The Inquirer has been running a monthly series by Ilene Raymond Rush on diabetes. It is all the rage these days. Tom Hanks announced in October, 2013, that he has type 2 diabetes. More locally my fellow blogger John Morgan (at the Pennsylvania Progressive) wrote in March, 2014 that he has it as well. All the cool kids are getting it.
Not to be outdone, I joined the club myself a little more than two years ago. The doctor had been telling me for some time that I needed to lose weight and that my blood sugar was on the high side of normal, but I thought there was time. Most of the people I know who lost significant amounts of weight or drastically changed the way they ate, did so after their children left home, and I expected and planned to do the same. Time ran out for me, though, and I went from pre-diabetes to full fledged type 2.
Diabetes is serious business and so I took it seriously. It was like fingernails across a chalkboard or a needle across a record (for those old enough to remember those sounds – for younger readers this refers to something that gets your attention). I immediately changed the way I ate. The medication I took to get my blood sugar under control made me nauseous, which helped with weight loss. In a little more than a year I lost 30 pounds (and have reliably kept 25 of it off). I was able to go off the medication and, although it has ticked up a bit recently, my blood sugar has stayed low enough that I can control the disease with diet and exercise. It has not been easy or fun. This is not that common and is impossible for some people, not through any fault of their own, but just due to physiology. As I get older it is likely that I will have to take medication again, and perhaps eventually insulin, but for now it is manageable without. I miss pizza, donuts, ice cream, bagels, sandwiches, dinner rolls, mango juice, hamburgers, brownies, candy bars, and the many other foods I no longer eat, but when self-discipline flags I google images of diabetic feet. This is grim viewing but an effective motivating force. How many toes is a bag of M&Ms worth? None.
I found the educational process confusing. After the initial diagnosis I was referred to a place that provides, among other things, training sessions for newly diagnosed diabetics. There was an individual consultation followed by four two hour group sessions. Insurance would only pay for four total sessions. I chose the individual consultation, where I learned to use, and was given, a blood sugar testing meter, and some nutritional basics, and three of the four group sessions, each of which focuses on a particular topic. They were very informative, though I think I could have learned just as much from canned videos. At the end of each session the instructor went over a quiz with us, having us work out the answers together before marking the test paper. Miraculously, we all got all the answers right! Some people prefer to learn in a group setting and these sessions would be very helpful for them. For those who prefer, or find just as acceptable, printed materials or a webinar, the same information could be done for considerably less money. I think the cost was something like $200 per hour for the sessions I attended.
It doesn’t make a lot of sense but losing weight for health reasons is different from losing weight for appearance reasons, even though the result is the same. For me, at least, it starts at either end – slender ankles, just one chin, bony knees and bony shoulders, clavicles, hipbones, and ribs. The middle part remains doughy. I had to buy smaller pants, and could tuck in my shirt. Then I had to buy even smaller pants. While people’s pants falling off is a staple of slapstick humor and home videos, holding onto one’s waistband with one hand and trying to carry groceries to the car with the other is not amusing in the least. I now wear the same size pants I did when I was 25, which is great, but not really my goal. Several friends, neighbors, and co-workers noticed my diminishing profile and made positive comments. A regular visitor to my workplace pulled me aside and asked why I was losing so much weight. I think he thought I was dying. All the concern and praise was nice but, to be honest, it just made me self-conscious. The number I thinking about wasn’t so much the scale but my a1c (blood sugar numbers). And, sad but true, no matter how thin, a body that is 50 odd years old, is not going to look like a body that is 25 or 35 or even 45. As my mother says “the baggage shifts.” So, while I no longer resemble the Sta-Puft marshmallow man, I’m never going to have the same figure I did as a young woman. I sort of look like one of those pasty snow peeps you see at Christmas. What was kind of annoying was that in the previous year I had cleaned out my closet and gave away most of the clothes I couldn’t fit into anymore, and had bought two winter coats, which were soon hanging on my thinner frame, and eventually just became unwearable. I don’t really enjoy shopping that much (my husband the household bookkeeper might disagree with this statement) so having to buy two new wardrobes in a year was not as enjoyable for me as it might be for other people.
What I came to be aware of during this process is that, like most things, having some disposable income makes life much easier. People on a strict budget can’t afford to buy new clothes, or premium test strips to check blood sugar, or fresh fruit and vegetables (or throw them out when they go bad before you can eat them), or prepare two meals so others in the household don’t have to follow your diet, and so on. Inexpensive food is usually not good for you. Fast food is pretty much out of the question.
I’ve had to change more than my eating patterns. Stress and sleep are also factors. I can’t stay up till all hours writing blog posts anymore. I have to juggle this health issue along with work, parenting teens, and all other aspects of life. To cut back on stress I stepped back from some community work – it was satisfying in some ways but at times aggravating. I put in a birdfeeder right outside my kitchen window and discovered that great refuge of the middle-aged, gardening. I enjoy my plants and my birdies. It is relaxing. I dusted off my sewing machine and quilting hoop. This, too, is relaxing. Travel, always one of my great pleasures is no longer as enjoyable. Eating on the road is tricky and enforced sitting is no longer my friend. I no longer try to group errands at home or work, as the extra trips going up and down stairs are good for me. Inefficiency is a positive. I pack my lunch most days to make sure I’m eating right, but that means I have another thing to carry on the train. I joined a gym. One or two days a week, weather permitting, I walk the last two miles of my morning commute. The scenery is beautiful. When I have a day full of meetings I look for ways to stretch my legs under the table; this is much easier when videoconferencing – no chance of accidentally kicking someone under the table. I keep a jump rope and a set of weights in the kitchen. Of course, even with all these measures I still do not exercise as much as I should. A gym membership does not equal regular workouts. A kitchen jump rope does not equal regular jumping sessions while dinner is in the oven.
So my life has changed permanently. I wish I had taken some of these steps before my blood sugar numbers tipped over the edge into diabetes, but I didn’t. For now things are going well. I’m off the medication and I still have all my toes. From time to time I might write about this again. It does explain, to a degree, why I’ve been blogging less often than in previous years. Hours sitting transcribing debates or looking at campaign finance reports aren’t that good for me. Nor is driving a few hours roundtrip to attend a political event featuring food I can’t eat. But now that I sort of have a handle on things I’m hoping to find a balance that will let me do at least some of these activities, at least some of the time. I enjoy them and I miss them. As my children get older my daily parenting duties will diminish (or so I am told) which will mean more time for personal hobbies. But, most importantly, I still have all my toes.