Do you remember the day you were diagnosed with type 1 diabetes — your D-Day? Do you remember the events that led up to it? D-Day is such a fitting term for Diabetes Diagnosis Day because D-Day marks the invasion of Normandy by the Allied Army during World War 2. The tides of history changed that day, and so did people’s lives — just as your life changed on your own D-Day.
Not many people care to dwell on the confusion and anxiety surrounding that day, but for many, D-Day will be permanently imprinted in their minds. Today’s guest blogger is Emma Kleck, Carb DM’s former Program Coordinator. Emma has had T1D for almost 16 years and is currently studying to become a Pediatric Nurse Practitioner at Yale University. Recently, Emma was able to relive her diagnosis in a very real way: by watching a little boy deal with his own.
by Emma Kleck
*names and details have been changed to protect patient privacy.
Ever since starting nursing school, I had been wanting to witness a new-onset type 1 diabetes admission for a while. I had dreams of grandeur, of comforting parents and showing kids that they’re not alone. I thought if I would ever see one, I would see it in this rotation in the pediatric ED. Sure enough, as I was shadowing a Child Life Specialist, I saw Tyler’s name pop up on the track-board with “HYPERGLYCEMIA – NEW ONSET” and pointed it out to her. We decided to go check in on him, as he was likely to need an IV of fluids and insulin.
Tyler was lying in a hospital stretcher in a tiny room, his mom, dad, and grandma surrounding him. His lips were dry and cracked, his eyes were half open, and he looked so weak. But the thing I noticed first was his breathing – in-out, pause, in-out, pause. I know exactly how you feel, like all the water inside of you is gone, and all you want to do is sleep. It’s a horrible feeling, but once we give you some medicine you will start to feel better, I promise, I thought, but I bit my tongue. We found out that his teenage aunt was recently diagnosed with type 1 diabetes as well.
Tyler’s parents talked about his excessive water intake, his lethargy, and his vomiting for the past two weeks. I wanted to scream at them, You knew the warning signs, you know diabetes, look at your kid, he is so sick, why didn’t you bring him in sooner, but I stayed quiet. I watched as the Child Life Specialist showed Tyler what was going to happen with the IV placement, and as first the PA, then the Attending came in to examine him. Their voices were calm as they told the parents they were going to move Tyler to the front room so that we could have more space, and that they were going to do a CT scan of his head just to make sure that his brain wasn’t swelling. I could tell they were worried.
Nurses and techs bustled around Tyler, trying to place an IV. Tyler’s parents were in the corner, silently watching. His grandma was plastered to the end of the bed, keeping a tight hold on Tyler’s legs for comfort. His face screwed up with pain whenever he was poked, and the nurses kept telling him how good of a job he was doing. It’s okay to cry, Tyler. This is so scary. It hurts, and it sucks. You can cry, you can scream, you can be scared. I swallowed my words, but the Child Life Specialist said them for me. As I thought about how much this family’s life was about to change, I felt panic building in side of me. I began to mimic Tyler’s breathing patterns, to center myself on the only person in the room who mattered and who needed attention. I tried with all my might to send him positive energy and compassion, as if somehow he could sense that he was not the only person with diabetes in the room.
As I was focusing on Tyler and breathing with him, the room started to go fuzzy and I started to see spots. I stepped out of the room and the next thing I knew I was sitting on the bathroom floor with my head between my legs. I took deep, shuttering breaths and realized that I felt like I was watching my own diagnosis, 16 years ago. Everything that I wanted to say to Tyler was something that I wish someone had said to me. I felt ashamed for biting my tongue, for holding back something that could help Tyler. But then I realized, this is scary. For Tyler and his family to see someone who has diabetes may make them withdraw more; that realization that type 1 diabetes is a lifetime disease is not my burden to give them, not yet. All I could do is observe and watch, and take notes for when I have the training and knowledge to give Tyler that responsibility.
I gathered my thoughts and stepped out of the bathroom. Outside of the front room, the nurses were talking about how sick Tyler was. “He just needs some fluids and insulin, and he’ll be good as new tomorrow,” the charge nurse stated, waving her hands. No, tomorrow he’s going to be conscious enough to realize that nothing will ever be the same again, I thought, but again I swallowed my words and stepped into Tyler’s new room.
The scene was the same, with an addition of waste from multiple failed IV attempts. Tyler was mouthing the word “water,” but couldn’t get any sound to come out. I stood in the corner and observed, afraid to step into the mess of people surrounding his bed, nervous to add more stress of a strange face looming over him. Sometimes it’s best to step back. Tyler will have a support system; he will have the gift of a close relative with diabetes and a grandma who already knows the lingo and the tricks. His life will change, he arrived to the hospital as a kid who loved playing video games and race tracks, a happy, bubbly trouble-maker according to his mom. He will leave the hospital the same kid, he is still Tyler, but now he is more. He will have a new burden on his shoulders; one that may lessen with time but will never disappear. He will tell his friends stories of the time he went to the hospital and it took 10 IV tries with 5 nurses for them to find a vein. He may resist, and cry, and ask “why me?” when he does injections for the first time – or the 100th time. Each diagnosis is personal, a story that many kids bear with pride. Tyler is no different. Welcome, Tyler to a new world.