on their own.”

2. Don’t go crazy cooking, baking & cleaning. What?!? you say? Shouldn’t I have stuff in the freezer & the house spotless for when I come home to recover? Sure, if you were healthy before surgery to do that, it would be ideal. But consider, why are you having surgery? Your body is not running at full capacity. By stressing yourself out making, baking & cleaning you are depleting your immune system to a point that you may set yourself up for illness before surgery (then, it may be cancelled) or cause infection post-surgery. Although it may be tough, go to the local health food store & buy organic, pre-made meals that one of your team mates can heat up. Same with the kids lunches. I’m not meaning pre-packaged boxed/canned garbage…there are a variety of ‘homemade’ soups, sauces & meals available today that have only a few ingredients & are good for you. Just make sure to watch the sodium content…you don’t want to get all puffy & bloated.

3. Which leads me to my next point….eat clean, well-balanced nutritional meals & snacks leading up to surgery. I mean, we all should all the time but if you have lost focus, now is the time to get back on track. If you don’t have a Juicer, I urge you to buy one. Use it often. Eat a variety of fresh, organic vegetables & fruits. Keep your protein lean. Keep your carbs complex & low GI. If you nourish your body properly, it will be ready to perform at a high level of healing during & after surgery.

4. Test blood sugars more often. Keep them within target. Consult with your Diabetes Team to make sure you are running at optimal capacity for diabetes management. High sugars can cause infection and/or slow healing.

5. Be honest during your Pre-Op visit at the hospital about which meds you are taking. I mean, prescription, herbal & homeopathic remedies as well as essential fatty acids. I take herbal & homeopathic tinctures as well as EFA which I had to stop 2 weeks before surgery as they increased my risk for bleeding.

6. If you are physically active until this point, if the Specialist agrees it is okay, keep doing what you do or alter it to accommodate to your circumstance. I was not able to be as active as I used to be but I made sure to walk 5 – 10 km each day to keep my heart, lungs, mind & muscles working.

7. Get a minimum of 8 hours of sleep a night.

8. Drink a lot of water. More than 8-8oz glasses a day.

The Night Before Surgery:

1.  Pack a cooler bag of simple, instant food that is healthy & wholesome for your hospital visit. Below is what I packed in mine:

– Nature’s Path Organic Instant Oatmeal Plus Flax
– (2) glass jars of Green’s Juice I made with my Juicer
– (2) 1/4 cup containers of hemp seed to add to my oatmeal
– (2) containers of 2 tbsp of Skinny B Breakfast Cereal
– (2) containers of 2 tbsp of Holy Crap Breakfast Cereal
– (2) single servings of plain Greek Yogurt

The Day of Surgery:

1. Ask your surgery to be booked first thing in the morning. You will be asked to have nothing to eat or drink the night before. Some of your diabetes meds may be held. But, with the risk of fasting comes the risk of a low sugar. Being booked in the morning gives you the opportunity to have an IV put in place so that if you have a low blood sugar the staff can give you sugar through it.

2. Remember to breathe deeply, often. Stay calm. Getting anxious over the unknown & probably what won’t happen will raise your blood pressure, heart rate & blood sugar. All the hormones released that cause this will not help with the healing.

3. When you feel yourself getting anxious, visualize what you would love to do 6 weeks from now. Imagine yourself having a successful operation & healing process. Envision how much better you will feel afterwards.

3. Ask questions. Although they may seem dumb to you, they really aren’t.

4. Educate the team in the hospital about your diabetes. They don’t know as much as you do. They can’t! They don’t live with it.

5. Be your own advocate. If something doesn’t seem right, speak up.

The Hospital Stay:

1. Be aware of what’s on your food tray. For the 2 days I stayed, I was presented every processed juice & flavour of jello imaginable. Was that going to help my healing? Nope. It would just spike my sugars. I resorted to my cooler of food I brought. My Greens Juices got me through the first 24 hours. The oatmeal, hemp, yogurt & Skinny B got me through the rest of my stay. The nurses admired that I advocated for myself by bringing the cooler of food.

2. Take the pain meds. Again, don’t be a hero. No pain, no gain does not work. Pain releases hormones that will cause your sugars to go up….and your blood pressure and your heart rate…get it? 🙂 You will not get addicted.

3. Sleep and move. Sleep as much as you can. As soon as the nurse says it’s time to get out of bed, whether you just stand up or take a few steps, it is important to move. It gets the blood flowing which helps your surgical incision heal.

4. Test, test, test. The hospital staff will do that for you a lot too, but I bring my own meter as back up as well. It may not be calibrated to the hospital lab but at least I can report to them if it’s not time for them to test & I know something is off with my sugar. I also wear a Continuous Glucose Meter paired with my pump.

5. Be aware that the grogginess from pain meds can mask a low blood sugar.

6. Be aware of your body. Listen to it. Trust your gut. You know you best!

7. Drink lots of water! LOTS!!

Recovering At Home:

1. Abide by what the instruction sheet & the nursing staff have said. Don’t push yourself. You will not push yourself closer to recovery but closer to a risk of infection & slow it down.

2. Sleep a minimum of 8 hours a night, if your body says to go to bed at 8pm, do it.

3. Nap when you’re tired.

4. Be as mobile as your Doctor has permitted you to be.

5. Inspect your incision(s) daily. If they start to look red, inflamed or have discharge, you need to call your Doctor right away.

6. Test, test, test. Keep your sugars within target. I’ll repeat this again….high sugars will slow the healing process & promote infection.

7. Eat clean, eat well. Keep up with the Greens Juice. Eat lots of vegetables & fruits. Eat lean protein. Keep to low GI, complex carbs.

8. Call on your Team. Refer to #1 “Before Surgery”.

9. Drink lots of water. LOTS!!

These are general guidelines. Your circumstances may be unique & there may be some suggestions I have made that the Doctor has advised against or differently. Please listen to your Doctor. He & you, know your circumstance best.

A Masterpiece of Engineering

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A Masterpiece of Engineering

Standing, walking, pushing, squeezing, scrunching, running, kicking and again standing…shifting from one to the other, crossing your leg one way, then another, shift again, supporting your weight, the weight of your babies, toddlers, supporting the weight of your older parents or grandparents as they walk, groceries, gym bags, gym weights, bags of soil, stones, buckets of water, walking the dog, rising up and down on the stirrups of your horse, riding your bike, jumping up and down in excitement at a sports event, gardening, taking the garbage out. Whether you weigh 25 pounds or 300 pounds, your feet are your body’s greatest support.

Unless we feel a protest such as an ache, blister or spasm we expect our feet to carry on without giving them much respect. We bandage over any problems and push on. We refuse to baby them. In our mind they are infallible. They take us where we need to go, that’s their job, no exception. They must work at all costs. After all, they should be more forgiving than other parts of our body such as our heart, lungs, kidneys, brain. Right?!? They are just two feet with ten toes.

Now, the other side of the coin…once in a while we decide to treat ourselves…not necessarily to reward our feet but because it helps reduce stress, forget our woes, be in a space where nothing matters and life is simple….the Spa. Today, Nail Spa’s are everywhere, just walk through the mall. At any point one can walk in and sit down to forget it all and feel good.

Once in a while, I ‘treat’ my feet to some TLC with a Pedicure. I climb into the big, soft, lounge-like chair that is accompanied by a remote. This enables me to choose a variety of luxurious massages. Trashy entertainment magazines allow my mind to go into another world and offer mindless entertainment. There is nothing better than a foot and leg massage with the final product of walking away with a pretty colour on my toes feeling like a million bucks!! Years ago, I didn’t give much thought as to where I went or who was doing my pedicures. In my naïvety I assumed wherever I went and whoever did my pedicure must know what they were doing. Thankfully I haven’t had an infection or cut.

My eyes were opened the day I had a conversation with one of my clients as a Diabetes Consultant with Novo Nordisk. She lives with Type 2 diabetes. Upon visiting her one day, I notice her foot bandaged up. She informed me she went with her daughter for a pedicure. She ended up with a major infection. Scary stuff!! She was several months healing from this. She said that she would never go for a pedicure again. The risk wasn’t worth it.

So here is the educator in me giving some advise. You knew it was coming didn’t you! LOL.

In this day and age it’s very difficult to take the time to care for ourselves, whether we live with diabetes or not. BUT, in living with diabetes, if we don’t make that time, it will catch up with us. We will be in a place where we wish we had made that time.

Here are some things to consider to save you time spent with regret:

1. Inspect your feet daily.
2. Keep your feet warm and dry.
3. If you develop a sore spot, blister, callus or cut have it looked at by your physician and treated accordingly.
4. Cut your nails straight across. Don’t cut them too short.
5. Consult a professional to buy proper fitting footwear.
6. If you have an infection, ulcer, cut, blisters or neuropathy do not have a pedicure.
7. If you are free of complications and are healthy a pedicure is okay. (It would be nice to say “don’t do it” but since many are going to anyway…good to promote guidelines around it)

Pedicure Guidelines:

1. Search out a reputable salon and ask about their sanitation practices.
2. Inspect the foot tub before putting your feet in. Ask how it has been cleaned.
3. Ask how the tools are sterilized? Are they stainless steel? Stainless steel tools are more sanitary than wood.
4. Be open with the technician. If they are serious about their profession they will respect your concern for your feet.
5. Make sure the water is not too hot.
6. Ask the technician to avoid using sharp instruments including clipping the cuticles and filing your heels and calluses.
7. Ask the technician to massage your feet gently.
8. Do not shave your legs 2 days prior. This is to prevent the chance of bacteria or fungus getting into sores, cuts or nicks on your legs from shaving.

“The human foot is a masterpiece of engineering and a work of art.” – Leonardo da Vinci

Reaching Target and Realizations

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Reaching Target and Realizations

Further to my post yesterday, I met with my Diabetes Specialist today.

Albeit, I was still a little nervous. Not as much as yesterday. My “Too Funny” (see yesterdays Blog) moment helped alleviate the intensity. As I am sure you have experienced, the unknown can cause the mind to create various role plays. “If the Doctor asks this, I will say this.” “If he reacts this way to my answer, I will respond this way.”

After my “Too Funny” moment I asked myself, why am I aggressively role playing my visits?

The answers I came up with:

1. About 2 years ago I was asked by my Endocrinologist to take meds to lower my lipids & prophylactic kidney protecting meds. I reluctantly agreed although I did not see the reason. My ratio is incredible. My HDL is amazing. My kidneys are perfect. I decided about 8 months ago to stop my meds. I decided this based on 2 reasons:

First, my LDL (bad lipids) were still creeping up. Why should I keep taking a pill that was not doing it’s job?

Second, I met with my hormone specialist that deals with the bio identical hormones that I take. He convinced me that I didn’t need my lipid lowering agent. In his assessment of the medications that I took, he indicated that the lipid lowering agents would cause an increase in my bad lipids as opposed to decreasing them as they should have. He claims it was a plot by the pharmaceutical companies to amplify the symptoms so the pharmaceutical companies could sell more of the treatment. He claimed there was a better therapy that was natural & clinically worthy of taking…Astaxathanin.

I am all for ‘natural’ remedies, i.e.: therapy via food, herbs & vitamins. I believe in taking natures remedies before I will pop a pill made by the ‘powers that be’. I visit my local health food store frequently. I decided to become a one person clinical study. There is obviously no clinical significance but worthy of trying to see if it provided benefit to me. The last visit with my Endo 6 months ago showed it was going down, so I fibbed when he asked if I was compliant with my meds. I told him I was taking them off & on. I felt SO guilty! I wasn’t taking them at all but I respected him so much, I didn’t want to disappoint him. By habit, I am not a liar. As far as my diabetes goes, I am very concerned with the long term results and want to take the best course of action. With that being said, what were the implications of taking something that, up to this point, I had not seen any improvements but had a risk of side effects versus taking something that has no side effects but clinically provided signs of improvement.

2. I have always been guilty of too many low blood sugars. If I was to pick a high or low, I would pick a low. Not because it felt better, in no way did it feel better. I mean, come on, does a high or low blood sugar feel better or worse? They’re just different. I preferred them because I knew I didn’t risk complications. Frequent low blood sugars happen because I am so keen on running my sugars tight to target that I have increased the risk of lows. Also, until the past few years, I have been extremely active which have produced a lot of extra lows. I have noticed that as I get older, having low sugars is becoming very taxing. In the past 2 years my Diabetes Specialist has reinforced to me how hard these low sugars are on me (I’m feeling it!) & if they are in collaboration with a low A1C, they are not optimal. Also, I am alone throughout the night quite often. He reassured me it’s okay to run a little higher (above 6.2 – 6.4%) without the lows if it meant giving up the lows with the near normal tight control I was trying to achieve to feel good & stay safe through the night. Lows are not on purpose. They are caused because of being busy, being too active, taking too much insulin or not paying attention. In the past few years due to a lot of changes and stress in my life, I have been guilty of not paying as much attention to the fine details of my diabetes to achieve this goal.

3. In the past, a prominent Toronto Diabetes Specialist told me that due to the fact I have lived so long without complications with diabetes, I would never have any complications even if I ran higher than guidelines. I was told that my ‘success’ was purely genetic. I was excited by this but I didn’t decide to ‘screw it’ or decide that I was invincible. I’m still so afraid of complications. 38 years in, what guarantees do I have? I get nervous because I’m afraid one day he will assess my blood work, urinalysis, blood pressure or one of a number of tests and tell me I have a complication regardless of my choice for tight control.

The results of todays visit:

1. I am back on my lipid lowering agent based as my LDL has continued to increase. My one person clinical study failed.

2. I am a 10+ on a scale out of 10 on measuring stress. This will be for a few months more yet. The goal is to try to deal with it as best I can so I can manage my diabetes effectively. Cortisol & stress are a detriment to my well being with my general being, paired with living well with a chronic disease.

3. When I can afford it, I will wear a continuous glucose sensor to keep my blood sugars in check.

4. I will have fasting blood work done in 3 months to measure if the lipid lowering agents are working to decrease the LDL.

5. I will have random blood work done in 6 months & see my Endo again to see how my A1C is.

Today my A1C is 6.6. I am happy with today.