''I want to tell people this is possible.''
BELLEVILLE, W.Va. -- Dannie Cunningham, 61, climbed the steep hill behind his house, crunching briskly through oak leaves, whacking weeds with his walking stick. "Maybe I'll get lucky and flush out a rabbit," he said.
He was headed for his hunting camp at the top of the second hill, hustling up the path, laughing and teasing a reporter trailing along behind him. "I hear you puffing a bit there, don't I?" he called over his shoulder.
This is a man who beat back diabetes and chopped his blood pressure and cholesterol in half.
Experts have advised West Virginia to establish statewide diabetes management programs. Dannie Cunningham can testify that they work.
"Last year, I couldn't have climbed like this," he called. "I owe it to Devena."
Devena Moore is one of the state's too-few diabetes reduction counselors. "I lucked into her program," Cunningham said.
He stopped to philosophize. "Now I'll ask you a question," he said, jabbing the air with his finger. "Why aren't we as careful with our bodies as we are our cars? I'm a stickler when it comes to my cars and four-wheelers, stuff like that. I change the oil when I'm supposed to. I change the air filters. But before Devena, I was nowhere near as careful to maintain my own body. Why is that?"
Not missing a beat, he shrugged and started back up the path. "Now I'll tell you how I got in trouble," he said. "After my first wife died, I spent eight years as a bachelor. That's when I packed on the pounds."
He was working at a glass plant as he had for 20 years, he said, mostly running machines. "I had a long drive to work, so I got used to shoveling the fast food in. I'd eat a hamburger while I drove to work, then throw down a hamburger on the way home.
"I never thought a thing of it, kept it up till I got married again. To me, food was just food, like fuel for your car, except I have to say, I was a whole lot more careful about what I put in my car."
He stops to point out deer tracks. "These are fresh," he said.
He pointed up a second steep hill. "My wife and I, we'll stay up at hunting camp two or three days at a time," he said. "It's a real getaway." Turkey and deer stroll by their window in the morning, he said. Nobody can reach them by phone. The stars shine clear and bright at night.
"My grandkids love it up there," he said. They set a bathtub against the hillside by the stream. The pond's full of bass and bluegill. "My wife shot our first deer this year up there, with her crossbow.
"The grandkids like to wrassle their old poppy," he said. "I can keep them going now. Last year, I couldn't."
Last year, he weighed almost 250 pounds at 5' 7." "I couldn't go anywhere without huffing and puffing," he said. "In church, it had got so I had to prop my Bible on my belly, because I couldn't get it down between my legs."
Cunningham stopped walking and laid his hand over his heart. "I'll tell you what happened to me," he said. "One day, I was walking to the mailbox, and all the sudden, I felt like somebody had grabbed me from behind and was crushing my chest."
His blood pressure shot up to 220 over 180. His wife rushed him to the hospital. The doctors put a stent in his heart and sent him home. "Three months later, it happened again. That time, they put in a longer stent."
He patted his chest. "My doctor said if I didn't lose the extra weight, I'd be gone from this world," he said. "I made up my mind to shed some pounds."
He stretched out an arm over the broad farming valley rolling out below the hill. "You can see why I'd like to stick around,' he said.
"And I'll tell you something else," he said, cocking his head, "It's kind of embarrassing to see a doctor write out that word 'obese.' That was a real wakeup call all on its own."
Cunningham has lost about 56 pounds, gone from a size 40 waist to a 36, from a size 17 1/2 neck to a 15.
"I want you to tell people it's possible," he said. "I want people to know they can do it. That's why I'm talking to you. People need somebody like Devena to get them started right, but they can turn it around."
His doctor referred him to Devena Moore, who runs DREAM, the diabetes self-management program for the Mid-Ohio Valley Health Department in Parkersburg.
Nobody keeps an accurate list of such programs in West Virginia. At the professional diabetes educator site, fewer than 80 are listed for West Virginia, mostly located in Charleston, Huntington, Morgantown, Parkersburg, and the Eastern Panhandle.
Very few are listed in rural southern and central West Virginia, where the need is greatest.
Lucky for Dannie Cunningham, he lives near Parkersburg. When he first walked through Moore's door, he was diabetic, with high blood pressure and cholesterol and serious heart issues.
"It had never really hit me that my weight could be causing all those things," he said. "I didn't know you could get your blood sugar back down to normal level.
"Devena teaches you how to manage your own health," Cunningham said. "You learn what food does in your body and how exercise helps and what's in the food you buy. She teaches you how to measure a serving and little tricks that make medicine work better for you.
The first week in the program, he said, he wore a pedometer that counted his steps. "First thing, you find out what you're already doing, so you know where you're starting from. Then the second week, she starts you keeping a food log. You don't change anything you do. Just write down everything you eat.
"That's what I did, and I'm telling you, there were surprises! I found out I was eating more than I thought at night!
"Devena and me, we'd go over my list, and she'd make suggestions."
"It's not something you can do in 15 minutes, visiting a doctor," he said. "It takes more time than that."
After six months, his triglycerides had dropped from 597 to "a little less than 200," he said. He cut his cholesterol in half, to 130.
Moore taught him how to read food labels and count carbohydrates and keep track of the fuel he was putting into his body, compared with what his body burned with exercise.
As he marched up the hill toward the camp, he pulled back his flannel shirttail to show he had his pedometer on. "I've got a little book called Calorie King that breaks down fast food menus," he said. "I was getting Burger King spicy chicken sandwiches, thinking they were low-fat till I looked in there and found it has more fat than a hamburger." He switched to a low-fat sandwich.
His weight is staying off, but he still keeps his food log. "It's part of my life now. It keeps me on track. I check in with Devena once a month so I can show off."
At the top of the hill, he threw his arms wide, gesturing at a wide, round field. "Take a look at heaven," he said. A camper sits at the edge of the field under a shelter. He showed off the pathways he mows through the brush to attract deer.
"I climb up here several times a week," he said. "Right now, there's not much more I want out of life, except maybe a 10-point buck.
"My neighbor got a nine-point yesterday. That means I need to get a 10-point," he said. "I'll be back up here tonight, waiting for it.
"If I have to keep track of what I eat, to have this, it's worth it," he said. "I just wish everyone knew how to do it."
Reach Kate Long at 304-348-1798 or firstname.lastname@example.org.
This article was written with the help of the Dennis A. Hunt Fund for Health Journalism, administered by the California Endowment Health Journalism Fellowships, at the University of Southern California's Annenberg School for Communication and Journalism.