A Lifetime of Carb Consumption: Nate’s Type 1 Diagnosis Story
Nate is the co-founder and CEO of Rhone, and a co-captain of the 2019 Beyond Type Run team running the TCS New York City Marathon. Beyond Type Run is sponsored by Rhone, as well as lead sponsors Dexcom and Tandem Diabetes Care.
This post also appears on Rhone’s blog, the Pursuit.
Carbs and me: the early years
Like most adults diagnosed with type 1 diabetes, I most often just feel lucky to still be alive. I was always a very active, mostly healthy kid-turned-teenager with some level of athleticism and the ability to down an entire pizza solo. My focus in high school was on football, which my coach told me required an additional 15 pounds to reach my target weight of 185. I complied by trying to follow all the rules of weight gain, which included nearly a half-gallon of ice cream daily and peanut butter sandwiches at night right before bedtime. (NOTE: I’m not a doctor, but in hindsight, those are probably not the actual rules of weight gain and were also a really bad idea. But they “worked” for me in gaining the 15 pounds.) Post high school, I was fortunate to spend two years in Italy as a representative for my church, where I consumed more pasta than I ever did ice cream or peanut butter. Upon my return, I attended college, got married and finished cramming a lifetime of carb consumption into the first 25 years of my life.
Best vacay ever
After graduating from college, my wife and I took our dream vacation: a backpacking trip through Europe. Eleven countries in 30 days. I should add that I was a budding entrepreneur passing on a high-paying NYC salary at a prominent consulting firm to start a mobile software company. It might sound glamorous, but what it really means is I had given up a salary and health insurance while I tried to get the company off the ground. Two months after giving up the aforementioned health insurance, when we were getting ready for the dream vacation, I broke my ankle playing basketball, and we found out unexpectedly that my wife, Dayna, was pregnant. Our plan of “we-never-go-to-the-doctor-why-do-we-even-need-health-insurance-we-are-so-brilliant” had completely backfired. Nevertheless, we were soldiering on! We had booked the airfare months in advance and had saved for this trip, so we were going to take it—no health insurance, me in a walking boot, and Dayna eight weeks pregnant.
The vacation started with a cruise. As an entrepreneur, I was determined to make the all-you-can-consume cruise liner lose money on me as a customer. Having not previously ever been a heavy soda drinker, I signed up for the soda package and began to drink a steady three to four Cherry Cokes a day. On excursions through Florence, Rome, Istanbul, Mykonos and others, I spent my days sprinting from attractions to find the closest bathrooms. I couldn’t figure it out—what was going on? I believed that maybe it was just all the hydration and walking one does while on vacation. But it was so emergent, so sudden and absolutely inescapable. Dayna, who was handling her own challenges of morning sickness, thought it was hilarious. I remember her asking me, “Have you never had to hold it before?!” My remedy for needing to use the bathroom constantly was to, of course, consume more local juices and soda. (NOTE: I was a business major, not a nutritionist, so this seemed like a logical choice at the time. I mean, the juice was 100 percent pears, alright? You try turning that down while looking at the Parthenon.)
What on earth is going on?
Upon our return to the US, we stopped in New York to see my parents. We grew up (hold your breath and pinch your nose) diehard Yankees fans. So naturally, we met them at Yankee Stadium. While we were waiting for our tickets, the dance came on hard. You know, the dance? The one where you really have to go to the bathroom right now and yet said bathroom is on the other side of a security turnstile and is already filled with a line of post-tailgate intoxicated adult men in pinstripes. Yeah, that dance. As I tried to play it cool (but absolutely failed in the process), my dad said, “What on earth is going on?” I then explained that this “funny thing” happened on the way to the Forum (…anyone?) and I couldn’t explain it. All of a sudden, when I needed to go to the bathroom, it came on strongly. I don’t remember much about that night, but my dad kept giving me a look—that parental look like he knew something wasn’t right.
When we got home, he said to my mom, “Something is wrong with Nate. He needs to go to the doctor tomorrow.” Here I was, a married adult male expecting my first child and having started my own company, and my parents were still trying to tell me when I needed to go to the doctor. I stepped on the scale that night for the first time in at least a month. That 185 pounds that I had somewhat maintained since high school was down to 153. I couldn’t believe it. Busted scale, I told myself. I crawled into my childhood bed and went to sleep. But after waking up two or three times that night to pee yet again, I knew something was wrong.
When I went in to see my childhood pediatrician (yes, my mom set up the appointment at the same doctor’s office that watched me go through puberty), I couldn’t decide whether to sit in the kids’ or the adults’ section. But the kids’ section still had the Highlights magazines, so that was kind of a no-brainer. After I explained my symptoms to Dr. Westfal (my high school teammate’s father), he immediately said with his slight accent, “Sounds like diabetes, Nate.” I admit I didn’t know what diabetes really was—remember, business major—but I knew it wasn’t a good thing. I told him it probably wasn’t that. I have no family history on either side, and I have 60-plus first cousins. It couldn’t be. But my fasting blood glucose was of course off the charts at 450+, and my A1C was quite literally off their chart, which only went as high as 12. Mine was a 14.6. The bottom line is I was lucky to be alive.
Over the course of the next week, I started to grasp what “chronic illness” meant and what life as a person with type 1 diabetes would mean. I attended a training course, studied the materials and had the midnight lows and 2 a.m. highs. I have had the ups and the downs and unfortunately, even the scary situation of waking up in the hospital after a severe low with no functioning continuous glucose monitor (CGM).
Finding my people
At first, I really suffered in isolation. Yes, I had an amazing support group of family and friends, but I was the only one I knew with this crazy disease (besides the horror stories I always heard of so-and-so’s uncle or aunt). That was until one day about five years after being diagnosed. I was back living in the New York City area and riding the Metro-North train into work. I pulled out my glucometer to test my blood glucose levels, and the click of the lancet went off. When it did, a guy from behind me peeked his head over the row and said, “I thought I recognized that noise!” He came over and said, “I’m type 1, too!” Next thing I knew we were sitting there comparing pump models, telling our diagnosis stories and laughing about our biggest low cravings. I can’t fully explain it, but the closest thing I can think of is Harry Potter getting on the Hogwarts Express and realizing there were other kids just like him (don’t judge me—the train analogy works well).
Since that moment, I started to seek out my type 1 community, and I completely and totally regretted having waited so long. I found so much comfort and education in speaking with others who had experienced the awkward insulin-injecting moments at work or the maddening sync issues of a CGM or the constant alerts that seem to come at seriously inopportune times. It’s a beautiful community of poorly functioning pancreases that come from all walks of life.
For all of us
Most recently, I found Beyond Type 1, a nonprofit organization “changing what it means to live with diabetes.” It was true love. Honestly, I am so proud to belong to this community. So proud, in fact, that when I was asked to be a part of BT1’s Leadership Board, I said yes. This November, I will run 26.2 miles and co-captain the Beyond Type 1 NYC Marathon team for the 2019 TCS New York City Marathon. We have 30 amazing runners who I am so honored to run with.
But at the end of this, we are running for you—our community. For newly diagnosed children and adults, for the weathered and stalwart parents who wake up continually checking blood glucose levels, for those diabetic pioneers who have gone before us and paved the way for us to be where we are with our care. We are incredibly fortunate. I would only ask that if you are willing to contribute and support us, know that we will take it in whatever way you can send it. Cheers, videos, photos and definitely donations—your money is good here. Please share our race with your friends and remember that this disease does not have to limit you or your loved ones. It can challenge us and it can test our mettle, but at the end of the day, we are stronger and capable of overcoming this obstacle.
Great moments ahead for all of us!
Nate Checketts is raising money for Beyond Type 1 through Beyond Type Run—his fundraising will make a real difference in the lives of those living with T1D.