Long, long ago, I was dxed at the age of 18, actually, about a couple of weeks after my birthday. I'd returned home from what was then "College" (now a proper University) in the spectacularly named regional centre of Wagga Wagga to receive rather surprised looks from my mother. I hadn't been feeling wonderful for at least several weeks and as I was living alone in a caravan in the heat of summer in a very different climate to what I was used to, I'd assumed I was just a bit sick in the usual viral / stress sort of way. I'd been drinking huge amounts, mainly of Coke, beer or similar poisons but again figured it was just the extreme heat and much drier air. I'd been getting up to relieve myself of all this liquid a few times each night for months and hadn't assumed there was any problem with this, as again, you'd expect it when you're drinking so much. I'd also discovered that no matter what I was eating or drinking, it tasted terrible, especially afterwards. I could have been a bit slimmer but as I was always on the lean side, it wasn't a big enough contrast to get me thinking. Having felt pretty crappy for a while at College, I saw the campus GP, who told me that I was probably just homesick but that if I had any real concerns, I could somehow get myself the 20 kms from the College into town and then on to the hospital and ask them to do some tests; he didn't do any tests. Given I felt so bad, getting myself to the hospital via public transport (of which I had no understanding then) was too much bother, so I just sat under the shower for 3 hours (which of course makes some sense when you're so dehydrated). Given my mother's reaction when I got back home to Sydney, and that I was still feeling less than excellent with all the other symptoms persisting, I saw a local GP. He actually did a test (the old test-stick in the urine trick) and promptly had me admitted to intensive care. I got to go home first and tell my parents that I was actually pretty crook and the problem did have a name and that I'd been ordered to ICU ASAP. I can remember a bit of shock on my mum's part, nothing memorable from my father, but my reaction was oddly positive - I had felt bad for so long (several months really - enough that one of my high school teachers had serious concerns that I was using heavy drugs - I must have looked pretty wasted) that it was good news to know that I needn't always feel like this and that soon somebody would start to fix me up - there was no "oh shit" or shock or anything negative - at that stage it seemed like it couldn't change for anything other than the better. I was admitted to ICU and had at least 2 drips inserted - one would have been for insulin infusion, the other was saline and other electrolytes to treat the dehydration. The guy in the adjoining bed was surrounded by police, having just been shot by them when they arrested him for an armed robbery - this was in Westmead Hospital in western Sydney and it's probably a weekly occurrence. I remember the nurses had trouble getting the drips into me - I would have thought the veins were obvious on someone who was then only 45 kgs (I'm 175 cm tall so that more than a bit thin) - but maybe they had collapsed from the dehydration. I think it took three nurses, then the resident to get the lines in and at some point they gave up on veins and used an artery - got a bit messy until they had done enough practice - I had some idea what getting nails hammered through your wrists might feel like and probably contemplated that song from Monty Python's Holy Grail with "Jesus" singing "always look on the bright side of life" whilst enduring crucifixion (trust me - when you're that thin, inserting IV cannulas can be very painful). I have very little memory of what went on for what was probably a week or more that I was kept in hospital. There was some dietary advice, a lot of finger pricking with these industrial strength impalers that supplied blood to an old glucometer the size of the oldest known mobile phone, and eventually instruction as to how one sticks a needle into an orange. Then I understood that after the orange had its turn, it was my go and that wasn't at all amusing. I was quite happy with an insulin infusion via IV and I could balance it by fiddling with the dose on the dextrose drip into the other arm, which worked pretty well. But now they wanted me to inject myself with what were pretty big needles back then, and into what was still a very very thin body with no fat to pinch and skin that seemed incredibly resistant to allowing the smooth passage of anything resembling a needle. Little wonder I have a needle phobia. At some stage I was allowed home and remember walking around the area feeling ridiculously good. All this new dietary restraint, monitoring and jabbing with sharp things seemed irrelevant because I was actually feeling alive again after what, despite the advice of many texts and professionals, must have been as long as six months of seriously high bsls, weight loss, fungal infection on my tongue (from the fact that my saliva was probably a strong glucose solution on which anything would grow) that had made everything taste bad, major fatigue and chronic thirst. It all seemed pretty rosy for a while, though I remember feeling guilty about it because my mother was having the opposite experience trying to accept the nature of my diagnoses and all the responsibilities that went with it, most of which landed on her "desk". I was placed in the care of an endocrinologist who seemed like a nice bloke and who didn't treat me like a complete idiot. He also had an educator that he worked with and she was also diabetic so gained extra credibility from me on that score. I was given a very strict regime of diet, testing, injections (4 per day) and exercise and told in no uncertain terms what the consequences would be if I didn't comply - lots of scary stuff about horrible complications including the greatest fear an 18 year old male virgin can have - impotence! It was all very effect motivation for strict adherence to the regime, and I got my scientific head around it all pretty quickly and was soon challenging the educator and the endo with my titration method of insulin dosing versus their fixed dose approach.I stuck to my method of adjusting the dose for fixed amounts of carbs depending on what the bsl was before the meal - if it was high, I had more insulin to compensate and would sometimes wait longer before eating too - this was before genetically modified insulin was available and 30 minute post injection waiting time before meals was standard. Actually, that became one of the biggest bummers - having to time injections with meals. It made many situations difficult because once injected, you had a set amount of time within which you needed to have started to eat or else you were potentially in trouble. This caused a lot of stress for my mother who was already dealing with having to calculate carbs for every dinner and often prepare different food for me whilst also feeding the rest of the family. But my titration method worked and I've got the HbA1Cs and apparent absence of complications after 14 years to prove it, and sadly, the technique endured beyond my educator, who died of complications perhaps only 5 years after I was diagnosed. She had insisted that you can't correct a high bsl before a meal by increasing the dose - the past was the past and you should only deal with the set number of carbs in front of you. These days nobody sensible would argue that titration works as long as you have the data and relatively stable bsls to make it viable. Having got myself back together again with the aid of the magic juice called insulin (albeit delivered in a problematic way), I was encouraged to get a job. I'd been told to quit the college courses I'd been doing because it was considered that a career in wine grape growing and wine science was not appropriate for a diabetic (there was 4 hours of wine tasting prac' sessions each week). We now know that I could have pursued that career as the alcohol needn't have been a problem, but the need to have lived 600 km from home in a caravan with no medical support meant it wasn't a sensible thing to go back to at that stage. So whilst I was contemplating my future, I got a job in a local audio/video store selling TVs, video cameras and hifi stuff etc. This is where I started to hit "the wall" that is often talked about in trauma management. I was really isolated in that job, didn't get support from staff, was seriously harassed by the sales manager because of my difficulties in keeping my bsls level enough to be fully functional every minute of the working day, and was eventually forced out on the day that I had decided to resign anyway. I spent many lunch times alone in a dingy sandwich bar in a small suburban shop isolated from most of the people by a main road and the relatively new Kmart mega centre. This is where I really got to know depression and a fair bit of the "why me" question. My career plans were gone, my future appeared to entail being an unsuccessful salesman of electrical goods in a suburban backwater with a right bastard of a sales manager who behaved as an angel in front of the boss but was a complete dickhead when the boss wasn't looking. Nobody except my mother understood and nobody wanted to understand - I was "disabled" now and felt like a total reject. I had no friends to turn to as the few people I would have considered friends had all left for universities out of town or had otherwise moved away. This was not a good time. After some time on what was then called "the dole" (and there was a lot of shame involved in me having to receive this - it was the opposite end of the upper middle class if we could be perspective I'd been raised with), I got another job selling irrigation parts and helping to install and maintain irrigation systems. This looked like fun because I'd been doing the same things at home and for neighbours and found it just like Lego - nothing too difficult and it provided a mix of indoor and outdoor work. But again, the boss was a bastard and totally intolerant of my sometimes being unable to do exactly what he demanded when and how he demanded it, largely because of low bsls or just fatigue, remembering that I'd consumed most of my own muscle fat due to prolonged high bsls before diagnoses - I was pretty weak still. He put me through hell, deliberately trying to get me to quit. Telling me to drive his bomb of a work car to parts of Sydney I'd never heard of at early hours of the morning to endure a full day of hard work alongside his very fit and very strong assistant. He even forced me to drive his manual car across Sydney when I made it clear I'd never driven a manual car - that was not fun, but somehow both I and the car survived. Eventually, having unsuccessfully tried to get me to quit, the boss set me up with a customer who pretended to be a near neighbour of mine who wanted some irrigation work done. I told him the costs but he said he couldn't afford the company's fees and asked if I could do the work on the side for cash. Being the helpful fool that I am, and not appreciating how the boss might see this or that he was actually behind the scam, I told the guy I'd help him out. For some reason, this guy told the boss...proving it was a set-up. But it gave the boss grounds to sack me in a way that made him safe from unfair dismissal proceedings - he was apparently concerned that if he fired me due to poor performance, I would have countered with a claim of discrimination against me on the grounds of my being diabetic. So that was another job down. My mother and I then went into business doing landscaping and irrigation as at least with my mum as the boss, I wouldn't have the sort of problems I'd encountered from the other employers, plus she was tuned in enough to recognise when I needed jelly beans and time-out to recover. We only did one job, but it worked well, despite the dramas of my dealing with hard work and hypos. Being able to work in a more supportive environment meant I was able to regain some strength, but by then I was having multiple daily traumas with injections. I was using the first of the insulin "pens" and my injection technique was that appallingly ineffectual, slow and easy method rather than the quick stick approach. So I'd often be sitting in the car or later in public toilets trying to ease the damned needle in to my abdomen (such as it was) or thighs, sweating and shaking from the stress of it, only to find that when the needle did go in and the dose was received, I'd often hit a blood vessel and bleed out much of the dose, having to either do it again somewhere else or eat a lot less food.I'd decided to go back to Uni, but to the local one as this didn't entail another episode of leaving home, which based on the previous experience was likely to result in my getting another chronic illness. Part of my first year involved hiding in my car (with very very dark tinted windows so nobody could see in) to perform bsl tests and the drawn-out injection drama every lunch-time. Somehow I met this amazing person who thought that was plain stupid and who despite her diminutive stature, misaligned eye, silly haircut and penchant for outrageous '80's "cock rock", black t-shirts and Holden V8s, managed to convince me to get out of my car and have lunch like a normal person in the cafe or the park. So began something vaguely resembling normality. People were interested in watching bsl tests, some even wanted a "go" themselves, and even the injections seemed to be less of a drama when there was something else to distract me (often in the form of a spectacular staged argument about something of no substance but which made for considerable entertainment for many of the surrounding tables, due in large part to the amount of mock insults and shouting that was going on). It was a huge leap forward by my standards. Sure, most people were now into serious 1st year Uni party mode with all that this entails and I wasn't part of it because I had this incredibly strict diet, lived by my watch and feared alcohol as something that was likely to cause a coma. To give you an idea of just how strict my regime was, we used to adjust to daylight saving by moving meal and injection times 15 minutes a day over four days at each end of the season. I was told that the maximum I could delay a meal was 1 hour, or there'd be serious consequences. At that stage I knew no different, had only every heard the opinions of my endo and his educator, and had no contact with other diabetics, though I did catch one injecting in a room before the lecture started, but he didn't want to discuss any of that stuff other than agreeing how weird it was that we were both diagnosed not long after completing our Higher School Certificates and how the connection with severe or prolonged stress was pretty apparent. Having put up with major needle dramas for probably a year or two, I eventually got this new device called a Medijector - made in the USA using military technology (it had to work). This needle-free spring loaded injector worked spectacularly well for a few years, though it needed a range of modifications and replacement parts along the way. I stuck with it for probably far longer than I should have despite it becoming incredibly painful to use and causing sometimes major bruising or surface bleeding akin to the worst paintball injuries you can get and more like close range fire with rubber bullets - but it didn't involve needles so it was tolerable. I guess I thought it might return to its earlier days when its use was only detectable at the level of a mozzie bite at worst, but it didn't, and it later generated the same problems with failed insulin dosing that syringes and pens had. I finally retired the device pending its inclusion in a museum of diabetic technologies in March 2002 when I got my insulin pump. So I went through 4 years of full-time Uni and two years of part-time with the aid of my Medijector and strict adherence to carb counting, 4 daily injections and the use of my titration method. But during this time, I encountered another big downside to the big D - something I wasn't warned about because it wasn't even understood at that stage. It's called the Somogyi Effect, and is otherwise known as a delayed hypo. My first one nearly killed me. I'd been working hard moving house with my family from the long-held family home to a temporary rental where we were to stay whilst our new home out on the rural fringe was built. There were three days of hauling boxes and furniture and on the night of the third, I went to bed as usual but didn't wake up properly for some days, having had my liver take up almost all of the glucose from my blood to try and restore its glycogen stores which had been depleted over the previous three days. It resulted in a seizure that caused me to bite my tongue severely, fall out of bed, knock myself out on the bedside furniture and smash my nose. I was apparently found in a bloodied and semi-conscious state sometime the next morning, and was taken to hospital. I'm told that I had all sorts of tests done because no-one in ICU could work out what was wrong with me. I had amnesia and was only half there in terms of brain function. Apparently I was told to pee in bottle at some stage and decided this wasn't on for whatever reason. This lead to a fight (and I've never hit anyone when conscious) in which I flattened three nurses and a doctor and had to eventually be restrained by security and placed in a straight jacket. My mum turns white and gets all weird if this story is brought up - it must have been scary as hell for her to see me like that - unable to talk properly from my chewed tongue, bruised and bloodied, not making sense, and now violently defending my right to not urinate as instructed in what I was told was an episode to make Bruce Lee quake (I have no martial arts training but my mum says it looked quite the opposite at the time). I have no memory of this stage and there are at least 4 days missing. My brain had almost died from the severe hypoglycaemia though I was later given the full range of head tests and was ruled ok, testament to the body's healing abilities. Having been restrained by the security dudes, I was sedated and later given a lumbar puncture, presumably to test of some sort of meningococcal infection that might explain my behaviour. Nothing abnormal after that test and the staff were still believing that I was a drug user and was having some sort of resultant psychotic episode. My mum wasn't happy about that - I wouldn't have known where to get anything like that anyway, and hadn't been in any situations where I might have been drugged by someone. Eventually, some smart endos worked out that it must be just a severe delayed hypo. I'm told that my experience was later used as a case study in documenting this phenomenon and how cryptic it can be. Apparently many staff had gone through all sorts of other possible explanations but delayed hypo wasn't on their lists. I think I was in hospital for a week of so. I can later remember getting my head back together only to endure two more significant hypos that were actually caused by hospital kitchen staff not understanding the dietician's specifications for my food. I was on an insulin infusion and the food was intended to balance the specified doses but it didn't and then some of the nurses derided me for playing with the insulin drip and giving myself the hypos. Thankfully the dietician believed me and discovered that kitchen staff who can't read English properly shouldn't be allowed to complete medically specified food orders. That saga was damned scary. I thought I was really losing it for a while there. Total loss of consciousness and all that went with it, and what's more it was 3 days after the work had been done and in the middle of the night. It took a while to get my confidence back up, having been cleared on all the head tests and told that no, I wasn't psychotic or epileptic or anything other than diabetic (one "ic" is enough thanks). I met my first serious girlfriend in hospital then, so it wasn't all bad. She was a nurse and did wonders to restore my confidence in looking after myself and in general. She was also 5 years older than me and that boosted the otherwise flattened ego somewhat (probably too much on reflection, but that's how we learn). Despite learning a fair bit from that severe hypo, I've had several more since then, probably averaging 1 a year. We moved house again a year or so later and the same thing happened though not as badly. That was the last moving-induced severe hypo as I worked out what was likely to happen and took steps to prevent it - eating more during the days I was working to try to stop glycogen draw-down, then greatly reducing the insulin doses overnight. The other severe hypos were induced by unscheduled or different exercise that I hadn't made allowance for. I've since worked out that they happened all too easily because conventional long-acting insulin peaks when my need for it is at its lowest - between midnight and 3 am - that's when all of the hypos that were documented appear to have happened. There were a few more trips to hospital but no more long admissions, just enough to stabilise me. All of these episodes involved seizures, the worst aspect of which was the badly bitten tongue and lining of the mouth and these massive headaches that even strong codeine wouldn't touch. After Uni, I worked in a few different government jobs and didn't have any major dramas there in terms of D-stuff. I did well at Uni, or well enough anyway, and was pleased that my "disability" meant that I was allowed to do exams in very small rooms with other "special needs" students, could eat and drink as needed, and got extra time as partial compensation for the stresses of having to deal with my condition. I began working as a consultant about 7 years ago. Being largely my own boss had huge advantages, especially in terms of D-management and my adhering to the strict regime on which I believed my survival depended (though arguably it was the very strictness of that regime which was a contributing factor on my many severe hypos). The downside was the social isolation (no workmates and often little need to leave the house / office) and the financial uncertainty (no salary). The big change came when I was introduced to or discovered Reality Check. Finally, other people dealing with the same issues - real people, not just articles about them and not just fat geriatrics with Type 2 (apologies for the inaccurate stereotype but that's how it was and still largely is). I'd previous been involved in a very limited way with a Young Persons' group of DA members but had been outraged at their conduct - smoking (anything and everything), drinking like your average punter, eating whatever and whenever (all manner of junkfood included), injecting so they could eat more stuff that they shouldn't because some were already seriously overweight or unfit, and being contemptuous of anything resembling management discipline and commitment to avoiding complications if possible. I did not get along with that scene and they didn't like me either. It wasn't a support group so much as a bunch of people who had sort of given up and decided they were "rooted" anyway, so why not party just like everyone else. Sure, some had troubles that I hadn't contemplated and didn't appreciate, largely because they were diagnosed very young and some prior to the advent of home glucose monitors, but it certainly wasn't what I needed. Reality Check was intelligent and eclectic, broad-minded and non-judgemental. This was good for me because I had some extremely ingrained ideas about how things should be, largely through indoctrination (excuse subtle pun) and it was good to see how other people did things and that not only was I "not alone" but that there were options - it wasn't a case of my way (strict regime) or the highway (to complications). It was through the information available on the website that I was able to feel a lot more normal about all that D-stuff to which nobody else other than perhaps my mother, related. It did a lot for the psychological aspects of managing the condition and it also drew me into some technical aspects that most medicos didn't know about or wouldn't discuss with the insects that they call patients. It was empowering. It meant I could forget the routine visits to endos that did little or no benefit other than to their bank balances. I knew a lot more about it all than most GPs (not a big challenge though, let's face it) and only dealt with an endo when something was beyond my understanding and couldn't be answered by Reality Check (this might have happened once). It was also through Reality Check that I became informed about insulin pumps enough to make the necessary arrangements to be evaluated for and eventually receive one. This has turned out to be a massive change for the better, except for my bank balance, which suffers the drain of private health insurance that covered the cost of the pump but which doesn't extend to the expensive and unsubsidised consumables needed to make it work. I had major dramas with the pump initially. This was despite some of the best training and support available. But after many episodes of high bsls despite playing everything by the rules, I found the answer in the form of short cannulas. I can only use the ones designed for children. The normal ones are too long and easily hit muscle or blood vessels, making them ineffective. I'm not 45 kgs any more, but at 68 kgs there still isn't much fat to inject into, despite considerable efforts to change the situation. It seems as though I am naturally lean and just don't have the depth of fat layer that most people do. This explains some of the pain and ineffective dosing I had with needles and pens and later when the Medijector became unreliable. Even now, I have very limited areas in which I can use cannulas and even these short ones can still go too deep. But the pump has freed my from one of my greatest banes, the severe nocturnal hypo. Now I'm free of that horrible long-acting insulin that was a huge factor in causing those hypos and I have my basal rates set safely low during that vulnerable time between midnight and 3 am. I don't have to eat fixed amounts of carbs at set times. I can even fast if I want to. I can virtually eat like the rest of society, though I still count carbs by estimate of measuring and I use a mix of titration and insulin to carb ratio to determine my insulin doses. The standard insulin to carb ration doesn't work for me because my insulin sensitivity varies considerably throughout the day, so I have different ratios for different times. I haven't had any severe night hypos since I got my pump over 18 months ago. My hypo-sensitivity is pretty good, though at the moment I'm in a hyper phase due apparently to an overstimulated immune system responding to all the pollen, and to a lack of regular exercise of sufficient vigour to keep the muscle's glucose metabolism working properly. I do a lot of yoga but it is the slow and intense sort. I'll probably have to do some more vigorous stuff or just go for a walk more often. So I survived 14 years, 15 in March, and don't have any complications that I'm aware of. My last HbA1C was 5.6 though I suspect it is closer to 7 at the moment because of the several failed cannulas and general insulin resistance I'm dealing with now. I hope to maintain my freedom from severe hypos as I now live alone, something that the pump made possible, and my isolation though lack of work means that nobody would miss me for a few days if something went wrong. Frustration and related depression remain D-issues to deal with. I get very annoyed about high bsls still and especially when they stay high despite all sensible efforts and a lack of apparent explanations. Oh well, some times are easier than others and when I see what other people deal with, I really don't have any dramas - it's largely a matter of perspective and these days I have the skills to deal with that if it gets to be a problem.Bring on the subsidies or insurance coverage for pump consumables! Everyone should have access to a pump and the gear needed to run them. They aren't perfect and they won't suit everyone but I'm damned glad that through Reality Check I was able to learn about them and eventually get one to work for me. [chat about it on our forum] [join our mailing list]