(This was originally a blog post from October 6, 2010.)
Abe Ramos, a reader of this blog, has made it possible for me to share his inspiring story with you -- and I bet you're already bracing yourself for a story about a guy who has done something spectacular which you couldn't do in a million years!
That's the trouble with inspiring stories, isn't it? The fact that they're amazing is what gets us interested in them in the first place, but as soon as we've heard the amazing story, we decide that it's too amazing -- at least, too amazing to be relevant to our own lives. "It's great that he could do that, but I'm not like him", we think to ourselves. So, in the end, are we truly inspired, or are we merely impressed?
Being impressed is the reaction you have when you watch somebody win an Olympic gold medal in gymnastics. It doesn't make you think, "Hey, I bet I could do that!". (If you thought you could do it, you wouldn't have been impressed.) Being inspired is different. When you are inspired by something, you breathe it in. (That's the literal meaning of inspiration, by the way: inhaling.) Inspiration means accepting an influence from outside yourself, and letting it become a part of you. You metabolize it, so to speak.
So, as you read Abe's story, please try to cross that boundary between passive admiration and active inspiration. Think about letting some part of his story become part of your story. That's what I will try to do, anyway, and I hope you will too. I don't want you saying afterward, "Yeah, I read that story... but I didn't inhale".
When Abe sent me some photos from the Camp Pendleton Mud Run in June (an event which people sign up to do in 5-person teams), I assumed I knew which member of the team he was. The guy on the right, almost certainly. I mean, if you had to guess which was the guy who was getting himself in shape in order to bring his Type 2 diabetes under control, wouldn't you pick the guy on the right in this photo?
But I knew that diabetes can surprise you, so I asked him to confirm that he is the guy on the right. And it turns out that he's actually the other fellow.
Huh? What? This guy? This young athlete with the high-definition biceps? He's the Type 2 patient in this group?
I started to think that maybe there was a more dramatic story here than I had quite grasped. Abe helped me grasp it a little better by sharing some photographic evidence of how far he has come since he was diagnosed:
How's that for a before-and-after picture pairing? Would you even recognize them as the same person? (Abe is reluctant to use the word "after", as he says that diabetes patients "never really get to a finish line", but I don't think pictures get any more "after" than this one.) And it's worth pointing out that the transformation captured here is not an extremely lengthy one. The diabetes diagnosis which made him decide to lose weight and get in shape dates back only to April of 2009. You're looking at a metamorphosis which happened in little more than a year.
Abe describes himself as an all-or-nothing guy, who does something thoroughly or not at all, and based on the photographic evidence before me I am inclined to take his word for it. Anyway, I wanted to find out more about Abe's story (partly because I was disoriented to think that this was someone who listed me among his inspirations, when he has clearly achieved more than I have, and in less time). He kindly agreed to fill me in.
Abe is disarmingly candid about what preceded his entry into the world of Type 2 diabetes: at the point he was diagnosed, he says that he ate "garbage", drank "way too much beer", and never did any exercise. Unlike many Type 2 patients, he doesn't try to lay 100% of the blame for what has happened to him on his chromosomes: "My genetics loaded the bullets in the gun, but my lifestyle pulled the trigger," he says.
His weight had climbed to the vicinity of 260 pounds during the run-up to his diagnosis. He knew, just as everyone else knows, that this kind of weight-gain can have serious long-term health consequences, but he didn't realize that the consequences could arrive as early as age 34. The diabetes diagnosis came as a serious shock. Even so, he admits that by that point he was already concerned about what was happening to his health. His weight gain was already changing his life for the worse. Sleep apnea had turned him into "a zombie" (I can relate!), and outdoor activities which he had once enjoyed were only a memory. Climbing stairs -- or even descending them -- made him gasp for breath. He may not have realized that he had diabetes, but he realized that all was not well.
When the diagnosis came, he experienced many of the standard-issue emotional reactions (such as shock and anger), but he managed to skip the most dangerous one: denial. From the start he was determined to face the situation and get control of it. Which was a good thing, because facing up to what his doctor had to say to him took a fair amount of determination. "The Doc laid it out for me. What foods I couldn't have anymore. What meds I needed to start taking immediately. What would happen to me if I didn't comply with his every command. He put the 'fear of God' in me that day. I am not going to lie; fear was a motivating factor -- and still is (although not nearly as much) in trying to get a handle on my diabetes".
However, Abe found other motivating factors. "I was also motivated to change my life for other reasons; to be around to spend time with my family and friends (apparently some of them actually like me). To turn my life around."
He also looked for ways to turn his self-perceived weaknesses (stubbornness and egocentricity) into strengths. The stubbornness helped him stand his ground with his doctor (who seemingly did not have great faith in Abe's ability to get his diabetes under control through lifestyle changes). The egocentricity (by which he seems to mean nothing more grave than vanity) helped him stay the course with his diet and exercise program, because he wanted to be able to buy fashionable clothes and look good in them.
I can't see vanity as a sin, particularly for a diabetes patient who can use it to motivate himself to live a healthy life. If vanity enables you to get in shape, then you will not have been vain in vain!
I must say that it puzzles me when I hear gym members make comments about the other members whom they catch checking themselves out in the mirror -- as if people shouldn't care whether or not they are making progress! Show me a guy who lifts weights but never checks himself out in the mirror, and I'll show you a blind man.
If Abe feels he's being egotistical to want to be in great shape, then maybe the rest of us with Type 2 should strive to be a little more egotistical.
Okay -- are you feeling intimidated yet? Good, you're normal. Let's continue with Abe's story.
"How did I turn my life around? First off, I realized that the only way to change my life was not to treat this as a diet, a.k.a. a brief modification that would quickly revert back to my old routine. It had to be a lifestyle change. That is the only way to battle this lousy disease. I read, researched and educated myself about diabetes."
Educating himself about diabetes led him in the same direction which it leads everyone who is truly paying attention: he knew that he had to get into shape.
"Next, I put one foot in front of the other. I could barely walk around the block when I first started. I was too heavy to even jog. Through trial and error I discovered what foods were good for my BG levels and which ones weren't. I harassed my medical group for as much blood testing supplies as I could get. How can we diabetics figure out what is ok for us to eat without knowing how it affects our BG levels? Portion control was huge. I realized that we eat with our eyes as much as we do our stomachs. I cut back on my carbohydrates (including my beloved rice and beans), I became best friends with veggies. I put together a support team (including my wife, my family, doctors, friends and some great people on e-forums like dLife). Finally, I also became one with exercise. I haven't gone more than 2 days without running or lifting weights in over a year and a half. As much as holding down the couch came as second nature, I get agitated if I am not exercising. A body in motion tends to stay in motion. Like you said, ironically, being diagnosed as a diabetic ended up forcing me to get into the best shape I have ever been in."
By late May of 2009, he was posting on the dLife forum, reporting remarkable progress. His weight was already down to 222 pounds, and his initial fasting level (174 -- precisely the same as my own at diagnosis, I mention irrelevantly) was now averaging 100. His 2-hour post-prandial results were down to the range of 100-115. He was on Metformin, but had high hopes of being able to stop taking it (and getting the resulting diarrhea out of his life) once he could demonstrate enough improvement to his doctor.
I first heard from him in June of 2009, at which point he was both proud of his progress and frustrated that he nevertheless needed to stay on meds for the time being: "I am currently on 1000 mg of metaformin per day (2x 500 mg) and taking high blood pressure medication as well. My doctor was adamant about putting me on meds, so in the end I did not resist. Anyway, I made it clear to him that if I stuck with my lifestyle change (as opposed to "diet") and I saw significant results I wanted to get off of medication. My doctor has agreed to this and since I have seen amazing results already, I am very hopeful that I can get off the medication(s)."
His amazing results soon included a spectacular drop in his A1c result, from 8.1 upon diagnosis in April 2009 to 5.5 in July. (I'll bet that one made his doctor do a double-take when he received the lab report! Very, very few patients ever achieve that degree of reduction in so short a time.)
In October of 2009, Abe (who had been barely capable of taking a walk around the block in the spring of that year) ran his first 5K footrace (that's slightly over 3 miles). I checked the results of that race, and was greatly relieved to see that his running pace was comparable to my own -- then! (I'm sure he could beat the pants off me by today, at the rate he's been progressing.)
The following month he was finally able to convince his doctor that it was okay for him to stop taking Metformin -- which means that, on Thanksgiving this year, he will be be celebrating his one-year anniversary of freeing himself from the need to take diabetes medications.
I don't think he's been standing still since then. "I have never been so determined to accomplish anything in my life as I am right now. Today, things are going well, and one day that might change. But I can only live for today and to do the very best that I can to fight this disease off for another day. Don't let the bad stuff get to me too much; get right back up when I get knocked down. I am incredibly hard on myself, so I also make sure that I have to allow myself to celebrate the successes, big and small. I hope that anyone reading your incredible blog (educational, entertaining and inspirational), especially those who doubt that they can achieve success, at least consider the fact that Diabetic Medical Convention isn't always correct. YOU HAVE TO TAKE AN ACTIVE APPROACH TO YOUR OWN CARE. NO ONE ELSE CAN DO IT FOR YOU, NOT YOUR DOCTOR, NOT A SIGNIFICANT OTHER. YOU AND ONLY YOU! Being positive, eating right, exercise, testing, having a support team and not getting down when you screw up can help you live a long and successful life with Diabetes. It doesn't have to be a gradual (or quick) descent into pain, failure and an early death. Positivity and success IS an option."
Having achieved such a remarkable level of
success, Abe is feeling inclined to share the wealth, and not just in this
blog post. He would like to offer in-person encouragement to diabetes patients
who doubt that they can do anything like what he has done. He is
hoping to create a local diabetes support group in Orange County, California,
where he lives (he hasn't been able to find such a group in his area, so he
figures the sensible thing it to set one up himself). If you are interested in
communicating with him about that, his e-mail address is:
I warned Abe that people who were impressed by his achievement might neverthless assume that it must have been easy for him -- that he has some kind of supernatural gifts which enable him to do things which others cannot do. He rejects this idea with great firmness.
"Has it been easy? No. I might have lost 60 pounds in 4 months and 100 pounds in about 9 months, but it was never easy. It takes managing your disease one day at a time. Especially at the beginning when we get so caught up in how much we need to lose or what horrible dreaded thing can happen to you.
Same with the exercise. I could barely walk around the block a couple times without getting winded (and I am a slow walker). I was too heavy to even do a slow jog as it would hurt my knees. I started with baby steps. 20 minutes walking on the treadmill. Then it was 30 mins. Finally, after one month of my exercise consisting only of walking on the treadmill, I finally introduced jogging (no more than a couple minutes at a time). I remember the first time my sister dragged me out jogging at the park. 3 miles, we walked the first half. I jogged the last half and felt like I was going to die. But I also knew that the odds of me dying were a lot higher if I chose not to run.
Seriously, look at my 'before' pic. I was no athlete. I am not special. I merely refuse to accept excuses from myself. I am sure that there are plenty of people who read this blog who for whatever reason cannot get off meds or have some sort of physical disability that makes strenuous exercise very difficult. That's all ok. Just remember, that any exercise is better than none at all. Push yourself and you'll be surprised at the positive results."
If you're feeling slightly humbled by Abe's story, I have to admit that I share the feeling. Apparently he was able to learn something from me, in the early stages of dealing with his diagnosis, but it looks like it is now time for me to start learning from him.
I think I see some weight-lifting in my future...
Other people can do this
I always worry that people will think that I'm some kind of unique case, and that what worked for me won't work for anyone else. Actually, there are other people out there doing what I'm doing, and some of them are doing it better than I am.
Here's a story of one diabetes
patient who decided to push beyond the boundary of what his doctor thought was