Unrestricted Diet

Unrestricted = unlimited, free of restrictions

Diet = what I eat


I've typed "unrestricted diet" more times than I care to remember, as in "He is eating a totally unrestricted diet, I'm afraid!" (What the doctor says about patients who aren't listening to his warnings!) And up until about a month ago, that would have described me, too!

After all these years of typing medical reports, I know the good blood sugar numbers and the bad, what the HDL and LDL cholesterol should be, hundreds of meds and dosages. I know the serious symptoms and the ones the doctors call "of no concern."

Tuesday, February 15 -- I went to my doctor's office to get blood drawn for routine tests.
Thursday, February 17 -- I went in for a little checkup, years and years overdue, glad to know that all the blood work results would be waiting for us to discuss.

After a comfortable chat with the nurse who checked my blood pressure (perfect numbers) and took a little history, I sat on the cold table in my flimsy paper robe and even flimsier paper sheet with my legs dangling over the edge like a preschooler.

In bustled my no-nonsense doctor (whom I like very much) with a few pages in her hand. "Well," she said, "I have all your lab tests here with me. Let's take a look. Hmmm... your cholesterol numbers are great, thyroid function is normal, renal function is right where we want it... In fact, your numbers look pretty good, except for one thing. It looks like you have diabetes!" Wait! Numbers! I want exact numbers! But as soon as I heard what they were, I knew I had to get very serious about this. "Your blood sugar was 308. You were fasting that day, right?" Yes, I had been. "Your A1c is like an average of your blood sugars over the last 3 months, and that is quite high at 10.4." Wow! (I knew the doctors I type for want that to be below 6 if at all possible.) This was not borderline anything. This was full-blown diabetes.

Finally, an explanation for how terribly fatigued I had been feeling, the REAL reason (not snoring!) why I had been waking up with a very dry mouth. This also explained my recent tendency toward yeast infections and the little spots on my skin that responded to antifungal cream...

I left the office clutching a glucometer and chem strips, a sheaf of papers with info about diabetes, and a prescription for metformin. And a return appointment for the end of April. I asked about trying diet and exercise first before starting a medication, but my doc said she wanted me to take the med, and then later if I don't need it any more, I can stop it... "Our goal," she told me, "is to have fasting blood sugars in the morning of less than 120, and 2 hours after a meal they should be below 140." And she told me to check my blood sugars fasting in the morning and 2 hours after both lunch and supper.

On the way home, I decided to give myself one week. No metformin for a week. One week of a total change. No more unrestricted diet. Check blood sugars, keep a log of them, and see what a week could do.

I went into the kitchen and was afraid to eat anything! But slowly I was able to get my feet on the ground, and my one-week test began. I started checking blood sugars that Sunday. The first one, taken fasting first thing in the morning, was 260. 140 points above the goal. (Blah! I'm not sure what I had been hoping for.) One week went by, and on the last day, my 3 blood sugars were 144, 147, and 140. That last one was at the doctor's goal! Woo hoo! So my one week test was over, and I decided NOT to fill the metformin prescription.

Now it is the end of the 5th week. I have been brutal with my "unrestricted diet." It is gone. I have been walking briskly several days a week as a start in the exercise department. I am almost 10 pounds lighter.

Today my blood sugars were 118 and 113 and 117 -- without any medication! The doc would consider this success. But I am harder to please!





And there are definitely some things I would like to avoid!





(Next post: I will tell more about my current "restricted diet" and the other helpful things I have been doing.)


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Zzzzzzzz...

I'm planning now what to do in my spare moments for the next 2 weeks...

So if you call and I don't answer...
If you email and get no response...

That's right! I'll be at my desk...and I just might be snoozing!

In June, Barry and I spent 2 weeks away from home. First, we spent a week in New Jersey where we helped to provide special music for our church's annual convention, and then we drove up to Toronto, Canada, to visit my mother and sister and her family. (We had a great time, by the way!)

I wanted to work while I was gone, but as the time got closer, reality set in, and I knew I wouldn't be able to do it all. So... I kept up with the dictation from the internal med doctor who is my client close to home, and I took 2 weeks off from the work I do as an independent contractor for a transcription company in Missouri.

Other transcriptionists covered my work while I was gone, and now it is time for me to return the favor! So I have promised to put my fingers into overdrive and take my turn. (Thank goodness I don't have to type on a clunker like this!)

I'm in for a difficult and busy 2 weeks, but I'm thankful for my job, a job I really love (well, MOST of the time!)

Catch up time!

It's hard to believe that it is over a month now since I went to visit Carol-Ann and her family and my mother. I was in Canada for the last week of March, and it went by so quickly. I don't know why time has to act like that... skipping along when we are having fun, dragging its feet when we're not! It's high time I gave a little report!

Carol-Ann fixed up my bed in her large office area in the basement. This was perfect, as I took my laptop with me, and so down there I could keep up with my medical transcription whenever I wanted to. We settled into a homey routine, and most days I worked in the mornings. Then Bruce came home from work at noon time and shuttled me over to Mum's where I enjoyed the best lunches with her and her friend, Ruth. Then up to Mum's room where we would talk and laugh and catch up. One day I was so tired, I just curled up in her bed and took a nap. When I woke up, she was a bit disappointed that I had not gotten the full two hours of sleep she had hoped I would get! That's my Mum!

At supper time, Bruce would come and pick the two of us up to go back to their house for supper and the evening. I got to watch some of Kinza's favorite shows, which I thoroughly enjoyed, and I just had the best time sharing in their everyday life. I even got to help with homework!!

Here's a picture I took on the day I was leaving. Mum was sitting in the big chair in her room.

My Mum

March 31, 2009
She will be 92 in July.

I showed her this picture on my little camera display, and she exclaimed,
"Oh, there's Daddy's picture in the background!"
And so it is.

Another Update...

Elmo giving Coral a good morning hug
(He sleeps all night in Coral's wheelchair parked by her bed)

Tonight I have been catching up on blogland happenings that I have been missing out on for a couple of weeks now, and how encouraging it has been for me! Thank you to all of you!

This is just to update you on us, and I'm glad to report that we may actually have turned the corner. For the last 2 weeks, I have kept Coral home because she was having so much discomfort in sitting. She would lean this way and that in her chair trying to get comfortable, and it was much better for her to lie in bed longer each morning than to sit in her wheelchair for such long hours every day.

Yesterday was the Christmas party for her day program, so I called up the transportation lady and asked to have a pickup for Coral, and off she went, all bundled up against the 14-degree weather. When she balked, I promised that it was only for one day, and then she would be staying home again until after Christmas. She came home happy and animated with a note that said that there had been no problems.

At bedtime, she told me her foot (her weight-bearing foot) was hurting, and it looked all funny and cramped up again to me. I think that might have been due to having to use her abdominal muscles in the evening. Something happens in her back or hip that goes all the way down her leg. I was worried about her and checked several times during the night, but all seemed to be okay.

But then this morning as soon as I saw her face, I knew she was having tummy trouble. We began several hours of some nasty heaving from an empty stomach. What was that about? I thought maybe she did not get enough to eat yesterday, and it seems I was right, as just a few sips of weak Jello water put an end to that. As it turned out, she had a very fun day watching her TV programs with Mom sitting beside her doing fun stuff on her laptop. Lots of kissing and talking about how cute Elmo is!!

I have been feeling so thankful today. Coral is feeling better every day. The heave-ho episode was over so quickly. Even more wonderful, it did not happen overnight when she might have choked and aspirated fluid. And a little (actually, not so little) glitch in someone else's day made it so that I could just sit and have fun with Coral. Last night, much to my surprise, there were no dictation files from the doctor. He usually uploads them to me at the end of his workday.

So I called his office this morning... "Did the doctor work yesterday? ... He did?? ... Yes, I'll wait to talk to him." Oh, no! This could not be good! He told me that when he tried to send me the work, he got a nasty error message on his computer -- a message that included words like "corrupted" and "reformat"... Arghh! He had worried over it all night. I don't know how he will handle the redoing of the records for those 26 patients he saw, but I do know that today I was free to do what was good for both Coral and me. And for that I am so thankful!

Right now, we are all sitting companionably in the office, Barry at his computer and me at mine. Barry has records (yes, the old vinyl discs) going on the player by his computer. Coral is happy in her wheelchair with her headphones plugged into the amp. Elmo is overjoyed to be sitting on the trashcan looking at Coral! Every now and then she leans toward me for a kiss. She tells us to look at Elmo so we can see how cute he is! She sees Najee lying on the floor and says, "Mom!" in that voice that I know means "Look at Najee!" I tell her what a good job of looking at things she is doing! And she beams at me!

Yes, today I am very, very thankful!

UPDATE: Saturday afternoon -- Well, it was a short reprieve, but it came just when I needed it! Last night the doc uploaded Friday's dictation (19 patients) and this morning he has sent me Thursday's which he had to do all over again (26 patients). Guess what I am spending my weekend doing! But Coral is giggling and happy in her room watching all of her favorite stuff, so we are getting back to normal just in time for Christmas!

Grossly normal!

Hmm...Grossly normal! I'm thinking "wart!" Yep, that looks normal...for a wart. But gross just the same!

A few years back I had the worst time with a wart on my left heel. The thing was deep and nasty, and my doctor was afraid that if she froze it off, she might do some damage to my foot. So we left it alone. I tried everything, including duct tape! I know that sounds odd, but I read that if you stick a piece of duct tape over a wart, its oxygen supply will be cut off, and it will go away. I'm not sure that really did too much to help, but eventually my body got tired of that virus, and it gradually melted away to nothing. Now my foot is grossly normal!

Gross. As a medical transcriptionist, I type that little word every day, because to doctors it means something entirely different.
"The patient's physical exam is grossly normal."
"The legs are without edema and grossly normal."
"On gross examination, the patient is a middle-aged female who appears in no acute respiratory distress."

To doctors, "gross" means something that is visible to the naked eye. A "gross lesion" would be a lesion that is plainly visible without a microscope. (My wart was definitely a "gross lesion" in more ways than one!!) Or "gross hematuria" would be blood that is plainly visible in the urine just by looking at its color. Or "on gross examination" (what he can see by looking at her), the patient is a middle-aged woman who seems to have no difficulty breathing.

There is no such thing as "grossly normal" to God. He is not limited by my outward appearance and does not care a bit whether I look normal or abnormal. He isn't fooled by any of my attempts to fit in and does not value me more if I look good. He has the whole picture, straight down to my heart. And He loves me.

"Man looks at the outward appearance, but the Lord looks at the heart." --I Samuel 16:7

What on earth did the doctor say??

Today I feel like writing about my work, and it's probably because it has been taking so much of my time the last few weeks. This is not about housework or family care or anything like that. It's about medical transcription.

Life takes twists and turns, many that we would never expect, and that's exactly the case for me. I didn't foresee that after 25 years as a secretary in an office setting, I would need to work at home to cover Coral's care, but that is what happened, so with much trepidation I began to study things like medical terminology, body systems, drug names, and diseases. I have to admit that I didn't have a good picture of what this would be like, even though I had done lots and lots of office dictation. I soon realized that this is not common everyday language, and that doctors don't dictate slowly and clearly like my boss always had! But at the same time, I was thrilled at how the challenge and the constant learning energized me!

I began work over the internet for a small company that did not give me enough to do to even call it "work," but I plugged away at it hoping it would count as "experience" some day.

Then I heard of a local doctor who needed a new transcriptionist. My stomach was all nerves, but I put together my resume, wrote my best cover letter, and faxed them off to him with some samples of my "experience!" ("Lord, if this is what you want me to do, please make it work out, because you know I'm just not very confident!") In a couple of days, he called me, and I went in for an interview.

I'll never forget that first microcassette I brought home. I rushed out and bought a transcriber, popped the tape in, and got ready to type. My "experience" was almost useless! He talked so fast and swallowed so many of his words that even my very best try was full of blanks! But as time went on, I began to understand his way of talking, and what had taken me a whole day of painful relistening became half a day with time to spare. After that, I applied for a job with a transcription company in another state and began working for them, too, receiving digital voice files and sending back my work over the internet.

A few months ago, my local doctor client and I decided it was time to switch over to getting our work back and forth over the internet, too. We wanted to shorten the time it was taking to get his records back to him, plus I hate driving in the snow! Thus began the research (we had to find the best digital recorder for the least money!) and all the technical questions. This was all complicated somewhat by the fact that we must encrypt everything to send it over the internet because of the need to ensure the privacy of medical records. I do believe that my computer knowledge has been stretched, and I KNOW the doctor's has been!

This past week we began actually forgetting about the microcassettes and doing it the new way. Both of us messed up to begin with. I sent him blank documents somehow, and he tried to open encrypted documents with the wrong program, but by mid-week we were beginning to feel confident, and on Friday we didn't even have to call on the phone to be sure everything had gone right. Now I call that success!

People sometimes say, "It can't be that hard. You just type what you hear, right?" But what on earth did he say? What word did she just drown out with the flap and thwop of the x-ray film? What medication did he dictate just as the phone rang? Was that "lisinopril" or "fosinopril" that he said with a big yawn?? Hmm...she said 500 mg, but I know that drug is usually 10 mg. Is the drug name wrong, or is the dosage wrong? We have to do much more than type whatever we think it is we hear, because your life might depend on it.

"Whatever your hand finds to do, do it with all your might." --Ecclesiates 9:10

Lazy Louses!

It's late Sunday night. I should probably be in bed, because the morning is coming whether I'm ready or not. Today we woke up to howling wind and blowing snow. All plans for the day were canceled, so back to bed we went and lay there like lazy louses until nearly noon! Now I'm wide awake and raring to go, but the seemingly impossible has happened, and every bit of my medical transcription work is done. I feel so at loose ends without any work hanging over my head!

It seems so hard to just stay home, relax, and not get anything accomplished. Why is that? I should at least be cleaning something, or cooking something, or washing something, don't you think? As Barry and I relaxed over coffee, we talked about how hard it is just to stay home and do nothing. I loved it, but it was hard for me!

I want to learn to be still and know that God is God, be quiet long enough to actually hear some of His thoughts. I want to acknowledge Him as the leader and then learn how to follow. I want to understand His plan when he derails my train and puts a barrier across my comfortable little rut. No! I want to have confidence in His promise that everything will work out for our good, even when I don't understand His plan at all!

But there is so much that just must get done! There are the ever-present work deadlines, Coral needs constant care, others are depending on me for so much, my house needs cleaning, I just HAVE to fit in some exercise... I can't possibly get it all done if I am not busy every minute. I just don't know if I am up to it anymore.

Part of a verse memorized years ago is whispering: "In quietness and confidence shall be your strength." --Isaiah 30:15