Wednesday, June 5, 2013

Me and My Diabetes

     August 16, 2012 - After a wonderful summer vacation in the States in-between assignments in Germany and Hong Kong, Marisa and I found ourselves down in Port Orange, FL visiting my mom, stepdad, brother and his family.  It was wonderful to finally relax after spending the previous month working on visa paperwork and receiving/shipping boxes from Germany and to Hong Kong, closing one bank account, opening another and who knows what else.  The plan was to visit with family for a week and soaking up the sun both on the beach and at the pool and the plan was going quite well.......for the most part.  Almost immediately after I arrived I started noticing some strange symptoms going on with my body - excessive thirst that was unquenchable, an appetite that had fallen through the floor, constant urination during the day and waking up 3-4 times per night as well.  Something was definitely off.

     Then one morning Marisa and I decide to go for a short run in the neighborhood as I'd been doing all summer.  The sun was intense, but after a jog of less than a mile my body felt unbelievably fatigued and I could barely make it back to the house.  Strange.  The next day I noticed that my vision, which has always been perfect, had started to decline.  I rubbed my eyes as I tried to read covers of books from several feet away and I couldn't read street signs as we drove past.  I kept that to myself for most of the day until the evening when we went out to have dinner and a movie with my brother and his wife.  At dinner I asked everyone else if they could read a particular sign on one of the walls of the restaurant.  "Yeah.  Why?  Can you?"  We went ahead and watched the 2-hr movie, during which I had to use the restroom three times - and I pride myself on having an iron bladder.

     That night we got talking with my mom and I'm thinking that I have something wrong with my blood pressure medication.  I planned on sleeping it off and going to a clinic the next day but Marisa insisted that I go to the hospital.  At the local ER I explained my symptoms and the nurse immediately asked if I had a history of diabetes in my family.  "No.  No one in my family has ever had diabetes - why?  Isn't this about my blood pressure?"  It turns out that I had basically given her every symptom in the book for having high blood sugar, which pretty much always means you're a diabetic.  A quick blood glucose test would certainly rebut that silly suspicion as I was sure that this was a blood pressure thing.

     Whereas a normal blood glucose reading should be around 90-120 mg/dL, mine was around 880.  There was no doubt in their mind that I was a diabetic, but that bomb wasn't really settling in with me - surely there was another possibility.  This was completely off of my radar and I never saw it coming.  I would spend my last couple of days of my vacation in the hospital which was also the last time I would see my family for at least a year.  To say that it was a "bummer" would be an understatement.

     I was angry.  I was confused.  I was tired.  I was frustrated.  While I tend to think of myself being fairly fit, maintaining a good weight, exercising regularly, and doing better with eating healthier, I have been ailed with a peanut allergy at 21, high blood pressure at 22, and now diabetes at 30.  In all cases the doctors "can't really explain it" since I'm too young and in too good of shape to have these things.  Unlike the peanut allergy and hypertension, however, diabetes would change my life more dramatically.  Now to fast-forward a bit....

     Ten days later Marisa and I moved to Hong Kong and my vision would remain blurry for another 2-3 weeks (scary).  My mom, who has a lot of connections in the medical world due to her work experience, researched heavily endocrinologists and diabetes specialists in Hong Kong beforehand.  She was able to connect me to an amazing facility that is less than a 15-minute walk from our apartment.  This has been a huge blessing from God as I have received excellent treatment since arriving and I have been able to get all of my medication without complication.

     After a barrage of tests, it has now been confirmed that I have Type 1 Diabetes.  Allow me to briefly explain what that means............the pancreas is a vital organ that produces a chemical called insulin which is responsible for transporting sugar from the blood to the cells that need them for energy.  If the pancreas is working normally you can basically eat loads of sugar (think of the breakfast from Elf) and more insulin will be produced to keep the amount of sugar remaining in the blood at a normal level.  Diabetes is a disease in which the pancreas doesn't function normally.  There are two types, thoughtfully named: Type 1 and Type 2.  With Type 1 (normally the one that people have from early childhood) the pancreas doesn't really work at all and so insulin must be injected into the body with every meal.  With Type 2, the pancreas has been weakened due to an unhealthy diet and so either insulin must be injected or oral medication must be taken and the person's diet must be greatly adjusted so that the pancreas can recover.  One major difference here is that Type 1 is for life and Type 2 can be reversed.

     Having Type 1, that means that my diet had nothing to do with my pancreas failing which is somewhat comforting.  However, it's also been the most unsettling thing too because for some unknown reason (researchers still don't know the cause of Type 1 diabetes) my immune system attacked my pancreas and killed off most of the beta cells.  Any kind of auto-immune disease is a bit unsettling since you don't want to think of your body attacking itself.  So basically this took place probably when I was still in Germany and my sugar levels slowly elevated and my body adjusted until it got so high that it finally shut down.  With a blood glucose of 880 mg/dL it was probably like corn syrup running through my veins.  My vision finally went because the fluid in my eyes started to swell.  Luckily now I'm keeping my levels under control and with the rest of this post I'll show you my equipment and what day-to-day life is like now.

Any time we go out to eat or go on vacation, Marisa bought me this bag that holds everything that I need.


It's a lot of stuff but this is everything that I need to do a reading and injection, which happens four times daily.  From left to right we have:  lancing device (for pricking finger), alcohol swab, lancet (to stab finger for blood sample), needle top, blood test strip, blood glucose monitor, and up top we have the insulin pens (orange/blue for meals; gray for once/day long-acting).

I'll summarize the changes to my life in just a few questions:
     1.  How has my diet changed?
              Honestly, my diet is mostly the same with a few adjustments.  I use artificial sweetener when possible ( I prefer Splenda) - particularly in coffee, on oatmeal or when baking.  When going for soft drinks I only take Coke Zero - that switch wasn't too difficult actually.  Otherwise I just have to make a mental note of how many servings of carbohydrates (sugar, bread, pasta, tortilla chips, etc) that I am eating at each meal and give myself enough insulin to cover it.

     2.  Does it hurt/is it difficult to inject yourself with insulin?
               Sometimes.  Not really.  Since I go through four injections/day you definitely get used to it.  And the needles that I use are only 4mm long and very small/sharp so they usually go in and out painlessly.

     3.   How can you tell if your sugar is too high/too low?
              For me I can't really tell if my sugar is too high, but that's why I measure it at least once per day.  A bigger problem for me is if it gets too low (too much insulin or activity).  I can tell right away and the way that I describe it is that I feel shaky and clammy and sometimes light-headed.  There is also a feeling in my stomach, but not the same as when you're hungry.  My body is literally telling me that it needs something, but not necessarily food.  That's when I have to eat a quick snack or drink some juice.  This part confused me before when I had classmates in school that were diabetic.  They couldn't eat sweets, but if they felt bad they were supposed to eat something sweet - that's confusing as hell for a kid.

     4.  What else is different?
             The main difference now is that I always have to be THINKING about my meals whereas before I would never pay any mind to it.  I can't leave our place to go and eat without bringing my supplies and I have to make a judgment on each meal as to how many carbs I have and how much insulin is needed.  If I'm going to be exercising I have to be careful to eat a snack beforehand or to make sure I bring snacks if I'll be going on a hike or taking a long trip where I may not have access to snacks in an emergency.  That is the most annoying thing because no one else has to think about it - unless you're on a diet........but that's at least optional.  If I don't think about this stuff in advance I could find myself in a dangerous position where others might just get hungry.

     It's been nearly a year since my diagnosis and I've certainly learned a lot about diabetes.  I wish the condition were less permanent, but I always remember that it could be much worse.  For now I'm just thankful that it's manageable - and I can still eat what I want!

--Justin
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