Wow, it's been a while since I visited my own poor neglected blog.

I was diagnosed with type 2 diabetes in 2003 at the age of 25.  I don't think it phased me at the time.  My dad was diabetic, so I always expected it would happen sooner or later.  I was a little shocked that I was so young, but I dealt with it, I moved on.  I've been taking meds for it ever since, and basically maintaining effective control of my blood sugar.  That's a good thing, because the complications from mismanaged blood sugar are awfully scary:  Heart disease, blindness, hearing loss, kidney failure, neuropathy, impeded immune system, gum disease...  the list continues...

Well, over the past year, it became apparent that my original drug regimen was losing its effectiveness.  My past two A1C tests have been high.  My last urine test showed an elevated level of proteins in my urine, which is an indicator that my kidneys are definitely being damaged.  Not enough to be too concerned, but enough that they're not filtering as much protein as they should, which is a precursor for more serious kidney damage.  My doctor and I tweaked my meds, and I've got good control again, for now, at least.

The loss of my blood sugar control bothers me.  It bothers me quite a bit.  My new medication regimen will work for a while, but it'll probably lose effectiveness after a few years, and we'll tweak again.  Up and down.  Constantly fighting my diet, constantly living under the threat of complications.  Eventually suffering from some of those complications.  Very likely dying relatively young after years of being miserable.  I've seen it first hand in my father, and I don't look forward to it, nor do I particularly think my wife or kids deserve it. 

So...  I consider all that, my future, the drugs, the up and down battle, and the complications, and I desperately feel like I have to do something to get it under control.  The only thing that can put type 2 diabetes into remission is major weight loss, but I've fought that battle constantly my entire life, particularly since I became diabetic.  Diabetes meds make it very difficult to lose weight.  Believe me, I really, really tried. 

So what other options do I have?  Well, the one I've been considering, with the blessing of my wife and my doctor, is laproscopic gastric banding (aka Lap-Band).  This is a low-risk, completely reversible, outpatient laproscopic operation wherein a ring is placed around the upper part of the stomach, creating a very small stomach pouch.  The smaller stomach pouch helps the patient feel satiated very easily.  It successfully causes significant weight loss (generally a loss of around 20%) in almost all patients.  The really interesting thing is that a study in Australia last year showed that 70% of patients who were type 2 diabetic when they underwent the procedure went into complete remission within a year, while most of the rest had a far easier time controlling it.  It's generally thought that this is almost entirely attributable to the weight loss, although it could be tied to reduced nutrient intake, or some other unidentified cause.  The difficult part of it is that it's a complete lifestyle change:  The patient's stomach pouch can only hold 4-6 oz, so that nice big juicy porterhouse is out of the question.  In fact, there are a number of foods that are very difficult to eat, never mind the quantity.  It's also pricey, running around $17,000 in my area, and my employer's insurance plan specifically excludes it.

I've been wrestling with two factors:  The first is the cost.  We can afford it, but it'll have an impact on the family budget for a few years.  And something about having another monthly payment higher than my car payment is making it a little difficult for me to pull the trigger.

The other factor is fear.  I don't think I'm particular scared of the surgery itself (link is a YouTube video of the actual procedure, and is not safe for lunch).  Well, I guess I am maybe a bit scared of the surgery, but my rational mind knows there's nothing to be afraid of.  When I say Lap-Band is "scary," I mean it's scary like it was when I quit smoking - being afraid of a lifestyle change.  The first month will be a liquid diet of varying consistencies.  After that, when I'm back on solid foods, I'll have to completely re-learn how to eat my meals.  Compared to the prospect of diabetic complications, like losing a foot, or my eyesight, or a kidney, I suppose it should be an easy choice.

I've been to a local surgery center.  I've had my initial consult, and I cleared all my pre-op tests.  They called today to get my CareCredit (surgery financing) account number so we can schedule the surgery, and I chickened out.  I said I couldn't find my wallet with the CareCredit card, so I'd have to call them back.  The truth is, I'm trying to summon the courage to go through with it.  The thing I have to keep reminding myself is that my dad would have done it, had he the option when he was young and healthy.  And I don't want my kids to have to watch me suffer and die young like I witnessed with my dad.

Besides, I call myself a geek.  What could possibly be more geeky than having your own body's plumbing modded for improved efficiency?

I'll call the surgery center back in the morning.