Unofficial THM Guide to Macronutrients

I started following the Trim Healthy Mama way of eating two weeks ago and I'm still learning about it.  I've been reading and responding to some questions on the THM Beginners Facebook group and I see a trend in some of the confusion.  While the THM book provides all the information that you need to get started in the first section, people have a hard time putting it all together.  They struggle specifically with understanding which foods are proteins, carbs and fats.   So I'm going to see if I can help at all.

Protein foods- the anchor for all meals and snacks.
Protein is made up of amino acids and is used in our bodies as building blocks for repair and growth.  Some amount of protein is found in most foods, but for the purposes of THM eating, we need to know what foods are major protein sources that can anchor our meals.  We also need to be able to distinguish between lean proteins and fatty proteins.

Lean protein sources - these are FP foods and can be used in any meal or snack.

• lean meats like chicken breast, ground turkey breast, tuna (in water), salmon (in water), fish, lean game meats and lean deli meats.
• egg whites
• dairy* protein sources  - 0% greek yogurt, 1% cottage cheese, low fat ricotta
• specialty items - whey protein, collagen, just gelatin

Fatty protein sources - these proteins should only be used in S meals

• fattier cuts of meat - beef, pork, processed meats (salami, etc)
• whole eggs (the yolk is the fatty part of the egg)
• full fat greek yogurt, full fat cottage cheese, full fat ricotta
• hard cheeses - cheese is a mixed food with both protein and fat.  As such, small amounts may not provide enough protein to anchor a meal. 

*dairy foods can be confusing because whole milk in itself is a total combination food. it has lactose which is sugar, protein, and then fat in the cream. Whole milk is not on plan, but dairy sources of fat/protein are on plan.  It's helpful to think of which part of the milk is in your dairy product.

Healthy Carbohydrates- the fuel source in E meals.  It's not an E meal if it doesn't have carbs!

Carbohydrates are chains of glucose molecules.  Our bodies break up those chains and then use the glucose to make or store energy.  On plan carbohydrates are more complex, higher fiber, lower glycemic index carbohydrates.  They take longer to break down into glucose in the blood.  

Limit carbohydrates in a meal to 45 grams.  You don't need to know how to count carbs to do this, the lists in the book indicate appropriate portions. Limit fats used to cook the meal to 5 grams or 1 tsp. 

• whole grains - brown rice, farro, quinoa, barley, old fashioned rolled oats
• sprouted grain products - breads, tortillas
• soured whole grain bread
• dark rye bread
• on plan Wasa crackers - eat 3 or 4 to be a significant carb source.
• popcorn
• beans - kidney, pinto, black, etc
• fruit
• starchy vegetables - sweet potatoes,  corn, peas, winter squash

Healthy Fats - the fuel source in S meals. It's not an S meal if it doesn't have fats!

Fats are used to perform certain special roles in our body.

• the fat in fatty meats
• the yolks of whole eggs
• cream, 1/2 and 1/2, butter, sour cream
• cheese - a combo food with some protein and some fat
• oils - coconut, MCT, olive, etc
• full fat mayo and dressings
• nuts and nut butters
• avocado

Low Carb, Low Fat add-ons - These are considered FP foods and can go with any meal

• non-starchy vegetables
• berries in limited quantities
• lemons and limes
• low calorie, no-sugar condiments

A blogger named Gwen has made a THM Quick Start Guide that I recommend.  She has an exercise in the guide that helps you with the above separation of food types.

I see a lot of people confused by the "numbers game" - how many carbs can I have in this meal or that meal, how much fat, etc.  The numbers are very confusing to beginners and often get us side tracked from the basic method for planning the meals.  The book stresses that food type trumps the numbers every time. 

You don't need to know a lot of numbers to get started.  Just keep it basic; choose your protein, then add your fuel and round out your plate with FP items.  The only numbers you need to know to get started are the ones I listed above in the Healthy Carbs section. 

Eye-drop Alley

In the last week or so, I have become quite the expert eye-drop installer.  Let me 'splain.

First, Mom returned home from a week-long visit up to Yakima, Washington.  When she came over to collect her mail, I noticed that her eye was very reddened.  She is already scheduled to see her eye doctor in Portland soon, but that date was 2 weeks away.  So Denis prescribed her some basic antibiotic drops to see if it would improve.  So twice a day, Mom comes over and gets her drops for a week.  It seemed to be getting better initially, but after about 5 days, it became more reddened again.  So we bit the bullet and got her in to see a local ophthalmologist.  Fortunately, it doesn't seem to be anything serious.  Now we have antibiotic drops that also have a steroid in and a more aggressive schedule to follow.  So, four times a day, Mom comes over for her drop.

Meanwhile, Denis had cataract surgery on Thursday this week.  Starting Wednesday night, he had three different eye drops that need to be instilled on different schedules.  Denis' eye drop schedule continues for three weeks, so I will be doing this for a while....  :)

I'm excited about Denis' surgery.  He's had a pretty bad cataract in his left eye for several years.  In the last three months, it's gotten so bad that he gets a headache from lights and the stress of working hard to see.  So far, he still can't see too great, but it's only been 18 hours since the surgery.  His eye stings a bit and it's watering.  We got for a follow up appointment today.

Lazy Saturday

I am always wanting to get out and do something.  I am a restless wanderer, always seeking the fun thing to do and not wanting to miss out.  I'm married to a man who is a bit more content to lay low.  He often mentions an event that is coming up, but he doesn't necessarily mean that he wants to go to that event.  *sigh*

Today, we struck a pretty happy medium.  There were two music oriented events that we knew about and I would have loved to go to.  But instead, I went to the Grange Co-op with D to buy lawn fertilizer and then we drove out to the nearby historic town of Jacksonville.  We went to the kitchen store that he had given me a gift certificate to for Christmas.  (It only took 9 months for me to get around to spending it)

I got a potato ricer - a press that makes extra smooth mashed potatoes.  I think there are other uses for it as well, so I'm looking forward to experimenting with it.

This picture is of the nice view on our drive.  We do live in a beautiful part of the country.  this picture doesn't really do it justice cause it was taken out of the window.

Musicality

My poor old piano is getting tuned today.  The tuner lady said that it has gone rather flat during the past 7 years or so of neglect.  She is going to bring it up to pitch today, but it will probably need to be retuned in about 6 months, then a year.

The inspiration for getting the piano tuned is the fact that I have started taking violin lessons!  I started about three months ago with a violin that was borrowed from a family in my church.  Their daughter had played in high school, but gave it up when she went on to college and so it was just sitting unused under a bed in their house.

I ended up having difficulty playing the full size violin, so I recently bought a 3/4 size from a local string store with a really good reputation.  My teacher as well as a friend of mine are both well-known to this shop, and so I think I was treated rather exceptionally well.  :)  They let me borrow the two instruments I was most interested in for up to two weeks while I made a decision.  It was a hard one, but I finally chose the more expensive one.  It has a bit more shrill tone, but the notes sound a bit truer and I am able to hear myself playing better.

My new violin

Learning the violin is on the hard side as far as instruments go.  What looks easy - moving the bow across the strings to make a nice sound - is actually hard to learn.  I can tell the difference in sound when I am properly using the weight of my arm on the bow, but it's so hard to do that consistently.

Anyway, that is what is new right now in my neck of the woods.

Joni and Friends Camp Report

We are back! A little tired - in denial that we have to go back to work tomorrow. Loading pictures onto Facebook and looking at other's pics to relive the moments and wishing that they were not in the past already.

I have had about 48 hours to reflect on what I want to communicate about camp this year. I'll start back a few weeks. I wrote my last post (below) a few weeks before camp, knowing that we were short on STMs. I wrote about being nervous but trusting God that He's in control and why that is the best situation that we can be in - out of control. I wrote that primarily thinking of what fears that people have about being an STM and hoping to inspire confidence. Apparently I gave you all the impression that I was more nervous about being an STM than I really was, because I lot of friends commented about it.

The truth is that I was definitely a bit nervous, but my excitement about being an STM this year far outweighed my nervousness. So, on the night before camp, I decided that my new statement would be "I'm one part nervous, three parts excited."

As I thought about who I might be paired with for the week, I figured that I would get either a very small typical sibling, a child who uses a wheelchair, or possibly an adult with a disability who is more reserved. Since I already know many of the campers, I pondered the different folks I might get paired with.

One camper came to mind who made me more nervous. At some point, I definitely thought "I hope I don't get paired with Michelle". Michelle is an adult camper with spina bifida. During some illness, she had a trach and was left with separated vocal chords and she can only speak in a whisper. I had heard that Michelle was a very sweet gal, but I was worried that I wouldn't be able to hear her and we would both end up frustrated if we were paired. You see, since I'm deaf in one ear, I have a hard enough time hearing a regular conversation in a crowded room, let alone a whisper.

So, fast forward. It's Monday morning, day two of training, when we get our camper assignments. Who did I get? You guessed it - Michelle! I read her paper carefully, knowing that God had made this match and figuring He must know what He's doing. I was really happy that I got one of the adults, because that meant that I would get to attend the "Friendship Group" program and get to know all those beloved campers better.

It turns out that I was probably rather uniquely suited to be Michelle's STM. I was able to point my one good ear directly at her. Since I often miss some words in conversation, my mind is pretty skilled at searching the context for the right word to fill in the blank. As time went on, I also discovered that she sometimes will use sign language for a short message - and all her signs were ones that I knew. By Wednesday, I was getting really good at hearing and understanding her - she even said to me "you are so good at listening to me!" which was really reassuring. I became Michelle's voice when we were in group and she was talked over, when we visited with other people. I would wait to see if they understood, but if they didn't I would "interpret".

Besides the language issues, being an STM was ALL that I expected and hoped for it to be. It was so fabulous to be a participant in the programs and activities. To be involved in a family through the whole week. To get to know a particular camper's likes, dislikes, fears, interests and help her have the BEST experience.

Michelle's birthday was Wednesday during camp and she had an epic day! The whole camp sang Happy Birthday to her off key (camp tradition) at breakfast, went on a horse ride in the afternoon and was the closing act in the talent show that night.

Meanwhile, Denis and Cynthia (the nurse that we recruited) were kept quite busy this year. There were more medical issues this year than last year - but thankfully, none too serious. Cynthia had a ball and is hoping to return next year. I made a deal with her - as long as she wants to be the nurse, I will be an STM!

Getting ready

We are only three weeks away from the Oregon Joni and Friends family retreat, and it's kind of push time to get ourselves squared away and ready for camp. Denis and I have dragged the medical supply box into the living room, but have not inventoried it yet. Our friend who has agreed to work with Denis as the nurse this year is coming over today to look at the stuff with us. I've started reviewing the medical information from families and organized it into an easy to carry chart that we'll print out when it's complete.

One of the most exciting things for me is that I get to be a typical STM this year. For those of you new to Joni and Friends lingo, STM means Short Term Missionary, and that is what volunteers are called. Most STM's who go to a family retreat are paired up as a "buddy" for the week to a family member who has registered. That person might be a child with a disability, a typical child who has a parent or sibling with a disability or an adult with a disability. The week is spent hanging out with your "buddy", building a relationship, serving the family, attending activities through each day.

I have never gone to Joni and Friends Family Retreat as an STM, I've only been the nurse. As the nurse, I enjoyed having the freedom to rove and get to know everyone a little bit. But I know from observation that the STM experience is very different. STMs who are paired as a buddy get to know their one family very well and bond closely with them. It can be difficult, trying, challenging, but on the flipside so rewarding. STMs tend to leave camp exhausted, but overwhelmed by the blessing of being so intimately involved in an amazing family and having been a selfless servant for the week.

I have no idea who I will be paired with, hopefully someone slow - as I'm not fast myself. Not knowing is part of the situation that makes it stressful or scary to go as an STM. But, the pairing of STM to family is a total God-thing. Being out of control of that is precisely what makes it so wonderful. God pairs buddies very well. And if the pairing is hard or challenging, it's because God has a growing to do in me. Stepping out beyond my control is something that I am excited about, because that is precisely when I get to see God work.

We are still very short of STMs for our Oregon camp that is Aug. 14-19 at Rockaway Beach on the Northern Coast. We really would like 30-40 more STMs so that all of the families can be served. Aug. 14th is a training day, then families arrive for camp from the 15th to the 19th. If you know anyone who might be interested, please pass on the info.

Here is the website to find contact numbers and applications.

General information about family retreats

My report from last year

My report from 2009 at Mission Springs in CA

Amos Lee

"Cup Of Sorrow"

I want to drink from your cup of sorrow,
I want to bathe in your holy blood.
I want to sleep with the promise of tomorrow,
I know tomorrow may never come.

I send a prayer out across the ocean,
To a man that?s forced out of his home.
I send a prayer out across the ocean,
So that he may not suffer there alone.

I want to drink from your cup of sorrow,
I want to bathe in your holy blood.
I want to sleep with the promise of tomorrow,
I know tomorrow may never come.

I want to sit at your table of wisdom,
So that not one crumb shall go to waste,
For if we keep down this pathway to destruction,
Oh will our children will suffer for our haste.

I want to drink from your cup of sorrow,
I want to bathe in your holy blood.
I want to sleep with the promise of tomorrow,
I know tomorrow may never come

Amos Lee's newest album, called El Camino, has several tracks with Gospel lyrics and rythm. This one is my favorite. You can listen to the whole thing for free on his Facebook page.

Is it July already?!

What has happened in the last three months? Hmmm... let's see. Two main things stand out:

1. I started a new role at work - I am no longer doing the clinic-based diabetes classes and individual education. My new role is focused entirely on the hospital care. Up until this point, all of our diabetes dept. RN's have shared the job of rounding through the hospital, answering questions, reviewing charts of patients with high or low glucose as well as doing in-services for hospital staff, etc. Now, I am the one doing all of these things at the hospital here in Medford. I do rounds in the hospital 3 hours a day, Mon-Thurs. The rest of the time I spend planning, going to various meetings, and working on PI projects. This is a big change. I've been doing it for about two months now and so far, I don't miss the clinic stuff. I am quite passionate about us giving good care in the hospital, so I think this role is a good fit for me.

2. We went on a week-long vacation in Sonoma County, CA in June. Had a really nice time. We stayed in a cozy little cottage in a small town outside of Santa Rosa called Sebastopol. A former pharmacy student that did a rotation with our department and now lives in the East Bay area drove out of her way to meet up with us two days. IT was so fun to see her and to meet her fiancee. We sampled a bit of wine, ate at some slightly upscale restaurants, listened to some good music, had great coffee, saw the coast at Bodega Bay and drove home through the redwood forest. All in all, a relaxing time.

Mid-month report

OK, I've made it through the busy part of April and survived. It should be a downhill slide from here, but there are more events just around the corner, so I shouldn't get too cozy about relaxing.

The weekend in Portland with my coworkers was very enjoyable. The conference was interesting - great speakers and we came home with some good, useful ideas.

Yesterday was our Southern Oregon Sometimes Miracles Hide luncheon for moms of kids with disabilities. 64 people from my church volunteered to help, either cooking, serving the lunch, or helping in the carnival section. I had agreed to be the "Carnival Coordinator" which sounds more impressive than it was. I didn't actually plan anything - but I was the "check in" person who directed carnival helpers to the right spot and assigned duties. I was kind of nervous about assigning duties since I really didn't know the people I was assigning. I didn't know their personalities - so didn't know who would do well where. But it turned out well. (I actually had TONS of help from another couple in my church who were "leading games" but ended up roving with me for problem solving) I had put some kids working together who didn't know each other at the beginning of the day. As the carnival went on, I saw them working together really well, coordinating breaks for each other and having fun. Denis got to be a buddy for the first time and enjoyed having more to do.

So, next up is Easter, then our church's next respite day in early May.

It's Spring

It's April and as usual, it seems, life is very busy this month. I seem to recall writing very similar posts in years past... what is it about April? So far:

• I finally recorded a presentation that I've been planning for about two months to be viewed by physicians, pharmacists and nurses in my hospital. This is a REALLY big deal, because in it, I am presenting a "how to" type of instruction on Diabetes care in the hospital setting. (I actually recorded that in March, but it was this past week...)
• had our annual Diabetes healthfair yesterday - it was a new format this year, so we were all an extra bit on our toes. I messed up part of our facilities order, so there were a stressful 15 minutes, but it turned out well.
• I helped coordinate our church disability ministry getting T-shirts - ordering the right sizes and then handing them out today.

Still to come:

• church disability ministry planning meeting tomorrow
• meeting with a physician group Tuesday to explain and promote my Diabetes presentation - hoping they will want to view it for CME credits
• planning meeting at work Wednesday - have to make a pasta salad for the potluck lunch
• our group travels to Portland Thursday for a conference - FUN!
• the following week is the Southern Oregon Joni and Friends luncheon called Sometimes Miracles Hide - Denis and I are volunteering

Busy April, fun April. And it really is spring here now - we have daffodils up, the sun is shining. I even took Phoebe out for a little walk - she she is one happy kitty right now.