Direct and heavy-handed exhortation: OK, folks, we are surrounded in the U.S. and many other countries by too much sugar, too much fat. French Chef Julia Child said she didn't care about health issues, just eat judiciously, carefully. Easy for you to have said, Julia. Some of us, ahem, are -aholics.

What worked thousands of years ago in the pancreas sending insulin out after a little sugar, after some carbohydrates doesn't work when the body is flooded with junk food -- and in turn craves the sugar high. It's an addiction.

Let's do something about it. Think of the kids who at far too young an age are stricken with diabetes. Take a look at this lovely young man.  http://diabetesawarenesssite.com/?p=830

Childhood obesity is an epidemic. http://www.cdc.gov/obesity/data/childhood.html  And diabetes is one of the most common chronic diseases among children and adolescents. http://www.cdc.gov/diabetes/projects/cda2.htm

What can you do to help?

Bye-bye, bootie. Dr. Polun cleared me today to wear regular shoes. I'm grateful to have had the boot, because it enabled me to walk again. But it sure is nice to have shoes that weight the same -- never mind the esthetics of looking alike. I can begin to feel the toes on the right foot bending slightly as in a normal pace.   

The 2012 Olympics are beginning, and Claudia is driving down to Charlottesville early tomorrow to see the Kluge-Ruhe Aboriginal Art Collection.











I would love to have gone with her, but discretion said that walking two extensive exhibits at a museum might be a bit much.

Better to pace it. Maybe I'll bus down to the National Gallery tomorrow and see if I can do a gallery or two.


I've been trying too to continue making peace with the loss of part of the second toe. OK, my salutation to my niece Liz was: Hang 10, and I'll hang 9.6.

The visiting nurse, Shirl, told me she did not want to lose her molars. I was ok with the molars going, and the wisdom teeth. My toe...that's something else.

An idea in a book by theologian Jerry Korsmeyer is helpful. Writing about immortality -- affirmed in the resurrection of Jesus Christ and the divine promise to us of life beyond our life on this earth -- Korsmeyer points out that our individual experiences here occur in little units of time. As each experience reaches completion or satisfaction, he suggests, it is taken into the divine life.

"The divine life is constantly receiving the lives of everyone in the world, and adding each moment to all the collected moments of their past. All these moments are experienced in God with no loss of intensity or immediacy," he writes in Evolution and Eden. "The past of the world enters the everlasting present of the divine immediacy. The world is transformed in God, who weaves everything that is worthwhile into a greater harmony, a greater whole." Evils, he says, are dismissed into the triviality of individual facts, reduced to insignificance in terms of the divine harmony.

I do not think that what has befallen my toe is evil. It is a biological fact in the context of the biological fact of pre-diabetes. It is a sadness to me. But if my completed half toe can be taken into the divine life of God -- what an honor. What a blessing.

And not only the physical fact of the half toe, but the completed processes and procedures that have attended to this wound care by these fine people -- doctors, nurses, hyperbaric oxygen people, physical therapists -- all the good work of these good people and the friends and family who have given me support, their kindnesses...if all of these experiences can be offered to God to be taken into God's very life...our small steps are woven into the lasting harmony of God's love and providence.

Julia said: You got a toe in the door.


Photos: Da boot; Claudia, Julia, me at the 2011 Landon School azalea festival; Liz.


7/27/12

Come on, it's not hard to do these exercises. Really, while reading at night, watching tv, the movements can be done repeatedly -- or at least as much as required.

A few days of resistance: the outcome is less progress. Is it coincidental that I've slackened on my eating this week, too, giving into cookies at work? No coincidence.

I have to move the foot and the toes in order to develop range of motion and strength. I have to eat on a diabetes regimen now to keep diabetes at bay. I have to recognize the triggers in the direction of no-motion and glucose pursuit, and have steps ready to get on the right side.

At home, my next door neighbor Katie is my sweet taker; I email her when tempting food appears and she, 2 years out of college and a runner, takes them off my hands.


Yesterday I talked to the guy at work who's in sight of the candy bowl, and he agreed to speak up when I tip-toe in that direction.

I have my moves, perfected over many years -- including quietly stealing in and out of the back doors of our neighbors' kitchens at the San Rafael apartments, Prospect Ave., Milwaukee, when I was 5. People didn't lock their doors then. I could silently empty their sugar bowl and move on. When I was caught, my parents were seriously embarrassed.  I was enraged -- at being caught. No moral fiber for me at 5.

Karen, the physical therapist I saw today, manipulated the toes and foot and it felt much looser, more normal, afterwards. She suggested looking at all I am doing now -- walking, exercises, diet -- as helping my healing and moving. 

Even 5 minutes progress is worth the effort. If I have to live inside a bubble of good intentions -- do it.

Reaching my goals 5 minutes earlier is worth it. (And falling behind by 5 minutes, 5 hours, 5 days is not.) Nobody can do it but me.

It is still a THRILL to be able to walk down and up the stairs, rather than bumping on my rear. To be able to be out on the street and see -- shops, trees, cars, people! Not to be taken for granted.

A blessing.




Photos: Exercise sheets; Karen, physical therapist at NRH Regional Rehab at Friendship Heights; waiting for the bus after PT on Wisconsin Avenue.

He's staying on my heart, this man who stumbled into my glucose garden 2 days ago at physical therapy. I was waiting for my 3:30 pm appointment when he came in on 2 walking crutches. He was tall, maybe 6'4". Very heavy. Maybe 300 lbs. My age, probably, late 60s. In the waiting room I heard that his wish was for occupational therapy; the receptionist looked up his records, a therapist came out, and they explained he would have to stop hand therapy in order to start the OT. He sat down next to me with a little table between us, and filled out his paperwork. There had been an address change for him, and the receptionist inquired about it, whether there was some confirmation. "Sure," he answered wearily.

Finishing the forms, he started to try and get up. I did not try to help. He fell back into the chair, which strained to take his large size again. Receptionist, therapist, I were attentive. "Let me rest," he said. "It's the pain." He tried again. I rose too. With my right hand at his back, I could give support, not strength. The therapist came over. "Don't," she said to me. Then: "Are you with him?" No, I said. He turned to look me in the eye with a question. Then he turned back. The therapist took him back, I assumed to one of the private rooms, not the shared gym area. The receptionist said she was calling his medical emergency contact.

He is staying on my heart, and I am praying to the Lord for him -- that healing and recovery can come for him. Such a hard road to try and walk...each step involving pain, each attempt at rising to go forth a question. An imprisonment of pain and size that reinforces itself -- difficulty moving means that movement will be less, metabolism will slow down.

Not to be able to move...terrible.

Being able to move...such a blessing.

May you be able to move, soon, without pain and with joy, young brother.

Today I was discharged from the Potomac Home Health Care system for purposes of Medicare -- yay, Medicare! -- after many weeks of 2 or 3 visits a week from Shirl, a visiting nurse. She'd come every other day during the week (except for days when I had a doctor's appointment) to change the foot dressing. At the beginning I had 3 different salves -- an antibiotic on one area, Nitro Bid (a nitro patch in ointment form), and then a collagen/silver application, Prisma. Later just one -- SilvaSorb. Shirl showed me how to do the dressing and after a while I developed the confidence to do it myself. I'm slow but not a bad job.

She approached the situation comprehensively -- the pre-diabetes, and now the physical therapy. 

I showed her today the exercises I do -- pulling the big toe out gently, then pushing down and holding, releasing, pulling ("distracting" is the term), pulling up and holding. Another exercise pushing down and up gently. Another a step-stride to get a little movement in the toes of the right foot.

And from 2 days after the surgery when I couldn't move it, at the ankle pulling the foot back as far as I can, pushing forward like in a point, then pulling back as far as possible at the ankle. Shirl told me about a disability that can develop unless you do that exercise after an accident, trauma, and some diseases: Foot drop, which for some means they can never walk again. ttp://en.wikipedia.org/wiki/Foot_drop

Who knew? The wonderful abilities we have, and how fragile they can be; the things we need to do to protect and preserve these abilities.

She'd explain what she was seeing going on with the foot and talked about diabetes diets. Today she asked me from here on out, now that I'm on the road to recovery, how I am going to handle the pre-diabetes. That is the main focus of Glucose Garden, so my exploration will be going on for some time. 

I told her that occasional finger sticks give me the glucose reading that tell the consequences of, say, french bread (no white bread, no white rice). The numbers tell the story.

If I eat in a balanced way -- protein, vegetables, and maybe one slice of french bread (ahhhh!), the numbers can be ok. Since I am a sweet- and fataholic, I know how easily sweets and fats can run away with the show for me. She explained the glucose response to high sugar intake, then the moody, weak, fatigued, sickish response to glucose levels plummeting.

Very encouraging lady. I gave her a little pressie, as the Aussies say. And the vegetables in today's photos? From her garden.

I am so grateful that for all of us who live alone and have a medical crisis, that people like her are available to help. Visting nurses, angels.

And if all goes well, I'll never see her again.

Occurred to me to email my doctor today: Can I wash my right foot now when I take a shower?

I think we all might be happier if I could, the two physical therapists and me (tho they have not said a word nor have they indicated the least discomfort by way of body language.)

Dr. Polun replied: I would say wait one more week to bathe regularly.
:)

I answered: OK
: (

First physical therapy today at the National Rehab Hospital clinic on Wisconsin Ave. (5530). I expected to be pretty tired after a workout, but it was, of course, a workup today and a few beginning exercises toward increasing the strength and range of motion of the toes of the right foot. That really does not exhaust you. I like John Jowers, the foot and ankle therapist; he's careful and explained everything clearly. This could take a couple of months.  But I can walk in the bigboot, drive in the sandal, and do a whole lot of what I did in normal bipedal life.

Saw Dr. Polun earlier in the day. He was really pleased with the progress. Me too!

7/6/12