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Milk, sweetened with coffee

November 8, 2008

A cold, dry start brought us beautiful Fall color this year. It isn’t that often that Tacoma’s yards and streets billow with crimson and gold. When they do, the leaves typically fall with the rain, and don’t crunch. This year the trees kept their leaves for several weeks. Now, the color is nearly gone, the leaves are soggy, and we have rain, but November’s days are warmer than those of September–or June. And squash abounds.

I never gave squash much thought before. I always took it for sort of vapid, lumping it in with the category of food I least like: vegetables. I like zucchini least of all, but I use it in soups because it is easy to slice. Now, I fairly live on butternut squash.

In order to restrain my glucose levels, which suddenly began pitching between the 50s and the 190s, I’ve given up bread, pasta, rice, potatoes, all sugar, and all foods consisting of simple carbohydrates. I had to become interested in low-glycemic foods. Squashes, particularly butternut, were among them. So were beans, which I already considered an ally in the cholesterol battle. Beans and squash without rice seemed anomalous, but the rice would cause glucose spikes, so I cut it out. With high cholesterol, I didn’t want to eat meat more than once a day, so I eat butternut squash with tahini, which is filling and presumably friendly.

Hydrocortisone requires ingestion with food or milk, and rice milk had proved the most efficient buffer. But rice milk became a casualty in the campaign against kite-and-crash glucose. I have been a milk hater most of my life, a positive adaptation to lactose intolerance. I went through a lot of Bosco as a child, graduating to Ovaltine in college, and rice milk more recently. Lactaid works to combat the stomach spasms caused by lactose. What works for the morning meds now is heated milk, sweetened with coffee. When I’m too hypoglycemic to make coffee, half an avocado fills in nicely.

Incredibly, I’m not gaining weight with this increased fat intake. My understanding is that this is because a more regulated metabolism converts carbohydrates to muscle-feeding glycogen, rather than fat. Lack of glycogen makes us “bonk,” with exhaustion, leg cramps, and a sense of woodenness in the muscles. Instead of glycogen, a poorly-regulated metabolism converts carbohydrates to fat, storing it in little chubby caches throughout the body. Cortisol, the hormone that people with Addison’s disease don’t produce, has many critical functions, among which is glycogen production and storage.

Cortisol and insulin sort of share information, so consistent management of both is important. I’ve decided that I need to eat like a diabetic so I don’t become one. Diabetes isn’t inevitable, but my present signs of insulin resistance aren’t too comforting. The simple fact is that I would rather manage my diet than another disease.

With autoimmune Addison’s disease, you learn it is important to regulate what you can, knowing that your endocrine system is a minefield. If you are disciplined, you learn to adapt to changes in diet and every routine on your docket, perhaps under penalty of losing another endocrine function, a low-fun scenario.

I have followed this diet for two weeks, and have also taken DHEA for the same period of time, 25 mg, 4 days a week. I have begun to see a difference in my glucose levels. I am more likely now to be in the 60s or even 70s than in the 50s in the morning. I had a surprising reading of 174 one afternoon, and can’t account for it. My post-prandial readings in the evening have improved markedly: 80s and 90s, instead of 160s to 190s.

For those dealing with these things, and who have a high tolerance for fairly bland, repetitive meals, I’ll list my typical fare. My husband is good about eating what I eat, except he’ll use butter where I’ll use tahini, and he’ll have rice or bread, at which I longingly stare. Except for weekends, he’s only home for dinner, anyway. I sometimes need small meals between meals, and these are typically components of the usual meals, i.e., another serving of beans and cheese.

By “beans,” I mean that I cook dry beans. I don’t use canned beans. If you prefer to use canned beans, do examine the ingredients; many will have sauces added that contain sugar or corn starch or some other sinister high-glycemic substance.

I suppose I am an activist by nature.  I have asked the meat manager where I shop to lobby his suppliers for turkey and ham that are not cured with sugar.  Until I find sugar-free (and that includes honey and maple syrup) versions, I will avoid ham and turkey.

Breakfast
1 egg

Scoop of pinto beans topped with melted Gouda cheese
1/2 pear

Lunch
Beans and cheese as above, maybe with tahini
Dinner
Small serving of lean beef (fish or chicken would be lower in cholesterol but I don’t like them)

Squash or asparagus with tahini
Beans

We don’t eat dessert, but sometimes we might have a slice of cheese and a hot non-caffeine beverage, like Inka. It seems to be the case that I can manage fruit in the morning without a major glucose spike, but in the evening fruit is more likely to cause a spike.

My objective is to uncomplicate my erratic insulin responses before they become more complicated. I spend a lot more time and energy cutting up squash and baking it than I ever considered doing before, but this seems a small adaptation compared to the benefits. There is life after starch, and things become more agreeable than they once seemed: even milk, sweetened with coffee.

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