10: Dr. Thrift

 

As an undergraduate student getting my bachelor's degree in Nursing, I remember saying, "I'm NEVER going back to school again."

I was done.

The bachelor's Degree in Nursing is one of the most demanding professional degrees you can pursue anywhere. The standard expected is profound. The reason for the standard is more profound. It's all about helping people. Don't let anyone ever tell you anything different about nursing.

You're here to serve when you're a nurse.

But I struggled mightily to earn a bachelor's degree. It was no easy task to learn what is needed to be a nurse, much less a good one. To be a good nurse takes time and a lot of patience. You can read my thoughts on motivation to earn a nursing degree in an article I recently published, You're Not Cut Out for This: Motivation to Succeed.

That article addresses some of the dilemmas I faced as I attempted to understand the course of my young adult life. Little did I know, though, some of those same issues would arise again about diabetes.

"Did you have a lot of patients? Did you have a lot of patience?" That is one of two questions my mom used to ask me when I began my career as a nurse. I'm working on a manuscript for another article I want to publish addressing these two questions and how important they were to founding my career as a nurse. But patience was at the heart of my issues from November 2021-May 2022.

I wasn't being patient with myself.

As mentioned, the A1c of 5.8 was no big issue, and by June 2022, I had reduced the A1c back down to 5.6. This considerable victory allowed me to settle down and focus on the tasks. In this case, finishing my Ph.D.

June 28, 2022, was the deadline for my Ph.D. final defense. I was over a month away from completing my Ph.D. when I got the news of the lowered A1c. This helped my mindset in so many ways. But it also helped me see that I needed to stop stressing over things beyond my control.

It has yet to be determined precisely how an A1c will respond. Now, if you eat things you shouldn't all the time, are constantly overindulging, never exercise, are pretty sedentary, and have a family history of diabetic concerns, then it shouldn't be a massive surprise that A1c issues might happen. I was shocked that I had an A1c of 10 on March 31, 2021, but I knew something was off. But the A1c of 5.8 is a fluctuation of sorts.

Your heart rate bounces around between 60-100 beats per minute. There's a usual ebb and flow as your heart pumps blood. You do get concerned if it ever remains at a rapid pace or prolonged, but ultimately if it resides between those numbers all the time, you're great. A1c results measure a timeframe of 3 months. So, during those 3 months, your A1c probably goes up and down some, but it shouldn't be drastic. A1c isn't static. The result after 3 months depends on what you have eaten, how much you exercised, and frankly, your mindset sometimes.

During that 3 months, you ate a few more sweets than you thought. Indulged in more food than you should have. Once you reach the age where your metabolism slows down, this could be a reason for the A1c rising slightly. This could seem normal when you have sugar issues like I do while taking Glucophage. Regardless, you can't completely control the ebb and flow of an A1c. That's up to how your pancreas and body are working. All you can control is what you eat and do and your mindset.

That's where I struggled, the mindset. But once the A1c result was 5.6, I realized I must stop doing that. Stressing had caused a lot of issues around that time. I worried about everything, from finances to work, school, sugar control, you name it.

With my A1c and heart in good shape, I only had to think about work and school. Progressing through June, I was nearing the culmination of 7 years of work. If you google the time it takes to complete a Ph.D., the result says initially 8 years, but a minimum of 4-6, depending on the sources used. My degree was falling in line with what most takes to complete because it is hard. People have asked me how I would compare a Ph.D. to a master's degree. I tell them there is no comparison. Ph.D. is much more complicated. The coursework for a Ph.D. is comparable to a master's degree coursework, but there's nothing else like it in the dissertation phase. You're going to work very hard. I compare my Ph.D. struggles with my bachelor's degree struggles.

Somewhere along the way, you must decide whether you want to do this? I had to do that for my nursing degree, and I had to do the same for my Ph.D.

Finally, on June 28, 2022, when my defense was concluded and all the questions had been asked, my committee finished deliberating, and I was back on Zoom face-to-face with them; my Chair looked at me and said, "Congratulations, Dr. Thrift."

That was the moment I knew it was finished. Everything that followed was just icing on the cake. On vacation that year at the beach, we watched people shooting fireworks up and down the shore. It was the 4th of July, and everyone on the beach was shooting them off. Except for me, for a change. I sat back, watching and smiling as my mom said, "They are doing this for you, son. A celebration for you being done."

Not just done with the Ph.D., but done with school FOREVER! I still have much to learn, mind you, but I won't be returning back to school for any degrees again. I'll save degree programs for my children to pursue if they so desire. But as far as degrees, I've done all I wanted to do. Like I said, I never thought I would return to school for any more degrees after my bachelor's, but life has a way of adjusting your priorities. I knew this all too well from the A1c issues too.

I didn't know what was coming next. Once you let down your guard and delight in reverie, the greatest of issues can arise sometimes. Sounds similar to A Christmas Story, right. In this case, it wasn't about the loss of a turkey. This time it was COVID.

Tune in next time for 10: COVID. 

10: May Day

 

May 2022 was an exciting time. A lot of things were starting to culminate. I was deep into finishing my Ph.D., just one month away from the final defense, when I went to have my annual check-up with my provider. May 19 was the date I went in, just a few days earlier, getting a good report from my cardiologist about my heart concerns.

I had no issues with my heart, it turns out. All of the symptoms were attributed to stress. That wasn't surprising. I was stressed out by the start of April due to everything happening. But I did feel better about my stress by mid-May, and calm was over me I hadn't had prior. Don't get me wrong, there was still much to do by May 19, but I felt better about everything.

The A1c of 5.8 from November 2021 was no longer an issue too. Whatever the new reading was, I'd figure it out. Again, I had been trying to diet like I needed to, and the heart issues made me adjust some things too. My exercise routine had taken a slight hit in April, with me mostly walking through the remainder of that month into May. Once cleared by the cardiologist, I was ready to run the Flight for the Fight in Six Mile again. The race had moved from August to May from the previous year. Although I hadn't run much since the end of March, I could still run just fine.

But today was all about the A1c reading. Did it go up some more? I had been good, but was I good enough. My weight has gone up, so will that make it rise? I was going to find out shortly.

Here were my vitals when I arrived that day:

5/19/2022

BP: 120/70

Weight: 210 (up from 202 in November)

BMI: 28.48

My weight was up 8 pounds since November 2021. That wasn't awful, but I wasn't happy with it either. I wanted to stay the same weight. I would work on it later as best I could. But for this visit, I got some other numbers for comparison. These were the findings.

Glucose 107 (up from 87 in November)

BUN 17 (no change)

Creatinine 0.910 (down from 1.020-both normal)

GFR >60 (normal)

Calcium 8.9 (up from 8.6-both normal)

Sodium 140 (down from 142-both normal)

Potassium 4 (down from 4.10-both normal)

Chloride 104 (down from 106-both normal)

CO2 29 (down from 32.5-now within normal limits)

Anion Gap 11 (up from 8-now within normal limits)

Finally, I got my new A1c reading:

5.6

Ironically enough, my glucose level that day at the office visit was elevated and was the only abnormal lab value recorded. I was back to "normal" again.

So, after all my worry that did nothing but stress me out, my A1c was fine. It had never been that elevated, to begin with, but this just shows the scrutiny I was putting myself under at the time and why my stress levels were so elevated, leading to a heart concern.

I was still doing everything correctly, as I had before. Yes, my weight had increased, but it was not bad. I was experiencing the residual effects of my fear of dealing with sugar issues from 2021.

I was so scared of any elevation in my A1c that I had convinced myself I would fail. Besides, I had failed before at controlling my sugars, which led to an A1c of 10. This situation was different, though. Leading up to May 2022, I spent a year working out regularly. Right before I had heart concerns, I had celebrated one year of closing my circles on my Apple watch for 365 consecutive days. That was no small feat and was snapped within a couple of days due to heart concerns. However, as soon as I felt up to it again, I returned to walking and exercising daily. I ran slow at the Flight for the Fight race. 31:06 for the 5K, but earned another medal in the process. Participation medals are the best when you're a runner.

My diet had also drastically improved since April 2021. I wasn't eating all the junk I had before, and if I did have any, it was sparingly placed throughout my week. I had increased some fried foods, but that was still okay. I had put on a few pounds and could quickly shed that by tightening up.

The biggest thing, though, was that my mindset changed that day. I felt good emotionally. Having a good report from the cardiologist and my provider propelled me forward for the other things I needed to do. I was optimistic I could complete my Ph.D. now. I believed in myself, no matter what. At that point, I still didn't know if I would get the new job at Clemson, but regardless of the outcome, I would move forward there too. The main thing I had was peace. I was doing everything I needed to do, and my provider was happy with the results. We didn't change anything about my medications, and I was okay with that too. Working through sugar control would be a lifelong fight and require just as much learning. I felt good about my chances.

For now, though, I needed to jump one last hurdle I had worked on for 7 years. It was time to advance my degree. I couldn't wait for June 28, 2022, because that day would mark the first time someone called me a doctor, and it was legit.

Tune in next time for 10: Dr. Thrift.

10: Ups and Downs of Heartache

 

Have you ever seen the film Serendipity? John Cusack and Kate Beckinsale in a romantic comedy for the ages. Cusack was well established in Rom-Coms by 2001, and Beckinsale was just beginning her career, hot on the heels of Pearl Harbor from earlier that summer. The film was a much-needed break at the time from the world events taking place. You see, that movie premiered two days after September 11, 2001. 

Fate was a big theme in the film. In the case of the movie, fate was a good thing bringing two people together in love. It was an inspiring film for me then, as I was in love with my girlfriend at that time. A sweet, young woman by the name of Leslie Bowen, who later became Leslie Thrift. The film was merely a stepping stone along the way of things that led me to my fate of marrying the love of my life. So, perhaps it is fate that started weaving its threads by January 2022, trying to help me see where my life needed to go next.

When bad things happen, you have one of two choices. You can choose to wallow in it, or you can choose to rise above.

I needed to take my advice from 2001, don't wallow in the bad, no matter how bad it can get. Nothing could have been worse than the events of 9/11, yet I chose to find the good in life and move forward like many others. Many people came together, standing united for those whose lives had been lost that day. In my own personal life, I knew what would make me happy. It was a serendipitous moment, to say the least.

But in January 2022, I chose to wallow in negativity. I wasn't feeling '22 by any means.

I just kept playing that number, 5.8, over and over again in my head. In this case, it was not serendipitous. It was just plain being vane, and took me months to get over it. Even then, months later, it wasn't at my own behest but at my heart's.

Your heart will tell you a lot of things throughout life. It told me who I was in love with many years ago. It also will tell you when something is wrong. Something was definitely wrong at the beginning of 2022 with my own mentality. To use a quote from Star Wars, "I have a bad feeling about this." That one line perfectly surmises the initial months of 2022.

After I got through Christmas, I put on some weight. I actually took this as a good sign because, unlike the Christmas before, where I lost weight through the holidays, I gained some. That seemed "normal." Because of the delicious food, you should gain weight through the holidays. Losing weight in 2020 was odd, but gaining in 2021 made me feel like my body was working the way it is supposed to now. I went up only 4 pounds, but that wasn't bad. Sometimes in the past, my weight went way higher than that during the holidays. So, I took this in stride and tried not to worry. I would lose that weight later.

My heart was saying otherwise, though. I kept having the PVCs off and on. Premature Ventricular Contractions, or PVCs, just a reminder, are pretty common. I was having them quite a bit, though. More than you should. They weren't bad, but the PVCs just kept coming. Like I said before, stress can play a part in PVCs occurring. I was decidedly under a lot of stress.

My eating habits shifted back to pre-holiday ways, some anyway, and my workout routine remained the same, minus lifting weights. I just didn't have time to lift weights right now. Not while trying to get my dissertation study underway. That being said, a big stress early on in that year was getting IRB approval wrapped up. It was taking forever, and it was being compounded by OMICRON.

I like to call Omicron Unicron. That's the big transformer from Transformers the Movie back in 1986. Omicron was wreaking havoc and caused a lot of sickness. Not nearly as many deaths, but so many people got that variant compared to previous ones. I was fortunate not to get it at that time. However, Omicron impacted everyone's work, including my own. I was stressing a lot. There didn't seem to be any real help in January additionally. Finally, in February, my study was approved, and I was able to begin. My stress came down some but clearly was still playing a big factor.

So, what do you do when you're stressed? Sometimes you tend to overeat.

Now, I wasn't doing horrible with my eating, but I was eating things sometimes that I had reduced. More ice cream. More popcorn. More junk. Consequently, my weight kept creeping up. That creeping was stressful. Add that to trying to get my study where it needed to be, plus analyzing things, plus regular work, and it was beginning to add up. The next thing thrown on the pile was a new job consideration.

Really and truly, I didn't need to be applying for any jobs during this time. I didn't need any more stress than I was already under. But I believed I had a good chance to get the job. So, naturally, by March, I had applied and interviewed and did my very best, as always. But all I did was stress. Stress about work. Stress about school. Stress about my diet. Stress about this new job venture. Stress about the 5.8 A1c. Four months later, at the end of March, I was still stressing about my A1c going up. My next A1c evaluation was looming in May, so that added more stress. Will my A1c go up again? That's all I could think about. By the anniversary of the A1c of 10 on March 31, 2022, my weight had gone up 6 pounds since November's check-up. I wasn't eating that great, but mostly because I was focusing on the few times I had eaten poorly instead of all the times I was doing well. Additionally, on that particular day, I ran 1.5 miles just for a tune-up run to prepare for my next 5K race. I was commemorating the anniversary of 1 year since the high A1c, truly high too, with a run that I hadn't been doing the year before. That's when my heart didn't want to go on.

My heart was racing after that run, and it unnerved me greatly. Eventually, my heart settled down. But over the next few days, that feeling kept happening. Even when I went for walks around the neighborhood, that racing feeling would happen. Until one day, I felt short of breath. Then I felt some pain in my back. Then my wife and I both got scared. I first went to Urgent Care to be checked, and everything seemed "normal." They said if I had more sensations like that, go to the emergency room (ER). The next morning, the pain happened again. So, I went to the ER. I got to spend most of my day hooked up to a monitor trying to figure out what was going on with my heart. During that time in the ER, I got a text from someone who needed something work-related. They didn't know I was in the ER, so I had to tell them what was happening. That's when they replied, "You need to SLOW DOWN."

They were right.

I was going forward on all thrusters. Full speed ahead. I was running a race in my head all the time, with racing thoughts about work, life, school, you name it. It finally affected something more vital, my heart.

I spent the next month and a half trying to understand what was going on with my heart. Had the damage already been done from the A1c the previous year? This was my one big thought at that time. Did the elevated A1c of 10 cause some damage. It made me lose weight, urinate frequently, and feel irrational leading up to the day I realized it, so why couldn't an A1c of 10 affect my heart too.

The only problem with this thought, I didn't have an A1c of 10 anymore. I hadn't had one that high in a year. 5.8 was the worst it had been since March 31, 2021. That's when it hit me. That's not bad.

I'm sure you're thinking, FINALLY!!!

I realized I was stressing too much. I was being ridiculous, honestly. The A1c of 5.8 was nothing to be this concerned about. It went up, but not bad. That was something I could easily bring back down, far easier than the 10 I had to spend 4 months bringing down to 5.6 by August 2021. I was stressing needlessly and attributing things in negative ways. My heart issue ended up being serendipitous.

I slowed down, stopped worrying about things so much, and did what I needed to do. 

By mid-May 2022 I had multiple EKGs, an Echocardiogram, and stress tests, and all said the same thing. Your heart is fine, Jason. You're the problem. Quit being part of the problem and start being part of the solution (to steal a line from Die Hard, minus the color metaphors). 

The point of the film Serendipity is fate or destiny can lead you where you need to be. By May 2022, I was finally going in the right direction. Much like the film, there were many twists and turns along the way since November, but they all pointed me to where I needed to be. I needed to stop worrying. As the bible verse says, "Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own."-Matthew 6:34. The rest of the passage is one I like too, and you can see it here: Matthew 6:25-34. 

I like this excerpt that really speaks directly to what I was going through at that time:

"Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food and the body more than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? Can any one of you by worrying add a single hour to your life?"-Matthew 6:25-27.

As my wife would say, "You're a worry wart. Stop it!" She's very good about telling me like it is sometimes. I love that. Twenty-one years strong with that too. Just one of the many reasons I married her. She's my Kate Beckinsale, and I'm her John Cusack. Like their characters Sara and Jonathan, Leslie and I are destined to be together.

I am a worry wart. I was worrying needlessly about EVERYTHING. All it got me was a visit to the doctor that could have been avoided. If I had never worried about the A1c of 5.8, the whole beginning of 2022 might have gone somewhat differently. But those were my serendipitous moments along the way, leading me to a beneficial moment to come. Now, after the cardiology visit, the big day was approaching for the A1c evaluation. What would it be this time? Whatever it would be, I'd take it in stride, stop worrying, and whatever will be, will be. Que sera sera.

Tune in for the next segment, 10: May Day.

10: Ups and Downs Into Darkness

 

This Star Trek: The Next Generation scene summarizes what happened after November 18, 2021. Data struggled after losing a game to a biological creature, an alien. Data being an android did not feel he should have lost. He made all the correct moves and did everything right from his calculations, but ultimately, he lost the game. He could not process this failure and questioned all of his capabilities, including serving aboard the Enterprise. In this scene, Picard had to remind Data of his duties with the quote above, more sternly as a captain would. Data had to recognize that we all lose sometimes. Such is life.

While living with diabetes, I convinced myself it was possible to eliminate the problem. To win no matter what. I was going to beat this with no issues, and although it seemed to be heading that way, there was one thing standing in my way--vanity. Remember that word? Data experienced it too. Self-pity makes you do strange things sometimes. You start questioning everything. But all self-pity represents is another form of vanity. When your ego can't take what has happened. "Definitely my favorite sin." Always keep that quote in mind.

It broke my heart that day to see my A1c go up, especially with all the work I had put in to accomplish my goal of staying healthy. Coupled with increasing the Glucophage, I felt utterly defeated. Never mind all of the other accomplishments I had made. All of my other numbers were excellent. My weight was exactly where I wanted it. I was about to run my third 5K that year at the Electric City Gobbler, yet another race under 29 minutes for my time on Thanksgiving Day, but none of that mattered.

The A1c went up! I have to take more medicine! Woes me.

It's the same response as remembering how the Atlanta Braves of the 1990s lost 4 World Series instead of always thinking about the 1 championship they did win and, of course, all of the team's other accomplishments. They should have won more. That is a bad thought process spurred by worldly nonsense.

In this case, I was giving in to the worldly nonsense myself instead of enjoying the accomplishments I had made, much like Data.

With my Glucophage being increased, that unnerved me. I convinced myself I'll have to start eating more. That was probably not true, but that's what I did anyway.

But the worst part was the next day.

I did something I hadn't done before after my visit with my provider in April 2021. I donated blood to the Clemson/South Carolina Blood Drive. This blood drive is an annual event set up right before Clemson and South Carolina play each other in the Palmetto State Bowl at the end of the football season. It's all part of Rivalry Week in College Football. I had never donated to this event, so I looked forward to doing so for the first time.

I loved donating blood. The gift of life or a chance to save one. Those slogans are a mix of the common ones I see. I have been giving blood almost annually since working at AnMed Health. I even gave during the height of the Covid Pandemic in the Fall of 2020. So, giving blood when I was perfectly healthy in November 2021 seemed like a great idea. My hemoglobin was still excellent, and I was feeling good. However, I couldn't shake some of the negativity in my mind, and something was telling me not to give blood that day. Probably because of self-pity.

However, my blood wasn't coming out like it should during the donation. The phlebotomist kept having to move the needle around in my arm to try and help, but that only hindered me. Eventually, I had a vagal response.  What that means is the pain of the needle moving, combined with a lower amount of blood, started making my blood pressure drop. I began to feel woozy and had tunnel vision. I turned pale and almost passed out. They put all of these fans on me and lowered the head of the bed I was in to help send blood back up to my heart. It was a terrifying experience I had never had when donating blood. Because of this experience, I've never given blood again. This was only the beginning of the negative things I was letting in, and it was only a day after the higher A1c result.

I got to feeling better that weekend and ran my 5K the next week, again doing well and feeling good. Amidst all this turmoil with the slightly higher A1c, I was also stressing pretty well. I had defended my proposal for my PhD, but now I had to submit the IRB application to conduct the study. That process was not nearly as involved, but I had a deadline to get it done by the beginning of December. I also threw in earning certification for the first time, as if I needed something else to occupy my time. However, I earned my Certified Healthcare Simulation Educator certification, also known as CHSE, pronounced "chessy."  I was proud of all that I had done by the end of November, but in league with the negatives of the higher A1c, the blood donation gone wrong, and being overly stressed finally took its toll.

My heart skipped a beat that day in early December.

This took me completely off guard and scared the life out of me that day. It kept happening too. I contacted my provider to let them know what was happening. They were very helpful, trying to get me to calm down more than anything. What was happening was known as a PVC. Premature Ventricular Contraction. A PVC gives the impression of fluttering of the heart. It can sometimes feel like racing or even like your heart skips a beat. For a brief instant, you get this sensation as if your heart stops, then starts back up again. It's unnerving the first time you feel one.

I've had palpitations before, once when I got really dehydrated during the summer while out walking the kids as they sat in a stroller. That was my bad for not drinking enough water before, during, and after.

This, too, was my fault that day in December.

I had worked myself up into a frenzy worrying about this A1c. How could I do everything right, and this ends up being the result?

Deep down, something was trying to tell me to chill, but I didn't want to listen to it. My vanity wouldn't let me settle down. I think the point of this is to illustrate how our mindset can shift very quickly. When it does, it's because you let it. I let myself get carried away, and I had to regroup. The problem is that regrouping would take several months to achieve.

My stress level was so high by December 2021. I knew I had to finish my PhD by July 1, 2022, or was out of the program. That's right! If I didn't finish by July, I didn't earn the degree I had been pursuing for almost 7 years at that point. I was also trying to apply for a new position at Clemson and kept stressing about that. I needed to begin my study no later than February 2022 if I wanted to get done in time to defend my dissertation and complete my degree. I still had all of my usual stressors of family, work, and life, with these added on, and managing sugar issues. Let's not forget Omicron variant showed up too about this time and wreaked havoc well into 2022, although in no way near as deadly as the variants that came before it. 

All of this was enough to stress anyone out, but I was letting one thing drive my stress. A slightly elevated A1c. Two-tenths of a point was all it took to drive my mindset backward. 5.8 isn't even bad, folks. It isn't even bad and something you can fix easily. But it would take its toll on me in the weeks ahead as I headed further down that rabbit hole, descending further into darkness until heartache commenced. My only hope was that I would get it together, much like Data, and realize a new plan of action.

Stay tuned for the next segment, 10: Ups and Downs of Heartache.

10: The Ups and Downs

I remember the first time I rode a roller coaster. I was terrified.

It was the Georgia Cyclone at Six Flags Over Georgia. A wooden coaster that took you through turns and hills up to 60 miles per hour. That was fast at that time when Six Flags had fewer coasters. Goliath more than buries the Georgia Cyclone today and so many other coasters that have come along since then too.

But I remember getting on it with my friend Nick Brenchak and climbing that hill to the top. I was so scared, I couldn't look up. I held on to the handlebar in front of me as tightly as I could and tried to breathe normally, my heart pumping. Once you reached the top, a camera captures your final moment before you plunge into the twists and turns of the coaster. In the picture afterward, Nick has his hands raised high, his mouth wide open, looking forward to the descent. I was hunched over in fear, still gripping the handlebar, holding on for dear life.

Did I also mention I was 17 at the time? I was so scared of rides like that when I was younger that I hardly ever went near a theme park like Six Flags. I remember one time my parents wanted to take me there on a trip to Atlanta, but instead I asked if we could go to Hartsville-Jackson International Airport instead. I wanted to watch the planes take off and land. It was so much fun. Back in the 1980s, you could go to the airport anytime before the days of September 11 and Homeland Security. I was so happy watching that, yet still scared to get on a plane. My first flight wouldn't be until I was 35 years old.

Yet, here I was at 44 years old, dealing with something truly terrifying. For all the things that seemed to be delayed in my life, diabetes came on early.

The good news was that I had conquered the beast a bit. With a reading of 5.6 for my A1c, I was physically, mentally, and spiritually in a great place. My provider even said it wasn't true to say I was diabetic now. I was dealing with hyperglycemia, but saying I was fully diabetic would have been a stretch. So, everything was looking good. I was still living with something I had to work on, but it wasn't as bad as I thought. That sounds like how I felt after riding roller coasters and airplanes.

But now came the hardest part, the real part of living with something--maintaining.

It was so easy to shed the excess weight. It was so easy to start up a better exercise routine. Going from an A1c of 10 down to 5.6 seemed so easy. But maintaining from here on would take real work.

Things from August on seemed to be going in the right direction for me. I was scheduled to visit my provider again in November, this time checking an array of labs in addition to my A1c. So, I wanted that visit to shine. Fortunately, things appeared to be going that way.

For one, my weight was maintained at a stable level I was happy with. The goal my provider and I deduced would be good for me regarding weight was to stay between 200-205 lbs. So, the changes I had made to my diet remained in place from August through November. I decided to go to Canes again on campus. My gosh, those are some good chicken fingers and fries. Eating that meal again was like manna from God. I still was not eating Chick-Fil-a regular sandwiches, though, which could be a bummer. But I was managing to eat the grilled chicken sandwich instead from Chick-fil-a. I've really developed a love for it. Other diet pieces were in place, and I felt like I was doing exactly what I needed to in order to maintain the 5.6 or lower.

My exercise routine was going perfectly. I ran and walked quite a bit, but the weightlifting became problematic. I gradually increased the amount of weight for lifting, but eventually, my right shoulder began to have some issues. This issue stemmed from an injury I had as a teenager, where my shoulder separated. The shoulder issues have been something I have to live with. My shoulder ached all the time, forcing me to reduce my weightlifting routine. I had been lifting weights almost every day since April of that year, so by September, I had to reduce that. The last thing I wanted was to injure myself, trying to stay healthy.

Additionally, things at work and school were going well. I was nearing my proposal defense for my Ph.D. That created some heavy stress. But the proposal defense was good stress because it was nearing completion. Next, work was going well. I was enjoying teaching in a course I had been in for 7 years, at that point, more than I ever had before. I felt more positive at work and looked forward to what might be at Clemson. Unexpectedly, I found myself in a television commercial for Clemson, which was a huge bright spot. I was asked by a student in the program to come to a photo shoot because they wanted an instructor present too. I had no idea that would be on the jumbotron at football games, almost every sporting event at Clemson, and television commercials. That was good and bad stress because it was awesome, but I felt bad for it because that was never my intent. 

Even during this stretch of time from August through November, my favorite sports team, the Atlanta Braves, won the World Series for the first time in 26 years. The last time they won it, I was at Game 6 that year to see them win it in person in 1995. 

All of these things, the proposal on October 27, my diet and weight holding strong, the World Champs, the commercial, it all felt like such great things were happening. I was really living it up and felt so positive and happy about the direction things were heading. I couldn't wait to get to my next appointment at my provider to see the A1c result. I was sure that vast changes would ensue for the better. My A1c would be excellent. Maybe the meds would be reduced or gone. I would be completely back to "normal." 

So, you can imagine my surprise when I got my A1c result back on November 18, 2021.

When I went for my visit that day, here were my vital signs and other demographics:

11/18/2021

BP 120/70, down from 142/78 in April

Weight: 202, maintained from August

BMI: 27.40

These were so good! Then came some other labs.

Cholesterol 151, down from 205

Triglycerides 46, down from 162

HDL 51, up from 41

LDL 91, down from 132

Risk Ratio 3, down from 5

Glucose 87 (WNL)

AST 17 (15-37), ALT 29 (14-63), so my liver was in great shape.

All of this was very good too. In the past, I had high liver enzymes due to obesity when I was 29, so I knew these numbers were great.

That brought me to my A1c:

Now, let's be clear on this result. This is not a terrible result for an A1c. 5.8 falls in the range of 5.7-6.4, indicative of prediabetes. People typically must make lifestyle modifications at this level before the medicine is included. So, this is nothing near like the 10 level I had 7 months earlier. But I was discouraged.

All the happiness and joy I had felt was hollow suddenly. Everything had been going well for me during that time. EVERYTHING. And then suddenly, my A1c went UP??? I didn't understand it at all. I hadn't changed my diet much. I hadn't changed my workout routine much. My weight was stable. How could my A1c go up AT ALL?

I was not happy with this result, as you can tell. I was even less happy with the decision to INCREASE my Glucophage. I had been taking 1000 mg per day since April. Now, I was going to have to take 2000 mg per day, 1000 mg twice daily. I was very discouraged by this. If anything, I wanted to reduce the Glucophage, if not eliminate it. So, being told to increase the medications made me feel like I was being punished in some way.

I wasn't being truly punished, but I had a sinking feeling. My mindset instantly switched in that direction. I didn't want to take MORE medicine. I didn't want to have to do MORE. I wanted things to stay on an even keel. When this happened, it really felt like I had just hit an iceberg. Fortunately, this wasn't the Titanic. But the ups and downs continued from there as I progressed, trying to unravel how to work through this hurdle.

This hurdle had its twists and turns I didn't see coming as it turned out. But that's a story for next time. Look for more about the ups and downs on 10: Ups and Downs Into Darkness.