EP222: Coaching Call with Char

[00:00:03] Speaker A: Hello there, and welcome to the reversing diabetes with Delane MD podcast. I'm Delane Vaughn. I'm a board certified family practice doctor, an emergency former emergency room nurse, a veteran healthcare provider, and the host of this podcast. This podcast is for women who are not ready to let go of their longevity, their vitality, and their vigor. It's for women that know that life is a gift and they're not ready to start the downward spiral of letting that go. This podcast is for women who are total badasses in other parts of their life, but are struggling to let go of the chocolate cake. If that's you, let's talk. Today we have a special guest. Many women have reached out to me and been willing to do this. Have a coaching call that's recorded for the podcast listeners so the podcast listeners can see what it's like to be coached. Such a gift to you. Hopefully a helpful gift to them. But that's what we have going on today. Before we get started with that, I do want to remind you if you are on medications, I want you to be careful if you are making dietary changes, the changes that I recommend in this podcast. You have been medicated because the way you've eaten in the past, and if you change the way you eat, you're going to need to change your medications. If you do not, you may get very sick, kind of sickness that involves emergency room visits and hospitalizations and possibly even death. So I need you, before you start making these dietary changes, to call your primary care provider to let them know what you intend to do and to let them know that you want to be able to have a way to give them your blood sugar logs and for them to give you feedback on those blood sugar logs and what you need to do with your medications to work off of those medications. It's a very important step to keep you safe. So if you haven't already done that, please do that. Please also share this podcast with other people that you think need this help. Nine out of ten Americans have this hyperinsulinemic problem. They are getting sick because the food that we eat, that's what this podcast helps people stop doing. So if you're getting help, share it with other people so they can get that help too. Rate the podcast. Leave a review for the podcast. Share it on your social media. All of these things so other people can get the same help that you're getting, especially if you're finding amazing benefits with this. Follow me on Instagram. Follow me on Facebook join the Delane MD reversing Diabetes Facebook group. It's such a fun group of people there to help you out along this way. Lastly, if you are interested, sign up for a reverse your diabetes assessment call. These are 45 minutes calls where you and I will sit down and discuss where your specific obstacles are and why you haven't been able to overcome them. These calls are for women who have been frustrated and worried and concerned about fixing their type two diabetes and haven't been able to figure that out. These calls help you get some clarity on that. If you're interested. At the end of the call, you can get some information about my group and how you can get the help that you need to finally put this diabetes business behind you. All right, so we are going to start with the next call with this call, this coaching call. So I am going to pull her on. All right, so we're here with Shar. Shar has agreed to have a coaching call with us before we get started. Is it that? [00:03:15] Speaker B: It is? Yep. Perfect. [00:03:16] Speaker A: From Delane, who I'm always like having to get that know. I want to make sure that I'm saying your name correctly. So I'm really grateful that you've agreed to do this and I appreciate you being here and I just want to welcome you to the call. So tell me, what do you want to dive into? [00:03:34] Speaker B: Well, I sent you a note and I guess I didn't come back and read the note. I don't have a lot of experience with what you do on the coaching call, so maybe you should get yeah. [00:03:45] Speaker A: You okay with me reading it? Not all of it necessarily, but topics for coaching. Not sure how it works, but here's some info about me. Pre diabetic two months ago and about two months ago I started working on lowering it and using my diet follow functional medicine doctors recommendations, which I think is awesome. Changed my diet. Retested a month and a half later. A one c had actually gone from 5.8 to 5.9. I was frustrated. That made me commit further. I'm doing a savory breakfast, no snacks, minimal carbs at lunch and dinner. I've been pretty consistent for about three weeks now. Here are some things that are challenging for me. I'm pretty analytical and could get some feedback daily or weekly or something. I know I could wear a CGM, but I don't really want that level of tracking on my food. I cut back from two cups of coffee to one, but I really wish I could have two. I'm also being treated for lower back pain that's gotten significantly worse. Okay. My doctor said she expected that. Part of my issue is the stress, and probably especially if your functional doctor said that. I totally agree. I would agree even if your primary doctor had said that. But I retired early and really should not have stress. But here we are. I am trying to add in more walking and other activities to get more exercise, but I've not done it with the same commitment that I have with my meal changes. So I think that that's great. I want to one thing that probably. [00:05:10] Speaker B: Wasn'T clear in there, my a one C has been testing high with my primary doctor all the way back to 2018, and with really very little direction on that I should make any changes. And it wasn't until I went to the functional medicine doctor that she's like, you're pre diabetic and you should do something. [00:05:29] Speaker A: Yeah, look at us going like, hey, you don't have to wait until you're nearly on death's door. We can actually change it right now. [00:05:36] Speaker B: Yeah. [00:05:38] Speaker A: Okay. And that's pretty typical, honestly. And it's so interesting now as a physician and working with women who are diabetic, I certainly see all the biomarkers, and I start to see them climb long before they get a formal diagnosis. And it's interesting even. So, you may or may not be aware, I was a nurse before I went to medical school, and I can remember even in nursing schools. So this was in 1999, like 2000 era, that we were taught that you had probably had the disease state of type two diabetes for at least a decade prior to diagnosis. And we're starting to realize that that disease pathophysiology, the process that's causing the disease, is impacting so many more areas, not just your blood sugars, that really, we can't just let it ride. You would never let cancer sit in your body for ten years before you decided to do something about it, right? [00:06:43] Speaker B: Right. [00:06:44] Speaker A: Yeah. I'm not surprised. Anytime any woman comes to me and they're like, oh, I've got the diagnosis, or even I'm pre diabetic in my brain, I'm like, subtracting a decade before as to when that disease process was probably present. So, yeah, that makes sense to me. Okay, so you just started doing things. So there's a couple of things I want to talk about, and this is just information, this is not coaching, but sure. Tell me what you think about two cups of coffee. As I drink my coffee. Think about that. [00:07:12] Speaker B: I don't know that I'm really dependent on it. It's a habit that I really got once I retired. And I just really like to sit on the couch and drink two cups of coffee and watch the Today show. And I really created that habit myself. And I feel like it's a luxury that I never had when I was working full time. I think maybe that's the big part of it with me, is, hey, I have the ability to sit here for an hour and a half and watch tv. I would have never done that even on the weekend before. What I've been trying to do lately is kind of reframe that habit to just one. One cup and then replace it with water or something. I don't think I'm addicted to the caffeine. I think it's literally. It's just a habit I've enjoyed. [00:08:03] Speaker A: Yeah. Why not decaf coffee? [00:08:06] Speaker B: I did actually switch to decaf, and she said that she felt like that it was actually better to just drink the coffee. [00:08:16] Speaker A: And your functional med doctor said that? [00:08:18] Speaker B: Yeah. [00:08:19] Speaker A: Because of that encouraged you to get off the coffee. [00:08:21] Speaker B: She's the one that encouraged it, yes. [00:08:23] Speaker A: Okay. And so there definitely is rationale behind that. And definitely, if she thinks stress is a big player, certainly there are studies out there that say that two to four cups. Now, granted, when I think of a cup, it's like a huge ginormous cup. That's literally. Is it really the size of my head? It pretty much is. I think of these as two cups, but really, it's probably a little less than this. Two to four cups of caffeine is actually beneficial in studies to your blood sugar management. [00:09:01] Speaker B: Oh, interesting. [00:09:03] Speaker A: So it's not that the caffeine or the coffee is likely causing the issue. It's likely the increased stress and the sympathetic nervous system stimulation of the caffeine that your functional med doc is like. Maybe we rein that in a little bit. Okay. Just so you know, like, one cup of coffee and one cup of switching to decaf and doing decaf. Do you want to do a tea? If it's really this experience of sitting on the sofa and having something warm in your hand? And there is also evidence, I've heard science, although I cannot repeat the science because I don't remember it well enough, that there is something about the warmth, the warm liquid drinking it, that's stimulating to us and actually starts to wake us up. So even if it's just warm tea, warm lemon, water, whatever it is, so you may find that relaxation, and if that's really what you're looking for, and you know that that's what you're looking for, you probably can create that in a variety of different ways. I always ask people why they want to cut back on coffee, and a lot of times there is this belief that coffee is bad for us, and I don't know that that's supported by the evidence entirely, like, it's bad for their blood sugars. I don't know that that's supported entirely. Definitely it is stimulating to your stress response, and if that's what your functional med doctor is trying to work on, then that's probably something that you need to consider, interestingly about the back pain, and you may have some spinal stenosis or degenerative disc disease. All of those things. Most of us within a birthday is under our belt. We get some element of that. Insulin resistance, though, is inflammatory. So insulin resistance is the root cause of the diabetes. And when you have that process going on. So if you're having an a one c in that insulin resistant or diabetic or pre diabetic range, then likely you're having a systemic all over your body inflammatory response with the insulin in your system. So you may find benefit as those numbers start to improve. Makes sense. [00:11:14] Speaker B: I hope so. [00:11:15] Speaker A: Yeah. I've actually had clients who start to. Maybe they have 40 pounds to lose, and they'll drop ten or 15 pounds, and they start to feel better, and they're like, I already feel better. It's amazing. And their brain, it's like the weight. And yes, there is that impact on the joints, on the body with the extra weight that they carry, but I think a lot of it, just as, if not more effective, is that reversing that insulin resistance. All right, so what do you want to coach on on these things? [00:11:52] Speaker B: I don't understand, when you say the word coaching, what that means, what do. [00:11:56] Speaker A: You think that you need help with? If you could fix your type two diabetes, what do you believe the one thing you need help with would be? [00:12:05] Speaker B: I think that over the last, probably closer to four weeks now, I have been very consistently working super hard on. It shocked me when I thought that I was working hard, and then your a one came back, it was actually higher, and so I feel like I'm even more attentive to it. And I have actually seen some weight loss that I was not seeing before. And I think for years, I mean, I haven't been able to lose any weight, no matter. I think I could have stopped eating, and I still have not lost weight. But I do worry that I understand the whole concept of building habits, but I do worry that about getting to the mindset of that this is forever. [00:12:58] Speaker A: Yeah. So tell me more about the mind, like, why you worry about. What does it mean? What is the mindset of this is forever? Talk about that a little bit. [00:13:09] Speaker B: Well, my gut says, and I'm not a doctor, that if I can't continue to manage my blood sugar, that it will come back if I'm successful on getting it lower and lower, that I could ruin that just as easily as I did whenever it was ten years ago. And because of that, it feels like there's a sort of bigger thing in front of me that I don't have to deal with yet, I have to deal with today, but I still worry about that. [00:13:41] Speaker A: Yeah. What's that bigger thing in front of you? [00:13:43] Speaker B: That I'm not able to do it long term. [00:13:49] Speaker A: Yeah. So it sounds like you have a thought that I may not be able to do this long term, and there's worry. [00:13:55] Speaker B: Yeah. [00:13:56] Speaker A: And that keeps you in this kind. Do you feel like in the past, have you ever had a place, a time in your life where you made healthy lifestyle changes and you were able to do them for however long and then you stopped? [00:14:12] Speaker B: Yeah, I did. I mean, there was a point when I started to run or walk or someplace in between that and kept that up for a year and a half. That's kind of when the back pain started, though, is when I kind of stopped it. But I think we've all done that. Or maybe not. But. [00:14:34] Speaker A: Why do you think you stopped it? [00:14:37] Speaker B: In the case of that, I think it was more because I just started having so much back. I mean, I don't know that I've really had other things where I don't. [00:14:55] Speaker A: Yeah. So you've not done any, like, it's not like that. One time I joined Jenny Craig and I lost x a number of pounds, and life was going good. And then I stopped, or frequently I hear I did keto one year for, like, six months, and it was amazing. And then I stopped. So what foods do you. [00:15:12] Speaker B: I did all kinds of things like keto and whatever, but I never saw weight. [00:15:17] Speaker A: Any results from it. Yeah. So if you could take out a food, what foods do you think are giving you a hard time? Like, what foods caused this? If you had to say, like me, it was Eminem's and Diet Coke. Right. Very clearly, that was my problem child. Right. There were a lot of other things involved with that, but that was foundational for me. What foods do you think it is that's hard for you? [00:15:42] Speaker B: I think it was sugars. It really was like, ice cream and then probably snacking. I would equate to a lot of it. It was not managing it well to have true meals versus just snack. [00:16:01] Speaker A: Yeah. So is there a belief that you may not be able to cut the sugars or cut the snacking long term? Is that the thing that has you worried? [00:16:11] Speaker B: I think it's maybe more the sugars. I like to cook, and I'm working hard to make sure that I have variety and flavors and whatever right now. But sugars are good. [00:16:29] Speaker A: Yeah, they sure are. What does your brain tell you? Or what is your worry about cutting sugars out forever? [00:16:38] Speaker B: I think it affects your lifestyle in such interesting ways. Like, when you go to a restaurant. I notice it now that I'm like, what am I supposed to order on this menu? And I'm smart enough to know that it's literally, there is nothing on the menu that's not full of sugar. [00:16:58] Speaker A: Yeah. Give me an example of when that happened. [00:17:01] Speaker B: It happened yesterday morning. We went out for breakfast at a brunch place, and I opened the menu, and there's all the sweet breakfast, which is not usually my thing anyway. And then there's a whole bunch of things with bread in them. There's potatoes. It felt like everything on the menu had some level of carbs that I didn't know any background on. I made a pretty good choice, I think. [00:17:30] Speaker A: What did you choose? [00:17:32] Speaker B: It was a piece, like, one slice of toast. So it was open face. It had an egg on it and avocado and then tomato and feta. [00:17:41] Speaker A: Was it good? Did you like it? [00:17:42] Speaker B: It was delicious. [00:17:46] Speaker A: So a couple of things. Right? There is strategy to manage that, and you can dig in. Like, what would have happened if you would have said, I want this, but without the toast? [00:17:56] Speaker B: Oh, they would have brought it to me without the toast. [00:17:59] Speaker A: Yeah. Why wasn't that an option for you? [00:18:01] Speaker B: I didn't even think of it. [00:18:03] Speaker A: Okay. And I love. And again, it's a thought. Like, everybody doesn't have to have this thought, but it is my favorite thought. Their business plan is to exchange their food for my money. It is literally the thing that they want to do all day long. Right? So if we can find a way to come to terms on how they can exchange my money for their food, let's work at that. Right? I always ask for substitutions or changes. There's a variety of reasons. Sometimes I can't have beef. So I'm like, I really need you to be serious about turkey sausage. If it's not turkey sausage, I'm going to have a problem. Like, I'm going to get sick. Sometimes there's that part, and it feels very easy to ask for them because I'm going to have an allergy. Some people get really mixed up in their head about asking for them to pull out the carbs just because we're trying to get healthy, which is ironic. Right? It's the same thing. We're both doing it for our health. Both times it's for the health. It's just people have funny feelings about it, so sometimes that comes up and we need to coach through that. But it sounds like sometimes we just don't think, oh, I could just ask for it without the carb component. Right. Sometimes there is that strategy, but curiously, so, there is this idea that it's hard to live life without that. I want to ask you about what you did choose, though. Do you think that eggs and avocado and tomato and feta and a piece of bread led to your diabetes or your pre diabetes? [00:19:39] Speaker B: Probably not. It's probably not what I would have ordered ten years ago either. [00:19:47] Speaker A: Yeah. What would you have ordered ten years ago? This is always fun. [00:19:52] Speaker B: Probably. Like I said, I probably would have ordered eggs and sausage and potato, hash browns and toast. [00:20:07] Speaker A: I guess my question to you, do you feel like you could do eggs and sausage and a little bit of the potatoes and a little bit of the toast long term? [00:20:16] Speaker B: Yes. I can't. [00:20:24] Speaker A: Yes. Well, yeah, no, but you should be in my ears. Sorry. Technical glitch. So, see, that your brain is offering you worry and a belief that you can't do it long term, where if we actually. And that's the way our brain does it. Right. Like, there's a question and it's unanswered. It's just left hanging. And when it's just left hanging like that, we suddenly can't find an answer. Right. Like, we can't even imagine going forward long term because we don't give ourselves an answer to that question. And that creates this worry. Right. Does that sound like something you could move forward with? [00:21:14] Speaker B: Yeah. Well, a. I just like the idea of, like, why didn't you just ask them for what you wanted? [00:21:24] Speaker A: When I walk into a restaurant and I'm like, they literally want to give. [00:21:27] Speaker B: No. [00:21:28] Speaker A: There are really highfalutin restaurants, as my dad would have called them. There are really fancy schmancy restaurants where the chef really wants you to eat the food that he gives you and that's. Or she gives you, and that's great and fine. It's not where we're spending most of our life, right. It's not where we're going all of the time. The restaurants that you go to all the time, they know you and they likely want you to keep coming there, and they want to exchange your money for their food. So that's a strategy. Does that resolve all of your worry? [00:22:02] Speaker B: No. [00:22:02] Speaker A: Yeah. What else comes up? [00:22:05] Speaker B: Well, I think it's just sort of like living life, and maybe because so much of it's new to me and I've been trying to learn so much, it's going to take a while, I think, to figure out what things can you do? For example, we'd like to go get ice cream probably once a week. And I've pretty much just said, no, thank you, but I don't want to do that for the rest of my life. It's part of our relationship, I guess, almost, is to do something like that. But I guess I need to learn. Is a small portion going to hurt? And if it's only once a week and, you know, like, I don't know any of that stuff, just because this is also new to me. [00:22:58] Speaker A: And so there is going to be an element of learning how frequently. And I will tell you that there is no answer that I can give you right now. It's really like, so what I recommend with my clients is about ten to twelve weeks of pulling the carbs out, really holding it low, and then seeing what happens with your blood sugar. And then we do what's called a carb challenge test. We eat the thing, whatever it is, a sundae, a piece of cake, ice cream, pasta, whatever the thing is. And you get to decide, like it's individualized for everybody. And then what you do after that is you check your blood sugar in increments to see how well your cells respond to pulling that blood sugar down. If your cells respond in a normal way, then you can start adding foods back in, right? Easy peasy. Then you kind of decide and you monitor your blood sugars and see, when I have once a week ice cream with three times a week pieces of bread or potatoes, my fasting blood sugar starts to creep up. That's too much. What do I want to rein in? You just monitor it and see. Are you going to be able to. So my question to you is, I want to offer that one piece of toast with breakfast on the way out. On eating out never made you diabetic, even combined with once a week ice cream. So those were unlikely to have created your disease. Like the biology in your body right now. What was it that was creating it? [00:24:38] Speaker B: It was consistently doing those things. And I think it was super high stress job, very little exercise, all of those things. Up until she mentioned, she talked to me more about it, I hadn't really thought about how much stress mattered. [00:25:07] Speaker A: Absolutely. And once you get to the place where your cells are insulin resistant, you do have to rein those things in. But I always remind and please do not hear that. I don't think it's important. And I talk with my clients constantly about stress management, but there's no amount of meditation and zenness that's going to normalize your cellular function at this point. Right. What food is it that you're really worried about letting go of on a regular basis? Or like, what is the way that you were living that you're like, I can't do that right now? [00:25:38] Speaker B: Yeah. I think this is such an interesting question because I felt like for years that I have been a pretty healthy eater. And when I say sugar, I think that that's maybe what it truly is, was like something after a meal or having some kind of sugary snack or whatever daily. [00:26:03] Speaker A: So do you feel like you ate snacks on a regular basis, like every day? What snacks were they? [00:26:10] Speaker B: They would vary. Like processed things. Cake and ice cream. [00:26:17] Speaker A: Yeah. So are you really worried about letting those things go long term? Are you worried about not snacking on tasty, sugary stuff every day? [00:26:27] Speaker B: I don't think so. I don't think I'm worried about that. When I say that, I'm just kind of skeptical. I guess that maybe that's a better word than worried. That it can be long lasting. [00:26:45] Speaker A: Yeah. And so figuring out, getting to the bottom of that. Let's dig into that. Why do you believe it can't be long lasting? We talked about the restaurants and it is everywhere. Right. Why do you believe it can't be long lasting? [00:27:00] Speaker B: Outside of that, I think there's a lot of messages in the media. Like I said, I haven't been able to be successful at it myself. I'm very much an accomplished person, and this has not been something that I've been able to manage, I guess. [00:27:17] Speaker A: But you've been doing it recently, right? [00:27:20] Speaker B: Yeah. [00:27:23] Speaker A: Give me an example of when you weren't able to manage it. When you were like, I really wanted to create this and I made this other decision. [00:27:30] Speaker B: I can't really think of. I don't think it's like some specific day that I said, oh, today I'm going to stop doing. [00:27:37] Speaker A: I'm going to have pancakes. Yeah. [00:27:40] Speaker B: I think it just sort of, like, creeps in. And then you wake up one day, and you're like, oh, wow, diabetic. [00:27:59] Speaker A: It sounds like right now you're making consistent choices that you like. [00:28:03] Speaker B: Yeah. [00:28:05] Speaker A: And you're seeing corrections of those numbers. Is there any place else in your life where you've kind of had this skepticism that something can happen and you're like, I don't know. That's true. [00:28:18] Speaker B: I don't think it's fair to say that I'm seeing corrections in the numbers. Right. Because it's only been these four weeks, and I'm pre diabetic. So, like I said, I'm not doing any kind of tracking or glucose monitoring. My next appointment is two more months from now. [00:28:39] Speaker A: Okay. [00:28:40] Speaker B: There's no feedback to me that I can see other than the weight loss that I have felt a little bit right recently. [00:28:47] Speaker A: Okay. What is your plan? What is your current protocol? What are you doing to create to fix this for you? [00:28:56] Speaker B: Trying to have way more protein. A savory breakfast and then just lots of vegetables and meat, basically, is mostly what I've been eating. [00:29:09] Speaker A: Okay. And on it, like, if you had to give yourself a zero to 100% grade, like ABC grade, how did you do yesterday? [00:29:19] Speaker B: 85%, probably 90. Like I said, it's working. Okay. [00:29:25] Speaker A: Right now, what was the 10% or 15% that kept you from 100%? [00:29:33] Speaker B: I had dinner last night with a friend, and I probably had a way bigger portion size. It was like a tortilla wrap and greasy. It just felt like. I think it was one of the better choices on the menu, but it was a large portion, and I ate it all. [00:29:52] Speaker A: How did you do the day before? Is there a day where you're like, I did 50% that day. [00:29:58] Speaker B: I literally don't think I've gotten. I would say I went to 50%. I think there were a couple of days, like, maybe 60, 65, and that was more like, we went out for dinner, and I had dessert one day. [00:30:12] Speaker A: Okay. [00:30:13] Speaker B: So I would put that on this. Like I said, I've been really trying to be as attentive as I could. [00:30:23] Speaker A: Sure. So it sounds like you actually are doing that. Is there any belief, like, living this way sucks, and I don't want to do this long term? Is there anything like that? [00:30:34] Speaker B: Well, it's challenging and time consuming right now, mostly because I don't want to eat the same thing over and over again, but I feel like that becomes something. I can figure that out. Long term, it's just more about reframing what I cook. [00:30:54] Speaker A: Some of it is reframing what you cook. I do think it's always interesting, and I don't think that that particular belief is hindering you. So I don't know that there's any necessary to dive into it. But I always encourage people like, what were you eating? Give me the month before you made these changes, what were you eating on a day? And it's still like five to ten meals that we cycle through, finding five to ten that we can cycle through, that we enjoy, that don't make ourselves sick. It can be time consuming. Absolutely right. It sounds like you don't have any problem. [00:31:32] Speaker B: I think maybe the other thing is, I've been for the last three weeks at our condo in Florida and mostly by myself, and so I'm not eating out as much right now either, which could have. That could be one of the reasons why it's easier right now. [00:31:52] Speaker A: So what do you think about eating out? Like, just in general, broad spectrum, what are your beliefs about eating out? [00:32:04] Speaker B: I don't know. It's something that I enjoy, that we enjoy. And I don't necessarily know that I think of it as a time when I want to try new things, but I don't necessarily think that I think of it as a time to be indulgent. [00:32:20] Speaker A: Yeah. Is there a thought that if you have to change the way you're eating, that you're not going to enjoy those experiences as much? [00:32:28] Speaker B: Yeah, possibly. [00:32:31] Speaker A: And that is probably the heart of what the concern that I don't know that I can do this long term is. Yeah, that could be right. When you think. When anybody thinks, I don't know that I'm going to be able to do this thing that I've enjoyed, that we enjoy, that's part of my life. I don't know that I'm going to be able to do this and fix my numbers long term. You create that worry from that, and then, of course, just the way the brain works, you will then start looking for evidence of why you're not going to be able to do this long term and what that will look like for you, I suspect, and maybe I'm wrong, but you'll see, you're going to get the results because you are a driven human, you're a driven woman. You've done things like you're accomplished, you're going to get the results, and then you're going to be like, I don't want to live this way if I've got to have these results. Like, if this is the way I've got to live. I don't want to live this way because this is an important thing to me and I don't see how I can do this long term. And you're going to create evidence about why it's so uncomfortable as long as you're like, I don't see how I'm going to do this long term. Does that make sense? [00:33:40] Speaker B: It does. [00:33:41] Speaker A: Do you think that's a source of your worry? [00:33:44] Speaker B: Probably. It's a good chunk of it, yeah, for sure. [00:33:49] Speaker A: So how do you feel about that when I lay that out, when you're thinking, I don't know, that I can live this way long term and enjoy this thing that's important to me, and you feel worry and you start to see the places that it's hard for you to make these changes and you see how that's going to create this result of you not being able to keep it long term. What do you think when I tell you that? [00:34:15] Speaker B: Well, it's interesting to identify that that might be what's happening. When you say you're not going to get the results, that concerns me. [00:34:29] Speaker A: Right. Because it depends on the results that you want. I think you will get the results, but do you want them long term? That long term result might be questionable, but yeah, go on. [00:34:39] Speaker B: Yeah. I don't even know what number I'm trying to get to. I just know I want it to be lower. Right. That's the message I heard. [00:34:48] Speaker A: Yeah. So I do think there needs to be some clarification and we'll talk about that, but go on. [00:34:54] Speaker B: Yeah. And so I think maybe the worry is more about making sure that whatever that number is when I get to it, because I do think that I will. What then? [00:35:13] Speaker A: Absolutely. I think we have some information to talk about. Just give me the parameters I need to work within so, you know, so it doesn't feel like you're walking through a foggy forest, you know what I mean? And not sure, but do understand, I would encourage you, I want to welcome you, to start looking like, oh, how am I going to do this forever? How am I going to enjoy eating out with my family and the loved ones in my life and enjoy this experience that I do love in a way that doesn't make me sick, that keeps these results long term for me. Your brain, like the heart's job is to pump blood and it beats all the time. And the lungs jobs are to breathe in oxygen and exchange it for carbon dioxide. The only time that they stop doing that is when we die. Our brain's job is to think. And the only time it stops doing that is when we die. Right. If you don't put an intentional, like, if we don't set our brain to think about the things that we want to think about or that serve us, it will think about all these other crazy things, like, I don't know that I'm going to be able to do this for longer term. Right. And start creating evidence and seeing that evidence. So I would encourage you to put it to work. How am I going to keep this thing in my life that I love, eating out with my family, spending time with my family, and not be sick with type two diabetes? How am I going to do both? Okay, so let's talk biomarkers. Okay. The biomarkers that we look at with just metabolic disease and being healthy. One, of course. Your a, one c, two, a. Serum insulin level. A fasting serum insulin level. Your functional med doc may have already drawn one of those. Your traditional medical doctor will look like you have four heads on your shoulders if you ask for one. So prepare yourself if you do that. But the insulin level, the alt on your chemistry panel, it's a liver enzyme. That's another one we look at. Triglycerides is one we look at on your lipid panel. So again, your a, one c, the insulin level, the alt triglycerides. And then some people will look at blood pressure because certainly elevated blood pressure is impacted by insulin resistance. Okay. Meaning that the way that the kidneys function, it doesn't matter how low your sodium count is during the week or during a day, you're going to run your blood pressures high because of the effect of insulin resistance on your kidneys. So those are the things you want to look at. You would probably benefit from getting what we call in the group, a prick machine, an accu check machine, one of the finger stickers, and checking your fasting blood sugar, that is the way that you're going to get the most precise information about what you're doing from day to day. Okay. The scale is helpful, and the fact that you're seeing weight loss is awesome. But a lot of times that's driven by water retention. Everybody knows when you eat too much salt, you retain water. Carbohydrates. The hide of carbohydrates is a water. The more carbohydrates you eat, the more you retain water also. Okay. [00:38:29] Speaker B: Okay. [00:38:30] Speaker A: So it's just not as precise as a way to watch your blood sugars and your insulin resistance and how it normalizes the fasting blood sugar is the last blood sugar to normalize, but it is the most indicative of what's going on with your insulin resistance. Okay. So you have to come to that number with a lot of patience, but understanding that you're getting the most information from it. Okay. When that number falls below 100, that's when your insulin consistently falls below 100. That's when your insulin resistance is starting to resolve. Okay. There are a number of nuances that I think giving all at once are very overwhelming, so we won't talk about that. But if you see for two weeks, your average blood sugar for two weeks is 95, you can feel really good that you're on the right path. Okay. [00:39:27] Speaker B: And that's like, if you were to do the prick your finger right away in the morning. [00:39:32] Speaker A: Yeah. [00:39:33] Speaker B: Okay. [00:39:34] Speaker A: So making adjustments on how many carbs you're eating in a day. And I know that there is an element of, like, I don't know that I want to watch that closely. You won't need to watch that closely forever. I put my CGM, I put it back on for the first time in probably two and a half months today. I check my blood sugar pretty frequently in the morning. But again, it's like, when I say pretty frequently, I had a test strip of, like, a thing of 30, maybe it was 50 test strips, and it's lasted me that two and a half months. It's not like I'm doing it every single day. You don't have to do it every single day. Once your numbers are reversed and you understand, you have a clear understanding of what you can and cannot eat. Right? I don't like the word cannot eat. You can grown ass woman. You can eat whatever you want. But if your goal is to keep your blood sugars in a certain range, there are foods that will pop you out of that range, and there's a frequency of those foods that will pop you out of that range. Okay. So once you understand kind of the parameters which you eat within to keep that result that you like, then you don't need to be testing all the time. You just need to test whenever the holidays are a big one, because usually there are. I know that my fasting blood sugar pops up from, like, 85 to 97, 95. My blood sugar goes up. It doesn't usually go into a pathologic range or a disease state range, but definitely there's a jump in it. My weight goes up. All of it happens over the holiday season. That's just the way it is. And I know what that means is in January and February, I do a lot of cleaning up. Like, there's nothing I can't fix because I know what I need to do. Okay. And that, I think, comes full circle to this. I don't know that I can do this long term. There is nothing in your life that you cannot have. There's truly nothing. There is no wedding cake. There is no birthday cake. There is no anything. There is no ice cream. That is. You're never going to be able to eat it again. Nobody got sick from one thing of ice cream. Right. There was not one piece of cake that made anybody sick. It was years and decades of living that way. Right. What do you think about all that? [00:41:58] Speaker B: That's helpful? Yeah. I like the suggestion of just taking my fasting blood sugar once a day, even, and just to start to have that piece of feedback rather than wondering if I'm on the right track for the next two more months. [00:42:16] Speaker A: Yeah. It's no wonder it's worrisome for you. Really, truly. It's no wonder it's worrisome. You don't have anything to anchor into. [00:42:24] Speaker B: Right. [00:42:25] Speaker A: Yeah. Along with this idea, I'm going to have to let go of these things that I love in life. That, combined with a lack of anchor, probably does feel really worrisome. [00:42:37] Speaker B: Yeah. Just in general, I have an analytical personality. [00:42:42] Speaker A: We like numbers. I always say that whenever I'm working as a clinical physician and I'm like, I want labs. And they're like, we don't need labs on everybody. I'm like, yeah, but they're nice. I love my numbers. Right. It gives me something to tinker with. Those few things probably would take you a long way. I think that where you're starting at, your numbers are going to reverse. This is something I see with my women within the first six to ten weeks of working together. When they start in your. It is definitely different. When I see women who have 100 units of insulin or have all the. They've had diabetes for 30 years and they've been on insulin for 20 of them, it is definitely different for them. But for where you're starting, we definitely see this reversal happen very quickly. By six months out, you're feeling like you're in a really steady place. [00:43:40] Speaker B: Good message that she's giving to me is she's like, you can do this. [00:43:49] Speaker A: And I will offer again, I highly recommend stress management. And there have been women, I have worked with two women who. That was their thing. They ate clean, they didn't want to lose weight. Their weight was in a healthy range and they could just not seem to get their numbers down. And we worked one of them. She's lovely. She was so wonderful. And we worked together for, like, I don't know, probably 1314 weeks before she was finally like, okay, tell me more about this stress thing. We keep talking about it, and that was the thing. Within about four weeks of working on stress, specifically meditation, journaling, looking at our thoughts, deciding what we want to be stressed out, like, what do I want to invest my mental energy into and what is not that important to me, and I'm going to just let it go, those things. Four weeks, her number is normalized. [00:44:40] Speaker B: Wow. [00:44:41] Speaker A: Stress can be very powerful. But again, there's no amount of meditation all day long. That's going to make eating Twinkies an okay issue for me. Right? Does that make sense? [00:44:52] Speaker B: Yeah, it does. [00:44:54] Speaker A: All right. Any other questions that you have about the kind of parameters, the boundaries, the science that we talked about or any other questions about this worry thought or you sure I'm not going to be able to. Are you sure I'm going to be able to eat out sometimes? Anything? Questions about that? [00:45:10] Speaker B: No, I don't think so. Yeah, that was good. [00:45:14] Speaker A: Good. I hope it was, and I hope it's helpful for everybody. We're going to sign off. If anybody has any questions about anything that I presented in this podcast, don't ever hesitate to reach out to me. Delaine at Delanemd and I will be back next week. Bye.