Paul's Heart

A Test You Cannot Cheat On

It is a pretty safe bet that anyone reading my posts has had to have a blood test done at some point of their lives.  Whether it be for marriage, an employment physical, medical follow-up, whatever the reason.  Some blood tests, you have to “fast,” not eat or drink for a period of certain hours.  This is to give a “clean” number reading, not affected by nutrients or ingredients in food such as caffeine or sugar.

So, we do just that.  Knowing that we have a blood test coming up, that is meant to measure sugar, or cholesterol, or something else affected by our diet, I can at least admit that I go overboard in the starvation of my body of the foods I enjoy, just to have the possible lowest number on that test.  And it usually works.  And as I hide nothing in my posts, immediately following the blood test, I go for a nice lunch of the very things I denied myself.  At that point, with the blood test done, my cheesesteak and fries will not affect my results.

The truth is, we all have a tendency to “cheat” on certain blood tests.  And it was a matter of time, before a blood test was created to prevent misleading numbers that do not reflect accurately the test being measured.

As I have been followed up for a long time with all the late side health effects I deal with, I get blood work done annually.  I get the usual things checked, like cholesterol, and of course sugar.  For as long as I can remember, I have had a test done called an “A1C” though never really paid attention to it.  I just watched the “sugar” and “triglycerides” because these were the things I always heard discussed.  Knowing that these were impacted by drinking sodas, eating candy bars, ice cream… you know… all the good stuff, I made sure to go easy on those things when I had these tests done.  But this A1C was always in the background, hovering around 5.7 to 5.9.  I had no idea what that meant until two years ago, when I was warned that with numbers like that, I was “pre-diabetic.”

Well, to me that just mean I was not diabetic, so really all I needed to do was just reduce my intake a little bit and I should be fine.

Last year, during my summer time with my daughters, I was unable to use my barbecue grille for a period of time.  I tried to use my oven to broil things, but it was just not the same.  And it would be too expensive to eat out every night.  So, while I waited for the grille to get repaired, we ate pasta.  A LOT OF PASTA.  Which of course most know, pasta is carbs, which turn to sugar.  It was two weeks before the grille was fixed.  At the end of the summer, I finally got around to my blood test (mainly because of my fear of needles I always drag the test as far as I can).

8.9

The A1C test measures your average blood sugar levels for the last 60-90 days, in particular, how much of your hemoglobin is covered in sugar.  That is right, unless you have been “cheating” for the last 60-90 days, the A1C is going to be the determining factor of being or pre-disposition to, diabetes.  As stated above the picture, my number was 8.9.

Of course, as soon as my doctor informed me that I was now being diagnosed with diabetes, out came the excuses… the grille, my daughters visiting…  The test measures 60-90 days average.  My daughters were with me for 49 days.  Fortunately I was not at the point where I need insulin (which I would never be able to afford), but my local grocery store sells a very affordable 90 days supply of the medicine I was prescribed to force my A1C down to a safe level, and get back to being “non-diabetic.”

I have other factors that play into a possible diabetic diagnosis, but the sugar was a definite.  But after a year on the medicine, my A1C is back down to “pre-diabetes” level, my weight is down.  Stress also plays a major role affecting the A1C as well.  And as a long term survivor of Hodgkin’s Lymphoma, exposed to an extreme amount of radiation for treatment therapy thirty years ago, radiation can impact the pancreas which can affect the production of insulin.  Great, just what I needed, yet another health issue from surviving my cancer.

Some of my fellow survivors are in the same situation as me.  There are those that had huge spikes in their A1C once they stopped taking their medicine, having to return to taking the medicine, or worse, taking insulin.  Since many of us have heart issues because of our treatments, we really do not need the complications of diabetes added to our lists.

A recent study by Springer states that there is a 16% increase in childhood cancer survivors who received radiation of 10Gy (units of radiation) to the pancreas.  To put that into perspective, myself, and many of my fellow survivors decades ago received nearly 4000Gy.

If you are currently a normally healthy person, just keep doing what you are doing, but keep an eye on your health.  Follow up annually.  Get your blood levels checked.  For me, and others, it is just another thing we have to add to our list.  Once diagnosed with diabetes, and I know many who are, the complications only get worse.  If you are lucky to be able to prevent diabetes, do it.

A Promise I Cannot Make

There are many events in a parent’s life, there is not training for, only “on the job” experience.  I recall telling the story recently to my daughters that prior to their adoption, I was confident that I was “ready” to be a Dad.  I mean really confident.  Changing diapers.  No problem.  First date.  Um… okay, thought about it, eventually was okay.  There would even come a time eventually, when my daughters would learn about my experience with cancer, many years before their birth, and the many medical crisis they would actually witness in their youth.  But it was one particular moment in the Emergency Room, that I found out, just how difficult it was going to be, to be a parent.

There was a small child in the room next to me.  I could tell it was a small child, because of her screams of terror.  She was obviously the patient.  I could not tell why she was there because her words never mentioned what was traumatizing her body to be in the emergency room.  She definitely did not want to be there.  The little girl wanted only one thing, and was depending on the one person she should have been able to count on to protect her.

“DADDY!!!  THEY’RE HURTING ME!!!!  MAKE THEM STOP!!!!  DADDY!!!

This went on for several minutes.  Probably a lifetime for not only the little girl, but as a future Dad myself, it hit me as all of a sudden, I now realized one of the aspects of being a father I was not prepared for, but a lifetime for the father of that little girl.  No parent EVER wants to hear their child scream in such anguish, pleading for comfort, all the while as a parent, all we can do is our best to assure our child, “it will be over soon.”

Luckily, the times that there have been medical emergencies for either of my daughters, the doctors were blessed with calmly demeanored or all-too-willing patients.  So having my role as support was locked up pretty good, providing a sense of security for them when it was needed.

If not dealing with their physical pain would be bad enough, emotional pain was something that would be felt some day, probably in the form of loss either in a relationship, divorce, or even death of a loved one.  Every parent always grapples with how to handle death with a child, because most likely, depending on the age of the child, that child will never really understand what has happened, or be able to comprehend the loss.

I can only think of two situations that my children were at funerals, one as toddlers for a distant relative, definitely having no clue what was going on, the other, a much closer relative, their uncle, who had passed away from ALS (Lou Gehrig’s Disease) just a couple years after this photo was taken.  Again, my daughters were fairly young at the time, and in the moment, they knew death was not a good thing, at the same time, not realizing it was also permanent.  They would never see their uncle again.

I make sure that my daughters know stories about my late brother-in-law.  He was a good man, a good friend, a good Dad.

My daughters are much older now, still youth, but now have a different reaction when it comes to death.

Yesterday, my daughters were notified by their mother, that someone close to us had passed away suddenly.  He was a family friend.  And also had a major connection to our family.  We both adopted our daughters (my youngest) together.  This was a bond with someone, that they have known their entire lives so far.  Of course, their thoughts are with his wife, and as importantly, their daughter, who just like their cousin of the uncle that passed away, no longer has her father.

Here is where it gets more complicated for my daughters.  If children are lucky, they never have to go through their days wondering about their parent’s mortality.  Hopefully Mom or Dad takes care of themselves, and other than an unexpected event, there is nothing to worry about.  My daughters do not have that chance.  They have witnessed three times, when my body challenged me too hard (not including my cancer), once being taken out of my house on an ambulance stretcher.  They know my health will always be challenged because of the treatments for Hodgkin’s Lymphoma thirty years ago.  And as hard as I try not to let my fear show, as hard as I try to get past my limitations, I cannot keep them from knowing that my body is not well.

This is why it is hard for them to understand what happened to our friend.  The cause of his passing is unknown at this time.  But the comments from my daughters was how well he was doing, and looked, a bit of a contrast from a time when he may not have been in the best of condition.  But they know something happened to him, to cause his passing.  Oh, and he was around the same age as me.  You can see where this conversation was going with my daughters, what their concerns are.

I know my daughters worry about me.  They know about the many health issues I have related to late effects from my treatments, and they know how serious they are.  They know how close they have been to losing me, several times.  I am lucky to have had the doctors and nurses that have cared for me, to get me through each event.  And I can assure my daughters that I am doing all I can to take as good care of myself, to increase my chances of a longer life.  Especially eating healthier when they visit me, something I need to learn to do on my own when they are not with me.  And I know my doctors are doing all they can to stay on top of things as they develop.

But my daughters know I cannot make that promise to them, that it will not happen to me.  And that is what scares them.

My daughters do not remember this time, when they learned “Daddy’s body” was no longer perfect.  I still have the heart pillow (pressed between my daughter’s head and my week old open heart surgery incision).  I still have my daughters.  And they still have me, something I know they do not take for granted.