The Worried Well
When Worlds Collide Part I: My Almost Pre-Diabetes Diagnosis
A month ago, I got some sobering news. My doctor said I “almost” had pre-diabetes.
“Almost?” I asked.
I can’t say the news came as a shock. For years, my weight and blood work had been inching in the wrong direction. No one likes to admit that their lifestyle might be doing them harm, and I’ve used every excuse in the book. Fatherhood, stressful job, “special” occasions, never enough time. For the last seven years, I’ve had one of the best excuses of all–small business ownership. Running a brick and mortar butcher shop meant that my health always took a backseat to–well–everything else.
But when I played that movie moment wake-up call in my head, when my doctor puts his hand on my shoulder and gives me the news, I have to admit, it didn’t start with the word, “almost.” Almost pre-diabetes. It was like getting a participation trophy for poor health choices.
And it turns out, ‘almost’ pre-diabetes isn’t even a diagnosis. It's the medical equivalent of your mom saying she's "not mad, just disappointed." I'm almost on the wrong road. I'm almost sick.
Maybe my doctor was too polite to say what was really on his mind. "Hey buddy, that late-night popcorn and Kentucky Mule isn't doing you any favors." (God I love popcorn and bourbon. It’s right up there with popcorn and red wine. Popcorn and anything really.) If he had said that, I probably would have ignored him.
But I have to admit. This ‘almost’ diagnosis actually got under my skin. It was so ridiculous in its lack of specificity, that it got my attention. It was almost insulting. Almost worth fighting. It was like being told I was ‘almost’ tall enough to ride the roller coaster of poor health, just give me one more year.
So what did I do with this “almost” diagnosis? Remember two weeks ago I talked about my double life as a Health Care Public Relations Spin Doctor? Turns out, I know a lot of smart people in the Diabetes world. I needed to brush up on my diabetes knowledge. So, I started with the big guns. One of the foremost experts on the subject, my good friend Francine Kaufman, MD.
Fran wrote the book Diabesity, one of the first works to comprehensively explore the interconnected relationship between obesity and type 2 diabetes. A world-renowned endocrinologist–that’s diabetes doc for the layperson–Fran knows the societal, environmental, and physical factors that have caused the astronomical rise in diabetes and obesity globally. In addition to being brilliant, Fran has a heart of goal, and has made it her life mission to help disadvantaged communities that are always getting the short end of the stick when it comes to healthcare.
I told Fran my stats. Gave her my bloodwork, and then mentioned the ‘almost’ diagnosis. Should I be concerned?
She didn’t even pause. She didn’t treat me like I had ‘almost’ anything. She gave me the cold hard facts.
“We know diet and exercise can get rid of diabetes. But it simply doesn’t motivate people when we tell them their lifestyle is going to kill them. Even I have started lowering my carbs lately,” this wasn’t lost on me considering Fran can’t weigh 100 pounds. “But it’s so hard to sustain any lifestyle change for very long.”
Then she said something I didn’t expect.
“You don’t want to become one of the worried well.”
I hadn’t heard this term before, but I got it right away. There is a trend of mostly healthy, overly-anxious people out there who turn every minor health blip into a personal medical drama. Think of the friend who chokes down a handful of multivitamins every morning despite any evidence it will work. Or the growing number of gaunt actors and influencers using the diabetes medication Ozempic to lose that last five pounds.
Was I just another privileged hypochondriac? Were my anxious questions feeding the wellness industrial complex America has perfected? I remembered recently reading about Tony Robbins’ The Estate, a luxury “wellness” hotel complete with MRIs, cold plunges and oxygen chambers. Or the “Blueprint Guy” Bryan Johnson, the tech CEO using his own body like a guinea pig to find the 21st Century fountain of youth?
I didn’t want to go down that worried well.
“Ok. So what you’re saying is that all I need to do is eat more mindfully, increase activity, and drop some weight; a proven solution that most people fail at and get diabetes anyway, right? Problem solved. Almost?
Could there be another way?
I had to ask one more question. In all her years of research, was there a magic anecdote to reversing diabetes that she just hadn't been able to study? Like something Big Pharma had buried in order to maintain their drug profits, or that the Illuminati were hiding from the rest of us in their Doomsday island hideouts.
This time she paused for a second.
“There is something in South America, I think. A berry or something like that, that has a positive study or two.”
I imagined hiking into the rainforests of the Amazon, swinging my machete through impenetrable vines only to uncover a magenta fruit glistening from the mist. Fieldtrip anyone?
“Early in my career,” Fran continued. “Doctors said garlic was supposed to help. Then they said eggs were bad. Now they’re good. And there was the grapefruit fad. But how much of those things can you eat every day, and how much effect does each one actually have? It’s not realistic.”
Imagining grapefruits with every meal made my mouth pucker. I worried that handfuls of garlic might make me unpopular. It was starting to sink in. There probably wasn’t a pre-diabetes silver bullet. But before I ruled out any more natural remedies, I needed more data.
Oodles of Data
For the first time ever, I clicked on a social media healthcare ad on purpose. Bezos or Zuckerberg (or both) had obviously been listening to my conversation with Fran. Over the next several days, my phone erupted with diabetes advertisements. Top of the list was an ad for a brand new product, a patch-like continuous glucose monitor. In my previous life as a healthcare marketing executive, I’d actually worn a similar device that had yet to be FDA approved. Times had changed, and now there were several options on the market that didn’t need a prescription. I pulled out my credit card and paid $89 for two 15-day patches.
When the device showed up in the mail, it came in slick packaging that looked more like a cell phone box than a medical device. WIthin five minutes of opening it, I had read the pictures-only instruction manual, and placed the bulky plastic applicator against my upper arm. Holding my breath and closing my eyes, I pushed the ergonomically-designed button.
“Shoonk.” the applicator sounded without hardly moving. At first, I thought it had misfired. I hadn’t felt a thing. But when I pulled it away, I could see in the mirror a small gray plastic patch, outlined in adhesive, and attached firmly just behind my elbow. In another few minutes, blood glucose data was bluetooth beaming directly to an app on my phone.
Holy shit, we ARE in the 21st Century.
For the next week, I was glued to the app, watching my blood sugar react to everyday life. I have to admit, the data was pretty boring at first. Mostly because I wasn’t eating anything that moved my blood sugar, nor was I moving much. Since my ‘almost’ diagnosis, I’d cut out the majority of carbs, all alcohol, and any eating after 8pm. This new “lifestyle” was making me generally unhappy, and discouraging my regular hikes or long walks.
After a week of flatlining blood sugars, I decided to liven things up. I ate an apple. I figured that its 25 carbs would be a subtle test of the monitor. There is a 15-minute lag with the technology, so I had finished the apple and almost forgot about the experiment, when my phone buzzed.
My blood sugar had “spiked.”
I opened the app to see that my blood glucose numbers were through the roof, more than double my average for the whole week. How long would I stay in the danger zone? Panicking, I jumped on my phone and Googled what might bring it down. One TikTok influencer suggested rubbing lemons on your feet. Another had a crystal that would help. A third suggested cold plunges while drinking water “charged” by moonlight. I was starting to think I should just book a flight to Peru and find that rainforest fruit Fran had mentioned after all.
Then, my frantic research reunited me with an old friend.
Chaga. Black Gold. Birch Fungus. Cinder Conk. King of the medicinal mushrooms.
Next in the series, I'll share my venture into the world of medicinal mushrooms and diabetes. From my “worried-well” spiral into the wellness industrial complex, to brewing cups of tea from what looks suspiciously like burnt tree bark. Maybe, just maybe, there's something to be learned from walking the line between hypochondria and health consciousness, between ancient remedies and modern technology. And if I don’t learn anything else, at least my continuous glucose monitor will tell me if my popcorn pairs better with Chaga than bourbon.