George

Around the end of October 2001 I was scheduled to go into the hospital for surgery. The day before the surgery I was scheduled for a pre-op physical with both the surgeon and the anesthesiologist. I completed the physical and went home to spend what turned out to be a sleepless night thinking of the planned surgery.

Next morning, bright and early, my guardian angel took me to the hospital. As I sat in the surgical prep room a nurse came in and told me the surgery had been canceled. Seems the blood test I took showed a high level of glucose in my system indicating that I might be diabetic. The hospital scheduled me for Diabetes Education classes, for which I will be eternally grateful. I learned more about the human body and it's quirks in the month since then than I have learned in my entire life. I learned about the pancreas, insulin, neuropathy, nephropathy, retinopathy, blood glucose testing, and the complications of diabetes if blood glucose levels are not maintained in the normal range. I feel that I learned the "How" I'm going to die even if I don't know the "When."

Some of the things I learned I would like to throw out there for anyone to see, to show how my doctor and I missed the obvious symptoms of diabetes.

I retired about a year and a half ago and quit smoking at the same time. My guardian angel still works, so I kinda picked up the role of chief cook and bottle washer around here and the added chore of baby-sitting my dawg Lucia. I, of course, started spending a lot of time on the computer and that added to my yet undiscovered problem.

Around a year ago I noticed a burning sensation in my feet with stinging such as you get when your foot falls asleep. I attributed it to sitting on my butt so much so I'd get up and play fetch with Lucia, my Siberian Husky. I also had a physical around that time and told my doctor about the sensation in my feet. He checked my blood sugar and it was normal. Now, I have learned that the normal range of a person's blood glucose level is 80-120mg/dl (4.4-6.7mmol/L).

Mine at the pre-op was 382mg/dl (21.2mmol/L). They scheduled me for a fasting blood glucose test for the next morning which I took and it was 352mg/dl (19.5mmol/L). Down some, but not nearly enough. It was determined that I had Type 2 Diabetes. This condition, I've since learned, has several factors that contribute to the cause. Age, weight, physical activity, or the lack of it, are among the things that contribute to the condition getting a foot hold in a person's system. The three things that cause your blood sugar level to rise as I learned in the education classes are:

• Carbohydrates
• Protein
• Fat

All three of these turn into glucose (sugar) in your blood after eating them. With Carbohydrates being the main culprit by 100% of any carbohydrate you eat turning into glucose within two hours of eating them. Only about 80% of Protein turns into glucose and it takes about two hours longer to peak out in your system. Fat is a non factor because only a small percentage of fat turns into glucose over a much longer period of time (8 hours according to the textbooks I have obtained). So, Carbohydrates are the main culprit and bears watching continuously.

My doctor gave me a blood glucose test meter (Accu-chek Advantage) so that I could test my blood glucose level and a little booklet to maintain a record of the results of the tests. Since then I have also downloaded some free software to generate reports for my doctor. I test my blood glucose level when I awake in the morning, then two hours after eating breakfast. I test again before I eat lunch, then two hours after I finish lunch. I test again before dinner and one more time two hours after dinner. Then one more test before bed time. The test consists of using a tool called a Lancet, which is a sharp little mother that is loaded into a spring-loaded thing that looks like a fat ballpoint pen. A pack of little "testing strips" come with the meter and when you run out, the little mothers are the expensive part of the operation. You hold the fat pen against the side of your finger tip, or the back of your finger and press the button on it. "Zap" sometimes I feel a little sting and at other times I don't. After squeezing the crap out of my fingertip a tiny drop of blood oozes out and I slide the strip into the drop of blood on a little spot for it and the meter "beeps" letting you know it has recognized the blood. Then you wait for 45 seconds while it hums and whirls then pops up a number that you hope with all your heart is between 80-120mg/dl (4.4-6.7mmol/L).

It took about 10 days for my numbers to start dropping toward normal as I learned from trial-and-error how what I ate affected my blood glucose levels. Glucose is used as fuel (energy) for your muscles and body by entering the cells in your body. Glucose needs a key to open the door to the cells and Insulin is that key that allows the glucose to enter the cell. In Type 1 Diabetics no insulin is produced at all by the pancreas, so must be injected. Type 2 folks have insulin, but for whatever reason it is sitting down on the job and not allowing the glucose to enter the cells.

Several interesting things start to happen to a person's body because glucose is not entering cells. The glucose starts to build up in the body causing havoc to every part of the human body it touches. The first thing that happens, and it happened to me last summer like a sledgehammer. You get thirsty, I mean double-D thirsty. The body is dehydrating because of the sugar and it begins to give you a dry mouth, and an unquenchable thirst. I was drinking 10 Cherry Cokes a day and ice water so fast that the fridge could not make ice cubes quick enough for me. I drank, and drank, and drank without quenching that thirst one iota. Now, all this fluid has to go somewhere, so it is trip-after-trip every 20 minutes to the bathroom to get rid of all this fluids you drink to quench the unquenchable. That's how Diabetes got it's name.

Back in the Roman and Greek days they were aware of Diabetes but being in the dark ages someone found a way to test for Diabetes and this was to taste the urine of a person suspected of having the disease. In Italian, sweetness is translated as "Millitus". In the meantime, the Greeks recognized the connection between the great, unquenchable thirst and the frequent trips to the bathroom. Someone decided that the disease was like a "siphon" and "siphon" translated into Greek is, you guessed it, "Diabetes" thereby giving the disease it's present name of "Diabetes Millitus."

The glucose that can not enter the cells starts doing it's damage to any part of the body it can reach, and that is just about the whole shebang. It attacks the sheathing that covers the nerves interfering with the signals sent through those nerves to the brain. The glucose coats those sheaths and there are enzymes released in the body to gobble up those glucose buzzards. Trouble is those enzymes don't know when to stop munching after eating the glucose and continue right on eating through the sheath of the nerve. Sorta good news here though. If a person keeps their blood glucose levels in the normal range, those nerves can regenerate themselves. I notice now that my numbers are under control and in the normal zone, the burning sensation and the stinging in my toes have decreased. Sometimes it comes back and bothers me, but not as bad as it has been in the past. The damage to those nerve sheaths was given the name Neuropathy, one of those buzz words I mentioned earlier.

The next thing I noticed and this little problem cost me some $350. In January 2001 I had to get new glasses as I lost the only remaining pair I had. For $575 I had my eyes examined and two pair of glasses made with what I thought were snazzy frames. Within four months I could not see out of these new glasses because everything was blurry. When I got them in January they were perfect and I could see better with them than I could in years past. But by May I could not use the damn things. I bounced along until September finally giving in to the necessity of having to see things. I went back to the eye doctor and told him that those glasses he made for me were useless now. In my mind I was thinking this old geezer was probably a drunk and misread the eyecheck and made a bad prescription, forgetting that I could see perfectly with them in January. The poor old gent examined my eyes again and was shocked at the difference in the test from January and the one in September. He asked me if I had Diabetes and of course I told him hell no. He sold me two new pairs that I could see out of perfectly for two or three weeks then I could not see out of those either. Now I was convinced the old coot was a drunkard and didn't know what he was doing. Well, this is when a new word in entered my vocabulary, "Retinopathy." Seems when you have diabetes and are going to the bathroom every 20 minutes getting rid of all that fluid you've been guzzling your body is starving for that fluid. When it can't get that fluid in the normal way it starts pulling it in from all over and the eyes are one of the first to be drained of fluid by the body. When the eyes lose fluid, they change shape causing "Blurry vision.” Another problem left untreated could become something named "Retinopathy" another buzz word. With Retinopathy, glucose in your system damages blood vessels in the eye. The body starts making other blood vessels to replace the damaged ones. But, in doing this the vessels are placed through the Macula and begins to destroy “sight.” This requires a thorough eye examination twice a year, if possible. Some of this could be corrected by “laser” surgery I am told.

Well, if all that crap is not bad enough, the glucose starts meddling in your kidney function by clogging up the filter system that your kidneys perform and this kills a lot of diabetics. When the kidneys start to fail, brothers and sisters, it is dialysis time and renal failure time. The name for this? Another buzz word, "Nephropathy." So, even though there are more dangers lurking for diabetics, these three are the ones that do the most damage to the Diabetic.

• Neuropathy = Loss of sensation in extremities there by causing amputations if not examined very carefully for injuries or damage.
• Nephropathy = Kidney failure and eventual, well you get the picture.
• Retinophy = Blindness.

I then scheduled an eye examination. They gave me the most thorough eye examination I have ever had in my life. They poked, prodded, inserted two kinds of drops, they slid my head in a frame and almost stood me on my head. They looked, they studied, they hemmed and hawed. Finally, when the one examining me decided to call another doctor in the room to look at something in my left eye, I decided they were too serious and needed a little fun poked at them. After the second doctor, a female of about 27-30 years of age, repeated the same things as the first doctor, a young Asian male, I said to her that I had a question. In her most serious doctor voice she responded yes? I said to her, and folks this is the gospel truth I swear, "Doctor I need a second opinion to confirm what your fellow doctor here told me. She got a puzzled look on her face and said, 'Of course, what is the question?'" I got real serious and said to her "He told me that my optical nerve was connected to my sphincter muscle and that's why I had a crappy outlook on life, is it possible for you to confirm his diagnoses?" Well, folks, I wish you could have seen the look that came over her face. She thought it was a serious question and started to digest the question before it dawned on her that I was joking. The little Asian doctor was holding his stomach and doubled over with laughter and after a minute the femaled doctor cracked up in uncontrollable laughter. Believe it or not, neither one of them had ever heard that old joke it was completely new to them. They called all the other doctors, nurses, staff and technicians into the examining room for me to go through the whole rigmarole all over again. Can you believe it? Eye doctors and workers have never heard that joke before? They take life too serious I told them. Finally the examination was over and I had to drive home with my eyes dilated into the California sunset. What a trip! It tickles me how serious they were.

The female doctor told me that usually Retinopathy didn't start until 10 years after a patient is diagnosed as diabetic. I said, "Hell Doc, that is fantastic news" and, incredulously, she asked "why is that so fantastic?" I said, "Hell, no one in my whole family has lived past the age of 65 so I'm darn sure that I won't be around in 10 years for that crap to hit me!" She couldn't believe my attitude and that tickled the stuffing right outta me! Good news on the diabetes front though.

After learning I was diabetic I threw out all sugar and switched to Equal and diet Pepsi from cherry coke. Within a week I had my blood sugar level down to around 250mg/dl (13.9mmol/L) with a few spikes here and there. I have been testing about every 2 hours out of curiosity and keeping a diary of what I eat and my activity prior to and 2 hours after eating. Try as I may, I could not get much lower than 250 (13.8mmol/L) for the past week. Well, I finally got around to reading one of the diabetes education books the hospital gave me and in it I read that if you walk an hour after eating for a short time that it would decrease your blood glucose level. I know the nurse told me that in the diabetes education class, but it just went over my head. In the garage is a brand new treadmill that my Guardian Angel bought for me a couple Christmas's ago and it still had the big red bow on it that she had wrapped around it. She cleaned the dust off for me and I got on it and walked for close to 10 minutes before I gave out. When I was at UPS I walked on a treadmill 15 miles a day. This little 10-minute walk was exactly an hour after I had eaten and an hour before I tested my self. When I did test my self an hour later my blood sugar level was 150mg/dl (8.3mmol/L)! I couldn't believe it! Struggle for a week and hover around 250, then take a 10 minute walk on the treadmill and bam I'm down to 150. Well, I had Chicken Cachitori with a little Spagetti on the side for dinner, waited an hour then walked for about 5 minutes on the treadmill. Tested my self an hour later and bam, it was 159mg/dl (8.8mmol/L). So, my future is pretty set of getting to know that treadmill intimately, and working up to my max eventually.

Keeping your blood suger levels near normal is no guarantee that you will prevent complications from diabetes, but what is the alternative if you don’t maintain tight conterol? I found my trusty scales in the garage and dusted it off, then stepped on it for the first time in several years. I had lost 10 pounds in the two weeks since I discovered I was diabetic. The world looks bright again!