At age 19, Jerry Alley was a young man just beginning to experience the independence of early adulthood. But that freedom would be shortlived. He was soon diagnosed with type 1 diabetes. The next four decades would see the disease take its toll on his body and life, with plummeting blood glucose levels sending him collapsing into unconsciousness or seizures more than 300 times.
Last February, Alley, now 60, underwent islet cell transplantation at City of Hope, a procedure that that may let him resume a life interrupted — and savor again the taste of independence.
|Jerry Alley checks in with his islet transplant nurse coordinator, Lisa Johnson. (Photo by p.cunningham)|
“If I would have been able to have this when I was 19, my whole life would have been different,” Alley said.
Type 1 diabetes is an autoimmune disease in which the body’s immune system destroys the cells that make insulin. Without insulin, blood sugar levels can swing wildly, causing many severe health problems, including unconsciousness and seizures such as those Alley experienced.
Although he was meticulous about sticking to his diabetic diet, exercising and monitoring blood glucose levels, Alley “had insulin reactions with seizures on the bus, in the supermarket, at my church — everywhere. It was a constant; the paramedics at the fire station six blocks away know me by name.”
The disease and its trappings constrained him. Because too much blood glucose can lead to coma or death, Alley carried juice or injections of the hormone glucagon with him everywhere. His daughters and friends learned how to revive him just in case he lost consciousness. “I felt so dependent on everyone for everything,” he said. “I couldn’t go anywhere or do anything.”
When Alley heard about the islet transplant program at City of Hope, directed by Fouad R. Kandeel, M.D., Ph.D., chair of the Department of Diabetes, Endocrinology & Metabolism, and supported through the Leslie and Susan Gonda (Goldschmied) Foundation, he eagerly enrolled.
Islet transplantation involves isolating the Islets of Langerhans, groups of cells that produce insulin and other hormones, from the pancreas of a deceased donor. Physicians infuse the donor islets into the large vein leading into the patient’s liver. Once the islets are implanted, they produce insulin in response to the patient’s blood sugar levels, just as the patient’s own islets once did.
Most patients require at least two transplants to get enough islets. Alley received his transplants in January and February 2008. He has not used insulin in 10 months.
The transplants have changed Alley’s life, according to Lisa Johnson, R.N., nurse coordinator in the Islet Cell Transplantation Program. “Simple things such as walking his dog and working in his garden give him such joy, and he’s able to do them again without the worry of the debilitating effects of hypoglycemia,” she said.
One day Alley hopes to regain his driver’s license and perhaps return to backpacking and surfing. “Independence is the most important thing that anyone can have,” he said. “The seizures are gone; the insulin reactions are gone. That in itself is an answer to prayers.
“It’s like my life is beginning again.”