Health Update

As I lay on the floor, my consciousness receding, my body heavy, sweat pouring off me like I was emptying myself of life itself, I looked up at my child and felt regret. Regret not at the life I had led, but that I might not be able to raise my child. I recited the shahāda just in case, because you just never know.

My wife found me and called the ambulance. After a few minutes, we were able to get me off the floor and into the nearby bed. One minute I had been raring to go, set for another Friday in the office, my day planned out and my goals set. The next, I was on the floor wondering if this was it. Life can be like that.

When the paramedics arrived, I was already thinking about whether I could make it to work or not. I was still determined to go. Meanwhile, my wife was calling my boss to let him know that despite my ill-informed protestations, I wouldn’t be going in. I accepted that so long as I didn’t have to go to hospital.

The paramedics were as usual, excellent. They ran some tests. They could barely detect my pulse. My blood pressure was very low, which is odd because I’ve been taking medication for high blood pressure since the late 1990s. They ran an ECG and found abnormalities consistent with the ravages of long-term type 1 diabetes, but thankfully, no sign of a heart attack, though I’m pretty sure we all thought that’s what it might be. They stayed for a while and carried on running tests and my pulse became stronger and my blood pressure though still low, was at least better than when they arrived. I signed the disclaimer for hospital admission on the understanding that should my condition deteriorate again, I would not hesitate the next time. Thankfully, thus far, that’s not been necessary.

It’s too early to point to any one thing, though it wasn’t my diabetes. I’m intimately familiar with the symptoms of a hypoglycaemia, and my blood sugar was perfectly normal. I had no chest pains, just a ringing in my head that I’d experienced the last time I was suddenly unconscious about a decade ago. Was it a virus playing havoc? I don’t think so. There’s no point in speculating. Some have pointed to stress. I have never been less stressed. As you all know, the last two years have been the most enjoyable period of my working life, and although I’ve certainly worked very hard, it rarely feels like effort. I only understand “overwork” in the context of activity that is not enjoyable, so I don’t think we can point to that.

What I can say is that I could probably use more sleep, so I have been sleeping more since this episode, and today I tried to do more work than perhaps I should have and suffered two ocular migraines, the second turning into a full blown migraine, so I need to easy back into things.

I’ve been profoundly taken aback by all the messages of support on Twitter, both from my friends, and those who barely know me. I feel enormous gratitude for that. I’m also looking forward to getting back to my full schedule, but I will ease back into that, listening carefully to my body and ensuring I make my health my number one priority. It’s probably fair to criticise me for not always putting my health first, but that’s always been my choice, and not a wise one at that. I will adjust my values accordingly.

It’s a testament to how fantastic my work environment is that upon regaining my wits, my first thought was irritation that I was taking my first sick day in the whole year. That’s three in two years. Anyone know knows my medical history will realise that this is quite outstanding and a better record than most. I’m also grateful that none of these three days have had anything to do with my diabetes, which I’ve been looking after better than at any time in my life.

I don’t have answers, but that’s OK, I’m used to not having answers. To be able to operate comfortably from a position of discomfort is an important part of success. I’ve got a lot better at that. I will visit my GP to make sure everything is OK and I look forward to operating with my usual energy levels very soon.

Thanks again for your support and love. It means a lot to me.

Johanna

It would have been my friend Jo’s birthday today. She passed away too young, in 2007. This is more or less what I wrote after her funeral.

Bye Jo

My friend Johanna died recently. She wasn’t yet 40. Today, I attended her funeral service near Richmond.

i met Johanna at Dr. Valabhji’s (brilliant diabetologist, the man I credit with saving my life and extending it) clinic last year. I noticed her immediately, because she was having difficulty sitting down and she appeared to be unusually young for a person with absolutely zero eyesight.

I don’t usually start up conversations with people. You could say I go to some lengths to keep myself to myself. I keep a very small circle of friends, I prefer small groups and my favourite form of friendship is one-to-one.

For some reason, I felt drawn to talk to Jo. Sometimes I break all my own rules for no obvious reason and start conversations with people. It doesn’t happen often. It’s just this feeling. A voice (my voice, of course) telling me that this opportunity cannot be passed up. I struggled with the worry that I was going to start talking just because she was blind. Then I thought, “am I not talking to her just because she is?”

Somebody else was telling her about the electronic eye implant recently mentioned in the news. Such do-gooders make me feel uncomfortable. He was insensitive, perhaps tactless, and how was he to know that Jo didn’t have her own eyes in which to put such devices in anyway? No thanks to diabetes…

So I stopped the buffoon from talking any more crap by butting in at a convenient moment and letting her know where her stick was without touching her arm. People who have lost their sight don’t like to be led. Imagine being blindfolded and then kicked down the stairs, that’s how uncomfortable it is.

We talked about our diabetes. Hers had gone thanks to a combined kidney/pancreas transplant, but not before she had completely lost her eyes and a few toes to the ravages of this pernicious disease. Unfortunately, the kidney had failed and she was on dialysis.

We exchanged numbers. Her ‘phone spoke text messages and phone numbers to her. She hadn’t quite got used to it, but did her best and she never learned braille because she had very little sensation in her fingertips thanks again, to diabetes.

She was remarkably phlegmatic. I feel bad describing her as a list of ills. I do so only to point out that the person who was Johanna, the person that was my friend, was everything she was in spite of all of this and that is who I knew.

After we had spoken for a bit, I asked her what she missed and she mentioned not being able to read the papers. I offered to call her up from time to time to read to her. And so I did. Mostly the Daily Mail (which I despise, but that’s friendship. You are friends regardless of differences.) Rarely the Independent and on Sundays, the News of the World.

I didn’t call her as often as I would have liked, but it wasn’t just about reading her the paper, we talked about our lives and she always asked me if I’d managed to see my kids. She called me her favourite reader once and I can’t tell you how happy that made me. Then I had problems with the eye and my reading slowed down a great deal and I could not go on as long as before, but I read a few stories to her every few days or so, slowly. (Despite the damage to my eyesight, with full magnification on the monitor, my left eye could pick up words if I scanned many times before reading.)

I visited her in the hospital when she’d had some problems with autonomic neuropathy and read to her there. (It was the only time I’d met her mother, who ended up texting me this morning with the sad news.) Then more recently, I visited Jo during dialysis. Jo was asleep for most of it. I waited for almost a couple of hours, just watching her. Eventually, I had to leave. She apologised for sleeping and I felt terrible, on the verge of tears, that my friend who liked the Mail and who once asked me if I was one of those “vocal Muslims” should be worried about listening to me read the news to her while she was plugged into a machine that endlessly cleaned her blood before my working, witnessing eyes.

Every so often she’d tell me that she had fallen, or had suffered a setback with autonomic neuropathy (her blood pressure was very low too, sometimes causing her to pass out) and I would worry. Sometimes she would be too tired to listen and would say so.

I would get the odd text from her. It never ceased to amaze me that an unsighted person who didn’t do Braille could be so patient. She was always asking about my health. She was delighted when my eye recovered. She had been through operation after operation and yet she was so supportive of my (relatively) minor procedures. When reading got difficult for me, she would demand that I rest my eyes and her concern was always genuine and touching. Very few people are like that anymore.

Jo spoke slowly, deliberately, with pauses to allow meaning to sink in, to allow space, a living, breathing conversation where nobody trampled on the other. Nobody else quite does that anymore. We just rush into the wide open space if we hear it. Jo and I didn’t do that. I will miss that.

I got the text this morning. I cried for a few seconds. I said “I’m sorry Jo”. I wish I could have read more to my friend. I had hoped she would be around for a while. I called my boss in a daze, he was understanding – I do so love all of my colleagues, they are all wonderful people. For some reason, I recalled The Lord’s Prayer:

Our Father, who art in heaven

Hallowed be Thy Name

Thy Kingdom come

Thy Will be done on earth, as it is in Heaven

Give us this day our daily bread

And forgive us our trespasses

As we forgive those who trespass against us

Lead us not into temptation, but deliver us from evil

For thine is the Kingdom, the Power and the Glory For ever and ever Amen

I wondered wistfully how many Christians know the Qur’an’s Surat al-Fatiha – the Oft Repeated Verses that Muslims recite at least 17 times every single day.

In the name of Allah, All-Merciful, Most Merciful

Praise be to Allah, the Lord of all the worlds

The All-Merciful, the Most Merciful

The King of the Day of Judgement

You alone we worship. You alone we ask for help

Guide us on the Straight Path

The Path of those You have blessed, not of those with anger on them, nor of the misguided.

I took the bus to Willesden Green, then a tube to West Hampstead and finally a Silverlink overground train to Kew Gardens. I can’t think of Kew Gardens without remembering the warden from the made-for-TV film “Scum” from the late 1970s that was so shocking at the time. For the benefit of younger readers, Scum heralded the start of illustrious careers for Ray Winstone and Phil Daniels.

The sun beat hard through my black trousers, the first time I have worn trousers in London all year. It was a longer walk than I expected. I arrived just after the service had started and though others were ushered in, I chose to wait inside so as not to disturb the proceedings.

They played “We Are The Champions” at her funeral service this (Tuesday) morning. Jo did go on fighting till the end. She did it in the manner that I think is the strongest, most noble quality the British ever cultivated…with stoicism. Jo’s mother, who had texted me this morning so kindly, met me and thanked me for coming. She too was the embodiment of stoicism. I felt like the 10-year old in the presence of my primary school teacher again.

I watched the water feature outside the chapel and I remembered our times together and her voice. Ever so slightly croaky (tracheotomy), but gentle.

I’m sorry I didn’t read more often to you Jo. And no Jo, I haven’t seen my kids for the whole of the summer holiday so far and have not spoken to them for over a week either, but don’t worry, there is still time.

And you and I will meet again. Insha’Allah.

For the last time, bye Jo. Take care.

Why the Kindle is Better for Reading

Marco Arment writes about the benefits of e-reader displays. I’m on his side on every issue, which shouldn’t surprise anyone, but there is one important benefit he’s missed out on.

There is a pure ergonomic benefit to e-ink that LCDs will never be able to offer, and that is that like paper, they rely on ambient light. It might seem curious that I should point to a restriction as a benefit, but e-ink gives us more than just great battery life.

I recently spent 24 hours in a sleep centre, where I was monitored very closely by skilled professionals armed with some seriously heavy duty equipment. I went to sleep at night (kind of) wired up like some kind of pre-wakened Frankstein’s monster.

During the day, I was asked to try to go to sleep every two hours. For half an hour preceding my nap, I was told to stop using my iPad. I was surprised as I used the iPad to help me reach a soporific  state, or so I thought. It turns out that emitted light falling on the retinas stimulates wakefulness. I shouldn’t have been surprised.

It appears that this problem with iPad displays causing insomnia is more common than I thought and for this reason, e-ink displays, such as the one on the Kindle I bought after my sleep centre session, should be popular for some time to come.

Happy Birthday, Alhamdulillah

Birthdays don’t mean anything other than that which we ascribe to them, but they serve as a useful milestone for reflecting on change, growth, status and so on, whilst also giving us pause for thought about our direction and our future. So in the tradition of past birthday posts, I’m going to reflect briefly on the above.

Alhamdulillah, things have never been better on a personal level. My family continues to fill me with joy. My friends are truly generous, loyal and supportive. My colleagues inspire me with their talents, their courtesy and their friendship. I cannot say enough good things about my wife and kids. They are truly magnificent, just the most wonderful people a man could ever ask for in his life. My cup runneth over.

My health is as good, if not better, than at any time in my life. My weight is spectacularly heading back to the lows of a decade ago. The kidney disease that threatened me in 1997 has receded, miraculously. 14 years on from that fateful diagnosis and my creatinine levels are in normal range. My thyroid is fine. My eyes are fine. I have strong foot pulses. My HbA1c is heading in the right direction, finally in the 7% ballpark. My fitness has improved dramatically and I regularly play table tennis at a good level for an hour and a half. I can walk for miles with no discomfort. I can take the stairs up 10 flights and not be finished at the top. Alhamdulillah for all this.

My home is serene. Even the once noisy neighbours have piped down. The respect I have from my working network is humbling. To use the modern parlance, check out the love I get on LinkedIn. I look at that from time to time and wonder if my colleagues, past and present, are talking about a different, mythical person.

My faith, now in its 8th year, continues to be the source of peace and harmony, providing a rock on which the rest of my life continues to grow and develop as I look on in amazement at the countless blessings. Two of my close friends from my Qadiani days have joined me in Islam and are flourishing. I have great relationships with many wonderful Muslims from all over the world. They inspire and motivate me. I hear story after story after story of people unwittingly trapped in the Qadiani Ahmadiyya cult coming back to Islam and I am gratified and grateful. Guidance comes from Allah alone.

After hardship, there is ease. And of course, if hardship comes again, as it does, I will, insha’Allah accept it as part of the pattern of life and still say alhamdulillah.

So yes, whilst birthdays mean nothing in themselves, and with the deepest humility in light of all the suffering in the world and through the lens of my past, personal suffering, a very, very, very happy 46th birthday to me.

alhamdulillah

85 Kilos? Done. Ticked. Trophy Awarded.

Sweating, drained and utterly hammered at table tennis over 90 gruelling minutes this evening, I came home and stood on the scales. It’s an unusual time for me to weigh myself, I usually do it in the mornings. I knew it would be special. I knew I’d lost some water, and I just wanted to see it.

I was pleasantly surprised. 84.6 kilos. It’s not my real weight of course. Tomorrow morning it will have climbed to just over 85 as I regain my water, but that figure is as real as the 101 kilos I saw not that long ago. Only two months ago I was at 95 kilos.

The target had been set by my diabetic consultant at around the 8th of August or thereabouts. All I knew was this time, my life depended on it.

So I did what it took and I hit my target in record time. Do I have a slim stomach? Nope. Am I still chubby? Yep. But I look so much better than I did two months ago, it’s shocking. I feel so much better than I did two months ago, it’s shocking. My resting heart rate has dropped from 80bpm to 60bpm. I’m seriously looking forward to seeing my blood pressure results in December, when I’m supposed to check back in with my diabetic consultant having lost 10 kilos.

I can’t wait to see the surprise on her face when she sees I’ve lost 15. That’s right. Between now and December, I’m going to lose, insha’Allah, another 5 kilos.

In honour of Tim Ferriss, whose brilliant book The Four-Hour-Body changed the way I approached my weight attack this time around, I am going to have a cheat meal of disgraceful proportions this Saturday. A Subway, one foot, filled to the brim with the filthiest stuff imaginable. And you know what? I will put on two kilos in two days as a result. Then it will fall lower than before. Ferriss exploits the fact that your body needs to be shocked from time to time out of its complacency. OK, he is far more scientific than that, but what it boils down to, and what you will see from my charts, is that despite a couple (maybe three) cheat days, despite the temporary blip, my weight would keep dropping. And that’s because as you diet-survivors know, if you starve the body, even a little, it will start to fight with everything it’s got to hold on to its fat stores. Subway tells your plateauing body that “it’s all good dude, there’s no situation here, burn that fat”.

There are complications. A diabetic doesn’t just put on a bit of weight on a cheat day, but your blood sugar also goes out of control. There is little you can do about it except measure your insulin doses very carefully. I can’t stress this enough. The great thing about the rest of the time is that my diabetes has never been in better control. I know some of you Type 1s might have been thinking “he’s dropping insulin to drop weight” but I can assure you, I’ve had the complications, and I don’t want to die of them. I have not cheated with insulin. For those who don’t know what I’m talking about, I’ll explain later.

In the meantime, just know this:

  • My diabetes has been brilliantly controlled
  • My fasting blood sugars are decent(ish)
  • My energy has been high
  • My table tennis keeps improving
  • My suits keep getting looser
  • People keep commenting on the difference
  • I’m dropping weight by the bucket
  • I’m incredibly happy about it
  • I’ve hit my target a full 7 weeks early.

And from the post after next, promise, I’m going to tell you how I did it, and how you will never be able to do it unless….

You’re Looking Well!

“You’re looking well!”

“You’re glowing”

“You’re a lot slimmer!”

“Is that Shahid?”

“You’re looking sharp”

“You’re setting the standard”

“You’re raising the bar”

I’ve heard all of the above and a lot more these last 7 weeks. As a Type 1 diabetic who’d become obese without noticing, I spent a long time, years in fact, unable to lose weight despite seemingly eating small portions. To start hearing such platitudes from people close to me is quite a pleasant surprise.

Seven weeks ago, my diabetic consultant wanted to put me on more blood pressure medication and once they do that, they’re always reluctant to take you off it again. I’m already on 300mg of Irbesartan for the kidneys, and the last time I tried something, Amlodipine if you must ask, it discoloured my feet and caused my ankles to swell. We soon put an end to that, but the obesity stayed.

The turning point was seeing my reflection in my switched-off-iPad and finding what I saw repulsive. The biggest shock is the incongruence, the moment you come face-to-fat-face with your cognitive dissonance about how fat you’ve really become. Still, all that happened was that I faced the reality, but I took no action.

At the turn of last year, Tim Ferriss’ UK agent was kind enough to send me a preview of The Four-Hour-Body. If you click that, you’ll be able to buy it from Amazon through my affiliate link and I’ll get a tiny kickback, but my mission is not to shamelessly promote Tim’s book. In this series of articles, I’m going to tell you what I loved about it, and what didn’t quite work for me; what I had to adjust and what I was able to aggressively pursue. I’ll also explain why it’s one of the best books I’ve ever read, and why I am definitely a Ferriss fan. So go ahead, buy the book, because even if you disagree with everything he writes, even if you don’t act on it, you will enjoy the style. It’s compulsive, and it beats reading another God-forsaken misery memoir.

I’ve been tracking my weight on the iPhone, the charts make for interesting viewing:

August weight

After one week of what I’ll call for want of a better term The Four Hour Diabetic plan, I’d dropped from 95 to almost 90kgs. How the hell did that happen, and how did I break the 90kg barrier before the month was out? Did I crash back up in September? What the hell happened on the 20th, or rather, what did I eat on the 19th to make the 20th look like a disaster? Let’s take a look at September.

September weight

Pretty spectacular, right? The trend line does not lie. And at the end of the month, I’m within a Krispy Kreme of my goal weight, which I should remind you, I’m supposed to reach by about December the 6th. Apart from that stupendous peak around the 19th, there is no altering the fact that over the course of the month, I’m dropping about a kilo a week. That’s the upper limit of what you can safely expect, but as Ferriss suggests, go with what works for you. If you’re prepared to break convention, expect unconventional results.

October weight

We’re barely into October and we start with a blip up at the beginning, but the trend line tells me I will beat my goal weight 7 weeks before my deadline. That’s spectacular, and I haven’t been to the gym once. I haven’t run once. I haven’t cycled. I did a few kettle bells, but nothing serious and not since August as far as I recall.

Whatever I’m doing works. Look at the comments at the top of the article. I’m getting into suits I haven’t worn since 2006. People who haven’t seen me for two months are not recognising me. I can tie my shoelaces. I can walk reasonable distances. I can take the stairs.

In the next few weeks, I’m going to tell you exactly what I did, how brutally hard it is and how easy it has become to stay with the plan when the results are so amazing. Dieticians will gasp with horror and conventional wisdom will indeed be damned. I will answer with my renewed vitality, my sense of purpose, my hunger for life, my diminishing gut bucket and the three notches in my belt I no longer need.

 

The 4-Hour Body or the 4-Minute Body?

What’s Google search if not the perfect embodiment of the omniscient computers from old spy films, able to pull up and cross reference all manner of data, sometimes even in real time, on any person that a spy needed to know about? Now we all have access to this tool and we apply it to everything. So when I learned about Tim Ferriss some years ago, I did then what I do now when faced with any new person, or concept, or book, or film, or quote, or line of dialogue. I google it. There, I even lower-cased it. If the Shorter Oxford English says “google” is now an English verb, who am I to argue?

Tim ferriss scam

Anyone who hadn’t previously heard of Ferriss would, I’d imagine, be sorely tempted to click on that second suggestion. I did. And what I found were a bunch of negative, moaning, obvious losers, but we’ll come to that later.

First I’m going to explain how I lost 8 kilos in 6 weeks. You might not be impressed with that, but there are a number of reasons that figure is impressive. First, that three times in this period, I ate insane quantities of food, to the point where I felt I was a bite away from genuine nausea. And second, that the only regular exercise I’ve had has been ping pong and third, that I’m a Type 1 Diabetic. Until recently, an obese type 1 diabetic. The doctors out there know just how hard it is for an obese type 1 diabetic to lose weight.

The difference has transformed my life and more importantly, my wardrobe. It is staggering how quickly a vicious circle can become a virtuous one. I am in almost every conceivable way, a completely different person to the one I was two months ago. Ferriss is metrics-mad and if I didn’t have so much to do, I would be too. (That’s a subject for the 4-Hour Work Week, which I will also cover in this series of posts)

Want some highlights?

  • I lost 8kgs of weight in 6 weeks
  • I undid 5 years of steady weight gain
  • I can now tie my shoelaces comfortably
  • I can now wash and dry my feet comfortably
  • I can walk to the tube station without having to stop several times for a breather
  • I can play ping pong for four hours.
  • My mood is massively elevated and I’m fired up
  • I have far more energy than I’ve had in years
  • Stomach aches and bloating gone
  • Diabetic control massively improved
  • My skin is better
  • My night-time Lantus dose has dropped from 36 units at peak to a regular 16 units. That is truly remarkable.

Was it easy? No. Can you do it in four hours? No – you can do it in 4 minutes per week. Tim’s book titles are ruthlessly optimised to sell. He even split tests them in Google Adwords. Told you he was metrics-mad, but there is method as well as madness.

I promised Tim a review of his book when he kindly sent it to me over Christmas last year through his agent. There is a reason I didn’t write the review at the time. It didn’t work.

I couldn’t make it work until I really understood the principles that Ferriss used to research the book in the first place. I’d read it twice over before the New Year. I applied as much as I could afford to apply. Ferriss was even considerate enough to reply to my tweet on adjusting it for diabetes. The man is clearly smart – he too put up with the pain of a 24-hour glucose monitor to understand how his pancreas behaved in the presence of different foodstuffs. You couldn’t fault him for commitment.

Over the next few posts, I’m going to explain how I dropped three notches from my belt and I’m also going to tell you whether Tim Ferriss played a part in shaping my new life. If I can do it, I think you probably can.