Yoder
The summer between my junior and senior years of college, my blood sugar got low overnight.
I’ve had type 1 diabetes since before I was five years old, so it’s not like it was the first time it had happened. Blood sugar swings are just a part of the deal, and my body has always dealt with them fairly well — it feels, recognizes, and signals them quickly; and it’s always been resilient to their effects. I’m fortunate.
That night, though, for a host of reasons known and not, something went wrong. I went to bed at 2 AM, my blood sugar got low, it didn’t wake me up, my pump kept dripping insulin, and I just stayed under. I worked part time at a hockey rink and was a work-study assistant at a hot yoga studio, neither of which were highly professional environments where a 20-year-old employee — especially one who was, uh, less than structured herself — not showing up was unusual enough to signal a problem to anyone. I lived with my grandparents at the time, and they were out of town. Most of my friends were home in other states for the summer. And my diabetes interferes with my life little enough (fortunately) that (unfortunately) it wasn’t something half the people I knew were more than vaguely aware I had at the time.
22 hours later, I came to — but in the really weird, half-conscious way of a body trying to tightly manage a very small amount of energy resource. You know how things look in a dream, when everything is kind of moving around, completely non-dimensional? Everything seemed like that. I used my last dredges of muscle tone to call my dad, pull my pump off, somehow crawl to the kitchen, and eat some dried fruit before just kind of passing back out.
I couldn’t talk, so my parents didn’t know what exactly was wrong; but it turns out parents don’t forget about their kids’ chronic medical conditions the way their kids can and do, so it didn’t take them long to find some family friends in my area to come break into the house and take me to the ER. The sugar I’d eaten was kicking in by then, but I’d been low for almost a full day, and it took my brain and body a while to catch up. The doctor at the local hospital wasn’t super familiar with type 1 and was a nightmare to deal with, letting my blood sugar spike afterwards and refusing to give me insulin. “You have to eat more,” he kept telling me in the voice you use to speak to toddlers. “You can’t go 24 hours without food, do you understand me?” I tried to explain to him that it is very difficult to eat food when you are unconscious, and also that I was going to puke back up the food he had made me eat if I didn’t get some Novolog soon, but I was still only operating at like 50 percent human capacity and arguing was hard. When I realized that semi-conscious Ryley had done conscious Ryley a solid and somehow kept her phone in her pocket, I called my dad again, explained what was going on in a haze, and handed the doctor my phone. I don’t know what he said, but it was loud, and I got the insulin I’d been asking for a few minutes later. My mom was already on a flight to Virginia.
Less than 24 hours later, I was back in the airport with her, on the way to meet the rest of the family in Colorado. It was supposed to be the first year I’d miss the annual trip because of work, but suddenly me living in a house alone for the next week or so sounded reckless and stupid, as opposed to, you know, my normal life. I vividly remember sitting in the seats at the gate with a cup of coffee trying to act normal while, like a track skipping, my mind thought over and over, “I almost died yesterday.” I don’t think I can transfer that state of mind or feeling to you in words.
I like to think I am an exceptionally alive person. I go big. I go big for my people, I really feel my feelings, I’m passionate about the things I believe in. I like climbing and running and biking and hiking and snowboarding badly and jumping into rivers and if you convince me that my 80-year-old self will be proud I did it I’ll probably do it and I cry when things are really beautiful and if you invite me to go on a trip you better be serious because I will buy the tickets and I will show up.
So almost dying is not really my thing, and it was very important to me, in the wake of that incident, to make sure that it was not a thing of mine for others. I told almost no one about what had happened. Partly because I wasn’t sure how — it felt awkward or unbelievable, in the actual sense of that word, to try and explain. “Hey, I know I seem like a completely, totally normal person to you, but I spent 22 hours in a coma due to a serious medical issue recently. How was your weekend?” It sounded dramatic to the point of being fake. I was sure that my boss, when I met with him briefly to explain why I would be taking off for a week and going to Colorado after all, looked doubtful.
But mostly, I just wanted to feel normal again, and nothing makes me feel less normal than being bubble-wrapped. My adventurousness in general already made my family nervous. The medical scare introduced new fears for me and added new layers and leverage to their old ones. And I resented the whole thing.
I can look back now and better empathize with how terrifying it could be to have a daughter/granddaughter have a serious brush with a medical condition and cope with activities that already involve an element of risk. I wish 20-year-old me had been kinder when my mom tried to keep me from trail running once we got to Colorado. My solo hikes were swiftly shot down. I insisted on biking everywhere and pedaled stubbornly up every steep hill with my dad in tow. I bristled when blood sugars or site changes were checked up on. I’m fine, I’m fine, I’m fine.
A few weeks later, back in Virginia, I made the last-minute decision to drive to Indiana and spend the Fourth of July with my roommate and her family. I called my dad to let him know, and he hesitated.
“Are you sure?” he asked. “After what happened last month, I don’t know that it’s smart. You’d be by yourself, something could happen—”
“If I used that reasoning I’d never do anything,” I snapped.
It went silent for a few seconds.
“Okay,” he finally said. “Be careful.”
To this day, I feel a wave of guilt every time I think of that conversation. And I also feel enormous, overwhelming love for him backing down and letting me go.
For years after that incident in college, I didn’t have another type 1 run-in of that scale. I took a few more precautions in years after — not living alone, making sure coworkers are aware of my situation, having a generally more structured and adult life, blah blah blah. But mostly, my body just fell back into its old, reliable state. My go-to joke became that one hospitalization in two decades of diabetes really wasn’t a bad track record, and largely moved on with my life.
Over time, glucose monitoring technology further developed and improved, and every time something new was released, doctors and family urged me to take advantage of it. And I have, some; but that underlying resentment of needing it in the first place, and the technology’s often-finicky reliability, means I haven’t utilized it to its full extent. The sensors, for a long time, were painful to put in and painful while on. Now that they’re not, they’re still a pain to set up; and they fall out fairly easily, especially for someone as active as I am. Wearing an insulin pump is being attached to a mini-IV at all times, essentially; and I don’t love having yet another appendage stuck to my arm — or peppering my biceps with needle marks to match my already-hopelessly-scarred stomach. And technology is still technology, flawed at best. It’s not unusual for the numbers to be off. Or for the device to just not quite work.
Is it still worth it? I mean, yes. And for someone who puts a high priority on her general health, I can’t fully explain why I don’t pay closer attention to the biggest threat to it. I could absolutely do better. That’s my confession. But it’s easy to get stuck on the unfairness of the situation, and easier to get lax when things are trucking along just fine. Which they were. So I marched along doing okay, not factoring diabetes into 90 percent of my decisions, and feeling great annoyance the other 10 percent of the time.
In January of this year, my parents went to Ohio to bring home a service dog for my youngest sister, Lily. She has a host of special needs, and had waited two years to be placed with a dog trained specifically for her and the family. When they got home, my mom was excited about Opie, Lily’s new buddy; but she was almost as excited about what she thought was the perfect solution for me, diabetes-wise. Something more reliable than technology and perfectly suited for my life.
There were, she informed me, diabetic alert dogs. And I needed to get one.
Honestly, I was skeptical at first, for a number of different reasons. First, I couldn’t imagine how in the world that worked. Second, if it did work, I imagined it working where the dog told you when you were low or high, which I could almost always tell on my own. Third, it sounded way out of my price range. And four, where in the world was I going to get one? The company Lily and Opie were matched through services, pretty exclusively, special needs kids and their families. I did some vague googling out of curiosity, but not much past that.
In March, the same week that the country closed down for coronavirus, I went for a run and had to stop because I noticed my blood sugar getting high. I tried correcting it throughout the day, but it stayed on the rise; and finally, in the middle of the night, I caved and went to the ER in a panic, my dad with me this time instead of on the other end of a phone line. (The doctor, though, was amazing — maybe the best I’ve ever experienced.) The experience shook me, but could be blamed on failed equipment; and again, I fell back on joking that one hospitalization for a low and one for a high in two decades of diabetes felt like a very fair quota, and that I was obviously set for 20 more years, my dues paid.
At that point, my mom insisted I take a closer look at diabetic alert dogs, and I was surprised at what I found out. They don’t just tell you when your BG is low or high — they can tell you when it’s rising or sinking, just like sensors can, but with no needle in my arm, and less margin for error. Their work is based on scent, and I watched YouTube videos in amazement as trainers showed dogs signaling at the mere opening of a tin labeled “60-80” or “160-180” or even smaller, more specific increments.
One of the top trainers from the company my family worked with was splitting off and starting his own training business with his wife, and my mom sent me their info in the following weeks. It was still expensive and seemed more like a pipe dream than an actual reality, but my mom brought it up again and again, mentioning it to friends and family to try to get them on board. I felt almost ridiculous considering it.
Then, in late July, my blood sugar got low overnight. And for the second time ever, I just kept sleeping. I became vaguely conscious that I was having convulsions sometime in the early morning, and once I knew for sure it wasn’t a dream, managed to make enough noise to get the attention of one roommate. She rallied the others, who each took on separate and important roles with a level-headedness and urgency that makes me cry anytime I try to tell people about it. They called EMS and let a few other key people know what was going on. After a few minutes of IV fluids, I was okay, but freaked out. A friend came over for the rest of the day, and I spent the bulk of it curled up in a ball watching movies with him and taking naps and generally staying distracted, keeping tabs on my glucose levels as they yo-yoed in response to the event, trying to level back out.
Sometime that afternoon, my mom forwarded me an email she’d sent to the service dog trainer she and my dad knew from Ohio, explaining my situation. He’d responded positively, and sent a preliminary info form for me to fill out. “Fill it out,” she said.
My friend seconded the message on his way out the door that night. All three roommates, too. A couple days later, I sent an email back with the form attached and a handful of questions. I still felt like I couldn’t get my hopes up. When they approved my initial form and sent back the full application, along with cost info, I stared at the email for a long time. It was steep, but it was doable; and three strikes — two of them in a span of 6 months — finally felt like enough. I was tired of daring something bad to happen to me. And at 26, I was able to see the selfishness of doing so a little more clearly than I had at 20. I hit snooze a few times too many on my alarm a few mornings after my roommates called EMS, and one of them cracked open my bedroom door, looking legitimately scared.
“I just — I was just making sure,” she laughed nervously, backing out of the room. I felt bad, but for the first time, I didn’t feel resentful. I felt tired, and knew that my family and friends were more tired than they let on. And I felt like maybe I finally had a real solution.
When I filled out the full application, I started to let myself dream a little bit. I answered questions about my job, my housing situation, my people, my personality. I told Jeremy and Jen, the trainers, all about my hobbies, and the ways that diabetes interfered with them and the limitations of continuous glucose sensors. I told them about travel and my road trip tendencies. I hadn’t really thought about, or even known, how much freedom and peace of mind an alert dog could give me before then. Now I was really hopeful.
The last section asked what kind of dog I wanted — breed preferences, male or female, hair type/length. You could get really specific. I wrote, “No preference — you guys know more about dogs than me, I just want a dog who would be happy/healthy doing all the things I do.”
Then I added, “But, big. Big dog.”
I sent them the full application and expected to hear back about timeline before too long. Based on Lily and Opie, I figured I was looking at a year-long wait.
“I am not sure how soon you were wanting to get a dog,” their email back a week later read, “but we do have a dog in training right now that may be a possibility for a good placement for you. It is a male german shepherd.” They attached a match form with some more specific questions.
I filled it out and sent it back the next day. “How soon would it be, out of curiosity?”
2-3 months, the reply came back. And the match paperwork confirmed what they thought — we were a good fit for each other. A really good fit. He was exceptional with scent, and the trainers had been thinking of police work for him, but he was “too soft,” Jeremy laughed. He was sweet and social, but “a little much” for a kid or typical, more domestic adult. They’d speculated that he’d be a good match for an active teenage boy.
Or, you know, a single woman in her twenties with the energy and hobbies of an active teenage boy.
I needed to throw down half the cost as a deposit to make it official, and I braced myself. I stared at the computer screen at my bank account. It was worth it, I knew, but it was still a lot; and a lot sooner than I’d expected.
“CAN I DO THIS?” I shrieked on the phone to my mom. “I HAVE TO PROVIDE FOR HIM. I WORK AT A ROCK CLIMBING GYM. CAN I PROVIDE FOR THIS FAMILY?”
I think she told me to stop yelling, and then she said, yes, you can; and you should. It’s worth it.
And she reminded me, gently, that she and my dad and a lot of other people had been worrying about my diabetes for 22 years, and that this wasn’t just worth it for me. “It’s worth it for all of us,” she said. “We can help you. Go for it.”
The people I love, and who love me, and who are more ready than I am to not spend my climbing trips or road travels or just regular weeknights worrying about the amount of sugar floating around my bloodstream, offered what they could. It was, and is, stunning and humbling and more than any of them know. Over and over again, everyone has reminded me that it’s not just my peace of mind they’re after; it’s theirs. But still. I’ll never get over it. A friend and her husband handed me a check at one point, completely out of the blue, and I just burst into tears.
“We love you, Ry,” she laughed. “And we love your stay-alive dog.”
I paid the deposit. I signed the contract. I sent his picture to just about everyone.
And in November, I’m going to drive to Ohio to get my buddy, Yoder. (He’s named after one of my favorite snowboarders. I wish I had a more meaningful reason for you than that, but I just liked the way it sounded, and it felt right. Don’t think about it too hard. He is who he is.)
I’ll spend a week there getting to know him and training with him. Thanks to Jeremy and Jen’s system, he’ll already be scent-trained to me, so he’s got a definite advantage.
But after that, he’ll drive back to Texas to climb and run and sleep and eat and work and play and hang and travel with me.
And yeah, he’ll keep me alive.
