You are not special. – Tyler Durden, Fight Club

They tried to make me go to rehab, and I said no, no, .no. – Amy Winehouse

Before I disclose the following, I want to say at the outset that these new developments in my health picture only strengthen my resolve to continue the path of weight loss and exercise, with increasing effort.

OK, now here’s the bad news.

It appears from further testing, that I am officially a TYPE II Diabetic, not just pre-diabetic.

I have reached that conclusion by successive fasting blood glucose tests. The one from my life insurance exam (Dec 30) was 123, which was just under the diagnosis level of 125. Friday February 5, I had one done in a medical laboratory, and it was 142. A home monitoring kit has shown daily first readings (after at least 8 hours fasting) of 136, 136 and 112)

I’ve been monitoring it several times a day for 3 days now, to get a handle on fluctuations. It’s never below 100, and it hasn’t gone above 200. The worst spikes were 186 after finishing a chalice of wine at church (the wine we use would send most people into a coma with more than a few ounces), and 175 following our superbowl party, where I threw caution to the wind to see where the register would end up.

I told Meghan this, and people reading this may react the same as she did, and I understand if you do. But as ridiculous as this may sound, I would rather announce to the world that I was an alcoholic and needed to go to rehab. I’m that embarrassed and angry about this. I am ashamed. This is something I have dreaded for years, yet I followed on a course that inevitably would lead to it. It has been completely avoidable. And I ran right into it. So that’s why I would rather people think me an alcoholic. We’re aware of that addiction in society and react to it in a way that is sympathetic. Good for you for admitting it – get to rehab. In my case, what more is there to say than “way to go fatass, what did you expect? Join the millions of other over-priviledged over-fed idiot Americans who frankly deserve it!”

Ugly words? Sure. But warranted. It is the height of hypocrisy to stand in front of people at church and ask for donations to the World Hunger Appeal, meanwhile treating food not like a precious resource, but an amusement, and eating myself into illness. I absolutely had it coming. Without admitting that, I couldn’t be honest. I didn’t catch this like cholera, and it’s not some mystery disease that just showed up. I earned it.

Ugly truth #2 from Friday……

I also had another DEXA scan Friday. I am enrolled as a participant in a study from Marywood University, measuring the effectiveness of a resveratrol supplement. It lasts 4 weeks. I’ll have this bloodwork, scan, cognitive test, and artery stress test again on March 4th. I had a DEXA in October of 2007. At the time, I was 300 pounds. At the time of this one, I was 273.5. So that should be a pretty big improvement on the body composition picture, right?

Wrong. As it turns out, while the scale has moved 27.5 pounds, only 16 pounds of that was body fat. The other 9.5 pounds lost was LEAN MASS. This is tragic in its own right. This is throwing out the baby with the bathwater. This is your garbageman stoppping at your house to pick up 3 bags, then coming inside and packing up 2 bags of your valuables and taking that too.

This is unacceptable. What it means, is that running and swimming are all fine and good, but without strength training, I will continue to lose the only support system I have for getting through life in a new healthful direction. I add in weight training tonight. It is almost impossible to simultaneously lose fat and gain muscle, except for the extremely overweight. Hey that’s me! Even so, my best hope over the next several months is to do enough strength training to simply maintain the lean mass that I have, and not lose more, while burning fat. That alone is going to be difficult work. In 4 weeks at my next scan, if I have 2 grams more lean weight than I do now, I will be thrilled.

OK, so with that off my chest, the question is “now what?”

I’ve been resisting the obvious, which is “see a doctor.” I have two reasons to resist that. #1, the truth… I’m too convinced I know everything I need to know, and a doctor isn’t going to tell me anything new. This is maybe 80% reality, 20% my own fantasy. But reason #2 is that living in Central PA, there is such a low expectation of health, and such a high occurrence of Type II diabetes, that to most physicians, frankly, this is no big deal. If I were at the family practice next door, and someone like me came in to talk about this, I would sigh and have no expectations that this person would be capable of any serious change. Also, I have a previous experience that has made me skeptical of the level of expectations among the medical personnel of Central PA. *see anecdote at end of post

However, the reality is that I am determined to reverse the effects of this with significant exercise and weight loss, and I will do it in under 2 years, possibly 1. But as much as I know that myself, how can I expect the docs around here to take that seriously? All they see is an endless stream of messed up, miserable, sickly, fat people. I make this cruel assessment by observing the parking lot next to my house. Aside from the drug dealers who are 20% or more of the door traffic, that’s what I see. It’s what I saw at the podiatrist and the orthopaedist in December.

This is a mental block I am trying to get over. On one hand, it is good to feel the inner athlete fighting at this, saying it’s not inevitable, and crying out to the world that this fat shell IS NOT THE REAL ME! That’s how I stay motivated. But at the same time, reality check: this is me. This is me right now. And trying to avoid all the shame and embarrassment won’t change the glucose levels in my blood.

So, at this point, I am spiritually, emotionally and intellectually feeling like the biggest idiot ever. It’s been my typical response to this situation to become more defensive, more insulated by my own justifications and smug know-it-all attitude, and say “I’ll figure this out on my own. I know what to do.”

As Dr. Phil would say…. “how’s that been working out for you?”

So now I am forced to admit, I need to see a doctor. But I’m not just going to go next door where I’ve been underwhelmed by their standard of care. I am going to try and get an appointment with an endocrinologist. If I can’t get an insured visit without a referral, fine, I’ll pay out of pocket. And maybe along the way I will visit my “regular doctor” (which just means the place with my records) to get a legitimate referral.

So the roller coaster ride gets bumpier. The more I make the effort to really learn about my whole health picture, the worse it looks. If I wanted to be stupid about it, I’d take the attitude of a lot of people I’ve met who would rather just die of cancer than ever be told they had it, and try to treat it. I could say “no more testing! No need to find out bad news.” – No, if things are really going to be different now, it means putting aside my pride, accepting humility, and admitting there may be more than I thought. Maybe this is finally my rock-bottom, and I can let go and accept help.


* – Here’s the anecdote of why I have my own low expectations of doctors’ expectations. A couple years ago, maybe not even that long ago, a local eye center had a free screening for diabetes. I went in. I learned that by looking at the back of a person’s eye, the health of the blood vessels are an excellent indicator of diabetes. My screening went well, and my eye looked great. The staff seemed puzzled as to why I thought I was at risk, with no indicators. I said “I’m over 35 and extremely obese. Do I need more to make me worry?” They all seemed genuinely surprised. This was one incident, but it feeds into my assumption that we’re so fat and sick in Central PA that expectations are extremely low.


One thought on “Coming to Terms with Some More Serious News

  1. Hey Andy! I haven’t commented on your earlier posts, but I’ve been reading them actively. I know this must feel like an emotional wound. You’re one of the bravest and smartest people I know. Brave, because you’re facing things head on, and smart because you are taking charge of your own health. There are so many terrible doctors out there, but I know you’ll find one who sees the big picture and will brag about his/her amazing patient to colleagues. You’re awesome and I’m proud of you!

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