Saturday, July 28, 2007

Diabetic Again

Feels like the first time; feels like the very first time.

I recently experienced a bit of a health scare -- I won't go into the gory details, but something happened one afternoon that sent me immediately to the doctor's office. I was diagnosed with a fairly simple and common infection, and given some antibiotics. Within three or four days, I not only felt fantastic, but I had managed to kick my major, major caffeine habit that I had fostered under many years of working in morning radio. The nurse practitioner that I saw told me that caffeine and alcohol would only aggravate my condition, and as it was pretty painful in the beginning, I didn't want to make it any worse. After the symptoms cleared up, it just seemed like a good idea to kick caffeine once and hopefully for all. So I have gone from drinking 4-8 cans of Diet Mountain Dew per day (the diet version because I am diabetic and sugared sodas are definitely not on the menu for me) to drinking nothing but water, lots of it, and about one bottle of Diet Green Tea (no sugar, no caffeine, plus hopefully some antioxidants) every day.

During my visit to the doctor's office, the subject of my diabetes came up, and here's where it gets complicated and hard to talk about for me. But I want this blog to be an honest discussion of whatever is on my mind. I'm writing this one for me, really, not for you. Although those of you that stick around, I am extremely grateful to you, and you might even learn something about the arrogance and denial that have fucked up my health a bit.

Where to start? Well, I was first diagnosed with Type 2 ("adult onset") diabetes on (you'll love this) Friday the 13th of November, 1998. I had been overwhelmed with fatigue and peeing every 30 minutes around the clock for weeks, so I knew something was wrong, but even with a family history of the disease (my mother was diabetic), I was ignorant and arrogant enough to actually hope, when I first went to see the doctor because of these symptoms, that maybe I was just suffering some sort of urinary tract infection.

I wasn't, of course. I found out that day that my blood sugar was 307, 300 percent of what a healthy person's reading would be. The news that I was diabetic hit me, at the grand old age of 32, like a brick to the skull. It was raining that day, and as I drove from the doctor's office to the supermarket, I remembering crying and feeling quite a bit like I had been handed a death sentence.

A lot of that emotion stemmed from the fact that I knew little to nothing about diabetes, despite my mother having had it (at this time she had been dead for four years, a victim of Alzheimer's and brain cancer). When I went to the store I bought healthier foods for the most part, but having yet not had any education about my disease at all, I also bought a big jug of orange juice. Mom had always had one in the fridge, and I realize now it was in case her blood sugar went too low. Orange juice has an enormous amount of sugar in it, so while it's good for reviving you if you're hypoglycemic (as in-control diabetics can sometimes become), for me, hyper-glycemic, it was not a very good thing to be drinking.

Luckily for me, within a week or two I had seen a nutritionist and done everything in my power (thank God for the internet, even in 1998) to learn as much as I could about diabetes. So I soon learned not to drink OJ unless it was medically necessary (and even then, it wouldn't take much to get your sugar back up to normal), and I began a radical diet program that consisted of -- amazing, for an American -- eating fewer calories than I was burning every day. This strict meal plan coupled with mild but committed exercise -- usually a half-hour or so walk every day -- allowed me to lose a mid-size child's worth of weight in less than a year, my blood sugar returned to low enough averages that my doctor cut the amount of diabetic medication I had to take every day, my eyesight improved, my libido returned to an 18-year-old's level, basically, life was incredibly good.

I didn't feel arrogant about it at first. For quite some time -- two or three years, I would say -- I felt extremely lucky. Blessed. I had been diagnosed with an incurable illness (I heard diabetes lumped with AIDS and cancer as incurable illnesses in a radio commercial one day, and it brought me to tears), and I had, through modern medicine and what seems to me now an enormous force of will, managed to bring my blood sugar levels basically to normal. All the complications of the disease -- blindness, amputations, heart disease, death -- seemed a lot further away than they did on that rainy day back in November of 1998.

But, as they do, things changed.

My job changed in late summer of 1999, and I think that's where it began. I had made my 30 minute walk a part of my daily routine at work, using my break time to keep myself healthy. When I switched jobs and started working at an all-news radio station in Albany, I now had to sit in a chair basically for seven or eight hours a day with no opportunity at all for exercise. I more or less stuck to my meal plan, but between the lack of opportunities for movement at work and the two-hour, 110 mile or so commute every day, I was just too exhausted by the end of the day to consider exercising at home.

That all-news radio job lasted about two years, then I decided to move on to a Public Radio station in 2001. The new job actually began a week and a day before the attacks of September 11th. The pay was out-of-this world compared to my Glens Falls radio days, or even the Albany job that immediately preceded it. I was a producer, editor and anchor, and also assignment editor for reporters ("bureau chiefs") over a wide swath of the northeastern United States. So I had mad cash, a lot of responsibility, felt like I was genuinely making a better world through my work in radio (a first in what was then about 15 years in broadcasting), and more or less thought I was on top of the world. As you might guess, I would trace the beginning of my arrogance to this period.

Because I had previously had such great control over my blood sugar, I went from 1998 and testing three or four times a day, to maybe once a day by 2000, and probably once a week or less by 2002 or so. I left the Public Radio station in late summer of 2004 under what I felt were less-than-ideal circumstances, and that's where I think the depression set in, depression that I experienced I would say from that time up until maybe the beginning of this year, 2007. So, for two or three years, beginning in August of 2004, I entered what was probably the darkest and most hopeless period of my life.

I took a new radio job in late April of 2005, a time that coincided almost to the day with the accident that destroyed my red car. And while the decision not to buy a new one was based as much on ideology as budget constraints, I have to say that the lack of freedom was yet another blow to my ego and sense of self. These days I am a lot more philosophical about being carless -- if not proud -- but when the accident happened, it was just more crap to deal with, at a time when I wasn't dealing well with all the crap that was already on my plate.

The new job was stressful at first -- there was a lot to wrap my brain around, because although I had been in radio 19 years at that point, I was now doing things and charged with responsibilities I had never experienced before. The learning curve was steep, but eventually I came to grips with it, and came to love it more than any radio job I have ever had. That was a big part of coming out of what I now realized was probably a pretty deep depression, and for most of 2007, I have felt pretty good about my family and my job, while more or less ignoring my diabetes.

I think it was a combination of arrogance stemming from how quickly and effectively I got it under control circa 1998, and the subsequent improvement I experienced in many areas of my health. And dealing with all the different things I did in radio from 1998 to 2007, I find that it was really easy to just forget the fact that I am diabetic. Any of my fellow diabetics may or may not be shocked when I tell you this, but I don't think I tested my blood sugar more than once or twice a year over the past two or three years.

Physically, I felt fine -- artificially propped up by all that caffeine in the Diet Mountain Dew I drank like water -- and I was actively avoiding my doctor, for a number of reasons. Primarily I assumed -- wrongly -- that my sugar was still under control. He had also been a huge fan of the Public Radio station I worked at, so I was a bit humbled by the fact that I no longer worked there. Also, his very pro-active (and very wise) approach to managing my diabetes was just not something I felt I could deal with during this time, late 2004 to early 2007. So, I went to ground, abandoned totally my monitoring of my disease, and as any diabetic will tell you, when it comes to monitoring your blood sugar, out of sight is out of mind.

When I went in to the doctor's office a few weeks back, that was the beginning of digging my way out of all this. Emotionally I feel much better than I have in years -- I don't think I'm suffering from clinical depression anymore -- and I've started monitoring my blood sugar multiple times daily. My highest fasting blood sugar has been 180, and the lowest, this morning, after a few days back on my proper meds and with some real adjustments to my diet, was 135. But I know I've probably done some damage to my body in the time I was out of touch with my diabetes, and I know I have a lot of work to do before I can start to feel that it's under my control again.

I will say that there could not have come a better time for Michael Moore's Sicko, about the abhorrent state of U.S. health care even for people with insurance. Just in the past three weeks, I have experienced some of the stupidity, contempt, bureaucracy and outright hostility the system here in Los Estados Unidos has for people with serious, life-threatening issues. I have been confronted with a lack of knowledge and thoughtfulness by people in a position to help me, that made me realize a meeker, or poorer person than myself might have just given up. Hell, maybe I would have, myself, if I was still in the depression I was in not that long ago.

There's a scorched-earth war on right now against the health and well-being of anyone in this country who needs health care but isn't spectacularly wealthy. Anyone who tells you different is either lying or incredibly naive. I really wonder how much longer I'll be able to afford to take care of myself and my family, even with both my wife and I working full-time jobs. But the lesson of the past few weeks, and of the past few years of my living in denial about a gravely serious disease I will have the rest of my life, has made me realize more than ever that if I don't take full command of my life and my health, no one else will.

The message I am getting is that here in the United States, our leaders and our health care system are staggeringly indifferent to the health and safety of the people. Of course, I need to watch out for my own health. Because it's crystal clear that no one else is going to do it, and in fact, the current system would prefer if we all just quietly suffer and die while politicians and pharmacological companies and anyone who profits from this clusterfuck of U.S. health care gets richer, and richer, and richer.

This is not a compassionate nation. In fact, health care is our national catastrophe, and we should all be ashamed. And we should all demand change, right fucking now. The billions we've wasted on the lie that is the Iraq war could have saved millions of lives. Lives not taken in the name of U.S. aggression, and lives of those receiving poor-to-no health care right here at home.

I'm not depressed anymore, I'm just pissed off. And determined to get myself better. This is a big change for me, and I hope you'll consider what you can and should change, yourself. If you're in denial about your health, or if you are in a position to effect or demand change in the way this country cares for its people -- all its people -- I hope you'll do so. If the people of this country can't watch out for each other, it's not a country worth saving. And right now we're all in grave danger, because of a corrupt and dysfunctional health care system. A good country is one that cares for and protects all its people before it wastes it resources elsewhere. This one has a lot of work to do to get where it should be, but luckily there are great examples -- Britain, Canada and France, for example -- of countries that get health care much more right than this one. What's needed is monumental change, which I fear will only be effected by monumental outrage. I'm starting to feel it. Are you?