I had to slow down or die

Al Kags at 96 Kgs

Last September, I came this close to dying. I had been travelling on some family business when I found that I was getting weaker by the day. My mouth was getting extra dry despite drinking copious amounts of water and I had significantly lost weight.

 Losing weight in itself had been a mission of mine (at the beginning of last year I weighed a whopping 116 kg!) and I had been steadily coming down the scale but in September, I suddenly lost 10kg - just like that!

 I came back to Kenya and I was scheduled to leave for the UN General Assembly in New York two days later. The plan was that I would get home early in the morning and hang out with my wife Liz and children that day. The next day I would go to the office, where my team would prepare me for the meetings I would attend in the big apple.

 Things went according to plan - sort of. I spent the day with the kids but by then I was so weak that I was not quite conscious. I was moving and talking, but it was like I was in a dream state. I went to the office on the next day and my colleagues were shocked to see how gaunt I had become - my skin was grey, I was thinner than they thought. Still, I had work to do and a trip the next day so I toughened up and focused on the day.

 By noon, I couldn’t take it anymore. I went home and two hours or so later, my friends came by and drove me to the hospital. I just needed our friend, a doctor, to review me and give me “something” to tide me over through the New York trip. My friend runs a specialist clinic at Mater Hospital and so we went there.

 I signed myself in, went through triage and there, I started to appreciate just how bad things were. My blood pressure was 150/120. Normal blood pressure is 120/80. At that level, it was deemed an emergency and I was fast-tracked to see a casualty doctor. This doctor was visibly disturbed as he asked me questions. Normally, what doctors in casualty would do is to send one over to the lab for tests and then he would review them when they were out. Not on this day. He dropped everything on his plate and focused on me.

 Nothing looked good. My blood pressure was very high. When they checked my blood sugar, it was too high to give a figure – it simply said “HHH” – High, High, High, which meant that it was higher than a reading of 33. Normal blood sugar should read between 4 and 7.2. They checked on the levels of various minerals that you need in the body – Potassium (which helps your muscles move), sodium, etc. I was in the negative on all of them.

It’s an emergency

In short, I was severely malnourished and dehydrated (had lost more than 10 per cent of my body water), my blood pressure was high and I had sustained ridiculously high blood sugar levels for several days or weeks and therefore I had become diabetic. They checked my hormonal levels and cortisol (what I call the tired hormone) and adrenaline (the fight or flight one) were too high.

I was diagnosed with Diabetic Ketoacidosis, a major emergency. I was also told that my body organs had gone into shock. It was a wonder, the doctors told me, that I was even conscious. “Even if you could not afford this hospital, I am required to detain you and stabilise you whether you like it or not,” the doctor told me as I protested being admitted - to the High Dependency unit no less!

“Besides,” said the doctor, “You are also exhausted and you need to rest.”

I was under intensive care for about 7 days and then I was allowed to the ward to regain my strength before going home. In that time, I was simply in shock and devastated that I had irrevocably “broken” my body. As the days went by, I learnt that I had had no organ damage and that although I was diabetic and hypertensive, I have a chance to live again.

Too much advice, too little sense

In the first few days of my recovery, I received a lot of advice - most of it confusing and some of it contradictory. I was told to prepare to inject myself with insulin for the rest of my life, that I could no longer eat and be full. I needed to be very careful about what I ate. I was told many stories of people who had lived long lives like that. My life was about to completely change.

I later went to see my family doctor, Dr Dennis Nturibi, who runs a lifestyle modification programme for many urbanites - especially executives and for the first time. I started to understand what was happening to me.

Let me break it down for you in the way you can explain it to a five-year-old. Normally, your body functions automatically. Imagine all your organs as departments in which little people work and operate the machinery that is your organs. When you eat the food goes to the stomach, where the little people in there pour in chemicals and enzymes that extract sugar from the food. They pour that sugar into the bloodstream.

When there is a lot of sugar in the bloodstream, a message is sent to your pancreas. The little people in the pancreas are called Insulin and their job is to swoop into the bloodstream, arrest the sugar and throw it in the cells. In each of the billions of cells in your body, a little person burns the sugar and therefore generates energy which your body needs.

In my body, the system crashed. After many years of flooding my bloodstream with sugar, the insulin tribe had become overworked - they were working overtime to arrest sugar from the bloodstream and put it in the cells only to find that there was too much to deal with. So they went back into the Pancreas and shut the machines down. They were on strike.

Now that there was no sugar being delivered into the cells, even though it was flooding the bloodstream, the cells sent alarms to the brain, which told the people in the mouth to take in more sugar. Eventually, there was too much sugar in the bloodstream - and the blood became like syrup. That is why blood pressure went up. The system eventually crashed altogether and I was in intensive care.

The wonder diet

 Dr Nturibi told me that I was not going to die and that there are ways to reverse the condition. If I was consistent and I worked towards it, I would stop all medication and insulin in time. The secret was food.

He introduced me to a diet that has had a tremendous impact in my life. I was off insulin in three weeks and off all medication within five weeks.

 My diet is simple. I eat a green salad three times a day, before every meal. For breakfast after salad, I have black tea and arrowroots or sweet potatoes or oats. My favourite meal for breakfast is last night’s food. For lunch and dinner, I have a lot of vegetables, a lot of plant protein and some whole carbohydrates - brown rice, githeri, potatoes, brown ugali. I do not eat processed foods - not even juice (juicing is processing fruit), I avoid animal protein (milk, meat or cheese) and I quit sugar and alcohol altogether.

“So long as you are eating the right things, eat as much as you want,”

Dr. Dennis Nturibi, Ask-a-Doc

With these measures, I have continued to lose weight steadily, my blood sugar is normal and the little people in my pancreas are back to work. Of course, none of it would be possible if it wasn’t for Liz, my wife who has been both a caregiver and “policewoman”, making sure that I stuck to my diet - even when all I wanted was a burger, fries and an extra thick chocolate milkshake.

“Here’s some fruit,” she’d say.

I have learnt to plan ahead of every day and to pack my salad, food and fruit for the next day. That way I am never hungry because hunger is what makes us eat unhealthy things. So long as I have the right things to eat near me all the time, I am using food as the best medicine of all.

What is diabetic ketoacidosis

Diabetic ketoacidosis is a serious, sometimes life-threatening complication that affects people with diabetes. It is brought about when the blood becomes too acidic from a high amount of ketones present. Ketones are produced when one doesn’t have enough insulin to turn sugars into energy and thus the body turns to the fat. The liver then turns the fat into ketones and sends it into the bloodstream.

Ketone production can be brought about by:

·         Untreated Type 1 diabetes

·         Long periods of low food intake

·         Restricted diets

·         Prolonged intense exercise

·         Alcoholism