Monday, September 10, 2007

Hey, No Fair!

Now you might think that God or "the Gods" (depending on your persuasion) would be content to present a family with major challenges one at a time. Turns out not to be the case.

When we got back from Cayucos, Erica became very tired and lethargic. All she could do was sleep. We began to think this was something more than a simple case of the flu, as I first thought, since she had no detectable fever. Frances took her in to Huntington Hospital, and quickly they had the diagnosis: Type I Diabetes. This is the type of diabetes that typically begins in childhood (around Erica's age of 10), and is not the result of poor diet, or obesity (NONE of which Erica has), but seems to be just one of those things that happens sometimes, due to some random mutation.

As I understand it, in Type I Diabetes, the pancreas simply has too few cells that make the insulin that is needed to "unlock" the cell walls so that the glucose (sugar) in the bloodstream can get into the cells where it is needed to provide the energy for the cell to carry out its task. Unlike Type II Diabetes, where the insulin produced is somehow altered so that it is not capable of "unlocking" the cells anymore, in Type I the insulin produced is still high quality, but there is just not enough of it to do the job.

(To the doctors and biologists reading this: I hope you will excuse this oversimplified explanation... it is based on an explanation given by the Huntington medical staff to the CHILDREN, and designed for 10 year olds with no previous exposure to biology. So it was just right for me!)

Apparently there is a very promising line of research in which stem cells may be specialized to become extra insulin-producing cells of the pancreas. So maybe before long diabetes will become a curable disease! Yet another reason to support stem cell research! (I don't know if the stem cells in question are adult or embryonic...)

But for the time being, the treatment for Type I Diabetes is to manually and very carefully control the blood sugar level, using external insulin, and by carefully watching one's diet, so that levels of various things in the blood stay at acceptable levels. With computers and more sensitive detectors, this is getting much easier than it was in the "old" days. So Type I Diabetes is a manageable, chronic disease.

Very many people lead full and fulfilling lives with Type I Diabetes. Erica's AYSO Soccer Coach (and a good friend of ours, and neighbor on our block) said that he once had a girl on the team he coached who had an insulin pump that she ran during games, especially when she needed a bit more energy on the field. As a mechanical engineer, this reminds me of supercharging (or turbocharging) an internal combustion engine, or adding an afterburner to a jet engine. Maybe I'll be the first one at Caltech to have a turbocharged kid!

Anyway, all joking aside, Erica is handling this like a champion. She is not complaining at all, and is usually more concerned about how the rest of us are holding up than how she is, because that's just Erica - one of the most giving, considerate, sweet, and kind people you are likely ever to meet (in the opinion of her dad...) She knows she is strong so she's not worried about herself (but she's not so sure about the rest of us...). As her dad, I must say I am very, very proud of her! (I would like to take some credit for the genes she got from my side, but actually I think these qualities may be "Teng" genes. OK, let's compromise and say both contribute...)

She is already reading about how to give herself insulin shots, and learning which foods she can eat, which she can't, how to account for the "carbohydrate content" of each item of a meal and stay within budget, etc. I am very confident that she will come through this with flying colors! (And yet, I still think it is somehow "unfair" that she has to go through this at all.... Oh well, nothing good can come from following that line of thinking. No use in complaining - all we can do is take whatever comes our way and make the very best we can from it.)

She has spent the last 2 nights in the hospital, with Frances sleeping on a couch in the room, right by her side. But tonight she gets to come home! I am looking forward to having my little girl back where she should be! However, she has more nuanced feelings.... although she too misses all of us, they do serve quite a good breakfast, selected from a menu just like in a restaurant, the bed can be adjusted to a comfortable angle to watch TV (and they have quite a few cable channels), and all you are expected to do is rest, eat, read, watch TV, play games, ... (no chores, homework, etc.). Hard to compete with that... but we'll do what we can - we'll at least clean up around here so she comes home to a sparkling clean house. Well, that will at least please Frances, but maybe we'd also better pick up some tasty (but approved and appropriate) treats to win over Erica... OK, I guess I'd better get into action and shape this place up!


Verma G said...

We were totally shocked and surprised when you called us the other night with the news about Erica. She is such a picture of health. With her sweet nature, she will cooperate fully, I'm sure, with the necessary careful diet and treatments.

Yes, just one more example of why stem cell research is so badly needed. It sounds like her hospital stay was not traumatic at all. Give her two hugs, one from Grandpa and one from Grandma. She is a very special girl.

Corin said...

Poor little Erica! We'll be praying for her as well!

Just think, with learning to budget carbs at 10, budgeting money as an adult should be a breeze! ;-) It's nice that there are so many low-carb goodies out now, that she can enjoy :-D

Ravi said...

Hi Dave

We do not have words to describe the multiple doses of bad luck you have had with the Gods (or God) recently. People have long pondered the question: "why does God do bad things to good people", or "why do bad things happen to good people" (if you do not believe in God). Of course, there is no satisfactory answer...

We are writing with some other bit of news. You may have heard that Louisa and I had a baby girl on Sept 9 at 3.43 am. She was delivered by your wife, who is quite a remarkable woman as I am sure you know. We were wondering what she was doing in the hospital, specially because her partner was on call that night, and was in the hospital too; and her partner had indicated that "Dr. Teng may not be available tonite".

And yet, she came and delivered our baby. Now that we know the background, we are even more greatful.

Louisa & Ravi

Dave said...

Mom and Dad -

Erica is doing fine now. She's home, and we're learning about all the things we need to do to manage her condition. She was a VERY brave girl in the hospital!

Corin -

Thank you very much for your prayers! We really do appreciate it! Yes, there seem to be lots of low-carb things available now, fortunately!

Ravi -

Frances told me that you and Louisa had your baby! Congratulations!! She's your first, right? As you'll see, your lives will change forever. Even though parenthood can have its tough moments at times, I think most parents will tell you it is the best thing they ever did. I know that's true with me. Again, congratulations, and if "Daddy Duties" in the next few years interfere with any of our planned joint research projects, don't worry about it - after all, you've got to keep your priorities straight (family 1st, then work), which I'm sure you will.

Copper's Wife said...

Adding Erica to our prayer list here, too! (And those aren't just words, you know, we really do pray for you guys!)

A blog about Rosalind & Amelia Verma said...

Hi Dave

Rosalind is our 2nd one. Big sister Amelia was also a Frances Teng special. She was born on Aug 29, 2005..right after you had returned from your Galapagos vacation... my recollection is that Dr. Teng drove from the airport to the hospital.


Martha said...

We are so very sorry learn about your family's further travails. Much love and well wishes to Erica from us all. Just last night our local news carried a piece on UCLA immunologist Daniel Kaufman, who has developed a vaccine for Type 1 diabetes. His research may be worth a look. Sending ALL of our best vibes your way. Love, Martha and gang

Leo said...


It is said that we are given challenges no larger than our ability to handle them. You and your family are clearly highly regarded... My mother was diagnosed with Type I diabetes at about the same age as Erica, I believe. She has always been rail thin, and eaten well, so I agree that there is a great deal of randomness involved. I can happily report that she is very well and going strong in her 70's. Given that this challenge lends itself to straightforward energy analysis, I won't be at all surprised to see Erica written up for some impressive accomplishments over the years.

Emre said...

Hi Dave,
It was great to see you and Erica today. You both looked great! Erica, I look forward to hearing you play the piano sometime.
Sending my best wishes,