Inside the Clinic: Fasting Edition
Hello Community!
Spring is such a beautiful season, and it is also a very important season among our Abrahamic faith communities, with Passover, Easter (and Orthodox Easter coming up), and currently Ramadan being observed and celebrated.
Ramadan is most famously known for its month of fasting from sunrise to sunset and, depending on what time of the year Ramadan falls and where you live, that can be a very long day!
Fasting, of course, is incorporated into the practice of most faiths to some degree, and abstinence from food (and sometimes water) is not to be seen as a form of suffering, but rather as an opportunity for prayer, contemplation, and charitable acts. It can be done in private, as part of one’s individual spiritual practice, or in community with others, building or rebuilding a sense of common faith.
Fasting has also been used for other reasons, from political protests (think of the Suffragettes and Mahatma Gandhi) to physical preparation for the Olympics (that was apparently the regimen for Ancient Greek athletes) to building mental acuity in preparation for one’s exams (or at least Pythagoras is famed for doing so!).
Fasting, it seems, is just something we all do and need to do so our body can take a rest from eating and digesting.
I don’t know about you, but when I look back on the days of my youth, I remember meals being served just three times a day and we were always told not to snack in between, so we wouldn’t spoil our appetite for dinner. Of course, rascals that we were, we often nipped down to the sweet shop in between meals to buy a quarter of Midget Gems or Lemon Bonbons with our hard-earned pocket money; but heaven forbid if we couldn’t finish our dinner because our bellies were full of sweeties!
Now that I think about it, missing a meal was never considered a major existential crisis in our home, as we learned when we were sent to bed with no dinner for getting into some mischief or other (and no, it was never my fault…). Needless to say, missing that evening meal sure made the bowl of porridge on the breakfast table next day unusually appetizing!
Fasting, my Googling tells me, has long been a medical intervention, too. We all know the old adage, “Starve a fever, feed a cold”; well, apparently, restricting how often you eat has been used for centuries in treating a number of ailments such as diabetes.
Diabetes has been recorded from as far back as 1552 BC/BCE and was usually diagnosed by a physician after tasting a patient’s urine to detect a characteristic sweetness. (Aren’t you glad you don’t have to do that anymore, dear Clinicians?!). The Persian physician, Avicenna (930-1037) was the first to distinguish between diabetes insipidus and diabetes mellitus, but it wasn’t till centuries later in 1936 when Sir. Harry Himsworth discovered a difference between Type I and Type II diabetes.
Type II diabetes has become one of the greatest scourges of our time, and it is unfortunately one of the top three medical problems facing Culmore Clinic’s patients, leading to a multitude of other ailments that can shorten the patient’s life significantly. Medical intervention alone is not enough to improve the health outcomes of these patients; but when an integrated approach is taken to diabetic patient care – such as by adding an educational/lifestyle adjustment component, as offered at Culmore Clinic – the impact can be quite significant according to our diabetes educator, Kathy Gold:
Mr. G. was diagnosed with diabetes in November, with a blood sugar level or A1C of 13.2% (below 5.7% is considered normal). He was placed on insulin twice a day. In speaking with him at diagnosis, he explained that he did lawn and landscaping work, normally drank 4-5 large cokes a day, and ate out in fast food restaurants. In November his work was greatly reduced due to weather, but he continued to drink a large number of cokes. In explaining diabetes to him, we reviewed his food intake and discussed the foods that affect blood sugar. He agreed to eliminate soda and reduce the numbers of tortillas he ate at a meal. He would prepare his own meals and stopped going to fast food restaurants. I spoke to him again in February and he said he had lost 25 pounds and was skinny. He eliminated his soda, only drank water, and was eating salads. Since he wasn't working, he began to walk 3 miles every day. His A1C had dropped to 6.4%, and he had stopped taking insulin in the evening because he was having low blood sugar reactions. His fasting blood sugar was 120. Due to his lifestyle changes, he was taken off the insulin and was able to manage his diabetes by eating healthily and engaging in physical activity.
We learned during the height of the pandemic that folks who were unhealthy and had comorbidities like diabetes, obesity, and hypertension were more likely to succumb to a bad bout of COVID 19, so that has given us even greater impetus to help our pre-diabetic and diabetic patients with an integrated care approach.
Talking of COVID-19, I just heard from our Clinical Director that 47 of our high-risk patients have been fully vaccinated and 19 partially vaccinated. The team continues to work hard to find slots at vaccination clinics for our patients, and those slots get filled up fast!
Well, I think I have gone on long enough, don’t you think?
Let me end by saying Happy National Volunteer Week! What would we do without our amazing volunteers? Check out our Volunteer of the Week posts when you have a moment and leave a comment if you can!
Until next time,
Anne-Lise