Monday, August 15, 2011


In the view  of the medical establishment, I took a big step backwards Friday.  I retired the new  pump and its fancy “continuous glucose monitoring” system  I purchased in January and went back to injecting myself with insulin using a syringe. 

My doctor was a bit appalled, “Why?”  I replied quickly, because I knew I only had ten minutes with him ($380).  “Because I’m leaving the country.  I don’t know how I am going to pay for the supplies on the pump and I have to be able to work with what might be available.  And I want to transfer now so I’m up to speed before I leave. “  He scurried out of the office and I heard him rustling with paper bags, opening and closing cabinets and he returned laden with free samples.  My eyes widened.  Here was the ticket for survival, free of charge, vials of the drugs that normally go retail for $150 a bottle.

In the bags were a slew of the new fangled “pens”  that contain a weeks worth of the medication I need to metabolize carbohydrates.  “You have to prime this the first time you use it.  And the needles are too fine to reuse. Fax me your blood sugars in a couple of weeks.”  And he went on to the next patient.   I was stunned and relieved.  I’d been stockpiling for a while, and here I had three months of supplies just handed to me.

Canadian Scientists Frederick Banting and Charles Best, with one of their diabetic dogs that helped uncover insulin's ability to impact  blood glucose.
Canadian Scientists Frederick Banting
and Charles Best, with one of their diabetic
 dogs that helped uncover
insulin's ability to impact blood glucose.
When the pump reservoir ran its normal course to empty, I ripped the adhered plastic tubing from my body and went retro, relatively.    My grandfather, George Crosswell Cressy Maling, was diagnosed with diabetes just after Banting and Best discovered insulin in 1922. 

Daddy George used  glass syringes, with needles that he would sterilize and sharpen himself.  My father’s father was relatively healthy until he died. But then again, he ate ratatouille for lunch. Every day for about 20 years.  This was a protective mechanism I’m sure.  It’s always easier to prevent problems when you stick with the routine.   The unexpected and the unpredictable requires flexibility, rapid adaptation, preparation.  With the decision to abandon the pump,  I’ve launched into a different level of responsibility for my own health.  It’s a new weight in my being, an aggregate filled with obligation and awareness.  There are flecks of resentment, the desire to succeed and the underlying  nagging feeling of fear for what will result.  I have to take it one choice at a time.

Eating has become a lot more conscious.  No longer can I cavalierly push buttons on the pump to deliver the insulin.  I find myself anticipating the awkward social situations in the weeks ahead, rationing my carb intake, needing to think about what’s next.  Each infusion of carbohydrates requires a few steps:  find med kit, get insulin pen, rummage for little pen needle and unwrap the safety seal at the bottom, screw needle on pen, turn dial to deliver dosage for anticipated carb intake, inject, unscrew and throw away needle, secure pen, zip kit and then eat.  Test the blood two hours later.  Repeat and repeat and repeat.   

I am now feeling the profundity of this step away from the familiar.  It’s less than eight weeks until I expect to Anchorage.  Time to take stock of the reserves.  Finances? Check.  Medications?  Better.   I can conserve the insulin if I cut down on the simple carbs and follow the diet that is better for everyone anyway.   Do I have the reserves of the resolve needed to carry me through making all good choices?    Is pursuing this dream going to have unrealized implications for my health?   Why am I putting myself through this?   I am feeling vulnerable and unsure, standing on a small boat in confused seas.   It is certain to get better after a week with the new protocol. Now I need to lower deep into the center,  grab the paddle, set a slow and steady pace and keep on the course to the next destination.

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