Chapter 2 - Training

Monday - Six years old, in the middle of winter; I could be home sleigh riding. Instead I'm in Boston at the Joslin Clinic learning about diabetes. This place is huge.

Yesterday, we (my class and I) learned about what insulinˆ was, how it worked, the differences in types of insulinˆ , and why I was on a combination of ' regularˆ ' and ' NPHˆ '. We learned the necessity of boiling our syringe and needle before each use, how to draw a mixture of insulin, and practiced injecting an orange because its skin has the same resistance as our own.

Tuesday - Today we're learning about using Clinitestˆ kits: the correct number of drops of urine combined with the correct number of drops of water, dropping in the Clinitestˆ tablet, watching the fizz then waiting for the color to tell us the result. Because urine is part of body waste, this result was telling us what amount of sugar was spilling into the urine within the last four hours. Negative (a blue color) meant we weren't spilling any sugar, while 4+ (orange) showed that we could have from a moderate blood sugar to a high blood sugar. There were also ranges in the middle. If we were negative, our insulin dose was considered sufficient (a grown up word for OK). If 4+ we also had to test for ketonesˆ . Joslin told us what these were but I didn't care. I knew the word, knew how to test for them, knew to call my doctor if the test appeared positive. That's going to have to be enough.

We were warned about complications from long term uncontrolled diabetes but I guess I wasn't listening to that either. No way was I going to get anything else. Why won't they let me go play baseball, instead? Mom's here somewhere taking a course on what I'm supposed to eat and when.

Oh yeah, I was given my own gramˆ scale this morning. Did you know a medium sized potato weighs around 60 gramsˆ . Doctor Root has given me a 1200 calorie diet and it actually looks pretty good. Mom says I won't have any trouble with it because she hasn't found any food yet that I won't eat, even vegetables. I eat six times a day now, isn't that great? Breakfast, lunch, and dinner, plus a snack mid morning, another mid afternoon and a third before I go to bed. This is to keep my carbohydrateˆ intake as regular as possible throughout the entire day. I only take one shot in the morning, right now: four units of ' regularˆ ' and sixteen units of ' NPHˆ ' before breakfast. The regular works real fast but doesn't last long. The NPH doesn't start working for a while but lasts a lot longer. Once I get out of the hospital, I'm told that the amount of insulin may go down when I start to get more exercise. To keep everything in balance my exercise is supposed to be scheduled for the same times each day and stop after a certain amount of time.

Wednesday - You should have seen what I just did. I went to the lab this morning to have a blood test. The nurse took it from my arm and while we were waiting to get the result, she taught me how to draw my own blood. There was a small tube about a foot long, a pipette (that's a long slender glass tube), a lancet and a mirror. I swabbed one of my earlobes with isopropol alcohol, pricked it with the lancet, and put one end of the tube onto the pipette with the other end in my mouth. Sucking on the tube and pinching my earlobe with my fingers, the blood went right up into the pipette. When it was full, we emptied it into a glass tube with a stopper, then put it into a centrifuge. A centrifuge is a machine that spins in a circle with clips on it to hold the tubes. This keeps the blood from coagulating (another grown up word that means it stops it from getting thick - like cream on top of a bottle of milk). How they test the blood is a mystery. I wasn't allowed to watch that, but a man came back and said my test was 120. We were taught that a good result was 110-130.

This afternoon was a little scary. A nurse was showing Mom and I what I would look like, act like and feel like when I went into an insulin reactionˆ . That's when my blood sugar level goes too low. When it gets real low my body starts to secrete adrenalin because it doesn't know how to handle it. The nurse gave me an injection of regularˆ insulin and started taking blood sugars every five minutes. After about ten minutes I started feeling funny. My sugar was 85, I was starting to sweat, and my tongue felt too large. When it got down to 60 my words started to slur and my legs wouldn't hold me up any more. By the time it dropped to 50 I don't remember much except Mom made me drink a glass of orange juice. I felt better about five minutes later. My blood sugar went back up to 120 and everything was back to normal.

Thursday - Can you imagine that a colored pair of socks can cause all sorts of problems for a diabetic? Neither could I. But now my socks are supposed to be white cotton so that no dye can get into my feet. Poor circulation can be a big problem. It can lead to all sorts of things. Mom and I are supposed to find me a doctor who knows about diabetes. We live in a farming community in northern New York State and Mom thinks that might be a problem.

Mom's been great. She and I have been praying together a lot this week. But she doesn't seem to be as excited to go home as I am. She tells me over and over that I need to have enough courage to handle the responsibility. Don't worry, Mom, I'll handle it.

Friday - We go home this afternoon. Wow! Prior to leaving we're learning how to increase my diet when it's necessary. I've learned more about calories and gramsˆ and vegetables than I'll ever need to know. A 3% vegetable, like lettuce, can be eaten almost as a free food. Vegetables like spinach are 6%. It's funny about carrots. Raw, they're 3%; cooked they're 6%. Potatoes are 20%. The percentage stands for the amount of carbohydrateˆ content by weight. All foods are broken down by the body into different things like protein, fat and carbohydrateˆ . We had to learn what each did, and what foods created what, so that we could calculate how much insulin to take every day.

Mom and I met Dr. Priscilla White today. What a nice lady. We talked about enrolling me at the Joslin Camp in Charlton, Massachusetts next summer. It's a camp for diabetic boys that teaches them (she means me) how to interact with other kids and stay on my regime (that means my balance of diet, insulin, and exercise).

Finally; we're on our way home!

I should have listened more in class. I'm having way too many insulin reactionsˆ . Maybe this is what Mom was worried about. I'll try harder.

The Joslin Clinic, IMHOˆ , is probably the greatest training facility for youngsters or adults for diabetic training. The staff has always been superb in their knowledge and bedside manner; the doctors, well known in their fields, are both personable and willing to give of their time. Many thanks, Joslin.

Through the intervening years insulin reactions were too numerous to even count. My main problem was that I was an exercise junky. Once we had moved to Pennsylvania, sports, even though I wasn't very good at them, consumed me. I constantly argued with my Mother about leaving a ball game "just to go home and eat". Or why couldn't I ride my bike up to the dairy farm before supper to help milk the cows? Just because I wouldn't get back before seven o'clock shouldn't make any difference.

As a parent -now a grandparent- I see, too late, the aggravation we can cause in our parents lives. I've never seen a more concerned, loving, caring individual than my Mother. God bless you, Mom.

Ephesians 6:4-NIV Fathers, do not exasperate your children; instead, bring them up in the training and instruction of the Lord.