DIABETES MY WAY
By Miss Kate
In 1948 my parents bought a 24 acre farm in the rolling green rural hills of Maryland. Dad was a horticulturalist. Mom had been a high school English teacher, until the day she married Dad. In those days (the 1930s) once a couple married, the wife did not typically work outside the home. Especially if she married my Dad. He was a very stubborn and proud man, set in his beliefs. One of those beliefs was that the man is the provider, so Mom became the housewife and, ultimately the mother of four children.
I remember the day we moved into what eventually became Country Gardens. I was 4 at the time. I remember there had been several trips to the place to work on it and begin moving belongings in, but the final realization that it was home was when we were all standing in the door of what would become our livingroom. There was a bushel basket full of kid’s toys and the one on the very top was my beloved stuffed dog, Blackie. I still remember the thought, “well, if Blackie is here then this must be home”.
By the sweat of their brow and relentless hard, physical labor, Mom and Dad turned what had been a farm into Country Gardens, a nursery back in the days when people bought plants, trees, shrubs, flowers that were carefully grown in rows in the ground, and garden centers and potted trees were unheard of. If you bought a 30 foot weeping willow Mom or Dad, or eventually one of us growing kids, dug it out of the ground, balled and burlapped it, got it into a wheelbarrow, and into the trunk of your car or bed of your truck. We were a family operation,with each child joining in the work at whatever age they could haul stuff, dig stuff, prune stuff — whatever.
We grew whatever fruits and vegetables the family would need every year and we canned everything we would eat during the off season months when it could not just be picked fresh. Canning was also a family chore, with every family member working side-by-side in the kitchen (if you can wrap your brain around the concept, we had no T V. Computers, iPads, iPods —all of that stuff may possibly have existed in the farthest reaches of inventor’s brains, but they surely were not in our world.) We had a cow or three for milk and meat, chickens for eggs and meat. Now, I can look back and realize life was ideal.
Somewhere, possibly around the 4th, or maybe 5th grade I remember one of my good friends, Sharon, telling me her father had sugar diabetes. I had no idea what that was. From her explanation I got the idea that it was a disease people could get from eating too many sweet foods. I also got the idea that a person with sugar diabetes was supposed to stop eating sweet foods, not drink beer, and had to give themselves shots all the time or they would die. Sharon told me her father did not do the things he was supposed to do, and he did die. I believe he was the first person I actually knew who actually died. And not taking care of sugar diabetes killed him. I never forgot that.
As we kids were busy growing up our Mom gained quite a reputation within our family, our church (back then we had frequent church suppers and Mom’s contributions were always a huge hit), and the annual County Fair baking, canning, cooking entries. I absolutely loved coming home from school and walking into the old house smelling of the rich and heady aroma of whatever she was fixing for supper. I would gravitate to the kitchen and peer into pots and pans asking what was for supper. Always, after every supper, there was dessert. Fresh, warm pie, or cake, or cookies, or cobbler, or whatever wonder Mom had baked. The absolute rule was, you had to clean your plate before you could have dessert. That usually wasn’t hard, because Mom’s food was really good. Except when it wasn’t. Every now and again there would be something that, in my opinion, simply was not meant to be eaten (Brussels sprouts, calf brains in scrambled eggs). Another absolute rule in the house was “if you can’t say something good, don’t say anything at all”. Combine that with, “the plate has to be clean before you get dessert”. Well, one way or the other, no matter the antics I had to go through to hide the gagging, I always got dessert. And seconds of dessert if there was any left over. And any of the remaining left-overs, if I could sneak into the kitchen later and snag them before siblings beat me to it! And Sharon’s father died from not taking care of the sugar diabetes he got from eating too many sweet things. That pretty much never left my mind. Little did I know, pretty much until the year I turned 50, that Diabetes Mellitus does not come only as a result of eating too many sweet foods.
The year I turned 50 a doctor told me I had Type 2 Diabetes. NO! Could not be. And here is why. Through all the years that I just skipped over, obviously, I lived life. I graduated High School, graduated college, married, taught school, quit that and went full time to graduate school, graduated with a Master of Science in Speech Pathology and Audiology, worked as a Speech Pathologist, divorced, re-married, had a child, started my own Private Practice in Speech Pathology, divorced (my parents were married to each other for 63 years. Somehow I missed that step in my life). Along the way I met, and worked with many people with diabetes. For one of my work experiences I did week-end and vacation work in a rehabilitation hospital.
Over and over and over again, I would be working with a patient who had suffered a stroke and they would say “well, I have diabetes, but I never took care of it”. There was a sort of classic picture. A patient would be laboriously moving their wheelchair down the hall with one side of the body paralyzed from a stroke, often one limb amputated, and only partially sighted. The typical story was, “I have diabetes, but I never took care of it.”
I am very well educated. I have a quite solid, high enough I.Q. I am considered by many to be a tad more intelligent than the average bear. But, I could never quite wrap my brain around the notion that a person (actually thousands of persons) could have a deadly, terminal illness that could be controlled by diligence, and never take care of it. For me, that did not compute. I made it through my adult years slim, trim, athletic. I spent many years on horseback, and walked/ran/bicycled as close to 365 days every year as I could possibly manage. Absolutely nothing about my lifestyle, my physique, my food choices fit the classic textbook definitions of people who became Diabetic. I had grandparents, siblings, lots of cousins. Nobody had Diabetes. So when a doctor told me I did, well, obviously he was wrong. At the time my son was a late teen ager and there was a certain amount of “junk food” in the house. Not huge amounts, but enough. The evening I was diagnosed I decided to prove the doctor was wrong.
I ate everything in the house that had sugar and carbs galore. Among them a whole box of ice cream drumsticks, cookies, chips, bread, anything I could find. And I topped it off with a huge glass of orange juice! I remember saying, as I went to bed that night, “well, if I wake up alive in the morning then I am not a Diabetic”!! Unfortunately, I did wake up in the morning. Or let’s say, I woke up again and again and again and again all night, and then one final time in the morning. I had had such violent sweats throughout the night that I had to change my bed clothes twice. I had a thirst so massive I could have drunk an entire lake and not quenched the dry mouth. I was so recently diagnosed that I did not yet have a glucometer. That is probably a good thing because, knowing what I know now, my blood sugar was most certainly so high it may have blown the thing up. Yes, I woke up in the morning, but so desperately sick I wished I had not. So. O K. Maybe the doctor was right.
I made the conscious decision, and promise to myself, that Diabetes was not going to take me out one limb, one organ, one system at a time. Once I ultimately hit the casket, I was going to be there intact, not missing parts! I tend to be a reader, a studier, a person who researches relentlessly rather than just taking things at face value and quietly accepting. By this point in life, the Internet was invented, up and running. Through books from the library, books I purchased, magazines, and my best friend Google, I read everything I could possibly get my hands on about Diabetes and it’s management. I was started on two kinds of pills, made all the necessary changes in what I ate, and upped my activity level, even going through the rigorous training to become a member of the Ski Patrol. I took up fairly extreme mountain biking and long distance bicycle riding, in my 50s and later. I dropped 40 pounds. And my sugars became increasingly difficult to control. Over time, I was put on insulin with the pills, then insulin and another injectable, and pills. I switched doctors to the most esteemed Endocrinologist in New Mexico. He ran tests that showed my pancreas had ultimately shut down and I had become a Type 1 Diabetic. Even after the volumes and volumes I had read, I did not know that was possible, but it most certainly is.
Throughout my life I had become passionate about cooking, baking, creating in the kitchen. At Christmas time I typically baked and decorated 200 dozen Christmas cookies and gave them to friends. I was really exceptional at cakes, pies, and various breads, (carrot bead, banana bread, strawberry bread, just about every fruit/nut/vegetable bread you ever heard of as well as sourdough, whole wheat, rye. You name it). I became quite depressed because a Diabetic simply cannot eat those things, and, If I cannot enjoy them, why bake them? I thought that chapter of my life was over. Then I started studying the art of substitution. I ruined a lot of wonderful treats and meals substituting low carb ingredients for the high carb, and low to no sugar ingredients for the high sugar. Sometimes even following a special Diabetic recipe was a disaster. One day my sister came out from Maryland for a visit. It was my birthday and I commented that I really missed having a birthday cake. I had a huge, exceptionally thick cookbook written by master chefs at a Diabetes Center in Boston whose web cite says it is “The world’s most esteemed diabetes research center, diabetes clinic, and provider of diabetes education.” We found a cake recipe in it that looked delicious and we set about baking it.
Between us we had massive year’s worth of experience in the kitchen, and we followed the recipe exactly. First clue that there was a problem, when we set about mixing the ingredients the batter was so thick one of us has to hold the bowl while the other one, using two hands on the spoon and exhausting effort, stirred it. We thought about throwing it out, but divided it into 2 layer cake pans and baked it. It did not rise, as a self-respecting cake should. After it cooled, it again took two-person powerful effort to get the layers out of the pans. We thumped on it. We took the layers and slammed them HARD on the edge of the kitchen counter top. Eventually, we took them outside and flung them frisbee style as hard as we could off the edge of the mountain ridge I live on top of. They not only did not crumble when they hit, they bounced! My dogs went to investigate, sniffed, tried to take a bite, and ultimately the male lifted his leg and peed on it. We were laughing so hard we could barely stand up. When we got back in the house my sister looked at the cover of the “esteemed” cookbook and said she saw the problem. “Look at all the degree-letters after the author’s names. They have spent their entire lives in school learning how to be master chefs and have never taken the time to get into the kitchen and learn how to cook.” Well said,Sis. Eventually, in one of my house cleaning episodes, I put that book in the bag of items for Goodwill.
I had much better results just taking my old tried and true recipes and making substitutions. My goal was to make baked goods that were low in fat, low in salt, low in carbs, and low in sugars— and still tasted worth a darn, or much better. That’s hard to do. I learned that any cake-type bread, cake, muffin, that calls for a fat or oil can be made just as well with a substitution of unsweetened applesauce. And I made my own applesauce, which ensured it really was unsweetened. Low salt had to be REALLY experimented with. The typical American is so accustomed to salt in everything that reducing it can quickly make a person feel deprived of flavor, but I figured that one out. No sugar was a big problem. Some of the artificial sweeteners say on the package that they are not good for baking. High temperature changes things and the taste deteriorates. Some brands say they are fine for baking, but there still would be a slight after-taste in the mouth that screamed “artificial sweetener”. I finally found stevia to be the best.
Even better is using 3/4 the requested amount of sweetener as stevia and the remaining 1/4 as a mildly tasting honey. I am going to start making some concrete suggestions, so, I guess,here it is time for a disclaimer. I am NOT a Diabetes Educator. I am NOT a Dietician. I am a Speech Pathologist who loves to cook and bake, who has adjusted that love successfully to accommodate for Diabetes.
O K. Disclaimer stated. I calculate the calories and grams of carbohydrates in everything I prepare, write it down, and then understand the calories and grams of carbohydrate in what I eat. Starting out, I had no clue how to do that, but I quickly figured it out. I have three “Bibles”. They are so worn and tired they are held together with tape, staples, paperclips, whatever. One of them, I believe, may be out of print. The first is titled Nutritive Value of Foods. It is published by the United States Department of Agriculture. I have replaced it a couple of times over the years and it is extremely inexpensive. The second is The Carbohydrate Addict’s Gram Counter written by Dr. Richard F. Heller and Dr. Rachael F. Heller. This is the one I think may be out of print. Mine is desperately tattered and I have not been able to find it again to replace my old one. The third one is The Calorie King Calorie Fat and Carbohydrate Counter copyrighted by Allan Borushek. I have the 2012 edition, and am awaiting the arrival of the most recent edition.
And then, of course there is my good friend Google. If I cannot find something in my three books, I Google it. When I am cooking/baking something, I write down and look up every single ingredient. I write the calories in the amount I am using, and the grams of carbohydrate in the amount I am using. Once I am finished, I total each column (cals, and carbs.) and divide by the quantity I made (18 muffins, 20 cups of stew—-whatever). This is not scientific. It is not proven in a test kitchen. It has not been subjected to double blind studies of the blood-sugar impact in Diabetics and non-Diabetics. It’s how a Speech Pathologist experienced in the kitchen figures out how to keep track of things. It appears to be quite reliable. when I eat a certain item, I take the amount of insulin my calculations dictate, and at least 99% of the time, I am right. When I am not right I am not very far off. Don’t know about you, but that’s good enough for me. I have been asked why I focus on carbohydrates and not sugars. When I read the nutrition label on a box of anything, I don’t even read the sugar content. The sugars are incorporated in and a part of the carbohydrate content. Also, when carbohydrates are eaten they metabolize into sugar in the body. The three books I mentioned don’t even report sugars. They are included in the carbs.
My one real serious difficulty comes when I eat out. My life is such that I very, very rarely do eat out. If I happen to do so, and eat at a “chain” the Calorie King book does a great job of covering “chain” restaurant foods. Trouble is, I don’t carry the book around in my purse. I have one very dear friend who enjoys spoiling me a few times a year and she takes me to off-the-beaten-path, non chain restaurants. The foods are out-of-this-world delicious, and I typically under guess the grams of carbs and get in trouble. Often, I can come out a winner anyway. I can very discreetly test my blood sugar in my lap under the edge of the table and just as discreetly inject a a dose of insulin if necessary. I have been at this disease for 20 years, so I have gotten fairly good at guestimating both carbs and insulin when I am eating foods not prepared by me. One thing I NEVER do is just eat whatever without consideration for the disease. I am shocked at how many people do. They are the ones who have become statistics. I still don’t intend to take that path if my diligence can avoid it.
Enjoy the site and recipes I hope you find them useful!
– Miss Kate