6-3-11 Friday  + 7 months

Status:  Hey there.  Haven’t written for a while because the time between visits to Hopkins have lengthened (that’s a good sign).  Doing better and getting my blood sugars under control.  Lisa and others say I look much better than I did these last couple of weeks when my blood glucose was way too high.  It’s a complicated task dealing with it – watching your carbs, timing your meals, taking blood sugars 4 times a day.  Gives me more respect for people with diabetes.

Events: My brother Terry came up for the weekend, and we went to a Nationals baseball game.  It pretty much tired me out, but he got to see the new stadium and a typical game (they lost in the 9th).

Simple lab check at Hopkins today and a quick visit.  Gained some pounds.  Liver enzymes are back to normal and hematology counts are up.

Comments: My goal has been trying to keep my carbs under 200 grams day but get in 2000 calories (a 10:1 ratio).  Those food nutrition labels are invaluable.  Now “carbs” are carbohydrates (sugars and starches).  They each have the same amount of calories (as  do proteins).  So a tablespoon of sugar, or of rice, or of tuna fish all have the same number of calories.  The difference is that protein (meat, fish, poultry) gives you calories without the carbs.

And complex carbohydrates (starches) as in bread, fruit, or pasta are digested and turned into sugar, but a much slower rate than simple sugars and with less demands on insulin production.  Eating a teaspoon of honey will give you the same number of calories and carbs as a teaspoon of rice, but without the instant sugar rush – the so-called high glycemic index.

And a shortcut (I’ve looked up nearly every food that I eat) is that, in general, all fruits have about a 4:1 ratio of calories to carbs.  Veggies are about 6:1.  Eating fruits and vegetables would give me 500 carbs a day on a 2000 calorie diet (way beyond my 200 gm carb limit).  The only way to beat the system is to substitute proteins and fats (foods with about a 100:1 ratio).  In fact, eating ice cream (8:1) ratio for my purposes is better than blueberries (4:1 ratio).  Eating pork chops and ice cream would work as  well except for that cardiac stuff everyone talks about.  So while it’s not a long-term diet plan, I’ll stick to it until I’m off of prednisone.

Now keeping a daily routine gets pretty complex when you have to plan your meals around an Excel spreadsheet, take some meds with food, some without.  Time your finger sticks for blood glucose before and 1 ½ hour after meals.  And for those of you who don’t have to use a blood glucose meter here’s the routine:

  1. Take out and unzip handy glucose monitoring kit
  2. Grab an alcohol swab and Kleenex
  3. Select a glucose monitoring strip from included canister
  4. Take out a lancet needle and with its plastic safety cap from pouch
  5. Twist off plastic lancet safety cap and set aside for another step below
  6. Take off the top of the needle injector and insert lancet
  7. Replace top and dial in the penetration setting on the injector
  8. Take out glucose monitor and insert glucose monitoring strip (bar code side in)
  9. Wait for bar code query and confirm bar code
  10. Wipe finger with alcohol swab
  11. Cock the injector
  12. Press injector firmly against finger pad and fire the spring loaded needle
  13. Wait for proper size of blood drop
  14. Slide monitoring strip edge against blood drop
  15. Hold Kleenex against needle stick
  16. Wait the 5 second calculating period
  17. Read off blood glucose level
  18. Take top off injector and extract lancet
  19. Push lancet needle into set aside safety cap and dispose
  20. Put injector top back on and put all items back in handy-dandy pouch
  21. Ascertain whether puncture site has stopped bleeding and dispose of Kleenex

Now, that’s what happens when all goes well.  If your needle stick doesn’t get enough blood on the strip, the monitor reports an error, and you have to start again, getting out another glucose strip, recocking the injector, all the while holding Kleenex against previous puncture site, and sticking yourself again.  [Shampoo, rinse, repeat].

The first time I tried this I had to stick myself 7 times. Then I finally called my Mom to tell me what I was doing wrong.  Besides the frustration of not doing it well, each strip and lancet costs $1 a piece.

The last two weeks have been spent modifying the dosage of my oral diabetic meds, cooking for myself (can’t eat what everyone else is having) and trying to get back on a daily physical therapy schedule.  But feel I’m back in the groove now.  And I don’t have to go back to Hopkins for a week and a half for the 4th of my 6th post-transplant lumbar punctures.  Glad when that’s over.

So have a great weekend, and we’ll report a week from Monday if there’s no other news.




9 Responses to “”

  1. Andrea Tuttle Says:

    Now try that procedure with diabetic neuropathy and lack of visual acuity. There has got to be a better way!! Glad for you it is simply a temporary nuisance. And good thing you are so well organized and methodical. Glad for the good report.

  2. Laurie Samuels Says:

    So happy to hear the good report…. I hope you continue to improve steadily and feel good. I look forward to your next upbeat report! Continued prayers and lots of love to all. Laurie

  3. Bill Israel Says:

    Bruce –

    I do hope that you’ll use these installments in savings for what will be an edifying and important book. We continue to be delighted at your progress, and helped by all you teach us. Very best wishes, Bill

  4. joel steinberg Says:

    I didn’t know that diabetics have to go through this much rigmarole (at least not so frequently). What a pain. But at least you can look forward to not having to do this indefinitely. Things are so much better for you compared to six months ago. We are so glad to get this good report. Joel and Margaret S.

  5. Ashby Says:

    I like Number 11. “Cock the injector.” It seems much more manly than Number 21. “Ascertain whether puncture site has stopped bleeding and dispose of Kleenex.” OK, terribly juvenile on my part, but who cares? On the other hand, if it takes 21 steps to do it right, I say keep on doing them all, brother.

  6. Lewis Lefkowitz Says:

    Karnak the Magnifent says: Ther may be a “-statin” in your future.

  7. mike magee Says:


    What can I say – I love reading your reports. You’re the best health reporter I know. Glad things are stable.

    Best, Mike

  8. Suzy DeFrancis Says:

    So glad to hear things are improving. Think about you all the time and put you on my prayer list. I’m thankful for all the ways you helped me in my career.


  9. Sally Ann Barton Says:

    Dearest Bruce,
    I am so happy to hear the upbeat report on your health. I continue to keep you in my prayers and hope you have a wonderful father’s day this weekend. I’ll be back in touch soon.
    Big hugs,

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