Showing posts with label type 1 diabetes. Show all posts
Showing posts with label type 1 diabetes. Show all posts

Friday, June 3, 2016

Diabetes and Faith's Fallacy

I was diagnosed with type 1 diabetes on April 15, 1976, at the age of 3, ironically up until recently tax day in the U.S. I have now lived over 40 years with this chronic, yet treatable, disease.

Once again, I discover that foolish parents with misguided religious faith have opted for prayer to "help" their child rather than proven medical science.

I have gone to a hospital emergency room with perilously low blood glucose levels. In humans not afflicted by diabetes or other metabolic dysfunction, "normal" blood glucose level in humans ranges from around 70 to 100 mg/dL. Using a modern glucometer, I (or my wife, if my sugar were so very low) would measure ranges as "high" as 30 to as low as 17 (my personal all-time record on the low end of the blood sugar spectrum).

Why does low blood sugar happen in the first place? 

Sometimes in those with so-called labile or brittle diabetes, one's system is compromised such that blood glucose levels fluctuate wildly. For others with type 1 diabetes though, it can simply be the result of poor choices and lack of education and emotional factors like denial or depression about managing the condition. Bottom line, the body needs glucose in the bloodstream, and suffers when levels of glucose fall below normal levels.
Islets within the pancreas contain beta cells, which make insulin and release it into the blood.

How does LOW blood sugar feel?

Some people occasionally experience hypoglycemia, a kind of low blood sugar which isn't brought on by the same stuff behind type 1 diabetes. After exerting themselves or undergoing stress of one kind or another, they might feel light-headed, tired, weak. For these people, a sugary beverage or candy or just a healthful meal might bring them out of the blood sugar doldrums. While this occasional occurrence might signal future metabolic issues, it's not necessarily chronic.

Type 1 diabetes, however, is a different and potentially deadly animal. Type 1 diabetes means that a person's insulin-producing cells have been mostly or completely decimated by their own overzealous immune system. Without intervention, their body can gobble up all available blood glucose, and without the beta cells which are a vital key in the homeostasis that derives energy from glucose for the body's cells, it will start to shut down and die due to a lack glucose of in their system. 

How does HIGH blood sugar feel?

Short-term, a high blood sugar can lead to irritability, extreme thirst, and irritatingly dry skin. Sustained long-term high blood sugar can devastate the body. Blindness, deafness, neuropathy, renal failure, and subsequent amputation, all can result from someone neglecting to rein in their blood glucose levels. Worse, this can apply to those with either type 1 or type 2 diabetes. Poor diet and lack of exercise can exacerbate the deleterious progress of the disease by ensuring that dangerously high levels of blood glucose remain in the bloodstream, and that the body's tissues are in a grim way marinated in that abnormally high concentration of glucose. 

What is it like to DIE from uncontrolled diabetes?

Thankfully, I cannot say. I can, however, relate what it's like to almost die.

I'd just begun living in an apartment, away from my parents, on my own, for the most part. I also happened to have turned 21, and decided to have some beer to celebrate. Unwisely, I had a couple of beers shortly before bed, and didn't follow that up with a snack. 

The insulin regimen I was on consisted of a mix of a fast-acting insulin combined with a slow-acting insulin injected before breakfast which generally remained active throughout the day and into the evening. The fast-acting insulin would "kickstart" my system to ensure my body had insulin available to deal with meals throughout the day, and the slow-acting would keep my blood sugar in check throughout the night, in theory, at least. That theory, however, didn't take alcohol into account.

I vaguely recall my then girlfriend having called me at the apartment first thing the next morning. Apparently I didn't sound too good; my speech was slurred, I was making no sense, and eventually I managed to just hang up. Worried, she called 911, and a couple of friendly but determined EMTs arrived at my apartment, discovered my blood sugar was dangerously low, and set me up with an IV dextrose solution and loaded me up into an ambulance for transport to a nearby hospital. 

I only remember a few sketchy details. I recall being loaded onto a stretcher and being wheeled into the "business end" of the ambulance. I remember fluorescent lighting, a faint odor of bleach and plastic and other clinical smells, and the sensation of being jarred occasionally as the ambulance trekked across our city's poorly-maintained roads to the ER. 

Eventually, I woke up in a hospital bed with a terrible headache. As my system got back to normal (thanks to a trickle of IV fluids and the worst hockey puck hospital oatmeal I'd ever eaten in my life), I realized something didn't quite seem right with my head. For lack of a better description, I felt as if there were a void behind my eyes, or at least seemingly so. I had some marked difficulty speaking and with my memory, and it suddenly seemed harder to do math in my head. I realized later that my sugar managed to get low enough to deprive some of my brain cells of glucose enough to die.

That was well over 20 years ago. Since then, the wondrous neuroplasticity of the brain seems to have enabled me to largely work around whatever deficits took hold around that time. When I'm very tired, little spurts of aphasia come back to visit, but otherwise I'm mostly my old self, as far as I can tell. 

What is it like to suffer uncontrolled diabetes without medical intervention?

That is a disturbing concept. In spite of the wonders of today's medical science, the leaps and bounds by which doctors and scientists have over decades pieced together the intricacies of how the body metabolizes food to create energy readily taken up by the body, there are still foolish, naive parents who raise a child who happens to develop type 1 diabetes, and then disregard all the valuable knowledge garnered by science and instead rely on the fallacy of prayer to cure their supposedly beloved offspring.

If your child is beset with uncontrolled blood sugar levels and fervent prayer doesn't seem to snap them out of it, it should be clear that they need medical attention. Hubris might lead you to think "no, MY chosen God could never allow this to happen, I just need to try harder, pray better". Meanwhile, though, that child is suffering through what I have to only a limited extent, and survived, because my parents wisely heeded my doctor's advice and followed their recommendations which were based on proven medical technique. 

What if I am a person of faith and my child has been diagnosed with diabetes?

SEEK PROFESSIONAL MEDICAL ADVICE! Good doctors who treat diabetics aren't just sitting on their hands thumbing through medical journals. They see patients every day and tweak their medications, make recommendations about diet and exercise, and otherwise use proven medical science to help ensure as normal a life for their patients as possible. For the most part I would heartily suggest, follow their advice! If you truly love your child, you don't want them to go what many children have died from, and what I have on several occasions nearly succumbed to.

Thursday, March 6, 2014

Total Thyroidectomy

Around 18 years of age, my thyroid gland decided to start getting busy.

Meaning, bigger.

Called a "goiter", the result of Hashimoto's thyroiditis, my immune system assaulted the gland over the years and prompted it to create scar tissue and increase its size. As far as it was concerned, this thing was a foreign body needing termination.

Fast-forward to age 40.

A friend of mine who works with kids contracts pertussis, aka "whooping cough", a childhood disease largely controlled with childhood vaccines, but which has found new life thanks at least in part to anti-vaccination activism. I happen to contract almost identical symptoms a short while later. I wake up nights with unprecedented difficulty breathing. My throat feels clogged with mucus, and the hacking cough lasts a good month or two.

I decide it's time to get this thing out of me. Total thyroidectomy.

I consult a local ear-nose-throat doctor. We commit to surgery. She gives me a warm hug on my way out of the initial appointment.

I go to a pre-op appointment. Alex, a Korean physician's assistant, opens the floor to me to ask questions. I ask my wife's questions first, how soon prior to the surgery can she see me? How long is recovery?

Questions answered, I'm out. The following Friday, I wake up at 5-dark-thirty to arrive at the hospital around 7am. The reception nurse, sleepy but awake, leads me into the prep area. I'm asked to disrobe into one of those humiliating ass-open hospital robes, and need help tying off the lower part. She reassures me, she's seen plenty o' butts, and helps tie the knot.

I'm led to a bed, where an intake nurse sees me next. We review my meds, whether I've taken aspirin, fish oil, any other OTC drugs that might cause excessive bleeding. Being a compliant patient, I've refrained from taking these for a full 5 days prior. I've even showered and scrubbed the area with a chlorhexidine-containing soap to minimize the number of microbes loitering around my neck.

The nurse inserts the IV into my forearm. The vein is sketchy, so apologetically she tries again, this time atop my hand. Success!

Bruce, the anesthesiology nurse, warmly greets me. A friend snaps a shot of me smiling wanly in the hospital bed, and then I'm wheeled off toward the operating room.

Upon arrival, Bruce whips a syringe out from his chest pocket, then injects its contents into my IV. Versed, he says. Cool! I'm hopefully I'll start feeling woozy, euphoric. No such luck, however.

I'm there, in the OR, a few minutes. Someone places a mask halfway across my nose and mouth. I breathe normally and then... like some ridiculously swift transition in a movie, I find myself in recovery. I have utterly no recollection of the events that transpired.

I gingerly probe my neck, and it seems genuinely less massive. The thyroid is gone, it would seem. A tube leading to a squeeze bulb meant to suck out fluids hangs at my chest, and the remainder of the wound is sealed with some sort of novel purple "glue" meant to bind incisions.

A friend along with my wife rescue me from the hospital and we drive. We decide to have dinner at a local sushi restaurant we enjoy. Despite the lingering haze of the anesthetic (which imposes a noticeable delay as I try to piss in the restroom), I find I can fairly easily chew and swallow our food. Famished, I devour it eagerly.

The first few days following surgery, I numb the pain with hydrocodone provided by the surgeon. Recovery is, thankfully, largely uneventful. Now at a week afterwards, the glue has all but fallen away, and the surfacemost areas of the scar have healed over. I now apply Mederma several times daily to deter the formation of an annoyingly visible scar.

I can swallow much more easily, and although now I add another medication to my daily regimen (levothyroxine, the brand name of the well-regarded thyroid replacement hormone), along with Humalog and Lantus to manage my type 1 diabetes.

It doesn't bother me as much. Just being able to breathe and swallow more easily is a wondrous thing.