Wednesday, December 27, 2006


Here is my brand new prized possession. It was my Christmas present to myself, thanks to the generosity of my siblings. It will be my friend for the rest of my life. Or whichever wears out first. Every morning, I will test my blood after a night of fasting, assuming that my last meal was eaten early in the evening. Then, I will test it again, just before I retire for the night. I have been using my mother's kit for the last month and a half. Those test strips run a buck a piece, so that's been $2 a day. Fortunately, Medicare pays for it, but I could not justify continuously using hers. One day, she would have to run out and that wouldn't be a good thing. Plus, when I am up for taking a trip somewhere, I would still have to test myself wherever I am.

I have been keeping a log of my blood glucose levels for the last 2 weeks. This is something I will have to do for the rest of my life, too. On Glipizide, my numbers have come down, although not to normal levels. Last Friday, I began taking 400mg of
chromium picolinate (1)(2)(3)(4), an over the counter nutritional supplement. Since I began taking it, my numbers have come down, but I have no idea if it is strictly attributable to that. I will have to monitor my counts for a considerable length of time to make that determination and there is nothing scientific about it since my diet will vary from day to day. Anyone who considers it should talk to their physician first. Of course, I didn't, but I will when I go to my final visit at Shepherd's Hope clinic. Who knows, I may be told to stop taking it. In the meantime, life goes on and I have pretty much adjusted to my diabetes since the initial shock and denial has finally worn off.

Wednesday, December 20, 2006


I just got back from one of my walks. I cannot stress enough the importance of daily exercise. Diabetes is such a debilitating disease. It begins to consume you. God knows how long I've had it. Certainly, it’s been a lot longer than when it was officially diagnosed last week and there’s no test to determine when it stealthily crept into my life. There are many out there who have no clue what may be lurking under the surface.

This morning, my arms were tingly from my elbows to the tips of my pinkies, all along the lower part. From my knees to my toes, I go from numb to exaggerated bouts of the same thing. Today is no exception. I've felt that way all morning and when I walked, my legs felt like they were made of lead. Sometimes, my toes feel like someone hooked up jumper cables and turned the juice on in quick, stabbing pulses. Then, it goes away. There isn't a day that goes by when I don't feel achy and fatigued. Some days, I have no energy at all. Today, I actually feel better than usual in spite of the numbness. One way to explain the ache is to try to imagine someone taking a knife and scraping the meat off your bones. Perhaps, that description is a little too harsh and I never really feel that bad, but it gives you an idea. At times, my heart pumps so strongly, it feels like it is going to explode out of my body.

Since I began taking the medication, my sugar has slowly dropped. I keep waiting for a small miracle to happen, that I will gain my strength again. I'm sure I will. Little things bother me. Lids on jars that, in the past, were so easy to remove are proving more difficult. Frustrating little things that gnaw at your very fiber. Sugar levels that ran in the 200-400 range are now down to 100-170. 170 is still too high, but it is an improvement. Last night, it was 136. This morning, it was 154. The closer in margin, the better. Saturday night, it was 276 and I have no idea why. That morning, it was 160. I don't think I ate anything wrong. Other diabetics have told me that's one of the strange things about it, that there's no rhyme or reason why your numbers can vary so much. You can eat something one day and repeat it the next and your numbers can be strikingly different.

Every night now, I have to get up about a half dozen times to relieve myself. That's a symptom. Of course, I drink lots of water now. I have to. Life as a diabetic must take on a very regimented structure. I should strive to eat at the same times every day, in spite of the fact that I am always hungry and sometimes nauseous. I should consume the same amount of calories per meal, per day, too. Food groups must be balanced, such as protein at every meal, especially in the morning. Proper sleep is of the utmost importance. Getting up to pee every hour is exasperating and disturbs the natural rhythm of the mind and body.

I can't take aspirin or ibuprofen any more, on account of the Glipizide. One of the warnings is to not take any over-the-counter pain medications without talking to your doctor. Instead, I asked the pharmacist if I could take Tylenol. Yes, you can. I think they know more about drugs, anyway. I also told her what Dr. Chang said about Lisinopril not helping the kidneys. She asked me if he knew what he was talking about. She told me to finish taking it and to demand a refill when I go back again. I said I don't go back for another month and I only have a 2 week supply. Take it every other day, she said. I don't know, maybe Dr. Chang has been in practice too long. Everyone else at Shepherd's Hope has been great, but he was not kind to me. The doctors and nurses there, and most of the other staff donate one night per month from their regular jobs. I don't think pharmacists would contradict a doctor unless they are pretty adamant about it. I started taking it the next day. Soon, I will have a primary care physician. That person will keep close tabs on me and will more than likely set me up with an endocrinologist, who will make sure I am put on the proper path. All diabetics react differently. All need special care.

When I was dealt this hand, it took me a while to adjust to altering my "set in his ways" lifestyle. I always played by my rules. No one ever wants to think they will get permanently sick. Where did I go wrong in life? What could I have done differently? Believe me, those are dumb questions and there is no truth to them. What is true is that I am sitting across the table from diabetes. I will play my cards right. I will keep a close watch on my opponent. I may not always win, but I will never fold. I will not be intimidated. So it must be true with any disease or disability. It's the game of life you're playing and you never let the one sitting across from you get the upper hand.

Thursday, December 14, 2006


Tuesday night, I went to the clinic for my blood test results and an official diagnosis on the diabetes. Gulp. I was not looking forward to the inevitable bad news. I sat patiently in one of those "holding" rooms the nurse stuffs you in to wait for the doctor. Why does it seem to last for hours before their grand entrance?

"Hello. I am Dr. Chan." That was as friendly as he got. He had the bedside manner of a Gestapo agent. Oh well, perhaps his manner was correct, given the somber news he was about to tell me. He scanned over the report and circled the (Comprehensive Metabolic Panel w/EGFR) glucose number. It was 182. That is the fasting number and 65-99 is what to aim for. He went to the second page and circled the Hemoglobin A1C number. Less than 6 is ideal. Mine is 8.0.

"You are a diabetic." He proceeded to give me strong directives. "You can eat all the fruits and vegetables you want. Do not eat coconut. No butter. Only poly and mono-unsaturated oil. NO SUGAR! Eat more fish. Avoid shellfish. Shrimp. Lobster. Cut all fat off beef. No chicken skin. Drink lots of water."

"What about cheese?"

"Follow this order," he said sternly. "Zero, zero, zero. That means you only eat things with 0% saturated fat, 0% trans fat and 0% cholesterol. Two egg yolks a week only. EXERCISE, EXERCISE, EXERCISE!!! You must eat 3 meals a day. You may have small snack in between." Protein is essential at each meal.

"What about salt?" I never put salt on anything, anyway.

"You don't worry about salt. Why you take Lisinopril?" Lisinopril is a BP med, an ACE inhibitor. "You don't need."

"Kelly, the Physician's Assistant wrote me the prescription two weeks ago when I was here. She told me it was to protect my kidneys from damage. She..."

"It does not help your kidneys. You don't need it."

"What should I do? Should I finish or stop taking it?"

"I don't care. You do what you want."

"But... but?"

"I don't care. You do what you want."

"She also told me I will have to go on a cholesterol drug."

"You may. We see when you come back. OK. Sit on table." He listened to my chest and heart. "We do another blood test. You wait here for nurse." And off he went. She came in a few minutes later and asked how things went.

"Well, he certainly laid it on the line. No messing around with Dr. Chan."

"Nope." She handed me the diagnostic test request for lipids and glucose. Oh, I have to pee when I go. He wants that, too. She gave me a prescription for Glucotrol. Typical doctor handwriting. I have no clue how pharmacists decipher that chicken scratch. Minus the skin, of course. I went across the hall to make an appointment a month from now for those results. It will be up to me to schedule the lab work. They only need a 24-48 hour turnover time. That will be my final visit to this clinic. I will need to find another doctor. For the rest of my life, I will need to take this medicine (or, eventually, insulin), test my sugar twice daily and have the A1C test done every 3 months. The test strips run about a buck apiece. This is not going to be a cheap disease, especially without insurance.

My platelet count is down. The normal range is 140-400. Mine is 102. He wasn't too concerned about that. He talked about my cholesterol level. The ideal number is below 200. Mine is 213. HDL (the good kind) is 41. That's good. LDL (the bad stuff) is 134. Not good. It's supposed to be less than 130. My triglycerides are high. 190. Less than 150 is best. My bilirubin is high. That's got something to do with the liver. Other than that, I checked out pretty good.

Last week, I was IMing with by best and oldest friend. He said it was from all those beers and pizza. Cheap women, too. I told him I haven't had a beer in a long time. Up until today, it was Bacardi & (DIET!) Coke. I typed in that it was from all those years working at the Weiner King, eating all those hot dogs, hamburgers and french fries. Who would think back then that all that junk would take its toll? How was I to know my mother and her sister would get it and be insulin-dependent? That's something we don't think about when we're young. We're going to live forever and never get old. I said it's also from all the trans fat that's in everything today, something food manufacturers have known will kill you for years.

This morning, I popped my first pill. I chose a generic brand because it's a lot cheaper. Glipizide ER 2.5mg. It is an anti-diabetic drug (sulfonylurea-type) used to control high blood sugar in patients with type 2 diabetes. It's meant to stimulate the release of natural insulin. With a proper diet and exercise, hopefully it will work. It's supposed to help prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (impotence). I'm waiting.

I would like to thank my family and friends for all the support they have given me. I also want to thank David W. Boles at Urban Semiotic and his dedicated legion of loyal readers and contributors, like Chris and Nicola. I especially want to thank fred for being such a caring person. He has helped me a lot by proffering some much needed advice. Many of the comments can be read here and here.

Monday, December 11, 2006

'Tis the Season to be...Treeless!

When all nine Christmas trees were removed from Sea-Tac International Airport instead of adding a giant Jewish menorah to the holiday display as Rabbi Elazar Bogomilsky requested, he said, "Everyone should have their spirit of the holiday. For many people the trees are the spirit of the holidays, and adding a menorah adds light to the season." Bogomilsky works in Seattle at the regional headquarters for Chabad Lubavitch, a Jewish education foundation. After consulting with lawyers, the port authority staff believed that including the menorah would have required adding symbols for other religions and cultures indicative of the Northwest. The holiday season is the busiest time at the airport, airport spokeswoman Terri-Ann Betancourt stated, and the staff just didn't have time to play cultural anthropologists. Besides, Bogomilsky had hired a lawyer and threatened to sue.

Let's start with a brief history of the Christmas (or holiday) tree. In the northern hemisphere, the shortest day and longest night of the year falls around December 21. Many ancient people believed that the sun was a god and after that date, this god was going to make a remarkable recovery from being sick and weak and would bring forth fresh flora and vegetation. Evergreen boughs were used to celebrate the return of summer, since that was all that remained green at that time of year. Early Egyptians filled their homes with green palm rushes to symbolize the triumph of life over death. Romans marked the solstice with a feast called Saturnalia to honor Saturn, the god of agriculture, and decorated their homes and temples with evergreen boughs. So did the ancient Druids and Vikings.

Nowhere in the New Testament is there a reference of a tree to honor the birth of Christ. As a matter of fact, Germany is credited as being the first to start a Christmas tree tradition in the 16th century when devout Christians brought decorated trees into their homes. Early German settlers in Pennsylvania brought this custom with them, which most colonists found to be an oddity. Pilgrims abhorred it and banned them in 1659 Massachusetts, along with carols and any other form of "paganism". All worship could only be done in churches. Period. That continued into the 19th century, but too many German and Irish immigrants undermined the Puritans' decree and Christmas trees found their way into homes in America. In Europe, they had already been established.

The menorah, on the other hand, is sacred and one of the oldest symbols of the Jewish faith. It is a seven-branched candelabrum used in the Temple and represents the nation of Israel and its mission to be "a light unto the nations." (Isaiah 42:6). Did I mention the book of Isaiah is in the Old Testament? The Torah states that God revealed the design for the menorah to Moses.

I know many people of all religions and no religion at all who celebrate the season by putting up and decorating a tree. To some, it is no different than dressing up your house and handing out treats on Halloween. That's another story, by the way. There is nothing sacred about a Christmas tree. Christianity does not recognize it as a symbol of their faith. The menorah and Christmas tree have nothing in common. One stands for religion. The other does not. If you don't believe me, go ask Santa Claus. If you don't believe him, wait until spring rolls around and ask the Easter Bunny. Better yet, don't. I don't want to have to explain the history of some rabbit to a disgruntled cleric, expecting equal religious billing. Then, I'd also have to explain dyed and hard-boiled eggs and how they got their rise in early pagan spring rituals.

Monday, December 04, 2006


This is going to be a series of posts about my experiences with diabetes, at least, until I get it under control. It allows me to vent, but primarily, it is about educating people. There are millions out there who have Type II and don't know it. Hopefully, some will gain knowledge about themselves or someone they know and take the necessary steps to catch it before too much damage is done. Before you go on, please read my first post, titled I Never Liked Needles.

"Diabetes is not a disease!"

"Is it contagious?"

The first statement came arrogantly from a friend of mine who thinks I made it up. To him, I was probably trying to elicit sympathy from friends as I sipped on a Bacardi & Diet Coke, my new drink. I knew my days of bellying up to the bar with buddies were coming to an end. His statement was cynical, at best, and, quite obviously, he knows nothing about it. The second question was from an innocent bystander who stepped back upon my pronouncement. Yes - it is a disease and - no - it is not contagious. What I can tell you is that it is often hereditary. My mother has been diabetic for almost 20 years and takes insulin daily. Her older sister is, too. My father has onset. He takes an oral medication. I have researched it over the years because of my mother.

I have no health insurance. My mother tried to get me in to see her primary care physician for blood work and a proper diagnosis. She tried to make an appointment with her endocrinologist, who would not see me without a physician's referral. This was all going to be very expensive. To just peer through the door was going to cost me hundreds of dollars per office visit and a whole lot more for the blood tests. This is money I don't have readily available. I knew I had to do something. I went to a search engine and typed in these four words, "free medical clinics orlando" and came back with a very promising hit, Shepherd's Hope. I went to the website and called the number to explain my predicament. "Yes, we can help you," the woman at the other end told me. They only see those with no insurance.

I had been feeling rundown for some time, at about 93 percent, before that fateful morning I took my first glucose test. I showed many of the signs and symptoms, but was never willing to acknowledge why I was feeling so achy and fatigued. It's not unusual to have this state of denial. I lost 25 lbs in a 6 month period, but I had tried to lose weight anyway. For the next 2 weeks, I took this sugar test morning and night and ran anywhere from 200-370. Not good numbers, and it didn't take a doctor to figure out what my condition was. In the meantime, I've changed my diet and have started to exercise. Some days, I am too weak to. Today, I feel better. Soon, I will take a nice, brisk walk.

When I got to Shepherd's Hope, there were a handful of people waiting for it to open at 6PM. The staff are all volunteers there to help those who can't afford medical attention otherwise. Depending on location, the clinic may only be open one day a week. A woman came out and assigned us all numbers. Some had appointments. We were to write our names and what kind of problem we have. I put down diabetes. When my name was called, the first thing I was asked about was what made me think I had it. I explained. Then, I went into a private room and waited for a doctor. I guess most of the people who go to free clinics are there for the flu or other simple, treatable maladies. Diabetes? I'll bet I was the first one to do that. She knocked. "Come in," I said, "like, I was going to tell you to stay out?" She laughed.

We discussed everything about it. She asked me plenty of questions and I gave her plenty of answers. Do I feel numb here? Tingly there? I told her about the sharp pains I've been getting in my toes, a sign of neuropathy. Mostly, she talked of fatigue. She asked me, if I could, what I would pick my overall average blood sugar level to be during the period of my testing. I guessed around 225. The normal range is around 100 or below, give or take a few. I was well above that mark. She got her stethoscope out and listened to me. "Have you ever had pains here?" she asked, as she pointed to my chest. I had. She said nothing more.

"OK, I cannot tell you that you are, absolutely, diabetic. I am setting you up for some blood work and I can't properly say that until the results come in. I will say that we both know you are and I am going to start you right away on a blood pressure medication, not that it's too high right now, but borderline, yes. Diabetes will bring about all sorts of complications, such as strokes and heart attacks. This is to mostly protect your kidneys from damage. The previous generation of diabetics didn't get this and other drugs you're going to get. Once properly diagnosed, you will also go on cholesterol meds, on top of what your disease is treated with, and regardless of what your cholesterol level is." She wrote a prescription for Lisinopril, an ACE inhibitor. "We have [all donated] new drugs here I could prescribe free, but they are $100 a pop. If we run out, can you afford to stay on them?" No, I can't.

My mother has had a series of mini-strokes. Her kidneys are damaged. I asked her if she had taken any blood pressure meds when she was first diagnosed. She hadn't. This doctor (or Physician's Assistant) knows what she is talking about. I think you can call it preventive maintenance. She was very good, very caring and professional in appearance and demeanor. The next morning, I went to Quest Diagnostics where they drew lots of vials of blood for all kinds of tests, including A1C, which monitors sugar for the 2-3 previous months. I have an appointment with Shepherd's Hope on December 12 to find out the results. I will probably be given prescriptions then to get me on the right path. I will have to find a physician after that. The clinic is not there for continuous care. Right now, I'll take it one step at a time.

I have often read about the benefits of cinnamon in lowering blood sugar levels. My sister-in-law, Lindsay, bought me pills, along with dandelion root tea. So far, they haven't helped. I've always been a firm believer in alternative medicines, and I've been looking at other magic herbs, elixirs and anything else associated with "curing" diabetes. Online, I found out about the remarkable benefits of apple cider vinegar, which, at the same time, will eliminate warts. I read about chromium, the magic of bee pollen, how cranberries help and how just about every natural substance known to man will rid you of this dreadful disease. Cancer, too, probably. I wonder, if I switch to eating nothing but a combination of all of these wonderful things, will I be cured? I think, I'll stick with the conventional for now. Take that, Kevin Trudeau, you huckster, you.

This morning, my siblings told me the best Christmas present I could give them was no present at all, to take what I would have spent on them and apply it towards the medications I will need. They want to see me stick around for a long, long time. Their presents to me will be in the form of money, too. I protested to no avail, but they insisted.

Family, you gotta love them. I feel better already.

Please feel free to ask me any questions. If I don't know, I will do my best to find the answers.