Alternative titles for this Blog Post are “Now it can be told” or “Now you know the rest of the story”. But after I got the news yesterday, I literally thought of that “EXTRA etc” line (Sung when Tommy, in the rock opera, is cured of his affliction of being blind, deaf and dumb.)
I’ll share yesterday’s news in a moment, but first I am telling you my full story, one that not even my family knows until now, with the exception of my children. Maybe you know someone with my circumstances who might be interested in it.
I was invited to be a volunteer in December. I was greatly relieved, since I went into the application process thinking I had no relevant skills to offer. All I had to do now was clear legal and medical evaluations. As to legal, I had never been arrested, so I didn’t have any fear there. It’s scary though. They kept saying “We are going to do a deep review. Are you sure you don’t have anything to tell us?” Uh oh, what will the NSA think of all my emails criticizing Bush and Obama? You are never actually told about legal clearance, perhaps to rope in those DUIs you can get right before departure.
As to medical clearance, I never get sick. I did not miss a single day of school from grade school through law school, and that pattern has held for the rest of my life so far, with the exception of a spell of kidney stones about 10 years ago. Sure, I take those pills for cholesterol, and high blood pressure, and I was overweight, but there seemed to be no consequences to it. To the contrary, being forced to do a lot of walking in Uganda would get me out from behind my desk and the two years here would get me in shape. Nevertheless, I decided not to announce my invitation until I received my clearances.
My doctor at Kaiser was off on reserve duty, so I switched to my wife Jan’s G.P. for my Peace Corps physical. Monica and I had become pretty well acquainted. There was a pile of forms for her to fill out, and frankly, during the next four months, the requests from the Peace Corps for more info and documentation never stopped. They are thorough.
I remember my physical on January 8 was a very light-hearted event. I was more concerned the Peace Corps was going to say I was jumping into this too soon after Jan’s passing. In fact, I had to submit a short essay about this. (The head shrink in D.C. for the Peace Corps was at our IST for a day last week. He recalled my file. He said when he saw my age he cleared me immediately. Had I been 25, my circumstances would have been an issue).
On the following Sunday, I was driving home in my neighborhood, and saw Monica with her husband and two kids out walking (such a good example!). I rolled down my window and said hi. Monica replied “Please call me Monday.” I asked “What’s up? Why can’t you just tell me now?” She leaned into the window and said, “You have diabetes”. I was gobsmacked. Immediately I drove home and jumped on the computer to see what this might mean for my medical clearance. It did not look good. Then I drove all over my neighborhood until I found Monica and her family again (I don’t know where she lives-her husband must have thought I was a loon). I drilled her for information as we walked. She recommended I attend diabetes classes, but her responses did not assuage me regarding my medical clearance.
The hbA1c is a relatively new test to measure your blood sugar. You don’t need to fast for it, and it measures the cumulative effects on your blood from the last three months. My A1c was 7.6%. The upper limit for normal is 5.6%. I will admit that the recent Holidays did not help me on this test. While I was excited to be invited to the Peace Corps, it was the first time I did not have my Jan with me during the Holidays. I was pretty self-indulgent and probably “ate my grief”. Watching me, my son Clark was pretty disgusted. I kept rationalizing “I’ll start getting healthy in June”. Now it looked like I might be doomed well before June.
A few days later, after I learned of this result, I wrote to the D.C. medical staff about this finding. A nurse on staff was in charge of my file. I called her Nurse Ratchet in my mind the next 4 months- but she was my pal by the end of the clearance process. She replied in no uncertain terms that I certainly would not get medical clearance with this finding.
The following month or so, I was very despondent. My own research indicated that the Peace Corps demanded a measurement of 7.0% or below for clearance, and you had to prove stability by keeping it this low for at least six months. How rigid was this? The end of six months was in July and the plane to Uganda would leave June 2. Everything in my life was targeting that June departure. I thought at a minimum I would get deferred until November (I didn’t know, but in fact I would have had to wait a year, since November is only for Education volunteers). My plan had been to sell my house and wait until I came back to buy a new place. Now I needed a new place immediately, since I might have to stay in Denver. One more big chore on my “to do” pile.
There was also a huge embarrassment factor. My fraternity brother and poker group friend Wayne has had Type 1 diabetes for several years. He has pointed out, Type 1 is genetic. My diabetes was Type 2, which is caused by poor lifestyle choices in eating and lack of exercise. This was my own fault. All those years of chiding by Jan were coming home to roost. I was certainly glad I did not announce my invitation except to immediate family, a few close friends, and my references. The thought of getting everyone excited for me and then announcing a rejection because I had Type 2 diabetes would have been humiliating.
First thing, I wrote a very lengthy email in reply to Nurse Ratchet. I did a lot of cajoling, begging, groveling, and persuading. It was something I had vast experience in, representing hapless clients. She gave me a glimmer of hope by saying she would not deactivate me “yet”. After all, I hadn’t even submitted the initial test results to her, which were not due until February 15.
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July 2, 2015 in my Peace Corps T-Shirt
I described in one of my first blog posts how I lost 30 lbs. So you can review that process here. Perhaps a few of you guessed then I had diabetes. Ultimately my total weight loss was 47 lbs. by late June, after a month here. I have stabilized in the four months since, remaining at 165 lbs from the original 212 lbs. which I weighed at my physical in January.
I did everything my doctor and the classes recommended. My deadline to submit all my tests was February 15. I asked for a new A1c test on February 13. Monica said it would not change much, since only one month had passed and it measured three months. Nevertheless, it came back at 6.3%, well below the Peace Corps threshold. Monica said it was one of the fastest changes she had ever seen. I sent that result off to Nurse Ratchet. Now I regretted telling them about my first test. Nurse Ratchet was glad to see it, but said my clearance ultimately would rest with her supervisor.
I was focused on my blood, but the consequences of my lifestyle changes showed up in my thinning face and shrinking waistline. Peace Corps made Monica and myself write about the changes I was going through and my “plan” to keep the A1c stable. There were other steps. Nurse Ratchet requested I visit the Kaiser eye doctor to look for ruptured vessels in the back of my eye. This is supposedly the first place to find symptoms. Nothing there. By April, my A1c had declined to 5.8% which was just above normal.
Yay! New Orleans Jazz Fest with my kids!
Finally, at the end of April, I was medically cleared. My kids and I attended the New Orleans Jazz Fest for one last activity together, but continued my discipline, resisting much of that great New Orleans food. In August, I got my first test since entering Uganda. My A1c was 6.0%, a tick upwards. I doubled down, resisting even the occasional pop, except Coke Zero when I can find it. Coke, Mountain Dew and Orange Fanta are pretty dominant here. I enjoy the cold teas I brew. There are many carbs-laden foods here, so I really have to exercise portion control in the restaurants. I usually have a plastic container in my backpack and save half of it.
Almost another three months had passed since my last test in August. Returning from IST, I stopped at the Peace Corps medical office for another blood draw. Yesterday my Peace Corps doctor called and said I was at 4.8%. I had totally reversed out of diabetes. I can stop taking Metformin, which my dentist says is bad for my teeth. They want me to come in to learn glucose monitoring. Monica confirmed by email I was no longer a diabetic and agreed with the recommendations. I plan to maintain my discipline and check again in three more months, especially to see the impact of stopping Metformin.
My pal Nurse Ratchet told me the thoroughness of Peace Corps physical often uncovers new, previously unknown health problems. I have often thought, what if I wasn’t going to the Peace Corps and not had a physical? How much worse would it have been, what symptoms would have driven me in to the doctor? What if it had been a routine physical and I was told I had diabetes? I would like to think I would have still buckled down, for the sake of my own health and due to my embarrassment. But no doubt, my motivation to get cleared was through the roof. I really needed to leave in June for a desired radical change after the previous two years, and my further desire to retire from my tired old career sooner rather than later.
I certainly appreciate that it is hard to change a negative lifestyle. I don’t want to be like those former smokers who feel superior because they could stop. Yet, the steps I took are ridiculously simple. Eat fewer carbs and exercise more. The exercise causes the sugar in your blood to fire your muscles rather than getting stored as fat. Hence why athletes will load up on carbs before a race. I am also aware that the biggest challenge is ahead, since so many people lose a lot of weight, and gain it all back, perhaps more. I would have more fear of this if I was just trying to lose weight. But it is now coupled with the threat of becoming diabetic again. I hope staying here for two more years will help with the good habits. I eat no processed foods here. I have two skinny friends at home, both named Greg, who demonstrate great discipline and are part of my inspiration.
Clark said on WhatsApp: “Congrats daddy!!!! Losing you for two years has added ten years of your older, senile self we can have!” There is that advantage too.
Now you know…………..the rest of the story.
