Life with Keto

If you want something badly enough, you’ll do whatever it takes to get it. Fear something enough, and you’ll do whatever it takes to escape it.

I was parking the car when my doctor phoned with test results that showed elevated blood sugar. I had him on my headset, but almost ran into the wall when I heard.

Diabetes runs in the family. Mom had it, and I remember her bold prediction: “Your sugars were out of whack when you were born. You’re going to get it.” She was a great mother, loving and doting on me. She also had the ability to transform into a dark prophetess of doom at all the wrong times. That was one of them.

After the call, I dove into research and found two things that could reliably improve the situation: diet and exercise. I could wrap my head around exercise, even if I didn’t love it, but diet was another thing completely.

I loved my carbohydrates.

I loved sugar so much, I made honey sandwiches regularly as a kid. I’d lick my finger and stick it into the sugar jar to satisfy my cravings. Dessert was an essential food group, and one of my main joys in life was to visit a fine French patisserie and linger over the oeuvres before selecting the most decadent one to savour.

A farewell to carbs

All that went out the window with keto.

The ketogenic diet dramatically cuts carbohydrates, increases fat intake and moderates protein. It fuels your body without the carbs that raise blood sugar. True keto is hard to follow: it cuts out practically every carb from potatoes to rice, bread to pasta, and ups animal fats. So I follow a modestly low-carb version. But following even that version can be socially awkward.

My wife is Italian. Bread and pasta are at her core. She had a minor meltdown on learning about my new reality, and to this day I’m not sure the in-laws fully understand. But I committed to do whatever it took to get my blood sugar back in the green. I became friends with leafy vegetables, nuts and seeds. Cheese blunted the urge for sweets. I reluctantly embraced exercise with the mantra, “I don’t have to love it. I just have to do it.”

My blood sugar came back down to the point where my doctor said, “You know, you can ease up — it’s lower than mine.” But fear doesn’t evaporate when your doctor gives you a pat on the back. I remember mom pricking her finger six times a day to test her sugars, and injecting insulin morning, noon and night. Even then, it was a struggle to keep her blood sugar level.

Diabetes has been one of the leading causes of death in Canada since before I was born. It was effectively a death sentence for those with Type 1 — and for many with Type 2 — until the discovery of insulin a century ago. But insulin is a daily, imperfect treatment, not a cure. So my fear endures.

A voyage of keto discovery

I’ve discovered food substitutes, including a low-carb pasta that’s decent enough for my wife to mooch from when I make it. There are keto bread options that taste passably close to the real thing. There’s low-carb beer, almond crust pizzas and more.

But nothing comes close to the real thing, and I always feel like the odd man out when everyone else at the restaurant is twirling their pasta while I’m waltzing with my old friend, the salad.

My world changed the day I discovered an ice cream with a sugar substitute. It felt like the clouds parted, and God shone a light beam onto my head, whispering “You’ve suffered enough, son.”

I grabbed the chocolate chip mint flavour, dug in, and in one sweet, glorious instant, I was a kid again in Swensen’s ice cream parlour in Halifax. Whenever I got good grades, mom would treat me, and I would invariably order five scoops of chocolate chip mint and do my best to demolish them.

About a year after my beautiful ice cream revelation, research linked the magic ingredient to an increase in heart attack and stroke. My newfound relationship with ice cream ended in bitter divorce.

Hope springs eternal

I know that no matter what I do, my blood sugar isn’t going to improve dramatically anymore. There’s a good chance it’ll head in the opposite direction eventually. But I’m an optimist. There’s a lot of money driving research, and I live in hope that one day we’ll find a cure, not a treatment.

I can see that day clearly in my mind’s eye. I know the ice cream parlour I’ll visit. I can see the scoops of chocolate chip mint lined up. I can taste the first bite, and once more — for one glorious moment — I’ll become a little boy again, with a warm joy spreading through me.

Until then, I’ll keep on keto.

A Piece of Cake

View this post at the Globe and Mail.
Illustration by Alex Deadman-Wylie.

He said it as if he were a little boy, not an 86-year-old man.

“Are we having chocolate cake?”

My first instinct was to blurt out, “I bought you lunch, set it out nicely, and that’s not enough?!”

I bit my tongue. I’m young enough to lose my cool but old enough to know better. It was the kind of question a little boy or an old man like my father might ask if they don’t understand the subtleties of a situation. The little boy will learn, but the old man has forgotten. The world is opening up for one of them, and they’re picking up on things like social niceties and expressing gratitude. The world is becoming smaller for the other as it coalesces around them, and they’re less able to think and see beyond their immediate circumstances.

I was angry, and it showed, but it had nothing to do with Dad. I had just received a text from my wife about an unexpected $6,000 tax bill. I was frantically trying to think of what had gone wrong, how I managed to miss it, and how I was going to explain all that to my wife. It pushed every other thought out of my head as I walked to pick up lunch. The last thing on my mind was dessert.

Getting takeout was one of the few things I could do for him since I lived so far away. One of my sisters who still lives in town was our family’s boots on the ground, shouldering the weekly slog of dad’s doctor appointments, medical consultations, finances and other responsibilities. Picking up chicken and chips a few times was the least I could do when I was around.

Visits often centred on me fixing his computer problems until dementia stole his ability to operate one. Then our time together focused on watching Blue Jays reruns, until he lost the ability to operate a remote control. At that point, he would get hopelessly mired in on-screen menus until he started falling asleep and I would steal the remote before it slipped to the floor.

In May I got “the call,” the one everyone dreads but can’t avoid. The first call was that he had fallen, broken his hip and was in hospital. The second was about a cancer that had been detected, and that he was considered too frail for surgery. I flew to Halifax two days later.

Funny things go through your head when loved ones are dying. There’s regret, anger, bargaining and all kinds of crazy emotions.

My Goodbye Tour

I’m 52, comparatively young for some, but old for more. To me it’s indeterminate, but closer to the far end of the spectrum than the start. I think about that far end more and more, reminded of my own mortality by the growing count of friends and family who have fallen victim to disease, accidents or other ends. Who knows? I might drop dead in the next moment from some terrible undiagnosed ailment, an accident, a falling piano … the list is endless. Or, medical science might take its next great leap forward and finally discover the fountain of youth.

I’m not taking any chances, and I’m not waiting for the fountain to appear. I’m starting my goodbye tour. A goodbye tour, not a bucket list. The latter is grandiose, a willful denial of mortality by indulging every suppressed travel urge and risky behaviour that’s ever haunted you. It’s the stuff of midlife crises, Hollywood and too many Paulo Coelho novels.

My goodbye tour is about little things, the legion of small but non-trivial moments that make a life. If I’m lucky enough to lead a long one, at the end I have a hunch I’m not going to be sprawled on my deathbed muttering, “God, I regret not seeing Machu Picchu.” That’s too big a thing to haunt me, too grandiose. Bucket list items aren’t woven into the fabric of our lives; the little things are. They’re the everyday, but are by no means mundane companions on our journeys around the sun. They have wormed their way into my heart through simple repetition and familiarity. Isn’t that how a stranger becomes a friend, after all?

Toronto’s High Park in the sun, down by the pond where gentlemen anglers gather to catch carp. Or is it perch? Who knows?

Elias’s falafel joint on Jarvis, so I can hear him try unsuccessfully to sell me an apple cake for the umpteen-millionth time.

The bike trails by the Don River, where new pathways beckon, if the hidden tree roots don’t dump you on your butt first.

Those are the things I think I’ll miss if I live long enough to one day find myself propped up on a pillow, wondering if I’ll shuffle off this mortal coil during my next nap. They’re the things that have found a way into my heart while the Alhambra, Empire State Building and Louvre haven’t. Those are amazing things. They enrich our lives. They help us dream and take us outside our little existences to see a bigger world.

The unintended consequence of looking at our little lives from outside is that we can see what actually makes a life, and it’s not the broad strokes, the grandiose swooshes of jetting off to another exotic location. What makes a life are the little things, repeated, that form a foundation and help us understand that the most heartfelt parts of life are often the smallest and most subtle.

The cat that waits for you to come home every day so he can show you how much he loves you by rolling around on his back all over the dirty floor.

The shop at the market where you can travel the world by sampling all manner of fancy cheeses impaled on toothpicks.

The hidden vista on Toronto’s harbour islands. It’s just a concrete slab squatting ungainly in the water, but its semi-secrecy means almost no one goes there, so you have it to yourself with the best view of the downtown anywhere in the city.

These are the things I think I’ll miss as I wonder which breath will be my last. They take root in your heart when you’re not looking. I’ve been to Paris, Tokyo, New York and plenty of other amazing cities. I’ve seen fabulous museums and wonders of nature, and there are countless more that would take my breath away. But no memory of these wonders will break my heart as I say goodbye to this world, the way the memories of my life’s constant companions will. I like to think of those little things as good friends I choose to spend time with, instead of the big, bright shiny things I could spend time chasing down.

That’s why I’m taking time to live the little things, in case I realize one day it’s too late to live them any more.

The chocolate shop where I know exactly which four absurdly expensive truffles I’ll get, and are worth every cent.

Strolling through ritzy neighbourhoods in early spring, wondering what it’s like to have that kind of money, but not caring too much about it.

Greeting every dog in the elevator with “Hello, puppy!” because I secretly hope that’s a signal to the owner to let me pet them.

I remember an article from ten years ago about the regrets of the dying. Nowhere did it mention, “I wish I had climbed Kilimanjaro.” It talked about having the courage to live life on your terms, staying in touch with friends, not working so hard, things like that. Kilimanjaro is no doubt a life-enriching experience, but life isn’t built out of mountains. Thanks to social media, our culture now fetishizes dramatic selfies staged in front of ruined temples, mountains, desert landscapes, expensive restaurants and other exotic locales. Sure, I will make time in my life for them; they’re amazing and wonderful and give me perspective about what awaits us in the world outside the 9-to-5.

But I feel confident no one posing in front of the Amalfi coast on Instagram is going to reach for their phone as life draws to a close, gaze longingly at that picture and whisper, “No regrets!” I think that person will understand that life isn’t built on drama: it’s built on the quiet magic of little things.

Originally published in the Globe and Mail.