The Spirituality of Diabetes

by Michael J. Spoula

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The Spirituality of Diabetes

by Michael J. Spoula

2

Title:
The Spirituality of Diabetes, The Chronicle of A Chronic Disease Sufferer

Dedication
I dedicate this book to my wife Mary without whom this book would not have been written. To my friend Bonnie who has fought the sugar wars for years now.

Lord, Make me an instrument of thy peace, Where there is hatred, let me sow love. Where there is doubt, faith, Where there is despair, hope Where there is sadness joy And where there is Darkness light. Oh Divine Master grant that I may not so much seek to be consoled as to console, to be understood as to understand, to love rather then to be loved. For it is in giving that we receive, it is in pardoning that we are pardoned, and it is in dying that we are born to eternal life. St. Francis of Assisi Let us begin now, for until now we have done nothing. St. Francis of Assisi

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Chapter 1 - The axe falls
“I’ve overcome the blow, I’ve learned to take it well…” Jim Croce

I don’t know what possessed me to go to the doctor. I was in reasonably good health, at least I thought so. The last time I had been to a doctor was about ten years ago when I needed to have a doctor sign a statement that I had been counseled regarding HIV. I was not at risk for the disease but since we were going to get married in the State of Michigan they required that I present a doctor’s certificate stating that I had been told about this disease. That particular examination was painless but complete and I enjoyed nine years without intervention by the medical profession. I really had no symptoms of diabetes. My weight had ballooned up to two hundred fifty six pounds in that time. I was a plump size forty-six waist and my pants were tight at that. I began working a night shift job. I hated the shift but I started to lose weight while I was on it. Before I realized what happened I had dropped down to two hundred fifteen pounds. I congratulated myself on how well I was staying away from snack foods. Little did I know at the time that my dramatic weight loss was the result of my body starting to waste away because it was unable to use the sugar I was taking in. Sugar began to accumulate in my tissues and to be delicate, I began to excrete it. I thought nothing of this because I was drinking mass quantities of water, “for my health..” I was simply pleased that I was losing weight. I

got rid of my size 46 pants and purchased size 44. The weight rolled off, I was loosing two or three pounds every week, all without effort on my part. Finally I leveled off at

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two hundred fifteen pounds. I was not feeling bad. I had episodes where my eyesight got blurry and I thought nothing of this since I always had bad eyes and I just thought my age was catching up with me. I went to the doctor and his office tested my urine and they told me that they found sugar in it and decided to test my blood. The nurse told me that they would mail me the results in a week or so. The next day my doctor’s partner called me at work and strongly suggested that I come in the next day for a consultation. I did and my doctor announced to me that I had diabetes. He told me that my blood sugar was some ungodly number such as 625, it was a number so high that what it actually was does not matter. 625 is a good guess. (You would think that I would remember it.) So faced with this evidence I did not argue. I figured I had dodged the bullet for a good long time. Diabetes runs in my family, I was over forty, overweight, inactive and it was not surprising that I had the disease. I had to make a decision right there in the doctor’s office. This decision would affect the rest of my life. I decided to fight the disease and do what I could do to make my life as pleasant as possible while I fought the good fight. This sounds good, but before I could fight the good fight I had to determine how to fight it. Since I accepted the diagnosis right away, on the way home, clutching my script for my medication, I stopped at the drug store. I put my script in and began the customary twenty minute wait. (Why do all pharmacies make you wait twenty minutes? Does it take that long to count out thirty pills?) While I was waiting, I scoped out the various types of glucose meters. Each of them were about the same price. I was going to pick a fancy one but then saw that the meter manufacturers almost gave the meters away so that they could sell you test strips. The test strips ranged in price between twenty five dollars for fifty and seventy five dollars for fifty. Now, I decided early on in the game that it

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would be prudent to stick to the meters that sold less expensive test strips. This is so that if for some reason I lose my insurance, I will still be able to afford the test strips. I picked a “Prestige Smart System” meter that came complete with sixty test strips for only thirty dollars. The pharmacist told me that all meters had to pass government standards or else they would not be sold. I was told by my doctor to get one that recorded test results and one that had a cable interface so I could download the data to my computer. The Prestige Smart System had both, although I had to mail in and pay for the cable later. My prescription being ready I purchased it and the meter and went home. Operating the meter was simplicity in itself. You simply turned it on and set the date, time and a code number from the vial of test strips. I was now ready to go. I sat in our small bathroom and read what I had to do to check my glucose level. It was a three step process that started with sticking your finger. I do not like pain, never have, never will, so it took an act of will to prepare the lancet for use and willingly and knowingly place it next to my finger and pulled the trigger. When I did it I was surprised that there was no real pain involved. There wasn’t much blood either but what little of it there was I got on the bathroom counter leaving the test strip in pristine condition. So I had to punch another hole in my finger. This time I got it right and put a “rounded drop of blood” on the test strip. I immediately put it into the machine. Wrong! I was supposed to wait for the little window on the back of the test strip to turn from white to a bluish color. The meter could not read the sample. The third attempt was the charm. This time I got the blood out, got it on the test strip and waited for the window on the back to turn blue. I had taken my pill right after I got home so I expected a miracle. The doctor said I should strive for readings of between eighty and one hundred twenty. My machine began counting up. Suddenly it

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beeped and what did I see…the number two hundred fifty six was proudly displayed. This number hit me like a ton of bricks. It finally sunk home that I, Michael J. Spoula, was a diabetic. I had accepted the diagnosis in the doctor’s office but the reality of it didn’t hit home until I saw that number, a perfectly terrible number. It was my wake up call. I began to formulate a plan of action.

Chapter 2 - Good Intentions that Scare the Hell out of You “Sometimes you eat the bear and sometimes the bear eats you…” Jim Croce Having resolved to fight this disease as best as I could, I went on to the internet and looked up “diabetes.” I have to caution you, young warrior, if you do this, please be prepared, because every website I went to had only bad news. Each site gleefully reports that if you don’t control your disease the medical profession will be happy to hack off parts of your body for you. That is one way to lose weight that I think would be most unpleasant. Now, please don’t get me wrong. The webmasters that tend these sites have only the best of intentions. The information that they provide is important and education is important if you are going to win battles against the sugar monster. But for this diabetic it was too much too soon, feeling overwhelmed I climbed aboard the Pity Train for a short ride. I suffered for a couple of days with the “Oh woe is me” feelings that come when disaster strikes. Further, well meaning friends and coworkers told me how their Aunt Bessie had her toes and leg amputated because of diabetes. What I thought then and say now is “Too bad for Bessie.” But I did not need to hear about the possible consequences at this time. I decided that I am not Aunt Bessie and the path I walk down will lead to a different destination.. I still think that I made a wise decision to bury my

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head in the sand as far as this potentially bad news was concerned and concentrated on researching solutions, not possible complications. I have been a diagnosed diabetic now only since February 2002 so I am still very much a beginner. What I am going to say next must be taken with that in mind. I believe that many newly diagnosed diabetics that have problems early on do so because they refuse to face the disease and fight it head on. A diabetic that will not lose weight is one that longs for the antiseptic aroma of a doctor’s office. A diabetic that will not alter the patterns of his or her life is volunteering for complications. A diabetic that smokes should save time and money by sawing off his or her own foot. A diabetic that will not watch his or her carbohydrate intake is not accepting what life has brought to them on life’s terms. This is a potentially fatal character flaw and at the very least will lead to serious complications. I do not say this as a judgment on others, I say it as a reminder to myself. I am not God or the Sugar Police. I cannot know what is going on inside the head of another diabetic. I cannot know what tragic turns this disease has wrought in other’s lives. Further, I have not been on a strict regimen for a prolonged period of time and so am not road weary yet. But I do know that as a diabetic I must do all I can to take over for my broken body. I must face the reality that automatic processes that others take for granted no longer work for me. I also must keep in the back of my mind the fact that even if I do everything right, if I fight the good fight that it may not be enough, the diabetes dragon might win some battles. But, if I, as a human being can say that I truly did everything in my power to keep my disease in check and it still goes out of control, I can rest easy in my mind that I could do no more. The disease may be able to ravage my body but in my mind, in the very core of my soul, it cannot touch me if I do what is right no matter what the outcome of my actions are.

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This is true victory over the disease. My best effort is what I owe to myself and nothing less will do. This attitude allows me to look at things in a fresh way. Things that I “could not do without” in my diet before the war against sugar was declared, I am able to be lay aside and keep in my “have some as a treat later” locker. This disease is showing me that you do not need “will power” to change your way of living, you need only a certain self respect for yourself. You need to be willing to change and to accept change as a challenge. The most dangerous attitude for a diabetic as far as I can tell is the attitude of denial. If we deny the disease its rightful place in our life, then it will silently and without mercy, ravage us. It will give no quarter. It operates under a scorched earth policy. We will join Aunt Bessie and suffer the consequences of unchecked sugar flowing through our veins. If we say that “we just can’t give up our (fill in the blank) and we know that it is not good for us, then we sail into the shoals of disaster. If we do not follow the recommendations of our medical team, then they will shake their heads and we will pay their bills and our body will pay the price.

It helps me to think of diabetes not as something of my body, but something that has invaded from the outside. I think of it as an enemy with different faces. My particular monster sometimes looks like pie, most often like a sausage pizza and sometimes like my comfortable chair. That is what is so dangerous about this disease. The monster takes the ordinary things of life and turns them against us, using our inordinate love of them as his passkey into the depths of our soul. That is where the crafty monster will attempt to do the most damage, inside of us. Luckily for us while the monster is a brute, very tricky and clever, he is none the less a bit on the dumb side. Our mind, the great gift that God

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bestowed on us will save us from this monstrous murderer if we allow it to and are open to make the necessary changes in our lifestyles. The rest of this work was written to

share my ideas on how to fight the good fight. My ultimate goal is to have peace of mind. One caution: Take what you like and leave the rest. It’s your life, your body and your spirit and only you know what is best for you. I am not the Pope of Diabetes, you must think of and formulate a plan of action that works for YOU. My intention is to share some ideas with my brother and sister diabetics and to possibly help you to get off to a good start. I do not intend to hurt anyone’s feelings. If something I write seems terse, please chalk it up to a lack of writing ability and not to a lack of charity or compassion. We need to help one another, for only a diabetic can know how another diabetic feels and sees the rest of the world.

Chapter 3 Listen Very Carefully
“You can observe much just by watching…” Yogi Bera

A doctor is NOT a god. A doctor is your employee and should be looking out for your best interests. One thing to remember when you are dealing with the medical profession is to have a healthy bit of distrust about anything they tell you. Be an informed consumer and you will live longer in spite of what the healing profession throws at you. The days when you could absolutely trust a doctor to keep your best interest at heart are gone. This is because of the way we pay for our medicine. We use insurance and in our society those that pay have a large say in how and when they will pay and what others have to do to get the money. But can you trust a doctor in these days of insurance company tyranny? Most medical professionals do their best to provide you with the best

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treatment. Many of them hate the way insurance comes between them and their patients. But beware of the doctor whose only reason for being in the business is to make as much money as possible. They will seldom, if ever, have your best interests at heart. For example, my best buddy was diagnosed as a diabetic by a doctor that was always having his records confiscated by the state due to allegations of fraud. This doctor would routinely bill the state indicating he had seen 20 or 30 patients in an hour. My friend had to fill out new paperwork almost every time he came to the office! Now I really don’t know too much about my doctor yet. Doctor George seems to be an honest man but then again I have only seen him twice since February.1 I did have a couple of discussions with his office. He had me take the HBA1C test which is able to show what your blood glucose has been over the last three months. He had me take it in March when I had been medicated for only a little over a month. The results came back and it showed that my BS (Blood Sugar) was still high. He ordered me to take one and a half pills a day. This was in spite of the fact that my lunch and dinner tests showed LOW readings in the 60’s and some as low as the mid 40’s. I am not a doctor but I thought that for the HBA1C value to change in my favor we had to wait at least three months. I gently prodded his office to change my dosage to fit what my meter was showing. We went to half a pill in the morning and half in the evening instead of increasing my dosage to a pill and a half a day. This seems to be working out. I don’t drag my BS quite as low during the day as I did before and I shudder to think what my glucose levels would have been if I had been the meek little lamb of a patient that many doctors expect you to be. My point is not that

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I have seen Dr. George a several of more times since I wrote this and I am VERY impressed at his care and concern for his patients. My wife has recently become one of Dr. George’s patients…he is good!

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the doctor made a mistake, he didn’t make a mistake. He saw lab values that were high and simply did his job and recommended treatment. I simply voiced my opinion and in this case he listened and changed the course of treatment he prescribed. The important thing is he listened. His ego did not get in the way of treating a patient. Another point to keep in mind is that your doctor won’t know how you feel unless you tell him. They are professionals but not mind readers. If your doctor wants you to do something that you do not believe is in your best interest, you must talk with him about it. Be sure to keep an open mind at all times but make sure he understands your point of view as well. Sometimes you will have to bite the bullet and admit you are wrong or that the professional has more and better information then you have. This will often be the case, after all that is why you are paying him. Yet sometimes as in my case because of additional information you provide he will change his mind and the course of your treatment. It is very important that you do not suffer in silence. (An aside here…please use “her” to describe your doctor if appropriate or if it pleases you, I use “he” because my doctor is male). People who meekly follow all of their doctor’s advice without understanding it have a technical name, they are called “corpses“. To fight the good fight against diabetes you must be an educated consumer. Your doctor must take some time to educate you. You must understand what is expected of you and what direction your treatment is taking. If your doctor is unwilling to explain or talk over your

treatment plan, then you must fire him and find another more responsive professional. It is your life we are talking about here so you not only have the right but the duty to have a professional that you are happy with. You have to live with the consequences of the treatment plan so it had better be one you can live with. If you have a doctor that

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understands you, that listens to you and explains things to you, then by all means keep him. If not, go shopping for another. Always be the squeaky wheel. You are not going to the doctor to make friends with him or his staff. You are going there to receive his best professional services. Sometimes that will mean that they will have to bend for you. This is not unreasonable on occasion. A doctor’s office is made good or bad not only by the doctor but also by the staff that assists the doctor. The staff includes professionals such as nurses and phlebotomists and appointment secretaries and insurance specialists. An uncaring or browbeaten staff will make your medical visits tedious at best and dangerous to you at worst, while a good staff helps the doctor help you. By the way, if your doctor is too busy, do both of you a favor and find another doctor. If he is too busy, he certainly doesn’t have time to give your case the attention it deserves. This means that no matter what his reputation is, he may be treating you while thinking of the next patient, or next procedure to be done at the hospital that is on his schedule. Further, keep in mind that no matter if it is you or your insurance company that is paying your doctor, he is receiving money to treat you. Part of your treatment should include listening to you. If he is not listening then he is not earning the money you are paying him. Even if your insurance pays one-hundred percent of the bill, they pay because you or your employer or someone else pays them premiums so the money does ultimately come from your pocket. Would you pay an exterminator that came into your house and said that he didn’t see any bugs and then simply left? Would you pay a painter that didn’t paint the wall the color you wanted him to? No, you would not. My point is, be a picky medical consumer. If your medical professional does not like that, then perhaps a new one should be found. On the other hand, if you find a doctor that is responsive to your needs, that is

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willing to listen to you, that is willing to sit and design a treatment program around your life style then by all means stay aboard. This type of doctor is a national treasure! One final observation about doctors in general. Remember that they are trained to diagnose and look for problems but they cannot do this unless they have your input. If something hurts, tell them about it. Tell them your concerns and be totally honest and open. They have heard it all and seen it all. If you do this, even a mediocre diagnostician will be able to help you. If you do this a good doctor becomes great and a great doctor becomes a superstar. All too often we go to the doctor and do not give enough information thinking that; “it will go away.” It probably won’t. Give yourself and your sawbones a fighting chance. Tell all and don’t be shy about it.

Chapter 4 - I Refuse to Exercise….well sort of.
“Live to Ride…Ride to Live” Motorcyclists Motto

Some years ago I went on a “get healthy kick“. I joined a “health club” and went to work out several times a week. I always was amazed that the patrons of this health club would circle the parking lot for half of an hour waiting for a parking spot that was close to the entrance. These same people would then get into exercise gear, and walk in place while standing in line while waiting for their turn to walk up an artificial moving staircase. Is it just me, or do you see something wrong with this picture? As it turned out, all of the sweating I did at the club did not cause me to lose one ounce of weight or even feel better about myself. I still felt and looked “fat” and had not learned the proper way I should

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eat. The club got richer. I quit going. With respect to health clubs, unless you have an iron will, stay away from them especially when they offer special deals that sound too good to be true. You will go in for their $19.95 special membership and leave with their 299.95 Golden Platypus Membership that entitles you to one free hour of aerobics each week and a clean locker. The $19.95 special locker is specially conditioned to smell like sweat socks! They will try to high pressure you into something you probably don’t need or want. So, I resolved that I would not be taken in by health clubs. I have a mental problem when it comes to doing artificial work to stay healthy. I have never been very athletic so I decided that I would walk to help my poor broken body to use the insulin it was making in such great quantities. I started in March of this year.2 Around the place

where I work there is a walking path which is quite pleasant to roam on. It cover 8/10ths of a mile and has gentle hills to exercise your legs. To begin with, I checked with Dr, George. He said that this would probably work for me. I then purchased a heart rate monitor watch, various models are available, I got one for $49. Various companies make them and they range in price from $49 to over $100. Mine works just fine. When I “power walk” I try to raise my heart rate from the 75 where it normally is to around 120 or so. I try to keep this rate up for at least twenty minutes. At first it was easy to get the old heart rate up. After all, Couch Potato Mike’s heart was used to lifting potato chips up to his lips and not to walking so it had to push blood faster then it was used to. Now, it is getting harder and harder to raise my heart rate that high, and I am told that this is a good thing. Walking is an inexpensive, low impact method of burning that excess sugar that

As of the end of June, I have logged 150 miles and over 200,000 steps! The pedometer I wear keeps me honest and working towards my fitness goal.

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we diabetics have in such abundance. Actually burning is not correct, what happens is the muscles are forced to take in the insulin that your body has made. The wonderful thing is what I noticed was the day after I started walking. My morning blood sugar readings dropped from the 150’s down to the 80’s, which is a great territory to be in. I try to walk at least two miles every day. I have walked with snow hitting me in the face and felt kind of foolish, out there in my parka, but it has been worth it. On the days I cannot walk I feel cheated. Here are some things to watch out for. First, be sure you speak with your doctor and get his/her approval. If you are on insulin be sure to check your blood sugar before and after you exercise and medicate/feed appropriately. All diabetics should take a quick source of energy with them on their walks, such as some candy, or glucose pills or gel. Bring water and schedule stops in your walk to drink some even if you don’t feel thirsty. Start out slowly, let your body get accustomed to moving again. If you have been inactive for a long time, like I was, make your early walks short, say just around the block. Don’t strive for distance or speed at first. If you are very overweight, just carrying your bulk around will help you burn calories. Increase the distance you walk over time. After all, you have the rest of your life and now that you have resolved to take care of yourself, that will be a very long time indeed. After you acclimate your body to non couch related activities again, bring along your favorite tunes and march to their beat. You will need to make sure that your shoes and socks fit well. Moisturize your feet before you begin and have socks that do not slide around or you will grow a blister or callus and that could be very bad news for diabetics. When you are done, moisturize and rub your feet again, you will find this a very soothing reward for a job well done. With that said, enjoy your walk. Look around at nature, at the trees and birds, and become one

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with them as you walk. Meditation can replace some of your medication some have said. Walking is a good way to meditate. Our blood sugar readings are affected greatly by our emotions. Walking and meditating can lower our reading in two ways. First of course, when you use a muscle it will be forced to take in energy, and it does so long after the walk is done and that means our blood sugar level will go down. Secondly, when we get the good feelings that walking brings to us, our emotions get under control and the world looks to be just a bit brighter place. This contentment will have a positive impact on our blood sugar readings. Finally, you must remember that walking or other exercise is not a guarantee that your disease will be brought under control. But not exercising is a sure way of allowing the disease to dominate your life by providing you with a seemingly endless series of complications. Check with your diabetes educator because sometimes exercise is exactly the wrong thing to do especially if your blood glucose number is very high or very low. Remember, for a diabetic the rules have changed. Make yourself aware of the rules and keep them in mind as you go through life. Walking is most assuredly one way we can be sure that we are doing all we can to help ourselves. Once again, and please forgive me for emphasizing this point, that is what counts. If we know that we have done all we can do, the disease can ravage our body without touching our soul and that I have learned as I walked in the March cold with snow hitting me in the face. I look forward to the Summer so I can learn more about myself through the miracle of my legs as my God speaks to me through His creation, while I walk in the beautiful garden we call Earth.

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Chapter 5 Food - The Ultimate Question “You may eat of anything in the garden except the fruit of the tree at the center of it.” The Bible
“Please sir, May I have some more?” Oliver Twist “Once I was lost at sea and nothing to eat but food and water for seven days ” W.C. Fields

Food has stirred controversy from the beginning of time. In the Garden of Eden, food was the downfall of man. The devil tempted Eve, who should have known better, who tempted Adam, who should have known better. Then Adam, in a flash of desperate depraved inspiration assured himself a cold night outside of the cave when he went and blamed the debacle on Eve. Well, Adam actually blamed God, because he blamed the woman God put in the garden. Theological niceties aside, the reason why Adam and Eve ate the apple (although an apple is not actually mentioned in Genesis) is because they were told they could not do it. Because it was a “no no” it became desirable. Because it was desirable it became their main focus. Because it was their main focus it obtained a power over them that it would not normally have. So the game began, Apple 1 Humankind-0. So it is for us diabetics. We focus in on the wrong side of the equation. Our mind tells us we cannot eat that pint of ice cream. (I love ice cream.) We despair because those M and M’s are now out of reach (I love M and M‘s) . We mourn for what

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we cannot have. What we need to do, and do swiftly if we are to take over for our wounded or broken automatic system is to focus on what we can have. In short ALL food choices are open to us. There is not a thing we diabetics cannot eat. With this being said, we have to approach the bounty God provides scientifically and with an eye as to what will help us keep our body working well. Your first stop should be a session with a dietician or nutritionist. Together you will decide in conjunction with your doctor what goals you should strive for. The dietician will help you in forming your game plan. It is interesting, if you look at my BS charts, you can tell by looking at them the day I had my appointment with the nutritionist. My levels were slowly coming down just because of the medication I was on and the increased activity my body was experiencing. But when I started eating the right things in the suggested quantities my BS levels dropped dramatically into the normal range and sometimes even below it. Diabetic meal

planning is no different then other meal planning except for one minor difference. Diabetics measure what they eat and the portions that diabetics eat fit neatly on their plates. Diabetics stay away from “Supersize” portions and many bad fast foods.. The

diabetic diet can be healthy for everyone who wants to lose weight and feel better about themselves. If you want to lose weight the formula is very simple. Use more energy calories then the food calories you take in during the day and you will burn some of the reserves your body stores as a substance called “fat.” For us balance is an all important concept. We need to have a good variety of foods from each of the basic food groups. I am not qualified to lecture on this subject so I am going to let you visit with a nutritionist to get the nuts and bolts of the system. I can however tell you what has worked for me thus far and some concepts that I know are important to win battles against the Sugar

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Demon. First I would suggest you keep a food diary. Write down EVERYTHING you put into your mouth during the day. Be sure to include the condiments, such as butter, margarine, breadcrumbs and the like. Next get a chart that tells you about the food you eat. I use a program called Cybernetic Dietician (Available for download from Satori Publishing, about $20.00) and I use a book called Barrons Quick Check Food Facts (Carolyn E. Moore, PhD, Barrons Educational Series Inc, ISBN 0-7641-0874-3, $4.95) Both the program and the book were the most reasonably priced, yet extensive resources I could find. Some of the diabetic diet programs will actually “help you” plan meals, but this function comes at great cost. In any event, the day of a “special” diabetic diet has come to an end. Next you will want a good kitchen scale. They are not expensive either. Remember I said that the diabetic meal is measured. This scale will teach you what four ounces of meat looks like in one piece. You will also need a couple of good measuring cups and spoons. Armed with all of this you are ready to have fun in your “diabetic” kitchen. I can’t presume to tell you what to eat. What did you eat before? It is possible that you can eat the same sort of things you ate before you were diagnosed, just not in the same robust quantities. Common sense should dictate some of your choices. Let’s stay away from sugary things such as sweet rolls and doughnuts…(ouch?). But let’s enjoy a good variety of fish, poultry and vegetable cooked in innovative ways. You can be a gourmet and be a diabetic. As a matter of fact, you will become a more imaginative cook with diabetes then you ever thought possible. Here are some ideas for you. Maintain a list of everything that you eat. Record what, how much, and when you eat. Using your computer program and/or food reference guide be sure to record the number of calories, carbohydrates, cholesterol and sodium you are taking in. Also have a space to record

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your blood sugar levels so you can see what certain foods do to you. Don’t panic. I don’t think you need to do all of this detailed record keeping for the rest of your life. I did it faithfully for two months until I could recognize the patterns of my eating habits. Every so often I will do it again to check my progress. Early in your war against sugar this list will also “keep you honest.” This is true especially if you vow to yourself to write down everything that makes it past your teeth. By everything I mean down to an estimate of how much breading was on the chicken breast. Compulsive? Anal Retentive? You betcha! After awhile reading packages and recording what you eat will become second nature to you and will provide you with valuable information about what foods are best for your body. Take your food listing to your next doctor’s appointment along with your blood glucose log. These two documents will help you and your doctor tweak your war plan. One final note, at the start, measure everything. Soon you will be able to judge what four ounces of meat looks like or what a half cup of peas is. I want to close this section by touching on the general side of food. We Americans eat too much of the wrong stuff. We diabetics have to watch and balance our meals with care. In the old days many diabetics ate a lot of meat because protein does not convert to sugar in the blood. Ten percent of the fat in meat does. Today we know that diabetics have to watch out for sugar’s evil partner, cholesterol. If you are a diabetic you probably have been diagnosed with high cholesterol too. What happens is your body gets confused by the excess sugar in the blood and has to do something with it. A message goes out from your liver saying, “Hurray! Let’s make some cholesterol.” Cholesterol is the culprit that will clog your veins and cause heart attack and stroke. So, don’t be allured by the fact that meat does not create sugar. It creates sugar’s evil cousin cholesterol. I decided early on in the

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game that if it didn’t have fins or feathers while it was alive I probably wouldn’t eat it. I also decided that vegetables would play a larger role in my diet then they had before. Strive for balance in your diet. Eat smart and you will be able to defeat this disease and live a happy normal life. Eating right is another first line of defense in our war against blood sugar. Make your defensive line strong by following the recommendations of the dietician. Make it strong by being creative in the kitchen so you don’t get bored. And educate yourself through trial and error, through frequent blood testing, and common sense so that you will know what foods work for you and which ones do not. Treat yourself well because you deserve nothing less!

Chapter 6 - Now What?
“The only thing we have to fear, is fear itself” FDR

“Let us begin now for until now we have done nothing.” St Francis of Assisi” So you have been told that you have a disease called diabetes. Your body no longer is able to break down and use sugar. You are now condemned to a life that is somehow not worth as much as it was the day before you were diagnosed. Oh poor you. Forgive me for saying this but if you believe what I just wrote you are probably a candidate to purchase certain bridges that are placed up for sale in New York!

When your doctor told you that you were a diabetic he did not tell you that your life was over. He told you that you were going to have to watch your intake of sugar. Your

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future is very bright. Soon you will learn things that you (and all other Americans) should have been taught from day one in school. You will learn how to nourish your body properly. In learning this you will see that all choices are open to you even with your inability to use the sugar that food provides. Once you begin taking your

medication you will feel better. For me the benefits began early. The day after I started my “pancreas helper” as I call my little blue pill a veil was seemingly lifted from my mind. I began to think clearer. My memory, which I thought was being ravaged by age improved. My vision became more acute, less blurry and those small letters I couldn’t see on the computer screen jumped into focus again. I learned the simple joy of

communicating with my body. It tells me when I need to get off my dead…..ah…when I need to exercise. I love my walking because it keeps me in touch with my body. Diabetes has meant that I have had to change many things in my life. The changes have not always been pleasant but most of them have been easy and simply a matter of adjusting my focus. I used to look for ways to avoid exercise. Now I try to find ways to do it. For example, I have ridden the elevator at work twice since February. Once because someone gave me a plate of cookies to carry down from a meeting room. (I did not eat any of them.) And a second time simply because I was lazy. Holy cow, I didn’t realize that they had remodeled the interior of the elevator cars! I also have to plan my life a little more so as to take better care of myself. For example, my wife and I visit a resort community called Door County two or three times during the summer. We had our haunts last year. We went to breakfast buffets, and lasagna dinners. This year we both avoided buffets. I brought my breakfast with me and we both ate sensibly and well and did not miss the things we both had to change. This brings me to the point of this

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chapter. My point is that how well you cope with diabetes will depend largely on the attitude you form about your life, post diagnosis. It is very normal and even important to mourn and weep a bit because the disease seemingly has taken away some of your freedom. For me it took away the freedom to be fat. For me it took away the freedom to be lazy. For me it took away the freedom to eat like a swine every time I dined. These are freedoms that I never needed to have in my life anyway. Do I miss anything about my former way of life? If I were to tell you “no” it would be a lie. I miss sitting down and eating most of a large pizza for dinner. I miss not being able to put my hand in the candy dish at work. When I was able to do this I did so non-stop. And certainly, sometimes I feel sad that some of the things I used to eat I choose to avoid now but because my body has a broken part, and I need to make adjustments to allow for it. That is what we diabetics have to do. Now for the spiritual side. Don’t worry, I am not going to talk about God, although I am a believer and believe that a person with God in their life will cope better with diabetes, I have no intention of preaching to you. If you want to be preached to, get thee to a church! Instead I want to tell you how I cope with this challenge we call diabetes on a daily basis.

First, I try to live one day at a time. Sometimes I fail. I have to think in a new manner. Right now, at this very minute, I have a roof over my head and food in my ample stomach and two cars, parts of which I own, in the parking lot outside the apartment building. That is all I need to worry about, right now. If you spend your life with one leg in the past and the other in the future what part of the body is aimed squarely at the present? So, live in the present with what you have to deal with now. Tomorrow will

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present a whole new series of challenges, but we don’t have to deal with them until then. Our body listens to our mind. If I am worried or tense, my body goes to work and prepares me for fight or flight. This can increase the amount of sugar in my blood so I try to keep worry to a minimum. I try to deal with things one at a time, as they occur. This keeps me sane. (As I understand sanity!)

I also claim the right to start my day over again as many times as it is necessary to make it a good day. This means that no matter how bad a day starts out, I can cancel that day and begin another at any time. This concept sounds nice but in practice can be difficult to do unless at the same time you restart your day you change your attitude about the situation or event that prompted the change.

Everything that is “us” comes from the inside. Smiles and frowns have the same beginning. Prior to our diagnosis we gave no thought to our pancreas. We need not let it rule our life now either To adopt a healthy attitude and a healthy way of living will make dealing with this chronic condition a lot easier for us and for those around us. As I said before our choices are without limit provided we are prudent.

Support is everything especially at the start of the fight. Unfortunately for us our first attempts at reaching out may cause mental discomfort to us as we read the horrible things that can happen to a person with unchecked diabetes. (Remember poor Aunt Bessie?) Our family is one place support should be available, but there too, there may be more

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misunderstanding then understanding about diabetes. Some relatives might discourage you with horror stories as well. Real support will come from other diabetics. Only a diabetic knows the fear and the utter loneliness that you can feel as you struggle to come to grips with the condition especially at the start of the war. For example, I felt really sad the first time the place where I work had a pot luck luncheon and I had to stick to my carefully measured meal. But you must reach out. For some of us that will be hard to do because all of our life we have been trained to be self sufficient and not a burden to others. If we are to succeed in building a new life for ourselves we will need the good counsel of others with the same problem. What you are feeling right now they have felt. The questions you have, they have had and have asked as well. Reach out in the darkness and you will find light. Your first stop should be the internet. Services such as “Yahoo!” have clubs or groups that cater to people with many different interests. Diabetes clubs and groups flourish. Check them out.. Don’t stop there. The idea is to acquire a broad based support system. Check with your local hospital and find out if there is a support group that meets there. Many hospitals have them and most of the time membership is free of charge. The American Diabetes Association may be a good resource too. I must confess that I don’t know too much about them. I receive their email newsletters which are free and informative if very brief. Their website is rather disappointing because the emphasis seems to be on selling information. But I assume that they do good work in ways my eyes cannot see at this moment so I would suggest you visit their website. You definitely need to read the information that they provide about the complications that can arise if we do not address the disease. This will help you decide which road you will want to follow. Also their books are concise treatises on

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what a diabetic should do. I think that their standard price of $14.95 is a bit high, but that is opinion and the data is very useful to have although with a little searching less expensive sources might be able to be developed.

Depression goes hand and hand with diabetes. Know the warning signs of clinical depression. Keep in touch with your feelings and express them using your support system. Everyone has “blue” days and not all of them are related to blood sugar. If you string fourteen or more blue days together or you lose interest in things that used to interest you, then see your doctor at once. Help is there. You must take charge of your care and reach out and find the help you need. Blue days do come to us all. As human beings we react in certain ways. Some of us cry, some of us get angry, some of us eat when we feel things are piling up. Be very careful how you react to stress. Find creative outlets such as exercise. Become creative. Write or paint or do something else that you enjoy. Always strive to make your ride on the pity train a short one.

But is this a game that we can win? Can we really take over for our broken body and do for it what it cannot do for itself? I believe the answer is yes, even though my “yes” is a provisional answer. Victory is not a state of being, victory is an attitude. If you follow your food and exercise plan faithfully chances are very good that you will have a good deal of success in defeating the enemy. Take each victory as it comes and enjoy it. You must know that the disease will win on occasion. There will be times that no matter what you do, no matter how faithful you are to your war plan, battles will be lost. When this happens, how you react will either confirm your defeat or will snatch the victory away

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from the enemy.

There are so very many things we diabetics have to remember.

Especially at the beginning. If we think of going “the long haul” then we will get road weary and tired. Control will slip from our fingers. My personal motto reminds me what I am to do on a daily basis. On a daily basis I am to begin again as if it was the first day. I need not look to the future or dwell in the past. My motto is: “Let us begin now, for until now we have done nothing.” Begin every day fresh and keep your attitude good and no matter what this damnable disease does to you, you will be okay on the inside.

Is it worth the fight? I think so. I know the pain of hearing the initial diagnosis. I know the strange sense of loneliness that comes when you watch someone stuffing themselves with a treat that we used to find especially wonderful. (Make mine cheese cake, I used to cut a Sarah Lee Cheesecake into four slices, that way it would last two days…why did I put on so much weight?)

Chapter 7 Ten Suggestions “LET US BEGIN NOW FOR UNTIL NOW WE HAVE DONE NOTHING”

Forgive me if I have used the words that you see above before in this document. It has a powerful effect on my life because it was uttered by St. Francis of Assisi just before he died. Any authority on the life of the Poverello will tell you that these were the utterance of a dying man. Anyone knowing the story of Francis will be amazed that the saint could have said these words when he did, at the end of his life. He did so much and yet he

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counted none of it to his credit. He was willing to begin again and again and once again until he had it right. As a diabetic I too must be willing to begin again for it is not possible to remain completely faithful, one hundred percent of the time. Here are ten suggestions that may help you live a more productive life in spite of your condition: 1. Do not be lazy Laziness will ruin your program. You must remain vigilant and active, both physically and mentally. Physical activity will allow your body to use the insulin you have no matter if it is made by your pancreas or if you have to inject it. It will allow you to use less of the drug. Mental activity will allow you to discover new ways to control your disease and even prosper with it. 2. Eat right Measure your food until you have a good idea the amount you should have looks like. Embrace more vegetables and less meat. Make sweets the treat that they were meant to be and give them a place in your diet. Eat many different foods, balanced.

3. Focus Focus on what you can eat and not what you cannot. Focus on the good things in life and not the bad. 4. Be Creative Be creative in the way you cook, the way you exercise, the way you look at life. Nothing will destroy your plan quicker boredom. Nothing will bring on boredom quicker then a lack of creativity in your planning. 5. Never Look Back

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Your post diagnosis life is much better then it was before you began to get your disease under control. Your efforts at control will net good results and you will live well in the future. To look back is slapping the future in the face and ignoring the good you have in the present. 6. Don’t Swim in the River Don’t swim in the great Egyptian river, you know “denial.” (sorry about that) Accept the word of your medical team and get on with your life under the new rules you have been given. 7. Sympathize with Aunt Bessie, but don’t imitate her. Remember the Aunt Bessie I spoke of that lost toes and legs to diabetes? Sympathize with her and understand that what happened was not her fault. Then resolve to do your best to defeat the Great Demon Sugar. Bessie’s path and yours are different. 8. Realize that for right now there is no cure. At this moment, diabetes has no cure. Great advances are being made almost on a daily basis. But we can’t live on tomorrow’s promises. We need to live in today’s realities. That miracle herb that medical science won’t approve probably does not work. Grasping at miracle cures is a waste of time and money. Clinical trials of course are worth while activities and by all means look into them, provided that they are being conducted by reputable people.

9. Reach out for help when you need it and give help when you are asked for it. You are a member of an ever expanding fraternity. While the fact that more and more of us are being diagnosed each year is sad, it also means there are more of us to lend support

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and comfort to each other. Don’t be proud. You will do better with help then you will do without help. Also, be ready to help another if asked. I remember how I felt when I was diagnosed. I remember the loneliness I felt and how I was afraid of what the future would hold for me. My friend Bonnie, a world class diabetic, helped me get over the shock of diagnosis and gave me comfort and courage just by being there for me. I remember that first Saturday I saw her after I was diagnosed when I told her my blood sugar that day was 252, (it had been 600 the day before) she did not panic me by telling me how bad 252 was, she simply said, “Hmm, we have some work to do yet…”

10. Be Spiritual Give to Diabetes only what belongs to Diabetes and make sure you keep what is yours and don’t let the bastard have any part of what belongs to you. By this I mean work on changing your attitudes and actions in those things that affect your blood sugar. You are a person with an inability to use sugar. Deep down inside you are the same person that you were before you were diagnosed. Nourish the spirit inside you. Always be ready to learn. Do not become a mental loafer. Take time each day to sit down and count the many blessings that are yours in spite of and perhaps because of diabetes. If you do this and make it a habit, you will be free of the mental ravages that a chronic process like diabetes can bring to a persons life. If you are feeling blue for a long period of time, realize that this is not normal and get some help. It is nothing to be ashamed of, it is a chemical problem, not a moral one!

Chapter 8 After A Year

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“There is a joy in the journey…” Michael Card I have been writing this little paper for about a year now. I began it shortly after I was diagnosed and just read the whole thing again tonight. I like it. I still agree with most of the things I said above. I have visited my doctor several more times and have a deepening respect for the quality care he has lavished on me. Dr. George is a national treasure as far as I am concerned. After a year I have learned more about myself and my body. I have come to respect it more. I am amazed that my body continued to work as long as it did before it broke finally down. I am amazed at how resilient it was and is. It took a lot of abuse from me. I am grateful to the Great God that provided me with such a magnificent engine. Now, a year after diagnosis, I am enjoying the journey I am on. I try to do healthy things. Making healthy choices has become easier for me now then it was before. But I would be lying to you if I told you that my discipline was as strict today as it was nine months ago. While I still am very careful as to what I eat, I sometimes allow myself to enjoy a treat, something that I would not have even come close to considering when I was first diagnosed. At the beginning diabetes was almost an obsession. My doctor’s office even told me my record keeping was too stringent. I didn’t understand then, but I understand what they meant now. I still keep good records. I watch for trends in my numbers. I still do what I need to do to keep the Demon in

check. But now I have learned to give it its proper place. I think that I am coming to think of myself as a person with diabetes and not a diabetic. The difference in my mind is subtle but important. A diabetic, in my mind, is a person with a fundamental physical weakness. The disease is in control and a twenty-four by seven fight has to be joined to defeat it. On the other hand if I consider myself as a person with diabetes, I have placed

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the fight into proper perspective. Yes, I must watch what I eat, and I must make certain that I get my exercise and take my medication and so on. Yet if at times I fail, I learn to forgive myself and I pick myself up and get back into the fight. The former will get tired of the fight, while the latter incorporates healthy changes and attitudes that can be nurtured and become sources of strength.

My goals after one year are modest and attainable. I was just weighed today and weighed in at 192. My goal that I wish to attain by the fall of this coming year will be to weigh between 175 and 180 pounds. Secondly last walking season I walked over 500 miles. I want to at least duplicate this distance. Third, one Saturday I want to walk from my home to my church, a distance of some 14 miles. My longest walk last season was 9 miles.

I am about done with this paper. I cannot think of anything else to say that would be particularly useful to the novice. I guess I will close with a message of hope. I hope that the reader, if newly diagnosed, takes the fight against this disease process seriously and begins to fight the good fight. I hope that someday there will be a cure, but I hope also that the reader does not place faith in the nebulous future, but rather deals with the disease in the hear and now. I hope that the spirit of the newly diagnosed person does not grow weary or despairs at the prospect of change that diabetes brings, but rather accepts the challenge and incorporates the required changes into the totality of their being. Finally, I hope that the newly diagnosed finds peace and serenity in their life as they adopt the healthy changes in lifestyle that will defeat the Dragon we call diabetes.

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