High on the front façade of the former high school in our town are two engraved sayings. The one pertinent in my life right now? “New occasions teach new duties.”

I’ll say.

In mid-July, I was diag­nosed with type 2 diabetes. For the record, it runs in my family on both sides. Further, for the record, my personal physician and I had been watching for it. So it was not a surprise when my HbA1C level, a key test for diabetes, came back high for a second time.

Just because it wasn’t a surprise doesn’t mean it didn’t take me aback.

My doctor and I held a huddle. She knew I was headed to see my myeloma specialist soon for my quar­terly check-in. Because of that trip, she did not want me to start taking the prescribed metformin until after the specialist appoint­ment. Why? Because the drug can interfere with contrast tests in case any were ordered. But she did want me to start checking my blood sugar twice a day.

New occasions teach new duties. New duties bring new equipment. I can check my blood in under a minute now, but that first time? A lot of frustration, a lot of stress, a lot of I-don’t-know-how-to-put-the-test-strip-in swearing, some angry tears, and a ridiculously long time figuring out that the end cap needed to be removed from the lancing device before I could insert a lancet for the finger prick.

Letting others know I have diabetes was a whole different ballgame from telling people when I was diag­nosed with multiple myeloma. One of the stunning differences? I have not been told by friends, family, friends of friends, and com­plete strangers how to treat the disease, why I need to take this or do that ^[1], how they know someone who had a totally unrelated disease and survived, or how the last person they knew with diabetes died in a matter of days.

New occasions, fewer know-it-alls coming out of the woodwork?

On the other hand, many responses seemed entirely out of proportion to the announcement. “Oh, I am so very sorry,” said one, lowering his head and folding his hands. “Oh, dear, what terrible news,” in a hushed voice usually reserved for a funeral home, was another.

I have lived with multiple myeloma for almost 14 years. I have been in continuous treat­ment for most of the last six. Compared to myeloma, diabetes is a cakewalk. So I have to watch my diet. So I have to take a pill and check my blood twice a day. That’s nothing. I much preferred the reac­tion of my baby brother when I told him: “So you have another chronic, incurable, progressive disease on top of a chronic, incurable, progressive disease. Dang.”

The biggest hurdle I have faced so far is that the diabetes treat­ment inadvertently triggered a post-traumatic stress disorder reac­tion in me. Why? Because the metformin sped up my metabolism so much that I was dropping weight fast. Really fast. Three pounds in two days fast. That reminded me so much of the weeks leading up to my myeloma diag­nosis, when I dropped weight so rapidly that my husband Warren had to reassure me that all my labs were stable and there was no indi­ca­tion that the myeloma had turned on me. “But it can get very aggressive,” I said. “But you just met with your myeloma specialist and everything is fine,” he patiently replied. When my physician cut the metformin dose in half and ordered me to add fat to my diet, the weight loss slowed and then turned around.

New occasions, old trauma? Hey, I’m breathing easier.

With a little more than a month of being officially diabetic under my belt, I have settled into the routine of it: the testing, the lifestyle changes, the monitoring. I sleep more heavily now, an unexpected benefit of the medication. I am more conscientious about what I eat and when. There are times I don’t feel well that I ascribe to the new medication. I am relieved to discover that the unwell feeling from that is very different from the extremely distinct unwell feeling I have always had with the myeloma ^[2]. The former comes and goes, sometimes quickly. The latter increasingly comes and stays.

I am in and out of that old high school often in my line of work with the courts. I drive by it at least once a week. I have taken to glancing up, whether on foot or behind the wheel, when I am nearby.

“New occasions teach new duties.”

I’ll say they do.