Tuesday, August 13, 2013

Diabetic Neuropathy and Amputations

by Dr. Margaret Aranda

When I was finally diagnosed with dysautonomia, it was a relief to have a name to put on my condition. When I was diagnosed with Pre-Diabetes, I stared at the lab value in shock. It was then, that I remembered that my Grandmother, who was not obese, died from diabetes and kidney failure.  

Why didn’t I title this blog just ‘Diabetes’? It’s because I want you to know that just taking a little extra insulin for that ice cream isn’t going to make your diabetes better. It’s going to make it worse as your body acquires insulin resistance. When your blood is constantly circulating with high levels of insulin in it, you can’t burn fat. Read that again. The only way to keep your insulin level down is to not eat carbohydrates or sugars. Then POOF! Just like magic, there’s no reason for your pancreas to make any insulin, and your body can’t become immune to it. And the glucose molecules can’t damage your eyes to make you blind. The glucose molecules can’t mess up your delicate glomeruli or nephrons in your kidneys, so your kidneys won’t fail. Who wants to spend 4 hrs/day, 3 days/week getting to dialysis? With a headache afterward? Who wants to lose their foot after waking up to green pus on the sheets? 

Hey, I don't want any of this for you; that's why I'm letting you know what millions before you have undergone. You aren't immune to disease, no matter how much money you have.  But if you are at risk, you can do everything you can to decrease your individual risk factors. And that is what it is all about. Looking at You as an Individual and not applying Protocols to you. Providing you with some 'necessities' of life with dysautonomia, for example would be to get a loved one to give you a Medi-Basket(TM) with supplies and an armamentarium for your defense.

I didn't know that black licorce increases blood pressure for a good two years after I was diagnosed with dysautonomia. I sure wish I had a package of 'stuff' for my home that would have made me feel less alienated, less isolated, and more connected. Maybe that's how I ended up with over 7,000 Facebook friends. It has been a positive network for me and many others with the same disease, both for advice and practical questions affecting Quality of Life, but also for just socialization with someone who understands. We can't just live at home alone and never get out unless it's a doctor's appointment. We have to keep socially adjusted so that our mental well-being is optimized. We aren't looking for a cure, although that will undoubtedly come in time as we learn more about the brainstem. So in the meantime, we have one another.

Diabetes is an Invisible Disease. There are an estimated 25.8 million Amerians with diabetes, which is about 8% of the population. About 7 million Americans are undiagnosed and continuing to sustain damage to internal organs due to diabetes. About 80 million Americans have Pre-diabetes.  For diabetes and Pre-diabetes, obesity, fat distribution in your body, and fat percent in your body matter.

Diabetes and ethnicity matter, affecting 7% of Caucasians, 8% of Asians, 12% of Hispanics, and 13% of African-Americans. Some (not all) complications include heart disease, "silent" heart attacks that you can't feel, stroke, high blood pressure, blindness, kidney failure, neuropathy or nerve damage, which can lead to foot, lower leg, or full leg amputations. Both genders doubled their rates of diabetes from 1980 to 2011.

So put down that cake and get rid of that ice cream in the freezer. Get the Medi-Bag ™ for grocery shopping, and fill it with groceries that include plenty of apples and vegetables, salmon or tuna rich in omega-3 fatty acids, and little in the way of processed food. Some say, “Shop the perimeter of the grocery store”. Stay out of the soda (even diet soda with aspartate eats away at the bones, leading to early osteopenia and osteoporosis) and potato chip aisle. Don’t bring it home, and you can’t eat it. You have to be strong. It’s your life and you can choose to live healthy so your grandchildren can enjoy you more. So start now. Get your blood lab, your Hemoglobin A1C level down, as it reflects 3 months of glucose (sugar) on your red blood cells. Watch every spoon that goes into your mouth. Not every meal. Ask your doctor for a referral to a Nutritionist.

Live long, live healthy. We’re trying to keep you in the Community with both your legs, your eyesight, and your kidneys. Wear anti-microbial socks, check your feet in the mirror daily for scratches or cuts, and use a hand-held mirror. We don’t want to see you in the hospital. We want to see you stay in the Community with the people you love at the places you love to be (like home).

And we don’t want to see your children growing up obese and with diabetes, either. So welcome to your new world of lifestyle change. We do hope you learn to enjoy being well. After a lifestyle change leading to Pre-diabetes going away, or the need for insulin going away, most people say, “I’m never going back to the way I used to be.” Those words can come out of your mouth, too. And, “Thank you no, my doctor said I can’t eat that.” You have to get used to saying that and then walking away. 

We want you to feel so good with your new lifestyle changes, and to know that you will never go back to what you were. You won’t want to. You must live the second half of your life differently than the first half, so that you are not overcome by disease. You can do it. If I can do it after a diagnosis of Pre-diabetes, you can do it. One Spoon at a Time.

Women, American men gained in life expectancy compared to us over the last couple of years. Why is that? It's time to take a close look at every spoon you eat, and evaluate everything in your world. Is it positive? Does it contribute to make your life easier? It is good and not evil? Let's learn to be good to ourselves. We are so good at taking care of others. It's time for a change.

Let's focus on Women for a while. There's a huge gap in health care information dissemination for Women, and it is common knowledge that research and studies on women have been questionable (like the Women's Health Initiative, the WHI). I figuratively shred that article apart in my newest book on Women's Health, and it behooves every single perimenopausal woman to know her individual risk for hormone replacement therapy (HRT). You just look at the Chart that lists the risk factors, you put yourself down where you 'land', and make a decision from there (in conjunction with your doctor and possibly a second opinion). C'mon women, your life matters, and so does the Quality of your life. 

And spoon by spoon, every food, every bite you put in your mouth can either strengthen you, or it can be your slowest form of poison. What you eat matters. 

We can get it together.

I know we can.


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Aranda MD Enterprises, LLC
26500-102 Agoura Road
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Calabasas, CA 91302

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