The D day

We were planning on traveling to India in December for about 3.5 weeks during Sriram's winter break.  We met the pediatrician couple of days before thanksgiving as a travel visit and to get the kids' yearly flu shots.  The pediatrician made a passing reference about Sriram's weight by comparing it with Raghav's.  Sriram's weight was always on the lower end of the curve while Raghav was right on target since birth.  Therefore, I didn't take her comments too seriously.

Sriram looked more and more agitated that week and was hardly eating anything.  I was able to notice it obviously as the school was off that week and he was at home almost all day.  I was wondering if there was some underlying behavioral condition such as ADHD.  My husband said that probably we should see the pediatrician again and discuss about our concerns as were planning on going to India the following month.  When I called the pediatrician's office I was asked the reason for the appointment.  I just said that my son's appetite is going down with each day and I need to see the doctor.  The front office assistant replied that there is "no treatment" for this issue.  I simply shot back that I need to see the doctor.  We were scheduled to meet the doctor on the Saturday after thanksgiving.  Sriram has lost 3 pounds since she saw him only a few days earlier.  She found it very unusual and ordered some blood work and stool test.  She said that we can do the blood work the following week after we get the results for the stool test.  But, we did the blood work on the same day anyway.

I got a call back from the pediatrician on Monday.  She wanted to see us right away as she noticed high levels of alkaline phosphate in his blood work.  She never mentioned about the elevated blood glucose level.   She said that she spoke with an endocrinologist at Stanford and wanted to do more blood work.  We hurried back to the lab and did the blood work.  I got a call back the following day that the second blood work also had some abnormal results and she has arranged for us to meet with the endocrinologist the next day at Stanford.  I felt a knot in my stomach as I knew that this should be something bad.  I have never got an appointment with any doctor at Stanford in a day's notice.

When I looked at the test results we got the earlier day, I noticed that the glucose level was 290.  It stood out to me right away.  I knew that he had a high carb lunch couple of hours before the blood work. But, 290 is a big number for a non-diabetic child.  I remember hearing a talk about stem cells research in 2004 Democratic party convention(I'm a news geek).  The speaker explains how a young girl manages her  has Type 1 diabetes with insulin shots and the various side effects of diabetes itself.  He urged the legislators to fund more money in to the embryonic stem cell research that could cure the juvenile diabetes eventually.  So, I know that kids can get diabetes and its a life sentence.  I didn't google on this intentionally.  When I mentioned this to my parents that evening, they said that Sriram couldn't have diabetes as he is so thin and also we don't give him much sugary treats.    The only form of diabetes they know of is Type 2 as my grandfather had it.  I didn't mention my thoughts to anyone after that because I know that once I get in to an argument, I will try to prove myself correct by researching and showing the facts. In this scenario that means proving that my kid has an incurable condition.

The next day, Sriram, my husband Senthil and I went to the appointment as though its a regular office visit. I was hoping against the hope.  I told the front office staff during check in that I have an endocrinologist appointment.  They couldn't find his name in their list.  Finally, the front office lady found his name under the Diabetic specialist department. 

We were taken to a room with the label "Type 1 diabetes new onset".  I felt as though I'm walking into a dark tunnel with no end.  We were there for the next 6 hours.  The appointment started with a group of endocrinologists breaking the news to us.  This was followed by a session with the Certified Diabetic Educator.  She tried to engage us with lots of small talks by getting to know our family first.  She told us that it is possible to live a normal life with Type 1 diabetes.  But, she didn't say that the word normal is going to have a whole new meaning now.

I was still in denial.  The endocrinologist came back with the dietician to teach us how to give insulin shots.  I asked her if we have do anymore tests to confirm.  She just said that there are no more tests to do.  It was almost lunch time by then.  The dietician introduced a lots of words like carb counting, bolusing, corrections etc. They told us that our son will be getting one shot of long lasting insulin every day and multiple fast acting shots through out the day to make sure we supply enough insulin for each meal.  They asked us if we brought lunch.  We didn't as I didn't expect to stay there that long.

The dietician said that she is going to teach us how to bolus as we have the meal.  She asked all the three of us to test our blood glucose first.  All of us were between 100 and 140.  We grabbed peanut butter and jelly sandwiches for lunch.  We all ate as she was trying to teach us on how to count carbs for different kinds of food.  The doctor asked us to test again 20 mins after eating.  My husband and I were in 150s while Sriram's BG was over 200.  The whole thing looked like an experiment that proved Sriram was indeed diabetic.

The endocrinologist told us we need to give him insulin now.  She gave us syringes with saline.  My husband and I injected it on ourselves first to learn how to give / get shots.  Then, she asked us to give the first insulin shot to Sriram.  Tears started to roll down my eyes as this is a kid who is afraid of flu shot.  I had no idea how I'm going to do this day in and day out.  With that shot, we were officially inducted in to our new lives.  I cry every time I think about that moment.

But, not everything we heard that day was scary.  We met a research assistant next.  She explained to us about Continuous Glucose Monitors(CGM) and how it works.  She said that she herself has type 1 diabetes and showed us where she wears the seSensors.  She showed us the iphone with the glucose reading.  She assured us that life is less stressful after she got the CGM.  She explained about insulin pumps too.  She gave us information about various clinical trials at Stanford.  At that point, I wasn't sure if I should start mourning on my state of my son's pancreas or be glad that there are tons of tools in 2016 to push our lives closer to normalcy.

We met an Indian child while checking out of the clinic.  When Sriram saw them, he immediately said, "look he goes to Challenger(Sriram's old school) and he also has Type 1 diabetes like me".  The child's father came and spoke with me immediately.   We exchanged phone numbers and he said that he will keep in touch.  That was the first taste the T1D community for me. Finally, our hospital visit came to an end with our endocrinologist taking us to the pharmacy across the building and clarified some more questions.

I have met a whole lot of people with type 1 diabetes since that fateful day.  Almost everyone I know of were diagnosed in an emergency room / urgent care centers due to diabetic ketoacidosis (DKA).  As a result, they had to stay in the hospital atleast for a few days.  I'm glad that we didn't end up in such a scenario and Sriram was in good health even during the diagnosis.  But, at the same time, I feel that we were totally unprepared when we stepped out of the hospital that day.  We were told that insulin is the only medication that could keep our son healthy.  At the same time, we were told that too much insulin is dangerous.   Therefore, we meticulously followed the instructions for each and every meal. 

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