I've read buckets, on the internet and in print, in the last couple of months.
The two standout resources - if you're going to buy two books, buy these - are:
TAKING CHARGE OF DIABETES: a practical guide to managing your health and wellbeing
by Richard Laliberte
Readers Digest (Australia)
Endorsed by Diabetes Australia.
Lots of clear, practical information and a great, friendly, informative tone to the writing. There is a review in this newsletter, including an image of the cover.
THE TYPE 2 DIABETES SOURCEBOOK
by David Drum and Terry Zierenberg
Third edition
McGraw Hill (US)
Again, more than recipes and prescriptions - lots made clear, again an encouraging and knowledgeable tone. In Australia, you can buy it here, and the listing includes a cover image.
There have been other books that aren't bad, but these two are the standout ones I can see myself keeping for ongoing long term reference.
Most booksellers can do special orders, if you can't find these easily in a bookshop - go to an independent bookshop and they'll take the time and trouble to track things down.
Saturday, September 29, 2007
Nurturing
It's so important to find new ways to feed yourself other than with food - to serve your senses, the humanity of your body in ways that nourish it safely.
I was given a garden-grown rose this week as a thank you. It smells utterly divine.
Another gardening friend gave me a bunch of spring flowers from her garden, ranunculus and roses, a riot of colour, a feast for the eyes.
Over the weekend I'm going to do some housework, sorting things out a bit and putting things in order.
In their different ways, these all feed the senses and nurture daily life. Mindfulness is part of it, but there's more. It's another daily challenge of diabetes, to replace long term habits which are no longer sustainable as strategies for nurturing, with new habits that are both effective and can, in their turn, be long term.
I'll go smell that rose again. It's almost fully out, and will soon start dropping its petals.
I was given a garden-grown rose this week as a thank you. It smells utterly divine.
Another gardening friend gave me a bunch of spring flowers from her garden, ranunculus and roses, a riot of colour, a feast for the eyes.
Over the weekend I'm going to do some housework, sorting things out a bit and putting things in order.
In their different ways, these all feed the senses and nurture daily life. Mindfulness is part of it, but there's more. It's another daily challenge of diabetes, to replace long term habits which are no longer sustainable as strategies for nurturing, with new habits that are both effective and can, in their turn, be long term.
I'll go smell that rose again. It's almost fully out, and will soon start dropping its petals.
Busy/numbers
My experience of the last couple of weeks is that busy + stress challenges even behaviours I thought I'd got fairly in order. Didn't walk every day. Didn't eat every meal. Didn't stay away from past solutions to busy + stress (um, that would be chocolate...). Didn't keep up with the daily diary of food intake and numbers, although I did most of the four tests a day.
Didn't go overboard, but the combination of all meant it was harder to get the right numbers, which is hardly surprising. And diabetes - not just the diagnosis, but the daily chronic nature of it, lends itself to self-flagellation when your numbers are bad. Yes, the diagnosis is associated with poor diet and insufficient exercise, but it also has a genetic component - and you can't do nuffin about that. In daily terms, nobody is going to be perfect all the time - you need to be careful most of the time, and willing to pick yourself up and start again when you do feel like you've fallen off the wagon. The diabetes isn't going to go away - you have to work with it, or else.
On the plus side, most meals were healthy. Having a regular lunch order for a ham or corned beef salad sandwich that's THICK with salad is simple and manageable. If I've been out and about at dinner time, a Subway 6-inch low-fat roll on honey oat bread has carb and protein and salad and fibre, so that's OK. No scorched almonds (a personal failing) were bought this week, so there are none to consume.
What does cheese you off a bit is when you know you've been good, and the numbers are contrary. Healthy dinner, nothing overnight, and the fasting number is still not around 6mmol. Morning number of 7mmol and after exercise, it's gone up rather than down - and this the same exercise that previously put it down.
While it's no excuse to stop exercising or to eat unhealthily, a frustration of diabetes is the contrariness of it - you cannot wholly control it, however hard you try. It's so important to focus on the trends, not the daily quirks.
Things will be calmer for the next couple of weeks, so here are some starting numbers, and it will be interesting to see how they are in a fortnight or three weeks' time.
Weight:
Starting: 115kg (July 2007)
BMI: 41.2 (morbidly obese)
Current: 104kg
BMI: 37.3 (severely obese)
One month ago (3 Sept)
107kg
BMI: 38.4 (severely obese)
BGL:
Ideal range: 4-8mmol
Current:
8.3mmol ( 7 day average)
7.9mmol (14 day average)
7.7mmol (30 day average)
A month ago (3 Sept)
7.7mmol ( 7 day average)
7.6mmol (14 day average)
8.3mmol (30 day average)
Blood pressure: fine.
I'm really looking forward to clocking under 100kg, to see the needle on the scales stop before triple figures. It's a goal to reach (having started at 115kg).
Didn't go overboard, but the combination of all meant it was harder to get the right numbers, which is hardly surprising. And diabetes - not just the diagnosis, but the daily chronic nature of it, lends itself to self-flagellation when your numbers are bad. Yes, the diagnosis is associated with poor diet and insufficient exercise, but it also has a genetic component - and you can't do nuffin about that. In daily terms, nobody is going to be perfect all the time - you need to be careful most of the time, and willing to pick yourself up and start again when you do feel like you've fallen off the wagon. The diabetes isn't going to go away - you have to work with it, or else.
On the plus side, most meals were healthy. Having a regular lunch order for a ham or corned beef salad sandwich that's THICK with salad is simple and manageable. If I've been out and about at dinner time, a Subway 6-inch low-fat roll on honey oat bread has carb and protein and salad and fibre, so that's OK. No scorched almonds (a personal failing) were bought this week, so there are none to consume.
What does cheese you off a bit is when you know you've been good, and the numbers are contrary. Healthy dinner, nothing overnight, and the fasting number is still not around 6mmol. Morning number of 7mmol and after exercise, it's gone up rather than down - and this the same exercise that previously put it down.
While it's no excuse to stop exercising or to eat unhealthily, a frustration of diabetes is the contrariness of it - you cannot wholly control it, however hard you try. It's so important to focus on the trends, not the daily quirks.
Things will be calmer for the next couple of weeks, so here are some starting numbers, and it will be interesting to see how they are in a fortnight or three weeks' time.
Weight:
Starting: 115kg (July 2007)
BMI: 41.2 (morbidly obese)
Current: 104kg
BMI: 37.3 (severely obese)
One month ago (3 Sept)
107kg
BMI: 38.4 (severely obese)
BGL:
Ideal range: 4-8mmol
Current:
8.3mmol ( 7 day average)
7.9mmol (14 day average)
7.7mmol (30 day average)
A month ago (3 Sept)
7.7mmol ( 7 day average)
7.6mmol (14 day average)
8.3mmol (30 day average)
Blood pressure: fine.
I'm really looking forward to clocking under 100kg, to see the needle on the scales stop before triple figures. It's a goal to reach (having started at 115kg).
Saturday, September 15, 2007
Simplifying your life
Diabetes is stressful. That's just the way things are. Simplifying your life is one way to manage stress and the challenges of each day.
Zen Habits has an excellent post with a Simple Living Manifesto. Worth reading.
Zen Habits has an excellent post with a Simple Living Manifesto. Worth reading.
Mindfulness
Given that Type 2 diabetes usually is accompanied by issues related to eating, and can be a source of stress, as is the case with any chronic illness, mindfulness is a useful concept to consider as one way of coping/managing. A dietitian mentioned it to me a couple of weeks ago, and I've found a couple of links to share here.
What is mindfulness?
Based on her book, Susan Albers has online a brief overview of mindfulness related to eating. She defines a mindful eater thus:
From the link, click on the separate links - they're all useful, but I particularly liked the seven habits and four foundations.
The Black Dog Institute, which deals with mood disorders, has a helpful outline of mindfulness that mentions both eating and stress, including mindfulness exercises to try here.
What is mindfulness?
Mindfulness points to: Being aware of and paying attention to the moment in
which we find ourselves (source)
Based on her book, Susan Albers has online a brief overview of mindfulness related to eating. She defines a mindful eater thus:
A mindful eater is nonjudgmental, compassionate and above all aware of the
taste, texture and process of eating. Being mindful means knowing exactly how
your body feels at all times. You are so closely in touch with what is going on
inside that you know the exact moment you are satisfied rather than stuffed or
starving by learning the why, what, when and how you eat. -Susan Albers
From the link, click on the separate links - they're all useful, but I particularly liked the seven habits and four foundations.
The Black Dog Institute, which deals with mood disorders, has a helpful outline of mindfulness that mentions both eating and stress, including mindfulness exercises to try here.
BMI benchmarks
While I don't want to look too far ahead (someone asked me how much weight I had to lose, and I answered, the next 5kg. And then the 5kg after that. Just one step at a time), I thought I'd play with a Body Mass Indicator calculator and find out some benchmarks for my height (167cm). (Nonmetric calculator here).
- Superobese is a BMI >50, or at my height >139kg.
- Morbidly obese is a BMI >40, or at my height >111kg.
- Severely obese is a BMI >35, or at my height >97kg
- Obese is a BMI >30, or at my height >84kg
- Overweight is a BMI >25, or at my height >69kg
- Normal is a BMI 18.6 - 25, or at my height 52kg - 68kg
- Underweight is a BMI <18.5,>
It's an interesting game to play - try it for your height. It's another way to measure progress, falling through the categories.
Etymological sideline: the word 'obese' is derived from the Latin that has eaten itself fat. The adjective 'obese' is attested from 1651 (that's a lot of centuries of fat people...).
Clothing sizes (in Australia)
This started off being a brief account of clothes shopping for me right now, but evolved, as I googled and fossicked through the internet, into a longer piece on clothing sizes in Australia. Is it out of kilter with a blog with a focus on a Type 2 diabetes journey? No, because with weight loss - a significant recommendation for those with the disease - you have to engage with clothing sizes, and moving through them as your weight changes. So it's even trickier than when you're at a stable weight.
A little while ago, I remember reading that the Australian authorities were going to come up with new definitions of clothing sizes, given that the current ones were established maybe fifty years ago, and with changing shapes and bodies, and a more ethnically diverse population, it was worth revisiting and clarifying this. According to this article, the last comprehensive survey in Australia was done by Berlei in 1926.
Seems as though the research still hasn't taken place. There's an article here from Standards Australia from 2003 that recommends research - but so far I haven't been able to find that the research has been done (there is an abstract of a Master's thesis here, dating from 1999). The current Standards Australia document on women's clothing sizes is here, but costs from nearly $60AU to buy.
Part of the problem seems to be that any revision of sizing needs to include data from a valid anthropometric survey - which in the 1950s would have involved tape measures and pins, and today involves 3D computer body scanning software capable of mapping human body dimensions with considerably more precision. A 2004 National Sizing Forum discussed this (article here) but indicated that compliance by garment manufacturers would still be voluntary.
Senator Kate Lundy put out a press release in 2005 about the issue of clothing sizes in Australia (her call for change appears to be unanswered) and the Sydney Morning Herald discussed the same issue that year. Both seem influenced by this 2005 press release from Andre Haermeyer, Victoria's Minister for Manufacturing and Export, covered by The Age here.
Standards Australia has a committee dealing with clothing sizes - CS-092 Sizing Systems for clothing. The (illuminating) minutes of the 2003 National Sizing Forum are here and a brief account here.
The Australian Defence Forces have a great interest in anthropometric surveys, not only for uniform but for crew accommodation. There was a survey (ADAPT) in which they were involved - brief information here. The Centre for Applied Anthropometry at the University of South Australia indicates that it plans to build a database of measurements, not only for clothing but for a number of applications, such as furniture and vehicle manufacture etc. A thesis abstract from the Centre indicates that there is a disparity between the standards and current actual sizes.
As a mere consumer, my question is: how many times does this have to be stated before something is done to drive constructive change?
Sharp Dummies have a table on their website indicating the results of a survey of Australian women, but it just gives basic data such as average age, height, weight, BMI - although it does compare the average in 1926 (Berlei survey) with the data it found. The site also has a list of published papers on the sizing issue. The most recent one, from March 2007, still only talks about the need for a comprehensive survey - it appears as though this still hasn't happened.
In 2006 The Age newspaper published an article on the discrepancies in clothing sizes that highlighted some of the reasons - such as customer flattery (women won't buy size 12 at this shop if they fit into size 10 at that one). Maybe some consumers like it, but those on this Vogue Australia forum certainly don't.
The establishment of a consortium called SCALE: Sizing Consortium of Australia Landmark Evaluation is a step towards change - but it needs funding, which doesn't seem to be forthcoming from either industry or government. The Courier Mail has an informative June 2007 article on clothing sizes here, Ninemsn has a brief one from 2006 here, and Textiles NZ mentions participation in SCALE here. In 2006 The China Daily canvassed the issue too, and the problem of 'vanity sizing' (this link is to Google's cached copy as my security software thinks the main site could have security issues).
The funding would apparently need to be around $AU 5 million. Given the trade and manufacturing implications, and the benefit to all Australian consumers, isn't that fairly small beer? APEC in Sydney this month cost $AU300 million.
Shopping for clothes, I wonder if size labels mean much at all. OK, I understand that there may be small variations between manufacturers, but do you really have to always carry three sizes of each item into the change room to find which one fits?
(If you're not in Australia, there's a chart here or a converter here to translate sizes I mention for other countries' systems). To give one indication, US size 0 is AU size 4.
For instance: a shop that has (both its own house labels) 'ordinary' size clothes from 8-18 and 'plus' size clothes from 18-26. Ah, but unless you ask the shop assistant, you don't learn that the plus size 18 is cut more generously than the ordinary 18, so 18 means two different sizes, depending on whether it's plus or ordinary. So while you might fit a plus 18, an ordinary 18 might still be a bit tighter.
So customer flattery/vanity sizing is part of it -oooo, I'm in 18 (plus), not 20 - but if ordinary went up to 20, that's probably the equivalent.
As my size is changing, it is really difficult to determine what size to try on. The clothes I have are undergoing a process of discarding - try it on, see if it's still reasonable or now ridiculous and therefore if it stays for a little while longer or goes into the charity bag - and so I need to do some replacing to ensure that I have enough to wear to work etc. So I'm spending more time than I'm accustomed to in clothes shops, and a lot more time in changing rooms guessing what might fit. Currently I'm wearing clothes sized from 16-24 - although the 24s won't be staying much longer, and I'm sure I don't yet fit into a lot of size 16 clothes.
If you have further useful links on the topic of clothing sizes and clothing size research in Australia, please leave a comment.
A little while ago, I remember reading that the Australian authorities were going to come up with new definitions of clothing sizes, given that the current ones were established maybe fifty years ago, and with changing shapes and bodies, and a more ethnically diverse population, it was worth revisiting and clarifying this. According to this article, the last comprehensive survey in Australia was done by Berlei in 1926.
Seems as though the research still hasn't taken place. There's an article here from Standards Australia from 2003 that recommends research - but so far I haven't been able to find that the research has been done (there is an abstract of a Master's thesis here, dating from 1999). The current Standards Australia document on women's clothing sizes is here, but costs from nearly $60AU to buy.
Part of the problem seems to be that any revision of sizing needs to include data from a valid anthropometric survey - which in the 1950s would have involved tape measures and pins, and today involves 3D computer body scanning software capable of mapping human body dimensions with considerably more precision. A 2004 National Sizing Forum discussed this (article here) but indicated that compliance by garment manufacturers would still be voluntary.
Senator Kate Lundy put out a press release in 2005 about the issue of clothing sizes in Australia (her call for change appears to be unanswered) and the Sydney Morning Herald discussed the same issue that year. Both seem influenced by this 2005 press release from Andre Haermeyer, Victoria's Minister for Manufacturing and Export, covered by The Age here.
Standards Australia has a committee dealing with clothing sizes - CS-092 Sizing Systems for clothing. The (illuminating) minutes of the 2003 National Sizing Forum are here and a brief account here.
The Australian Defence Forces have a great interest in anthropometric surveys, not only for uniform but for crew accommodation. There was a survey (ADAPT) in which they were involved - brief information here. The Centre for Applied Anthropometry at the University of South Australia indicates that it plans to build a database of measurements, not only for clothing but for a number of applications, such as furniture and vehicle manufacture etc. A thesis abstract from the Centre indicates that there is a disparity between the standards and current actual sizes.
As a mere consumer, my question is: how many times does this have to be stated before something is done to drive constructive change?
Sharp Dummies have a table on their website indicating the results of a survey of Australian women, but it just gives basic data such as average age, height, weight, BMI - although it does compare the average in 1926 (Berlei survey) with the data it found. The site also has a list of published papers on the sizing issue. The most recent one, from March 2007, still only talks about the need for a comprehensive survey - it appears as though this still hasn't happened.
In 2006 The Age newspaper published an article on the discrepancies in clothing sizes that highlighted some of the reasons - such as customer flattery (women won't buy size 12 at this shop if they fit into size 10 at that one). Maybe some consumers like it, but those on this Vogue Australia forum certainly don't.
The establishment of a consortium called SCALE: Sizing Consortium of Australia Landmark Evaluation is a step towards change - but it needs funding, which doesn't seem to be forthcoming from either industry or government. The Courier Mail has an informative June 2007 article on clothing sizes here, Ninemsn has a brief one from 2006 here, and Textiles NZ mentions participation in SCALE here. In 2006 The China Daily canvassed the issue too, and the problem of 'vanity sizing' (this link is to Google's cached copy as my security software thinks the main site could have security issues).
The funding would apparently need to be around $AU 5 million. Given the trade and manufacturing implications, and the benefit to all Australian consumers, isn't that fairly small beer? APEC in Sydney this month cost $AU300 million.
Shopping for clothes, I wonder if size labels mean much at all. OK, I understand that there may be small variations between manufacturers, but do you really have to always carry three sizes of each item into the change room to find which one fits?
(If you're not in Australia, there's a chart here or a converter here to translate sizes I mention for other countries' systems). To give one indication, US size 0 is AU size 4.
For instance: a shop that has (both its own house labels) 'ordinary' size clothes from 8-18 and 'plus' size clothes from 18-26. Ah, but unless you ask the shop assistant, you don't learn that the plus size 18 is cut more generously than the ordinary 18, so 18 means two different sizes, depending on whether it's plus or ordinary. So while you might fit a plus 18, an ordinary 18 might still be a bit tighter.
So customer flattery/vanity sizing is part of it -oooo, I'm in 18 (plus), not 20 - but if ordinary went up to 20, that's probably the equivalent.
As my size is changing, it is really difficult to determine what size to try on. The clothes I have are undergoing a process of discarding - try it on, see if it's still reasonable or now ridiculous and therefore if it stays for a little while longer or goes into the charity bag - and so I need to do some replacing to ensure that I have enough to wear to work etc. So I'm spending more time than I'm accustomed to in clothes shops, and a lot more time in changing rooms guessing what might fit. Currently I'm wearing clothes sized from 16-24 - although the 24s won't be staying much longer, and I'm sure I don't yet fit into a lot of size 16 clothes.
If you have further useful links on the topic of clothing sizes and clothing size research in Australia, please leave a comment.
Wednesday, September 12, 2007
Lunch
Settling on a standard lunch is another way of simplifying food choices and eating wisely.
For now, I'm having a corned beef and salad sandwich on weekdays. Current bread choice is this one from Burgen, partly because it's low GI and partly because it's high in iron. Tastes good, too (I found another wholemeal one with added iron, but it tasted like pap. Much prefer this one). Sambo ends up about an inch thick with lettuce, tomato, cucumber, Spanish onion, carrot etc.
Bevvy: Diet Coke
Weekends: if I'm out and about, Subway offers healthy possibilities - current favourite is honey oat bread, 6in, not toasted, ham, Old English cheese, lettuce, tomato, cucumber, capsicum, Spanish onion, carrot and a little mayo. I wandered through a shopping centre food court a while ago, and it wasn't easy to find something appropriate - lots of brown food, fried food, food that would fall outside healthy eating parameters. I don't write this to sound smug, or like the food police - it was just really interesting to scan the offerings and see how little there was to choose from if you were aiming to eat healthily, and manage a general 'plate' of 1/2 veg, 1/4 protein, 1/4 carb, low fat food.
For now, I'm having a corned beef and salad sandwich on weekdays. Current bread choice is this one from Burgen, partly because it's low GI and partly because it's high in iron. Tastes good, too (I found another wholemeal one with added iron, but it tasted like pap. Much prefer this one). Sambo ends up about an inch thick with lettuce, tomato, cucumber, Spanish onion, carrot etc.
Bevvy: Diet Coke
Weekends: if I'm out and about, Subway offers healthy possibilities - current favourite is honey oat bread, 6in, not toasted, ham, Old English cheese, lettuce, tomato, cucumber, capsicum, Spanish onion, carrot and a little mayo. I wandered through a shopping centre food court a while ago, and it wasn't easy to find something appropriate - lots of brown food, fried food, food that would fall outside healthy eating parameters. I don't write this to sound smug, or like the food police - it was just really interesting to scan the offerings and see how little there was to choose from if you were aiming to eat healthily, and manage a general 'plate' of 1/2 veg, 1/4 protein, 1/4 carb, low fat food.
Today's news
From the ABC, the plan proposed by the Australian Divisions of General Practice for the government to fund overweight/obese people attending weight loss programs. Apparently such programs in the UK have resulted in about 20% of attendees losing weight in the long term.
Article begins: A doctors group has proposed that overweight people be given a $170 subsidy to attend an accredited weight-loss program.
From the Sydney Morning Herald, the costs involved for GPs in paperwork for diabetics, and the consequences of the disparity between time and compensation.
Article begins: Diabetics are not getting the right treatment because doctors are being overwhelmed by the paperwork required to manage their condition, experts say.
From Richard Glover's Drive program on 702 ABC Sydney, Midweek Conference this week discussed the emotional aspects of overeating. It's not on the story list right now, but keep an eye on this page and it will no doubt appear shortly. Guest was Petrea King from the Quest for Life Foundation. This edition of the foundation's newsletter includes discussion of food issues.
From the Sydney Morning Herald, Byetta is a new medication now available to people with Type 2 diabetes in Australia.
Article begins: A new drug inspired by a hormone in lizard saliva has hit the Australian market to help diabetics manage their condition and their weight.
Article begins: A doctors group has proposed that overweight people be given a $170 subsidy to attend an accredited weight-loss program.
From the Sydney Morning Herald, the costs involved for GPs in paperwork for diabetics, and the consequences of the disparity between time and compensation.
Article begins: Diabetics are not getting the right treatment because doctors are being overwhelmed by the paperwork required to manage their condition, experts say.
From Richard Glover's Drive program on 702 ABC Sydney, Midweek Conference this week discussed the emotional aspects of overeating. It's not on the story list right now, but keep an eye on this page and it will no doubt appear shortly. Guest was Petrea King from the Quest for Life Foundation. This edition of the foundation's newsletter includes discussion of food issues.
From the Sydney Morning Herald, Byetta is a new medication now available to people with Type 2 diabetes in Australia.
Article begins: A new drug inspired by a hormone in lizard saliva has hit the Australian market to help diabetics manage their condition and their weight.
Saturday, September 08, 2007
Exercise myths debunked
The Australian Consumers' Association publishes Choice magazine - the latest issue contains an article about exercise myths, which is also available to read free online here.
Scroll down on each page for additional information and sometimes links. For example:
The Australian Sports Commission (ASC) conducts an annual national survey on participation in exercise (not including work-related activity or household chores), active recreational pursuits and sports.
In the latest survey, published in 2006, ASC found that only about one in four people aged 15 or over had exercised at least five times a week. 16.7% hadn’t taken part in any such activity in the previous 12 months, and another 14.1% had done so less than once a week. Not surprising that more than half of all Australian adults are overweight or obese.
Source.
Scroll down on each page for additional information and sometimes links. For example:
The Australian Sports Commission (ASC) conducts an annual national survey on participation in exercise (not including work-related activity or household chores), active recreational pursuits and sports.
In the latest survey, published in 2006, ASC found that only about one in four people aged 15 or over had exercised at least five times a week. 16.7% hadn’t taken part in any such activity in the previous 12 months, and another 14.1% had done so less than once a week. Not surprising that more than half of all Australian adults are overweight or obese.
Source.
Fewer than 5%....
This report describes three health targets/national lifestyle guidelines for Australians:
- 2 1/2 hours of moderate intensity exercise per week
- 2 x 1/2 cup servings of fruit per day
- 5 1/2 cup servings of vegetables per day
According to the results of the Australian National Health Survey 2004-5:
- exercise: achieved by 25%
- fruit: achieved by 55%
- vegetables: achieved by 15%
However: fewer than 5% met all three targets. Men had poorer rates than women, and overweight/obese people had poorer rates too.
All of which has direct implications for obesity and disease. (The survey included 16,000 people).
Me? I'm meeting them all, now.
More on clothes: The rule of in and out
So as my wardrobe gradually becomes ridiculous and therefore redundant (I put on a shirt this week that fitted last year, and it was ridiculous - could have fitted invisible triplets under it. Had to wear a buttoned cardigan over it) a rule taught me by my Virgo chuck-it pals comes to mind.
What comes in has to be matched with what goes out.
So every new item of clothing that arrives (I bought two knit tops today, both on special), one has to leave.
It's going to be very odd at the end of winter to basically toss (to charity/rags) all my winter clothes. But given what's unwearable now, how can I not assume that, if I keep going as I have been, it will all be unwearable in six months?
I'm a natural hoarder, but that isn't a useful way to think about this. For today, two in, two out.
It was kinda nice to browse for smaller sizes - although not easy to work out what size really is me, right now. As ever with clothes, it's a bit dependent on the item - from the ones I tried on today, they ranged over four sizes, and different items fitted at different sizes.
I'm avoiding buying what I really don't fit into, yet. Time enough to buy when I do fit, or else I'll be engaging in another kind of hoarding.
What comes in has to be matched with what goes out.
So every new item of clothing that arrives (I bought two knit tops today, both on special), one has to leave.
It's going to be very odd at the end of winter to basically toss (to charity/rags) all my winter clothes. But given what's unwearable now, how can I not assume that, if I keep going as I have been, it will all be unwearable in six months?
I'm a natural hoarder, but that isn't a useful way to think about this. For today, two in, two out.
It was kinda nice to browse for smaller sizes - although not easy to work out what size really is me, right now. As ever with clothes, it's a bit dependent on the item - from the ones I tried on today, they ranged over four sizes, and different items fitted at different sizes.
I'm avoiding buying what I really don't fit into, yet. Time enough to buy when I do fit, or else I'll be engaging in another kind of hoarding.
Friday, September 07, 2007
Breakfast (slower version)
So what am I eating, that means I'm losing weight?
A food plan worked out with dietitians, and based on stuff I like (which makes it sustainable, as opposed to faddy diets).
Slow breakfast (when I'm not rushing out the door to work):
A food plan worked out with dietitians, and based on stuff I like (which makes it sustainable, as opposed to faddy diets).
Slow breakfast (when I'm not rushing out the door to work):
- 3/4 cup Allbran cereal
- 1 small banana, sliced
- 1 cup Boost milk (low fat, high calcium)
Which is 3 carbs, high fibre and lowish GI, and lasts me through without feeling hungry. The banana makes the Allbran go down nicely - it's a bit blah without it. I cut the banana thinly, so it goes a long way.
Thursday, September 06, 2007
The clothes dilemma
See, the thing that happens when you lose weight is that your clothes stop fitting. The ones that have fitted for ages. And yes, it's a matter for celebration, that commitment to changed food habits is having the desired result, in terms of insulin preservation.
But it's a nuisance, in some ways, too. Because yes, OK, you can throw out some clothes (worn out for rags, others to charity collection) but what size do you buy next? Because if you keep going, then then the ones you buy won't fit indefinitely either.
But it's also odd to put on something that used to fit, and feel it swim on you. It's like putting on an old skin for a body you don't have any more.
I've been overweight for so long, I'm not used to this sensation at all (and I'm still a long way from normal weight range).
For right now, there are a bunch of things in my wardrobe that will be going when summer is properly here, because by next winter, if things go all right (not saying all the weight will be gone, but more of it should be), nothing from this winter is going to even vaguely fit. It will all be superfluous. Some things will go sooner - I try them on, and they swim and are ridiculous, so I take them off and consign them for reuse, out of the house and out of my life.
You get the odd pang, though. The midnight blue panne velvet dress with the beading I put around the neckline. I wore that to lots of places, and loved its texture and flow. I always felt good in it. That one was a bit harder to put in the charity bag. Maybe I"ll take a photograph first, then consign it.
I have got a few things at the back of the wardrobe that fit now where they didn't before - not a lot, because my weight hasn't been especially variable for a long time. So I haven't got 'fat clothes' and 'thin clothes', just the fat ones, mostly. I've decided elastic waists make sense (and make things last for a while). But mostly, clothes will be bare basics while I travel through the sizes. Enough for work and to get by.
This evening it was late night shopping, and I spent a little bit of time browsing for clothes. Not buying. Not yet. But browsing the sort of shops I've not been able to buy at for years, the ones with clothes size 18 and UNDER (not OVER). Wow. The breadth of choice is immensely larger than for larger sizes. I won't know what to do with myself.
For now, I'm sitting here in jeans that are loose where they used to be snug, a shirt that can only be worn under something else that hides its ridiculous largeness, and a pretty pink cardigan that's loose where it used to fit. This is the last winter ever that I'll wear them.
But it's a nuisance, in some ways, too. Because yes, OK, you can throw out some clothes (worn out for rags, others to charity collection) but what size do you buy next? Because if you keep going, then then the ones you buy won't fit indefinitely either.
But it's also odd to put on something that used to fit, and feel it swim on you. It's like putting on an old skin for a body you don't have any more.
I've been overweight for so long, I'm not used to this sensation at all (and I'm still a long way from normal weight range).
For right now, there are a bunch of things in my wardrobe that will be going when summer is properly here, because by next winter, if things go all right (not saying all the weight will be gone, but more of it should be), nothing from this winter is going to even vaguely fit. It will all be superfluous. Some things will go sooner - I try them on, and they swim and are ridiculous, so I take them off and consign them for reuse, out of the house and out of my life.
You get the odd pang, though. The midnight blue panne velvet dress with the beading I put around the neckline. I wore that to lots of places, and loved its texture and flow. I always felt good in it. That one was a bit harder to put in the charity bag. Maybe I"ll take a photograph first, then consign it.
I have got a few things at the back of the wardrobe that fit now where they didn't before - not a lot, because my weight hasn't been especially variable for a long time. So I haven't got 'fat clothes' and 'thin clothes', just the fat ones, mostly. I've decided elastic waists make sense (and make things last for a while). But mostly, clothes will be bare basics while I travel through the sizes. Enough for work and to get by.
This evening it was late night shopping, and I spent a little bit of time browsing for clothes. Not buying. Not yet. But browsing the sort of shops I've not been able to buy at for years, the ones with clothes size 18 and UNDER (not OVER). Wow. The breadth of choice is immensely larger than for larger sizes. I won't know what to do with myself.
For now, I'm sitting here in jeans that are loose where they used to be snug, a shirt that can only be worn under something else that hides its ridiculous largeness, and a pretty pink cardigan that's loose where it used to fit. This is the last winter ever that I'll wear them.
Monday, September 03, 2007
Numbers and progress
Weight
Starting: 115kg (July 2007)
BMI: 41.2 (morbidly obese)
Current: 107kg
BMI: 38.4 (severely obese)
BGL:
Diagnosis: Fasting 14mmol, 2 hour 20mmol
Ideal range: 4-8mmol
Current:
7.7mmol ( 7 day average)
7.6mmol (14 day average)*
8.3mmol (30 day average)
HbA1c: 7.7% (magic number is 7%)
Cholesterol, triglycerides, blood pressure, microalbumin excretion: all fine
*Right now I have a cold, and so some readings are up, which is why 14 day average is better than 7. Darn it.
Starting: 115kg (July 2007)
BMI: 41.2 (morbidly obese)
Current: 107kg
BMI: 38.4 (severely obese)
BGL:
Diagnosis: Fasting 14mmol, 2 hour 20mmol
Ideal range: 4-8mmol
Current:
7.7mmol ( 7 day average)
7.6mmol (14 day average)*
8.3mmol (30 day average)
HbA1c: 7.7% (magic number is 7%)
Cholesterol, triglycerides, blood pressure, microalbumin excretion: all fine
*Right now I have a cold, and so some readings are up, which is why 14 day average is better than 7. Darn it.
Statistics and how they relate to me
Been doing some internet research. Reading the Australian Bureau of Statistics snapshot on Diabetes 2004/5, some interesting, scary figures emerge relating to people in Australia with Type 2 diabetes.
- Over 90% took their prescribed medication
- Over 80% had modified their diet due to the diabetes
However:
- 69% of people with diabetes were overweight/obese, compared to 51% of the general population. (OK, it's a risk factor. But they weren't all diagnosed in the last few weeks or months - some have had it for years).
- Amongst those who reported taking action for diabetes, 30% reported exercising most days.
- In 2004-05, 74% of those with diabetes aged 15 and over had no, or low levels of exercise, compared to 69% of those without diabetes (after adjusting for age differences)
So even though exercise is one of the standard prescribed treatments/actions to take, even fewer people with diabetes exercise than the rest of the population. Over two thirds don't exercise - they can't all be frail, elderly people....
And then:
- Amongst those who reported taking action for diabetes, 18% of persons lost weight in response to their diagnosis of diabetes. So one thing within the control of the patient - it's not easy, but it's possible - is not changed in over 80% of people with diabetes. However diets are being modified, it's clearly not making a difference for many people.
Just to be even scarier:
- From the ABS 2003 Survey of Disability, Ageing and Carers, it was estimated that about 357,000 persons with a disability had diabetes (approximately 9% of all persons who reported a disability). Of these, about 86,000 reported diabetes as their main disabling condition (ABS 2004).
- In 2004 a total of 8.9% of deaths (approximately 11,700 deaths) were related to diabetes.
Another document: the Australian National Priorities 2007-2008 goes through the many costs associated with diabetes, and figures such as lower workforce participation (around 50% compared to the non-diabetic average of around 70%) and then arrives at this key point:
- Research also demonstrates that complications are the major driver of all costs in diabetes care.
So the avoidance of complications is critical, not just for the national budget, but on a personal level. All the scary stats about blindness and amputation and kidney failure and heart disease rest on the presence of complications. A good quality of life rests on avoidance of complications.
In my daily life, this then means:
- care with diet
- commitment to exercise
- consistency with medication
- conscientiousness with bgl readings (recording them and achieving numbers within range)
These are all the things I can control. I won't be perfect, but I can aim for my best shot. I KNOW I'm not perfect.
Realistically, with the numbers I had at diagnosis, I'm apparently unlikely to ever get off medication, and am likely in 5-10 years to need insulin to maintain good bgl numbers. Don't really want to think about that much now. The diabetic educator remarked that, with those diagnosis numbers, it was only the action I'd taken in relation to diet and exercise that had staved off needing insulin now. That's scary. Good, and scary. She said that 75% of my beta cells are probably exhausted already, so the remainder - which will, over time, fail, as this is a progressive disease - need the prop of medication.
Someone asked me the other day how much weight I had to lose. The next five kilos, I answered. And then the five kilos after that....
It's not worth thinking in the big numbers. Work on today, and tomorrow.
Monday, August 06, 2007
Numbers and progress
Returned to the doctor to check some stuff and ask more questions: I suspect he withheld info on the diagnosis visit to avoid information overload and also because I was clearly upset and mightn't have taken it in anyway (ie. a reasonable call, I'm not criticising him).
I've done a bunch of reading and it was good to be able to ask some questions. He was Very Pleased at my weight loss: 4kg so far. Toddled me off into the treatment room to have my blood sugar checked, as it was two hours since lunch. I've been Pretty Darn Good with both eating and exercise, but it was still good to get a reading of 9.2mmol and see the (slightly surprised)look on his face. The initial post-prandial reading that led to the diagnosis was a high 20mmol, so this is a great improvement, and almost within a normal range. Certainly classed as moderate (as opposed to ideal), but that's still progress.
I'll put up some info on the books I've read shortly - I went some distance to a Borders, which has a comprehensive range that's far more than a suburban bookshop could stock, and picked up a couple of useful titles.
This week I'm booked to go to the diabetes clinic at the hospital for an initial meeting for newly diagnosed people, and next week is the initial appointment with the dietitian. I'm guessing after the hospital one I'll know which blood glucose meter to buy, and how often to test.
Back to work today, but it was very good to have had three days last week in which to sort things out, in my head as much as anything.
I've done a bunch of reading and it was good to be able to ask some questions. He was Very Pleased at my weight loss: 4kg so far. Toddled me off into the treatment room to have my blood sugar checked, as it was two hours since lunch. I've been Pretty Darn Good with both eating and exercise, but it was still good to get a reading of 9.2mmol and see the (slightly surprised)look on his face. The initial post-prandial reading that led to the diagnosis was a high 20mmol, so this is a great improvement, and almost within a normal range. Certainly classed as moderate (as opposed to ideal), but that's still progress.
I'll put up some info on the books I've read shortly - I went some distance to a Borders, which has a comprehensive range that's far more than a suburban bookshop could stock, and picked up a couple of useful titles.
This week I'm booked to go to the diabetes clinic at the hospital for an initial meeting for newly diagnosed people, and next week is the initial appointment with the dietitian. I'm guessing after the hospital one I'll know which blood glucose meter to buy, and how often to test.
Back to work today, but it was very good to have had three days last week in which to sort things out, in my head as much as anything.
Friday, August 03, 2007
Wednesday, August 01, 2007
Quick...
What should I be doing? Going for a walk. What am I doing? Dallying on the computer. OK, the alarm went off at 6am, but I've usefully (um) employed the time since then to read the latest Romantic Homes magazine, finish all the relevant chapters of the diabetes handbook I bought on the weekend, whizz through half of Simple Scrapbooks magazine...
I think it's called procrastination. Always been one of my gifts.
But now I'm dressed and ready to go, there are plenty of podcasts on the mp3 player (several Lake Wobegons, hurrah!) and all I need to do is collect my water bottle, the player, the gloves (it's winter and cold enough to need them) and the door keys and go.
Oh, and get off the computer.
But let me just tell you, first, that it's been a week. One heck of a rollercoaster week, particularly emotionally. With food, though, almost all the time (3 lapses) I've been very disciplined. Despite, I have to tell you, temptation (I didn't touch the home made scones with jam and cream on Monday, but oh I wanted to!).
I'll talk later about the food pattern I'm in (dietitian appointment is still a fortnight away, the earliest I could get), but it seems OK with the handbook's suggestions and works in terms of what I like to eat (well, not everything. Chocolate, waaaaaaaaaaaaaaaaaaaaaaaaah!).
Numbers:
On the scales this morning, 111kg (244lb).
I know you lose more weight in the first week of any diet. I'm NOT crash dieting, or doing anything that I'm aware is stupid. Fruit and veg, low GI carbs, sensible regular healthy eating. A walk almost every day (occasionally life gets in the way).
But it's encouraging. 4kg gone. About 50kg to go.
Going for that walk now. Then breakfast: a bowl of All Bran with a banana and Boost milk (low fat, high calcium).
I think it's called procrastination. Always been one of my gifts.
But now I'm dressed and ready to go, there are plenty of podcasts on the mp3 player (several Lake Wobegons, hurrah!) and all I need to do is collect my water bottle, the player, the gloves (it's winter and cold enough to need them) and the door keys and go.
Oh, and get off the computer.
But let me just tell you, first, that it's been a week. One heck of a rollercoaster week, particularly emotionally. With food, though, almost all the time (3 lapses) I've been very disciplined. Despite, I have to tell you, temptation (I didn't touch the home made scones with jam and cream on Monday, but oh I wanted to!).
I'll talk later about the food pattern I'm in (dietitian appointment is still a fortnight away, the earliest I could get), but it seems OK with the handbook's suggestions and works in terms of what I like to eat (well, not everything. Chocolate, waaaaaaaaaaaaaaaaaaaaaaaaah!).
Numbers:
On the scales this morning, 111kg (244lb).
I know you lose more weight in the first week of any diet. I'm NOT crash dieting, or doing anything that I'm aware is stupid. Fruit and veg, low GI carbs, sensible regular healthy eating. A walk almost every day (occasionally life gets in the way).
But it's encouraging. 4kg gone. About 50kg to go.
Going for that walk now. Then breakfast: a bowl of All Bran with a banana and Boost milk (low fat, high calcium).
Sunday, July 22, 2007
Diagnosis
Monday, 22 July, 2007. Everything changes. The doctor says, "Hmm, the test," and there's something in his voice that tells me before he finishes on the computer keys, before the results of the glucose tolerance test come up on his screen. About five years ago, I did the same test and it came up with impaired glucose tolerance. Nowadays, I learn, that's called pre-diabetes. Maybe to rightfully scare you better. I didn't get scared enough, so here I am, and the doctor looks me in the eye and says, "You have Type 2 diabetes. You're diabetic." He repeats it, maybe as he watches my face crumple and wonders if I've properly heard. "You're diabetic."
So. Everything changes. I can't expect my body to cope any more. Without changes, I am heading to a hell of blindness and amputation and heart disease and kidney disease and a shortened life span.
I'm in my mid-forties and have been overweight for years.
It took me a little while to write that last sentence. Instead, I went hunting for an online converter to see if figures make it any better. (Delusional procrastination would be one label for it).
Here are the numbers.
I'm 167cm tall (or 5'6").
I currently weigh 115kg (253lb).
My BMI is 40.8 (obese is over 30). Calculated here.
My ideal weight is between 58 and 65kg (130 and 144lb). A long way away. The doctor says that even if I lose 20kg (44lb) it's unlikely to be enough to make medication unnecessary, or do as much as needs to be done.
For now, maybe my initial target should be 99kg (218lb). Double figures.
The test results were high enough to have the doctor put me on medication straight away, a version of metformin, which I gather is a common and effective medication for type 2 diabetes. I've never before had a script with such bulk or longevity. It makes this all hit home, when you see the big box, know you have five repeats and that this is longterm. I don't know if I can lose enough weight and achieve good enough blood sugar readings to make medication unnecessary. I have to remember to take one every night with dinner, every night, every night of my life for the indefinite future.
I don't know is a wall I find myself up against in many ways. I'm a well-educated, well-read person, but I'm suddenly in a whole new world, at sea and trying to make sense of it all, not generically but in specific reference to me, to this body I inhabit.
The doctor gives me a double-sided sheet of patient information about type 2 diabetes. It has the things I sort of know already. Insulin is important. It's not working properly in your body. Lose weight. Exercise. Watch your diet.
I've been on diets before - a fad here and there, but mostly proper, considered ones. For three different time periods I've visited a dietitian, a wonderful woman and my failure to lose and keep off weight is my own, nothing to do with what she might have done or could have done. I refined what I ate to some excellent choices: but where I've fallen down is mostly chocolate, the fat and sugar hit that can kybosh a sensible breakfast, a nutritious lunch and a wise dinner. Chocolate is peace. And sanity. And time out. And a mouthfeel that greets you every time. It's a medication for stress and a reward for exhausting effort.
And now, it's poison.
After getting the biggest prescription of my life filled at the pharmacy, I head down to the supermarket. It's dinnertime, and although I have reasonable food choices at home, I feel as though I have to start the changes NOW, with the next meal.
One of the food options I developed from the dietitian's input was my personal salad. Like most people, there are salad ingredients that work for me (eg. carrot, tomato, lettuce, mushroom, capsicum, shallots, cucumber) and those that don't (never avocado; celery cooked but not raw). I trundle my basket around the supermarket and buy for the new life. The salad ingredients I like. Small portions of lean beef. A couple of salad dressings.
And I'm reading labels, and I'm still at sea. I can understand what I need to do to lose weight, but if you add in the complication of whatever it is I need to do in terms of carbs/blood sugar, I don't know. It's not just about the calories or fat content.
The doctor is organising referrals to the dietitian and to a diabetes nurse educator, but in the meantime I'm on my own.
My breakfast choice since they came on the market is All-bran bars. The dietitian originally suggested Fruity-bix bars, and I ate them for breakfast for a while. I usually eat breakfast while driving to work - it's a long drive, and this way I savour breakfast. All-bran bars are higher in fibre and from memory came up well on the comparison, so I went with them. For now, they seem like an OK choice, along with a banana. That's breakfast sorted.
Morning tea and lunch - it seems right to do these, I haven't always been having them. Harris Farm Markets have a wonderful plain yoghurt, while bananas I like and apples (Royal Gala) I like too.
Dinner: the big salad, with lean meat and should I be factoring in a serve of carbs? I remember the dietitian talking about one rice being particularly low GI. Mahatma brand, I think. Maybe I'll just use up the long grain I have in the cupboard first, then switch to brown rice (I'll miss jasmine rice, such a wonderful fragrance).
I haven't been eating a lot of takeaway food. Occasional Thai, pizza maybe four times a year? For all the reading I'm doing and the blame that's being laid on preprepared meals and takeaway, it's not been how I eat. I'm more likely to go for a tin of soup, although I'm aware that they can have issues with sodium. For fast work lunches, though, there must be some reasonable options among the better-quality ones. I come away with some tetra-bricks of mostly vegetable soups.
And so I come home, and cook a midget lean steak and make two big salads, one for dinner and one for tomorrow's lunch, and try not to cry. But I do. It's fear and anger and despair and anger and the fact that everything's changed. Some test results on a page mean that any excuse fades away. Unless I change, and aim to be wise, I sail off the map where there be dragons.
So. Everything changes. I can't expect my body to cope any more. Without changes, I am heading to a hell of blindness and amputation and heart disease and kidney disease and a shortened life span.
I'm in my mid-forties and have been overweight for years.
It took me a little while to write that last sentence. Instead, I went hunting for an online converter to see if figures make it any better. (Delusional procrastination would be one label for it).
Here are the numbers.
I'm 167cm tall (or 5'6").
I currently weigh 115kg (253lb).
My BMI is 40.8 (obese is over 30). Calculated here.
My ideal weight is between 58 and 65kg (130 and 144lb). A long way away. The doctor says that even if I lose 20kg (44lb) it's unlikely to be enough to make medication unnecessary, or do as much as needs to be done.
For now, maybe my initial target should be 99kg (218lb). Double figures.
The test results were high enough to have the doctor put me on medication straight away, a version of metformin, which I gather is a common and effective medication for type 2 diabetes. I've never before had a script with such bulk or longevity. It makes this all hit home, when you see the big box, know you have five repeats and that this is longterm. I don't know if I can lose enough weight and achieve good enough blood sugar readings to make medication unnecessary. I have to remember to take one every night with dinner, every night, every night of my life for the indefinite future.
I don't know is a wall I find myself up against in many ways. I'm a well-educated, well-read person, but I'm suddenly in a whole new world, at sea and trying to make sense of it all, not generically but in specific reference to me, to this body I inhabit.
The doctor gives me a double-sided sheet of patient information about type 2 diabetes. It has the things I sort of know already. Insulin is important. It's not working properly in your body. Lose weight. Exercise. Watch your diet.
I've been on diets before - a fad here and there, but mostly proper, considered ones. For three different time periods I've visited a dietitian, a wonderful woman and my failure to lose and keep off weight is my own, nothing to do with what she might have done or could have done. I refined what I ate to some excellent choices: but where I've fallen down is mostly chocolate, the fat and sugar hit that can kybosh a sensible breakfast, a nutritious lunch and a wise dinner. Chocolate is peace. And sanity. And time out. And a mouthfeel that greets you every time. It's a medication for stress and a reward for exhausting effort.
And now, it's poison.
After getting the biggest prescription of my life filled at the pharmacy, I head down to the supermarket. It's dinnertime, and although I have reasonable food choices at home, I feel as though I have to start the changes NOW, with the next meal.
One of the food options I developed from the dietitian's input was my personal salad. Like most people, there are salad ingredients that work for me (eg. carrot, tomato, lettuce, mushroom, capsicum, shallots, cucumber) and those that don't (never avocado; celery cooked but not raw). I trundle my basket around the supermarket and buy for the new life. The salad ingredients I like. Small portions of lean beef. A couple of salad dressings.
And I'm reading labels, and I'm still at sea. I can understand what I need to do to lose weight, but if you add in the complication of whatever it is I need to do in terms of carbs/blood sugar, I don't know. It's not just about the calories or fat content.
The doctor is organising referrals to the dietitian and to a diabetes nurse educator, but in the meantime I'm on my own.
My breakfast choice since they came on the market is All-bran bars. The dietitian originally suggested Fruity-bix bars, and I ate them for breakfast for a while. I usually eat breakfast while driving to work - it's a long drive, and this way I savour breakfast. All-bran bars are higher in fibre and from memory came up well on the comparison, so I went with them. For now, they seem like an OK choice, along with a banana. That's breakfast sorted.
Morning tea and lunch - it seems right to do these, I haven't always been having them. Harris Farm Markets have a wonderful plain yoghurt, while bananas I like and apples (Royal Gala) I like too.
Dinner: the big salad, with lean meat and should I be factoring in a serve of carbs? I remember the dietitian talking about one rice being particularly low GI. Mahatma brand, I think. Maybe I'll just use up the long grain I have in the cupboard first, then switch to brown rice (I'll miss jasmine rice, such a wonderful fragrance).
I haven't been eating a lot of takeaway food. Occasional Thai, pizza maybe four times a year? For all the reading I'm doing and the blame that's being laid on preprepared meals and takeaway, it's not been how I eat. I'm more likely to go for a tin of soup, although I'm aware that they can have issues with sodium. For fast work lunches, though, there must be some reasonable options among the better-quality ones. I come away with some tetra-bricks of mostly vegetable soups.
And so I come home, and cook a midget lean steak and make two big salads, one for dinner and one for tomorrow's lunch, and try not to cry. But I do. It's fear and anger and despair and anger and the fact that everything's changed. Some test results on a page mean that any excuse fades away. Unless I change, and aim to be wise, I sail off the map where there be dragons.
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