Sunday, November 11, 2012

90 Days with Diabetes


For as long I can remember, I’ve always weighed about two-hundred and fifty pounds and stood six foot two inches tall. My weight has never fluctuated much over the years and I've always eaten fresh food and good food. Annual medical checkups were obligatory and completed without much fanfare or issue. That is until this year…

My annual checkup was pretty much standard fare. They weighed me, hit my knees with a rubber mallet, and so on and so forth. However, this time, near the end, the doctor said “I just want you to know you’re pre-diabetic.”  He said it very mater-of-factly and like it was no big deal. I smiled and said “Okay, thanks for letting me know,” and he didn’t pursue it any further. That was that and the conversation ended. I left with advice that my cholesterol was within normal ranges, my high blood pressure was under control and I was pre-diabetic. As I was leaving, I remember telling myself that I could just cut out on eating the sweets that I treated myself too once in awhile and that should be fine.  Those were really the only sugars I ate.   

True to my word. I did indeed cut out the sweets. I stopped buying any type of pastry, pies, cakes or doughnuts at all. I never really had a sweet tooth and so these little extra indulgences were easy to eliminate. I didn’t really need em’ anyway and never had them that often anyway. I never drank anything but diet soft drinks, never used sugar in my coffee and never chewed anything but sugarless gum.

Looking back; what I didn’t understand, was that the term “pre-diabetic” MEANS something specific within the medical community. It means that you have passed a threshold as far as the glucose in your blood. It means specifically that the glucose level has risen above a pre-defined threshold. The ability of your body to get energy from sugar and deal with glucose in your blood is getting more difficult.  I also understood nearly nothing about "carbs."
 
In addition to my annual medical assessment, I always schedule an annual Optometric visit. A few weeks after my annual medical checkup it was time for the eye examination. This year my “eye doctor” had a new gizmo. It is a device which takes a picture of your inner eye. I thought it was pretty cool and completed the test becasue she said it would help her in her diagnosis. It was an easy test to complete, and did help her, but it really helped me because as an outcome of that test my Optometrist discovered a medical condition and advised me to consult my doctor.
 
A week later, I was again sitting in my doctor’s office… The doctor checked me over, and I took a blood test. Several days later, she shared the results which were that that my H1AC number was above a 7 which means that I was now officially “a diabetic” with Type2.   I was shocked. Just a month earlier the doctor told me I was pre-diabetic and now even though I had cut out sweets, I was a Diabetic!  I was also completely concerned because my Grandmother died from Diabetes. My doctor advised me that she was placing me on a medication called Metformin. I asked if I could just start a diet of some type or eat differently and not take the pill but she said it was important now that I start taking the medication.

That was ninety days ago, in August of 2012, and that was the start of my type 2 diabetes journey. Looking back, I can see now that the symptoms I’d been reporting to my doctor (legs pains and weakness) were actually symptoms that were probably caused by pre-diabetes and yet not one of the doctors I’d seen for the last ten years ever said anything about Diabetes at all.

Having Diabetes means that your cells can no longer effectively use sugar for energy and so your body starts pulling energy from fat stores and muscles. This makes you incredibly tierd and achy all the time. The body must remove the extra sugar (Glucose) in your blood through much more urination. That water loss dries your skin till you itch quite a lot and lastly it also dehydrates you so that your very thirsty.
 
The Kübler-Ross model, commonly known as The Five Stages of Grief, includes denial, anger, bargaining, depression, and acceptance. I never went through any Denial, Anger or Bargaining stages with my Diabetes diagnosis and so I have to alter this model for me. My stages are: Fear, Learning, Commitment, Depression, and Acceptance.  

The Fear stage was that my Grandmother died from Diabetes complications. I never knew the details of what exactly caused her death because I was a kid at the time. My mother told me “It runs in the family;” and now it had me. This causes me great concern.

Learning - Initially I didn’t know anything about Diabetes, and I'm still learning. However, as soon as I had my diagnosis, I started reading everything I could get my hands on related to the disease, its causes, what foods to eat, and not to eat, and so on. I spent eight days away from the office and thinking and reading about this disease. During that time, I designed a diabetic friendly diet for myself which was also healthy for my heart and that would cause me to lose weight.  I’d be happy to send the diet to anyone sending an email request to infinityman@cox.net. I subscribed to a Diabetic Living magazine, bought and read electronic versions of books related to the topic, subscribed to a number of Diabetes related web sites and tried my best to come up to speed with information. I get regular email updates and newsletters. Who knows, they might find a cure!

Commitment – One of the things I had asked my doctor during the meeting where she told me I was Diabetic was if I would need to take insulin or test my blood or anything like that. She advised that I would not need to do any of those things for now except change my diet, take the Metformin, lose weight, &c.  However, being in the Information Technology field I know; the only way to make critical decisions with quality is to have quality data available. The only way to get data about the glucose levels in my blood is to test. So I immediately spent a week or so researching the best testing devices on the market, how to test with accuracy; and then ordered the device, the strips and the lancet device. I learned that it is normal for blood glucose levels to be between 70-130 prior to a meal and two hours after the meal to be as high at 180. It also seems that anything above 144 is considered as “high”.   These are the parameters I am working with and doing everything I can to clearly understand what foods tend to take my glucose levels outside of these thresholds.

Depression – Initially, I really felt like I could beat Diabetes. I could put the disease into remission by doing the right things consistently. What I learned in my reading what that this is not reality. Instead, I learned that my diabetes was coming on for about 10 years. That most people diagnosed as pre-diabetic can only stave off becoming fully diabetic for an average of 2 years. The bottom line is that your body is having a more and more difficult time getting energy from food and effectively dealing with glucose in your blood. This will get progressively worse over time and will be a contributing factor in your death unless a cure is found. This fact must be faced head on and dealt with. It can be a source for depression, but you have to beat that back and accept the disease for what it is.

Acceptance – When all is said and done, one must accept and deal with the fact that you have a disease; through no fault of your own. This is not something you planned and not something you can turn back. It is here, it is real and it has to be managed effectively. Diabetics must:

1)     Watch everything they eat. They must count carbs, watch the nutrition labels and serving sizes and substitute good food items for bad food items. If you screw this up, you stand a good chance of having your feet amputated or other really nasty things (i.e. like eyesight problems, kidney failure) to deal with. It’s not a nice-to-have or something you can follow half-heatedly; but rather a complete necessity for your life and wellbeing. You have to lose weight and get your weight to a level prescribed by the medical professional your working with.  

2)     Watch their hands and feet. Many diabetics experience degrees of neuropathy. This is the tingling and loss of sensation in your hands and feet. Cuts and abrasions and wounds no longer heal as quickly and you don’t even feel them sometimes. There is a huge risk of infection. You must inspect and protect your feet and effectively deal with any wounds. You need to pay attention to this daily and get to the doctor to discuss if there is a wound that is not looking right or healing properly.

3)     Test our blood and record the results. I have two Apps on my smartphone. Each links to a web site so there’s a backup in case anything happens to my phone.

a.     I use the first to record everything I eat. It has a bar scanner and I can scan anything to get exact portions and nutritional information. It tells me how many carbs, calories, fat and other nutritional elements. This way, I can see a clear correlation between what I put in my mouth and my weight and my blood glucose levels.  

b.     The second is an app used to record glucose levels. I test just before meals and two hours after. I test up to six times a day. Sometimes less and sometimes more. I use this data to maintain a spreadsheet of my blood glucose levels; which is useful for discussions with my doctor and for my own understanding of the disease and how it might be progressing. It will get worse over time, so something I eat today that my body can deal with, might not impact my body in the same way in the future. One has to test and record the results in order to be empowered with enough information to make the right decisions.

Ninety days after diagnoses and I now weigh two-hundred and thirty pounds. My goal is 200 which I’ll most likely reach mid-year 2013. Right now, I consume 1500 or fewer calories per day. I’ll keep that up until I reach my goal weight and will then gradually increase the number of calories until I achieve stasis – (I don’t gain or lose weight). There is so much to learn and I'll blog more as I learn and experience more over time.

If you’d like to contact me to discuss or for additional information, send email to infinityman@cox.net.   

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