A wise man once said that ‘bad things will happen to you if you live long enough’. It rang true for Irene as she stood outside a her father’s nursing home. She recalled her father sitting on a single couch, staring into space. He would have been there all morning from when they got him out of bed hours ago. She felt a wave of sadness gnawing at her chest. In anticipation of the familiar tears, she pulled a tissue from her handbag.
‘Mum, are you okay?’ Winnie, her twenty-one year old daughter moved closer to her and held on to her arm.
‘Yeah, I’m fine. It’s just terrible to see your grandfather in that state,’ Irene wiped her eyes with her tissue.
‘It was depressing in there. At least grandpa can still recognise us. He’s actually in better shape than many others in the nursing home. Some of them can’t even hold their heads up,’ Winnie lowered her head she recalled the scenes from the nursing home.
‘You know, your grandpa used to be fiercely intelligent. He loved debating and would win almost all arguments. He urged us to read, to learn and to question everything. He said that it was important to think for ourselves. I miss him. Whoever he is now is not him,’ Irene blew her nose into her tissue.
‘Right. I remember that my head used to hurt when he gave us so many puzzles to do each time he came to visit,’ Winnie giggled.
‘And then before you know it, it’s all gone. He spent a lifetime enriching his mind and then in the end, he couldn’t hold on to it. He sits in a chair all day and stares into space. My heart breaks for him,’ Irene sighed.
‘Mum, don’t think like that. Grandpa has had a good life. He’d achieved a lot of successes in his time and he did what he wanted to do. He got what he wanted in life.’
‘I’m not sure that he wanted this now but you’re right, he’s had a good life and gave us one too. Nothing lasts forever though. So Sweetie, we must not waste our time. Use it wisely while we still have it,’ Irene smiled and looked lovingly at her daughter. At the sight of Winnie’s youthful face, the heaviness in her chest lifted. It was quickly replaced by a sense of pride.
‘Oh Mum, on the note of time, we should hurry. Our flight is in a couple of hours. We don’t want to miss it.’ Winnie reached immediately for her phone to book an Uber.
‘Right, let’s get out of here. I’m so glad that you came with me to visit your grandpa. I hate flying alone.’
‘I’m sorry Mum that I couldn’t come with you to more often.’
‘Don’t be silly. You need to focus on your own goals and career. Grandpa has had his life, you’re just starting out. How’s everything going by the way?’
‘Everything is great Mum. Work is good. Everyone’s friendly and supportive. Netball is brilliant as well. We’re on a winning streaking and won four games in a row. Not a lot to complain about. Oh, here’s our Uber. Let’s go.’
On the plane, Irene occupied the aisle seat while Winnie took the window seat. Irene preferred the aisle seat for easier access to the toilet. However, on this trip, it was Winnie who seemed to need it more. When Winnie clambered over Irene for the third time, Irene was concerned.
‘Are you going to the toilet again? What’s going on?’
‘Mum, I don’t know. I’m just dying to pee again.’
‘Stop drinking so much water. You had a bottle at the airport and you’ve another bottle here.’
‘Alright, but I need to pee right now. Excusey!’ Winnie winked at her mum and climbed over her to go to the toilet.
When Winnie got back to her seat, she joked that maybe she was getting old too as she used to be the champion of holding it in.
‘Winnie, it’s not good to hold your pee in you know,’ Irene said.
‘Now I can’t stop letting it out, it’s payback time,’ Winnie giggled.
‘Try to strive for a middle ground, will you?’ Irene squeezed Winnie’s cheek gently as if she was still a little girl.
Losing her ability to hold her pee wasn’t the only thing that happened to Winnie though. A few days later, she found it hard to read the road signs. Maybe she needed glasses. She booked an appointment to see an optometrist. She hoped that wearing glasses would not get into the way of her playing netball. Perhaps she could consider wearing contact lens when push came to shove. She would discuss this option with her optometrist.
‘Winnie, how long have you been a diabetic?’ The optometrist asked.
‘Sorry, what? Oh no, I am not a diabetic. I’ve never been. You must be mistaken.’ Winnie couldn’t believe her ears.
‘Really? You know what, I strongly suggest that you have it checked out though. I’m serious.’
Winnie followed her optometrist’s instruction and went to see her family GP.
‘You a diabetic?’ Dr. Robertson laughed when Winnie reported the conversation that she had with the optometrist to him.
‘Oh Winnie, it’s highly likely. But we’ll have a look,’ Dr. Robertson turned to get his glucose meter out. Winnie felt a sting in her finger when he pricked it with a lancer.
‘What a strange thing to say eh?’ Dr. Robertson was still smiling when he put the droplet of blood into the metre. A few seconds later, his smile disappeared from his face.
‘Look Winnie, I am not expecting to see this. Your blood glucose is very high. I need to carry out more tests for you. Can you go down to the pathologist today if you can please? I will call you as soon as I get the blood test results back,’ Dr. Robertson handed a script to Winnie with a furrowed brow.
Winnie tried to brush off her uneasy feeling and fear. Whatever it was, it could not be serious. She felt fine and she was not in pain. She told herself to stay calm and not to worry. She googled “high blood glucose” and saw pictures of people who had diabetes. They were older people. She was not one and couldn’t be one.
When she got back to work, there was a pile of papers waiting for her to process and she threw herself at it. She decided to keep this to herself in case it was a nothing. Work was a great distraction.
Then her phone rang a few days later. She answered it and a tense voice came over the earpiece.
‘Hello Winnie? This is Dr. Robertson.’
‘Hi Dr. Robertson, how are you?’
‘Winnie, where are you now?’
‘I’m at work. What’s up doctor?’
‘Can you go to the emergency department of the hospital immediately?’
‘What? You want me to go the hospital now?’
‘Yes Winnie, now. Please catch a cab and do not drive. Winnie, do not drive.’
‘Alright, alright. I understand.’ Winnie was stunned by what her GP was asking her to do and did not quite know what to say.
‘When you get to the emergency department, please tell them that your glucose level is 31.’
‘Okay Dr. Robertson.’
Winnie went to her supervisor and explained to her supervisor what her doctor told her. She said that she felt fine and didn’t understand what the fuss was about. Her work organised a cab for her and she took herself to the ER department. She walked up to the reception desk and told the triage nurse that her GP had asked her to come here. She passed on to the nurse the information that Dr. Robertson had given her. She did as she was told.
‘Okay Winnie, please take a seat over here and we’ll come to you,’ the triage nurse instructed.
Winnie looked around the place. The last time she was in an emergency department, she was unconscious. This was the first time she saw it properly. She was half expecting to see blood and chaos but there was none. Apart from the ambulances around the outside, the place felt more like an oversized GP waiting room. She looked for a quiet area and started to make her way over to sit down. However, before she could make more than a few steps, a voice called out behind her.
‘Sorry Miss, did you say that your glucose level was 31?’ The voice belonged to the triage nurse.
‘Yes, that’s what my doctor said.’
Everything changed in that moment. The nurse’s eyes grew to double its size. Blood drained from her face and her complexion resembled a white sheet. Even though no words passed her lips, her face spelled fear and panic. She ran out from behind the window counter and got hold of a wheelchair. She made Winnie sit on the wheelchair and then rushed her into a treatment room. A needle went into Winnie before she knew what was going on. Then a barrage of tests were carried out.
Irene rushed to the hospital when she received a call that Winnie was in the ER. She located Winnie and sat nervously by her bedside.
‘Mum, I’m fine seriously. I don’t feel pain or anything,’ Winnie tried to comfort Irene.
Eventually, a doctor approached and spoke to both Winnie and Irene.
‘Hi, you must be Winne’s mother,’ the doctor said.
‘Yes, my name is Irene.’
‘Hi Irene. Look, we have examined Winnie and we found that she has type 1 diabetes,’ the doctor announced.
‘How could Winnie have diabetes? She is young and fit. She eats healthy and plays sports. She could be a swimsuit model if I let her. She doesn’t even catch colds.’
‘Oh Mum, please.’ Winnie went red in the face.
‘Type 1 diabetes is very different disease to the more commonly known type 2 diabetes. It has nothing to do with lifestyle. Type 1 is typically caused by an autoimmune condition where the body attacks itself. In this case, the pancreas is being attacked such that it is no longer able to produce insulin. Insulin is required to put away the glucose in our body. Without insulin, the glucose in our body accumulates and wrecks havoc to our organs. This is why Winnie’s blood glucose level went through the roof. And this also explained why she needed to urinate so much as her kidney desparately tries to dump the glucose in her body.’
‘How on earth did Winnie get that?’
‘It’s a good question. Type 1 diabetes are usually diagnosed very early on when the patient is still a child. However, it can be brought on by a virus or trauma as well.’
‘Like I said, Winnie is young and fit. She doesn’t even catch colds. We would know it wouldn’t we if she has a virus. And she hasn’t been ill at all,’ Irene shook her head.
‘Was Winnie in any accidents where her pancreas could have received injuries?’ The doctor pointed to where the pancreas would be.
‘Oh, she was in a skiing accident last year. She had a few broken ribs but we thought she had fully recovered though. Do you think that this is caused by the skiing accident?’
‘We could never tell completely what triggered this but it is the most likely cause in Winnie’s case.’
‘Now I really want to kill that idiot who knocked her down the mountain. Even thinking about it sends shivers down my back. What he did was so dangerous. He was skiing recklessly and he knocked Winnie down a steep slope. She could have been killed if she wasn’t held up by the last tree before a drop down a cliff on her way down. I was willing to forgive him once Winnie had recovered. Now I want him back, skinned and put into jail.’
‘Mum, this is not helpful,’ Winnie interjected.
‘Look, I think the most important thing to discuss is her treatment. Winnie will be need to be given insulin to replace the insulin that her pancreas isn’t producing. There will be a bit of a learning curve but I’ll connect you with a Diabetes educator. He or she will be able to guide Winnie on how to manage this disease. While we can’t cure the disease at the moment, we can certainly manage it. She’s going to be fine,’ the ER doctor explained.
It was easier said than done as Winnie and Irene discovered.
‘How much insulin are you injecting?’ Irene called out to Winnie.
‘I need one unit for every 12 to 15 grams of carbs,’ Winnie replied.
‘So how much carbs do we have in this chicken breast?’ Irene asked.
‘Mum, none. Meat doesn’t have carbs.’
‘Oh, but you said there are carbs in vegetables.’
‘Yes, all plants have carbs.’
‘I thought only pasta and breads have carbs.’
‘They have more carbs than any other foods. And sweet things. They are actually already sugars. I will need insulin for things like cakes and lollies as well not that I eat them much anyway.’
‘Sounds like you are getting quite good at this,’ Irene smiled at Winnie and pondered how she could have such a wonderful and competent daughter.
Only that Winnie wasn’t as competent at managing her new disease as she thought.
Winnie passed out at her gym. That was that. There was no warning. She was running on a treadmill and when she was done, she sat down to rest. The next thing she knew, she was out cold on the floor.
‘Oh my GOD, someone’s passed out on the floor. Does anybody know first aid?’ A person spotted Winnie called out in alarm. A crowd quickly gathered around her. Towels were brought over as were water. She was put into a recovery person but could not be roused. An ambulance was called and was eventually restored by an injection of glucose.
It turned out that she had given herself some insulin for a snack. But she got distracted and didn’t eat it. She then completely forgot about it before heading to the gym. Her blood glucose dropped too low and she passed out.
A good lesson learned, Winnie thought to herself. It would never happen again as she would be more careful. So she thought anyway.
It was a Friday and the weather could not be nicer. Winnie and her team was taken out for a fancy degustation lunch to celebrate the successful completion of big project. Winnie had a look at the menu but could not quite work out what was in the food. She also underestimated the amount of foods there were to be consumed. The course ended with three desserts. She just didn’t bring enough insulin. Suffice it to say that the afternoon did not end well for Winnie with an episode of hyperglycaemia. What was worse than the discomfort was the embarrassment. She felt ashamed for getting ill in front of her work colleagues.
Weeks passed and then Irene noticed a change in Winnie. She seemed more withdrawn. She had also lost her spontaneity. Winnie used to have lots of random ideas and make suggestions for unplanned activities all the time. She hadn’t made one for a while. She was at home a lot when she wasn’t working.
‘Sweetie, how’s things? You don’t seem to be quite yourself lately,” Irene asked Winnie when she found a quiet moment.
‘Well, my life has changed and I have to live differently now,’ Winnie replied nonchalantly with a straight face.
‘What do you mean?’
‘I thought I had the management of my insulin under control but I didn’t. They tell you that you can eat and do whatever you want as long as you administer your insulin correctly. It’s not true. I pay a heavy price every time I make a mistake. I never knew that my pancreas was more clever than me.’
Irene let out a laugh. Winnie still got her sense of humour.
‘It’s not exactly a fair comparison. Your pancreas may be better at dosing insulin units, but it can’t play netball or cook or drive a car,’ Irene smiled at Winnie.
‘Mum, the reality is that I have to take over my pancreas job but I can never be as good as a real pancreas. So, the solution is to control or restrict the environment to a degree that I can manage the insulin. This means that I can’t just say yes to events and activities and try to figure out what to do then. There are consequences,’ Winnie explained.
‘That make sense. Do you feel like you’re missing out though?’
‘A bit. I did feel hard done by for a while. But then I figured out it that it wasn’t all that good anyway. It just isn’t worth the grief. I’m okay with it.’
How did my daughter get so smart? Irene thought to herself.
‘Sweetie, I’m impressed at your reasoning. This is a mature way of looking at it. But you’re still so young. There’s a whole life ahead of you to experience. I don’t want you to be boxed in so early on in your life. I think I have a better idea,’ Irene suddenly thought of something.
‘What’s your idea Mum?’
‘Nobody gets good at something without learning and practicing. You didn’t play brilliant netball in the first year, did you? We need to learn and practice.’
‘Learn and practice what?’
‘We’re going to figure out how to be a smart pancreas. For that, we need to understand food. We have to become knowledgeable in various cuisines and styles of meals. Then we can learn how to dose insulin appropriately,’ Irene beamed at her own suggestion.
‘Are you saying that we should try various foods and see what happens when I eat them?’
‘Why do you sound like I’m trying to kill you? No! Well, we will research the meals ahead of time and makes all the calculations. Then we go out and monitor your response carefully. We will do Italian, Japanese, French, Spanish and we will be reviewing magazines to see what’s new. That way, you become better equiped with dealing with more social situations. We can also repeat the experiment as well if we particularly like something,’ Irene elaborated.
‘Oh Mum, we don’t have to do that. Doing that will cost a fortune. I’m okay with just eating healthy and simple.’
‘Of course, you will eat healthy. However, there’s nothing wrong with learning more about food and cuisines. It’s an great skill to acquire to everyone and a particularly important one for you. You can’t eat the same thing all the time. Most of our social interactions revolve around food. You need to get good at it,’ Irene challenged Winnie.
‘But I don’t think I can afford to eat out that much,’ Winnie lowered her head.
‘Don’t worry. I’ll pay,’ Irene nodded.
‘How are you going to afford all of that? They’re expensive,’ Winnie puckered her lips.
‘This is how I look at it. I see this as part of your education. Your father and I have long decided that the most important job as parents is to educate our child. You need to know more about food than anyone else in your situation. It’s a really important subject for you. It’s also important that you enjoy your social life. You can only do that if you learn how to look after yourself, ‘ Irene reached out and placed a hand on Winnie’s shoulder.
‘Thanks Mum. You’re right. So shall we start with Japanese? I do love sushi,’ Winnie grabbed her mum’s hand on her shoulder and leaned her head in to kiss it. She then squeezed her eyes shut and gave her mother a big smile.
Irene laughed at her daughter’s cheeky smile. Her heart felt full in that moment. It was filled with gratitude, joy and pride. The knots in her stomach loosened. Those nasty knots formed on the day of the diagnosis and they had been growing tighter and tighter each day. The claws on her shoulder had also relaxed their grip. She felt a strong wave of relief.
The fear of losing her daughter had been eating at Irene ever since the diagnosis. Every incoming call on her phone would send her into a full alert. She was on edge all day. She could not bare the thought of anything happening to Winnie. Why do these things happen to good people? Winnie had been nothing but kind to everyone around her. Why can’t I keep my family safe? Irene knew that these negative thoughts were not healthy but she couldn’t stop ruminating over them.
When Irene saw how Winnie quickly adapted to the situation, she realised that she was still in denial when Winnie had moved on. Her daughter had been the adult here.
The bitter taste in Irene’s mouth cleared. She figured that bad things do happen to everyone. It’s the process of life. Perhaps, we actually needed it. Dad needed it so that he didn’t have to know what he has lost. Winnie needed it so that she could live more consciously and I needed it so that I can develop the courage to face reality. Maybe it’s not that bad.
