Underlying Conditions

By Allyson Wuerth

So, you wouldn’t know by looking at me, but I’m one of those “high-risk” individuals with “underlying conditions,” one of those unfortunate groups likely to become seriously ill if they contract COVID-19. I’m 42, I exercise regularly, I eat pretty well, and, oh yeah. . .I have type 1 Diabetes, also incorrectly known as “juvenile diabetes.” This means my pancreas suddenly stopped producing insulin, and it didn’t matter how old I was, or how much I did or didn’t exercise or eat. It means that my small intestine spends all its days cradling a dead organ, like a grieving mother whale carrying her dead baby across the sea again and again, hoping maybe one more good push and it would heal within the magic of all that water.

But instead, the pancreas remains unresponsive, shrivels up like one of those jarred baby shark souvenirs. Remember those? The ones that stared back at you like pickled rag dolls in blue water? I haven’t actually seen it, my pancreas. But since becoming diabetic, I’ve always imagined the organ inside me like this, all slick and puckered.

I was diagnosed at age 25, and it took almost dying for doctors to diagnose me. . .because children get type 1 diabetes, not 25 year old women. It was easier for them to believe I’d developed diabetes when they found out that my father was also a type 1 diabetic. Of course, I only know this second hand, as I was unconscious and unknowingly suffering from a diabetic complication called ketoacidosis, which is often triggered by illness or infection. If the body does not get the insulin it needs, it will begin turning fat into fuel. Acids clog the blood and the body simultaneously shrinks in size and bloats in confusion and disorientation. The body tries to die, is actively dying, but you’re too gauzy-brained to notice. Ketoacidosis is why illnesses like the flu or Coronavirus make me panic. I’m one of the people who needs to be vigilant despite the slim-chance statistics that apply to most everyone else my age. Keto Week ‘03 flashbacks are enough to make me rage when sick colleagues or sick students come into school. Remember, your “little fever” could be a near death experience or worse  for the immuno-compromised. I didn’t fight my way back so ketoacidosis could try and ruin me again.

After four days in the ICU, I was transferred to a regular room where I had to practice injecting oranges with saline, and then finally myself (the orange) with insulin (the saline) before I could go home. It’s silly now, but at the time I thought I’d rather die than stick a needle in my own stomach. And as insulin dripped off the tip of the syringe, I thought, this is exactly the smell of the blue bath.

My father’s bathroom in the house where I grew up was hideously blue. Seventies-made sky blue-tiled walls and a matching toilet,  blue floral wallpaper, even a blue tulip-shaped plastic trash bin where my father dropped used alcohol pads, over-used syringes, blood speckled cotton balls—the scraps of diabetes. I’d sit on my mom’s side of their bed and tell him about my day as he took his evening dose of insulin with the blue bathroom door opened just a crack so he could hear me. Through the crack, I could see him with his shirt off, plunging a syringe deep into the subcutaneous fat of his abdomen. And that smell that I always imagined was just the smell of the blue bath, was actually the sting of insulin. I have no idea why, but the moment in the hospital when I connected these two smells, was one of the first and last moments I’ve ever felt true self-pity. Diabetes had always been a part of my life—that smell contained its permanence, its vice grip over the many rooms of my life. Spaces I hadn’t even seen yet. Doorways with walls I couldn’t begin to imagine.

Would this illness wreck my life? Would my future be all Julia Roberts tearing out her freshly coiffed hair, orange juice staining her wedding dress? Would I die on the floor of my kitchen surrounded by boiling pots of pasta and my screaming toddler? Would I even have a baby at all? After all, that’s what killed Shelby in Steel Magnolias. They warned her not to have a baby (Later my fiancé, who is now my husband, told me the first words I spoke to the nurse when I regained consciousness were: “Can I still have kids?”). Spoiler alert: We have two amazing and healthy children, though they challenged my body in ways my pre-diabetic self never could’ve imagined.

Alone in my room, I wonder what this virus will mean to me in two weeks, a month, a year. Will it spare my family? My 70yr old, diabetic father? Myself?

Alongside all these ‘what ifs’, I also know I must be vigilant. This means doing my best to keep my blood sugar within a normal range. Too high and I’ll be more susceptible to an illness like COVID-19. Too low and I could put myself in immediate danger of passing out. The line is fine and difficult to navigate, dependent on so many variables. It’s not just food that affects blood sugar; one also must consider hormonal shifts, stress, exercise, fatigue, temperature, etc. Any one of these variables and 20 minutes time could find you and your oh-so-confident-I-can-drive-with-a-blood-sugar-of-175 self  in a fugue state in the Kohl’s parking lot with a blood sugar of 13 and your five month old baby in the backseat. And no matter how many times you crunch the numbers, you’ll never know where you went wrong, though your OB will suspect nursing is the culprit and urge you to consider formula.

These variables were my first thought when I got a call last Thursday night that my school would close indefinitely due to the spreading Coronavirus. Before I put my phone down, I thought about the number of steps I usually take by 9:36am on a school morning (nearly 3000) and how my insulin needs would change if I cut those steps in half or ¾ even. Do I change my basal rate in my insulin pump now or do I wait and see how things go? If I wait, how many days do I let my blood sugar remain in a higher range before I put myself at risk for infection? Is this when the virus will get me? The questions overwhelm me.

But instead, I pick up my phone and text some colleagues—“God, I knew I should’ve brought those mask projects home to grade. What the hell was I thinking?”

 

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