dropped from a veryhigh risk level of7.9 to a below-average level of3.0.
His hemoglobin A1C test, which reflects average blood sugar for the prior four months, has dropped from 10.1 percent (very high) to 5.6 percent (nearly in the nondiabetic range).
His R-R interval study (see Chapter 2), an indicator ofinjury to nerves thatcontrol heart rate, has progressed from an initial value of9percent variation (very abnormal) to a current value of33 percent, which is normal for hisage. "I probably had mild diabetes for most of my adult life without re alizing it.
It first appeared as lethargy, later as fainting, stumbling, or falling, but asrare occurrences.
I also had difficulty attaining full erec tion of my penis. "In early 1980,1 beganto experience dizziness, sweating, arm pains, tendencies to fainting, andthe symptoms usually associated with heart problems.
An angiogram revealed severe disease of the arteries that supplied my heart.
I therefore had surgery to open up these arteries.
All waswell for the next sevenyears, and I again enjoyed good health. "In late 1985,1began to notice a loss of feeling in my toes.
My in ternist diagnosed it as neuropathyprobably due to high blood sugar.
He did the usual blood test, and my blood sugarwas 400.
His advice wasto watch my diet,especially to avoidsweets.
I returned for another checkup in 30 days.
My blood sugar was 350.
Meanwhile, my neu ropathy was increasing, along with the frequency of visits.
My blood test results were consistently at the 350 level, my feet were growing more numb, and I was becoming alarmed. "I feltokay physically, walked atleast two milesa day, worked out in the gym once or twice a week, worked a full schedule as a business consultant, and didn't worry a great deal about it.
But I did begin to inquireof friends and acquaintances about any knowledge or experi encethey might haverelative to neuropathyor diabetes. "My first jolt came from a story from one of my friends who had di abetes, foot neuropathy, deep nerve pain in his feet, and a nonhealing ulceron a toe.
He told me that asthe neuropathy progressed, amputa tion of the feet was likely, elaborating by describing the gruesome 'salami surger/ of uncheckeddiabetes. "That's when I became emotionally unglued, asthey say.
One thing about aging and disease, you think a great deal about the utter horror ofbecoming a cripple, dependent upon others for your mobility.
Sud denly foot numbness is no longer acasual matter, more like a head-on crash into reality. "Then I met awealthycardealer at the golf club,with his legscut off
Beforeand After 13
ashigh aslegs go, who explained he hadn't paid too much attentionto his diabetes at the time and his doctor couldn't help him.
He could never leavehis chair, except for relief and sleep, and he had to be lifted for that.
Oh, he was cheerful enough.
He joked that they would cut him off at the middle of his butt the next time, that is, if he didn't die first.
A display of courageto others was a macabrenightmare to me.
I got serious about getting someone, somewhere, to tell me what to do about my ever-worseningnumbness, which by now had spread to my penis.
My condition became an ever-present, gnawing anxiety with me, a creepingpresenceI couldn't fight against becauseI simply didn't know how to fight it. "Then, in earlyApril 1986, my wife and I went to visit Dr.Bernstein.
The first visit lasted llh hours.
Each detail of diagnosis and treatment wasdiscussed.
Each symptom of the disease, however minute, was de scribed in greatdetail,the importance of eachbalancedwith another, with specific remedies for managing them.
Take the seemingly in significant matter of scaly feet, a common, dangerous symptom of di abetes.
Dr.
B. prescribed mink oil, rubbed into the feet morning and night.
Practiced as directed, instead of split skin and running foot sores, you have skin as soft and smooth as velvet.
Consider the alter native , feet split, painful, and slow (if at all) to heal , which can change your entire life.
Special shoes, debilitating gait, not to mention the horrible possibility of progressive amputation; all things that reallycan happen if your diabetes is not treated properly. "What is of highest importance, I believe, is the in-depth explana tion of diabetes, its causes, symptoms, and treatment.
He givesyou the rationale for treatment, so that you have a comprehensive under standing of what is wrong and how it can be corrected. "First, through frequent finger-stick blood testing, we came to an understanding as to the specifics of how to attack my diabetes.
We started with diet.
It wasn't just eat this, don't eat that, but eat this for these reasons and eat that for other reasons.
Know the reasons and the differences.
Knowing the how and why of diet keeps you on the track, and the discipline of that knowledge makes control easy.
Forwithout continuous diet observance,you will surely worsen your diabetes.
He explains that the effect of uncontrolled diabetes on the heart can be much more deleterious than the other popular demons , choles terol, fat in the diet, stress, tension, et cetera , demons not to be ig nored, obviously, but merely put into proper perspectiveto the main villain , diabetes.
14 Beforeand After
"Well, the results for me arethe numbness of my feet and penis have regressed, and my erections have improved.
My feet are now beauti fully supple and healthy.
The severe belching, flatulence, and heart burn after meals have disappeared.
The other ills of diabetes have apparently not greatly affected me, and now that I know that control ling my diabetes is the key to ahealthyheart,I expect to reducegreatly any future risk of heartattacks. "One great result of my abilityto normalize my blood sugars has been the stabilizing of my emotional attitude toward the disease.
I no longer have a sense of helplessness in the face of it; no longer wonder what to do; no longer feel hopelessly dependent on people who have no answers to my problems.
I feel free to exercise, walk vigorously, en joy good health without worry, enjoy my precious eyesight without fear of diabetic blindness, yes, even have a new confidence in normal sexual activities. "All of the enjoyments of health that were slowly ebbing away are now within my control, and for that I thank my new knowledge and skills."
LeVerne Watkins isa sixty-eight-year-old grandmother and associate ex ecutive director ofa social service agency.
When wefirstmet, she hadbeen taking insulin for two years, after developing type 2 diabetes thirteen years earlier.
Hercomments relate inpart to the effects of large amounts of dietary carbohydrate, covered by large amounts of insulin, while she wasfollowing a conventional treatmentplan. "In less than two years, my weight had increased from 125 to 155 pounds; my appetite was always ready for the next snack or the next meal.
All my waking hours were focused on eating.
I always carried a bag of goodies , unsalted saltine crackers, regular Coca-Cola, and glucose tablets.
I always had to eat'on time.' If I was a half-hour late at mealtime, my hands would begin sweating, I would become very jit tery, and if in a social gathering or a conference or meeting at work, I would have to force myself to concentrate on what was taking place.
During a meeting that I waschairing, the lastthing I remember saying was,'Oh, I'm so sorry,' before I toppled out ofthe chair to wake up and find myself in the emergencyroom of a local hospital. "During a subway ridewhich generally took about 25 minutes, the train was delayed for close to 2 hours and , to my utter dismay , I had forgotten my bag of goodies.
As I felt myself 'going bananas,'
Before and After 15
sweating profusely and perhaps acting a little strange, a man sitting across from me recognized my MedicAlert bracelet, grabbed my arm, and screamed, 'She has diabetes!' "Food, juice, candy bars, cookies, and fruit came from all direc tions.
It was a cold,wintery day, but people fanned and fed me.
And I was so grateful and so very embarrassed.
I stoppedridingthe subway, and rescheduled as many meetings and conferences as I could to take place directly after lunch so that I would have more time before the next snack or meal would be necessary. "I felt that I had no control over my fife; I was constantly eating, I outgrew allmy clothing, shoes and underwear included.
I had been a rather stylish dresser since college days.
Now I felt rather frumpy, to say the least.
Once, I tried to discuss with my diabetologist how I was feeling about gaining weight and eating all the time.
I was told,'You just don't have any willpower,' and 'If you put your mind to it, you wouldn't eat so much.' I was very, very angry, so much so that I never consulted him again. "On my own, I triedWeight Watchers, but the diet I hadbeen given by the dietitian to whom the diabetologist had referred me did not mesh with the WeightWatchers diet.
So along I limped, trying to ac cept that I was getting fatter each day, was always hungry, had no willpower, and most of the time was feeling unhappy. "My husband was my constant support through all this.
He would say, 'You look good with a few more pounds Go buy yourselfsome new clothes,' especially when I would askhim to zip somethingthat I was trying to squeeze into.
He always clipped newspaper and maga zinearticles aboutdiabetes andwouldremindme to watch specials on TV.
He encouraged me to be active in the local diabetes association, and would accompany me to lectures and various workshops.
Then, on Sunday, April 3, 1988 , Easter Sunday , he clipped an article from the New York Times entitled 'Diabetic Doctor Offers a New Treat ment.' Little did I realize that this thin news article would be a new be ginning of my life with diabetes.
I must have read it several dozen times before I finally met with Dr.
Bernstein.
Since that first meeting, I haven't had one single episode of hypoglycemia, which I had for merly experienced veryoften.
Following the regimen of correcting my high and low blood sugars, taking small doses and different kinds of insulin, and eating meals calibrated for specific amounts of carbohy drates and protein, my outlook brightened and I began to feel more energetic and more in charge of myselfand my life.
I could now hop
16 Beforeand After