April 25, 2014

Another Meeting with the New Member

On April 22, Jill called Tim to see if he could bring Allen and me the next evening. Tim said he would check and get back to her. Jill said they both had received the equipment and were ready for more learning. After Tim had talked to each of us, we agreed if he would alert Dr. Tom. He said he had already done this and had specific instructions from Dr. Tom.

Tim sent an email to Allen and I with these instructions and what we needed to cover and not cover at this meeting. We had to pay attention to their questions and make sure we answered each one. We were to be careful not to overload them with information, but let them absorb what we were telling them. The first thing we were to cover was the downloading of the meter to the computer and what had been set for the different parameters. Then Dr. Tom wanted a print out to-date.

The next evening, Tim picked us up and we talked briefly until we arrived at their place. James and Jill met us at the door and invited us in. James wanted to go over the program for downloading his meter and Tim went with him. Allen and I followed Jill to the kitchen where she had laid out two cookbooks which she identified as new for them. She proudly brought out the scale and hesitantly asked what tare meant.

Allen turned to me and I said there is one easy way to remember. I asked for a bowl that was often used for serving food. Jill reached into a cupboard and set one on the table. I turned the scale on and waited until it processed. Then I set the bowl on the scale. Jill said that is tare. I laughed and said sort of, but watch what happens when I push the tare button. Jill said the scale just went to zero. I said right, the bowl will not be recorded as weight when you put something in the bowl. Jill reached into the refrigerator and placed a packaged salad in the bowl. The scale now read 12.5 ounces. Jill said the salad is only 12 ounces. I said and the packaging weighs supposedly 0.5 ounces. That means that the contents of the pack of salad is very close to 12 ounces. Tare means the zeroing of the container weight to obtain an accurate weight of the food in the bowl.

I asked her to get a plate they used for a meal. Then I had her reset the scale and once it was reset, to set the plate on the scale. The scale showed the plate weighed 18 ounces. Jill pushed the tare button and put the salad package on the plate. The package of salad weighed 12.5 ounces again. Jill said now I understand why you wanted this in a scale. I said if you clear this again it will weight the pan or pot you use to cook in if you also put a pad under the pan for tare weight. Then when the pan is hot, you can weigh the contents in the pan. If the recipe serves four, then you can take the pan off the scale, after recording the weight.  Then clear it again because you know the weight and put a plate on and tare the plate. By putting food on the plate or in a bowl, you can know what weight is one fourth of the total.

If you have a cookbook with nutrients listed, then you will know what the carbohydrates are for your husband. By the same procedure and a handy calculator, you can determine the size of serving your husband needs. With that, Jill asked Allen to hand her one of her cookbooks. She opened it to the page she had paper-clipped and said this is one of the recipes she and her family liked, but it has 78 grams of carbohydrates.

Allen said what else do you have with the meal. Jill said normally James has one or two slices of bread and a glass of milk at the evening meal. Allen asked if she had the bread package to look at. Jill reached into the cupboard and brought out the bread. I looked at the label and it was 18 carbs per slice. Next, she brought out the milk and Allen read the label and asked what size of glass he used. Jill reached for a glass and Allen asked how full it was normally filled. She indicated about two-thirds of a glass and rarely more. Allen said that 10 carbs will very close. He did say that if they changed to another milk or whole milk to refigure.

Tim and James came into the kitchen then and Jill said the scale did more than they had thought and that I had showed her how to use the tare button. Tim put the printout of the meter readings in front of Allen. Allen asked if he had discussed this with James and James said he has to make some improvements. Then he added - some drastic changes. His readings were in the upper 200's and he was not testing after every meal and at bedtime. Allen asked if Dr. Tom had him approved for more test strips and James answered yes and he would be testing more often. His insurance would allow the extra testing for four months before cutting him to four test strips per day.

James said Dr. Tom had told him to lose at least 15 pounds to be at ideal weight. Tim said he had brought up the Health Central weight calculator and for his frame size and Dr. Tom had used the same chart. Allen asked if he was ready to learn about food or leave this for later this week. Jill asked if Allen and I could come the next evening, as she wanted to go over what she had learned with her husband and to start teaching him how to count carbs. Tim said that he would come the following week to see how he was doing with testing and insulin. James said on Tuesday if possible as he had a meeting Wednesday evening for work he needed to attend. Everyone agreed and Tim, Allen, and I left.

Tim said he is making progress, but is somewhat intimidated by insulin and is slowly gaining confidence. Tim said he had given him a range to work toward for carbs now and to see where testing was telling him to go. He said the amount of insulin he is taking indicates with the numbers he is getting that the carbs are too many and he is not insulin resistant. I said that they got the right scale and she was learning about carbohydrates and how to calculate. I said she even has a calculator and I would show her additional help tomorrow.

Tim said to call him after our meeting was done.

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