diabetes diary

Bloodwork

2009-04-28T15:33:00.001-04:00

Had an appointment yesterday with the pharmacist attached to my doctor’s family medical practice, to discuss the results of my latest bloodwork. It was mostly good news. I no longer need to self-test five to seven times daily. Once or twice a day will suffice to keep track of my currently acceptable blood-sugar levels.

That will be much easier on the fingertips of my left hand, and should please executives at the insurance company that provides coverage for our prescription medications. They’ve already balked once at the frequency of filling my prescription for glucose test strips. At just under $90 for 100 of the little suckers, not including dispensing fee, I can’t say I blame them. Use five a day, that’s nearly $100 every three weeks. One or two a day stretches the supply to nearly two months. The difference is about $1,000 annually, and I've yet to mention the price of lancets.

On the other hand, who wouldn’t pay another thousand bucks to feel good all year? I’m slowing a bit, but there was a time the ticker on my annual booze meter must have swept past the one-grand mark without a backward glance. Maybe it would help if pharmacies dispensed prescription drugs to the back-beat of a solid blues ensemble, accompanied by go-go girls and an ambiance of questionable possibilities. Then again, pharmacies don’t have cover charges. Then again, again, “dispensing fee” might just be another phrase for “cover charge.” One way and another, every service has its cost.

Life in a mature, integrated economy is like laundry. My non-essential expenditures are someone else’s mortgage payments and grocery money, while essential expenditures make sure the economy stays in rotation, like it or not, until everyone gets a little dizzy from a couple go-rounds in the spin-cycle. At least the technology keeps getting better. Blood glucose monitors are endlessly improving marvels right up there with mouthwash and cell phones. Actually, as my monitor already lights up, reads and stores data for computer download, tells time, sounds alarms and indicates operational problems, how many more buttons would be required for it to phone readings directly to my medical records, or take collect calls when the wife is stranded penniless in Wally World? It has to be worth something that the 38 page manual is NOT an unreadable translation from Chinese, let alone that the monitor should help keep me going long enough to buy more test strips.

If you blanch at the thought of insurance company executives giggling over new-found savings, take heart from the knowledge that my daily dosage of Ramipril is going up. High though improving blood pressure readings, not to mention the protein in my urine, should wipe smiles from boardroom faces. Sorry guys. Must look after those kidneys. Man’s gotta pee.

The Winds

2009-04-17T18:21:00.003-04:00

“Four Strong Winds” Ian Tyson wrote, meaning, I suppose, the points of the compass. My father had a fifth: his own. “I’ve got the winds,” he would say shortly before or after sharing. We couldn’t place blame; he wasn’t well. Blame is a wasted sentiment anyway. A good toot is one of life’s more reliable, if passing, satisfactions. “Better to let it out and bear the shame than hold it in and bear the pain,” a friend used to say.

Life is definitely breezier around here since my nutritionist recommended I consume a half cup of Bran Buds daily. They’re packaged by the Kellogg cereal folks, whose website claims that psyllium fibre, the noticeably active ingredient, can reduce bad cholesterol, helping to reduce risk of heart disease. More to the point, the fibre helps manage blood glucose levels and body weight, the latter by increasing satiety. That’s important for diabetics like me. I like that word: “satiety.”

The effect is achieved with mucilage, a somewhat less delightful word. In past experience that’s the stuff we used to stick paper together in grade-school art classes. I thought they made it from knackered horses, but apparently the stuff is found in the seed shells of plants native to Asia. It absorbs water, bulking up to ten times its dry size, starting a rush through the intestines and sweeping along lots of the other things found down there. I am now anecdotal evidence of this, and can attest also that it does generate “the winds.”

The water-soluble fibre has been used for some time in the treatment of constipation and as a binding agent in foods such as ice-cream. There’s more on that in an article at Wikipedia if you’re interested, but now that psyllium fibre is on grocery store shelves in cardboard boxes with happy, smiling faces on the outside, you can shake some out for breakfast with either eye barely open.

I sprinkle about 1/3 cup of Bran Buds into my morning cereal bowl, with bran flakes, milk and walnuts. The old familiar rolled bran fibre melted into a disagreeable mush with the first splash of milk, but these little budders hold their own, adding a slightly sweet flavour and crunchy texture to salads, soups, stews, casseroles, yogurt smoothies, even sandwiches. Kellogg suggests baking them into muffins, cookies and bread and adding them to meat loaf and hamburger patties. Well, they would, but really it sounds worth a try. In addition to the health benefits Bran Buds are a versatile and appetizing ingredient: Food, with occasional music.

Little Pricks

2009-04-09T16:50:00.002-04:00

Tykes marching around the family room to the Oliver soundtrack: “Food glorious food . . . never before has a boy asked for more! . . . we don’t want to make no fuss” and then “pip pip cheerio but be back soon,” which reminds me that I haven’t taken my portable blood-sugar tester out with me since getting it from the pharmacist.

This has been ragging my mind for some time now, but not so much I’ve actually started packing. What’s with me? I donated blood for decades, monthly toward the end, so it’s not like I’m afraid of a few little pricks. Is it? Not afraid to break skin. Not troubled breaching the envelope, drawing a little red. Not me.

What if, subconsciously, I’m not the tough egg I think I am? I’ve found some spots on the fingertips are a little more sensitive than others, and sometimes I’ve noticed a small amount of bruising, but nothing so bad it’s slowed my typing, you’ll notice. The blood clots quickly. No red-stained strips of toilet paper trailing across the computer keyboard. So what’s bugging me?

I’m maxing about five tests a day, which isn’t enough, and I’m often late with the post-meal pricks. Two hours after the munchies I’m in another world. You know how it is in front of the computer; time buggers off at a rate would make Einstein’s head spin. Maybe in another dimension I nudge little paper test strips against tiny blood bubbles exactly 120 minutes after my Wheeties, but it’s in this dimension, here with you, I have diabetes. In my other dimensions, I’m skinny.

I should carry the kit with me at all times. It’s high-tech, made for travel through time and space. Comes with its own little nylon pack to hold all the bits and pieces. I carry a small Kleenex pack to clean up (also handy for wiping the nose and the weary brow.) I removed the spool from a square, dental-floss box and it’s perfect for safely storing used lances when on the move. Slips into a pocket on the outside of the kit. Kit has a little Velcro strap to loop through my belt. If I wore a belt. I’m strictly a braces man now, and anyway the kit bulges like a snub-nosed .038 in the waistband of an ill fitting suit. Ruins my whole profile. Wouldn’t want to end my international modelling career before it’s started.

And suppose I’m shy? Don’t want to invite stares or comments, like a breastfeeding mom in a public park. Don’t want some offended ex-bricklayer to sidle up and slap me with her purse. Who needs that? Not me. Maybe I’m not the tough egg I think I am.

Sixteen Tons

2009-04-03T17:00:00.001-04:00

What do they put into diapers these days?

Yes, I know that, but there must be more. Since my daughter and almost two year old granddaughter have come to live with us the weight of our weekly garbage output has doubled. I swear it. The most notable addition is a steady output of disposable diapers.

I’m no neophyte. I helped raise the toddler’s mother after all, and her two aunts. I assure you they knew what to do with those squares of white fabric we (well, my wife) wrapped around their butts. Back then we had a semi-weekly laundry service pick up the contents of a sizeable white pail: wash, fold, bundle, return. I always pitied the service’s delivery van drivers. Theirs were the only vehicles coursing winter’s sub-zero streets with all windows wide open. And if a diaper van unexpectedly cut you off on a hot, still, August by-way it simply meant the driver was too teary-eyed from ammonia fumes to see. You had to make allowances, but still the service disappeared.

So the modern generation uses disposables, but I don’t remember diapers being so heavy. The midget poop factory now stomping our grounds must put out her own weight weekly. Can that be right? Can it be natural? Or are disposable diaper manufacturers pumping their products full of heavy chemicals and assorted weight adding whiz-bangs to fulfill the promises of their happy-land commercials? If so, if this carries on, our little girl will have Arnie Schwarzenegger’s legs before she’s three.

The problem is that, coincident with our increased output, our city is working to divert more garbage from landfill to other assorted projects. They’ll only take one container of non-recyclable garbage, 23kg. max, and apparently nobody is making new and exciting products from what my granddaughter and her colleagues put into their diapers. That’s a shame as this might be humanity’s most dependable natural resource. Nevertheless, ecological concerns don’t slow our mini-pooper down, so we’ve something of a disposal dilemma and it’s up to us to deal with it.

It’s amazing how the introduction of one small child into a home messes with household routines. I am a lucky guy. My daughter is a trained chef, willing and able to incorporate the Canadian Diabetes Association’s healthy eating guidelines into the family diet. I appreciate her support, but declined her offer. It is easy, for me anyway, to let someone else take responsibility and blame them when things don’t work out because something else comes up.

That’s not just unfair, it doesn’t work. I’m the one who must decide when to have a rare slice of chocolate cake, a banana or to skip desert. When other priorities arise, I’m the one must create the time and space for my balanced meal instead of partaking from the thick, cheesy, ordered pizza. I’m the one who compromised my health, and I’m the one committed to dealing with the consequences. Otherwise I may not have the strength to put out the garbage.

Who Me?

2009-03-30T15:40:00.000-04:00

It’s almost two months now since I was diagnosed with Type 2 Diabetes, sliding over the blood-test line from “in danger of developing” to “yep, you’ve gone and done it.” I can’t say I was surprised. Through much of my adult life I exercised regularly but I also developed a big appetite. When exercise became difficult as I gained weight and switched careers, the hunger remained. My eyesight was in decline. I felt bad more often than I felt good.

Now I must accept that I am old. Just shy of 60, I knew I was old but now I must practice the routines of old men: remembering if it’s the pink pill with breakfast and the white pill with dinner, the white pill with breakfast and the pink pill with dinner, or both; poring over restaurant menus and grilling wait staff for acceptable selections; pricking fingertips six times plus daily without mewling; taking frequent, long bike rides to nowhere in particular. I’m not getting old; I am old. I am also obese. Well over 300lb. Accepting these facts is the most challenging consequence of my diagnosis.

One benefit of diagnosis is that I now have help establishing habits to control my diet. In fact, with the guidance of the nutritionist and pharmacist who are part of my family doctor’s medical practice group, I am already losing weight in small but steady increments. I feel good more often than not. Good enough to start writing this blog.

Diabetes is an existential disease, a part of life. There is no “cure”. I can hope and pray it away until the cows come home, but if I don’t get on with keeping on I’ll be home with my maker well before the bovines arrive. Diabetes is just one more part of what Camus identified as the absurdity of existence and, like Camus, my choice is to embrace the absurd. As a writer of crime fiction, I’ve decided that the protagonist of my series’ novels and short stories (whom some critics have astutely noted superficially resembles the author) will also be diagnosed with diabetes. How will low blood sugar affect a criminal investigation? I figure to know that soon enough.

To keep track of the diabetic’s daily routine for the fiction, I’ll maintain this diary. Another routine to help maintain my work routine and my new health routines both: who says I’m not still a glutton? If you’re one of the nearly 250 million people worldwide who are affected by this diabetes epidemic, or among their friends and families, I hope you’ll find this blog helpful. Or at least amusing.