Tuesday, May 01, 2007

I Have a HOLE in my FOOT

So, I went in to see the podiatrist yesterday to have this callous on my toe checked out. I first noticed it last year just before I went into the hospital, and since then, I've been frantically looking up horrific pictures of diabetic foot ulcers, worrying that this was going to turn into something gangrenous that would eat my whole foot off (warning: none of these are happy pictures).

It was, thus, with much trepadation that I finally went in to have my foot looked at. Why now, you may ask? Because it felt like so much had gone wrong this year that this would just turn out to be the icing on the cake. It would just figure.

After a long wait at an understaffed office (I really should think about going into the healthcare field. God knows every single office is understaffed), I settled up on the podiatrist's chair, waited some more, and he came in, took one look at my toe and said, "Oh, that's a wart."

"Oh, thank God," I said.

But can you blame me for being extra paranoid these days?

We chatted about diabetes. He wanted to know how they'd figured I was a type 1 and not a type 2. Did they do a test?

"Uh, well," I said, "I was brought into the hospital in a coma."

"What did they say triggered it?"

This question didn't surprise me, because the "cause" of type one is still apparently a really contentious thing. You'll hear different things, but what my doctor told me, and what sounds right as far as my experience goes is, I was already predisposed to be a type 1 (my dad and his cousins in France are type 2s, and if you have diabetics of any kind in your family, you're going to have a bigger chance of having t1 or t2) and then I got some kind of virus. The virus triggered my body's immune response, but instead of just killing the virus, it caused my body to turn on the beta cells in my pancreas. The reason I didn't get t1 sooner is because whatever it was that triggered the response didn't happen until I was 25. It could have happened at 5 months, 5 years, 15... or 25. It just so happened mine got triggered at 25 (I then spent a year getting progressively sicker until I went into a coma).

The podiatrist said he's always interested to know the sugar # for a type 1 who was brought in to the hospital for the first time. I told him I was a 680, which I used to think was pretty impressive, but Anne Rice apparently had something closer to 1100, and the podiatrist insisted he had a guy come in who said he'd gone into the hospital fully conscious with a 1300 number.

I'm not so sure I believe that one, but it sure does put my little 680 to shame. I was comatose for a whole day at 680? Sheesh!

I asked him what a "real" foot ulcer would look like in the first stages, and he said it would start out with some red swelling and then look more like a blood blister, not a callous.

OK, I'll keep that in mind for next time...

The med assistant brought me into the room with the little laser thing to zap the wart, and asked me why I'd been diagnosed with type 1 instead of type 2. I realized that at this particular clinic, which is in an upper-middle class neighborhood full of older people, they probably hadn't seen a lot of type 1s. Still, dude, you've worked here EIGHT YEARS. Treating DIABETIC FEET. You should know these things.

"Uh," I said, "it's not that I produce too little insulin or that it's not absorbed well. I don't produce any insulin at all. My body ate all of my beta cells, which is what produces insulin."

"No shit?" she said (she was a very entertaining, gruff, and disillusioned med assistant).

So they shot me up with some anasthetic and the doctor lasered out a GIANT HOLE in my foot.

I was astounded at its giantness this morning when I took off the dressing. And here I'd gone into the podatrist to AVOID giant holes in my feet.

Ah well. I have a follow-up in two weeks to make sure I don't get an infection and get a REAL foot ulcer, and in the meantime, I have super antibiotic cream and band aids.

Oh, and an interview today.

The excitement never stops, I'm TELLING you.

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