A few weeks ago, on a Thursday night, I was strolling to my new AA home group (I just moved), when my phone rang. It was an unfamiliar number, but I answered anyway. "Mr. R--?", queried the caller. Oh boy, I thought; what is this guy selling? "This is Dr. S--, and I just got your lab results back. We need you to come to the hospital."
Thus began the first conversation of my new life. The life in which I am a diabetic.
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Of course, in retrospect, I realize that I've been a diabetic for a while now. Just as I was an alcoholic long before I admitted it to myself. I have been in denial. Addicts do that. They (we) ignore cold, hard reality, preferring the sweet whispers of delusion to the truth.
Do you mean now?
Mr. R--, your blood sugar is 600.
I'm guessing that's bad.
A normal blood sugar is less than 100.
Oh.
My love affair with sugar began in childhood. I used to get 25 cents a week for my allowance. I would take my quarter, walk down the hill to the local store, and buy candy. My favorite snack was Mrs. Butterworth's Syrup with white sugar mixed it. The weekends meant pancakes for breakfast. Mom mom didn't buy fruity drinks, but Phil Gallagher's mom, who was so big that she always wore brightly colored muumuu's, did. Especially Hawaiian Punch.
On special occasions, my dad would conjure up his hot fudge sauce, using Hershey's Cocoa, sugar, butter and a pinch of salt to work his alchemy. The sauce would pour hot and liquid onto the ice cream, then harden to a soft toffee-like chewy consistency. Nowadays, three heart attacks, one quintuple bypass and a diagnosis of congestive heart failure later, Dad doesn't remember how to make the sauce any more.
A trip into the city meant Rocky Road ice cream at the Swensen's parlor at the top of Russian Hill, Mocha Fudge ice cream from Bud's down in Noe Valley, or Coffee Toffee cake from Fantasia Bakery in the Sunset district.
Doctor, I can't come in tonight. I have nobody to watch my autistic son.
Well then, we'll see you first thing in the morning.
I got braces in junior high school. By the time I got them off, I had thirteen cavities. It took two visits to the dentist to fill them all.
I started drinking during the summer between junior high and high school. Not because my friends were. For the first time ever, I was alone with my parents. My sister was off to college, and my brother was in Germany. By that point, my parents were drinking every night. They were upstairs and passed out by ten at the latest. At that point, I got my sugar fix from booze. I usually drank until 1 or 2AM, and then passed out. My parents never noticed.
Off to college I went. The first year was a haze engendered from the by-products of various plants. Dining Service was all you could eat, and I did. Especially desserts. On penniless weekends, I took trips to the store, to load up on Twinkies, Three Musketeers bars and Dr. Pepper.
The years went by; I (barely) graduated from college and got a job. Every morning on the way to work, I would stop by Rindelaub's Bakery for one of their manhole-sized apple fritters. It was a sad day for me when they closed. By this point, I was beginning to lose my svelte shape. After ten years of abuse, but holding at 135 pounds, I began to finally gain weight. I remember seeing a video of myself entering the company lunch room for an event. I was unconsciously tapping my belly.
My drinking was ruling my life, but one day a window of clarity opened, and I was able to see the truth about myself. With the help of an institution, a power greater than myself and countless loving strangers, I stopped drinking. In the beginning, I used to get cravings to drink. I got in the habit of carrying bags of plain M&Ms around. I found that some quick candy would blunt the cravings.
We want to keep you in the hospital for another day, Mr. R--. We want to move you to the family medicine unit and to continue to monitor you.
But my blood sugar is down to 300. That's one hell of an improvement. And you told me I could leave today.
We spoke with Family Medicine; this is their directive. They want to have time to train you to use insulin, and so on.
Wait a minute. You told me metformin would be enough.
Well, they have other ideas.
I am not staying here overnight. You need to understand something. My ex is watching my son. My son is autistic. This is only the third time in eight years that she has watched him overnight, and it's not going well. I am going home today. Figure out a way to make that happen.
Five years sober, I quit smoking. The following spring, I took that trip to Ireland that booze had always promised me but never delivered. And then I got married.
My new wife was a baker. Jewish apple cake to die for (in retrospect, literally). Pizzelles with oil, not extract. Cakes, cookies..life was good.
We were opposites who were attracted. Sometimes, a lot of times, that works out. In our case, it didn't. But long before that became obvious, we had a child together. Evan Robert Patrick Maron R--. The light of my life. The most beautiful child ever born. She breastfed him for an entire year. He glowed with health.
I remember when we got married at the Maronite church in South Philadelphia. Father Sharbel needed to kill some time, as our singer was late in arriving, having elected to pull a wedding two-fer that day. He looked at the assembly of family and friends, and shook his finger. "Don't just be here for the wedding. You must be like the cedars of Lebanon, and stand with this couple as time goes by." In the very beginning, especially after Evan was born, that happened.
Evan was slow to reach the infant benchmarks. One day, when I took him to visit his great-aunt Diane, she touched him on his back. Evan screamed as if he had been scalded. A few months later, as Evan was sitting in the high chair, his eyelids started fluttering. His mom cried out "Evan is having a seizure. I had a dog who had seizures. That's what they looked like." We rushed to the hospital and, yes, our boy was indeed having seizures. If you were like me, you thought of epilepsy as something that causes people to roll around and bit their tongue. But Evan was just staring off into space. I used to joke that he was conversing with the angels. "Your son is having perhaps hundreds of petit mal seizures every day. It's as if his brain is a blackboard, and is being erased over and over again."
OK, Mr. R--. A nurse who works with Type 1 diabetic children is going to train you how to read your blood sugar, and how to inject yourself with insulin. You will be out of here by late afternoon.
Thank you. I'm sorry if I offended you, but I can't spend another night away from my son.
Well, I don't understand what it is like to have an autistic child, but I empathize with you.
Right, about that. We were devastated to learn that our boy had epilepsy. Imagine that he might never be able to drive a car. But it might be juvenile diabetes. It might go away some day. Two weeks later, the neurologist dropped an anvil on us. Evan was autistic. (Today, I say an autistic. But in the beginning, I thought of autism as a disease, rather than a state of being).
I remember the doctor's visit when we got the formal diagnosis. I knew what was coming, although my wife didn't. My brother had flown in from California and my sister came down from New York. The doctor was an older woman (although when I Googled her later, it turned out she was a new doctor. Appearances can be deceiving). The doctor said, "Mr. and Mrs. R--, your son is autistic." My wife blurted out in despair "What are we going to do?". The doctor shot her a withering look, and said "Well, you can always have more children." No. Really. You can't make up sh** like that.
I work in the financial field, and it was pretty tough to make a living at the time. (This was right after 9/11). So, my wife was a mess, work was brutal, and my boy was autistic. Needless to say, I was feeling a lot of stress. I am happy to tell you that this did not lead me back to a drink. But I can't say the same thing about food.
I started binging with food from time to time. Pizza for lunch; ice cream late at night. The pounds started adding up. By the time I was finished, I had gone from around 165 to around 200. Then my marriage started falling apart. By the time that process was through, I was up to over 225.
I don't want to bore you with the details of my failed marriage. As with any relationship, there were plenty of variables which added up to disaster. Suffice it to say that our friendship now is much better than our marriage then. I will say that the strain of having an autistic child did not help matters for my wife. And that, as time went along, her family, uncomfortable with our son, increasingly distanced themselves. The bottom line was that she left, and our boy stayed with me.
Now lift your shirt, Mr. R--. Good. Do you see that fat around your belly?
Well, Nurse ---, it's pretty hard to miss.
That's where you're going to stick the needle.
Will it hurt?
You'll get used to it.
We entered into an uneasy partnership. Although, at the beginning, I thought she would have not objected if I took my son to California to be near my family, I knew that would be short-lived. Even as she could not spend a whole day and night with him, as their energies over time created a toxic storm, she still loved (and loves) him like crazy.
Whatever else I might say about her, my wife was a great cook. Not just baking, everything. And she cared about proper nutrition. After she left, although I was careful what my son ate, I went to town on junk food and sweets. Until I got up to 242. At which point I got scared, for a while at least.
My dad had his quintuple bypass around that time, and had gone on the South Beach Diet. He had lost a lot of weight, and my mom had joined him. I decided to give it a whirl. It worked. By the time I stopped the diet, I was down near 200 pounds. And feeling great.
Mr. R--, you're going to need to watch what you eat.
Oh I know, doctor. I'll be careful.
No, that's not what I mean. You need to start counting carbohydrates.
Why is that?
We need to make certain that you are eating consistently, so that your blood sugar doesn't spike too high or drop too low?
Why is that important?
On the one side, it could cause major health issues. On the other side, you might get faint, and even go into a coma.
Ulp!
Part of what was working was that I began consistently preparing meals for myself. There was a great farmers' market near me on Sundays, and I was loading up on great food. Once the season ended, I began to slip off the wagon. The next thing I knew, I was back to 242.
(Note: I may be giving the impression that this all happened rapidly. It actually was a process spread over many years.)
At this point, I went to the doctor. My family doctor, who knew of me only through rumor and whispers. My ex goes to him as well, so he at least knew of my existence. Heaven forbid that I should ever darken his door. Now, I can make a lot of excuses as to why I hadn't gone earlier: I was raised a Christian Scientist, I'm a man, I've never been sick, whatever. It's all malarkey. The truth is that I was afraid. Better not to know than to know. Once again, malarkey. But I am operating in this diary under the old Biblical admonition: Ye shall know the truth, and the truth shall set you free.
So I went to Dr. S--, and the truth is that I liked him right away. I mentioned my weight, and he was positive and encouraging. He advised me to lose a few pounds and exercise, and then we would take some tests, rather than suggest that I go on cholesterol drugs right away (my numbers were high; at least my bad numbers were.)
I walked out of the office resolved to follow his advice. And then did nothing. That is until I hit 250. Another thing started to happen. My boy, you know the autistic chap, was getting stronger. I began to have trouble keeping up with him. And I was beginning to accept what I had already realized earlier. Namely, that there was a very good chance that he would be living with me a lot longer than I had first presumed. And that his mom would not be able to handle him if anything happened to me. Also, my siblings, whom I had vaguely considered a back up for me, couldn't either. My sister, the only member of my family on the East Coast, certainly made an effort. She moved here for a while, and would babysit every once in a while so I could get a break. My boy loves her to bits. My brother loves Evan, but an experience on vacation, when he walked away from us when Evan melted down on the sidewalk, was an eye-opener. Neither sibling is married; neither has kids.
And, Mr. R--, you need to exercise.
Should I join a gym?
No, that never works. Folks start with good intentions, and you know what they say about good intentions. Walk a half hour twice a day, and do push ups and pull ups. "Girly" push ups are fine. I want you to do something you will continue to do.
I can do that.
Of course, I couldn't go back to the doctor until I lost some weight. So I didn't go back. I did, however, with the assistance of my ex, begin to diet. Not South Beach. Not even any kind of formal diet. Just cook whenever possible, use fresh ingredients, and eat until I'm satisfied, instead of until I'm full. And drink water; loads of water.
I started this diet in March of 2010. And it was working. I lost weight. Not too fast, not too slow, but consistently. By the time I went on vacation with my siblings and my son in July, I had lost 35 pounds. Something else happened around that time. I started to get this urge to pee suddenly. I figured that it was because of all the water I was drinking. That's not entirely true. There was a small voice in my head which started yammering about my prostate. You know, enlarged, cancer, whatever. I dismissed the voice. I just needed to keep losing weight. By the way, this sudden urge was brutal. That summer, as I pulled up to the hotel at Cape May where I would be spending a week with my boy and my siblings, the urge hit with a vengeance. I tried to drag my son up the stairs to our room, yelling at him to hurry. We got in the room, and I made it to the bathroom. But not to the toilet. Urine streamed down my leg through my shorts, and soaked my shoes. Fortunately, they were my "beach" sneakers, so I just threw them out. That's obviously not the point.
Did I go to the doctor, klaxons wailing? Of course not. As the cliche goes Denial is not a river in Egypt. I convince myself that if I lost more weight, that would take care of the problem. And over the course of the rest of the year, I continued to lose weight. By Thanksgiving, I was down to 182 pounds. I was elated. Of course, I had by that time learned the location of every public bathroom in Center City Philadelphia, and many of the surrounding suburbs. But did that send me to the doctor? Of course not.
At this point, I was pretty near my goal of 169, which would allow me to call myself "normal" as opposed to overweight. I started incorporating diet soda into my routine. And desserts from time to time. Then real soda, and desserts all the time. I continued to lose weight. (Those of you familiar with diabetes will recognize the train coming down the tracks.) I convinced myself that my body had adjusted to the point that my metabolism was burning more calories than in used to.
Then, late this spring, something happened which shook me. I started to get numbness on areas of my feet. Now that clearly had nothing to do with weight loss, or potential prostate issues. At this point, I did what many men do. No, not go to the doctor, you silly goose. Pshaw! I Googled the combination of sudden urge to pee, weight loss and numbness in one's feet. Ten cents to the lady or gentleman who guesses what the results were. Yep. Diabetes.
By now, many of you will be questioning my state of mind. What kind of loon must I be to have gotten that answer, and still not go to the doctor? I can't answer that question. Well, I can, actually. An alcoholic who has reverted to his old way of thinking. A dry, not a sober alcoholic. Driven by alternations of fear and denial. Humbling to admit less that a week away from 24 years of continuous sobriety. But there it is.
At this point, my denial kicked into high gear. I continued to lose weight. My friends stopped congratulating me on my weight loss, and started to question my health. And I kept eating sweets and swigging soda. Finally, summer rolled around, where I met up with my siblings again, with Evan in tow. By this point, just walking is a chore. How I kept being able to handle my son is a testament to my genetic stock and my stubbornness. My sister took one look at me and said "[aravir]. I want you to do something for my birthday. Go to the doctor." I agreed to do so.
After vacation, I got a call from my dad. "[aravir]", he said, "I've talked to your brother and sister. You need to go to the doctor. Promise me you will." I did so. Incidentally, that call meant a lot to me. It had been several years before, while I was still with my ex, when my whole family had gathered in Philadelphia, and we had hosted the family Thanksgiving meal. In traditional fashion, my father and I had gone for a walk. He started popping nitroglycerine pills every block or so. I asked my brother and mom about it. "Oh, he does that all the time." It's the frog in the water syndrome. I demanded he go to the doctor, and he did. It was then he had his quintuple bypass. Apple, meet tree.
I had every intention of going to the doctor right away. Then my apartment building ended up getting sold, and the new landlord wanted to live in my apartment. All of a sudden, I needed to find a new place to live. Fast. So it took several weeks for me to get to the doctor. And let me tell you, if you haven't experienced it: Moving dozens of boxes with no leg strength is hell on wheels.
That brings us back to the beginning of the diary, where I get the call from the doctor, insisting that I go to the hospital.
Where are we today?
How am I doing, doctor?
Everything is much better, Mr. R--. I'm going to keep you on the Lantus for now, but I am confident that, if you keep doing what you're doing, you will be off of insulin one of these days.
I certainly hope so, doctor.
Hi folks. My name is aravir, and I am a diabetic. I am also the father of a boy who is an autistic. And I will be here for him for as long as he needs me, no matter what it takes. No more denial; no more fear. Free at last, free at last. Thank God Almighty, I am free at last.