This column will serve as a reminder that the Vanguard takes off from Thursday (Thanksgiving) until Sunday. In fact, there are only five days a year that I take off and that means that, including illness and planned vacation, since September of 2006, the Vanguard has not published for a combined total of less than six weeks over a more than eight-year period.
I decided to do a personal piece and talk about my struggles with my own health. While growing up, people might have mistaken my personality for a type B, but the reality is that I have probably always had a kind of all or nothing personality – I’m either all in or all out, but there is little in between.
Since I was probably 17 or so, I have had a constant battle with my weight. In my adulthood, I have been as low as 160 pounds and up close to, though never exceeding, 300 pounds. When I was in college, I went from about 240 pounds down to 170 pounds. I started running, I would run sometimes five miles or more in the morning and then bike to school, which in San Luis Obispo was uphill both ways (that’s not a joke, by the way).
When I was in DC, I started getting into weight lifting, and, while my weight would fluctuate over my time in graduate school, by the summer of 2003, I was able to bench over 300 pounds. But that would turn out to be a downfall, as well.
One day in July of 2003 I was at the gym and my right shoulder started hurting – bad. I pushed through my workout, but something was wrong, I thought I had hurt it somehow. After a few days off, I woke up one morning and I had an intense pain in my chest – to the point where I was screaming with no one around. I thought I was having a heart attack.
By the time I got to the doctor, the pain had subsided. The doctor didn’t find anything. Over the next few days, I went back to the doctor three times, and my arm was hurting and swelling up. I went from getting Tylenol with codeine to Vicodin to Percocet. Nothing helped.
Finally, my wife, on a walk, was concerned enough as she was looking at my arm to decide to take me to Sutter-Davis. I would eventually go to Kaiser and after 22 hours they found the culprit – a blood clot in my arm, and later we discovered I had one in my lung. I was pretty fortunate that I didn’t suffer anything worse than unbearable pain and high fevers for weeks.
I was eventually able to resume workouts, but even wearing a sleeve, it was never quite the same. By 2008, my weight had ballooned up. I was out of graduate school and helping Cecilia run for city council. Toward the end of her campaign, I began feeling very fatigued, to the point where there were days I just had to lie down on the couch.
Then I started a drinking problem. Not alcohol, but water. I had this unbearable thirst and I counted one night getting up to go about 16 times (again, not exaggerating). Each time I got up to go, I had a glass of water. At some point it dawned on me – this isn’t normal, there is something wrong with me.
I went into the doctor and, sure enough, my blood sugar was over 660. Diabetes. So, naturally I did what I always did and went to the other extreme. I changed my diet, I started walking and going back to the gym. I dropped about 70 pounds and got my sugars under control.
But then kids came along. The Vanguard grew. Responsibilities increased. Workloads and stress and pressure, and over time my weight and my numbers crept up.
My lifestyle and my preferences were bad. I love to eat. I have a bottomless stomach in a lot of ways. I love to eat the very foods that I can’t have – or at least shouldn’t. I worked long hours, I went out to eat or grabbed quick food to make, and this was not good.
It was September of this year and I had put off getting a blood test for too long. I was busy. A lot of stuff was going on. The excuses not to do what you should do. Finally, I went in.
My numbers weren’t where they were in 2008 but they weren’t good. I was drinking too much water, fatigued and getting cramps. I knew I needed to change.
The most interesting thing was that a couple of people over at Kaiser were persistent – they wouldn’t take no for an answer, and they pressed me to make changes. First one meal, then all my meals. Then some exercise. But it was different this time.
Back in 2008, I was able to basically get my sugar numbers under control within a week or two. But this time, it wasn’t moving at all. My numbers started out in the 300 range, but they weren’t moving down quickly.
It took three weeks to get from the 200s down the 100s. I came very close to having to go on insulin. We had set a date of October 27 that I would be meeting with the nurse and dietician and going on insulin. That morning, for the first time, my numbers were under 200.
I did not want to go on insulin. I was able to get into the gym that week and, for the first time, my numbers were normal. On Sunday, after running, I drew a 92.
It’s been a long and difficult journey and it is a constant battle. I know that I’m going to have to fight this every day for the rest of my life.
At the same time, I’m very thankful for the health that I have, the support I have from my wife and family and those around me. I know many people have far worse adversity that they have had to overcome, and unfortunately we have lost far too many good people in the last year.
So, everyone, as you spend your week with your families and loved ones, be grateful for what you have and never take things for granted.
See you next Monday.
—David M. Greenwald reporting
Very courageous revelation. I don’t think I could make such a public personal disclosure.
I learned long ago that, you and immediate family having good health, the love of family and friends, a sense of self-worth, and meeting basic financial needs are the ONLY really important aspects of life. Everything else means nothing by comparison.
It takes a while for many of us to learn these priorities, many of us never do. Each day anybody who is in this boat can ask of any arising irritant, “Is this REALLY important?” The answer almost always is, “Nope.” Welcome to the club, David.
Thanks for reminding us what’s really important. Hope you & your family have a wonderful Thanksgiving.
“I love to eat the very foods that I can’t have – or at least shouldn’t.”
I know this one. I have a severe medical disability that requires I eat the very things that are bad for weight gain and other health factors. It is a constant balancing act, and extremely frustrating, especially for someone like me who has always been very fit and active. But as you have noted David, lifestyle changes have to take place on a permanent basis in order to keep a disability in check.
Health should be a number one priority for everyone. If you are fortunate enough to be in good health, count your blessings. If you struggle with a medical issue, know that you are not alone, and seek out medical assistance sooner rather than later. I am extremely grateful I can manage my disease successfully. I have known unfortunate individuals who have died from it. Enjoy the little things in life, family, friends, a day at the beach, a quiet moment of self-reflection, satisfaction of volunteering your time to a worthy cause. There is so much to be thankful for.
For anyone who struggles with his weight and anyone who has a blood family member with type 2 diabetes, I highly recommend reading Dr. Mark Hyman’s book:
The Blood Sugar Solution.
I bought this book for a relative who has diabetes. She never looked at it. But I read it (because I used to struggle with my weight) and have followed Dr. Hyman’s advice. The Blood Sugar Solution is a bit unorthodox. But I can personally attest it works. And because following it will fix your gut and repair your brain chemistry, it is easy to follow for the long term. The problem with so many weight loss or weight control programs is that they are hard to stick to for the long term. I have been on Hyman’s program for 2.5 years and have never slipped. It is not too hard and does not take too much discipline.
If I have any problems with Dr. Hyman it is that he is somewhat of a huckster. You may have seen his specials on PBS. He also appears on afternoon chat shows talking about his books or giving health advice. My approach to that is to take The Blood Sugar Solution seriously, but to take him with a grain of salt. I do consume most of the supplements he recommends, but not all of them. And I don’t buy anything from him. You can get much better deals at CVS or online. … I should add that I know that some scientists don’t think that supplements are worth anything. They may be right. However, the truth in this area is very hard to prove one way or the other in a controlled scientific study. I tend to conclude they work for me.
If you struggle with weight and you only take a few things away from The Blood Sugar solution, they should be these four things:
1. Remove all added sugar, all dairy and all gluten from your diet;
2. Eat lots and lots of green vegetables, lean animal proteins and fibrous fruits; and
3. Exercise vigorously 7 days a week, including aerobic exercise, stretching and weight lifting; and
4. For a minute or two every morning and every evening, you should meditate.
David, thank you for writing this article. I lost a dear, close relative to diabetes at 53, far, far too young. She always battled the weight issue, and I’m not sure how many years she could have had if she got it under control. (She was insulin dependent since her youth.) A second physical issue (with her foot) made it extremely difficult to exercise, and I’m told that operating on a lower extremity on a person with diabetes comes with it’s own set of added risks.
Another friend didn’t watch his diet, and is now going blind in his late 50s. I also know very fit seniors in their 60s and 70s who lead very active lives, made good decisions, were lucky with their DNA, and they appear to have no limitations.
Best wishes.
David
I also want to thank you for sharing your story. I think your trait of being all in or not in at all is very common, at least in our culture. We spend inordinate amounts of time seeking the best dietary advice, the best work out programs and the best supplements. So as someone who does health counseling as a major part of my job, I would like to give my prescription.
1. For best results, start before you become pregnant so that your children will not be predisposed to or learn the bad habits you may have acquired. Men the same things apply to you and are a great way to support your partner, your children and all those you care about.
2. Exercise daily. Walking is the best and safest for most people who are not athletes and will get you the nearly the same cardiovascular results as more rigorous exercise if you walk at a brisk pace. If your have leg or foot problems, you can still exercise – just focus on the upper body with light weights, or water aerobics or swimming. A foot problem does not mean that you cannot exercise ! Thirty minutes is just fine unless you are training for something more strenuous.
3, No regular consumption of sweetened beverages, no regular consumption of sweets, no regular consumption of alcohol. This does not have to be derivational. Of course you can have an occasional treat. And be creative. Learn to enjoy more fresh fruit and vegetables. It is never too late to retrain your taste buds.
4. Eat slowly and savor every bite instead of shoveling the food in regardless of how hungry you feel. Stop eating when you are no longer hungry…..not when you feel full.
5. Don’t eat when you are not hungry. Sounds obvious, but a lot of our eating is emotionally driven. If what you are feeling is elated, sad, angry, lonely, frustrated….find an activity other than eating to provide comfort. Take a walk, read a book, call a friend, direct a snarky comment to me on the Vanguard…..just don’t eat.
6. Use activities instead of food as rewards for yourself and especially for your kids.
7. Join me in being extremely grateful for all the wonderful things in life ! Happy Thanksgiving !
Supplementing Point 5 with a quote from–of all people–Henry Ford. ”
Always leave the dinner table a little bit hungry.” Life-sequence photographs of Henry clearly showed he never had an obesity problem.
“direct a snarky comment to me on the Vanguard…..just don’t eat.”
Tia, your entire seven comments prove you should go into another profession!!!
Strange, I have the urge to fast for Thanksgiving . . . and I think I’ll just toss the plate of fries in front of my face.
# Happy stuffing day to all . . . well, most #
I think this is very good advice for most people. And it is logical for overweight people. However, I think it is actually bad advice for overweight people, especially those who have diabetes or have a family history of diabetes. I think eating sugary foods as “an occasional treat” for this subset of our population is analogous to telling an alcoholic he can have a beer or two as an occasional treat. It just does not work for alcoholics. They need to abstain 100 percent. Ideally, they would learn to drink responsibly. But practically, I don’t think they ever can. And the same is true with fat people and sugar. They should ideally try to consume sweets in a responsible manner as an occasional treat. But, in reality, that does not work, due to the nature of their brain chemistry. It will very soon lead to serious problems with sugar. It is simply a much better idea to completely stop eating all foods with added sugar; and it is likewise vital they avoid foods that are high on the glycemic index, like white rice. (Note that diabetes is growing faster in east Asia than it is in the U.S., and there one of the main culprits is the increased consumption of white rice, which has the fiber removed and hence it raises one’s blood sugar too fast.)
I think the other big thing that a lot of medical doctors need to stress more with their patients is to stop eating foods which contribute to chronic inflammation. The consequences are not the same for everyone, but many people become inflamed from eating gluten, dairy and sugar. If a person has chronically high levels of Tumor necrosis factor alpha (TNF-α), Nuclear factor kappa-B (NF-kB), Interleukins, C-reactive protein (CRP), Eicosanoids, Cyclooxygenases or Lipoxygenases, he needs to change his diet.
Rich
I would agree with your advice except for a couple of factors. Control of Type II diabetes may be simply about added sugar for some, but is is not so simple for others. For many Type II diabetics, the issue is not sugar but how their body processes animal protein. I am a pre diabetic. I initially chose an absolutist means of controlling my blood sugar which had nothing to do with sweets, which I use on an “occasional” basis. I became a vegan. It worked,. My blood sugar normalized.The only problem was that despite eating what I was able to eat ( my problem never having been too much but sometimes too little weight) I could not maintain a healthy weight and just kept losing. When I had dropped 15 pounds in 6 weeks, ( starting at 5’8″ and 145 lbs) I decided I would have to moderate. Any unmonitored extreme dietary change can have deleterious as well as beneficial consequences, so it is very important to not assume that what works for some will also work for you.
I agree that sugar can be addictive for some as is alcohol, but I also believe that this is the minority ( and that these folks will already know who they are since they will acknowledge that “once they start,they can’t stop) and that for most people the balance will lie in between. Blood sugar control is very complicated and there is a great deal of individual variation making one size fits all recommendations ineffective, if not actually dangerous for some. My recommendation was written as common sense advice for general consumption, not as specific advice about what would work best for any given individual. That requires a complicated conversation about familial patterns of body type and dietary habits, previous weight status, how long the person has had problems with weight management,have they ever had an recognized eating disorder, whether or not they have had a history of successful loss followed by overshoot on regaining and what triggered the weight increase, whether their principle problem is overeating or food choice or lack of exercise ( usually some combination of all three), the components of their diet with emphasis on healthier alternatives, their current blood work including not only their blood sugars but also their thyroid function and their lipid panel at a minimum. For women it will entail knowing their reproductive history. Have they had gestational diabetes with any pregnancy or a child weighing over nine pounds at birth ? Both are independent risk factors for Type II diabetes in the future regardless of the woman’s diet and exercise regimen. Sorry guys, I don’t know if there are any gender specific risk factors for you, but since everyone who is still readying by now is probably bored to tears…I think I will stop anyway.
“I became a vegan. It worked”
Tia, Did you transition into becoming a vegan or do it in one fell swoop? I have been seriously contemplating this as I am also a pre-diabetic.
David, Thanks for the uncensored and raw personal story. Such frank revelations can touch others with similar challenges more than anything else. It takes courage to lay something out that personal, especially the failures along with the successes. Laying it all out makes it real and accessible to others.
Alan
“Tia, your entire seven comments prove you should go into another profession!!!”
Not a bad thought. What did you have in mind ?
When one requests snark, I deliver. Glad to be of service.
Perhaps you could become the new City Innovation Officer.
Happy stuffing day!
Alan
How kind of you ! I mean the Thanksgiving best wishes, not the highly improbably suggestion for my new career !
I have thought about suggesting the position of a City Health and Wellness Officer ( as a volunteer position for which I might be suited in my post retirement life) but feel that most will find that ……just silly !
Happy Thanksgiving to all !
Go for it. You’ll make $240K less than my suggestion, but follow your dreams . . . follow your dreams . . .
Several years ago my blood sugar level came up at 115 mg, which these days is considered pre-diabetic. Since then I have cut my sugar intake by nearly half. I notice my energy levels are more steady during weeks when I don’t have much sugar.
I find it difficult to find ordinary everyday foods that are low in sugar
most brand name ordinary breads, including whole grain breads, have several grams of sugar or more per slice
most peanut-butter brands have unnecessary sugars (Adams crunchy is low; and tastes best!)
crackers, which generally are salty, often have unneccessary sugar in addition to salt.
many frozen food meals (I’m a bachelor and generally nuke something for dinner) have sugar added to the main course, including meat & potatoes, pasta, etc.
On the positive side–no-sugar added (just some lactose from the dairy) ice-creams have gotton a lot tastier over the last decade or so!
There are some sugar-free cookies that aren’t bad; as well as sugar free cocoas and mocha mixes.
Wish we could get the message back to the food industry that we really don’t want those few added grams (or more) of sugar added to each serving of most food items
Maybe due to national epidemic of diabetes and obesity, we could revise labeling laws to place sugar content in bold, prominent large-type letters; so it’s easy to spot sugar content immediately, and people can understand and veer away from those everyday food brands that include so much unneccessary sugar.
tribeUSA
“many frozen food meals (I’m a bachelor and generally nuke something for dinner) have sugar added to the main course, including meat & potatoes, pasta, etc.”
I have a suggestion for you. I recommend that you stop nuking and start cooking. Even if you have never cooked before. A rice maker, a few chopped up veggies and slices of lean meat and a skillet and you have a great stir fry in under a 1/2 hour. Many stores in town have salads, soups, and other healthy entrees in their “hot foods” section which are just as convenient as “nuking”. Pasta with a marinara sauce is another really easy and delicious beginner’s meal in under a 1/2 hour. Substituting fresh fruit for your cookies and ice cream makes a great and much healthier dessert. I can guarantee that it would be much easier for you to change to a fresh food based diet than it would be to get the processed food manufacturers to produce truly healthful food !
One way to get started is to just type in “meals for one” which will get you lots of sites with quick healthy meals for one person.
Sorry to sound preachy……but this is what I do for a living.
Tia–thanks for the tips! My sister has been encouraging me to stir fry vegetables (and lean meats) as a quick and healthy alternative to frozen. I hear the italian diet is one of the most healthy; I do like italian food and might try the marinara–maybe I’ll add this to my Christmas list this year. I’ve been meaning to find the optimal apple plate and knife, and carving an apple on the comfortable plate for my TV dinner dessert.
Good to hear that you help your patients with nutritional advice–I heard on the radio that many medical schools do not require any courses in nutrition for medical students; when it seems to me good nutrition could help in so many ailments (and conversely bad eating habits result in so much poor health/disease).
Thursday I’m going to a friends for Thanksgiving dinner; and Friday I will be cooking (not nuking) my own leftovers to last a week, including turkey/cranberry sandwiches (light on the cranberry to keep sugar intake low)!
tribeUSA
Thanks for your gracious response. As a doc, it is always tempting to pass out advice, whether it is desired or not. I agree that medical schools spend too little time on nutrition classes. We had one, but since it was now over thirty years ago, I am largely self taught. Since prevention is by far the biggest emphasis of my practice whether the goal of the prevention is no pregnancy, or no obesity, or no cardiovascular disease, or no cancer….. my emphasis is always on risk reduction. This almost always starts with a behavioral approach. One problem a doctor faces is how to frame their advice so as to make it acceptable to the individual before them who often would prefer a “quick fix” when what is indicated is permanent lifestyle change .
So every positive comment that comes back to me is a small inspiration to keep trying to promote health on all levels, individual, family and community.
As Frankly said below good health is always a primary cause for gratitude and the basis for all else.
Thanks for sharing this David. I appreciate the directness, but more than anything I appreciate your determination and accomplisments doing the things that you can to get well. I wish more people I knew would do the same. Last time I saw you in person I should have commented that you are looking spiffy. Keep up the good work!
I had a personal health-related epiphany dealing with my own issues (everyone has em’)… that I will likely never have the potentiatl to feel and look as good as I do presently. Age happens and hair leaves and turns gray, things breakdown and gravity takes over. With that in mind I tell myself to be thankful for how I feel and look today… and take care of myself today.
The other thing that drives my motivation to consistently eat well and exercize is to extend the number of years I can be active doing the things I love to do.
But good health is always my primary thing to be thankful for. With that, everything else is possible.