Tuesday, November 1, 2011

The Tall Weeds

Yesterday, in the midst of my bi-monthly doctor's appointment to regulate, observe and hopefully manipulate my Type II Diabetes, I was told I now have Type I Diabetes - which is the older, crueler step-sister of Type II Diabetes.

I also had a fleeting glimpse into my own mortality which, all things being equal, I could have done without.

I have a buddy, in years past very close, but like all buddies eventually, now far away and emotionally remote, who used to say about stuff like this, 'you're in the tall weeds now.' He's right. I felt the weeds were very tall for a while yesterday. So tall, in fact, I couldn't quite get my mind around them for a bit.

Type I Diabetes means I have to take four shots a day for the rest of my life, all in my stomach. I was given a little pamphlet when I left, with stick figures and cartoon characters representing sugar and insulin and various cells and abstract hyperglycemia drawings. The figures drawn to represent the cells hungry for sugar are particularly cute. One has the hard-working insulin, smiling of course, feeding the grateful cell as it shepherds the sugar through the bloodstream. It's comforting to know there's a whole Electric Company segment taking place inside me on a daily basis, teaching the kids the alphabet and overseeing my blood sugar.

A couple weeks ago I had a battery of blood tests run over at Cedar's Sinai, a hoity-toity hospital facility here in Southern California. Although I can't say I was particularly surprised, one of the conclusions apparently indicated my pancreas was no longer producing any insulin. "It happens," my doctor said. "Sometimes when you're older (that would be me, 'older') the pancreas gives one last push, one last surge and then gives out." So that's what mine did. Like Anthony Quinn in Requiem for a Heavyweight, the old pancreas gave it one last shot, one last fight, with everything on the table, and then gave out.

"How do you feel about insulin?" she asked. "Well, I voted for it in '96 but felt it didn't live up to it's campaign promises," I joked appropos of nothing, just trying to be Reagan-esque about it all ("Honey, I forgot to duck.") She smiled and said I would have to go to 'the pens.' The pens are the syringes. They're called 'insulin pens.'

While Angie and I waited for what seemed like hours and in fact WAS hours, I kept picturing the 'insulin pens' in my head. After a while they took on a diabolical shape in my mind. Finally, a very petite and earnest young lady called us in and showed us how to inject myself. I almost wrote 'inject ourself.' And that's because during the wait I think Angie was more upset about the whole ordeal than I was. She kept saying 'this is a GOOD thing, this will mean you won't feel so bad all the time.' But I'm observant if nothing else, and I could hear the faint strains of the whistle as we both quietly padded by the graveyard. So the earnest and petite RN showed me how to stick needles in my stomach. How to carefully acquire three or five cc's of insulin and then, at a 45 degree angle, push a needle into my stomach. This is where the fleeting glimpse-of-mortality-thing took place.

Fitting that this entire episode happened on Halloween, because it certainly had a grotesque quality to it.

I remember some years ago in Chicago, a friend had a bunch of us over for a Super Bowl party. The beer and sodas were in the fridge, of course, and as I entered his house, he said as much. "Just help yourself," he said, "beer and whatever else you want is in the fridge." So I wandered into the kitchen and grabbed myself a Dr. Pepper. And I noticed as I grabbed my soda that there on the inside shelf of the fridge, next to the ketchup and soy sauce were vials of clear liquid, small ones, with little rubber tops, scientific-looking, slightly dangerous - insulin bottles. They seemed to say something ominous, just sitting there out of place among the Dijon mustard and half-empty jar of dill pickles. They seemed to carry an importance not altogether welcome in that atmosphere of football and corn chips. They seemed to say, "Even today, right in the middle of all this laughing and joviality and witty friendship, I'm here to remind you that you're broken."

I learned long ago that self-pity has a shelf life. That way there be dragons. So I allowed myself a half hour or so, as we were driving home from the doctor, and then put it aside. One image the doctor left me with was particularly on my mind. She said, "If you're out at a restaurant, just excuse yourself right before you eat, preferably once the food is actually in front of you, and slip off to the bathroom and give yourself an injection." For some reason this image made this whole Type I Diabetes thing real for me. The tall weeds were suddenly very tangible.

So last night, once the last trickle of trick or treaters had left, Angie prepared my shot. I injected it myself. It didn't hurt, really. I took a handful of my stomach, pinched it between my fingers and slid the needle into it. Fortunately I've become a huge, fat pig the last few years and it wasn't difficult to grab hold. It was the fourth shot of the day, ostensibly, the last one, with 10 cc's of insulin, 'to be given at bedtime.' I did it standing alone in the kitchen, quickly, not thinking about it, just following the directions of the earnest, petite girl nurse. And I thought to myself, I have to do this four times a day for the rest of my life. Which meant absolutely nothing to me. Kind of like a prisoner's first day in jail, "Well, I'm here for the rest of my life." What does that even mean?

Angie tells me of a lady she knew back in Missouri when she was younger - someone named Sharon - who, after a troubled time with Diabetes, lost her legs and finally died. She's mentioned this a few times, actually. Well, I have my legs, they're just fine, thank you very much, and they don't seem particularly concerned with my Diabetes. They don't act up in any why whatsoever and they most certainly don't seem to be in any danger of being 'cut off.' I listen to this story, depressing as it is, and I think, 'well, maybe my diabetes is a less violent strain, a type not quite so malignant.' Of course, that's just hooey, it's all the same strain.

It's going to take a while to incorporate this whole sticking-myself-with-a-needle thing into my lifestyle. A whole different set of rules are on the table now. And I despise rules, always have. So it'll take some concessions on my part, obviously. And I'm fond of my legs. I often use them for walking. So I'll figure it out. I'll make it work. And as I reached into the fridge to grab our cannister of Trader Joe's coffee this morning I noticed the two vials of clear liquid, sitting there, unassuming, next to the hot sauce and the mayonaise, silently reminding me that something just got rotten in Denmark. And the weeds in my own kitchen were too high to see over.

See you tomorrow.