Monday, October 20, 2014


I haven't had diabetes for the past three years.

That's what my endocrinologist informed me during my most recent checkup.  Yes, once again my A1C came back "normal" - a 5.4.  Which, to my doctor, indicates that I don't have diabetes.  Yay, me!

The problem that I have with this diagnosis is that I haven't somehow "cured" my diabetes.  Yes, I don't take medication to keep my glucose numbers low, but I do eat a carb-conscious diet and exercise a ton.  Hard work and consistency are my medication.  If I were a member of the 5 percent club by loading up on metformin and shooting up with insulin, would that indicate to my doctor that I didn't have diabetes?  Probably not.  I would imagine that if I ate what I wanted and didn't work out to the degree I did, I would see my numbers rise because I'm a diabetic.  I presume if that happened and my A1C rose to over 6, my doctor would inform me that my diabetes "came back."

I don't dislike my doctor.  And I'm very appreciative of the help he gave me -- especially after being initially diagnosed -- but I cringe when I hear stuff like this come from his mouth.  For a doctor -- especially a diabetes specialist -- to say that I don't have the disease is like a historian saying that Columbus "discovered" the New World in 1492.  It's not only an old school way of looking at the world but it's quite frankly incorrect.

I am happy about my number.  I'm happy to have the glucose levels of a "normal" person.  I know that this fact should help me live a long(er) life with fewer complications than if I had continued down the path that led to a diagnosis with an 11.3 A1C.  But at the same time, it would be easy to be lulled into complacency -- to assume that perhaps I don't have to work so hard to maintain these numbers because I don't have diabetes.  I cringe whenever I hear my doctor say this because while I know better, I worry about his other patients who might not understand the distinction between being a diabetic with good numbers and someone who has somehow been "cured."

I started this blog to talk about what it is like to manage Type II diabetes but I somehow find myself in a strange "New World" of my own -- or perhaps, more appropriately, stuck in between two worlds.  Having the disease has left me a broken person who will never truly be "normal" again yet because of my success in making healthier choices in my diet and exercise, I find myself not necessarily fitting in among other persons with diabetes.  It's easy to get jealous when "normies" like my wife and daughter enjoy treats as they want and it's hard to truly understand how "diabetics" suffer from high glucose numbers, dawn phenomenon or liver dumps.

All I know is that I've apparently found what works for me.  I'm lucky to be able to enjoy more carbs than most diabetics without the negative consequences and I'm lucky to have found how a more active lifestyle has made me healthier than the average person.  I may no longer have diabetes but I will always be diabetic.  And as long as I understand this fact, it shouldn't bother me so much that my doctor might not.

Sunday, August 24, 2014

A Half and a Half Equal a Whole, Right?

A week from my writing this, I will have completed my second half marathon in a year.  13.1 miles of sweat.  13.1 miles of trying to keep my breath.  13.1 miles of potential pain in my feet, knees and legs.  And I can't wait.

Before my diabetes diagnosis, I wouldn't have ever dreamed that I'd be running such a distance.  I hate running. Yet three and a half years of being physically active for at least an hour a day, I know that I am capable of running without dying.  From time to time, I get tired of having to measure my food and calculate my carb intake but I have yet to burnout from exercise.  Not sure I would call myself and athlete but I do consider myself athletic.

My first half marathon was a year ago.  After having tried training to run it and continuing to get a pain in my knee, I decided that I could walk it in the allotted time instead.  I like walking.  At slightly more than 4 mph, I could finish the race in a little over 3 hours.  But plans went out the window when I actually started the race and found myself walking much faster than my normal pace.  That brisk walk turned into a slow jog as I tried to get around the clusters of other runners on the course, which became a faster run after finding some other people I could pace behind.  I hit a bit of a wall at mile 10 that caused me to walk on and off for another couple of miles before picking it up for an ending kick that allowed me to cross the finish line in the picture above in 2 hours, 34 minutes and 11 seconds. I had visualized my goal of crossing that finish line in my head many times but the actual feat of it was better than what I could have imagined.

I paid the price for the run though with burning legs for about a week.  But it was so worth it.  I decided to sign up for the same event this year but with the plan to run the whole thing.  For a number of months now, I have been training -- mostly without pain -- trying to get my endurance and speed up.  I run about 6 miles a couple of nights a week with a longer run on Saturdays.  I can easily do the distance in about 2 hours and 11 minutes; good for a 10-minute-a-mile pace.  As much as I'd like to ride an adrenaline rush to a sub-2 hour time, I'm happy with shaving nearly 30 minutes off of last year's pace.

But this year's half marathon is actually just a stepping stone for a bigger goal come January when I attempt to run my first -- and presumably only -- full marathon.  Last year's race brought lots of kudos from friends and family who over credited my run for something more than it was.  I don't discount running 13.1 miles at all but didn't want to accept marathon-sized congratulations for half the distance.  I can't say doing a full marathon is anything I'd have on a bucket list but the thought of completing such an endurance run motivates me.

What else excites me is that I've gotten my wife and daughter into the act a bit too.  The day before my half marathon, I'll be walking a 10K with my wife.  My daughter will be running a 400-meter dash later that morning.  Though neither have put in the long training and increased physical activity preparing for their runs like I have, I'm proud that they have decided to set their own fitness goals and will participate in something that has become such a daily part of my life.

I know I should never say never but after the full marathon one weekend in January and another half marathon the following weekend, I don't plan on doing any more long-distance running.  I've enjoyed the challenge but even in as good of shape as I've become, I'm feeling my age.  The copious amounts of sweat, constant trying to keep my breath and achy feet, mainly, have made me decide to hang up my running shoes and return to walking as my main form of diabetes-managing exercise.

When I first was diagnosed with diabetes, I'd occasionally walk a loop from my house around the local park and back.  Then I increased the frequency and speed of that walk until I could go farther for longer.  Walking has been a great way for me to get in a good workout.  I like listening to some music and being alone with my thoughts.  Typical walks for me now average about 6 miles in an hour and a half, which I go on after my daughter goes to bed at night -- usually three times a week.  I supplement the days in between with other activity -- an aerobics class, stepping while watching TV or using the exercise bike.  I know it has been an important component to my managing diabetes without the need for medication.

I look forward to crossing a number of finish lines in the next several months -- a 10K, two half marathons and a full marathon.  I'll feel a sense of accomplishment afterward whenever I look at my finisher medals.  But what's more is that each step I make continues to help me keep my diabetes at bay.  That's the ultimate goal and one I'll never step away from even as I retire from future long-distance runs.

Tuesday, August 19, 2014

Windows to the Soul

I'm not a big fan of the "Scared Straight" approach to behavior modification.  I much prefer the carrot to the stick.  But sometimes the reality of dealing with a disease like diabetes means that you're going to experience some scary stuff.

After getting my diagnosis of Type II diabetes more than 3 years ago, I made an appointment with my optometrist to make sure there wasn't any damage to my eyes caused by elevated blood sugar levels.   Despite having dilated eye exams every two years -- and having my eyes being declared healthy as a result -- retinopathy had developed and I was sent to a specialist for treatment.

Having seemingly skipped the symptoms of diabetes and going straight to the complications, I've tightly controlled my glucose levels since diagnosis.  I'd like to think I would have even without the neuropathies and retinopathies but I'll admit to being "scared straight" with the thought of losing limbs or vision due to consistently high blood sugar.  Many of the posts I read in online diabetes communities gave me hope that controlling elevated levels would result in numbness subsiding and visual acuity returning.  But that hasn't happened.

To help stop the bleeding in my eye, I've had laser beams shot into it to burn the leaking blood vessels.  But because the bleeding is in the central vision of my left eye, the doctor can't effectively get close enough to some of the vessels without the risk of blindness.  The laser seemed to have helped stop the progression of the retinopathy but it didn't do as much as hoped for restoring any vision that had been lost.

I've also been prescribed a variety of eye drops, the most recent being a steroid of sorts that is supposed to do ... something.  What that something is, I'm not entirely sure but I diligently plop the solution in my eye every day with the hope that something positive will happen.  The drops don't have a generic component so I'm asked to pay a $50 co-pay with each 16-day supply.  Not exactly where I'd hoped to spend my money.

Again, despite my tight control with the thought that complications would improve, my vision has gotten worse.  I used to have perfect vision.  With age, I'd develop an astigmatism that glasses corrects.  But over time since diagnosis, I saw my vision get progressively worse.  Vision in my left eye had gotten as bad as 20/80. 

It's hard to explain what I'm capable of seeing and what I'm not able to see.  There's a significant amount of distortion that makes straight lines look wavy.  Although it is not discernable, there is a "spot" in the middle of the peripheral field where things "disappear."  For the most part, it makes reading hard but with my right eye not experiencing the same middle-of-the-retina bleeds (its out of my central vision in that eye), I typically "see" fine.

Something that has helped restore some of that acuity have been injections I've received in my eye.  As pictured above, they numb my eye, force my eyelids open and then take a big needle and push some stuff into it.  After the first two injections, six weeks apart, my vision had returned to 20/25 in that eye.  We did a wait-and-see period of three months and the vision once again began to step back.  I've had a third injection recently and will go back shortly to see what effect the latest round has had.  Apparently, the injectable itself is not permanent, hence the need for multiple injections.  My insurance doesn't cover the entire cost of the procedure and at $300 to $400 out of pocket for each injection, my wallet feels more pain than my numbed-up eye.

I desperately want to keep my vision.  I'm lucky enough to be financially sound enough to afford the treatments I've had thus far.  Despite the burning brightness of the laser or the pricks of needles into the whites of my eyes, the pain has been endurable.  I understand that my retina specialist is taking a conservative approach because there are risks involved and I'm not "that bad" yet to warrant more intrusive treatments.

The hardest part for me is that I feel like there's nothing I can do at this point.  I'm eating as well as possible.  I exercise as I should.  I keep my doctors' appointments.  And yet I still suffer and will probably continue to do so for the rest of my life.

It's scary to think that I will probably go blind sooner than later.  Or at least have significantly reduced visual acuity.  I'm hoping that other nerve damage I've suffered as a result of diabetes don't continue to progress, resulting in the loss of limbs.  Sometimes I'm not sure if I'm asking the right questions but so far my doctors don't have answers for me.  I just keep plugging along, doing what I can.  I try hard every day to enjoy the sights I can.  I try hard every day to enjoy walking wherever I can.  I try hard every day to enjoy life the best I can.

The old axiom that carrots help your vision is one that I wish was true right now.  I'd prefer the carrot to the stick.  However, I'm afraid that life doesn't always work like that.  For any of those with diabetes who are reading this right now, do all that you can to avoid complications.  Because doing better after the fact isn't always enough.

Thursday, June 19, 2014

Rumors of My Demise Have Been Greatly Exaggerated

Something I often find myself reminding my family is "You can't do everything."

I've been reminded by readers of this blog that it's been awhile since I've posted anything.  It's not that I don't have something to say -- quite the opposite actually -- it's just that you can't do everything and one of the things that I don't seem to find the time for is writing new content here.

The good news is that I'm still alive.  Doing reasonably well with managing my diabetes.  Glucose readings still average in the mid- to upper-70s or low-80s.  Something I do make sure I have time for is daily exercise, which further keeps levels in check.  I went to an urgent care earlier this year for an ear infection and the nurse practitioner said that my A1C was lower than hers -- and she's not diabetic.

Unfortunately, some of my diabetic complications have continued to prove problematic despite the tight control.  Over the past 6 months or so, I've had to endure a couple of injections in my left eye to stop the proliferation of retinopathy.  I've also stopped the baby aspirin regimen that my endo put me on because it didn't seem to make sense that I'd be using a blood-thinning agent when I've got a bleed in my eye.  My vision had decreased to about 20/80 in my left eye but the injections and a course of prescription eye drops has helped regain some of that lost acuity and I'm back to about 20/25 vision. 

While it's easy to blame lack of time for lack of postings, the other reason why I don't put more stuff up here is that I wasn't sure that anything I had to say really resonated with the Type II diabetic community as a whole.  I've mentioned before about not easily fitting in as a "typical" diabetic and I've grown disenfranchised with visiting online communities that offer support and advice.  Frankly, I got tired of hearing about how "we" diabetics can or can't eat certain things or process carbs in certain ways.  The experiences of many of those proffering advice were not my experiences.  And, as such, I wasn't sure that anything I had to share here would apply to anyone but me.

Is it inspirational to read about someone who is able to pull a 5.3 A1C with diet and exercise alone or is it frustrating to be on multiple medications, eat nearly no carbs, still have higher than normal glucose levels and read about that guy?  If I tell people how I'm training to run an upcoming marathon, does it make them feel bad about their physical efforts if they can barely walk without pain and discomfort?  If I say that I enjoy breakfast of cereal and yogurt but they can't even look at a grain without a spike, am I reaching people in a positive way or making them wonder what's wrong with them?

I started this blog for me but I live with me in my head 24/7.  I don't need to write my thoughts, feelings and experiences as part of this blog to know how I'm doing.  I do so because I want someone who feels outside the norm to know that they are not alone.  I do so because maybe some of the tips and tricks I've learned over the past 3 years can help someone else.  I do so because I want to show that this disease doesn't have to win.

I'm much more than a diabetic.  I'm a father.  I'm a husband.  I'm an employee.  I'm a friend.  I've got interests outside of this disease that I don't always have time for.  I've spent a good amount of my free time over the past few months planning for a wonderful 2-week vacation that I just returned from.  So this blog has suffered.

Thanks to everyone who wrote and showed interest in my continuing story.  I can't promise that I'll always have the time to add new posts here but knowing that others are out there reading and gaining something from my words encourages me to continue making the effort.  I may not be able to do everything but I can some things.  And I'll do my best to ensure that one of those things is more frequent updates here.

Friday, October 18, 2013

Still Improving; Still Learning

I've never been somebody that one might call "normal."  I like my slightly off-center humor, interests and personality.  In fact, I celebrate being somewhat different.  I think being unique is fun,

But for the past 2 1/2 years, I've actually sought a "normal" life.  After finding out that my blood sugars were abnormally high, I've worked diligently to bring those numbers back to a normal range.  I certainly don't eat a normal American diet -- I'm much stricter -- and I don't have the normal American's activity level -- I'm much more active -- but my continued dedication to managing my diabetes has allowed me to achieve blood sugar numbers that would be considered normal for anyone without the disease.

I got my latest A1C results earlier this week and it was an improvement over my last test 8 months ago.  I'm at a 5.3 percent -- down from 5.5 at last measurement and the lowest I've pulled since the being diagnosed at an 11.3 percent.  I've maintained the lower numbers for the past 2 years with exercise and diet alone -- no diabetes medication.

In that regard, I've found that I'm not what one would consider a "normal" diabetic either.  I recently read that only 16 percent of Type 2 diabetics manage their disease with lifestyle changes alone.  I also got diabetes earlier than the typical Type 2 person and while at a lower BMI.  I don't seem to have the insulin resistance that many Type 2 experience.  I don't seem to suffer from dawn phenomenon or liver dumps.  I have complications of neuropathy and retinopathy that don't inflict other diabetics until much later and after a much longer apparent period of living with uncontrolled blood sugars.

I don't know whether this is different from most people, but there isn't a day that goes by that I don't think about what I'm eating or whether I'm getting in enough physical activity to continue pulling these numbers.  And I still worry every day whether the diligence will continue to pay off on my meter and on these A1C results.

I feel lucky to be where I'm at.  I don't often feel like I'm doing without.  I've cut way back on the quantity and variety of carbs that I eat but I don't consider myself to be on a low-carb diet by any means.  I eat much more in a day than I read from others on diabetic discussion boards.  I consider what I do as eating a carb-conscious diet.  And I'm lucky to be in otherwise good health and young enough to do the amount of physicality that I do.  I recently completed a half marathon; something I wouldn't have even thought possible before my diagnosis.

While I'm proud of this latest A1C result, there's still room for improvement.  I could be stricter with my diet.  I could exercise with more intensity.  But overall I'm pretty happy with my effort.  We'll see what the future holds.  I'm happy to keep learning what works for me.  Hopefully, with that knowledge, I can keep on improving.  I understand that I'll never be able to achieve normal numbers by living a normal lifestyle but I'm OK with that.  I like being a little less than normal anyway.

Tuesday, August 20, 2013

Here We Go Again

The doctors' appointments have started anew and we're off on some more diabetic adventures.

First up was my annual visit to the neurologist.  This was the guy who discovered my diabetes after my primary said I didn't have it.  So, I'm thankful to him.  But he also did so only after performing a litany of tests that cost me a bunch of money.  I think it was a "throw everything at the wall and see what sticks" approach.  He's a nice guy, checks my feet for sensation and my hands for weakness.  Usually tells me how great I'm doing and to see him again in a year.

Only this time, after proclaiming me doing OK and to come back in a year, I opened my big mouth.  It was a simple question, I thought, but I made the mistake of asking it to the guy who likes to perform tests.  "Is it unusual for the issues I experience with my neuropathy and retinopathy to be asymmetrical," I asked.  I reiterated that the sensations are much more noticeable in my left foot and hand and that my left eye has moderate issues while my right eye has mild.  From what I've read, most diabetics seem to have similar issues on both sides at the same time.

He looked at me somewhat stunned and said that he didn't realize that it was as severe a distinction as I made it and said that I seem pretty in-tuned with my body.  " I think you should get an MRI of your brain," he said.  "Um, OK, I guess?" I answered.  I mean this guy should know, right?

A few days later, I found myself lying on my back inside a small tube while they scanned my head for nearly half an hour.  My wife was worried sick, literally.  I tried to reassure her that it was nothing; that this guy just likes to do tests.  But she still worried.  My mom would worry, too.  She wanted to know why I was getting an MRI and I played coy.  She said that if I didn't tell her, she'd think the worst.  I asked what the worst was and she replied, "Brain cancer."  All because of a little MRI.  I reassured each of them that it was nothing, which I felt it was.  The only other issue I could have seen it being was MS but I really didn't think that was the case.

Anyway, long story short, the neurologist's office called back a few days later and said that my brain looked normal (I'd beg to differ with that -- Normal!  Hmph!) and to come in and see him in six months.  Why not a year?  I don't know.  And though the insurance agreed that the procedure was "medically necessary," who knows what it's going to cost me?

Next up was a visit to the retina specialist.  My optometrist had grown concerned about changes in my vision during my last annual eye exam in June even though, again, I didn't think there was anything to worry about.  Yes, my vision had seemed to regress a bit but I hadn't noticed much of a change from the year before.  But my optometrist was concerned that there might be an issue with the retina despite photographs that looked much, much better than when I was first diagnosed.

I communicated the concerns to the retinopathist, who said that he understood why the optometrist might be concerned even though my visual acuity hadn't seemed to worsen since I last saw him.  But the bleeds in my left eye were just poorly located -- in the center of my retina -- which is causing the distortion and blurriness.  I've already undergone a laser procedure to try to burn the hemorrhages but he said that he can't shoot into the center of the retina without risking my total vision.  I told him I'm not naive enough to think that I'll regain the vision that I've lost but I'd like to keep what I've got.   He said that I should be able to and thought perhaps steroid eye drops might help. 

Strangely enough, my pharmacy called to say that they were out of one of the drops prescribed,  which surprised me because I thought I only had to do one drop.  When they got it in, I found that the steroid cost me a $5 co-pay, which was fine, but the "other" was a $50 co-pay.  Ouch!  I'd also notice that it is only a two-week supply rather than for a month like the other.  Double ouch!  I'm not sure I can afford to use this long term.  So now do I root for it to work or fail?  Failure might mean that I wouldn't need it anymore while success might indicate that I need to continue with this line of treatment.  It's always something.

Anyway, I go back to see him in three months.  In the meantime, I'll have visited my endocrinologist for an 8-month checkup of all my vital blood work.  Hopefully, that will go as usual and I'll be close to no longer needing to visit him.

So, here we go again with the diabetes craziness.  It's been 2 1/2 years and things look as bright and as bleak as ever.  I think the lesson I've learned with these last couple of doctors' visits is to keep my mouth shut and not ask questions.  I desperately want to have answers about the "whys" of my disease but the best my doctors can do is guess and test.  I'm sick of the tests at this point.  I'm doing everything in my power to keep my glucose levels under control and I'm succeeding.  Despite hearing that I'll regain this function or that sensation, I've stopped believing it.  This is as good as it gets and I'm OK with that.  I don't need more tests to validate or invalidate this simple fact.  If it were to improve, I think it would have by now.  If it progresses, there might not be much that I can do about it.  Like I told my loved ones, there's nothing to worry about.  I was right then and I'm right now.

Tuesday, May 28, 2013

Back to Basics

When I started this blog a couple of years ago, it was meant to be a place where my sarcastic side could come out to play.  A place where I could bitch and moan about being diabetic.  A place where I can share all the horror stories I was experiencing with the diagnosis and treatment of my disease.

Somewhere along the way, I came to accept my fate, made the adjustments necessary to not only control my blood sugar physically but the way I approached diabetes mentally as well.  This site became a bit more mellow than I had expected.  I seemed to be sharing many more successes than failures.  And I found myself only wanting to post words of encouragement and support rather than bringing up "the bad stuff."

While that's a nice approach, sometimes I find myself with little to say that way.  Actually, that's not entirely true.  I usually have plenty to say but perhaps not the time, opportunity or wherewithal to do it.  The seemingly radio-silence in the frequency of my posting does not actually equal my lack of things to say.

All of this is a prelude to explaining why there is such infrequent posting.  The truth is that I've found myself scuffling (again) as of late and chose not to share it here for fear that my woe-is-me feelings might bring readers down.  I want to project strength and positivity because I believe there's more power in these than expressing the glumness and feelings that things are only going to get worse.  In reality, there's two sides to the coin and I have to show them both from time to time.

I have been overwhelmed by life lately.  Work is busy.  My health seems to be deteriorating.  Issues at home have been stressful.  And I haven't been coping with any of it very well.  To compensate (or to commiserate), I've found myself getting away from the very things that have led to my success, practically inviting failure to rear its ugly head.

I've found myself binge eating at times.  Sometimes, it is from feelings of extreme hunger that I can't seem to satisfy.  Sometimes, I do it because eating, especially "forbidden" things, makes me feel good.  Sometimes, I do it because I don't know how else to cope.  The good news is that despite my errant ways, my glucose levels have remained under really good control.  The bad news is that I've found other pillars of my wellness plan going to pot.

While I still monitor my blood sugar three times a week at random times on my official meter and whenever I feel I might be off with my unofficial meter, I hadn't been monitoring my weight on a daily basis like I had.  I hadn't been monitoring my blood pressure multiple times per week like I had.

I realized that I hadn't been feeling as ill lately, which should be a good thing, and thought I should check my blood pressure.  It was a bit high.  Stress, lack of sleep, poor eating habits.  My annual visit to the optometrist found that my vision has decreased again and he suggested that I get in to the retina specialist to check for bleeding or swelling.  Since blood pressure can affect my retinopathy as much as high glucose, running high numbers maybe making my vision worse.

I was also surprised to find that I had gained 10 pounds in a week, which was on top of an extra 2 that I had previously been carrying.  While still not fat, I just felt sluggish.  I didn't feel as toned and tight as I'd like.  I'd let myself go.

So, I've gotten back to basics.  Went back to the program that afforded me so much success in the first place.  I stopped the binge eating by not allowing myself to get started with foods that I shouldn't be eating or high-calorie snacks in between meals.  I'm weighing myself every day again and have lost the extra 12 pounds that I had picked up.  I'm checking my blood pressure more often, and while it isn't as low as it had been, it is better than some of the highs I seemed to be experiencing.  I'm sure that the exercise I'm doing and the attempts to accept the stresses in my life better have helped.

I'm equal parts angry at the world and happy with my place in it.  I'm both mad at my complications and happy that I'm doing so well to manage them.  I'm confused at why my issues seem to be so overwhelming at the same time that I'm understanding of the fact that I could have it much, much worse.

I don't have all the answers about diabetes.  I don't know if what works for me will work for others.  But I feel better sharing where I'm at in case anyone else out there is struggling like I sometimes do.  Life has its ups and downs but I've learned that I'm the one responsible for making sure I don't go so high or low with it.  I know what I need to do when things go sidewards.  Getting back to basics will make sure that I stay right where I need to be.