Diabetes shut down both of David Cowan's kidneys four years ago, about the same time his lower left leg was amputated to save him from rampant infection.
Before that, Cowan, 49, nearly died from stepping on a rusty nail, which put him in a coma for four months.
Even now, as he gets about on an artificial leg and goes in for blood-cleansing dialysis three days a week, Cowan, 49, a Sebastopol resident and former commercial fisherman, has trouble fighting off a common cold.
Colds invariably turn to bronchitis and require antibiotics, he said.
"It's a crapshoot," Cowan said last week at Santa Rosa Memorial Hospital's Wound Care Clinic, getting treatment for five cuts on the calloused stump of his leg.
He was referring, with a wry smile, to the litany of things that can go wrong for a man who's lived with diabetes for more than 30 years.
"My eyes are OK," he said.
Blindness, heart disease, kidney failure and leg amputations are among the serious complications from diabetes, which affects 24 million people in the United States, nearly 8 percent of the population.
Another 57 million people are estimated to be at risk for diabetes, the nation's seventh-leading cause of death.
Cowan, who has lived with diabetes for more than 30 years, accepts the indignities the disease has inflicted on him. "You gotta keep going," he said.
He's on a kidney transplant list, takes 10 different medications and hopes, as he gets more accustomed to his prosthetic leg, to get back on a basketball court someday soon.
"This condition could take me out - in a matter of months," said Cowan, a stocky man with a light mustache and goatee. "But no, I want to live. So I do what I have to do. It's just a way of life."
Cowan has Type 1 diabetes, once called juvenile diabetes, which afflicts children and young adults and is treated with insulin to keep blood sugar in check.
Diabetics often lose feeling in their feet and won't sense pain from a rock or needle in their shoes. Cowan once stepped on a barbecue grate so hot it burned through his sandal, but didn't feel a thing.
The cuts on his calloused stump came from pressure against his prosthesis.
"You've got to stay off it," advised Suzanne Drake, wound care manager at Memorial.
"I wish I could," Cowan replied.
Cowan, a 1980 graduate from El Molino High School in Forestville, was an active, hearty teenager when his weight plummeted from 200 pounds to 160. A blood test showed he had the elevated sugar level associated with diabetes, which upsets the body's ability to produce sugar-burning insulin.
He wound up at Palm Drive Hospital, where doctors discovered Cowan had testicular cancer, most likely unrelated to his diabetes.
Surgery, followed by chemotherapy and radiation, eliminated the cancer but left Cowan sterile. He is "thankful" for the diabetes, he said, because it enabled doctors to catch a cancer that could have killed him.
In 2007, Cowan suffered a diabetes-induced spasm in both legs and crashed to the floor of his kitchen, shattering his tibia and fibula into 17 pieces. The bones failed to heal, and ultimately an infection set in, forcing the amputation in early 2008.
During rehab for the broken leg, doctors told Cowan his kidneys had failed.
Now, Cowan is well-versed in life with diabetes.
"You've got to really know what your sugar level is and take your insulin to adjust it," he said.
Cowan credits his survival to family support, his Christian faith and good doctors.
A Baptist who attends the Hessel Church in Sebastopol, Cowan thanks his parents for instilling in him a belief in God and Jesus Christ.
"I can fall back on my faith," he said. Without it, "I would not be here."
You can reach Staff Writer Guy Kovner at 521-5457 or guy.kovner@pressdemocrat.com.
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