The reluctant vegan: Diabetic changes life

Robert Kluttz hadn’t seen a doctor in 30 years.

He was ashen, his gait so wobbly he could hardly walk across the room. He was losing weight and complaining about being tired. He saw halos around lights.

One night, his words were so slurred his wife thought he’d been drinking. But still, he refused to go. Even pleas from his sister, who flew in from out of town, seemed to make no difference.

That is until the night he borrowed his wife’s car and had trouble driving. He agreed to go the next morning.

In the exam room of Dr. Sven Jonsson’s office in St. Matthews, Kluttz didn’t have time to put on a gown. The entire assessment took less than 15 minutes. His blood pressure was 225/117. His hands trembled. He couldn't stand.

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The doctor was certain he was having a stroke.

"He told me he was afraid I was going to die," Kluttz remembered.

He watched the door close as Jonsson hurried to call the hospital for an emergency admission. Sitting on the exam table, Kluttz was alone with his wife.

"It was scary," Kluttz remembered. "You don't know what the future holds."

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Like many Americans, Kluttz had diabetes and didn't know it. Every day for 22 years, he ate a chicken biscuit for breakfast and a fried chicken sandwich with fries for lunch. He threw back 15 Cokes or Mountain Dews a day at his two Chick-fil-A restaurants.

By age 57, he weighed 258 pounds.

At the hospital, Kluttz's blood pressure set off alarms. Doctors confirmed he had a stroke. Hospital labs showed his fasting blood sugar was 346, triple the daily level of a healthy person. And the next test, called an A1c, showed his average blood sugar over three months was 13.4, more than twice the normal limit.

An ultrasound showed cholesterol deposits blocked more than half the blood flow inside both his carotid arteries. Blood wasn’t getting to his brain.

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Too much sugar circulating in his blood for too long had damaged tiny nerve endings and capillaries. That’s why Kluttz saw blurry halos around lights. His retinas were damaged. It’s also why he had little feeling in his fingers and feet.

The partial blockage in the half-inch-wide artery to his brain stem – a blow to the command center that governs speech, balance and motor control – is what caused the slurred speech and vertigo.

After doctors stabilized Kluttz, they told him Type 2 diabetes was the underlying cause of his problems.

“I couldn’t hardly walk,” Kluttz remembered. “Everything runs through your mind. Here I’m disabled. I’m 57-years-old. What a terrible retirement.”

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Two days later, he left the hospital with eight prescriptions and a regimen of four daily insulin shots. Gone was the sausage, beef, ham, bacon and pepperoni pizza — his favorite Mighty Meaty Wick pie — with three or four 20-ounce Cokes.

His wife served measured portions of the standard diabetes diet. She recorded each day's meals. One October day's menu: a poached egg with heart healthy toast and apple for breakfast, turkey sandwich for lunch and vegetable soup for dinner.

"I felt cheated in life," Kluttz said.

He spent the next year in his La-Z-Boy watching CNN. Just getting up to walk to the bathroom made him dizzy. He followed the diabetic diet because it’s what his wife cooked.

Despite day after day of turkey burgers, baked chicken, sugar-free JELL-O, soup and whole wheat bread, Kluttz's morning blood sugar still tested above the safe range of 130. Discouraged, he refused to prick his finger to check his blood sugar during the day.

Sometimes, Kluttz threw up after those bland diabetic meals. The food simply didn’t satisfy his taste buds. He missed the warm, buttered Chick-fil-A bun in his mouth, the bite of crispy chicken and the tang of the two pickles on top.

"It made you feel good,” he said. “It was comfort food. I was craving that fat. My body just needed it. It was like a drug."

His nervous system was damaged by the stroke, so Kluttz still wobbled when he walked.

"I should have had a cane, but I refused that."

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He burned himself on a hot coffee cup but didn't notice pain because diabetes had numbed his fingers. When his wife asked to check those burns, he refused.

"Mood seems worse," Anne Kluttz wrote in her journal a month after the stroke. "Having trouble getting him to eat ... feels he can't have anything ... refuses to take charge ... watching an awful lot of TV."

"I wanted a big fat juicy hamburger," Kluttz remembered thinking as he toggled between CNN and CNBC in his La-Z-Boy. "I knew I was going to get some broccoli for lunch."

"I thought I would be on insulin for life."

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By accident, Kluttz had happened upon one of the rare general practitioners in Louisville treating diabetes patients with an evidence-based, strict regimen of vegan foods and no oil. Beginning in 2011, the year Kluttz fell ill, Dr. Jonsson had begun helping patients recover from heart disease, diabetes and high cholesterol by eating no meat, fish, milk, cheese, eggs, nuts or oil.

The vegan, no oil regimen follows research findings by physicians from Harvard and the Mayo and Cleveland clinics and has been popularized by documentaries like "Forks Over Knives," and "PlantPure Nation.”

The science behind it reveals this: Within hours of eating a cheeseburger, gelatinous fat — like bacon grease that sits too long on a cold stove — floats in the blood stream. The body perceives it as an invader. So cells lining the blood vessels become sticky to attract the fat so white blood cells can then gobble up the invaders. As the white blood cells destroy the fat, they release enzymes that can damage and inflame blood vessels. That inflammation makes it harder for the body to process sugar.

Insulin is the body’s hormone that signals cells to absorb sugar for energy. But those oils and fats short-circuit the message. As a result, cells can't absorb energy effectively from the bloodstream.

However, when fruits, vegetables and whole grains like oatmeal make up 70 percent of a person’s diet, the increased fiber slows down digestion to gradually release sugar into the bloodstream — instead of the steep spikes caused by sugary desserts and soda. Inflammation wanes. Blood pressure comes down. Cells can again absorb insulin to restore the flow of energy throughout the body.

According to Harvard researcher Dr. George King, when Type 2 diabetics eat this way, insulin and cholesterol levels quickly return to normal.

That’s why, Jonsson said, diabetics are fun to treat.

"We get them off their medicine fairly quickly if we do this right,” he said.

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Dr. Jonsson talked to Kluttz about the diet at every 90-day checkup following Kluttz’s release from the hospital.

"He didn't know how to eat,” Jonsson said. “But he didn't want to die. I told him we could continue down the same path or we could do something healthier."

The idea was radical, but Kluttz decided to give it a try.

"He told me if I would go on this diet and stick to it, I would get better," Kluttz remembered.

Kluttz’s traditional diabetic food diary entries stopped March 3, 2012, when he ate a blueberry muffin for breakfast, a peanut butter sandwich and apple for lunch, and fajitas for dinner.

The new vegan rules were simple but severe. Fat was out. No meat, milk, eggs, fish or oil — not even nuts, coconut or avocado. Anne Kluttz no longer counted her husband's carbs.

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Confident of results to come, Jonsson cut Kluttz's daily insulin dose by one-third.

Liberated from portion control, breakfast became hefty: four cups of cooked, steel-cut oats with all the fruit he wanted. Lunch was grilled skewers of vegetables with rice and lentils. Steamed broccoli, baked sweet potato and rice filled a typical dinner plate — a meal he and his wife ate in silence.

"I was miserable,” Kluttz said of the food change. “I’m surprised I didn't get divorced. I would just rough it. We would have the same meals every week."

Nine months later, in December of 2012, Jonsson greeted his patient with a high five.

Kluttz had dropped 83 pounds. His morning blood sugar tested normal. The long-term test for diabetes, called the A1c, had fallen by more than half to a healthy 5.6.

Though Kluttz' body was healing, the food battle still raged in his head.

"With the food thing, he was like an alcoholic not having something to drink," his wife said.

Kluttz grumbled at every doctor visit, Jonsson said.

"All the way through 2013, he would come in and he was like a stubborn old mule," the doctor said.

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Almost two years into his new vegan lifestyle, she talked him into dinner with two couples at Fiesta Time, a Mexican restaurant, an annual holiday tradition.

Kluttz reluctantly agreed. Driving from Lyndon in their Honda CRV, his mind dwelled on what lay ahead in lieu of his old favorite beef burrito platter piled high with refried beans and rice. The last time he consented to go, the only thing on the menu he ate was a plate of tomato and lettuce with a beer.

"Imagine just sitting at a table and everybody is eating all this food," he said. "I didn't want to go there again and do that."

He parked the Honda and refused to follow his wife inside. Instead, he walked next door to sulk in the lobby of the Holiday Inn Express.

"Anne kept texting me to come on back over there,” Kluttz said. “I just ignored her. We rode home in silence. It was not a good time."

That was Christmas. But the changes kept coming.

The following March, Jonsson dropped all prescriptions for insulin control and high blood pressure.

At that 2014 doctor visit, an ultrasound also showed Kluttz's carotid arteries beginning to clear. His dizziness had subsided. The doctor added a daily dose of Paxil to help Kluttz cope with anxiety and depression.

Anne Kluttz saw something in her husband: He realized he was going to live.

"The food just stopped being the most important thing in his life," she said.

Today, Kluttz continues a tiny daily dose of Metformin, a diabetes pill, to protect his still-recovering eyes. Long retired from the Chick-fil-A business, he walks two to four miles each day.  At 5 feet 10 inches, he weighs 184 pounds.

To help patients like Kluttz help themselves stay on this diet, Jonsson started support groups in Louisville and Spencer County. With potlucks and restaurant outings, Kluttz renewed his main social pastime of dining out.

"Your taste buds do change," he said. "If I were to change now and eat a hamburger, I would throw up."

Jonsson said many people think this diet is on the fringe.

"But the science is right behind it,” he said. “What is really great is that patients who follow this invariably need less medicine."

Anne Kluttz has mastered the vegan cooking. Today, she serves her husband’s favorite comfort food, vegan style: tortilla casserole, soups, dirty rice or lasagna. Kluttz frequents the restaurants he knows are safe, whether it's bean soup from The Fishery in St. Matthews, rice and lentils from the Grape Leaf in Crescent Hill, or Whole Foods' buffet bar items marked with the purple, oil-free, vegan sticker.

"I am thinner now than I was in high school,” he said. “I am 61, but I feel like I am 30. When I was stuck in that chair, I couldn't hardly do anything. When I accepted the new way of eating, I got my strength back. I am getting a second chance in life."

Still in his wallet is a Chick-fil-A card Kluttz can use to eat free anytime, a perk for former franchisees.

That's a treat for his grandchildren from time to time, but not him.

​Jere Downs can be reached at (502) 582-4669, JDowns@Courier-Journal.com and Jere Downs on Facebook.​

DEFINITIONS

Vegan: A person who does not eat or use animal products and follows a strict plant-based diet.

Vegetarian: A person who does not eat meat, but may consume dairy products and eggs.

MORE INFORMATION

To learn more about the Esselstyn Support Group, email nooil4u@gmail.com.

Find out more about plant-based nutrition and cardiac rehabilitation created by Dr. Dean Ornish at Jewish Hospital and elsewhere at www.kentuckyonehealth.org/ornish.  Follow physicians like Dr. Neal Barnard of the Physicians Committee for Responsible Medicine and Dr. Caldwell Esselstyn at the Cleveland Clinic.