10

 "Have you ever been diagnosed with diabetes?"

I replied right away, "No."

"Well, guess what?"

Some conversations are more memorable than others in our lives. Memorable phrases and conversations have both positive and negative things associated with them. That's what makes you remember them. This conversation was different.

The month of March has always been a special one for me. One big reason March is special, it's my birth month. Most people regard their birth month as a special time of year, right up there with holidays like Christmas or Halloween, to name a few. March has also been special to me because it ushers in the season of spring. Spring is a time of new beginnings, sometimes associated with rebirth or renewal. But March 2021 had a different feel than any that came before it or even since.

For me, March 2021 started rough. First, my favorite truck I ever owned and had the longest of my life had issues and stranded me on the side of the road. The fuel pump on Great White, as I called it, died, and $1000 later, it was back in action. My pockets were slightly emptier, but this issue was minor compared to what would come that month. To compare it to something, I suggest the film Apollo 13. When one of their engines failed near the beginning of their mission, the astronauts believed they had encountered their glitch for that trip. They were wrong, and so was I about March 2021.

Next came a more significant concern, my dissertation in the Ph.D. program I was enrolled in. I had been working diligently for 3 years, trying to get my dissertation in the right place to allow me to progress toward completion. I found out, entering that month, that my efforts needed more. After some discussions with my committee, I was going nowhere fast. I was so angry after that meeting, and because of the interaction that day, I had all but decided to quit the Ph.D. program. So much so I had already begun discussing with a colleague about other options for my career. And it was only March 3, 2021.

The Ph.D. concerns waged on throughout March 2021 as I decided my future, and to me, that was the equivalent of the disaster the Apollo 13 crew encountered. I believed my time in the Ph.D. program was over, and now I had to limp back home as best I could. The month of March could have looked better at this point. I had two meetings with educators and leadership at school to discuss my future in the Ph.D. program, neither of which truly helped to resolve anything. It was more indecisiveness and uncertainty from both directions. Ultimately the decision would be mine, and I would need time to make it.

Compound all of these issues with living in a world of COVID. Covid-19 was still quite prominent one year after the outbreak of the pandemic. I became used to living at home a lot more over that year. But, for the first time since the fall of 2019, my family and I decided to venture out on a short vacation to unwind and relax. It was still a stressful vacation that March. So much uncertainty about being around a large group of people in an enclosed space. I was nervous, but I tried to make the most of it. My family and I lived it up, indulging in our short trip with delightful treats from various restaurants and food bars. I ate like a pig that weekend, but it filled me with joy. I had my sweet tea in hand at every meal. I made vast helpings of yogurt with whipped cream, chocolate chips, and fudge piled on. It was so good.

When we came home, still in March 2021, my wife weighed and told me she had gained 5 pounds during the trip. Obviously, we ate well that weekend. The stimulus helped a lot of people eat well that month. So, I decided to see how much I had gained. If my tiny wife packed on 5 pounds, how much did I gain with my overindulgence? Maybe 10 pounds? I hope not 15 pounds. But that was the thing. I didn't feel any heavier than before I left. I didn't feel heavier at all. When I went to weigh, the scales said the same thing I weighed before leaving. No change. Exactly the same numbers.

Before the trip, I had noticed that my clothes were starting to fit looser. They had been doing so for several weeks now. The interesting thing is that I wasn't trying to lose weight. I was still indulging in everything I loved up to that point, but my weight went down. Now, occasionally I would think I don't need to eat something to "get back in shape," but I wasn't trying hard. My exercise routine had suffered for years during school. You sit a lot writing a dissertation, so that's not surprising. I was not doing anything to help my weight decrease, and yet it was going down.

That's when I knew something was wrong.

At that time, the hospital I worked at did annual check-ups on staff during their birthday month. Before that year, I had not done one of the checks since 2018. I hadn't done a check because I no longer worked there full-time. It was required for full-time staff then, but not part-time, so I didn't. However, I am over 40 now. I should have been going for a check-up. Because of this weight, I decided to go and do the annual check-up.

When I went, my blood pressure was acceptable. Of course, my weight seemed great because it was down over the past year. In March 2020, I weighed myself right as the pandemic began to see where I was before lockdowns confined me to my home. I weighed 249.8 lbs that day. On March 30, 2021, I weighed 232 lbs. So, my weight was down from the previous year by a lot. 17 lbs, to be exact. That seemed terrific, but deep down, I thought, why is it going down? It shouldn't be.

The nurse inside me knew my body wasn't right, and I denied it with ego defense mechanisms. Outright denial, there's no problem. Maybe my body has adapted to a new way of dealing with things? Rationalization, I'm not eating as much as I think I am because the pandemic changed my habits. Everything you could think of went through my mind to make me feel something else was happening than the truth I actually knew. Something is wrong with my body, and I must know what it is.

MARCH 31, 2021

It was a rainy, cold day, even in late March. I was lying in bed, knowing I had work to do but I didn't feel like getting up. Then my phone started ringing. I could see on the screen that it was the hospital where I had been for the check-up. They never call you unless something is a concern. In the age of electronic health records, you can look up your labs and results on your own time most often, negating the need for a phone call. I knew of only one other time anyone had ever called me about concerns with a check-up before when I had liver enzyme issues in 2006. My provider then chalked those issues up to obesity. Yeah, there's a word you love to hear at 29 years old, weighing 229 lbs. But that's what that provider used to describe my situation then, and they were right to do so.

I knew a phone call was terrible. They left a message, and I decided to call them back. As I called back, I looked up my labs online. My cholesterol was up, so I thought that maybe that was it. Is that what they are calling about? I knew better, though. A cholesterol level of over 200 was concerning but may not have warranted a phone call. That's when I looked at my Hgb A1c.

Hemoglobin A1c measures the amount of glucose in your blood over 3 months. It's a solid indicator of how well your body is processing sugar and whether or not concerns can arise associated with diabetes. An average person's A1c should reside at 5.6 or lower, indicating their pancreas is working well, insulin production is stable, and sugar is being processed accordingly. Some labs may vary on the 5.6 limits, with some suggesting that the level is pre-diabetic, but most articles and platforms I have seen suggest 5.6 or lower as an expected or standard value. Pre-diabetic levels are 5.7 to 6.4, indicating concerns that insulin production has been affected and sugars are not being processed in the body as well as they could. When A1c levels are 6.5 or higher, concerns the individual is now diabetic arise. Medical management of diabetes typically begins in the pre-diabetic range. Still, once you hit 6.5, management has to be in place as the body is not processing sugars well, and the person begins living with controlled diabetes.

That day, March 31, 2021, the result online for my Hgb A1c was 10.

I couldn't believe my eyes. The person on the phone said that 10 indicates uncontrolled diabetes. After that statement from the caller, I tuned out completely. The rain started coming down harder outside. I stared at the screen, not hearing anything and only responding with half-hearted answers. When the call ended, I laid the phone down and continued staring at the screen.

What have I done?

That thought kept going through my mind over and over. If you compared this moment to something, for me, this was like dropping the atomic bomb on Hiroshima. I was so stunned that I didn't even care that it was pouring down rain, so I decided to go for a walk around the block. I was drenched when I came back home. As I was walking, only one thing came to mind...Niney.

Niney was my grandmother who died due to complications from uncontrolled diabetes. I had a front-row seat to her demise as I grew up with her living in my immediate family with my parents and me. Several times in my teen years and early twenties, I took her to doctors, to the hospital, and even spent the night after some of her surgeries. I saw her body deteriorate with time. Diabetes ate her from the inside over the final 7 years of her life.

I still remember the first time I saw how bad diabetes can get. Niney once came to my room where I was alone watching television and said, "Jason, does this look ok?"

I looked down at the foot that she was pointing to. On her foot was a piece of her toe dangling to the side, hanging from a sliver of skin still attached. Her little toe had a callus on it, and that callus had apparently broken loose. I could see down into her little toe with the hole left behind. After looking at that, I looked back up at her. Even at 14 and not being a nurse yet, I knew that wasn't right. Having a hole appear in your toe is not normal. She saw the look on my face, and all she said after that was, "Don't tell your mom and dad."

I could see the fear in her eyes. She knew her body was starting to deteriorate. On March 31, 2021, I was face-to-face wondering, Is this the beginning of my body declining?

I was losing weight without trying. My A1c was 10. I was on the verge of quitting the Ph.D. program. March 2021 seemed like the worst month of my life. This moment was definitely rock bottom. Was the end of this month marking the beginning of the end for me?

As I kneeled on the road that day during my walk in the rain and prayed to God to help me, the end was only the beginning. 

This post is only the beginning of the journey I want to share with you, describing the pitfalls and the possibilities of working through things that happen in life that we don't always understand, but have to learn from to help ourselves grow in faith, hope, and love. I hope you'll join each month as I add new details to this story and share my journey living with diabetes. Because as my provider once said to me, if you can be someone living with diabetes, then that can mean you may eventually be someone living without diabetes.