GUTS TO GLORY
Journey to Testament Falls

By Colin Portnuff

In August of 2001, I went for a hike with my 19-year old son. It was a short hike at Camp Cooper, the Boy Scout camp where he worked for the summer. He promised a great view of a beautiful Oregon waterfall, Testament Falls. After a few minutes, I was huffing and puffing and my legs were shot. I got to the top of the waterfall, where he took pity on me and didn’t suggest that we continue to the further viewpoint at the bottom of the falls. Although he was courteous enough not to say anything, I could read the concern and shock on his face as he watched me labor. I was embarrassed, humiliated, and distressed to see how far I had slid down the easy slope to obesity. Fifty years old, five-foot seven inches, 220 pounds, a 44-inch waist, and when I bought suits I looked for “portly” cuts!

That was the day I resolved to get into better shape. I didn’t really get around to doing much about it until November when I went for a full physical. I told my doctor I wanted to get an ECG stress test to see if the occasional chest pains I had been experiencing were harbingers of ischemic heart disease. I also told my doctor I wanted to begin to design a program to improve my fitness. He agreed, and drew blood for cholesterol and other tests to provide to the cardiologist.

My doctor’s office called the following day, and asked me to come in the next day to discuss my test results. All the assistant would tell me was that it was very important that I come in right away. You can imagine all the things that went through my mind that day and evening. I was almost relieved to learn from my doctor that I have Type II diabetes! My fasting blood glucose level was 288 mg/ldL (normal is less than 120). My HbAIC was 9.4% (normal is less than 7%). There was no question about the diagnosis, no room for denial.

Type II diabetes is the most common form of diabetes — the one that over 90% of diabetics have. It is characterized by insulin resistance, the impaired ability of the body to respond to insulin. Insulin is the hormone that opens the doors of the cells of the body to allow them to utilize glucose. The result of increased insulin resistance is that the pancreas has to churn out more and more insulin. Increased insulin levels and increased glucose levels are toxic and cause the dreaded complications of diabetes. Most people need oral medications to reduce insulin resistance. Eventually, the pancreas often fails. It’s simply unable to keep up the overproduction that the high blood glucose levels are triggering. Then it’s on to insulin shots.

Type II diabetes is associated with obesity and with family history. The medical community is pretty compassionate about telling us that it’s not our fault that we’ve been afflicted with diabetes. There’s some question as to whether obesity causes insulin resistance or vice-versa, but no question that there is a strong correlation between obesity and Type II diabetes. The disease has historically afflicted adults, but there is a very frightening upsurge in cases of overweight children with Type II diabetes.

My doctor was sympathetic as he began to explain what I was facing. While he was betting that I would need to go on medication soon, he wanted me to spend a few weeks working really hard at diet and exercise to control my blood sugar. He said losing weight was probably the single most important thing I could do to control my illness.

I said I’d take his bet.

My first stop was the bookstore. I picked up every book that I thought might help me. One of the best was by Gretchen Becker: The First Year Type 2 Diabetes: An Essential Guide for the Newly Diagnosed. I spent the next 72 hours devouring every word, reading other books, and spending countless hours browsing websites.

My doctor referred me to the Legacy Health Systems diabetes education program. The program taught me what I needed to do to manage my blood glucose: daily monitoring, daily exercise, eating smaller meals more often, and restricting carbohydrates to specific levels — for me that meant less than 60 grams per meal and 240 grams per day.It seems pretty simple, but it’s important to recognize that it’s only in the last few years that close control of blood glucose has been proven to delay or prevent the onset of the serious complications of diabetes including:

• Diabetic retinopathy: damage to the blood vessels in the retina, leading to blindness.
• Diabetic neuropathy: damage to the peripheral nerves, which can lead to infections in the extremities and
amputation.
• Cardiovascular disease: damage to the heart and circulatory system, which kills 80% of diabetics.
• Kidney failure.

I’ve since learned that 40% of people diagnosed with Type II diabetes will die within 10 years. I’d very much like to be in the other 60%. So here’s what I’ve done about it.

I had my thallium stress test and found to my great relief that there was no sign of coronary heart disease so far. I also had a full echocardiographic exam and found that there were no serious abnormalities in the function and motion of my heart valves and myocardium (heart muscle). I got the green light to begin my exercise program. In fact, my cardiologist, (who I privately nicknamed Genghis for his shall-we-say direct bedside manner), was insistent that I change my lifestyle. He gave me another term to research when he told me I had Syndrome X. I learned that Syndrome X is a constellation of symptoms, which predict a greatly increased risk of death from cardiovascular disease.

Syndrome X is characterized by obesity, insulin resistance, hypertension (high blood pressure), low HDL cholesterol (the good one), male gender, and being over 40 years old. While I can’t do anything about my age, and I am not interested in changing gender, the rest of the risk factors are within my control. Last stop: the ophthalmologist, who determined that I had no retinopathy.

At the beginning of December, I started walking every day. Just like every educator says, I started slow, with easy walks around the block. I walked around the block, then increased the distance and my pace gradually to the point where I was walking 3 1/2 miles, briskly, every day, rain or shine. Within a few weeks, my blood glucose levels were falling dramatically, and within a couple of months they had returned to near-normal.

In February or March, I ran across a brochure for a group called Portland Fit on the counter at the Fred Meyers pharmacy. “Change Your Life” screamed the headline, and if ever there were a message meant for me, that was it. Even so, I took the brochure home and some inner doubt caused me to forget about it and lose the brochure. A week later, I called the pharmacy and asked if they still had the brochure. Fortunately they did. Mike Northcott, a good friend of mine, and I registered with Portland Fit, a group of about 1,400 enthusiastic people of every age, shape, and size. These folks have one thing in common: all are resolved to improve their level of fitness and run or walk the Portland Marathon.

I learned walking every day was not a good thing. I was actually implementing negative training by tearing down muscle through exercise without giving it time to build during periods of inactivity. To build up muscle strength and endurance, recovery days are essential, so although I still needed daily exercise for glucose control, I needed to vary my routine so I wasn’t doing the same thing every day. I bought a set of dumbbells and added weight training to my regime. I also hauled out the CardioGlide, a sort of push/pull rowing machine that I purchased from an infomercial years ago. It had been living in the unfinished storage room in our house for the past 10 years.

At the end of June last year, seven months after my diagnosis, I walked the Helvetia Half Marathon organized by Portland Team Diabetes head coach Paula Harkin, herself an elite marathoner. This meant 1,100 smiling people and 13.1 miles of grueling hills. I finished in 2 hours, 58 minutes, and 29 seconds, a 13-minute 38-second per mile pace, well ahead of my goal, ninth among male walkers, 46th among all 312 walkers, and ahead of 58 runners! I stayed well hydrated, as I’d been taught. As a direct result of the training that Portland Fit had given me, the education that my diabetes educators had provided, and some terrific chiropractic and massage therapy, I did the half marathon without injury or pain (or at least only a little pain).

In July, I returned to Camp Cooper, where my son was working for another summer. We repeated our hike, scampering without difficulty to the top of Testament Falls. Without hesitation I headed down the steep trail to the bottom of the falls and returned by the “hard” trail. And it was hard. But we finished together, smiling and victorious. I will testify that it’s a lot easier to hike and climb when you’re not carrying a 60-pound suitcase along with you. That’s how much I’d lost in the previous year.

I joined Team Diabetes, the merry band of fundraisers and athletes who raise money for the American Diabetes Association (ADA). I’m pleased to say that my generous sponsors contributed $10,000 supporting me in walking the Portland Marathon on October 6, and the Dublin Ireland Marathon on October 28. I finished both marathons in just over 5 hours and 45 minutes, exhausted but upright and smiling. The day after the Dublin Marathon I was even able to go sightseeing.

When I returned from Dublin, I took my first running steps and then ran the Las Vegas half-marathon in February 2002. I continued to run through the winter and rejoined Portland Fit, this year as an assistant coach and runner. For the Helvetia Half Marathon I ran and finished it in 2:09, ahead of my goal of a 10-minute/mile pace. I ran 18.6 miles on August 16, and am registered to run the Chicago Marathon in October.

It’s now been 21 months since I learned I have diabetes. My doctor proudly calls me his best personal success story. My glucose levels are well controlled without medication. My HbAIC was 5.1 the last time I had it checked. Fasting glucose levels are ranging from 95 to 115, and I’m on target after pretty much all meals. Now I’m not kidding myself — this is a progressive illness, and the name of the game for all of us is to stay as healthy as we can, long enough for someone to find a cure. Let’s not forget that it was research that was partly funded by the efforts of the ADA that resulted in the development of the guidelines for self-care. ADA research and education programs have contributed tremendously to my quality of life and I am hopeful that research funded by the ADA will bear fruit in the form of a cure. There are 17 million of us in this country hoping for the same thing.

Oh, and by the way, I now tip the scales at 162 pounds, down about 60 pounds since this all began. Down to a 33” waist, 40” jacket, and feeling great!

Colin carries this August 2001 photo in his wallet as a constant reminderr.

July 2002, at the bottom of Testament Falls.