Another diagnosis story
Summer of 1990.
It was only a couple months before Marshall’s junior year and he was on his third year working at the Poland Spring Inn. He worked in the pro-shop, an ideal job for a teenage boy who liked to golf. He went to work first thing in the morning and was done by mid-afternoon. Instead of going out to meet friends after work, he would go straight home to nap for the better part of the day. He drank glass upon glass of water, and lost 20 pounds in a matter of weeks. It wasn’t until a family trip to Polar Caves in New Hampshire that his mom noticed how many times Marshall needed to stop to use the restroom that she discovered something was wrong.
When they got home from the trip to the caves Marshall’s mom scheduled an appointment with their family doctor. At the clinic Marshall did a fasting blood glucose: 256. They went home before heading back out to the nearby hospital to be admitted for a few days. He still remembers how it felt to finally get insulin back into his system, and how almost instantly he began to feel better. For many weeks he had felt exhausted, weak, and utterly drained. Finally he felt energy coming back into his body. He remembers the hospital and being constantly prodded and poked by nurses and doctors throughout the night. It was made clear, at 16 years old, Marshall was the one expected to drive his care. From the very beginning he was administering his own insulin shots. It was his illness. A hefty weight for a young kid.
Teenage diagnoses often look very different than those of young ones. Not because one is any more serious than the other, but because it often goes unnoticed for so long. Puberty, growth spurts, increase in sports and exercise, and crazy eating habits are some of the ways we “explain away” the symptoms in teenagers. But I think the biggest reason being teenage independence. Marshall’s mom wasn’t cooking all his meals, or scheduling his day, or tucking him in at night. Parents of little ones are so intimately involved with every detail of every moment of their child’s days that we notice the tiniest hint that something is amiss. But a teenager isn’t quick to share these details with their mom.
Things were very different 28 years ago. With a diagnosis of Type 1 came a drastic lifestyle change. In a matter of minutes Marshall’s life became scheduled and regimented: eat at a certain time every day, diet restrictions, exercise restrictions, and the loss of teenage spontaneity. There were no CGMs or insulin pumps. Even glucometers were different; today it takes only 5 seconds from finger prick to blood sugar read, compared to the 2 minute wait of 1990. There was no “long acting” insulin or “fast acting” insulin. He mixed Regular and NPH insulins, and took them at the same time every morning and night. The rest of the day he had to either eat or not eat, exercise or not exercise, in order to keep glucose levels somewhat in range. At that time the insulin dictated his life, as opposed to how we manage the illness today.
Not only did the logistics of this new life scare 16 year old Marshall, but it brought forth a flood of memories for the entire family. His dad also had Type 1, and nearly 12 years before Marshall’s diagnosis his father died from an accident caused by hypoglycemia. This particular diagnosis carried with it fear, loss, and sadness beyond any typical diagnosis.
