After a hard summer of anxiety and concern, I came round to believing that insulin was the answer. My last Hba1c had been 10.6 which was down from the first one of 16 about 5 years ago, but it wasn't ever going to get down low enough. The needles had scared me, and i had put it off too long. So i strode into the surgery, hands outstretched.
"Give me the insulin."
I wasn't expecting that.
"No, you are right, i have come to understand that. Let's do it. Give me the insulin."
"We have been thinking..."
This was confusing. This was upsetting. This was not what I was expecting. 6 months of worrying - after 6 years my blood levels had never been below 10 and i had never experienced anything remotely resembling a hypo. And now i was resigned to injecting myself with this mysterious, frightening, life changing, no returning drug that was going to send me hurtling towards hypos. It was serious. I was serious. I was ready to take control.
"..that you would be ideal for Byetta."
"Byetta. It's a fairly new drug which we think you should try for 6 months before insulin."
"But... What?...Do you know what i have put myself through mentally to be ready to accept the insulin? To finally, finally get the importance of taking control, taking back ownership of my body..."
"We think you should try it."
And so it continued. Two nurses, a heap of medical training and experience behind them, were telling me I should try it. I was the ideal candidate. Basically, I was fat, forty and not taking it seriously. And then they abused my scientific mind.
"You will lose weight."
"Yes. You won't need to do any exercise or change your diet. You will just lose weight."
"Really?" This seemed to go against everything I had ever known. How?
"It makes you nauseous. It gives you diarrhoea and vomiting, and you simply dont want to eat."
That is not a line that is going to win any plaudits in the advertising industry. But the idea of a drug that makes you thin with no effort from you. That can't be true?
So we argued back and forth, and in the end the idea that it was a 6 month trial and then we could start insulin, made me think why not try it. The pen wouldn't arrive for a couple of days, so I went home to look on the web. Some of the forums were very blunt. It did make you ill. 90% of users said they felt appalling for a month, and then settled into a life of feeling just rubbish. But they all lost weight. Some only a few pounds, some claimed fantastical figures of 60 pounds. It did seem the fatter you started, the more you lost. I tip the scales about 17 and a half stone (112 kgs in Euros) so I could probably lose a couple of stone (12 kgs) without worrying about the onset of winter. So I have to try this stuff...
Unwrapping the plastic lid from the needle and screwing it on to the pen creates all the feelings of apprehension and fear that I was expecting, just on a much larger scale. You screw the little plastic tool onto the end of the pen, pull the cover off and slide off the needle case. And there it sits, 8mms of cold thin steel that you have to push into your stomach. You twist the end of the pen to prime it, pinch up a layer of blubber (anywhere around your belly button she said, and let's be honest that is a sizable target for me) and start to move the pen closer.
You expect the pain. You expect the coldness. You expect the sharp feeling shooting up your nerves and colliding in your brain. But there is nothing. It slides in effortlessly and without any feeling at all. The top of the pen pushes against your stomach and you realise you are pushing too hard. You relax a little. Press the end. Hold it. Still nothing. No feeling. Pull it out. Slowly, expecting the blood to pour out, the muscle to spasm, the nerves to wake up... but nothing. Didnt feel anything.
And then the brain switches to the drug. It's inside you. Is it working yet? Is that nausea? Am i going to hypo right now? No, nothing is happening. Maybe it takes more than 10 seconds. I sit down. The dog jumps onto the sofa, I leap up, worried that it might catch the wound and my guts will spill out. I check. No, everything is holding together.
Am i over-reacting? Probably, but then it was less than a minute ago when i stabbed myself for the first time. The wife needs to go out to pick up one of the boys. "Don't leave me."
"I have to pick him up..."
"Ok..." What if i die? How will i get to hospital? Who will call the ambulance? What's for dinner?
In hindsight, yes it was a lot easier than i expected. And maybe i was just a little over sensitive and over anxious. The actual injection was painless. And what about the drug? What was it doing?
No nausea. No vomiting. Dinner was taken, I deliberately ate small - not my style and went to bed hungry, but expecting to be woken up in the night with the cold, icy hand of death throwing me to the bathroom.
I slept well.