Six Things Diabetics Are Sick Of Hearing

Oh face

Actually, other things make you go blind, too.
Gregg O’Connell, Creative Commons

Diabetes sucks. You can’t eat a lot of sweets. You have to prick your finger, which is not as much fun as fingering your prick. (Ahem)They might, yanno, chop off your leg if it starts rotting on you. (Always wanted a pegleg, though. It’d be a hit on International Talk Like a Pirate Day.) You might even go blind.

For some, like me, it’s manageable. Pop a couple of pills, exercise, and watch what you eat, and life is somewhat normal. Others have to shoot insulin several times a day, since their pancreas is basically just bogarting space below the liver. For those with diabetes that bad, life is an adventure. And not the good kind. However, there is one hazard of diabetes that even those with the mildest cases cannot avoid once it gets out that you pee urine sweeter than anything at Dairy Queen. What are they? Find out after the jump.

Go ahead. You taste it.

Go ahead. You taste it.

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Remission: A Wake-Up Call

So all the weight I took off came back . Mind you, it took longer to put it back on than to lose it, so I did something right. Unfortunately, I also had a serious wake-up call.

Last week, I had an itch on my foot, probably residual athlete’s foot. It was driving me crazy, so I took off one shoe and rubbed the heel of the other on it.

Don’t do that. You could break the skin. I did. But I never put anything on it. Bad move.

Yesterday morning, I woke up after a rough couple of days. I got only two hours of sleep Friday night and had to go to class Saturday morning. I spent the afternoon sleeping and didn’t really feel all that good when I woke up. No biggie. I’ve had insomnia before, and it usually takes a couple of days to recover. Sunday morning…

Yikes!

The wound not only got infected, but it started its merry way up my leg. Off to the urgent care. I almost went to the ER. Worse, they took my sugar. I hadn’t eaten, and my sugar was high.

Crap. Not only am I taking lousy care of my feet – a no-no for diabetics – but I’d pretty much wiped out most of the progress I’d made on weight, blood sugar, blood pressure…

And now I can’t do anything about it for a few days because I’m confined to the recliner (Oh, darn. Have to write and watch television. Woe is me.)

At the same time, the numbers I got from one urgent care visit told me everything I need to know: I need to get back to where I was in the spring. I need to go further than that. It’s one thing to knock off 20 pounds. But even that’s not enough. I need to get the weight down to where I no longer have to worry about the numbers. Well, I don’t have to sweat the numbers.

And on a morning when I probably should have gone with my wife to a local park for a two-mile hike, I’m instead wondering, do I go to the new Mercy emergency center in Norwood? Or Christ Hospital, to which my doctor is attached? Coming home won out.

I stated here I want to run the Flying Pig Marathon the week of my fiftieth birthday. I can see now I’m going to have to redouble my efforts. I was up to an easy four miles running earlier in the year. At some point, I tried Insanity. Wasn’t ready for it, but I learned some moves that will get me through the short, dark days of winter.

Getting my foot amputated because I didn’t do one simple thing – clean up a wound and keep it bandaged – would make that difficult. And I’d have nobody to blame but myself.

Remission: The Numbers Are In!

I went to the doctor a couple weeks ago for bloodwork. I get this done three or four times a year, checking for cholesterol, blood sugar, and liver emzymes, the three numbers that have given me the most trouble.

A week went by. No phone call. Two weeks. Nothing. Did I owe something on my bill?

I called.

“Oh, the doctor didn’t think he needed to call you. Your numbers were all good.”

“Well, I’m kind of keeping track.”

They read them off. Cholesterol? Well… They took a wait-and-see approach.

Liver emzymes, a sign your liver is not happy with you for either excessive weight or excessive drinking or both? Down for the first time in three years.

And the biggie, A1C hemoglobin, a cumulative measure of blood sugar over the previous 90 days?

5.9.

Diabetic is 6.1. Yes, kids, I’m off all but two medications now. Even when my weight spikes, my blood pressure and sugar stays down now. Of course, I have to be careful. A weekend of fun can throw me off or a day where everyone brings in the latest sweets or a box of donuts can really throw everything out of whack.

Remission: Medication

I spent most of last year maintaining a weight between 275 and 280. I wasn’t gaining, but my numbers weren’t improving either. In fact, they were getting worse.

Late last year, my doctor took my blood and dropped the “I” word on me: Insulin. I looked at the reading he had from my previous checkup. The numbers were going down. But they were not good. I had gone from an A1C hemoglobin – a cumulative measure of blood sugar over the past 90 days – of 10.2 to 8.1. 6 is the threshold for diabetes. Soooo… Did I need insulin?

I balked. Insulin is produced in the pancreas, and I clearly was still making insulin. Type 1 diabetics have to have insulin shots. That’s the very definition of Type 1. The body no longer produces any insulin. I had a friend who had this. She described the horrific week she had when she was 11, when they discovered her condition. I have Type 2. There are many causes, but essentially, the body simply becomes resistant to insulin, leaving a lot of sugar in the bloodstream that can’t be absorbed. In my case, it’s because I packed on over 50 pounds from 1997 to 2004, maxing out at 305 pounds. And I don’t show all the weight I gain. That kind of weight makes the fat cells expand, which makes it hard for insulin to deposit sugar.

In short, being a fat ass was killing me. Hence, this feature on the blog.

I balked on the insulin partly from fear and partly from some well-founded reasons. The fear comes from my mother. Very obese when she died, she spent the last decade of her life shooting insulin after every meal. In the back of my mind, that was the start of the downward spiral. Now, my mother had back problems and heart problems that kept her from exercising properly, which might have extended her life another 10-15 years. That’s probably irrational, but there it is. In reality, I wasn’t too thrilled with the idea of injecting myself with something my body was not only producing, but that my resistance to it was on the decline.

But being the lazy bastard that I am, I hadn’t been pricking my finger twice a day. You want a blood sugar number between 70 and 120. I was regularly waking up with numbers as high as 180 and coming home from work to 130, 140, even 150. So I started running. And I decided I would do P90X in the spring. And I would not neglect my annual tradition of biking the Little Miami Trail section by section this summer. And I would start counting calories.

This was not a New Year’s resolution. This was a decision to stick around for a long time. My wife bugged me several times, telling me to at least have my life insurance paid up if I didn’t want to stick around. Nita is not the type to want to “change a man.” So if she was bugging me about it, I had to get off my ass. First, I found the right cocktail to swallow twice a day. My doctor started with metformin (which I already took) and a drug called Tradjenta. I added a supplement called Alpha Lipoic Acid (ALA) that’s been suggested as a means of lowering blood sugar.  The numbers dropped, along with my weight, but not low enough. I was still waking up with high blood sugar. I added chromium supplements, which helped a little, but still didn’t do the trick. So we brought back an early drug called glimiperide.

Boom. Numbers went into the normal range, and, unless I decided to drink a lot, stayed there. (No one wakes up the morning after heavy drinking with normal blood sugar, but usually, that’s the least of your problems by then. I recommend lots of water and scrambled eggs for the hangover.)

After the first of the year, I ramped up my exercise, which I’ll talk about here soon. Coupled with keeping the calories under a set number everyday, I’ve managed to dump 14 pounds from my New Year’s Day weight of 274. The result?

I quit taking Tradjenta (which doesn’t seem to work anyway) and am about to stop metformin altogether. I may even drop a blood pressure medication.

Medications are expensive, especially Tradjenta, which I rely on samples to get. Also, I’ve never been a fan of pumping chemicals in my body, not even for recreation. Caffeine remains my addiction of choice, and alcohol is less and less appealing as I get older. If I can reduce my intake to a mutlivitamin every morning, I’ll be happy.

I’m not done yet. 260 pounds for my age and height is still overweight, but now I’m moderately overweight instead of severely. But I need to keep going.

Besides, I have a goal of running the Pig at 50.

Remission: At The Six-Week Mark

  • Under 265 pounds, threatening to dip into the 250’s. This is significant because the last time I did not need a Darth Vader mask for sleep apnea, I weighed between 245 and 255 pounds.
  • I almost don’t need to count calories. Almost. When I go over 2400 too many days in a row, I see it on the scale the next morning.
  • I am about to lose more medication. Finally. Blood sugar seems to be the most responsive to weight loss and exercise. I’ll take it, though I’m not going to miss that damn cholesterol tablet if I can get rid of it.
  • Up to almost a half hour running solid. I know this is slow going, but going out and running a mile straight without building up to it, especially at my age and weight in my condition, is risky. That said, I’m still going to run the Pig at 50.
  • P90X looms on my horizon. I suppose I better break out the DVD’s and figure out what equipment I need.

Remission: So Far

As January enters its, one might think I’ve given up on my fitness New Year’s resolution. Not so. This was not a resolution. If we didn’t have a holiday season in December, I would have started this right after Thanksgiving. That said, I’ve actually made some progress.

  • I started the year at 274 pounds. Right now, I’m hovering around 265 pounds. My goal was to hit that mark by February 14 and be nice and svelte for Nita when we go out for the fifth anniversary of our first date. No stopping now. I intend to be down to 260 by spring break in March.
  • I’m running intervals, this past weekend 3 two-minute intervals in a 30-minute walk. This coming weekend, it’ll be four-minute intervals. Next week, I’ll pretty much be running most of the workout, working up to a solid 30-40 minutes.
  • Blood sugar: NORMAL! It takes diet, medication, and a couple of supplements, but it’s one monkey off my back.
  • I have more energy.
  • I’m less irritable. My wife is overjoyed.

By mid-March, I will be running 1-2 miles three days a week. In April, I dive into P90X despite taking summer classes. (Remember when I said I wasn’t going to do that? It’s doable.) And on Easter, I begin my annual Sunday rides along the Little Miami Trail. By the end of summer, I plan to start training for my first 5K races since high school.

Hopefully, this will result in an emptier medicine cabinet, sleep without a Darth Vader mask, and a lighter touch on the scale.

//

Remission: Juice Fast

I first need to point out that I am not a healthcare expert or a doctor or a dietician. I’m simply a middle-aged, overweight man fighting back against his own bad choices over the years. My battle with Type II diabetes began in 2005 when I reached 310 pounds, had ringing in my ears, and had every joint in my body ache. What I talk about here, I do at risk only to myself. I write this to share with others with similar problems and to hold myself publicly accountable for improving my health. While you are certainly free to follow what I talk about here, please see your doctor. Your condition will likely not mirror mine, and I could very well post here about something that went horribly wrong in the near future. I hope not. All I can tell you is it’s a risk I’m willing to take, and I hope you will find and share your own path. – Jim

With the holidays over and done with, I decided to start the New Year off by purging. No, I didn’t crawl into the john at the corner bar at 12:15 to expel my New Year’s Eve consumption into the toilet. Dude, that’s just gross, both the restrooms at the corner bar and the expulsion.

Instead, I decided to fast. Not a real fast, mind you. I did that once, and never again. No, I did what’s called a juice fast. Eat nothing, and drink only juices for 24 hours. I don’t recommend this if your blood sugar is prone to radical lows or you need any kind of medication to function. And since my next drink would be the beer club’s weekly selection the following week, New Year’s Day is as good a time as any to clear out the digestive track.

I’ve tried juice fasts in the past. I did a three-day fast about six years ago and only made it through 2 1/2 days. That one came with a strict program to get back on solid food quickly. I tried it again four years ago, to which Nita thought I was insane. Living with a wife and a child made that more difficult as it’s easier to cook everyone the same dinner. And when your kid is a picky eater (even at 18, he’s picky as hell), it’s suddenly a bit inconvenient to sit out dinner with the family. I lasted a day.

But a day is all I need. All I’m doing is letting everything I ate over that final holiday weekend pass on without throwing anything down on top of it. There are a number of juice fasts out there on the Internet. Check them out, but choose wisely. Remember, some people have an agenda when they recommend these things, and while their purpose might be noble (or quite often not), it might not be in your best interests. So what did I do?

  • Begin the morning with a smoothie. Not really juice, and you’ll never see that on any juice fast regimen, but I’m improvising. I’m also trying to amp up my metabolism.
  • Drink 64 ounces of water. Not all at once, of course, but I’ve found water throughout the day counters the hungries quite nicely, especially for someone like me whose insulin is out of whack.
  • Drink orange juice and grape juice at various times. Somewhat filling, and I like orange juice. I wish I could drink it more often, but not until the weight comes off and I don’t have to worry about spikes in blood sugar.
  • Drink tomato juice or V-8 around lunch and dinner time. This is a no-brainer. Both are quite filling, and I have to scold Nita not to drink all my tomato juice until the next day.
  • No alcohol and no soda. Alcohol brings with it a whole host of problems and makes resetting your body chemistry a tad difficult.

The next day, I resume eating normally, whatever the new normal is. I suspect I’ve written a blog post about that since I wrote this. There’s a nice drop in weight the following morning, but remember, that’s because your not digesting anything more than a bunch of liquids you drank.

I’m thinking this might not be a bad ritual to perform after the holidays or vacations, when we tend to eat whatever’s in front of us, drink to excess, and generally enjoy ourselves gastrically. Let’s face it. I love food. It’s how I got into this mess in the first place. But at least I don’t weigh 310 pounds. (I haven’t since 2005.)

Remission: Being Fat Is Getting Expensive

The last time I went to the doctor, I got scolded. He was ready to put me on insulin in spite of the fact he hadn’t checked my A1C yet. (That’s the cumulative measure of blood sugar over 90 days.) I wasn’t ready for that for reasons I won’t get into right now. But one of the drugs I now have to take I have to get by samples. I also have a $50 prescription added.

I am on HSA, which means there is no deductible for drugs. I pay full price. And my little pill box is at capacity.

I talked a couple weeks ago about getting into shape. That post was written in early December, but the goal still holds. Every single problem I have – blood sugar, blood pressure, angry liver, joint pain – all ties back to being a lot fatter than I look.

School has played a big part of this. I had three very writing-intensive courses this past semester. Then the school announced that they were going to a four-credit hour system in the fall. We won’t be spending more time in the classroom, just more time on homework. This is not an option for most working adults. That took up a lot of time.

I had this silly goal of reading 100 books in a year last year. Sometimes, I found myself reading at times I should have been exercising or writing or doing coursework. That went out the window.

But it’s the diet and exercise that are the core of the problem. I ate a lot of carbs and a lot of bar food and a lot of sweets. I drank a lot of alcohol at times when I probably should have laid off of it. So 2013 is bringing changes. This isn’t the new normal. I’ll need to figure out what that is over the course of the year. But I do need to implement a plan to get to that point. How do I get to where my blood sugar is normal without drugs, my blood pressure is low without pills, my liver doesn’t look like a drunk’s, and the scale doesn’t scream in agony when I step on it?

So I’m posting the transition plan here, mainly for accountability. You can play along at home, or you can figure your own out. My wife has different issues and is going to parallel her health efforts with mine.

So here goes. Winter’s health plan for 2013:

  1. Juice fast on New Year’s Day.
  2. No alcohol except for the beer club at work and wine on Valentine’s Day until after April 15
  3. Ramp up the running program
  4. Calorie counting
  5. Virtually no sweets – candy, pie, cake – until my birthday in May. (Then I have to decide if I want cake or pie.) This is actually fairly easy since sweets tend to make me a little ill.
  6. Much more fruit, usually for breakfast.
  7. The vegetarian lunch. In a household where we all have to eat the same thing for dinner, breakfast and lunch are the best opportunities to control caloric intake. Lunch will not be entirely meatless, but it will be meat-light and vegetarian most of the time.
  8. Beginning in May (End of Wilmington College’s spring semester), P90X. I have a choice: Go to school in the summer or devote 90 days to my personal fitness. A bachelors degree is not worth dying for, especially when the school administration stupidly believes that their academic requirements take precedence over a working adult’s day job, family, or health. So, sorry, Wilmington, but I gotta get my health back. Deal with it.
  9. The Little Miami Trail – I didn’t do this last year, and I regret it. So assuming AJ lets me use his car (Our reliable old Santa Fe that can hold my bike in the back), Sunday mornings from May through the end of June will be devoted to riding a leg of this trail. This year, I plan to go all the way to Yellow Springs, a suburb of Dayton. There’s more trail to ride this year, and construction on the final leg begins this year. That’s good. I plan to have Nita take me all the way to Yellow Springs on my fiftieth birthday so I can ride the trail all the way to Newport, Kentucky, across the river from downtown Cincinnati.
  10. After P90X, start training for my first 5K race since 1983. I haven’t run one since my last cross country race in high school.

It’s ambitious and subject to change, but I need to get serious. Otherwise, I’m jabbing myself with a needle every time I eat. Not happening.

Remission: Spitting In The Devil’s Face

A couple of weeks ago, I got into a discussion about Mayor Mike Bloomberg’s ban on 20-ounce sodas in New York. I said that next time I went to Manhattan, I would buy a 2-liter of Coke and drink it on the steps of Gracie Mansion (the mayor’s residence). “It’ll put me in a diabetic coma, but it’ll be worth it.”

Someone took offense at that. “If you had diabetes, you wouldn’t think that was funny.”

I responded that I had Type II and was well aware what the risks were. Oops.

What some people don’t understand is when you have a condition like that, you have two options: Cry “Woe is me!” or laugh at it. If I had cancer, I’d be making jokes about it. The trouble is some people squirm when you do that. Much of it is political correctness. People assume that you can only make jokes about something like that if you have that particular condition, and people who have that condition don’t think it’s funny.

Well, no, it’s not funny, but I reject your attempts to deprive me of fighting back with humor. It does no good to sit around and be somber about it. Besides, my condition is one that is quite likely reversible. Why should I not joke about it? Much of the humor is at my own expense. There are those who suggest I might not be taking things seriously enough. However, I’ve learned that taking things too seriously has worse side effects than most medications.

Remission: Little Brown Bottles

Last year, when I dropped 20 pounds in six weeks, I also managed to lose one of my medications. Now?

I need to really start watching my intake more closely. I’ve maintained my weight, but that hasn’t translated into maintaining my numbers as well. Where, last year, I was convinced I’d be losing all my blood sugar medication and reducing my blood pressure medication by half, I’m now up to two BP meds and two sugar meds. I suppose my addiction to Reese’s Pieces has played a role. Now, however, I’m also on a cholesterol med.

Part of my motivation to have 10-15 pounds gone by the end of the year is those little brown bottles. When you’re on HSA, they’re expensive. And it seems every time I go to the doctor, they keep adding more.

I have an additional inducement. Since 2000, I’ve used a CPAP machine, which is what keeps me from snoring myself to death. Assuming I don’t choke on a collapsed airway, my wife would be forced to smother me for the sake of her own nerves. Unfortunately, to get supplies, I now have to visit an aggressive sleep disorder specialist who likes to lecture me on the evils of caffeine, sleeping with the television on, and not coming in every three months for him to tell me to give up caffeine and quit sleeping with the TV on. “Dude, I just want a new hose and facemask. I know I snore already.”

I know I won’t get rid of the Darth Vader mask by the end of the year. I’d need to lose about twenty pounds for that. But I do want a couple of bottles off my shelf. Three of them, in fact. I’m not a big fan of better living through chemistry.