{"id":20138,"date":"2019-01-07T15:59:05","date_gmt":"2019-01-07T22:59:05","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=20138"},"modified":"2023-06-23T10:53:08","modified_gmt":"2023-06-23T16:53:08","slug":"shes-ditched-her-diet-of-fast-food-and-the-oxygen-tank","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/shes-ditched-her-diet-of-fast-food-and-the-oxygen-tank\/","title":{"rendered":"She’s ditched her diet of fast food and the oxygen tank"},"content":{"rendered":"
<\/div>

In the wee hours of a summer night in 2017, Ann Marshall\u2019s eyes fluttered open. She was on the floor of a bedroom she\u2019d turned into an office in her Aurora home. She was woozy, her head hurting from hitting a file cabinet when she fell after passing out.<\/p>\n

\"A
Ann Marshall gave up fast food and made other dramatic lifestyle changes to improve her health. She has lost 62 pounds.<\/figcaption><\/figure>\n

What caused the blackout? Marshall, now 62, didn\u2019t know. But a short trip to the Emergency Department at UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus for treatment put her on a long road to recovery from issues that are all too common in the United States and take a powerful toll on the health care system.<\/p>\n

Too little air, too much sugar<\/strong><\/h3>\n

Providers at UCH found that the blow to Marshall\u2019s head was the least of her problems. She was severely hypoxic \u2013 oxygen starved \u2013 the result of extra body weight that compressed her lungs and led to the bedroom tumble. She went from the ED to an inpatient unit and left the hospital with an oxygen tank that delivered three liters to her laboring lungs 24 hours a day.<\/p>\n

Marshall\u2019s troubles were to worsen. She\u2019d been diagnosed with Type 2 diabetes in 2015, about a year after her husband died, and by her own admission she\u2019d done a poor job of managing her diet for a long time. The problem wasn\u2019t how much she was eating; it was what she chose to eat.<\/p>\n

\u201cYou wouldn\u2019t believe the amount of fast food I ate,\u201d she said. \u201cIt was a really unbelievably unhealthy lifestyle I was leading.\u201d<\/p>\n

\"Ann
Ann Marshall before she took steps to lose weight. Photo courtesy Ann Marshall.<\/figcaption><\/figure>\n

During her hospitalization, her A1C levels, a key measure of blood glucose, hovered around 7 percent \u2013 borderline high. But when she visited her endocrinologist at UCH<\/a> in December 2017, she got another shock. Her A1C was 10 percent, well above the danger line established by the American Diabetes Association<\/a>. Marshall went home with a prescription for insulin and the prospect of injecting it every day \u2013 as she maintained her oxygen around the clock.<\/p>\n

Her response? \u201cI was told I\u2019d be on oxygen the rest of my life. Same with insulin too,\u201d Marshall recalled. \u201cI said, \u2018Nope, that\u2019s not happening.\u2019\u201d<\/p>\n

Flipping the script<\/strong><\/h3>\n

Mission accomplished. Today, Marshall no longer lugs the oxygen tank around, and she\u2019s off insulin. She owes that to spiritual belief, lifestyle changes and a helping hand from her medical providers, especially UCH pulmonologist<\/a> Dr. Jeff Sippel<\/a> and his team.<\/p>\n

There was no magic formula for the success. Marshall shed 62 pounds, mostly by drastically cutting her fast-food and carbohydrate intake in favor of proteins and vegetables and increasing her activity on a stationary bike. Sippel prescribed a CPAP (continuous positive airway pressure) machine to treat the obstructive sleep apnea that was a big contributor to both her low oxygen and high blood sugar levels as well as, unsurprisingly, fatigue that became so severe that she frequently fell asleep during the day.<\/p>\n

Thanks to the CPAP, Marshall said she now sleeps through the night, is alert all day and maintains healthy blood oxygen levels consistently. That\u2019s earned her freedom from the oxygen tank \u2013 a considerable relief.<\/p>\n

\u201cI had to pull the hose and tank all over the place. It was a huge hindrance and I hated it,\u201d Marshall said. \u201cNow I\u2019m off it. I didn\u2019t want to be on it and I knew I had to find a way.\u201d<\/p>\n

\"Marshall
Marshall says she and her sister joked about how skinny her legs looked in this picture after her weight loss. Photo courtesy Ann Marshall.<\/figcaption><\/figure>\n

The CPAP machine\u2019s role in improving oxygen flow is no surprise, but how did it help Marshall manage her blood sugar? Sippel explained that in some patients, untreated sleep apnea contributes to high levels of two hormones, adrenaline and cortisol, that promote weight gain and can make it harder to lose weight. Cortisol, he added, triggers the liver to produce blood sugar and resist insulin. That combined with genetics, body type, and lifestyle, makes the hormone a risk factor for diabetes.<\/p>\n

The gains from change<\/strong><\/h3>\n

Three months after beginning to wear the CPAP machine and taking her insulin regularly, Marshall said she lowered her dangerously high A1C level to a manageable 6.9 percent. She stopped taking insulin early last summer and her last A1C reading stood at a very healthy 5.9 percent. But Marshall takes nothing for granted. She said she checks her blood sugar three times a day.<\/p>\n

\u201cSo long as I can keep track of it during the day, it hasn\u2019t gotten away from me,\u201d she said, adding that thanks to Sippel and his team, she knows that keeping her blood oxygen saturation at 90 percent or above will also help keep her blood sugar in check.<\/p>\n

Sippel believes that while Ann Marshall\u2019s story is not the stuff of front-page medical news, it is vitally important \u2013 precisely because her health care struggles are so common.<\/p>\n

\u201cA lot of people are overweight with sleep apnea,\u201d he said. \u201cThe fact that she got to victory underscores the opportunity for many other people to get to victory. She paid attention to her symptoms, admitted she didn\u2019t feel well and adhered to the recommendations for improving her health. Those are the nuts and bolts, the blocking and tackling of health care.\u201d<\/p>\n

Marshall\u2019s example illustrates the benefits both patients and society at large reap from that effort, Sippel added. Reducing reliance on oxygen produces direct savings for patients and the system as a whole, he said. Patients who manage their sleep apnea are more productive and less likely to miss work, while those like Marshall who have diabetes are better able to manage their disease and avoid complications \u2013 another potential source of enormous cost savings.<\/p>\n

\"A
Dr. Jeff Sippel says changes like those Marshall made can greatly improve lives and save the health care system millions of dollars.<\/figcaption><\/figure>\n

In addition, Sippel said, some patients with sleep apnea end up with congestive heart failure, leading to emergency department visits and hospitalizations that could in many cases be avoided with effective and comparatively inexpensive treatment.<\/p>\n

Patient power<\/strong><\/h3>\n

There are no shortcuts to these improvements. Sippel said he and his team spend considerable clinic time educating patients, but he sees the encounters as a dialogue, not a lecture from on high.<\/p>\n

\u201cIt really means talking to patients about what is this diagnosis and what does it mean, how may it affect [your] life?\u201d he said. \u201cI feel that if we can empower patients with that knowledge, they will ultimately be able to make the best recommendations and decisions for themselves.\u201d<\/p>\n

An important element to that approach is motivational interviewing techniques that Sippel said he gleaned from his own efforts and from the hospital\u2019s tobacco treatment specialists, notably Kathleen Moreira. The idea is to work with patients to identify their own reasons for changing their behaviors.<\/p>\n

\u201cWe say, \u2018Let\u2019s find something of value that could be improved on if you adhere to this therapy,\u2019\u201d Sippel said.<\/p>\n

He readily admitted the extended discussions lengthen the standard clinic visit. \u201cIt\u2019s a matter of balancing out how efficiently or inefficiently we might spend our time,\u201d he said. \u201cBut if our goals are lifestyle and behavioral changes, it\u2019s worth spending some time with patients trying to understand that.\u201d<\/p>\n

Marshall credits Sippel for being honest with her and \u201cnot sugar-coating\u201d information about her condition. \u201cI got my tests quickly, and my questions were answered. Things were explained well,\u201d she said. At the same time, she advises other people with conditions similar to hers to take an active role in their own care and find intrinsic motivations for improving.<\/p>\n

\u201cI\u2019d also say, don\u2019t sit back and listen only to your doctors,\u201d Marshall added. \u201cFind out for yourself. Investigate it, research it, and figure it out. My diet is going to be a lot different than somebody else\u2019s because my metabolism is different.\u201d She also stresses that her reliance on God played a big role in her recovery.<\/p>\n

One year after her health cratered, Marshall said she\u2019s made a 180-degree turnaround. \u201cLast year I was pulling along an oxygen tank. I was tired. I felt really bad. Now I don\u2019t,\u201d she said.<\/p>\n

With her weight down to 195 pounds, Marshall said she\u2019s plateaued, at least for now. She\u2019d like to lose more but is concentrating on maintaining the improvements she\u2019s made.<\/p>\n

\u201cIf I don\u2019t lose more weight, it\u2019s not the end of the world,\u201d Marshall said. \u201cI can move around really well, I can breathe and bend over and not pass out. That\u2019s really good.\u201d<\/p>\n

Marshall\u2019s story and others like it are \u201cnot necessarily made for TV,\u201d Sippel acknowledged. \u201cDramatic, exciting cases are awesome. This one, on one hand, is not dramatic or exciting. But it is incredibly successful and meaningful.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

In the wee hours of a summer night in 2017, Ann Marshall\u2019s eyes fluttered open. She was on the floor of a bedroom she\u2019d turned into an office in her Aurora home. She was woozy, her head hurting from hitting a file cabinet when she fell after passing out. What caused the blackout? Marshall, now […]<\/p>\n","protected":false},"author":2143,"featured_media":20140,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[988,2635,342,177,9187,4202],"class_list":["post-20138","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-diabetes-endocrinology-care","tag-diabetes-management","tag-endocrinology","tag-pulmonology","tag-readysetco","tag-sleep-disorders"],"acf":[],"yoast_head":"\nShe's ditched her diet of fast food and the oxygen tank - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Ann Marshall gave up fast food and then her oxygen tank after she made dramatic lifestyle changes that have dramatically improved her health.\" \/>\n<meta name=\"robots\" content=\"noindex, follow\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"She's ditched her diet of fast food and the oxygen tank\" \/>\n<meta property=\"og:description\" content=\"Ann Marshall gave up fast food and then her oxygen tank after she made dramatic lifestyle changes that have dramatically improved her health.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.uchealth.org\/today\/shes-ditched-her-diet-of-fast-food-and-the-oxygen-tank\/\" \/>\n<meta property=\"og:site_name\" content=\"UCHealth Today\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uchealthorg\/\" \/>\n<meta property=\"article:published_time\" content=\"2019-01-07T22:59:05+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-23T16:53:08+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/07154433\/GettyImages-910049866.jpg\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Tyler Smith\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@uchealth\" \/>\n<meta name=\"twitter:site\" content=\"@uchealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tyler Smith\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/shes-ditched-her-diet-of-fast-food-and-the-oxygen-tank\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/shes-ditched-her-diet-of-fast-food-and-the-oxygen-tank\\\/\"},\"author\":{\"name\":\"Tyler Smith\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/98c85c0e40c4933eedcec2cd054f349d\"},\"headline\":\"She’s ditched her diet of fast food and the oxygen tank\",\"datePublished\":\"2019-01-07T22:59:05+00:00\",\"dateModified\":\"2023-06-23T16:53:08+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/shes-ditched-her-diet-of-fast-food-and-the-oxygen-tank\\\/\"},\"wordCount\":1549,\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/shes-ditched-her-diet-of-fast-food-and-the-oxygen-tank\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2019\\\/01\\\/07154433\\\/GettyImages-910049866.webp\",\"keywords\":[\"Diabetes & endocrinology care\",\"Diabetes management\",\"Endocrinology\",\"Pulmonology\",\"Ready. 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