Ilene Raymond Rush - Diabetes My Way

Ilene Raymond Rush's diabetes journey started with a diagnosis of gestational diabetes 25 years ago, while pregnant with her first son. For seven years, she avoided a diagnosis of type 2 diabetes with daily six-mile runs, but with her second pregnancy the gestational diabetes returned. In 1987, she was diagnosed with type 2 diabetes, and started on a regimen of drugs, diet and exercise. Read full bio

Who’s in Charge?

Ilene Raymond Rush | March 08, 2013

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This morning  I was standing in line at the drug store to get my diabetes drugs when I felt that familiar sudden dip in my stomach and throat. Color drained from my face and my fingers started to tremble and I realized with a thump that my sugar was dropping. Again. 

Outside the store it was lightly snowing; inside I worried that I might collapse on the floor. I fished in my handbag for my glucose tabs and quick, before I actually did hit the linoleum, found the tablets and swallowed them, willing that the three would boost my sugars high enough to allow me  to drive into the city for a doctor’s appointment. In the line, I closed my eyes until the sugar did its magic and I was suddenly aware of how angry I was. Mad at diabetes, mad at my low, mad at everybody and everything. Focus, I told myself. Think of how many times you’ve been through this in the past and how many times you’ve solved this problem. Shrug it off. But this morning, for some reason, I couldn’t. I was tired — tired of taking medicine, tired of watching what I ate, tired of being held hostage to my metabolism.

Which is ironic, since I spent the morning counseling a friend who has just developed acid reflux in her throat. Fed up with her newly limited diet, she told me how her new therapist told her she has to ‘take control’ of the illness, and not let it overrun her. That’s right, I told her, that’s exactly what I’ve done with my diabetes. I’ve traversed all the stages of grief and come out on top — diabetes isn’t the boss of me.

But at this moment, when I’ve moved from the drug store line to the driver’s seat of my car,  wondering if it’s safe  yet for me to drive downtown, it’s all I can do to try to control my annoyance at my body for having betrayed me yet again.

I wonder who really is in charge.

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The Truth About Needles

Ilene Raymond Rush | February 05, 2013

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I’m thinking about needles.

About how, if you asked me twenty-seven years ago to stick a needle into my finger, two, three or four times a day, I would have found you mad. How the first time the doctor showed me how to pinprick my finger when I was found to have gestational diabetes, I shied away, nervous and afraid. How, when I first was told I needed insulin to forestall my gestational diabetes, I exercised like a crazy person – two, three, four hours a day – any amount not to not have to stick a needle into my skin. How with the second pregnancy I put aside that fear, and learned to give myself insulin. How, for the past three or four years I’ve been injecting myself with Byetta twice a day and how I didn’t even flinch when the nurse brought out another slightly longer needle for a new drug, Byreudeon.

“I know needles,” I tell her.

I remember drawing blood from my dying father’s hands, a long process given the many callouses that had formed on the tips of his working man’s fingers, pricking him again and again to reap the tiniest drop of blood to measure his glucose readings. I remember tapping the vials of insulin to remove the bubbles, swabbing his stomach with an alcohol wipe, and injecting him. I remember thinking how as a little girl, such a moment would have been unimaginable, me the squeamish one, wary at the sight of blood, shielding my eyes from the slightest bit of movie gore.

“Most people don’t feel that way,” the nurse tells me, as she hands me the needle for the new drug. “Most people try not to take the drug, just to avoid the needle.”

I remember how a friend, who has watched me inject myself, asked for my help in injecting a drug she needed, how she asked me to come over to her house to watch her put the needle in her thigh. We joked about how we were both now ‘shooting up’ but the truth is, the idea that I can withstand a needle without fainting or whining or complaining makes me kind of high. It’s not something everyone has to do, of course, or something everyone (or anyone) wants to do. But it’s something that I – the one-time scaredy- cat, the one who blanched at blood – have learned to handle. It’s a skill I have, a badge I’ve earned. I can take a piece of hard sharpened steel and stick it into my skin.

In the small room with the nurse, I practice mixing up the new drug, and then shove the needle into a hard orange pillow for practice.

“You’re so optimistic about your diabetes,” the nurse smiles. “I wish I had more patients like you.”

Here’s the thing about needles. I fucking hate needles. But I know I have a choice. Either I refuse the needle, refuse the sticks, refuse the tests and let diabetes win. Or I make the hard bargain to inject myself, keep my sugars low and manage my A1C’s. It’s a bargain I make every day before I stick the needles in. I won’t let the needles win. 

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New Stuff

Ilene Raymond Rush | February 04, 2013

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One of the great pleasures of my diabetes life is playing with new gadgets and getting to try out novel and more effective medications. I know that might not excite everyone, but since today is a double hitter — a new medication plus the first time using a new meter — I really do feel as though it’s a bit like a type 2 Christmas celebration around my house.

First, the drug. A once-a-week injection of Byreudeon is going to replace my twice daily injections of Byetta. If it works as well as Byetta, I’ll be a lifer. While I was initially put off by having to mix my own drug compound and the warning labels stamped on all the introductory  materials about Byreudeon possibly causing thyroid cancer, I met with my endo’s nurse a few weeks back and was reassured that the mixing wasn’t that difficult (it really wasn’t, only time consuming) and that the warnings were  prompted by occurrences in mice and not humans. While that might have not convinced everyone — and I am still a bit nervous — the idea of only having to inject the medicine once a week was too appealing to pass up. And though the warnings also mention nausea, which I suffered mightily upon first taking Byetta, so far, so good: I got to play chemistry set and am feeling no pain.

The other new toy is a One Touch Mini, which makes my old tester look like a Model A. The device is tiny and fast and seems to give good readings — or at least readings that match up with my old meter, which I had nicknamed Old Reliable. Opening up all the new packaging and setting up dates and times made me feel as though once again, I’m restating my vows to keep up with good diabetes care.

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A New Way to Shop

Ilene Raymond Rush | December 19, 2012

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Shopping for delicious food that doesn’t get in the way of good sugar readings is always a challenge for me. In some ways, the more the variety,  the more temptations. For example, it’s easy to be walking around in a market (I’m looking at  you, Trader Joe’s) and to quickly realize that so-called health food stores aren’t always quite so healthy. Sure, they offer whole grain breads and flax seed, fresh fruit and Greek yogurt. But, perched right next to the “good for you” snacks lurk chocolate covered dried cherries, frozen mousse cakes, and Triple Gingersnap Lemon Ice Cream (agh!) that despite my spartan grocery list, often accompany me out the door.

When I point out this inconsistency to the cashiers, they nod, only a bit sheepish and not at all surprised.  They’re willing to  admit that’s how the chain makes money — good food next to your basic crap masquerading as healthy treats.

Which brings me to the latest entry in our  Elkins Park neighborhood — the Creekside Co-op. At coffee with Jess and Mike a week ago in Philadelphia, I mentioned the Co-op, which was four years in the planning and currently involves over 400 families in our small suburban community. Jess was immediately intrigued. The idea of having a store where you get to control the content is intriguing, and enpowering. And true to the founding vision, a recent visit shows that indeed the community has spoken — the store is filled with local fruits and vegetables, organic meats and fish, deli, fresh breads, and surprisingly little junk. The sight of such freshness is inspiring and lends me to believe that I might be able to make it home from shopping without so much buyer’s remorse.

To be honest, the prices at the Co-op aren’t cheap. But the idea of a market where you get to be the boss, complete with tasting nights where shareholders can decide which new products will be granted shelf space, is a bit intoxicating. So much so that I may be closing my eyes to the few cents more here and there and replacing some of my frequent Trader Joe runs with trips to the Co-op.

What are we paying for when we pay for food, anyway?

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A Momentary Truce

Ilene Raymond Rush | December 07, 2012

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As I left the endocrinologist’s office today with an A1c reading of 5.6, I had an odd thought: I am at peace with my diabetes. It’s odd because in many ways and on many fronts, I’ve spent the past twenty or so years in thrall to, in awe of, and in fear about my diabetes, worrying about everything I ate, obsessing over exercise routines, and dreading the readings on my glucose meter. But today, after a talk with  my endocrinologist about reducing my meds, and the news that my twice daily Byetta sticks can be reduced to once a week  by using a newly formulated long-lasting drug, I felt at peace. And while diabetes continues to be no fun, I’ve come to terms with it, and am  truly doing all I can do to  deal with it.

It’s a funny feeling, because I’m the sort of person who does not often feel this way — not about work, not about relationships, not about family and friends. I’m much more  often to be found full of angst, worried about an assignment or concerned that someone is nursing a slight against me. Of all the areas in my life that I felt I could possibly gain control, diabetes was not my first thought.

But miraculously, that is what happened. I’ve figured out a decent diet that includes carbohydrates, whittled down an exercise program that keeps my sugar in fighting range, and avoided the stress that has, in the past, sent my sugars soaring. And save for an occasional low now and then, I’ve actually balanced that part of my life.

The revelation may be momentary, and the balance — knowing how fickle the body can be — may not last. But I wanted to document that on December 7th of 2012, I feel pretty good about my diabetes. It’s not going away. It’s not solved. But it’s become manageable, and I’m managing it and for that I’m giving myself a pat on the back and saying, Good job.

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Eating Up A Storm

Ilene Raymond Rush | November 07, 2012

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A small post in the Science section of the New  York Times caught my eye this week: it concerned the comfort food that readers turned to during last week’s Hurricane Sandy. Caught in the middle of the storm — which downed innumerable trees, robbed us of power and internet connections for five days and kept both my sons from getting back to their perches in Brooklyn and Middletown, Connecticut after their attendance at an Eagles game — it amazed me that really, when it comes right down to it, when you don’t have lights or heat, your thoughts really do turn to food. Intensely. Readers of the Times talked about pumpkin soups and outstanding chocolate chip cookies. We mainly stuck to the many foodstuffs that were rapidly defrosting in our frig — from the excellent Trader Joe’s Pumpkin Ice Cream to the turkey meatballs I whipped up one night to serve with big plates of whole wheat pasta. We made yummy breakfasts out of once frozen bagels and a carton of hardboiled eggs, lunched on all of the cheeses that were about to spoil, and dined on said meatballs, plus vegetarian chili, pot roast and a duck breast that I’d been saving for months.

And what about diabetes? Well, another thought about the hurricane: it isn’t the best time to have a chronic disease. I tried hard to avoid the Halloween candy — which I had bought before the storm hit — but the need for an uncomfortably full feeling trumped my will power. We tried to exercise once the worst of the winds were over by taking walks around the neighborhood to inspect the damage and downed wires, but it wasn’t equal to my usual one hour biking a day. During daylight hours, we voyaged to a local coffee shop, where I tried to limit my order to salad. But to be honest, I’d have to say that when the power came back is when my bad diet habits also came to an end. But here’s the kicker — a Nor’easter is currently pounding the East Coast and my thoughts are once again turning to…you guessed it, food.

 

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A little Italian magic…

Ilene Raymond Rush | October 11, 2012

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Last week, I spent a magical week with Natalie Goldberg, author of (among other books) Writing Down the Bones, at Villa Lina in Italy, an 84 acre estate filled with fig trees, olive groves, vineyards, and hazelnut trees. Each morning, participants gathered in the Zendo — a large white room filled with colorful mats and rugs — around a bouquet of seasonal flowers and meditated for a half hour with Wendy Johnson, author of Gardening at the Dragon’s Gate. After meditation, we gathered for breakfast, followed by a class with Natalie on writing practice, a method of writing that involved following the path of your mind as you responded to various ‘prompts’, such as “I remember…” or “I don’t remember” or “Jello.” In the afternoons, we broke into small groups to respond to these prompts for ten minutes at a time, then read our writing to our groups, who sat in silence, listening to what we wrote.

I had come to the retreat with my natural skepticism intact; I had never meditated before and didn’t quite understand how writing practice worked. As a long time freelancer, the idea of finding a new way of writing seemed doubtful at best; I wasn’t in search of a guru. But whether it was the sheer beauty of the several houses located on the Villa Lina property, or the peacocks seated on the roofs, or the stone fountains bubbling throughout the property or the three swimming pools, or the refreshing sound of silence from ten at night to ten in the morning when we were not supposed to talk, the retreat worked it’s magic on me, and I came back more relaxed than I have been in years. Eating an all organic almost all vegetarian diet and walking through the tall linden trees and umbrella pines didn’t hurt either — I dropped those pesky five pounds that I’ve been fighting for years and my sugars stabilized without worrying about the occasional hazelnut cookie or slice of liqueur soaked cake. All in all a once in a lifetime experience, for which I am profoundly grateful. A week with my own thoughts, good company, and good sugars — what more could I want?

 

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Low-Glycemic = Weight Loss?

Ilene Raymond Rush | September 10, 2012

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It’s something that people with type 2 diabetes have known for years – a diet for diabetes can actually be a healthy diet for everyone. And this morning brings additional proof with a National Public Radio report on a small study that notes that the best way to lose weight may turn out to be a low glycemic diet.

The study, published by the Journal of the American Medical Association, compared calories found in low-carb, low-fat, and low glycemic diets. It found that low carb diets cut the most calories and low fat the fewest.  But low glycemic diets burned more calories than low fat diets and were easier for subjects to stick with than low-carb diets.

Why? Because low-glycemic foods are slow to digest, they tend to burn more calories than a diet of highly processed, highly refined foods. Since low glycemic foods take longer to digest, they also tend to fill you up longer — without the spikes and subsequent drops in blood sugar you get from more quickly digested sugary foods.

Although this is a new finding, I’ll bet this research news won’t surprise most type 2’s. I think eating a low glycemic diet is something many people with type 2’s may have intuitively discovered a while back – that moderate consumption of non-processed foods, including beans, nuts, grains and fruits and vegetables have a great effect not only on blood sugar but also on the waistline.

What shocks me is how long some of the principles that we type 2’s have long accepted take to sift down into popular culture: it seems that the importance of the glycemic index to weight loss was being talked up by my nutritionist at least eight years ago, if not before.

It’s nice to see that science is catching up with common sense, and healthy eating.

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Foiled again

Ilene Raymond Rush | August 25, 2012

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As someone who has controlled her blood sugars with diet and medications for over twenty years, type 2 diabetes remains a mystery to me.

Although there are times when I know my sugars will be high (say after this summer’s total pig-out on rocky road fudge), and times when I know they will go low (too much exercise, too little fuel), there remain puzzles that I can’t solve. Case in point is my recent A1c reading of 5.8 following a summer when I consciously broke every no- and low-carb  rule that I had followed for eons. While I’m happy for the results, I don’t have a clue on why the A1C reading was so low.

My escape from very low carb eating was prompted by total boredom. I’d eliminated fruit, bread and pasta from my diet, and one day early this summer I stared at a peach with such longing that I began to question why I was denying myself such a  treat. I’d had good sugars for months and months, and when I gave into temptation and took a bite, my sugars remained reasonable. After that, I rediscovered blueberries, watermelon and oranges. Rye bread and wheat pasta were not far behind. I didn’t go crazy (except for that one fudge day) and measured my portions. And while I expected to feel sluggish and  my sugars to rise, neither occurred. If anything, I had more energy, felt more awake during the day and more satisfied with my food intake. The most prominent emotion — if anything — was guilt at breaking with my low-carb regimen. But even that vanished in the bounty of my newly balanced diet.

So what’s the take away here? I really don’t know. I can’t recommend this for anyone else because I still haven’t figured out why my body isn’t responding differently to my change in diet. My exercise remained the same throughout — two or three exercise classes a week and hour bike rides on the other days. My meds — Byetta, Amryl and Glucophage — have also remained unchanged. Has my body taken a temporary vacation? Has it learned to counter carbs? Am I under some witches’ spell?Has this happened to anyone else??

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Mixing it Up

Ilene Raymond Rush | July 15, 2012

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An article in last month’s The Atlantic covered on line apps that help people to lose weight, exercise, manage their blood sugars, blood pressures, etc. I’m betting that this won’t be too much news for many of the readers out there who track their blood sugars on apps. I’ve been tracking mine for awhile now, and recently started using the LiveStrong app to track calories. I find it keeps me a little more honest when I have to write down what I eat.

But what has really impressed me has been how the LiveStrong app has changed my exercise habits. I’m a regular exerciser who logs an hour a day on the stationary bike five times a week and an hour at a killer weight workout class twice a week. I’ve promised myself that I was going to try to vary this routine at some point, but it wasn’t until I used the app that I had a breakthrough. The ability to actually see that every exercise calorie spent meant extra calories to consume during the day was extremely motivating. So much so that in addition to my usual routine, last week I managed to finally make it to a yoga class, a stretch class, and swim two sets of 20 laps at an outdoor pool.

Would I have managed this extra exercise without the trusty app? Perhaps. But in a year, I hadn’t come close to my goal of mixing up my workouts. That little visual boost pushed me to do just a little bit more.

Sure, it’s a little creepy being thinking that my behavior is being controlled by my i-Phone, but hey, whatever works, right?

 

 

 

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