Wake-Up Call From My Almost-Useless-Doctor

DiabetesOn February 3, 2006, about 6:30pm, I was leaving the hospital after visiting my dad. My cell phone rang and it was my doctor. I thought it was odd that she was calling me on a Friday night, after hours.

With an urgent tone, she asked me to come in for an appointment, Monday, rather than wait until my scheduled time on Thursday. Somewhat dumbfounded, I asked what the hurry was, and she seemed hesitant to answer. So, I sat down in the hospital lobby and brought her up to date on a couple of issues: My dad hospitalized two days before, and Jessica’s dad was also in the hospital. So, if there was anything I needed to know, perhaps she could give me a clue.

She announced that blood test results indicated a high likelihood that I was diabetic. And that my ‘glucose numbers’ were scary high, hence the urgency. She suggested I do some research on the weekend and see her Monday morning. I took a deep breath and agreed.

Diabetes is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced

The commercials you see on TV for checking glucose levels are ‘in the moment’ tests. A normal range of those glucose readings, during a day, would be a low of 60 to a high of 180, varying as to when the reading was taken (before meals, after meals, etc.). My reading, taken the day of the blood test was over 400… and that measurement was taken after fasting. We took a confirming measurement on Monday morning (without fasting), and it was over 500. With those numbers, I had no business even walking around. I should have been unconscious.

I then learned about the magic A1C test. That test, taken after fasting, is a 90-day average of glucose levels. It is a much truer measurement of overall well-being. My initial reading was about 12.0. A decent score is 7.0 or below. When one scores below 6.0, then things are really under control.

My Diabetes is Type 2, not the most severe. It is treated with medication, careful diet, exercise, and avoidance of stress. I started taking appropriate medication right away. That’s easy. Exercise is not so easy; at least for me. Careful diet generally means low carbohydrates; however, you soon find that there is no one-diet-fits-all. Each human being is their own science experiment. A ‘good food choice’ may work well for someone else, but for me, it might spike my glucose. A very frustrating experience.

The wild-card is stress. ‘Surprises’ that trigger stress often have a physical reaction in diabetics. Magically, one’s glucose can shoot up, in response. High-glucose has lots of symptoms, including lethargy, headaches, inability to focus, mood swings, to name a few… all rather counter-productive.

Fast Forward

In these last six years, I am on my third doctor (in the same office). My first physician has put more focus on building a family, and now has three children. During that period, I started seeing her husband and partner in the practice. When I scheduled for January 2012, her husband had left the practice and there was now a new doctor in the picture. I decided I’d see him.

We went through the perfunctory get-to-know-you period, and he gave me the usual scary lecture about all the various bad outcomes that would occur, eventually, if I didn’t get a better grip on my glucose. I don’t mean to sound glib, but I had reached the point where I felt like my doctors were treating symptoms, not a patient.

I decided to start anew on all fronts of self-care, and visited the doctor, quarterly. My numbers started to improve and my confidence buoyed with it.

Going into my June visit, I was coming off a a previous A1C score or 8.4. I didn’t feel like I had reached 7.0 yet, but I thought I had made progress. The panel of blood tests ordered included about a dozen measurements. I always ask the nurse-assistant to print out the results, so I can read them prior to the doctor’s arrival.

There was something missing. An A1C score. I was ticked!! I would soon be more ticked. I went to the nurse assistant and pointed it out. Seeming rather unconcerned, she said, “Oh, the doctor must have forgotten to order it.”

“What the hell am I here for then? That’s the most important measurement!!” I responded, less than calmly. She said she would call the lab and order the test… they would run it IF they still had a sufficient sample of my blood and had not disposed of it. Not encouraging.

The doctor entered the exam room, rather calmly. We went through all the numbers, and I restrained my anger. He said, “You look like you’re doing great… everything is improved… your glucose reading on the day of the test was only 110. You’re doing fine.”

I called b*llsh*t on him. One, momentary sample, tells us nothing.

Fortunately, the lab was able to do the test and four days later, I got my A1C results. My number had risen from 8.4 to 8.8. 

That was the turning point

Doctors or not magicians. They see too many people in too little time. If my diabetes conditions were to improve, it would be up to me. I reviewed every bit of diet advice and devised my optimum grocery list with Jessica. It has been just over two months since then, and glucose readings have been consistently the best I’ve seen since my diagnosis…. by far.

I just scheduled my next appointment for August 22nd. I am confident I will achieve an A1C reading of 7.0, or perhaps lower. And if it’s slightly higher, I won’t consider it a failure. It will still be major progress.

Taking Control

Diabetes is a disease that can be managed. A lifelong challenge, going forward. I will have good days and bad days. The goal is to the right things and have mostly good days.

And, not to expect any doctor, who sees you 3-4 times a year, for a total of about an hour, to provide any magic cure or motivation. The only motivation he provided was that he ticked me off by playing down the absence of the most important test. So, inadvertently, that was the important motivational tool, for me.

I haven’t decided if I’m going to tell him. I’d rather just be thrilled with whatever progress I make, and know that I took control on my own.

Morale

A wise friend shared words of wisdom from her father, who say…

“When you have your health, you have countless problems. When you don’t have your health, you only have ONE problem.”

To me, that appears to be correct. While the skies are cloudy on some days, no matter what I do, the skies appear blue on most days. And that, looks good from here.

Andy Ebon
First Generation New Yorker

A Spoonful of American Optimism from Ellis Island

Ellis Island Spoon (with case) - Circa 1938

Ellis Island Spoon (with case) – Circa 1938

The year, 2006, was my most difficult year, to date. Jessica and I lost about a dozen friends and relatives… actually, we stopped counting, at some point.

In February 2006, both of our fathers passed away, and I was diagnosed with Diabetes. The day after the ‘life celebration’ for Jessica‘s dad (Irv Kluger), she blacked out at the wheel and totaled her car. She was unconscious for the better part of an hour.

When she awoke and refused an ambulance ride to the emergency room, the metro officer, at the scene, decided to arrest her when she couldn’t navigate a straight line. This, after being unconscious for an extended period. He didn’t take into account the floating bone chip in her left ankle or arthritic left knee. Nor did he seek out the handicap flag in her car, to corroborate those limitations.

At various times, well-meaning friends would say, “Well, it couldn’t get worse.” We would explain that, indeed, it could get worse, and it had… our follow-up became,  “Please don’t tempt fate by ever uttering that cliche, again, to anyone.”

When things go to hell, entirely, you look for things to remind of you good times, particularly of those you have lost. In working my way through my dad’s possessions, there are both the obvious, and the rare. His collection of published books fill a 6′ tall book-case in our living room. The total process of sifting through a parent’s possessions is not unlike an archeological dig. 

Almost none of daddy’s clothes fit me. One of favorites his was a black cashmere overcoat. That does fit me and continues to warm me on cold winter days, here, and in my travels.

Martin Ebon, 20-something

Martin Ebon, 20-something

The most interesting family relics are the photos and possessions one has never seen and didn’t know about. The item, pictured in this post, is one of those. A small cafeteria spoon, used by my dad (Martin Ebon), at Ellis Island, upon his arrival in the United States. He carefully inscribed the place and date (1938) and tucked the artifact away as a keepsake.

In 1938, cafeteria spoons didn’t come in thin, plastic wrappers. They came in a plastic box, with a sponge bottom. The packaging preceded eco-friendly by decades, but makes a wonderful showcase, today. The spoon wasn’t plastic, but pressed paper product of some sort.

When I was my dad’s age, I was in college in Arizona, experiencing no such landmark moments comparable to Ellis Island. Today, July 4th, 2012, I have given this historic spoon a place, directly in my view, just below my computer monitor. It will stay there to remind me just how fortunate my dad was to escape Nazi Germany, and just how lucky I have been in countless ways.

We all have good times and bad times. To appreciate freedom, in its core sense, is to know the good fortune of independence. That, under even the most challenging of circumstances, there can be better days ahead.

Today, I reflect on 2006 as a blur and a bad memory. I prefer to focus on this little spoon as beacon of optimism.

Andy Ebon
The Wedding Marketing Blog