by Fred MacDonald
I first learned I had type 2 diabetes on the night of October 9, 2003. I was
resting in the local hospital with a severe infection in my left big toe (the
"greater toe," on my medical chart). Neuropathy had deadened the feeling
in my feet to such an extent I wasn't aware I'd developed an infection in a
small cut -- and that had led to gangrene. I was a very sick person.
Now I learned the surprising news that I was diabetic. I had never shown any
classic signs of the disease: excess thirst, frequent urination, I was never
overly tired, and my weight, 150 pounds, was not that heavy either. I knew of
no history of diabetes in my family, so I was stumped on how I had developed
this condition (a more detailed check of the family history revealed one family
member did develop diabetes, but only near the end of his life, so this information
was ignored).
With the word "diabetes" ringing in my ears, I realized everything
in my life was changed. I had always considered myself fairly healthy, and now
I was facing a disease that would always be with me. As expected, my first reactions
to the news were equal bouts of anger and denial, but as I was currently suffering
from a serious side effect of the disease, it was hard to remain in the state
of denial for very long.
The anger took longer to channel out of my system. My fiancee, and to a lesser
extent my parents, had to deal with a person who wanted to lash out at the world.
The hospital staff were doing a good job of treating the problems of my diabetes
and gangrene, but I wasn't a 'willing' patient yet. I did what the doctors and
nurses wanted, but nothing more. I was simply in a passive mode.
Julia, my fiancee, has dealt with low blood sugar for nearly 20 years, so she
had some information about my new diagnosis. She gave my mother a number of
books and magazines, so she could learn about my condition. Then, on one of
her visits to the hospital, she brought two books for me to look over. I'm afraid
her suggestion that I read them didn't go down well at first (let's just say
that this was one of Julia's shorter visits).
As the days went by, my boredom started to take over, and finally I decided
to look at one of the books. The introduction caught my attention -- this writer
had the same problems I had.
I started to read like a person possessed. The information was clear; there
was humor in it as well. Side stories and case notes made the work very easy
to understand; but the best thing was the tone of the book. Anger over the disease,
denial, doubts, and fears of the unknown, everything I'd been feeling was there,
yet the volume also spoke of hope.
As I read more, my mood quickly changed. Yes, I had diabetes; but it wasn't
going to rule my life. I was going to be its MASTER.
I spent time learning about my condition. My focus changed; I now worked with
the staff to get well as soon as possible. I was determined to have a normal
life again.
There were still serious problems. Since I had always been healthy, I had very
limited experience with the general health care system. I learned I had to switch
doctors, due to my insurance coverage (before this event I had always paid out
of my own pocket for whatever care I needed). I was going to be out of work
for quite a while, so I had to set up the paper work for short-term disability,
but I was lucky, my insurance company had always given very good coverage, and
was willing to do almost anything to help me get better, fast.
My employer's attitude was even better. Because I work for a human service organization
dealing with people with various disabilities, they have a rather open attitude
in dealing with matters such as this. I was told to take care of myself. My
job would be waiting for me on my return.
My friends and family made certain I was visited regularly at the hospital.
Get-well cards and gifts arrived, to keep my spirits up, but there were long
periods of loneliness. Time seemed to stand still, every once in a while, and
I kept hoping this would be the day I would finally get out of the hospital.
There was good reason for the delay. The infection in my foot was lessening,
but was still powerful enough to pose a risk to my general health. Finally,
one of the staff members made the decision to bring in a foot surgeon. After
a careful review of the case notes and a glance at my foot itself, the specialist
stated removal of the toe was my best option.
I told him I wanted the surgery done as soon as possible, so one day after being
discharged from the hospital, I was back in, getting my left toe removed.
The infection was so strong that, besides having the toe removed, the doctor
had to cut off two additional inches, to scrape the infection out of the good
bone. After an extra day of bed rest, came the long road of home health care.
While it was good to be out of the hospital room, I still had to deal with many
doctor appointments, paperwork for the insurance company, moving around on crutches,
and keeping my injured foot up as much as possible. I discovered I was considered
a "fast healer," for a diabetic, yet it seemed to me things were moving
at a snail's pace. Finally, in early November, I was allowed out of the house
to go to a local science fiction convention. I still had trouble moving around,
but being around my friends and talking about something other than my diabetes
did wonders for my spirits. Life was slowly returning to a more normal existence.
The holiday season was a bit strained, due to my limited ability to get around;
but on the plus side, my oral medications were doing a good job of controlling
my sugar levels. I could eat almost everything I wanted, as long as the quantities
were limited. Yes, there were some things I had to give up; but if I needed
a reminder about what could happen, all I had to do was look down at my left
foot.
At the start of the new year, I went to another surgeon, to see what could be
done with the large open wound on my foot. A surface skin graft was discussed;
but the wound had to close up some more before the attempt could be made, thus
more waiting. During this time, I often met with a diabetes educator to learn
more about my new lifestyle, and with a dietitian, to deal with my food concerns.
Upon being discharged from the hospital, I had been placed on a 2000-calorie
meal plan, but this had left me underweight. I was currently 137 pounds, and
most of my regular clothes were too loose on me. I couldn't increase my carbs
that much or my sugar levels would spike. Even by eating a lot of extra meat
my weight wasn't going up. Finally, the sugar-free energy shakes were approved
for my use. There are two types -- one to lose weight, and one to gain. Needless
to say, I was given the latter. These shakes, taken twice a day, with some extra
food, finally brought my weight to a more normal level. I'm still roughly five
to eight pounds under my old weight of 150 pounds, but at least I look okay
in my clothes now.
By mid-January my wound had healed enough to try the skin graft. The procedure
was a limited success. For the first week it appeared the skin graft was going
to take with no problem, but during the second week it started to fail. By the
end of week three, most of the skin graft was dead, but as it died, it acted
like a bandage, allowing the tissue underneath it to knit together faster. I
still had a decent size wound, but its depth had decreased. This was a setback,
but by now I was getting used to them.
Near the end of January, I was permitted to return to work. It had been almost
four months, and I wondered if I would be able to do all my duties. I quickly
discovered that it wasn't a big problem. Walking around the various work sites
on crutches was difficult, but I could do it. My strength wasn't back up to
full potential yet, but I had enough to get by. I was also very lucky there
was very little snow or ice in my state that year.
After a few more weeks another great day came -- I was told I could put my crutches
away and use a cane. My sense of freedom grew. Now I could carry something in
my free hand.
The wound kept healing, at a fairly stable rate, but I was getting a bit frustrated.
I was still wearing winter ski boots because of the dressing on my left foot.
However, warmer weather was now in the area and my feet started to get very
warm. At one point, I tried a pair of my dad's extra wide sneakers instead,
but after two days I noticed some breakdown in the surrounding tissue, so I
put the boots back on.
Currently I'm at a point where my injury is almost completely healed. I have
been allowed to switch into any type of shoe, as long as it doesn't put any
strain on the healing tissue. My sugar levels are under control, and there are
not other signs of the dangerous side effects of diabetes. I have even regained
a good sense of feeling in both feet. I was lucky my body has been able to repair
itself. Even though I lost my big toe, my balance is still good, so I don't
believe I will need special shoes. I also have friends, family, and co-workers
ready to help me at a moment's notice.
Yes, I would prefer not to have diabetes; but I have learned some important
guidelines about living with this condition. First is to seek out any information
relating to the problems you have. With the data, you can make a better decision
on the various problems diabetes throws at you. Second, remember diabetes is
something you can LIVE WITH. There will be days the world seems against you,
and you may want to give up dealing with your diabetes. DON'T GIVE INTO THOSE
FEELINGS. Talk to a doctor, a family member, a friend, a co-worker, anyone who
can give you a different viewpoint. It's true you have diabetes, but you don't
have to deal with it just by yourself. Other people can help.
As one person told me: "With diabetes you have two kinds of people. The
ones who work with their doctors, and the ones who don't. Doctors are more willing
to work with people who take an active interest in the treatment of the disease,
than to deal with the ones who just half-follow their advice."
This seem a pretty good standard for the care of diabetes. Be willing to work on the problem and you'll feel better, and most likely have a longer and better life. Do little or nothing and you start on the slow side to an early death. The final choice is your own.