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Saturday, April 30, 2011

Celebrating An Anniversary

I have a terrible memory for birthdays and anniversaries. I usually have to use memory aids such as calendars and computers to remind me of them. But there is one I never forget. Today is the last Saturday in April. That is a day I need no reminders for.

On the last Saturday in April 2002, exactly nine years ago as I write this, I was having a lazy weekend morning in bed and the bedside phone rang.

A couple of months before that I had been tentatively diagnosed with CLL from a routine blood test showing a high white count. That led to lots of confirming blood tests and a bone marrow aspiration. Apparently they can be painless, but no-one seems to have told the haematologist that performed mine. He remained my haematologist until a couple of years later when he wanted to do another one to “check on progress”. That guy was never going to laboriously drill holes in in my “strong” bones ever again; I found another haematologist that was happy to state that I did not need one. Time has proved him right.

I spent that two months searching for something I could do about my CLL and finding I could do nothing at all but “Watch and Wait”. Wonderful. I was well into the depths of diagnosis depression.

So, when the phone rang my mood was hardly bright and cheerful. It was about to get worse.

Caller: "Hi Alan, this is Dr ............ 's reception here. The Doctor wants me to make an appointment for you for Tuesday."

Me: "That's fine. I presume it's to discuss the latest test results for the leukaemia?"

Caller: "No, it's about your diabetes."

Me: "......stunned silence......."

Caller: "Hullo - are you there?"

Me: "About what?"

Caller: "Your diabetes."

Me: “I don't have diabetes, are you sure you have the right person?”

Eventually she convinced me that she did.

I have learned to like and respect my doctor. He is the best doctor I have ever encountered. If not for his knowledge and expertise my CLL and diabetes might not have been diagnosed for another five or more years. Less competent doctors had missed some very obvious signs, such as fasting blood glucose levels of 7.9 mmol/L (140 mg/dL) for at least five years before that. He certainly gained my attention; if he had not made it clear that if I did not gain control of the diabetes I may not live long enough to worry about the cancer, I might not have maintained the discipline to achieve control. But at that time we did not really know each other and I was also unaware of the stress on that very overworked small village practice.

So I hope he won't mind me mentioning this. When I received that call he had left for the day. I'm pretty resourceful when I'm scared. I'm sure he didn't appreciate the call at his home a few hours later after I tracked down his number, but I'm also sure that phone advice by the receptionist of diagnosis of a major chronic condition has not happened often since.

Waiting for that Tuesday appointment was one of the worst weekends of my life. In hindsight, my ignorance of anything to do with type 2 diabetes and everything associated with it such as complications, diet, exercise and the myriad other things we need to know to take control of this condition was abysmal. Much of my fear and worry over that terrible weekend was caused by that ignorance.

I have made up for that ignorance since; see my story here: Turning Points

If a diabetes diagnosis seems an odd thing to celebrate, look at it from my different perspective. It has been a bit of a bumpy ride at times, but I reckon the simple fact of being here, moderately fit and well for a 64 year old, to write this nine years later without any diabetes complications at all is well worth celebrating.

I think I'll open one of the better bottles of Shiraz from the "cellar" in my back bedroom cupboard tonight.


Cheers, Alan
Everything in Moderation - Except Laughter.


igloo said...

Congratulation on beating the beast! I'm 20 months on from diagnosis (20 mmol/l) - thankfully the doctor was a little bit more restrained in breaking the news of the blood test - more a good news/bad news scenario - your prostate is fine, but your sugar....
With the loss of 34 kgs and a low carb diet I have reduced the medication to only 500 g metformin p.d. and this morning the reading was 5.4! Come to think about it, I'll join you in breaking a good bottle of red tonight! Cheers!

Alan said...

Nice to see you again igloo; especially when you report losing 34Kgs (that's 75lbs for US readers) and an A1c of 5.4%. That is bloody marvellous!

Thanks for joining the toast. I wish you could see me waving my glass of '07 Jacobs creek Shiraz Cabernet in your general direction *hic* :)

Cheers, Alan

Rosemarie said...

Alan, you said that your FBG had been 140 for at least 4 years before your official T2 diagnosis and now at 64 you have NO diabetes complications at all.
I am close to your age (68).

Your comments feed into a question I've had for a long time: Are the new guidelines (FBG under 100 and spikes no higher than 140) and the warning that even one excursion over 140 will damage your organs....overblown?

I’m asking because my FBG for the last ten years has been between 104 to 125 (average about 110). My endocronologist never said anything because the cut off line for FBG was 126. (My A1C ranged from 5.6-6.1 presently 5.8) I only started testing at home about 4 years ago when I became aware of the dangers of high blood sugar.

During the last 4 years of testing my FBG dipped below 100 only a handful of times using different food combinations, but I had frequent spikes up to 180 – sometimes 200.

On the positive side I have NEVER been hypglycemic which most doctors agree is much more damaging. If 140 damages your organs I should be in pretty bad shape – I’m not. (still doesn’t make me feel secure though).

Born and raised in Europe I was never a SAD eater but loved fruits/grains, some meat/chicken/fish/yogurt/cheese/nuts and lots of veggies raw and cooked – incl. legumes.

On the personal side, I’ve been slender all my life, quite active, lots of energy.
There is NO diabetes in my family – so finding this inability of mine to handle carbs came as quite a surprise to me. I’m slightly hypothyroid and started taking the lowest dose of synthroid a year ago.

An additional problem I have now is that eating to keep bloodsugar down poses a problem for me as I need to gain some weight and I just have trouble finding the right combination to do that. All the diet recommendations are targeting WEIGHT LOSS…..frustrating!!!

I know you have a lot of experience in this area and would love to hear your take on this.

Thanks for listening.

meg atieono said...

I can only imagine the shock.MY mum went through the same thing as she kept feeling dizzy ,having blurry vision.by the time she went to the hospital it was almost too late,but thank God she is learning how to manage her diabetes 3 years later

Alan said...

Sorry about the delay; I am travelling. This is written on my netbook in a hotel in Kuala Lumpur :)

There are no official guidelines as tight as that. They are guidelines I followed myself when I first started testing systematically but the official guidelines are far less stringent. The official ones are posted in "Blood Glucose Targets" (search on this blog) and I used Jennifer's "Test, test, test" (search for that too) as own my guide.

I do not believe the guidelines I follow are too strict; in fact I have tighter ones for post-prandial limits these days. I have learned to accept that my FBG will be a tad higher than 5.5(100) because of my dawn phenomenon, but it's not a lot higher.

They are guidelines, not absolute limits. I don't get stressed on the odd occasions, like right now while I am travelling, when I exceed them as long as those are odd occasions and not the norm. I do believe that each high excursion can cause damage but I also believe that damage can be healed by longer periods of good control. I have no scientific basis for that belief, just my experience.

The cutoff line for full diabetes is 126 but the cutoff for pre-diabetes, or impaired fasting glucose, is 100 and has been for some time. You should have been diagnosed with that after the second time your endo saw a result over 99. Pre-diabetes is a point on the continuum; it is still diabetes, just an earlier stage. Some people if diagnosed early enough, can prevent or delay further progression. Most don't.

Your past numbers confirm that you are pre-diabetic. If a doctor had also seen any spikes over 200 that would have been enough for a full diabetes diagnosis.

I think your lifestyle has been shielding you. I don't mean that in a negative way. Your active energetic life is a great way to help manage your diabetes and it is obviously working pretty well for you. Keep it up. But that is also a concern for the longer term. Let's face it, our 70s and 80s aren't that far away. How long can we keep up that energy and activity? Changing the food plan slightly as time goes on may be a way to compensate.

All those other diets cut fats. Fat is NOT your problem; carbs are. The only fats I avoid are partially hydrogenated oils or transfats. Apart from those I eat (in moderation) animal and vegetable fats and protein to my heart's content - literally.

ShottleBop said...

Congratulations on another anniversary!

Alan said...

Thanks Shottlebop :)

Rosemarie said...

Thanks for the input, Alan. I must admit that your delay made me wonder if you didn't want to tackle this issue. I should have known better.

I still find it encouraging that 4 years of 140 FBG apparently did not do any permanent damage in your case. My FBG has never been that high.

Enjoy the rest of your trip and thanks again for your thoughts on this.

Rosemarie said...

One more thing, Alan, I've considered getting your book but haven't so far because I figure it is all about weight loss and keeping weight down to control blood sugar with lowcarb eating.

But my problem is too little weight. I'd like to gain a few pounds and definitely NOT lose any more.

I am presently trying to juggle enough carbs (around 100g) to gain weight and keep my BS from getting too high. It's not an easy task and there's not much written on how to accomplish THAT.

Can you tell me if your book would help me KEEP or gain some weight?

No hurry to answer, take your time.

Alan said...

I'm transitting through KL briefly after visiting Kerala, India.

The book includes a section on weight loss but it is not about weight loss. It is about blood glucose management.

Rosemarie, without knowing more about you personally my general suggestions in your case is to increase, in moderation, the other two macronutrients in your menu: protein and fats.

To attain your optimum weight enjoy normal levels of fat and protein without guilt. The levels advocated by most dieticians are abnormally low in my opinion.

Enjoy more meats, fish, eggs, cheese and high-protein veges.

Cheers, Alan

igloo said...


From my experience - and I've documented everything in the last 21 months - monitor calories for weight and carbs for blood sugar! So, follow Alan's advice, eat as much as you like of protein (eggs, fish, meat, cheese) and the good fats (either saturated or polyunsaturated, NOT the partially hydrogenated oils or transfats) and try and keep the carbs down, preferably 60 g or below. Avoid processed grains; i.e. flour!

For a snack try a bit of continental sausage, cheese and lettuce, or my current favourite: an avocado and a small tin of tuna/salmon. Reasonably healthy, almost zero carbs and fills a void.

Good luck!

queen47 said...

Congrats on being healthy! I was diagnosed 6 years ago and have been slacking ever since. I know that my window of opportunity to turn this around is closing, so reading your story had made me motivated again to get on the ball. I can have a longer life shopping at Trader Joe's instead of Pizza Hut!

Bravo659 said...

Hi Alan, Congratulation on your success being diabete free. This is a type of beast that need to be overcome and manage a daily life without the worries. I do also celebrate my anniversary being a year later. In July 2010 i was diagnosed Type 2 Diabetes A1C 14.75% which was a scary moment in my life. I continued on meds Januvia and Metformin (ActoPlusMet) for six months and every three months bloodworks to determine A1C progress. Sure enough i was slowly progressing until in June 2011 i was diagnosed normal with a A1C 5.6%. Today i maintain my glucose level ranging from 76-100 daily and 2-hour after dinner range 95-120. I also celebrate my non-smoking anniversary for 2 1/2 years month of January. Thanks for sharing you story and proud of you. There is always a solution for diabetics.


Anonymous said...

Useful info. Hope to see more good posts in the future.

How To Control Diabetes Type 2 said...
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