What Do You Mean I’m Diabetic?

As an RN for 10 years in the summer of 1995, I knew the symptoms of diabetes.  I had them all. And I ignored them.  I peed a lot, couldn’t get enough to drink (non-alcoholic, thank you), was losing weight (a good thing), and had times when my vision was so blurred that I couldn’t differentiate the words on a page- it was all just gray blur.  I figured it was just because of a recent diet change (to lose weight), and I’d be fine.  *palm forehead*

I started (or restarted) a job at a community hospital in the Texas Hill Country.  It was their practice to do a urinalysis, drug test,  back x-rays, and have one of the ER docs do a viability check once the offer of employment tentatively had been made (adjusted if anything came back on the back x-rays, or drug test in particular).  I’d worked there before; I knew the drill.  I got a call to go talk to the employee health nurse. That was odd.  I knew Patsy (pseudonym) and she didn’t just call people to her office to chat.  She had something to tell me.

I got to her office, and she was her usual friendly self, but had a look of ‘this is business’ on her face.  She had me sit down across from her desk, and handed me my urinalysis.  She asked me if I saw anything wrong.  It was glaring.  There should be no glucose in urine.  I had a level over 2000.  There was only one logical deduction. I had diabetes.   I just looked up and started bawling.

She told me they’d get me into the diabetic teaching classes; being a nurse taking care of someone was way different than having the disease (boy, she wasn’t kidding).  She’d get me in contact with Charlene (not her real name, either), the in-house diabetic support person (who also taught the classes). And, they’d get me an appointment with a family practice doctor to get this all seen and verified with fasting lab work.  My random fingerstick was 389mg/dl- with no symptoms, and on a basic, ordinary day. Not good.

I saw the doctor, who ordered a fasting blood sugar (240mg/dl) and A1C- 10.2 (should be below 6 for a non-diabetic, and ideally below 7 for a diabetic).  She didn’t want to start insulin until a trial of diet and exercise was done.  She also didn’t want to start any oral diabetic meds.  I was fine with that.  I did well on diet and exercise- and before long had my blood sugars in the normal range for a non-diabetic.

I went to the classes and learned a LOT.  Charlene was a major advocate for diabetics, and knew a lot from having a diabetic son.  She had invaluable information.  She taught the day to day living stuff. As a nurse, I knew the clinical stuff. There’s a huge difference.

I’d been taught the signs and symptoms of low blood sugars, and one of my supervisors would go running for a half of a pimento cheese sandwich if I ever said I felt tired, edgy, shaky, had a headache, or felt my heart racing (never mind I’d be running around all over the hospital floor where I was the charge RN).  She was taking NO chances 🙂

I lost weight to the tune of about 100 pounds total, from the weight loss before being diagnosed, and then by not so healthy ways when I tried to lose weight after being diagnosed (focusing on food and weight loss had been an additional factor in relapsing into eating disorders about 5 months later).   My blood sugars were normal nearly all of the time.

I want to emphasize that this didn’t mean I was no longer diabetic.  I was in control of the diabetes.  There’s a huge difference.  I still had to monitor my blood sugars (though not as often), and let doctors know I was diabetic if I had to have any medical testing done.  I couldn’t go back to my pre-diagnosis state, and just ignore that it was there.  I did have episodic lows, which isn’t that common, but can happen in type IIs not on medication.

It took 12  years before I needed to start medication. That pill made my stomach a mess.  I started insulin later in 2007 ( a few months after the cruddy pill) , and that was the best thing ever for my blood sugar control.  It was some work initially to figure out the dosage of the long-acting ‘basal’ insulin (Lantus for me), and the rapid acting (NovoLog) for before meals.  I had to do a lot of testing before and after meals to get the right ratio down, and I found that the more tightly I calculated my carbohydrates, the more flexibility I actually had.  Things were going well until I was diagnosed with leukemia, and have had bizarre blood sugars on, and now off,  chemo.  I’m still working on getting it back to a reasonable level.  It gets frustrating.

I’m a stickler for numbers. When I saw my AIC going up prior to starting insulin, I wanted something done. I didn’t want to wait until it got into the ‘bad’ range.  I saw no reason not to  be proactive, and waiting around for bad numbers made me mad.  The endocrinologist I saw was dragging her feet so I talked to my Coumadin nurse (a nurse practitioner) who had no problem starting me on Lantus.  My numbers almost immediately got better.  I had to be my own advocate.  The fired endocrinologist wasn’t doing anything productive.

I also learned that having diabetes is so different than taking care of patients with diabetes as a nurse.  There is no connection.  Those sliding scale doses of insulin are useless unless they are very specific for the specific patient’s numbers. If I didn’t tell the doctors and nurses  I have my ratios figured out, I would have gotten some ridiculously low dose when in the hospital.  I had to speak up.  I also know what foods make my blood sugars weird- they’re different for each person.  I know to have proteins and/or fat with carbs to level things out. Some emergency room folks don’t have a clue about that when treating lows.  There was a lot to learn, and in the process I learned to look at each diabetic person I took care of as what they were- an individual.

Now, just to get things back to normal after chemo…that was a game changer.

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One thought on “What Do You Mean I’m Diabetic?

  1. You can definitely see your skills within the work you write. The arena hopes for even more passionate writers such as you who are not afraid to mention how they believe. All the time follow your heart.

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