Wednesday, April 18, 2012

Learned the Hard Way

OK, a day late on this prompt, but it's one I can't skip. Because I learned something very important the hard way. And that is, I have diabetes.

I have always joked and called my diabetes Type Weird, mostly because I never fit into any of the boxes very well. My diabetes developed relatively slowly -- in 1990 I had a normal fasting glucose, in 1991, I had numbers that would be diagnosable today, but weren't then, in 1992, I was just at the number for diagnosis, but since I had had a coronary artery spasm, they chalked it up to being sick, and in 1993, I went over the line and got a diagnosis.

Needless to say, during these years, I was emotionally in bad shape, because my family was terrified of diabetes since my grandmother had had it, and I was raised with "Natalie, don't eat that, you're going to get fat, and you're going to get diabetes!" And my reaction was always a quiet, mental "shut up!" So as my numbers started to go up, I was scared and rebellious. On the one hand, I wanted a diagnosis, because I wanted to take care of it so as not to get any complications, but on the other hand, I DIDN'T want to be bothered with thinking about diet and exercise. And on the third hand (there is always a third hand!), I desperately didn't want to be considered fat, and be told that I had caused my diabetes by getting fat. (Thank you, family and media!)

Well, the fact was that I wasn't fat, although I was overweight, and diet and exercise didn't work for very long, and then Glucotrol, a sulfonylurea didn't work at all, and I was on insulin 5 months after my formal diagnosis. Insulin worked like a charm, and control was pretty easy, because I DID still have some endogenous insulin production. And because control was so easy, I would often omit insulin, and watch my BGs climb for a few days until I had to admit that no, the diabetes did not go away while I wasn't looking. But all I had to do was take a little insulin, and my BGs would go right back down again. And meanwhile, I lost 20 lb. and if I had been a true T2, that should have improved my situation, but it didn't do a thing -- my insulin production continued to deteriorate slowly.

OK, fast forward to 2010. During all those years, I had been playing at not having diabetes, and always caught myself before I got into real trouble. But 2010 proved different. I was feeling really rebellious and REALLY didn't want to deal with the food restrictions, and I started bingeing badly. I had always binge eaten, but this was a crisis situation. I didn't omit insulin entirely, because I did wear my pump, and always had that basal going in. And I did take boluses, but not always, and often not enough. So my BGs started going up and I just sat there and watched them, but didn't do anything about it.

Until I started going and staying above 400 all the time. With excursions into the 500's and sometimes HI. Then I started trying to fix it, but was having no luck. One day I took 150 units of insulin and nothing happened. I have since learned that when the BGs are that high, all the cells in the body become extremely insulin resistant, and the metabolism gets totally screwed up, and it's time for the ER.

But I didn't know that at the time, and I tried calling the local Diabetes Wellness Center for help, and all I got from them was a pamphlet on counting carbs. Then I went to my doc, with a fasting BG of 302 and an A1c of 10.1, and liver enzymes in the 100's (normal is below 40), and he had no suggestions and just sent me home. 6 days later, I didn't show up at a picnic, so my friends came looking for me, and found me near-comatose. They got me to the hospital and the doc there told them that if they hadn't found me, I would have been dead by morning. Obviously, I didn't die.

So the lesson learned, but not gratefully, is that yes, I have diabetes, and no, it's not going to go away while I'm not looking. In addition, I learned that yes, I'm dependent on insulin, and my CDE told me that for my own safety, I need to make sure that all medical professionals treat me as a Type 1, because while I was in the hospital, first they tried Type 2 protocols, and they didn't work. But the rest of you can call me Type Weird, just because I don't fit into the boxes. Except the big box that says "Diabetes". :-)

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