...a time to keep silent and a time to speak up...

From the Project Gutenberg version of the King James Bible:

"Ecclesiastes 003:007 A time to rend, and a time to sew; a time to keep silence, and a time to speak;"

Last Thursday (10 June 2004), I took a CPR course at work. This was combined with a first aid course which emphasized the doctrine that falling to the floor unconscious is a serious event and should lead to a hospital visit. They also emphasized that a symptom of shock is "cold clammy skin". (i.e. cold sweat)

I went home and one standing in front of my couch when I suddenly realized that I wasn't breathing. Everything went a dark gray and I remember thinking  "I'd better start panting or I'm going to collapse." The next thing I knew, I realized I was sitting on the floor and felt a sharp pain over the base of my skull. I looked around the room and from the appearance of things, it looked like I had fainted and struck the folding TV tray; the stuff on it was stead over the living room. Something had hit a table lamp next to the couch and it was on the floor.

I was having trouble breathing and couldn't stop deep breathing. I tried my asthmatic inhaler to no avail. I tried the old "breath in for 5 second, hold for 5 seconds and breath our for 5 seconds". (I still thought that I was simply hysterical and not suffering from a lung problem.) When Kathie got home, I talked about everything else first and mentioned in passing
that I had fainted. She was very upset. (I'll explain why in a few sentences.)

I called my MD's office and both he and his nurse were out of the office. None of the other Md. or Nurse Practitioners had openings. I was advised to go to the Emergency Room and go to the Family Practice room. We did. A nurse asking my symptoms asked "are you a diabetic"? I was rather startled and replied "yes". A couple of minutes later, I asked "why
did you ask if I am a diabetic"? Her reply: "what happened to you was a classic diabetic action".

I had been thinking of telling my Mother that I had fainted, had trouble breathing and went to the hospital. That business of "classic action" reminded me that my Mother is a highly skilled RN (albeit retired). She would undoubtedly realize that I'm a diabetic and I have been trying to avoid her finding out. So, the letter I eventually wrote was nicely sanitized
of any diabetic related information.

What had upset my wife and would have really upset my Mother is something that I had blocked out: the day before my Father died of congestive heart failure, he had gone to the bathroom and after leaving it said "I just fainted". Ok, so, he was a type 1 diabetic, had been a 2-3 pack a day unfiltered cigarette smoker for about 35 years and had had a triple bypass years before. He was far less healthy that I am! But, that
is no excuse when you consider the comparison!

They checked my blood oxygen level and found it to be 68% normal. No wonder I was out of breath.

They then took  me back to an examining room, put me on O₂, wrapped a blood pressure cuff around my right arm and then left me there for a while. About a half hour later, the second nurse to see me "handed me off" to a third nurse, wrapped a name tag around my right wrist and kept scaring me by talking about "checking me in". To me, that sounded like a "room with[out] a view" for the night. They
finally reassured me that I wasn't going to be a "house guest for the night". They took a blood sample and left.

The MD finally arrived and we had a long talk about my symptoms. Dr. Johnson said it wasn't heart related but needed to see X-rays. They offered to wheel me to the X-Ray room in a wheelchair and I politely declined this offer. The X-Ray tech was a fine young man with a Caribbean accent. I could understand maybe 60% of what he said. (My wife said one of the nurses complained bitterly about the difficulty of understanding this young man.)

Dr. Johnson explained the images on the two X-Ray images and said I had pneumonia.

After that, it was just a matter of getting a very large shot in the butt and going to a local drug store to buy the medicine  (ZITHROMAX
TAB 250 MG). I then went out to work, filled out and turned in a leave [of absence] request form and showed the acting boss the "Medical excuse form". The "medical excuse form" was an order for me to stay at home, rest and not exert myself. It was a good thing that I had this as my acting boss didn't seem to happy at having to authorize my time off. He is one of those fellows who never gets sick and doesn't believe in missing work for merely being sick...

As an aside, I wonder why my acting boss, who is scheduled to work 8 am to 4:30 pm, was still there at past 8 pm?

Then, it was home to take the first two pills, pain killers for headache and body pain and drinking lots of water.

When I have an upper respiratory disorder and cough a lot, I strain my vocal cords and end up with laryngitis. So, my mother called the evening of Sunday, the 13th and asked about my voice. I told her it was pneumonia and she got quite upset. I reassured her that the prognosis was good and I believe the Do.

This was just confirmation that I should keep my mouth shut about this. I know folks who say with sincerity "We all have our crosses to bear". Well, the knowledge of "my" diabetics is my "cross to bear" and is now something my wife and her father bear; it is not a cross for my Mother to bear. She has had to carry too damn many crosses of
her own...

This is probably going to be about the longest of my diatribes.

Verbosely yours,

Michael

P.S.: I suppose it would not hurt to leave my last name as the folks who know my writing style will correlate name and style easily. But, being secretive by nature, I will leave it one of life's little mysteries...

PS2: I wrote this in Word proofread it in Word; I didn't check what Word changed the final time I used the Word proofreader and it replaced "X-Ray" with "Ray". What a system!?!?!?!

Not a good morning...

I don't eat before my morning blood sugar test. So, I sat down this morning and was more than a bit shakey. I put the test strip into the meter and used the needle device to poke a hole in my left arm. Not enough blood. So, I recocked the device and put another hole in my arm. I put the strip against the blood drop and the meter did not respond. I pushed the meter against the spot again and got a FAILURE MESSAGE on the meter.

This mean the test strip was useless.

I cursed, put a fresh strip in the meter, poked a new hole in my arm and made sure there was plenty of blood in the drop. This time, the meter ""liked the amount of blood available and gave me a reading of 73. (Normal reading for me should be 70 to 150 units so I'm fine!)

This was not a good morning.

This was the morning that blood testing suddenly got old and the rush of excitement at the "new thing" has worn off...

Now, off to get meself weighed. (Ah, more disillusinment?)

Weight loss and changes to eating habits...

My family MD said the metformin (or metformin hydrochloride or glucophage) would help me lose weight. I thought this simply meant a reduced appetite but I now think it had more to do with changes in my eating habits. In the past, when I work the 5 am to 1 pm shift, I would get up at 4:15 am, walk our dog and eat something about 4:30 am. Then, I would be quite hungry by 8 am and have a second breakfast. Lunch followed at 1:15 pm and I'd eat dinner between 6 pm and 7 pm. I was eating too much but then I was trying to blend my schedule and my
wife's. Well, with the need to fast before the blood test at or about 7 am, I couldn't eat that 4:30 am breakfast. I decided that if I ate then on non-blood testing days then my body would be expecting breakfast at 4:30 am. I quit eating at 4:30 am and have gotten used to feeling hungry till I eat between 7:30 am and 8:30 am.

I am now used to being hungry in the late morning and early afternoon before going home to eat lunch. I do confess to occasionally having a snack or two during the morning. I also have given up on eating snacks before going to bed when I'm on the 3 pm to 11 pm shift. That may have been the real reason for me losing weight.

Anyway, I went shopping for summer shorts and it appears that I've lost about 4 inches of girth. (Of course, my trousers don't feel any looser so I have to question my optimistic assumption.) I'll go weigh myself tomorrow and see what the past month has led to...

Preception vs Reality and Cautionary Tales...

It finally occurred to me that folks concentrate on any serious illness that someone might have and don't think much of any other traits of that person. For example, I think of my brother as being a diabetic and don't think of him as the fellow who is about to be divorced, as the fellow who likes "Calvin and Hobbs" cartoons, as the youngest brother I used to tell stories to when he was a pre-nursery school type. (I haven't really known him since I enlisted in the U.S. Navy in 1970 and left home forever.) I've been trying to do better.

I used to work with a man named "Carl" who was your basic out-of-control type 1 diabetic. Carl was subject to severe mood swings and would often get pedantic when he should have been practical. (i.e. When you've got a crisis because your computer network is down and I'd ask him for help in relaying data, I didn't need a lecture on how to relay the data,
I need Carl to push the buttons and make the relay happen!

One of the stories about Carl is that he was seen giving himself an insulin shot in evening. Carl was going to a party and planned on having chocolate cake; he was guessing the proper insulin dosage. (Carl died of complications early in 2004.)

I remember seeing my late father do the same thing and also inject himself before planning on drinking a lot of beer at a steak barby. Christ Mass of 2003, I saw my baby brother wander off into the kitchen and give himself a guesstimated shot because he was planning on eating Christ Mass cake and pie! Well, he's not dead yet but he'd better get his shit together...
I tend to worry about him and tend to worry about losing my feet, etc.

So, I don't plan on telling many folks who know me for fear of being seen only as "the diabetic" and not as me!

Are there rumours floating about me?

On May 26th, I sat down across from a co-worker (and friend for that
matter) and said:

"What rumors have you heard about me?"

"Nothing! I'd don't hear any rumors; I'm too busy trying to dig myself
out from the hole I'm in." (This man is still trying to survive a couple
of DWIs...)

"Well, on May 7th, I was diagnosed as being a diabetic and I'm wondering
if anyone has talked about that?"

"Humm. I thought Jesse was the new diabetic. I saw the links to diabetic
website and figured it was him."

"No, it was me." (I wonder how to tell Jesse as he is quite overweight;
he is maybe 8 years younger than me and might not be there yet...)

So we discussed me being "on the pill", testing for blood
sugar levels and that was that.  It also affirmed my suspicion that
people were editing my "favorite" list on browser and could explain who
removed my link to the Scotsman online

I learn to use the Blood Sugar Meter (ane what a joke that was)...

Feeling rather strange, I went to the clinic on Monday, 9 May 2004. Kathie and her father stayed home as I was simply going to pick up the medications and the blood sugar testing stuff. I was wrong...

The Pharmacist was out to lunch and was due "back in 15 minutes" so I sat down to wait. I wait closer to a half hour (it must be nice to be the boss and thus able to set your own hours.) While waiting, a friend (a retired minister) in his 70s came in. I told him why I was there and he said he was a diabetic himself and had been taking "the pill" for years. It was a comforting feeling to know that I wasn't the only person with this problem.

The Pharmacist had the medicines all right but no instructions on which blood sugar meter to sell me. He had a little pen shaped needle device meant for poking holes in one's finger. I asked for one that would punscure the forearm. He also had a couple of varieties of testing devices, some cheap and the best a bit more expensive. I told him that I wanted the "take-it-from-the-arm" device and he said he'd check with the family MD. Unfortunately, the family MD and his nurse had taken the afternoon off. I said that I'd be back the next morning between 9 am and 9:30 am.

We (Kathie, her visiting father and I) rolled in at almost 10 am on Tuesday, 11 May 2004. The Pharmacist had asked the family MD which blood sugar tester to sell me. Dr. H. said to leave it up to me...

I figured that if I was going to be using this blood sugar tester for years to come, I might as well buy the expensive one, the US$80 one. I asked the Pharmacist how to use it. He pulled out the device and showed it to me; then, he gave me the pen shaped puncture device and said to practice with a supply of old test strips. At this time, my MD's nurse (Midge) showed up and took charge of the situation. We went to a vacant treatment room and got ready.

First, we had to calibrate the meter by setting the time in it. (We used my wrist watch as I had set it to the nearest second a few days before.) Then, we tried opening the pen to put a needle in. We could not get the damned thing to open. We thought we were in danger of breaking it when Dr. H (family MD) stuck his head in the door. He showed us how to open it and insert the needle.

Next, it was time to learn how to use the device.

I figured that since I was going to be using it, then I should be the one to be stabbing myself. We wiped off a section of my left forearm, set the needle depth at a medium range and I stabbed my arm. You could tell that a hole had been made but no blood came out. I then reset the needle depth for the maximum and after a total of seven (7!) trials, realized this needle was never going to lead to a geyser, just dry holes. I poked the finger and it bleed nicely. Then, a last failure on the forearm. Midge went and got a different variety of needle device, one with a stronger spring and made for forearms. This produced a nicely productive hole.

We were in business and we then tried using the testing device. We couldn't get it to work. Dr. H dropped by to see how we were doing and told us the test strip had to be positioned just right for capillary action to suck in the blood. After that, it worked just fine.

By this time, it was past 10:30 am and Kathie and her father had been sitting out front in the waiting room. I bought the required gear and we left. Kathie said that she'd seen quite a number of people that she knew and they had not gotten bored.

When I went to work that night, I told my boss that I'd become a diabetic and would be taking blood sugar readings twice a day, two days a week. (Tuesday and Friday about 7 am and 7 pm.) John, my first level supervisor simply listened and said "OK". My second level supervisor was obviously creeped out at the notion of poking holes in one's self and asked if there was anything that I needed. I said "no" and that I would be doing this in private.

That evening, I wondered over to an office cube that was hidden from the rest of the audience and did my first at work test. It was far more stressful planning for and anticipating the blood test than it was to do it. Odd how that can happen...

the MD speaks...

I am now a diabetic (type 2).

This is the day that I was forced to realize that I am a diabetic and will have to accept that. I've suspected that I was close to being diabetic or actually a diabetic for about 3 years now; I was simply in denial. But, the Fasting Blood Sugar test of 195 (after fasting for roughly 13 hours) was pretty damningly convincing; I am now a diabetic and will have to deal with this.

I will be on a pill (metforman), two pills a day. I'll have to test my blood sugar twice a day, two days a week. Dr. H. says he'll write a script for a finger testing machine; I would rather have urine strips or that sample-from-the-arm that is being advertised on TV. Either way, I am not looking forward to having to endure this. Oh, taking the pills (not a needle, Thank God!)
will just mean adding another pill to my morning regime of lisinopril (10mg) and the buffered aspirin (81mg). That simply means that I have to keep track of when the pills will run out and make sure that I keep supplied. (Maybe I can get the VA to start supplying me at a cheaper rate than the hospital rate of $18 per month?)

I wonder if this will keep me from donating blood?

It is the stabbing my finger that has me getting stressed...

Kathie and I talked about this briefly. The Doc called her, she had him call me and called me after Dr. H. talked with me. I don't want to stress my mother with this or my brother Charlie either. (Part of what killed my father was dibetics and my brother Charlie has been in and out of hosipials for years and recently lost his right leg in mid thigh.) I'm not sure how my
brother Jim would react (probably unemotionally) and I really don't know how Jeff would react. (Would he even care? I'm too estranged from him to think it would care. Would he just get snippy and snide about me not losing 100 pounds years ago? That is the snitty response and probably the "real life" response.)

I'll have to start checking my feet and will probably get overly concerned about them.

I'll be worrying that if I don't lose weight, I will end up having to "move up to" the needle and I'm not sure that I'll ever be able to face that...

After my MD called, I told Fritz and several other people in the office (Jen, Rick and one or two others) about this. They were sympathetic and that helped. I didn't tell my immediate supervisor as he was gone for the day or the office manager as he was in his office. By the time the "big boss" had left his office, I was not in the mood to talk about this. I'm not in denial anymore but just didn't want to discuss it...

There is a great Calvin and Hobb cartoon where in:

Miss Wormwood: "Calvin, do you know what state you live in?"Stern expression on her face.

Calvin, eyes rolling: "Denial."

Miss Wormwood, muttering: "I can't argue with that."
Walked off, shaking her head.