Marci Page Sloane, MS, RD, LD/N, CDE
Gertrude Samuels came in with her husband, Harry, for her first diabetes education session when she was eighty-seven years old. “Gertrude, I’m going to give you a meal plan and explain why it’s important to make healthy food choices,” I said, hoping she would be willing to control this disease even at her advanced age. Some of my younger patients felt that it infringed on their lives and virtually ignored their condition.
“Marci, you tell me what to do and I will do it!,” Gertrude said with a serious tone.
“I have diabetes too, and we need to take care of each other,” a timid Harry Samuels added. Harry looked to be about his wife’s age. “We’ve been married for 65 years. We do everything together – even get diabetes!”
Harry, like Gertrude, had a slight build. He sat close to his wife and touched her arm gently as he spoke. “I’ve tested her blood sugar and it runs high and low, high and low. I just don’t know what to do. Harry looked worried.
“That’s why you’re here. By the time you leave my office you will know exactly what you need to do. Can I take your blood sugar now, Gertrude?” I asked, hoping to see how her breakfast meal affected her reading.
“Surely.” Gertrude held out her hand. I cleaned her finger with alcohol and dried it with a gauze pad and then I took a small sample of blood from her middle finger. The results came five seconds later and read 38 mg/dl (milligrams per deciliter).
“Thirty-eight! You’ve got extremely low blood sugar. How do you feel?” I was shocked that her blood sugar was so far below 70; the more typical low blood sugar level.
“I feel just fine,” Gertrude stated honestly.
“Let me double-check this reading with another machine just in case.” I hurriedly grabbed another machine and it was indeed correct. “Yes, it’s 38 mg/dl. Well, let me get you some juice before you pass out on me!” I stepped out of my office and literally ran to the refrigerator to get a large glass of juice and some cheese and crackers. “Here you go. Please drink this juice and then we will re-test the blood sugar and see if it gets up to at least 100.”
Gertrude drank her juice and fifteen minutes later her blood sugar went up to 124 mg/dl. “Okay, now you can eat these crackers and cheese, if you don’t mind. We don’t want your blood sugar to drop back down again and that can happen unless you eat something more substantial. Protein and fat help you to digest your food more slowly so if you combine the cheese (protein and fat) with carbohydrates (crackers, for example) then you will maintain a more level blood sugar.” I felt more comfortable with this new reading and confident that she wouldn’t get that awful low blood sugar. “We’ll just check it one more time before you leave to be absolutely sure you are okay.”
During the next five years I thought about them at times. I thought about being in love with the same person for sixty-five years, having had children, grandchildren and great-grandchildren and how lucky and comforting it must be to have the same person by your side as long as you or they would live. Then, I thought of the inconceivable devastation one must feel to lose their lifelong partner whom they spent most of their years with.
One morning my phone rang at work, “Marci, this is Gertrude Samuels, how are you?”
“Fine!” I said, so very pleased to hear her voice. “And how are you and your husband? I hesitantly asked. After all, it was five years later and they were now ninety-two years plus.
“We’re both great! Can I ask you a question?”
“Of course, what can I help you with?” I asked feeling somewhat emotional that she and Harry were alive and well.
“I wanted to buy one of those new blood sugar monitors I saw advertised that need a tiny bit of blood. Which one would you recommend?” Gertrude sounded strong, healthy and happy. I couldn’t get over it. I was thrilled to have been able to give them the knowledge to control their diabetes and that they chose to use it. I was more than impressed that these two lovebirds wanted an updated blood sugar monitor to use. “Why don’t you come in for a quick hello and I’ll give you a monitor – my favorite one- and I’ll show you how to use it as well. I’d love to see you both.” I wanted the chance to see my favorite couple; both with diabetes, married for seventy years now and still going strong.
“You’re so sweet, what time would be good?” Gertrude hadn’t changed.
The next day Gertrude and Harry Samuels came into my office. They looked the same. I showed them how to use their new blood sugar monitor and quickly checked their blood sugar. “105 for you, Gertrude, and 106 for you, Harry, and that was after eating the same breakfast I recommended over five years ago: oatmeal, blueberries, cinnamon and chopped walnuts. Excellent, great job! Keep up the good work.” Apparently, they had followed my recommendations to the letter.
“We couldn’t have stayed so healthy without the knowledge you provided us with. You saved my wife and because of that you saved me too,” Harry said as tears welled up in his eyes.
As they walked out the door I thought, may they live at least as many years as their blood sugar readings that morning.