4 months and counting…

In July, my weight fluctuated between 285 and 290. When you’re that heavy, five pounds is pretty much inconsequential. I was scheduled to have my annual physical and was not particularly concerned. I had been this weight for years and it hadn’t been an issue.  Sure, I had been diagnosed with diabetes a year earlier, but I was on medication. No prob. I could eat the same as before and let the meds do their job. Right? RIGHT?

Let me step back a little and explain what diabetes mellitus type two is. From Wikipedia:

Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. This is in contrast to diabetes mellitus type 1, in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas. The classic symptoms are excess thirst, frequent urination, and constant hunger. Type 2 diabetes makes up about 90% of cases of diabetes. Obesity is thought to be the primary cause of type 2 diabetes in people who are genetically predisposed to the disease. (emphasis mine)

The recommendation is for your blood sugars to be below 125 and your HgA1C to be below 7.

I last tested for it the previous year and my HgA1C was 9.2. I was ready to see how far it was down. The physical itself was uneventful, except for the fact that, turning 50, I now had to face tests and procedures that, heretofore, had not been necessary (don’t ask. It involves a camera and one’s ass). I waited eagerly for the results (okay, I wasn’t particularly eager, but as I mentioned earlier, unconcerned).

I got the call from my PMD and got the result.

9.1.

I was stunned. This couldn’t be. I took my meds religiously. My blood pressure was controlled well by meds, as was my cholesterol. Why hadn’t my diabetes? I researched some more and I talked to my doc some (one advantage to working at the same place as your doc is that you see them all the time and get free face-to-face time with them) and found out that DM type 2 has some pretty significant issues that manifest itself in many nasty ways. Such as:

• a ten-year-shorter life expectancy.
• two to four times the risk of cardiovascular disease
• a 20-fold increase in lower limb amputations (!!!)
• blindness
• kidney failure
• cognitive dysfunction and dementia
• increased infections
• sexual dysfunction
• frequent infections

Fuck.

Here I was, with two young kids, probably eating myself into a state where I would not see them marry and have children. I got scared. So I started talking to bariatric surgeons, since getting the surgery was the quickest way to resolve the issue. After much deliberation and constant talking with friends, and most importantly, my wife, I decided AGAINST the surgery.

Either path would have been difficult, but I chose the slow painful way over the fast painful way. I am still on this path and and have reconciled myself to being on this path the rest of my life. I made very small changes.

• I switched to a smaller plate at dinner
• I ate less rice
• I stopped eating fast food
• I brought lunch most days
• I started working out 10 minutes a day twice a week
• I went and signed up, not for a gym membership, but a personal trainer

Now, four months later, I have increased my workout regimen to 30 minutes of elliptical five days a week, 30 minute training sessions three days a week and Pilates one day a week. I have maintained the dietary changes I listed, but, unlike the surgery (which would have prevented me from eating some foods and beverages), I am able to have whatever within reason. I have a great time with my trainers and even though Pilates is hard as shit, I want to keep it going. I’m down to 242 and have given away all my larger sized clothes. I have no end point in mind, because there IS NO END POINT. I don’t have a target weight, I have a target number.

About four weeks ago, I re-tested my HgA1C.

6.2

Now excuse me while I work out.

March 2012 at Disney World

Summer 2012

Working out with my personal trainer

Before and now