My Bizarre Diabetes Life
(Written in 2001)
“Don’t eat anything after midnight, and be sure to bring your insurance card and two raw eggs.”
Not eating after midnight and bringing insurance information are routine fare for many medical tests, but raw eggs? A little bizarre. Then again, having lived with type 1 (also known as “juvenile-onset”) diabetes for 28 of my 37 years, weird medical stuff is nothing new.
For a week straight, I’d been feeling full after only eating a little, very bloated, and a little nauseated. Those symptoms are all typical of a condition called diabetic gastropathy, in which the stomach, because of nerve damage, loses its ability to move food efficiently through the digestive system.
This test, called a gastric emptying study, uses a radiolabeled food—eggs, in this case—to determine how quickly the stomach can move the food into the small intestine. A normal stomach empties about half of its contents in 55 to 95 minutes. In many diabetics, the rate is slower.
When I arrived at Shady Grove Radiology, the nuclear medicine technologist put my eggs in a bowl and squirted in a big syringeful of radioactive material. She stirred up the concoction and put it in a microwave. I then ate the radioactive scrambled eggs, and washed them down with a glass of water.
She positioned me on a table, with a large scanner poised above my midsection. I was stuck motionless for the next 90 minutes, watching my glowing stomach contents on a little TV screen. Clumped together, they looked like an asteroid with bits of stardust flying in all directions.
At the end of the test, the celestial body looked to me as if it had barely moved at all. She assured me it had. The results were normal, and my symptoms have subsided—For the time being.
That was my first gastric emptying study, but another diabetes-related test I dutifully carry out every year might seem equally odd to the uninitiated. The 24-hour urine test is a measure of kidney function in people with diabetes. Urine collected by a patient over the course of a whole day is sent to a lab, and its protein content measured. A high protein level is a signal of diabetic kidney damage.
My urinary protein level is already a little above normal, so now I take a daily pill called Zestril to keep it in check. The test helps my physician keep tabs on how well the drug is working to preserve my kidney function.
Twenty-Four Hour Urine Day is a major event. My doctor gives me a special plastic cup to pee in, and a large brown plastic jug to pour the urine into. It must be kept refrigerated. This is much easier now that I no longer have a roommate.
Of course, the test must be done on a weekend day when I don’t plan to stray far from home. One year, though, I decided to push the envelope and go to the Tacoma Park Street Festival. I stayed for a few hours before nature began calling. I made it back home to Rockville with time to spare—My little private victory.
Eating radioactive eggs and hoarding pee in a jug might seem a little strange, but people’s eyes really widen when I tell them about my daily diabetes routine: I control my blood sugar levels with four to seven fingerstick blood sugar tests and insulin injections every day.
I’d say that taking insulin shots “is like brushing my teeth,” but it’s not exactly true. Not only do I inject insulin more often—I only brush two or three times a day—but I’m better at it. I’ve successfully injected insulin while driving 60 mph on the Pennsylvania Turnpike (not recommended), in an airplane lavatory during turbulence, and in a dark, yucky Port-O-Jane on the Mall on the Fourth of July. Meanwhile, my dentist still says I’m not brushing right.
People often ask if it “bothers” me to take so many shots. That’s kind of like asking if it bothers you to have to open the door to go outside, or turn the key in the ignition before your car will start. Yeah, I’d rather not have to do it, but I really don’t think about it all that much. It’s just a part of life. And no, it doesn’t hurt…most of the time.
What does bother me, though, is the fact that all those tests and injections don’t guarantee that my blood sugar will be where it should be. If I underestimate how much insulin I need for the amount of food I plan to eat, my blood sugar soars too high. Over time, that’s what damages the nerves, kidneys, and other organs. If I overestimate my insulin dose or exercise more than I planned, my blood sugar drops and I have to quickly eat something with sugar in it to avoid passing out.
It’s a constant balancing act, requiring lots of mental gyrations to keep it all straight. But those, too, are just simply facts of my life.
Despite the highs and lows, I do a pretty good overall job of controlling my diabetes. I’m proud of that. The fact that I manage this disease on top of all the other daily hassles that everyone faces is like a badge of honor for me, and a source of self-esteem.
A while back, a friend and I were discussing the exciting news from the University of Alberta in Edmonton: Using a new protocol, surgeons essentially cured diabetes in a group of patients by giving them transplants of pancreatic islet cells, the insulin-manufacturing cells that don’t function in type 1 diabetes. Although these patients must now take potentially toxic immune suppressant drugs to keep their bodies from rejecting the cells, the achievement is still a major step forward.
My friend, a physician, asked, “Can you imagine not having diabetes any more? No more shots, no more worrying about everything you eat, or about dropping low in the middle of the night?” The question startled me. While I had read about the transplants with great interest, I had done so more with the detached perspective of a journalist than with the thought that the breakthrough might affect me personally.
To be honest, I have a great deal of difficulty envisioning the scenario my friend described. It’s just too bizarre. ### |
Copyright 2006 Miriam E. Tucker. All rights reserved. |
|
