Angela Murphy: When diabetes became personal

Dr Angela Murphy tells us how she went from being a diabetes doctor to a mother of a child who has diabetes.

Angela Murphy (54) lives in Brakpan, Gauteng with her husband and three children.

I woke on the morning of 25 November 2005 to a new world. For the third morning in a row, my two-year-old daughter, Olivia, complained of being very thirsty at 5am. I had been trying to suppress a worry for the previous few days and decided to do a blood glucose test on her: 16, 6 – a number I will never forget.

By the end of the day, my husband, Olivia, and I were sitting in the offices of my medical school classmate and colleague, getting a prescription for insulin. In one day, I was unceremoniously pushed from being diabetic doctor to diabetic mother.

Our lives became consumed by numbers: fear of the low ones, annoyance with the high ones, relief if the numbers were good. Olivia had to learn that being injected several times a day with a sharp needle was her new normal. We were blessed to be able to put her on an insulin pump within six months of her diagnosis. It took the injection burden away but not the testing.

Support and special bonds

My first thought as I woke and my last at night was: What is her blood glucose? Handing her over to the care of her teachers was terrifying but we were so blessed that she was well looked after at St Dominic’s School, Boksburg. Special bonds were made with people that helped so much in those earlier years, especially the wonderful diabetes educator Jen Whittall. Through her we met other families and formed a support group on the East Rand that met once a month: Super Kids With Diabetes (SKWID). Our children always had friends with diabetes, so they never felt odd.

Coming to terms with the diagnosis

When Olivia was diagnosed with diabetes, I was almost eight months pregnant with her sister, Julia. Her brother, Lorenzo was just four years old. In that first year, I lived in a fog, battling an immense sense of loss. I clearly remember seeing billboards advertising fruit juice and being heartbroken that Olivia would not be able to just drink that without thinking and planning. I was angry that she would have restrictions and anxious to keep her safe.

Doctor vs mother

The comment I heard most often was how lucky Olivia was to have me as a mother. I understood what was meant, that all my knowledge about diabetes could be used to care for her. However, as a specialist physician my patients are adults; a toddler with diabetes was completely outside my clinical realm.

As a doctor I knew controlling the glucose levels to target was vital. As a mother, I was terrified of my child slipping into a hypoglycaemic coma. I was privileged to attend the International Society for Paediatric and Adolescent Diabetes conference in Durban 2008. I gained so much new knowledge and insight, not only medical but also on parenting a child with Type 1 diabetes. One statement was a light-bulb moment for me: “A child’s HbA1c is proportional to the mother’s fear of hypoglycaemia – the higher the fear, the higher the HbA1c”.

With the guidance of her endocrinologist, we adjusted insulin doses and gradually Olivia gained good control. I still woke to check her glucose every night for years to come but learnt not to accept higher glucose levels out of fear. This was a big step among many small steps in learning to manage the constant tight rope of highs and lows.

The realisation that there is no holiday or break from diabetes can be crippling in the days after diagnosis, something I have felt with my own patients. Having crossed the line from advising about diabetes to living with diabetes (a parent with a young child almost takes on the diagnosis), I do truly empathise with my patients. However, it’s still my job to guide, advise and help them aim to reach those diabetic goals. I never judge, as I know how tedious glucose testing, carb counting, and bolus timing can be. I have really had to try and practice what I preach. We all need to learn to ride the diabetes rollercoaster while we live our daily lives.

Proud mom

I would still wish Olivia’s diabetes away, but I know she can cope. However, I’m so grateful for the technological advances and the fact Oliva can use an insulin pump and glucose monitoring system. I remain hopeful that more breakthroughs will be made, and as radical a discovery as insulin was 100 years ago, something else may change the burden of diabetes in the future. In the meantime, I know Olivia will continue to live her best life.