How Not So Sweet It Is

"Dr. Claydon needs you to come back in."

 

Two days after my physical last month, that was the message Dr. Claydon’s nurse left on our answering machine.

 

Huh? Why?

 

Never before had a doctor asked me to come back in for any reason and worry did all it could to creep into my reckoning: They found something, and it’s horrible. I’ve got six months to live. Have I updated my will recently? With all these unanswered fears swimming through my cranial cavity, the earliest I could get the follow-up appointment was two weeks out. But if it was that bad, they’d want me back sooner, right?

Maybe. Maybe not.

 

A few years ago, I had a different medical problem. A real one with some actual tangible evidence; I felt lousy. It started on Memorial Day Monday 2003 with a bolt-out-of-the-blue horrific stomach ache. I'd never felt so awful. Doubled over in pain, the kind I'd never felt before, had it been anatomically possible I'd swear I was giving birth that day; when I could stand up at all, all I could do was drag myself to the bathroom to throw up. This went on for nearly four solid hours before things began to settle down.

 

I went to the doctor the next day, but it was nearly two years before I felt right again, and I mean, really right. Normal, right. Healthy. From Memorial Day 2003 until mid-summer 2005, this malady hung on; not all the time, it waxed and waned, sometimes I didn’t notice it much at all, sometimes it dogged me as often as five days a week. Regardless, it always had me feeling lousy with a capital 'L'. 

 

On the first visit to Dr. Claydon, right off the bat his first suspicion was gall bladder disease. I wasn’t completely sure what or where the gall bladder was, but if it was somewhere in the abdomen and could make you feel sick all the time, I was willing to go with it. To confirm the diagnosis, Claydon sent me to a couple specialists. Apparently I needed to not only feel near death I actually had to be near death to be seen right away because I had to wait a week to see one and a week and half after that to see the other.

 

But after all that waiting around I'd say neither specialist was all that special because neither found anything wrong. They poked and prodded and did blood work- lots of blood work- yet always they found me to be pretty healthy. In fact, one of these guys dismissed the g-bladder idea out of hand. His exact words? “Nah. No way is it your gall bladder.”

It was during these first doctor visits though, that Dr. Claydon discovered I had hypertension, a fatty liver, elevated cholesterol and extremely elevated triglycerides. I was only 48, but left untreated I was a ticking time bomb for a major coronary. Knowing what I know now, had I not become aware of these issues, unrelated to why I went to the doc in the first place, I might be here today.

 

I was quickly started on medication, and within a year my cholesterol, triglycerides, and blood pressure levels were all at or below the norms of a healthy adult, and my liver was completely clear and free of fat. So guys, there’s a lesson there- after 40, go see the doctor. You don’t know what’s going on inside your body sometimes until it’s too late. For me, I got there on time. 

 

But the pain and illness persisted. Even after multiple visits to my GP and other tummy docs, there was no change: no firm diagnosis and little permanent relief from my stomach woes. So Doctor Claydon sent me to another medical expert. This one did lots of poking and blood work, too- and an even more invasive test, called an endoscopy. They stick a lighted tube down my throat to study the upper GI from the inside. That was pleasant- not- fortunately they knock you out first. And when I woke up, they sent me home and told me I was fine. Well, mostly anyway.

 

While the endoscopy did reveal some inflammation of the stomach lining, a little gastric reflux and some other odds and ends, none of the discoveries were terribly serious and all of it could be treated with medication and a change in life style. Added to my high blood pressure and bad cholesterol readings (which would soon start showing improvement), I was otherwise good to go. Which was certainly good news; except I seldom still felt very good.

 

Yeah, I did the medicine they prescribed and altered my diet and did all the other things they recommended. But the discomfort, nausea and general yuckiness was always only one disagreeable meal away, and by the spring of 2005 it was almost more than I could stomach.

As the weather warmed, I began losing my energy, then my appetite and then my weight. By June, I was sick almost every day and during endless nights when I couldn't sleep, sat alone in the living room, crying out to God and nearly crying for real. In the darkness of the night, feeling awful and with no light at the end of the tunnel, I convinced myself I had cancer and was surely going to die; and hopefully soon. I prayed for the pain to go away; pacing and praying, then curling up in a ball on the floor and praying some more until I'd finally go to sleep, if only for a little while. And though I still felt crappy when I woke up, I took some comfort knowing I’d made it through to another morning.

 

In July, with no relief or improvement in sight, Doc Claydon sent me to one more specialist, this one a surgeon. A surgeon? Geez Louise, I really am gonna die, I thought while sitting in his waiting room one really hot sticky morning. But where Dr. Claydon had nearly run out of ideas, and the specialists basically dismissed what I was going through as basic run-of-the-mill, middle age GI issues, the surgeon took me and my symptoms much more serious.

Dr. Moaldonado ran a CT Scan on my abdomen, which showed nothing wrong except for a dying gall bladder. The next day, I had to go through another MRI, called a HIDA Scan which, after another 45 minutes in or under a machine where I couldn’t move, corroborated that the organ was functioning at around 13 percent and falling. Normal function for a healthy gall bladder is anything above 35 percent so it was no wonder I was sick.

But not as sick as realizing this was the preliminary diagnosis Dr. Claydon had reached in 2003!!

Five days later, on August 2, 2005, my nearly dead gall bladder and I parted ways. Dr. Maldonado said it popped out like a cork I groggily heard him say- maybe to me, maybe to Amy, as I slowly drifted back into consciousness in the recovery room. But the two year ordeal was finally over, though I wished confirming the diagnosis had gone as quickly as the surgery. I went to the hospital that day around noon, the surgery was at one and I was home recuperating in our living room by 5:00 the same afternoon.

That was the second time I had surgery. The first time I was ten and had my tonsils out. But the solution to what ails me here in August 2011 won't be as simple as a childhood tonsillectomy or laproscopic gall bladder surgery 6 summers ago.

"You have diabetes", Dr. Claydon informed me, matter-of-factly and looking at me over his laptop from across the room. The laptop held all the numbers from my latest blood work. “But your cholesterol numbers are darn near perfect", he added, after running through the laundry list of levels that weren’t all that great. So it wasn't the worst news I could've heard at the doctor's office. I wasn’t going to die. It wasn't the best news either. A diabetes diagnosis never is. I’ve got two close examples of what diabetes does to people, living and dead, and why it's a disease to avoid.

Mom developed diabetes around 40. She took pills and had to give herself insulin shots every day, yet made little effort to change her lifestyle; eating things she shouldn’t and not getting a lot of exercise. Although she managed to live with Type 2 Diabetes for another thirty five years, in spite of not always managing it as she should’ve been, I believe the quality of her life was appreciatively diminished and, I know it significantly contributed to her death. Meanwhile, my father-in-law has lived with diabetes since his mid-20’s. He’s still kicking, but has lost an eye, his circulation is poor and he's this close from having to go on kidney dialysis.  Life is a challenge for him and he’s only in his late 60’s

I’m considerably younger and know I don’t want to go through what he’s had to endure, or what my mother had to live through, for however many years I have left. Of course, I never thought I’d have to. Somehow, I thought I was always in better shape, took better care of myself and, though tits an inherited disease, thought I could simply outlast. But running from it all my life, apparently, diabetes has finally caught up with me.

But it’s not all bad news. The blood test they used on me, which has a name longer than a giraffe's neck and averages the blood sugar level for the previous four months, was at 129. The baseline for being diabetic is 120. So I'm only a few ticks above the line. And the treatment is a lot simpler too. No shots; just medication and watching what I eat, especially my sugar intake. I'm not on insulin, but the pill I'm taking, Metformin, suppresses my metabolism and digestive system and leaves me sometimes feeling quite sluggish and unwell. I don't like it. I have no choice though but to keep taking it- at least for now.

I'm also living on between 1000 and 1500 calories a day.  I'm not a big person and have never been a big eater, but didn't know just how much beyond that I was eating till Amy and I started aiming for that number by writing down everything I take in and counting the calories.  We found out, it doesn’t take much to exceed it.

At work, I used to like having a Coke or Snickers Bar in the afternoon, as an energy boost, and then maybe a cookie or a handful of crackers in the evening for desert. Well, that's about 4-500 extra empty calories, I didn’t need and had to be crossed off the list starting on the first day. And going out to eat? Don't even ask. Not on purpose, but I was not really aware that I could consume almost an entire days’ allotment of calories on one entree. So, when we go out, I've had to seek out the items with the smallest caloric count. And surprisingly, I've been able to find some that are even tasty and fill me up. Who knew?

But I still crave things; things I don't really even want. Last week at work, there was a plate full of chocolate chip cookies in our break room. Fresh baked by some unnamed co-worker, they were just sitting there, saying "We're really yummy, come have one". But I had to ignore them and walk away. Twice. The next day, somebody else brought in a cheesecake. I love cheesecake, but had to turn my back on that pretty looking pastry, too. Then yesterday there was an office bake sale going on, with cupcakes, cookies, muffins and pies all over the place. There was a treat at almost every turn, a treat I really wanted. It made me want to run from the building screaming. Instead, I was good and quietly stayed away.

I guess it’s true though; you never know what you've lost until you can't have it anymore.

However, I may only have to be this restrictive till the next blood draw. That happens in December and , as Dr. Claydon suggests, the number drops below 120 again- he says he thinks it will if I stick to all this stuff- then I can at least get off the medication. Good. I already have to take medication for my blood pressure and I’d be quite happy to someday be able to wean myself off those too. But in the meantime, not having to stay on this Metformin crud for too long would be a nice early bonus.

When Claydon and I had this chat earlier in the month, he also said it'd be helpful if I’d drop ten pounds or so. Nobody likes to hear that but, since starting this rather spartan diet two weeks ago Monday I'm more than two thirds there, down 7 whole L. B.’s.

But even if I do lose all ten pounds and even if I do get my blood sugar levels back down to acceptable levels, I can't eat like I'm still 25 anymore.  I simply can’t go back to living and eating as I did before. If I'm not careful, I know now that the weight and elevated blood sugar can come back quicker than a 3-day binge at McDonald's. So I really mean it. While I may again allow myself more than 1500 calories a day and the occasional treat, the calorie counting notes Amy and I are compiling will never be far from reach, whether at home or on the road. Food tracking is going to have to be my handy little post-it note and cheat sheet to keep me nutritionally accountable the rest of my life.

I'll admit, knowing the family history I was kind of scared when Dr. Claydon told me I have the diesase. But maybe scared in a good way, and blessed. Scared of knowing the devastating end game diabetes usually takes; and blessed to given a chance to stop it in its tracks before it does the ruinous things it did to my Mom and is doing to my father-in-law. I don't want that. I don't want any of it.

I hate writing about this stuff though; it reminds me so much that I'm starting to wear out. I hate having to come to grips with knowing my best days- health wise anyway- are probably behind me now. It reminds me of my not necessarily imminent, but approaching mortality. But I need to talk about it so it doesn't drive me nuts while my body adjusts to all these changes and my mind accepts life’s new realities. Fortunately, I don’t have to do any of this stuff alone either; I have Amy, my friends and especially my God to see me through this current chapter, and the future chapters I want to look forward to, beyond Diabetes101. 

So, if you’re a praying person, keep me in your prayers as I maneuver my way through this somewhat challenging time.  I'd really appreciate it.  Pray that God sees me though it successfully, pray the medication will stop making me sick, pray I can continue to get by on minimal daily calories without getting headaches...

And pray I quit dreaming about chocolate chip cookies and Snickers Bars!!!