Gloom and Doom

Well, we're back to the dark season... and in the weeks ahead the days will go so short that I'll start to wonder if they even started. 

When we moved across the country from Maine to Washington I had thought that the weather would be similar... I mean both states are kind of located way up there in the tippy-top corners of the US.  But no, Washington (at least where we live) is much more mild with little shifts in the temperature, but huge shifts with the amount of sunlight we get -  in comparison to Maine.  We get a bad rep for being rainy, but really it's just super drizzly starting about now (September) through to the spring.  Once we hit November there will be days when the sky seems to go dark by 4:00P.

Now that I've properly depressed everyone, I'm desperately trying to figure out how I'm going to keep my energy level up this year while the weather encourages everyone to walk around in comfy sweat pants and never quite crawl out of bed.

I'm stocked up on Vitamin D... popping my 2000 IU's daily since there's zero chance my skin will be making any with the sun not making appearances for weeks at a time.

I even started taking it earlier this year, ordered up my first bottle about 3 weeks ago now.  I feel better... maybe it's all in my head... but who cares if I feel like I have more energy then I'm all for it.  I snag mine off Amazon.  Have you ever used their Subscribe & Save thing?  So you go on their website, you look around for stuff you would normally grab at the grocery store or a Walmart/Target store, stick it in your cart and then decide how frequently you need to get more (it ships as frequently as once a month).  I love it for a couple of reasons. 

1. It's cheaper!  Hello!  I hate giving away my money when I don't have to.  So I just make sure I've got 5 or 6 items coming each month and I save an extra 15% off the price... and BTW the price is already cheaper than Walmart's prices, so double bonus!
2. I don't have to think about it.  I am notorious for getting to snag the paper towels or toilet paper when I'm grocery shopping.  And let me tell you, it's horrible to be the one who finds out you've used the last square and there's no backup supply.
3. My shopping trips are super quick now... and that is an incredibly great thing especially when you're a military wife (whose husband is constantly deployed) who is having to make trips to the grocery store with a pair of insatiable elementary school-age boys!  Grah!  At this point I really just have to hit up the chicken, meat and dairy sections of the store and I can head home - because I have our toiletry products being delivered by Amazon, and I get a weekly produce delivery from a local organic farm - genius!

Wow, I totally went off on a tangent there... back to the task at hand - figuring out how to keep energy levels up while the dark season creeps in.  A couple years ago I had some nursing aid at my doctor's office tell me I should put in daylight light bulbs.

To preserve your sanity, please don't do this!  Maybe this would work well for a desk lamp, or for the occasional light bulb here and there, but my kitchen has approximately 12 recessed lights and replacing all of these with daylight flood bulbs was not only a little expensive for an experiment, but also created the worst lighting ever!  It was bright, that's for sure.  But bright in a sterile, operating room, going to perform brain surgery... and then later make dinner... kind of way.  It was super irritating.  It reminded me of being in a Walmart.  Do those lights make you feel pissed off and angry too?  So lesson learned.  Won't be doing that again.

 

Exercise seems like a good way to keep the energy levels up, so I'll be making a point of getting in the habit of heading over to the gym - as outdoor exercise becomes infrequent.

 

Anyone have any other ideas or things they resort to when the days get super short?

I don't like to run...

...but I sure love how I feel after a productive run, and I really like being able to fit into my clothes...

About 6 months back I started having an uncomfortable feeling in my knee.  I blew it off for a while, but it just wouldn't go away.  I made an appointment with my doctor just to be sure I hadn't really damaged anything.  She said it wasn't a meniscus tear and I had most like sprained my ACL (anterior cruciate ligament).  She sent me home with stretches and strengthening exercises, which I naturally didn't want to do, but occasionally did anyway.  But it wouldn't go away.  This thing was annoying beyond belief.  It didn't just bug me when I was running or walking, it was all day everyday, sitting, standing still, and then some in my sleep too.  Not that I wanted to overrule my doctor, but it just seemed like the pain was coming in a weird spot for it to be my ACL.  It was on the inside of my knee, but about 1-2 inches below the level of my knee cap.  And no matter what I did, or didn't do, it wouldn't go away.

I investigated further and finally came across information on "pes anserine bursitis".  They described the location where three ligaments converge and attach to your shin, on the inside just below the knee cap.  The ligaments are protected from rubbing on the bone with the aid of a sweet bursa (fluid filled sac) that lies between them and the bone.  Buy bad shoes, over-train, accidentally twist your leg while your foot remains planted, sport some tight hamstrings etc., and you can overstretch those ligaments and irritate the bursa.

Wait?  What?  Back that up?  Buy bad shoes???  AHHHHH!  Yup, 7-8 months prior I bought the worst pair of Adidas of my life and now I was suffering for it.  I love Adidas, they have never done me wrong, so when I saw a pair on sale I thought nothing of it, didn't even try them on.  I certainly wasn't over-training... I mean I'm no marathon runner and if my body can't handle 3-6 miles at a time without throwing in the towel, then I'm going to scream!

I read more on this pes anserine bursitis.  You have to rest the leg, stretch the hamstrings well, reduce inflammation... hmmm, rest the leg.  Rest is not something I relish in.  I'll sleep when I'm dead.  How was I going to keep myself on "the bench" for even a day after this thing felt better?  Our disgusting dog helped with that.  A while back (I'd say about 2 years now), I relayed a story of stress incontinence (http://www.mygradeabologna.blogspot.com/search/label/pee) for which I sought help and was granted the most miraculous "anti-pee-your-pants" device without surgery - and this thing changed my whole after mommyhood world.  It normally was stored in the safest of places  ;)  but on this particular day it was readily available in the shower and our adolescent dog was all over it.  Needless to say, after being able to run for the past 2 years without having to worry about wet pants, now I was back in that position again.  Anywhoo, certainly made it easier to rest my knee while I waited for an appointment to get a replacement device.

So I rested up, my knee felt 100% better, I bought new shoes, I got my new vagina accessory... and it was time again to go for a run.  Or maybe not.  I've been for 3 runs now, and the dull pain is starting to come back.  My knee doesn't feel swollen like it had before (though it was never really puffy, just didn't feel as bony as it normally does), but I know it's only a matter of time if I keep using it.  I'm frustrated.  I don't have time for this.  So I discussed it with a good friend who had knee trouble 100-times worse than mine.  She gave me some of the best suggestions, and the next time I see her she doesn't even know the sweet SWEET lovin' she's got in store.

She first suggested using Turmeric (which contains the active component Curcumin).  Now this I'm familiar with, because I'd been recommending it to a few people at the nursing home, and I had written up on it's uses as an anti-inflammatory spice, but I guess I was correlating it more to chronic systemic inflammation, not necessarily inflammation that occurs with exercise or arthritis - but she was so right to clear my head on that one - because Curcumin doesn't care what kind of inflammation it is, it helps with it all!  So I have some ordered and on it's way - and am so excited to test it out - though I will say I'm not looking forward to possibly orange-colored poop which can happen with so much Turmeric going through you.

hmmm, Curcumin BP?  Blood Pressure?  No that doesn't make sense.  Ah, BP stands for Black Pepper, they use that to enhance the absorption of it.

Then she suggested talking to a Physical Therapist about kinesio tape.  Years back when I played Rugby (and I mean forever ago in college) I used to get taped up a bit to support my dumb achilles tendons which had a tendency to strain.  I kind of thought it would be the same sort of situation, until I looked up a youtube video to see what she was talking about.  Found this one produced by KT tape, which is some awesome kinesio tape!

KT Tape Application for Pes Anserine Bursitis

Went to Walmart last night to see what was available.  They have tons, but I think next time I'll just order it off Amazon as the prices were pretty much the same and Amazon had a better selection.  There are 2 different types of kinesio tape, Cotton and Synthetic.  I would guess the kind used in the video was the synthetic.  I grabbed the cotton as it was cheaper and I just wanted to see if I could replicate the video, but next time I'm definitely going for the synthetic.  It stays on longer and provides more support.

 They have a variety of colors available.  I highly recommend going for a color as far away from your skin color as possible - because if you're trying to make it look less obvious, you're going to fail.  A flesh-toned tape is going to look like you had some sort of massive skin graft as opposed to looking like you applied the tape, on purpose, for an injury.  Just my opinion, but I'm usually right...  ;)

So I applied the tape, I think I did a pretty good job of mimicking the video.  And I can say that I instantly felt better.  It seems weird that tape could do that, no matter how fancy or flexible it is, but it really did.  It felt as though instead of those ligaments pulling at that sore spot by my knee, their pull was relocated further up my thigh which felt way better.  You don't take it off for a few days, which is fine with me.  It stayed on perfectly all night and I even slept better - maybe with 50% of the pain I was used to at night.  I'm in love.  If you have some other sort of injury, like a muscle or ligament strain, I highly recommend trying this stuff out.  KT Tape has tons of youtube videos to show you how to tape just about anything, or you could ask your favorite physical therapist to show you how.

Leptin, the little brother of Ghrelin

Okay, so yesterday I ranted about ghrelin and importance of enough sleep to make sure you ghrelin stays manageable.  Ghrelin is what lets you know that you are hungry.  Leptin is opposing force of ghrelin.  Sort of like a little brother, it is always in competition with ghrelin.  But leptin does oh so much more.  Years back I recall a study being done with mice that showed those mice who didn't produce enough leptin were obese, and almost overnight people were trying to figure out how to gives themselves some more to help with weight loss.  Here's what we are learning about leptin.  Leptin is a hormone produced in our fat cells (adipose) that signals the brain that we are satisfied.  Leptin tries to help us maintain a leaner figure.  So, the more fat cells we have, theoretically the more leptin we are producing and thus the more satisfied we should feel.  Leptin also sends out a signal when we are eating.  So ghrelin tells us we are hungry, we eat something, and leptin tells us we are satisfied.  Seems simple enough.  The problem comes when we eat too frequently and/or we have too much fat tissue.  It seems that putting out large amounts of leptin would help us to lose weight because we would constantly be telling that part of the brain that we are satified - this is why everyone was so excited when the research first came out with those obese mice.  The problem is that the satiety center of the brain gets tired of listening to leptin yelling at it, and it starts to desensitize.  I liken this to when my boys are screaming/whining about pretty much anything and I start to tune them out.  This doesn't stop the boys from doing it, and it doesn't stop leptin from doing it either but it does make it harder to sense that we are satisfied.  So you would think we could just overcome this by continuing to send the brain more signals.  But our body is a wonderfully, mysterious thing.  While leptin is screaming at our brain, it's also working to tell our pancreas that we don't need quite so much insulin.  After all, we need insulin to process any carbohydrate we just ate, and if we're telling the brain that we are satified, then theoretically there won't be more carbs coming in and thus there won't be a need for more insulin.  You would think this is harmless, however constantly telling our pancreas that we don't need more insulin just keeps it alert.  It would be like putting a pot on the stove instead of keeping it in the cupboard - it's ready to be used even though you haven't called upon it to heat something yet.  So when food does enter our system and needs insulin to allow for utilization of all that nice energy, our pancreas has been sitting there, chomping at the bit - ready for action!  At a moments notice, it overwhelms the system with a push of insulin in an attempt to drive that nice sugar (glucose from carbohydrate) into our cells.  Too bad all that fatty tissue around our bellies makes it harder for insulin to get the job done.  Ah well, we'll just produce some more insulin (hyperinsulinemia) to bring down our blood sugar (hyperglycemia) all the while telling leptin to respond more because we are really satisfied but having trouble sensing it.

Phew, I'm out of breath just thinking about it.  Our body really is miraculous in the ways it tries to keep us on track.  Too bad we are so pig-headed that we constantly feel the need to work against it.  So what does all this mumbo jumbo above mean?  In order for us to improve the sensitivity of our brain, we are going to have to cut down on some of that fatty tissue we carry around, and stop constantly encouraging our pancreas to pump out more insulin... in other words, how about a little exercise and maybe no snacking between meals??  Seriously, everytime you put food in your system you are activating this pathway - don't you think it could use a little down-time between meals?  And... stop looking for that quick fix.  I mean really, if you're looking for a quick way to satisfy that part of the brain that leptin works with, I've heard a little crack/cocaine will do the trick too (note, I do not advise use of crack/cocaine for dieting purposes, just maybe for a hard day at work - hahahaha, okay not for that either).

Peeing your pants is not cool

I don't care what you say, Billy Madison, peeing your pants is definitely not cool.  Although if it was, then I would have been "the coolest", and amongst my friends you pretty much had to be a pants pee'er to get into our cool gang.  Alright, I'm lying about entrance to the cool group, but we certainly had many good laughs about our accidents.  And in case you were not yet aware, I'm not shy about talking about... anything!  Do I care that you now know that I peed my pants?  Nope!  Because if you ever had a conversation with me, I'd tell you all about it.  I'm a walking after-school special right here.

My journey with stress incontinence (peeing your pants when you cough, sneeze, or run) began when I squeezed out my first baby.  Yes, you could say that I pretty destroyed myself with that experience.  I recall laying in my hospital bed, recovering and thinking to myself that I should get up to go to the bathroom.  So I got out of bed and stopped to take a long peek at my new little monkey.  Suddenly I realized that I had to pee NOW!!  I started waddling to the bathroom, as you have to walk that way with the enormous diaper you wear after delivering, and commented to my husband that, "I'm peeing right now and I can't stop!!"  He thought this was hilarious, and has shared the story with all kinds of expectant parents.  My ability to control the pee got better as time went by.  I did my kegel exercises like crazy, but still had trouble when it came to jumping in dance class or attempting to jog.  If I felt a big sneeze coming on... look out!  And if I saw a trampoline all I really saw was soggy pants.  It was literally awful to be unable to get a grip on something that I thought I had mastered before kindergarten.

After my second baby came along, I decided to look into physical therapy.  I had heard that if your control muscles are weak enough, they will give you a "device" that's inserted into your "lady business" and then it gives you a little stimulation to encourage your muscles to contract.  Literally does a kegel for you.  Hello!  Sign me up!  Insurance will now pay for a vibrator??  Poor me, my muscles were too strong to show a need for this device, so I was stuck with more kegels and routine appointments to help my pelvis align correctly.  Did it help?  Well, in dance class I could now do leaps to the left with my better aligned body, but landing was still sketchy.  I gave up.  I had resigned myself to the fact that I would have to wear Depends, or a huge maxi pad, every time I wanted to go for a run.   It was my heel striking the pavement that caused the peeing, which wouldn't have been a big deal if I didn't want to be active... but I WANTED TO BE ACTIVE!!


I set up a routine check-up at the OB/GYN office and decided to inquire about a bladder sling surgery.  The surgery is supposed to lift your bladder back up to where it had been and hold it there, like you're putting it in a nice hammock.  The doctor informed me that a pessary might be a good starting point.  He also said that if enough damage had been done, then all the kegels in the world weren't going to help!  A pessary is like a rubber ring that you insert and pops into place just above your pubic bone and it pushes your bladder back up.  It also helps clamp down on your urethra a little.  So with my bladder back in place and a little extra leakage control on the urethra, I went for my first run in 5 years without peeing my pants.  It was as if the clouds had parted, and angels were singing to me while I ran.  Was I completely dry at the end?  Nope!  I sweat like a farm animal when I run, but at least it wasn't pee!  Do you pee your pants?  You don't have to tell me.  Most people are more shy about the topic, but according to webmd, 13.7% of women suffer with this on a daily basis - and it only gets worse as we get older.  Call your doctor today!  Don't deal with this for another moment when you don't have to.  I wouldn't advise running to the doctor's office as we know what happens when we do that, but perhaps afterwards you can celebrate on a trampoline.

Miraculous Trick for Weight Loss

Got your attention, didn't I?  Do people really believe this crap?  I see advertisements for it everywhere so clearly someone is eating this stuff up.  I truly believe it was my frustration with patients and their intense desire for a quick fix that caused me to become burned out when I was still working full-time at the hospital.  They would come into my office for some diet education, but they weren't there to be educated, they wanted me to tell them the big secret.  That miracle food to eat... the secret exercise trick that could be done in 3 minutes without sweating or getting off the couch.  Couldn't I give them a pill?  They had, after all, tried "everything"!!  I mean why wasn't the weight coming off?  They were making at least 20 laps to the fridge every single night after eating dinner.  Doesn't that distance count for exercise?  Ooooh, I was right - some of my the bitterness still exists today.

So I would ask them what they ate on a typical day, and they would either lie to me, or be completely honest.  There was no in between.  Those that lied to me, were obviously smart enough to recognize what they were eating that I was going to tell them to modify, "I only eat a salad with light dressing for the whole day."??  Those that were completely honest had not yet come to understand how poor their choices were, and thus saw no issue with 3 ice cream sandwiches after their 16 ounce steak and loaded mashed potatoes.  So we would start talking about my recommendations, the first of which was always to avoid snacking between meals.  I would get looks of desperation.  What?  What did you say?  No snacking?  But the magazine I read at the grocery store said to eat 5-6 small meals and the lady on the cover has lost weight!  I believe I had one outpatient that actually followed this advice and reported back to me about it, because she had lost weight.  The rest were not strong enough to craft their meals to be satisfying nor could they avoid the temptation mid-morning and mid-afternoon.  Why no snacking?  Well, if we give our bodies and opportunity to use stored fat for energy... it will!  If we eat every time we have a little dip in our blood sugar, then it doesn't need to use the stored fat because you're shoveling more energy into your mouth.  Plus, we can only fit a certain amount of food in our bellies before we feel uncomfortable.  So if you filled up your stomach at your meal, the odds are you would be eating less total calories than if you ate some at your meal and then added in snacks. 

When did we become such weak individuals?  There are so many things that play into whether we gain, lose or maintain our weight.  Food and exercise are two of the primary things we do have some control over so why are we unable to make the right choices?  Why are we so quick to choose surgical procedures?  Liposuction?  Honestly, those that look at this as an option are typically too large to utilize this for the type of results they want.  You can only remove so much volume before you have major life-threatening issues.  Gastric bypass entered the scene a while back, and actually is a great option for those who were morbidly obese or with co-morbidities like Diabetes.  This has become one option that has improve life-expectancy and health for those patients - but not without huge lifestyle changes and occasional complications.  Gastric banding entered the scene afterwards. 

Now what is the difference?  Gastric bypass is cutting and stapling the stomach.  The intestine is then re-routed to a new outlet from the stomach.  The procedure creates a smaller stomach pouch, and also removes a portion of the small intestine from the digestion line.  It works because you can't eat as much at one time, and you have to think harder about eating methods and your food choices.  Eat too much?  You'll throw up.  Eat too much sugar?  It will dump from the stomach into the intestine and you'll start sweating and feel like you're going to pass out.  Manage your diet well?  You'll lose weight because you're eating less and you're missing that part of the intestine, thus causing some malabsorption.  Gastric banding?  Honestly, my least favorite.  Still a surgical procedure, where they essentially put a belt around your stomach.  Shrinks the available size of your stomach, but is completely reversible as no cuts are made.  No removal of part of the intestine, so no malabsorption.  With gastric banding, they have made it so you can't eat as much at one sitting, so weight loss occurs because you are eating less.  What?  What did I just say?  "Weight loss occurs because you are eating less."  Holy crap!  It's a miracle!  You are forced now, to eat less, and weight loss happens.  Imagine if we could toughen up and do it on our own?  Would we get the same results, without an expensive procedure?  YES!!!  What's the difference?  If you make the changes on your own, you'll stick to it.  If you have the procedure done yet don't make changes in your habits, you will lose weight initially, but the stapled stomach can stretch back out after a few years and the lap band can be removed, and then what are you going to do?

The rewards are sweeter when we toughen up and make those hard choices.  Is it a long road ahead of you.  Most definitely.  But so worth it.

The End of an Era

I received news today that the Ron Trell Studio of Dance would not be reopening this fall.  I instantly was speechless.  I wanted to cry.  How could this be?  I know that places open and close all the time.  And I knew that Ron couldn't keep going forever, but I was so sad to hear it was over already.

I started dancing at the studio when I was 10.  I had just entered 6th grade, which is late to be starting to dance, and my mom asked if I wanted to give it a shot.  Sure!  Why not?!  I was in beginner ballet and had to start in a class with girls who were years younger, but I was okay with that.  I worked at it, learned the basic moves, and by the next year I was in ballet class with my friends and also started learning Character (like Broadway musical dance/Jazz/Hip Hop).  I loved to dance.  Was I any good at it?  Nope, but I liked doing it anyway.  I continued dancing all through middle school and through high school.  Recitals came around every other year, and on the off years we participated in a benefit show to raise money for the nearby Barbara Bush Children's Wing of the hospital.  There was something about going out on that stage and performing.  The butterflies in my stomach were intense, but I could hardly wait for my next chance to do it.  I graduated high school and continued on to college, but would return home and attend dance classes.  After college graduation I found myself back in Brunswick, feeling like I had no real direction.  My college friends were off still in college or doing other things and here I was working and finishing up my internship, but not quite knowing what to do in this adult world.  So I started taking classes again.

It was different this time around.  Ballet and Character had a different spot in my life when I was younger.  I liked to perform, but the work ethic wasn't there, nor the desire to make a huge fool of myself.  Now I found myself wanting to go to class because it gave me an opportunity to push myself in a new way, and I could show off my ridiculous moves and fit right in.  I started making life-long friends on those crazy Thursday nights.  The kind of friends that are there for you on your toughest day and to remind you that you deserve your shining moments.  The friends that don't disappear when you move 3000 miles away.  We would dance our asses off for hours, laughing at each other most of the time, and then follow it up with a cold beer and scrumptious food at Joshua's or Pedro O'Hara's.  And the laughs never stopped.  Somehow 10 o'clock would roll around much too quickly, and we would be heading home just counting the moments until Thursday rolled around again.  Dance class was the last place I went while we were packing up for our cross country move, and it was the only place where I really broke down and started crying about leaving all my friends and family.

Was it dance class or my friends that gave me the confidence I continue to possess today... I can't be sure.  Does it really matter?  I can only imagine how awful my girls must be feeling knowing they won't have classes to look forward to and this break from daily life that was devoted to doing something just for ourselves.  I think perhaps my personal sadness comes from the fact that when I'm able to return home for visits, I won't be able to stop in to say hello or sneak in a class.  And that down the road another girl like me, who is feeling lost, won't have this inspiring place to find herself.

Halloween Treats - The "Fun Size" Candy Bar

Ooooh, I love Halloween.  My pants don't, but for some reason I can convince myself that eating a dozen fun size snickers bars isn't really like eating a couple regular size ones.  I recently heard a story regarding the use of a small candy bar that is going to make it impossible for me to eat these in a couple months.  First let me throw out a little background nutrition information.  There is a growing incidence of Diabetes in this country.  Type 2 (previous called "adult onset") is expanding exponentially, to the point where adolescents are being diagnosed.  Type 2 diabetes is preceded by insulin resistance where if left unmanaged will lead to an individual's inability to maintain regular blood sugars.  The next step may be an attempt to manage it with changes in diet and exercise, but a large number of people are not identified early enough and often have to start taking oral medications immediately.  Some have let it progress too far, or the oral medications are no longer effective, and find themselves with daily insulin injections.  Okay, so for people who are maintaining their blood sugars with diet/exercise and/or oral medications the risk of running a low blood sugar is minimal, whereas those who take insulin injections need to be more careful and be sure to adjust insulin levels depending on what foods they are eating and when exercise is being done to avoid this.  Alright, enough with boring background crap.

So my friend tells me this story of 30-40 year old man who was told that since he has diabetes (we are assuming non-insulin dependent based upon his physical makeup and age) and is doing some extra exercise, he needs to be careful to avoid a low blood sugar.  In an attempt to prevent going into a diabetic coma (highly unlikely with non-insulin dependent diabetes) he must carry around with him a ziploc with a little tube of lube and a fun size candy bar.  He informed my friend's husband that if he passes out, they should turn him over and insert the candy bar into his colon.  ............  pffffft....  Excuse me a moment, I had to get a good laugh out again about this.  He was dead serious!!  He claimed his doctor had told him to follow this procedure.  My friend is going to school for nursing and had never heard of such a thing, but she wanted to see what my response was since I had worked with so many diabetics.  My initial response was to wonder why he needed the lube.  I mean really, if you're inserting a chocolate bar, like a Twix, won't the chocolate melt and become easy to insert?  Next I wondered who was going to step up and handle that particular task if this guy passed out.  And on top of that, was someone going to shove this tiny "fun size" treat all the way up to jejunum (small intestine)?  It wouldn't be as simple just popping it in his butt?  Your rectum doesn't do much, but put stuff out, and your colon (next up the line) isn't going to absorb carbohydrates.  Finally, if someone is passed out because of a low blood sugar, the first thing you want to get into their system is some pure high-octane sugar.  You don't want a candy bar because it has a nice combination of carbohydrate, protein and fat (which slows down the absorption rate of the sugar).

Take home message??  Sometimes your doctor might have a sense of humor and it helps if you do to!  Oh, and if you have diabetes and you want to carry around something in case your blood sugar runs low, how about some Gluco-Tabs or Glucose Gel packs - not a sandwich baggie with a Milky Way and lube.