Wednesday, August 7, 2013

Stick Shift

Stick Shift


When I got my Drivers’ Learning Permit at age 15, my dad taught me to drive a “stick shift”, a manual transmission.  Several hard stops, stalled engines, and bouts of whiplash later, I got the hang of it. That’s how I learned.  Learn the hard way first, then the “easy” way is so much easier and more comfortable! However, driving an automatic is so much easier, and it’s what I prefer.  Despite learning to shift a manual transmission, I chose an automatic car.  The one brief time I had an “stick shift” car, I HATED it, and quickly reverted back to an automatic. But, being able to drive a manual transmission vehicle is a skill I cherish and one that has served me well in this life.  Frankly, driving a stick shift is practically impossible with kids is tow as I typically have one hand on the wheel, and the other hand adjusting the radio, handling trash, air-drumming to Bon Jovi, or refereeing a fight, but I digress.  I will always choose an automatic transmission.

When my boys were born, their pancreases were automatic.  Carbohydrates in, insulin out.  Much like driving that automatic transmission vehicle, there was little thought involved in the process.  We aimed to put healthy stuff in, good insulin out. Their “engines” adjusted to all extrinsic factors that impact processing carbohydrates.  Activity, diet, age, growth, heat, etc.  At age 7, however, their automatic “transmissions” broke, and we had to revert to manual.  My dad may have taught me to operate a manual transmission, but nobody taught me how to be a manual pancreas.  And, much like learning to drive that stick shift, there have been some bumps, hard stops, and bouts of whiplash in learning to be a manual pancreas…times two.  The best mechanic can’t overhaul these transmissions!

Now I press the clutch (calculate insulin), and the amount I have to press varies over the course of the day and increases over time.  It’s up to me to figure out how much and when an adjustment is needed. Then, I add the gas (carbohydrates, protein & fat).  Too much makes their engine rev to a dangerous level (hyperglycemia), and too little makes them stall out (hypoglycemia).  When the combo of gas and clutch is just right, we can switch gears and move about our day!  As with any engine, other factors can impact how that car drives.  Heat, type of gas (type and quality of diet), mileage (age of the child and length of disease), changing the oil (new pumps, new sites, new insulin vials), heavy usage (exercise), and low fluids (dehydration).  Despite having the right gas and clutch combo, any of these can cause the engine to rev or stall.  My job is to figure out which one is the culprit. 

I’ve just completed two “first years” of diabetes.  Being a nurse, I had a basic foundational knowledge of Type One Diabetes, but that was it.  Being a healthcare provider did not prepare me for the daily ins and outs of being a pancreas to two little growing active boys.  It didn’t prepare me for the crippling worry that accompanies this disease.  It didn’t prepare me for the sleep deprivation, which is Diabetes’ parental torture tactic.  Nursing school didn’t prepare me for the ignorant remarks that well-meaning others say.  Being a nurse didn’t prevent my mommy heart from breaking in two when I heard the words, “He has Diabetes”….twice

And, it didn’t prepare me to forever be on the stick shift.

Now, I am stuck on this “stick shift”.  I stick.  I stick fingers.  I stick toes.  I stick tummies, arms, and legs.  I stick pumps on.  I stick in the morning, afternoon, evening, and middle of the night.  I stick in daylight and dark. I stick awake and half-asleep.  I stick.  And, until a cure is found, I’ll be stuck on the stick shift, manually shifting their transmissions, waiting, hoping, and praying that someday, they can go back to automatic!  I’ve learned and semi-mastered the hard manual way; can we go back to the easy automatic way now?  Please?

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