hypothesis re my chest pain: dehydration

i used to get very rare chest pain, usually just a twinge when i was stressed at work. but during my period last month and this month i had episodes of severe, scary chest pain that felt like a heart attack. i took 4 baby aspirin for both. in the first case the pain went away in about 15 minutes. in the second case it was instantaneous, leading me to believe it wasn't the aspirin at all. it may have been the cup of water i drank with the aspirin?? anyway, the commonalities are that these last 2 very severe episodes didn't happen when i was under physical or psychological stress. they both happened during my period- i tend to have such a heavy flow i have to take aleve to cut it down or have anemia from cumulative blood loss. also around my period i crave sweets and junk more, and i eat clean 90% of the time, so it is a big difference glucose-wise or soybean oil-wise when i eat junk. so my previous 2 hypotheses were that 1) that the pain was due to hormone fluctuation 2) some reaction to a glucose spike, soybean oil, etc. the first one is scary cuz i don't want to manipulate my hormones because of increased chance of getting breast cancer. the junk food one should be easy to do- just don't eat it, especially around my period. but i couldn't resist all those chocolate bars in my daughter's pillow case!!! my third hypothesis is dehydration. eating lower carb + a little more coffee as diuretic + losing fluid from my period + never thirsty/thirst mechanism is messed up = super constipated/chapped lips/dry skin AND it may also be messing with my electrolyte balance and just the necessary amount of water the body needs to function minimally. easy fix. i am making sure i have lots of bone soup and at least 1 bottled water a day. plus i try to have some magnesium at night. my calf muscles have been cramping a lot since i went lower carb. the drive for low carb came when i realized i seem to have impaired glucose tolerance. today i had half an apple though in case i am overdoing it with low carb. i just recently had an echocardiogram to rule out any irregularities. i am waiting for the doctor's follow up phone call. it was fun seeing my cute little valves seem to raise their 'arms' up and down together! so anyway, besides carrying around baby aspirin everywhere just in case, i will be strict no junk food at all around my period. i will also continue to drink more fluids- at least so i don't have constipation and chapped lips!!! then i'll see by my next period if maybe one (or both) of my hypotheses was correct. update: i also have to consider gastric reflux: http://www.mayoclinic.com/health/heartburn-gerd/DG00016/NSECTIONGROUP=2

a post in which i will collect yummie low carb recipes

http://mariahealth.blogspot.com/2010/03/french-toast-with-no-bread.html

this recipe makes something with the texture of french toast/apple fritters out of eggplant.  at the family farm there is tons of free eggplant i'm going to get tomorrow and try this out!!!!

again the incomparable jenny ruhl has lots of yummie suggestions:

http://diabetesupdate.blogspot.com/search?q=low+carb+cocoa

http://www.kraftrecipes.com/recipes/philadelphia-3-step-cappuccino-cheesecake-52996.aspx

for the above cheese cake:  "...substitute DaVinci sugar free syrup for the sugar and bake for a few minutes longer than usual. Instead of graham crackers, use a crushed nut crust made by chopping walnuts or almonds and pressing them into the pan."  -thanks Jenny!


also from Jenny:  Homemade low carb cocoa (Hershey's cocoa, Davinci syrup, and half and half)

who will get diabetes- what points the way

The 1-Hour Glucose Tolerance Test Not the Fasting Glucose Testing Accurately Identifies Diabetes Risk

Most doctors who screen you for diabetes give you a fasting glucose test or an A1c test--though the American Diabetes Association specifically states that the A1c test should not be used for diagnosing diabetes. But research published in 2008 that was based on studying a group of 2,442 subjects who were free of type 2 diabetes at the beginning of the study found that fasting glucose tests were a very poor predictor of who in this group would develop diabetes. 

The researchers found that people whose one hour glucose tolerance test results were over 155 mg/dl and who had markers for metabolic syndrome--such as a concentration of fat around the belly and high blood pressure were those who were more accurately predicted to be likely to develop diabetes. 

Fasting Versus Postload Plasma Glucose Concentration and the Risk for Future Type 2 Diabetes Muhammad A. Abdul-Ghani et al. Diabetes Care 32:281-286, 2009 DOI: 10.2337/dc08-1264

the above is from Jenny Ruhl's site

what i have learned about diagnosing diabetes- mostly thx to jenny

this is what i have learned:

1. test your blood glucose with the most accurate meter you can get. in the diabetes solution book dr. bernstein doesn't recommend a meter since he says the technology is always improving. dr. bernsten says in the book to call his office and his secretary will tell you what they are currently recommending. his number is: 914 698 7525. as of now his secretary says he recommends the accuchek viva. so the strips are a little expensive. nov 2011 consumer reports mag also lists this meter as one of the most accurate. could be 15 point off in either direction and this is the most accurate!!! that means a reading of 85 might mean anything from 70 to 100. so you want to shoot for 85 because 70 to 100 is the healthiest range we can shoot for with the current technological accuracy of meters.

2. don't share a meter with someone- you never know if they have a blood borne disease and you don't know if you sterilized the meter/lancer well enough. i'm on the careful side and i can afford an $18 meter for peace of mind.

3. realize plenty of people can have a normal fasting glucose but also have high, even damaging post prandial blood glucose numbers that they don't even know about. don't just depend of the fasting glucose test.

4. don't just depend of the A1c test either since it is an average of blood glucose levels and doesn't reflect spikes. it is years of blood sugar spiking over i believe 140 which damages organs. my mom has delayed stomach emptying since her vagus nerve has been damaged by high blood sugars. that makes taking insulin even harder for her- she has to be careful not to give herself too which would risk life threatening low blood sugar.

5. if your numbers look good on fasting blood glucose, the A1c, and your do-it-yourself post eating testing, you still need to test how much insulin your pancreas is pumping out. maybe you have good numbers because of a massive amount of insulin your pancreas has to put out because you are insulin resistant. professor de vany recommends the fasting insulin test. i have seen the c peptide test recommended by bernstein for this. i don't know if one is better than the other or not. hence the title of this thread.

6. here is the kicker for me. if you only get the fasting insulin test that professor devany recommends- it still may not be revealing enough. professor de vany says a low fasting insulin result means you are insulin sensitive. but what if you have a low level of fasting insulin because your pancreas for whatever reason ( like auto immune disease casuing beta cells to be destroyed as in LADA; beta cell burn out)is not pumping out sufficient insulin? then a low fasting insulin level can be a sign of disease. on the NMR lipoprofile test i got an insulin resistance score of 2. that means i'm not insulin resistant. i should be putting up great post prandial numbers if i am that insulin sensitive, shouldn't i? my lipid numbers are all excellent and not indicative of insulin resistance. so in that case, more extensive testing needs to be done. now i have to go around begging medical professionals for GAD antibody tests.

- i'm laying this all out so that if anyone sees any flaws in my logic that can point it out to me as andrew has been. it would make my life easier to be proven wrong. 

this site has all sorts of good info on diabetes

http://www.healthy-eating-politics.com/diabetic-diet.html

LC cheesecake from Galina

I had to steal this easy recipe from Galina:



For my husband's birthday at the end of June I didn't want to use an oven (it was already too hot in a Florida), bought a sugar-free cheese-cake, put it in a bigger container, mixed juice from frozen cherries with gelatin and 1/3 cup of sour cream, 2 whipped egg whiles,cherries,poured all that over the cheesecake (I covered sides of container with a parchment paper and put a parchment paper strip under the cheesecake in order to lift it after the jello will make the cherry mousse solid ). You can use a chocolate mouse and any nuts as topping as well

trying to decide if metformin/glucophage would help me

From the wikipedia entry on metformin (I underlined parts I want to remember):

Metformin treatment of people at risk for type 2 diabetes may decrease their chances of developing the disease, although intensive physical exercise and dieting work significantly better for this purpose. In a large U.S. study known as the Diabetes Prevention Program, participants were divided into groups and given either placebo, metformin, or lifestyle intervention, and followed for an average of three years. The intensive program of lifestyle modifications included a 16-lesson training on dieting and exercise followed by monthly individualized sessions with the goals to decrease the body weight by 7% and engage in a physical activity for at least 150 minutes per week. The incidence of diabetes was 58% lower in the lifestyle group and 31% lower in those given metformin. Among younger people with a higher body mass index, lifestyle modification was no more effective than metformin, and for older individuals with a lower body mass index, metformin was no better than placebo in preventing diabetes.^[20] After ten years, the incidence of diabetes was 34% lower in the group of participants given diet and exercise and 18% lower in those given metformin.^[21] It is unclear whether metformin slowed down the progression of prediabetes to diabetes (true preventive effect), or the decrease of diabetes in the treated population was simply due to its glucose-lowering action (treatment effect).^[22]

here is a link to the study mentioned above:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1370926/


looking through the study, the medication intervention is less that stellar as the participants must have been eating pretty high carb (relative to what I eat) since they were encouraged to follow the 'Food pyramid'.  What that means to me is that the medication intervention potentially could have seen even greater success if they had suggested lower carb:

"The standard lifestyle recommendations for the medication groups were provided in the form of written information and in an annual 20-to-30-minute individual session that emphasized the importance of a healthy lifestyle. Participants were encouraged to follow the Food Guide Pyramid 14 and the equivalent of a National Cholesterol Education Program Step 1 diet, 15 to reduce their weight, and to increase their physical activity."

the recommendations for the intensive lifestyle modification group don't mention low-carb, although it was low- calories and emphasized walking:

The goals for the participants assigned to the intensive lifestyle intervention were to achieve and maintain a weight reduction of at least 7 percent of initial body weight through a healthy low-calorie, low-fat diet and to engage in physical activity of moderate intensity, such as brisk walking, for at least 150 minutes per week. A 16-lesson curriculum covering diet, exercise, and behavior modification was designed to help the participants achieve these goals. The curriculum, taught by case managers on a one-to-one basis during the first 24 weeks after enrollment, was flexible, culturally sensitive, and individualized. Subsequent individual sessions (usually monthly) and group sessions with the case managers were designed to reinforce the behavioral changes.

i lost 10% of my body weight and have kept it off for 3 years (although my lower abdomen is still big) and this not did cure me of impaired glucose tolerance, although i probably was worse off before i lost the weight.

[edit]

cancer and high blood sugars

Rates of Cancer Rise Significantly with "Mildly" impaired Blood Sugars A Swedish study that followed 64,597 people for 10 years discovered that there was a very strong increase in the risk of cancer for those participants, no matter what their weight who had fasting blood sugars over 110 mg/dl (6.1 mmol/L) or who scored over 160 mg/dl (8.9 mmol/L) two hours after a glucose tolerance test. The risk continued to grow as participants moved into the diabetic category, but not by the same increment as it did when they moved from normal to what most doctors consider "mildly" impaired. The cancers most responsive to the higher blood sugars appear to those of the pancreas, endometrium, urinary tract, and malignant melanoma.Prospective Study of Hyperglycemia and Cancer Risk.Pär Stattin, MD, PHD, Ove Björ, BSC, Pietro Ferrari, BSC, Annekatrin Lukanova, MD, PHD, Per Lenner, MD, PHD, Bernt Lindahl, MD, PHD, Göran Hallmans, MD, PHD and Rudolf Kaaks, PHD.Diabetes Care 30:561-567, 2007

diabetes with no symptoms/probable cardiovascular system damage

two more things i wanted to add:

1. my blood work has been good for lipids and fasting glucose- my A1c was 5.6, which i knew would be off since i was anemic at the two times i had it done. what i didn't realize is that the A1c will be artificially low if someone is anemic and in actuality should be much higher.

2. i have been eating not extremely high fat, but fatty sausage, burgers, eggs, etc thinking it was OK since I was eating low-carb. The problem is my diet was actually just like a high carb diet since my body couldn't process glucose correctly and my blood sugars were probably high. so i probably did some damage to my heart and vascular system which i will try to reverse.

what symptoms did i have that i was diabetic? none. sometimes you have to test based on factors other than symptoms (such as family history and other abnormalities, such as giving birth to large babies) 

8/12/12 first test disbelief

i did the test:

fasting blood sugar: 90

ate 60 grams of a fast-acting carb (oatmeal)

1 hour later: 219- measured again in disbelief: 265

2 hours later: 197-measured again in disbelief: 191

3 hours later: (after vigorous exercise): 101

from jenny ruhl's website (the same one linked below):

If your blood sugar went over 200 mg/dl (11.1 mmol/L) at any time you testedd, you just registered a diabetic blood sugar level and should consult with a doctor as soon as possible. Two random tests results of 200 mg/dl are considered diagnostic of diabetes according to the Diagnostic Criteria for Diabetes Mellitus published by the highly conservative American Diabetes Association. 

since i don't want to take medicine, i'm going to see if i can control this according to dr. bernstein's target of 30 grams of carb a day plus exercise plus going leaning more to eating 2 meals a day instead of 3. he says a normal person will have a reading of 85 even right after eating, except for a very carb-laden meal. if the meter is off +/- 10 its, that means i could go up to 95, but i might be hypoglycemic at 75- so i won't strictly shoot for 75.

i shudder to think where i would be if i hadn't started my version of ef in 2009. i now know that i need to implement a much stricter version of ef. i would never have known to do this if i hadn't bought the glucose meter and if i had never found dr. bernstein/jenny ruhl. i didn't even want to buy it- my husband did. i thought he might be pre diabetic, but using the same 60 grams of carbs, this numbers were much better. At 1 hour after the 60 grams of carbs, he was 137/143, at 2 hours he was 110/111. 

Because i eat lower carb, i can maybe subtract 10 points from my 2 hour reading, but even then i am over 200. 

predicting who gets diabetes from jenny ruhl's info

i am starting to delete past posts that i think led to dead ends.  right now wooo has put me on to jenny ruhl who has collected some awesome info on diabetes of which i am taking the bullet points and saving them here:

What this means is that if your blood sugar tests over 100 mg/dl fasting more than once, your fastingblood sugar is likely to go over the 125 mg/dl (7.0 mmol/L) level used to diagnose full diabetes within 3 years. More importantly, and not addressed in this article, if your blood sugar is at 100 mg/dl fasting, it is very likely that your post-meal blood sugar is heading towards the diabetic range, which is over 200 mg/dl (11.1 mmol/L) which is why your fasting blood sugar is deteriorating. High post-meal blood sugars kill beta cells. If you can bring down those post-meal highs, you may be able to prevent the beta cell death that is destroying your fasting control! ps i don't know why the above didn't paste right- i will try to fix it later and put link up More: The data here suggest strongly that truly normal people--people whose fasting blood sugar is close to 82 mg/dl and whose 2-h result on an OGTT is closer to 90 than 140 probably don't become diabetic.Those whose blood sugars are higher than this true "normal" do even though the current diagnostic standard embraced by the American Diabetes Association tells them they are normal. They may go on for many years showing only slight changes from year to year, but eventually they suddenly hit a critical point where their blood sugar control suddenly deteriorates very swiftly.