Living with Diabetes and Lapband

First, the lap band was successful.  I took off 60 pounds with it. 

+However, it takes more than that.  If you look at the literature, I’m typical.  I needed more.

A program where you have a certain number of calories or points has never worked for me.  I run out of them.  (Weight Watchers).

A program that is punitive doesn’t either – I tired Slim4Life, and man, it might work for some people but not me.  Every thing was a formula or magic.

What I needed is what I get from Jenny Craig. 

• A list of things to eat.  Do I always eat that food and only that food, no.  But it’s a starting point.
• Positive support – no matter what I weight, my consultant is support about it.
• Someone I can talk to about it.  Though I have other people.

First I had done Jenny Craig years ago, but when I tried to restart, my primary care physician insisted I go for the band.  There are a lot of days its made me unhappy, but it does have an impact on binge eating.

And on the goal.

My consultant wanted me to have an attainable goal, so she insisted on going with about 60 pounds.  Basically it was something I could do in less than a year if you figure on losing 1 1/2 pounds a week (basically 10% of a healthy persons weight).  I get my money back if I hit that goal and maintain it.  Though I think the 10% on the food covers the enrollment fee.

And here’s the smart way to do the food.  Always buy 1 week at a time (you don’t get the discount otherwise).  Keep your extra food on one shelve and the food for the menu you are on another shelf.  When you have 7 extra snacks, 7 extra breakfasts, and 14 extra meals, don’t buy food that week.  I like to have a day or so cushion myself, so that’s an estimate.  Also the travel meal DOES count as a full week, but not all consultants know that.  Mine had to call in and ask.

Also keep easy to eat foods on hand.  I keep a couple of salad kits in the car, in case I want to stay on plan when I’m out and about.  I also do the same with the breakfast bars.  In fact, buy a few one the week you are buying a few menu so you get the discount.

I joined Jenny Craig again last summer and today I hit the halfway point according to the goal my consultant set for me!

Very pleased!

in a simple phrase: word of mouth

It’s very important to me to have a diabetes doctor who has some understanding of lifestyle challenges.  My gynecologist is from West Africa but that doesn’t really matter, because I need someone who gets menopause and she does.  Especially menopause in someone who has been on hormones all her life.  I also think that having a common culture is important with my sleep doctor.  Again, that’s lifestyle as much as anything.

Each time I’ve gone with a diabetes doctor, I’ve used word of mouth.  I’ve found local people with diabetes and who have a common background and flat out asked them who their diabetes doctor was and what was there experience.  The diabetes online community can help with that.  For other doctors I’ve always taken another doctors advice first, and I did ask my previous doctor his opinion of my choice.  While they are both Baylor Scott and White, apparently there are different branches, so my previous doctor didn’t recommend them.  The current doctor has worked with the previous one, though my previous doctor didn’t mention that.  I’m not sure he knew who was at the clinic I am going to.  (hoping this isn’t too confusing but I’m not comfortable sharing names)

I had also seen Diabetes Center of America when I was out and about at health fairs and other diabetes related events. I was happy to see that they have CDE’s.  My original diabetes doctor had a very good one that I saw on a regular basis when I first became a patient.  Unfortunately that was one of the first things to go.

The new patient experience of seeing a nurse assistant for labs, the CDE and the doctor was great. 

There are a couple of things I wish they did better – I always liked doing the labs in a separate visit and I’m going to approach them that next time.  Of course, the pump tells us more but that’s a shorter window.  The A1C gives a broader picture though we’re all getting better an interpreting the CGMS.

If I didn’t have a CGMS, I would think advance labs would be more important. 

Several years ago, when I was still teaching face – to – face, I had an opportunity to present a robotics workshop, expenses paid.  It let me go to a professional conference I enjoy.  At the time, I had just lost 60 pounds.

I also knew that the way I was dressing wasn’t appropriate for the event.  I wasn’t sure what to do.  I’d been watching What Not to Wear, and new I was wearing it.

I’m also a huge fan of Sunday Morning.  A few months before the conference, they had a segment on how JC Penney’s was changing and in that segment that also talked about Nordstrom’s and why their business model was so successful.  That’s the first time I’d heard of a personal shopper.  I figured it wouldn’t hurt to try and gave them a call.  I also called Macy’s and gave them a try but their quality just wasn’t as good, nor was their tailoring free.

Here’s what I loved about Nordstrom’s – the clothing fit and made me look good.  It also made me feel good.  When things didn’t quite fit, they had a free tailor that fixed them.

I will be honest and went a bit overboard, but they have always taken things back, especially when I ended up not wearing them.

Even better, several years later, I still have that wardrobe and it still fits and it still looks good – I’ve had to have some things taken in.  But that was the personal shoppers plan.  Buy very quality things that fit, make adjustments on the way, and then add to them with quality things.

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However, now I live in their Zella exercise line.  I buy most it on sale.  Again, it fits and makes me look good.  And even in exercise wear, I look like I thought about it before I put it on.

That original wardrobe is working well for dog shows and I’m slowly downsizing it.

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I’ve also had two good customer experiences.  Though the first one was kind of weird.  I needed a new pair of pants for dog shows.  Plain black pants with pockets.  I went through the Encore section and pulled a bunch of pants, then organized them by price in the sales room.  I found a pair that I really liked that were marked with a sale price.  Got the tailor in and got them marked.  Went to pay for them, and the sales lady said they weren’t on sale.  I thought that was really weird at the time, but shrugged and bought them.

Guess what – 21 days later, those pants were on sale at the price I originally bought them.

Called the store and they gave me the store credit.  Yeah, it was luck and I really think they should have been on sale then.

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I had a Clarisonic body brush I really liked.  It came with a handle but it stopped working.  I contacted Clarisonic – they don’t make it any more, and the most they would do was 25% off.  Nordstrom gave me store credit for the last price they sold it for – considerably higher than Clarisonic’ s offer.

So this is why I have Nordstrom’s ads on the website.

My current endocrinologist  is closing his practice tomorrow.  He gave me too suggestions, but I wasn’t real happy with either of them.  A very early Facebook friend mentioned on Facebook that she was getting a new pump (the same one I have), through Diabetes Center of America, but she goes to their Plano location.

It’s super easy to get to, and at least three alternate routes if they decide to kill a highway or road between here and there.

Now, the front office experience as a new patient was horrible today.  They were training a new employee from another center, and apparently the guy who is currently running the front office doesn’t usually do that.  They made me stand waiting for ever, especially for someone who can’t do that well.  They never indicated I should sit or took my name.

My appointment was at 10:30, I got there at 10:00 and didn’t see a care provider until 11:30, when I finally asked if I could pee.  The guy at least knew they would need a blood sample. They seem to milk out every lab charge known to man, including a glucose test, using a meter than uses the same test strips mine does.

I refused most of the tests, as I had recently had them done and I knew that the dental surgery on Monday would scew the results.

I saw the nurse assistant first, and my needing to use the restroom interrupted her normal procedures, but she did manage to get everything they wanted: blood pressure (high but same high as before the surgery Monday), weight, blood glucose, pulse rate etc.

The diabetes educator was pretty cool.  When I told her I was doing Jenny Craig, she told me she was doing weight watchers.  She asked about the meal plan, carb/protein ratios, and I had to go out to the Jenny Craig weight site to tell her.  I got mildly scolded for not changing infusion sets enough and she should me where that was affecting my blood sugar.  Something I told her I was working on.  She also made some suggestions of points I should look out for after I recover from my procedure and how to change them.  She liked my method of changing thing == I plug my numbers into a diabetes calculator app, but only change .5 values at a time.

I like the doctor, but he’s the same age as the doctor I just lost, so I’m sure I won’t be with him for 10 years.  Though in this case, I doubt they will shut down the practice, probably just hire a different doctor.

I did have them update one prescription – Enlight Sensors.  I’ve got six of them right now, and don’t want to order them too soon, they have an extremely short expiration date.  All the other scripts should be good. And I shouldn’t need a new script for the Enlight but you can’t argue with Express Scripts.

Express Scripts is currently processing the order according to the web site.

All in all, a stressful but productive day.

I have been barely escaping periodontal problems most of my adult life.   I was sent to a periodontist when I first moved to Dallas.   I have even had some medication injected into my gums.

Also gum (periodontal) disease is a common complication of diabetes.

A few years ago, I had to have a tooth extracted and ended up going to Baylor Dental School for it.  The experience was pretty good as dental issues goes, so I signed up to be a patient for students.  I don't think it is cheaper than private dentistry but I trust them more.

The good and bad thing -- at least one professor is going to be in your mouth, in my case, generally 2 or 3 each visit.

My dental student has not been able to clear up my gum problems so I was sent to the grad school and have been working with a great graduate student.  She did a really deep cleaning, but I was still left with two pockets.  She wanted to repair them but agreed to wait and see.  I was actually scheduled for surgery in December, but ended up with a root canal and a crown removal instead.

The crown removal was the worst -- my student couldn't get a temporary crown to stay so I was referred to periodontal for a crown lengthening.  That was scheduled for yesterday.

The best news is that the pockets have healed and we're still watching them.  I did have the crown lengthening on the right side.  The 4th year wanted the left side done too, but there is no way I could have tolerated having both sides done, so we have the second crown lengthening schedule for March.

I still think we can skip that.

The crown lengthening itself was a bit scary but not as scary as the pocket repair is to me.  I left with a sore jaw and after care directions.  Basically soft food and nothing hot for 24 hours.  I've managed to do that.  The good news is that I'm not sensitive to cold, so last night was ice cream and room temperature tomato soup.  Yogurt before I went to bed.

The absolute worse part -- being "benched" from all activity.

I just read an online article about how a woman was body shamed while shopping at Lululemom.

I've had retail sales people be rude to me, and I can tell you from experience, getting the apology doesn't get me back in the store.   There is an Avenue near me that I haven't shopped at since one of the employees accused me of having a fake service dog.  I rarely even go into any of their stores now, even though I don't use the service dog. 

On the other hand, I've always been treated graciously at Nordstrom, with or without dog.  Their small touches, such as giving gift cards, merchandise and their generous return policy get me going back.

I will say that getting a substantial gift card has gotten me back into stores, but only if the employees are gracious.  Retail needs to treat all customers with open arms. 

This week has been full of @SunstoneFIT milestones.

First Barre class, and I will be back.  

Third 90 challenge, though I still don't think they count them right. 

And drumroll...

My 200th class, mostly hot yoga. 

If you would like to try Sunstone, let me know, I have 15 free class passes I can give away. 

Though I still think I made the right decisions.  My pump warranty expired in November, and at the visit before that, I learned my endo was leaving private practice for the VA.

I wanted his support through the pump change, which I had.  And he did renew MOST of my prescriptions in December, but missed one.  That’s when I realized I may have waiting too long.  Last week I got emails from my pharmacy saying they couldn’t get a script signed off.  I had to call the office and be on hold for awhile before I got through.

Then last Wednesday when I got labs had to wait outside while the office got him to sign off on the labs.  And while they took lots of bodily fluids, only my A1C came back.

While I had made the decision to switch and who to switch to, I hadn’t pulled the trigger yet.  So as soon as I said good bye to Doctor Milburn and got in the car, I called Diabetes Center of America.  I was halfway home when I found out that I needed to fill out a paper form so the medical records would get transferred, so I had to turn around and go back.

But I do have an appointment next week, and I won’t have to go in Fasting.

Oddly enough people do recognize me without her, and it still generates conversations.

But at least they are people who have at least a nodding acquaintance with me and not total strangers.

I started using Dulce because I couldn't control my blood sugar, it was affecting my health and it was driving her crazy.  Training her and listening to her made her a better dog.  I stopped using her for a while because I was working as a contractor and just couldn't wrap my head around making it work.  I did use her at home and for some outings.

Back in the spring when we went to Alaska I had a nasty low with no warning and ended up eating every bit of sugar I had on me and begging people on the tour bus for more.

However, with the new A1C of 6.4, and the new pump and CGMS sensor that actually work, Dulce is not working.  I even left her home all weekend while Summer and I went out of town.  Yes, we were only 1 and 1/2 hours a way, and I could have come home and got her, but I foresee doing this in the future.

She is a lot happier and relaxed with my good A1C.  I think I'm moving around better.  I actually set up jumps at agility yesterday, something I rarely have the energy to do.  I have other people say I move better too. 

But ethically, I believe its wrong to use a service dog if you don't need one.  Yes, sometimes it would make my life a bit easier if I used her -- it would have been nice to go into Fry's yesterday after agility but it wasn't necessary.