My Long Time Due Gratitude to Joslin Clinic

By José N. Abbo, T1D since age 10.

Forty-five years ago, at age 10, I wet my bed. Something which had not happened since I was two years old.?Initially my parents were not concerned. But then, this wet bedding thing became too recurrent. But this was not only happening at night. My late mother noticed during the day, that I was constantly thirsty, losing weight fast, and throughout the day, often urinating. Physically I was getting too tired, sleepy, nauseous, and constantly vomiting. These were all the typical symptoms of Diabetes Mellitus Type 1, an immunological condition which is estimated to affect over 650,000 children worldwide.

To confirm if I had been affected by the condition, my blood sugar level was tested. The result came in at 300 milligrams per deciliter (mpd), a very high level. Normal levels for a person without diabetes, are usually in the range of 70 (mpd) to 110 (mpd). My parents were hoping that the first test was a false positive, so I was tested again. This time the result came in even worst, at over 400 mpd. At this level, my body was dangerously close to developing ketoacidosis, a life-threatening diabetic complication, which if not controlled on time, can cause death. I was formally diagnosed with insulin dependent Type 1 Diabetes Mellitus on May 11th, 1977.

The first day at Joslin Clinic with my beloved mother, back in 1977. She passed away in 2017. She was my guiding light as I grew up with the condition. Always telling me that if I was able to overcome diabetes, I would be able to move mountains.?

Before the 1920’s, dead by diabetes was a very tragic and painful one. With no medication nor proper treatment of high levels of blood sugars, people with type 1 diabetes were given a life spam of no more than two years. Affected patients would die because of high levels of sugar in the blood, leading to the ketoacidosis complication mentioned before.

During this affliction, the internal energy of the body is sucked, as cells desperate look for a source of energy from within the body. The first sign for a diabetic of developing ketoacidosis, is the appearance of ketones in the urine along with a considerable loss of weight. Ketones build up in the blood. The acidic substance then blocks the blood stream to reach critical organs and limbs. The later which would be amputated and the former which would simply stop functioning leading up to death. There is also the high possibility of suffering neuropathy, leading to blindness.

All of us diabetics diagnosed with the Type I condition after the 1920's, where lucky enough to live through the miracle which came in 1921. The development of purified insulin for human use. This was the inflection point which marked the beginning of major progress in the treatment and management of diabetes.

My Long Time Due Gratitude to Joslin Clinic

Having confirmed that I had diabetes, the first reaction as it is typical in this shock and awe situations, was negation, disbelief that could be happening. Back then in my home country, there were not too many doctors specializing in the treatment of pediatric diabetes. After some days of frustration, confusion, and fear in my family of what would happen, my mother rose to the task. She was a very resilient person, and my diagnosis would not derail her focus, to find the best treatment for me. She spent long hours speaking with friends, relatives, local doctors, and anyone she could think to give her guidance for my treatment. Her persistence led to a clinic in Boston, called Joslin Clinic, and off to Boston we left. Joslin Clinic was considered at the time (when it was fully operational), the best medical care center for diabetics in the United States. The clinic was part of the Deaconess Hospital.

Life is a Game of Chance

The dice was rolled. At age 10, I had to learn and accept my new life. It is never easy to re-engineer oneself, specially at a very young age. But there was no choice. Like it or not I had to cope with a treacherous condition. Diabetes can become your worst enemy or your best enemy. If you fail to learn and apply the basic rules of engagement, diabetes will become your worst enemy. However, if you learn to follow those rules, then you will be able to look forward to a joyful, healthy long life.

As a well-behaved diabetic being trained at Joslin, I opted to follow the rules of engagement by the book. The day when I took for the first time in my life an insulin shot, marked my life changing moment. From then on, I realized that my live would be supported by shots of insulin for all my living years. And you know what? After 45 years of taking those shots religiously I had never, ever complained about having to take these during my live.

The “burden” of being a diabetic for the rest of my life, never got into me, thanks to the teachings at Joslin.?As I grew up, my resilient mother tough me never to think that the diabetes would become an obstacle in my life. It never did, and it never will. My daily routine goes like this. Wake up, do some workout, prepare my insulin, take my shot, eat breakfast, and go on with my life. Not a single minute in that routine, has me thinking, “oh what a hassle this insulin shot” or asking Gd “why this diabetes thing, happened to me?”.

Blood sugar testing at Joslin back in 1977. They would prick the ear lobes, as it was the easiest way to pull in the blood through thin glass tubes. The ear lobes hold large amounts of stored blood.

At age fifty-five, I barely test my blood sugar levels. As you get older, you get “diabetically wiser” and for some interesting phenomena, you learn to read the physiology of your body and the tail tell signs of some of the "inconveniences" of diabetes. At Joslin, they would teach you how to to read your body and signs of how high or low your sugar levels might be. Blurred vision, increased thirst which goes along frequent urination, are the most common signs of hyperglycemia (high sugar levels). Check your tongue, if its yellow, you might have developed ketoacidosis due to the high blood sugar. In the case hypoglycemia (low sugar levels), check for cold sweating, the feeling of being hungry as a lion, an air head sensation, deep empty stomach, and an inability to concentrate.

Joslin Clinic was an incredible place. It was a university for diabetics. Once you had settled on what would become your “dorm room” teaching nurses flood you with all sorts of books on the condition. I learned a lot from these books. If you learn to follow the script to the letter, you will be able to live a normal live as any other person without the condition. If you did not, the consequences would be painful and cruel. Organ deficiency, lost eyesight, neuropathy, leg amputation, not a pretty picture. At 10 years of age, my eyes opened to life’s challenging imperfections.

I opted to follow Joslin Clinic books to the letter and pay attention to the teaching nurses, who patiently explained me how I would have to follow a disciplined daily drill of exercise, daily insulin shots, and avoid too many sweets and fats. Something that I keep doing for the last 45 years since diagnosed with the condition. Controlling diabetes is not difficult. Your willpower is what makes the difference to move forward with diabetes. If its strong, you got everything going for you. If its weak and you go careless with the condition, down the line you will have serious health complications. At 10 years of age, I had no idea what it meant to have willpower, I learned it a Joslin. If you have willpower you will overcome the so many obstacles which comes with diabetes. Where there is a will there is a way.

After 45 years of having the condition, even the cure for diabetes would be discovered, I would still be taking my insulin shots. It takes less than a minute of my time. So short, that as soon as I head to work, being diabetic does not cross a millisecond on my mind.

For many years, I wanted to give my gratitude to Joslin Clinic. To my great Doctor, George P. Kozak who was part of shaping my character to accept and live with diabetes. To the whole team who 45 years ago, took incredibly good care of me and gave my parents the tranquility that I would live a normal life. Which I have.

My great ever smiling, teaching nurse Denise, the glucose testers team who would take blood samples from our ear lobes, the ladies who would bring the menu with their corresponding dietary information, and all others who I interacted with me at the institution, patiently explaining, teaching, and preparing me to enjoy and live a long lasting life as a diabetic. These people did an astonishing job preparing me for what was to become a whole new perspective of my life as a diabetic.

My favorite teaching nurse at Joslin Clinic was Denise, who unfortunately I can not recall her last name. I hope she is still around and be able to contact her after so many years since the last time I was at Joslin.

After 45 years of having diabetes, I take this opportunity to thank Joslin Clinic, for teaching me and helping me live a normal life for almost half a decade and counting. Diabetes though me to live my life in stride. This gratitude was due longtime ago. But better late than never. I owe my life to this great institution, and for this I want to thank you Joslin for helping me go through life with many of your teachings, and instilling in me a willpower to move along life with its wonderful imperfections.