Friday, April 15, 2011

The Bad Night

Last night, I wrote about being out and about in the world, being silly with most humans I encountered. What I failed to discuss in that post, as well as with Becky, was exactly how bad I was actually feeling.

This right ankle of mine, which has yet to be looked at by a doctor, was aching beyond the capacity of my meds. It's my assumption that it's a result of Charcot's foot, as it resembles many of the pictures I've seen of the condition as it advances. It's something to consider what the pain would have been like had I not been taking morphine, oxycodone, AND dilaudid. Recent glances stolen at the ankle have me thinking that BIG trouble is brewing there.

Thankfully, I'm seeing an endocrinologist on the 20th and a podiatrist on the 25th.

That said, something funny happened this morning. I received a call from what is apparently an education center for diabetes. They were referred to me by my new PCP. This poor woman on the phone...She sat there, trying to tell me about the referral, and I'm saying in disbelief to the idea, "Ummm...I'm a diabetic for over 36 years and writing a book about diabetes. I don't think I need to be educated on it." I told her I'd discuss the referral with my doctor when I saw him, but I have to admit that I was tempted to make an appointment, just to go there and see if they knew something I didn't.

In a recent correspondence with another diabetic, I shared a tiny snippet of my manuscript. I told him not to share it, but then it's not really anything so personal that it can't be shared openly. What's more, it's an accurate answer to the question, "What is diabetes?"

Within the pancreas are approximately 100,000 islets of Langerhans. This is where insulin is produced, stored, and released. Each islet has about 1000 to 2000 beta cells. The beta cells are primarily responsible for insulin production.

Other important regions of the islets of Langerhans are the alpha cells and delta cells. Alpha cells produce and release glucagon, which is used to raise blood sugar levels when necessary. Delta cells create somatostatin, a chemical that mediates on behalf of insulin by blocking glucagon. Finally, there are PP cells that release pancreatic polypeptides to control all of the insulin, glucagon, and somatostatin activity.

“How does all of this work together?” It’s like this…If you intake sugar, the regulatory parts of the brain sends messages to the beta cells by way of the PP cells to release insulin. As the sugar gets broken down, the insulin attaches to various cells to allow the glucose molecules (sugar) into those cells. Keep in mind that sugar is a major source of energy, right on down to a microscopic level. If the cells inside your body can’t get their sugar fix, they will force other substances to become energy. That’s very bad. (Diabetic ketoacidosis is discussed later.)

Those who are active in sports benefit from the actions of the alpha cells. As you run, jump, sing, dance, or what have you, the alphas release glucagon to give you a much needed boost in fuel.

If there is confusion inside the body, however, and the alpha cells try to raise your blood glucose when you don’t need it, the delta cells will release the somatostatin to block the glucagon, thereby allowing the insulin to do its job. (Don’t ask me how or where the confusion originates. I can only assume it involves some kind of naturally occurring chemical imbalance.)

After all that, it becomes quite simple. If you don’t have any insulin, only a small amount of insulin being produced, or your body is unable to use the insulin in your body…You’re a diabetic.

Far more accurate than the common statement, "Diabetics simply aren't allowed sugar." Said statement is inaccurate and virtually impossible to make a reality, as almost everything eaten produces some kind of sugar in the end.

So...does it seem like I'd need a diabetic educator of any sort? =P

No, what I need is this foot fixed, and I'm fearful of what that'll entail. There are times when I want to "skip to the chase," as they say, and have the foot removed. The problem with that is that it doesn't solve anything. Not really. It just exchanges one set of problems for another. I've lived with an amputee. Things weren't easy.

I'm also a brilliant kind of klutz. I can easily see myself on more than one morning, waking up and forgetting that I'm missing a foot. "Face, meet floor. Floor, this is face."

And now that I'm thinking about it so clearly, I think it's time to take some anxiety medication and get some rest. Be well, all, and DFTBA.

No comments: