10: Reality

 On April 6, 2021, I had an appointment with a provider about the A1c of 10.

Even though the numbers were clear, I was still in denial. There's no way that number is right. I'm only 44. I shouldn't be diabetic.

Part of me thought, maybe they'll do the test again. Yeah, they can do another test and compare to see if this is truly accurate, like blood pressure. That's not how A1c results work, though. Diagnosing someone with a condition like hypertension requires multiple blood pressure readings over numerous months to conclude the condition is present. With an A1c result, however, one reading is needed. Again, it accurately indicates how well your body makes insulin and processed sugars.

So, as I sat in the waiting room for what seemed like an eternity in the minutes I was there, I began thinking about any outward indications of possibly being diabetic. Before this visit, I contacted the provider to ask them about the reading. They gave me a laundry list of symptoms that could manifest with an A1c of level 10. They asked me about urinating a lot or polyuria. They asked if I had experienced weight loss. They asked if I had been fatigued.

The answer was yes to all of these, and they can be indicators of excessive sugar in my system.

I experienced polyuria around the month of November. I went to the bathroom a lot to urinate, sometimes 3 times during the night as I tried to sleep. I did this so much that I went to a clinic to get checked for a urinary tract infection (UTI). Because another symptom I was experiencing during the bouts of urination was fatigue. These two signs can be associated with a UTI, sometimes, so I assumed maybe I had acquired something. At that time, in the midst of the pandemic in late 2020, I would much rather have a UTI than COVID. However, when the results of the culture came back, there were no bacteria. The provider then prescribed an antibiotic for me, but nothing was present that would cause a UTI. The antibiotic was precautionary but clearly unneeded under the circumstances. So, I was confused. I was still going to the bathroom a lot and feeling tired. I wasn't connecting the dots yet. This was red flag number one.

Then came the weight loss.

Christmas is a time of year filled with lots of good things. One of those big things at Christmas is food. Most people do eat more during the holidays than at any other time of year. I was no different, even in December 2020. Again, COVID certainly changed things that year. There were no parties, except with close family. I spent a lot more time at home, and thus I thought I wasn't eating as much, but that wasn't true. Despite the lockdown holidays, I was still eating well, and my body did something I hadn't expected. I lost weight through the season. I weighed 5 pounds lighter at the end of December than I had at the beginning, right after Thanksgiving. I went from 240 lbs to 235 lbs. Honestly, losing weight through Christmas had never occurred before in my life. This was red flag number 2.

Thinking about those 3 things as I sat in the waiting room was troubling enough and should have been an obvious indication of sugar issues. I still thought about other things that could have been considered symptoms as well. 

The next thing that came to mind was my attitude during the past 6 months leading up to April 6. I was not happy about things, but more so than usual. Much of that concern over attitude I chalked up to my dissertation. As I mentioned, it was a stressful time working through that process. It didn't warrant the attitude I was showing sometimes, however. I would get angry, aggressively angry about things. Now, anyone else knows there were many factors that could have precipitated aggressive anger in anyone from November 2020-April 2021. The state of the world was ridiculous at that time. Politics alone were enough to drive someone insane. Whether you were for Donald Trump, Joe Biden, Republicans, or Democrats, it didn't matter. The behavior being displayed was abhorrent, not only by them but anyone else with a social media account. January 6, 2021, was particularly trying for all Americans. Watching colleagues and friends say whatever they wanted on social media, criticizing COVID efforts such as the vaccine or guidelines, particularly coming from those in healthcare, was enough to enrage anyone. Looking back on it now, how bad things got during that 6 months was truly remarkable. 

So, without question, my stress levels were much higher than usual due to a myriad of internal and external factors. Decisions were still mine, though. I didn't have to let anything external affect me; in reality, it didn't. My heightened sense of anger and irritability was not due to those factors but to my body attempting to understand how to adapt to my internal problems. Once in February 2021, I had an episode where my smart watch alerted me to an issue I was having. While sitting there working, my heart rate shot up over 130 beats per minute. I wasn't doing anything but sitting there working on the computer, and suddenly this was recorded on the watch. However, one other thing did take place as I sat there, extreme anger. I was incredibly upset by something at work, and for whatever reason, my watch detected a massive change in my heart rate. That had never happened before. Then it happened again. This time I was angry at home, again in front of the computer working and the watch recorded the same thing again. My heart rate elevated well above 130 beats per minute. The watch had never sent an alert like this before. I have owned the watch since August 2018, so it wasn't new. The watch was simply responding to whatever my body was doing.

My body was screaming for help!

The issues of fatigue, polyuria, weight loss, and elevated heart rate can all be indicators of excessive sugar in the body. One of the issues that cause this is acidosis. Specifically keto-acidosis. I had not tested my urine for the presence of ketones, but I imagine I would have had some. I was spilling ketones because my body was trying to produce energy in any way it could. Once my sugars stopped being processed correctly, my body was essentially starving. Whatever you eat is meant to nurture the body and allow it to function adequately. It's like having old oil in your car. Once it's past the time for an oil change, the lubrication doesn't work either, and thus the car's parts will not operate correctly if not fixed immediately. The same thing happens with the body. Sugar is the oil that is needed to fuel all your necessary parts. When that sugar stays in the blood rather than going to vital organs, adverse effects take place.

The fatigue was brought on by a lack of sugar to help nourish the body effectively. I was tired a lot and complained about it more than I ever had before. So, to help the fatigue, the body started using the only other resource available to provide energy-muscle and fat. Ketones result from the breakdown of fat so the body can use it for energy. This was a point made in the old Adkin's Diets of the past, and possibly keto diets today, as the expectation was to have ketones show up in the urine when doing this type of diet. That means fat is being burned, and thus you will lose weight. Now, we all burn fat at times, so its nothing to be overly alarmed about, and a brief time of ketones being in your urine may not be detrimental since many people have tried these types of diets. Prolonged concerns where noticeable changes take place, however, are a concern. Particularly if you are not meaning to do them. For 6 months, I had been losing weight without trying. Because of the lack of sugars to help my body function, my muscles, and fat were being used, thus leading to wasting. I was losing weight because I was losing muscle mass and fat very quickly, which was not good.

Fatigue, losing weight, the next was polyuria, which was brought on by the body trying to remove as much excess sugar as possible. The sugar had to go somewhere, so my kidneys were working overtime to try and get rid of it. I remember when I had all that excessive urination, I honestly thought something was wrong with my prostate at first. I remembered those signs and symptoms but wasn't paying attention to something I was at much higher risk for. As I mentioned, my grandmother Niney had been diabetic. That put me at increased risk of having diabetes later. I didn't think at 44 years old I would have it, however. That's, unfortunately, how it worked out.

The final piece was the irritability and anger. Well, if you aren't getting enough nutrients in your diet, that's pretty clear where the cause is coming from. Being hangry is real. When you're starving, think about how you have felt. When anyone dares to come between you and a plate of food when you're starving, they risk their life. All joking aside, I was starving all the time and didn't know it. My irritability and anger were through the roof, sometimes compounded by external factors, but mostly due to my body not properly working and processing sugars.

It all added up. I was diabetic.

They called my name at the provider's office, and I went back to see my verdict. There was no discussion about the results being faulty. That was just my own wishful thinking. The discussion centered around what I needed to do now that I had uncontrolled diabetes. To hear all of this from a professional was a lot to take. I started breaking down some in front of them. Tears were welling up, and I was scared to death. I told them all I could think about was how this disease had killed my grandmother many years ago. I didn't want to lose my legs. I didn't want to die far younger than she ever had been. 

The provider handed me a tissue and tried to help me see another way. That's when they said, "If you can be someone living with diabetes, then maybe that can mean you can become someone living without diabetes."

Now, I want to be clear, diabetes is not something that comes and goes. Sugar issues are not that easily corrected. It takes a lot of work and faith to believe you can reverse the effects of the symptoms present. But the risk of diabetes will always remain. My provider was trying to help me see that if you work to better your body and take care of yourself, you can feel 100% better than you do now. They told me I would feel much better when I began altering my diet and exercise. Additionally, I would have to start taking Glucophage (Metformin). The Glucophage would help my pancreas regulate things better with insulin production and the processing of sugar. They believed I could make great strides following a regimen to reduce my A1c from the terrifying 10 to an expected level.

Despite their positivity, I thought, can I do this? Can I really? 

Something told me, "Yes, you can." That voice was always inside, spurring me on through anything, thick and thin. It was there again. It had been there in dreams and was there each and every day since, helping to guide me toward a better outcome. But that's a story for another day...