For whatever reason (though I now believe that Ghanaian doctors tend to avoid \u201cscaring\u201d a patient), urgency was never voiced.\u00a0 No explanation of how time was of the essence, or how quickly Alex’s condition could become critical given her high sugar level and the large ketones in her blood.\u00a0 We went home to regroup.\u00a0 In retrospect, we were very lucky the night was uneventful.<\/p>\n
The next morning, unsure of where exactly we were headed, we made our way through Accra.\u00a0 Have you ever been stuck in a traffic jam inside a major city?\u00a0 Well, this is nothing like that.\u00a0 Yes, there are too many cars and not enough roadways, but here there are also people who dart between the slow-moving cars.\u00a0 They are known as hawkers, and they carry huge bowls atop their heads from which they sell water, plantain chips, candy, tissue boxes, exercise equipment, mouse traps, gum, ice cream, and more.<\/p>\n
Private cars, taxis and local mini vans (called tro tros) inched slowly along, most with windows opened wide.\u00a0 I watched passengers mop sweat from their faces while beckoning a pure water seller to come.\u00a0 Some lucky individuals sat inside air conditioned splendor.\u00a0 We were not among them; we endured the heat and the smell of fumes and the constant staring by the hawkers who were sure we\u2019d buy something from them.<\/p>\n
Nearly two hours after we set off from our home, we arrived at Korle-Bu<\/a>, only 25 miles away. The elevator to Dr. Renner\u2019s floor was not working.\u00a0 (We\u2019d later learn that it hardly ever worked.)\u00a0 Alex looked at the steps and started to cry.\u00a0 She couldn\u2019t climb them, she said.\u00a0 Sylvester picked her up in his arms like a baby and we walked up four flights.<\/p>\n Dr. Renner greeted us in the hallway.\u00a0 She was a woman about my age (late 40s), dressed in a traditional wax-print outfit, neat as a pin and bustling with efficiency, professionalism and concern.\u00a0\u00a0 She told Sylvester to carry Alex upstairs to the nurses\u2019 station in the children\u2019s ward for a weigh-in.\u00a0 She was only forty pounds, closer to the weight of a toddler than a seven-year-old girl.<\/p>\n Dr. Renner read the note from our doctor, and perhaps under the assumption we\u2019d already been briefed on what to expect, told me to grab my purse and she\u2019d show us where \u201cwe\u201d would be staying.\u00a0 \u201cWe?\u201d\u00a0 \u201cStaying?\u201d\u00a0 I really should have Googled further.\u00a0 I thought they\u2019d give us some medicine and we\u2019d be sent home. \u00a0I wasn\u2019t alone in my na\u00efvet\u00e9.\u00a0 My husband was also surprised (shocked<\/em> was more like it) to learn Alex and I would be there for a few days.<\/p>\n As a private pay patient Alex would not have to stay in the regular children\u2019s ward, so she was assigned to the Amenity Ward.\u00a0 What set the Amenity Ward apart were curtains between the beds, a small refrigerator, a sink, and access to a private (locked) toilet and shower down the hallway.\u00a0 What designated our area as a children\u2019s area were the grotesquely disproportionate cartoon characters drawn on the wall.\u00a0 There was nothing else that suggested that children would be cared for there; no toys, no children\u2019s books, nothing.\u00a0 The cost for the Amenity Ward was equivalent to about $8 per day.<\/p>\n While Alex and I waited for her bed to be readied, Sylvester had his own assignments.\u00a0 First, he had to head to the main lab to pay for the blood work that Alex would need.\u00a0 He\u2019d pick up the empty vials so that a doctor could draw her blood (there was no way Alex could have walked to the lab, nearly 1\/8th of a mile away).\u00a0 Then he had to return the filled vials for analysis.\u00a0 Eventually, we\u2019d learn that Alex\u2019s very first HbA1c was 14.7%.<\/p>\n Next, he was given a list of things he had to buy, immediately.\u00a0 They included a glucose meter, glucose strips, insulin, syringes and saline. He had to find and buy everything, get it all back to me, then drive home, pack our belongings, bring them to us, and return home \u2013 all before Alex\u2019s older brothers got home from school.\u00a0 At Korle-Bu you must supply your own soap, shampoo, toilet paper, sheets, towels, and washcloths.\u00a0 We also needed entertainment; my laptop with a single movie (The Wizard of Oz), some games, books, crayons, toys and a cell phone would have to suffice.\u00a0 And we needed Simon, Alex\u2019s doll.<\/p>\n While we waited for my husband to return with our things, the nurse came in to give Alex her first insulin injection.\u00a0 The nurse offered me the syringe and vial, and I deferred on that injection, knowing that it wouldn\u2019t ever be an option again.\u00a0 \u201cShe\u2019ll have to do this for the rest of her life\u201d<\/em> kept popping into my head.\u00a0 I remember it was all I could do not to cry.<\/p>\n During our first night there, the Korle-Bu nurses came in every two hours to check Alex\u2019s blood sugar on our<\/em> glucose meter. (I learned later that they didn\u2019t have a glucose meter in the ward.)\u00a0 Every four hours they were there to give her more insulin.\u00a0 Alex remained on a drip for 36 hours, dragging the IV pole with her down the hall to the bathroom.\u00a0 She was only disconnected from the drip long enough to take a (cold water) bucket bath.<\/p>\n To get to the shower room we had to pass through the children’s ward, a large, ugly room fitted with a dozen cribs for the patients; the mothers (in most cases) slept on the floor beside the cribs. The first night, as we passed through to the bathroom, we were clearly an object of curiosity to the other mothers.\u00a0 Surely, no obroni<\/em> (white person) would be at Korle-Bu if she had a choice.\u00a0 Eventually, though, they accepted me for what I was, a mother, just like them, taking care of her very sick child.<\/p>\n It was a long first night.\u00a0 Alex\u2019s glucose meter stopped saying HI but never budged below 600 mg\/dl.\u00a0 In my mind I kept returning to our conversation with Dr. Renner, \u201cHer sugar level should be between 70 and 140.\u201d\u00a0 Was that even achievable?\u00a0 I had to wonder.\u00a0 After 12 hours it finally budged.\u00a0 In fact, it did more than budge; at 3 a.m., it plummeted to 52 mg\/dl. I called the nurse who asked if I had any candy?\u00a0 A Mars Bar.\u00a0 Would that work?\u00a0 She \u201cthought\u201d so, so I woke up Alex and force-fed her a chocolate bar.<\/p>\n The next morning, ready or not, I had to begin learning to take care of my own daughter in a whole new way.\u00a0 I read the instruction manual for the glucose meter, became comfortable with it, and checked her faithfully, on the schedule the doctor recommended.\u00a0 I drew up the insulin through the syringe under the careful eye of the nurse and then injected my daughter.<\/p>\n As someone who\u2019d undergone IVF treatment, I knew how to handle a syringe.\u00a0 I thought I knew how to give an injection.\u00a0 I thought wrong.\u00a0 Injecting insulin is nothing like injecting Pergonal, which requires a wrist-flicking movement much like a professional dart player.\u00a0 And the syringes are very different sizes.\u00a0 I hurt Alex.\u00a0 She cried.\u00a0 I cried.<\/p>\n There was no one to help me figure out which foods were okay for Alex.\u00a0 I gave her fresh pineapple from a street vendor \u2013 amazingly sweet and juicy \u2013 and her sugar skyrocketed.\u00a0 The nurse yelled at me.\u00a0 \u00a0I had an internet connection so in the middle of the night I began to Google and I found Children With Diabetes<\/a>.\u00a0 I had so many questions.\u00a0 Parents who understood my situation explained everything to me, about sugar-free foods and carbs, and about how insulin works.\u00a0 I learned more from my new cyber friends, than the nurses (at Korle-Bu, anyway) will ever know.\u00a0 All told, Alex (and I) spent five nights in the hospital, with my husband and Alex\u2019s brothers coming every day to visit.\u00a0 With the exception of a single visit to the hospital nutritionist, who\u00a0 suggested restricting Alex\u2019s diet in a way that she\u2019d never have grown, the days were uneventful.\u00a0 Time passed as we tried, not quite successfully, to stabilize Alex’s vastly fluctuating sugar levels.<\/p>\n The conditions in Korle-Bu, a government-owned hospital, are not nice, even in the Amenity Ward.\u00a0 The sink water doesn\u2019t always run \u2013 certainly it\u2019s not drinkable, and I kept bottled water next to our bed.\u00a0 During a heavy rainstorm late one night, the ceiling leaked in the hallway, creating a mini lake just outside the door to our room.\u00a0 I had to walk through it to get to the nurses\u2019 station.\u00a0 The puddle was still there in the morning \u2013 no janitor on duty to clean it up.\u00a0 I could hear conversations quite clearly taking place in the hallway because beside the door was a giant, screened window.\u00a0 And the room was bright day and night, because the hallway lights were always lit.\u00a0 Because Korle-Bu is a teaching hospital, the best in the country (even underfunded as it is), at any time of the day or night we might have a half dozen interns coming in to check on us, and asking questions.<\/p>\n By our final day in Korle-Bu I couldn\u2019t wait to get out, for us to go home and figure it all out for ourselves.\u00a0 The nurses really hadn\u2019t done anything for us in the last two days, but they couldn\u2019t discharge us because the Billing Office wasn\u2019t open over the weekend.\u00a0 And so we waited until Monday.\u00a0 Finally, we got the bill, equivalent to $75.\u00a0 With everything Alex had needed during those five days, we spent about $350 in total, the glucose meter (without strips) being the highest priced item at $100.<\/p>\n We\u2019ve come a long, long way since Korle-Bu.\u00a0 Alex has gone from being on Mixtard (now, no longer used) and Humulin R injections at diagnosis to twice-a-day injections of Humalog 70\/30.\u00a0 From there, with guidance from my cyber support group, I asked for Alex to be switched to an MDI regimen using Lantus and Humalog.<\/p>\n![\"\"](\"https:\/\/asweetlife.org\/wp-content\/uploads\/2011\/05\/yes-i-am-cute-alex.jpg\" "\\"yes")
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![\"\"](\"https:\/\/asweetlife.org\/wp-content\/uploads\/2011\/05\/alexpump.jpg\" "\\"alex&pump\\"")
<\/a>Not long after Alex\u2019s diagnosis, Dr. Renner held a patient support group meeting.\u00a0 Of 25 type 1 children in the room, Alex was only one of three with her own glucose meter.\u00a0 I was shocked, but Dr. Renner confirmed that most parents in Ghana can\u2019t afford to buy one, much less the expensive strips that are necessary to make it useful.<\/p>\n