I've settled on the following pattern for walking and fasting: I fast on the same day I walk, but my fast starts after a quick smoothie in the morning, then I'm done consuming nutrition for the day. I might have a diet drink or three, and technically, diet drinks break your fast (strictly speaking, most "real" fasts are water fasts), but the drinks have zero sugar and zero calories, so despite the possibility of an insulin spike from the sweetness (called the "cephalic reaction" or "cephalic response," in which your brain perceives sweetness and triggers insulin, which is a bad thing because insulin is a fat-storing hormone*), I risk hormonal revenge yet still consider my entire post-smoothie day to be one big fast. I'm walking on Monday, Wednesday, and Saturday, with Saturday being the day for a long walk (18-35K). Mondays and Wednesdays are for the more modest, two-hour walks out to the river and back.
My diabetes doc added back some of the meds that had been cut out at my previous visit. I'm not experiencing any wooziness, luckily; perhaps my body has developed a tolerance to the new suite of meds. I hope tonight's walk doesn't involve any chest pain, but we'll see. About those meds, though: I think they're finally pushing down my blood-sugar numbers, keeping in mind that the meds don't make the blood sugar disappear, but only shove the sugar aside into your organs—which is the very thing we're trying to prevent from happening. Diabetes is associated with organ failure as the various departments of your body get overloaded with sugar: a fine reason to get off meds entirely. But getting off the meds will mean getting off most or all carbs, so my path seems to be leading toward intensive keto or carnivore.
I had a blood-glucose level of 108 the day of my April doctor's appointment. Since then, I've been as high as 286 for a day (May 5, probably a day on which I was off the chain, dietarily speaking), but this morning, following a downward pattern since my most recent hospital visit this past Friday, I was at 113, and that's after a non-fasting day. Again, given the dangers that I highlighted above, 113 doesn't mean much in the grander scheme of things, but at this point, I'll take whatever good news I can get. The longer I stay relatively low like this, the greater the chances that my A1c, a three-month average, will be around 7-point-something by the time I go back for my next appointment on July 12.
I also finally tweaked my workout chart now that I'm back to nighttime walking which, frankly, suits my temperament better. Getting up at 5:30 a.m. and doing the apartment stairs in January/February was a bit of a burden; I'm naturally a night owl unless I'm walking cross-country. Workouts are now all clustered in the evening; I've given myself a three-hour block for them. On walking days, I'll use all three hours, but on the other days, which are mainly about strength, flexibility, etc., I'm starting slow and building up. This isn't Square One; it's more like Square Negative 10: I have to work my way up to zero, and only then can I start making some real progress. Kettlebell and heavy-club work will be crucial for that: I need to strengthen my limbs and my core. To keep myself honest, I might even start a blog where I post videos of my workouts, which will all be lame at first before they finally begin to improve.
One bit of bad news is that my blood pressure has been rising over the past few days, and I don't know why. The numbers are still fairly low compared to where I was before I was hospitalized a second time, but this morning, for example, my BP was at 132/87, i.e., hypertensive. After weeks of being spoiled by super-low BP scores (e.g., 94/69 on May 21), this is disappointing, and I don't know why it's happening. It's during these moments that I miss Bill Keezer; he would read posts like this one and send me a private email explaining the medical reasons for what was happening.
And so I soldier on. At some point, I need to get braver about straining my heart if I'm ever to strengthen it. But if I plan to do staircase work at night from now on, I'd rather go back to doing it outside, using the creekside staircases. They're spaced apart at roughly 100-200-meter intervals, giving me time to recover before I ascend the next set of stairs, and the walk along the Yangjae Creek is a long one. If I get to the point where I'm again doing the longest version of that walk, I'll be going up and down about 35 staircases. Walking upstream against the current of the Yangjae means I'm going ever so slightly uphill, which means the staircases get shorter and shorter the farther I go. The biggest and baddest of the staircases, right at the confluence of the Yangjae and the Tan Creeks, has 80 or 81 steps. That's how the creekside walk begins. The number of steps for the first fourteen staircases along the creek drops to the 70s, then the 60s, then the 50s. After that, there's a radical drop to the 30s and 20s, with one or two anomalously long staircases toward the end, but with a between-staircase interval of nearly a kilometer. By that point, I've walked out of Seoul and into Gwacheon, and it's usually late and very quiet—an introvert's ideal environment. I should do a MapMyWalk plot of that route to get some stats. I do all the staircases on the way out to Gwacheon, but none of them when I turn around and walk back to my apartment. It would be truly badass to do all 35 staircases on the way back, but I'm usually too tired by that point.
More on all of this later. Today's a fasting-and-walking day, so wish me luck.
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*The deeper problem is insulin resistance, which is when your body builds up a tolerance to insulin, which in turn makes the insulin released into your bloodstream less effective at lowering blood sugar, which is insulin's other function (aside from fat storage). Insulin resistance is one symptom of metabolic syndrome, of which diabetes is a corollary. The goal is to minimize the frequency of insulin spikes, lose body fat—especially the so-called "visceral" fat around the organs—and achieve metabolic balance. For us fatties, that's a tall order.
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