Tag Archives: T1D

Camino Santiago Passports, Stamps & Symbols

Chapter 6 – Camino Santiago Symbols, what are they about?

Travel brings power and love back into your life – Rumi

I’ve talked about much of my preparation for the Camino but I haven’t really talked about the process of the Camino, how one walks the Camino path. When I heard about the Camino I started to research about it – I could find tons of website and blogs and there was a symbol that kept showing up over and over again – it was the scallop shell. The scallop shell signifies rebirth and it’s the symbol of Camino and the apostle Saint James and the French call it Coquilles Saint Jacques (Scallops of Saint James/Jacob)

Legend of the Santiago de Compostela

Who was Saint James? Why did so many of his followers or pilgrims take the road to Compostela as early as year 1000? According to the bible James the Greater was one of Christ’s first apostles who died in Jerusalem in the year 44 AD. He said to be been beheaded by order of King Herod Agrippa, who was apposed to the new religion. Legend has it two disciples brought his body back by boat to Galicia where the tomb was discovered by 9th century by a hermit who was led to it by a star. Relic worship was widespread at the time and the site rapidly took on its vocation as a major pilgrimage center comparable with Jerusalem and Rome. Campus Stellae or “filed of stars” became Santiago de Compostela and this town tip of Galicia soon built a Romanesque church that was to become one of the most imposing Gothic Cathedrals in Europe.

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From all the pictures of the Camino the directional sign to Santiago were all directed by the shell using it as a walkway symbol or a yellow arrow sign pointing to a direction to walk ahead. From my trip I’ve seen the yellow arrow on rocks, roads, trees and trust me you will be happy to see it on your path so that you don’t miss your path. The scallop shell is also modified like a sunburst used sideways signifying many paths around Europe leading to one meeting point, Santiago! How cool is that!

When the pilgrims start the Camino everyone gets a passport called “credentials” from the tourist office at the starting point (in my case at St. Jean PP) a passport where each pilgrim will register their personal information. Once a pilgrim obtains a passport then they can collect stamps to indicate that they have passed the proper Camino path through various villages. The passport is used as a credential to get accommodations at albergues (Hostel, Pension). When you reach Santiago, to get the Compostela (the Camino certificate) the passport is examined at the Tourist office to make sure all the necessary stamps,  the last 100 km have been walked by the pilgrim. So these stamps are given out in most albergues, churches and municipal offices – they are unique to each place. But all the stamps are verified and the certificates are given out to everyone who walks the Camino to Santiago.

My passport, my first stamp from SJPP and Camino Shell

My passport, my first stamp from SJPP and Camino Shell

You are also asked a question at the Tourist office why you walked the Camino – this is not a test question that one must pass but to let one reflect on the whole journey and answer why they did the walk and then you are given the certificate. I have a degree in Computer Science, Diploma for Culinary Arts, many awards and certificates but I think this one will be very special to me. This certificate is not easy to get – and it’s not about how fast or how many days it took to finish rather how one did the walk and the quality of it. This is truly a reflection of oneself how you want to do the Camino walk.

Santiago de Compostela for me!

I’ve given permission to myself to do something totally different where my body and soul hope to work in synch without being too hard and judgemental about myself. I also hope to find a balance in my life, balance my blood sugar with the heavy physical activity and to achieve a taste/test of walking close to 880 km where I’ve done this similar distance by plans, trains and automobiles but never by foot and that’s some achievement I can do and be proud of. Especially with type1 diabetes (T1D), I’ve never challenged myself to long physical activity where I can really speak to so many others challenged by diabetes who limit themselves to travel or long distance physical activity that they can with proper planning and training.

Buen Camino!

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The Camino Training with Type1 Diabetes

Chapter 2 – My Camino started 3 months ago

In my previous post I had talked about the history of the Camino de Santiago and why I decided to take the challenge and in this post I will discuss how I got my training started.

“It does not take much strength to do things, but it requires great strength to decide on what to do” – Elbert Hubbard

It’s easier to make a decision to do anything but where it gets challenging is the execution of it. I had no idea how to start the training. Having type1 diabetes (T1D) I have insulin sensitivity, low blood sugar (hypoglycemia), high blood sugar (hyperglycemia) these are all common symptoms in my body on a regular basis. My biggest fear is low blood sugar. My legs become like noodle and unable to do anything until my body is recovered with glucose. I carry glucose tablets everywhere I go along with juice and snacks. Walking 30+ km a day is about 6 to 7 hours (5 km per 1 hr. estimating on flat surface, no hills) plus lunch and breaks. It’s a long day for the body to be put through that type of fitness regime if you haven’t done it before.

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How do Athletes train?

I asked my friend Michael who does marathons and Ironman and how he trains for it, his answer was “you don’t think about the whole race, you think about the next km and the next and so on and let the training guide you”. Motivational speaker, super athlete Sebastian Sasseville with T1D (climbed Mr. Everest summit and ran 250 km Sahara race) and Endocrinologist Dr. Perkins and the team from Mt. Sinai Diabetes Education Centre have been a huge help providing their insight and telling me to figure out “my numbers” before I get to Spain.

Sasseville said “figure out all your numbers before you get to Spain including plan A, plan B and plan C so that you are prepared for every kind of emergency and you go on autopilot when you get there”. Great advise because that’s exactly what I have to do, figure out my basel insulin setting (slow acting insulin intake) for the entire day including hourly intake during the walk.

Its all Numbers

I started my walk with 6km around my neighbourhood using an iPhone app called “MapMyWalk” which is great for walking (training) – and will keep track of your steps, km and calories burned plus the map of your path so you can save it for future use, tweet it/ facebook it for bragging rights. I started my walk every other day in early March, it was so cold and raining and I got sick. It took me 4 weeks to recover – recovering from cold/fever with diabetes takes longer. Then started training again in April – every other day and slowly increasing to 10, 12 14 km  … and eventually walking every day. By mid June I was walking 30 km with no problems. Hiking training few weekends with my husband was a huge payoff –  including going to Rattlesnake Point and Bruce Trail really helped with me the rough terrain, uneven surface plus it mimicked some parts of the Camino.

Its been tricky and hard to walk a full day of training with a major renovation going on in my house for the last 3 months and ignoring my personal life –  but I had to put my training as priority as I had committed to the Camino and booked the ticket. In some ways it was good to have a target and train for it and sticking to my commitment as it helped me to focus. Part of it was due to being just scared as I didn’t want to get into trouble in during my climb if I ran into trouble.

 “Nothing is more difficult, and therefore more precious, than to be able to decide” Napoleon Bonaparte

As I said on my earlier post about the first day of Camino is to trek from St. Jean Pied de Port to Roncesvalles 20 km straight up the Pyrenees and decent 5 km to Roncesvalles. The ancient Napoleon path goes through the middle of the mountain as there are other options of taking gravel roads with less strain. But the whole idea to train was to see the summit on top and to find out about my body.

Climbing straight up for 20 km on a tough terrain to maintain healthy blood sugar without having too high or too low sugar (chances are low sugar) as it’s a tough exercise is a challenge. So my training had to be 99.9% figuring out numbers (how much insulin to take for the day and during meals).

During my trainings I reduced my insulin to 40% to 50% during exercise and during rough terrain even reduced more and no insulin during meals which kept my blood sugar perfect. Of course I had many low sugars but it was all part of the training to tweak the numbers.

Here is a video from my hike at Rattlesnake point

The Plan, the plan

Well I think I have my numbers figured as I will post them later. In terms of snacks and energy Dr. Perkins, my dietitian and nurse at the hospital agree that I should be having a good snack and replenishing my fluids every hour.

Snack = .5 g of Carb (CHO) x total body weight in km for every hour

During my training I ate trail mix and drank coconut water (carb, salt – great electrolytes) but my dietitian indicated that nuts are great for day hikes but not for everyday 30 km hike, so I need to skip the nuts and go straight for the sugar and carb combo since it will give me more energy like Fig Newtons . And it would be difficult to find coconut water in Spain so I will settle for Gatorade (as I plan to carry Gatorade crystals and make them as I need them).

I am so eager to put all my training and things that I just learned the last few months into production as the days are getting closer to our trek, like my friend Melinda said “my training started 3 months ago here in Toronto”.

I am so excited to be sharing this with you and I hope you’ll join me on my journey as I will try to post our progress (internet permitting) of course!

Buen Camino!

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Fiddleheads Barley Risotto

Spring in the Epicurean world

Spring is one of my favourite seasons for amazing ingredients like wild leeks (ramps), fiddleheads and morals. Due to long cool spring this year, we had abundant supply of fiddleheads. One of my favourite dishes to make in the spring is fiddleheads risotto.

Risotto is like a kryptonite for me – as much as I love it, it doesn’t love me back.  Risotto is generally made with Italian Arborio rice (white short grain rice with a hard kernel) which is quite high in starch and its high GI – which really doesn’t agree with my type1 diabetes (T1D) where it elevates my blood glucose high.  At restaurants I usually get it as a side dish or take a lot of insulin for it.

Barley is a great substitute for Arborio rice even if you don’t have diabetes – as it gives it a rich firm texture without being so being high GI.  It’s making appearance in many high end restaurants in North America as it’s very popular in Italy. So here I am sharing my favourite Barley Risotto recipe and it’s not rich as it doesn’t need lot of butter, cream or cheese. It’s very light and perfect as a main dish or as a side dish.

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Chefs Note: Pot barley has more fibre than pearl barley as they remove some of the bran.

Fiddlehead Barley Risotto

Fiddlehead Barley Risotto

Barley Risotto with Fiddleheads

Prep time 10 min              Cooking time 30 min                       Serves 4

Ingredients

1 tbsp extra light olive oil

1 medium onion, chopped

1 bay leaf

1 cinnamon stick

1 cup pot parley (soaked 1 hr and washed, drained)

2 ½ cups vegetable stock (low sodium)

1 cup fiddleheads, whole (trimmed and washed)

1 tbsp chopped mint

1 tbsp unsalted butter

2 tbsp low-fat parmesan

Salt and pepper for taste

Method

Warm the oil in medium sauce pan over medium heat and sauté the onion and add bay leaf and cinnamon stick.

Add pot parley and sauté well until all ingredients are incorporated well and add vegetable stock and bring it boil. Add fiddleheads and reduce heat to low and cook 25 minutes or until almost all the water is absorbed.

Add butter and parmesan to arrest the cooking as the risotto will thicken once you add the parmesan, adjust taste with salt and pepper as you will need no salt at all (due to parmesan and stock) and fold in gently chopped mint and cover for 5 minutes.

Serve warm with a spinach or arugula salad as the combination is great!

Nutritional Analysis per 1 serving: 1/2 cup = 125 ml: Calories 238; Carbohydrate 32g; Fibre 3g; Fat 9g; Saturated fat 3g; Sodium 245 mg; Protein 8g

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My Camino Way

camino2Chapter 1 – Brief History of Camino de Santiago

For some time I’ve been thinking about doing the Camino de Santiago  (long walking trek over 800 km)  – an ancient pathway to pilgrims, even Napoleon took this path to visit the large cathedral of Saint James in the ancient city of Santiago in Galicia, Spain. Ancient time they thought Finisterre (Atlantic coast of Galicia) was ‘end of the world’ (costa de morte) – where there was no landmass, leaving civilization at the edge of Atlantic Ocean until the new world was discovered in 1492.

“People tend to forget the word “history” contains the word “story” – Ken Burns

There are many routes to get there within Europe. I’ve always been fascinated by the sheer faith and spirituality people have in achieving this massive goal by walking approximately 25+ km each day – walking through tough terrains, mountains, foot hills and valleys and sleeping in albergues, monasteries and eating what is available along way.

Why the Camino for me?

Not being an athlete or a religious person I wanted to undertake the Camino to learn about myself and my body as I haven’t pushed myself to do anything challenging after being diagnosed with type1 diabetes (November 14, 2005 – ironically its World Diabetes Day). Having type1 diabetes (T1D) has its challenges, to maintain healthy blood glucose (blood sugar) throughout this trip, eating what is available and walking 25+ km a day (exercise and tons of it) is an enormous challenge without proper planning and training.

camino5March of this year I decided to take this challenge and to train for it. Walking is something I can do as I’ve tried running many times but it didn’t click for me, neither did biking. But walking 25+ km each and every day for 32+ (approximate days to walk 800 km) days? – Well it has a good ring to it. It’s like training for anything, all I had to do was to step out of my house (my comfort zone) and walk on the sidewalk and viola I could do 6 km for an hour, wow I can do this Camino!

Well not so fast – I will talk about my training on my next entry but just wanted to talk a bit more about the Camino.  My first day’s journey at the Camino would start at St. Jean Pied de Port (SJPP), France at the foothills of Pyrenees where you climb 1500 meters straight up the mountain for about 20 km and descend to 900 meters, 5 km to Roncesvalles, Spain. After 10 km from SJPP on the mountain there is no stopping as there are no hostels or huts to stay as its a rough terrain, only the mountain.  So this is the challenge that really pushed my training to figure out how to get ready for this challenging climb and descend and keeping up energy for 25+ km for each day.

Did I mention that I will be doing the 1st segment of the Camino with my husband John – he will be my coach to remind me to take my snacks, test my blood sugar every hour and cheering me on as he has done many challenging climbs in his earlier days including the Kilimanjaro.

We will start our journey from SJPP (France) to Logrono (Rioja, Spain) approximately 200 km to be completed in 8 days. I am also thinking of starting my 2nd journey from where I leave off at Logrono, Rioja to Finisterre, Galicia about 700 km across northern Spain over a month later this summer.

Talk about exciting, I am thrilled. Not only it will be a huge challenge but being a cook exposed to this amazing culinary journey across northern Spain, eating, walking, doing a fitness holiday, meeting travelers from all over the world along the way and breathtaking scenery and history to boot? Why not? This is sounding amazing already and I can’t wait to get there!

Check out the film The Way directed by Emilio Estevez starring Martin Sheen (plays on screen father too) – a powerful story that takes place in the Camino trail where life’s questions, quests are questioned or answered as you’ll meet interesting characters along the path of the movie. Very uplifting and moving film which I really enjoy myself at TIFF few years ago and had the opportunity to talk to both Estevez and Sheen about their journey in the Camino and how it was to play onscreen father and son about life’s existential crisis. They were so happy to share their stories.

I plan to blog about my trip while on the Camino – hopefully the internet connection will cooperate so that I can share my experiences and the culinary journey with you guys and I hope you’ll join me along the way to cheer me on send me positive vibes with your feedback.

Buen Camino!

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Pump me up!

IMG_2031April 15, today I went from MDI (Multiple Daily insulin injection) to an insulin pump. I was really scared of insulin pump for many reasons… but before we get started I would like to share my story with you.

I was diagnosed with type1 diabetes November 14, 2005. November 14th is world diabetes day and it was quite dramatic to find out about this chronic disease in my adult life on this particular day. Is it really possible to get type1 diabetes (T1D) at adult life? Yes it is possible. So the last 4.5 years I have been taking multiple insulin injections 5 times a day (3 rapid insulin (bolus) injections before meals and 2 slow acting insulin (basel), one at bed time and one at breakfast). I will tell you about my symptoms and being diagnosed on one of my future blogs.

Anyways I have been taking good care of myself but my H1a1c results weren’t always good and I got lazy with my carbohydrate (carb) counting and insulin ratio was never accurate. I am a chef and I know about food and this should be easy right?

No! Why? Too many variables, if you are a person with T1D you know about them. Everyday stress of life, activities, hormones  and many other factors have always brought my blood glucose (BG) up and down and my Endo (Endocrinologist) was stressing me out because my numbers were not good enough.

Insulin Pumps have come long way baby!

Two years ago I tested myself using a CGM (continuous glucose monitor) for 3 days to figure out what was going on my BG. It was an archaic machine with a big fat needle that hurt like crazy and of course wearing the CGM my BG was perfect for 3 days. So they really couldn’t figure what was going on but my BG continue to go up and down.

Government of Ontario two years ago approved Adults with type-1 diabetes for EDP program and can have a pump at no cost. Well I didn’t jump at that chance, since I know how much work it is to get the pump working the way you want it to work for you. I belong to a insulin support group and everyone but me was on the pump and hearing their stories wasn’t easy. For some people it clicked right away and for some people it didn’t. It has nothing to do with whether you are doing right or not, but everybody is unique and getting the pump to understand your body is much harder than you think. I will explain all of that in my future blogs.

Ready to cook and learn?

Anyways renovation in my cooking studio is over and I have no more excuses so I signed up for a pump. I am cooking up diabetes recipes and will be logging them here too. Here is my journey. If you are a person with type-1 or type-2 diabetes and want to exchange ideas, information and learn to cook some lovely food that is suitable for people diabetes come join me here. I look forward to hearing your stories and ideas because with diabetes, there is so much to learn and everyday is a new day.

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Pretzel Story!

Pretzel1To Pretzel or not to Pretzel

I went to a type1 Diabetes (T1D) symposium two nights ago and there was a topic on type 1 diabetes: the creative, adventurous and active life. Diabetes and food go hand and hand and I should know this since being diagnosed with type-1 diabetes over two years ago. I pay attention to what I eat. Taking it further, I teach healthy diabetic cooking class at the hospital, at my cooking school and provide education and awareness about diabetes and advocacy for the South Asian Diabetes Chapter of the Canadian Diabetes Association. I put my brain and my thinking where my mouth is so to speak and conscious of what I eat all the time, it’s a 24/7 numbers game since it affects my blood sugar and my well being.

Most people with diabetes (type1 or type2) have to think about their carbohydrate intake to balance their blood sugar level. People with T1D diabetes have to count the carbohydrates to consume in order to take insulin. I won’t go into too much detail and save it for another post, but you really have to get good at counting the total carbohydrates of what you eat, most of the times eyeballing an estimate (you do get good at it) so you can take the proper insulin dosage.

It’s an art, it’s science and its critical and its survival. I have been counting carbs since I started my insulin regiment over two years ago. The hardest part is not knowing new food items, choices are millions. Especially when the item is freshly cooked or it doesn’t have the nutritional value label on it.

For example, take the simple warm soft pretzel with sprinkles of sea salt on them – they sell them at many events these days, New York streets (it brings back memories) –  how harmful can it be?

Well at the talk, one of the doctors talked about carb intake and asked us to guess carb amount for  few items. Every T1D person knows a slice of bread (white or brown) is approximately 15g of carb, its the fibre that makes the glycemic load (absorption different), that’s another post in the future. Next item was a soft pretzel and asked people to guess. People guessed 30g, 40g even 60g. The innocent looking soft pretzel that I loved eating with mustard in balls parks, New York streets and on my last visit to Germany for a snack… I couldn’t even guess. They are harmless looking – soft, light and I thought it could be as much as a half bagel which is about whopping 35g of carb (this is why I can’t eat a bagel). I can have two slices of bread and be still under half a bagel’s carb rate due to fibre.

Well the good doctor said the soft pretzel was 200g of carbohydrate. The audience jaws just dropped. I could easily eat two of them for a snack and it’s one of the national snacks in Germany. Everybody eats them and they are great.

I went home heavy hearted and sad. I go to Germany at least once a year and for me not to be tempted for a snack, how can this be? Sure I can take insulin for 200g of carbs, but it’s like blowing all your carb in one item for the whole day (more or less). I didn’t sleep well – I kept tossing and turning and pondering about “to pretzel or not to pretzel”, the question kept plaguing me all night.

Well the next morning I was tired but I did some research and was happy to find that the good doctor didn’t do his research well or he just wanted us to be aware of the high carb snack with slight exaggeration. I still can’t eat it everyday but it can be done.

One soft pretzel is approximately about (143g in weigh approx.) and 99g of carbohydrate, 483 calories and 2008mg of sodium (one full day’s worth of salt supply almost) *facts provided by Nutrition data

I haveT1D and have strong insulin resistance. Most people take 1 unit of Insulin for 15g of carb, but I will still need 11 units of rapid insulin to battle this soft tasty pretzel, so I guess Pizza, Bagel and now soft Pretzel are off my list and only allowed for special occasions when I feel like taking 12 units of insulin before consuming it.

Some interesting facts to think about before eating this tasty soft pretzel for people with diabetes or not:

Exercise required (Based on a 35 year old female that’s 5.74′ ft. tall and weighs 144 lbs.) * facts provided by Calorieking.com

To burn the calories of this soft tasty pretzel you could do any of the following:

94 minutes of walking OR 39 minutes of jogging OR 28 minutes of swimming OR 52 minutes of cycling

At the end of the day, I am relieved that the soft pretzel is not 200g of carb but 99g of carb – but I am still not convinced to take 12 units of rapid insulin but will reach for a cookie instead (mare 15g of carb) and save the soft pretzel for my next trip to Germany or New York instead.

 

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