Ken's Story - How Exercise Helped My Diabetes
By Ken Sanders
In the fall of 2002, a good friend and fellow book collector and book dealer, Kent Walgren, decided to sell off his book holdings and move to Paris. My friend was so concerned about my health that he insisted that I go see his physician, because as he put it, he "wasn’t going to need her anymore because I'm moving to Paris." Not being a person who goes to the doctor much, I hadn’t had a physical for over ten years. I reluctantly agreed to humor my friend and go see his doctor. After a thorough physical, my new doctor, Dr. Patrice Hirning, informed me that my cholesterol levels were out of control (around 300, I believe) and that I had diabetes: my fasting blood sugar was over 200, on a scale of which 100 is the norm.
Sure, we’ve all heard of diabetes, but most of us, myself included, have very little real knowledge of the disease. Initially I was terrified to eat anything out of fear of the disease. I was literally afraid of food. I began to read books on diabetes, download information off the internet and found my way to the Utah Diabetes Center in Research Park, where Dr. Dana Clark became my diabetes physician. Dr. Clark has also been my father’s diabetes doctor for the past 25 years.
No one can tell me how long I might have had diabetes prior to my diagnosis. It’s impossible to say. In the early stages of the disease there really aren’t any symptoms. I should add here that I have Type 2 diabetes, or "adult onset diabetes," as opposed to Type 1 diabetes or what used to be called "juvenile onset diabetes." The main difference between the two types of diabetes is that Type 1 is insulin dependent and Type 2 is usually controlled by oral medication (sometimes insulin is needed) coupled with diet and exercise. The pancreas is an organ in your body that produces insulin. As I understand diabetes, in my case (Type 2 diabetes) my pancreas is damaged but still retains some ability to produce insulin, whereas in Type 1 diabetes, the pancreas is completely disabled and physically unable to produce any insulin at all. In Type 1 diabetes, without any insulin to take glucose out of the blood stream, blood sugar levels can get dangerously high and lead to a diabetic coma.
At the time I was diagnosed with diabetes, two colleagues in the antiquarian book and antiques trade were also suffering from diabetes. In one case the disease had advanced so far that his leg was amputated to save his life. In the other case, my colleague died because of complications from his diabetes. As I learned more about the disease, it became apparent to me that through a combination of diet and exercise I needed to control my own blood glucose levels and keep them within normal ranges, or face dire consequences. Diabetes attacks all of the organs of the body over time, hence blindness, liver failure, etc., as well as attacking the circulatory system, leading to amputation, and elevated risks of heart attacks and strokes. This gave me renewed inspiration to learn all I could about the disease and to be be an active participant fighting the disease in my body. In the beginning, as I have already said, I was terrified of diabetes. I felt as if my own body had somehow betrayed me, and was in active revolt against me.
I began my own exercise program, and for the first time in my life began reading the nutrition labels on various foods. I haven’t ever really gone on a diet as such, but have begun to pay attention to what I eat. My daughter Melissa has constantly reminded me over the years, “Dad, you do not have a healthy diet.” While this is undoubtedly true, I do now pay attention to what I eat and drink and eat much healthier than at any previous time in my life. For example, I now might eat at “fast food” establishments 5-10 times a year, where previously the count might be as high as 3-4 times a week. The plain unvarnished truth is, if I had paid any attention to my health and diet say from age 25 to 50, and had not gained some 50 pounds of extra unwanted weight over those years, the diabetes may have not onset. I will never know. But poor diet and weight gain are known contributing factors in Type II diabetes, along with genetics.
For the first two years of my diabetes, I took the disease pretty seriously and exercised regularly. Not being one who is attracted to either exercise for exercise sake or to the formality of gyms peopled with what I term “hedonistic body Nazis”, I devised my own exercise program. I should also add that I loathe running or jogging so I determined that if I must exercise, I would choose to run up and down stairs and steps wherever I might find them. The concept was that if running or jogging was good for one’s health, well then, running up and down flights of stairs would be even better. Ala "Rocky," and I mean the movie hero, not our former mayor, I ran up State Street from my bookshop and ran up and down the state capitol steps, but then they were closed for seismic renovations. Then I discovered two sets up stairs leading up and onto the Gallivan Center, also nearby the shop and began running up and down the steep flight of stairs behind the State Street Marriott Hotel, and the more “easy rider” steps to the west by the Wells Fargo Building and KUTV, where reporter Peter Rosen once accosted me and asked me what on earth I was doing.
At approximately the same time as my diagnosis with diabetes, the grand new Salt Lake City Public Library opened at Library Square with the long winding staircase that leads to the roof. I discovered that the “Stairway to Heaven” (I named it after the Led Zeppelin song) also proved to be an excellent running venue, despite the puzzled looks I got from patrons and library workers. The "Stairway to Heaven” is quite a challenging run, and I have only ever been able to complete about a dozen laps on it so far.
Unfortunately, after two years of more or less regular exercise, mostly between the Gallivan Center, Library Square and other staircases throughout the greater downtown area, I fell off the exercise wagon. I returned to my former slothful ways, and put all the weight back on that I had lost. I also began paying less attention to my diet and not checking my blood glucose levels often enough. I suspect that this is a fairly common occurrence among diabetics and that I am not alone in rebelling against my disease.
In the spring of 2007, my diabetes doctor, Dr. Dana Clark, gave me information on a new study that was about to commence at the University Utah. The program would study the effects of exercise upon diabetics, and how regular exercise might build muscle tissue and reduce fat tissue, and how that increased muscle tissue might affect the body’s ability to process and reduce glucose in the blood. (Please forgive my laymen’s nomenclature, but as I have previously stated, I have very little familiarity with the world of medicine and I would appreciate any corrections in my prose from health care professionals that actually know what they’re speaking about.)
At Dr. Clark’s suggestion, I called Sheldon Smith who was heading up the study and volunteered to become a "guinea pig." At this point in my life, I was at my heaviest ever, 278 pounds, and feeling every ounce of it. My weight and lack of conditioning was affecting both my physical and mental health. The study was designed to see if a new high intensity resistance training program had more of an impact at improving glucose levels than traditionally well accepted aerobic training. I met two remarkable women, Sheldon Smith and Robin Marcus and was introduced to the Rehabilitation and Wellness Clinic in the Division of Physical Therapy at Research Park on the University of Utah campus. After a number of tests, which I apparently passed, the 16-week exercise study program began. The exercise study class itself consisted three hour sessions three days a week, and a combination of the usual weight and cardio equipment: elliptical machines, weight machines, treadmills, rowers, bicycles, and one unusual machine, the eccentron. This machine was described to me as a “negative resistance machine.” It’s designed like a recumbent bicycle, hooked up to both a computer and a motor. It allows people with serious diseases like Parkinson’s Disease, Multiple Sclerosis, those who have had cancer and strokes who may not have much in the way of cardiovascular endurance, to use this high force yet “low impact” machine and still build muscle mass.
Another great advantage of this particular exercise program, a benefit that I hadn’t expected, was the great staff at the University Rehabilitation and Wellness Clinic, and my fellow patients or "guinea pigs." In addition to Sheldon Smith and Robin Marcus, with whom I’ve had the most personal contact, the rest of the staff was an ever changing guard of students, who are all at various paths on some future health care related career. Collectively, they taught me how to use the various equipment in the gym, and more importantly, the correct way to use that equipment. I most appreciate their patience with this doddering fat old man.
One thing everyone has in common up here is a desire to improve our own health, and my fellow workout mates, whatever shape they are in, we are all here to get better. It has been an interesting experience to exercise with a group of fellow diabetics over this time period. During the sixteen weeks of the study, my group worked out at the same time as a group of recovering stroke victims, and that has had a very
sobering influence on my own attitudes about disease in general, diabetes specifically, and has made me a much more motivated person in regards to taking care of my own physical problems with disease. Seeing what the stroke victims are going through to regain some sort of control over their own lives and physical abilities has been both a sobering and inspiring experience.
Once the initial, diabetes exercise study program was concluded, Sheldon and Robin formed an ongoing diabetes exercise group that currently meets twice a week and has enabled those of us that can and wish to, to continue our exercise and improve our diabetes control. It has made an immeasurable difference in my own life and my own control of my diabetes. I have now been, as of this writing, exercising for eight months. Recently, I recorded my first weekly weight under 250 pounds. While I realize that most folks would not be bragging about weighing 250 pounds, at six feet tall, I am a very dense fellow (I never get any argument about that) and I have large dense bones. This represents an almost thirty pound weight loss for me, but more importantly, my conditioning is ten times better than it was last year prior to beginning this program.
I have no allusions about running 26k marathons like some of the students involved in the study, after all I hate running. I am cognizant of the fact that although I will never fit onto those ridiculous BMI charts they like to use, and I would still like to lose approximately another 25 pounds, I am today, a far healthier human than I was less than one year ago, and I am managing my diabetes much more intelligently than at any time over the past five plus years that I have been aware that I had this disease. And although I’m the one actually doing the work; I owe a great deal to Sheldon and Robin and all the rest, and I’m grateful to Dr. Clark for first suggesting the diabetes exercise program in the first place ("Belly fat, belly fat," as Dr. Clark always points out to me. "Lose the belly fat.") I could not have done it without each and every one of you.
See you in the gym,
My friend and fellow bookseller, Kent Walgren, sold his bookshop to me in 2002 and moved to Paris to live his dream and to write the next great American novel. He sold his house, his car, and his shop, and uprooted himself from his family, friends and country. For nine months, Kent Walgren lived that dream. Sadly it ended abruptly. My old friend was found dead of a heart attack in his apartment in Paris in the summer of 2003. For Kent Walgren, the dream died abruptly. I owe him a debt that I will never be able to repay.