Knowing about the 4Ts helped my own diagnosis – by Amy
My name is Amy and I am a person living with diabetes. But hey, that’s not all I am. Like every other 26-year-old (or anyone, of any age for that matter), I am trying to find my way in life by pursuing the things I enjoy and learning how to cope when faced with challenges, of which there have been many.
I love walking, singing, reading, and cuddling up with my dog after a hard day’s work and chatting with friends. So diabetes is just one thing of many that makes me, me.
So now that we’ve cleared that up, where do I start? Well, I suppose the most appropriate place to begin is my diagnosis and the events that led to it.
When I was 11, I was really good friends with a boy in my P7 class called Chris. We shared a mutual love of the Nintendo 64 game ‘Zelda the Ocarina of Time’, amongst other novel things like Digimon and Pokemon (don’t judge too harshly, they were very trendy in their day). One day however, Chris stopped coming to class. Weeks went by and we heard nothing, except for some sorry looking faces exchanged between the classroom assistants and shared incoherent whispers.
One morning – I guess when the school finally decided Chris’ absence had to be publicly acknowledged – our teacher Mr. Brown announced: “Chris has been very sick. He will be returning this week, but he has a serious illness that will change his life forever. It’s called diabetes.”I can’t exactly remember how Mr. Brown then continued to explain the repercussions of diabetes, except that it involved daily injections and zero sugar intake.
Surely it couldn’t be true?
“Daily injections?” I thought. “Never being able to eat…sweets!?!” I was in total shock. For an 11-year-old who had no idea of chronic illness and an irrepressible appetite for sugar, it really sounded awful. All I wanted was to see my friend Chris and to ask him if it was true, for surely it couldn’t be? Surely he didn’t need injections and we would still share the Reese’s Cups he brought back from America?
When Chris did return to class a few days later, he looked tired, pale and uncomfortably thin. I barely got round to saying hello to him when Mr. Brown made him stand up in front of the class to explain to us what exactly had happened and “what diabetes is”.
Talking about his diagnosis, Chris told us he knew something was wrong because he was going to the toilet a lot, he couldn’t shake off his tiredness despite how much he slept, was getting thinner despite how much he ate, and grew more thirsty despite how much he drank.
This toxic mix left Chris in a serious condition called Diabetes Ketoacidosis (DKA) where his body wasn’t producing enough insulin to help him break down sugars (hence why he wasn’t able to eat the Reese’s Cups anymore) and therefore his body was burning fat to fuel itself (which explains the rapid weight loss).
As a result, poisonous acids called ketones built up in his body leaving him in a critical condition and officially, a child with type one diabetes.
Afterwards, Chris sat down at his desk and he was able to reassure me he was ok. We carried on the last few months of school as normal, chatting about computer games and swapping Pokemon cards, but I couldn’t get what he said about diabetes out of my mind. “Poor Chris” I thought while admiring his bravery as he received his injections, “I couldn’t do it.”
Fast forward a few months to August 2001. I had just returned from a family holiday in Barbados and it was my first day back attending my Saturday stage school class, with only a few more weeks to go until I started grammar school. I had been feeling tired for a while, but I remember the dance routines that Saturday exhausting me completely inside and out. A bottle of water that would normally last the whole four hours of class, was consumed every 10 minutes and my frequent trips to the toilet never seemed to end. Something was wrong. I knew it. Something was definitely wrong.
No matter how much I slept, I still felt tired
After class I went home to my mum (a nurse) and dad (a doctor) and rather melodramatically announced “I think I’m diabetic.”They were in the middle of watching some BBC drama and turned to me with that kind of “don’t be silly’ look and asked how I even knew ‘what diabetes is’. That’s when Chris’ words about his diagnosis became real. I was usually really energetic, but now I was spending most of my afternoons napping on the sofa and waking up feeling even more exhausted than before. No matter how much I slept, I still felt tired.
“That’s just jet lag, you’re only back from holiday!” my parents said. I was never a fan of water and never really drank much, but I remember the unquenchable thirst I felt was all consuming. All I could think about was drinking water and in dance class I would hold my mouth to the tap for as long as I could, just gulping down mouthfuls to try and keep the thirst at bay – which never worked. Nothing worked. No matter how much I drank, I was still thirsty.
“It’s because you’re exercising so much Amy. You’re probably dehydrated, just keep drinking water and you’ll feel better!” My parents reassured me (and perhaps themselves too). Going to the toilet multiple times in the middle of the night was certainly not normal for me either. No matter how much I went to the toilet, I still felt like I needed to go. “That’s just because you’re drinking so much, don’t you worry.” They said.
And lastly, while I was always a slim child I noticed my ribs were sticking out a lot more. This didn’t really make sense considering I was eating as much as I always did, in fact I was eating more because I was trying to distract my mind from the thirst. It just seemed that no matter how much I ate, I was still getting thinner. “You’ve always been like that Amy.” My parents concluded.
Two more weeks went by were nothing changed, except I just felt worse. One day, when my best friend at the time was staying over and we had overindulged in chocolate the night before, my mum saw me plastered to a large carton of orange juice desperately trying to quench my thirst all in one large gulp. She brought out a spare blood monitor from her car (one of the perks of having a mum who is a nurse) so she could test my blood glucose and expect a reading between 4.0 – 7.8 mmol/L.
I’ll never forget the look on mum’s face when the monitor flashed that fateful result though. Her hand was held to her gaping mouth and her eyes seemed like they were going to bulge out of their sockets. “Wash your hands Amy.” She said in a panic. “You must have some orange juice on your hands.” Before I did, I quickly looked at my reading. It was 32mmol/L. I washed my hands as hard as I could, then once more felt the sharp prick of the needle into my finger so I could get a second reading to reconcile our fears. However, this hope was squashed with an even higher reading of 34mmol/L.
Mum stood there in shock
I knew what it meant. We all did. While mum stood there in shock, I filled the deafening silence with hysterical laughter, not because it was particularly funny – for believe me, it wasn’t – but because I knew what lay ahead and I was just so frightened. It was psychologically overwhelming. I then looked at my poor mum. The laughter subsided and was replaced with uncontrollable tears, the rest is a bit of a blur.
The next few hours involved an emergency admission to hospital with a Type One diabetes diagnosis. I was told very briefly what it meant and what injections I would be put on (which back in the day was slow acting humalog insulin). During my two day stint in hospital, I was briefly told about carb counting (I had no clue about nutritional values at the time and it took me years to get the hang of it) and how each meal was limited to 40g of carbohydrates, which equated to EXACTLY 12 chips with each hospital dinner (I watched the nurses count it out).
I was given a leaflet about hypos and hypers, explaining what they are and how both are bad for you and to avoid them as much as possible. And sweets? Well, you can forget about them kid. Dad still laughs to this day as he recalls me pressing my nose up against a chocolate vending machine in hospital and crying “I’ll never be able to have a snickers bar again!!” This was wrong, but at the time I truly believed it.
My first injection made me decide how I was going to dictate the management of my diabetes for the rest of my life also. Dad was given the injection by the consultant to pop into my thigh with all the nurses eyes on him – no pressure. I was repeatedly told “whatever you do, don’t jump! DON’T. JUMP!”, but Dad looked so nervous. His hand was shaking and his eyes were filled with fear and who can blame him, it’s a lot for parents to take on too.
As his trembling hand came towards me I grew more and more anxious, for if Dad is scared (who is usually quite stoic) then shouldn’t I be too? So despite my best efforts and much to the disappointment of the medical staff, I jumped as soon as the needle hit my skin making the pain much more intense due to the contracting muscles. That’s when I decided no one was ever going to inject me again, except myself. It’s my body, so it was up to me to manage it and it’s stayed that way ever since.
Despite such a high BG reading of 34mmol/L I wasn’t in DKA. This is what I will be forever grateful to my friend Chris for. If it wasn’t for him explaining the 4 Ts of diabetes (thirsty, thin, toilet, tiredness), I most likely wouldn’t have had an early(ish) diagnosis and I was thankfully spared from being in a critical condition, which would have made the situation so much more traumatic for everyone. That’s why, for anyone who may be reading this, I urge you to spread the word of the four Ts for it honestly can save lives. While it’s easy to think “It’ll never happen to me” or “It’ll never happen to my child” it’s potentially dangerous to do so. My parents are experienced medical professionals and they never thought it would happen to them, but look what happened.
I hope by sharing my experiences, both good and bad ones, it’ll help to unveil some of the preconceptions of diabetes and reach out to those who are living with it, but not defined by it. Stay tuned for more and would love to hear your thoughts if there is anything you would like me to talk about!
Read more about the 4Ts and diabetes