Projects

Image: gratitude journal.
https://linktr.ee/matthiasjbarker?fbclid=PAAabOSCj2THoNkFK8nkKoP0OquO5P7L8HeLBBjQkatc1YYQb1W-ott8E8IfQ

I have a number of projects that I have trouble completing.

I am interested in internal family systems therapy. I have a book and workbook to use on your own but I have trouble getting started. I have an appointment with a new therapist in Jan and hope she can help.

I am in the process of reading Brain Energy about how mental illnesses are metabolic disorders. I skimmed through looking for explicit directions for how to deal with anxiety and schizoaffective disorder. He talks a lot about keto but I like to have targets for macros and he does not get specific or I missed it.

I got an activity journal that looks fun but I have only glanced at it.

My cousin, @AnnSloan, wrote a book called Suffer, that I have on kindle waiting to be read

I have a gratitude journal by @matthiasjbarker (pictured) that I just started today. It has prompts for everyday for 6 weeks. He also has a motivational zoom I signed up for. Maybe I can get some sense of priority with these projects and a timeline.

I started keto last month. I slipped a little eating some more carbs than I should. I have type 2 diabetes and keto really helps me with glucose control. My sugars went higher than normal and I am having trouble getting to a level I would like. I have not lost weight but I lose slowly usually.

I had a scare where my blood pressure was high at a Dr , not PCP. I tested at home and it was high on several days. I contacted PCP and she said to decrease salt and exercise more. Still high. I went for office visit and she read bp manually. It was normal. She thinks for some reason the automatic readers don’t pick it up right on me. I can go for manual checks if I need. I am a little confused about sodium. Usually you increase it with keto but my Dr wants me to stay to below around 2 g. I had been drinking bullion but I stopped. Grateful my BP is normal.

My sleep had not been well. It is improving. I can get 6-7 hours straight, the problem is it is shifted. I don’t fall asleep until about 3 am and am tired during the day. I cut back on caffeine and my psychiatrist reduced my medication. It is easier to stay asleep with the cooler weather.

Update

Whoops..I’m Awesome workbook by Melissa Villasenor

I saw my current therapist telehealth last week. He moved me back to as needed. He seems to think I am fine but I don’t feel that way. I am on a waiting list for a new therapist who does internal family systems therapy. I don’t know how long that will take.

I stopped keto last year when the Virta program stopped because my insurance changed. I have since gained some weight and don’t feel as well. I am going to try doing keto on my own, after Thanksgiving. I am going to try an app called Healthi that helps count calories, carbs or what they call bites that are like WW points. I did not do well on WW but I did not stick with logging food.

I have been making chia pudding with coconut milk instead of yogurt. So much easier but you don’t get the probiotics. I have been eating fruit which I will miss when I go back to keto, I can still have some berries.

I watched a webinar with Dr Christopher Palmer about keto and mental health, he uses it for treatment resistant patients. My meds work well, but it can’t hurt to add it. He has a book releasing tomorrow, called “Brain Energy” I am going to get the kindle version. Hopefully, it motivates me for when I start keto.

I used to love to read. Now, I have a bunch of things on kindle but I don’t read often. I think I need to put it on my to do list. I got a journal called “Whoops…I’m Awesome” by Melissa Villasenor. It has activities and stories. I have not done anything with it yet but it looks fun.

From Keto to Weight Watchers

Image: blue circle containing letters WW vertically

I stopped keto in Dec. I thought I would get back to it after the New Year but I have been resisting. It is great for my glucose but I found the diet restrictive in food choices. It is sustainable for some. I am gaining back weight. I know someone involved in a MLM that is geared to weight loss, but it is very calorie restricting and you are supposed to purchase their food. I don’t think that would work for me.

I decided to give WW (Weight Watchers) a try. They have a digital plan that is the app, but I don’t know if I can do it on my own. So, I signed up for workshops + digital. It is more expensive but I think it will make me feel accountable. I signed up for 6 months. I am hoping I pick up enough to do it on my own or switch to the digital plan. They have lifetime memberships where if you lose and maintain your weight loss you can have access for free, but I don’t know how that works.

They give you some zero point foods. Mine are poultry, non starchy veggies and legumes. The more zero point foods you choose, the less total points you have to start with. It is pretty easy to track in the app and it is a little different than calorie counting. They guide you toward making healthier choices. You get points back for activity, drinking water and eating non starchy veggies.

I even went to lunch and the most points were for my iced tea. I had minestrone soup and salad. I normally would have eyed the pasta dishes but I wanted to have some points left over for dinner. There are no restrictions on what you can eat. I checked and a shot of liquor is 4 points (out of my 32 total). I went to a virtual meeting for beginners which was helpful. I am planning to go in person on Fri.

What is one thing you have always wanted to do?

Image palm trees and water

I saw my therapist today telehealth. One thing he asked me was what do I do for fun or to relax. My knee jerk reaction was that I don’t know how, but I corrected myself. I am a couch potato but I enjoy computer games. I am happy on my couch with my dog typing right now. He asked what is one thing I have always wanted to do, for example, travel, and would I be disappointed if I never do it. I rarely travel, and would like to, but I don’t have a dream destination that I would be upset about not going. I can vacation in my backyard. We go on short overnight trips about an hour away that I enjoy.

It did get me thinking, though, I want to visit my sister in Boston when the weather is nicer. She suggested summer or fall, I have been there once when she first moved but it was a different house. She has a lake she likes to go to that I want to see. I can start planning that trip. My nephew is getting married out of the country but I don’t think I will go. I would like to but it won’t upset me not to be there. Just the coat is too much.

I have new health insurance and took a survey and the result said I am depressed but I feel fine. I am going to ignore that result.

I joined this zoom journaling group through the Mighty. I know everyone has a health condition, not sure if it is all mental health. They list prompts, give 10 minutes to write, share and then repeat. It goes for 3 hours but I leave early because I have another zoom, DBSA later. I feel like my writing is rainbows and puppy dogs and other people go deep. They are nice to me, I can’t go this week but I think I will continue. I know I have other emotions they just aren’t being prompted.

i zoomed with endocrinologist after therapist.My labs were good. I told her I stopped keto in dec and don’t want to go back to where I started but I don’t like logging food and counting carbs. She said I can visually see if my meals are less than 1/4 starchy carbs. I fill myself up with veggies. Beans are my main starchy food. I can do that.

I got a call from an old co worker. we worked at an activity center for adults with mental health issues. we have both moved on. he is now working at a new peer advocacy non profit, I don’t know if it is the grass looking greener. I am content where I am but get antsy when I am not busy I have a lot of down time that should change once I can get trained on some more tasks.

Intermittent Fasting (IF) and Stigma in Plasma Donation

Image of insulin and glucagon levels over time source Digbi Health

I saw the image above of how insulin drops between meals and while fasting. While insulin is low, glucagon can burn body fat. I was intrigued. I am 10 lbs away from a healthy BMI, but still have abdominal fat. I am type 2 diabetic and asked my doctor if fasting would be safe. My glucose is pretty well controlled and I don’t have hypoglycemic episodes. She said it is fine, but recommended 12-14 hour fasts. Which is mainly cutting out the nighttime snacking and eating breakfast later.

So far, no change. My weight has been stalled for awhile. My diabetes medication was reduced in June and my biometrics went south. Glucose up, ketones down, weight up. Thankfully, that stabilized but I can’t get my weight to go down. I log my food on an app (Cronometer) but sometimes I estimate weights. I am going to have to get better at calorie counting to start losing again.

So I am gung ho on intermittent fasting. Watching Dr Fung YouTube videos. Then, I saw this study. https://pubmed.ncbi.nlm.nih.gov/34135111/
A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults

All I can see is the abstract and I heard a review but this is what I got out of it. There were 3 groups. One calorie restricted, one calorie restricted (same as group 1) but alternate day Fasting and a third group with no calorie restriction. The calorie restricted groups both lost the same amount of weight but the non fasting group lost more fat.

It was a short study 4 weeks, I think, and these were lean adults. Also, they were doing longer fasts than I am. But, I don’t know what to make of it. I would have expected the fat loss to either be similar or more for the fasting group since they have lowered insulin during the fasting period. if anyone has any insights let me know in the comments. I will stay with 12-14 hr fasts and keto diet for now.

I tried donating plasma at a donation center. I tried calling ahead to ask about restrictions but they do not give that information over the phone. And, they don’t take appointments for first time donors so I had to walk in and wait. For what it was it was not too bad. First someone checked my veins, which are fine. Then I had to fill out a bunch of paperwork. Then, I watched a video on plasma donation and read through a manual for first time donors.

Then, a woman, I don’t know her title, took me to an office to go over my paperwork. She got to the medications and asked what each was for and looked them up in a huge book. I take 7 medications for various conditions. After she goes through the medications she goes over them with me.

Most were fine. I take antidepressants but as long as anxiety and depression are under control it is fine. But, I take metformin for diabetes. She said that is a temporary deferral. If I was off it for a year I could come back. I don’t know what the likelihood of me maintaining my diabetes by diet alone is, my husband is able to, so possibly. Then she got to abilify which is an antipsychotic although it is sometimes used along with an antidepressant for depression. But, I told her I take it for schizoaffective disorder. That is a permanent deferral.

Bone marrow donation has the same policy. It is not the safety of the product. They consider me a safety hazard. I have been stable for 15 years but still people are afraid of me because of a diagnosis. They should have a sign out front: schizophrenics need not apply. So, I would not have had to waste my time.

Empathy Postcards, CGM, and my week

Image Cover of Empathy Postcards

As part of a gift in a gift exchange I was given Empathy Postcards by Emily McDowell. It reminded me of a time I was hospitalized for my mental health . In art class I made a card to myself. No one brings cards when you are you in the behavioral health unit. I think they just don’t know what to say. These empathy Postcards are perfect for times like that. I think I will use them for friends when they are having a rough time.

Image if this is God’s plan, God is a terrible planner (No offense if you’re reading this God. You did a really good job with other stuff, like waterfalls and pandas.)

I also was given some keto friendly snacks, a little stuffed poodle that looks like my dog, dog treats and a nice note.

As far as keto, things are going well. My labs were good last month, so.my Dr took me off of one med, Januvia. Everything went wacky for a few weeks. My weight was going up, glucose went higher than when I started keto and I was out of ketosis. My Dr gave me the option to give it a couple of weeks more or to go back on Januvia. I decided to see how it goes in a week. It started improving. My weight started dropping and fasting glucose lowered. I am back in ketosis

I asked my coach from the program I am in, for type 2 diabetes, Virta, about a CGM, continuous glucose monitor. The Virta Dr called in a prescription for Freestyle Libre 14 day sensor. I got a voucher from the freestyle libre US website to bring to the pharmacy. It is a free trial. My insurance won’t cover more sensors but I am getting a lot of data. My glucose drops in the early morning and then rises. The sensor does not always agree with the fingerstick. It reads interstitial fluid. The range is set at 70-140 mg/dl and I am in range. I am going to lower it to 126 to see if I can tell the difference. It has a graph but it is hard to read. It is small. So far the biggest rise in glucose is just from waking up and not from my food. The app lets you write notes to go with the readings.

I have sleep apnea and wear a dental appliance. After my dentist adjusts it, he orders a home sleep study. I have done about 4 so far. I did one this week and have seen the results. I wore a t-shirt with tennis balls that is supposed to keep me in my side but the device read as if I was on my back most of the night. I still have mild apnea with the appliance so he will most likely adjust it more. It is not painful but it gets uncomfortable the more he moves my jaw forward and it takes time to get it back in position in the morning.

I talked with my therapist this week. She asked how much time I spend online. I don’t know so I told her that, but it is a lot. She said she spends an hour. She wants me to keep track. I don’t have to change but she says I should know. I like her but don’t like her assignments

The Keto Roller Coaster

Image of roller coaster

I have been on a ketogenic diet for about 5 months to help treat type 2 diabetes. I was taking 2 medications. Metformin and Januvia. I am monitored through a program called Virta. I have a coach and a physician through Virta, it is all done virtually. There is also an online community for people on the program. It is covered by my insurance.

At the beginning of this month I had labs that my endocrinologist had ordered. The results were really good. A1C of 4.8 and fasting glucose 98. Everything else was normal, too. For some reason my endocrinologist office cancelled my appointment so I had to reschedule for August. The Virta dr said that I could try going off Januvia since my labs are so good.

So, I go off Januvia and everything goes screwy. I get ravenous at night and have to eat after dinner. I had been slowly losing, now I am gaining weight. My fasting glucose is higher than before I started keto. I test my ketones and they are low. I chatted with people in the community and they tell me to stick it out, that my body will adapt. I am not so sure. I put in a message to the Virta dr to ask for his opinion but I won’t hear until at least Monday. I did not even know if the Januvia was doing anything but I now notice a difference without it.

I rarely talk about work, but here I go. My opinions do not represent my employer.

I work in peer support in a 20 bed mental health crisis stabilization unit (CSU). I have worked in peer support at an activity center for people with mental health issues and in a residential program. The people we see are much more symptomatic than I had worked with in the past. I am available to talk and offer groups but I don’t get much interaction because people want to sleep, are too symptomatic, want to be left alone etc.

It is a new facility and peer support is a new position for my employer. I have been there about 5 months and still have not found my footing. My boss is aware of the issues of people not wanting to interact and told me to keep being available and offering groups. She is going to give me some additional duties once they are approved.

It also can be anxiety provoking when patients are loud or aggressive. I am not involved with dealing with those situations but I feel tense. I help out where I can. I like the place and what we do.

Advice From a Dietician on Brain Health

Image of highlighted brain

I zoomed with a dietician this week.  We talked about ketogenic diet and brain health, specifically schizoaffective disorder.  She gave me goals for macros and ketones.  I am having trouble just staying in the requirements of Virta, the company that is monitoring my diabetes, so she suggested following that and then make changes.

The suggestions she made was: going from 30g carb a day to 22g. And, cutback on artificial sweeteners.  Keep my protein the same, and increase fat.  She also suggested, for my particular issue, that I should have 2-3 mmol/l ketones in blood.  When I started keto, I was getting numbers in that range, but now it runs around 1.0 so she suggested adding mct oil.  She also suggested balancing the unsaturated fat I use with some monounsaturated fats.

I am trying to hit the macro targets now, but will really start in earnest in May.

I had asked my psychiatrist if he would talk with the Virta doctor and he agreed, but I don’t think he has called. I have been stable a long time, and am wary of making any medication changes. The dietician told me to work with my psychiatrist about any changes, which I would do anyhow.

I really can’t believe I have stuck with this as long as I have. I want to make it a lifestyle change but it is hard. I feel good and am thinking clearly. My main issue is that something does not agree with my gut. My fasting glucose has dropped 20 pts. Still not low enough to change my diabetes meds, but it is an improvement. I have lost about 1 lb/week, it’s not melting off, but I think it is reasonable.

I am in a medically monitored nutritional ketosis program and working with a psychiatrist for my mental illness. Please don’t try this alone.

Medical ketosis for psychiatric illness

Image of highlighted brain

I have been on a ketogenic diet to treat type 2 diabetes, through a company called Virta for about 3 months. I have lost about 1 lb/week, my fasting glucose has dropped 20 pts, and I feel good.

My friend was pushing me to try the diet and now he has been pressuring me to find out information on medical ketosis for psychiatry. He says it has greatly helped his depression. My provider from Virta agreed to talk with my psychiatrist about how a keto diet can affect mental health. But, I started wondering what am I doing. I have schizoaffective disorder controlled with medication and also take medication and use coping skills for anxiety. I don’t know that I want to change anything.

My therapist coached me on how to tell my friend thanks, but I feel pressured. I am not great at setting boundaries. I took her advice and he was cool. He said it is not his business what I decide to do and he is just making suggestions.

Then, I read a post on Reddit where someone is working with a dietician from the Charlie Foundation on a keto diet for schizophrenia. They work on keto for epilepsy in children and have expanded. I emailed and they gave me info on a dietician and I made an appointment for a zoom call on Wed.

The diet I am on now is 30 g total carbs, 13 oz protein containing food and fat to satiate. I am sure the dietician will have something more precise with macro g or percentages. Right now I weigh some but estimate amounts, where I will be measuring more.

My therapist gives me homework. The last thing she gave me was to give examples on where I could be more assertive, like with my friend. And to think of things I am grateful for and proud of. I am grateful for many things. The people in my life, especially my husband and even my pushy friend. My car, dog, food, home… i could go on, but proud of had me stumped.

I work and take care of my family but there is nothing I can identify as I am really proud about. I thought some more. I am proud I have been alcohol free for 6 months and have a plan for moderation. I am proud I have been able to stick with keto 3 months and with the results.

Taking a Break From AA

Virta supplies

I have had problems with the spirituality part of AA.  I am not religious and don’t feel comfortable praying.  I am okay with the Serenity Prayer at meetings, but don’t usually pray on my own.  I also started getting busier in my life. 

I started a new job this month and am also starting the ketogenic diet. It is fewer days, but 8 hr shifts so I have to plan lunch. I have been bringing nuts and cheese and making it more of a break. So far that is working well. But, I do have to think more about meals and planning until I get keto down.

I have lost 10 lbs in a month, which is great for me, but the main reason I am doing the diet is for type 2 diabetes. When I stick to the plan, 30 g total carbs moderate protein and fats to satiate I am good, but the store bought “keto” products that go by net carbs, not counting sugar alcohols and fiber, still raise my blood sugar a little. It is still better than when I started.

I am in a program through my insurance called Virta.  They provide me with supplies, a health coach, a dr and a forum.  I report weight, glucose and blood ketones daily.  At first the additional fat in my diet upset my stomach, but I think I have adjusted.  My sister started when I told her how well it worked for my blood sugar, so I have someone to talk about keto.  It is a huge change for me. I am a big fruit and sweets eater but I don’t get many cravings and rarely feel hungry.

The job is going well. I am a peer advocate in mental health crisis stabilization unit. Basically, a mental health urgent care.  We just opened and it has been quiet,  sometimes they send me home early because I have nothing to do,  I have been making a binder of resources,  I will be providing therapeutic communication when we have patients,  so far, I have only been there with one patient who was not very talkative.

As far as AA, I had cut way back in going to meetings because of things going on in my life. My sponsor suggested I go to more meetings and pray every morning and evening. I thought about it and decided to take a break from it all. I can meditate but I don’t want to pray every day and I felt pressured about going to meetings, I have not been drinking. I just don’t know if it is the right program for me.