Welcome to Type 1 Diabetes

Allysan shows us her diabetic ID dog tag. ~ Our granddaughter was diagnosed with Type 1 diabetes a few weeks ago. The diagnosis blindsided us. She was wasting away before our eyes, becoming more listless and tired, but it happened so gradually. Her father, JD, was the one who sounded the alarm, and I give him credit for saving her life. We took her to Fulton Family Medicine one Saturday morning to have her checked out. Thanks and a tip of the hat to Sarah Hebert, who examined Allysan, took blood, and called us the next day. Sarah told us to go to the Emergency Room immediately because Allysan had Type 1 diabetes and was in diabetic ketoacidosis, a condition which can be life-threatening. We said yes, ma’am, and took Allysan in to Children’s Hospital, where she began her new life. How could this happen? How could a child be so ill, and appear so ill, and we did not pick up on it until she was dangerously ill? I’ll tell you how it happens. It sneaks up on you. Diabetes is called “the sneaky disease” for a reason. I have heard the warning signs of diabetes more than once – drinking a lot of water, peeing a lot, eating a lot but losing weight. I had noticed that toilet paper was going fast on the weekends. I thought, boy, little girls sure use a lot of toilet paper. News flash: they don’t use that much. These things were right in front of us, but we didn’t see them. She wears long sleeved shirts and jeans. It wasn’t until she put on shorts and a tank top one night that we saw it. How did she get so thin? How could our granddaughter, our slip of a girl who is thin naturally, get diabetes? Don’t you have to be fat? No. Diabetes strikes where it will. It can be genetic. The closest relatives Allysan has with type 1 diabetes are two of my brother’s grandchildren, one of whom was diagnosed as an infant of 20 months. This might indicate that there is a diabetes gene hiding in my family DNA, but we know of no other relatives that have it or had it in the past. As with most terrible things that happen, you don’t have time to sit around asking why and how. You hit the ground running and learn how to count carbohydrate grams and give insulin injections, among other things. Allysan is on the mend now – gaining weight and more her kid self. I admit I’m still in shock. I’m in awe of her parents, JD and Nycol, who have stepped up to the plate and are taking care of their girl, working as a team. They are truly rising to this demanding occasion. And I am grateful. I am so grateful that Allysan’s diabetes has been diagnosed and is being treated, grateful for the prayers and good wishes people sent our way. She has begun to gain a little weight, and is much more lively again. A couple of people have asked me if she’ll outgrow it. No. This is for life. I am writing about it here because even though Type 1 diabetes is rare, it happens, and it sneaks up on you gradually. I’m telling Allysan’s story so you can look at your child or grandchild or even an older person who might have Type 2, adult onset, diabetes. Or how about yourself? Do you or someone you know, drink tons of water and go to the bathroom constantly? Is this person always hungry, eating constantly, and losing weight? Take a new look and ask yourself what you haven’t been seeing because you didn’t think there was any need to look. If you read this and it leads to even one person getting diagnosed and beginning treatment for this killer disease, then hurrah. If you or someone you love gets checked out and is healthy, double hurrah. Diabetes is sneaky, it is deadly, and you need to get on top of it. Pay attention. So that’s my public service announcement for this week. May you and your children and grandchildren all be healthy and live long.

A Wartime Romance

Mark & Dawn Tuel, December 1943.~ My husband, Rick, has time to write now that he has retired, and he recently wrote up this recounting of how his parents met during World War II. He writes: My dad, Mark Tuel, was born in Lehigh, Iowa, in 1921, the elder of two brothers. Two years later Mom was born on Sugar Creek Road in Dover, Ohio, the younger of two sisters. Dad was raised in Lehigh and Ford Dodge, Iowa. He was a small town boy who grew up swimming and fishing in the Des Moines River. His dad was a tailor and sign painter. After graduation from high school he and three of his buddies pooled their money and bought a well-used Ford Model A flivver which they named “Penelope.” Together the four of them drove to Los Angeles and back in a month, sleeping on the seats and running boards and following U.S. Route 66, when they weren’t patching flat tires. My mom, Dawn Kennedy, grew up on her parents’ farm on Sugar Creek Road, essentially being raised by her older sister Doris. In those Depression years the farm couldn’t support itself and like most farmers in the area her dad worked at the Reeves Steel Mill to help make ends meet. The tradition in rural Ohio farming communities was for the children to grow up and take their places within the social fabric of their forebears, preserving and strengthening it for the succeeding generation. When Mom completed the 12th grade, her parents asked her what she wanted for a graduation present and were shocked to the roots of the family tree when she instantly answered, “Luggage.” They complied reluctantly and in July of 1943 she shook the dust of Sugar Creek Road from her feet and boarded a train for Los Angeles. It was not a random decision. Some months earlier two of Mom’s acquaintances from Dover High School made a break for it and landed in Los Angeles. Gladys and Hilda found jobs there and a nice house close to the beach and apparently the Great Depression was finally ending as the wartime economy began to rev up. It was freedom, excitement, and a whole new life out on the West Coast. The early years of World War II shook an entire generation of kids out of their nests, some to return, some not. One of the first casualties of the war was tradition itself as the new generation took wing, leaving its parents wondering what the world was coming to. By that time Dad had literally taken wing. He had enlisted in the Army in April of 1942 and was commissioned a second lieutenant in the Army Air Corps. He was deep into flight training starting with the Stearman Biplane, a forgiving aircraft that allowed the cadets to learn the basic skills of flight control, takeoffs and landings. It was like flying a box kite with a 12-cylinder radial engine. The next step up the ladder was the BT-13-A, a fixed single wing trainer that the cadets called “the Vultee Vibrator.” A day in the trainer was the equivalent of taking a laxative. Dad was in training throughout the war, advancing to pursuit fighter aircraft and light bombers. As his skills increased he was shifted through a variety of duties from towing airborne targets for aerial gunnery training to flight controller duty on the ground. Here the miraculous begins to unfold. While working the Flight Control Center in L.A. he met Gladdy and Hilda. Off duty Gladdy and Hilda would go out night-clubbing with the flyboys and would invite homesick young men to their house for meals and socializing. At about this point, another train filled with Midwest-American refugees pulled into Union Station and in the fullness of time, Hilda invited Mark to come over to the house. There was someone staying with her and Gladdy who she wanted him to meet. And so Mom and Dad’s separate paths finally crossed and their meeting was…tepid. “Mom didn’t like me much at first,” Dad said years later. “She thought I was too cocky.” Likewise, years later, Mom added her own thoughts. “I had only been on my own for a few months,” she said. “I wanted more of that.” But there was a war on; there was no time for more of that. Dad didn’t know when he’d be shipped out and didn’t want her to be “the girl I left behind” to be snapped up by some other guy. When he received orders for further flight training in Baton Rouge, Louisiana, he popped the big question right away. Mom went back to Ohio to think it over while Dad changed duty stations. Mom’s family tree got its roots shaken once again when she abruptly flew the coop and caught a train for Dalhart, Texas. Fears of shame and scandal back in Dover finally were put to rest when Dad and mom were united in marriage on Christmas Day, 1943.

You Never Know, Does One?

A sunny day at the KVI beach It is the season of Lent in the Christian church, a time of reflection, penitence, and self-denial, one object of these practices being humility. I have mentioned before that my definition of humility is to have a clear, true perception of yourself, which does not mean self-bashing or delusions of grandeur, but rather an objective view of who you are. I think it’s impossible to be objective about yourself when you’re looking from inside your own head, but where else can you stand? It’s worth the effort to try. If you’re lying to yourself about who you are, whether you’re lying about being more than you are or less than you are, you’re lying. Living a lie makes nonsense of your life, so clear your head as well as you can, and see what you can see. One good way to clear your head is to take a walk. Yesterday was sunny, one of those early false spring days, and Marley the dog and I went down to the KVI beach for a walk. The sun was hot on my back and the wind was cold in my face as we went. Marley ecstatically sniffed practically every blade of grass, and left her own mite of communication in a spot which I now think of as Poop Central for dogs on KVI beach. When I walk on the beach I am looking for where I would run in the event of a large earthquake and tsunami. If this makes me neurotic and paranoid, so be it. This paranoia is based on my knowledge that these things have happened here in the past, and could happen again. I took the Vashon 101 class a few years ago in which one of the lecturers took glee in telling us that when the Seattle Fault lets go, we will have about four minutes before the tsunami hits Vashon. So now when I walk on the beach, hobbling along on my arthritic joints and assisted by my walking stick (thank you, Becky), I am calculating: how far could I go in four minutes? Is that a trail up the bluff there in the salal? Would my worn-out knees allow me to get up to safety in a hurry? Should I stand there and kiss the world good-bye and watch the wave come to take me? Then I tell myself that while there will be an earthquake, the likelihood of it happening right this minute is slim. I’ve been walking on these beaches for over 40 years now. So far so good. I go back to limping along, picking up rocks that catch my eye, as well as things people have left behind. Yesterday’s haul: twenty white pebbles for my garden cairn, one pair of plaid sleep pants (size XL), and a pink plastic clothes pin. In 1966 I lived in Alameda (another island) and commuted to San Francisco on the AC Transit. Every day on the way home as we crossed the Bay Bridge, I would worry. What if there was an earthquake? What if the bridge collapsed? Mind you, I’d lived near the San Andreas Fault all my life, and had experienced many quakes, though no really large ones at that time. The large earthquake came later, in February, 1971, in Los Angeles. It gave me respect for earthquakes and what they can do. I moved up here in 1973, thinking that I was getting away from earthquakes. That’s how ignorant I was at the time. But getting back to my story… On October 17, 1989, at 5:04 p.m., the Loma Prieta earthquake struck. The San Andreas Fault shifted in the Santa Cruz Mountains, and guess what? A section of the Bay Bridge collapsed. One woman died when her car plummeted into the gap. All other vehicles were turned around and sent back to San Francisco. Meanwhile, in Oakland, the double-decker Cyprus freeway, which had been part of my daily commute in 1966, collapsed on itself, and 42 people died. I had never worried about that freeway collapsing, only the Bay Bridge. In retrospect, I’d say my paranoia was at least partially not paranoia, but the worst that happened when the earthquake hit was not something I had foreseen, or worried about. That’s the thing about worry and paranoia – you are preparing to defend yourself from what you imagine, and you might have it all, or partially, wrong. You never know. There was no earthquake while I was at the beach yesterday. The dog and I made it back to the car fine. I took some snapshots of the sunny scene so I could look at them on days like today, when the overcast is high and white and unbroken. Is my head clearer for yesterday’s walk? I find that head clearing needs to be done every day for best results. The dog likes to clear her head, too, so we’ll go out walking again today. I wish you a blessed Lent, if Christianity is your spiritual practice, and a clear head regardless of your spiritual practice.

After a Mammogram

There is a joke that if the genders took turns having babies – if the woman had the first, the man had the second, and the woman had the third, there would never be any fourth babies. I thought about that this morning as I drove home from having a mammogram. If men had to put their secondary sexual characteristics between a couple of flat plates and have them squeezed flat while being told that compression is necessary for a good reading, they’d get busy and invent a better way to take a look at the inner man. As it is, men don’t get compressed in this fashion and women are encouraged to get a mammogram every year or two. I encourage any women inventors and researchers to get busy on inventing a better way to look at the inner woman. Getting machine-mangled while the technician calls me “honey” and “dear” and pushes me this way and that, telling me to turn my feet this way and my arm that way and my chin a third way, is not my idea of a great way to spend the morning, but I went and did it out of a sense of duty, and oh yeah, because I had a lumpectomy a couple of years ago and it’s good to keep an eye on these things. I was told I’d hear from my doctor in ten days or so, and I can wait. When I was younger I would panic at the thought of having cancer, and rightly so – I was too young to die. Now – well, let me tell you a story. I was online one night when an ad from Swedish Hospital popped up encouraging me to take a quiz to see what my greatest health threat might be. I figured I knew already – I’m fat. I’ve been told to lose weight and get my cholesterol down for years. So I took their quiz, and according to Swedish – and they claim they know – my biggest health risk is my age. It’s not the fat, the cholesterol, the angina, the lurking type II diabetes, the lingering effects of injuries, the lung congestion, the fatigue, all the conditions I worry about which I wonder, “Which one is the bullet with my name on it?” No, my greatest threat now is that I’m old. That’s the bullet. We used to say that people died of old age, and no one thought much about it. Now the cause of death is detected and people die of pneumonia or its effects, or myocardial infarction, or renal failure, or complications of cancer or its treatment, or whatever. There’s usually a name for what finally gets you. Saying that we lived it up until we were used up is not a medical label. Too bad. We used to have a sense that a person went when it was their time. Now it’s that one medical condition that could not be cured and took you down like a cheetah leaping on a wheezing gazelle. We’ve lost the big picture. Ah, well. It’s easy to think about such things when coming home from a diagnostic test. I was told I’d hear from my doctor in ten days or so. Until then I live in the limbo of unknowing – didja find anything? Or not? I want to hear what the result has usually been over time: I’m fine, and I can go on my yippy-skippy way and not think about it for another year or two. Unfortunately, the last time I had this test, three years ago, there was something found, and that led to surgery and a recovery that seemed to take a long, long time. It was tedious, friends. A person gets tired of waiting rooms and magazines full of helpful advice on how to be healthy, all left lying around for perusal by people who wouldn’t be there if they were healthy. I think it’s the smiling models in these magazines that annoy me the most. Have you noticed how the people in drug ads are always grinning like they won the lottery? “I have cancer/heart disease/erectile dysfunction/bipolar disorder but I couldn’t be any barking happier because I am using this drug!” Aah, that’s enough out of me for one day. I have ten days to live in ignorance, and I plan to enjoy those ten days. If the results are negative, hallelujah. If they’re not, we’ll cross that bridge when we come to it. Either way I’m going to keep sitting out on the kitchen porch in the morning, drinking my coffee and listening to the birds sing. And that’s the truth. Post Script: I have been called and asked to come in for further images, on the side which had surgery three years ago. So I'll be going in for that this week. Stay tuned, but I'm really hoping that will be the end of it.

Dogs, Dialysis, and Deep Valleys

A dog with dense molecules About 4:30 this morning my husband and I were lying there petting the dog and talking about our random sleep schedules. He is hooked up to his dialysis machine at night, and it makes various beeps and boops, with accompanying blinking lights, so he tends to be awake often during the night. I read in bed, and sometimes am awake until after two, depending on how gripping the narrative is, or how insomniac I am. I hear him waking, fiddling with the dialysis machine, and drifting back to sleep. Sometimes the machine wakes me up, too, and we have these early morning conversations. We were discussing whether our sleep has become so off and on because of our age, our medications, his machine, the dog, or, our best guess, all of these things. Rick and I have one of those foam mattresses that are all the thing these days. I bought it at the discount store a few years ago. It is probably the most comfortable mattress we’ve ever had. No hard pressure points for arthritic limbs and joints, and it practically hugs you and says, “There, there, baby, you get your rest,” when you lie down on it. Ah, we sigh, and snuggle in, and the dog snuggles in next to us. There are downsides to this cuddly mattress. The dog tends to slide in my direction during the night. Some nights I wake up clinging to the edge of the mattress. Garrison Keillor used to do ads for the “Deep Valley” bed, an old mattress with a sag in the middle that rolled the occupants of the bed toward each other. The foam mattress does not have a deep valley, but it does dip where you and the dog lie on it. Nature abhors a vacuum, and a dog abhors leaving you any space in bed. I know the truth of this when I wake up in the wee hours being pushed over the edge by the impressive bulk of our affectionate pit bull. She looked so small the day we met her. After living with an 85-pound Doberman-Pit Bull and a 60-pound Collabrador, Marley looked downright petite. We soon learned that she has what my husband calls “dense molecules.” Marley may not look very big, but she is a chunk of muscle, and when she hops up on the bed and lies down it’s a lot like sharing the space with a sack of wet cement. There is another problem with a soft mattress. After a while your back protests at the lack of support and you can develop muscle cramps and spasms. So sometimes I nap on the floor. A few hours on a flat hard surface and my back is much happier. I think the reason for this is that the human body slept on the ground or the floor, without much padding, for centuries. We’re not designed for soft and comfy. We’re designed for hard and unyielding. When I lie on the floor, I note in passing, the dog does not join me. She stays up on the nice soft couch. I think of the mattress ads I’ve seen, with a body, usually an attractive, height-weight proportional female silhouette, lying on a mattress. The illustration points out how the mattress shapes itself to the contours of the human body, going up at the waist and down at the hip and shoulder, a perfect fit for every physical idiosyncrasy. There is never a dog in these ads.

Listen up: we are not made for beds that shape themselves to us. We are made to sleep on the floor or the ground, with the dogs cuddled up next to us so we supply each other body heat, perhaps next to a fire that stays lit all night if we’re lucky. That’s my theory. I heard when I was young, “Old people don’t need as much sleep.” Well, phooey. I think we need as much sleep, but we don’t get it, at least in one stretch. When my mom was in her later years, she was always dozing off in her chair while watching TV. I understand that now. If you get eight hours of sleep in a row, do not have medical machines keeping you alive, and don’t have a dog pushing you off the bed, you have none of these complaints. Congratulations. I’m happy for you. But I don’t want to hear about it.

For Better, For Worse, For Lunch

Sometime in the last couple of years I saw a young standup comic, a guy, riffing on relationships, which is a pretty reliable comic vein to mine. He said that no one he knew looked at people who had been together for 30 years and thought, “Man, I gotta get me some of that.” That is the perspective of a young person, for whom sexy appearance is all. Yep, when we’re young we all want to have the zip and appeal of a 1958 Porsche Speedster, although in fact most of us could be more aptly compared to a 1958 Nash Metropolitan. By the time you’ve been married for over 30 years you’re more like a 1959 Cadillac – you’re wide, you have tail fins, your mileage is pretty high and your miles per gallon are pretty low, and the repairs and maintenance are murder. You know what else you are after thirty years? A really comfortable ride. Rick and I have been married for going on thirty-four years now, and I have to say I’m pretty happy I’ve got me some of that. It’s after thirty years, when attrition has set in to your physical being and you have to do what my spiritual director calls the “spiritual heavy lifting of later life,” that you are glad if you are fortunate enough to have your one true friend by your side. We are currently in that period of adjustment that takes place whenever one of us goes through a major change. In this case, he is now retired and is at home full time. That’s a pretty big change. For most of our married life, he was gone at work. There is an old joke that goes like this: the wife of a retired man says, “I married him for better or for worse, not for lunch.” This joke dates from the days when the traditional roles were more defined and adhered to. The man went to work and the woman stayed home. When he retired he came home and started sticking his nose into what had been her well-oiled and organized life. Resentment ensued. It’s no mystery why retired guys get part-time jobs, or play a lot of golf, or spend a lot of time out in the shop, or are otherwise processed out of the house. Their marriages depend on them getting out from underfoot. I am not criticizing this paradigm. We all make our bargains with life, and live with the consequences. I am glad that Rick and I don’t have that situation. We were friends for years before we became romantically involved, and that bedrock friendship has been a saving grace over the years. It was always there, no matter what happened. The friendship and the smart ass remarks – that’s what we’ve always had. It may not be Paris, but it’s worked for us. So now that he’s home, it turns out we still enjoy each other’s company, and we’re returning to the comedy that was our friendship back at the beginning. For example, when I get out of bed to go down the hall and return to find that the dog has slithered into my warm spot, Rick suggests we should have named her “401K,” because I have to roll her over. Rick and I are blessed in each other, we think. Still, it is weird having him at home all the time, probably more for him than for me. Our friend John once explained to me that this is how it is, especially for men. The job is your identity, it’s what you do and it’s who you are, and your whole life is centered on it. I started laughing as John explained this, and told him that I have never, not once in my life, felt that way about a job. For me a job was a way to pay bills so I could go on singing and writing, and buy some shoes for the kids. I abhorred workplace politics. I wanted to do my job and go home, where my real life is. Now real life is at home for both of us. It’s a change. Last night I called a friend whom I was going to visit today. I asked if her husband would be home, because if he was, I’d bring Rick along so the two of them could meet. I know that Rick and my friend’s husband have some things in common, starting with growing up as military brats. As I waited on the phone while my friend talked to her husband about my bringing Rick to visit, I suddenly had this thought: I feel like I am arranging a play date for my husband. When I told him that, he laughed. I’m going to have to watch that tendency to arrange things for him, though. I know we’ll both be happier if I mind my own business and let him mind his. That’s the kind of thing you realize after the first thirty years together, and if you’re fortunate, you’ll get yourself some of that.

Our Own Personal Fiscal Cliff (with a Segue into Chicken Heart Stew)

This year, on top of the holiday stress, we are looking at my husband’s being laid off from his job. He plans to make the best of the cards he has been dealt by calling himself retired. The man is 67, after all, and on dialysis. People have retired with less justification. Over the years I’ve heard many people talk about how they wished they could live and work on the island. This is the dream – not to have to commute, but to live here in paradise all day, every day, and only leave when absolutely necessary. Rick and I have lived that dream. The only fly in the “live and work on the island” ointment is that most jobs pay lower wages than you’d get on the mainland for the same work, and most jobs do not have benefits or pension plans. You accept those conditions because you’re so gosh darned lucky to have a job on the island, and most island businesses can’t afford benefits and pensions, anyway. Like some others who have lived the dream, we will now have an income from Social Security and nothing else. I keep crunching the numbers and it looks like we’ll be fine, except for not having any money in the budget for food. I’m not sure how we’re going to roll with this. I am thinking lentils, peas, and beans. This is okay. Lots of people become unintentional vegetarians after they become unintentionally retired. We’re okay. We have a home, and good friends and family, and it turns out that all those platitudes about friends, family, and love being the things that really count are true. The one about having your health is true, too, but that ship has sailed for us, so, eh. The non-vegetarian recipe I’ll be making a lot is chicken heart stew. In November of 1977 I did a folk concert tour in the interior of British Columbia. While I was there winter set in. I learned the joy of using an outhouse at -20 Celsius, which in Fahrenheit terms is, “really really cold.” I arrived for my last concert in Prince George, B.C. and took a taxi to the house where I was being put up. When I got there, I found a note from my absent hostess welcoming me, saying she’d be back later and to help myself to some chicken heart stew that was simmering on the wood stove. It was the first time I’d ever heard of chicken heart stew. I was a little worried. There was an “eeyew” factor. I dipped up a bowl and ate it and liked it a lot. When I got home to the island I tried to re-create it, and it became a family staple over the years. Even the kids liked it. It’s a great warm cheap stew for a January night. Here it is: Chicken Heart Stew, a la Casa Tuel Take a package of chicken hearts and rinse the hearts in cold water, then throw them in a pot of water and bring it to a boil. Simmer them on medium for 45 minutes or so, skimming any foamy sludge that forms on the top and throwing it away, unless you’re one of those creative people who has a good use for boiling chicken heart sludge. While the hearts boil, chop up: One green pepper, seeds and membrane removed One onion One large carrot Two stalks of celery Add them to the stew after that first 45 minutes. Let the stew simmer for a further 15 minutes. Drain the vegetables and hearts, reserving the stock. While they’re draining, make gravy.

Here's a picture of my gravy whisk. My mom had one. By the end of her life, the metal on the bottom was worn thin from decades of whisking. Melt 2 tablespoons of butter in a medium skillet, add 2 tablespoons of flour, and let the flour cook in the butter until it turns light brown, stirring constantly, 3 or 4 minutes of so. Mix in one cup of the stock you reserved, and you can throw in a little white wine if you’d like, to make your gravy. Add the drained hearts and vegetables to the gravy and season to taste. We eat it with a savory blend – Italian seasoning for example. If it’s not wet enough to suit you, or if you need to stretch the recipe to go around to more bowls, add as much of the stock as you wish. You can eat it on its own, or add toast, corn bread, and/or a salad if you like, same as any other stew or soup. So there you go, a good cheap winter meal if you’re not quite committed to that vegetarian diet, which I’m not. Enjoy.