Highs & Lows with Diabetes

  Corn Bread Diabetes: B.W. Dortch

B.W. DortchI was born in August of 1930, and when I was a young child our family doctor told my mother that she should be careful in what she fed me and to avoid sweets, with the exception of honey, because it was naturally sweet and could not hurt me. Perhaps because I was a large baby, weighing in at 11 lbs, he thought I might develop diabetes someday. Back then people thought diabetes was caused by eating sugar . . . I hate the term “Sugar Diabetes.” You might just as well call it “Corn Bread Diabetes,” because most everything you eat turns into sugar after you eat it. 

Years later, my mother found out that she had Type 2 diabetes, and I have often wondered if she had Gestational Diabetes while she was pregnant with me. My diabetes first showed up during a routine exam in 1958, when my Doctor found sugar in my urine, but my fasting BGs didn’t show I had diabetes so nothing was done. At the time I worked in an area that was considered hazardous and I was required to have a yearly physical. So, in the early 1960s they found that my fasting BG was very high, and the test tape used to check my urine was black.

My Doctor put me on some of the early oral medications that stimulated the pancreas to make more insulin, and for several years that’s what I took. But I never did well, and during those years I had very little energy, and had constant urination and thirst. I believe that if they had been familiar with term “Type 1½ Diabetes” back then they would have diagnosed me with it, because they didn’t think people of my age developed Type 1 diabetes.

One weekend after years of taking those oral medications, I was so weak and tired that I slept the weekend away. My wife and brother finally convinced me to go to the hospital, and I weighed in at 116 lbs . . . Just a tad under weight for a 6’ 2” fellow! My wife begged the doctor to put me on insulin, and after much discussion she finally convinced my Doctor to give it a try. I started to improve some, but I still had no way of testing my blood sugar, and had to test my urine to see if sugar was spilling over.  

The insulin we used was erratic in the way it absorbed and I had a lot of low blood sugars. My wife used to find me shaking in the bed at night with cold and clammy skin, and we had no idea why. When we later found out that I was having seizures, due to hypoglycemia, my wife stayed awake nights, worrying whether or not I was OK. So my doctor changed the timing of my insulin dosage and it helped some. We learned as we went, and for the most part it seemed we knew more about diabetes then my Doctors, and we were always searching to find answers.   

It was not until the early 1980s that I received my first blood glucose meter which required very precise measurement and timing in wiping off the strip. It seemed to give accurate readings, but nothing as advanced as the meters we now have that store readings. I traveled a lot for work and it concerned my wife a great deal, so I often overate to prevent low blood sugars.  

Then in 1991 my wife and I moved to Chattanooga and found an endocrinologist who knew more about diabetes than we did . . . I think because he had diabetes himself. Dr Huffman watched my blood sugars closely and gradually increased the number of injections I was taking, so I could match the insulin I was taking to the amount of food I ate.  

In 2000 my Granddaughter was diagnosed with Type 1 diabetes, and while I was visiting her in the hospital the nurses told her about insulin pumps. My Granddaughter was not impressed, but it was most intriguing to me. So I went back and asked Dr Huffman if I could have an insulin pump. Although he is an expert in use of pumps, he never pushes his patients in making a decision on advanced diabetes management until they were ready.

Starting use of a pump made all the difference in the world and I had more level blood sugar readings, with fewer highs and lows. I love my pump and I love gadgets. It is so convenient and it has given me great piece of mind. And, since going on my pump I have not had another severe night time low.  

Despite the lack of available knowledge and diabetes management tools available to me in the early years of my diabetes, it was not until the early 1980s that I began to see any complications of diabetes. My feet started tingling and it felt like I was walking on pins and needles. Then in 1986 a blood vessel burst in my right eye and my vision became extremely blurred. At that time they had just started using laser surgery to correct the problem, and little was known about the ways to best utilize it. I never regained vision in that eye, and in later years I began to have problems with my left eye. My vision has gradually declined in that eye as well, and this past year, after 50 plus years of living with diabetes, I was given the diagnosis of being “legally blind.” I can no longer drive, but am able to walk around on my own, program some of my own boluses, and I use my computer with special adaptations.  

I continue to exercise at home with use of an exercise bike, an exercise band, and dumbbells. I stay active, but am starting to feel some of the health challenges befitting a man of 79 years, unrelated to diabetes . . . And I don’t figure I have more than 28 years left!

BW spent most of his working career in the US Civil Service, working for the Department of the Army in the field of communications and data processing. He traveled about 50% of the time, from one Army post to another, and moved his entire household on many occasions. Over the last 10 years of his career he worked at Redstone Arsenal in Huntsville, Alabama where he served as Director of Communications. Throughout his career, he says that the rules of good diabetes care were often forgotten. But, during his time in Alabama, he became acquainted with his first diabetes specialist who taught him about Insulin to CHO ratios, and ways he could adjust insulin dosages to the amount of food eaten.  Following his retirement in 1991, BW and his wife moved to Chattanooga TN, and since that time, BW says he has taken his “hobby” of managing diabetes a lot more seriously! 

 

 

         50 Year Medalist: by Claire M. Blum, MS Ed, RN, CDE

50 Year Medalist

B.W. Dortch was one of my very first patients after I became a Certified Diabetes Educator in 2001. And he tells me that I was his very first Diabetes Educator. . . But I have to say, that B.W. has taught me far more than I ever taught him, and that his example has inspired me through some of my most difficult days!

At time of our first visit, I clearly remember asking B.W. to tell me his legal name, and him saying “I’d have to kill you if I ever told you what my certifiably legal initials stand for.” He has a sense of humor that I believe contributes to his incredible resilience through the most difficult of times in his 80 + years of life,  and 50 + years of life with diabetes. And you know he has to be doing something right to have outlived 3 of his Endocrinologists!

Despite the many challenges B.W. has faced, he continues to live with a great deal of honor, courage, humor, and commitment to his diabetes care. Courage, according to Merriam Webster, means the mental or moral strength to venture, persevere, and withstand danger, fear, or difficulty. And courage never comes without fear. Living WELL with diabetes doesn’t either and requires commitment to transcend the every day challenges and frustrations of blood glucose management, in order to contribute to something far greater. 

Sometimes there aren't any trumpets - just lots of dragons. Sometimes there aren't any medals to win, no golden chalice, no honor in having fought a fierce dragon. Sometimes all you can say is, 'the day is done and I tried my best. Sometimes the very best you can do is keep trying." Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I'll try again tomorrow." by Bobi Serecich

I believe that is why the Joslin Diabetes Center calls the prestigious "50 Year Medalist Award" a medal of Courage. On August the 18th 2010, B.W. Dortch was awarded his 50 Year Medal, as an honored member of the Board of Directors for Partners & Peers for Diabetes Care, Inc. Thanks B.W. for being our friend and HERO!

50 Year Medal Award Collage

Joslin’s Medal Program recognizes individuals who have lived with insulin-dependent diabetes to commemorate their dedication to lifelong diabetes management. They began awarding medals to people with diabetes in 1948 with a 25-Year Victory Medal. The program was a vision of Elliot P. Joslin, MD who believed that proper self-management was the key to minimizing long-term complications, and it has served as an incentive for many in commitment to good, though challenging, Diabetes Care. In the early 1950s the 25 year award was changed to a Blue Ribbon, and as more and more people lived long and healthy lives with diabetes it became the 25-Year Certificate that is awarded today. Then, in 1970, Joslin expanded their program to begin awarding a 50-Year bronze medal, and in 1996, they awarded their first 75-Year medal.

 

Joslin 50 Year Medalist Award and Study

Joslin 50 Year Medalists Give Clues to Cures: Diabetes Health 

 

Blue Bart

Symptoms of Low & High Blood Glucose

The metabolic changes that occur with diabetes often contribute to mood swings, and can be an indication of Low or High Blood Glucose levels.

Low Blood Glucose (Hypoglycemia) is caused by too little food, skipping meals, more insulin or diabetes medication then is needed, more activity than usual. The onset is often sudden.

High Blood Glucose (Hyperglycemia) is caused by too much food, not enough insulin or diabetes medication, sickness, or stress. The onset is often gradual, but it can be rapid when an insulin dosage is missed, or when a person wearing an Insulin Pump has poor Infusion at through their infusion site.

Symptoms of Low BG

Shaking
Rapid Heartbeat
Sweating
Hunger
Blurry Vision
Weakness or Fatigue
Irritability
Dizziness
Anxiety
Headache
May not feel anything

Symptoms of High BG

Extreme Thirst
Frequent Urination
Dry Skin
Hunger
Blurry Vision
Sleepiness or Fatigue
Irritability
Nausea and Vomiting
Difficulty Breathing
Slow Healing Wounds
May not feel anything

 NOTE: Low or High Blood Glucose that is left untreated can lead to a medical emergency.               

It is important to discuss proper treatment with your Diabetes Care Team.

 

Tool Box

Symptoms of Hypoglycemia and Hyperglycemia: Changing Life with Diabetes

When Blood Glucose is Too High or Too Low: National Institute of Health (NIH)

What is Hypoglycemia: National Institute of Health (NIH)

Diabetic Hypoglycemia: Mayo Clinic

Hypoglycemia (Low Blood Glucose): American Diabetes Association (ADA)

Diabetes Low Blood Sugar Self Care: NIH Medline Plus

Hypoglycemia: Planet D

Hyperglycemia (High Blood Glucose): American Diabetes Association (ADA)

Hyperglycemia: Planet D

Caution: Don't Get Caught with Ketones: Diabetes Health

Diabetic Hyperglycemic Hyperosmolar Syndrome: NIH Medline Plus

Diabetic Ketoacidosis: Mayo Clinic

Ketoacidosis DKA: American Diabetes Association (ADA)

Diabetes and Alcohol: What You Need to Know: Diabetes Health

Hypoglycemia: What Every Person on Insulin Should Know: Diabetes Health

Medical ID Bracelets: The $15 Lifesaver: Diabetes Health

What is the Impact of Exercise on Diabetes? Diabetes Health