I mentioned missing a month of school due to diabetes. Going to culinary school required a physical exam and verification that I was up to date on such shots as Hep B, tetanus, etc. Something something something sharp objects. (I suppose it was a reasonable fear, considering I ended up in the hospital after catching my finger on a meat slicer.) So I get a call from my doctor’s office saying they needed to schedule me with a nutritionist and then a nurse about my diabetes. Uh.. what diabetes? First I’d heard of it. You’d think they could have come up with a better way to break the news. So I go in and meet with a nurse who shows me how to use a blood test meter. For those of you who have never had the pleasure, you poke your finger with a lancet (Latin for stop poking me with that thing.) Then you put a drop of blood onto a strip, which is plugged into the meter, which then tells you what your blood sugar is. At least that’s how it is supposed to work. What actually happens is you poke your finger, realize you forgot to put the test strip into the meter, poke your finger again because the first hole already closed up like a badly pierced ear, try to squeeze enough blood onto the strip, fail, poke your finger again, and squeeze out just enough blood that the meter registers the drop but then gives you an error because it’s not enough blood. Replace the test strip because the last attempt was not enough to get a reading but just enough to ruin the test strip and they can only be used once, poke a different finger because the first one is starting to hurt, try to squeeze blood out, fail, poke another hole, now there is blood coming out of both spots, get way more than enough blood, now your meter gives you a number like a bathroom scale the morning after the office Christmas party. I recall the nurse telling me a lot of people get the meter, then go home and drink a 24 pack of Mountain Dew to see how high a number they can get. (I can identify, my weekends were spent playing World of Warcraft and drinking Mountain Dew Code Red.) So she gets me to take a reading, which was way over 200. She looks at me and says “I see you’ve already done that.” Odd thing, all I had that morning was a bottle of tea. She tells me I am what they call “pre-diabetic,” which basically means one candy bar away from full-blown diabetes. But not to worry, I can control it with proper diet and exercise. So I spend the next few months at culinary school not eating properly.
I had my own apartment in Montpelier while I attended school. I knew I would never survive staying in one of the dorm houses. I was in my late 30’s, and the majority of the students were fresh out of high school. I confirmed my fears the first week – they were there to party all night and every weekend. I was there to learn and do well. The two cultures can occasionally mix, but I was not too confident that I would be that lucky. So I had my own little place. It was a little place on the top floor of a woman’s house up the hill from the center of town. She was known as “the chicken lady,” mainly because she had a dozen pet chickens. My place had its own entrance and a small flat spot on the roof where I could set up a chair and a small grill. It had a full kitchen and living room that doubled as a bedroom. I had cable TV and internet, air conditioning, all the comforts of home. So, you’d think I’d be okay providing decent meals, given that I already knew how to cook. Eh, not so much.
I have always had a bad habit of sleeping too late. I would fly out of bed and through the shower with barely enough time to get to work (or in this case class) which left no time for breakfast. If I did eat anything it might have been a cold piece of pizza from the night before or a scone someone brought over from La Brioche (the school’s pastry shop where the baking students trained.) So, already off to a bad start. Lunch was mostly non-existent. We would work the Main Street Grill, do lunch rush for customers, cook up a bunch of food for student lunches, then clean the kitchen and go eat. What actually happened is everyone would run off to eat lunch and leave a messy kitchen, and the chef instructor would yell at us. So after we put out the student lunch, I would make sure my station was clean, and realize that no one else bothered to clean their station. So I would do it. I would spend 15-20 minutes wiping down counters and making sure stoves weren’t caked with crud (on the days when there was not another class in right after us. Most of the time, they were shoving people off their stations before we were even done filling lunch tickets, so there was no time to clean.) Either way, by the time I would get out to eat lunch, there wasn’t anything left. There would be a tray of burgers or chicken sandwiches put out along with a bigger tray of french fries or potato wedges. The sandwiches would always go first, leaving nothing but potatoes. As a newly-diagnosed diabetic, I was told to avoid starches, so I might nibble a few fries but that was all I would get. Then I would finish the rest of my classes, drag myself home, too exhausted to cook anything so I would grab Chinese food or pizza for dinner.
All the stress and improper diet got me sick to the point where I couldn’t stay in class. I was sent home for a month to meet with a nutritionist again. During that time, I met with the student advisor who was appalled to find out that a student was sick from malnutrition in a culinary school. After that, they started making sure a staff member was in the lunch room to find out what was going on (apparently I was not the only one who reported that there was not enough food, but I was the only one to get sick over it.) Turns out the kids fresh out of high school who were used to getting whatever they wanted were taking two or even three burgers, eating part of one, then throwing the rest away. This did not go over well with management, who are trying to keep food costs down and keep students healthy.
I can’t help but think I was a pain in the ass for the advisor. Another time I was in her office was because one of the chef instructors yelled at me because I had a medical alert bracelet on. He said you’re not allowed to wear watches or jewelry in the kitchen. I tried to tell him it was for medical reasons, but he would have none of it. I mentioned that to the advisor as well, next day the chef instructor gives me a dirty look but says nothing about the bracelet. Of course years later I learned most of the time emergency people don’t even read the bracelet anyway. Mine clearly stated that I was allergic to morphine, but every time I ended up in the hospital from some sort of injury, the first thing they did was put me on morphine. Second thing was always “ask me a bunch of questions that are answered by the bracelet.”)
By the time I was done with NECI (as in, no longer going – I did not complete the program) a doctor told me that diet and exercise alone were not working. (Ya think?) So he puts me on metformin. That does nothing but make me sick. So he adds insulin to the regimen. Oh boy, that’s how you know you’ve arrived, except in my case I tripped over the carpet and fell down the stairs. The beginning of my ordeal was with Elliot Health System, then I started going to an office in New London. They were kinda useless when it came to diabetes education. I recall a physician’s assistant basically handing me a prescription for Novalog and saying “have fun.” I exaggerate, but not by much. He gave me no instruction, just a basic guess of how much to inject. I remember a few times where I took a wild guess at how much insulin to inject and was way off. First time I had low blood sugar, I was making dinner and my legs started to get wobbly. I checked with the meter and I was at 44. I figured it was just hot in the kitchen because I was cooking. I spent the next half hour eating anything sugary in my apartment, checking my blood sugar every 5 minutes until all my fingers were sore. It happened other times, more than once I panicked and called 911 because I could not get my blood sugar back over 70, only to be over 300 by the time they got to me. With proper instruction I could have avoided all that. It wasn’t until 2 years later that I started going to Dartmouth Hitchcock and got a diabetes educator who actually took the time to make sure I knew what I was doing.
If you’ve never experienced low blood sugar, I don’t recommend it. A common misconception about diabetes (other than “only fat people get diabetes”) is that if you are diabetic you can never ever again eat sugar. People will constantly question you if they see you drinking soda or eating a bag of M&M’s. Truth of it is, your body needs sugar but “all things in moderation.” Your body digests carbohydrates and converts them to glucose, which goes to your organs. Your muscles and your brain need glucose to function. Diabetes makes it so your body does not properly handle the excess glucose. A normally functioning system creates insulin to counter the glucose and keep it in check. A diabetic person does not create insulin at all (type 1) or only sporadically (type 2 and yes I am over-simplifying a bit. This post is already almost 1900 words.) So you have to use injected insulin to keep your glucose in check. Let your glucose go too high for too long and it can cause problems like organ failure, blindness, clogged blood vessels and stroke (ask me how I know.) Let it drop too much and your muscles can cramp up and you pass out. Normal glucose level should be around 90-100, with a slight elevation after eating. A non-diabetic person’s blood sugar will normalize on its own, but a diabetic has to inject insulin to lower it. It’s a carefully calculated number that I did not have enough education to properly calculate, so I was injecting too much or too little. Many years ago a co-worker died from low blood sugar. Scary shit.
So fast forward to the present day. The educator I saw at DHMC was great. She put me on a Freestyle Libre, which is a sensor you wear on your arm or stomach and scan with a reader or a smart phone. You then get a digital reading of your blood sugar, along with a chart showing how you’re trending (like if you’re rising or dropping fast.) That worked great and did not require finger poking unless I was changing faster than the Libre could keep up. (There is a difference in blood test via finger stick vs reading the glucose in your fatty tissue, which is what a glucose sensor does.) After she retired, I started seeing an educator with Newport Health Center (part of New London Hospital) who got me approved for a Dexcom continuous glucose monitor. Difference between the Libre and a true CGM is the Dexcom transmits the readings to my phone on its own. I don’t have to manually scan the sensor. This means I can set alarms to alert me when my blood sugar is going up or crashing (headed for a dangerous low, which it tends to do for some odd rason no one can explain.) It will let me know before it’s too late to do anything about it.
I’ve also been working towards getting set up with an OmniPod, a new kind of insulin pump. My last educator (before DHMC bought New London Hospital and got rid of anyone useful) suspected that injecting 2 or 3 times a day was not working, and perhaps a pump that gives a continuous flow of insulin would be better. Difference between a pump and an OmniPod is the Pod has no tube to get caught on things. The whole thing just sticks to your skin like the Dexcom, you just change out the insulin cartridge every few days. As much as I did not want to have to rely on a pump, I guess if I have to do it the Pod is the way to go.