Navigating a Diagnosis of Diabetes and Chronic Lymphocytic Leukemia

Chester Freeman was diagnosed with bladder cancer and most recently with chronic lymphocytic leukemia (CLL). Read Chester's blogs here!

I was diagnosed with diabetes at the age of 60. Ten years later, I was diagnosed with chronic lymphocytic leukemia. When my primary care physician diagnosed me as diabetic, it wasn’t a shock because my father was diagnosed at the age of 20, while in the Army. I always knew I had a 50/50 chance of becoming diabetic because this was part of my family history. With that in mind, I worked hard to exercise, eat right, and watch my weight. And I always followed up with yearly checkups.

However, when the reality hit me, I became angry and depressed. I couldn’t understand how this could happen to me since I’d done all the right things, especially keeping my weight under control. I’m a medium-frame guy, 5 feet, 8 inches tall, and for my entire adult life, I’ve weighed between 140 lbs. and 150 lbs. But then I realized that genetics plays a big role in my makeup, so I was predisposed to diabetes from the very beginning. There was one thing that helped me to deal with my depression. My primary care physician called me in for a consultation and said the following:

“Chester, just think, you’ve been free of diabetes for 60 years. So, let’s focus on all those years and how grateful you can be for that. Since your father was diabetic, the family genetics were not on your side.” At that moment, his words hit me, and my spirits were lifted. He said, “I’ve been your doctor for 20 years, and I know you can cope with this. You have the strength. I know this about you.” It’s amazing how the words of a doctor can inspire us and encourage us to do the right thing.

The next time I went for a checkup, my A1C was perfect, and my PCP was proud of me. His support meant everything to me.

Then over the past few years, cancer came into my life and uprooted my balance. I felt as if I was walking a tightrope and tilting over all the time to hold myself together.

In doing some research, I discovered that diabetes itself can make us vulnerable to other diseases. Then I discovered that my medication, metformin, could make me susceptible to other cancers such as prostate, colorectal, and even breast cancer. There is controversial research about this drug, but I’m still taking it and hoping it helps. I’m also taking Jardiance, which reduces the risk of cardiovascular and kidney disease. But it too has a harmful side effect of causing ketoacidosis. Fortunately, I haven’t experienced that side effect. Either way, it means that I’m in a precarious position. It's like a double whammy!

When I began chemotherapy for my chronic lymphocytic leukemia, I learned more lessons, which were outlined in my essay, “What I’ve Learned about Having Cancer.” My oncologist prescribed medication for nausea and vomiting before the chemotherapy started. Fortunately, that worked, and I didn’t experience any of those symptoms. However, the very medication that was used to treat my cancer was also raising my blood glucose level.

Eventually, my oncologist and primary care physician worked together and prescribed Ozempic. This medication resulted in weight loss to the extent that the doctors discontinued that medication. I was never overweight, and this weight loss began to make me look like a skeleton.

My primary care physician changed the medication to Trulicity, and my A1C lowered somewhat. But now that I’ve completed the second round of chemotherapy, my diabetes has gotten out of control, and my A1C is up again. When I met with my primary care physician, I told him I hadn’t been eating right. I do walk every day for my exercise, but I realize the real issue is diet.

My partner also has metastatic prostate cancer, and both of us were scammed by contractors who worked on our new home. The loss of money from that and dealing with both of us being ill has increased my stress. As a result, I’m stress eating. I know this is something I shouldn’t do, but I’m finding it difficult to stop. I’m injecting myself with insulin each day now. I also have a continuous glucose monitor, which makes me aware of my blood glucose level, whether I like it or not. I’ve learned that taking a large dose of vitamin C can cause a false reading on the glucose monitor, so I try to be aware of that when taking multivitamins or eating oranges. Currently, I’m trying to find a way to improve my condition.

I’m a Quaker, and we normally don’t observe Lent. However, since it’s a time of self-reflection and evaluation, I’m using this Lenten season as a way of disciplining myself and trying to get myself under control. When I was a chaplain in the college setting, I used to conduct ecumenical services during Lent. The students would ask each other what they were giving up for Lent. However, I don’t want to focus on giving up something. I’d rather put my energy into trying to change my diet and eating habits. During this Lenten season, I’m trying to improve myself, both on a spiritual and a psychological level. I want to add courage, faith, and strength to my body, mind, and spirit. We all have to find a way to cope, and everyone has to find their own way. This is what I’m trying to do.

Navigating two diagnoses of diabetes and cancer is difficult. It involves making a lifestyle change. I made that change years ago, but I’ve drifted away from it. So, now I need to consult with a dietitian and try to manage my eating habits. I need to focus on eating fresh vegetables, whole grains, fruits, and low-fat dairy products as well as lean meats. This type of diet will help reduce my risk of heart and kidney disease since I’m prone to those conditions in my situation. I try to stay well hydrated because some of my medications can. Be hard on the kidneys and liver. I’m an herbal tea lover and drink lots of it, along with spring water.

The latest cancer research shows that eating salmon and tuna can help boost my immune system. I have discovered a new cereal called “Nutrail Blueberry Cinnamon.” It has 2 grams of net carbs and 2 grams of total sugars. It is 160 calories per serving. It tastes great and has pecans, sunflower seeds, pumpkin seeds, almonds, coconut, dried blueberries, cinnamon, butter, salt, and monk fruit extract. It even has 3 grams of dietary fiber. It has been hard to find a cereal for breakfast without tons of sugar. This find is a real joy for me. New studies on red wine suggest that, instead of being anti-inflammatory and supporting heart health, all wine can contribute to cancer. This was disappointing news as I loved to have a glass of red wine with dinner on Sunday nights. That was one of my little delights.

As I look back on my cancer journey, there are other areas of concern that have been beneficial to me. I need to seek out a massage therapist to assist with the stress in my life. When I was first diagnosed with cancer, the hospital provided free massage therapy once a week. Since it was a great benefit to me in the past, I think I should return to this as a way to deal with my stress level. The main thing that has kept me going thus far is my practice of mindfulness meditation. It has been a lifesaver.

I’m always proactive with my medical team. I make copies of my current test results and medical notes to take to my appointments. Additionally, I make sure that one is up to date and on the same page. I include my medical oncologist/hematologist, radiology oncologist, pharmacological specialist, nutritionist/dietitian, and primary care physician. I always type a list of questions to have ready, so I can give them to my oncologists at my appointments. By addressing all these concerns, I will improve my diabetes as well as my cancer.

In all honesty, I must admit that I’m struggling right now, but I’m trying to make baby steps in the right direction every day. Hopefully, my faith will be a bulwark for me to lean on. I’ve made it this far, and maybe I can make it further in my journey of managing both diagnoses. Coping with diabetes and cancer is like walking a tightrope. It’s a balancing act, but being careful and health-conscious will allow me to succeed.

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