Vihang: Past and Present

Chapter 3 · Vihang Rahul Vasa

This chapter is the reason the rest of this book exists.

There are two versions of me. One lived without looking at his own life. The other is writing to you now. Between them stands one truth I learned the hard way: your body will tell you what it needs, and if you refuse to listen, it will find louder ways to speak.

This is not written to inspire you or to lecture you. If you are newly diagnosed, or have lived with diabetes for years quietly hoping it will go away on its own, it will not; you have to work on it, you deserve to know that change is real, it is possible, and it does not need you to be extraordinary. It only needs a starting point.

Mine was a gall bladder.

Before

Overweight. Type 2 Diabetes that was climbing, not controlled. Insulin resistance so high that even my medicines were struggling to keep up. My vision had started to lose its sharpness, and no change of glasses fixed it.

There were warnings written on my skin too: painful, recurring boils in the folds of my armpits: hidradenitis suppurativa, a condition far more common in people with metabolic disease than most people realise (see Chapter 42). Nobody saw that these were all one problem. Each flare was treated as a separate misfortune, and life moved on.

Inside me, silently, my liver was filling with fat. MASLD (Metabolic dysfunction–associated steatotic liver disease: liver fat linked to metabolic problems like obesity, diabetes, cholesterol or insulin resistance) had been growing for years without a single symptom I could feel. Nobody knew it was there, not even me, and nobody thought to test for it.

Then came a gall bladder stone. Painful enough that surgery was unavoidable. And here is where the most fortunate accident of my medical life happened. My surgeon, while operating on the gall bladder, took one look at the colour and texture of my liver and stopped to look again. After the surgery, he came out and spoke to me plainly: “your liver did not look the way a healthy liver should look. You need to investigate this.”

That ten-second observation, from a surgeon who had no duty to comment on an organ outside his field, was the moment my life turned. Had he said nothing, I could have walked out with a healed incision and a silently failing liver, and carried on for years without a clue. This book would probably not exist.

The “Before” was not just what my body looked like. It was also how I lived, and you deserve the full picture, because the body was only the outcome of the life.

My diet was full of sugar: soft drinks, up to three teaspoons of sugar in every cup of tea and coffee, restaurant food more often than home food, rich and oily, large portions, second helpings. Exercise did not exist: no walking, no gym, no sports. My work meant long hours at a desk or in meetings, and sitting was my default state for years. Cigarettes, yes. Alcohol occasionally, not heavily, but regularly enough to matter.

And most damaging of all: I was not listening. Family raised concerns. Friends made gentle suggestions. Doctors, when I saw them, told me what needed to change. My answer was the one every person heading for a health crisis gives: “this will pass. I am fine. Nothing bad has happened yet.” Doctor visits were avoided, and when they happened, the advice was sorted into what suited me and what could be quietly ignored. My body, I told myself, was tougher than my choices.

The body, of course, was keeping count. And one day it showed me the damage, as it always does.

Before, every line that mattered in my reports was in the wrong place, weight, HbA1c (glycated haemoglobin), triglycerides, lipase, blood pressure, and I felt nothing. The lipase and triglyceride levels were high enough to put me at serious risk of pancreatitis, a fact I did not fully understand until later. Now, every one of those lines is back in the normal or near-normal range. That is not a small improvement. It is the difference between a body in crisis and a body in working order.

One of those lines deserves its own warning: blood pressure. It quietly multiplies every risk diabetes carries, heart, brain, kidneys, eyes, and you feel nothing. Never ignore it; take your doctor’s guidance and treat it exactly as advised (see Chapter 34).

After

Everything you have just read changed. Not all at once, but decisively. And the honest reason matters, because it was not willpower. Nobody wakes up one morning a different person. Several forces came into my life at about the same time, and together they made change not just possible but unavoidable.

Poonam entered my life. My wife, Dr. Poonam Gupta VASA, is a physician. She did not lecture me. She did what a good doctor and a good partner does: she showed me the evidence, and explained what was happening inside my body in language I understood. When someone shows you a scan and explains what the fat on your liver means, and shows you an HbA1c (glycated haemoglobin) trend and explains what it predicts for your kidneys, denial becomes very hard to keep up. Medical evidence, presented calmly and repeatedly by someone who loves you, is more powerful than any warning.

My doctors and hospitals were extraordinary: physicians who took real time, explained without hurry, followed up, and treated me as a person in their care, not a chart. My family reorganised itself around my needs without ever making me feel like a burden; meals became healthier for everyone. My friends chose restaurants where I could eat, stopped ordering what I would find hard to resist, and some sat in hospital waiting rooms so I would not be alone. I was blessed to be surrounded by people who chose me over their own convenience, again and again, without asking to be thanked.

This support, Poonam, my family, my doctors, my friends, is not a luxury in a diabetes journey. It is medical infrastructure. Tell the people who love you what you need; most of them will show up. And if you are the family member or friend of someone with diabetes: your quiet, consistent adjustments matter more to us than any grand gesture.

Where that has brought me

My weight has come down a long way, and the work continues, slowly. This is not a diet: it is a life. My blood reports have improved dramatically. My liver has stabilised. My vision is under control, though it will always need watching.

Work takes me abroad and on location, far from my regular doctors, and diabetes travels with me: managed with confidence and discipline on the move. No meetings missed because of health. No opportunities turned down for fear that the body would not cooperate.

Meals are planned. Cleaning and maintaining the home is my regular exercise. Sleep is protected. Sugar is not part of my day. And the honest thing you should know, especially if you are early in your own journey: none of it is missed, not the soft drinks, not the sugar in my coffee, not the late-night restaurant meals. For years I braced myself to miss them. Instead, once my body recalibrated, those things stopped being pleasures and started feeling like burdens I had once carried without knowing it.

Alcohol and smoking went completely, over fifteen years ago. Not one drink. Not one cigarette. The decision was final because the reasoning behind it was final, and once it was obvious, it stopped feeling like sacrifice and started feeling like relief.

Over the years, quietly, things became less. My medicines became fewer, not because I stopped them; I never would, and neither should you, but because my doctors saw better reports and reduced them. My tests became fewer. My doctor visits went from frequent and worried to regular and calm. The hospital stays of my early years have simply stopped.

Today there is energy, and there is happiness. When I visit my doctors, I go smiling, because I know the news will be good, and even if it is not, I have done my part and the rest is the good work of medicine.

Why I Am Telling You This

This chapter was not written to be admired. It was written because you are probably reading it from a place I have already stood in.

Maybe you are where I was: heavier than you should be, drinking sugar without thinking, avoiding the doctor, telling yourself this will pass. It will not pass. But it can be turned around, and the turnaround is closer than you think. Maybe you are in the middle: diagnosed, following some of the rules, hoping it is enough. It is probably not. The middle path with diabetes is a slow slide; either you commit or you drift. Or maybe you have already made your change, and you picked up this book to see someone describe the road you have walked. If so: welcome. You know what I know: on the other side of the discipline is not deprivation, but freedom.

Diabetes does not own you. It never did. It only owns the version of you that refuses to look at it honestly.

The moment you turn and face it, with a good doctor, with the right evidence, with people who love you, diabetes becomes something you carry, not something that carries you.

The “After” is not a special person. He is the same person as the “Before”, same body, same history, same DNA, the genes you were born with. The only thing that changed was the choices, and the people who made those choices possible.

If a surgeon had not told me the truth, if Poonam had not entered my life, if my doctors had not been generous with their time, if my family had not changed its meals, if my friends had not sat in waiting rooms: this book would not exist. But it does. And so do you, reading it. That is enough of a starting point for the rest of your story to begin.

This is the chapter I most wanted to write. If you have read it once, please read it again. And then close the book, take a breath, and decide which version of yourself you want to be tomorrow morning.

Illustration: Chapter 3 illustrated summary. The author's journey moves from a sedentary routine to a liver finding, support from family, friends and doctors, home cleaning and planned meals, and renewed energy for work and travel..

Chapter 3 The author's journey moves from a sedentary routine to a liver finding, support from family, friends and doctors, home cleaning and planned meals, and renewed energy for work and travel.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.