Cluttered Confidence

I missed my doctor’s appointment this morning, besmirched and slightly jaded by the handling of my person by the medical industry thus far. I have been diabetic for 17 years now. Some things I have begrudgingly submitted to, others I refuse to contemplate. And then there are those things that are, but shouldn’t be. I remember once, when I was 11 or so, I had an intense compulsion to never again take an insulin shot. It was as if my fingers wouldn’t move, my mind wouldn’t accept its resignation to this new form of survival. But it had to be done, or there would have been the eventual coma and the (hopefully) eventual death. It took me an hour or so, but my pre-teen mind found ways to convince itself of the necessity of stabbing small needles into my body.

And so it goes. Life has continued from that day to this day with myriad syringes (roughly 130 a month or 1560 a year) and myriad pricks of the finger to make myself bleed. The resignation to my position has been massive. There is no fighter left, except to fight for life. And there certainly is no sympathy from anyone I know, which is, truthfully, as it should be. 17 years of sympathy and I would be paralyzed by my supposed deserving of some sort of complete cure. But no cure is coming and I have slowly, properly, withered into my set position at the bottom of the pile of healthy young men.

They have rescheduled me a 15 minute appointment for tomorrow morning. 15 minutes with the man who is supposed to understand my experiences better than most. He is paid (handsomely) to provide valuable advice and medical wizardry that will somehow improve my experience. I have never met this man before in my life. But they have given me 15 minutes with him. Should I feel grateful? Certainly I am meant to give him my money without question. But, after quite a few visits like this, I have come to understand that there is no particular care to be expected from this man. The measure of his value has come from his time sitting and listening to another man or woman speak. Am I to honor him? Believe he can know my struggles in 15 minutes? Should I expect him to care? I doubt he will.

Over at the University of Washington, just a couple of hours away from me, they’re doing some sort of testing  that involves an artificial pancreas. There is hope for people like me. The millions of us. And our numbers swell daily. Whole ranks of children, soon to understand that survival is more complicated than they thought. That one bad decision on their part could mean their life or, at very least, could cost them their eyes or their feet. There are the vast number of us who are now adults, living in worry that our teenage years (which are very difficult for type 1 diabetics due to hormone shifts and other internal changes) have damaged us beyond repair. That someday soon we will be a younger version of that older man that we’ve seen in his wheelchair, unable to walk after they removed his feet. Unable to see after his eyes failed him. Is that me? How soon?

It is a crushing weight. The daily pattern of syringe and lancet is the least of our concerns. Waking in the dead of night, sweating and shaking and unable to make our minds work because the insulin we put in ourselves was a little too much for what we’d eaten. I know what dying feels like. As the insulin allows the sugar to feed the cells and too much sugar is allowed to leave the blood stream because of a miscalculation of insulin, or any number of random, unexpected reasons, the body begins to die. It starts to slowly shut the brain down. The hands shake and you begin to sweat for no reason, which can be very uncomfortable depending on the circumstances. You become irritable or lose lucidity. Finally, if left to run its course, your body puts itself in a protective coma. Sometimes you die. Sometimes you don’t.

The other side of that is high blood sugar levels, when you haven’t given yourself enough insulin for the situation you’re in. Perhaps you’ve eaten the types of sugars that take a long time to break down and your sugar rises unexpectedly an hour or so after eating. Or perhaps you are playing some sport and the chemical changes within your body increase the amount of sugar a healthy body would expect and thrive on. You begin to urinate frequently, as the body tries to get the sugar out of it in any way possible. In order to urinate, your body demands huge quantities of water and it often feels as if you haven’t drank in days. Your skin becomes uncomfortable and your eyes start to have trouble focusing. You become short-tempered and irritable, which has damaged more than one relationship in my life. You become sluggish and frustrated and, eventually, your body can go into a protective coma in this state as well. I believe you are less likely to die in that circumstance, but high blood sugar is still the more dangerous situation. High blood sugar leads to blindness and amputations when the veins are damaged over a long period.

Diabetes is exhausting. This man I will go see tomorrow knows all of those things. He will give me my 15 minutes and he will be done with me. Because my diabetes, monstrous as it is, is no worse than the arthritis of his next patient. Or the legion of sicknesses that have their hold on man.

So I couldn’t convince myself to go today. Just like the 11-year-old me, I had to argue with myself. Had to convince myself  that there is value in these actions. I hope there is.

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