Metabolic Demons

Metabolic what? 

Well, here I am: 52 years old, and as my dear Margo is wont to say, “rode hard and put up wet.”  I suppose it’s not surprising that after a lifetime of non-stop adrenalin, trauma, relocation, loss, stress and struggle, I ended up in a gastroenterologist’s office this morning with a young doctor there on fellowship and his supervisor, both questioning me closely about my alcohol intake, sex life, tattoos, diet and exercise.  An ultrasound of my liver was “fatty” and enlarged.  My liver enzymes are bad.  And, just in case the fact that my primary care doctor issued me a blood sugar meter and accompanying paraphernalia didn’t make it clear, I am, without a doubt, diabetic (damn, I was hoping that just because she said I was ‘borderline’ I had somehow not quite jumped that line).  Plus, I have high blood pressure and my cholesterol is always just below or at the warning level.  And sleep apnea.

“We call this ‘metabolic syndrome’” the younger doctor, all bright-eyed and bushy-tailed, informed me.  “Diet.  Exercise.  Otherwise, that fat will start to scar your liver.  Do you know what we call that?” 

Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.  If you have metabolic syndrome or any of the components of metabolic syndrome, aggressive lifestyle changes can delay or even prevent the development of serious health problems.

 - Mayo Clinic 

I hate it when doctors act like patients live in a dark cave and never listen to the news or don’t pay attention to a million warnings from their doctors . . . or don’t have fifteen relatives with liver-related diseases.

“Cirrhosis,” I replied, wearily.

“Yes, and its very, very painful, you do NOT want to go there,” the senior doctor warned, wiggling his admirable gray caterpillar-like eyebrows as if he were waving me off the wrong exit on the freeway.

Tell me about it.  At eleven years old, I waited outside a hospital room doorway listening to my brother scream as he underwent a liver biopsy, watched him battle back from the edge of serious illness.  As an adult, I’ve visited two of my sisters – at different times and different hospitals - post-liver transplant. I know the routine.  I know the procedures.  I know the drugs.  This doctor may be an Andy Griffith look-alike, but he knew his stuff and he was letting me have it with both barrels.  I don’t want to mess around with my liver, he assured me.  At least, not any more than I already have.

It’s true, I have dragged my poor liver with me through all kinds of trauma, welfare and commodity foods and massive stress – and that was just my childhood.  Adulthood was another string of years on low budget food, an increasing dependence on sugar (my drug of choice; it’s as bad for me as alcohol or other drugs have been for other family members), and less and less vigorous, steady exercise.  Grad school?  One long surge of adrenalin, a hernia, and more sugar.  Fourteen years as a professor?  Um, think grad school with more money for more sugar.  I used to carry my weight evenly, all over my body, a nice survival suit of back-up energy and insulation.  But in the past fifteen years, the fat has concentrated itself in my abdomen like a child I can’t give birth to.

But I have never been a drinker, never taken a questionable substance of the pharmaceutical nature.  I’ve never even tried to smoke a joint, although being in the same room with folks doing so once made me vomit violently off the front porch. Although I have two tattoos, I got them at highly reputable places with the highest standards.  And sexual partners?  Don’t make me laugh (or tell you just how Victorian I really am).  It’s kind of unfair, really.  All those relatives I know who are or have been such heavy drinkers or drug users – my mother and father included! – and who ends up with a lousy liver???  The woman who has been drunk maybe three times in her life.

Still, I haven’t been good to my liver in terms of food.  And, let’s face it, as a woman with at least half my ancestry coming from California Native tribes, my body has a predisposition to metabolic syndrome, possibly even an inherited liver intolerance for the kinds of high fat and sugars my generation grew up on. (Okay, NOW can I get Federal Recognition?!)

I used my brain to pull myself out of poverty – my brain, and learning to trust my instincts, wherever those are located – but I guess I forgot to include my body in that rescue mission.   

In the process of earning a Ph.D., becoming a published author and full professor, I left my body behind, ignored my body’s needs.  Well, guess what?  These are not two independently situated places.  Brain needs body.  Body needs brain.

No brainer, right?

It’s called denial.  It’s called, too stressed out and obsessive about ‘getting things done’ to get up from the desk and go for a walk.

It’s called winning the battle but losing the war.

So I sat there this morning and took my tongue-lashing like a woman, admitted my negligence, promised to get to work on diet and exercise, gave three vials of blood for more testing, and set up an appointment for a liver biopsy.

Then I called my wife.  To her credit, she did not choose that moment to say “I told you so” (she did that later, after I came home), but commiserated and agreed that I probably needed to go to the bead store and do a little retail therapy before heading back to Lexington.

You might be thinking, oh come on, how hard can this be?  Lose the weight.  Go for some walks.  Get over yourself, whiner.  You have health insurance.  You live in a very walkable area.  You have a supportive partner who can cook healthy food like she’s a professional or something.  Why all this moaning and groaning?

Listen.  If you’ve ever been a smoker, or a hard drinker, or addicted to some substance that wasn’t good for you (whether that be speed or wheat), you know that beneath every addiction is a demon eating up that crack, or that whiskey, or that Snickers bar.  Maybe even more than one demon.  Demons like Loss, Grief, Fear, Abandonment, Loneliness, Inadequacy, Hunger.  Demons like Denial, Anger, Self-Destructiveness, Pain.  Demons so complex they can’t ever have a name.  Demons as much a part of you as your DNA, Demons you can never quite completely wash out of your blood.

Those are the demons who need the fried donut, the big bowl of ice cream, the candy bar between classes, the Coke at the end of the term when you just can’t make it through one more round of student conferences without a ‘lift.’  These are the demons who crawled out of some dark place when you were a baby and your parents drank and fought, slammed doors and each other, right over your head.  These are the demons who constructed themselves out of your mother’s absence or your father’s disappearance or the sudden amputation of siblings from your life.  Once those demons got a hold in your body, they dug into your veins and your organs like parasites in for the long haul.  They thrive on divorce, coming out, homelessness, term papers in grad school, competition for TAships, the job hunt, proposals for panels and papers and books.

They do not let go just because you have good intentions about going clean.  They do not give up when your doctor tells you your blood sugar is too high for too long.  These kinds of demons stay, they grow, fed by stress and worry and fear, they get real comfortable, real fat. Real real. 

As real as real gets, my friends.

These are the demons who, even when you DO go cold turkey on sugar, exercise daily, lose 30 or 40 pounds - as I have done TWICE in the past ten years - simply lie in wait, looking for that new stressor to pop up, or that old one to hold a massive reunion.  And then, they POUNCE.  That's called relapse.  Just like an alcoholic is always an alcoholic, I will always be a sugar junkie who can't let her guard down.  But who does, anyway.

So here I sit in my comfortable living room mulling over the fact that at the age of fifty-two, I have accomplished many things of which I am very proud – at the price of my health.  It’s not a very good feeling.  I’d kind of like a big bowl of peanut butter and chocolate ice cream, in fact.

Oh wait.

Maybe I’ll just sit with the demons and listen to them scream.