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"Mary," my husband said to me quietly, "Linden has seemed awfully thirsty in the past few days."  I looked at him with a sideways glance.  I knew where this was going; we had talked about the possibility in the past.  The possibility that any of my babies could be diabetic.  I shrugged and replied, "It is Easter weekend, we just had dinner, and maybe visiting with everyone has been a lot on him."  Our three year old son, Linden, had been playing a lot with his siblings and cousins, and it was a busy weekend after all.  However, the thought had nagged at me a smidge all week, too.  I imagined the finger pricks, the measuring, the telling of "No more sugar" more than we already had to, the carb to insulin ratio/math calculations.  I suck at math.  Really suck at math.  I took a certain route in college just so I wouldn't have to do much math.  It just couldn't be. 

The unspoken discourse was all over our faces.  "He doesn't even have the other symptoms," I went on, "He hasn't lost weight and his hunger is the same."  I'm standing now, hands on hips daring him to say it.  Daring my husband to say, "I think he might have Diabetes."  Scott just looked at me.  He didn't need to say anything.  I blinked back at him, unreproved.  "He can't be diabetic, he's only threeee!", I pleaded.  But we knew.  We knew that it was a possibility.  A huge one.  My husband is what is called a "Type 1" diabetic, diagnosed when he was 14; his father, when he was 21, his little brother, when he was just ten.  Of anyone, my husband would know the signs.  So would I, as my family is rife with the disease, but my father, grandmother and aunt all have or had the "other" kind: Type 2, as does my step-father-in-law.  Type 2 is still Diabetes, just on the "lite" or "diet" side.  All these diabetics surround me like some sort of twisted, special club that I particularly don't want to be invited, or worse, be initiated into.  We decided to dismiss our fears  and check his sugar with my husband's blood-sugar monitor.  I mean, he's only three, he can't have Diabetes...can he?

What is Diabetes?  WebMd.com explains:

"Type 1 diabetes occurs when the body's own immune system destroys the insulin-producing cells of the pancreas....Insulin's main role is to help move certain nutrients -- especially glucose -- into the cells of the body's tissues. Cells use sugars and other nutrients from meals as a source of energy to function." 

In other words, insulin is a hormone that helps sugar to travel around the body so that it may be nourished and function properly.  The pancreas in a Type 1 dibetic has shut down and stopped producing insulin.  No one is sure why this happens, but it is generally handed down genetically on the father's side.  Insulin needs to be administered via syringe in fatty tissue: arms, thighs or buttocks.  Managing diabetes is not an exact science.  Strict monitoring of what is eaten, exercise, and blood sugar levels by finger prick is required on a regular basis in order to know much insulin is needed.  Once you get the hang of Diabetes, most of time you are right with your calculations; sometimes you are not.  Lots of finger-pricking and judgement calls.

Type 2 is similar, but people with Type 2 still produce insulin, but not at sufficient levels for their body.  It can usually be controlled with diet, exercise and sometimes with pills and insulin injections.  Insulin was once derived from pig insulin, but is now reproduced synthetically.  There are several types of insulin, but that is for a different blog.

Too high of blood-sugar levels over time can cause damage to eyes (blindness), kidneys, heart, blood vessels (amputation of feet, limbs) and nerves and can even lead to coma and death.  Too low of sugar, and quickly the person can become nauseous, dizzy, disoriented, paranoid, confused, have trouble walking, or can go into a coma, or die.  Either way, the outcome can be death.  Not good.  We were not dealing with an easy disease, here.  Yes, it can be controlled, and yes, there are much worse things our child could be diagnosed with, but it doesn't matter.  We still weren't ready for this.  At least not now.  I don't think you ever are ready to have your child go through anything more than a nasty cold or a bump on the head.

We calmly explained to Linden what was about to happen.  "Daddy is going to prick your finger and get a little blood out, okay?  It shouldn't hurt, just a pinch."  My husband pricked this wide-eyed, anticipating child's finger.  We bated our breath, waiting for the howl of pain.  It never came.  "That doesn't hurt!", exclaimed our little amazing guy.  Whew.  We waited for the results.  Ten seconds for the results felt like ten hours.  The high-pitched tone let us know the machine was done with its deed.  "HIGH", it read.  No.  We weren't going to believe it.  "Hmmmm....Let's try it again."  The panic was starting to fill my voice.  Another long minute of repeating the process.  "HIGH".  Damn that infernal contraption.  So we tried my step-father-in-law's blood sugar monitor (I told you we were surrounded, didn't I?).  541.  Oh God.  Oh no. No...No. No. No. No!!!!  This cannot be.  You see, sugar levels for a normal person are between 80 and 120.  Linden's was five times that.  Sure a sign as any.

The next several hours were a blur of two emergency rooms (as we were out-of-state for the first one; the other, was three hours away near our home outside of Chicago), I.V.s, blood work, strange people touching his tummy, the smell of a hospital, urine samples, bright lights, the wailing and desperate cries of a scared child who had never been restrained at the arms and legs by his parents.  "Mommeeee, Daddeeee, make it stop!"  "Why?!?!"  and  "I don't want this!"  were the mantras for the night.  To hear your child plead for you to take the pain away, to make it better, even though you knew it had to be done, and you were the one participating, watching his face turn purple from the sheer want of freedom, the want to have people stop poking him, well, that is the most abhorrent, wretched feeling in the world.

The doctor ran all the necessary tests, and indeed it was confirmed he was a Type 1 Diabetic.  The antibodies were high in his blood stream, a sure sign his body was rejecting his pancreas.  We knew his life would never be the same, but in a way, it was a blessing it happened now.  Being a diabetic is all Linden will know, unlike my husband who was at the age when life was already so difficult, so full of hormones, teen angst and acne, that fourteen-year-old boy had to tack on another issue.

Thankfully, Linden did not have what is called Diabetic Ketoacidosis, or DKA.  We arrived in time.  DKA is when a lack of insulin causes the body's cells to be starved of energy, so in turn the body breaks down fat cells. Kind of like what happens on a low-carb diet, but way more intense and life-threatening.  In the search for this energy, the fat breakdown produces acidic chemicals called ketones.   The blood becomes increasingly acidic , and your liver is working to release the sugar it stores for a "rainy day".  The body cannot use these sugars without insulin, so more sugar is piled into the battered blood stream. This combination of high excess sugars, dehydration and acid build up can be life-threatening if not treated immediately.

He finally fell asleep at about 6 a.m. on that Easter Sunday morning.  He woke up a couple of hours later to the Easter Bunny and the local police department making a visit to all the children in the hospital.  A reporter was there, and Linden even made the paper, albeit a snippet.  The hospital made up easter baskets for all the kids, including the siblings that had to endure sitting by their kid sister or big brother in a boring hospital room rather than hunting or coloring Easter Eggs.  For us to  see Linden smile, no, not cry, for the first time in fourteen hours really made us swell with emotion.  He was going to be okay.  We knew this. The question was: were we?

A lot was to be learned not only for him, but for the whole family.  After all, it was my husband and me who had to check the sugar levels, give the shots.  It was my teenage son who had to learn emergency measures like Glucagon in case we ever wanted a "date-night" again and Linden falls comatose from lack of sugar.  We already watched what we ate.  I already knew the dangers of white flour, high fructose corn syrup, fructose, lactose, all the other "-oses", and made sure they had clearance to come through the garage door on shopping day, but  but now we were on "Maximum Sugar Security Lockdown".  Life was certainly going to be different.

Fast forward to today: Less than a year later, things did change, but has gone better than expected.  We are very lucky parents, to have a child that lets us poke him with needles and lancets without too many struggles.  He definitely does not enjoy his routine, and occasionally rebels (who wouldn't?), but we know it could be so much worse.  Linden's previous doctor in Illinois told us of a patient that is Linden's age that has to be chased down and held for every finger prick and shot.  That is about six or eight fights a day with a three-year-old.  I am betting a really strong three-year-old.  I can only imagine the agony of that poor mother, getting her workout whether she wanted it or not, emotionally and physically.  But I know she does it out of love for her baby, so her baby can live a long and healthy life. 

You don't have to have Diabetes in your family history for it to happen.  Doctors and nurses at the hospital told us of how "lucky" we were to know the subtle signs, as a lot of children come in when they are in grave condition, bordering on death because their parents thought that maybe they just had the latest "bug" or flu.  I wouldn't call it "luck" for knowing what to look for, but I am thankful for that heightened awareness.

Here are the signs to look for in your little one, as they may be subtle, but you as a parent know when something is "different":

    •    Increased thirst
    •    Frequent urination
    •    Dry mouth
    •    Increased appetite (even after just eating)
    •    Unexplained weight loss despite eating and drinking
    •    Blurred vision
    •    Abdominal pain
    •    Fatigue
    •    "Fruity" smell of the breath
    •    Confusion
    •    Shaking
    •    Frequent infections of the urinary tract or vagina
    •    Loss of consciousness (rare)

If you notice any of these signs, go immediately to the nearest emergency room and tell them of your suspicions.  They will check your child's sugar and give the appropriate medical attention before it gets out of hand.  Your child may have just been thirsty from the hot weather, or playing too much, but to err on the side of caution is to save your child's life.