Details

Written by: Super User

Category: Continued

Published: 10 June 2025

Hits: 335

Update August 30, 2025: After looking over this message board thread, the thought occurs it might be good to start where such bad advice for diabetics and heart patients started.  We would have to go back to the '50s and '60s to the time of Eisenhower, his doctor, and the epic battle between two nutritionists: Ancel Keys and John Yudkin.  Yudkin should have won that battle, but didn't.  Keys had the ear of Eisenhower's doctor, now we are living with the consequences.  Some history from the Guardian with this classic article: 'The Sugar Conspiracy'.  Some notable quotes are at the end of this webpage.

P.S. This message thread starts out with my wife's over 30 year battle with diabetes.  My battle with heart disease is near the end of this webpage.  For those also battling heart disease I thought it would be helpful to break out the heart disease section in this article.  Four years on a low carb diet, and we haven't looked back.

(The following was copied from the old IHateDialysis message board.  Years ago the board was started by a kidney dialysis patient who went by the handle Epoman (R.I.P.).  He had found the forums at the time run by the dialysis companies highly moderated and censored.  He wanted a board where patients could tell what they were seeing on the ground and in their clinics.  It was quite a popular board back in its day.  As of June 2025 it appears the board has gone to the 'Great Bit Bucket in the Sky'.  However it looks like the successors of the board still have a presence going on Facebook.)

Off-Topic => Diabetes => Topic started by: plugger on September 06, 2021, 02:55:30 AM

Title: Low Carb diet for diabetes
Post by: plugger on September 06, 2021, 02:55:30 AM

Part 1 (see part 2 in the next post)

Besides having a daughter who was on dialysis for 6 months back in 2000 (transplant now) I have a wife who has been dealing with type 2 diabetes for 30 years and has slowly been going downhill - until recently!  She started watching this youtuber by the name of Dennis Pollock and he is someone many might consider diabetic, but he might describe himself as just carb sensitive.  He is a low carb diet advocate with his A1C and labs in the normal range.  My wife started watching him and got me watching him too.  My first thought was "con man or crazy man - or both!".  But after watching him he started to make sense - and he is backed up by some heavy hitter doctors: Dr. Richard K. Bernstein - and  more on Dr. Bernstein (endocrinologist and type 1 diabetic), cardiologist Dr. Bret Scher, and nephrologist Dr. Jason Fung.

Lately my wife's blood glucose has been all over the place before she found Mr. Pollock.  He helped convince us to try a low carb diet these last months.  Both of us reached our target weights after about 2 months.  Now for the last month or so we have been trying to control her blood sugars better with diet (low carb and keto recipes - upped the protein), exercise, and just a little bit of insulin (NPH) - and she dropped the glimepiride meds after taking them for 5 years (really glad, we were worried about the side effects).  It looks like she is making great progress!  However she may never get off the insulin since after 30 years it looks like she has a tired pancreas, still she is a whole lot better!  (her feet and eyes have seen major improvements!)

I will also mention it can be a bit harder being on a low carb diet at first while taking insulin - hypoglycemia can be a worry if a person isn't careful!

Besides her diet we've been implementing an exercise program for her.  She is making gains after an initial setback.  She did a youtube 30 minute kettlebell workout that was too strenuous for her and wound up shooting up her blood glucose from 118 to 207!  We throttled it back and it looks like we are finally dialing in a good program for her level of fitness.

I just thought I would share the good news and see what others thought.

Edit 11/20/2022: According to this Dr. Bernstein video at 5:00 officially my wife shouldn't have been on the glimepiride (one of the sulfonylureas) more than 2 years!  I would agree with Dr. Bernstein she probably shouldn't have been on it at all!  And would have been better off starting insulin first.  Yeah, I'm not happy right now.

------------------------------------------------------------------------------------------------------------------------------------------

Edit 10/24/2021: And more gurus:

Dr. Robert Lustig:
Profile at University of California, San Francisco 
FoodGate 

Dr. Sarah Hallberg:
Edit 11/03/2022: She was a Medical Director at  Virta  (an organization that has been running very successful clinical trials for years -  see testimonials  
(Her classic TED talk)

Dr. Jeffry Gerber:  Hosted many low carb conferences, his and other conferences mentioned here 
Dr. Gerber's YouTube channel 

Gary Taubes: classic 2002 article in New York Times Magazine, mentions Dr. Atkins - and even a low-carb diet book from 1825! (Edit: 10/18/2022)
article:What if It's All Been a Big Fat Lie? 
and Gary Taubes website 

Nina Teicholz: New York Times Best-Selling author and Science Journalist
The Big Fat Surprise 

Dr. Tony Hampton: Has a type 1 wife, excellent resources
Linktree resources 
Interview with Dennis Pollock

Fat Fiction:
The Movie Cast

"Fat: A Documentary 2"  (edit: 10/8/2022)
full documentary 

Edit 12/28/2022:  More Gurus & Stories 

I will say I seem to remember hearing blurbs about the low carb diet over the years and thinking it must be a bunch of hooey!  But then my wife started diving into it and I remember thinking: "well ok, maybe it is just a short term diet to get weight down and blood glucose under control a bit better".  Then I saw the results - then we ran into Dr. Richard K. Bernstein.  He is an 87 year old Endocrinologist, low carb diet pioneer, and type 1 diabetic with one hell of a story!  He is someone who has probably outlived most of his critics and one of the few type 1 diabetics left from his generation!  Ok, maybe this low carb thing could be longer term.

I was thinking about directing some people having a hard time believing it, like we were, this way.  If some still think I'm blowing smoke, maybe it would be helpful to throw down my credentials.  I helped head up a group of people that got a bill through the Colorado State legislature in 2007, then renewed in 2012 and 2019.  I like to think I have a nose for a pile of doody.  And I'll just say I'm not impressed with the American Diabetes Association standard diet (I don't like to brag about my statehouse experience - who am I kidding, yes I do!) 

It comes in handy as an ace when my family gives me static.  As an example in a "sparring session" with my son he'll throw down his ace "well, I'm a doctor!" (M.D. Internal Medicine) -then I'll throw down mine "ever been to the statehouse buddy boy?")

-----------------------------------------------------------------------------------------

It is also worth noting that Tracey Brown President of the American Diabetes Association (who recently stepped down?) shared she got off insulin with a low carb diet - and took some flak for it.  The ADA does now lists a low carb diet as an option.  If my wife is any indication, it ought to be the standard!

And here ADA president Tracy Brown is with Dr. Richard K. Bernstein who has been a frequent critic of the ADA:
Tracey Brown and Dr. Bernstein.

-----------------------------------------------------------------------------------------

Edit October 26, 2021: 

Don't let people tell you, you need carbs!  Doctors Richard K. Bernstein and Sarah Hallberg will tell you there are no essential carbs. There are essential proteins and essential fats - but no essential carbs! The only reason a person would have carbs is to get the vitamins and minerals in such things as low carb veggies.

(for those who fear the fat, I would recommend these movies Fat Fiction and Fat: A Documentary 2: for those who fear the protein I recommend this  talk by Dr. Richard K. Bernstein

That said Dr. Bernstein recommends a limit of 6 grams of carbs for breakfast, 12 grams for lunch, and 12 grams for dinner for a 140 pound person. That is much less than the ADA will tell you!

-----------------------------------------------------------------------------------------

Edit November 7th, 2021:

A conversation about  "Why Physicians don't always tell the truth"

----------------------------------------------------------------------------------------

Dr. Richard K. Bernstein's documentary Diabetes Solution came out November 9th, 2021!!  He is an 87 year old doctor and endocrinologist, a type one diabetic (one of the few left from his generation), and low carb pioneer!

----------------------------------------------------------------------------------------

Edit November 12th 2021: You can view 'Diabetes Solution' featuring Dr. Richard K. Bernstein by visiting his Facebook page and using the media links for viewing.

If you like the documentary I would suggest writing a review on Rotten Tomatoes. 

----------------------------------------------------------------------------------------

Edit 11/16/2021 - 11/17/2021: Why YouTuber Dennis Pollock might be motivated about diabetes (besides being predisposed for it):  talks about his Mother in this video  

Dennis Pollock is real good at finding testimonials from people.  If you are like me and are tired of trying to figure out dueling studies you might be more impressed with testimonials like I am.  Besides Dennis Pollock's channel, you can find testimonials in Dr. Bernstein's new documentary 'The Diabetes Solution' (ways to watch), the documentary Fat Fiction on YouTube, and of course in Dr. Bernstein's book.  And did I mention my wife's transformation?  I think I did.

-----------------------------------------------------------------------------------------

Edit 10/7/2022: My wife's A1C has dropped from a fairly recent high of 8.3 to 5.5!!!!  No complaints about her feet or eyes recently!

Title: Re: Low Carb diet for diabetes
Post by: plugger on October 13, 2021, 09:46:35 AM

Part 2

(That first post was getting a little long)

Edit 11/17/2021: For those trying to find a Low Carb diet friendly doctor in their area, I would suggest checking out this website.  I found the link in Dr. Richard K. Bernstein's forum.  While I'm at it, again here is the documentary just recently released featuring him.

Edit 10/20/2022: For Type 1s and their parents I would highly recommend the group TypeOneGrit.

----------------------------------------------------------------

Edit 12/2/2021: It was noticed that there were questions about short-term blood glucose spikes on Reddit.  Dennis Pollock on Youtube did an eyeopening show about blood sugar spikes

----------------------------------------------------------------

Edit 12/4/2021:  My wife has been getting static for her now high LDL cholesterol from her doctor (actually a nurse called).  It was totally expected, the high cholesterol and the call.  However it wasn't mentioned her HDL is higher and her triglycerides were lower.  I'm not concerned after listening to things like Dr. Robert Lustig's Food Gate video on Youtube.  She is a little spooked. 

However if anybody is going to get a heart attack, it would be me.  I had one about 12 years ago, my father died at 44 from a heart attack, my brother died at 50 from a heart attack, and I've got another brother with six stents in him.  So to reassure her I'm thinking of getting a Calcium Heart Scan- wish me luck! 

(good luck, not bad.  There have been a few people who have wished me the 2nd kind I've mentioned)

--------------------------------------------------------------

Edit 10/3/2022: I just recently had some blood work done and my hdl is now in the acceptable range (barely) and my triglycerides are down!  As for the Calcium Heart Scan I had some months back - I'm not looking so good.  But I've decided to try and control it with it a vegetarian low-carb diet (Dr. Robert Lustig, who I've mentioned, implied the heme iron in meat might be a danger for me, dairy fat is protective, and I've had a problem with gout and purines found in meat - for more info on diet see Reddit's r/vegetarianketo and  r/veganketo subreddits).  My wife is still low-carb and eating meat, but has cut back some to control her cholesterol - even though I'm not sure it is a danger for her.

          --------------------------------------------------------------

Title: Re: Low Carb diet for diabetes
Post by: cassandra on October 14, 2021, 09:58:03 AM

Thanx for the update Plugger. Great to read a possitive story, and fantastic how much improvements your wife has made.


Lots of love, luck and strength to you and your fam, Cas

--------------------------------------------------------------

Title: Re: Low Carb diet for diabetes
Post by: SooMK on October 14, 2021, 03:38:38 PM

I love these kinds of stories. With you to encourage her and to share it with her makes so much difference. Wonderful to keep an open mind and to try something as difficult as adjusting diet. Bravo!

           --------------------------------------------------------------

Title: Re: Low Carb diet for diabetes
Post by: plugger on October 24, 2021, 05:00:52 AM

Thank you for your kind words!  I did do some modifying of the top two comments, added more gurus there for one thing.  I thought I might send some low carb doubters this way.  Who knows, maybe they will wander around here.  I don't know what dialysis is like now, but I like to think it is better than in my daughter's day!  I can't believe it has been 21 years since she has been in a clinic!  Time flies!

I'll mention I've been posting on Reddit's r/diabetes subreddit and I've been getting some push back.  I totally understand, just some months ago I wouldn't have believed me.

I hope you two and many of the people here are doing well!  I know this site and a lot of the people here helped us back in the day!

           --------------------------------------------------------------

Title: Re: Low Carb diet for diabetes
Post by: plugger on September 03, 2022, 11:45:47 AM

I recently commented on a YouTube video by a doctor who was promoting a Whole Foods Plant Based diet for diabetics (WFPB).  I mentioned our experience with a low-carb diet.  The doctor replied to me and mentioned the WFPB diet needs to be acclimated to and from what I'm hearing it might take 1-2 months.  Another person commented and wrote I ought to check out the book 'Mastering Diabetes' by Cyrus Khambatta PhD and Robby Barbaro MPH.

So I looked a bit into it and did find this article.  The author only experimented with the diet for about 9 days so I don't know how valid her results are, but she did have this to say at the end of the article:

"I’ve been directing people to Cyrus’ site for years whenever I hear come across someone expressing frustration that low-carb isn’t working for them or that they simply don’t want to eat that way."

"I wish the two extremes of eating could respect each other’s differences and appreciate each other’s passionate devotion to what works best for them."  (Very good advice!)

I thought I would mention this in case there is anybody out there who finds low-carb isn't for them.

-----------------------------------------------------

Edit: 09/07/2022 May have just really decided the low fat high carb WFPB diet may not be for us after listening to Dennis Pollock's take on it starting at minute 9 of this video

----------------------------------------------------

Edit: 10/4/2022 Though I don't know of a low-carb vegan guru I would trust, I do know there are a couple of subreddits for those who want to eat more low-carb, but want to get the meat out of their diet: Vegetarian Keto and Vegan Keto.  As Dr. Richard K. Bernstein might say, make sure you get enough protein!  Me, I'll be sticking to low-carb vegetarian for reasons I've mentioned.

---------------------------------------------------

Edit: 10/24/2022 We came across someone with a more positive take on a modified WFPB diet he experimented with (at the end of his 90 day trial period he did add back in fish, eggs, avocados, nuts, and olive oil - but still high carb).  It sounded tempting to try, but we still worry about the spikes he mentioned.  But if somebody wants to try it, we couldn't blame them!  Type One Talks makes a convincing case for it, however in my opinion I don't see the gurus for this diet getting as far with this diet as they would like until they get the spikes under control!
Diabetic goes vegan for 180 days. This happened.
He mentions having a hard time staying on low carb - at over a year doing low carb, we aren't having a problem - but that's us!

Title: Re: Low Carb diet for diabetes
Post by: plugger on September 10, 2022, 06:31:20 AM

I've mentioned some talks and documentaries I like: Dr. Bernstein's 'Diabetes Solution', Dr. Sarah Hallberg's TED talk, Dr. Robert Lustig and friends Foodgate talk, 'Fat Fiction', and 'Fat: A Documentary 2'. 

I did think of another classic from Australia's ABC broadcasting system on YouTube: 'Low Carb Diet: Fat or Fiction? Does it work?'

-----------------------------------------------------------------------

Edit September 11, 2022:

The ABC video reminded me I like to look at athletes and their diets at times to see what seems to be working for them.  Athletic competition can be where the rubber hits the road when it comes to exercise - and sometimes possibly diet lessons!  Someone who has impressed me is the ultra-marathoner Zach Bitter.  For me, he hit the nail on the head concerning carbs when he called them 'rocket fuel'.

-----------------------------------------------------------------------

Edit September 18, 2022

Recently on Reddit I've been linking quite a bit to a fairly recent YouTube video by Dr. Richard K. Bernstein:   19 Facts your Doctor May Not Know.  Mostly I've pointed out his remarks about the dawn phenomenon, growth hormone, and the drug somatostatin starting at minute 21.  He also has a lot of other great info:

*Target blood sugars for diabetics and pregnant diabetics
*Long term complications can be avoided
*Why shooting long-acting insulin into the thigh can be a bad idea
*How to diagnose and treat gastroparesis (stomach can't empty itself of food in a normal fashion)
*Other things besides carbs that can affect blood sugar
*Ketones from diet and ketoacidosis are not the same!  (the later can be deadly)
*A person on a keto diet can get in trouble if they don't have enough protein ( protein along with fat are essential in a diet)
*Insulin pens have the problem of being too leaky
*Half-life of insulin
*Glycation of collagen causing things like carpal tunnel syndrome, claw hand, and ITB syndrome

-------------------------------------------------------------------------
-------------------------------------------------------------------------

Title: Re: Low Carb diet for diabetes
Post by: plugger on September 21, 2022, 12:46:02 PM

I've wrote about my wife's experience with diabetes.  Lately I've been thinking I really ought to add more of my own.  I've been prediabetic but as I mentioned before, what really has done in so many males in my family is heart attacks - and as many of you might know, diabetes and heart attacks are closely linked!  My Dad died at 44 and my brother at 50 - both from heart attacks.  Another brother has six stents in him, and I had an attack 13 years ago.  I don't make hdl cholesterol very easily for one thing.

I mention it again because those of us on a low carb diet have been criticized for the fat in our diets.  I've addressed some of that already.  And as I said before, if fat was going to kill somebody it would probably be me - I'm over a year out since going low carb, still kicking.  My triglycerides are down (which I worry more about) and my hdl cholesterol is up a bit, finally into the lower end of the acceptable range!  My doctor's nurse was concerned about my LDL, but I let him know why I'm not concerned.

So I thought I would go more in-depth on why I don't worry about the fat anymore:

Q1: Regarding High Cholesterol - Dr. Bernstein's Diabetes University 
at 4:00 minutes he states we should be worrying more about things like lipoprotein small a, "Stop looking at cholesterol!"

Dr. Robert Lustig and friends Foodgate YouTube video
10:30 minute mark - dairy fat is protective against heart disease and diabetes (but stay away from lactose, a carbohydrate, which is normally in milk)
12:30 minute mark - we should be worrying about triglycerides
14:15 minute mark - we should be looking at the ldl particle number
16:00 minute mark - we should be worrying about our triglycerides (cause of ldl B’s?) AND hdl
17:30 minute mark - trials show statins aren’t much help and there might be a problem with rhabdomyolysis
(edit 12/11/2022: also notable is he links heme iron in red meat to heart attacks at 7:00)

The Blood Triglyceride:HDL Ratio and LDL Particle Size: Critical Issues for Determining Risk of Coronary Heart Disease! 
"So, the next time you have blood work done, calculate your Trig:HDL ratio if you do not see this value on your report."

YouTuber Dennis Pollock and 'Beat Diabetes': On a KETO DIET? What about CHOLESTEROL? 

Low Carb Conferences Podcast with Dr. David Diamond: Statins, Cholesterol and Low Carb Diets 
I like this video that just recently came out.  It points out statins may have their place if someone is out of shape and has been eating unhealthy, like I might have been when I had my heart attack.  However the person being interviewed points out one side effect of statins might be contributing to dementia.

-----------------------------------------------------------------------------------

And if you dear reader want a history of how we got to where we are with obesity, diabetes, heart disease, and yes kidney failure. Besides the documentary 'Fat Fiction' I might also suggest this article.  One of the things it mentions is the epic 1950s' to the 1970s' battle between John Yudkin, a British professor of nutrition, and Ancel Keys a nutritionist at the University of Minnesota - the wrong person lost.

Some notable quotes:
"France, the country with the highest intake of saturated fat, has the lowest rate of heart disease; Ukraine, the country with the lowest intake of saturated fat, has the highest"

"Years later, the (Ancel Keys's) Seven Countries study’s lead Italian researcher, Alessandro Menotti, went back to the data, and found that the food that correlated most closely with deaths from heart disease was not saturated fat, but sugar.

"A “fad” (as low-carb has been accused of) implies something new-fangled. But low-carbohydrate, high-fat diets had been popular for well over a century before Atkins (optimal protein low-carb diet), and were, until the 1960s, a method of weight loss endorsed by mainstream science."

--------------------------------------------------------------------------------

Edit 09/27/2022: I was reminded by a reliable poster on Reddit we should probably stay away from one category of fats - seed oils.  We use olive oil, avocado, and coconut.

Edit 01/09/2023: When buying olive oil make sure it is the real thing and not something diluted with such things as sunflower oil.   This article gave some great suggestions.  Also 60 minutes did a story on olive oil and the Mafia.

--------------------------------------------------------------------------------

Edit 10/8/2022: A modern day version of Ancel Keys looks to be Walter Willett of Harvard, mentioned in the documentary Fat: A Documentary 2.

MORE GURUS AND STORIES

Details

Written by: Super User

Category: Continued

Published: 09 May 2025

Hits: 211

Diabetes University Teleseminar 75. April 2022
*Can reverse kidney disease at minute 7:30

Diabetes University Teleseminar 66. July 2021
*his chronic kidney disease reversed when he upped his protein (can't comment on other's kidney disease) 56:30

Diabetes University Teleseminar 64. May 2021
*avoid metformin if liver and kidney disease 1:02:45

Diabetes University Teleseminar 60. January 2021
*kidney disease+reversed 20:00
*kidney disease and protein restriction in advanced (gfr's)35:15

Diabetes University Teleseminar 58. November 2020
*kidney serum creatine, exercise, weight loss, fasting on day of test 5:30

Diabetes University Teleseminar 56. September 2020.
*c-reactive protein, infection, kidney disease 24:30
*ace inhibitors+statins, kidney disease 35:00

Diabetes University Teleseminar 54. July 2020.
*protein in urine, kidney disease 37:20

Dr. Bernstein Teleseminar 40. February 2019.
*vitamin C, calcium pills, tea+kidney stones 1:00:45

Details

Written by: Super User

Category: Continued

Published: 19 January 2025

Hits: 303

My first impression is the Colorado Rapid Response Network mainly observes and makes sure things are being run according to the law with ICE warrants and such - during and after their rapid responses to active raids.  However they aren't above getting in the middle of it if they don't like what is going on - that would be the job of the onsite action people on the lower left of the flowchart below.

More about the meeting itself is further down below, but first people mentioned in the flowchart are:

*Target of Injustice - (at the top of flowchart) who ICE is looking for

*Caller - (at the top of the flowchart) who is calling with information an ICE raid is in progress, may not be the person targeted

*Dispatchers - (heart in the middle of the flowchart chart) they put out text messages to confirmers etc.. to show up at the site of an active raid

*Confirmers (left middle of the flowchart) - observe, ask questions at an active ICE site.  Fill out paperwork after the raid.

*Onsite Action people - (lower left of the flowchart) if it is observed that the ICE raid is proceeding illegally, unethically, these people will nonviolently intervene to do things like slowing down the raid and protecting those unfairly targeted

*Legal Observers - (middle right of the flowchart) watch raid to make sure ICE is dotting their 'i-s', will look into who has been detained

*Legal Team - (lower right of the flowchart) will take a look at the raid after it has happened

*Public Response - what is put out to public - media, social media, etc...  THIS CAME WITH A BIG WARNING TO BE CAREFUL IF PUTTING OUT VIDEO AND PICS TO SOCIAL MEDIA, IT PROBABLY SHOULD FIRST BE CLEARED BY THE ORGANIZATION FIRST

My next impression of the meeting was they were mainly trying to recruit 'Confirmers', people who would show up at active raids to observe what is going on and question law enforcement, bystanders, and maybe even targets of the raids?  (I might need some more clarification on that)  Examples of the kinds of questions asked are below:

The Meeting Itself

If I said it before I'll say it again - there must have been over 100 people at this meeting!  It was quite crowded!  There were speakers, and at the back of the meeting there was a translator for the Spanish speakers - of which there was a number - using electronic devices the Spanish speakers would use to receive the translator's broadcasts.  At least that looked like what was going on?

Besides listening to speakers, we also paired off and role-played being a confirmer and an ICE officer with the confirmer asking questions, then switching roles.  We then went into the groups I mentioned plus bystanders and law officers.  We would then do things like form stories for the groups and interact with the other groups.

The next event is January 25th, 2025 (looks to be a protest from the information I'm getting)

Update January 30th, 2025: the event below was a protest/rally.  It was covered well by the local media.  One source that did an article was the Aurora Sentinel.

The final impression is they wouldn't mind a little veteran help (this writer is a member of the veteran-led organization Common Defense).  And I'll add CRRN looks to me they have been at this for awhile and seem to be quite good at it!

Details

Written by: Super User

Category: Continued

Published: 16 November 2024

Hits: 684

First, fight every fight in Congress.

We won’t always win, but we can slow or sometimes limit Trump’s destruction. With every fight, we can build political power to put more checks on his administration and build the foundation for future wins. Remember that during the first Trump term, mass mobilization—including some of the largest peaceful protests in world history—was the battery that charged the resistance. There is power in solidarity, and we can’t win if we don’t get in the fight.

During the Trump years, Congress stepped up its oversight of his unprecedented corruption and abuses of power. In the Senate, Democrats gave no quarter to radical Trump nominees; we asked tough questions and held the Senate floor for hours to slow down confirmation and expose Republican extremism. These tactics doomed some nominations entirely, laid the groundwork for other cabinet officials to later resign in disgrace, and brought scrutiny that somewhat constrained Trump’s efforts.

When all this work came together, we won some of the toughest fights. Remember Republicans’ attempts to repeal the Affordable Care Act? Democrats did not have the votes to stop the repeal. Nevertheless, we fought on. Patients kept up a relentless rotation of meetings in Congress, activists in wheelchairs performed civil disobedience, and lawmakers used every tactic possible—late night speeches, forums highlighting patient stories, committee reports, and procedural tactics—to draw attention to the Republican repeal effort. This sustained resistance ultimately shifted the politics of health care repeal. The final vote was a squeaker, but Republicans lost and the ACA survived.

Democrats should also acknowledge that seeking a middle ground with a man who calls immigrants “animals” and says he will “protect” women “whether the women like it or not” is unlikely to land in a good place. Uniting against Trump’s legislative agenda is good politics because it is good policy. It was Democratic opposition to Trump’s tax bill that drove Trump’s approval ratings to what was then the lowest levels of his administration, forcing Republicans to scrap all mention of the law ahead of the 2018 midterm election and helping spark one of the largest blue waves in recent history.

Second, fight Trump in the courts.

Yes, extremist courts, including a Supreme Court stocked with MAGA loyalists, are poised to rubber-stamp Trump’s lawlessness. But litigation can slow Trump down, give us time to prepare and help the vulnerable, and deliver some victories.

Third, focus on what each of us can do.

I understand my assignment in the Senate, but we all have a part to play. During the first Trump administration, Democrats vigorously contested every special election and laid the groundwork to take back the House in the 2018 midterms, creating a powerful check on Trump and breaking the Republican trifecta. Whether it’s stepping up to run for office, supporting a neighbor’s campaign, or getting involved in an organization taking action, we all have to continue to make investments in our democracy—including in states that are passed over as “too red.” The political position we’re in is not permanent, and we have the power to make change if we fight for it.

Finally, Democrats currently in office must work with urgency.

While still in charge of the Senate and the White House, we must do all we can to safeguard our democracy. To resist Trump’s threats to abuse state power against what he calls “the enemy within,” Pentagon leaders should issue a directive now reiterating that the military’s oath is to the Constitution. Senate Majority Leader Chuck Schumer must use every minute of the end-of-year legislative session to confirm federal judges and key regulators—none of whom can be removed by the next President.

To those feeling despair: I understand. But remember, every step toward progress in American history came after the darkness of defeat. Abolitionists, suffragettes, Dreamers, and marchers for civil rights and marriage equality all faced impossible odds, but they persisted. Now it is our turn to pull up our socks and get back in the fight.