Showing a Little Leg

That's right, mute members of my malcontent musings, it's time for a little alliteration and to look in on my leg wound. Because I know all of you secretly thrill to images of open flesh, right? Right.

For the record, or so those that are responsible for the record have told me, podiatrists are responsible for everything below the knees. Since this is the case, I'm going to start qualifying leg wounds like the one I'm treating as "Wound Care for Feet" in the "labels section."

That said, I'll post all of the pictures again, finishing with the one I took this morning.

The initial wound.

After 10 days of wound care.

After 20 days of wound care.

The progress is far more obvious than the previous update. The single wound has been split in two by the bridge of new skin. 

Something I haven't brought up is a diabetic's inability to heal swiftly. Microvascular damage prevents blood flow to injuries, slowing the healing process. That's why it's imperative to engage in proper wound care. So, again...

1. Keep the wound clean. Gently wash with soap and water and PAD the wound dry with sterile gauze*. Unless there's dirt or other foreign matter in the wound, do not scrub!
2. Disinfect with betadine or iodine. Either will help eliminate microbial growth that could lead to infection.
3. Coat the wound with antibiotic ointment. This step is optional, but I recommend it to prevent scabs from sticking to anything you use to cover the wound. That means the next step is...
4. Cover the wound. Depending on the wound's size, use gauze or Band-Aids. I prefer not to use anything that will stick to my skin, since is was just such an adhesive that made the original wound larger. 
5. Stay alert for signs of infection. That includes increased pain, pus, the area around the wound becoming hot to the touch, the area around the wound becoming particularly red and angry, a foul odor coming from the wound or gauze during dressing changes, and/or fever.
6. Keep the wound covered. Studies have show that "allowing a wound to air out to dry" doesn't help the healing process. Keeping it covered and protected does.

If you noticed the asterisk in step one, sterile gauze can be expensive. If I don't have any on hand, I'll cut corners, but do so very carefully. You see, I keep 91% isopropyl alcohol in a small spray bottle on hand. I'll take a paper towel, spray it a few times, getting it moist, but not soaking it. Wave it a bit so it dries, then use it to pad the wound. Do not use isopropyl alcohol on an open wound! It will kill healthy cells that are trying to heal you. And it'll STING!!! 

That's it for today. My right thumb is screaming at me, and I didn't even use it while typing this! So until my next action-packed entry, be well!

Posting Schedule Derailed

My posts are going to be erratic for quite some time. I'll still be posting, despite the deafening silence of the minute masses, but a serious problem has arisen.

In my 8 September 2022 post, "My Poor Beleaguered Psyche," I mentioned the possibility that I was developing carpal tunnel syndrome - CTS - and how diabetes can be a causal factor. It hasn't been officially diagnosed yet, but a new symptom has been added to the mix.

Calm down. I know it's exciting to watch me slowly fall apart, but control yourselves, you savages.

Yesterday, without the slightest provocation, the pad of my right thumb started to hurt. It wasn't a pain that slowly developed. It went from 0 to 60 instantly. (I know the pain scale is 1 to 10. I wasn't using that. I was using... ~ grumble-grumble-grumble ~ Never mind.) I took 1,000 mg. of acetaminophen, 400 mg. of ibuprofen, 5 mg. of oxycodone, and wrapped my thumb with a trimmed down lidocaine patch. I got some relief, but not a lot.

Some of my pains... If I ignore them overnight, I wake up and they don't bother me anymore. I chalk such things up to my nervous system having been ravaged by diabetic neuropathy and leave it at that. But this thumb pain was just as intense this morning, so I committed the cardinal sin of "doing my own research."

It's cancer. It's always cancer when you look things up on your own. Obviously, I have thumb cancer. "Thumb cancer" isn't real, but now I have it. Fite me! 😛

In review, I have an intense tingling throughout my right hand that never abates. It will vary in intensity, but it's always there. Now there's this incredible pain in my thumb, so I looked up "pad of thumb pain" on Google. In all honesty, I expected to get no results. No one in the world experiences intense pain in just the pad of their thumb. That weird symptom is reserved for me and my miserable luck. But to my surprise, it's a specific symptom of arthritis or CTS. Combining my two symptoms, I'm gonna say it's a good guess that I have the latter.

So I'm not a happy camper, and I'm going to have to slow down my posts a but to give my poor hand a break. I'm going to aim for every four or five days. I know this is heartbreaking for you, so let's not dwell on it.

Instead, let us celebrate this day, 22 September 2022, the First Day of Fall!

Mmm... Yummy brake pads! 💖

Every Post Could Be My Last

Yeah, I know I've been complaining lately about the lack of interaction with my real or imagined readers. But this isn't about that. No, really. No, wait! Don't leave!

You left, didn't you? Fine. Then you don't get to read my very serious post about very serious things.

Waiting in the wings are posts about heart disease and alcohol, but I thought I should solidify my reality to bring absolute clarity about my current health. I've been truthful with all of you. My everything is broken to some extent. It's all being monitored by doctors and controlled with medications. Alas, that doesn't discount the idea that I could quite suddenly kick the bucket.

"Gee, Rob. You're such an incredible ball of happiness today. What's got you in such a good mood?" 

Easy there, Captain Sarcasm. But I'll tell you. I recently watched a video from the Weird History channel about 2020, and it seemed like EVERYONE died. Not from COVID. These people just died. Some of them not all that much older than me. When you consider that I'm a 55-year-old man living in a body that functions as well as an 80-year-old man, the risks become apparent.

There's a little more than that. It was a discussion I had with a podiatrist some years ago. (I think I've already mentioned this, but if you think I'm gonna reread my every post to find it, you got another think comin'.) I mentioned that diabetics tend to live an average of 10 years after a major amputation. After a thoughtful pause, he agreed with me. October will officially make it four years since my left foot had to be removed. So... Maybe six years left?

I don't know. My current PCP believes I can beat the odds because I'm taking much better care of myself than other late-stage diabetics.

But he's also aware of something relatively new to my list of complications. It's a fun little problem that comes with advanced diabetic neuropathy. I don't always feel my blood sugar dropping. I have gone as low as 55 without feeling any symptoms. Remember my tale about passing out that one and only time? Imagine my glucose already being so low when I finally notice it that stand to get something to raise it, but by that point I don't have enough sugar to continue functioning. Down I go. "Rob's face, Floor. Floor, this is Rob's face." I suppose I could try to get a service dog that can sense a diabetic's glucose levels, but I don't have the maximum price of $25,000 lying around. (Besides, I don't have the means to care for a dog.)

I have a few tales of low blood sugar, but one that stands out is when I was being hospitalized and woke in the middle of the night. Rather than ring for my nurse and have her eventually come to my room, I sought her out. We went straight to the nurse's station, where she checked my glucose. I was a whopping 34. She saw the result, looked up and me, and asked, "How are you still standing?" 

That was 22 years ago. Things change in an aging body, and not usually for the better.

A fact that bears repeating is that the brain needs glucose to function just as much as it needs oxygen. I live alone. If I pass out from hypoglycemia, it's officially coma time. Without fuel to keep everything inside me fueled, coma time would become... Well, dead time.

Forgive me a moment as I turn into something of a drama queen (king?). After only four people responded to a birthday request, I got depressed and decided to run an experiment. I temporarily suspended my Facebook account (where us old fogies still hang out) and waited. I stayed off for longer that 30 days so they wouldn't think I was merely in Facebook jail. Care to guess how many people called, messaged, or came by to check on me? Zero. Some of them noticed my absence, but didn't do anything about it. They just... let it go.

My FRIENDS made that choice.

Y'know what taxes my beleaguered psyche about that? Some of my friends love me, and the rest seem to at least like me. They laugh at my comedic posts and comments. If I write something heartfelt, they respond with the "care" or "sad" reactions. So with my silence, was I missed or not?! I feel like I had become Schrödinger's human. (Okay, what is that? Sometimes it happens when I c-n-p, and sometimes it just happens because. That's it. Just because.)

I'm not harping on that. I'm simply pointing it out. And, hey! If I DO die and go unnoticed for a while, I should be lighter to carry out of my apartment, what with decomposition removing a little of that unwanted weight.

Silver linings, people. 😉

Okay. News shared. Drama played out. Let's all take a deep breath and appreciate this post's blatant lie about who my wife is this time.

This is Monica Barbaro,

AKA "Phoenix" in

Top Gun: Maverick.

Yeesh. Yet another "wife" who's young enough to be my daughter. I should be ashamed of myself... but for the sake of the silliness of it all, I'm not. 😛

We're All DOOOOOMED! But Not Really.

It occurs to me that a lot of my posts are... Well, terrifying, if I'm completely honest. "This happened to me. That happened to me. It's going to happen to you." Etc. I try to emphasize that my complications are the result of not taking care of my diabetes when I was younger, and that you, my commentless audience, run the same risks. When - not if - they happen to you, they will probably happen differently.

That being said, let's all take a deep breath and consider this statement: "Diabetes is the healthiest disease you could ever have." It sounds like utter nonsense. "It's a disease, ya dummy. Diseases ain't healthy," you say to me. And you're right. Diabetes, however, is the one disease that makes healthy eating and exercise key parts of its management.

"But Rob... I'm like you. I'm so old that I'll be turning into crude oil on my next birthday." Well, I feel your anguish in that regard. If you're 40+ years old and have been diagnosed as Type 2, you might have had decades to develop poor eating habits, and the most exercise you get is lifting a fork to your mouth. Diabetes imposes a sense of urgency in changing those habits, and you should. But asking you to get a gym membership and overhaul your eating habits overnight would be unreasonable. (And yet doctors will ask, anyway.)

Allow me to make two immediately horrible suggestions on the dietary front. My go-to snacks are pork rinds and string cheese. (No, I don't peel the cheese. I bite into it like the savage that I am!) If you're a young diabetic, you can dig into these things as much as you want because - and here's the kicker - ZERO CARBS! Yes, pork rinds and string cheese have no carbs to upset your blood sugars.

BUT - and there's always a "but," isn't there? - these snack items are absolutely terrible for fat and salt content. Older diabetics need to be on top of those things, especially if a cardiologist has been added to the list of doctors you need to see regularly. The reason I get away with eating such garbage is because my cholesterol is under control and I haven't been retaining water.

"Hey, Rob... What about sugar free candies? I can eat plenty of those, right?" No... for a few reasons.

1. "Sugar free" does not mean "carb free." As bothersome as it is, look at the labels. Eating so many pieces equals one serving size, and that serving will have a carb count. It's annoyingly deceptive to make such things look like a good dietary replacement when they really aren't.
2. The cost. I don't know about you, but I'm not made of money. Sugar free candy comes in nearly microscopic packages and two or three times the price of a full bag of the sugary stuff. It's just not worth it, especially because...
3. They may have a laxative effect! Yeah, this one caught me off guard at one of the worst moments in my life. Mind you, I learned of this effect before it struck because I was bored and started reading the near-empty tin of some sugar free hard candies someone gave me. And right there, in the tiniest print possible, were the words: Caution! May have a laxative effect. That was not a good day.

Like my post made to Type 2 diabetics, diabetes mellitus is ultimately annoying in many aspects of its management. Reading food labels...? Utter pain in the tuchas. But it's also essential if you want to maintain good glucose control.

Now for the exercise. If you are young and slim, this shouldn't be too difficult. Heck, if you're older and slim, it's still not much of a problem. Remember that obesity isn't the sole cause of Type 2 diabetes. Just maintain an active lifestyle and all should be well.

If you DO decide to kick your exercise routine up, do it incrementally! A drastic increase while still taking your previously established medication doses could have adverse effects on your blood sugars! You could also hurt yourself if you try to do more than what your body is prepared to handle. Don't start with 100 pushups. Start with 10... then two sets of ten... then three... etc. Build your way up to it. Yes, you might feel a bit of pain initially. "No pain, no gain" and all that. But if the pain is extreme, LISTEN TO YOUR BODY! You're doing too much. Back down a bit. Obtain reasonable goals in a reasonable amount of time.

Or become a cyborg. Because cyborgs are cool.

For heavier folks... This is going to be rough. Your body is already struggling to carry the extra weight, so your true physical condition is a HUGE variable. I urge you to talk to your doctor about this! Y'see, I'M STILL NOT A DOCTOR! (Yeah, I know it's been a few weeks since I said it, but one doesn't earn an M.D. or D.O. in a couple of weeks, especially when not going to med school at all.) Instead of going right into an exercise regimen, your doctor may recommend physical therapy to get you started.

In fact, while I'm recommending seeking professional help, you should also probably consult a dietician about the changes you need to make to your eating habits. If you say, "Some guy in the internet suggested pork rinds and string cheese," I promise that you'll get disapproving looks from a dietician. 

The reason why my PCP hasn't complained about my dietary choices is because... Well, I've made it 48 years as a Type 1 diabetic and I'm still not dead, (despite my best efforts). My cholesterol is within normal range thanks to the statin I'm already taking. (A statin is for controlling one's cholesterol.) My Hgb A1c has been between 6.0 and 7.0 for seven or eight years, so I might as well keep on truckin' the way I have.

Try to keep in mind that this blog is meant to be educational and amusing, but that I'm not a medical professional. I could be a "professional diabetic," since I have decades of experience. But there's more to learn, and "doing your own research" on the internet can only take you so far. I'm not reading medical journals or attending lectures on new treatments. I'm hoping to educate and warn you against the consequences of mismanaging your diabetes, and hopefully make you smile along the way.

But if you'd rather "do your own research," then look up images of "diabetic foot ulcers." "Diabetic blisters." "Diabetic retinopathy." "Vitrectomy." "Charcot foot x-rays." Those images might bring more than an education than reading these pesky words. They might also include trauma, which is always fun, right?

This post became something of a mess, but that will happen when a dozen ideas pop into my head simultaneously. My main message is that you try to take immediate steps to alter your lifestyle, but it's okay to take two steps forward and one step back. As long as you're moving toward proper care of yourself and your diabetes, then all should be well... or at least better.

And now...

This... will take too long.

Hang on...

This is Jane Douglas. She is "YouTube famous," has a degree in physics, loves video games, and has a brilliant smile. I love her. She is my wife, even if she doesn't know it. In fairness, I've sent divorce papers to her in an effort to allow her to escape, but by addressing them to "Somewhere in England," I doubt they'll reach her.

(Jane, if you ever see this, please don't hate me for being silly. My blog isn't monetized, so I'm not using you in that regard. I'm using you to make me look ridiculous. But you are beautiful, and if an old troll like myself even stood a chance with a lovely woman like you, I'd at least ask you to... ummm... come over and help me clean my apartment, because it's starting to get away from me, and I could really use the help. 🙂)

A Little Update

Did you read my last post? Did you recommend to a friend? Did you leave a like? Did you subscribe? DID YOU COMMENT?!? If you didn't do any of those things, then you are giving me cancer! Social anxiety cancer or something. And the only thing I know that people actually CAN do is comment.

The thing is, if my audience remains small and unresponsive, I'm going to start questioning my reasons for writing. I'll keep going if I KNOW I have been and still am helping at least one person, but if the views my blog is getting are from people who are actually bringing up my blog  by accident, then working toward a post every other day isn't going to feel good. This will go from a desire to do good in the world to feeling like actual work, and no one is paying me for what started out as a labor of love.

And now for the update mentioned in the post's title. I posted pictures of the skin, or lack thereof, from the diabetic blister I experienced. Well, here's a look at 10 days worth of healing.

What it looked like the day after

it happened.

A week and a half later.

I'm actually glad I took the photos, as I can now chart my own progress in healing. You can see healthy skin growing in, the area of the original wound visibly shrinking. The oddities you may notice in the second picture... That horizontal line is from the ace bandage I've been using to keep gauze in place. I didn't want to risk tape pulling away more skin. And the blue socks with the white print are the non-slip socks they give patients at hospitals. I have several pairs that have followed me over the years, and I sometimes wear them over my white socks to prevent the whites from getting dirty when I go downstairs to check my mail.

That's it. I'm sneaking this post in just under the wire. In 10 minutes, the 16th will become the 17th.

Please... I know I'm coming across as thirsty for validation, but it's needed. Say something so I know if my scribbling is reaching someone who values it.

Please Like, Subscribe, and Comment Below

Greetings and salutations, internet denizens! I am... goin' through it, y'all. Whenever a complication of my diabetes becomes the focus of my life, it's like my emotions are wearing cement shoes and have been dropped into the Hudson River. 

That giant blister, for example. I may have an alternative method for getting cleaned up, but it's hardly a replacement for a good shower. And the timing could have been better. I need a haircut, but I can't cut my hair until I have the capacity to properly rinse away all of the stray clippings. When my hair gets long enough, the sides start growing upwards into what I call "horns." It's silly and annoying.

Alas, "silly and annoying" is what eventually gets me down. The blister site stings at random - probably a combination of diabetic neuropathy and the fact that I've lost a few layers of skin. I have to change the dressing daily. I have to go out and buy more wound care supplies because I have to change the dressing daily. These are not the normal interruptions one would expect in adulthood. I should be annoyed that I have to go to the supermarket because I'm running low on vegetable spread, not 4x4 gauze. And insurance doesn't cover basic first aid supplies, so it's an out-of-pocket expense that I really can't afford.

So I come here and write about my experiences. I share in the hopes of educating others so that they take proper care of their diabetes, or to help non-diabetics learn what their diabetic friends and family have to face. Their experiences will be different from mine, but the mechanisms beneath my complications are the same as theirs.

That said, SOMEONE is reading this blog. Sometimes the analytics crack double digits, and that's VERY exciting. I've asked for feedback a few times, and thus far the response has been nonexistent. Like every human on the planet, I need a little validation. Heck, it's not the validation, it's human interactions that I crave! Tell me I'm doing well. Tell me I could be doing better. Tell me I'm doing terribly. Correct information I may have gotten wrong. Share YOUR experiences with diabetes. Or... 

ASK QUESTIONS. The all caps, italicized letters are my way of saying that I'll answer just about any question put to me. I can be honest to a fault, which some people find unnerving, while others find it refreshing.

I've tried to promote this blog so it reaches more people who may need the information within. That personal experience with dollops of humor mixed in. Unfortunately, I don't actually know HOW to promote it. The best I could do was ask a few YouTubers to read the first few entries to try and hook a few more readers. 

But you know what YouTubers are absolutely TERRIBLE at? Replying to e-mails. I end every message with a request that they at least acknowledge the e-mail, even if it's with a "Thanks, but no thanks." 

Nothing. 

That's how I wound up with this post's title. They're always for likes, subscribers, and comments, and it seems to work for them. So maybe it'll work for me. And, you know... Maybe a couple of recommendations from my readers. 😁

Finally... While there are more risqué pictures of the beautiful young woman, you may finally see her "scantily clad." It's a bikini, but still.

Now it's just a matter of someone

convincing me to post a pic of her

in lingerie. 😉

Taking a few days off

This is unrelated to diabetes, so if you're not interested in every little detail of my life, you can skip this post and know I'll be back later next week.

I was born in Brooklyn. Grew up on Long Island. I have been to NYC countless times. And while I have wandered the States for a good chunk of my adult life, I was on Long Island on 9/11.

On that fateful Tuesday morning, I was sleeping in. My filing for disability was underway, so all I had was time. One of my housemates came charging into my room to say, "Someone flew a plane into the Twin Towers!" 

By the time I reached the TV, the second plane had hit. My housemates and I watched in horror as they collapsed. Time seemed to stop moving. The only thing happening in the entirety of the world was the terrorist attack on New York City. I remembered a time when I was in my early twenties, when I stood beneath the towers, captivated by their majesty despite being a NY native.

As the talking heads on numerous news channels began their repetitious recap of what we'd all seen and speculating on all of the details, I gathered up my "wandering stuff" and left the house. My "stuff" was a backpack containing a CD Walkman, a good book to read, and usually the means to take some insulin. I had no real destination. I just needed to not be surrounded by other people.

My feet, however, seemed to have a plan. They brought me to the nearby public library. After proving that I did indeed have a library card, I logged on to one of the computers - my only access to the internet back then - and e-mailed a friend in TX. This was my exact message: Today, they blew up my home. That was it. I could find no other words. I was too shocked to do anything else, so I wandered back to the house and crawled into bed.

Since discovering it, I've watched the following documentary on every anniversary of 9/11. I own the DVD, so I'm not reliant on streaming services. It was made by a pair of French brothers, Jules and Gedeon Naudet. Purely by accident, they caught the first collision on camera. The documentary is disturbing and filled with adult language, so I'm not recommending this for people easily upset or for children. But if you have the time, I suggest it be watched to find out what it was like to be in the Tower lobby as history unfolded. The link I'm providing was put up just under a year ago, so there's no telling when or if it will be taken down. It's simply called 9/11. I recommend you look for it using the brothers' names as well to narrow down your search if you ever need to find it again.

Optimistically, I'll have a new post for 14 September, but realistically I should say it'll be 16 September.

My Poor, Beleaguered Psyche

Welcome back. We need to talk a bit about psychology, folks. I know, I know. You'd rather we didn't. "Got enough on my plate right now, Rob. Thanks, but no thanks." Alas, it can't be avoided.

Before I go on, however, I need to be clear that what I'm going to discuss are things I've learned through conversations and experience, not from extensive reading. Some of the people I've spoken to were medical professionals. Some were not. All of them contributed in some way to my way of thinking.

The diagnosis of a chronic illness brings with it a degree of emotional trauma. It really doesn't matter what the illness is. If the illness is permanent, it's going to require a mental shift in how you view yourself and the world around you. 

Heck, I've developed allergies to A LOT of plant-like substances that travel through the air in the last few years, causing my nose to not only shut down, but throb as it does so. And, yes, you CAN develop allergies later in life. With all of the things I've already mentioned in this blog, do you really think I was able to accept one more thing with any degree of casualness? NNNNNOPE! Had I been even slightly religious, I would have stepped outside and raged at the sky... after I took a fistful of antihistamines first, of course.

Diabetes is kind of a double-whammy, because a lot of people also have trypanophobia - a fear of needles. People who are willing to jump off a diving board into a pool of nails will experience a spike in their blood pressure at the very suggestion that they might need to have a needle inserted into them, be it for a blood test or to receive medication. If I had a dollar for every time I heard someone say, "I could never take shots. I'd rather die," I'd have... Well, not enough to be rich. Just a lot of dollars.

My response is always, "Then die, you shall. Painfully. Diabetes doesn't care about your fear of needles. It will end you." They don't understand, of course, but inside my head I'm picturing the symptoms of diabetic ketoacidosis. Unquenchable thirst (polydipsia). Constant urination (polyuria). Vomiting so hard and so often, even when your stomach is empty, that blood vessels break beneath the skin in your face. Desperate, deep breathing (Kussmaul breathing) as your body tries to expel acid through your lungs. And weakness so profound that you literally have difficulty lifting your arms.

Of course, I've never heard of someone outright refusing insulin injections due to a fear of needles. 

A lack of control of diabetes means you're going to wind up piling on new diseases later on. And with each new diagnosis comes that psychological impact. Imagine accumulating these as you grow older.

1. Diabetic retinopathy - a leading cause of new blindness.
2. Diabetic neuropathy - permanent nerve damage.
3. Charcot foot - advanced diabetic neuropathy.
4. Diabetic nephropathy - permanent kidney damage.
5. Cardiovascular disease caused by diabetes.
6. Diabetic blisters - actual cause beyond uncontrolled diabetes is unknown.
7. Gastroparesis - inability to digest food properly.
8. Diabetic gum disease!

Yeah. Number eight. Look at it. Sounds absurd, doesn't it? To be truthful, it's not that diabetes causes damage to your gums. Due to the weakened immune system of Type 1 diabetics, however, diabetics are more susceptible to gum disease by way of bacterial infection. So there you are, calling your PCP or dentist to say, "Doc, a near-microscopic particle of food got trapped between my gums and a tooth, and now I need antibiotics because the pain is making me pray for death." 

And did you notice me sneak in a complication I've never mentioned before? Diabetic nephropathy. Kidney damage. I can't begin to tell you how insanely lucky I am to not have this one... yet. Oh, there was a time when I started showing the most minimal signs that it was happening, but then it just "went away." How? No idea. But now my daily routine includes eight ounces of sugar free cranberry juice in an effort to promote the health of my kidneys. 

Recently, I've started experiencing a brand new problem. Carpal tunnel syndrome. "But Rob... People don't need to have diabetes to develop carpal tunnel syndrome." And you're right. Typing a lot, which I do. Using game controllers for near-countless hours, which I also do. These things contribute... until you're told that high glucose levels affect the blood vessels connected to the median nerve, intensifying the pain associated with the nerve becoming pinched. Lately, I've had intense, lengthy bouts of a pins and needles sensation in my right hand. My dominant hand.

Where's my bottle of Dammitol when I need it? (It was a joke product I once saw as a kid, with a "medicinal" label, and the bottle was filled with cinnamon jelly beans.)

I looked it up and found this among

the images. Seems legit.

When one takes into account all of the other stressful nonsense we have to deal with, it's no wonder that we have to add psychiatric care to our list of needs. And for me...? Well, I've told you of my early life and some of the "fun" I endured. Therapy and antidepressants became necessities.

So, lovely readers... There's more. There's always more. But I'm going to save my delves into therapy for my next post, because some of them are sagas unto themselves. Meanwhile, I've decided to let you all get to know me a little more by showing you my beautiful wife.

What do you mean "that's Jenna Coleman"?

Clara from Doctor Who? You're all

insane. That's my wife, Jenna... Coleman...

Wait a minute!

Disaster Supplements

Oh, have I got a treat for you! It's the wounds on my legs! That's right! I've decided to let you bask in the glory of the nonsense I have to deal with. These pictures are fresh from this morning. And remember, all this can be yours for the low, low price of ignoring your blood sugars!

I'll start with the wound that started this adventure almost two weeks ago.

It's a terrible angle, but that little line near the bottom started out as a crusty scab that was looking somewhat annoyed. Keeping it clean. Keeping it covered with antibiotic ointment and fresh gauze. Taking the antibiotics as prescribed by my PCP. These actions have it looking pretty good today.

BONUS WOUND! This little guy higher up on my shin is from the components of a shelving unit falling on my leg. This was one of those wounds that I felt and treated immediately. Because I received it at the tail end of the antibiotics I was already taking, infection didn't really have a chance to settle in.

This is the section of skin that peeled away when I removed the taped dressing a few days ago. Mmm! Looks deliciously moist, doesn't it? And just look at that discolored flesh from wounds in the same spot repeatedly! I tell ya, it's a wonder I can keep women from climbing all over me!

And now... for the absolute... without the shadow of doubt in my mind... dumbest development yet!

Yup. I accidentally managed to make it bigger. All I did was gently probe to see if there was still fluid buildup around the wound and the skin simply sloughed off! You can see a small fold of skin. It was so soft that it was a miracle the skin was attached to me AT ALL! 

Do you know what this means? It means I CAN'T SHOWER! Not until I've done about a week of decent healing. "But Rob... Why can't you shower?" Because the skin has become almost inconsequential, barely performing its function, and softening it further in the shower risks removing even more. If I had two feet, I could cover the area with a trash bag and seal it higher on my leg, where the skin is healthier. However, I sometimes have to stand on my remaining foot in the shower, and the bag would create a fall risk too dangerous for a guy living alone.

Thankfully, I have an alternative method of staying clean. Hospital grade antibacterial wipes. They'll at least keep me from being followed by a cloud of stink wherever I go.

That's it, folks. No funny pics or teases about beautiful women. You got four pics of my "sexy" wounds today. No, no... You don't have to thank me. It's a service I'm only too happy to provide free of any cost to you.

Look, Honey. Another Disaster.

I have a completely different post all ready to go, but events from yesterday and today have prompted me to write about how damnably frustrating the complications of diabetes can be.

This tale actually starts about 12 days ago, when a friend took me to do some food shopping. It's easier to do by car, and I haven't driven since being declared disabled decades ago. While we were out, something caught my eye on the floor, and when I looked down, I discovered a cut near to where my foreleg meets my foot. No idea when I got it, but it looked angry.

Let me pause here and remind everyone that I have advanced diabetic neuropathy. That I didn't feel this wound when I got it wasn't a surprise. The wounds that I DO notice come from collisions where deeper nerves have registered the impact.

"Rob, you promised humor in your posts. This sounds pretty serious so far." You're right. So here's a moldy oldie. Q: If a one-L lama is a priest and a two-L llama is an animal, what's a three-L lllama? A: A really big fire. (Get it? A three alarm fire? Three fire stations show up to fight the... Never mind. I heard it back in junior high. Oh, sorry, "middle school" for you kids today.)

So my friend and I notice the wound, but we were almost done with my errands, so we finished up and he got me home. Once the groceries were put away, it was time to assess my wound. 

Quick! Change tense to make it extra confusing!

1. How does it look? The surrounding skin looks red and angry, but not blazing red. Due to the discoloration of my skin from countless wounds and scarring, it's sometimes difficult to make a visual assessment. If it's visibly red, it's getting infected.
2. Does it hurt? Now that I know it's there, I concentrate. If I can sense even a small bit of pain, it means that the infection is creeping its way deeper. On the scale of 1 to 10, with 1 being no pain whatsoever, I was at a 2.
3. Is it warm to the touch?* This one requires taking a bit of care if the wound is fresh. You really don't want to stick your fingers into an open wound. During this assessment, however, it had already scabbed over, so I didn't need to be as careful. DON'T EVER PICK AT A SCAB ON YOUR LEGS AND FEET! You'd only be inviting more bacteria into the wound. This one is a little tricky for me. My wounds often don't feel any warmer than the rest of my leg. But if I elevate my leg and allow the blood to flow properly, my wounds can wind up feeling very warn indeed.
4. If there's fluid leaking from the wound, what color is it? Clear fluid, like that which comes from a blister, isn't too worrying. White pus is an indicator that it's getting more seriously infected.
5. Is there swelling? This one's tough, especially if you're an older diabetic with any degree of water retention in your legs and feet. Your clearest indicator will be if the wound itself is raised. If you can't tell, simply move on.
6. Is there a foul odor? If you can smell the wound at all, things aren't good. So...
7. Check for a fever. Most hospitals define a fever as 100.5 F (38.06 C).

Depending on severity, any one of these things can require you to drop everything and head for the nearest hospital. But for me on that day, there was nothing that made me panic. Red, mildly painful...? Meh. I contacted my PCP through the patient portal with his office and reported the wound. The next day, an antibiotic was delivered. No muss. No fuss.

For the record, regardless of the severity, if you are concerned about the state of a new or new-ish wound, call your doctor if it's daytime, or head to the ER if it's night. Better to be a bit overly cautious than under-cautious.

I basically treat all of my wounds the same in terms of dressing them. If small enough, I'll use gauze with two adhesive edges. Even if it claims to ne "non-stick," I use some antibiotic ointment to prevent a scab from sticking to the dressing, because they'll sometimes do that regardless of the claims on the box.

But sometimes these dressings can be finicky. My skin is dry and flaky, so the edges of the gauze can start to lift up. My solution - and I really should stop doing this - is to apply a little medical tape to hold it down... which is exactly what I did on Sunday. When I went to change the dressing, the tape I'd used to hold it down ripped off a chunk of skin!

Diabetic blisters. I've mentioned them a couple of times. Their cause is unknown. They just show up to become a health hazard. The blisters that I develop start off in stealth mode. The area is flat, but with a little probing I can feel the pocket of fluid underneath. Because there'd been fluid between the layers of my skin, the tape ripped off the topmost layers on Monday.

I live alone. I don't even have a pet. But that doesn't stop me from vocalizing my frustrations. Not "verbalizing." No, that would require intelligible words. Instead, I start swearing like Fred Flintstone. Basically a lot of grumbling and growling.

Great. More holes in my flesh to worry about. Diabetes mellitus really is the gift that keeps on giving.

Which brings us to this morning. Time for a fresh dressing on all of the holes. And while inspecting the area around where I'd ripped off that patch of skin, I could feel more fluid underneath. The surface hadn't bubbled like a proper blister, so how was I to know that it would burst? And burst, it did! Just a copious jet of stuff exploding and dripping down into my sock.

This. This is a spectacular day. 

Now I have two separate areas of my lower leg with gauze over them, and I was smart enough to use an old ace bandage to hold everything in place... or so I hope. The problem with using an ace to hold the gauze down is that there's nothing holding the elastic in place. Thus, it can slip up, down, or even around my lower leg.

It wasn't all that long ago that I was ignorant of diabetic blisters. I wasn't affected by them, so there was no reason for me to know they even existed. Once they started, however, they wouldn't give up. Sometimes I get a few months reprieve, but they always come back.

What's my current status? I've called my doctor's office to request "the big guns." The area where the skin came off looks dark and ugly, and it's stinging quite a bit. I don't want to play any games with it, so I asked for a stronger antibiotic.

Meanwhile, if any of you are diabetics that aren't controlling your blood sugars, know that exciting nonsense like this awaits you. Take my words to heart, not Cookie Monster's.

But we do, Cookie. We really do.

"Happy" Anniversary

Let us all raise a glass of something sugar free and toast this momentous time. It was 48 years ago - not to the day - that I was diagnosed with Type 1 diabetes mellitus. We were into the second week of second grade when I was rushed to the hospital, but no one was marking the day on their calendars, hence this anniversary being an approximation.

I wrote about my diagnosis already, but I don't think I covered my feelings very well. To this day, as clear as it could ever be in my mind... I don't remember much. I was a kid. I was confused at the fuss being made over me. Mr. Hypo is My Friend did nothing to improve my understanding. I knew whatever was happening was serious because, like my older brother who'd had leukemia, hospitals were reserved for serious illnesses. The explanations that followed over the following week in the hospital only impressed upon me that being a normal kid wasn't going to be possible.

Actually, now that I think about it, I recall feeling "special." Mine was a fairly populace town*. (According to the Census Bureau, as of April 2020, its population was 18,613, which was actually down a couple hundred from 2010.) So let's round the number down by 2,000 for 1974 and say it was around 16,000 as a guesstimate. (OMG! "Guesstimate" is an actual word?!? I was expecting a little red line beneath it to say I'd abused English again, but NOPE! It's a word. Whodda thunk it?) That's a fairly well-populated area*, and I was the only Type 1 diabetic as far as I knew. That made me... more awesome? 🤨

Again, I was seven. I didn't know anything. Beneath the thoughts of being unique - which I certainly wasn't - was the ongoing thought that I'd have to remind the adults around me that all of the garbage I used to love to eat were no longer permitted. I HATED that I had to remind them, but if I didn't, the incubator would, and then a different adult would be reprimanding me with, "Why didn't you tell me?"

And would you look at that? What followed that fateful September and its major alterations to my life? HALLOWEEN! I can remember an old Super 8 film of my cousin and I at age five, dressed up in cheap Batman and Superman costumes. The ones with the mask held on by a flimsy rubber band that would slip from the staple that held it in place after the mask was removed/lifted half a dozen times. We'd go house-to-house with an old pillow case until we could barely stand. And then... And then... 

Yeah, Halloween sucked. Absolutely - 100%, with nary a doubt in my mind - sucked.

Thankfully, Dad took some of the sucky-ness out by offering up a trade. He would give me five cents for every piece of candy I collected. Six or seven dollars was a fortune to a child, so at least I had "wealth" to assuage my upset with Halloween. And to my benefit, Dad would always round up to the nearest dollar.

My feelings now...? I wish I had a time machine so that I could go back and set my young self straight. "It's bad, but not that bad. Diabetes is an inconvenience, not the end of the world. Take your insulin as prescribed. Follow your diet. When home glucose tests become available, do them. And for the love of all the gods in every known pantheon, a pound of Twizzlers does NOT make Stephen King novels better! Stay out of the hospital. Yes, your home life is a nightmare because of the incubator, but 18 isn't really that far off, and nurses being nice to you in the hospital isn't actually 'better.' Odds are pretty good that they're telling one another that you're a moron for making yourself so sick, and that you'll pay the price later."

That would just be the beginning. Given the power of time travel and a few hours, I'd tell that stupid kid all sorts of things that would help him avoid being declared disabled by age 33.

So what would you tell your younger self? Would you focus on your health? Your financial situation? The girls/women you should avoid or keep in your life? Which employment path is the best? Our would you just show them how cool videos games will get down the line?

As I bring this post to a close, I've decided to give the beautiful, scantily clad young woman a break to play a bit of Never Have I Ever... Play along if you'd like.

My actual score is 1.

The Good, the Bad, the Ugly... and They All Went to Med School

When I sat down to write this, I was hoping a word rhyming with "ugly" would come to mind that was relevant to the subject. Alas, my Muse is apparently on holiday.

As mentioned in my post a few days back, I thought about covering good and bad doctors. It then occurred to me that there was at least ONE that I encountered that would qualify as "ugly," because he was a good doctor, but was motivated by something other than helping sick people.

So let's look at "the good." I've had a number of very good doctors in my life. Hey! This is the perfect place for a list!

1. They should have gone to medical school. (I said at the very beginning of this blog that I would infuse it with humor! That you made it this far is YOUR doing!)
2. They should listen to your complaints and concerns without preconceptions. When I visit a new doctor and explain that I've only had success addressing my neuropathy pain with tramadol and they flat-out declare that they don't prescribe narcotics under ANY circumstances, I can't leave their office fast enough. They have this preconceived notion of "Narcotics bad!" My resulting judgment? "Doctor bad."
3. They suggest alternative treatments. Not "alternative," like essential oils or realigning your aura. I'm talking about treatments other than what you might have already tried. Like with the giant crevasse in my foot. The second wound specialist I saw suggested amputation out of the gate, but also suggested I consult a surgeon to see if there was another option. When I did, the surgeon suggested cautious optimism and exploratory surgery, not jumping to "lopping off my foot" as the only viable solution.
4. Good bedside manner. You don't have to be in a hospital bed to experience bedside manner. This is the doctor's general demeanor. Maybe you prefer a doctor who is extremely serious all the time, but I like them to have a sense of humor. At one point or another, I'll test them. If they can't even muster a smile, I'm never going back to their office.
5. COMMUNCATION! I don't know how many times I've brought up talking to your doctor openly and honestly, but communication is a two-way street. They need to be able to voice their own concerns about treatments, as well as ensure that you - the patient - understand what they're saying. Don't ever say that you understand if you don't! If the doctor needs to spend an extra five minutes explaining things to you, so be it. 
6. I can't believe I have to mention this one, but experience has taught me otherwise. Make sure they do an exam! I was actually discharged from an emergency room without ever seeing the doctor AT ALL! I'll tell you more about him in a short bit, but you've already read about this jerk in an earlier post.

I'm almost certain I'm missing a few things in there, but those are the basics.

To exemplify "The Good," I'll use a little anecdote about my current PCP. (Did I already use this one? I can't remember.) He ordered all sorts of tests. Blood and urine. No studying required. I was given the results by way of the patient portal. Looking over them, I took out a pad and made notes about those results that were highlighted in yellow. Even my Hgb A1c was yellow, even though it was 6.4. It's excused because the testing system isn't assuming I'm a diabetic. Because I am STILL not a doctor, I had to Google some of the tests to get an basic understanding of what the results meant. I mean, one test was labeled "Occult Blood," and I haven't sacrificed anyone to my Dark Lord in years!

Oops. I may have said too much. 😬

After every single one of my notes, I scribbled, "Cancer?" Yes, I included the A1c and the Occult Blood. (Occult Blood looks for blood in urine that may not be visible to the eye.) So when I followed up with him, I pointed out that I looked everything up and the online diagnosis was cancer. The highlights, of course, were the Occult Blood and A1c. For the former, I believe I said it must be demonic cancer. For the latter, I declared that I obviously had diabetes cancer... and cancer of the diabetes is very, very serio... It's silly. It's very silly. And the doc got a good laugh out of my shtick.

"The Ugly" is more of a story than a list, and so far there's only one doctor that ever qualified for this one.

I developed a kidney stone. After an ER visit and a CAT scan, I was sent to this guy because he was affiliated with the hospital. The stone I had was 3 x 7 mm. The male ureter - the tube where waste passes from your kidneys to your bladder - is about 4 mm. My stone was going nowhere without help.

The doctor I saw ordered some extra tests, including one where a camera was sent up through my... ummm... 

~ medical terms, Rob... think medical terms ~ 

...up through my winkie to look for any indications of stone damage or something. To be honest, I was too distracted by pain from the stone or too foggy-headed from painkillers to take notes. In the end, I saw him four times over a month and a half, including the procedure to look inside, which is considered surgical because I absolutely refused to be awake for that event. (I told him I didn't want to be conscious for that one, but he managed to not make a note of it, so I actually wasted a visit to his office, where he was prepared to do it in office, and I had to use little words that I use to explain to the simpleminded that that was NOT happening.) It was on the fourth and final visit to discuss the results of the procedure that he said, "You're going to have to go see a different doctor to get the stone out. Our hospital doesn't have the equipment to get it out."

I left his office utterly flabbergasted. He knew the size of the stone from the start. He knew his hospital didn't have the equipment needed to break up the stone and remove it. He knew the stone was causing me a lot of discomfort. But he saw me FOUR TIMES?!? Why? Well, that was obvious. To milk Medicaid for all the money he could get. Really, my visits tended to be very short, so he could bill them for his incredibly inflated fees for a three to five-minute visit. Only the procedure took longer, and his fee would be mixed in with everything else the hospital would bill insurance for.

Mind you, I'd been dealing with this stone for TWO MONTHS by the time he told me this. So he was a good doctor in that he knew what he was doing and was very friendly doing so... but became "The Ugly" with this final revelation. He also leans into the final category, since being motivated by money is obviously bad.

Now we come to "The Bad." Gods above and below, where do I even begin? I've met so many bad doctors in my lifetime that I think I've lost count. So I'll tell you about the first, one in the middle, and the most recent.

I was too young to understand what Dr. Needles had done during my diabetes diagnosis, so the first bad doctor I encountered was an attending during one of my numerous DKA hospitalizations. I believe I was around 15 at the time, and he'd prescribed bedrest for me. This was a first, so I asked why. His response was, and this is a startlingly clear memory in my head, "You're too stupid to understand why." And with that, he walked away.

For every action, there is an equal, opposite reaction. And my reaction was to call my dad, who in turn called the hospital with barely contained rage. Surprise, surprise, Dr. Snark was back two hours after his initial insult to apologize and explain that being up and about would only help the high levels of acetone in my bloodstream do more damage. I'm sure it was a shock to his ego when I told him that I was apparently NOT too dumb to understand.

The middle "doctor" is the one that treated me like a drug-seeking addict when I had that severe pain in the ball of my foot. (See my 13 August 2022 post, It Runs Deep.) Well, I wound up with this jackass again during an incident with my chest catheter. There was a build-up of pus - albeit very small - around the tube, and it had started stinging rather badly. The home nurse told me that her guidelines didn't allow her to see me if the catheter was becoming infected and instructed me to go to the ER. So I did, and Dr. Arrogant was the one assigned to me.

He never even came to see me visually! Sight unseen, he discharged me from the hospital. When I refused, I actually HEARD HIM proclaim to another staff member that they weren't a fast food join, so I don't get to have it my way. He then had security summoned to escort me from the premises. 

This did not bode well... for him. I allowed security to escort me out of the ER, and then to the nearest hospital administrator, where I had me a well and good heated rant. I pointed out that this particular ER doctor might very well be the cause for my osteomyelitis, which the chest catheter was being used to treat, and to discharge me without even SEEING me was fertile ground for a malpractice lawsuit against the doctor AND the hospital.

In an instant, I was treated like royalty... or as close as I would come to being treated like royalty. The administrator escorted me back to the ER and had a different doctor examine the port. I was entirely too angry to remember the rest of the visit, and I don't know what actually happened to Dr. Arrogant. At the very least, I'm hoping he was sent back to med school to retake the class about bedside manners. At the most, I hope he was dismissed with prejudice and wished well with his future as a janitor.

The final bad doctor I saw was a pain specialist. What makes this one special is that he was a bad doctor before I even made it to the office! I was referred to this pain specialist by my PCP, and a question was immediately relayed back to me through my PCP's office. "He understands we don't prescribe pain medications, right?" Yes, I was fully aware.

They immediately set up a hoop for me to jump through. My last spinal MRI - magnetic resonance imaging - was over a year prior, so they said another would be required. I deemed this so important that, instead of relying on public transportation, I took a cab to and from the hospital. With the test done...

No call from the pain specialist's office to schedule an appointment.

So my PCP's office called them again, and the pain doctor's office asked, "He understands we don't prescribe pain medications, right?" Yes, I still understood.

Still no call to schedule a visit.

My PCP called them a THIRD time, and Dr. Deaf's staff asked, "He understands we don't prescribe pain medications, right?" YES! GODS ABOVE AND BELOW, I'M LOOKING FOR TREATMENT OF PAIN, NOT A FIX! It's a safe assumption that if I was looking to get high, I could find a source on the streets that's a lot easier to access than this damn doctor's office!

To think, it only took three requests to get them to call me to set up an appointment. Again, I deemed this important enough not to rely on public transportation. I got there early enough to fill out all sorts of paperwork, including one that specified that they don't prescribe pain medications.

I was ready to use my go-to declaration of frustration, "You people are giving me cancer!" 

When the doctor arrived at the exam room, I was tempted to hold a mirror under his nose to see if it fogged, what with signs of life being rather important. (I should probably have included "be alive" as one of the traits of a good doctor.) He then proceeded to talk to me like I was a child learning shapes. When I said I understood something, he'd go on explaining further, almost like I hadn't spoken at all. When I did try to communicate my concerns, he would interrupt to say other things that had entered his head.

He was very nearly scraping the bottom of the barrel, when he finally shut up and began his exam. My primary complaint for seeing him was the perpetual pain in my lower spine. He tapped that area fairly gently, but I still jumped from the pain and joked about what he just did qualifying as "assault." He immediately stopped his exam to explain quite seriously why it wasn't assault. And I... was done. Even though he said he could probably treat my pain, he had evaporated any trust I might have had in him. I mean, when you go to see a new doctor, you have to have at least a modicum of trust, since they're likely going to touch you in places no other stranger would have access to the first time you meet them.

There you have it, ladies, gentlemen, and children of all ages. Just a little bit about good and bad doctors. "Just a little bit." Because in all honesty, I could tell you more stories the bad ones. The callous pain doctor that brought me to tears with his apathy. The doctor that fabricated her reasons for releasing me from her care. The doctor that threatened to spank me for my sense of humor.

No, wait. That last one was one of the good ones. 😁

Seriously, her staff bought her a paddle for her birthday as a joke gift for misbehaving patients and staff, which was written on the paddle! She pulled it out after we got the results of an AIDS screening. There was no real reason for doing it, but when it came back negative, she demanded I keep it that way, and I joked, "No promises." Out came the paddle! 🤣

Oh... and a little edit of information. Remember in my last post, how I ranted about the annoyance of glucose testing supplies being undeliverable? I learned that the legislation was reversed a month ago. So one of the main reasons that I, a BK amputee, worked so hard to get the scooter was eliminated with absolutely no fanfare whatsoever.

Now, I know I've been promising the beautiful, scantily clad young woman for many of my posts. Well guess what I found on the internet!

Boobies!

I know, boobies are all over the internet,

but this includes baby boobies!

Wow, that sounded bad. Apologies.