Recently, after changing insulins and adjusting my regiment, I was having trouble controlling my sugar: it was way too high before dinner and way too high when I woke up, even if I took significantly more insulin than usual at dinner and exercised rigorously afterwards. Really, it just takes time for the body to adjust to a new insulin and a new routine, but I was frustrated.
One day, I spend nearly 24 hours hovering near 200, more than twice a normal reading, and am fed up. Before lunch, I’m at 166, and decide to shoot seven units of insulin into my arm instead of the usual five or six. I also decide to eat a tub of “Spicy PowerFu Salad” for lunch instead of a “Spicy PowerFu Salad Sandwich,” because I feel the carbs in a whole-wheat pita are now something to which I can only treat myself as a reward for good readings.
Worried that a sedentary desk job isn’t helping my sugar levels either, I also decide to take a healthy walk after lunch. I get two blocks away from The L’s offices, down Jay Street in DUMBO, when it feels like I stepped in dog shit. I take a look behind me but don’t see anything unusual. Maybe the sidewalk turns to mush in front of Pedro’s? I make a mental note to check on my way back.
But then it happens again a block later, and then again a few steps after that, and I realize it isn’t the ground that’s gone soft—it’s my knees. Soon, I look like I’m futterwacking as I try to walk: my legs splaying out involuntarily, my knees trembling, like a toddler taking its first steps. I make it almost two blocks like this, until I’m standing in the shadow of the office, and I have to stop and cling to a nearby staircase’s railing, lest I collapse. Misting rain brushes my face like water from a showerhead. I must look drunk, I think. Diabetics are often confused for drunks.
Because my brain’s not working, I tell myself, “pull yourself together!” instead of, say, chewing up a few of the glucose tablets knocking around in my pocket. After a few moments I futterwack to the building’s main entrance and wait for an elevator. I always use the side entrance and climb the stairs, but I have enough sense not to overexert myself. Exertion is making it worse. Once I make it to the office door, I stumble through and fall roughly into a sitting position onto the boxes of back issues near the front door. With my back to the intern at the front desk, I pop a glucose tablet, hoping it’ll stop the tremors in my legs, and start reading, not realizing that I’m sniffling from the rain.
In a moment, I feel a hand on my back. “Are you OK?” the intern asks sweetly, like a nurse. I force an easy smile; that I can do so must mean I am, that I’m re-sugared. “Yes,” I say, “thank you.”
“Oh, OK!” she says with relief. “I thought you were crying!”
That would be a few days later, when I weep uncontrollably in bed for nearly an hour before I think to check my blood sugar and discover it’s severely low—about 25—which would account for why I had suddenly lost my mind. I had given myself a slightly larger shot of insulin that evening because I was planning to break my strict diet by eating three sugar-free cookies for dessert. (They are made with white flour, which is essentially sugar, as far as my metabolism is concerned.) Just to be careful, I also rode my roommate’s stationary bike for 15 minutes—some form of activity, even just washing the dishes, usually helps insulin to do its job—and drank a mug of a tea meant to lower blood sugar levels (which it actually does, thanks to some magical natural compound). Turns out I had been overly vigilant.
Of course, a diabetic could be conservative about his insulin shots and intentionally keep his blood sugar high. And, in fact, this is what many in the medical community recommend; doctors are more concerned with the short-term dangers than the long. My doctor is happy if I keep my blood sugar at or below 200, even though a reading of, say, 185 would be roughly double a normal level. Chronic high blood sugars—though there’s some small disagreement about when high becomes too high—are responsible for the disease’s terrifying, long-term side effects, which afflict many diabetics later in life: amputated limbs, failed kidneys, blindness. Because of these threats, I’m paranoid about playing it safe. But, at a certain point, being cautious becomes putting myself at risk.
The fourth and final installment, in which Henry discusses health insurance, car crashes and antiquated medicine, appears tomorrow.