Tuesday, March 3, 2009

Life as a Diabetic

As many of you know, I am a diabetic. Type 2. They used to call this adult onset diabetes. I think I was diagnosed about 12 years ago. I would have been an adult as I would have been 47 years old. The diagnosis wasn’t a surprise. Diabetes runs in the family. My Grand mother on my dad’s side of the family had diabetes and so did my dad. My sister, who is seven years older than I am, has it. My Grand father on dad’s side had it too.

Grandpa Alphonso Spada lived until he was 77 years old and died of Cirrhosis, lung problems and complications from diabetes. The three vises. Smoking, eating and drinking. I would only hope, or maybe not, that I live to be 77.

Grandma Mary Masi Spada lived to be over 100 years old. She passed soon after she had a foot amputated from diabetes complications, but she was already over 100 years old when that happened. She lived more of her life as a diabetic than she did not being a diabetic. She lived with my Aunt Angie, who is a diabetic, and kept her own apartment in the lower level of my Aunt’s house well into her nineties.

She cooked her own meals and obviously took care of herself and her diabetes. I don’t recall exercise being a big part of anyone’s life in the family. My dad never took a walk that I remember. He passed 25 years ago, in November of 1983. He was 63 years old and heart failure, from complications of diabetes, was stated as the cause of death.

Since being diagnosed. I have tried numerous times to beat this disease. I learned a lot about it and what is happening in the body when you have it. I learned what needs to be done to control it. By having diabetes under control to some extent, a person can ward off the nastiest of effects that are caused by the disease.

Heart failure, stroke, blindness, loss of limbs by amputation to name a few of the more drastic physical maladies that are caused by diabetes. I already have heart disease. My heart problems started in 1985. I was 36 years old when I had my first heart episode. They called it a heart attack because when they took a blood test, the test showed enzyme changes that will associate with having a heart attack. Not every heart attack is writhing on the floor gasping for breath. Some are subtle and in my case, I had some pain in my chest, but it didn’t double me over. This article might shed some light on the blood enzyme topic.

My heart history is quite extraordinary. A heart attack in September of 1985. They used the balloon angioplasty and tried to open my clogged arteries with these balloons. That lasted for about six weeks. That balloon treatment collapsed and they tried it again. Six weeks and another try. It was of no use. My arteries needed bypass as each time the balloon restenosed, or collapsed, I had another enzyme change, another heart attack or episode. In January of 1986 I had a triple bypass operation.

My heart was taken out of my body and patched. I recovered nicely and went on about my life for a number of years.

Again in 1993 I had a heart episode similar to the ones I had in the 1980’s. This time, they let me lay in a hospital bed for a week and did nothing, telling me that the place in my heart that was causing me the pain was on the right side of my heart and in the back and I could live without surgery or intervention. I did recover, and I have a small piece of dead heart tissue from that.

In 2003 I had chest pains again. This time I was airlifted from Eureka, California to the VA hospital at Stanford University in Palo Alto, CA. I got another triple bypass surgery. The surgeon was so proud that she opened my chest cavity using the same scar that I had from the 1986 procedure. It looks like I only have one scar, but I know I’ve had two surgeries.

Since that fateful day in 1985, I have tried on and off to change my diet, lose weight and add regular daily exercise into my daily routine. I have had success here and there for periods of time, but invariably I went back to old habits and stopped daily, or regular, physical activity and stopped eating a balanced diet rich in fruits and vegetables and lower in fat.

With diabetes, carbohydrates are the culprits. All carbs have sugar in them, not just cake and ice cream and those delicious doughnuts and cookies. I have to watch how many servings of carbohydrates I eat as well as balance the amount of fat and protein in my overall diet. That realistically means eating less of everything, smaller portions, and balance the amount of each. Along with what I am eating, exercise like walking or bike riding must be part of the equation.

I have done this like a yo yo as well over the years. Sometimes reaching great success. Sometimes dropping the whole program and stuffing myself into heavenly oblivion with large quantities of everything that is bad for the diabetic. Plenty of cookies and milk, ice cream, cake and pastries, rich fatty meat and pasta, potatoes and rice in excess. I’d load my bread with copious quantities of butter.

At other times, I’d walk three to four miles every day, eat a balanced diet and actually lose weight naturally. My blood glucose readings would be normal for periods of time. The blood glucose is measured by taking a drop of blood and placing it on a slide. A small meter measures the amount of glucose in the blood. Here is some information about blood glucose.

I was given pills to help me with bringing down the blood glucose levels. I was suppose to help myself with the diet changes and the regular exercise while taking the pills. When I went off to Cleveland in January for a 5 week stay there, I was taking two different kinds of oral diabetes medication and my blood glucose levels were still high. By walking 2-3 times every day for a half hour or longer each time, and by eating a balanced and much smaller diet, richer in fresh fruits and vegetables, I managed to lose about 10 pounds. This weight loss triggered a drop in the blood glucose. This made the amount of diabetes medication I was taking be way too much. I went from taking four glyburide pills, two in the morning with breakfast and two before dinner, and two 1000 mg tablets of Metformin per day to taking one glypizide in the morning, and two 500 mg Metformin. That was quite a reduction in medications and that is the dosage I am on right now.

I understand the importance of keeping up the regular exercise. I understand the importance of staying on a balanced diet and not over indulging in the “bad” foods. I see the results and I do feel better. More energy and better circulation. And I can feel it.

With diabetes, I have experienced neuropathy in my legs and feet. This is a numb tingling feeling in my toes and bottoms of my feet. I get terrible stinging pain sometimes, like a hot needle, being poked into my toes. Since I have brought my blood sugar levels into the proper range over the past two months, I have seen this sensation diminish drastically. I am losing weight at a slow natural pace. The weight loss makes me feel good physically and mentally.

I also know that stress plays a big part in the glucose level. I don’t know how it does this, but I know when I’m stressed out, I tend to eat more and more often, and I don’t care what I am putting into my pie hole. I’ll eat a whole carton of chocolate almond fudge ice cream when I’m not even hungry. When I have reduced stress in my life, I can be more focused on the change of eating habits and not overindulge. I’m sure there is a more scientific explanation, but all I know is this is what happens with stress and the accompanying depression, anxiety and feeling of low self worth.

I guess I am writing this as a way of helping myself. If it is helpful to others who suffer with diabetes or know someone that suffers and it helps them too, then that’s a good thing. Like anything, feel free to take what you want or need and leave the rest. I help myself by narrating what I’ve been through and this helps to keep me motivated to add these drastic lifestyle changes into my life and make them habits.

I mean, it is a beneficial habit to snack on carrot sticks. The habit of eating the aforementioned quart of chocolate almond fudge ice cream every evening in front of the TV is not a good habit to have. These wholesale habit changes are the ones I need to start and keep. It won’t let me live forever, but it will let me live until I die.

Briefly, here are some of the changes I have attempted to make into habits this last go round:

I eat a bowl of what I call fortified oatmeal every morning. I take my pills on a schedule and make this great tasting oatmeal. I’ll put the recipe at the end of this post.

I eat only whole grain bread, in moderation, and do not use any butter or other spreads. I like mine toasted. I find that a great tasting whole grain bread toasted and free of butter or other spreads tastes great.

I try very hard to not eat anything after dinner. If I do have a snack, it is one thing like a few graham crackers or a bowl of sugar free jello, but no sitting around watching TV and making trips back and forth to the kitchen. One snack and that’s all.

I walk once per day, about an hours worth, at least five times per week. I do this at the Mall of America. In my own anal retentive way, I counted the paces. Did you know that once around the MOA and following the contours of the outside ring of stores, it is 1720 paces? When I was in Cleveland, I walked off 10 paces and then went back and counted the one foot tiles and found in 10 paces, I cover 24 feet. (when I’m walking faster with longer strides, this is more like 25-26 feet, but I use the 24 feet as a reference and measure of the distance I cover).

This 1720 paces times four times around is about 6880 paces. Divided by 10 equals 688 10 pace 24 footers, or 16, 512 feet. There are 5280 feet per mile, so, I walk approximately 3.12 miles, and that is not counting the paces to and from the bus, light rail station and into and out of the building itself. I get quite a workout, but it takes effort.

I’d much rather it be nice enough weather outside to walk right out my front door or ride my bicycle on the many miles of paved bike trails here in the Twin Cities area. In a month or so, after I move to River Falls, WI, I’ll have a walking/bike path right outside the back of my home. I can walk endless sidewalks through town and through the University of Wisconsin campus which is close by. Trails along the KinniKinnick River, as this trout stream traverses through River Falls, are close to my house.

The beautiful Kinnikinnick River in Wisconsin.

Lastly, to write about this subject is important to me. It motivates and inspires me. I would hope that there are others that will express their triumphs and tribulations with diabetes or other problems in their lives and use these pages as a place to comment or vent. Submit a post of your own and I’ll publish it here. Maybe this will turn into another blog altogether with many authors. A forum of sorts for self help and helping others by support, reading about others and how they deal with specific problems, sharing ideas, recipes. Anything.

I don't use that big slab of butter on mine, but I bet it tastes good!

I’m on a roll and want to add these habits into my life. I believe it is never too late to take the first step, and when I fail, I take another first step and go on from there.

Here is my fortified oatmeal recipe:

I measure 1 Cup, and a little more, water into a small sauce pan

I add a Tablespoon of Flax seeds, Golden or Brown

I add a Tablespoon of Oat Bran into the pan

I take some walnuts and put them in there. (I don’t measure, I get about 15-20 pieces)

I use 1/4 Cup of fresh blueberries, (use strawberry pieces or other fruit if you wish)

I bring the water to a boil and stir. Then I add 1/3 Cup of oatmeal. My oatmeal is a mixture of equal parts of oat meal, barley meal and rye meal.

I stir it until it boils for a moment, then put the lid on, turn off the heat and let it stand for about 15 minutes.

I scrape it into a bowl and enjoy it. I use a little soy milk, but I also eat it just like that. I enjoy the flavors of the nuts and berries and try to taste all the goodness. I put my spoon down between each mouthful and use a small teaspoon and not a giant tablespoon to eat.

I drink a full 12 ounce glass of water when i am finished, then go brush the flax seeds out of my teeth:-)

The water helps with the use of the oat bran and adds to keep you hydrated.

Peace to all of you.


billie said...

sounds tasty- i will have to copy it- i usually just eat plain oatmeal with a teaspoon of brown sugar (i know, i know) and a splash of milk. after my morning cuppa :) i have been exercising regularly- every day- on the total gym and i hope to gain strength and retrain my body to not store the food i eat. i have gardening to do this summer! we will have to keep each other encouraged as it's easy for me to slip back into my comfy, lazy routine.

fjb said...

Had my first ECG in '96. I'm still a work in progress, and I'm living proof that you don't have to be over-weight or sedentary to have problems. I've always been an over-active bean-pole, but stress damn near killed me. I still smoke (like Bet said - I know, I know). My kid gives me s**t at least once a day.:) Effectively dealing with stress was first, healthy diet came next and hopefully cigarettes will be gone soon.

Keep up the good work Joe, you've inspired me to try once again to give up the smokes.

Fran said...

For all practical purposes, I have fallen off the wagon.
there is always some really good excuse.... one of the best is the bitch of working in the corporate world.
I can prattle off all kinds of reasons why I am not keeping it together.
So for me, I need to go back to the specialist, get the labwork done- get the lecture, and get into some routine that puts me back on track.
Oh! The old HR people told me I could NOT use FMLA time to take time off for whatever I needed to take care of my health - i.e. Your own serious/chronic medical condition. My Doctor said NO WAY! You can absolutely have FMLA to care for diabetes.
So 2009 will be the year I finally get that together.
I can then schedule appointments w/o workplace hassle.
So that will be my personal challenge.
Turn in the paperwork, & get myself back on the wagon.
Oh yes! Stress blows the glucose out of the water.
It is the adrenaline that makes the liver kick out glucose.... same reason for the dawn effect-- sky high glucose when you wake up in the am after not eating for many hours.
So I need to g

Unknown said...

I found this extremely helpful. I am going through the 'I don't want to change' phase, I guess. I know I have to make changes, but can't get motivated to do it. One thing I have noticed is that when I eat too many carbs, I get sleepy as hell. I cannot stay awake. Of course my blood sugar is up, but does this happen to you? Bread, for instance, really spikes my blood sugar.

Anyway, I so admire your dedication to your health. You inspire me to do the same.

D.K. Raed said...

I'm very late to this, just finally catching up. Wanted to wish you good luck with those lifestyle changes. I used to think I had willpower, but the natural aging process has shown me otherwise. It's a real battle!Diabetes runs in my family so I avoid sweets, but now you mention carbs ... oh boy, I love my carbs ... and I hate to exercise, no wonder I'm having trouble losing 10-lbs.