Edward Adrift

that bothers me about seeing Dr. Rex Helton: My appointment time says 11:45, but experience tells me that it could be 11:48 or 11:55 or even 12:01 before my name is called. That never happened at Dr. Buckley’s office. With her, I had a 10:00 a.m. appointment every single Tuesday, and she never failed to have me in her office by that time. I can only conclude that the Broadwater clinic isn’t as interested in precision as she was.
    Here’s another thing that bothers me about seeing Dr. Rex Helton: When the nurse finally calls my name, at 11:47 a.m., and after I’m weighed (290.2 pounds—holy shit!) and my blood pressure is taken (138 systolic, 92 diastolic—holy shit!), I’m placed alone in a room at 11:51 a.m. and told that Dr. Helton will see me shortly. (I don’t like a word like “shortly.” It’s imprecise and owes too much to individual interpretation. Dr. Rex Helton’s “shortly” and my “shortly” could be two completely different things.)
    When Dr. Rex Helton finally comes in—at 12:02 p.m.—he says “Hello, Edward,” and then he gets right to it. Directness is the only thing I appreciate about Dr. Rex Helton.
    “I’ll be blunt. It’s not good,” he says. “It’s not good at all. It’s not just the weight, which you know is going in the wrong direction.We’ve seen the results of the fasting plasma glucose test you took a couple of days ago, and you’ve tipped into type two diabetes.”
    “What was the reading?” I ask.
    “Well, your six-month average is two hundred and twelve. It’s far outside normal.”
    Holy shit!
    Dr. Rex Helton goes on. “I’m also worried about your blood pressure. We need to get aggressive with this. You have to eat better, you have to exercise, and you’re going to have to go on medication.”
    “How much medication?”
    “Fifteen milligrams of lisinopril for the hypertension. Forty milligrams of furosemide, a diuretic to leach some of the water out of your body. Thirty milligrams of actos, which will help increase your sensitivity to insulin. A thousand milligrams twice a day of metformin, which should help control the glucose in your blood. And, finally, a daily potassium chloride tablet to help with your kidney function. That furosemide is going to put a lot of stress on them, so we don’t want problems there.”
    “You mean, I’m going to be peeing a lot?”
    “Yep.”
    “Holy shit!”
    I can’t believe I actually said this out loud, in front of Dr. Rex Helton.
    “Edward, I know it sounds like a lot. It is a lot. But we have to get out in front of this thing. Lose the weight. Control your diet. You don’t have to take this stuff forever. I’ve seen people come off it. But you have to do the work. Is there any reason you can’t?”
    I could make a lot of excuses about all of the things that have happened to me this year, but I don’t.
    “No, Dr. Rex Helton. There’s no reason I can’t. What should I weigh?”
    Dr. Rex Helton doesn’t know this, but it’s better for me when I have tangible goals.
    “Less than you do now, OK? It’s not just about weight. It’s the whole picture. You’re tall”—in fact, I am 6 feet 3 5 ⁄ 16 inches tall—“but you’re still overweight. Lose some of the weight, adjust the diet, and we’ll see improvement.”
    “But how much?” Dr. Rex Helton is not answering my question.
    “Let’s say you should weigh two hundred pounds.”
    Holy shit! I do the math in my head. I need to lose 31 percent of my weight. More than that, really. I don’t have time to calculate the fractions of a pound before Dr. Rex Helton is talking again.
    “Now,” he says, “here’s what I want you to do. Get a notebook and keep track of how much you exercise. Thirty minutes a day, Edward. It can be as simple as a brisk walk. As for meals, imagine a plate divided into thirds. I want two-thirds of that to be vegetables—salad, carrots, green beans, peas, whatever you like. The other third can be lean meat. You can have pasta, but it needs to be an occasional thing, not the everyday meal it’s been. Those days are over. And look into sugar-free options for dessert. There are a ton of them. You need to be serious about this. Do you hear me?”
    I smile. Dr. Rex Helton smiles back at me. I hear him. I’m getting new entries in my daily logbook. I wouldn’t go so far as to say that type 2 diabetes has been a good development, but I’ve found a silver lining, at least.

    When I go home, I don’t follow my