The surgeons who huddled around Julie Allred tried to convince her it would be best if she slept through the procedure. But she didn't want general anesthesia.
They were about to puncture her side between two ribs and send thousands of pancreatic islet cells directly into her liver. It was part of a clinical trial to control the Type 1 diabetes she had struggled with since childhood.
"I said, 'You're about ready to change my life. I'm very fortunate to get this opportunity, and I want to see it,' " Allred pleaded. Her eyes welled with tears and her voice quavered as she retold the conversation.
The doctors relented. Allred stayed awake throughout the procedure, accepting just one pain pill as she watched 337,680 islet cells - visible to the naked eye, although each was no bigger than a grain of salt - course through a clear tube into her body.
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There they began producing insulin, something she hadn't been able to do on her own for the last 33 years.
Although still in the early stages of research, islet cell transplants are proof that advances in the treatment and possible cure of diabetes are no longer far beyond the horizon, but within range and approaching quickly.
At Emory Transplant Center in Atlanta - one of only a few facilities that perform islet cell transplants - doctors have successfully performed 22 such surgeries on 15 patients since 2010.
Allred, 43, a nurse who lives in Concord's Moss Creek neighborhood, was one of them.
Pancreatic islet cells make insulin, the hormone that helps the body break glucose down into energy. In a Type 1 diabetic, the immune system has destroyed the islet cells, leaving the patient's body unable to make insulin.
For the rest of their lives, Type 1 diabetics must depend on synthetic insulin, usually given through a series of shots or an insulin pump.
Since Allred's islet cell transplant, her energy level has soared to a height she never remembered experiencing, even as a child.
"I didn't realize how bad I felt before," she said. "I always felt tired, like I needed to lie down and rest. I have so much more energy now."
Although she still relies on synthetic insulin since the transplant, Allred has gone from needing 50 units daily to only between eight and 11 units. The uncontrollable high and low blood sugar fluctuations she used to experience - a chief concern for diabetics - disappeared after the surgery.
Low blood sugar in diabetics can cause seizures, coma and death. High levels can cause kidney failure, amputations and blindness.
"The ultimate goal is to make me insulin-free," she said. "Secondarily it's to eliminate those highs and lows in your blood sugar and prevent you from having complications from those big swings."
Ready for 2nd transplant
Other participants in the trial have become insulin-free; that can happen after a second or third transplant. Allred hopes for the same result soon.
"I'm on call for a second (transplant)," she said. Pancreatic islet cells first must be harvested from a matching organ donor.
Throughout her life, Allred always kept up to date on the newest gadgets to make living with diabetes easier. She remembered the excitement she would feel every time a more advanced glucometer, which tests blood sugar, would become available.
"It was like a new toy. It was such an important part of my life," she said. "Every time the amount of time you had to wait was cut down, or the amount of blood needed was cut down, it was exciting."
She looks forward to when no child diagnosed with Type 1 diabetes will need to get excited over a new gadget for the disease.
"Hearing that a cure is right around the corner, really now more than ever, these kids are going to see a big change in their lives a lot earlier."