Since her type 2 diabetes diagnosis, Megan Whelan feels like she's doing pretty well. But if she is, a large part of that has to do with the resources she's bringing to the fight.
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This week we're going to talk about something that makes me extremely uncomfortable. Yes, me, the woman who has spent 10 weeks oversharing on the pages of our national public media company is uncomfortable talking about something. Not body stuff, or trauma, or awkward social exchanges, but money.
One of the things that has started to happen, either when I tell people I have type 2 or they know but haven't seen me in a while, is a conversation about how I am. It involves a tilted head, a sympathetic look, and "how are you, really?"
And look, it sucks. It sucks to have to think about food all the time, and to restrict what I really want to eat. It sucks to have to find ways to get ever more protein in my day. It sucks to have to feel like I can't eat out and I'm boring all my friends with my, "if I have waffles now, and I am going to the gym later, will that offset the carbs, or should I just have eggs on avocado or something" calculus. (My friends are wonderful, and don't tell me they are bored, at least.)
It sucks that after decades of feeling like exercise was only good for losing weight, and then having found some joy in moving my body, exercise is now a vital part of managing my condition. It sucks that I can't just celebrate getting stronger, I have to think about how muscles use glucose.
Lying awake at night imagining the worst possible complications - amputations, kidney failure, blindness? That sucks too. People with chronic illnesses will understand this, and this is hardly something I am alone in, but the worst part is the way my diabetes is a shadow over my whole life. It's a constant companion I live with and try to placate.
But here's the thing. I am doing an ok job of placating it. I feel better now than I have for years. I don't need to pee all the time. I don't have tingling in my feet when I lie in bed at night. I have energy to do things, and I seem to be healing faster and getting fewer infections. We will talk about blood sugars in a few weeks, but for now, I feel like I am winning the battle.
And a huge part of that is that I can afford to. In the spirit of transparency, here's a list of the ways I am spending money on my health.
The biggest expense is about $800 a month on the gym. Between sessions with my personal trainer, and gym membership, I spend almost $200 a week. On top of that is gym gear (plus sized sports bras do not come cheap, my friends), as well as shoes and socks and things like that. Let's say, another $100 a month.
I've fallen off the wagon on cooking at home a little recently, but for most of this year (I was diagnosed in December), I've averaged about $250 a week on groceries. This feeds two people, for breakfasts, some lunches, and 4-5 dinners (some of those lunches are leftovers.) Admittedly, I am boujee, and I love cooking, so my grocery bill is higher than it needs to be. But $250 doesn't buy a lot of meat or fish, fruit and vegetables anymore. I feel very guilty about how much I spend on food, but at the same time I also need to make myself food I will actually eat, so... I am not sure how to win this battle.
I now see a doctor once every couple of months. I would have been able to use a publicly funded dietician, but the waiting list was several months, so I paid for it myself. The optometrist visit was free. So far this year, those costs average out at about $100 a month.
As I mentioned, I eat A LOT of protein now. On the advice of my dietician, I supplement with protein powder either in my morning smoothie, or before or after working out. I also keep a supply of protein bars on hand. (Most of them are about $4 each.) Let's add another $150 a month.
I didn't have health insurance before my diagnosis, and I haven't tried to since, because I assume it would be prohibitively expensive. I am also lucky enough that the medication I take is funded. I don't test my blood sugar on a regular basis, and I don't require a continuous glucose monitor unlike many diabetics. (One of these costs as much as $5000 a year).
I'm not counting the regular pedicures I get now as a way to force myself to look at my feet to check for changes. And I am sure there are other things I pay for that I have missed, and things to come I haven't even considered.
A report last year estimated that "When comparing the lifetime cost of someone diagnosed with type 2 diabetes at age 25 years ($565k) to the lifetime cost of someone diagnosed at age 75 years ($44k), the cost differential is $521k or a factor of 13. This is significant given the shift towards younger cohorts of New Zealanders developing type 2 diabetes." My personal cost $2250 a month seems about right. If anything, I am getting off lightly.
I am incredibly lucky I can afford to do all these things. I have disposable income I can spend on the gym, and I can manage my life so I can get to the gym when it's convenient to me. I don't have kids to look after and I work a somewhat flexible job. I am not having to make regular calls about whether to see my doctor or put food on the table.
I've seen, and I've had emails, suggesting that diabetes is a lack of discipline, or a matter of some flaw in personal responsibility. And yet, complex carbs are cheap and accessible. People say, "go for a walk around the block, fatty" as though streets are safe, and energy is abundant. Type 2 diabetes is, for some people, reversible, or at least manageable. But the cost of doing so isn't just that of swearing off processed foods.
There seems to be this idea that if we just eat "right" and move our bodies in the proper way, we'll magically be healthy. If I've learned anything in the past six months, it's that that just isn't true. Even if it just meant getting enough sleep, drinking enough water, and avoiding stress, that would be pretty difficult for most people.
I feel for the people who aren't in the same situation as me. There are many studies that show deprivation is a significant factor in both developing type 2, and in having complications from it. People who are having to choose between buying fresh vegetables and sending the kids to school camp aren't quibbling over which protein powder brand is the best.
Sharing this feels vulnerable in a way talking about my body isn't. But it feels important to do. People keep congratulating me on how hard I have worked, and it's true that I have. I've overhauled major parts of my life. But I've also had a huge amount of help, and the luck of having a job that pays me well. I said I am winning the battle? It's only because I have the resources to do so. It's not magic at all.