Conquering diabetes: A gift to my family

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These three men: That's why I need to deal with my diabetes

Someone asked me recently why I have been so motivated to get my diabetes under control when so many people fail to take it seriously.

See the three guys in the photo above? They are the reason.

And it's not some kind of fluffy "I need to be here for my family." I mean, YES, of course I want to continue to live, and I want to live a healthy life, and I want to see my grandchildren someday and all that.

But there's a much more concrete reason I need to take responsibility for my health, keep my blood sugar under control and try to avoid the long-term damage diabetes can cause in my body.

I do not want to be a burden on my family.

No one does. No one wants their spouse or children to have to take care of them.

And sometimes it happens, and we get sick, and it's beyond our control. If we're lucky it doesn't happen until we're very old and we've lived a long, meaningful life.

But diabetes, if uncontrolled, can quickly lead to all kinds of awful and debilitating problems. Heart disease. Kidney disease. Infections that require toes to be amputated. Blindness.

And diabetes is something I can control, at least for now.

So if I choose not to control it...

...if I ignore it, eat candy (and other stuff), fail to exercise, and let my blood sugar run wild...

...isn't that me telling my husband and kids that I don't care about them?

Isn't that me putting a pretty big burden on them that I can choose to avoid?

Taking control of my health is my responsibility as a parent and a wife.

Celebrating our 20th anniversary

Over the past few months I watched one of my friends take care of her husband. Complications of his diabetes led to kidney disease, heart problems, and I think a stroke. He died recently.

I was and am extremely sad for my friend and her kids. Their loss is huge.

But watching the toll it took on my friend - who went from working mother and wife to working mother and wife and full-time caregiver in an instant, who saw her entire life turned upside-down - made me even more determined that I was not going to do that to my husband.

When I get on the elliptical every morning, I'm doing it for me. But I'm also doing it for Michael. If I keep my diabetes under control, maybe he'll never have to spend his afternoons driving me to dialysis.

When I avoid sugar, bread and pasta, I'm doing it for my kids. If I keep my blood sugar under control, maybe they'll never have to push me around in a wheelchair because I had to have my toes amputated.

To be clear, I know that some health problems are beyond all control. If I were to get cancer or some other serious, unavoidable illness (God forbid), I know my family would take care of me.

But diabetes is not beyond my control. There are things I can do, and am doing, to keep it at bay.

It's the least I can do for my family.

My health transformation story in DR. OZ THE GOOD LIFE

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I share my health transformation story in the November 2016 issue of Dr. Oz The Good Life. 

The editors added the phrase "kick diabetes to the curb" and I've adopted it. Because that's exactly what I'm doing: giving diabetes a huge boot in the rear end and keeping it Out. Of. My. Life.

Enjoy the article. I think they did a great job. I've told the writer, Lambeth Hochwald, that she managed to capture my story exactly the way I would have written it myself. Which is the biggest compliment one writer can give another.

Read it online: 'I Ate My Way to Healthy:' Erika's Weight-Loss Success Story

Conquering diabetes: Talking to myself

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One of the tools I have used as I attacked my diabetes and made some long-overdue lifestyle changes over the past year has been talking to myself, or what I like to call "the script in my head." Sort of like Stuart Smalley and his "Daily Affirmations" from Saturday Night Live.

When you're trying to break bad habits, every day is a series of decision points. And at every point, you have a choice: You can make a good decision that moves you closer to your goals, or a worse decision that doesn't.

During the first few months of trying to break my bad habits and kick my diabetes to the curb, I found it helpful to have a prepared "script" in my head as I met each decision point. 

Actors have scripts that (mostly) have beginnings, middles and ends. They know where the story is going. They know how they're supposed to react when other actors say their lines or do something. They rehearse their lines so that when they speak them on camera it sounds natural. 

So I figured if I had lines, a script, that I could go back to and practice, eventually that script would feel natural. The words, but more important the feelings and actions, would start to come naturally.

Here are some of my internal conversations:

When I look in the mirror and get frustrated with my size and shape

• It took a long time for your body to get this way. It's changing because you're making good decisions and taking care of yourself. It won't be perfect overnight, or maybe ever. That's okay.
• If your diabetes is under control and your health is getting better, it doesn't matter what your stomach looks like.
• Grandma Rose always had a belly, and she was the most beautiful woman in the world. (A fact.)

My Grandma Rose and me, c. 1989. Isn't she gorgeous?

When someone offers me food that doesn't fit my current eating preferences

• Just because they're asking doesn't mean you need to say yes.
• Is that food going to make you healthier or sicker?
• Are you actually hungry? Physically hungry?
• You don't have to eat that to know what it tastes like.
• You don't have to eat that just because everyone else is eating it.

When I have a craving for food that doesn't fit my current eating preferences

• Don't think about how it looks or smells. Think about how it will make you feel.
• You think you want it, but is it going to make you healthier or sicker?
• Will taking one bite make you want more or will it be enough to satisfy you? Be honest now.
• What can you eat that will hit the same flavor notes but fits within your current preferences? (That's how I created my low-carb eggplant parmesan casserole - I was craving pizza.)

When I don't feel like exercising

• Would you rather get on the elliptical / go for a walk / ride your bike or take another pill?
• You'll feel better five minutes after you start.
• Exercise is a non-negotiable part of your day.
• Put on your exercise clothes and sneakers, then decide. (Once I'm dressed, I figure I might as well.)
• Exercising will lower your blood pressure and blood sugar instantly. Skipping it is stupid.

Notice that none of these scripts is about losing weight. Not one. For me, this journey toward better health has not been about losing weight. It's about getting healthy, and that's it. After a few months I realized that I wasn't hearing these voices in my head as often because I needed them less. 

Have you ever tried to change your habits by talking to yourself? How did it work for you?

Conquering diabetes: This is not about losing weight

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I go hiking because I love it and it's making me healthier - not to lose weight

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I have spent the past year changing my life to battle my diabetes and improve my health.

I've changed the way I eat. I've made a commitment to daily exercise.

But most important, I've changed the way I think about food, exercise and my health.

When I decided last year to make these changes, I set a goal.

Unlike all the health-related goals I had set in the past, this goal was not about losing weight. This one had nothing to do with a number on a scale.

What do I really want?

That day in August 2015 when my doctor called to tell me that I had diabetes, I thought about what I really wanted for the rest of my life, however long that is.

I realized I want two things.

I want to be healthy. And I want to be happy.

Everything else matters less.

I hate dieting. And dieting doesn't work for me.

I know I'm not the only one who hates the word "diet."

Here's what goes through my brain when I think about dieting:

Deprivation. Longing. Missing out. Spartan. Measuring. Boring. Strict. Rigid. Proscribed. Negative. Irritable. Temporary.

Temporary.

If I want to stay healthy for the rest of my life, my new way of eating can't be temporary. It has to be permanent.

No wonder dieting never worked for me in the past.

I don't use the word "diet" anymore. Food can make me sick, or it can make me healthy.

Retraining my brain

Every change I have made this year has been about getting healthier, not about losing weight.

A year ago, when I was trying to figure out what and how to eat, I decided I would look at food and ask one question:

Is this going to make me healthier, or is this going to make me sicker?

Making the right decisions instantly got easier.

But not only easier. Happier. Choosing foods that would make me healthier felt good. Being in control felt good. And knowing that I was doing something to change my life for the better made me happy.

Being happy made it easier for me to continue to make the right choices for my health.

This journey is not about losing weight.

Three months after my doctor's fateful call, I went in to see him again.

In three months, the changes I had made dropped all the worrisome blood sugar numbers back into safe territory. I was no longer sick.

As it happened, I had also lost weight. But that wasn't what put the smile on my face. That wasn't what was making me happy that day.

I love my doctor very much. He's supportive, gentle and eminently reasonable. But I had to change the way he thought about my health, too.

"What's your goal?" he asked me at that three-month checkup.

"My goal is not to be sick," I answered.

"No," he responded, "I meant, what's your weight loss goal?"

"My weight loss goal is not to be sick," I said. "If I never lose another pound in my entire life, and my blood tests and other exams tell us that I'm healthy, then I will have reached my goal."

Few changes truly happen overnight.

Next time I see him, my doctor will probably ask me again about my weight loss goal. And I will probably have to remind him that, for me, this is not about losing weight.

My brain is still in transition mode, too. Sometimes I catch myself looking at my body sideways in the mirror, thinking "Why is my stomach still so huge? If I'm doing all the right things every single day, why haven't I lost more weight? Why aren't I smaller yet?"

And then I think about what I want. What I really, really want.

And I realize that I'm getting there.

And I step away from the mirror.

Conquering diabetes: Breaking bad habits

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One new habit: I take my lunch to work instead of relying on takeout

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Shortly after I got the doctor's call last summer and decided to attack my diabetes and take control of my health, I realized that I had developed a lot of bad habits.

It felt like the bad habits had crept up on me.

It's not like I had actually decided to eat poorly, eat too much, and stop exercising. I mean...who would make those decisions consciously?

But for whatever reason, that's exactly what I had done for years: eat poorly, eat too much, and avoid exercise.

My bad habits

These were a few of my bad habits:

• Eating because it was time to eat, not because I was hungry
• Eating because I was bored, not because I was hungry
• Eating because I was afraid that at some point in the future I might be hungry
• Sitting on my ass instead of exercising
• Building meals around carbohydrates

In the past I might have sat around for a few days, or weeks, or months, trying to figure out how I'd gotten to where I was. Thinking that if I understood how it happened, I'd be able to avoid it in the future.

This time I didn't give the past a moment's thought. It didn't matter why or how I'd developed those bad habits. All that mattered was what I could do to change them.

Breaking habits is hard.

I was about to write "I can't tell you how many times I had tried to break these bad habits in the past."

But as I was typing it, I realized that it wasn't true.

I had never really tried to break these habits before. Instead, I made excuses for why I didn't need to break them.

I might have made half-hearted attempts to change my eating and exercise habits. But in my mind, the changes were temporary. They were things I had to do to achieve whatever short-term goal was in front of me: losing weight, mostly.

But as soon as I was near the goal, I screamed "I'M DONE!" in my head and went right back to my old habits. With predictable results.

This time is different.

This time is different because I have decided that the bad habits are gone for good.

My new habits are the way it's going to be for the rest of my life. Without excuses.

Another new habit: Evening walk-and-talks with friends (hi Sue!)

This next part is going to sound a little crazy, but it's true: I started breaking my bad habits by talking to myself. 

I'll write more about this in another post, but for now, think of it like leaving yourself notes on your bathroom mirror.

Focusing on long-term goals felt overwhelming. So I decided to stay in the moment. And that's what I talked to myself about.

Every day I asked myself: What am I going to do today? What can I do right now, right this second, to make myself healthier? What decisions will I make today that will move things in the right direction?

I figured if I could do the right things today, then I could wake up and decide to do the right things again tomorrow. And then the day after that.

One day at a time, I ate better, ate less, ate only when I was hungry, and exercised.

One day at a time, I made new habits.

My new habits

I like my new habits. And I plan to keep them. Some of them are:

• Exercise, every single day, usually first thing in the morning
• Eat only when I am physically hungry
• Avoid most carbohydrates (here are the details on what I choose to eat, what I choose to avoid, and why)
• Build meals around vegetables and protein, in that order
• Pack lunch to take to work (mostly to save money, but also to make sure I have food I like that's good for me)
• Drink more liquids (water, iced decaffeinated tea, and iced decaffeinated coffee with unsweetened almond milk)
• Eat some dark chocolate every day...because, you know, CHOCOLATE
• Put myself and my needs first as often as possible

That last one is important. It's easy for parents, particularly moms, to subjugate our needs to those of our children. 

Sometimes, of course, it's the right thing to do. If my kid is bleeding and needs to go to the emergency room, I'm not going to say "Hang on, honey, I've only got 10 minutes left on the elliptical."

But daily exercise is a need for me. It's not a nice-to-have. It's a have-to-have, or my health will suffer.

So if my kid wants a ride to school because he's running late and doesn't feel like race-walking with a heavy backpack, and giving him a ride means I won't get to exercise before going to work...guess what? He's walking.

If there's one portion of last night's dinner left and I can either pack it in my lunchbox or leave it for my husband...I pack it.

If my husband and kids want to go out for sushi, or Chinese food, or burgers and fries, or ice cream, and I'm either not hungry or don't want to eat what they want to eat...I stay home and knit while watching something extremely girly on Netflix. Or I get a pedicure. (When you live with three men, you seize all opportunities to do girly things.)

There's one new habit I have tried hard not to set, by the way: I am not my family's Food and Exercise Police. And I don't intend to be. I'm leading by example, but they need to do what's right for them and make their own decisions.

Conquering diabetes: What I eat

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Yes, kale - just one of the many vegetables I'm eating a lot of these days

Previous: Need vs. want
Series index: How to change your life

Ever since I decided to attack my diabetes, improve my health and change my life, I have gotten one question more than any other from friends, family, and even strangers.

What do you eat?

The short answer: I eat anything I believe will help me get healthier and stay that way.

I want to share with you the basic low-carb guidelines I try to follow 95% of the time to control my diabetes.

I want to stress that this is the approach I decided to take for my body and my health. I am not saying this is what you should do. This is what has worked for me, period.

What I eat daily: protein, vegetables, and fat

Protein includes beef, lamb, bison, pork, chicken, turkey, fish, shellfish, eggs, some tofu, and probably a few more animals I'm forgetting. I eat protein at every meal — sometimes a little, sometimes a lot.

Vegetables includes everything green and most things orange, red, yellow and purple. I eat lettuce, kale, chard, bell peppers, carrots, tomatoes, onions, eggplant and zucchini. I eat more vegetables than anything else.

Fat includes butter, olive oil, avocado oil, avocados, nuts, nut butter, coconut, coconut oil and cheese. I don't skimp on fat. 

What I eat occasionally: fruit, legumes, chocolate

Fruit includes strawberries, raspberries, blackberries, blueberries, and occasionally other summer fruits like nectarines, melons, peaches and cherries. By "occasionally" I mean once or twice a week. In the winter I hardly ate any fruit at all; now that it's summer I'll probably have one serving of fruit 3-4 times per week. Why the seasonal difference? I like summer fruit more than winter fruit.

Legumes includes black beans, garbanzo beans or other incidental legumes that show up in restaurant dishes. I don't seek legumes out, but if they're in something I've ordered I won't pick them out.

Chocolate includes dark chocolate, usually 85%. I also like the stevia-sweetened chocolate from Lily's Sweets. I eat a few squares each week. A girl needs her antioxidants.

What I choose to avoid: grains, starchy vegetables, sugar

Grains includes wheat, barley, rye, corn, millet, oats...the whole category. The one exception I make sometimes are these low-carb tortillas by La Tortilla Factory. I eat 3-4 of these per week.

Starchy vegetables include potatoes, sweet potatoes, yucca, plantains and butternut squash.

Sugar includes anything containing sugar, honey, molasses, coconut sugar, agave, or any other sweetener.

No, I don't feel deprived

I settled on this way of eating because I thought it was well-suited for my tastes, my body and my life.

• I am apple-shaped and thus more likely to suffer from the cluster of challenges associated with metabolic syndrome. Some studies have recommended a low-carb diet for people with metabolic syndrome.
• I like low-carb foods.
• I wanted to focus on eating more vegetables.
• I don't have a sweet tooth. 
• I had never tried eating low-carb and know people who find it satisfying and helpful.
• I tend to overdo it on starchy foods, so for now it's easier to eliminate them entirely. (This may not always be the case. Or it may. I don't actually miss them.)
• It felt like something I might be able to do every single day for the rest of my life. I was looking for a lifestyle, not a diet. This has to last.

Got questions? I'd love to hear them, so leave me a comment. Just know that some of the answers are going to be along the lines of "because that's what felt right to me" instead of having any scientific foundation.

Conquering diabetes: Need vs. want

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Previous: Actions and consequences | Next: What I eat
Series index: How to change your life

When I decided that it was time to kick my diabetes to the curb and change the way I thought about my health, I realized that for a long time I had been confusing two important words: need and want.

There were a lot of food-related things I thought I needed.

I thought I needed to eat every few hours or I would get light-headed.

I thought I needed desserts and treats to feel happy and satisfied.

I thought I needed to eat when everyone else was eating or I would feel left out.

I thought I needed to eat breakfast or I would have no energy.

Now, to be clear, some people may in fact need some or all of these things. Some people do need to eat snacks or they get hypoglycemic and don't feel well. Some people do need to eat breakfast. Everyone's body is different.

But when I put some of the things I thought were my needs under a microscope, it turned out they weren't needs. They were wants.

This is about me and my health

In order to approach food, eating and exercise in a healthier way for my own body and life, I decided to reorganize my list of what I need vs. what I want.

My revised list looks something like this:

I need to get healthier. And stay that way.

That's pretty much it on the "need" side.

And that's when I realized that when the things I thought were needs conflicted with this one very basic need - the need to get healthier - then they weren't really needs. They were wants.

I might want cake, but I do not need cake. I am not going to die if I don't have cake. Quite the opposite, in fact: If I eat too much cake, I might very well die because of it (at some point).

I might want to eat just because everyone else is eating, but I do not need to. If I'm hungry and there's something that falls into the "make me healthier" category, I'll eat. But if not, not. I can still talk and socialize and sit at the table. Whether I eat or don't eat, it's my choice. And that's why I don't feel left out or deprived at those moments: I am making the choice that is right for me and my health, and that is the most important thing to me.

I might want to eat breakfast when I get up, but as it turns out, I can wait. After reading about intermittent fasting and how it helps some people lose weight and boost their metabolism, I decided to give it a try. (More on that in a future post.) Now I often don't eat until 10am or later - not because I'm actively trying to deprive myself, but because I am truly not hungry.

I have a choice

You get the idea. Once I realized that the only true need I had was to help my body get healthier, everything else became a choice. And I have committed to myself to make better choices. Every. Single. Day.

Are you wondering whether I ever give in to the "want"? Yes, of course, sometimes. I'm not going to go the rest of my life without eating pizza. But I clearly recognize those times as the exception, not the rule. Because if I eat too much pizza, it's going to get in the way of what I need: to get healthier and stay that way.

(Also, I no longer settle for bad pizza. Or mediocre pizza. If I'm going to have pizza twice a year, it's going to be darn good pizza.)

Note: This is the second post in a series on how I improved my health by making some pretty big changes to the way I cook, eat, and take care of my middle-aged body. Nothing in this post is intended as medical or nutritional advice - it's my own experience with my own body. I listen to and consult with my doctors, and you should too. Start at the beginning with How to change your life: Actions and consequences

Conquering diabetes: Actions and consequences

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A random selfie in May 2016, about nine months into my new lifestyle

Next: Need vs. want
Series index: How to change your life

Author's note: This is the first post in a series on how I kicked diabetes to the curb and improved my health by making some pretty big changes to the way I cook, eat, and take care of my middle-aged body. Nothing in this post is intended as medical or nutritional advice - it's my own experience with my own body. I listen to and consult with my doctors, and you should too. 

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Almost a year ago, I decided to change my life.

It started with a call from my doctor. Diabetes. My blood sugar numbers had crossed the line, moving from "we should watch it" to "that's not good and it's time to do something about it." I knew that, to some extent, my lifestyle habits were to blame.

Actions and consequences

As a parent, I have thought a lot about actions and consequences. I've tried to teach my boys to think about the results of their choices.

But when it came to my own life and my own health, I was in denial.

I have always struggled with my weight. I have had an on-and-off relationship with exercise. I have always hated and rebelled against dieting, being told what I can (or can't) eat, and how much I can (or can't) eat, and when I can (or can't) eat.

When I'm under stress, I eat whatever I want and I stop exercising. Self-destructive behavior, to be sure.

I started Not Ketchup, my condiment business, in 2014. Starting a new business is stressful on all fronts: You worry about money, you worry about sales, you dig deep for superhuman strength and try to create 27 hours in every day.

Combine that with normal family dynamics and you get stress. Which, for me, meant a lot of the wrong kinds of food and little to no exercise.

Giving out Not Ketchup samples at Central Market in Texas, June 2014

What did I think was going to happen?

The doctor's call telling me I now had diabetes wasn't a surprise. But it made me feel sad, and angry, and most of all guilty.

I brought this on myself. I ate badly, and too much, for too long. I sat on my ass and didn't move my body. Yes, there was probably some genetic predisposition involved. But my actions had developed into very predictable consequences.

The good news: I was not powerless. I could make different choices.

I could fix it.

The first day: Desperation and determination

As it happened, I was alone in my house the day my doctor called. My husband and both kids were away all week. Which meant I had seven days without anyone else around to get used to the idea that I was going to have to make some changes, decide what I was going to do, and get on with it.

That week was hard. Really, really hard.

The first thing I did was put on my sneakers and go for a walk. A long walk. That day, and the next day, and every day that week. Getting back in the groove when it came to exercise actually turned out to be the easiest part of my new lifestyle.

The second thing I did, and the much harder thing for me, was to decide to change my attitude about food.

Act as if

I am a big fan of the "act as if" approach to change. Act as if you're happy, and eventually you will be happy. Act as if you're extroverted, and eventually you'll feel comfortable making small talk at a party.

Act as if you want to eat like a healthy person, and eventually...you will be eating like a healthy person. And then, at some point, you'll be healthy. Or healthier, at least.

But my first step wasn't about acting. It wasn't in my body.

My first step was in my head. It was about thinking.

My first step was to think about food like a healthy person.

The unhealthy Erika thought about food as reward, as comfort, as compensation. The unhealthy Erika craved carbohydrates, particularly the white ones: bread, rice, potatoes, pasta. Craved them all the time, in any quantities, without restriction, without balance.

The unhealthy Erika thought about food with absolutely no consideration for the consequences.

No gray area

On that first day, I decided that I had to be able to look at food and think one of two things:

"That will make my body healthier."

Or...

"That will make me sick. Maybe not today...but someday."

I realize this is extreme. This is black and white.

But this is the way I have decided to approach it. This is what works for me.

Because it's not an exaggeration to say that, for me, at this point in my life, a large bowl of pasta or a piece of cake is going to make me sick. My doctor has the numbers to prove it.

And I have never been good at having a small bowl of pasta. Or "just a bite" of cake.

I made changes. I took action.

First action, then consequences

My actions over the past year have led to (mostly) very good consequences.

All the numbers that were scary a year ago are now normal, without medication.

I've had to replace every piece of clothing in my closet with a smaller size, including my underwear.

I've lost weight. I don't know how much, because I don't weigh myself and I don't own a scale. (More on that choice in another post.) And to be clear, losing weight was never my goal. My goal was not to be sick.

But most important: I feel better. I didn't realize how awful I was feeling until I made changes and started to feel better. I have more energy, my body hurts less, I sleep better, and I'm happier.

(The one negative consequence: I've lost three full bra sizes. My boobs have gotten smaller at twice the rate of the rest of my body. I guess I'm not complaining...but...seriously?)

In the following posts in this series, I'll share the details of the changes I decided to make: cutting out carbohydrates, eating more fat, finding healthy substitutions, and forming new habits.

These changes have worked for me. That doesn't mean my approach will definitely work for you. We are different people, you and I, with different body chemistry, different metabolisms, different shapes. Take it all with a grain of salt and understand that I am not preaching. My way is my way. You will find your way.

For anyone who wants to make changes but feels like it's just too hard - know that I have been there. For almost 50 years, I felt like becoming a healthier person just wasn't possible for me.

But I'm doing it. Because I want to. And I decided it was time.

Me in March 2016. Not perfect. But better.