For the past few months I have been gaining weight. A lot of it. My doctor gave me an excuse; “It’s a fact that people on insulin gain weight. It’s one of the reasons I tried to keep you off it all these years.”
This week I went to the doctor for an unrelated issue. Stepped on the scales. I weighed 300 lbs.I had officially entered the ranks of the super obese. No links; you can find all the disgusting pictures you like on the web by entering the term into Google. I’ll wait.
Let’s be clear: it wasn’t the insulin, or at least not directly. It was my behavior. I would eat more to “protect against low blood sugar.” Then I would up my insulin dose to cover the blood sugar. Then I would eat more to protect against low blood sugar. Round and round, chasing numbers that never seemed to stabilize. Right before I started the Nutrisystem diabetes foods I was up to 100 units of Lantus insulin. I was using 2 .5 ml syringes a day, an extra injection, just to support my food habit.
And sure, my blood sugars had stabilized, I had hit the “goal” hemoglobin A1C of 7%. I had also gained 40 pounds. 40 pounds in the wrong direction 20 pounds that I had worked so very hard to lose plus another 20. 40 pounds that was making my diabetes harder to control, were producing swelling in my feet and ankles, and frankly made me hate to look at myself.
I have to look at myself in the mirror. I’m clean shaven, so that’s one look. I have to inspect my BAHA implant site, so I have to look from the side/back. And every time I walked into the bathroom I had to look at myself as I faced the mirror washing my hands. I was reaching level of self-loathing was becoming unbearable. Something was going to give.
A week ago I was doing my diabetic foot inspection (a regular ritual for those of us who wish to keep our toes and feet) when I noticed that from the knee down I was beginning to resemble some of my cardiac patients. I had the classic redness, swelling, and mottling of venous stasis, meaning that the blood was pooling in my legs and having trouble getting back to my heart. And that’s when I realized I was kidding myself. To death.
Now nobody makes it out of here alive, but there is no point in a self-imposed slow, painful dwindle to the end either. It was time to either get busy or get out. And yeah, “get out” is a euphemism for committing suicide, either slowly and painfully as I was already in process or by more expedient measures. After a long day of thinking about it, I decided I wanted to live after all. Not just for my wife or my kids or my parents or my acquaintances, but for me.
So it’s been an interesting weekend. I had to cut my insulin dose in half almost immediately with the decreased calorie intake, and if I still continue to run as low as I have been I may start dropping in 5% increments until I have some wiggle room. I was able to hike up and down the hill outside my house without keeling over in heart failure, so good news there. Vital signs nominal, no chest pain, no anginal equivalents. All good.
So: Moment of clarity over. Time to stop kidding myself and get down to the hard work.