Eleven years ago, I was working as a mountain guide while living in Yosemite National Park. I led backpacking trips, as well as day trips to the summit of Half Dome, and I spent almost every day off climbing on granite. I also happened to be slowly starving to death because of uncontrolled high blood sugar levels.

My very first A1C was 16.7% and now (as of April 2018) my A1C is 7.6%.

I was living in Las Vegas during the winter of 2007-2008 waiting for the new guiding season to begin when I was diagnosed. You would think (if you know anything about diabetes) that with an A1C as high as 16.7% that I would have been to the doctor at least once with some kind of complaint or another. But it wasn’t until my mom came to Vegas for a visit, and we went to the Bellagio for a buffet breakfast, that I finally was knocked off my feet enough to convince me to seek medical care.

I had dropped from a size 8 down to a loose-fitting size 4 by the time I was too sick to stay awake for longer than ten minutes at a time. I had simply assumed that my time spent hiking in Yosemite carrying a pack weighing around 50-60 lbs during the previous summer had been enough of a workout to accomplish the significant weight loss. I can

still vividly remember the nights spent in the backcountry feeling as if there was a vast and bottomless void in my stomach. I have never felt so incredibly hungry and un-satiated after eating as I did during those few months. I would dream about food and wake up in the mornings feeling cramped from being so hungry. But, I thought, of course I’m hungry. I’ve hiked at least 8-12 miles everyday and am carrying a backpack heavier than a third grader. It’s not strange for me to be this hungry. I just have to keep eating everything I can get my hands on. Especially yummy white rice and noodles!

My winter days spent climbing and working in Vegas did nothing to help me reclaim the lost weight. My clothes were steadily becoming looser and hanging off of my hips for the first time in my life. I LOVED being thin! I remember one morning waking up at my

boyfriend’s house after he and his roommates had left for work, eating an entire box of donuts, and not feeling the slightest bit sick–just hungry. Thinking back now, I have to wonder: how could I have felt any sicker than I already was, when I wasn’t even aware of how sick I actually was?

The intriguing uniqueness of my particular type of diabetes (Latent Autoimmune Diabetes in Adults) is that it is very slow to progress. When other Type 1 diabetics start to become sick, it is usually a swift and obvious progression of symptoms that sends them to the hospital immediately (it also usually happens in early childhood or adolescence). It wasn’t that I ignored my health. It was simply that because my health was deteriorating so slowly over the years, my symptoms became normalized without my awareness. It was normal for me to not be able to stay awake throughout an entire movie. It was so normal, in fact, that my friends were perfectly aware of the fact

that I would never stay awake, and it was accepted as normal by everyone I spent time with that I would eventually wind up curled on the couch or in a chair and fall asleep, even at a party. It was also normal for me to drink water continuously and not go an hour or so without having to pee.

It wasn’t until after that buffet breakfast (the last buffet I will ever attend) at the Bellagio with my mom, that my symptoms finally became obvious and severe enough to send me to Urgent Care. We had only walked a few blocks from the hotel to go shopping when I began to feel nauseous. I finally had to turn around and go back to my mom’s hotel room to rest and wait for her return. I threw up three times on the short walk back to the hotel. Once I crawled into her bed, I wasn’t able to stay awake long enough to finish watching an entire sitcom episode on the T.V. In fact, we had to turn on the television just so I was able to focus on a show and manage to stay awake for more than ten minutes at a time. We thought it was a vicious virus and we tried to manage my nausea with crackers and orange juice. Nothing stayed down, and I wasn’t staying awake.

Finally, my mom made the decision to take me to Urgent Care (which was the first of many mistakes in my experience of being diabetic) and I learned of my condition when the doctor looked at me in disdain and contemptuously said, “you know you’re diabetic, right?”

“I do now,” was the only reply I could painfully manage.

I was immediately misdiagnosed as Type 2 because of my 32 years of age. It never occurred to the Urgent Care doctor to ask about my family history of diabetes (of which there is NONE) and I was never diagnosed as being in Diabetic Ketoacidosis (which I am now fully aware was my prognosis in hindsight, due to the two other times I have been properly diagnosed since). I was simply pumped full of two bags of saline and sent home with an appointment to begin oral treatment in a couple days.

I spent almost a month taking Metformin and some other pill that was supposed to lower my blood sugars. I read the literature explaining how to measure proper serving sizes of carbohydrates. I measured a handful of rice twice a day and ate nothing else but vegetables. Like I said, I was never one to simply ignore my health. Yet, my blood sugars

never went below 300. Finally, the Type 2 doctor I was seeing put me on 40 units of Lantus to be taken before bed. The pharmacist at the Target I went to fulfill my prescription for the insulin, and a box of syringes, asked me if I had ever injected myself before. I looked at him in terror and mutely shook my head. Luckily, he took pity on me and took a syringe out of the box to show me how to do the impossible.

***A quick side note: to give you an idea of how much syringes petrified me, let me tell you a short story. My mom was in the Navy and just before my senior year of high school she was transferred to a small island in the Aleutian chain of Alaska. I was living with my dad at the time, but decided to live with her for the first semester of school so I could experience the great white north. Before we could leave the lower 48, however, I needed a vaccine. I remember sitting in the waiting room in the Navy hospital surrounded by mothers with young children and infants all waiting for their own vaccines. When it was my turn, and I was in the exam room, the doctor told me to relax. I was so stressed at the knowledge that I was about to be poked in the arm with a needle that I unintentionally yelled, “WHY?!?” The doctor sighed and told me I was too tense. So, I replied (loudly) “OKAY!” At seventeen years of age, I was so scared of a small needle that my shouts, from within the exam room with a closed door, had scared every child and baby in the waiting room, and they were ALL crying when I came out five minutes later.***

What happened the very first time I gave myself an injection of insulin now makes me smile with a feeling of carefree acceptance that has only been earned through the experience of eight and a half years of diligently injecting myself with needles at least five times a day…every day. I stood in my kitchen in Las Vegas, bare feet cold on the tile floor, and held the carefully prepared syringe in my right hand. My left hand held a pinch of skin on my belly, and I stood there looking at the syringe in my hand, waiting for the courage to stab myself on purpose. Finally, finally, I was able to jab myself in my stomach with my very first syringe and the shock of the event caused me to let go of everything and stick my hands up into the air. I chuckle every time I think of how that syringe looked sticking out of my stomach, jiggling slightly as I shook with dread from what I had just accomplished.

 

What I cannot smile, or chuckle about, is the memory of how I wound up that night (and

the next four nights) crawling into the kitchen at three in the morning and sitting on that cold tile floor eating an entire box of cereal with violently shaking hands, and the same devastating hunger that had haunted me on my backpacking trips the previous summer. With the initial prescription for insulin, the Type 2 doctor had also provided me with a referral to see an endocrinologist in six weeks. After the second night of using Lantus I called the endo’s office to ask if they could fit me in sooner because, as I told the receptionist, “something is horribly wrong and I’m scared.”

I was told there was an opening that Thursday and was asked if I wanted it. I have never been so enthusiastic, or relieved, as I was at that exact moment when I answered YES!!

I remember the day of that first endocrinologist appointment being a Thursday because it also happened to be May 21, which was my 33^rd birthday. I learned I would be dependent on insulin every day for the rest of my life and, as much as I hated that fact (and still do), it was also the best present the Universe could ever have given me—because the endocrinologist properly prescribed me to take FOUR units of Lantus in the evening before going to sleep. The greatest birthday gift I have ever received in my life was the opportunity to STAY ALIVE.

Needless to say, I do NOT like Urgent Care units…or Type 2 doctors.