Friday, 13 April 2012

Looking Back

Sometimes it's important to look back, to see where we've come from, what has changed for the better and what has changed for the worse. Since I wrote this piece for English class almost four years ago, I have been using the pump and CGMS. Diabetes has become harder to manage, and I've tried my best to rise to the challenge. I still have the same undercurrent of fear that I can feel when I read this essay, but I think it has become less strong. I have been forced to face up to the clinical depression which has been present in my life for a long time but which recently became more severe. I have been weakened, and I have grown stronger. I have tested my blood glucose tens of thousands more times. I have changed hundreds of pump sites. I have been faced with serious lows and highs which made my head sticky and my mouth feel like the Sahara. I have tried hard, I have struggled, I have won, I have lost and I am still fighting.

A Silent Attack
Four thousand two hundred blood sugar tests; one thousand seven hundred and fifty insulin injections; one thousand and fifty high blood sugar levels and seven hundred low blood sugar levels. Four hospital appointments; six blood tests and three days in the paediatric hospital ward with an intravenous insulin drip.

On Friday July 6th 2007 my life was changed forever.

On June 27th my Grandma came over for dinner. When she arrived, she hugged me, and drew back, surprised. She was shocked that she could feel my ribs through my clothing. I hadn't been feeling too good for a while; it had been harder than usual to focus at school, and I was sleeping a good 12 hours a night.

On July 6th, I went to my doctor. She tested my blood sugar levels, and acknowledged the result with a short, hesitant gasp - the drawing of breath that I knew even then was going to change my life forever. As if I were someone else, watching from far away, I saw disbelief on my mother's face; she never thought this would happen to her daughter, who was still, at fourteen, her little girl.

"I have a girl here who needs to be admitted to the children's ward. Blood monitor reads off the scale, ketones positive times 5. Some symptoms of ketoacidosis, but her blood acids haven't been tested. Only weighs 40 kilograms." These foreign words broke through the fog of my mind, bringing to life my situation and sending me down to earth with a bang.

My hospital stay was a flurry of "don't worry, this won't hurt"s and "you'll just feel a little prick"s, none of them true for me. I was shocked, even then, by the extent of the pain of a chronic illness. Everybody said it would get better with time, but I didn't believe them - why would I have done? I had just been thrown into my worst nightmare.

Once I'd had my first shot of insulin, my blood sugar level plummeted back into the 'normal range,' which shocked my body, which was used to elevated levels, used to being off the scale. That shaking, the fog, which seemed to seep through every passage of my brain, that feeling of losing control, was my first of many experiences of what hypoglycaemia felt like.

"Now, don't worry, Emma, you'll still be able to have children. They will have a 3-4% chance of developing type one diabetes, but as long as you keep your blood sugar in good control throughout the pregnancy, there shouldn't be any complications." These words stunned me - not because I'd thought I wouldn't be able to have children, quite the opposite, but because nothing like that had ever crossed my mind. I hadn't had time to think, at that point, that somehow this disease was going to infect every aspect of my life, to somehow become a part of me.

It was when the nurse handed me the insulin pen that I broke down, for the first time. The needle was only small, but what it symbolised was much greater. A new lifetime dedication was being forced upon me, a condition which I had never asked for and certainly did not want.

The first night was the worst; my head was still spinning from flashbacks of the doctor's face when she had gasped... When she had phoned the hospital... When the letters "HI" had appeared on the blood glucose meter. The hospital contained everything I didn't want to face; the smell of the food and the hallways jolted my mind back to just one month before, when I'd seen my granddad for the last time in that same hospital.

Type One Diabetes is a chronic condition, which results when the body develops antibodies towards the insulin producing beta cells in the pancreas. An auto-immune attack results, which eventually entirely destroys that part of the pancreas, leaving it incapable of producing insulin. The function of insulin in the body is to lower the level of glucose in the blood, by allowing it to pass into cells in the body and be used to provide energy. When there is no insulin, therefore, the blood sugar level just keeps rising, until, in a worst case scenario, the person could go into a coma or even die.

I learnt all this during my time in hospital. At first it seemed a foreign language to me, the words meant nothing, but now each of those words registers clearly in my brain, and I know what it means almost too well. I now know the carbohydrate contents of most common foods (I have to count carbohydrates in order to balance them out with insulin); I know my acceptable blood glucose levels for all times of day, every day; I know how I feel when my sugar level is high; I know how I start to act when it gets too low.

In the beginning, to treat my diabetes, I was put on a treatment of two insulin injections a day. Whilst taking this, I had to eat a set quantity of carbohydrate every two hours in order to keep my blood glucose levels steady. This treatment did not work for me; my blood sugars stayed high and would not come down, no matter how little I ate, or how much insulin I took.

I have now moved onto a more effective treatment - injecting insulin every day in the evening, as well as whenever my blood sugar is high, and whenever I eat something containing carbohydrate. This generally totals to around six injections a day, but can be as little as four or as many as eleven or twelve. Sometimes I still become frustrated - it is a heavy burden for anybody to carry, every second, every minute, of every day. And sometimes it still feels that I live for my health - everything must be weighed, factored and counted, nothing can be spontaneous anymore. A simple cold or flu, or sickness, can turn into something serious, possibly requiring hospitalisation. However, a life like this becomes normal, and most of the time I don't even think about it anymore.

Soon, I will be tied - quite literally - even closer to my health. An insulin pump is another method, uncommonly used in the UK, to gain tighter control on blood glucose levels than it is possible to do on injections. Using this treatment, insulin continuously infuses into the fat below the skin using a tube from the 'pump' (an object around the size of a mobile phone, which contains insulin) which is connected to a cannula, a flexible plastic tube which must be inserted into the fat on the abdomen, thigh or arm every two days. I will still have to test my blood sugar levels, program my doses into the pump, and count my carbohydrates, but new technology provides better accuracy and precision, and less room for error.

I am not condemned to die young, or to suffer greatly in the preceding years. But when uncontrolled, diabetes is a silent killer, causing the diabetic to battle with the prospect of kidney failure, blindness, stroke, heart attack, and many other potential complications.

People with diabetes have an average life expectancy less than those without, but I will not become another statistic. With everlasting vigilance, and the best control I can hope for, I will live as long as I can, and achieve everything in my life that it is possible to achieve.


  1. Saw your tweets tonight about panic-eating and the aftermath. I felt like I should do something, but I don't know what.
    I can't pretend to know what the panic is like, and I know that giving you rational arguments about why you shouldn't feel so bad isn't helpful.
    I just want to say I care what happens to you. I wish I could help. I know you have others who care much more than I do.
    Better days.

    1. I just wanted to comment on this so that it didn't go unnoticed - this particular blog was written by me and the tweets you saw last night were from Kate (we are actually two different people, not just split personalities ;)). I will let her know about this comment, and hopefully she'll write another blog here soon. :)