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kelseyfrahlich

The Way Mom Sees It

A few months back, I shared the story of my T1D diagnosis. If you read it, you know my mom was there through it all, and has been ever since. She took the time to write inserts in the story from her perspective in real time. Her comments are below in red. I occasionally forget, on top of my own challenges with T1D, being the mother of a child with a chronic condition brings its own difficulties and uncertainties. I know I cannot understand that now, since I am not a parent, just like she cannot fully understand my perspective. However, we choose to recognize this fact with a mutual understanding of our unique challenges and unconditional love. I am so lucky to have my mom as my mom. I thank her for her unwavering support and bravery in her own obstacles. Also, if you are a parent of a child with T1D and this resonates with you, I know my mom is always willing to offer you support as well.



II. IX. MMXI. February 9, 2011. This date has great significance in my life. In

fact, the Roman Numerals are tattooed on my rib cage (basic location, I

know). Another great story, for another time. This is the day in which this

journey began, the day I was diagnosed with Type 1 Diabetes. My

“diaversary,” if you will. Here is the story…


In February of 2011, I was a freshman at Plymouth North High School. I was

doing well in school, surrounded by inspirational teachers and great friends. I

was working hard to get good grades. I wanted to be a writer. I was active

and had unlimited energy. My parents used to refer to me as the “Energizer

Bunny.” I was part of an indoor lacrosse league, working tirelessly to make

varsity as a freshman for the spring season. I was a normal fourteen-year-old

gal.


Then I got sick, nothing crazy - just a bad cold. It must have been the first

week of February. I missed school for a few days, binge watched the Disney

Channel and I was fine. Unbeknownst to me at the time, as my cold symptom

began to improve, my diabetes symptoms kicked in.


Quick pause in the story for a little science lesson, stick with me.

Symptoms of Type 1 Diabetes include extreme thirst, excessive urination,

hunger, weight loss, irritability, and fatigue. The symptoms make a lot of

sense if you understand the physiology of T1D. Type 1 Diabetes is an

autoimmune disease. It is not caused by eating too much sugar (or anything

else for that matter), there is no way to prevent it, and there is currently no

cure. GRRRR!!


The pancreas is made up of islet cells, which produce alpha and beta cells.

Beta cells secrete the hormone insulin and alpha cells secrete the hormone

glucagon. These two hormones regulate the body’s glucose levels. In

someone with T1D, the body’s immune system mistakes these cells as

intruders, therefore attacking and killing them. My mom likes to say my

immune system is just overprotective. This seemed like a reasonable in-part

explanation to a 14-year-old.


So how does this correlate with the symptoms of T1D?


Well, the initial symptoms of T1D are also the ongoing symptoms for

hyperglycemia, or high blood sugar. Let me explain.


Let’s say I have a smoothie for breakfast. (You can substitute your favorite

breakfast food in there, the smoothie really isn’t important to my point.) The

sugar enters the bloodstream and needs to enter the cell to be used as

energy. Think of insulin as the key that unlocks, and allows, the sugar to go

from the blood stream into the cells. Now, without the insulin, there is no way

for the sugar to enter the cells and it will remain in the blood stream. Hence,

high blood sugar. This is where those symptoms kick in. It is uncomfortable

for the body to be in this state, so it does everything it can to help (which like,

thanks for trying bod but you’re literally not helping at all). The extreme thirst

is the body’s attempt to flush out the sugar from the blood stream. This

correlates directly to the excessive urination… and neither is successful.

Since the sugar is simply sitting in the blood stream, the cells are starving

without energy… and so are you. No matter how much you eat, the body

cannot use the majority of the nutrients. You are hungry, losing weight, and

exhausted since your body cannot find a source of energy. This is why T1Ds

need insulin. We will die without it.


But let’s get back to the story. I began to have all of these symptoms. L

ooking back, I may have had them for a few weeks, but they certainly ramped

up after my virus and in the week leading to my diagnosis.


I. was. so. thirsty. This is an understatement! Kelsey would wake up in the

morning, have a tall glass of water. She’d disappear to straighten her hair (as

she said, typical 14-year-old high school freshman), and within minutes, would

be back for another tall glass of water. At the time, I was a distributor for a

health and wellness company. Purified water was one of our products. We

were all a bit crazy about it. We were all drinking a lot of it. But it did register

for me that her intake was excessive. A mental note was made.


I couldn’t handle it. My mom initially said I was just dehydrated from the virus

and my active lifestyle, but we quickly realized something was wrong. I

couldn’t get enough water. There wasn’t enough water in the world, I thought.

I remember taking a flashlight and looking all around my mouth because I was

convinced that I had crystallized salt particles stuck to my cheeks that I simply

could not wash away. I woke up in the night, dumped out the gallon of milk in

the fridge, filled it with water and poured it down my throat as fast as I

could…… about three times. It was unbearable. See above.


I was peeing every 20 minutes. I was exhausted. I was getting spoken to in

school because I was constantly leaving class to go to the bathroom, or fill up

my water, and when I was at my desk I was nodding off. I was cranky. I was

snippy with my family. Yep.


I was starving. I was eating all the junk food in the world and was still less

than 100 lbs. We’re talking Boston cream donuts, Monster Mash Ice Cream

Sundaes from Friendly’s, two lunches and multiple helpings of dinner. This is

accurate. Looking back, it seems so obvious. At the time, however, she was

a growing adolescent, or at least that was the thought. She wasn’t losing

weight, but at a time she should have been gaining, that wasn’t happening.


Something was wrong and it was becoming more and more obvious. My

mom googled my symptoms that Tuesday night, February 8th. We stupidly

thought, “No way it’s diabetes.” I had a physical planned for the next morning

anyway, so we would get everything figured out then. What Kelsey didn’t

know at the time was that on Monday, February 7th, I called the pediatrician. I

informed the nurse of Kelsey’s symptoms and I said I was very worried that

she might have Type One Diabetes. I knew about the thirst, and the mood

swings. I asked if I should bring her in. I was asked a few more question and

was told in that she had a physical scheduled for Wednesday, she could wait

until then. I was told what to watch for if it became necessary to go to the

Emergency Department. Sidebar, I’m not blaming the pediatrician’s office. In

retrospect, I wish I’d been more persistent, but I was scared and didn’t want

this to be so, and if they weren’t overly concerned, well, then perhaps I was

overthinking my assumption. Kelsey and I did look up the symptoms the

following night. To be honest, I was starting to mentally prepare.


The next day, February 9th, I woke up and got dressed for school. I still

remember what I wore. Light flared jeans, a white long sleeve shirt, white

sneakers, and I stole my older sister’s black and white striped scarf. I put on

my favorite silver flower earrings and left my hair in its natural curl. I do not

remember what she wore, or what I wore. I went off to Plymouth North High

School and struggled through first period Spanish with Mr. Wooten. Finally,

my mom picked me up to dismiss me and we headed to my appointment.


On the drive from the school to the doctor’s office, Kelsey asked, “What if I do

have diabetes? I’ll be like Nick Jonas!” Sorry Nick. I was relieved that you

were one of her celebrity crushes, and that you were healthy and young and

living your life with this diagnosis. If you could do it, so could Kelsey. I didn’t

say that to her. I think I said, “Oh, you don’t have it, Honey.” All the while

thinking, “Please don’t let her have it.” I wasn’t nervous walking into Long

Pond Pediatrics. I was young and healthy. I felt invincible, like any other

teenager. We checked in and sat in the waiting area, which had a large

wooden whale hanging from the ceiling. I stared at it as we waited for the

nurse to call my name. When she did, my mom and I walked into the exam

room. The nurse took my vitals and asked how I was doing overall. We

explained my symptoms and with a newly pale face, the nurse excused

herself from the room. She returned moments later with a urine cup. She

said Dr. Ingalls, my pediatrician, wanted to get a urine sample.


This was no problem for me. I could’ve peed constantly around the clock if

that was an option. I left the cup in the bathroom and returned to the exam

room. Dr. Ingalls knocked on the door several minutes later with a half-

hearted smile. My mom grasped my hand.


She went on to explain that there was an abnormal amount of sugar and

ketones in my urine. These are indicative of Type 1 Diabetes, but I would

need to go to the hospital for further testing and a formal diagnosis. I don’t

remember if we asked her many questions. I do. I point blank asked if this

could be indicative of anything other than T1D. She shook her head and said,

“No.” It was pretty obvious she couldn’t officially tell us much more. But she

was kind and supportive. She told us to drive to South Shore Hospital in

Weymouth. Here they would do blood work and a few other tests and then let

us know what to do from there.


My mom and I got back in the car. Looking back, I can’t believe we did the

next two things, but we did. I guess at that point neither of us realized how

serious this situation was. I told my mom I wanted to drop off my homework

at school. (Yes, I’ve always been a nerd.) So, we drove down the road back

to PNHS and I strolled into my English class with Ms. Roderick. I remember

her saying, “Oh shoot. I just marked you absent.” I told her to keep me

marked as absent because I had to go to the hospital. The whole class heard

and my best friends, Jamie, Theresa, and Alli, ran to my side to ask questions.

I told everyone what I knew. Classic fourteen-year-old Kelsey (and let’s be

honest, every-age Kelsey) loved the attention. I hugged my friends goodbye,

walked back out to the car, and told my mom I was STARVING. Again,

classic.


You, the reader, might be shocked by this next sentence.


We went to McDonalds. Hmmm mmm. We did. I know, I know. But I was so

hungry. I needed something quick. We didn’t understand that this was…. like

such a bad idea. LOL. SUCH A BAD IDEA! But, I mean everything ended up

fine, obviously, or you wouldn’t be reading this I guess.


So, we went through the McDonalds drive through. I ordered a cheeseburger,

a large fry, and a large sprite. Now, if you know anything about carb counting,

you know this is a lot. OMG - Sprite, geeze!! Could I have some sugar with

my sugar for my precious daughter’s sugary sugared blood??


Whenever I tell this story, I always mention the McDonalds. I don’t always

mention what I was wearing or that there is a random whale hanging in my

pediatrician’s office. But I always mention the McDonalds. Not because it

was a bad idea or to emphasize how hungry I was, but because this was the

last time, for the next 8 years, 11 months and counting, that I ate something

without THINKING. Type 1 involves so much thinking. Every time I eat,

whether it’s a Thanksgiving meal or a snack on the go, I have to think about it.

I have to prick my finger, I have to do math, I have to inject insulin or enter

information into my pump. I have to make sure it is the right dose and make

any adjustments based on if I’m sick, or if I’m planning on going to the gym

later, or a dozen other things. And that is okay. I am okay with that because I

don’t have a choice. But, I always mention the McDonalds because it was the

last time I ate before I knew I had Type 1. I found a picture of 13-year-old

Kelsey a couple of years ago. I think it must have been the first time I had

looked at pictures in a long while. There she was in the photo, no diagnosis.

I’m typically pretty in control of my emotions, but I lost it. Spontaneously cried.

It hit me what a simple time that was, and we didn’t even know it. I didn’t cry

because I longed for the previous days. I cried because it hit me how much

goes into each and every day for her. I think this is in part what she is

describing in the McDonald’s story.


Finally, after my silly escapades, we headed to the hospital. We parked and

walked into the Emergency Room. My doctor had called and they were

expecting us. The nurse asked us to sit in the waiting room and someone

would be with me soon. We sat for about ten minutes before I started to feel

very sick. My head was throbbing (one of the symptoms I had been warned

about when I called the pediatrician’s office two days earlier), I was nauseous,

I felt faint. My mom told one of the nurses and they took me right away.

I sat with one of the nurses and she told me she was going to check my blood

sugar. It was my first finger prick and the meter read back “639.” I asked her,

“Is that good?” Now, for those of you that don’t know; 639 is NOT GOOD.

NOT EVEN CLOSE TO GOOD! Very bad actually. A normal blood glucose

range is…. are you ready??? 70-120.


Yeah, so, not great. Such newbies, we were.


She walked us back into the exam room and a doctor and nurse walked in.

They had those pale faces with half-hearted smiles we had been seeing all

day.


I barely remember the doctor. I just know there must have been one

diagnosing me. I vividly remember the nurse. Her name was Barbie. As the

doctor explained he was diagnosing me with Type 1 Diabetes and went into

detail about the physiology and blah blah blah, Barbie translated it for both the

fourteen-year-old girl and the panicking mother to understand. (A little

foreshadowing to me realizing I wanted to be a nurse.)


I always found it ironic that her name was Barbie. In our society, Barbie is a

symbol of perfection. Barbie is a symbol of childhood. There I was, being

diagnosed with this imperfection. I would try hard to hold on to my childhood,

but I would have to grow up quickly in some ways in order to manage this

disease. Fun fact, I wrote my college essay on nurse Barbie and this irony.

It’s an amazing essay and I will encourage Kelsey to post it to this blog!


Barbie and the doctor said I needed to urgently go to Boston Children’s

Hospital for further management. I was in the early stages of Diabetic

Ketoacidosis or DKA. (I will make another post about DKA in the future, for

now just know it is a life-threatening form of hyperglycemia.) I was loaded

quickly into an ambulance and off we went. I don’t remember much of the ambulance

ride. I remember my mom holding my hand and telling me we would handle

everything thrown our way. Spoiler alert, we have done just that.


Time passed and before we knew it, I was unloaded onto a floor at Children’s.

They didn’t have any rooms available, so I was admitted into a makeshift...

closet, for lack of a better description. To be fair, it was a big closet. And they

managed to get all of the emergency equipment in there, so that was a plus.


The next few hours were a blur. Everything happened so fast. There were a

lot of questions and tests and exams and medicine and IVs. I remember I

thought the doctor was cute. I was probably embarrassed when he asked

some of the questions. A slew of interns came in and out of the room (closet),

and continued to do so for the duration of our stay. They ALWAYS asked the

same question. “Soooooo, how are you doing with your diabetes?” Huh? Ah,

frightened, kind of in shock, completely ignorant, no precedent for this, did I

mention frightened? That’s what went through my head. Kelsey paused, and

just said, “Um. Good.” We laughed about this throughout our time there, and

still do today.


It was obvious we were going to be there for a while. They would first need to

stabilize my blood sugar and treat the subsequent complications of

dehydration and electrolyte imbalance. Once I was stable, we would need to

stay for some additional days. I needed to be able to leave the hospital with

the skills to manage this disease on my own.


By this point, its evening time… and I’m starving. I asked if I could have

something to eat. I ordered two boxes of Frosted Flakes and a bagel. I

realize now how much sugar that meal contains. I’m glad the nurses and

doctors allowed me to have it though. It was an important lesson (without

knowing it at the time), that I can still eat what I want, as long as I cover the

carbs with insulin. Ah yes, insulin. Carb counting. Injections. This was my first

lesson.


The nurse put all the food out in front of me. She spewed out some gibberish

that went right over my head. It went something like this.


“Okay one box of Frosted Flakes is 46 carbs, you’re having two so that’s 92.

Two milk cartons, 24. So 116. Plus 30 for the mini bagel. Butter is nothing.

146. 146 divided by 15, 9.7. So let’s round down to 9 units. I’ll draw it up.

We’re going to pinch the back of your arm in… one two three (surprise,

injection!). Awesome job. Okay, go ahead and eat. Remember you have to

eat the whole thing because we covered for the whole thing.”

I had no idea what was going on or had just happened. I didn’t care. I

thought I was sick. They have to do this just while I’m sick in the hospital. I’m

thinking at this point, math. Lots of math, every day, from now on. Math.


“Don’t worry, I’ll explain all of that later,” she said.


Cool, whatever. Bon appetite.


You probably guessed it wasn’t a problem for me to eat the whole thing.


When I was done eating, some visitors came to my room (closet). It was my

best friend, Alyssa, and her mom, Pam. Pam was always like a second mom

to me, and one of my mom’s good friends. My sister was away at college,

and we needed some things from home, so they essentially broke into our

house to get what we needed for our stay at Children’s. And, of course they

came to offer support and share some laughs. Which is exactly what we did.

It was a relief and a comfort to be with friends. Pam and I shared the look

only mothers understand. The one that says, “Oh geeze. This is frightening.

So much uncertainty. I feel for you and I’m here for you.” So much in just a

passing glance. I was grateful for her company, and for that look.


Towards the end of their visit we received the exciting news that an actual

room had become available. They moved us to a beautiful large, private room.

I did not take notice of the beauty, or the size. I’ve only just learned upon

reading this that it was an impressive room. We stayed there for the first

night. The nurses came in every hour to check my blood sugar and correct

appropriately. I didn’t get much sleep. I doubt my mom did either, for different

reasons. Word.


In the morning, they broke the news that we couldn’t stay in the private room

and would be moved to a shared room with another young girl also being

diagnosed with T1D. Her name was Katherine. She was 11 and at first the

only things we seemingly had in common were our diagnoses and our shoe

size (8…abnormally large for two young gals). We eventually learned we had

other similarities. We were both interested in music and theatre. We had

differences. I was more of an athlete. More importantly, she hated Justin

Bieber. I was practically signing my name, Kelsey Bieber. I even made a

Justin Bieber wallet out of duct tape in one of the hospital craft rooms. Cute

right. Not creepy. I’ve always had this thought when filing onto an airplane.

When I look around and see children, I tell myself, “This flight will be safe.”

The thought is, “They are young, it is not their time to go.” I’m not an anxious

person in general, but I was then, and there was comfort in being with another

mother and daughter in the same boat (plane).


Katherine and I took diabetes classes together. We were told we could not

leave until we could show that we could manage this on our own. What???

Math, changing scenarios, medications, do’s and don’t, exceptions to the

rules. WHAT??? The nurses would come in and teach us different lessons:

the basics, various situations, challenges, emergencies, etc. We had to learn

carb counting, carb ratios, correction factors, basal doses, how to draw up

insulin, how to give ourselves injections, how to check our blood sugar, how to

recognize and manage a high blood sugar, how to check for ketones, what to

do if ketones are positive, how to recognize and manage a low blood sugar,

how to manage a “sick” day, how to manage and plan for exercise, how

things will change when menstruating… just to name a few. Seriously. I

could write a book on all the things I learned.


I asked a ton of questions, as did my mom. We didn’t really have a choice not

to. In a few days, I would be back at school, living my normal fourteen-year-

old life, but so many things were different. It was overwhelming, but the

system was a well-oiled machine. I had to learn how to give Kelsey a shot.

Another requirement before we could be discharged. They let me practice on

an orange, twice. Then I had to give the shot to her. I did it, and I did just

fine. Much more worthy of note, is that that is the one and only shot I have

ever given to her. Immediately, and not because I didn’t do well, she took

charge. I offered periodically when we first got home, but she always refused.

I have nothing but great things to say about Boston Children’s Hospital.

These nurses and doctors knew what they were doing and knew exactly how

to get the information across. They were patient and explained things several

times until we were all confident in the lesson. My life was being flipped

upside down, I would have to do everything differently, and they gave me the

foundation to live a healthy life, as well as the confidence to live a normal life.


I was constantly encouraged to never sacrifice anything because of this

diagnosis. One nurse told me, “The only things you cannot do are join the

military or become a pilot. For everything else, ask “How can I make this

work,” rather than “Why can’t I do that?” My mom and I recite that quote to

each other from time to time. Like when I had a meltdown because my insulin

pump wouldn’t fit anywhere in my prom dress. Or when I was constantly

reminding her that I’d be fine on Spring Break. Both ended up fine, btw.


Kelsey was also told that adolescents and parents sometimes argue each

other. She was told that she was allowed to argue with me about anything,

anything at all, except diabetes care. That was the one topic that was sacred

and needed to be treated as such. This seemed like a valuable tip at the time.

Over the next few years if there was conflict, this was a contract to which we

faithfully adhered. We never did argue about diabetes care. This is a tip I

share now with moms of T1D newly diagnosed teens or pre-teens.


As overwhelming as everything was, I remember having fun. I remember

laughing a lot. I remember the names of all the nurses. I remember feeling

positive, powerful, inspired. I remember feeling strong the entire time. I never

once doubted I would be able to handle the challenge.


I’m sure some of that came from being so young. Some is just my

personality type, I like to think. There was a touch of blissful ignorance. But

most of it was because of my mom. Huh? Words on this page could never

express how much of a superhero my mom is. I cry just thinking about it

because she is so…. There’s not even a word! She must have been scared,

but she never showed it. She had a smile on her face the entire time. When I

had to give myself shots, she sang silly songs to distract me from the pain. I

was cracking up. Giving myself shots, and cracking up. We made it one of

our little adventures, and we still do.


As I get older, I realize she wasn’t only scared, but she was stressed. My

parents had recently separated. My dad was out of the country teaching

classes on a Coast Guard ship. Money was tight. We had minimal insurance.

In fact, our plan was called “non-catastrophic coverage.” While this wasn’t

exactly a catastrophe and things could have been drastically worse, it wasn’t

your average check-up, and it was life changing. Children’s wouldn’t let us

leave the hospital until we had enough insulin and supplies for a full month. If

you watch the news, you know insulin is dangerously expensive.


She figured it out. As she always does when my sister or I have a problem.

We had incredible support from family and friends. But my mom is a

superhero. She handled it with such grace, strength, independence, humor,

and bravery . I never saw an ounce of her stress or fear. I am so proud to be

her daughter. And I, her mother. Indeed, there are no words.


Anyway, before I cry…


I had other visitors, which was fun. My friend Theresa visited me with her

family, her sister passed out in the hospital. Low blood sugar. Apparently, it

had happened to her before. She was fine, but we always chuckle about it.

Some of my teachers sent cards. Everyone was texting me and I loved the

attention.


Before I knew it, it was time to go. I had passed all the tests, asked all my

questions, knew the resources for when more questions came up (which they

did, and still do). I didn’t want to go. Me neither. I felt safe there. Me too! I

was having fun. I loved the nurses. I loved learning. I loved being in a

bubble where having to do this thing on my own was still a “when.”


Katherine was discharged a few hours before me. She and her mom packed

up their things and handed me a bag. It contained a letter and a necklace

from the gift shop that read “kindness.” The letter explained how much I had

helped Katherine during our time as roommates. She wrote about bravery,

kindness, how we made things fun. She said a lot of the questions I asked,

helped her as well. She said the way I explained things to her when we were

alone really clicked. It meant everything to me.


Then something clicked for me. Diabetes for me isn’t meant to be a death

sentence or a burden. Sure, it will always be a challenge, but it is a challenge

I was meant to face. I was meant to face this challenge because so much

good will come from it. I’ll help people. I’ll learn so much about myself.


I’ll be a nurse. I’ll make a difference just like my nurses did for me.


Type 1 Diabetes has given me so many gifts: a career I am passionate about,

the opportunity to educate others, an amazing community of support. I have

been gifted with incredible friends and family who show me the meaning of

friendship and love every chance they get. I have learned about the strength I

possess. I have been humbled by the support and interest my teachers,

professors, coaches, employers, colleagues, and peers have shown.


Of course, T1D is a challenge. Some days, or parts of days, it is a f***ing

burden! But it always passes. This was another tip offered at the hospital.

“You will have THOSE days. It’s ok. It will pass.” Let me tell you, early on,

THOSE days were dreadful. If you are a parent, you understand that the

worst moments are those in which we are helpless to make things better.

Kelsey was a sophomore in college when at the end of a particularly difficult

diabetes day, she called and apologized for taking it out on me, and added, “It

was just one of THOSE days, Mom. Like they said at the hospital. I’m ok

now.” Once again, I was grateful for the experience we had at Children’s

Hospital, Boston. I always figure it out, relying on various resources and one

heck of a support system. I don’t wish that this had never happened. I would

love for there to be a cure one day, but I wouldn’t change this story. Because

this isn’t just the story of my diagnosis, but this is the story of my life and a key

piece to whom I have become.


I left the hospital with a positive outlook. I went back to school and received

nothing but encouragement from my friends, teachers, and the school nurse,

Nurse Patty. LOVE Nurse Patty. I took it day by day. And I still do.


I choose to celebrate February 9th, as many T1Ds celebrate their

diaversaries, because it is a reminder of how far I have come, how blessed I

am, and how I am still writing this story, in whatever way I want to. I am so

lucky to have this as my story. Other T1Ds are not as fortunate, whether that

be due to presenting with more life-threatening conditions, or lacking support

and means. I am so grateful to be here writing THIS story. I mean I used the

word “fun” five times. (Maybe I’ll invest in a thesaurus for future posts, btw.)


So, thank you for reading my story. I know everyone has one. I hope you are

having fun writing yours as well.


Once again, THERE ARE NO WORDS!

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II. IX. MMXI

II. IX. MMXI. February 9, 2011. This date has great significance in my life. In fact, the Roman Numerals are tattooed on my rib cage...

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