Diabetes -- Living With a Whole New Challenge

(This blog pertains to events that took place in 2007/early 2008.) 

The whole diabetes thing became another dimension of me. I became active with the American Diabetes Association and its Step Out for Diabetes walk. I formed a team and raised money for the cause. I also realized I needed to be an advocate for diabetes, just as I was becoming one for cancer. I now had year round volunteer activities between both ACS and ADA. Both were important causes to me and I wanted to help make a difference. 

Being a cancer survivor who is also a diabetic simply ups the odds. That is, the odds that I will have major health problems due to both of these medical issues. As a diabetic, my risk of heart disease rises as does my risk of stroke. Many of the tests I must take for cancer control can be influenced by diabetes. The PET scan requires a special diet and no exercise regimen for 24 hours prior to testing. During this time, I had to eat a high protein only diet (no carbs or sweets) plus I had to remain sedentary. Glucose levels would drop throughout the day so I had to remain diligent to ensure I did not drop dangerously low. When I arrived for testing, an extra step involved checking my glucose levels. Now, as a result of my diabetes, I also had to remain on extremely high doses of cholesterol medication and medication for HBP. My doctors wanted to ensure my cholesterol and HBP remained within healthy limits since as a diabetic, I am much more prone to heart disease. (My family history does not help since my Dad died from a massive heart attack at age 52. My Mom was treated for high cholesterol as well as diabetes. In her case, however, her blood pressure generally ran low.) 

Being grateful for diabetes. There is something strange about that. Yet, I truly am glad that I was diagnosed when I was since before that, it seemed that no one was taking my weight gain seriously. I had asked about it, but until late 2006, most of my doctors had ignored my weight issues. They were more concerned with other health matters. By the time it was recognized and they were ready to deal with it (I had a doctor indicate I needed to see a dietitian) it was already time for me to go to classes with a Certified Diabetes Educator. As I see it, everything worked out for the best. I may be much lighter now and healthier, but I am still a diabetic. 

I bring that up, since many people (when they see me) do not believe I am a diabetic. They actually say, to my face, that I am too thin, too skinny. That, I must protest, is a real error and in general the public needs to understand that being overweight or underweight or just right -- that does not necessarily mean you will or will not develop diabetes. Yes, research has shown that being overweight can lead to diabetes but even after one losses weight, that does not mean the diabetes goes away. An individual who undergoes gastric bypass may very well no longer need diabetes medication after surgery, however, simply losing weight will not take away the disease. I still need to remain vigilant -- eating right and exercising. Otherwise, my glucose levels can be high. That does not change with weight loss. What does change is how the body works overall. Less strain on the heart, less stress on the bones and muscles... a better way to control diabetes is weight control. 

I am not happy that I must identify myself as a cancer survivor -- as someone with asthma or as a person with diabetes. Having all three is no prize. I am not a winner except for the fact that I am beating the cancer, controlling the asthma and working hard at keeping my diabetes in check. If that’s winning, then I get the big prize! 

Since 2007, I have been active with the American Diabetes Association’s Step Out for Diabetes walk. In Orlando, the event is held in the fall, usually early November. My first year, I joined a team formed by an ADA staff member. It was just me, so on the day of the event, I arrived early and prepared for the 5K walk. At that time, I was still using my Hugo walker. Walking the streets of Orlando could prove challenging since there were surface changes every few blocks. It went from asphalt to brick and sometimes, very uneven sidewalks, if I could not navigate the streets. But, I was determined to make the entire distance and I did. The roars of the crowd at the finish line were deafening - they were screaming with delight as we passed under the archway of balloons and back into Loch Haven Park. I had done my first Step Out. A major physical accomplishment! 

http://www.diabetes.org/

Happy Thanksgiving!

As a cancer survivor (as well as someone dealing with other life threatening illnesses) I especially have plenty of reasons to give thanks on this special day. My list is quite long, but for the purposes of this blog, I will give you the abbreviated, abridged version of my "thankful list."

I am most grateful for my wonderful family. I have Edward, Brian, Adrienne, Gary & Michael who make up my immediate family. And this year, I can add a new person to the list - my son-in-law, Jason. I also want to add my son's girlfriend, Sultana. I feel so "fortunate" to have all of them in my life. Added to this list is a group of people who now make up the circle of "my special peeps."  Janice, Gary, Eric, Kristin and Marybeth ... now considered family via Adrienne's marriage into the McIntosh family and Brian dating Marybeth's daughter. I also have a nephew, Eric, who recently got engaged to Kassandra, so the family continues to grow!

I have many friends - way too many to list in this brief thank you list. I'm sure you know who you are -- I always tell you how much you mean to me! I also have family members now located in Arizona, PA, FL and WV. I miss you all and wish we could see each other more often. I am grateful for a social networking site - Facebook - that keeps me connected with my relatives scattered around the country. (I even have relatives in Belgium! Very cool! Wish I could visit!!)

I remain extremely grateful for my health care "peeps." The doctors, nurses, technicians, admitting clerks, volunteers, etc., etc. Anyway who has, in anyway, been a part of my journey is a special part of my life. I thank you for all you do. The professionalism you demonstrate; the compassionate care you provide. I am thankful to be a patient at MD Anderson Cancer Center Orlando, part of Orlando Health. I also thank members of the staffs at South Seminole and ORMC, all of whom are an integral part of my team.

May all of you enjoy this Thanksgiving holiday. And, as we enter into this major holiday season, please know that I am so happy to have all of you in my life. I may not have ever wanted to be a cancer survivor, but since I am, I am so grateful to be in such great company. Happy Holidays to you, my family & friends. And to those now reading my blog and getting to know me .. thanks for becoming part of my journey. Enjoy the adventure!

Oh, I’m Also a Diabetic!

(This segment pertains to events that took place in 2007.) 

As you have already discovered, I have had my share of medical challenges since 2000. For someone who was relatively healthy before that time, I have more than made up for it since with not only my cancer diagnosis but being told I have asthma and finally diabetes. I call it the winning trio. Three potentially deadly diseases. How lucky could I be? 

Cancer diagnosis - 2000. Asthma - 2002. And now, in early 2007, I learn I have type 2 diabetes. Not a total surprise considering it runs on both sides of my family. My Mom was an insulin dependent type 2 diabetic. I learned that Gary had been dealing with it for years and Michael was finally diagnosed in 2010. Of my Mom’s two sisters, one also had the disease and of her three brothers, I now that two had it as well. My Dad’s sister was also a diabetic. I have no idea how many of my cousins are affected, but I know it runs high throughout my family tree. 

However, I was still shocked by those words and by the diagnosis. My A1C was 9.2 and I was weighing in at approximately 186 pounds. (A1C is also known as glycosylated hemoglobin and reflects the average blood sugar or glucose levels in the body over a two to three months period of time.)  I immediately began diabetic classes where I learned about things like portion control and how to take my own glucose readings. It was a process I took very seriously. In fact, I believe I was scared to death by the idea that I now had this third major medical problem. Fortunately, I was already working out at the YMCA, so I stepped up my regimen. And, a year later, I was weighing in 50 pounds less. 

I took portion control to heart, literally. I now understood that a lot of the food I was eating (especially at area restaurants) ... the portions were way too large. A single plate had enough food on it for three or more servings. So, I began to take home doggy bags. I began to eat smaller servings. I learned to share meals at restaurants. And, my at- home plate looked much healthier. I cut back on the servings of carbs (the pastas, rice, sweets) and loaded up instead on healthier options and better proteins. That 50 pound weight loss was incredible.  My A1C was now at a non-diabetic level (less than 6) and I was able to now control my diabetes with only exercise and diet. I was taken off the oral medication after only six months since my glucose levels dropped so low. I finally had one health challenge that I could actually take control of on my own without any medication. That was huge in my book. Being able to control my diabetes by exercise and diet alone may not be easy, but I realize that in the long run, it is worth the energy.

Every doctor commended me for my success. My cardiologist was thrilled. My pulmonary doctor was able to remove me off of one of my inhalers since my asthma was coming under better control as a result of the weight loss. My oncologist was happy with the results as well. All aspects of my life improved as the weight loss continued and my blood glucose levels balanced. I was now happy that I had diabetes. It had made such a significant difference in my life. Having to think more consciously about my diet, having to make better choices. Needing to watch my intake of carbs and knowing that if I did exercise, I could not only control my numbers but watch the pounds come off. The combination of exercise and diet did work -- I had proven it. And, I never did do an actual diet.  My biggest change was portion control. I continued to eat my favorite foods, but did so in moderation. I learned to eat smaller portions of food and enjoy each and every bite of my favorites. I learned to eat chocolate in a healthier way. I could still indulge, but I had to do so in a healthy way. I realized that I simply needed the chocolate taste, so one small bite could suffice instead of the entire huge slice of cake or pie. Sharing was a wonderful option for dessert. I also learned that I could still enjoy iced tea, just not sweetened ice tea -- unless I used an artificial sweetener.

Having Fun and Getting Stronger at my Local YMCA

(This blog entry covers experiences from the summer of 2006 until later that year.)

The instructors at the Oviedo Y were amazing. So patient and understanding. They always made sure I was safe and they kept a watchful eye on me as we went through the various water exercise routines. I also felt safer knowing that the life guards were right there, too. When I was ready to exit the pool, the life guard on duty would come to the edge of the pool, near the stairway, and would bring my walker over to a location where I could readily reach out and get it. They did this for everyone with special needs and their kindness was most appreciated. Instructors such as Jane, Yolanda, Kim and Barbara -- all gave me their time and guidance as I made my way through this difficult period of adjustment. 

The simple act of getting in and out of the pool was an exercise routine all its own. I was still having challenges with steps, which is why I did some follow up physical therapy in the summer of 2006. Stairs would continue to be a “problem area” for me. 

Weeks turned into months and before I knew it, I was going regularly to the pool for sessions and getting stronger with each passing month. I felt great and loved the freedom that the water offered me. Where I had so many “on land” restrictions, in the pool, I felt so free and carefree. I could jump and enjoy myself without pain. It was such a wonderful feeling. 

After I became stronger and felt ready to tackle a new program, I began a chair exercise class. This is where the participants are seated, usually in a circle, and work routines to strengthen the upper body as well as the lower body. However, all routines are done while sitting. We used equipment such as exercise bands, light hand weights and balls. 

Once I became even stronger, (This was a decision I personally made.) I started the popular Silver Sneakers class. This 45-minute class is done with participants sitting and standing for various routines. (You can choose to sit through a routine, if necessary or preferred.) Chairs are lined up in rows and attendees also use the bands, weights and balls as part of the session. Music helps make the sessions lively. 

When I began Silver Sneakers, I met two other Y instructors -- Andrea “Dre” and Jamie. Instantly, they became good friends. Since I like variety, I tired to vary my work out schedule each week. I did, at least, two water classes per week. Then, I added two Silver Sneaker workouts. I was definitely keeping active, and the more I exercised, the better I felt. My personal program of “getting better and stronger” was actually working. There was no way anyone could have ever convinced me that I would enjoy exercise classes as much as I did. The more I did, the better I felt. (Yes, I have heard professionals say this all the time, but seriously, I never believed it.) 

The Silver Sneakers “gang” (as I personally referred to them) were also a great bunch of men and women. Some did water classes as well, while others were simply committed to the Silver Sneaker program. Again, I was basically the “baby” of the “class.” However, I was made to feel welcome and I must add -- many of these individuals gave me a “real run for the money.” That is, I had to work extremely hard to keep up with some of the participants. My classmates may have been 10-30 years older, but many were in “fantastic” physical condition. As I saw it, I had my work cut out for me. They inspired me to work to a level I never thought possible. 

(Just a quick note. If you ever find yourself needing rehabilitation of this kind, do not hesitate to utilize any facility that offers up a heated pool, especially an indoor one. To this day, it remains my favorite type of exercise. I love the overall freedom I feel in the pool -- it’s exhilarating! I can jump up and down and not feel any pain. That amazes me. When I do other forms of exercise, there is definitely pressure on my joints and on my hips, knees and feet. But in the water, I have this buoyancy that is nearly beyond description. It is a great form of exercise for those suffering from any form of arthritis or who have had an injury that affects that joints or bones. Consult with your physician first before doing any type of exercise but chances are, they will sign off on this type of activity when you are ready.)

Rehab is My New Exercise Program

(This blog pertains to experiences that happened in July/August 2005.) 

I spent two full months in the rehab center, watching most people who arrived after me, leave before me. Those with knee or hip replacements were long gone before me. Apparently, as I would discover, insurance carriers have their own idea of how long rehab takes. That is, if a patient has undergone knee replacement surgery, Medicare allows three weeks of in-house rehab. After that, the patient goes home. As someone with a broken femur, I was in a class by myself. There was no time line for recovery and rehab. The staff at Terra Vista needed to make sure I could fully function on my own before they set me free. I had to be able to walk to the bathroom on my own, with a walker. I also had to be able feed to go to the kitchen and prepare a basic meal and take it to the table to eat on my own. Since I could not count on someone always being at home with me, they had to be sure I was self sufficient before sending me home. That took extra time and work. But it was worth it, even if it did mean more time away from home and family. There were moments I did become depressed by the long time away from home. This was far from an easy experience. 

When I finally left, I was given a script for a home health aide and eventually outpatient therapy. All part of the process to my getting better. Each step had challenges. But, again, I was determined to reach every new goal I put before myself. Once home, I wanted to get around better, so I did my PT with gusto. When I graduated to outpatient PT, I had other goals. To drive again. To walk stairs. To move faster and steadier. All within reason. Every goal attainable, with practice. Tiny, baby steps. I took one and moved forward.

When I finally was sent home, I was now living in a small two bedroom apartment in Sanford, FL. It was on the first floor so fortunately, I had no steps to deal with. The home health aide came several times a week, helping me with bathing and other personal hygiene activities. My physical therapist worked with me on a regular basis as well, either in my bedroom (doing a variety of exercises and movements to strengthen my legs) or taking me outside for walks once I was able to move about better and was more confident with my walker.  The whole idea was to get me out of the house and eventually, onto outpatient physical therapy. It was a long road -- with many twists and turns.

Damn. Nearly a year after I broke my right femur, I was still having physical challenges. I could hardly walk steps, and if I wanted to get myself back to where I was before, I needed to do be able to walk stairs. So, with a script from my doctor, I entered back into physical therapy where the emphasis was on learning to climb steps and simply increase my overall strength. I did a great deal of work on the stationary bike and lucky for me, the PT center I chose had a water rehab program. I was able to begin water therapy. Being inside this unit, where water temperatures were 98 degrees (body temp) meant an environment that was safe, comfortable and easy for me to handle. I enjoyed my sessions and began feeling better and stronger almost immediately. My therapist was pleased with my progress and suggested I look into other options, since my time with her would be limited.

Directly across the street from the PT office was the Oviedo YMCA.  I had known about this facility for a long time. I had watched it being built and knew of it when it first opened as a private health and wellness center. The indoor pool was one of its finest features -- heated and available for use year-round. I took myself across the street to check it out. That meant, walking over with my walker. I was using a Hugo walker - one with four wheels and a seat, if needed. Taking my time, I made my way over to the Y. 

Fortunately for me, they offered a great deal. At the time, I had an insurance program that would allow me to join a Y. So, I signed up for membership, and after my PT ended, I began water fitness classes. Trust me, as much as I enjoyed being in the water, it was not easy. Those first few sessions were tough. Just getting myself in and out of the pool was an endeavor, but actually working out. Exhausting. The classes were 60 minutes and I could barely make it, but I knew that I needed this type of exercise if I was to get back the use of my legs. Being in the water made certain exercises much easier -- and the stress on my hips, knees, etc... so much less than being on dry land. 

Yes, the water therapy was good for me and I knew it. I just had to be persistent and keep attending classes. So, I set a goal of going twice weekly. Those sessions were long and difficult at first. I really felt weak. There I was, in my mid-50s and I was the baby of the classes. Most of the men and women in the water fitness program were 20 to 30 years older. But, they quickly became my friends and my greatest supporters. They were there to cheer me on, one small step at a time. And, when the time came, I was able to cheer others on who found themselves in similar situations. Water therapy is often prescribed for patients after knee or hip surgery, so the classes were often a haven for individuals just out of surgery, recent outpatient therapy and who were now ready for the next step. 

Personally, I was ready to make “giant” steps into the future.