So I have a confession to make. The past few weeks I haven’t been feeling particularly well. Lots of headaches, dizziness; in particular when working out at the gym; sometimes feeling like my heart is going to explode out of my chest.
To put this into some sort of context I run a large scale, community based diabetes and hypertension program on the outskirts of Johannesburg for Project HOPE. As the boss of a team of ten staff, I try to be a role model to them and to the hundreds of patients we see monthly. Part of my role is to educate patients on the signs and symptoms of chronic diseases such as diabetes and hypertension, tell them how they can improve their lifestyles which will in turn improve their health and either reduce their risk of getting one of these diseases, of help improve their control of the disease.
I know what range your blood pressure should be in, what it does to your body when its too high, what uncontrolled sugar in your bloodstream can do to your eyes, nerves, and kidneys. I’m no expert, no doctor, but pretty well versed in these things as its my job.
So maybe you can see where this is going? After lots of putting it off I make an appointment to see our doctor at our local private clinic. I go and explain to the doc my symptoms, thinking that its low blood sugar as its happening at the gym (I don’t eat before working out). She knows what I do for a living so we talk, she takes some blood and then I go lie on her couch for my blood pressure reading. “Stefan”, she says, “your blood pressure is 160/110!” “Ahhh,” I say, putting all the pieces of the puzzle together in my head. She tells me that we will wait for the blood results, not to exercise for the next couple of days and see her a few days later for a repeat blood pressure reading.
The next couple of days bothered me. I was wondering why me? I exercise 4-5 times per week. I am not obese, but ok, could stand to lose a few pounds if I am honest. I may drink 2-3 beers per week. Have no immediate family history of high blood pressure. Sure like my food, but love fruit, eat veg and if I am honest have a fondness for MacDonald Big Mac burgers! I also started to think about epigenetics – was there an environmental occurrence in-utero that could have impacted my kidneys which predisposes me to greater risk of high blood pressure? I then start thinking about what my blood test results will be – what will my fasting sugar be like – please God, its got to be preferably below 5.6 mmol/l and definitely below 7.0 mmol/l.
I go back to the doctor with a splitting headache – probably more stress than anything. We go through my blood results – I recognize most of them as we carry them out on our patients at our clinic. They are all normal. I go lie on the couch at she takes my blood pressure again at its still 160/100. So, to my surprise I have been diagnosed with stage 2 hypertension.
We go sit back at her desk and talk about drug options. Hypertension has been classed as a chronic disease, and if you look at all the literature, the majority of people who start medication for hypertension don’t come off of it. We settle for a combination drug – HCTZ and a beta blocker and a check up in three months time to see if I can come off the medication.
So you might be wondering what the big deal about all this is? Its not like I am going to die, have a really serious illness that’s going to kill me soon. In fact many people in my situation would just and do, resign to the fact that they have high blood pressure, take their medicine and continue with their lives.
Well for me, being an educator I want to see if it is actually realistically possible for me to follow the advice that we give our patients and see if I can improve my health. There is nothing like a dose of my own medicine.
After some research, I decide that it would be good to lose 10kg to begin with. That will take me from 100kg down to 90kg – a 10% weight loss which according to the American Diabetes Association should see improvements in my health. I will follow the DASH (Dietary Approaches to Stop Hypertension) diet – voted in the US for being the healthiest diet to follow by the National Institutes of Health. The basic premise of the diet is to reduce the amount of sugar that you eat – simple carbs, eat healthy fats, lots of starchy vegetables, some fruit and lean protein. If you eat carbs it should be complex carbs – brown rice, whole wheat bread – but still in limited amounts.
Will I make it? I am not sure, but I will give it a good try? Are you in a similar position to me? Would you like to make some lifestyle changes that will see improvements in your health in 2013? Let me know, maybe we can go down this road together - slawson@projecthope.org