What do I mean by that, conscious pancreas?
It’s difficult to put into words, being a conscious pancreas has become so much a part of my life in the ensuing 16 years that I sometimes don’t think about it, but then a week happens like this past one which was extremely difficult. BG levels diving to 40 and soaring to 350 and back again in the space of a few hours insinuates itself into the brain and the body and the resulting feeling is akin to being severely beaten over and over again. I just don’t have the bruises to show for it on the outside. Today I can only describe myself as in “recovery” from this week-long bout. Now, I hadn’t binged on anything, except maybe celery. I also hadn’t skipped meals or done anything particularly differently than the week before. Yet, it happens. This is diabetes.
Technically, I am a Type 1. I was diagnosed when I was 37, just on the razor-edge of an invisible line that the endocrinology community used, at least in 1994, to distinguish between Type 1, or Juvenile Diabetes, and Type 2, Adult Onset Diabetes. It was as if my pancreas was stuttering, sputtering to a halt. It felt much like menopause when the women’s system shutters to a halt over years of sputtering. However, I have many symptoms that are apparently Type 2-esque and many more that are Type 1-esque. Confounding and confusing, my current endocrinologist has decided just to call me a “Type 3.” Great.
Endocrinological humor, I suppose.
I have since been in the hospital for another aggravation and had to have a “consultation” with the endocrinologist on staff. He suggested that I present as Type 1, but due to pancreatic failure. That sounds more correct. From 13 and the bleeding ulcers that almost took me out of this body, I was, what I now know to be Hypoglycemic. My BG dropped precipitously and unexpectedly for years. I had no idea, nor did my family, that it was pumping insulin to the point of exhausting itself. But, I digress, again. I was discussing being a conscious pancreas.
Think about this. When a body system fails, what happens? If it’s your heart and/or circulation system, you might have a heart attack. You might have congenital heart failure. You might have a stroke, aneurism, angina attack, etc. If you have arthritis, there are several types that can afflict the human body in some horribly painful and disfiguring ways. Your lungs can be afflicted by COPD, asthma, emphysema, and other painful breath-defying problems. There are brain issues, muscular issues, tendon issues, ocular issues, sinus issues, ad nauseam. Some of this unpleasantness can even be “controlled” with drugs, diet, and exercise. The control factor in all of these diseases is diet, exercise, and some medications. True enough for diabetes, as well, but you also have to factor in a need, no a necessity, to be conscious of everything that your body is telling you and to check in on that very often, especially if you are a busy and/or active person.
Now, consider Type 1 diabetes. Honestly, I can’t speak well to Type 2 since I don’t have that, but I assume at some point, insulin dependency will lead to a similar circumstance. Allow me to walk you through a day in my life in which everything goes according to plan.
7am-ish: Rise and Shine: [I’m doing a full-term workday, here, by the way.]
1—remove CPAP mask and smell the air
3—start coffee if spouse is still abed [so far, so good, right?]
4—take BG for the morning. Hope the number is between 80 and 180. Let’s say, 130 for the morning. That’s good. Plug it into the insulin pump and see if there is a recommendation for a correction. [there usually is not when BG is at that level in the morning.]
5—drink coffee and talk to my honey while the oat meal cooks.
6—shower and dress.
7—Bolus for oatmeal, 30 grams of carbohydrates, and eat.
8—take medicines for the day—blood pressure, check; Prozac, check, diuretic, check; statin, check, glucophage [remember I’m type 3], check; naproxen sodium or tramadol and Soma, if anything is aching, check.
9—kiss my honey, who, has already packed food for my day and started the car for me if it’s cold. We have a two-minute warning for the car.
10—drive to work. Go to my office.
11—get ready for my first class, always at 9:30am.
12—check BG before class. Let’s say 150. Good.
13—teach for one hour and fifteen minutes +-. Talk to students who need me.
14—return to my office. Chat with colleagues getting there.
15—check BG after class. Let’s say 113. Good, but iffy. Eat something, yogurt, granola, nuts, fruit, whatever. I cannot allow it to go too low.
16—go to next class or meeting [there’s always something!]
17—teach or meet for one hour and fifteen minutes +-. Talk as above. Return to my office, chat, etc.
18— check BG. Let’s say 176. Good.
19— correct and eat lunch, soup, leftovers, salad, etc. as I have one and one-half hours of down time.
Let’s just pause here for a moment. It’s now about 12:30 pm. That’s 5 hours. That’s five hours on a good day. Okay, on we go!
20—check BG. After lunch, it can go up a bit, so let’s say 185. Not bad, considering. And, since I’m going back to the classroom, I won’t correct.
21—go to the next class or meeting.
22—teach again, for one hour and fifteen minutes +-. Talk as above.
23—by now it is about 3:15 in the pm and I can either go home or go to one more class time. In either case, I check BG. After teaching, it can fall rapidly, so let’s say 99. Now I need to correct for the low-end of the BG spectrum, especially if there is some insulin still working in my system. Fortunately, the insulin pump I use tells me that information. Once I reach the 90s, chances are very good that if I don’t give myself a dose of sugar [usually in the form of a fast-acting glucose tablet or two], I will have a hypoglycemic, or insulin reaction, episode.
24—so, by 4:30 or so, I’m ready to back it up and hit the road to home.
25—check BG one more time before driving. Let’s say 125, remember, it’s a good day.
26—Home, Sweet, Home. These days my honey is likely to have some sort of supper in progress so I can actually relax and put my feet up for a while.
27—before eating the evening meal, check BG. Let’s say 170. Correct and bolus for the food and eat.
28—read, write, make jewelry or crochet or sew, watch a movie or TV, or just chat and listen to music with a glass of wine with my honey until bedtime, hopefully around 11pm. If it’s warm or cool enough out, maybe a bike ride to the beach.
29—check BG. Let’s say 140. Excellent. No correction needed for bedtime. If my body is aching, I’ll take a pain reliever to sleep undisturbed.
30—to get into bed, I fill my CPAP reservoir with distilled H2O and pull on the mask. It takes me a few minutes to fall asleep.
Thirty steps. From 7am to 11pm, every day, no matter what. The activities change if I’m home for the summer or winter break, or on vacation, or visiting family or friends, but the stages are the same as long as it’s a “good day.” Now, if it’s a not-so-good day, then add the following steps and feelings.