No Help at the Hospital

A Welcome From Dor

Dor photo by David Crow

Just about everyone we see at Suppers has — to a greater or lesser degree – “eaten their way” into the problems that motivate them to come to our program.  

The exceptions are our friends with Type I Diabetes. I had a special place in my heart for diabetics long before my son was diagnosed four years ago, in large part because of my relationship with Karen, who has been facilitating Suppers meetings almost as long as I have.

The learning curve for dealing with this disease is practically perpendicular because the consequences are so bad if you don’t take care of business. What surprised me most was how uninformed health care professionals are about what it’s like to live inside a body with diabetes and how the folks who do so need to be accommodated. We aren’t just cooking with our diabetic friends. With the help of our Board member Dr. Adi Benito and facilitator Fiona Capstick, we’re now training facilitators to use glucose monitors and to expand the availability of Suppers for people who feel lost in this diagnosis.

For our friend Lydia, there wasn’t any help where she worked, and she was working at  a hospital.


Lydia’s Story: No Help at the Hospital

I am a registered nurse and have enjoyed working in medicine for over 20 years. At the age of 50, I developed Type I Diabetes, and entered a world I was completely unprepared for in spite of all my experience in health care.

The people at work all know I have diabetes but they are clueless as to what that means in practical or personal terms.

I haven’t hidden the diagnosis, but I do conceal many of the details of what I have to put up with. There is no help at the hospital for people who have to maintain high standards of professionalism while living with a chronic disease.

Here’s an example of my predicament. I have been in the habit of letting my numbers run a little high because if I go at all low in the O.R., it’s a big problem. My brain gets fuzzy. There are lots of times when a nurse can’t drop what she’s doing to fiddle with pumps or take a sugar pill.

So the short-term needs of my profession conflict with my long-term need to keep the numbers as low as possible without going so low that I lose my ability to concentrate.

For the uninitiated, it may be hard to understand why it’s so tricky managing blood-sugar levels. There are so many different variables confounding the decision of how much insulin to take.

  • Eating carbs raises the dose, so now I have a PhD in the carb content of every mouthful of food.
  • Exercise – even walking – lowers the dose.
  • The volume of the food on my plate raises the need for insulin even if the carb content is low. I didn’t know about that before. It explains some past experiences I had after eating large but low-carb meals and ending up with high blood sugar since I did not take enough insulin to deal with the issue of volume.
  • Stimulants, like the caffeine in coffee, spike my sugars too, even if I have no carbs.
  • And too much stress messes everything up and makes it hard to know what to do, especially since my first reaction to stress is to look for chocolate. In general, stress also raises my need for insulin. 

I wouldn’t wish Type I Diabetes on anyone (although there are a few people at the hospital who I wish could have it for just one day). Even when I follow the directions, my blood sugar numbers are all over the place. So hearing others with Type I Diabetes talk at the Suppers table about how they resolve their issues prompts me to try new approaches. For one thing, we are all becoming skeptical of the party line that says go ahead and eat 45 carbs at a meal and cover it with insulin. The one person at our meeting who got her A1C (a three-month measure of blood sugar regulation) below the cut-off for diabetes doesn’t eat that many carbs in a whole day! The new pumps and monitors make it easier to track the consequences of my behavior. It’s fascinating to eat a low-carb meal at the Suppers table and watch the graph line on the continuous blood glucose monitor stay flat as we enjoy our blended asparagus, fresh garden salad, and grilled salmon. 


Lovely Quiche For Lydia, By Allie

But first, let me tell you about Insulin 

48465d_e59e795f6cb742439f1316e9dd4a1081The Insulin/Blood Sugar thing is one of those biological mathematical equations that – despite logic and a doctor’s best “I-think-I-definitely-understand-your-body” face – doesn’t always add up. I used to think it was pretty straightforward, after all it seems like it would be amazingly straightforward:

X carbohydrates + Y units of insulin = Z (Normal Blood Sugar)

Carbohydrates are molecules that break down into glucose molecules. Each glucose molecule contains 32 units of ATP, adenosine triphosphate, or cellular energy. (By the way I TOTALLY spelled “adenosine triphosphate” correctly BEFORE looking it up on Wikipedia for spellcheck. No one saw me do it so I’m telling you guys so you can be proud of me.)

Insulin is a hormone, a protein, produced in normal circumstances by the pancreas. It is excreted when glucose is found in the bloodstream, either through eating food or through the release of glucose storage centers (the liver, our muscles, and in extreme cases, fat) when the body is under some form of stress (like exercise, being chased by a clown, taking a test, or starvation.)

Insulin’s singular and incredibly important job is to shuffle individual molecules of glucose into our cells so that our cells can eat. (Cells gotta eat too, guys.) Insulin is specifically equipped to do this job because it contains (is shaped in) the form of the very “key” which fits into the cell’s “lock” (like a neurotransmitter).

In the case of Type I Diabetes, the pancreas stops producing Insulin and the body absolutely must get Insulin from outside sources or else all cells will starve.
In the case of Type II Diabetes, many cells have developed a resistance to Insulin and are no longer allowing their doors to open – in fact, that “lock” has often become warped on the outside of many cells and Insulin’s “key” doesn’t fit. In this case the cells are also starving so even if a typical Type II patient is overweight – their cells are in fact malnourished. 


 

It seems as though that’s a pretty straightforward explanation of a seemingly complicated biological reaction. Well, let me re-complicate that for you: the math doesn’t work exactly like that for everyone. There are a few reasons:
Food doesn’t just contain carbohydrates. Fat, fiber, protein – these things slow down the breaking apart of foods on a molecular level and therefore slow down the release of glucose.
We have different metabolisms! Some of our metabolisms are naturally zooming fast (and those metabolisms belong to people who I am more jealous of than happy for) and some are slower (like mine, which reminds me, I need to work out more).
Our lives are different, too. For Lydia, who is often in a high-stress environment, her cellular needs and blood sugar levels are guided more by her Adrenal System (hormones) than they are by the foods she eats and the exercise she completes.

Like Lydia said, she had to really, really learn her body, ever-changing through the days and nights in terms of what it needed. She had to learn her trends, learn her tricks, and most importantly learn something that everyone learns through attending Suppers – that she is not alone in her plight at Suppers even if she feels alone in her medical community. 

Join Suppers, learn your experiments, perform those experiments, and emotionally prepare yourself to be constantly amazed by your body. It’s the only one like it in the whole world, even if you are an identical twin.


So, but, like, what’s most likely to hold me over for awhile?

Well, probably protein rich food but in what form? Only you can know that. Eggs, meat, vegetarian protein – I don’t know what will work for you! But eggs are a good one to try out. So why don’t we try something easy to prepare and, obviously, delightfully scrumptious? Like quiche. 

I LOVE QUICHE. It’s fabulous, it’s classy, and Julia Child likes it and I love Julia Child. Look at her pegboard. Look. At her pegboard. 

Julia-Childs-Pegboard

Omigod. I love her so much. Photo credit goes to these folks. I want Ned to make me a pegboard for our new kitchen and first he was like “pegboards look stupid in kitchens” and I was like “uh, no they don’t, have you ever even heard of Julia Child?” and then showed him that exact photo and he was like “fine.” Me = winning (again). Let’s do this.

Step One: Forget everything you know about making a Julia Child quiche crust. We don’t want gluten or butter making a debut in this experiment dish when we’re trying to test rice and eggs.

Cook brown rice in a rice cooker until it’s done. On the side, prepare a mixture of:
1 small minced onion
1 egg or 1 flax egg (1 T. ground flax + 2 T water + stirring)
2 Tablespoons freshly grated parmesan cheese (or skip the cheese if you want)
sea salt, lemon juice, and olive oil.
Mix them all together with the rice and press into a deep dish pie pan. Bake in the oven for awhile so the quiche filling doesn’t fall through the crust.

Step Two: Prepare vegetables of your choice to go into your quiche. Today we are using roasted red pepper, garlic, and spinach. Another great combination is kale, portobello, onion. Get creative – what veggies do you like?

The trick is to try to get as much moisture out of the vegetables as possible before mixing them with eggs. 

Step Three: Whip eggs together and, honey, I mean WHIP those eggs. If you’re making a good amount of quiche, use a blender to mix eggs. Dor has a great, great tip for adding some good fat, silky texture, and wonderful flavor to dishes like these – mix eggs and canned coconut milk in a blender on low speed until very well mixed. 

Today we will be using eggs by themselves. (I used 7)


When done, fold in veggies and pour over prepared crust. If it doesn’t look like this and the egg mixture sort of gets sucked up by the rice, you didn’t bake the crust long enough and will definitely remember for next time.

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Step Four: Bake, remove, cool, slice, enjoy!


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Brown Rice Crusted Vegetable Quiche

For the crust:
1 cup brown rice
1 small onion or 1 small bunch scallions
1 egg or 1 flax egg (1 Tablespoon ground flax + 2 Tablespoons water)
2 Tablespoons parmesan cheese (*optional)
sea salt
2 teaspoons lemon juice
1 Tablespoon olive oil

For the filling:
1/2 Tablespoon coconut oil
2 cups spinach
2 Tablespoons roasted red pepper, minced
1 large clove garlic, minced
sea salt and black pepper
6-8 eggs

1. Grease a deep dish pie plate and preheat oven to 375.
2. Prepare rice in a rice cooker and set aside to cool slightly. Meanwhile, stir together egg or flax egg, parmesan cheese, sea salt, lemon juice, and olive oil. While rice is still warm, stir egg mixture into rice being careful not to cook the egg. Press into a greased pie dish and place in oven. Bake 15-20 minutes at 375 or until firm.
3. In a skillet over medium heat, melt coconut oil. Add spinach, red pepper, and minced garlic. Cook until spinach has wilted and remove.
4. Blend eggs together in a blender or using a whisk in a large bowl. Fold in spinach mixture and pour filling over crust. Don’t worry if filling comes up over quiche crust (or if you want the crust to be over the egg, make sure to press crust up higher on pan)
5. Bake at 350 for 25 minutes or until egg mixture does not jiggle when pan is gently shaken.

As always head to the Suppers Recipe Index to find the recipes that YOU want to experiment with! Today it’s all about you – and, when it comes to food, that’s every day!

One thought on “No Help at the Hospital

  1. As always a wonderful blog post.. this time on my favorite subject… living with diabetes.. and in my case type 1 diabetes for the past 20 years (but whose counting!). I’m thrilled that you highlighted that the math rarely adds up so simply of figuring the grams of carbs to insulin ratio for managing blood sugar at any one point in time. There are so many factors that also influence how your food breaks down in your stomach as well as your stress and other hormones which easily increase insulin resistance and all by themselves can raise your blood sugar. And yes there is exercise, type of exercise, hydration, sleep, and medications to name a few of the other variables involved… no it is not a simple formula!

    If you are living with diabetes of any kind, I invite you to join me at my monthly Suppers for Diabetes Success dinner meeting at my home on the first Tuesday of the month. There is also a monthly lunch meeting at Dor’s home on the 4th Wednesday of the month. And with a recent facilitator training specifically for hosting blood sugar-based meetings… there are several new meetings starting up where you can find support and learn to prepare healthy foods to keep you satisfied.

    Like

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