After All These Years: Al Lewis, Age 73, Living with Type 1 Diabetes for 69 Years

October 26th, 2008

From the book “50 Secrets of the Longest Living People With Diabetes”© 2007, by Sheri R. Colberg and Steven V. Edelman, to be published in November 2007. Appears by permission of the publisher, Marlowe & Company, an imprint of Avalon Publishing Company. Contact Dr. Colberg at www.shericolberg.com and Dr. Edelman at www.tcoyd.org.

Anyone who knows Al Lewis of Vancouver, BC, understands why he wouldn’t switch to an insulin pump until a waterproof model became available in 1977: His whole life has revolved around water.

By the time he was twelve years old, he was already fishing commercially off the coast of California. Despite having had type 1 diabetes since the age of four, he would be out at sea for days at a time, accompanied only by his fishing partner.

“I think it was harder on my parents than it was on me,” he reminisces. “My mom used to get up at 2:00 a.m. to make me breakfast before I would go out fishing, and she told me later that she would cry after I left.” He had just become a teenager when he earned a certificate from the United States Power Squadron for completing their small boat course, making him at that time the youngest person ever to be certified.

After a three-year foray into forestry at the start of college, Al found himself drawn to the study of oceanography instead (no big surprise there). He was on the swim team during both his undergraduate and his master’s degree studies, lettering at both levels. His PhD research at the University of Hawaii involved skin diving and some scuba diving. And until just recently, he swam competitively at the master’s level (defined as age 25 and older for swimming).

An emeritus professor of oceanography at the University of British Columbia, Al is convinced that his constant activity has played a large role in his diabetes longevity - close to 70 years already - and his lack of any major diabetes-related health problems.

Fear of complications is a driving motivation to take care of himself, though. “I think one secret of longevity with diabetes is to be very competitive with yourself,” he says, recalling that he was even more competitive with himself than he was with other swimmers over the years. “I think it’s key to being successful with diabetes.”

It’s clear that Al is a very dedicated swimmer. He once contacted a swimming outfitter in Portland, Oregon, to see if they could make a suit that could be worn in a swimming pool and hold an insulin pump (the waterproof kind, of course). He had been wearing a fanny pack with his pump inside - both for safety when he was out at sea as an oceanographer and while swimming. In the end, they couldn’t come up with anything for him, so he settled for swimming in a triathlete full-body suit with his insulin pump tucked inside.

Recent back problems have propelled Al out of the pool and into the gym for weight workouts, but he continues to commute to campus and back by bicycle. Given his lifetime of physical activity, it is highly unlikely that he will let anything stop him now, especially not a small thing like diabetes.

Story from: Diabetes Health

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Onward and Upward With Diabetes

October 25th, 2008

Swaying in rhythm like drunk fans singing their team fight song, we campers bellowed our camp theme, clapping and banging on dining tables: “Shock, shock for Camp Firefly! We take the insulin - try not to cry!”

Camp Firefly for Juvenile Diabetics, located in Springmount, Pennsylvania, was our summer haven. Free from our overprotective parents, we played in the river, pulled pranks on staff, and shared our fears and funny stories of living with diabetes.

We were free as birds until it was time for our diabetes education classes, thick with deadening medical jargon. Listening to campers’ horrific testimonies, I became imprisoned by silence. I remember one girl telling us about being placed in foster care because her parents neglected her health. I remained friends with my fellow campers long after camp ended, returning with them every summer until we were old enough to become counselors.

Today, August 2, 2007, at 7:02 a.m., is the thirty-fifth anniversary of my diagnosis with type 1 diabetes at the old Children’s Hospital of Philadelphia. I remember that foggy Monday morning so clearly, exactly what I wore and everything that was said. When I returned to the examining room after having left nearly a gallon of urine in the bathroom container, the doctor asked my mother, “Mrs. Gordon, have beverages been mysteriously disappearing from your refrigerator?” The list began: gallons daily of water, orange juice, milk, lemonade; even two entire cases of soda meant for the school fair.

Blurting that I had diabetes, the doctor summoned the nurse and told my mother to hold my arm as he drew blood. I was sure that my condition was only temporary. My favorite television show was Dr. Welby, and I credulously believed that doctors could cure anything. When the endocrinologist entered my hospital room, I faced the wall and refused to acknowledge him, hiccupping, sobbing, and wiping snot from my nose.

“Stop crying,” he told me sternly. “You’re acting like a child!” “But I am a child,” I sobbed. “And you’ve been taking blood since I arrived.” He apologized and tried to console me, but I heard only every other word: “There’s no cure, blah, blah, blah. I know you’re scared, but blah blah, blah.”

On the fourth day, the nurse demonstrated withdrawing insulin from two vials, stressing the importance of not contaminating one with the other. “What the hell!” I thought. “Why am I practicing injecting a navel orange when I could be eating it? I don’t know what to do, and I don’t care,” I was given a book about diabetes, edited for children. It was full of kids frolicking in the grass after learning that they had diabetes, and following protocol perfectly.

Walking the corridors as if I were a hotel concierge, I poked my nose into every new admission’s room. “What’s your name, and what brings you here?” Linda, age ten, had five older brothers with type 1 diabetes. While experimenting with their urine testing supplies, she had learned that she had diabetes too. As she told the story I panicked, returning to my room in tears. Linda and her brothers proved that diabetes was incurable. Even Dr. Welby verified it was incurable in an episode that aired during my second week in the hospital, featuring a child with symptoms like Linda’s and mine. During my remaining stay I refused to talk to anyone. I cried during arts & crafts, the magic act, and story time.

After I was released, a visiting nurse came every day for one week to monitor my health, diet, and mental state. That was during the “good old days,” when insurance gave you what you needed and did not rob you blind. As she and my mother talked, I hid behind the refrigerator, crying.

A diabetic guide traveled to school with me that September, along with a cigar box containing a syringe (without the needle, of course), a cotton ball, two empty vials of insulin, and other diabetic apparatus taped and arranged in order of importance. During my first class, my teacher asked, “And how did you spend your summer, Little Miss Gordon?” Showing him the box, I whispered in his ear. After he prepared the students for my presentation, I talked about being diagnosed with diabetes and how they could help me adjust.

The children were given literature, and a poster with illustrations of insulin reactions and high blood sugar symptoms was tacked to the door. The girls were happy because they hoped that they would be chosen to escort me to Nurse Chin’s office. When I visited her, she always seemed confused and asked me why I was there. A temperature was her only gauge for measuring illness.

After a year, I became lackadaisical. I still took my insulin, but neglected to test urine sugars and abandoned my diabetes paraphernalia. The night before every quarterly doctor’s visit, I stayed awake until three in the morning, creating three months’ worth of urine sugars. To make sure they were realistic, I logged a few 3 and 4+’s. I had to balance the ketoacidosis tests as well: mostly negatives and a few moderates. To top it off, I performed calisthenics, doing jumping jacks, jumping rope, and jogging in place in an attempt to lower my blood sugar before my check-up.

I appeared so zombie-like during my doctor visits that Dr. Baker asked my mother if I was getting ample rest. To my chagrin, he also told my mother that he believed I was creating fictitious urine and ketone tests. My behavior was not uncommon, he said, especially among female patients; male patients were apparently more honest when they failed to adhere. Dr. Baker told me that if I did not stop these shenanigans, I would be banned. He added that I was wasting my parents’ money and digging myself an early grave.

What harsh words for an eleven-year-old, I thought. But it was not out of character for Dr. Baker, who often took young diabetic patients on a hospital tour to impress upon them the consequences of neglected diabetes. He even coined a term, Frequent Flyers, to describe patients hospitalized two or more times per year due to personal negligence. Dr. Baker never dismissed me as a patient, though, and he didn’t put me into foster care either. And once I turned fourteen I began to understand the importance of managing diabetes.

This was the regimen: piss in a paper cup, measure five drops of urine and ten drops of water into a test tube, and then drop in a speckled blue pill that fizzed like Alka-Seltzer once it hit the concoction. Don’t dare touch the bottom of the tube; you might get burnt! Performing these test made me feel like a wizard in a lab, creating magic. Adding to the appeal was Dr. Baker’s handsome twenty-four-year-old assistant, Joe. Joe had type 1 diabetes as well, and he taught me the tricks of the trade. Once he arrived, Dr. Baker’s office became my after-school hang out. Having diabetes never felt so good, until Joe left for graduate school.

During the wee hours I would contact the glucose strip hotline to troubleshoot. Once my problems were solved, the operator and I would shoot the breeze for hours. Our topics ranged from being diagnosed, to relatives who had diabetes, to my quest to win free gifts. Each vial tab was worth points that you could trade in for prizes. “Okay, Monique, for twelve points you can get cotton balls, lancets, a diabetic fiction or nonfiction book, a cook book, or diabetic vitamins.” Stalling as if I were on “Let’s Make A Deal,” I would ask, “Can you repeat that?” “C’mon Monique, it’s 1:00 a.m. Shouldn’t you be in bed? Don’t you have school?” “Okay, okay, I’ll take the all-natural vitamins for nine points.” Two years later the point system was discontinued. My mother claimed that I called so often that I depleted the gift selection.

As technology progressed, injections became less painful. Home blood glucose monitor testing kits replaced urine tests, spelling the end, to my everlasting delight, of eye droppers and test tubes. Hemoglobin A1c tests appeared, and one insulin injection increased to multiple injections. Later, my multiple injections were replaced by the insulin pump. Sometimes I clip my pump to my attire’s waistband, or a thigh band if I want to conceal it under a skirt or dress. “Calling Agent 99!” my friends would jokingly say whenever I wore the leg band and operated the pump with my remote.

“Ms. G’s bugging the room! Everyone quiet! She has us under surveillance!” a student shouted as my pump tubing dangled while I reached to write an equation on the board. “She has a bomb - everybody duck!” another yelled. Amidst the laughter, I stopped to teach the students about insulin pumps, relating its functions to math, science, and nutrition. Students begin sharing tales about family members who had died or suffered from diabetic complications. “Don’t you hate carrying all that stuff?” one student questioned. “I would just have to die!” another shouted. Telling stories and sharing times when I felt like quitting brought my students to realize that some conditions make one stronger.

When I travel, I carry a black insulated medical case, 7″x 9″ x 2″, in my backpack. It holds glucose tablets, glucose gel, two syringes, alcohol swabs, one vial of insulin and an icepack, batteries, a glucose meter, strips, a log book, and pump supplies, not to mention the Medic Alert ID bracelet I wear in case I become ill and cannot communicate. Carrying the case invites the following responses: “Monique what the hell is in your backpack?” “Girrrrrl, your diabetes must be bad if you have to carry meds around.” “Do you always have to carry it? And so much? When do you carry a regular purse?” “Think about it,” I have to explain. A thief is more likely to steal a handbag than a backpack, so I save purses for special occasions. Being adherent means having control and knowing my blood sugar levels during the course of the day. If I didn’t carry this “stuff,” as people call it, and use it properly, I would be of no use to myself or anyone.

There was a period when I concealed my condition from dates, fearing they would run like the devil. But the number one “do” in the diabetic manual is “avoid unnecessary stress.” Now I refuse to make compromises just to make someone else feel comfortable. Usually, I have been the one to break the relationship because of my partner’s unhealthy lifestyle. One resumed smoking after my first insulin reaction, blaming his smoking addiction on that one episode. Another couldn’t understand why I didn’t prepare meals like his momma: full of fat, sugar, salt, and that poison red punch KoolAid. “Put your life insurance policy in my name and I’ll prepare any meal you desire,” I responded sarcastically.

“Oh, Monique, I don’t want you to die!” another one said. “Die!” I yelled into the phone, “With your lifestyle, I can have your grave prepared tomorrow!” After that comment, I was labeled insensitive.

I developed a sense of humor from having diabetes. Every day is an adventure. Although diabetes can be a nuisance, you can lead a somewhat normal life. My most comforting adventure was rescuing a two-year-old Chihuahua Rat Terrier. Endo Jesus Divo and I have a lot in common: a Napoleonic demeanor, a sense of humor, lots of energy, and many admirers. I prepare him home-cooked organic meals and bathe his paws after every walk, making me feel like Mary Magdalene. In return, he alerts me when I’m about to have an insulin reaction and wakens me at 3:00 am as a reminder to test my blood sugar:

I often meet newly diagnosed people and those who have struggled to manage their diabetes. Once I tried to advise a parent on the do’s and don’ts of soft drinks for her newly diagnosed daughter. As a result the mother arranged for us to meet. While I was discussing the ups and downs of diabetes, they both freaked and I was banned from ever communicating with the daughter again. Now, ten years later, the daughter and I are colleagues in the school system. After complimenting me on my appearance, she discussed her battle with diabetes and accused me of ignoring her plight because of what her mother did. “I’m afraid that I might scare you now, even though you’re thirty-four,” I responded. “I’d hate to have your mother threatening me again.”

I used to rate my health as “poor,” but my physician rates it as “excellent.” Having an illness does not mean you’re in poor health, I have learned. Examinations, mental state, and medical history are what count. People are free to do what they want, when they want. I choose to live.

“Shock, shock for Camp Firefly!
We take the insulin - try not to cry!
Take us campers for a swim
And don’t let a shocky camper in!
We never stumble! We never fall!
We sober up on orange juice all!
All us campers want to fight
Diabetes with all our might!
Fight! Fight! Fight! Fight!

Monique Gordon (Binky), a Philadelphia native, is a gifted poet, playwright, and performance artist.

Story from: Diabetes Health

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Living with Type 1 Diabetes for Over Eighty Years

October 24th, 2008

From the book “50 Secrets of the Longest Living People With Diabetes”© 2007, by Sheri R. Colberg and Steven V. Edelman, to be published in November 2007. Appears by permission of the publisher, Marlowe & Company, an imprint of Avalon Publishing Company. Contact Dr. Colberg at www.shericolberg.com and Dr. Edelman at www.tcoyd.org.

If ever there were a diabetic trailblazer, the honor should go to James William Quander, the longest-living African-American with type 1 diabetes on record. Born in 1918 in Washington, D.C., he was diagnosed with diabetes in early 1924, shortly before the age of six.

At the time of his diagnosis, there were few specialists available to treat diabetes and even fewer with admitting privileges at Children’s Hospital, the local pediatric hospital. As a result, young James was usually the only juvenile patient at Freedman’s Hospital (now called Howard University Hospital), the local adult hospital founded in 1863 to care for freed slaves and their descendants. There his doctor, also African-American, could care for him under the segregation laws in place during those years.

According to the doctors at the time, young James was supposed to be dead by the age of ten. His parents, however, chose not to pass on that expectation to their son. Instead, they told him that he had a very serious illness that he would have to work hard to manage, and they did all they could to give him the same quality of life as his four siblings.

Given the racial segregation of Washington, D.C., from the time of his diagnosis through the 1940s (and beyond), James repeatedly dealt with double discrimination. His race kept him from gaining higher-paying jobs, and his diabetes, viewed at the time as a potentially contagious disease, led many of his peers to shun him.

He applied for a position with the FBI but was told that because of his skin color, he qualified only to work for the postal service. Despite his start at a lowly postal worker job, he went on to work for the federal government for 33 years as an economist, statistician, computer programmer, and manpower labor specialist.

In another trailblazing moment, James married his wife, Joherra Rohulamin Quander, despite the fact that her family came from East Asian/European roots. At the time, during the 1940s, society was almost completely segregated.

Nevertheless, James announced, “I didn’t pick my family, but I plan to pick my wife.” She bore him three boys and one girl, none of whom has diabetes. (His ten grandchildren and two great-grandchildren are also diabetes-free.) They remained married until her death nearly sixty years later.

For the most part James chose to keep his diabetes a secret, not publicly coming out of the “diabetes closet” until he was in his fifties. By that time, during the 1970s, most people had come to realize that diabetes was not a communicable condition.

In 1971, James was ordained as one of the first Permanent Deacons in the Roman Catholic Church. On a trip to Rome in 1975, he served as sole assistant to Pope Paul VI in celebrating a daily mass.

James lived by five simple words: faith, hope, love, perseverance, and discipline. For him, “faith” meant his own faith in God and in himself. As for “hope,” he always maintained the hope that diabetes would be cured in his lifetime. In his later years, when it was apparent that a cure was unlikely for him, he put his energy into managing his blood sugars and teaching others to do the same.

“Love” meant the love given to and received from his family and friends, which sustained him when his disease was most troublesome. “Perseverance” helped him live life to the fullest in spite of having diabetes. Finally, “discipline” topped the list as the most important quality; he was undeniably disciplined in caring for his disease for over eight decades.

During his later years, James traced the history of the Quander family clear back to 1684. Originating in Ghana, a branch of his family had been slaves owned by George Washington (freed by Martha as decreed in the president’s will), while others had been freed shortly after their arrival in America. Late in James’ life, he and his oldest son, Judge Rohulamin Quander, set out to document his remarkable story.

Together they wrote a book, published in 2006, called The Quander Quality: The True Story of a Black Trailblazing Diabetic (www.TheQuanderQuality.com). James insisted that after his death, his son donate half of the book’s proceeds to Howard University College of Medicine. His is a story that will inspire people for many years to come.

Story from: Diabetes Health

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Chip Sullivan

October 23rd, 2008

Chip Sullivan is a golf pro. This June he played his best game ever, beating the top club professionals in the country and qualifying for the fourth time to play against the likes of Tiger Woods in the PGA championship tour.

The victory was particularly sweet because it had so recently seemed out of reach: Around Christmas of last year, Chip was diagnosed with type 2 diabetes and hemochromatosis, a potentially deadly disease of iron overload.

Chip’s sister had died of liver failure caused by hemochromatosis in 2004, at the age of 44. She’d been diagnosed with both type 2 diabetes and hemochromatosis only about a year before her death, and by that time years of organ damage had already been done.

In spite of the fact that hemochromatosis is an inherited disease that’s especially common in the Irish, Chip didn’t suspect that he was at risk. He was slender and fit, and he believed himself to be healthy.

He’d been feeling very tired for a long time, though, and in December 2006 he decided to ask his doctor what was going on. A blood test was done, and his blood glucose level came back at 368 mg/dl. When he mentioned the family history of hemochromatosis, a ferritin test was also carried out, and that was sky high as well.

In retrospect, Chip believes that he probably had both type 2 diabetes and hemochromatosis for years. But once he finally had his diagnoses pinned down, he went all out to fix them.

For three months, he underwent two phlebotomies (blood-lettings) a week to empty out iron from his system. A pint of blood was removed each time, until his ferritin level dropped from 1129 to 7.4 ng.ml. Now he’s on a maintenance schedule, having a phlebotomy every month or so to keep his iron levels within a normal range.

To combat his diabetes, Chip was put on insulin. First he tried Exubera, but inhaling insulin didn’t work for him because he kept going low. Next he was put on Lantus and Novolog, but he wasn’t too happy with that either, and the carb counting threw him for a loop.

When he found out that many people with type 2 take pills instead of insulin, he changed doctors. Now he manages very well on one morning shot of Lantus, 1500 mg of Janumet, and a diet that excludes soft drinks, pasta, or potatoes.

After Chip was first diagnosed, he called his older sister in Alaska and told her to go get tested. She turned out to have borderline hemochromatosis and type 2 diabetes as well, so now she’s getting phlebotomies too.

Chip believes that his grandparents may have died of undiagnosed hemochromatosis, and he worries about the future of his three children. But their pediatrician advises against having them genetically tested, for fear that insurance companies will refuse to insure them when they reach adulthood. The disease generally doesn’t surface until middle age, so Chip is still debating whether or not to have them tested.

Chip is confident that he has his diseases well under control now. He fully intends to see his children grow up, and he sees the future as very bright. “I don’t feel like 42 is that old, ” he says. “I have my best years of golf ahead of me.”

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Making Lemonade

October 22nd, 2008

I am a survivor and proud of it. Not only have I lived with diabetes for 52 years, since the age of five, but I am also a breast cancer survivor for over fifteen years.

Living with diabetes was not easy as a child in the mid-fifties. It was a real hassle having to test my urine, and no one ever told me to empty my bladder first or how to count carbs. Who knows how I survived this long? I really believe that walking to school each day benefited me.

Diabetes is definitely genetic in my family. Both my grandfathers had diabetes, as did my father and two of his siblings. A couple of years after I became diabetic, my sister also got it. One of my brothers got type 2 in his fifties. So far, only my mother and youngest brother do not have diabetes.

I was thrilled that neither of my two sons got diabetes, and then my younger son got diabetes just before his twenty-fifth birthday. My older son is still okay, but the worst day of my life was when his three-year-old daughter got diabetes. I knew it was not my fault, but I was just devastated to think that our darling granddaughter would have to take four shots a day. She is doing well and has no fear of needles. When I was a little girl, the shots hurt so much that to this day I am afraid of needles.

I am proud of the fact that I have coped with diabetes without any complications. I have worked hard at trying to maintain good blood sugars. Since beginning on the pump about fourteen years ago, I have maintained my A1c at around 6%. I do exercise every day, even when I don’t want to. It certainly has helped me maintain good health. When you feel good, you look good, and when you look good, you feel even better.

I never kept my diabetes a secret, just in case I did get low blood sugar. I am prone to more lows than highs, even though I take a total of only about 15 units of Novolog a day.

I always believed that something good comes out of something bad. I thought for sure that my life was over when I was diagnosed with breast cancer at the age of 42 and had to undergo chemo and radiation. It was not a comfortable situation, but I am a survivor. I made lemonade out of lemons by not letting diabetes or cancer drag me down.

It was after going through all those chemo injections in addition to insulin shots that I went on the pump, and I’ve never regretted it. Taking one needle every three days to insert the pump is so much better than three or more shots a day. I just hate needles.

Before my sons moved out of the house, I was the only person with diabetes in the household. I had to learn to cook so that I could eat correctly, and they all were happy with what I made. I love to cook and bake, and my favorite food is cookies. I learned to prepare foods the healthy way, and I continue to prepare dessert almost every night.

My men, family, and friends were all satisfied with what I prepared, and they loved my cookies, cakes, pies, and other tasty desserts made without artificial sweeteners. People with diabetes can incorporate sugar into their meals but must watch the carbs. My Craving Chocolate Cheesecake is the ultimate dessert that I can eat and not have to worry about blood sugar swings.

At my oldest son’s suggestion, I wrote my first cookbook. It sold very well, so I started teaching cooking classes and lecturing on healthy cooking. I never attended a culinary school nor went to college, but have done very well in helping others learn how to prepare foods the easy yet healthy way.

Even though my sons have their own families, I still cook and bake for my husband and guests and enjoy preparing foods that fit into my meal plan and satisfy everyone else. I have learned to prepare recipes using a minimum of fat, salt, and sugar while retaining flavor and texture. My latest cookbook contains over 300 recipes that even the novice cook can prepare. I am fortunate to have a very supporting husband who loves to taste-test whatever I make.

If I can survive diabetes for 52 years and breast cancer for over fifteen, so can you. A positive attitude is important since you never get a break from living with diabetes. It is your life, and if you want a satisfying life, you must work on it yourself.

Eating correctly and taking the correct medication are only part of good diabetes care. I believe that daily exercise is a major component to healthy living. I personally hate to exercise, but it is definitely worth the effort. My blood sugars are usually within the required range, and my weight is just fine. Exercise and drinking water throughout the day also help your skin.

Please join me in learning to accept life with diabetes and make the best of it. Turn those lemons in lemonade and enjoy life.

Kathy Kochan’s website can be found at www.healthyeatingcookbooks.com. Her email address is k.kochan@att.net.

Story from: Diabetes Health

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