Inherited Disease or Conditions That Would Cause Low HT?

[Icelander]

Originally Posted by johndallman

Heart arrhythmia can be inherited, and bouts of arrhythmia can become much more common in an individual after catching an infectious disease. Personal experience: I was having one bout a year until I got Covid, then they happened weekly. Medication made me very woozy and would have forced me to retire in the past. I got it fixed with methods that weren't created until the 1980s, and didn't become routine until this century.

Characters are born 1903 (father), 1928 (son), 1932 (son) and 1966 (grandson); but there were two other brothers who died in childhood, 1921 and 1926, so it might be present in almost all males in the family, but sometimes manifest immediately and dangerously enough to be fatal with 1920s medicine, while for others, not present until adulthood or even middle-age.

Originally Posted by johndallman

There are lots of arrhythmia conditions, so unless your players include a cardiologist, there seems no need to be specific.

One radiologist whose duties do involve a lot of diagnosis from CT scans and MRIs of the heart and one OB/GYN. Heart conditions aren't a major part of his job, but both of them have done several rotations as the duty doctor of a whole rural region, where they basically do all the classic GP stuff plus emergency calls, so I can't rely on neither of them having knowledge of the condition.

[cptbutton]

I knew someone with "Selective immunoglobulin A deficiency" which mostly meant getting lots of infections and having to be very very careful about tainted food.

In GURPS terms probably HT 8 or 9 and whatever the opposite of the cast iron stomach advantage is.

[WingedKagouti]

Originally Posted by Icelander

Characters are born 1903 (father), 1928 (son), 1932 (son) and 1966 (grandson); but there were two other brothers who died in childhood, 1921 and 1926, so it might be present in almost all males in the family, but sometimes manifest immediately and dangerously enough to be fatal with 1920s medicine, while for others, not present until adulthood or even middle-age.

Insulin was discovered in 1921, so the timeline isn't implausible for Type 1 Diabetes. While it usually appears in children, it can also be delayed until adulthood. The immune system of a diabetic can be compromised, but playing and being good at sports isn't off the table.

[Rupert]

If the onset is adulthood there's also Type 2 diabetes, though active men like this family would have to have a very strong genetic tendency towards it for it to manifest so reliably.

And for a relativity minor HT loss, there are allergies, as has been previously mentioned. Life-long allergies towards things that haven't been identified or can't be avoided are quite debilitating, especially before decent treatments (and they've become markedly better over my lifetime). Consider the current concern about chronic inflammation, and consider that a near-constant allergic reaction means quite a significant level of constant inflammation.

Celiac Disease is also an option, and its effects range from "never noticed" to "You'll die if you keep eating wheat", and it's got a strong genetic component.

[Icelander]

I should have been more specific about the characters, their respective lifespans and any periods of illness, to enable us to better craft a plausible explanation that fits all the data.

Especially, I should have mentioned that Tommaso, the patriarch of the first generation of immigrants and the great-grandfather, was in rude physical health more or less for his whole eighty-three years of life, despite being famously fond of wine, grappa and any other strong liquor, as well as well as pretty much all food, as much as he could get of it, and if his genes were presdisposed toward Diabetes Type 2, the only reason he didn't get it early in life would have been growing up in harder economic times and then living through the Great Depression, so that he was often forced to eat healthier food and and unable to overindulge.

Giancarlo, the grandfather, also lived to a decent age, though less than his father, reaching 73, despite having the same fondness as his father for food and drink in large amounts, and adding pipe-smoking to his vices in the 1940s (when he was in his forties). Giancarlo was also in good enough health until the day he died that he never stopped working, though retirement would have been difficult in any case, as his work as a machinist, smith, artisan and gunsmith was also his major hobby.

Giancarlo had a brother, Mose Bruno Manzano, who lived into his late 70s and was physically in robust health until his late 60s, developing Alzheimer's or dementia after losing his daughter and closest companion when he was around 70.

Tomasso, Giancarlo and Mose Bruno all shared an active lifestyle, a lot of long walks, much of it up or down hills and mountains, as well as a Mediterranean diet when they could get it, olive oil, red wine, fish when available, lots of garden-grown vegetables and herbs, etc. Their early years (and, for Tommaso, into his middle-age) were marked by scarcity, so that they physically could not overeat and had very little sugar, processed meat or other unhealthy staples of modern diets.

As a working theory, the sons of Giancarlo having inherited a gene which makes them more prone to Diabetes Type II from their Native American mother seems plausible, and then inherited another genetic medical condition or predisposition from the Italian side of the family, which on its own was not enough to make Giancarlo or Moses Bruno sickly or shorter-lived than usual for their age cohort, but combined with whatever they inherited from Juana Abeyta, makes for some high risk factors.

Whether that had anything to do with Santoro's and Marco's death before their fifth birthdays is not yet determined. Statistically, child death was much more common in the 1920s and 1930s than now, and out of twelve children, two deaths from childhood maladies is not even too far from the norm. Given that it's the men in the family who seem to have health issues, though, and it was two male babies who died, it should at least be a part of the initial diagnostic criteria, even if we later determine it to have been just bad luck.

The three youngest sons of Giancarlo and Juana each dealt with their health issues in some fashion, with Matteo's life being deeply marked, but he managed to live a very long time despite that, and Luca and Salvatore managing to stay healthy with good diets, exercises, mindfulness, meditation and Japanese alternative medicine.

See the males in the Manzano family from the first American generation onward in the next post. The women might or might not have inherited some health problems, but it seems more plausible that this is a male only thing, as none of the women had poor health or died young from disease (accidents at any age or death in childbirth during the Depression in a poor area are not indicative of anything)

[Icelander]

Characters Who Might or Might Not Have Been Ill

Giovanni Carlo 'Giancarlo' Manzano (b. March 29, 1903; Brescia, Lombardy, Kingdom of Italy; d. July 13, 1976).
Major illnesses unlikely, at least not debilitating ones, as he was working full-time until the day he died. Death was likely heart attack or stroke.

Mose Bruno Manzano (b. May 8, 1909; Albuquerque, NM. d. Agust 19, 1987; Isleta Pueblo, NM)
Healthy all his life until he developed Alzheimer's in his 70s and died at 78. Specific cause of death unrecorded, had become almost unresponsive with dementia or Alzheimer's by the time he died.
---

Sons of Giancarlo and Juana Abeyta:

Santoro Manzano (b. May 12, 1921; Isleta Pueblo. d. May 17, 1921; Isleta Pueblo, NM).
Died only five days after his birth, cause of death unrecorded.

Marco Manzano (b. September 20, 1926; Isleta Pueblo, NM. d. August 29, 1931; Isleta Pueblo, NM).
Cause of death recorded as 'Childhood illness'.

Tony Manzano (b. October 21, 1928; Isleta Pueblo, NM. d. October 6, 1978).
Died accidentally, maintained normal activity until then.
Could have had some condition. He was a childhood athlete, Golden Gloves boxer, indefatigable worker and as a child, could go hunting before dawn and roam the streets like for anything useful worth scrounging, work a full workday, and then stay in the workshop-shed with his grandfather or father until midnight, helping them build something or working on his own skills, without such twenty hour days seeming to tire him at all.
However, as an adult, he had 'merely' HT 10, despite having a lifestyle, work schedule and athletic achievements as a teenager that would suggest HT 12+. If he had HT 12+, had the talent to become a star boxer during his Army service, which would have meant never being sent into combat in Korea, so the fact that his HT continued to be much lower than an aspiring pro athlete doing nothing but training 'should have', has definitely had significant negative impact on his life.
Basically had much more willpower to force himself to do difficult things than his body could support. Might have had Diabetes II and/or some other inherited illness that weakened his constitution, but his healthy lifestyle kept mostly in check, so that he mostly did not experience debilitating symptoms, just worse HT than he would have wanted.

Matteo Manzano (b. September 10, 1932; Isleta Pueblo, NM).
Lived to at least 87 (that is, is still alive where the campaign is, 2019), but has had medical conditions in adulthood that he has had to manage with drugs, diet and physical therapy.
Active in sports as a teenager, drafted into the Army for Korea, where he was sent as an infantryman, never talks about his experiences. Might have had HT well above average until this time, but after Korea, his HT took, basically, a nose dive, ending up at HT 6 or so.
Worked as a security guard and armoured car driver for a cash-in-transit company, until he had to retire young, no more than in his mid-twenties.
As he'd been wounded in Korea, as well as fallen ill there, not to mention winning the Distinguished Service Cross, the company he worked for made a deal for early retirement on pretty good benefits, rather than go into court against the heroic soldier in a pretty small-town 1950s society where military heroes were still revered, plus he got full VA coverage and medical retirement, as he was still technically in the reserves after being drafted when he stopped working.
Could have struggled with Diabetes II, high blood pressure and coronary problems, whatever else we determine the family illnesses are, but has basically managed to outlive most his contemporaries despite having lived with serious illness his whole adult life (at least from his twenties).
Much of that is probably TL7 medicine and him being willing to live a healthy life, but at some point in his 70s, he clearly started alternative medicine that actually worked, thanks to emergent subtle supernatural elements which had crept up on the family. Might be something he picked up from his two younger brothers, might be something he gets from a different source, but Matteo is using something to stay alive.

Luca Manzano (b. March 18, 1934; Isleta Pueblo, NM).
Still alive in 2019.
Health and fitness fanatic, worked as an Air Police PT coach, SAC Combative Measures Coach as well doing rotations as basic training and recruiting NCO in the US Air Force. Retired after reaching his twenty years in the Air Force, moved to Hollywood and worked as a physical trainer for actors, before transitioning into stunt work.
Obsessive fitness and health practices and his constant health food fads, exercise and diet might have kept Diabetes II mostly in check and prevented him from suffering from whatever other hereditary conditions that are in the family.
Or... given that very subtle supernatural elements crept into the world after the 1980s, his Esoteric Medicine might actually work now, which is why he's still healthy, limber and actively practicing aikido, meditation and mindfulness.

Salvatore Manzano (b. March 22, 1939; Isleta Pueblo, MM).
The youngest son of Giancarlo and Juana, actually more than a decade younger than his nephew Travis.
Whatever health issues the rest of his family has, he doesn't. Still has the frankly incredible score of HT 12 at age seventy, doesn't smoke, drinks wine only in moderation, eats unbelievably healthy.
Like his older brother Luca, has practiced Japanese martial arts since he was young, and continues to perform them for their health benefits. Was stationed on Okinawa for several years during his service in the Marine Corps and is not only into Japanese martial arts, but has also been cultivating a Japanese garden around his arid New Mexico home, which means he's spent a lot of money on water fountains, sprinklers and water bills.
Also, is definitely using some kind of Esoteric Medicine or Japanese meditation magic to keep healthy, because while he looks weathered, he still moves like a teenager in the dojo, and seems almost immune to the effects of aging.
---

Sons of Antonio 'Tony' Manzano; grandsons of Giancarlo Manzano

Travis Manzano (b. August 8, 1957; Isleta Pueblo, NM).
Healthy and vigorous through his twenties, haven't determined what course his life takes later. That will depend on what health problems he inherits, among other things. So far, hard worker with healthy, outdoors-y hobbies, doesn't smoke. Drinks, but socially and not problematically, eats plenty of meat, especially wild game, likes sweet Italian desserts, but managed to cut down his consumption of candy, sugary drinks and sweets once he outgrew his awkward teenage phase.
The reason I haven't gone further with his personal history is that it depends on other characters, whose development is not complete yet. So, Travis is stuck in limbo in the early 1980s, without me having rolled for his future, but I expect him to survive into the 2010s if nothing unforeseen occurs. This health thing would have a big impact on those odds, though, so I'm trying to nail down what exactly, Travis might have inherited that could be a problem for him.

Arliss Manzano (b. April 13, 1966; Isleta Pueblo, NM).
Eagle Scout, active and athletic in childhood.
Attended the New Mexico Military Institute and was a star point guard on the Broncos basketball team, despite standing about 5'7".
Commissioned as a 2LT in the New Mexico Army National Guard at age 20, due to JROTC and ROTC and the Early Commissioning Program, which means he served as a non-deployable National Guard officer during the remainder of his college education. Graduated from the University of New Mexico in Albuquerque with a double major in Criminology and History in 1988.
Transferred to the Nevada Army National Guard when he moved to Las Vegas and became a police officer in the Las Vegas Metropolitan Police Department while concurrently pursuing a career as a cavalry officer of the Armor branch of the Nevada Army National Guard.
Not all that surprisingly, a marriage with a cocktail waitress did not work out, they were both young, worked weird hours which rarely synced up, and their relationship was based mostly around mutual physical attraction, rather than any real knowledge of each other.
Arliss eventually made homicide detective at the LSMPD, and some time later, achieved his lifelong goal to command a cavalry squadron at war, when he was a LTC and his 1st Squadron, 221st Cavalry Regiment, Nevada Army National Guard was deployed to Laghman Province, Afghanistan from May 2009 to April 2010.
While deployed, Arliss became seriously ill and had to medically retire from both the Nevada Army National Guard and the Las Vegas Metropolitan Police Department.
This means, whatever happened, Arliss had been fairly healthy for the first 44 years of his life, even an athlete as a child and a high-achieving officer both in the police and his National Guard service for most of his life.
Healthy lifestyle and avoidance of risk factors could have kept him healthy despite whatever genetic problems the Manzano men have, until his deployment to Afghanistan.
If Arliss had diabetes or had been made aware that he had a genetic predisposition to Type II diabetes, he would have been managing it well until the extreme stress of being responsible for so many men, men he knew well and was fond of, but could now have to order to go into harm's way. It's very plausible that Arliss drove himself far too hard during his command in Afghanistan, ate only protein or candy bars for quick energy, worked 20+ hour days, etc.

[Anthony]

Honestly... there's enough idiopathic illness out there that 'bad luck' is plausible enough.

[Icelander]

Originally Posted by Anthony

Honestly... there's enough idiopathic illness out there that 'bad luck' is plausible enough.

Still, there's a pattern in GURPS terms that could probably be described and defined in medical terms. Basically, I roll for Attributes of characters, interpreting results more or less according to Reaction Roll outcomes, within a range plausible given what I know of the character already. So, if it's established they are currently part of an elite organization or military SOF team, then the lowest possible result would be either the lowest score that could still pass the intake examinations, or it might mean a current illness, not yet diagnosed and the character is trying to conceal it.

Anyway, I take genetics into account more or less, in that if I don't know anything else, a roll of 10 or any other near average result likely means a score close to the average of their parents, or in the case where I might have already established characters who are children or siblings of a character, an average roll will mean similar scores as the relative, maybe not as high if the relative is more than one standard deviation off from the norm.

Point being, for the Manzano males, I specifically rolled low for HT in a lot of cases. Not all cases, but a lot of them. Usually, when I roll good ST and DX, it will tend to correlate with good HT, so if I rolled very high for ST for their size and 18 for DX, I'd review those earlier rolls if I rolled low HT, and figure out some plausible distribution of Attributes. You can't be a real human with low ST for your weight and low HT and still be a good athlete, and you generally don't see good ST for weight, good DX, but then low HT. You can have high ST and low DX and HT, that's realistic, would indicate a strongman with very high weight, so ST-for-weight was not good. But you generally don't see high-ST-for-weight, high-DX and then low HT, not unles the last score is some kind of recent damage to the system. So, I try to figure out how to explain that, maybe end up reducing the other scores a little too.

In any case, for males in the same family, more than half of them had decent to good physical traits, maybe even high school athletes, great ST-to-weight ratio, good to great DX, etc. But then, for two generations, out of eight of them, two died in childhood (bad roll at an early stage), and fully three of them had the statistically unlikely combination of athlete good enough to have scharship chances and the option of a pro career, folowed by serving as a combat arms soldier and becoming a war hero, but despite these factors, I roll very low HT. That's weird, for a lot of reasons, but one of them is that no matter how brave, a character can't be a war hero if their HT was low enough for them to become casualties due to illness, frostbite or exhaustion before the battle, like a lot of the men with normal HT did under the same conditions.

For Matteo, I rolled an 1-1-1 for his HT score, but other rolls had already established he was athletic at some point and that he earned a Distinguished Service Cross in Korea. I would have guessed crippled by a serious wound in the war, when winning the award, but the dice indicated he came home essentially fine, no major wound. So, whatever happened, he somehow had decent or good HT into his twenties, but then went to the lowest possible HT you can have while still living a very long life.

Tony, basically combination of facts previously noted in the backstory for other characters and dice rolls had established him as totally without fear, deadly combatant, and father to two sons with impressive athletic achievements. Ordinarily, that tends to mean at least good to decent athletic genes. However, rolled badly on HT. Not 1-1-1 badly, but his HT was way lower than you'd expect, given that his sons were amazing athletes as kids, and rolls for what happened to Tony in Korea indicated that he had performed prodigious feats of arms, for three battles in a row, while serving in a unit where most men became casualties, from the terrible combat almost every day or the cold, but Tony somehow was not affected, but was still commanding men when 97% of officers in his unit were casualties, from 'shell shock' or from their bodies giving out from the stress, lack of sleep or cold, or just regular killed or wounded.

From that, I expected Tony to have high HT to go with high Will and Unfazeable, but got, basically, 'lowest it could have been while still doing all that and continuing to amaze senior officers by being indefatigable and never quitting', also, lived out the war, came home and led a healthy, normal life. So, I put HT 10 as the lowest I could believe, figuring it might have been reduced some in the war, but he still continued to succed at a lot of HT rolls over the course of it.

And finally, Arliss, established as athletic, tough, with hobbies that suggest great healthy lifestyle, etc. Actually rolled well on all physical traits, including HT. Until the dice indicated that he was medically disabled during his Afghanistan deployment, not disabled by wounds, but rather some kind of illness. And I rolled to determine what kin of game mechanical effects this illness had for future reference, i.e. why was he medically retired, and got a result of 'HT reduced', meaning his HT went down badly enough so that he could no longer be a detective or military officer. From his previous HT 12, that meant, like, a drop of at least -3, more likely -4 or more.

So, anyway, whether lifelong or sudden, the common thread is game mechanical, reduced HT. And I'm looking to translate what being prone to sudden and massive HT loss means in real-world medical terms. I like Diabetes as part of the answer, but that doesn't, on its own, account for HT loss that bad or that sudden. Hence, maybe inherited cardiovascular problems, problems with the spleen or kidneys, or lung issues that interact with the diabetes?

Maybe they are also prone to some health issue when out of New Mexico's hot, dry climate? Korean War winter and rainy season could aggravate lung issues that were irrelevant while living in New Mexico. That wouldn't apply to Arliss though, as Laghman province is not among the mountainous or cold regions in Afghanistan, it's got a mild climate.

Out of the six sons of Juana Abeyta and Giancarlo Manzano, two died in childhood (could be bad luck, sure), but two of them had more or less the exact same symptoms, just different intensity. At age 20-25, during or after military service, their HT is reduced. For Tony, maybe -2 to HT, for Matteo, maybe -5 to -6 HT. That means that Tony loses any chance of an athletic career, but is still mostly healthy enough for a normal life, maybe with some lifestyle changes, diet he has to watch, maybe some pills, but he was mostly fine.

Matteo, he was basically an invalid for the rest of his life, though, granted, he did live for a very long time, maybe because his illness responded well to treatment and was some kind of chronic condition that can't be cured, but can be kept in check.

Luca and Salvatore never had the same kind of illness, but given their extremely healthy lifestyles, they might have avoided ever developing Diabetes Type II and thus never suffered any complications linked to diabetes that their genetics might predispose them to suffer. Or Luca might even have have suffered the effects of -1 or -2 HT, it just wouldn't be noticed because he's never been under serious stress, eaten unhealthy or failed to exercise regularly. Just because someone goes from HT 13 to HT 12 or HT 11, it doesn't mean that they get really sick, the way that a HT 10 person going to HT 8 would.

Salvatore might just have been lucky and avoided it entirely. Maybe he doesn't have the genetic factors. He even might not be Giancarlo's son at all... after all, just because Juana gave birth to him doesn't necessarily mean that it was her husband who sired him.

In the next generation, Arliss doesn't experience the same collapse as his uncle did in his twenties, but he might have suffered some penalty to HT in his twenties, maybe from HT 12 or HT 13 down -1 or -2, like his uncle Luca.
Luca and Arliss might also have been diagnosed earlier with diabetes and been on effective treatment regimens for them, while Tony wasn't diagnosed or treated in his twenties, and Matteo might not have been diagnosed until after he suffered serious complications, something that wouldn't go away just because they could now treat his diabetes.

But, once he was diagnosed, Matteo could live a long life, just with his systemic damage preventing him from work and any active hobbies, because his cardiovascular system was damaged and he was significantly immunocompromised (two symptoms which together pretty much make up most of 'reduced HT' in GURPS).

Then when Arliss goes to war in his forties, like his uncle and father did in their twenties, his health collapses, just like Matteo's did after his war and while it was more dramatic for Arliss than Tony, both of them did suffer from lower HT than they had before. For Arliss, stress and lack of attention to his own health could have lead to life-threatening diabetic ketoacidosis. That's one plausible explanation, one which fits them having a genetic predisposition for Diabetis Type II and maybe another factor which contributes to the life-threatening collapses that Matteo and Arliss suffered and was maybe what killed Santoro and Marco as children.

[Pursuivant]

Three other possibilities.

Native American Southwestern cooking tends to be high in fat and sugar (when they can get it). Look up Fry Bread. Diabetes and similar nutrition- and lifestyle-based ailments are endemic across Indian Reservations.

Chagas Disease is very common in poor Latin American communities, possibly including poor SW US communities.

Radiation poisoning. The Navajo/Hopi Indian reservations of NM naturally have high concentrations of uranium/radium ore (pitchblende, etc.) which can cause all kinds of health problems if ingested or inhaled. Drinking radioactive well water or accidentally inhaling radioactive dust could easily explain chronic, seemingly random health problems within a family. This might be particularly true for miners/prospectors.

Less exotic forms of heavy metal poisoning could also be a culprit and occupational antimony/lead, etc. exposure is a common hazard for gunsmiths. Being downwind from a lead smelter or similar operation could also cause severe problems and there were numerous metal refining operations in the Southwest in the late 19th and early- to mid-20th centuries.

If you want it to be, the territory where the family settles could have been a witch's brew of any or all of these hazards, which only get identified in the mid-20th century and only get remediated in the late 20th or early 21st centuries.

[Icelander]

Originally Posted by Pursuivant

Three other possibilities.

Native American Southwestern cooking tends to be high in fat and sugar (when they can get it). Look up Fry Bread. Diabetes and similar nutrition- and lifestyle-based ailments are endemic across Indian Reservations.

Chagas Disease is very common in poor Latin American communities, possibly including poor SW US communities.

Radiation poisoning. The Navajo/Hopi Indian reservations of NM naturally have high concentrations of uranium/radium ore (pitchblende, etc.) which can cause all kinds of health problems if ingested or inhaled. Drinking radioactive well water or accidentally inhaling radioactive dust could easily explain chronic, seemingly random health problems within a family. This might be particularly true for miners/prospectors.

Less exotic forms of heavy metal poisoning could also be a culprit and occupational antimony/lead, etc. exposure is a common hazard for gunsmiths. Being downwind from a lead smelter or similar operation could also cause severe problems and there were numerous metal refining operations in the Southwest in the late 19th and early- to mid-20th centuries.

If you want it to be, the territory where the family settles could have been a witch's brew of any or all of these hazards, which only get identified in the mid-20th century and only get remediated in the late 20th or early 21st centuries.

I've received several suggestions about an inherited risk factor for either Type 1 or Type 2 diabetes and I think the arguments for Type 2 make sense.

Tony and his brother Matteo, both developed health issues after joining the Army and being sent to Korea. Matteo to the point of medical retirement, down to HT 6, Tony just down to HT 10 and Fit at age 22, rather than the HT 12 and Fit that he had at age 18. Now, Tony was born just before the Great Depression and Matteo during the middle of it. Both of them grew up eating a lot of wild game, the products of a kitchen garden and lots of home-grown vegetables, maize, squash and beans, not to mention other fresh farm produce from neighbours paying in kind for smith services. They didn't starve, but neither of them had a lot of store-bought processed food and they certainly did not have the means to buy soda pops or candy for themselves.

WWII ended the Depression, eventually, but wartime rationing and the fact that the Manzanos were a huge family trying to live off a garden, hunting and providing gunsmithing, machining and blacksmithing for Native Americans in Pueblo Isleta, an economically-depressed community where subsidence farming was still a real thing, meant that not one of the ten children of Giancarlo and Juana Manzano who lived to adulthood ever managed to eat enough sugar or other simple carbs in their childhood or adolescence for them to develop Type II diabetes, even if they had big genetic risk factors.

After WWII, Tony got a job at Oxnard Field cutting surplus warbirds up and salvaging anything worth selling. He wasn't tall, but even at seventeen, he had a moustache, swagger and a passion for powerful engines, so instead of spending his wages on ice cream floats, cotton candy and gallons of Coca Cola, as some teenagers would do, he bought various spare parts at Oxnard that his bosses couldn't sell for much and used them to soup-up hot rods for high school boys with rich fathers, whom he got to know through varsity baseball. And he built himself a motorcycle from scrounged parts and a totalled bike from a crash.

Matteo was younger and during his high school years, the Manzanos were definitely doing better economically. Tony paid some of his salary home, as the oldest living son, and while he didn't think of spending any money on soda or candy for himself, he did buy some for his younger siblings. And there was plenty of posole with fry bread after the war, as well as all the pork rinds you could eat. Matteo might well have been pre-diabetic by the time he was drafted.

When Tony got to Korea, he lived on C-rations, candy bars, Livesavers candy, cigarettes and Coca Cola. He needed energy, fast, and their field kitchens weren't set up for most of the first six months, because they were further back, out of artillery range, but the promise that Robert W. Woodruff, the President of the Coca-Cola Company made in WWII continued to hold true for Korea; "To see that every man in uniform gets a bottle of Coca‑Cola for 5 cents, wherever he is and whatever it costs the Company."

I actually imagine that Tony started to increase his sugar and simple carb intake as soon as he started basic training. First time he could eat as much as he wanted without being afraid to deprive his younger siblings. First time there's ice cream just available for free. And always, no matter where he went, there was Coke available, from vending machines, from base Exchanges and at USO shows. He might have burned all those calories in basic, but once he was assigned to the 2d ECB, there was little exercise, a lot of free time, and cheap or free food.

Pueblo Isleta is not really a hotbed of Chagas Disease and Pueblo Isleta doesn't really have any proximity to uranium mining, processing or storage facilities that Albuquerque doesn't have, i.e. it's in the same state.