Samuel was an English gentleman hailing from London. Close to 10 percent of the U.S. population, more than 30 million people, live with diabetes. Five years ago, Samuel was diagnosed with type 2 diabetes. He now manages diabetes by taking lisinopril (an ACE inhibitor) and glipizide (similarly to metformin, it controls blood sugar), he also goes on hour-long walks every morning at 6:30 a.m. to keep his A1c at his comfort number of 5.5. It has not always been this way for Samuel as he was diagnosed abruptly in the ER.
“The night I went into diabetic shock, I remember five hours previously to that. I was finishing up at work and ate the rest of the chocolate cake that was leftover from my daughter’s birthday party. She just turned eight. And then I got home that night and downed a few beers. My wife looks at me and goes, ‘You’re not making any sense to me, Sam …’ I was like jibber jabbering and hallucinating.”
“I was completely out of my body, and I hit my head on the kitchen counter before falling face first to the floor. My arm went numb, and then it crossed suddenly over to the other arm. And then both my wrists twisted inwards. My wife called 911. I don’t remember the ambulance ride apart from the flashing lights and the bodies of people around me. I thought I was dying.”
“Long story short, I was diagnosed with type 2 diabetes in the emergency room. I don’t really remember what happened. I only remember a nurse struggling to put in an IV line. My A1c was a whopping 14 and was warned that if I didn’t take control of my life I would be a repeat customer.
“So, that was a wake-up call for me. I had to give up my late night eating binges for exercise and veggies. God, I just love carbs.”
“Oh, we all do,” I said.
“I admit, I love pizza. Stuffed crust sausage pizza from Pizza Hut.”
“I do, too! One of my favorites.”
“It’s like when you get older; you tend to get sort of fat around the middle.”
“Nothing exercise and the right diet can’t fix.”
“So anyway, it took me eight or so months to acclimate and to get back to some sense of normalcy. I thought I had a death sentence. I even told my parents, ‘If anything happens to me, here is I want etched on my tombstone.’ I mean, I was dead serious about it – no pun intended. I said, ‘I don’t know how long I can take this.’ And everyone told me, ‘Hey, just chill out. It’s going to be OK. Just get on a diet, exercise, drink lots and lots of water.’ I went to one doctor, and when I told him about my episode and that my A1c was 14, I was put on metformin. That made me drop so much weight; I looked like Gandhi.”
“How much weight did you lose?”
“Perhaps around 30 to 40 pounds? I was happy with the weight loss and knew it was a common side effect of metformin.”
“Interesting, I see that you are not on it now. When did you stop taking it?”
“So I ended up seeing a different doctor to get a second opinion because I was afraid I was losing too much weight and started feeling fatigued. She goes, “Stop taking the metformin for diabetes type 2 . Your sugar is at 40, which is way too low. I want you to continue exercising, do the diet, salads, drink lots of water.”
“And then, several months later, after moving to a new state, I went to another doctor. To him, I said, ‘The last doctor told me don’t even bother with metformin because my blood sugar went down to 40.’ He told me when your numbers get that low, he goes, ‘Either you could have a tumor on the pancreas … ,’ and I was like in my head, ‘You’re kidding me, right?’ I thought, ‘Oh, man … this doctor … he scared the crap out of me.’” Fortunately, there was no tumor.
“You’ve seen quite your fair share of doctors. It seems you’re in a good holding pattern with your current doctor.”
“I am. I know diabetes is a complicated thing to control. It can be genetic, poor diet, not exercising, a slew of things. I’ve been looking forever for a doctor that just understands me and my lifestyle. I’ve finally found that doctor.”
“Well, I am happy for you. Your A1c is 5.5, and things are looking great. I’ll go talk with my attending, but if I don’t see you again happy birthday in a few days.”
“Thank you so much, glad to be alive.”
Ton La, Jr. is a medical student and can be reached on LinkedIn.
