I have been working in mental health peer support. They recently brought certification to CA. I am glad we have standards and training. I did 80 hr training and am taking certification exam tomorrow. I think I am ready but I am nervous. I am going to a testing site. It is 2.5 hours. I think I will know right away if I pass.
I have been working part time. Lately 16 hr/week. I receive SSDI disability and have not earned enough to go over the limit. I recently accepted an offer for full time work. I am anxious that I won’t have the energy or it won’t work out for some reason. I will lose ssdi the first month because I will go over limit. Social security provides work incentives but I have used them all. The only one left is expedited reinstatement. After I lose disability pay I can apply and they expedite that. Hopefully, everything goes well and it is an unnecessary concern.
The job is peer support in housing. The clients have housing vouchers and we work as a team to get them in and keep them housed. The people I have met so far are nice. I start in May. There is a ton of onboarding: fingerprinting, physical, paperwork . I have to get a second tb test this week and get car inspected. Then I think I am ready. I am going on vacation at end of April and then start.
I am trying to get back on keto but I struggle. I live with husband and daughter and there are carby foods here that tempt me. I am going to sit down later this week and really think about what I want. I am doing keto to control diabetes but there are other avenues. My dr added rybelsus which is an oral semaglutide. I am losing really slowly at maximum dose. It does help me pause before impulsively eating. My glucose is better.
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.
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.
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.
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.
I recently discovered I am lactose intolerant. I just bought a yogurt maker and was making yogurt with half and half, which was a simple recipe, but now I am trying to switch to coconut milk. So far, I have had little success. I have made gelatin, which tasted okay but was definitely not yogurt. I had a batch that did not set and one that turned out sour. I used them in smoothies. They are fine to eat, but not what I am looking for.
I probably would give up and just buy non dairy yogurt, but I want to use the maker. I don’t know what else it could be used for.
I have been making green smoothies, too. I drink them most mornings now. Our blender died after 20 years so we got one that makes smoothies and is durable. I put in ice, soy or coconut milk, spinach, cucumber, coconut milk yogurt, ginger, chia seeds, plant protein powder and blend. It is pretty filling.
Image coffee mug with coffee and coconut milk, green smoothie
My weight has been stalled since I had a medication change in June, but my glucose is good and I am in ketosis (on ketogenic diet). I had been logging my food on Cronometer but I think it was overestimating my energy expenditure so I switched to myfitnesspal. You enter your foods and it calculates the calories, carbs, fats, protein etc. I am not perfect at logging but it gives me an idea of where I am at. I have it linked to my Fitbit and scale.
I am still doing 14 hour fasts. It is not too difficult for me. I have not noticed any changes with fasting. I do feel a lot better now that I am not having much dairy.
Image bottle of milk and glass with red circle and slash
I am in a weight loss program with Digbi Health. I found it looking through programs offered through my insurance. Unfortunately, they do not cover me because I have type 2 diabetes and they refer me to other programs. I called to find out why it is not covered and the sales rep explained that to me and gave me a discount that expired that evening. I thought about it and maybe impulsively signed up.
I am still doing keto. Digbi recommends a lot of veggies with meals and I am having trouble staying in ketosis but my glucose is okay. I want to find a way to work the Digbi program and Virta keto together. I tried asking both how I can blend them but I guess I was not clear because I have not got much of an answer from either program.
With Digbi they do a dna and gut biome analysis. I got the dna results. Some things I found out are that I am lactose intolerant and my blood pressure changes with sodium intake. I have been making yogurt with half and half and have had some digestive issues but I had not put the 2 together. I tried making yogurt with coconut milk and it became gelatin. Not sure if that was the recipe, the coconut milk brand or me. I am going to try a different recipe next time.
I don’t know if i have to avoid all dairy or if things like heavy cream and cheese are okay. I found a sub on Reddit. They were helpful, but they told me it is an individual thing. I got some lactaid tablets, too.
Some other things I found out were vitamin and mineral requirements, like I need more vitamin A and Copper. They don’t test levels, it is how you metabolize. I also have a lot of weight gain tendencies which just means I have to be diligent. Apparently, I have high heart capacity, poor flexibility. I found it interesting. I am going over the results with my coach this week.
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.
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
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.
Stronger Than You Think 