What I find delightful is peanut butter cookies. Here’s a version of the Joy of Cooking recipe toned down in fat and eliminating almost 95% 0f the sugar.
Heat oven 350 degrees. This recipe makes 3 doz. 2 1/2 inch cookies.

2 cups all purpose flour
1 1/4 teaspoons (t) baking powder
1/2 t baking soda
pinch of salt

In another bowl
2 Tablespoons (T) olive oil (light in flavor)
1/2 cup (c) smooth peanut butter
3/4 stick butter
2 T xylitol ( from the health food store)
1/4 c brown sugar – or 2 T if you like it less sweet

Taste- if you want it sweeter add more xylitol

In a small bowl or cup
Mix 1 1/2 eggs (1 egg + 1 egg white will do it)2 t of vanilla.
Mix flour into peanut mixture. Add eggs and vanilla.

Roll into balls, (I flour my hands) put ’em on a sprayed cookie sheet, flatten them with a fork. You can add a little more flour if the balls seem a bit loose.
Bake 10 minutes Add more time if necessary but don’t over bake. These cookies will firm as they cook.

They’ll still have a lot of fat, so try a 1/2 cookie to see how they settle in your tummy. Wait an hour and test BG again.

I make about 1/3 of this recipe but only make 6 cookies. They ring up about 45 grams of carb. YMMV.

They’re great for breakfast.

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Fresh Vegetable Soup

No fresh vegetables are allowed on the gicare.com diet for Gastroparesis. I thought I was visiting hell. But the ban on fresh vegetables and fruits really is a ban on raw vegetables and fruits – due to their higher fiber content. Vegetables? Cook the hxxx out of ’em to help break down the fiber content, peel them, seed them if necessary and eat them in small quantities. Also drink the broth. ( It’s full of cast off vitamins and minerals from the cooking process.)

But start with fresh veggies- from the garden, the Farmer’s Market, even the organic section of the supermarket. They’ll have fewer toxins, higher nutrients and best of all better flavor.

Chicken Nude
(that’s restaurant talk for chicken noodle )

4 cups noodles
2-4 chicken thighs (no skin or bone, cooked )
2 cloves garlic
1 yellow onion
1 summer squash -peeled @ seeded
3 fresh tomatoes (peeled and seeded)
8 cups chicken stock (or alternative)
1 Tablespoon olive oil
Salt and seasonings to taste (I like curry or Italian)
Freshly ground black pepper to taste

To prep tomatoes cut a small x on the bottom, dip into boiling water just long enough for the skin to curl a little (10-15 seconds). The skin should peel away easily with a little paring knife action. This brief dipping is also called blanching (blan-ching). Cut these in half and seed them by running an inverted spoon through the seeds on each side until the seeds fall out.

The squash can be peeled with a potato peeler, halved and seeded as above.
I cook my chicken in a bowl in the microwave. I figure 1-2 minutes per piece. Cover it. (Plate) If it’s a little on the raw side, don’t worry, we’re not through cooking in this recipe.
Put all the veggies in a food processor and pulse until tiny but not mush.

Put 9 cups of water/stock in a pan on the stove. Heat to boiling and add noodles.
Cook to desired texture.

Add oil at the end. (Sauteing the vegetables in oil uses much more fat,
so don’t.)

Add veggies and seasonings. Taste. Want more? Add a little. Taste. Cook for 30 minutes or simmer for an hour or more for better flavor. Add more stock if necessary.

This is a very thick soup and can be used for an entire meal.
2 cups will have approximately 50 grams carb, 3 oz. protein, 1 teaspoon healthy fat.

Enjoy! Coming soon – down-home Tuscan Tomato soup.

It was fairly easy to determine that blenders, grinders (as in coffee bean…) and food processors and sieves were going to figure prominently in my new life with gastroparesis (delayed stomach emptying). I found minimizing the size of food particles helps me to digest them.

I learned early on that liquifying or nearly doing so might save me from a life laden with nothing but salt-laden V-8 juices if I ever wanted to eat healthy food again. Sure, vegetables and fruits have fiber but that really depends on how much fiber you can tolerate, how much will still allow your food to digest?

For me at a nearly normal (stage 3, on the http://www.gicare.com site) I’ve found I can tolerate around 12 grams per day. I spread it out through the day. I’m speaking about insoluble fiber like seeds, not those that are more easily digested, which are also included in most fruits and veggies. My Certified Diabetes Educator told me that’s a lot. She has patients on all liquid diets and no fiber but my perspective says you’ll never know until you try.

I by, and adjust. Eat canned spinach. No? puree? No. puree and strained through a sieve? You’ll soon find out what you can handle. (But be sure to try during waking hours, in small [1/2 cup servings] and check your BG 2 hours postprandial to see what’s going on. Take the amount of insulin needed for the veggie’s too. Then if your BG is 125 instead of your usual 195, you’ll know the fiber is too much.)

Give it a whirl!

Signs and Symptoms

Sleepy day. I just woke from my nap and am ready for another. Frankly I blame all my gastro parties with the paramedics. Multiple ER visits. This recent blooming cold sore on my lip. I’m exhausted, and it shows. Whether it’s final exams, a year of broken bones, or a wedding, I have this marker when it’s through. I break out with cold sores. What does your body do?

Gastroparesis is a condition that can drain you, just like diabetes can.

When your insulin gets into your bloodstream faster than your food can, you may pass out if the food is delayed too long. If you have or suspect gastro
there are 3 things to remember
1. Gastroparesis is best handled by a Gerontologist, as it’s a digestive problem, so not your regular doctor or even your Certified Diabetes Educator. The doc who does your colonoscopy is the one to see. An endocrinologist is my number 1 recommendation for those with diabetes- they specialize in the intricacies of diabetes of which gastroparesis is a part.
2. This is most likely the premier cause of the”dead in bed” syndrome when your blood sugar goes way too low while sleeping. It’s serious.
3. The symptoms of gastroparesis vary a lot – you may be passing out for no discernible reason, feel nauseous, constipated or otherwise feeling your digestive system isn’t ‘right’. Don’t mess around. Go get help.

Start Here

Eating a diet for gastroparesis varies depending on your age and your ‘state’ of gastroparesis, which includes numerous stages – from feeding tubes to what I refer to as ‘nearly normal’. Also consider your own preferences and tolerances. I have a master’s degree in nutrition but I am following a gastroenterology diet I found online(www.gicare.com). adding foods I felt I had no reactions to one at a time.

I have had Type I diabetes for 48 years, gastroparesis for 14 of them. At the time I was diagnosed, I was nauseous all the time and got by just eating saltine crackers. I tried various medications but none worked for me. I ate a healthy high fiber diet that was ultimately my undoing. I started passing out stone cold on my cement floor. I have hypoglycemic unawareness. I felt nothing, came to at a paramedic party and continue to ask my insurance to cover a CGMS. At the moment I’m fighting for more test strips.

I found the no to low fiber diets (gicare.com) , low fat diet, etc. and immediately felt better. Later I found I could tolerate, actually digest other foods :>) I went slowly though. First I tried milk and yogurt, then lower fat cheese, peanut butter and forward. I’m on a pump and took a bolus more often, after checking my BG to see what foods made it through. Your mileage may vary (YMMV). Good luck.

Gastroparesis Exercises ala Bernstein

Blue skies, 70 degrees, what a wonderful morning to walk to the Community Garden, a short block away. This is bliss and it’s also good exercise. Exercise is good for gastroparesis, it gets the body moving.

Dr. Bernstein, the famous doctor who writes about diabetes encourages those with gastro to specifically do abdominal exercises, such as the yoga distension and retraction of the abdominal muscles.
. inhale slowly extend chest area AND stomach area
. exhale rapidly and contract muscles to spine
. repeat – Do as many as you can after eating until you reach 100 in 4 minutes. BUT start slowly then progress in movement and moments.

Another trick is to chew gum after meals. Bernstein recommends chewing for up to 1 1/2 hours.

There’s another exercise he calls the flip-back, you arch backwards and then flip forward. Haven’t tried this yet. It falls into my old ‘can’t hurt, might help’ category.

All of these are worth trying.

Gastro and Hypoglycemia Unawareness

Gastroparesis coupled with Hypoglycemia Unawareness is a lousy combination,but not uncommon for those with long term diabetes. If the nerves in your stomach are damaged for whatever reason, Your Vagus nerve may not function to facilitate digestion, (surgery, long term diabetes )digestion and you do not feel the hypo coming on, get a Continuous Glucose Monitoring System ASAP.

The CGMS can help you avoid passing out, at least while you’re conscious, it can alarm you when you’re sleeping so you can avoid the ‘dead in bed’ finality. The CGMS is critical but my insurance won’t cover it- yet. Medicare.

I am asking for more strips from my Medicare Advantage Plan. These wheels are moving soooo slowly, rage occasionally develops within me. I explain it is to our mutual advantage to prevent me from visiting the ER multiple times. I doubt that they’re interested if I’m at death’s door but I’m sure they’d like to save a few thousand. (I always present the worst case scenario as it is not so likely to happen, but it does happen (death and brain damage) and I want my Medicare Advantage Plan to know that.) Its nothing personal if you do die, just business. And friends wonder why I’m upset. Remember that the more often we mention it, write our insurance companies, or blog about it – the sooner we get the devices we need.

I’ve also purchased extra strips at lower prices online. I found Accu-Check, my meter strips, at Amazon.com with strips about $20.00 less than the drugstore. Check for your brand. Be sure to check the expiration date. Some have complained that it may be only a few weeks from delivery date. I haven’t had this problem but its good to know.

Not Nachos

Sometimes I crave all those salty, fatty Mexican foods that I relinquished when my gastroparesis set in. This Not Nachos recipe is so easy it hardly qualifies as a recipe but try it if you have a hankering for Mexican food.

Not Nachos

10 saltine crackers (on a microwavable plate)
1- 3 oz. low-fat cheese (I use mozzarella)
taco seasoning to taste (I use a package mix from the grocery) 1 tsp. or more

Microwave until cheese is gooey. (30 seconds)

That’s it!

I drink an 8oz. glass of V8 type juice (original tomato based) with this.
Mango, papaya, or pineapple – 1/2 cup. (The canned stuff!)

Voila! Easy meal.

Gastroparesis Foods

When I discovered less fiber made for better assimilation of my daily foods, I started drinking more of my meals. Kelly Booth turned me on to the different stages of gastroparesis (which range from a lower fiber diet to tube feeding for the severely compromised). See Kelly’s website at http://www.Trials and Triblations.com for links.)

I seem to be at the beginning stages brought on more by brain surgery than by diabetes (although 50 years OK 47 – with that hasn’t helped. But no one ever gave me any info about diets or anything like that. One of the recommendations was to try almost an entirely liquid diet with a few saltines, thrown in for good measure. From there I started adding and subtracting foods and I’ still tweaking.

You can usually tell you might have it if your BG is much lower than expected 2 hours after a meal and then goes high a few hours later. Although excess fat and protein digest about 6 hours after eating also.

Your doc can have you tested for gastoparesis. I went to a hospital where they fed me some ‘radio active’ oatmeal, then tracked the time it took for my stomach to empty.

For me, the next course of action was drugs. Reglan, which I had allergic reactions to, then Propulsid, of which a side effect turned out to be dearh. It’s still on the market in other countries and I always suspected the US death rates were do to abuse, as in,’if some is good more is better’ variations. Your doc can still order it for selected patients.

My latest thrill is sugar-free, vanilla Spiro-Tein (check your health food stores or many places online). Google it. I use 8 oz. skim milk, 2 T Hershey’s sf chocolate syrup, a little Stevia, and 6 ice cubes. It’s like a malt!

Every Day Diabetes Heroes

There are a world of diabetes heroes out there, more every day, as people like you and me survive year after year. Detours aside the early days of diabetes, say St. Luke’s alleged patients, fasted until death. And it probably was extant before that. Few survived. We waited another 1900 years before insulin. Jeez Louise!

Most people today don’t think of diabetes as a death sentence- well maybe after their first year they don’t. The Diabetes family, with all its types, have siblings, grandparents, aunts, uncles and cousins and has wandered down to the present. Our heritage. Our roots.

Heroes do include doctors, nurses, CDEs, plus all the moms and dads who go out of their way to help us feel better : Get up in the middle of the night to check on us. And as magazines inform us there’s no shortage of world travelers, rock stars, and actors to wow us with their refusal to let diabetes get in their way. I’d list them all and thank them personally, but I’d be afraid I’d leave some one out!

Every friend who encourages us to make the right choice is a hero in my book. They’ll pause the video while I go check my BG, or tell me my pump just pinged while I’m enthusiastically relating last night’s rendezvous with destiny.

Heroes are everywhere if you’ll just notice. They admire, inspire even fire you if you can’t keep up with your own self-designed protocol. I say bless them all – every day.Did I mention cats and dogs? Faithful friends. And all who support you online?

It’s an endless list and I’m grateful.