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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. 

 

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

The Chaos Within

 

In the last article, we discussed the 3 processes that the body uses to metabolize, utilize, and store glucose. In this article, we will discuss several conditions that occur when those processes become overwhelmed and organs are unable to keep up with their usual functions.

First of all, if you haven’t read my “peas and cornbread” article, you should. It’s the primer for this more complex article; without understanding it, this article may become difficult to understand.  You can check it out here.  https://ketonurses.wordpress.com/2017/03/16/how-did-i-get-fat-how-did-i-get-diabetes-how-did-i-get-so-unhealthy/

If you’ll recall, the blood stream only requires about 4 grams of glucose for 24 hours of normal daily functions and processes. Four grams is the equivalent to 1 teaspoon.  You read that correctly… 1 teaspoon of sugar is all the body requires to maintain body systems every day.  That is a tiny amount of sugar! Compare that to a day’s worth of intake suggested and recommended by nutritionists, medical providers, and respected non-profit organizations world-wide; most “experts” recommend 45 – 60 grams of carbs per meal (45 x 3 = 135; 60 x 3 = 180) and at least 15 grams per snack twice daily (another 30 grams).  The American Heart and Diabetes Associations are highly regarded as experts in guideline recommendations, but how in the world did they come to THIS conclusion?  A human needs 4 grams of glucose, yet we have been told for 50 years to consume approx. 200+ grams daily to maintain health.  What happens to all the excess?

The excess carbohydrate intake results in a variety of medical diagnoses, but all have one specific problem – insulin resistance. Insulin resistance is the cause of type 2 diabetes (DM2), hypertension, many types of infertility, polycystic ovary syndrome (PCOS), hypertriglyceridemia, various hormone imbalances, a variety of migraines, non-alcoholic fatty liver disease NAFLD), Alzheimer’s, coronary heart disease, and many other conditions.  We will discuss here how all of this chaos occurs within.

The human body was designed with multiple back-up systems and methods for overcoming a variety of stressors, including poor nutrition. Looking back over history, we can see periods of great famine where food was extremely scarce, yet people survived.  The human race has not gone extinct; our bodies and our organs were designed and well-prepared to face a variety of environmental & nutritional struggles.  Yet, we may have found one obstacle we cannot overcome:  ourselves.

After reviewing the “peas & cornbread” article, you will see that our bodies have 3 different processes for metabolizing glucose from the carbohydrates we consume. If any of these processes become overwhelmed, another process will be triggered and more glucose is removed from the bloodstream another way.  However, if all 3 processes are too busy and struggle to keep up, the human system gets sick.  Have you ever known a basement to flood? Did you see a sump pump trying to remove the water from the house? If the rain/flood waters are coming in faster than the pump can remove it, what happens?  The flood continues to rise; more damage is done to the home.  So it is with overconsumed carbohydrates over time.  As high carb intake continues, the pancreas, bloodstream, and liver work overtime trying to remove all the excess glucose.  After months or years, the system cannot keep up; organs never get to rest, even during sleep.  These overactive processes often contribute to insomnia, which increases body stress, raising glucose even more; it becomes a downward spiral to poor health.

Many patients, when told of their new diagnosis, often say, “but I don’t feel sick.” And it’s very true.  The human body is SO GOOD at managing our internal chemistry, the system can become very imbalanced before any symptoms are noticed; some symptoms are subtle and just disregarded.  Fatigue, or feeling tired, is often overlooked or ascribed to our busy lifestyles; gaining weight is often attributed to our genes, our lack of exercise, or even to poor nutrition.  Forgetfulness is usually attributed to being distracted or just part of normal aging; muscle aches & joint pains are often called fibromyalgia or arthritis.  Sugar cravings are seen as the body’s way of getting us to eat something we “need.” Feeling hungry all the time is often seen as poor thyroid function or just staying too busy to eat.  I could go on and on with the vague symptoms people report to medical providers during office visits; most of these symptoms are ignored or regarded as “not pertinent” to today’s problem-oriented office visit.  Millions of patients world-wide report these types of symptoms on a daily basis, and then when they are finally confronted with a life-altering diagnosis, most seem utterly shocked and surprised.  It truly is a shame; I see it regularly and wish I could do something more to help.  People do not seem to understand how they could possibly be diabetic or infertile, or have NAFLD when they’ve been eating according to nutrition guidelines for many years, with only occasional “cheats” or unhealthy foods.  They come in and complain that no provider ever told them this or that; they report many years of struggling with food addictions and cravings.  They even bring brochures and eating plans from other providers and nutritionists, saying, “I eat exactly according to this plan; how can I now have diabetes?”

It all begins with overworking our human systems; while the body is amazing at maintaining the appearance of health, our organs are often taking the brunt of the illness. Every carbohydrate we consume converts into glucose and/or fructose, triggering the pancreas to secrete insulin so that the excess sugars can be removed from the bloodstream because they do not belong there.  Over time, the pancreas either cannot keep up and is unable to secrete enough insulin, or it begins to make faulty insulin – insulin that is no longer functioning to move glucose out of the bloodstream.  This one organ, the pancreas, can become very ill, resulting in pancreatitis.  Difficult to heal, it can take many months or years for the pancreas to recover, and if carbs continue to be consumed in high quantities, it will never recover.

Another problem that develops with these high carb intakes is the body’s cells become resistant to the insulin; there’s so much glucose in the bloodstream, that there’s just not enough insulin to transport the glucose out of the bloodstream. Think about magnets for a moment – recall that magnets are polar.  One end of a magnet will be attracted to another, but the other end repels the other magnet.  Glucose and insulin can become that way in the bloodstream when there are too many glucose molecules in the blood.  If glucose repels insulin (or vice versa), glucose accumulates in the bloodstream instead of being moved into cells. This overload of glucose can contribute to thick, sticky blood which significantly contributes to non-alcoholic fatty liver disease NAFLD), Alzheimer’s, coronary heart disease, heart attacks, strokes, and many other conditions.  Imagine a family of beavers locating to a new stream.  Dad Beaver scouts out a great location and begins bringing limbs and moss to build a new home for his family.  Mom and kids soon begin to help out; at first, water flows easily through the creek.  As more limbs and debris are placed, water flow slows.  Although water is flowing, animals and plants downstream begin to feel the effects of less water.  Finally, after some time, the Beaver family stands proudly inside their new home, where no water is able to get through.  All the plants and animals downstream suffer.  So is the circulatory system within our bodies.  Capillaries are the tiniest blood vessels we have; it is through capillary walls that blood delivers oxygen and picks up wastes like carbon dioxide to be transported to kidneys and lungs for excretion. These capillaries are so tiny that they can only allow for 1 tiny red blood cell to get through at a time.  Take a look at this picture; the largest circle is of a human hair, greatly enlarged.  The darkest circle is the diameter of a red blood cell.  Can you see the image of the beaver dam happening inside blood vessels now?

MicronIllustration

Image from: http://www.baldwinfilter.com/fr/TechTips201403.html, Retrieved 4/3/17.

Now, let’s add to this imagery. Think about the beavers building their dam; are they using trimmed up logs that are nice and smooth – like those with which we might build a log cabin?  No, of course not.  The beavers are using limbs and debris from all over the riverbanks.  Crooked and jagged limbs stick together better and are easier for the beavers to use.  The jagged pieces literally intertwine and stick together even with waters moving through during early building stages.  This image is of a sugar molecule:

sugar-molecule-1

Image from: https://www.exploratorium.edu/cooking/candy/sugar.html, retrieved 4/3/17.

Notice how jagged and crooked this molecule is. Even when broken down into glucose and fructose, the molecule remains jagged and easy to snag on other molecules.  It’s not smooth like blood cells.  Now, imagine hundreds upon thousands of these molecules overfilling blood vessels that are tiny, tiny, tiny.  Can you see how circulation becomes terribly impaired, just as when a beaver dam is constructed in a creek?  Can you imagine all these sticky, syrup-like molecules just sticking together and building up tiny little beaver dams all throughout blood vessels?  This process, reducing blood flow, is what typically results in heart attacks, strokes, and amputations in people with diabetes and insulin resistance.  When blood flow cannot reach the target, tissues are deprived of oxygen and nutrients, resulting in beaver dams or microscopic clots in blood vessels.  Without oxygen and other nutrients, tissues cannot function properly, nerve tissue ceases to respond to stimuli, and sensation and use are impaired.  When enough blood vessels are blocked, tissue is damaged, like with diabetic neuropathy or chronic kidney damage.

In other tissues, this overflow of sticky blood and poor insulin activity also contributes to a myriad of problems. High insulin in the bloodstream triggers many hormone abnormalities.  The normal chemical balance in the human body is fragile; anytime one chemical drops low or jumps up high, a wide variety of abnormal processes may begin.  In women, one of the most common chemical imbalances results in abnormal reproductive hormones that usually regulate our monthly cycles and fertility. One of the pathways suggested for this imbalance goes something like this:  being overweight and/or insulin resistant contributes to hyperinsulinemia (high insulin in blood).  Having too much insulin, the bloodstream sends signals to the liver (remember the “peas & cornbread” story) and this effect signals a decrease in growth factor production/release which increases androgen activity; increased androgen activity causes an increase in estrogen and luteinizing hormone (LH).  Increases in estrogen and LH levels stimulate ovarian hyperplasia – or the overgrowth of tissue – which can result in endometriosis or polycystic ovaries.  Ovarian hyperplasia, overstimulation of ovaries and the increased levels of reproductive hormones all combine to cause anovulation, or ovaries that are not releasing eggs for possible fertilization; thus, infertility occurs.

In the liver the high levels of insulin, glucose, and associated inflammatory processes combine to trigger storage of glucose in the form of glycogen; once the liver has stored all it can hold and blood sugars remain high, the liver doesn’t know what to do with all the excess carbohydrate being ingested. It just keeps storing more and more.  Let’s imagine that you decide to put your household garbage in the pantry, instead of taking it outside to the trash bin for collection.  Keep doing this.  Every time you fill a garbage bag, you pull it out of the can, tie it up, and pile bag after bag in the pantry; then you run out of room, and begin filling kitchen cabinets.  Eventually, those cabinets fill as well; so where do you store it now?  Over time, the garbage comes to overwhelm the entire kitchen, so much so, that normal function in the kitchen is halted.  There is literally nowhere to work or accomplish cooking tasks.  That’s what happens in our livers with glycogen storage.  There’s room for a little glycogen, so in times of famine, the liver can release a few grams of glucose the body needs, but there’s not room for 200-300 grams of carbs per day for a lifetime.  This overwhelming storage of glycogen is what usually triggers non-alcoholic fatty liver disease.  (Alcohol can trigger similar, but that’s another whole story.)

In the brain, there’s a massive circulatory system used to control all our normal functions without us ever thinking. Parts of the brain control and manage our thirst, hunger, heartbeat, breathing, even most of our movements aren’t really conscious thoughts.  But now think back to the beaver dam analogy from before; most people with diabetes understand their neuropathy, or nerve pain, in their feet are caused by their high sugar levels because our feet are further away from the heart than our hands.  However, gravity can also influence blood flow somewhat; combining the physics of gravity and thick, sticky blood, the brain also suffers in a similar way.  Because the tiniest blood vessels in the brain are highly specialized to deliver certain neurotransmitters, hormones, and other chemicals to our brains (& control their release from other organs), anything that reduces blood flow in our bodies can also reduce blood flow, oxygen, and vital nutrients to the brain and associated organs. When blood flow is reduced to our brains, areas of the brain cannot adequately signal the nervous system to function properly; organs may be signaled to alter, stop, or begin a process that may become seriously damaging to health.  This reduction in blood flow to the brain is often called “microvascular ischemic changes” on a CT scan or MRI report.  In fact, many providers will see this on an otherwise normal imaging report, and never mention it to patients because it seems like such a minor problem.  However, given time and continued high carb intake, these tiny problems become bigger problems.  While most of the general population do attribute forgetfulness to “normal aging”, there’s nothing normal about it.  Aging does NOT in and of itself contribute to confusion or minor forgetfulness.  It is always worth an office visit for evaluation and workup at any age.  In 2008, The Journal of Diabetes Science & Technology published an article calling Alzheimer’s disease (AD), diabetes type 3 because “we conclude that the term “type 3 diabetes” accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 diabetes mellitus and T2DM.” (Retrieved 4/3/17 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/)

Even when none of these more serious health conditions are diagnosed, many of us do have these changes occurring inside; hypertension has been called “the silent killer” for many years, but I call insulin resistance the REAL silent killer as many chemical imbalances occur with minimal notice for most people. And mainstream medical providers typically never address root causes of many of these vague symptoms because there’s just not time in most office visits to address them and sometimes, it takes a lot of time & multiple diagnostic tests to identify certain problems.  Mild symptoms of hyperinsulinemia can contribute to high inflammatory markers in the bloodstream and if blood tests are not performed, there’s no way to know if inflammation or hyperinsulinemia contributes to your migraine headaches, your fatigue, or your fibromyalgia.  Many of us suffer with osteoarthritis, or general joint pains related to overuse or previous injury.  High carb diets can contribute to much of the joint pain because of high inflammation within the body; without a blood test and/or radiology to confirm it, many health care providers call it OA and tell you to take some OTC pain relievers.

So, now what? What does all of this physiology mean?  It means that we as a people have become terribly unhealthy because of the poor quality of fake foods we have eaten for the past 50 years.  We’ve followed the AHA and the ADA; we heeded the dietary advice; there’s recent research to prove it.  So, continuing to follow that advice certainly won’t improve our health.  What do YOU think would help?  After reading this article, I hope you say, “cut the crap.” Literally, that is the best advice ever.  Cut out all processed foods, carbonated drinks, artificial foods, fake foods, junk foods, refined sugars, and anything that even looks like it was manufactured in a plant.  Eat real food.  Eat from the farm.  Eat from the edge of the grocery store.  Think back in history; what did people eat before boxes of cereal lined the store shelves?

It’s time we the people took charge of our own health; the health care system is broken. We wait months sometimes to see health care providers who don’t have time for thorough medication reviews and physicals.  As consumers, we can change the face of nutrition in our homes, families, and our nation by making better choices and eating foods that heal our bodies.  In our next article, we’ll cover more details about what to eat and what to avoid eating.

diabetes, diet, gluten-free, Grain free, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, NAFLD, nurse, nurse practitioner, paleo, PCOS, Recipes, Uncategorized

Bac’n Brussel Sprouts

16 oz washed and quartered Brussel sprouts

6-8 slices of bacon

3-4 Tbsp butter

Salt, pepper, & garlic to taste


In skillet, fry bacon until to your liking. I like my bacon really crispy. Remove cooked bacon from pan and allow to cool for a few minutes. Add butter to bacon grease in pan. Add hopped Brussel sprouts to grease & butter. Sprinkle with seasonings to your preference.
Stir fry for about 12-15 minutes or until largest sprouts are softening. Smaller pieces will appear quite soft and pierce easily. You want a good mixture of soft to barely soft. With about 2-3 minutes left, add in broken bacon pieces and keep stirring until done.
Serve immediately.
This dish can be made using smaller or larger quantities, depending on size of your family or event. It even keeps well; I take it for lunch often!