Sweet Nothings—and Some Diabetic Adventures

  The newsfeed on Facebook just seemed too hard to bear.  It was a Saturday morning, five weeks into COVID-19’s social distancing, so that would seem understandable.  Except.  Except for the fact that almost all the feeds popping up were photos of friends’ gardens, jokes, and things nuns call spiritual “fervorinos.”  My chest started to tighten, my eyes moistened, and then I realized I was sweating atypically in an air-conditioned South Carolina house in April.  So I wobbled to the refrigerator, poured and chugged a glass of orange juice, and then grabbed my glucose meter and tested: 47.  That’s right, I thought.  When my sugar drops that low, I get choked up and tearful.

   So I wasn’t having a heart attack or going into the novel coronavirus breathlessness.  It was my latest manifestation of hypoglycemia, which at this point in my diabetic life stays quite asymptomatic in me till it has plummeted.  As of December 2021, it will be 52 years since I was diagnosed with Type 1 diabetes, at that time dubbed “juvenile.”  No longer eligible for that description, I sometimes have qualified for being called a “brittle” diabetic because of my lifelong high-low swings.  Most medical professionals, though, scratch that out because I get nice A1C readings.  Meanwhile, it seems that I’ve spent some of my life on an unamusing roller coaster ride or on those self-propelled merry-go-rounds in an unsupervised kiddie park.  The story by and large, though, isn’t that grim.  

   The one and only time I’ve been hospitalized with elevated blood sugar was the early December night when I was diagnosed.  I delivered a reading close to 300 and was spilling ketones.  The chair of my high school English department flagged my attention to a possible diagnosis by mentioning the symptoms his friend’s son had had that were first attributed to flu, then stomach problems, then a weird virus—until they did complete blood work.  I went to the library of the high school where I was teaching and could make check marks by the symptoms listed in a medical reference book: sudden nearsightedness, constant thirst, unaccountable weight loss, fatigue, rushes to the bathroom.  I phoned his office, and my physician saw me immediately after school and then shooed me off to the hospital.  Thanks to that department chair’s observant remarks, that’s the only time I came close to a diabetic coma.  The lows, though, have been another story.

   There’s a poem by Delmore Schwartz which I ran into around that time.  It starts with “The heavy bear that goes with me…”  Diabetes, I promptly learned, would be my heavy bear.  Low blood sugars have been the m.o. of a misbehaving stick-like-Velcro pet that resists more than light taming and expects to be doted on.

   From Friday night through Saturday during what turned out to be an 8-day hospitalization in Bristol, Pennsylvania, I shook, perspired copiously, and threw up.  The protocol had me jolted with 15 units of regular insulin and tossed me into my first experience of insulin shock.  It was a high dose for a skinny 22-year-old to tolerate.  As things normalized over the ensuing days, the physicians and their consultors determined that NPH insulin, then amassed from beef and pork pancreatic juices, would be a better idea than that fast-acting regular.

   During the days that followed, I learned how to give my shots, was educated on exchange lists for 1800, 2000, and 2200 calorie diets, received more than ample reading material, and was given a urine testing kit.  In those days, before urine test strips and way before home blood-testing, the project was to collect a specimen, put it in a test tube that came with the kit, and drop a reagent tablet in.  If it turned yellow or orange, the sugar was high, and a walk or calisthenics were in order.  It was forbidden to adjust one’s own doses of insulin.  At that time there was no way to tell when the sugar was low unless one happened to occur on the quarterly visit to the hospital lab for blood testing or classic signals started flashing.

   At first, those symptoms of the down-slide were quite dramatic: profuse perspiration, shaking hands, blurring or unfocused vision, a bit of agitation, an inability to concentrate, unsteady balance.  I had to be sure that I had candy in my pockets and juice and crackers in the top drawer of my classroom desk.  My students knew to flag my attention if I seemed not to be making sense.  

   “You mean not more than usual, right?” one in the senior honors English class asked.  Sweet.  It seemed that the group consensus was that my commentaries on Shakespeare or Faulkner or narratives of Igbos in Nigeria weren’t always easily comprehended.

   I tried to be gutsy.  Over time, though, after a number of nerve-wracking episodes, I found that I had to face my vulnerability and exercise some cautions.  That meant not taking 9-mile bike rides in the country or exploring hiking trails alone.  It meant having food handy in the car when I decided to drive from Philadelphia to Decatur, Illinois, for a reunion with a college friend.

   Since I moved several times and engaged in quite a few solo activities, I realized that being a diabetic required paying attention.  That heavy bear is one that never lets you forget its presence.  It may seem to be at bay, but at any time it may begin to grunt and growl and act like a grizzly.

   Some of the hypoglycemic episodes since those early days have been almost hallucinatory.  Others have just been silly.  There was the time when I did too much unpacking on move-in day and woke up drenched at 2:00 A.M. convinced that there were babies crying in the backyards of the row houses which stretched down the block.  I teared up because I knew I couldn’t rescue them.  I could barely focus.  After a chocolate bar, I realized that a few stray cats were whining.  

   Another time everything in a buffet turned metallic and looked like parts of spacecraft from Star Wars.  I was about to be vexed about my lack of astronaut gear when a friend shoved Life Savers into my hands and commanded, “Eat!”  In the days of fast-acting shots taken 30 minutes before a meal (before one got in line, that is) a delay in food delivery could toss blood sugar control akimbo.  

   One of the most terrifying times took place on the verge of a hurricane evacuation when I drove to fill the car’s gas tank and got confused.  A random crash of the blood sugar shortly after a quick lunch left me incapable of figuring how to put the nozzle into the gas tank, then going to another station where I was similarly non-functional, leaving, getting lost, and driving erratically enough for reports to go to the police.  The climax was a car accident I caused as everything I saw in front of me doubled and tripled.  Fortunately, no one had long-term injuries.  Days later, my new endocrinologist determined that I was injecting far too many units of insulin for my intake, calorie burn, and weight.

   There have been embarrassing moments—like being found in my underwear rifling through a closet when I was supposed to be heading downstairs for a festive Christmas Eve dinner.  Then there was the time when I’d given my supper injection, again got stuck in a stalled cafeteria line, and was told that someone standing close by wondered if I might give her a ride to the wake I had planned to attend later that evening.  “I suppose we can fit a woman of her size in,” I replied—in her hearing.  Sensory perceptions, common sense, good judgment, appropriate reactions, and tasteful remarks all go askew.

   Over the years, I’ve had episodes that were easily handled and ones that were nearly fatal—for myself or others.  Overall, however, things have gone better and better as I’ve aged.  Home blood testing, recombinant DNA technology that replicates human insulin, and the development of insulin pumps and glucose sensors have all been tremendous advances.  The emphasis on self-management has made it more likely that one can stave off complications, as I indeed have.

   The reading material handed me when I became a diabetic offered dreadful statistics concerning the likely development of diabetic retinopathy and consequent loss of vision, heart disease, kidney failure, and neuropathy that would cut off feeling in the feet.  The prospects of spending middle age with a white cane, on dialysis, and possibly in a wheel chair due to amputation were, to put it mildly, daunting.  In a way, those prospects were the bear that haunted yet also saved me.  I suppose one could say they terrified me into pro-activity and compliance.

   I became very focused on what to be and do going forward.  I determined that if my life might be shortened, it had better be meaningful and dedicated to good causes: educational, in pursuit of the societal common good, and ministerial.  As I have for all these decades, I continue to teach, speak, run workshops, serve on boards and committees, volunteer for service projects, and write.  My ministry has required intra-state and inter-state driving, which has gone well.  

   Every now and then the Lion’s Club or a woman’s group asks me to make a presentation on living with diabetes.  As a teacher, I favor mnemonics.  So I talk about three C’s: Cooperation, Combat, and Contemplation.  By that I mean that one can never forget about the diabetes, the hungry heavy bear.  It pays to cooperate with medical directives and to keep trying, even with all the vicissitudes of the disease.  The combat part has to do with fighting off the temptations to self-pity or carelessness or death-wish.  It also means developing a mindset that regards gooey, gorgeous desserts as works of art rather than items for consumption.  Finally, it helps to have meditative practices—regular prayer, reflective breaks from the everyday to gaze at marvelous scenery, frequenting places where art is displayed and music is performed, and taking time for pleasurable reading.

   I’ve lived quite a few places—in New York, Pennsylvania, Indiana, Michigan, and South Carolina.  Fascination with the new and a love of learning has not abated for me.  Passion can mean suffering, but it can also mean verve.  A wise woman once said “What you focus on grows.”  I see the truth in that.  Focusing on the good, the blessing, the victories, the small pleasures have bolstered and renewed my spirits and give me an unending passion to thrive.  

   While I don’t play as often as I once did, I periodically serve as a substitute church organist.  On one of those Sundays a presiding priest loped over to the choir corner to tell me that I could play anything appropriate, but he didn’t like “sweet nothings.”  I knew that the regular organist tended more to performance than choral support and liked to play interludes throughout the services.  So I played no sweet nothings.

   But the phrase stuck with me.  The sweet nothings that I can very well do without are plentiful but not necessary.  Bears like honey.  I’ve found that once a year, at the aforementioned ceremonial Christmas Eve supper, I manage it, gobs of it, on traditional Slavic wafers.  And when the sugar dips low, as it will, it is far better to have lots of sweet nothings around—for medicinal purposes.  Starbursts and Hershey minis and Tootsy Roll pops are far tastier than glucose tablets.

   I hope to be around for a good while longer.  There is so much to love about being alive and so much for which to be grateful—which means I expect a celebration of my 60th diabetic anniversary in 2029, complete with a heavy bear in tow.