Thursday, August 11, 2016

THE DIABETES EPIDEMIC

Two years ago I was seriously overweight to the point where I had full-blown type 2 diabetes.  I just didn't know it yet.  In August 2014 my diagnosis was a couple of months away.  Or perhaps I did know, somewhere deep inside.  About 3 years earlier I had finally done what my children had been pestering me to do for years and visited a doctor for a general health check.  He told me that I was "borderline diabetes", gave me the usual pep talk, and advised me to me to come back in 3 months or so.  That never happened, but I did walk around for another 3 years telling myself "I'm borderline, there's still time, I can get this under control ... but not tonight, I need my comfort food."

What saved my life was a Health Day, organised my GAJ (my day job) and BUPA (the medical aid society)  That was when I got my diagnosis and where I met Dr Ghada from the Boston Diabetes Clinic.  Two things had changed.  Firstly was put straight on to daily injections.  Secondly she gave me very specific dietary advice and made sure her staff arranged regular follow-up visits.  That was all it took to give me the motivation and confidence to take control of my diet and health.



Looking back I think there have been 3 main phases to my recovery.  Stage one was fear.  Just the fact of suddenly having to inject myself each morning shook me out of my lethargy.  I also had to prick my finger twice a day to record blood sugar levels, and remember a whole regime of pills (morning, night and weekly)  I am a citizen of Zimbabwe living in Dubai.  I am 65 years old and planning to work for as long as I can.  My only viable retirement plan is to go back to my house in Zimbabwe and live a simple life where the cost of living is low and the climate favourable.  What scared the crap out of me was the thought of living in deepest Africa and still being on all this medication.  Would I be able to afford it ?  Would it even be available in Zimbabwe ?



So fear motivated me to implement the radically different dietary regime that my doctor had carefully explained.  Three small meals and two small snacks.  Basically you are eating at 3 hour intervals to keep the energy levels up and the hunger pangs down.  Sugar, Oil, butter, soft drinks and fruit juice were out.  I haven't bought any of these things since I was diagnosed.  I drink water and green tea, plus a small amount of fresh milk.  A small snack is one piece of fruit: a banana or an orange, for example.  I have also cut back drastically on carbs.  My meals are usually either steamed vegetables or salads.  I was advised to have 2 portions of vegetables and 1 portion of carbs (rice, potatoes, pasta, bread) but in practice that just complicates things.  How do you cook one spoonful of rice ?  So my intake of "staple foods" is now very low. 



Stage 2 was the feelgood factor: the rewards of dramatic weight loss, people stopping me at work and expressing amazement at how I had changed.  That kept me on the straight and narrow for several months after the fear had faded.  It was great to experience this transition from the stick to the carrot.  My self esteem was soaring, I had so much more energy.  I felt more alert.  Just as an example, I always used to run up stairs.  It was a habit that I developed out of impatience, but of course it fell away about 10 years ago as I put on weight.  About 3 or 4 months into my weight-loss experience I just found myself running up a flight of stairs again.  I didn't even realise what was happening until I got to the top of the stairs and realised I had turned the clock back 10 years without even thinking about it. 



I started to dress more smartly.  Over the years, as my belly began to push over my belt, I had started to dress down, wearing jeans to work, eventually wearing loose shirts and not tucking them in.  You just walk around in this tent that masks the full enormity of what you have become.  There's nothing worse than fat people who insist on wearing tight clothes, right?  But now I could take trousers out from the back of the wardrobe that I had discarded ten years ago after wearing them a handful of times.  I really got a kick out of that.



Stage 3 is where I am now.  I've been through a couple of periods where my weight levelled out.  That happened after I had shed 20kg.  That was a huge achievement of course which gave me great pride, and I new it was going to be harder to lose the next 10kg.  So I got stuck at the same basic weight for 3 or 4 months, but I didn't panic.  Perhaps I needed to pause for breath, let the situation sink in.  Then I had one doctor's visit where, for the first time my weight recorded slightly higher than the last visit.  That motivated me to go back to my original strict diet.  I had gradually loosened my grip without fully realising it.  My assumption that "it just gets harder" to lose weight as you get nearer to the target was not really correct.  I found I could still lose weight rapidly if I returned to my original strict regime. 



So now I am 33kg down.  I started at 123kg and right now I am sitting at 90kg.  That's right, I've lost a quarter of my body mass.  It seems ridiculous, and looking back I can hardly believe that is my in those old photos.  So I am getting a broader perspective on the whole thing, and phase 3 amounts to a new perception of my identity and my place in the broader scheme of the Diabetes Epidemic.  I am motivated by the opportunity to share my story with friends and colleagues, to talk about the crazy world of runaway consumption that we inhabit.  I see people wherever I go with their puffy faces and waddling gait and think, "that used to be me".  I was trapped in that addiction, and I still have the cravings.  By luck I got the right advice at the right time, it set me on a new path and it feels so good to share that story when opportunities arise.  People approach me at work and ask for advice.  How did I do it?  What is my diet?  It's like I'm a born-again "healthy person".  So stage 3 is a kind of global awareness, an overview of the whole situation.  I will always be a food addict.  There will always be temptations.  But I now have the confidence that I can manage my own health.



I used to wear sandals, because it was too hard to put socks on.  As I lost weight it got easier, but still my joints were stiff.  But that can also be worked at.  I have discovered various stretching exercises that make a big difference over a period of weeks.  You can regain quite a lot of the flexibility that your body had lost.  So there is this general awareness of health issues and an enthusiasm for finding small solutions, here and there, that work for me.  It's a journey of discovery and I have embraced it. 



Two years ago I had basically resigned myself to the probability of being a semi-invalid for the rest of my life, to perhaps not seeing my grandson become a young adult.  That now seems crazy.  "Life begins at 60" is my new motto, and I'm convinced that other people can find a way out their "mind & body traps" just like I have.  BUPA and GAJ have responded to this by setting up two interviews for me to tell my story, one for a local newspaper and the other for a radio station.

http://khaleejtimes.com/nation/uae-health/when-the-silent-killer-sets-in

It's a small contribution but it's also part of my ongoing contemplation of the global issues.  Apparently there are around 400 million people struggling with the type 3 diabetes issue.  Our bodies are just not designed for the modern world.  They are telling us to gorge on foods rich in fat and sugar whenever we come across them, because those were rare events and stored fat in our bodies was a significant survival factor over the lean season each year, and even more so in periods of extended drought.  Three year droughts are quite frequent on the African savannah.  You can lose a lot of body mass in three years, so excess body fat can be a life saver.



It seems to me now that sweeping global measures are needed to curb this epidemic.  Everywhere I look I see people with puffy faces and bulging waist lines.  That was me for well over a decade, and I had internalised that identity, embraced it and insulated myself from the very real consequences of a distorted body chemistry.  Why don't we have health warnings on sugar-rich products like the ones that were introduced despite colossal outrage from the tobacco industry?  I suspect that sugar is doing far more harm now than tobacco.  Diabetes can lead to blindness and amputation.  That's on top of the 400 million people suffering from the general debilitating effects and the worry that this causes their families: presumably more than a billion people whose lives are impacted by this epidemic.  And of course the numbers are rising very rapidly. 

When I walk through a supermarket now, I am horrified by the kind of stuff that fills around 80% of the shelves.  This is an attitude that I would have ridiculed a few years ago, but it's based on a very real encounter with food addiction.  Whenever I speak at a BIM function in some Dubai hotel, there is a huge spread of unhealty foods laid out for the participants.  It's all flour and sugar, flour and sugar.  I really have to look hard to find something that I am willing to eat.  We just take it for granted.  I queue at the supermarket to pay for my little horde of fresh fruit and vegetables, surrounded by people with huge trolleys full of biscuits and ice cream and oils and fats.  When did I become such a fanatic?  Lighten up!  Why can't people choose to eat whatever they want? 


Unfortunately, that didn't work for me.  I was extremely luck to find a way out of that vicious downward spiral and it took 18 months to claw my way back to a healthy body chemistry.  I have good friends who feel inspired by my example, but have not been able to transfer this to their own lives.  We are all different.  I found the exit door.  You may not be so lucky.  I really think that those unhealthy foods should just be taken off the shelves.  The fast food chains should be given 2 years to transition to genuinely healthy balanced meals, or be shut down.  That probably sounds like fascism to you, but that's also how many people still feel about banning smoking in public bars and restaurants.

The facts are very clear.  We are ruining the health of millions of people.  We have over-developed bodies in an over-developed world that revolves around profit.  Neither capitalism nor communism, in their extreme forms is worth even discussing.  In practice all economies are a mix of state planning and free enterprise.  But how do we create a sustainable future?  How do we curtail this mad, runaway consumerism that is bloating our bodies, polluting the planet, trashing the rain forests?  Type 2 diabetes is the by-product of a prosperous, industrialised world.  It's an indicator that we are gripped by a progress trap of the kind that has brought countless civilizations down in the past.  I have found my personal exit door, but what about the world in general?

4 comments:

  1. Bravo, well done with your recovery, and with laying out what needs to be done for our population to stop the madness.

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  2. That's inspiring!!! Incredible, keep up the good work.

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  3. Great to see you looking and feeling so well.

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