rain on the parade or the possible downside of inhailed insulin...

This extract from an article on Slate (http://www.slate.com/id/2135087/) by Emily Biuso on Saturday, Jan. 28, 2006, is a bit less upbeat...

"The new insulin product, which will be sold under the brand name Exubera by Pfizer, may be available as soon as this summer. But the picture isn't entirely rosy: Some doctors are worried that Exubera's risks to lungs have not been properly tested and that inhaled insulin causes minor declines in the amount of air the lungs can hold. The FDA recommended that asthmatics, smokers, and others avoid the product, and the long-term effects are still unknown.

The WSJ points out that it's been a good week for Pfizer: On Thursday, the FDA approved another of the company's drugs, Sutent, as a treatment for two kinds of cancer."

This was quoted without permission but should be adequately sourced to avoid violating copyright...

My MD thinks I'm still at least a decade from needing needles (injected insulin) and so I'll wait to see the long term results. I'm in no hurry to add the expense of yet another medication...

bad boys, bad boyz...

We've probably all seen dibetics injecting insulin in the evening prior to eatting some cake or doing some drinking.

* My late Father used to inject before having a few beers too many with a steak dinner and eatting some cake. (This according to family stories; I didn't personally witness it.)

* Christmas of 2003, we were at my brother Charlie's house. He gestered me into the kitchen and he injected whilst telling me that "I'm going to have some of Roxie's cake".

* My boss and I both knew a man in Chicago who was caught injecting in the office "kitchen"; Carl explained he "was going to a party tonight and I'm going to have some choclate cake". This was about 1993; Carl retired around 1998; Carl died of heart failure in either 2001 or 2002.

I suppose you could say "Carl retired from life 'in either 2001 or 2002'?" Or maybe this is too morbid...

The dosage had to have been a WAG (Wild Ass Guess) or if they'd bothered checking their blood sugar level a SWAG (Scientic Wild Ass Guess)!

Maybe being able to inhail insulin could lead to a different senario:

The good news is such dibetics might do the "exhail, take a deep breath and hold it as long as you can" routine (I use an asmatha inhalor occassionally) and could be getting that added insulin needful for drinking too much beer or eatting too much cake!

The following conversation could occurr:

"Mike is snorting something."
"You don't suppose he's snorting coke?"
"Nah! He's too damn cheap! He's a piss beer drinker!"

"Piss" beer referrs to Budwiser and not the outstanding Michlob...real Michlob, no "lite" beers and certainly not that horrid/horrible Michlob "Ultra"!

DISCLAIMER "Michael" most emphatically discourages the useage of illegal drugs. "Michael" firmly believe that one can get fucked up quite adequately on legal drugs...

good news about inhalable insulin...

This article is basically "good news coming":
27-JAN-2006 FDA Expected to OK Inhaled Form of Insulin

This article, ironically issued the same day as the previous article basically says the "good news is here!:
27-JAN-2006 FDA Approves Inhalable Version of Insulin.
Here is a confirming article from CNN:
same good news!

A nice news source for diabetics.

Charlie as of 28 January 2006

He's not answering his phone and our Mother is distraut!

Something is very wrong with my brother and the MDs apparently can't figure it out. He's now got swelling including what my Mother told my wife, "swelling in his scrotum". (A big of graveyard humour here: My brother always joked about having "big balls" but that was a joke and this isn't a fucking joke!)

Last night, at work, a friend of mine asked me "how is your brother doing"? So I told him. His wife is a surgical nurse and Tim has absorbed enough of that mindset to realize how serious my brother's conditions really are.

I'm scared and would go out to Oregon if I thought it would do any good...

talking with Charlie, post surgery...

I just called my brother and this was the first time I've gotten thru to him since his surgery.

"Charlie, I've been trying to get a hold of you."
"Hi, Mike, can I call you later? I'm getting sick to my stomach."
"Utrrr, uh, bye."

I don't like to think I make my brother "sick to my stomach" so I'll blaim the "pain meds" and the lingering infections. I think I'll go walk now and enjoy having feet (even if my right toes are sore). So, I won't be home if he calls later...

news on the medical front...

The local cardiologist spoke at Lions Club.

Here are some quotes:

"Seventy percent of diabetics die of heart problems." (My Father died of congestive heart failure.)

"If you have a diabetic, you have vacular problems." (Can't argue with that...)

"The single best exercise you can do is walking." (Thank God for that! Walking is about the only heart helping exercise that I like and certainly the only one I can do with screwing up my feet due to stress fractures. If there are indoor swimming pools in town, I neither have heard of them and have to assume they'd be too expensive should they exist...)

"[It is] very important to watch your diet." That can be hard to do and losing weight can be damned hard - if not nearly impossible at my age - to do!

We faced the embarrasment of letting Dr. Kahn order a salad that turned out to be loaded with bacon. It wasn't deliberate. Lion Kathie and I were mortified to learn that a Muslim had been allowed to innocently order a pork product (i.e. bacon).

He spoke of future plans to bring in a heart surgeon and that southwest Kansas could exceed the minimum number of cases per year (200/year) that a "cardio" surgeon needs to keep in practice. This is both good in the sence of us getting a "chest cutter" and bad in that so many of us would need this surgeon. Such is the life that comes from living in a society of abundance...

eating bad and poverty (an antedotal link)

I went to high school in Biloxi Mississippi and lived in base housing on Keesler Air Force Base (my Father was Air Force). At the  basel theatre, the folks who sold popcorn, coke (nothing diet mind you) and candy were a black family of Mom, Dad and (presumedly) Oldest Daughter. At the time, I was worried about being 5 to 10 pounds overweight. All three of these folks had to have been 30 to 50 pounds overweight. They were obviously working at the theater to supplement the Dad and Mom's incomes.

I was ignorant enough to wonder how they could afford to eat enough to be so fat. I later learned that it wasn't from eating too much, it was from eating the wrong food!

I was laid off November 1989 and it wasn't until 1995 that my new job began paying me well enough for us to have decent food. I ate so much white rice with soy sauce and a little bit of tuna that my boss told me to eat something else. So, having gotten a bit of a pay raise (this was 1991), I started taking baked or mashed potatoes and overly cooked hamburger to work (not always but enough to be noticed). My boss gave up on tryng to get me to eat right. That was too bad...

The result of eatting what I later learned was the wrong food was:

* I gained 70 pounds,
* My blood pressure went up and I may have had a stroke (I'm being treated for hypertension)
* I became a type 2 dibetic (I'm being treated for this with metformin.)
* I eat much better and exercise now but I can't seem to lose that damned weight...

So, I have the answer to my question of why those three poor black folks were so fat. They ate what they could buy and what they bought was very bad for them!

CAVATE TIME: These black salespeople may have been well off and may have been working at the theater simply to meet folks coming to the theater. Sounds good but isn't consistent with the culture of Southern Mississippi in the late 1960s and they never struck me as being willing to talk with the audience (mostly white folks that we were). I could be wrong but I strongly feel I'm not. Alas...

latest and not very greatest on my brother...

At 4 pm, 18 January 2006, my Mother called and left this message on the answerig machine:

"Charlie is in a lot of pain and throwing up."

The surgery lead to beaucoup pain and the pain meds coupled with the shock led to a lot of vomiting. The vomiting means he can't keep anything down and that also will make getting his blood sugar under control a real bitch for the medics. I wish them all well!

What I wrote in irony is apparently true in fact: vomito ergo sum (I vomit, therefore I am)

Under the circumstances, it has suddenly lost it's humour.

NOTE: "Beaucoup" (bo' - coo) is French for "lots of".

some venting, some frustration, some fear...

I just called my brother's room, gave the person (a woman) who answered my name and asked for my brother. I then was put on hold and hung up after 3 minutes.

I called again, said who I was and that I was calling long distance. The same voice told me "I told you, you've got the wrong number". I snarled back "No, you didn't. I want to talk to a nurse". The bitch hung up right after I said "didn't". I was so tempted to call back and spit out "BITCH" to her when she answered the phone but I won't. I'll just bitch about it...

I'll call our Mother and maybe email my brother...

...two minutes later...

I just got my Mother's answering machine and left a message asking about my brother. He is probably in recovery or ICU and I don't have that umber. On the positive side, if they'd whacked his leg off or if he'd died on the table, someone in the family would have called by now. My family has a bad history of not giving out bad news...

I have to go to work in 20 minutes and this aborted telephone tag and venting this is keeping me from "At All Costs" by David Weber.

Now, about 15 minutes later, I'm feeling guilty about being rude to this bitch, who is a patient at the hospital. Oh, well, she didn't handle it very well either. Normally, I'm a very nice person but when I'm scared, I tend not to be quite so sweet.

partial news...

About 5:20 pm PST yesterday, my brother Jim called the house and reported that Charlie was still in surgery. That was the last word received when I got home at 11:15 pm CST (9:15 PST). So, I guess "no news is good news.

I'll have to call him this afternoon and just hope he remembered my work email address.

pre-surgury for Charlie...

I talked with my brother Charlie about 8:10 am Pacific time. As of then, they were planning on doing the vein transplant and will operate sometime this afternoon (Oregon time). He sounded up beat and alert but mentioned that he'd not had much sleep. It seems the nurses had been coming in every thirty minutes during the night to poke a hole in one of his fingers in order to check his blood sugar. This seemed excessive to me but then medical folks have their own strange ways.

My Mother, family friend Steve or our brother Jim will call me at work tonight with the results or call my wife. If this doesn't work, Jim has my work email address. Since Jim knows it is bad form to send bad news via email, I'll just have to hope he didn't see the need to email me (assuming that he doesn't email).

As I was writing that last sentence, I could just picture the disdain on my 8th grade English teacher's face; worst, I could picture the much more massive disdain on my 9th grade English teacher's face! (Maybe that's why I'm not fond of public school English teachers to this day???)

status on my brother Charlie...

As of last Thursday night, my brother Charlie was sort of scheduled for the vein replacement surgery on Tuesday 17 January 2006. Fortunately, however, his MD was very reluctant to see this happen. The good MD, while expressing his support for Charlie and stating that he would not derail the operation, thought it futile. It sounded like Charlie was beginning to come around to this viewpoint.

I do worry about him...

My brother Charlie remains in hospital...

I called my Mother last night to ask how she is doing and how my brother Charlie is doing. She said the surgeons were going to do a artery replacement. The veins in is left leg are closing up and not allowing sufficient blood flow. That is the reason the ulser on his left heel isn't healing. So, the surgeons want to take a "healthy" vein and run if from the "healthy" arteries nearest the ulser to the ulser. The premise is this will lead to a much higher blood flow and healing.

I told my Mother, "if the veins are so bad, then he's lucky to still have the leg."

She sniffed and I finally realized that I should have kept my big mouth shut. "You don't want to talk about this?"

"I can't", she said and I changed the subject.

Charlie was born after my parents thought their "family making days" were over. Since I was 14 when he was born, I became the built-in-baby sitter and (happily) the doting oldest brother who did his best to spoil "his boy". His life has not been a wonderful as we had hoped it would be; the juvenile onset diabetes, along with some other problems, lead to that. (It is admissions like this that keep me from blurting out who I am; I just don't want the family to know I'm pulling "a Howard Stern" and am letting the one or two readers of this electron rag "see the private parts". Oh well...

Back to practicing medicine without a license.

But, if the other veins are shot and are letting very little blood through, this seems like a pointless and ultimately futile operation. If what they told my brother Jim is correct, Charlie will end up losing the leg anyway. In my opinion, he will have suffered a useless operation. On the other hand, he would have kept that left leg a few days or weeks longer and will be able to scratch his calf or stretch it or even walk about on it for that extra time.

That alone may make this replacement worth doing...

I called him last night (after talking with our Mother) and he couldn't talk. He'd suffered a severe reaction to the (anti) "pain meds" the night before and had spent the night vomiting. (Something I'm used to from a couple of bouts of food poisoning in the local area.) His being a type 1 diabetic meant that he was losing any food he may have eatten and was unable to keep down anything.

So, the infection probably jacked up his blood sugar and the vomiting may well have lowered it (or raised it, I'll have to ask the "American Diabetics Association").

But, back to his leg. Even if this operation simply lets him keep his let for days or weeks longer, he will have had the leg that much longer. That is a good thing, even if his "co-payments" will continue to escaliate. What the hell, he's probably so in debt that only bankruptcy under the old rules could have saved him. Under the new rules, he fucked! Ah, another thing we can thank "our" Congress-critters for!!! (If irony were cash I'd be rich after that statement!)

It also galls me since I'm a life long Republican (but think the individual is more important than the company so maybe I'm really a Democrat?).

Maybe it really is the carbs??

Day before yesterday (10 January 2006), I should have gotten off work at noon and had lunch about 12:20 pm. Instead, I worked overtime to 1:30 pm due to a computer system I was changing passwords going tits up. Well, only one of the computers went tits up and we were able to force it to accept a new "root" password...

I left word at 1:35 pm (or so) dropped off a suit coat at the dry cleaner and thought of going to "a nice place" (nice for diabetics anyway). But I was hungry and didn't...

Being very hungry, I went to King's Buffet and had entirely too much "oriental" food. I had one plate of chicken and beef, about a tablespoon of noodles and maybe a third cup of sliced potatoes. Then, another plate of chicken, pork and more chicken and about the same amount of potatoes. Desert was a small bown of ice cream (which I didn't finish) and part of a creme puff (which looks a whole lot better than it tasted!)

I figured it was going to be a good thing I'll have about 5 hours
and 20 minutes between getting done then and testing my blood sugar at 7:15 pm. At 5:10 pm, I ate a salad that was mostly lettuce, several slices of peperoni, some cheese and a half cup or so of cottage cheese.

Desert, of course, was Pepto-Bismol...

I thought my blood sugar would be too damn high. It was 104!

Yup, 104!

This is better than many of my morning fasting readings.

Either the machine is off (unlikely) or the lunch I'd had was basically meat with very little in the way of carbs. My dinner was salad with very little in the way of carbs.

This business of trying to "manage" my diabetics often perpluxes me...

my diabetics coaches advice!

Go Diabetic Go!

Go Diabetic Go!

Go Diabetic Go!

Rah! Rah! Rah!

Actually, she didn't but she was encouraging and gave me some good advise.

"micturre ergo sum"...a diebetic's motto...

"micturre ergo sum"

This is my new motto and is Latin for "I urinate, therefore I am" (roughly translatted). Actually, in Latin,

"micturre" means "to want to urinate ",
"ergo" means "therefore" and
"sum" (roughly) "I am".

Hence, "micturre ergo sum", "I piss (urinate), therefore I am".