Tuesday, May 17, 2011

Four Years Ago Today...(Part One)

I was missing my college graduation.  I was in the critical care unit (CCU) of the Lehigh Valley Hospital-Muhlenberg. Four years ago today I was a type 1 diabetic, just like I am today and will be for the rest of my life.  Four years ago I was not taking any insulin, was incredibly depressed, and was slowly killing myself.  Most significantly, I was without any hope that things would ever get better. 
            I have had type 1 diabetic since I was three and a half years old.  People usually comment that it “sucks” that I’ve had it all my life, but it’s all I’ve ever known.  Most of my early memories involve life with diabetes:  my initial hospital stay following diagnosis and hanging out with my imaginary friend Geek, my grandparents babysitting me at a young age and my grandmother being terrified to inject me with my insulin, my mom going on almost all grade school field trips just in case anything should go awry with my diabetes, a family vacation to Washington, D.C. that got derailed by a low blood sugar related hospital trip. 
One would think that most of my diabetes memories would be negative, but I have had many amazing experiences as well.  I attended two diabetes camps (Camp Setebaid in Shickshinney, PA and Camp Crestfield in Slippery Rock, PA) for one week every summer from the ages of eight to thirteen with kids my own age who all had type 1 diabetes too.  I then went on to become a diabetes camp counselor at one of these camps and continued this endeavor through my college years.  At these camps, I realized I was not alone, met lifelong friends, and shared laughter at the “black humor” that comes part and parcel with a chronic disease – those little inside jokes that only someone else with diabetes could possibly understand. Freshman year of college, I was struggling through a brutal Biology lab and realized another girl in my class was also a type 1 diabetic.  We instantly bonded over this connection and became immediate friends.  All throughout college we shared diabetes related experiences. We would have been friends even without diabetes, but I know that the camaraderie that comes with sharing a chronic disease really cemented our friendship. Today she is still the person I text when I’m having “one of those days” with diabetes and need to vent or get some feedback.
            Diabetes has always been part of my life and I always did a fairly good job of managing it and still maintaining the life I wanted to lead.  As I grew up my parents were amazing– I played sports, went to sleepovers, lived at the pool in the summers and generally had a “normal” childhood; they made sure I was not inhibited by my diabetes.  My first year at diabetes camp, I learned how to give my own insulin injections and gained a lot of independence with this responsibility.  Life was good.  High school came and I began to struggle with my diabetes.  Some days I felt like I lived in the nurse’s office, drinking juice boxes when I was low and guzzling water when I was high.  There were stretches of time when I felt awful.  Looking back at school pictures from high school, my skin has a greenish tint and I just did not look healthy.  My blood sugars were wildly inconsistent and I gained a good deal of weight from feeding low blood sugars and taking massive amounts of insulin for high blood sugars.  I vividly remember one of the other diabetics in the school, a boy a year or two older than me, who seemed like he had the easiest time with it, breezing into the nurse’s office a minute or two before lunch to check his blood sugar and go about his day.  It was like one of those diabetes commercials where the meter always reads 108 (would love to see a commercial where it was realistic and the meter read 289 or 43). I felt like my diabetes was out of control and it affected the quality of my life.  I was able to maintain As and enjoy social events throughout high school, but I oftentimes felt lethargic and unhappy with how things were going.
            The transition to college was wonderful for me.  I loved Lafayette and made great friends quickly.  I began using the gym at school and started making healthy choices and lost some of the weight that the highs and lows of my blood sugars created.  I decided that the insulin pump was not for me and went back to using Lantus.  I had success with Lantus and my A1c (three month average of blood sugars) was in healthy range.  Freshman, sophomore, and junior years flew by and I enjoyed the typical college experiences.  At the start of senior year, I was uncomfortable with my weight.  I was also stressed with the thought of “the real world” looming and was unsure about what my plans would be once graduation day came.
             By second semester I had spiraled out of control. I was actively diabulimic.  Diabulimia is the condition in which a type 1 diabetic does not take the insulin that is needed to maintain good blood sugars and essentially sustain life.  I started off by just shaving a few units off here and there and saw that I was losing weight without having to watch what I ate and without having to work out. I gradually shaved more and more insulin off until I was taking the bare minimum needed to make it through the day. I felt horrible.  High blood sugar feels like you’re stuck in a desert without water anywhere in sight. You can’t think clearly, you have zero energy, you’re extremely cranky and you generally just want to be left alone to feel miserable and crave fluids.  You also need to urinate a million times a day. I am exaggerating when I saw a million, but it was upwards of fifty times a day sometimes. A lot of the time.
Despite this horrible feeling dictating my moods and energy levels, I was losing weight and I was getting compliments. I felt like I was in control of something when everything else was out of my control. It’s hard to hear, “keep doing whatever you’re doing because it’s working!” when you know what you’re doing is destroying your body and wreaking havoc on your life.  It’s hard to have clothes that never fit before suddenly fit like a glove and not keep going. It’s hard to have guys who were always “just friends” now wanting to buy you drinks and take you out and not try to shave just a few more units of insulin off the daily total. It became an obsession of seeing how much I could get away with.  Some of my friends knew something was going on, but like anyone who has tried to hide a secret of this magnitude, I snapped at them and told them I was fine whenever they mentioned anything. 
Literally every single night I would lie in bed and promise myself that the next day I would get back on track. I’m not stupid; I knew the things that I was doing to my body and I knew the complications I would be likely to face if I kept this up.  So many nights were spent crying in bed because I wanted so badly to give up this vice, this horrible secret that was dragging me down, but I honestly did not think I would ever be able to do so.  It was a vicious cycle of the sweet relief of saying “I’ll start over tomorrow” and then being sick all night and not sleeping and waking up with a horrifically high blood sugar that made me just want to give up and continue on the path that I felt I was doomed to take. It was a very dark time that culminated in being so sick with DKA (diabetic ketoacidosis or extremely high blood sugar coupled with ketones) that led me to be hospitalized for my college graduation.
            You would think that this hospitalization would have been the breaking point, the straw that broke the proverbial camel’s back, but I did not recover at this point.  I did not come clean to the doctors in the CCU or to my parents. I pretended I had no idea why my blood sugars were so high that they literally could not be read on my meter. I came home from the hospital and managed to do okay for a day before I succumbed to the siren call of high blood sugar. I was so used to feeling “high” that it became normal to me. Looking back now it is absurd to me that frequent urination, mind numbing headaches, ridiculous thirst, and general apathy towards life was my “normal,” but it is sad to say that that is what I could deal with and actual normalcy was unfathomable to me.  I was also absolutely terrified that if I even took a unit or two more of insulin than I was taking I would immediately gain ten pounds. It was a very real fear at the time and enough to keep me shackled to this lifestyle post graduation.
         That is a lot for one post, so I will end here and break this into two or three parts. Rest assured that things got better for me and my life in now incredibly different from the way it was four years ago. Stay tuned for part two!

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