And Then Life Sends You Sprawling

Well, I certainly did not see coming what happened last week. Of course, hindsight is wonderful and as I look back it's easy to smack myself on the forehead with a loud "Doh!" escaping my lips. But anticipating? No.

We have known since last summer that Justin was pre-diabetic. It was inevitable, really, thanks to his first nasty bout of pancreatitis wherein his pancreas attempted to destroy itself in one long temper tantrum. Thankfully the good doctors and nurses at the hospital intervened before it succeeded, but not before it permanently damaged itself. Justin came out of the experience with a smaller, more petulant pancreas than before, but one that still worked. Last summer, though, he began showing classic symptoms of diabetes and his doctor confirmed that his body wasn't managing insulin very well any more. He put Justin on a couple of typical medicines to try to regulate some things and stimulate others. Justin monitored his blood sugars faithfully for several months until everything leveled out.

This spring, though, it seems his pancreas decided it was done producing insulin and decided to not give official notice. It just quietly stopped doing its hormone job. Due to some other concerns, the doctor recommended Justin get a colonoscopy. We quickly discovered Justin's body couldn't handle the regular prep for that. The medicine made him so sick I had to take him to the ER and cancel the first colonoscopy appointment. We tried again 10 days ago, with a two-day prep and slightly more gentle medicine. Same physical response, but this time he went from the ER to the Adult ICU and stayed there for nearly a week.

It seems Justin has had full-blown diabetes for several months now without him realizing it. He feels awful all of the time anyway, so as the diabetes slowly cranked up he didn't notice. I don't know how long we would have gone before anyone would have thought to check his blood sugars and figured out how dangerously high they were. He had so much blood work done in the ICU that the first pair of phlebotomists bought him a smiley face get well bucket of goodies from the gift shop after having to come four or five times in one day, trying to find any kind of a vein from which to draw blood. The doctor finally ordered a PIC line.

His hospital stay centered on evening out his blood sugars, insulin, and electrolyte levels, plus trying to calm down his pancreas which had flared up with pancreatitis (thankfully not the necrotizing kind this time). We had doctors focused on his diabetes management saying "Eat food!" to work on balancing insulin and glucose, but towards the end another doctor saying, "Clear liquids only!" to calm down the pancreas. Eat. Don't Eat. Take this medicine. This medicine is too punishing on pancreases. It's been so confusing for two and a half years.

I have to admit it was a little scary coming home. Coming home with full-on diabetes is a little like coming home with a new baby. The Diabetes Baby needs constant monitoring, special supplies, and the learning curve at first is very steep. And you must be sure to have the special supplies with you everywhere you go. I'm in the process of trying to put together little kits for each car and for Justin's desk at work that will have back-ups of testing supplies, low blood sugar glucose tablets, and needles. Insulin can't be kept in the car. It's almost like carrying around a diaper bag, but more discrete. I've also made special shelves for diabetic supplies in kitchen and fridge, not unlike the shelves for baby formula and supplies when my children were infants.

I also didn't think I would ever be able to give someone else an injection, but at least with the insulin pen needles it's pretty slick. I haven't had to use a syringe yet, but we should probably get some of those as a back-up.

In a way, for me at least, a diagnosis of diabetes is almost a relief. I know Justin hurts and is often feeling nauseated. Doing something for those symptoms is a combination of imprecise, crossing-fingers-I-hope-this-helps-this-time, therapies. With diabetes, however, there is a clear, specific set of guidelines to take care of it. If blood sugars are low take three Jolly Rancher candies or drink a half cup of juice, wait 15 minutes, and retest. We know what to do if his blood glucose is high or how to compensate for the specific amounts of carbs he may eat at a meal or snack. Specific. Treatable. Precise. Everything Justin's health has NOT been for the past two and a half years. Hopefully treating this element will help Justin feel just a little better, like he has just a bit more energy. It's not going to solve the bulk of his health concerns, but I am hoping it will take the edge off the awfulness.

We got tripped up, certainly, but we're dusting ourselves off and standing back up.