I'd like to share my journey, through an equation I use:

T2Dx(DR+DPN) + (CVD+CKD) + (GAD+ADD)

Let me explain. These are the chronic conditions I live with: Type 2 Diabetes, Diabetic Retinopathy, Diabetic Peripheral Neuropathy, Cardiovascular Disease, Chronic Kidney Disease, General Anxiety Disorder, Attention Deficit Disorder.

It's a lot. 

Living with many conditions isn't easy. My doctor reinforces if I manage diabetes successfully, other conditions should stabilize. It is somewhat true, but not always.

My story

I was diagnosed in 1996 with type 2 diabetes. I managed it well for a while, then in 2006, going through a divorce, I turned my back on my health.

I was a fool.

In 2014, my health failed. Breathing and eye issues were discovered. In 2015, I was diagnosed with diabetic retinopathy, diabetic nerve pain, congestive heart failure, and an A1C of over 10.0. The HbA1c test monitors how well you're managing your blood sugar level. During the following months, and shortly after my brother's passing, I was informed that aortic valve replacement open-heart surgery was required. The surgeon discovered three blocked arteries and coronary artery disease. If surgery had not occurred, these issues would have never been found, until it was too late.

My realization: I was going to attempt to avoid death before I could see my kids go through the milestones of life. I made a choice.

Recently, the opportunity has arisen to inspire others through multiple forms of health advocacy. The reason I chose the written NCD Diary format is due to my mental health. My anxiety and ADD affect each other, and the opportunity to refine my story allows me to be at peace when sharing.

The key to succeeding in living with multiple chronic conditions in my opinion is one simple thing:

Take the condition seriously at diagnosis and learn everything you can.

Work with your doctor, add caring members to your healthcare team (nutritionist, educator, specialists), and read verified doctor-reviewed journals and online sources. Family and friends can also help you develop self-awareness. Each condition has its own need, so gaining awareness of how your body responds each day is required to create periods of balanced health.

Next month, I will discuss the importance of exercise. How it was explained to me is that it improves the metabolic needs of each condition, along with promoting "food choice freedom." The surprise will be how almost any movement is considered exercise.

Living with multiple chronic conditions is, well, confusing at times.

There are five areas to keep in line when living with multiple NCDs, daily. Balancing my diet, adhering to the care of multiple doctors, managing stress, and getting enough sleep. The final area, which I always find challenging, is exercise.

A year ago, I was reminded by a public health official that "doing anything is considered exercise."I’m glad I understood what he was saying, as this long winter, along with the pandemic, has added on physical weight.

What keeps me going?

It all starts with me and my attitude, but I am not alone. Let's start with the push from Kerri, my wife. The most important group is those around me, which also largely includes those I have met through my advocacy work and who are living with similar physical and mental conditions. My family and close friends encourage me to "just keep moving."

Here is the good news

When I am in stride, I walk my village (it has many hills), go to the gym (not a big fan), or play golf (not in several years due to injuries), yet with no consistency right now. I also love to eat, and years ago, my wife, a runner, explained that if you exercise consistently, you can eat what you like in moderation. Unfortunately, I start and stop exercising, until May comes around.

Eating my exercise

It was 2016 when I became serious about planting a vegetable garden. It has evolved into four garden boxes with green squash, a variety of tomatoes and peppers, and an area along a lattice fence with my cucumbers. Along with six pots of herbs, and two large planters with flowers, let me tell you, I am focused on "my plant babies."

Last month, I explained my conditions. With the garden, I am out there multiple times a day weeding, watering, tasting the herbs (yes, I do that), and adding dried hot pepper to keep the animals away.

It’s great for the body, mind, and spirit. The body appreciates fresh vegetables. Healthy eating is part of preventing and managing NCDs. It’s best for an entire family to develop a healthy lifestyle, including exercise, as well as stress relief and good sleeping habits. It takes many types of relationships to succeed in staying healthy.

Next month, I will dive deeper into my story and motivations as an NCD advocate.

Over the last several diary entries, I have shared and focused on the five areas of attention needed to stay healthy.

I live with three chronic physical conditions along with two chronic mental conditions. My attention deficit disorder (ADD) causes my general anxiety disorder to become an issue, and when my anxiety is a concern, my ADD joins in.

When living with mental health challenges, the ability to provide proper self-care becomes a serious challenge. My own wellbeing and the lives of those around me are affected, at home, at work, as well as in public settings. Stress causes blood sugar to rise, and heart rate and blood pressure to reach dangerous levels. At times, I need to take a little time to get everything back under control.

Just tonight in a conversation with my spouse, we talked about where the line is drawn to claim disability due to my NCDs? I am not sure, but here are some thoughts and suggestions.

I would like to start with my own state and federal government, who should adopt policies and laws that apply within the workplace and public spaces to help those who are living with NCDs, and provide the needed support to be successful in their career.

As we know, not every NCD will be an issue in the workplace, but we've learned during this time of the pandemic to create ways to work from home. This should no longer be seen (as it has been previously, though without merit), as a deterrent in hiring or retaining an employee.

For many years, organizations representing a single health concern advocated for their own needs, alone, to representatives in the government. Now is the time to align, not only at a global level, as already done through the NCD Alliance, but at a national and state level.

In the United States, we have a coalition of diverse organizations working in the area of chronic illnesses. To really be effective, there is a need for this coalition (as well as others globally) to bring together the different disease groups and associations focused on related risk factors, to be more visible and better supported.

Simply, more organizations serving as a unified voice will create the opportunity for real and faster change.