The Sugarless Plum: A Memoir (12 page)

After the first week, all-day rehearsals resumed. I was so physically sore from Peter's classes and from rehearsing six hours a day that I couldn't walk without pain. Every toe had a blister, but I didn't care. I was just ecstatic to be there and to realize that no one seemed to care about my diagnosis. Now all I needed to figure out was how to keep my blood sugars normal.

Whether it was because I was still in the honeymoon stage of my illness or because my body was still producing a small amount of insulin, the constant exercise and strict Grandma diet combined with the medication continued to bring my sugars down. Too much, in fact. I constantly felt shaky and tried to hide it. I kept a supply of quick-acting sugar like dried figs in my dance bag, and whenever Rosemary stopped the music to correct another dancer, I quickly popped a fig in my mouth, hoping that no one could see what I was doing.

 

When I called my doctor in L.A. and told him that I was having continual low blood sugars, he told me to cut back on the medi
cation. Following his instructions, I continued to reduce the dose until eventually I stopped taking it altogether. Elated, I was now completely convinced that I had “overcome” my disease with a healthy diet, exercise and determination. I vowed to only eat foods that wouldn't raise my blood sugar levels and to dance all day long.

Now that I was more confident, I was able to reconsider Rhonda's suggestion that, on some level, I had created my situation. I began to read spiritual books about why people become ill as well as stories about those who had succeeded in overcoming their illnesses. I needed to understand why some people got sick, and I wanted to know how other people felt about what had happened to them.

One of the books was written by a blind man who had regained his sight by using visualization techniques. He taught specific exercises, things to think and times to practice. I had been a believer ever since Suzanne Farrell taught me to use visualization before my debut as Sugar Plum. Now I started visualizing my pancreas healed and in perfect working order.

 

I was a disciplined dancer with a plan: A plus B equals C. I figured that as long as I was rigid about my routine, I wouldn't have to go back on medication. Sometimes, though, it wasn't so easy. Disciplined as I wanted to be, perfect as I expected I should be (especially since I was now aware of the consequences of not being perfect), sometimes I just couldn't resist that extra bite—or two or three—of an apple or pear. I simply had to eat the whole
thing, even though I knew my sugars were going to be high the next time I checked them. I'd try to talk myself out of it, but I'd take those bites, anyway, and then the guilt and self-blame would kick in. I wondered what was wrong and why I couldn't control myself.

In the end, however, self-discipline prevailed. Sure, I had slipups, but I'd get back on track pretty quickly—I had to because the repercussions of doing otherwise were unacceptable—and by the next day my levels would go down again. Every time I ate I'd test myself with the meter. I was becoming more and more obsessive about my food, exercise and blood sugar levels. But it was worth it because my plan was working. To me, the situation was a challenge, and for a full year and a half after I returned to the company in the spring of 1987, I managed to turn it into a major success story. I may have been obsessive about diet, exercise and blood sugar levels, but it was worth it because I was dancing and living without insulin or medication.

I felt as if I had everything under control. Every potential problem seemed to have an easy solution. So when, in the early fall of 1988, the company set off on a two-week tour of Japan, I packed almonds and cans of tuna fish, just in case I needed a quick, low-carb snack.

 

This was my first international tour, and Romy's very first tour with the company. There were a lot of new dancers now, all of us chosen by Peter, so I felt insulated by my close friends as well as by my sister and her friends.

Romy and I strolled through the airport, and I remember seeing Patricia McBride buying a scarf, Suzanne Farrell reading her book in the café, a group of older corps dancers smoking in the restaurants. They were all so cool; so chic. It had never occurred to me to get dressed up for a night flight, so I was wearing comfortable pants and feeling drab and ordinary. Still, traveling as a member of the New York City Ballet, I couldn't help feeling a part of the glamour in some way.

On the plane I sat next to Romy, and for the most part, we were quiet. She wanted to know how I was coping. I wanted to know how she was doing, but neither of us offered much information. Romy was in a relationship with a dancer in the company, and I suspected things were not going well—otherwise, why would she be sitting with me instead of him? But she didn't confide in me, so I couldn't be sure. We were in a bit of an awkward phase, Romy being in her first relationship, confiding in her friends more than me, and me obsessing about my health and dancing. We were experiencing different worlds. But it was still nice to have her by my side.

Romy dozed, and I tried to sleep, too, but I couldn't. I stayed awake the entire flight and, consequently, arrived in Japan exhausted. We had one day off before rehearsals and performances began, so there wasn't very much time to adjust to the vastly different time zone. After rehearsing all day and performing at night, I couldn't wait to get some sleep, but when I finally did go to bed, I would lie there totally awake, like the old days when I couldn't wind down after performances. My sugars were okay, but
something else was obviously completely off. My body could not adjust, and I couldn't fall asleep.

I didn't want anyone to know I was having a problem, because I didn't want anyone to suspect that it might have something to do with my diabetes. I rehearsed by day and performed each night with all the energy and enthusiasm I could muster. But night after night, I didn't sleep. I was so upset about having a problem no one else seemed to be having that I didn't even tell the physical therapist. And I didn't tell Romy, either. She was having fun and I didn't want to bother her with something she couldn't have fixed in any case.

Being on tour far from home was a license for company members to let go. After dancing all day and night, different groups hung out together, secret liaisons were made, and friends got a chance to spend some time together. Touring was fun and glamorous—but not for me, at least this time.

I was dazed and dizzy from sleep deprivation. I didn't care that my sister and my friends were out living it up while I was alone in my hotel room eating my almonds and tuna fish and checking my blood sugars. All I wanted to do was to sleep. We performed in Japan for two weeks and I slept for a total of about two hours.

A lot of dancers had made plans to stay in the Far East once the tour ended. Romy and I went with a group to Thailand. It had been almost twenty years since we'd lived there, and I looked forward to returning as a dancer with the New York City Ballet to the place where my life as a dancer began.

I wanted to relax and enjoy it, but I was nearly delirious by the
time we got there. In Japan, my sugars had stayed normal from dancing all day and performing every night, but once the performing and exercising ended, my levels shot up so high that I couldn't lower them no matter how well I ate. With my sugars soaring and no medication in my bag, I began to panic. Had I been living in some kind of fantasy world thinking that I'd conquered my diabetes? I could no longer avoid the truth: eating perfectly and dancing all day was not enough to keep my diabetes in control. I was supposed to stay in Thailand another week, but I changed my ticket and flew back to New York.

I needed to find a good doctor, one whom I could trust, in the city. Since I'd stopped taking my medication, I hadn't been in touch with the doctor in L.A., and there was no way I was going back to the woman who had diagnosed me. I was still angry with her for having broken confidentiality and telling another dancer about my diagnosis.

I had read a book by a well-known and highly respected diabetes specialist whose protocol I really liked. His approach to diabetes called for avoiding complications by adhering to a strict blood-sugar-monitoring regime and a rigid diet plan. He was a pioneer, adamant that blood sugars be kept as close to normal as possible. At that time most doctors preferred to allow their patients' levels to be a little high rather than put them at increased risk for low blood sugars, which could lead to insulin shock and death. But recent studies had shown that good blood sugar control was the key to avoiding the terrible consequences of high blood sugar levels, which had terrified me ever since I
was diagnosed. This doctor, who was himself a type 1 diabetic, had been saying for years what was now being proved.

I knew the discipline wouldn't be a problem for me because I had been successful for so long controlling my sugars with only minor slipups. I'd follow any regime, no matter how strict, if it meant keeping my limbs, and staying on my toes.

 

I first saw my new doctor on a cold fall day, reluctant to admit that I needed to keep this appointment, but forcing myself to follow through and end my denial.

The doctor looked over my previous blood work and listened to my story. He was personable and thorough and took a lot of time with me. I had not had this sort of treatment from a doctor before, and I liked him.

Then he offered his diagnosis: I had type 1, or insulin-dependent, diabetes.

I was stunned. Why hadn't either of my previous doctors discovered it? This guy had to be mistaken.

He went on to explain that, for reasons unknown, my immune system was attacking itself and had burned out the insulin-producing cells of my pancreas. “You're lucky,” he said. “Most likely you're still putting out a tiny bit of your own insulin. That's why the medication worked and why it sent you into low blood sugars.”

But the medication was ultimately having the destructive effect of pushing the islet cells of my pancreas to burn out faster. In time, it could burn out completely. There was no home remedy—
be it Grandma's diet, visualization, exercising all day or packing healthy snacks—that could even begin to restore the damaged cells. All my attempts to heal myself had been useless; in fact, the medication I'd been taking may have put me at further risk.

As the doctor continued talking, his tone was compassionate. He's the one who explained to me the honeymoon period, when for up to two years after the onset of type 1 diabetes there can be some spontaneous restoration of insulin production. But, he warned, “It's only a temporary situation, not an indication that the diabetes is improving, or in remission or cured. The exercise and your diet saved you—for a time.”

I wondered if the lack of sleep in Japan had pushed my system over the edge, but I didn't bother asking. What was the use? The honeymoon was over.

Then he spoke the words I never wanted to hear: “You will have to take insulin injections for the rest of your life.”

I got a huge lump in my throat and I wanted to cry, but I wouldn't let myself. Not there, not then. I stared blankly ahead as he went on to explain the other requirements of his protocol.

I'd have to check my blood sugar levels at least ten times a day to achieve the tight control he hoped for, which I'd been doing, anyway. And he strongly recommended a no-carbohydrate diet, which would also be easy for me. In fact, I wouldn't have to alter my diet at all, because Grandma's low-to-no-carbohydrate diet was really just a more healthful version of his.

When he'd finished his explanation, it was time to learn how to give myself the shot. I followed the doctor into another room,
where he checked my blood sugar level. It was at 200. He then calculated how much insulin I would need to bring it into the normal range of 70 to 120, his ideal target range.

The doctor took out a syringe and showed me the little lines indicating the number of units of insulin. Then he stuck the needle into the insulin vial, pushed the plunger forward and filled the vial with two units of air. Very slowly, with the needle still in the vial, he pulled the plunger back, letting the insulin fill the syringe. Then he flicked it with his finger to get the bubbles out. He made it look easy, but I wasn't convinced it really was. Today I use a prefilled insulin pen, which is a much easier delivery system that uses a thinner, less painful needle. But at the time there were no insulin pens.

 

He showed me all the areas where I could shoot: the fatty part of my upper arm, my stomach, my butt and my legs. He turned toward me with the needle in his hand and the insulin intact. As he asked me to pull up my sleeve, this sweet doctor with the constant grin began to look to me like Dr. Frankenstein. Then wham! He jabbed my upper arm. It was the tiniest pinch. I didn't like it, but it wasn't so bad.

Still, my head was spinning.

It was a lot to deal with. There was a different kind of insulin to inject at night, one that lasted longer. The stomach and buttocks were better for that. I'd have to check my levels and then figure out how much insulin to take. This was scary. The tiniest bit too much and I could go too low.

“Exercise acts like insulin,” the doctor said. “So if you're working out, be careful. It can be very dangerous.”

From everything I'd been reading, I knew about the risk of taking too much insulin, the worst-case scenario being insulin shock and even potential death.

I couldn't even think about that possibility, so I focused on smaller things. The thought of sticking a needle into my skin wasn't pleasant, but I was more alarmed about how I was going to juggle everything I needed to do and remember to do it. Yes, exercise was crucial and beneficial, but I wondered if my doctor realized how
much
I exercised. He knew I was a professional dancer, and I tried to explain that I danced up to seven-and-a-half hours in class and rehearsals and an additional three hours in a full-out performance. I wasn't sure that I was making myself clear. Not many people realize that being a ballerina is one of the most athletic careers you can have.

As I left the doctor's office, it all started to hit me. I looked at the needles and syringes he'd given me. Rehearsing all day and performing every night, how on earth would I know how much insulin to take? The protocol he had put me on required that I take a shot any time my blood sugars were even a tiny bit above normal. Keeping one's levels within normal range is certainly the ideal. But I would have to carefully calculate the correct dose, taking my level of exercise into consideration. How would I figure out how much I needed without overdoing it? It would be like walking a tightrope. It seemed nearly impossible.