May 13, 2005

How I got here, part 3

I was unprepared to be hospitalized. I had nothing with me but my purse and coat. I wasn’t even wearing clean clothes. And who would feed my cats? Worse still, who, upon feeding my cats, would witness the condition in which I had left my apartment? Even on good days I’m, um, somewhat messy. And I had barely been functioning for weeks.

The fact that I was able to think of these things at all meant—to my very good fortune, especially considering how long I had ignored my symptoms—that I wasn’t on the verge of a diabetic coma or other disaster. 395, I learned later, is not a typical hospitalization kinda number. But Dr. Ketones hadn’t seen a lot of 395s in newly presenting diabetics, and she wasn’t taking any chances.

Snide commentary aside, I do credit this doctor with ensuring that I entered a controlled environment in which I was well educated, in a newbie sort of way, on the basics of diabetes self care. Still, it was an alarming SIX HOURS after my arrival at the hospital—four days and nine hours after my diagnosis—before I was finally offered my first injection of insulin. Why rush over a teeny tiny 395, I guess…

I gave myself that first shot in the belly after a nurse showed me how to draw insulin from the vial. Five units of Regular, it was. Along with the rest of humanity, I don’t care much for injections. But I wanted that one very, very much. I felt a difference within hours, the tentative return of something resembling not quite strength, but a bit of energy.

The petty indignities of a hospital stay were, I decided, the compromise I would make in exchange for those shots. Okay, this wasn’t so much a decision as a rationalization, considering that I had no choice in the matter unless I wanted to leave without that little glass vial. Nurses, I found, are—like all collectives of humans—a mixed bunch. The best was the one who showed me how to chart my urine output (!) so that I didn’t have to ring for assistance every single time I used the bathroom. The worst was the singsongy, oh-so cheerful one who MADE ME GUESS what my blood glucose was the morning after I started taking insulin. She stood above the bed and hovered, smiling, until I babbled something that may have sounded like a string of numerals. Then she said, “How does 140 sound?” I suppose she thought this was a chipper, uplifting way to deliver medical information to a disempowered patient. Bitch.

Once I’d had some insulin, the thing I most wanted to know was whether I had type 1 or type 2. If it was type 1, I knew I’d be on insulin forever; type 2 might have more flexibility. But the doctors couldn’t agree about my diabetes. The length of time I’d experienced symptoms, as well as my age and the lack of full-blown DKA, pointed toward type 2. But my physical profile (skinniness etc.) pointed toward type 1. Finally, blood work showed that my pancreas had gone on permanent strike. Type 1.

Along the way, I was almost put on Lipitor because my cholesterol was through the roof. The internist who prescribed it told me that the combination of diabetes and high cholesterol meant I was a great candidate for cardiac failure. Oh, good. Later, an endocrinologist came by, and I asked him if the untreated diabetes might be causing elevated cholesterol. Certainly, he said. So could I try to get the diabetes under control before taking the dramatic step of starting on a statin? Why yes, yes I could. Good thing I wasn’t taking a nap when he stopped into my room, I guess.

The very best thing about being in the hospital was that my people came to the rescue. My friends brought me books and magazines. (The most appropriately creepy thing to read while learning to give yourself injections, I found, is a brilliant children’s book called Coraline by Neil Gaiman. Things just aren’t right in that book, which is exactly how I felt.) My mom came all the way from Arizona to help me adjust to my new life. Yeah, she was the one who fed the cats and washed my stacks of neglected dishes. Mr. Brooklyn called constantly. And his mom, whom I’d met only twice, called too to give me a pep talk.

Other skills I acquired during my hospital stay included learning to walk while attached to an IV, the ability to tune out the constant moaning sounds made by my poor roommate, who was plagued with an unfortunate respiratory ailment, and, of course, how to check my own blood glucose so as not to have to rely on singsongy nurses for this information. I muddled through. They let me out on the third day with a pile of prescriptions, a rudimentary lesson in carb counting, and a fixed scale for insulin since I didn’t know my ratios yet. With my mom at my side, I wandered off into a brave new world of syringes, test strips, and Humalog.

And that's what got me here.


  1. Hi Violet!

    I really enjoyed reading about your experiences of diagnosis. What a ride!

    And look how far you've come since then! Now you're calculating basal & bolus rates, counting carbs, stabbing your arse with a teflon cannula wrapped around a needle, trying to fashion cats toys out of old infusion sets, etc. Who woulda thought...


  2. Hi Violet,

    I enjoy your commentary and thanks for sharing the three part story of your diagnosis. Yours is similar to mine. I was diagnosed as a type 2 four years ago (glucophage, diet and exercise) and this past December / January went into DKA - lost 30 pounds, was very week, no appetite, high triglycerides (1300s) and cholesterol (550s), potassium level of 2.3! My admitting blood sugar was under 400 but I was in very advanced DKA. Doctors couldn't believe that I was sitting up in bed arguing against being admitted - they expected someone in a coma after looking at my labs. Imagine my shock when they wanted to put me in the ICU. I am now newly diagnosed as a type 1 and on a pump.

    When you were diagnosed as a type 1, did the lab work confirm you as having antibodies? I ask, only because my GAD test came back negative.

  3. Scott, you are right, the frontiers I've breached are truly astounding. Ahem. And all this by age 33! Who says you have to, say, climb a mountain or publish a novel to succeed in life?

    Hello Anon, thanks for commenting. Wow, it sounds like you went through an awful time. Hopefully this problem of mislabeling LADAs as type 2 is on the wane as more studies are published that detail what we're all about. For my part, no, I wasn't tested for antibodies. The endo was satisfied that my C peptide result and physical profile confirmed me as a type 1, and so was I. I've read that the antibody tests can generate false negatives, though I'm not sure why that is.

  4. Hey Violet,
    I hear you!! All I had with me was my purse and a thin sweater. My hair wasn't washed, and my 5-month-old baby and her two sisters were sick at home. And I beat you: they kept me in for 5 days!!

    (I've posted a rather condensed version of my story on my blog)

    But we're BETTER now, aren't we?

    - Amy

  5. Had to mention, Neil Gaiman is a NICE, NICE GUY. I met him on an online site as I was collecting items for a JDRF auction that romance author Brenda Novak is doing online. Without question he donated a signed first ed of .... CORALINE!

    I'll go to my blog and post the link to Brenda's auction now.