To my total shock, the result of my hemoglobin A1C test indicates that my diabetes is not gestational. Gestational diabetes usually strikes after the 20th week of pregnancy and disappears within an hour of giving birth. But at nine weeks along, it's apparent that I was diabetic before ever becoming pregnant. The test reveals my A1C level to be 8.4 percent. A normal count would be 6 percent, and many people are at 4 or 5 percent. Dr. Goland asks me about my family history (cancer galore). She asks me if I smoke (never). She asks me about my diet and fitness routine (used to see my trainer three times a week, currently see my refrigerator three times a night). Now it's my turn to ask the questions.
"What exactly is diabetes?"
"Well," she begins, "there's type 1 and type 2. Type 1 occurs because your own immune system attacks your insulin producing cells. When that happens, you can't make insulin, so to survive you have to take it by injection. Type 2 is much more common. That's a disease where the pancreas makes insulin but the body doesn't respond to it normally. We call that insulin resistance. And in the end, over years, the pancreas often has trouble making insulin. The result in both of these diseases is that the blood sugar goes too high."
"Then what happens?" I ask.
"Blindness, loss of limb, kidney failure, heart attack, stroke."
With each word I shift deeper into catatonic noodle mode.
"But," she adds, brightening, "every one of these things can be delayed or prevented. Because we didn't used to know how to keep blood sugar normal and how to prevent the complications, a lot of people are under the misconception that first you get the disease, then you get the problems, and that's that. The truth is, if you work to control it—and it is work—none of this is inevitable. You can be a healthy person with diabetes—you may never experience any of these complications."
My eyes scan the room as I try to take all of this in. There's a Harvard diploma hanging on the wall, pictures of three tanned tourist kids in front of some Greek ruins, a tiara-wearing teddy bear resting on the windowsill. I massage my ever expanding stomach and finally ask the million-dollar question: "Is my baby okay?"
Dr. Goland says it's too soon to tell. She wants to send me to a lab so they can run more tests, and I start a fresh round of sobbing. Directing me to the nearest box of tissues, she steps out of the room and returns followed by a band of angels. "You know what, Lisa, you don't need to get yourself to another lab. We're going to take some blood right now." Two nurses, Dr. Goland, and one vampire/medical assistant named Berenise ("She's the best") bring me into an examination room and start rolling up my sleeves in search of a good vein. It's a remarkable tribute to peer pressure and vanity that I ever allowed my ears to be pierced, and I explain how that procedure actually made me pass out. They have me lie down, and the process begins.
"So," says Dr. Goland, who seems to believe in the power of distraction, "what's Rosie really like?" Through clenched teeth, I tell her that I work for Oprah and that though I've never really said this to anyone before, "I guess the thing that makes Oprah so special to me"—they all lean forward—"is that she's never stabbed me in the arm with a sharp needle."
Next: Coping with diabetes—and needles
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