Bryn Smith, Internal Medicine Resident Coordinator at Northeastern Health System, was was diagnosed with non-familial Type 1 diabetes when she was eight years old. In recognition of November as Diabetes Awareness Month, Smith has offered her story to help create awareness of a disease held by millions of Americans.
“I was diagnosed with non-familial Type 1 diabetes when I was eight, in my home state of California,” said Smith. “I remember getting sick, vomiting for a few days. Then, as I recovered, I remember having the most uncharacteristically ravenous appetite ever, eating anything and everything I could get my hands on, while becoming thinner by the day. I was extremely thirsty as well, and began bruising for no apparent reason. My parents, despite being highly educated, preferred to keep things natural, living without most medications and choosing not to seek assistance from physicians.”
Smith’s parents changed their minds when she failed to improve. She was taken to a local pediatrician who immediately admitted her to the hospital.
“I was also placed in the custody of the state, while my parents were, ‘counseled,’ to appropriately parent a child with diabetes,” remembered Smith.
From the moment of hospitalization, life changed dramatically for Smith. At the time of diagnosis, management of diabetes was largely guesswork. There were no finger-stick blood tests available to determine blood glucose. Instead, all urine had to be collected, measured, tested, and recorded.
“My dad had to perform strange calculations to determine an approximation of my blood glucose levels,” said Smith.
During this time, insulin was different. It was derived from animals and poorly concentrated resulting in allergic welts at injection sites, and requiring larger amounts of insulin in every injection.
“My parents were scared to let me out of their sight, yet, they were also frightened by the burden of my care,” said Smith. “I grew up quickly and learned to manage my diabetes like a pro! Except when I didn’t. There were times I didn’t test my urine, and times I ate candy and ice cream. I got sick, of course, but, that was considered typical. I didn’t like being different from other kids and I loved candy.”
In her teens, Smith was thrilled to start using synthetic insulin which was highly concentrated, meaning no welts and less insulin in each injection. Then, blood glucose testing via finger-sticks and meters became the norm, instead of urine testing. Things improved but, each episode of low or high blood sugar became more and more severe, common in Type 1 diabetics.
“I went into my first diabetic coma at the age of 14,” remembered Smith. I had attended a party with my classmates, and drank punch that was undoubtedly laden with sugar. It wasn’t a quick process but, I was barely clinging to life once a physician was made aware of the situation. All I remember is waking up in the hospital with tubing entering and exiting my body. I experienced three more comas over the following three years.”
Experiencing high or low blood sugar is exceedingly uncomfortable, sometimes nearly painful. Each person feels things differently, and at different levels. For Smith, high blood sugar danger happens far more slowly than low blood sugar danger; but, either situation can affect patients mentally, and quite dramatically.
“It’s like being ‘hangry,’” explained Smith. “While I interact, speak, walk, I do all kinds of things while having low or high blood sugar. I rarely remember the episodes of low blood sugar. That’s probably a blessing.”
Today, there are many items of technology that make managing diabetes far easier, and much more precise. Still, complications occur that simply cannot be controlled or managed.
“From my personal perspective, one of the craziest things I’ve ever done happened in Las Vegas. Seriously,” said Smith. “My husband and I attended a National Finals Rodeo one year, and stayed in a hotel for the duration of the event. At around 4:00 a.m., I wandered out of our hotel room, wearing only pajamas. My husband awoke to the sound of banging and raised voices from the room next to us. He determined that I was not in the room and immediately suspected the worse. He opened the door to search for me; but, he quickly closed it to only a crack as he observed the situation. Please remember – I had and have no personal recollection of this happening.
“I was banging on the door of some poor, unsuspecting young ladies. For whatever reason, the young ladies opened the door to me. I smiled enthusiastically, as I cheerily announced that I wanted to join them for the party. The spokesperson of the group giggled, but informed me she had no idea who I was. I let her know with the utmost of gleeful enthusiasm and excitement that I did indeed know her as I had partied with her at the baby shower (what . . .?). She giggled again and proceeded to close the door.
“My husband was about to grab me, forcing me back into our room, when a huge Security Officer approached. He resumed his stance of hiding behind the door, listening to each word. The officer asked me what the problem was. I happily told him I was joining the party. He knocked on the hotel room door of the poor young ladies, announcing, ‘Security!’
“The ladies opened the door, while the Security Officer verified they had called him. They affirmed they had. He asked them to let them know what was going on. Again, they giggled as they related that I was insisting I knew them from some baby shower, and wanted to join the party. The officer asked me if this was true. I responded with ‘Yes. I’m coming to the party!’
“The gals stated that they didn’t know me. I insisted I did know them. They emphatically stated they had never met me, and that I was drunk. The confused officer went to take my arm and lead me away: but, I wasn’t about to allow that. I peeled his fingers off my arm, telling him, ‘No! You can’t touch me.’ He advised the ladies to close and lock their door, while he went to get help with me. He left.
“That was when my husband finally dashed out and grabbed me with all his might, and dragged me into our room. He gave me a shot of glucagon and put syrup in my mouth. Then, I passed out.
Smith had no recollection of the event.
“It is all so wildly out of character for me. I can’t even imagine that being part of some deep-seated personality issue,” said Smith. “
Fortunately, big events like this do not happen often for Smith. It a much milder type of event that occurs all too often.
“Recently, I went to Wal-Mart to pick up photographs I had sent in to be printed,” said Smith. I informed my daughter that I was leaving to do just that. An hour and a half passed before I finally returned. I cannot tell you what I did during that time; however, I had several sacks full of groceries, and no photographs.
“We looked at the items, each of us wondering why on earth I’d purchased them. They were things I just wouldn’t purchase. Among those items were the ugliest dishtowels I’ve ever seen. We both were worried that I had possibly stolen them. But, there was a receipt demonstrating otherwise. There was also a package of cookies that looked as though a wild beast had torn into them. Left to mere speculation, we determined that I recognized the onset of low blood sugar and grabbed the cookies.”
Smith and her daughter concluded that she likely wandered up to someone else’s temporarily abandoned cart and assumed responsibility for it.
“I think the question I am asked the most is what I feel when having high or low blood glucose,” said Smith. “High blood sugar levels, to me, feel like I have the flu, accompanied by vomiting. Only, it is worse. Perhaps it feels like being poisoned? I wouldn’t know.
“Low blood sugar feels immensely confusing – at least the parts I remember leading into and coming out of an episode. Frequently, I feel my lip getting numb. Sometimes, I feel a flash of darkness. Yes, I realize that sounds like an oxymoron. The worst part is coming out of an episode, drenched in perspiration, freezing, and wondering what I did this time. It can be terribly embarrassing but, I’ve learned to laugh at the stories I hear about myself. Trust me, my friends with diabetes have far more interesting stories than me.”
Despite episodes such as these, Smith is under the care of a qualified physician and she wears an insulin pump, a continuous blood glucose meter that transmits blood glucose readings to her husband, complete with alarms should her sugar get too low.
“Despite these measures, there is no way to achieve ideal blood glucose control using current tools available to me. Many people with diabetes experience similar situations. There just aren’t absolutes in the game of control. We can do much better.”
Today, diabetics are living longer and are healthier than ever before. New research continually reveals new methods that offer better blood sugar management.
“I am grateful for technology that allows a better and longer life for me. I do not look for or desire sympathy or much accommodation,” said Smith. “I like to share so that other people with diabetes know they are not alone, and family members understand slightly more what life can be like with one of us. I adore connecting with other diabetics via social media. I’ve learned so much!
“So, how would I describe life with someone like me? One entertaining adventure. Actually, that’s what it is like for me, too.”
Northeastern Health System now hosts a diabetes clinic, run by Dr. Sandra Escandor on Tuesday mornings. Those interested in this clinic are encouraged to speak with their primary healthcare provider about a referral.
The administration, providers and staff at Northeastern Health System strive to provide convenient and affordable access to a full range of services, including many primary and specialty care services, and consider it a privilege to serve the community.