 My Diagnosis Story
, My first few years with diabetes
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Let’s go back in time a little bit. It is now early January 1980. Imagine an 18 year old boy in his last year of high school (Grade 13 for those of you who remember the structure of the Ontario education system at that time) living in a small town in Eastern Ontario.
At that time, there were public service announcements that listed the symptoms of diabetes (does anyone remember these announcements – I know they ran on the CBC. I couldn’t get any other television stations, so I don’t know if they ran anywhere else). The list started thirst, frequent urination (I think there were 7 symptoms listed).
I definitely could check off every symptom in the list, so I was pretty sure what the diagnosis would be but I put off going to the doctor (probably because I didn’t want to face the diagnosis).
After about two weeks of these symptoms, my mother was going to the doctor for her appointment. I gave her a list of what I was feeling and asked her to show that to the doctor. As I pretty much expected, the doctor wanted to see me. I don’t remember the specifics of the initial appointment; I just remember that he sent me to the lab.
A day or two later, he wanted to see me again. When he said I had diabetes, I wasn’t surprised. I had pretty well resigned myself to this diagnosis. From where my blood sugars have gone now when they are high, this wasn’t all that bad – I’m sure it was under 500 (when we still used mg/dl as the measuring unit in Canada). (I should also mention here that my grandmother had Type 1 Diabetes. She was diagnosed when she was 39, so a “late” diagnosis of Type 1 was not a surprise to me. She was institutionalized mainly due to complications by this time. (There were complications due to other things as well – the important point for this story is that she had limited short term memory).
I spent a week in the hospital getting my blood sugar under control and learning how to inject insulin. Everyone say “orange”. At this time, the hospital didn’t have glucose meters available; the only way to get an actual measure of the blood sugar was from the lab. The initial treatment was with Lente insulin (beef/pork) only. Remember diastix? – I was to test before each meal and the doctor’s strategy was 1 unit per +. (I don’t remember if this was the total insulin; or if this was added to a base). Anyway, this must of worked fairly well because a week later I was ready to go home. One thing that I have never had a satisfactory explanation for is that when I left the hospital, I didn’t need my glasses (I had 20/20 vision in each eye, something I hadn’t had for at least 5 years by then. After a month or so, my vision went back to where it was before and I needed glasses again. Amazingly, my vision hasn’t changed since then, I could see now clearly with the glasses I wore then).
Two other things I remember from my hospital stay – the first was that my parents didn’t pay for me to have a phone. That meant that if I wanted to make any phone calls, I would have to use a pay phone (anyone remember these?), so I had a bag of dimes (anyone remember when it cost a dime to make a call from a pay phone?). One time as I walked by the nurses’ station (with the dimes rattling) one of them asked me if I was eating candy. The other memory I have is from the one day that I was served tomato juice for lunch. I cannot stand tomato juice (sorry tomato juice lovers), so I didn’t drink it. Of course, a couple of hours after lunch, I was feeling a little strange (having never experienced a low blood sugar before). I think at some point, I pressed that bedside buzzer and explained. I was given sugar of some sort (I don’t remember what), and was told this occurred because I didn’t drink my tomato juice. (You would have thought that when the tray was collected, I might have been offered some substitute juice – but no. (I don’t remember if nurses brought around the food or there were orderlies. Remember, this is small town hospital with at most 30 beds)). Later, when the doctor saw me, he said it was good that this occurred because it is better to have the first experience of a low blood sugar in the controlled environment of the hospital and also to know what it feels like)).
While I was in hospital, my aunt, who lives in Toronto, thought I should be moved to a larger city. (My father and his sister are the children of the Type 1 grandmother mentioned earlier). My father (I think he discussed this with the family doctor and with me) all agreed that I was better off where I was. The one concession that he made was that at sometime after being released from hospital, I would see an endocrinologist in Toronto (about a 6 hour drive from where we lived). I don’t remember much about that appointment. After about 3 years though, I went back to this endocrinologist and saw him for the next 10 years or more (until the time I got a pump).
The rest of the last year of high school was rather uneventful. I think I was getting by with taking 5 units of Lente in the morning (and this may have been too much).
Come September, I moved to Waterloo to start university. Here is where I probably made my biggest mistake early in my life with diabetes. I went to Health Services and introduced myself, and told them that I would like to have a doctor that I could see regularly. There was only one doctor there full time; the rest were part time and had their own practices off campus. There is a creek that separates part of the campus. In order to get to Health Services from the main campus, it was necessary to cross a bridge over the creek. I should have taken all the ducks hanging out near Health Services as a warning.
My first term on campus went reasonably well (diabetes wise). I did eventually reduce the amount of insulin I was taking to 4 units of Lente per day because I was being plagued with hypoglycemic episodes. (I still remain hypoglycemic aware and have never got to the point where I would require glucogon, emergency intervention, or even assistance from someone else in bring my blood sugar back up). When I came home for the December break, I saw my family doctor again, and everything looked fine. The only comment I remember was “No one had the courage to take you off insulin.” To this day, I don’t know if he was kidding, and if he wasn’t whether this would be beneficial.
Let’s now return to Waterloo and the January term (now getting close to one year since being diagnosed). This is when the trouble started. (I’m sure some of you will realize fairly quickly what was going on; I didn’t really find out until much later. As one of my doctors said, hindsight has 20/20 vision). The original diabetes symptoms started to recur. The doctor would send me to the lab for a blood test. My blood sugar was high (surprise, surprise). At first, I think the doctor suggested increasing insulin. (This worked to a limited degree). At one appointment, the doctor said to me, “You’re an Engineer; Engineer’s drink beer. Drink less beer.” I’m sure I had told him that I don’t drink at some point in the past. My sarcastic wit wasn’t yet honed, so I didn’t have a good reply for him at the time (mind you, my sarcastic wit still isn’t sharp). It was at this point I decided that this doctor was an idiot (perhaps I’m not being fair; he may have been inexperienced in dealing with diabetes). I think at some point, I phoned my father and he spoke to the family doctor. I believe he was the one who then suggested splitting the insulin and taking some in the morning and some in the afternoon. This did work a little better but still wasn’t great.
The Health Services doctor decided I should see an endocrinologist, so he sent me to one in Kitchener. I think this was the first time I met a doctor I genuinely did not like. One suggestion (which was valid but I wasn’t too happy about it) was to start testing my blood. This is still in the days before meters, so it was necessary to compare the colour on the strip to a colour on the bottle. There were no lancing devices (that I was aware of either), so I had to use this metal lancet and have one hand launch at attack on a finger of the other hand.
My blood sugar was still rising. I think I managed through the rest of the term somehow. When I returned to my home town, the doctor suggested adding Toronto insulin (called regular insulin everywhere else except Canada) to the mix. I was now on two shots per day and mixing Lente and Toronto insulin each time. This worked reasonably well for a while.
What happened at that time was the end of the honeymoon period with diabetes. I think this is when the last islet cell is destroyed and thus no more residual insulin production. So the insulin doses I was taking were insufficient. I think the Health Services doctor completely missed that this is what was happening. Had this been explained to me correctly at the time, I’m sure I could have dealt with it much better.
Eventually, I found a doctor at Health Services who had experience with diabetes. I also returned to the endocrinologist (in Toronto) that I saw after first being diagnosed. (This wasn’t too bad as Waterloo is less than 2 hours away from Toronto).
The reason I mentioned my grandmother earlier is that shortly after I was diagnosed we told here that I have diabetes. Despite her problems with memory, every time I saw her (until shortly before she died), she did remember this.
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Last update: Jun 13 2008, 09:36 PM by Aaron Created: Jun 13 2008, 09:36 PM by Aaron
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