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By , Spectrum Health Beat
South Vietnam’s Central Highlands was no place to be in 1969.
Double-rotored Chinook helicopters delivered Army Sgt. Scott Chesser, 19, and his soldiers into the enemy mountains, where they fired 33-pound Howitzer shells to support U.S. troops.
“When bullets were zinging around the LZ, when bullets bounced off (the helicopter), it was kind of disconcerting,” deadpans Chesser, now 70, Texas in his voice.
There was another unseen enemy: Agent Orange, a notorious defoliant, now known to cause numerous long-term disorders.
Chesser’s type 2 diabetes is presumably caused by dioxin, the problematic ingredient in the jungle defoliant.
He is an example to others hoping to control the disease—losing nearly 80 pounds with help from his wife, Janna, and the Spectrum Health Medical Group Diabetes and Endocrinology team.
On this summer afternoon, the retired oil industry design technician weighs 210 pounds and is 6 feet, 1.5 inches in height. “I used to be 6’3” before gravity took over,” he wryly notes. His A1C—a long-term blood sugar measure—is 5.6, the upper range of normal. He no longer takes insulin shots. His blood sugar readings average 100 to 110. About normal.
The diabetes connection
Among Vietnam veterans, combat-related diabetes passed post-traumatic stress disorder as the No. 1 cause for disability payments to Vietnam veterans eight years ago.
Because Chesser was in combat where Agent Orange was used, he is “presumed” by the U.S. Department of Veterans Affairs to have been in contact with the toxic defoliant. Harmful effects from Agent Orange were not known until years later.
About 270,000 Vietnam veterans are compensated for having diabetes, according to the Department of Veterans Affairs. Chesser does not receive payments.
In 2001, type 2 diabetes was named by the VA among a list of maladies believed tied to Agent Orange. Veterans no longer have to prove contact or a direct link. Service must be from Jan. 9, 1962, through May 7, 1975.
Chesser says Agent Orange was not as widely used in his area, and there is no evidence he or his firing battery came into contact with any.
That is a point of controversy. One in four Americans 65 or older has type 2 diabetes; that compares to one in eight overall. Once called “adult-onset” diabetes, a body’s blood sugar is consistently too high. It can lead to amputations, blindness, heart disease, stroke, kidney damage and nerve damage.
In 2001, the VA added diabetes to its Agent Orange complications after the National Academy of Sciences found “limited/suggestive” evidence due to increased insulin resistance. It was the year after Chesser’s diagnosis.
Life after Vietnam
In 1969, the Army’s storied 1st Cavalry Division (Airmobile) was mounting a counter-attack after North Vietnam’s surprise Tet New Year offensive.
Chesser’s was the Vietnam of combat movies. Heavy-lifting Chinooks, with their distinctive rotors front and aft, sped 7,000-pound Howitzers over perilous mountains. He was based near the demilitarized zone, the contested border between North and South Vietnam. (“You know why it’s called the DMZ? he asks. “Dead Marine Zone.”)
From landing zones hacked into the jungle, artillery batteries fired the cannons at targets miles away to support foot soldiers searching for the enemy. Sometimes they targeted ammo dumps and harassed enemy patrols. Chesser’s landing zone was LZ Action, just below Mang Yang Pass. The steep, narrow choke point was known for enemy snipers and ambushes on US convoys.
Chesser survived the jungle, Viet Cong guerrillas and North Vietnamese soldiers for 365 days. But No. 366 and 367? His return flight on Flying Tiger airway was grounded.
Enemy missiles targeted the Cam Rhan Air Base runway.
“Now, those two days really irritated me,” he said, his humor dry as a Texas oil well.
After the war, Chesser learned electrical and mechanical engineering. He designed and oversaw equipment used to find oil, from the swamps of Louisiana to the remotes of Oklahoma. A test hole was bored. Measuring equipment looked for tell-tale hydrocarbons. Oil.
“We’d break them or make them heroes,” Chesser says.
The Ohio native worked 30 years before retiring in 2010 from Schlumberger Oilfield Services, in Sugar Land, Texas, near Houston.
One summer Monday morning, Chesser arrived at his office in Sugar Land. He had spent an uncomfortable weekend, thirsty, urinating at all hours and generally feeling unwell.
A co-worker entered Chesser’s office to review drawings. The worker, a friend, told Chesser, “You know, you got symptoms of diabetes,” Chesser recalls.
The co-worker knew the symptoms well. “When he retired, he was only 59. Within a year he had passed. It was related to diabetes.”
Mustering resolve
Whatever the presumed cause of Chesser’s type 2 diabetes, the treatment is the same, said Gregory J. Deines, DO, a physician with Spectrum Health Medical Group.
Dr. Deines knew of the Agent Orange and Vietnam connection. He did not know the dramatics behind it. “It sounds like you are hearing the other side of the story,” said Dr. Deines, a specialist in endocrinology, diabetes and metabolism.
Initially, Chesser was prescribed oral metformin, a first-defense pill, Dr. Deines said. That worked for about 13 years, but Chesser steadily gained weight. He reached 280 pounds. He was officially obese. His blood-sugar levels were high altitude. And injections?
“I worked myself all the way up to eight insulin shots a day. Every time I ate a bite, I had to take a shot,” Chesser recalls. “I went to my endocrinologist. I said, ‘I’m really tired of this. I think it’s time to finally face it and lose some weight.’”
Physician assistant Gail Friedrick worked closely with Chesser.
“It seemed like the more weight he lost, the more motivated he became,” Friedrick said. “He did an excellent job of logging everything he ate on an app on his phone, along with his exercise, and when he reached his calorie limit for the day, he quit eating. …I don’t see a lot of patients that have the self-discipline to do this.”
Between appointments, Chesser and Friedrick communicated by email on MyHealth, Spectrum Health’s secure patient portal. “This allowed us to have a conversation about adjusting his medications as he lost weight, without the burden or cost of frequent appointments,” Friedrick said.
Chesser’s wife, Janna, 59, showed Chesser the way. She had seen Scott’s struggle.
“I knew if I didn’t lose the weight I was headed there and I didn’t want that,” said Janna, who began her own weight-loss plan before her husband.
Already 20 pounds lighter toward her planned 70, she and Scott ate healthier and exercised more. They paid attention to portion and diet. He used a free smart phone app “religiously” to monitor calories, consumed and burned, toward his weight goal.
Chesser’s insulin shots became smaller and less frequent.
Coming home
Chesser and Janna moved to 3.5 acres south of Lowell, Michigan, the year he retired.
Not long ago, Chesser stepped out of his pickup into his favorite repair shop, just as he had countless times in the small farm town, population 3,800.
“I said, ‘How you guys doing?’” Chesser recalls. “A worker responds, ‘Can I help out, sir?’ “And I say, ‘You gotta be kidding. I got a bay here with my name on it, I’ve been coming here so long.’
“A lot of people don’t recognize me,” he says.
On Day 580 of Chesser’s campaign, his blood-sugar levels averaged near normal. He lost the equivalent of a bag of concrete mix, 76 pounds. He consumes 1,700 calories a day.
“It’s a tremendous feeling,” Janna said. “I don’t have to watch him stick himself all the time.”
Chesser figures he had an advantage or two. “I don’t smoke or drink. Those things probably get me out of harm’s way.”
With his weight-loss goal met, the retiree now turns to monitoring and maintaining.
“If it helps anyone, even one person realize they can do it, then it’s worth it,” Chesser said. “There is nothing special about me. I finally got the gumption to do it.
“My cousin died of complications of diabetes. It was a horrible death, horrible way to go, and all because she didn’t take care of herself,” Chesser said. “If you see that and it doesn’t inspire you, I don’t know what will.”
Another motivator? “I just don’t want to lose my eyesight, a leg or a foot.”
