GIGI GOES GAGA

MATH 301: ADVANCED NUTRITION

When I got diagnosed with diabetes about a month ago I was under the (highly erroneous) notion that all I needed to do to fix my problem was cut out all sugar from my diet. It turns out that solution was way too simple (albeit in a horrible, not-worth-living sort of way).

I've since learned that sugar and diabetes do not exist ever-fixed in a causal relationship and so I can now stop blaming my sweet tooth for my current state. Diabetes is connected to genes, obesity, and/or lack of exercise, it appears. Where sugar comes into the picture is that it's a simple form of carbohydrate -- which causes blood glucose to spike up high and fast and then crash way, way down. If we keep doing this, if we keep it hurtling up and down as if it were on an endless rollercoaster ride then it takes revenge on us sooner or later. Wouldn't you do the same thing -- want to kill the guy with his finger on the power button -- if you were constantly dizzy and nauseous, after all?

What I'm saying here is that basically I knew nothing before yesterday, before I attended my second diabetes management class. For instance, I learned that not all sugar-free products are good for diabetics and that if I MUST indulge in ice cream, a high-fat variety would probably be better for me than a low-fat kind (although it's supposed to be reserved only as a rare treat. Rare being a highly subjective term for me, unfortunately).

I was also given a meal plan, a blueprint of how many servings (apparently dieticians like to use the strange term "exchanges") of protein, starches, fat, fruit, and vegetables, etc. I'm allowed to consume in a day. Great. Now I have to be a mathematician in order to eat, too (God forbid I hear anyone argue that no one needs math in order to be an actor or rock star, for instance. Most of these camera-ready folks are expected to be thin and thus need to follow a stringent diet, which requires advanced math skills apparently).

So now I'm one of these obsessive-compulsive folks in the grocery store who spend half an hour in each aisle reading all the labels on every single freakin' package (Okay, 35 grams of carbohydrates per serving. Not good. But six grams of dietary fiber. Very good. And I can subtract six from 35 which then gives me 29 grams of carbs. Now is that bad or good? Grrrr.). And I'm especially not looking forward to eating out at a restaurant, where I'll need to break apart each dish and try to figure out everything on my own; I mean, just how do I figure out a dish like kare-kare?

I'm highly tempted to sign up for this Zone diet home delivery service, just so I don't have to analyze each ingredient of every morsel I put into my mouth, though I suppose eating without thinking was part of what got me here in the first place (well, not so much as my parents' defective genes, of course). Or I could be like my neighbor Jay, who limits his food intake to no more than three tablespoons of brown rice and a few bite-sized pieces of meat per meal. That is, if he eats rice and meat at all.

I know I'll get the hang of this someday; I suppose like surgeons rely on their "muscle memory" I'll be able to put together a simple meal without charts, a pencil, and a calculator. In the meantime I'll have to remember that a 3 oz. portion of meat is the size of my palm (why oh why did my hand have to be so disproportionately small compared to the rest of my body?) and the thickness of a finger, and learn to use all the other visual tricks I was just taught.

Still, sometimes I wonder if what I learn today will only be replaced by new information tomorrow and I'll have to learn how to eat all over again. After all, what we know about food and healthful eating changes every decade it seems. Not too long ago we were taught to cut out all fat, until we learned there was good and bad fat but just no good carbs. And now it appears we need to add some carbohydrates back into our diets for balance.

I'm considering just sitting it out until someone figures out that bitter vegetables are bad for us and that white flour is good. Who knows, it probably won't be too long until that happens? We've just learned, after all, that (dark) chocolate is actually good for the body. The future is starting to look promising, I suppose; until then I think I just might have to take a basic accounting class to help me figure out how to balance my food groups. Or at least it might help me finally balance my checkbook -- which is another dilemma to discuss altogether.

WALLOPED

My doctor hit me with some pretty bad news today. Walloped is probably an accurate description of how I feel right now -- walloped on the head and whacked behind the knees. I'm feeling a bit wobbly still, although it all hasn't really sunk in yet.

Because my doctor is so wonderful, she started off with the good news: my cholesterol levels are good, blood pressure great, kidney functions good, liver okay, and then I heard a distinct but even if she didn't actually say the word. It was in her tone of voice, that pause, the slight hesitation. Then she went right ahead and just said it.

"You have diabetes," she announced, and she went on to explain how she even had my stuff retested to make sure. And she's quite sure: the numbers (which are frightening) don't lie.

Funny thing is I saw this coming. Both my parents are diabetic, my father was diagnosed when he was about my age. My mom a bit later on, but we all know she's like this because of all the crap she eats (she says she can because she's good about taking her medication anyway).

But I thought I could escape this, or at least beat it back. Recently I began taking better care of myself and even lost a dress size in the process. I guess I was simply too late -- all those years of feeling I was still young and invincible only made me delusional.

After I got off the phone with my doctor I knew my life -- as I currently know it -- was about to change abruptly. Or at least I had to make that change, starting with a few necessary adjustments (ah chocolate, I knew you well!). Then I thought about all the good things, the positives and pluses, regarding my new situation.

For instance, there is a plethora of information easily available and the technology is much more advanced -- the new versions of that doohickey thing you use to prick your finger and test your blood sugar, for example, supposedly make bloodletting practically painless now. I also discovered I have this disease while I'm still relatively young and everything else in my body -- heart, kidney, liver, eyes -- is healthy and functioning; the only challenge is to remain vigilant and make sure things stay that way. I also finally understand why I'm so freakin' tired all the time, that there's actually a reason for my constantly exhausted state.

And if vanity wasn't enough for me to care about proper and regular nutrition and exercise, then this just might do the trick. (Definitely no more skipping meals and workouts.) Oh -- and because I also found out I have hypothyroidism -- my doctor said I was most likely going to lose even more weight now that we'll be taking care of that problem, too (the pharmacist who dispensed my new medication also said the same thing - yay).

But the best part of my most awful day was when I phoned my husband to share the results of my physical. "Don't worry honey, I'll be here for you," he reassured. "We'll take care of this together." There was none of those dreaded I-told-you-so's and "It's all that chocolate you eat" admonitions I almost expected from him. (He's truly a guy's guy, that husband of mine; you tell him a problem, he thinks you want to hear a solution or a reason.)

And just like that, I knew everything would be okay. Like my boss told me today (she saw me walking around in a daze and wanted to know what was wrong): "You're a control freak -- I just know you're going to get this under control and you'll be great."

Despite her vote of confidence there's only one thing I'm sure of: I know I'm never going to be the same way again. And I suspect that's actually a good thing, you know?

LEGEND IN MY OWN MIND

I used to get in my car at odd hours of the night and drive when I wanted to clear my head. Sometimes I'd be sitting in my room, completely restless or perhaps bored, and decide I'd rather be in San Francisco instead -- so I'd jump in the car at midnight and get there before the sun came up. And so when Erwin asked me to drive cross-country with him to Indiana on Thanksgiving weekend, I said yes immediately, excited to see what lay between California and the Midwest (a lot of tumbleweeds, it turns out).

I no longer drive as freely or as far. I haven't, in fact, for a long while. And it's turned my life around completely.

I was driving home late at night when I should have been in bed instead. Just the day before, I was admitted to the ER, white as a sheet and barely breathing. As usual, I hadn't allowed a trivial thing like acute bronchitis stop me from working, so my body decided to go on strike. I was supposed to take my meds and take it easy, but I didn't listen to the doctors (see, I used to think I was invincible). I was on the fast lane of the I-10, driving way past the speed limit, when it happened.

I had my first panic attack.

It felt like a heart attack, although I've never had one. I imagine, however, that's what it would be like if I ever did. The first thing I remember feeling was complete and utter disorientation; I remember seeing the lights from the opposing cars filtering through the freeway divider. They were blinding-bright and pulsating, hypnotic even. Then it felt like my head was being squeezed into a box and separated from the rest of my body. I couldn't feel my fingers or feet; I didn't know if I was pressing down on the gas pedal or if I was still steering. My heart was racing and I had lost control of all my senses and faculties. I thought, Holy Shit -- I'm going to crash and die!

I remember slowing down to a crawl until the cars behind me moved out of my lane (if they were honking their horns at me, I didn't hear it at all), and then I merged to the I-5 like I'd done a thousand times before. The next thing I remember was getting off my exit, just a few miles away from the house. I was shaking all over, but I was afraid to stop -- I was afraid I'd never make it home.

I'd been in car accidents before; during the worst one, my tiny Honda looked like a silver accordion after getting slammed both in front and in the rear. But I always got back behind the wheel as soon as I could; my grandma once taught me to do that. So that night I went to sleep and resolved to beat my moment of madness into oblivion the following morning.

But that morning never came. I got into the car, headed for the Trader Joe's less than three miles away from home, and had panic attack no. 2. And soon enough, I stopped counting. When I was 14, I had learned how to drive against my father's wishes because I wanted to be free, independent, and self-sufficient; now I saw all that slipping away from me.

I thought I was going crazy. I had never heard of panic attacks before, at least not in the true sense of the term. I was so angry at myself: why was I so stupid and irrational, so weak and helpless? So I kept trying; after all, you can't survive in LA without being able to drive. Eventually I was able to drive on surface streets, but I couldn't survive long enough on the freeway without enduring another episode. I coped by driving on the rightmost lane, to make escape easy once an attack came on. Because I never knew when one would come, I became an expert on LA streets. In fact, if you ever find yourself stuck because the freeway you're on resembles a Disneyland parking lot, you would definitely wish I were on the passenger seat. I'd take charge as soon as you got off on the first exit. I can get anyone from, say, Pasadena or Northridge all the way down to Dana Point via surface streets; yep, I'm that good.

One day, my worst fear happened. I had a panic attack and hit a car. That was the last time I ever got on the freeway.

I've turned down dream jobs because they involved a lot of long-distance driving. I've had to pay higher rent just so I could live closer to work. I've had to take positions that didn't involve any driving at all. I've missed countless birthday celebrations and holiday parties, and let friends and family down because I couldn't get to them. I've inconvenienced my loved ones again and again. For instance, when I relocated to Orange County to open the DKNY store, I was in such a high state of stress (I was given only a few weeks notice to do so, was working nonstop and didn't have time to even find a new home). I was driving from Costa Mesa, where I had spent an entire day interviewing sales candidates, to Mission Viejo where I was going to train my new hires, and had one of my worst attacks halfway in-between. I got out of my car and seriously thought of killing myself; I hated my life, I hated being so useless. I called Arnel, and he left work just so he could rescue me. Until then, I don't think I'd ever been rescued by a man before.

I never wanted anyone to know what I was going through. In fact, the only reason I eventually told people about my panic disorder was so no one would hate me for being such a flake. Although I didn't want folks to think I was crazy or weak, it was better they thought I was flawed (i.e. not my fault) rather than that I was inconsiderate (i.e. my fault). And yet, even people who love me think I've gone bonkers (only those who suffer from a panic disorder know what it's truly like).

Because I never accepted the idea of getting help, my panic disorder generalized: soon enough, I was getting them while descending on escalators or traveling on bridges. So I'd had enough; if I let my ego get the best of me, I was going to turn into a recluse soon enough. Besides, I'd been relying too long on other people -- either for them to drive me or to drive to me -- and I really, really missed being free, independent, and self-sufficient.

So I'm seeing a professional now. She has me on Zoloft to help with the anxiety (although I insist I stay on the lowest dosage possible because I don't like the idea of being drugged), and says I'm now ready to get back on the freeway, but slowly. "Just hop on, and get off the next exit," she said during my last visit, "And then the next time, get off the second exit." When I've built up enough confidence to drive freeways again, she'll wean me off the medication slowly.

I'm no longer petrified by her instructions; I'm ready now. I know this is not going to be a quick fix and that it will take a lot of tough mental work and perseverance for me to get back to the days when driving was an escape rather than something to escape from. If -- and when -- I beat this, it will be my greatest accomplishment because it's no easy thing conquering your brain. When that day comes, I'll be a legend in my own mind. I can't wait; it will be the toughest -- but best -- road trip of my life.

MORE FOR LESS

According to today's health news as reported by Associated Press (AP) and Reuters, if you want to lose weight you need to do three things:

1. Eat More.
2. Sleep More.
3. Get a dog.

That explains it. I've been doing all the wrong things these past few years. I barely sleep, I rarely eat, and I have a cat.

Apparently, in a study of 18,000 adults who participated in the National Health and Nutrition Examination Survey (NHANES) in the 1980s, researchers found a strong link between the amount of sleep people get and their risk of becoming obese. Those who got less than four hours of sleep a night were 73 percent more likely to be obese than those who got the recommended seven to nine hours. People who averaged about five hours had a 50 percent increased risk, and those who got six hours had 23 percent more.

What scientists have discovered is that sleep deprivation lowers leptin, a blood protein that senses when the body has had enough food, and which also suppresses appetite. At the same time, lack of sleep also raises grehlin, which makes people want to eat.

A Pennsylvania State University study of 7,500 typical Americans interviewed by the US Department of Agriculture Continuing Survey of Food Intakes by Individuals, found that dieters who were told to eat foods heavy in water and fiber (such as vegetables and fruits) lost weight without counting calories and resorting to gimmicks.

And in a related study, 101 obese women were counseled to fill up on foods rich in water and fiber, as well as to select reduced-fat foods over full-fat ones. A second group, however, was put on a stricter diet which emphasized cutting portion size and fat. After six months, the first group lost an average of 21 pounds, while the second group lost only 15. What researchers found was a healthy diet is essential to successful weight loss, more than counting calories or fat grams. In addition, other recent studies have concluded that although high-protein diet regimens (such as Atkins) can help weight loss, the effects are only short-term.

My personal theory about how this works -- forget the scientific explanations about "low energy dense" Vs. calorie-dense foods -- is that most people really don't like to eat their veggies. So even if they're told to have as much of it as they want, they can only eat so much before they push their plate away. Either that, or it's just reverse psychology in action.

The canine connection is really a version of how "buddy systems" can help dieters lose weight. During a one-year study, Chicago doctors made test subjects attend weekly counseling sessions at Northwestern Medical School, and were also encouraged to walk at least 20 minutes and limit daily calories to 1,400. Dogs were put on a prescription diet and walked with their owners. Although dogs did better than their owners, the dog owners did slightly better than the dieters who walked and dieted alone.

I don't know if Boo will let me put a leash on her and take her out for a walk, especially since she likes to sleep so much. But the last time I put her on a diet, she lost weight -- and so did I. I guess I felt guilty about making her eat prescription diet food and depriving her of her favorite nightly treats, because she looked so sad. So I suffered the same way -- Lean Cuisine and no dessert for me. Our results mimicked the study results; Boo was declared to be of normal weight by her doctor, while I have yet to hear the same thing from mine.

Here's my disclaimer, effective immediately. If you discover these next few months that I'm asleep whenever you phone or send me an IM or text message, don't think I'm avoiding you -- I'm just trying to lose weight. Hopefully, the next time you see me, I'll be thinner and sleeker, the dark circles and bags under my eyes will be gone, and my skin will be clear and rosy. Then you'll just have to call me Sleeping Beauty.