Wednesday, March 19, 2008

An Explanation Of Sorts

Tabitha was diagnosed with Type 1 (Juvenile) Diabetes when she was 11 years old. Her mother noticed that she was constantly thirsty, had to go to the bathroom all of the time, and was losing weight. After about two weeks in the hospital, Tabitha was stable enough to go home.

But life had changed.

An intelligent, active, out-going girl who believed she could do anything suddenly had to deal with a chronic disease. People acted differently around her. Some of her friends stopped hanging around with her. Tabitha's teachers and parents started treating her with kid gloves.

Every diabetic eventually suffers from the same complications. Diabetics are prone to heart disease, blindness, amputations due to neuropathy, and kidney failure. By keeping tight control on their blood sugar, they can delay the onset of the complications as long as possible.

Insulin is a hormone that allows our bodies to metabolize carbohydrates. In Tabitha's case, her pancreas stopped producing insulin. If she doesn't take insulin, her blood sugar will rise out of control. This high blood sugar is what eventually causes the complications.

Another problem is hypoglycemia, low blood sugar. If she takes too much insulin, doesn't eat enough, or exercises too much her blood sugar can drop to dangerous levels. If she drops low enough she could go into a coma.

When Tabitha was first diagnosed with diabetes, insulin was like carpet bombing. It wasn't very precise. She had to balance two types of insulin that had different durations of effectiveness. She had to eat the right amounts of food at the right time. A sugary dessert could throw her levels completely out of whack. Insulin is now like a precision guided bomb - just the right amount, at just the right time. But it's still not as good as your healthy body producing its own insulin.

When she was pregnant with Abigail, Tabitha's doctor changed the insulin to a type that allowed her to tailor her insulin levels more closely to what she actually ate. It was closer to how a healthy body delivers insulin. This was much more effective but she was still very "brittle."

"Brittle" describes a diabetic who is very sensitive to insulin. If she exerts herself just a little more than normal or doesn't eat enough, her blood sugars drop. Several times, Tabitha's students have had to run to the office because she was acting "funny." Finally, last year she got an insulin pump.

The insulin pump is a small electronic device that delivers a programmed dose of insulin sub-cutaneously every hour - this is the "basal" rate. At meal times, Tabitha enters her blood sugar level and the anticipated number of carbohydrates she is going to eat. The pump then recommends an amount of insulin to cover the meal - this is the "bolus." The pump has allowed Tabitha to have much more control over her blood sugar levels.

But there's still a problem.


Sally said...

We love you Tabitha.

Bopop said...

Stricken. Under control, but still stricken. Stricken and optimistic. Tabitha is an inspiration. Thanks, Cast Iron Skillet.