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Bob's
Story
In January 1998, as I neared my 60th birthday,
I decided to give myself a birthday present by increasing my exercise
activity. To begin, I started walking each day starting at one mile a
day. Within two weeks this had increased to approximately three miles
each day. Within a couple of weeks I decided that if I was going to expend
this much effort in walking, I would make one change in my diet--I would
not eat candy and dessert, but instead would eat fresh fruit.
The results have been phenomenal. By November 1998 I had lost 60
pounds and reduced my body composition from approximately 37% body
fat to 14-15% body fat. My doctor is pleased with both the weight
loss and the improvement in my lab test results such as cholesterol,
triglycerides, and glycohemoglobin as well as blood pressure and heart
rate. I am perhaps more pleased by these results than the weight loss--it
has cost me a bundle to buy new clothes. I've dropped from a 42 inch
waist to a 34, an XL in sweaters to M, 46 or 48 in suits and jackets
to 42.As a young child I was so thin that my mother did not allow
me to wear shorts in the summer time because she did not want her
friends to see my scrawny little legs. When I was seven years of age
my tonsils and adenoids were removed and I immediately ballooned.
I remember that I came home from the hospital and was offered some
ice cream on the theory that it would sooth my sore throat. I finished
that bowl off immediately, was offered another, and continued to eat
large amounts until the start of this year. Within only a couple of
months I went from a skinny little kid to a very fat kid.
I was not encouraged to exercise, but in several cases was actively
discouraged. For example, one of my mother's cousins drowned when
I was an infant and she would not allow me to take swimming lessons.
Her fear transferred to me and I have been very much afraid of water
all of my life.
As an adult I maintained the same patterns that I had developed as
a child. Perhaps one factor in this is that the physical education
classes which I took were largely ineffective. I remember taking a
golf class (which I figured would teach me a game that I could play
throughout my life) in which the closest we got to a golf course was
the whole class hitting golf balls across a practice football field
at the same time. Of course you had no idea of how far or how straight
your balls had gone in the mess. I still embarrass myself and the
people I'm with if I even try to hit a golf ball. Other classes were
better, but they still didn't convince me that I would enjoy those
activities the rest of my life.
After marriage my weight rose to around 200 pounds and then gradually
crept upward to around 225-230. I developed high blood pressure and
ulcers while I was still in my twenties.
In 1984, when I was 46 years old, I was diagnosed with Type II Diabetes,
a disease primarily associated with obesity. After an initial period
of treatment with an oral hypoglycemic agent which led to a bleeding
ulcer, I tried to maintain control over blood sugar by diet and was
reasonably success until 1991 (age 53) when I started taking another
hypoglycemic, Glucotrol.
I started taking insulin in 1996 when I was no longer able to maintain
adequate control over blood sugars. In the fall of 1997 I was maintaining
fasting blood sugars in the 120-130 range by taking 50-55 units of
insulin divided into two injections daily. Despite seeming to have
good control, in early December my optometrist discovered a small
hemorrhage in the retina of my left eye. It was decided that the hemorrhage,
most likely a complication of the diabetes, was stable and small enough
to postpone treatment, such as laser coagulation, until after school
was out in the spring.
In June 1987 I had a mild myocardial infarction, which led to having
a balloon angioplasty in August of that year, with a second angioplasty
being done in June 1989. I have continued to have an annual evaluation
by a cardiologist, usually including a treadmill stress test. These
tests have shown a slow, but steady improvement since 1989.
For the first couple of months of my exercise program I experienced
almost no weight loss. This could have been a very discouraging time,
but I had the good fortune to have a friend, Kevin Middleton, who
was committed to walking with me. His help and encouragement are largely
responsible for the success I have had. Later my wife joined me to
a limited extent. She has now lost 15-20 pounds.
During those first months I did see changes, even though I didn't
lose any weight. My clothes became looser to the extent that I began
wearing suspenders to keep my trousers in place. After about 6 weeks
the pounds also began to disappear and the clothes fit even worse--to
the point that I was forced to buy new clothing. At this point I have
a limited wardrobe of brand new clothes.
The effect on the diabetes was quite dramatic. Within two weeks I
experienced low blood sugars, which produces shakiness, profuse sweating,
confusion, and extreme fatigue. This was a certain sign to reduce
the amount of insulin. Upon consultation with my family physician
(who was of course consulted before starting my program) about the
results of home blood glucose monitoring, I began to reduce the amount
of insulin injected each day. By the end of March (about 10 weeks
after starting the exercise program) I was able to discontinue the
insulin injections completely! I continued to take my oral hypoglycemic
although in June I was able to reduce it to half of its previous dose
and then in September it was discontinued also.
I continue to monitor my blood sugars at least once a day. I have
found that those times when I miss walking for several days in succession
that my blood sugars begin to creep up. Knowing that the way to keep
off the hypoglycemic agents is to keep walking is a powerful motivator
for me, as I am sure it would be for most anybody.
When I returned to the retinologist in May for reevaluation of the
retinal hemorrhage, he proclaimed, "You're trying to put us doctors
out of business! Congratulations! You've done what not one patient
in a hundred will do -- taken control and reversed the progress of
the disease." He said there was no sign of a hemorrhage and that overall
my retinas were in much better condition than when he had seen me
in January.
All the indications are that there has been similar improvement in
coronary artery disease. Cholesterol and triglycerides have gone from
borderline high to normal. In November I reduced the dosage of cholesterol
lowering drug by half and hope to reach the point that I can eliminate
it also. Since it is one of the most expensive drugs that I take almost
$100 per month) my health insurer should be very happy if I do so!
An amusing incident occurred when I had my annual visit to the Cardiologist
in July (I had lost about 40 pounds at the time). The assistant always
asks you to step on the scales first thing. When I did so and she
had started adjusting the beam weights I saw (out of the corner of
my eye) that she was squatting down and looking under the scale platform
to see if there was something caught under the platform. When she
couldn't see anything, she asked me to move my feet closer together
as if that would change the weight. Finally she asked rather incredulously,
"Have you lost weight?" "Yes, ma'am, about 40 pounds!" "Oh, that explains
it!"
If you have questions or comments, please contact Bob at ramsey@graceland.edu
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