Jimmy Kano in Toronto
I woke from a haze with a gasp realizing I’d been stripped of my belongings and returned to the state under which I’d been born. I was laying on a bed in the ICU of an emergency hospital. They said I had been in a coma for close to 5 hours. During that time, it seems I’d undergone various emergency medical examinations. I had been to the brink of death but had returned alive.
I found out I had lost consciousness and fallen over in the middle of a large supermarket then been rushed to this hospital in an ambulance. A stroke was suspected.
The results of a thorough examination established I had not had a stroke, instead, it was “pancreatic malfunction.” This is a very dangerous symptom of hypoglycemia (extremely low blood sugar) that develops due to abnormalities in the pancreatic hormone (insulin). In the worst case scenario, it can lead to death.
I had lived with Type 2 Diabetes for the past 30 years or so, but this was my first time falling over from low blood sugar. At the same time, I received the unimaginable news that progressive gangrene had been discovered unexpectedly in both my legs and if it got worse they could be amputated. Upon hearing the news my mind went blank from shock.
To add insult to injury, the day after I fell down, a “Notice of Immediate Suspension” letter arrived for my driver’s licence. It was a swiftness I didn’t think possible for government paperwork.
However, the sudden unforeseen incident that had befallen me was really a blessing in disguise. That’s because, through falling and being taken to hospital, the cause was identified (pancreatic malfunction) and the hard to believe gangrene in both legs was also discovered.
For the five or six years previous to that, I had thought the inflammation that had broken out on both my legs was only bad dermatitis. However, it seems that blood wasn’t going to the capillaries and the peripheral nerves were being paralyzed as there was no pain or itchiness. My family physician had not diagnosed gangrene and had merely prescribed me an antibiotic ointment and an anti-itch cream. Had I not been taken to hospital, these things would not have been discovered and the state of my disease would have progressively deteriorated inviting the worst.
In addition, if I had lost consciousness while driving my car, it would certainly have caused a big accident. Also, that morning, I had waited alone in the car in the parking lot of the clinic for my wife to return from her eye exam. If I had lost consciousness at that time in the car without anyone else around I would very likely not have been saved.
Yet I don’t remember why I suddenly went shopping at the supermarket. No matter how I think about it, surely it was a blessing in disguise. However, I was reminded of the fear of disease complications all over again.
For some time, I had understood the mechanisms of onset and horrors of complications of diabetes from having looked them up in textbooks and online. Well no, I had intended to know. Even though I had diabetes I thought about these things as other people’s problems.
In the beginning stages of diabetes, typical disease indications do not necessarily appear and there may be no self-awareness of symptoms. That is because there is no pain or itchiness. Carelessly, I had thought lightly about diabetes. The outcome of the worsening complications was that I was finally made to realize the fear of this disease.
It is said that Type 2 diabetes has typically three major complications: retinopathy, neuropathy, and nephropathy.
In my case, the first thing that became apparent was optical nerve damage. Due to that disease burden, I was seeing double and the nerves that move the eye were paralyzed. After that, it became difficult to hear voices and the sounds around me as the deafness started. This was also nerve damage.
When I was diagnosed with the heart condition called, “congestive heart failure,” I was forced to struggle with it for about three years before recovering. Ever since, my body had become ineffective at handling strain and I had come down with pneumonia, kidney failure, and prostate enlargement one after the other.
When I had cataract laser surgery and a corneal transplant, I had already become careful about driving a car by myself as the road signs became dim and hard to see, it was risky to drive after dark, and many times I was almost in a rear-end collision. Now when I think about it, the successive ailments were unmistakably complications from diabetes.
However, thanks to this incidence of emergency hospital transport, I was taken care of by a medical team comprised of excellent specialists and dedicated nurses as well as nutritionists in Scarborough hospital’s special education program for diabetes patients. Thanks to them, I could come to grips with diabetes for the first time and I began going to the hospital for examination every two weeks.
As I was taught, I put into practice taking a measurement of my blood sugar level once every two hours every day, reporting that measurement to the medical team, following the instructions of the specialists and nurses, and also following the necessary “sugar-restricted medical diet” from the nutritionist.
Typical diabetes patients are encouraged to have 50% vegetables, 25% protein and 25% carbohydrates. However, the “sugar-restricted medical diet” given to me was one meant to return function to my weak pancreas, improve the poor circulation that was the cause of gangrene in both my legs and return the alkalinity to my blood that had become acidic.
This special menu consisted of starting my meal every morning, noon, and night with a large helping of raw vegetables in a salad dressed only with lemon juice. Without exception, I couldn’t use salad dressing or oil. I was to aim to eat cabbage, onions, mushrooms, and seaweed especially. Carbohydrates were restricted to only 1/3 cup of oatmeal, or a small quantity of brown rice or rye bread.
All my intake of sugar was to come from fruit, but it had to be from determined types and in determined quantities. Table sugar or sugar- containing foods, especially cakes and sweet pastries, were strictly prohibited. Also, without exception, soft drinks and sugar-containing drinks were banned.
The quantity of meat, ham, and sausages was reduced and, instead of eating those, I was to eat the fish that I disliked especially blue fish such as mackerel, sardines, and pike. Foods fried or grilled using high-calorie cooking oil were forbidden and I couldn’t use butter or margarine.
Everything changed to a steamed or boiled cooking method. Coffee with plenty of cream and sugar was swapped for black. I also had to abide by an order of eating: vegetables first, meat or fish next, and carbohydrates (rice, noodles, bread) last.
In addition, the important thing was to definitely aim to eat three meals a day at set times in the morning, afternoon and evening. I absolutely was not to skip meals. I was not to eat at night. Also, I was definitely not to eat after 8 pm. Naturally, over-eating and drinking were forbidden.
I don’t drink alcohol, but I have a strong sweet tooth compared to other people. I dislike eating fish and my favourite meat dishes, white rice, noodles, pasta and so on were essential. Also, I liked well-seasoned and rich food. As well, I always lacked vegetables. My biggest fault was enjoying eating and being a glutton. Due to this, the diabetes prevention method was strange for me.
It was also true I had no confidence to begin because I knew myself well that I did not have the ability to sustain these lifestyle disease improvements. In this way, the “sugar-restricted medical diet” made for me was a significantly severe one. To improve my meal habits of many years, considerable tenacity and effort were necessary and patience and perseverance were demanded.
This was eating in a way that completely overturned my former meal habits, but I endured the ordeal and mental hardship that was a consequence of not taking diabetes seriously and diligently implemented the meal plan. Four months have already passed and I am thankful for my family’s help in pushing me through it.
By the way, my three brothers and I all came down with diabetes. Without question, my diabetes has a strong genetic factor. I remember well that my maternal grandmother was also diabetic. In addition, my inherent condition of difficulty in effectively using insulin (insulin resistance) is probably compounded by being overweight and lacking exercise.
However, already after continuing the “sugar- restricted medical diet” for four months, the specialists and members of the medical team were surprised at the quick appearance of signs of improvement. My starting body weight was 87 kg but is now 79 kg, so I was successful at losing 8 kg of weight. There are only 4 kg more to lose to reach the 75 kg goal.
As for the gangrene in my legs, the inflammation in my right leg has almost disappeared and the burn-like mark of inflammation on my left leg is becoming considerably smaller. The feeling in my toes is beginning to return and it seems the sense of numbness is going away little by little. Even so, it is disappointing that it is not possible for the nail of my big toe that had fallen off on my left foot to grow back. However, I totally had not believed at the beginning that such changes would appear just from the medical diet.
Another good thing is, from going up to an extreme degree then suddenly falling too much, my blood sugar level has settled into the determined range. Today, the amount of insulin I inject has been reduced to 1/7 of the amount from before. I am shocked by that unbelievable degree.
I had been following down the path of deterioration with my diabetes, but it has improved for the first time in ten years. It is no longer necessary to go for an examination with the medical specialists as I’d been doing once every two weeks from the time I fell. My appointment schedule has already been revised to once every 6 months. This was the best evidence that my condition had improved. If it continues to go favourably like this, in the near future when the medical specialist says, “It’s not necessary to inject insulin” I will be stamped with a metaphorical seal of approval.
I had been scrupulously going to receive a medical exam from my family doctor once every three months for the past 30 years. However, I had come down with diabetes complications and there had been no means for it to improve. It was like always carrying a bomb.
They say “Diabetes is the disease that is with you for your whole life”, but I had lightly thought of it as being a problem for other people. Also, as soon as I heard that it was a “lifelong incurable illness” I had half-resigned myself and developed something akin to a reckless attitude. I regret that all of it was my own doing.
I was flooded with a variety of information concerning diabetes. However, I didn’t know what to believe or understand which was best and probably just fell into self-despair. But now, I have been directed to the appropriate treatment method that I needed and despite the expectation that I have an incurable illness, the feeling that “diabetes will certainly be cured” has started to well up.
Now I start with the belief that “I will definitely show you a cure for diabetes!” and endeavor to make true my “escape from a lifestyle disease.”
-written March 15, 2017
Jimmy Kano in Toronto