Tuesday, April 18, 2006

Five Years on Sunday

I'd better just post this now...because I don't know if I'll be back (or awake enough) to post Sunday. The ADA Expo is Sat, and I may turn it into a weekend deal.

7.5 years with diabetes. Five, on the pump. Five year (increments) anniversaries always feel like big ones.

There's the "1" year (diabetes for one year, pumping for one year) anniversary- you think you know everything.

5 years- You bemoan the fact that there STILL isn't a cure, or a decent continuous glucose monitering system.

10 years- I expect to feel old, but I hope diabetes technology will have GREATLY improved. Always knowing what your bg is, would be so wonderful.

15 years- By then, a cure. Period. End of discussion.

But back to that day...

Monday, April 23, 2001 dawned clean and clear. I was more then ready- I'd been waiting months for this day.

6 A.M. (knock on parents' door)
"Dad, can we leave now?"
"NO-it's 6 AM. We don't have to be there till 9:30. Go back to bed."

7 AM (knock on parents' door)
"Can we leave NOW?"
"No, we're leaving at 8- we're not getting there really early!"

8 AM (knock on parents' door)
"Can we puh-lease leave now?"
"Ok. (sigh) Got all your stuff?"
"Daddd, of COURSE." (teenage indignation)

9:30 A.M.- Sitting in the CDE's office, impateintly waiting for the other trainee to show up. My dad, after talking to the CDE, leaves. (I'm a big girl, I'll pretend to be fine for the next 30 hrs.)

10:15 A.M. - Still no other trainee. I've bounced around, triple-checked my new pump + supplies, visited the restroom and read the the too numerous journal articles lining the walls of the room. Things need to start, before I go nuts.

10:30 A.M.- 12 year old trainee shows up, with her mom. It's re-training for her, she's already on a Disetronic.

Carb Counting. Basals/Boluses. Infusion sets. A brand new world.

And a brand new meter- the One Touch Ultra has hit the market. Pediatric CDE gives us both one, along with strips/lancets/ Minimed sets.

Blood Sugar Check- its time to put the training in action. 5,4,3, 2,1- I'm never going back to the 45 second Accucheck. This meter is so unbelievable.

236.

My fellow trainee smirks from across the table. "Ha ha, I'm 186."

Brief irratation at this immature juvenile. "Big deal, that's not a great number either."

Mom isn't watching. "Andi (CDE)- can I get you to look at her stomach sites? I'm really concerned about them."

CDE looks at them, studies them, analyzes them to the nth degree. Leaves room.
"She's got a rash- better stop using the stomach for awhile, put lotion on them. Talk to Dr. (X)
if they don't clear up."

CDE is busy quizzing me on what to do next. "How much insulin would you take for a corrective bolus?"
3 units, ok. Knew I'd be high anyway, I'd skipped the prior evening's Lente. (as per instructions)
12 year old is punching in her bolus like a pro. Well, she has been pumping 7 months. I try not to gape. Someday I'll be doing that.

Stuff all my new stuff into my supply box, self-consciously adjust the pump onto my jeans waistband, and prepare to move on out.
Next Step: Admission.

"Here, I can take that." My CDE relieves me of the supply box, I've only got my duffel bag and backpack to take care of now.
Past the Medical School Auditorium. Down the elevator. Down more hallways.
I see a sign for the Morgue.
"Are we near the morgue?!?"
"Yes, this is the basement."
I wish I hadn't asked. Probably lots of people who didn't take to pumping, ended up down here.
Up another elevator. Around to the cafeteria.
"Hon, I can take your stuff up. You can eat lunch with (the dietician), and she'll bring you up when you're done."
I hand over the rest of my stuff. "OK, thanks."

We have a very healthy lunch- which the dietician payed for. I couldn't eat anything sweet, until boluses were figured out, but I wasn't hungry anyway. Dieticians can be nice people- despite the intial awkwardness. She made sure I bolused appropriatly, for every bite.

Lunch being over, we headed up to the pediatric ward, where the nurse/intern on duty were waiting.
First, its the nurse's turn. Tons of paperwork. A blood sugar check, revealing a number deep into the 400's.
She freaks, and goes to tell the intern.

The intern shuffles in. Tall, skinny, shaved head. Facial complexion a chalkish white-green. Either an Ex-Member of the Grateful Dead, or having some serious medical issues himself.
"What're you in for?"
Brief confusion- aren't they supposed to already know this stuff?
"Starting an insulin pump."
"Ok. What's that?"
"Ummmmm, its a pager type thing, and it goes through a tube to my skin," I reply, wishing I could explain it better.
"Ok." Nothing on his face reveals whether he gets what I'm talking about. Suddenly, I wish very strongly that my own endocrinologist would show up + prevent an ensuing disaster. I don't feel confident that this guy knows squat about type 1 diabetes.
"Ok. Let's talk about your current medical history."
Yes/No/Yes/No.
Diagnosis: Perfectly healthy in every regard, except the D.
He reads the nurse's note. "Checked ketones?"
"Yeah, I'm moderate."
"Ok. Let me check on something." Leaves room. Comes back in. "Take 8 units."
I remember how to bolus, and I do so. Take nap, drink fluids, feel rather nauseus.
6 pm- Supper arrives, on the dot. I eat half of it, bolus for the whole thing.(still feel high)
8:30- 121.
Hourly blood sugar checks, all night. Study for final exam, watch movies, fall asleep.
7:30 AM- Ped. Endo checks in.
"Your overnight basals are great...you were between 110-121 ALL NIGHT. Still have to adjust the daytime. Couple of hours, we can discharge you."
8:30 AM- I eat breakfast, bolus, and promptly skyrocket to the mid 300's. Not so simple, this pumping thing.
9 AM- Intern pops back in, medical student in tow. "Wanna show my student your pump?"
I do so(while the intern scribbles in the chart). Medical student is duly impressed.
9:30 AM- Ped CDE pops in again, reviews various things. I still feel incredibly dumb, but figure eventually I'll know it all.
12 PM- Lunch time. Unfortuantly, I'm still mid 300's, and I have got ketones (yet again). Ketones= no discharge, and I'm in panic mode (thinking I won't get discharged in time to make my final exam, and if I don't make it to that class, I flunk). Of course, the more I worry about it, the higher my bg goes. I bolus well, skip lunch, and pray to get discharged quickly.
2:30 pm- Mid 300's, but ketone free.
"Ok, we can discharge you."
I'm packed, and ready to go in a matter of minutes. I call my parents, and my mom starts out to come get me.
3 pm- Still waiting on discharge paperwork. I may have to start walking, if these people don't hurry up. Can't be late for class!
3:15 pm- Admit to the other side of the room. Chat briefly with the mom, think how lucky I am that I just have diabetes.
3:30 pm- Nurse arrives with discharge paperwork. I sign, grab belongings, and make a beeline for the elevator.
3:35 pm- Mom arrives, picks me up.
5:30 pm- Deliver speech on childhood diabetes, (final exam) get an "A."
6:00 pm- Classmate gives speech on kids with diabetes/insulin pumps, looks in my general direction, and tells me I might want to consider getting one. I am too incensed/embarressed to merit an intelligent reply, I hunker down in my seat and glower darkly.(A. It was a really bad speech, and B. I'd wanted the topic) And I see her Disetronic, for the first time that semester. Never knew she even had diabetes, thought she just knew someone with it.
I mutter something to the effect of "Maybe" and long for class to end. (Never told her I'd just gotten a pump)
Every "Pumpversery", I go out to eat (pump anniversaries are much more fun then dx anniversaries!) Don't know where yet- as I still may be in DC.

4 comments:

Ellen said...

Zack loves the Ethiopian restaurants in DC - yummmy. Good luck estimating the carbs :-)...

Happy Pumpversary.

type1emt said...

Heh Heh..
I'm pretty bad guestimating Arabic/Middle Eastern foods, much as I love 'em.(Ethiopa is N. Africa,right?)
(I think I'd better stay away from foods that don't have the nutritional info provided!)

cHoCoMiLkRoCkS said...

can't wait til i've had my pump a year, i'll have a big night out and get drunk and have lots of hypos i gues!!

Anonymous said...

^^ nice blog!! ^@^

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