Diagnosis: Type 2 Diabetes

Photos by Dave Weatherwax/The Herald
Five times a day, Randy Mullen of Huntingburg, 57, has to give himself an insulin shot as part of his battle with Type 2 diabetes. On Thursday, Mullen gave himself his second shot of the day at about 10:30 a.m. in his Huntingburg apartment. Genetics plays a role in the cause of Type 2 diabetes, and Mullen’s illness was inherited from his father and mother, Tom and Janette. Both had Type 2 diabetes and required amputations.

By APRIL DITTMER
Herald Staff Writer

Six years ago, Randy Mullen was a self-described “health nut.”

The 57-year-old from Huntingburg used to spend his free time working out and eating healthy.
After a sore on his right toe wouldn’t heal, he was diagnosed with Type 2 diabetes and has been battling it ever since. As a result of complications from the illness, he has had five amputations.

Dr. Donald Vennekotter of Jasper Surgical Associates performed four of Mullen’s five amputations. He said it is common for diabetics to develop peripheral arterial disease, which is what happened in Mullen’s case. Many times the arterial disease leads to amputations.

“In diabetics (the arterial disease) typically starts with small vessels in the toes and feet,” Vennekotter said. “It starts with the smaller vessels and kind of works its way up. ... I’d say about 75 percent of all amputations in the United States are from the effects of diabetes.”

According to the American Diabetes Association, 25.8 million people in the United States have diabetes. Indiana is home to 714,000 of them.

Melanie Buschkoetter, a registered dietician and diabetes educator at Memorial Hospital and Health Care Center in Jasper, said the hospital uses a number from 2009: 250 new cases of diabetes were diagnosed in Dubois County that year, the most recent year for which numbers are available from the Centers for Disease Control and Prevention.

In 2007, Mullen was busy working a full-time job in the warehouse at Dubois Wood Products and spent his time away from work weightlifting and bodybuilding. His first indication that his health was declining came in the form of extreme weight loss. He stands 5 feet, 7 inches tall and when he lost nearly 100 pounds — dropping from 220 to 125 — he feared he had cancer.

After a sore developed underneath his right toe and would not heal, he went to see a doctor, who diagnosed him as a Type 2 diabetic and told him his days of work were over.

Because the smallest friction from shoes can cause the development of more sores, Mullen, who was on his feet all day, was forced to quit work. The sore on his toe never healed properly, leading to his first amputation of the toe and part of his right foot in 2007.

Margie Cooper, a driver for the City of Huntingburg transit, left, wheeled Randy Mullen onto the ramp to load him onto the bus to take him for his morning breakfast last Thursday at Dairy Queen in Huntingburg. Mullen relies on the transit program to get him to the restaurant six days a week. On Sunday, Mullen's friend Wilfred Bohnert of Huntingburg wheels him to the restaurant.

Genetics plays a role in development of both Type 1 and Type 2 diabetes. Type 1 diabetes develops when the body’s immune system destroys the cells that make the hormone insulin that regulates blood glucose. Type 2 begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it.

A person can inherit a predisposition for either type of the disease from his parents. Lifestyle choices like unhealthy eating and inadequate exercise also can trigger the development of Type 2.

Mullen’s illness was inherited from his father and mother, Tom and Janette. Both had Type 2 diabetes and required amputations later in life because of the illness. The disease eventually led to the deaths of Tom in 1996 and Janette 10 years later.

Though the illness ran in his family, Mullen had never thought to get tested for diabetes earlier in his life because he had never had any problems with it.

“I thought I was Mr. Invincible,” Mullen said while sitting in his wheelchair at his home. “But boy, was I wrong.”

Mullen’s battle with diabetes continued a year and a half ago when he had two amputations on his left leg. After the first amputation on this leg in 2011 did not heal, more of it had to be removed shortly after. The same happened to his right leg in April and June of this year. Mullen is now without the majority of his right leg and his left leg has been removed to just above the knee. He uses a wheelchair, but he hopes to get prosthetic legs eventually. He used a prosthetic on his left leg until his most recent surgeries.

Vennekotter said Mullen’s case progressed more rapidly than most. Usually the development of arterial disease and the need for amputations can be prevented or prolonged through the “tight control of blood sugar and blood pressure” Vennekotter said.

Buschkoetter said many cases of Type 2 diabetes go undiagnosed because symptoms are mild and are not easily recognized. That’s a main reason those with a family history of diabetes are encouraged to be screened — via a blood test — for the illness from time to time, especially once a person reaches the age of 40, Vennekotter said.

Mullen agrees.

“I just want people to go get tested,” he said. “I’m serious. Maybe I can help somebody else to prevent this.”

Leaving his Huntingburg apartment just about every morning to have breakfast at Dairy Queen is an important escape said Randy Mullen, who is largely confined to his apartment due to both of his legs being amputated. Mullen joked around with some of the restaurant's employees during his visit last Thursday morning.

Mullen has to take five shots of insulin every day and must maintain a healthy diet. He said he is basically on a low-carbohydrate diet, so he avoids eating bread and pasta whenever possible. Instead, he eats a lot of vegetables.

Mullen, who is single and has two adult daughters and five grandchildren, hasn’t let his bout with the illness dampen his spirits. He said he tries to have fun because life is too short. Every morning, he has breakfast at Dairy Queen with friends. Mullen usually has an omelet with tomatoes and onions, a piece of whole-wheat toast and a cup of coffee. It was at Dairy Queen that he met Butch Bohnert of Huntingburg. The two became good friends and Bohnert often accompanies Mullen to the grocery store where he helps Mullen by pushing the cart.

“I hate that this happened, but it’s leading me to people that I ordinarily didn’t know,” Mullen said.
Mullen knows his fight with diabetes is not finished, but he said he refuses to give up without a battle. After persevering through five amputations, Mullen said he feels lucky to be alive and sometimes feels like a cat with nine lives.

“Evidently God doesn’t want me yet,” he said. “He’s got a better plan that I do. I don’t know what it is and I’m not going to sit here and question it or complain about it. ... I try and make the best of it.”

Contact April Dittmer at news@dcherald.com.

 

Diabetes
ӢSymptoms
ӢUrinating often
ӢFeeling very thirsty
ӢFeeling very hungry, even though you are eating
ӢExtreme fatigue
ӢBlurry vision
ӢCuts/bruises that are slow to heal
ӢTingling, pain, numbness in the hands/feet

Preventative measures
ӢMaintaining a healthy diet
ӢIncreasing the level of physical activity
ӢMaintaining a healthy weight
ӢManaging cholesterol and blood glucose levels

Once you are diagnosed with diabetes:
ӢKeep your blood sugar and blood pressure down to slow the progression of the disease.
ӢQuit smoking if you are a smoker. Smoking multiplies the effects of arterial disease.
ӢWear supportive and comfortable shoes to reduce the risk of developing ulcers on the feet.
ӢGo for a short walk after each meal (three times a day) to prevent spikes in blood sugar.
ӢPlan a walking routine that totals 10,000 steps a day.
ӢMeditate for 12 minutes a day to reduce stress levels.
”¢Avoid added sugars and sugar syrups, any grain that isn’t 100 percent whole, and saturated and trans fats.
ӢLearn to control the intake of carbohydrates, like starches, sugars and fibers.
ӢSave desserts for special occasions and keep portion sizes small. Cravings for sweets can be satisfied with a piece of fresh fruit.

Information comes from the American Diabetes Association, Dr. Donald Vennekotter and “The Doctors” column by Drs. Mehmet Oz and Michael Roizen that runs in The Herald on Saturdays.

Local help
   Memorial Hospital and Health Care Center in Jasper offers a continuing education class, Your Health and Diabetes, for people with diabetes and those who want to learn more about the disease. The class is free to attend and meets from 7 to 8 p.m. on the third Monday of every month in the hospital’s Pavilion Classroom.
  The hospital also offers a weekly certified program to educate those with diabetes. Enrollment  requires a physician’s order and a fee is involved.




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