It was a regular Wednesday night just after dinner when we got The Question from the twins, Bobby and Mary. (I couldn’t decide whether it should be a boy or girl, why not both?) Their little faces looking at us in expectation of an answer. We knew we’d have to answer The Question sooner or later, but so soon? Weren’t they supposed to have Pancreatic Education in schools?
I’m in trouble now. The Question. Now, we had to answer it. I kind of hoped that Mommy would take Mary into another room, so Bobby and I could have a ‘man-to-man’ talk, but that just wasn’t going to happen. She was as unprepared for The Question as I was. I took a deep breath…got to keep it simple for them. No matter how I looked at it, I was in it deep.
“Well, the pancreas is an organ.” Hoping it would end there.
They just looked at me. Expecting me to go on. The silence kind of got a bit deafening – you know what I mean if you have had to answer The Question.
“Okay, the pancreas is a glandular organ. It sounds like a complicated name, but it just means it’s an organ that dispenses important stuff for your bodies. Like stuff to help you digest food (aka polypeptides). It’s great claim to fame is that it helps our bodies regulate glucose.”
There, that was a pretty good basic explanation. Wasn’t there a football game on?
“Glucose?” I swear they said it in unison.
“Uhhh…sugar. It helps the body release and absorb sugar. It signals the release of sugar for energy – like just before you wake up in the morning you need energy to get up and moving. And, it helps sugar get into your cells with insulin.”
There was silence for a minute. I thought I was done. Mommy was smiling and I’m thinking I might get away. In fact, I began to stand up. Too soon.
“Insulin?” said Bobby. “What’s insulin?” asked Mary.
I sat down heavily. They really wanted a complete answer to The Question. I could see Mommy almost laughing. She was not feeling my pain. Okay, I thought. I tried to protect you by giving you an age appropriate answer, but now, now you will get the full answer (more or less). I guess it’s better to have kids that know rather than having to pick-up answers on the street to The Question. Another deep breath…looking into their trusting young eyes…
“The pancreas is a glandular organ that lives just behind your small intestine…”
A chorus of yuks interrupted me.
“and it helps in digesting food. So, it’s good that it lives close to where it’s needed. It does a number of things, but for now, we will just talk about how it works with sugar. You know what sugar is and you like it. It’s what makes cookies sweet and candy yummy.”
Their smiles told me I was on the right track.
“Okay, your pancreas lets out – secretes is the word – glucagon to get your body to release sugar (glucose) when you need energy. Like when you are playing, running, riding your bike, or even doing your homework. Your body needs energy and it gets energy from sugar. Then, when you don’t need that sugar, it secretes insulin to get sugar back where it belongs – in your cells.”
Hmmm, they didn’t seem to understand what insulin does. I could see it in their eyes.
“It kind of makes sugar go home.” The nods told me I was on the right track. “It’s like this, when you want to go out and play, sugar comes out to play thanks to glucagon. Then, when it’s time to go home, insulin calls it in, like we call you in when it’s time for dinner. It’s not good if you have too much sugar in your blood, and insulin controls how well sugar leaves your blood and gets into cells; kind of opens the door to let it enter and go home.”
I could see them thinking about what I said. Bobby looked like he was ready to go off and play; he was done. I might be finished answering The Question until they got older. I was hoping, and then Mary asked:
“What happens if insulin doesn’t work right?”
She was too young. Should I tell her? Well, she asked. so I guess she is old enough to know.
“If the insulin is weak; if there isn’t enough to get the sugar out of your blood, you get Diabetes, which is not good. Diabetes means there is too much sugar in your blood and for some reason the insulin isn’t working right.”
“Diebetus?” asked Bobby. I nodded.
“Die-a-betese. Diabetes is not good, but it can be controlled. A lot of the time you get Diabetes when you don’t eat the right foods. That’s why Mommy and Daddy tell you to eat all of your vegetables and make sure you get play time everyday. We don’t want you to get Diabetes. It’s why Daddy and Mommy play everyday, too. But, if you, or we get Diabetes, it will be okay because we will control it through what we eat, playing and taking some medicine. Mostly, though, you do not want Diabetes. It can be bad if you don’t control it.”
Mary and Bobby were very serious for a minute while they struggled to understand about the pancreas, glucose, insulin and Diabetes. Finally, it either all clicked or they just figured it become clear later.
“Can we go play?” they asked in unison.
Whew. It was over. I was wrung out by trying to answer The Question. I looked over at Mommy and said, “You get the next one.”