Make sure that when you inject the glucagon, you push down on the plunger with lots of force,” said the nurse practitioner. “It’s very important that you remember to do that!”
My mom lowered her eyes and nodded. Although she was doing her best to stay calm, she was worried and I could tell.
I had just been diagnosed with type 1 diabetes!
It was painful for me to watch my mother during this ordeal. Now she had worries about my health and new, unforeseen responsibilities.
But on that August morning, it wasn’t just my mother whose outlook on life was changing. My view of myself as an individual was never going to be the same.
What About My Independence?
Up until that point, I had always prided myself on my independence. Being independent made me feel grown-up and mature. It gave me a sense of responsibility and control in a world that—in the eyes of a 13-year-old—seemed fast-paced and out of control.
Often I would do things alone—just to prove to myself that I could be independent. Earlier that same summer, when I vacationed in Manhattan for the first time with my family, I had spent much of my time exploring the city alone. Although I had friends, I often opted to go to movies or baseball games without them. And when my parents or friends offered to help me with my homework, I refused: I wanted to do it by myself.
But I soon saw that diabetes would be a major threat to the freedom I so valued. The nurse said it was best if someone kept an eye on me “just in case something happens.” It was no longer safe for me to go to the movies or to the city alone. And a trip I had planned to Nevada with an older teenager was deemed “unsafe.” It was best, I was told, for an older adult to be “in charge.”
Depending Upon the Kindness of Strangers
I felt trapped—imprisoned by my diabetes. I would also have to rely on other people for my health. My teachers and friends would need to know what to do if I had an episode of low blood glucose. And I would have to wear a bracelet indicating to emergency personnel that I had diabetes. Every time I looked down at that bracelet, it reminded me of my dependence on other people.
A Serious Responsibility
I also soon found that diabetes was a serious responsibility.
The process of monitoring my blood glucose and taking the appropriate amounts of insulin was challenging. I found it difficult to keep myself in a “normal range.”
I needed to be focused. When I was at school or a friend’s house, it was my responsibility to take shots and test my blood glucose.
I needed to remember to keep a bottle of glucose tablets in my pocket in case I became low.
And it was very important to keep detailed records of my insulin intake and blood glucose. This was the only way, I learned, that my doctor would know how much insulin to prescribe for me.
Learning an Important Lesson
Although I may not have realized it at the time, I was learning a greater, more important, lesson. Diabetes—though difficult—was giving me a stronger sense of responsibility and importance. I was in charge of monitoring a serious and complex disease.
I had much difficulty keeping my blood glucose within the appropriate range during the morning hours. My levels were either too high or too low. So I tinkered with my dosages.
I would decrease my morning dose of short-acting insulin and increase the amount of long-acting. But when I tested myself shortly before lunch, I would get a high number. Another morning, I would take more short-acting and less long-acting—and this time, my blood glucose would be too low.
It was not until I relayed my notes and blood-glucose records to my doctor that I was started on a different type of long-acting insulin, which improved the situation.
It took many months to adjust to my new condition. I eventually found my correct insulin-to-carbohydrate ratios. I became more comfortable with taking out my meter and needles in a restaurant. I was also getting better at balancing my schoolwork and diabetes. I worried less about Humalog and more about algebra tests. It finally seemed that things were under control.
Figuring Everything Out
When I did have problems, I was soon able to straighten them out myself.
I remember when I first realized I was achieving something truly valuable. One night, I accidentally took twice my intended dosage of long-acting insulin. Instead of panicking, I ate an extra meal and spent the night monitoring my blood glucose. The next day, it occurred to me that if the experience had taken place several months earlier, I would not have had enough confidence in my own abilities to manage such a situation. Now, however, I could control it myself.
The most important lesson I have learned from having diabetes is about independence. I was diagnosed at a time in my life when I was trying to break free from the people around me. At first, diabetes seemed to be dragging me back into dependency. As I soon found, however, the process of managing my diabetes has made me a more independent person.