Spotlight: Mary Ryan

Spotlight: Mary Ryan

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SPOTLIGHT: MARY RYAN

Photo: portrait. Caption: MARY RYAN

Mary Ryan, from Westfield, New Jersey, is a Eucharistic

Minister, a dispensor of Holy Communion, in the Catholic Church. She is a Licensed

Physician's Assistant (PA). A veteran parent, she has raised 30 foster children,

and has had three of her own. Forty-seven now, she has had type 1 diabetes for

36 years. She has been using an insulin pump for 20 years, and has been blind

from diabetic retinopathy approximately as long. She is a member of the Garden

State Chapter of the National Federation of the Blind of New Jersey. She has

a lot to say.

I was diagnosed with juvenile diabetes at the age of 11. About two years before,

my father had been diagnosed with type 2, adult onset diabetes. Our family had

just gotten around to understanding diet and exercise and how important they

were, when I became very sick. I lost about 30 pounds in maybe six weeks, and

became very lethargic -- with the typical symptoms of type 1 diabetes: excessive

thirst, excessive urination, and dramatic weight loss.

It didn't really dawn on my parents what was happening, even though they had

experienced my father's adult onset diabetes a short time before. They were

really thinking, and worrying, about leukemia!

I had been kind of a chubby girl -- and they got me to the doctor when they

realized the weight loss was not a good thing. I just became sicker and sicker.

When the diabetes was diagnosed, I was in the hospital for eight days. While

there, I learned about diet and exercise, talked to the dietician, and learned

how to give myself insulin injections.

Diabetes treatment, back in those days, was very different than it is today.

You went to the doctor every two or three months, and had a blood sample drawn,

and based on what he found then, the doctor would adjust your insulin dosage.

It seems ludicrous to us now, as we know insulin levels change from moment to

moment and certainly hour to hour, depending on your exercise and diet, and,

for women, your menstrual cycle. Unfortunately at that time, tracking diabetes

was not a "state of the art" thing.

After I had juvenile diabetes (type 1) for 16 years, I started to get "floaters"

in my vision. These are sure signs of diabetic retinopathy, and I had laser

surgery to try and halt the bleeding in my eyes.

I believe the retinopathy probably happened because my blood sugars, in high

school and college, were all over the place. I was a brittle diabetic; I had

very poor control. Thank God there was no kidney damage, but my eyesight was

compromised. But I didn't let it slow me down.

I graduated from college, and went on for 2 1/2 years' training as a Physician

Assistant, finished it, and worked for a diabetologist. Then I got married,

and was soon the mother of two small children (after a miscarriage first pregnancy).

Our first son was not quite two, and our second was ten months old, when I

became totally blind. During my second pregnancy (my first successful one),

I was admitted to the hospital nine times, with blood sugars around the 800mg/dl

range. That wasn't for lack of supervision -- remember that in 1978, home blood

glucose monitoring was almost unavailable.

I was going to the doctor for blood sugars about twice a week, but just as

some women, not normally diabetic, become diabetic during pregnancy, with gestational

diabetes, a diabetic woman's control can get radically worse during the pregnancy.

Most diabetic women do pretty well during the first trimester, but the second

trimester, the pregnancy just pours glucose into the system. The uterus becomes

gluconeogenic.

After nine admissions to the hospital, we were sure the baby was in jeopardy,

but he was born, one month early, by caesarian section. He weighed 6 lbs, 12

oz, pretty good, after what we'd been through; but we thought he had a "VSD,"

a ventricular septal defect, in his heart. A year later it was discovered he

had a much more serious "four-pronged" heart problem, one that would take his

life at age 14.

My second diabetic pregnancy occurred about 18 months after the first, and

was more typical, in that my control seemed to be better, but my second son

was also born a month early, by caesarian section. He weighed 10 lbs, 5 oz,

a typical large baby of a diabetic pregnancy. And it was when he was 10 months

old that the last of my vision left. I was blind.

At this point, I was working in my diabetologist's office, as a Physician Assistant,

instructing young, pregnant diabetic women, telling them what to expect, and

what to do, as I had just been through it myself. That was when it was suggested

I should try an insulin injection pump, as it would be the best way to save

my kidneys and reduce the chance of further complications.

With my husband, I went to the training, to see what using the pump entailed.

The criteria were that you had to be highly motivated, had to be willing to

really pay attention to diet and exercise, and had to commit to at least four

blood sugar tests per day. As home monitoring equipment was finally available

to me, this felt like salvation.

The pump sounded like a perfect fit for me. I was a Physician Assistant, and

at our practice, we were starting to put patients on the pump. I was used to

"selling" the idea to diabetics. I taught them this device could really change

their life.

I think I was the fourth person, and the first woman, to go on the insulin

pump in the state of New Jersey.

Shortly after I started pumping, with my blood glucose control good and tight

for the first time in my life, we started a third pregnancy, and it went perfectly.

My health stayed perfect, I tested my blood seven times a day, and the baby

(born two weeks premature, by caesarian section again) weighed a healthy 7 lbs,

8 oz. It was an entirely different experience, being pregnant on the pump. The

pump helped me avoid the fluctuations that are otherwise an inevitable part

of a pregnancy. It provided me good, tight control.

We were so grateful this last pregnancy had gone well, that we wanted to give

back, and give thanks to God. We started taking in children, becoming foster

parents.

When Brendan, our third son (who's pregnancy went so well) was 13 1/2 months

old, we took in our first foster child. I had already been blind for 2 1/2 years

-- but fostering seemed like a good idea, since I was at home with three boys

under age five anyway. It just kind of took off. We've never put the cradle

and bottles away -- we just keep going.

Twenty-two of the 30 foster infants we've taken in have been boys. We have

a sign on the door that says "Boys are Us!" My brother calls this place the

"testosterone theme park." Our first son, PJ, died at age 14, seven years ago.

Our son Tim is a junior at Fairfield University in Connecticut, and our son

Brendan is 17 1/2, and a senior at St. Peter's Prep in Jersey City. We also

adopted a son, Jason, who was 15 in December.

It's a lot of work. The infants keep me in good shape. Also, I go walking every

day, as much as I can. It's important. You have to be committed to your diabetes

control -- as the disease can be so deceiving. You think you're OK, maybe you're

not feeling great, but you're sure you're OK, and you're not. It's insidious

the way it can damage those organs. You have to really be committed to your

diet and exercise program.

I would say it's very much a human tendency to be lax not only in diet, but

also with exercise; and whether you're on the pump, or using daily insulin injections,

you really need to be vigilant. Your self-control and commitment to being as

healthy as you can will determine the success of your diabetes control. "Diet

and exercise," easy to say, and very difficult to do. You need to work with

your nutritionist and diabetologist, and use lots of common sense. I know it

took me a long time to understand that immediate gratification, eating that

cookie or having that pie, just isn't worth it. If I take something I know I

shouldn't have, I start to feel sleepy, sick, or unwell, within half an hour

or less, and it's just not worth it anymore. I would say that, especially for

parents of type 1 diabetics, if they really feel their child is well- motivated,

getting the patient on to the insulin infusion pump, as early as possible, is

your greatest ticket to avoiding end organ complications later on. With the

pump you have tight control, and you avoid the peaks and valleys. It's all levelled

off; you're getting basal insulin in micro-drips 24 hours a day. As I tell patients,

it's really as close to achieving a non-diabetic state as we can provide right

now.

From the Editor: Mary would be glad to help advise any interested blind

person, about using the insulin pump, about child care, or about Eucharistic

Ministry. Mary is the only blind person in her area who does such ministry.

You may contact Mary Ryan through VOICE OF THE DIABETIC.

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