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Discipline & Consequences 

I realize many of our followers aren’t religious or Christians, but I am, & as such, one of my goals is to share what’s on my heart from time to time. If you aren’t of faith, feel free to scroll on by. But for those of you who are, God laid this message on my heart and He is pushing me to share it. 

From today’s First 5 app and devotional study: ” Discipline is painful, but knowing it comes from a heart of love makes the experience more palatable. The idea is to live a life that obeys God without reservation and puts no others before Him. Along with stern warnings of discipline, God graciously gives hope of ending exile,“Your punishment will end, Daughter Zion; he will not prolong your exile” (Lamentations 4:22a). I don’t want to need discipline; however, I’m thankful for a Father who loves me enough to administer it when I do and assures me that even though discipline is certain, it’s not permanent.
Prayer: It’s hard to say, but thank You for discipline, Lord. Forgive me for my rebellion. Examine my heart. Reveal my sin. Help me to adhere to Your correction. It is Your desire for me to be holy as You are holy, and my sin keeps holiness at bay. Thank You for being long-suffering and full of grace. In Jesus’ name, amen.”

Today’s lesson is sometimes difficult to understand. Many Christians know God is love and He forgives easily. But many of us forget that He also created discipline and consequences. And we often forget that the 2 concepts are separate – NOT the same. 

First of all, let me preface my thoughts with a couple of things: 1. All disease is NOT the result of poor dietary choices or sin that must be punished. Loads of factors play a role. 2. If an immediate lashing thought crosses the mind, please pause and pray. I have NO ill will, malice, or pride in any of these words today. They are laid onto my heart & I’m trying to share what God reveals to me. 

Diet is an easy area to see the differences in discipline and consequences. And it’s also what KetoNurses is all about. 

Sooo… here goes… 

God gave us a world full of delicious plants for food and animals for meat. He provided our diet for thousands of years before humankind began altering His work, trying to “improve” upon His creation. Many illnesses did NOT exist until the past 50-60 years. What does altering food have to do with sin? Discipline? Consequences? 

First, any time we humans feel the need to alter God’s work, it is pride and arrogance that feed such concepts. That sin requires discipline and has consequences. God has tried for years to speak though a variety of experts and ministers – publishing and preaching His Word – we’ve turned a deaf ear to Him because we have experts and governmental agencies to tell us “more and better info.”  

Second, discipline has been tried – our poor eating habits cause fatigue, headaches, feeling bad, and so on. God is using mild symptoms, Holy Spirit conviction, & feelings of guilt/shame to try and speak directly to us but we don’t listen. We blame busy lifestyles, or work stress, or … 

We ignore the natural laws He’s established, the conscience within us, & the conviction of the Holy Spirit. 

Thirdly, there are consequences. Even when we DO heed His call to repentance during discipline, the consequences of our sin are not typically removed. If we choose to overeat or eat unhealthy, nutrient-poor foods, we can always ask forgiveness from Him. And He grants it freely. The consequences of those poor choices, though, remain. Just as if a murderer seeks forgiveness, repents and is saved by Jesus, the consequences of paying the price remains. 

I don’t like discipline any more than any of you. It hurts. It makes my heart cry out. It separates me from people and from God. I’ve said this often to my kids — “if I didn’t love you, I wouldn’t discipline you. There would be no rules. There would be no consequences.” 

In today’s study, God is telling us the same. He gives us choices. Our free will can choose. Our spirit can submit to His perfect will – or not. He chooses to LOVE us and grant us Mercy either way. 

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Creamy Keto Soup

This recipe is a great base for most any type of creamed soup you enjoy. I used frozen spinach in my batch, but sautéed Brussels sprouts,  mushrooms, or asparagus would work just fine instead. 


Creamy Keto Soup

32 oz heavy cream

1 1/2 cup water or broth 

6 oz cream cheese

1 cup shredded white cheddar

1 tsp minced garlic or 1/8 tsp garlic powder  

1/4 tsp salt

1/4 tsp pepper

1/8 tsp cayenne pepper powder (optional)   

Heat all ingredients in medium saucepan over low heat, stirring nearly constantly. Add additional seasonings to taste after about 20 minutes and all ingredients have melted and mixed well. 

Add 1 – 1 1/2 cups of frozen chopped spinach or other veggie of choice. Most veggies will do best if sautéed or parboiled prior to adding to creamed mixture.  

Heat thoroughly over low heat with frequent stirring; total cook time for my batch was about 45 minutes.  You can cook over low heat for a longer period of time, but remember that heavy cream will reduce down over time, creating a thicker Soup. Serve.  
Makes approx 2 quarts of Soup, unless you cook it down to thicken it more. Keeps well for several days in the fridge. I also think it tastes even better the next day!!

This creamy soup base is totally awesome for cooler fall days! Let us see your version; post pics of your Creamy Keto Soup on our Facebook page. 

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Measures of “Improving Health”

Recently, another health care provider mocked my use of the phrase, “improving the health of my patients”, saying that it’s vague and not measurable. 
Her comments gave me pause, because the goal of every nurse I’ve ever met has been to help people improve their health. Ask any nurse why he or she became a nurse, and you will hear a variety of ways people say it. We nurses help people get well, better, or over a health obstacle. How is that measured? 
First and foremost, there are many parameters used by health care providers to measure health. With diagnoses of diabetes and hypertension, we measure glucose and blood pressure, respectively. But we often have difficulty quantifying how people feel when they lower their glucose or blood pressure. When patients return for follow-up and I’m able to tell them their hemoglobin A1c dropped from 8.9 to 6.4 after weeks of diet changes and effort, people are thrilled. They grin from ear to ear. They clap. They shake a fist in the air. They “high five” me. Some even do a “happy dance.” What is measurable here? Yes, the glucose levels are numerical and easy to track. But how does anyone put a scale on happiness or joyfulness? Can the idea that diabetic complications no longer pose a looming hazard to health be measured? How is relief quantified when kidney damage has improved? 


These feelings are not measurable, yet they are extremely evident in behaviors and attitude. Patients who work toward improving health exhibit gratefulness that good instruction is provided; is that gratitude measurable? 
Measures are important in health care. Measurements of pulse or blood pressure provide vital information to us who render the care. I decided that some of you might be interested in knowing what measures we use for certain conditions so you can track your own progress over time. 
With diabetes, one of the most important measures is glucose, of course; in addition, the hemoglobin A1c that tells us the average glucose levels over the past 90-100 days provides a good correlation to patient effort in managing the condition. While mainstream medicine will say that “good” diabetes control occurs when the A1c is around 7, many studies have shown that diabetic complications occur when the A1c runs higher than about 6.2 or so. Normal A1c levels run around 5 or less; why should people diagnosed with diabetes be forced to run glucose levels so high that we KNOW organ damage will occur? Is that going to help patients “improve their health”? 
Elevated blood pressure is often associated with diabetes because high glucose levels cause thick, sticky blood; demanding that the heart pump thick, sticky blood to an overweight body will eventually result in high blood pressure. The heart will pump harder and with more force to move thick “syrupy” blood through tiny blood vessels, resulting in higher and higher blood pressure readings. When blood pressure increases, the heart muscle becomes compromised and weaker. Daily demands on the heart that continually exceed it’s designed capabilities can contribute to a multitude of vague symptoms which are not measurable, including headaches, fatigue, nausea, dizziness, or even mild swelling. While most of these symptoms have no quantifiable scale, patients will describe how much better they feel once blood pressure is lowered. While blood pressure is measurable, the feeling of lower and healthier blood pressure is described by patients as “improved health.”  
If blood pressure remains untreated or poorly managed, heart failure and/or kidney damage begin to occur. Highly pressurized blood flow moving through the kidneys will damage the fragile vessels, reducing the filtering ability of the kidneys. Elevated glucose can also damage these tiny vessels, resulting in inflammatory responses by the body that are designed to patch and repair damage – but this natural response by the body can result in blood vessel blockages. Think scar tissue. 

In this photo below, notice that cholesterol is serving as the patch, relating the damage to the blood vessel. Cholesterol is NOT the cause of clots; it’s part of the damage control/repair team of the body. 

In summary, how do we measure “improved health”? How can we quantify patient comments when they express gratitude for how they feel? How can we count the number of clinic visits these patients will NOT have? How do we track hospitalizations that do NOT occur for these patients? What evidence do we see when ER visits are no longer the norm for people with “normal” glucose or blood pressure? We can’t. But these numbers ARE real. These people ARE changing their lives and IMPROVING HEALTH! 
 

Cholesterol, diabetes, diet, Fat, Grain free, Guidelines, hormone, immune system, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, Media, NAFLD, nurse, nurse practitioner, paleo, PCOS, steroid, Uncategorized, vitamin

Connecting the dots… How Chronic Diseases Manifest

Oftentimes, a patient will come in or post on Facebook that new symptoms have occurred and evaluation is now needed. Today’s blog article will discuss some of the most common symptoms that bring patients in for diagnosis and treatment.  We’re going to give 2 fictitious patients a run through a visit with me:  Dick and Jane will be our patients today.

Jane is a 43 year old female, who comes in with a new complaint of “just tired all the time”. She occasionally takes a multivitamin, but not much else.  She reports no previous major medical history, but does report that her dad had a stroke at age 61 and is now disabled because of weakness on the left side.  She reports that her mom does have thyroid problems and takes some meds for it but she’s not sure of the exact problem.  During a review of systems, she also reveals that she is beginning to have trouble sleeping through the night, her hair seems brittle, and she’s only having 2 bowel movements a week.  She reports mostly normal menstrual periods, with occasional skipping of a month.  She says over the past 3 years, she’s probably missed 3-4 periods; all pregnancy tests were negative.  She also admits to very slow weight gain over the past 5-6 years; she says she used to weigh around 130 for most of her life.  During the physical exam, Jane appears pretty normal except for these findings:  weight is 214 lbs (height is 5’4”), her skin appears quite dry and even scaly on her arms & legs, very sluggish bowel sounds in all 4 quadrants of her abdomen, and her face just appears fatigued.  She denies problems with depression, but is beginning to think that she might be depressed because many mornings upon awakening, she is exhausted and dreads getting out of bed.  She requests lab work to help identify what is going on.

Image result for blood test image

Dick has made an appointment today because of several issues that don’t seem to be linked. Although he’s done some internet research, the symptoms he’s experiencing aren’t really connected, he reports.  He is somewhat tired, but not every day, and certainly not all day; fatigue just seems to hit randomly, requiring a nap to get through the rest of his day.  He does report a history of mild elevated blood pressure for which he sometimes takes his Lisinopril – averages about 3-5 days a week.  He also reports a recent onset of an annoying dry cough without fever or sinus/allergy drainage – which he does have a history for.  He says he had a biometric screening done several weeks ago at work and brings in a copy of those results for review.  His vital signs:  heart rate 84, BP 168/108, O2 sat of 90%, temp 98.5, respiratory rate 22.  During the physical exam, these abnormalities are noted of this 54-year-old male:  waist circumference is 52 with very protuberant abdomen (no distention, more of a “beer-belly” appearance), lung sounds are clear, but deep breathing triggers his cough, and an extra heart sound (S3) is noted.  In addition, he exhibits trace bilateral pedal edema, but normal pedal pulses.  In review of his biometric results, he has a random glucose level of 186, LDL 201, HDL of 32, Total cholesterol 259, and Triglycerides of 276.  He says they offered health coaching to him, but he hasn’t decided whether to do that or not; he says he wanted to be seen for good physical first.

During Jane’s visit, we decide to obtain some lab tests; drawing a Complete Blood Count (CBC) will help us recognize a possible anemia or subtle infection she may have. A CMP (compete metabolic panel) will tell us about her electrolyte balance, kidney and liver function, while thyroid studies will help identify thyroid problems.  In addition, we obtained a urine dip and a hemoglobin A1c in the office.  We discussed a variety of home remedies and OTC medications/supplements that can help improve fatigue in general, until we can review lab results.  Jane is much relieved to hear that B complex vitamins, Vitamin D, and magnesium are easy to access and often improve fatigue in many people.  She prefers to use supplements and lifestyle changes if possible.  She leaves the clinic feeling better about her outlook and has an appointment for a 2-week follow-up.

In reviewing Dick’s biometric results, we discuss the likelihood that he has diabetes; he agrees that he’s thought the same for a while now, but never tested for it. Reports his mom was diagnosed with Type 2 DM as an adult many years ago and has now progressed to insulin use with possibility of dialysis in the near future.  He expresses great concern over dialysis and states emphatically that he does NOT want to go down that road at all.  We draw similar labs on Dick as Jane had; we also get a BNP (brain natriuretic peptide) level and an office UA and A1c before sending him home with an appointment Friday for review of all the results; we also schedule an appointment for an EKG and an echocardiogram – both are tests to help determine cardiac muscle injury. The BNP is a blood test that helps us determine possible weakening of the heart muscle that often accompanies poorly controlled blood pressure and diabetes.

Image result for cholesterol test image

When Dick returns for his Friday appointment, we first begin with review of the abnormal test results, beginning with the mild abnormalities and working our way toward the more serious problems. His urine is mostly normal, except his protein which is mildly elevated and specific gravity is 1.030 which often indicates poor water intake as it shows high urine concentration.  Elevated blood pressure and diabetes will both contribute to protein spilling into urine – each for different reasons. High blood pressure will cause it because of the force of blood being pushed into the kidneys and the tiny little blood vessels literally burst sometimes.  Diabetes will cause protein to spill into urine because of tiny little “beaver dams” in blood vessels – thick, sticky, syrupy blood causes tiny components of glucose, triglycerides, and inflammation markers to bunch together, forming a bit of a “beaver dam” inside blood vessels.  When these blockages occur, protein is not filtered properly through the kidneys’ processing system and it spills out into urine.  Since Dick has both high BP and diabetes (DM2), it’s difficult to pinpoint his cause of protein in urine.  Moving along, his A1c is 7.8, meaning his blood sugars are averaging around 200 mg/dL. Review of the CMP reveals slightly elevated AST (a liver enzyme), slightly elevated BUN (kidney function test), but normal creatinine, and his BNP is somewhat elevated at 278 pg/mL.  Normal BNP is less than 100; CHF (congestive heart failure) is most likely over 400.  His EKG is mildly abnormal, but shows no significant electrical problem with his heart.  However, the ECHO (echocardiogram) does indicate weakened heart muscle, with an ejection fraction of about 45%.  Normal EF is approx. 50-65%, meaning that during each beat/contraction of the heart, approximately 65% of blood inside the heart is pumped out during that one beat.  Remember, Dick, that the heart’s 4 chambers each contain blood and only the ventricles (the 2 bottom chambers are pumping blood OUT of the heart during that beat, and the RIGHT ventricle is pushing blood to the lungs, while the LEFT ventricle is pushing blood out to the body for use by its cells.  The EF is calculated based on how much blood is leaving the LEFT ventricle during one beat.  You don’t want the EF to be 100%, or your heart would not be able to keep working properly.  It should push out 50-65% of its contents during any given beat or contraction.  When the EF falls too low, it signals that the heart muscle is trying to beat stronger and stronger to push out the blood for the body to use.

Dick expresses a bit of confusion and so we continue to explain. Have you ever been to the gym to work out?  What happens when you start working out? Lifting weights?  Your biceps get bigger and stronger, right?  But the heart muscle is NOT like skeletal muscle at all; when the heart muscle works more and harder, it gets weaker – NOT stronger.  Asking the heart to pump thick and stick blood to an overweight body is not healthy and will cause organ damage – in this case – heart muscle injury, kidney injury; the mild liver damage, likely non-alcoholic fatty liver disease (NAFLD) is related to long-term insulin resistance/high carb intake/elevated glucose & triglycerides. Dick says he’s beginning to understand how all of these health problems are related to one another and now wants to know how to reverse this damage.  He says he’s determined to improve his health. So, looking at Dick’s chart, and reviewing everything with him, we list the following as current medical diagnoses in his record:  hypertension, type 2 diabetes, congestive heart failure, hypercholesterolemia, proteinuria, & NAFLD.  Dick asks if all of this can be reversed without medications and is leery of taking home a shoebox full of meds today. We review the most important problems of high BP and heart injury and decide that these do need some medication, at least for now; Dick agrees to start on BP meds and a diuretic to reduce the workload of the heart.  After much discussion of diabetes meds, he agrees to start on metformin which does not directly lower glucose, but aids in liver health and insulin resistance.  He agrees to start other meds if needed, but wants a real chance with nutrition changes to see if he can eat better to get healthy.  We agree on a monthly visit schedule for a while, just to help and support Dick through these life-changing diagnoses; he came in for one visit and now has multiple life-altering diagnoses with multiple meds and a whole new outlook on life.

Jane is back today for her 2-week follow-up and review of her lab results. Most of her results are pretty normal; her random glucose is 146.  Her thyroid levels are within normal ranges, but just barely.  Her TSH is at the very upper end of the normal reference range; her T4 is pretty normal, but her T3 is right on the lower end of normal.  Her liver enzymes are all slightly elevated, but not very high at all.  Her A1c is 6.3; her urine is pretty normal, except her specific gravity is also 1.030.  It is determined that Jane has subclinical hypothyroidism, pre-diabetes, and likely NAFLD/insulin resistance.  Much of our discussion with Jane is similar to our meeting with Dick, except the heart failure topic.  We discuss starting her on thyroid meds, vitamin D and magnesium regularly with follow-up thyroid labs in about 6-8 weeks because it can take many weeks for thyroid hormone levels to improve.  Jane is thrilled to have some answers to her symptoms and agrees to start on thyroid meds.  We caution her to take thyroid meds, completely alone, with no other food/med for at least 30 minutes because thyroid meds bind easily to caffeine, calcium, and many chemicals/foods.  Jane agrees and leaves with hope that she will feel better soon, but she also asks about her sluggish bowel movements and wonders what she can do to become more “regular”.  We discuss many possible remedies for constipation, including various brands of colon cleansers, OTC laxatives, and foods that can trigger faster GI motility.  She agrees to find something when she picks up the thyroid prescription at the pharmacy.  She schedules her follow-up for about 6 weeks out.

Both of these patients teach us a lot about general health. First, we all minimize many of our symptoms from time to time, thinking it’s just growing older, being too busy, or just not resting well.  But we should always take note of even mild/vague symptoms that don’t improve after a week or so.  Secondly, there are many reasons for fatigue, and if a good evaluation by a provider reveals no likely source, trying vitamins or supplements might help boost energy levels.  Thirdly, there can be many, many mild abnormalities going on internally, that we cannot see, feel, or easily identify without lab tests.  And lastly, both patients had some carbohydrate intolerance, as evidenced by even mildly elevated glucose levels, weight, and missing menstrual periods.

I am a firm believer that high carbohydrate nutrition has led us all down a path to poor health, vague symptoms, and a variety of chronic health conditions. Look at nutrition labels for any processed food; very little actual nutrition, yet agencies PUSH us to eat that stuff. Why? Because Big Food has paid billions of dollars in advertising and donations to organizations like ADA, AHA, AMA, etc.  There was absolutely NO scientific evidence that our bodies EVER needed carbohydrates; if so, they would be considered ESSENTIAL to our health, but carbs are NOT essential.  The body will make any necessary glucose it needs from proteins and fatty acids. Start eliminating carbs today and reclaim your health!

We will follow-up with Dick and Jane in a few weeks to see how they are doing.  Make sure to follow us on Facebook for our latest posts!

 

 

Cholesterol, diabetes, diet, Fat, gluten-free, Grain free, Guidelines, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, nurse practitioner, Uncategorized

Tips & Tricks to Master LCHF 

Sometimes life impacts our food choices and our intake of processed foods increases, although they may be higher in fat or lower carb. Many times, I get messages, asking for our “approval” to consume off-plan foods like keto breads and ice creams. While some of these foods’ ingredients may be included on the LCHF food list, I strongly encourage people to consume the majority of your intake from real foods. Real meats. Real vegetables. Real fats. Eating from a bag, box or can/jar provides very few essential vitamins and minerals because many manufacturing methods contribute to decreased nutrients. Vegetables contain a lot of micronutrients and phytonutrients our bodies use daily; some have to be replaced regularly. Going days or weeks without any vegetables at all can contribute to a variety of vague symptoms, including increased fatigue, headache, & nausea. There are no magic vitamins in a bottle that can replace your veggies. Meats are strongly encouraged on LCHF as they also contain many essential nutrients, especially red meat – beef, venison, & other wild game. Red meat is about the only source of high quantities of b12 & iron – both of which are essential to our health. Chicken, turkey & pork contain only minuscule amounts of iron,if any at all. Iron is what gives meat its red color, thus the need for red meat. (Yes, vegetarians can eat LCHF, but must pay very special attention to the iron and b12 sources or risk poor health.) 

Do not fear red meat. Red meat has been falsely accused of causing health hazards. People survived eating red meat and its fat for centuries before the industrial revolution came along and packaged all our food. Manufacturing processes, including planting, harvesting, & packaging always decrease nutrient density – meaning everything that comes from a company and packaged, contains very little nutrition. Choose real bacon over turkey bacon. Choose 30% fat in burger meat. Choose real butter over margarine. Choose preservative-free foods when possible. 

Questions about bacon always surface… LOL Bacon IS best with fewest additives, or if you can find pork belly or side meat, it usually doesn’t have added sugars or preservatives; even so, most bacon is still way better for us than most anything in a bag or box. 

Baaaaacon!

Reading nutrition labels and ingredient lists is required reading for truly gaining control over health. Just because a nutrition label says 1.5 grams of carbs per serving doesn’t always mean it’s good for you. Look at ingredients –

Watch for hidden grains, sugars, and dextrin components. There are over

60 different terms that companies use to disguise sugar. Become aware of how companies sneak sugars and sweeteners into their packages. If the 1.5 grams of carbs come from wheat, and you’re sensitive to it, those carbs might send your glucose jumping! And then you’ll battle that glucose spike for hours or even days. Also, remember to check serving size. An example is a 20 ounce soda which is typically 2.5 servings; nutrient info then is NOT for the entire bottle.

Choose water over soda, sparkling drinks, and commercially prepared flavored waters – most of these items contain added sweeteners of one sort or the other and will almost always impact glucose level. Avoid ALL foods labeled as sugar-free and read labels extremely carefully. If it’s sugar free, the company has added SOMETHING to it to make it palatable and desirable. Manufacturers are catering to our “sweet tooth” by making foods sweeter and sweeter; heck, they are even modifying our fruit for maximal sweetness!!
Speaking of fruits… avoid them! In low carb nutrition, we recognize the horrible impact of fruits on our glucose levels. But most people who’ve followed the ADA way for many years are totally unaware that fruit has such an impact. They still believe fruits are good for us, but they aren’t. Only occasional berries – AFTER glucose normalization occurs – are allowed on our LCHF way of eating. If in doubt, perform your own experiment. Test before and after. For experts and such highly educated people to proclaim that fruits and grains are good for us over the past 50 years, is beyond my comprehension. They claim their diet is based on scientific data – tests – measurable numbers. But they’ve never run REAL tests! Their diet is based solely on hypothesis and conjecture. Our way of eating is based on 70+ scientific studies AND thousands of people who live LCHF every day.  
Read vitamin & supplement labels! Many contain cellulose, maltodextrin, corn syrup solids, and wheat as binders and fillers; these items will cause elevated glucose levels. Be very wary of any vitamin drink, protein shake, or miracle concoction that promises symptom relief or improved health. Most of these mixes are completely filled with difficult-to-pronounce chemicals, not foods. Even the “all-natural” ones are loaded with sugars. (Just a side note: cyanide & arsenic are natural.) Our bodies were meant to eat/chew food, not obtain empty calories from chemical concoctions. It’s important for the brain to perceive intake, and part of that process includes chewing. Drinking calories totally bypasses that signal to the brain, and so the body can still feel hungry and not satiated, even with hundreds of calories consumed. 


Hopefully, these tips will help y’all get a better grasp of how I eat and teach people to eat and how so many people are able to drastically reduce glucose levels and lose weight. If you are at a stall — your glucose just won’t fall any more, or your weight just isn’t budging — it may be time for re-evaluation of your intake; take a real look at the packaging you’re eating from. Look at all labels. Look at all ingredients. Look at serving sizes. Eat fresh or frozen veggies – without added sauces and such. Canned veggies can be ok – but always check labels.  
Record all intake and verify nutrient info in your app with google or label on package. The more accurate your info, the healthier your intake will be. Many apps are “editable” by users – meaning you could enter data that says your avocados only have 1 gram of carbs per avocado – very untrue. But if that’s what you select in your app, your numbers will not be accurate and it will show in your glucose level — but you will be posting about how frustrating it is to eat from the list but still have high glucose. 
If you’ve reached a stall, you should also re-evaluate your macros – the fats, proteins, & carbs – you’re consuming. There are many methods of identifying ideal weight, but this is the one I use. For the first 5 feet, one is allowed 100 pounds. For females, we’re allowed 5 pounds for every inch over 5′. Males are allowed 6 pounds for every inch over 5′. Divide your ideal weight by 2.2 and this will give you an approx protein need for you at your ideal weight. This is the number of grams of protein you’ll need in one day, and should be approx 15-25% of calories you consume daily. Divide this number of grams by the number of meals you typically have daily and then you’ll know how many grams of protein you’ll need in one meal; also remember that on average, there are approx 7 grams of protein in 1 ounce of meat. For instance, a 4 ounce filet would contain approx 28 grams of protein for one meal of your day. 

To determine your fat needs, double the number of fat grams per day. For example, if your protein needs are 56 grams per day, you should need approx 112 grams of fat in your meals daily, preferably evenly divided over all meals. 


For a female who is approximately 5′ 5″ tall, her protein needs would be approx 57 grams per day, and fat needs would be approx 114 grams per day. 20 grams of carbs would be the maximum allowed. Now, to calculate how much of this is CALORIC intake percentage, we have to convert grams into calories. Carbs provide 4 calories per gram, so for our female client here, that would be 20 x 4 = 80 calories. Protein also provides 4 calories per gram, so this lady would consume 57 x 4 = 228 calories of protein daily. Fats provide 9 calories per gram; 114 x 9= 1,026. Total these: 80 + 228 + 1026 = 1334 calories per day. Then, figure percent of caloric intake: 80/1334 = 6% of intake comes from carbohydrates. 228/1334= 17% of calorie intake is from protein. 1026/1334 = 77% of calories will come from fat. To calculate YOUR needs, follow this example carefully, & you will figure your grams and percentage of calories quite easily. 
If you use current weight or too high of an ideal weight to determine your macro needs, you’re likely to reach stalls and plateaus, becoming frustrated. If you’re very active, your protein needs will be a bit higher; if you’re pretty sedentary, your protein needs will be a bit less. 
I realize I’ve rambled on far too long, now. Sorry about that. I just wanted to share some of these tips because I see many of you struggling with these concepts and questions. 

 

BPC, breakfast, BulletProof Coffee, Cholesterol, diabetes, diet, Fat, gluten-free, Grain free, Guidelines, hormone, immune system, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, Media, NAFLD, nurse, nurse practitioner, paleo, PCOS, steroid, supplement, vitamin

Teresa Reversed Her Diabetes!

 

I am VERY honored to introduce y’all to a very special friend of mine.  I have known Teresa since our children were in kindergarten together, about 25  years ago.  She recently reached out to KetoNurses, looking for something different.  Here is her story in her words.

Teresa Toten, July, 2017

 

My name is Teresa, and I live in rural Mississippi.  I am a wife, a mother of four boys, and a grandmother to four.  Over the years, I have worked and taken care of my family, but I really did not pay attention to my health.  My weight slowly continued to creep up on me; after the birth of my children, I never really did go back to my pre-pregnancy weight.  I accepted the “fluffiness” as my new norm.  I worked, I came home, and the cycle repeated itself daily for years, leaving little time for exercise.

 

I have worked as a legal assistant for almost 17 years, during which time most of my work surrounded workers’ compensation claims and social security disability claims.  Little did I know, that I would also be injured on the job.  On February 20th, 2015, I underwent a multi-level anterior cervical discectomy and fusion (ACDF).  Recovery was slow and painful; in addition, I suffered another injury just weeks after my ACDF surgery – this time to my sternoclavicular (shoulder) joint and collarbone.  The doctor felt that the best course of action would be to undergo steroid injections along with trigger point injections.  Over the course of the next two years, I underwent many of these injections with little to no relief.

June, 2017

In July, 2016, I noticed that I was losing weight without trying; my hair was thinning and falling out in clumps; my face was red and splotchy; my vision was rapidly blurring, and I just all-around did not feel good at all.  I assumed that I was having an issue with my thyroid as thyroid problems do run in my family.  So, in August, 2016, I decided to see a doctor about my concerns.  He ordered the usual rounds of blood work and said he’d get back to me within a few days with the results.  Two days passed, and I received a call from the doctor’s office and said I needed to come in immediately to discuss the results.  I just knew it was my thyroid but at least I had an answer.

 

Day 1 of Keto Nutrition, April, 2017

I went in to the appointment the next morning, and he asked me if anyone had ever talked to me about the big “D”.  I must have looked confused so he patted me on the knee and said that it was diabetes.  We discussed my family history of diabetes (grandmother was diabetic; mother was hypoglycemic).  We discussed my personal history, my eating habits, my lack of exercise, my weight (200 pounds) and my recent surgery and ongoing injections.  He was concerned that my workers’ compensation doctor had not disclosed to me the dangers of rising blood glucose levels while on the injections, and I had been getting them for two years. He told me that my A1C was 12.8.  He explained to me that my blood was telling him the average blood glucose over the last three months was around 375; he also told me that those numbers were not good at all.  He immediately started me on Metformin ER, 500 mg twice a day but also wanted to test my kidney function before beginning.  The results came in… kidneys were okay.  So, he started me out on a long acting one called Tresiba.  I started out at 10 units.  My numbers remained high.  The next week, he added 2 units.  My numbers continued to climb.  My fasting blood glucose levels remained above 200.  My afternoon glucose levels barely dropped.  Insulin dosage increased.  So, after months of trying to stabilize my blood glucose levels, he added Novolog at mealtime.  This addition of mealtime insulin helped my afternoon blood glucose numbers come down a bit, but not where they needed to be.  So, he increased my Metformin to 2000 mg a day.

 

May, 2017

I attended every class that this small town offered to help me learn to manage my diabetes.  I followed the ADA guidelines to the letter.  My numbers continued to rise even though I was eating the way a diabetic is instructed to do.  I just did not understand why I could not get a grasp on my health, and this diabetes was trying to take over my life.  I meticulously kept a log of what I would eat on a daily basis, making sure that I had the proper amounts of protein, carbs and vegetables per the ADA recommendations.  My numbers continued to rise.  Yes, I managed to lose a few pounds in the process but was still grossly overweight at 188 pounds.
So, in frustration and heartache, I reached out to a friend of mine here at KetoNurses for advice on lowering my numbers.  She sent me links to articles on the blog, and she added me to a Facebook group whose main goal is to educate people on methods to use nutrition to help lower glucose and reverse diabetes.  I mean, what did I have to lose besides 2000 mg of Metformin, 30 units of Tresiba, and 16 units of Novolog (per meal) three times a day.  I was ready to get my life back in order, take control of my health, and come off of the medication I was on.

 

So, in April 2017, my keto food list in hand, I made my way to the grocery store to start my new way of eating.  I loaded my cart with items from the meat department, and produce department.  I did not shop down the center aisles for anything.  There were no foods in packages, boxes or bags.  There were no cereals, pastas, rice or potatoes.  There were no fruits, candies, cakes or cookies.  The only thing in my cart was good, wholesome and keto approved foods  I was ready to tackle this way of eating.

On day 1, I took a full length photo of myself.  I weighed in at 188 pounds.  And, I ate.  And, I ate.  I cooked using bacon grease.  I added fat to my vegetables.  I made a cinnamon apple butter tea.  I tracked everything that I did.  I measured all of my food so that my logs were precise.  Day 2 was more of the same.  On or about the 4th or 5th day, keto flu kicked in.  My friend advised me to drink salted broth.  I did and I muddled through the aches and tiredness.  Weeks went by, and I continued to count, to log, to experiment with my foods and my fats.  I got the hang of it.  However, it was not until my first doctor’s appointment after I started this way of eating that the realization kicked in.

My doctor made note of my weight.  He made note of my leaner appearance.   But what really got his attention was my blood glucose numbers; they rapidly fell and stabilized.  So, he had me decrease my insulin dosages and instructed me how to decrease it on my own so that I could do it by myself.  This visit was the first positive appointment I had with him since my diagnosis in 2016.  I was impressed.  So, I continued this way of eating.  I began to notice that my pants were looser, my acne was disappearing, my face was losing its puffiness, my energy levels were increasing, and I just felt better.  I discontinued my Novolog (3 injections a day) and my numbers did not go back up.  I was consistently getting blood glucose readings in the 80’s and 90’s which were a far cry from the 250-300 I was used to seeing.  So, I cut back on my Tresiba.  My dose was 30 units and I am down to 14 units per day.  I also saw my doctor this past week, and he said that he was proud of me.  He said that with the way I am going, that I should be off of my medications (blood pressure meds included) within the next 6 months.

My most recent A1C was done last week and the results are in…..  Last year it was 12.8…  Last week, it was 5.2.  What a tremendous drop!  My cholesterol was a little high at 205 but all other numbers were fantastic.  I enjoyed a great checkup, a great prognosis, a resounding “I’m proud of you” and a “keep up the great work” from my doctor.  He said to keep doing what I am doing, it obviously works. So, I will keto on and continue this way of eating.  It has saved my life, one buttery delicious morsel at a time.
As nurses, we recognize that diabetes has always been considered a progressive condition that always worsens, but we are here to offer another perspective and a totally different outcome for Type 2 Diabetes.  While diabetes may remain on your medical chart as a permanent diagnosis, it IS possible to reverse the condition to a point where complications are minimized or completely eliminated. 

diet, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, NAFLD, nurse, nurse practitioner, paleo, PCOS

Joining forces…

I’m currently working as a family nurse practitioner part-time in a family practice and part-time as a nursing professor. One of the physicians with whom I work is a certified lipidologist. He is a physician who specializes in the metabolism of fat. Two years ago, I had 40 pounds to lose. I had tried everything. Nothing worked. I decided to try the low-carb, high fat way of eating and lost all the weight and have kept it off. I found this plan is a very sustainable way of eating! I was warned by many of my medical colleagues that this “diet” was very unhealthy and would skyrocket my cholesterol. I found just the opposite! Two years later, I continue to eat this way, have maintained a healthy weight and my cholesterol readings are perfect.

I work with many who suffer from type II diabetes.