G'day To Diabetes
Some turning points we only see in hindsight. Others impact instantly.
By Alan Shanley
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
July 2008 — There are turning points in all our lives. Some we only recognize in hindsight, while others are immediately obvious.
My life changed completely on the 18th of February, 2002, four days before my 55th birthday. I went to see the doctor for a routine physical after a blood draw to renew a standing prescription for a statin. I had been placed on the statin a couple of years earlier by a previous doctor who said, "Your cholesterol is a little high, but you don't need to worry - we have a pill that fixes that." He prescribed Lipitor 20mg. He never mentioned my 120Kg (260lbs) weight, or my fasting BG's of 7.9mmol/l(140mg/dl), or diet, or exercise, or even the hint of diabetes. Just the instruction to "take this pill." So I took the pill, and changed nothing else. I was fat and happy. Does that sound familiar to anyone?
Then, on the day my life changed, I sat in the doctor's office and went into shock as he told me I had leukemia. You thought I was going to say type 2 diabetes, didn't you? Nope – on that day in February 2002 he told me I had CLL. Happy birthday...
I went home in a daze. But by the time I reached home, I had made up my mind to be "officially retired" and that I was going to do some of the things I had always wanted to do. I was not going to die with my song unsung. So I told my wife, as she opened the door, that I was going to travel around the world. I had always wanted to travel but always spent the time or money on something more important or more responsible. It was only later in the day I got up the courage to tell her why. A year later we went around the world for the first time.
Over the next two months I went through all the fun things of confirming my cancer diagnosis; a multitude of blood tests and a bone marrow aspiration. I got on the Web and searched for things I could do to help myself beat it. I found nothing.
The depression of diagnosis set in. I was told I was on "W&W: Watch and Wait." Wrong. "W&W" really means "wonder and worry."
And then, in early May I was told by my doctor I also had type 2 diabetes. Oh joy. But this was different. The doc told me to get a meter, and suggested I test fasting and pre-dinner blood glucose levels, and gave me targets for these numbers. What he didn't give me was any advice on how to achieve those targets, except to "lose 8% of your body-weight."
The CLL diagnosis had primed me. There I was, all frustrated and depressed, and suddenly I had a goal that I could achieve. I designed my own weight-loss cooking and eating plan, and put it into practice. And it worked. When I lost the 8%, I just kept going. But it wasn't enough. My A1C only dropped from 8.2% to 7.5%, despite my weight loss. So I started searching for more information. Over the next couple of months, I attended dietician's appointments and a course with a dietician. My weight loss stalled and my blood sugars got worse as I started adding extra carbohydrates to follow the dietician's advice. And then, like a new world, I discovered the anarchy of Usenet's diabetes groups and eventually the most powerful, simple, logical advice I've seen before or since for new type 2 diabetics.
This advice is written by a diabetic named Jennifer. In essence, she says to test after you eat to see what your food does to you. Then change what you eat to improve the results next time. That's basically it. So simple, but so incredibly effective and powerful if you think about it and then put it into practice. Naturally, everyone who uses it adapts it for themselves. I modified it for my own use. Of course, it is simplistic to concentrate only on blood glucose levels, as other aspects of nutrition had to be reviewed as I made those changes. But I always made blood glucose control the first priority.
Serendipity is a wonderful thing. These days I spend a lot of my time trying to persuade newly diagnosed diabetics to follow that testing advice and I am out-spoken on the effects of diet on diabetes, but I make no claims about diet and leukemia. But something odd happened. My CLL numbers also all improved since I took control of my diet.
For several years I was involved in the excellent ACOR mailing list for support and information for the CLL, eventually becoming one of the list managers. My improvement led to me resigning from that a year ago; it became increasingly difficult to see old friends passing away or in pain as I improved. If the Sword of Damocles drops and the numbers start rising again I'll return, but for now I just see the haemo a couple of times a year and get on with the rest of my life.
My haematologists remind me that it's serendipitous, but they also tell me to keep doing what I'm doing. That sounds like good advice to me, so I will.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
Laulau Corn and White Bean Soup Eggplant Rollitini (Gluten Free) Fresh Broccoli Pasta Oatmeal Raisin Cookies Sun-Dried Tomato and Mozzarella Focaccia Spicy Orange Hummus Mocha Frappuccino Smoothie Mushroom-Spinach Stuffed Beef Tenderloin Pineapple and Strawberry Gelatin
Occasionally my mailbox or follow-the-link browsing will come up with something discussing whether (and if so, when) to ease the restrictions on treatment goals when the patient is elderly, arguing either to favor a higher quality of remaining life (lifestyle choices less limited by chronic illness) or to take into consideration geriatric cognitive decline (aka "senility") and simplify, as much as possible, the regimen. While the goal of medicine is, obviously, not to...