When Diabetes Is "the OTHER" Problem

Hey, y'know that disease called diabetes? I certainly HOPE you do. This blog has been all about that silliness. Well, I've mentioned at some point or another that mental illness comes with chronic illness. It's part and parcel for the whole thing. And usually that mental illness is depression. "Why me?" becomes something you ask consciously or unconsciously almost every day. And, boy-howdy, does it suck! What I find most odd is that it's not called "diabetic depression." They tack "diabetic" on as a descriptor for almost every other thing that comes with the illness. Why does depression get left out?

After 48 years of Type 1 diabetes, I practically do everything required to maintain it as though I'm on autopilot. I've set alarms to keep me on that schedule I mentioned last post. When one goes off, I stop what I'm doing, check my glucose, take some insulin, eat a meal, and then go back to whatever it was that I was doing. (Performing these rituals is how I wound up turning "diabetes" into a verb. "Hang on a sec. I have to diabetes.") It's barely an existential speed bump in my day.

But staying on top of my OTHER medications... I wish it was that easy. Get the pills and divvy them up into the three-week pill container I have every third Saturday. This seemingly simple task becomes so arduous in my head. That's my severe recurrent depression in action. And so I fail to get that pill division done, fail to take them regularly, and before I know it those medications have lost their efficacy.

The big one... Well, antidepressants need to be built up to their therapeutic level. It takes four to six weeks for that to happen. What's more, the full dose shouldn't be given at the start. You have to build up to that dose. So it's 10 days at half a tablet to start, 10 days at a full tablet for stage two, and then another 10 days of one and half tablets to reach the full dose.

That said, my pill container only handles three weeks at a time. So I'm still struggling to reach that therapeutic level when it's time to refill it, and... "Oh, why bother? It doesn't matter anyway. No one really cares about me, so why should I work so hard at setting up my pills?" Yeah, that's my depression still holding sway.

I'll let you in on a little secret. I'd say 99% of this entire blog has been written while under the harsh effects of my mental illnesses.

Oh, yeah... Severe recurrent depression isn't my only psych issue. I'm also dealing with PTSD, which is the culmination of several events that either keep me awake all night or make me jump out of my skin while letting loose a scream of terror.

This morning, after taking my 24-hour insulin, (which only works for approximately 20 hours), I looked over at my empty container of other daily meds and... I just wanted to cry. Accompanying the urge to let the tears flow came the fun and exciting thoughts... "I don't care. It's not like missing those meds will cause me to suffer a painful death. Well, maybe my heart meds. I hear heart attacks are pretty painful. But maybe I'll get lucky and have one of those 'instantly fatal' heart attacks. The end. I can stop worrying about... well, everything. No bills. No scheduled medications. No having to put on an act so people think I'm happy and friendly. It can all just end and I can finally get some rest. And who knows? Maybe Heaven, (which I don't believe in), is as depicted in Supernatural. Everyone's Heaven is different. In mine, I'll be fit and healthy... and I'll be younger... and there'll be girls, and movies, and girls, and video games, and girls, and good food, and girls, and visiting D&D nerds to play with, and girls, and comfortable clothes, and girls, and really nice furniture, and girls... Yeah, staying alive is for chumps." 

Looks like nearly five years of being a bachelor is having a bit of an effect on me.

Such thoughts then begin to spiral. What comes next? Approximately 1,000 regrets from my decades of life come to mind. As I dwell on those, the short list of girls I had SERIOUS crushes on in high school pop into my head for a soul-sucking visit. And, hey, while I've got high school on my mind, how about remembering all of the abuse I suffered at the hands of the incubator? Oh, and here's a favorite memory: that job I absolutely LOVED and busted my butt to become an assistant manager, only to be rejected because I didn't suck up to the district manager, and the final result was him not only telling me that I did NOT get the job, but then gave me an absolutely insulting raise of $0.05 per hour for all of my hard work. Makes me wish I'd beaten him with a sack of hammers instead of quietly walking out of his office.

My mind is a playground for the morbidly obsessed.

I don't know if I've mentioned this previously, but I once told my doctor that I'm simply waiting for death. It's not that I'm actively suicidal. I just don't care anymore. And as I wait to shuffle loose this mortal coil, I don't want things to hurt. That's it. Like self-imposed palliative care, I just want to be comfortable while awaiting my demise.

That's why I take such great care of my diabetes. Because NOT taking care of it is a bad way to go. Too much discomfort.

The best part...? The cherry that sits atop this existential sundae made of psychological garbage... is that the complications of my diabetes are constantly reminding me that I could be so much healthier if I'd taken proper care of myself from the start.

Now... Who's in the mood to party?

No one, eh?

Okay. Maybe it's time to end this post. And to lift your spirits, here's a sign that should have mentioned juvenile diabetes instead of... Well...

I say we beat the little rugrats unconscious!

To My Type 2 Diabetics... Again

I'll start with an apology. I'm sorry if you feel left out. When I speak about bending the rules of a diabetic diet, many of you can't do what I suggest. You're probably on oral medications and a far less forgiving diet.

Or are you? 

Okay, let's start with my repetitive reminder: I AM NOT A DOCTOR! I've read a lot of stuff. I've made some reasonable leaps in logic. I have decades of experience as a Type 1 diabetic. So if you read medical advice from me and act on it without consulting your doctor, that's on you.

With that said, maybe you should have a sit-down with your doctor and ask if moving from oral meds to insulin injections would grant you more freedom. Obviously it would best if you simply followed instructions. A large portion of Type 2's are overweight, and the best course of action would be to lose weight. But that's a big ask when you're older and so out of shape that diet and exercise look like an insurmountable task.

Mind you, my first instinct is to tell you to try and lose the weight. No, it's not easy. But if you can afford to buy healthier foodstuffs, then please give it a shot. Because if you succeed, you'll get the natural high that comes with achieving a difficult goal.

If your doctor agrees that switching to insulin would be better for you, you need to understand that you cannot take this change lightly. You're not on the strictest timer in the world, but you better have a scheduled range in place of when to take your insulin regularly. Here. Have another list, this one of the time ranges for my insulin doses.

1. Breakfast: 6:30 - 8:00
2. Lunch: 12:00 - 1:30
3. Dinner: 6:00 - 7:00
4. Bedtime: Wildcard!

"Wildcard." This is my only one that isn't scheduled all that strictly. That's because bedtime could come between 10:00 and 1:00, and there's a sizeable gap between that dose and breakfast. But this is the dose that I'm the most careful with. No cheating with my evening snack. If you read my post about The Somogyi Effect, then you already know this dose is a balancing act. As careful as I am, I still manage to screw it up quite often.

The main point is that you have to take the switch to insulin VERY seriously. A poorly planned meal or dose could see you struggling with glucose readings that swing wildly up and down.

Let's look at two different dates on my glucose records.

The first is the day after I saw my doctor to receive a steroidal injection for, of all things, tennis elbow. How'd I get tennis elbow? No clue. I don't even know where a tennis court might exist where I live. But steroids do goofy things to one's blood sugars, so this is what 12 November 2022 looked like:

1. Breakfast: 273
2. Lunch: 360
3. Dinner: 277
4. Bedtime: 154

That was a rough day. I struggled all day to get my blood sugars in line, and was only partially succeeding toward the end of the day.

Now let's look at a more typical day. This is 22 November 2022.

1. Breakfast: 316 (As mentioned, I still haven't perfected avoiding The Somogyi Effect.)
2. Lunch: 75
3. Dinner: 165
4. Bedtime: 112

Timing. Care. Awareness. These are things that you need to keep in mind when taking insulin.

I have a friend from way back in high school that became a Type 2 diabetic, and he's on insulin now. He tells me how he takes 2 or 3 units per meal, and the tone of my voice switches to that of an adult addressing a child. "Awww, wook who's a big boy, taking his cute wittle insuwin dose." But that small dose is exactly what he needs to keep his glucose levels in line. Does he have it down perfectly? No, but he's trying. I think he said his last Hgb A1c was around 8.0, which isn't good, but far from the worst I've ever heard.

In my educated OPINION, your A1c is going to be your biggest indicator as to whether or not you should be on insulin. If oral meds aren't keeping you between 6.0 and 7.0, then your control might tighten up a lot more with insulin. TALK THIS OVER WITH YOUR DOCTOR!  My "educated opinion" means squat because I don't know your medical history, and I haven't been to med school.

And so we come to the close of yet another blog post filled with what could be excellent advice, or some of the dumbest words to ever come out a guy who thinks he's smart.

I think it's time we brought back the beautiful scantily clad young woman that I used as my shtick in my earliest posts. But this time...

Here she is, scantily clad

at last.

But this is as scantily clad as she ever gets. If you want more of my opinion about her and her "modelling," you'll have to ask. And we all know how that one will play out. 😛

Time for Me Time! (Or You Time.)

Okay, confess. How many of you Googled "kewpie doll" after the last post? C'mon, don't be shy. "I won't point and laugh," he said, pointing and laughing.

This blog about diabetes has been focused on a lot of doom and gloom. You shouldn't do this! Don't do that! You need to worry about the other thing! It really sets a person up for Failure Mentality. That feeling that the goals set in front of you are impossible to reach, so you might as well give up and embrace oblivion.

First, let me revisit the fact that diabetes is a pain in the butt. You have to keep an eye on your blood sugars, take your medication in a timely manner, and see your doctors regularly. There's also a lot of information about the disease that you should keep in mind. If you're young and relatively healthy, you have to think about how something like a lengthy bike ride might affect your blood sugar. If you're older and less mobile, like me, then you're trying to calculate the exact dose of insulin to take with every meal, because changing up our carb consumption is going to be too difficult at this late stage. Without a doubt, it's a mental juggling act.

Unfortunately, you can't ignore those aspects of diabetes. If you do, then feel free to reread all of the aforementioned doom and gloom, and then brace yourself for them to become a reality.

But if you can get a handle on your diabetes and keep your Hgb A1c between 6.0 and 7.0, then you have wiggle room to live a little more freely. Because truth be told, I'm a diabetic with a sweet tooth. And I cheat on my diet DAILY! 

"You want to know what the best junk food is? Ask a diabetic." I have been telling people this for decades. My latest favorite cheat? Cinnamon bears. Soft, chewy, tongue-tingling cinnamon bears. Mmmmmm! I could probably sit to watch a movie and polish off an entire bag.

But I don't. I can't. WE - you and I - CAN'T. That would be a guaranteed visit to the hospital, as well as the extreme discomfort of being sick enough to land there. So how do I do it?

I start with the near-ancient diabetic exchange diet. 15 grams of carbs = 1 piece of bread. I take a fixed number of units of insulin for each "bread" that's in a forthcoming meal. So if a label says there's 46 grams of carbs in the meal, I'm multiplying my dose per carb by three. (I'm not sharing actual numbers because I am EXTREMELY insulin resistant and take A LOT of insulin.)

If you're not seeing how I cheat, then I'm getting a solid gold kewpie doll and dropping it on your foot.

Okay, I'll explain anyway.

My dietary cheating comes with meals, and ONLY with meals. Taking randomly timed doses of insulin throughout the day is a quick way to wind up in a diabetic coma. (Have I even discussed insulin peak times? Let me know.) (See what I did there? I made a funny. Because no one comments. Ha-ha.) Having read the labels of my upcoming meal, I also read the label of what I want to cheat with. Those cinnamon bears of mine are pretty big, so three of them equals 22 grams of carbs. Six bears will be close enough to 44 grams, so I add three more "breads" to my insulin calculations. Now I'm all set for a meal and some dessert.

"But Rob... What if I'm out to eat with friends and want some cake or ice cream after a meal?" 

If you're keeping your A1c between 6.0 and 7.0, then you know your body pretty well. For a small serving, take at least enough insulin to cover one "bread." For larger servings, make it two. Later on, when it's time for that final test of the day, take a dose that covers any potential fallout from your cheating session.

Now that I've taught you all how to cheat on your fairly strict diet, let's get a few things straight.

1. If your Hgb A1c has been 7.1 or higher, don't cheat. Just don't. You need tighter control than that to live more freely. I haven't gone over 7.0 in... Okay, I'm honestly losing track, so let's say seven years. That's why I allow myself to have some fun with my diet.
2. Don't consult your dietician or endocrinologist for permission about this. No one is going to approve of you cheating on what's supposed to be a strict diet. They'll never say, "Sure, play Russian Roulette with gummy bears!" 
3. That said, when you bring your records to the medical professional trying to help you manage your diabetes, if there are upswings in your glucose that are a result of cheating, admit that and explain that that's why your sugar jumped so much. Better they should know than start thinking that you need major adjustments to your care, and they should be impressed with your honesty at the very least.
4. DO NOT, UNDER ANY CIRCUMSTANCES, DO ANY BINGE EATING USING THIS CHEATING METHOD! This is not a free pass to go nuts with all of the things you shouldn't be eating. Diabetes management is still a delicate dance of medication, diet, and exercise. Binge eating is the equivalent of entering a mosh pit. Don't do it!

I think that covers all I have to say on the subject of cheating on a diabetic diet. So now it's time for the glorious ending of my post, where I say or do something silly.

With winter coming in, I'm completely 

with Bernard, Destroyer of Worlds.

We Don't Get Off That Easy

Once you've managed to mismanage your diabetes long enough, everything medical is almost assured to be a lengthy drama. It's the nature of the beast. The main culprit is going to be all of those microvascular structures that have been effectively strangled by sugar.

Have you guessed where I'm going with this? Are you guessing, "infection"? If you are, then you win a kewpie doll! And if you asked yourself, "Is this another dentist thing?", then you'll find a silver nugget inside your kewpie doll!

I'm an absolute stickler for following a doctor's instructions. So when all of those teeth were removed, I avoided solid foods, carbonated drinks, using a straw to drink (like that was something I did regularly), and rinsed with warm salt water post-extractions. 

Here's the thing... Humans are inherently dumb. We do dumb little things regularly. When I'd swallow, my tongue would press against the hard palate of my mouth. Doing so made the point where the front tooth had been removed hurt intensely. So what did I do on the regular without even thinking about it? If you guessed "poked it repeatedly with the tip of your tongue," then the silver nugget inside your kewpie doll will be twice the size of the original.

Because this kind of thing is so "fun," poking it made me cry out in pain every time I did it. Mind you, I wasn't consciously doing it. It was as though my brain needed constant reminders that I still hadn't healed properly. And what's the most feared of all conditions post-tooth-extraction? If you guessed "dry socket," the silver nugget inside your kewpie doll will be replaced with a small gold nugget.

Of course I looked up "dry socket" on Google, looked at a few pictures, and then hopped to the bathroom to take a look. (I have one foot; I don't run anywhere.) Now... What have I said numerous times on this blog? That's right! I'M STILL NOT A DOCTOR! Let's enlarge that gold nugget inside your kewpie doll for getting that one correct, shall we? My immediate assumption was that I had dry socket. The weird part was that it wasn't nearly as agonizing as advertised. Dry socket is supposed to be INCREDIBLY painful at all times. Mine just hurt when poked.

So I called the dental clinic and said that I thought I had dry socket. I offered to avoid coming in if there was a simple solution that could be prescribed at my pharmacy, but the dental assistant I spoke with said dry socket usually occurs within a few days of the extraction and I was calling in the problem 11 days after the fact. I should definitely come in to be assessed.

Remember when I mentioned my previous "emergency" appointment was set three weeks out? Take a guess at how soon they could see me now. Did you guess "same day"? Double the size of the gold nugget in your kewpie doll if you did! Unfortunately, for me to arrange medical transportation, I need 24 hours, so I scheduled for the next day, which was 15 November 2022.

Meanwhile, I was in touch with my PCP about pain management again. Why my PCP and not the dentist? Because it's best to have ONLY ONE DOCTOR managing your pain medications at all times. If you start getting narcotic pain medications from multiple sources, even if it's for documented, legitimate pain, on paper it will look like you're displaying drug-seeking behavior. That's a red flag to other doctors and pharmacies. And in this age of computers, different pharmacies will know if you've received opioids from another dispenser of such medications.

It makes all of the silly conspiracies about tracking chips in vaccines seem incredibly nonsensical. 

The dental visit was short and sweet. The socket was healing just fine, but there was a visible spot of irritation at the tip of my hard palate that indicated I still had lingering infection. Remember that a lot of pus drained from that tooth when it was removed, so residual infection wasn't unexpected. And if you'd forgotten that this post was about infection, I'm afraid I'll have to revoke your kewpie doll.

Without fail, diabetes was part of the wrap-up discussion. "Diabetics are notorious for healing slowly." You might as well get used to hearing that one, since you'll hear it to the end of your days. Cuts, bruises, surgeries... Every medical professional you encounter will assume your recovery will be longer than expected because of diabetes.

So what have we learned, folks?

1. Infection is practically a way of life for diabetics. Seriously, how many times have I brought this up in this blog? Altered microvascular structures limit blood flow to affected areas, making healing exceptionally difficult.
2. Pain management from one source, and ONLY one source. If you're "doctor hopping" in an effort to get painkillers, you need to stop and examine your life, as you may have another serious problem besides diabetes.
3. I have an unnatural desire to stuff precious metals inside kewpie dolls.

And now... Boy, do I have a treat for you! Wait, what?! "A kewpie doll"?!? No one actually gives those out as prizes anymore. No, what I have is a prime example of the kind of hairstyles I grew up with in high school! You're going to love it!

Hair that teased so much that it's pissed!

"Dentist!"

It seemed suitable to give this post the title of one of my favorite songs from Little Shop of Horrors. It's also entirely possible that that very same song is the reason why I fear dentists. Oh, there are plenty of other reasons, but I'm not focused on those. And I'm sure they're out there somewhere, but I personally don't know anyone that's thrilled to go to the dentist, even if all the dentist says, "Looks great. See you in six months."

But those broken teeth of mine needed to be addressed. It was an "emergency" appointment that was set about three weeks from when I called. Nothing quite like a clinic that's overworked and understaffed. And when I initially called, it was the broken tooth to my lower left side that was the issue, causing so much swelling that it could be seen by looking at my cheek! Blessedly, antibiotics cleared that one up.

That's when the broken tooth along the upper front decided to start hurting. And hurting... and hurting... AND HURTING! More antibiotics and MANY more painkillers.

The thing about dental pain is how pervasive it is. It doesn't just hurt at the site of the problem. The pain radiates outward, causing severe pain all over your face and neck. I kept trying not to take 20 mg. of oxycodone every time I started to hurt, even though that would be the final dose in the end. A half-tablet taken every half hour, 5 mg... and 5 mg... and 5 mg... and 5 mg... It was stupid to take it this way. It made tracking when it was safe to take my next dose nearly impossible. Every four hours at the SOONEST! And, stupid me, I'd start the ritual all over again, thinking, This time it'll be different! This time a lower dose will work just fine! Nope.

I saw the dentist on the 3 November 2022. By then I had refined my pain management, taking 10 mg. every half hour and still landing on 20 mg. Because I'm, like, Einstein levels of brilliant. At night, my body was "flirting with a fever." No one would call 99.3 F (37.38 C) a real fever, but it was an indication that something was brewing, especially when my mean temp is lower than 98.6 F/37 C.

So the lovely dental assistant came in, took a couple of x-rays, and - 

Okay, when did x-ray machines become hand-held portable cameras? And does this speak to the speed of technology or to how infrequently I've gone to the dentist? What's more, the pictures were INSTANTLY on the laptop on the counter! I was like a Cro-Magnon man pulled into the future and seeing a wheel for the first time!

The doctor came in, looked at the x-rays, and informed me that the two teeth beside the broken tooth on the side were also beyond saving and preparing to shatter. After a quick chat, it was decided to remove four teeth. The shattered one up front and the three on the side.

LET THE NUMBING BEGIN!

I couldn't feel my left jaw, left side of my tongue, and the left corner of my lips. I also couldn't feel my right nostril, upper gums, and right side of my lips. But the infected tooth still hurt. GODS ABOVE AND BELOW, IT HURT!!! It hurt so much that I was sweating, moaning, and instinctively guarding my mouth with my hands! The doctor tried giving me more anesthetic, and while inserting the needle itself didn't hurt, the moment it got close to where the pain resided is when I cried out.

The doctor couldn't understand it... yet.

Deciding to give the lidocaine a little more time to take effect up front, he went after the side teeth. No problems there. All pressure, no pain. He stitched up the site and moved on to the front tooth.

Post tooth removal, he said that a lot of pus came out. The dental assistant added that when the dentist started applying pressure to get a hold of the tooth fragments, pus was being squeezed out of the sides. In other words, that tooth as SUPER infected! It explained why they couldn't numb it. And it continued to drain afterward. I know because the gauze they gave me to press against the site was decorated red and yellow.

Yes, I agree. EWWWWW!

So why bring this up in a blog about diabetes? To demonstrate that we are like walking, talking Petri dishes when it comes to infection. In rapid succession, I was now on my second round of 875 mg. amoxicillin. Despite this, I had an abscess growing beneath the tooth.

We become complacent when it comes to infection. That's because the most common infection is a break in the skin. You feel it, wash it, and maybe put a band-aid on it if it's still bleeding. But if you leave it uncovered... Well, whaddaya know! It gets infected. Some topical antibiotic and band-aids to cover it, and soon you're on the mend.

But what if you can't treat it topically? Like an abscessed tooth. We've come a long way in terms of medicine, so it has become less frequent, but even a dental infection can kill! Look it up if you don't believe me. Just type "dying from abscessed tooth" and marvel at the results. And common breaks in the skin that go untreated can become septic. Septicemia is when your blood is poisoned by bacteria. Or put it this way: your BLOOD becomes infected!

There is so much to worry about. It can be overwhelming. It can even be terrifying. But my goal isn't to turn you into quivering piles of jelly that hide from the world. My goal is to make you more vigilant. We're at a higher risk for infection, so be on the lookout for it. Be vigilant and you should be fine.

Or, you know, do like me and wait until the last minute to have your crumbling teeth looked at. "A lot of pus drained out when that tooth came out," is really the kind of thing you can bring up at parties and family dinners as a topic of conversation... if you don't want to be invited to future engagements.

Let's end on a laugh. There's a little band called Ninja Sex Party, and they have a perfectly 80's-sounding song called Mansion Party. You should give it a listen, if for no other reason than learning that a panda fighting pit is called a "Pandagon."

Seduction is like a game of Chess

And I'm the queen.

Wait -

NOTE: I chose this song because it's one of the safest NSP songs. No swearing and such. The ones I won't link, but are equally funny to me are: Courtship of the Mermaid (which was my introductory song to them), First Date, I Don't Know What We're Talking About, and Bedtime. Most have "colorful language" that would be unacceptable at work.

You Take One Down and Pass It Around...

It's probably a recurring nightmare for parents... that moment when the kids have learned to count WAY past 10 and start singing One Million Bottles of Beer on the Wall. Especially at the start of LONG a family trip. If you listen hard, you can hear the parents praying, "Please, whatever gods are out there... Kill me, my children, and/or all of us. Just make it stop." The alternative song that brings about prayers for a swift demise is The Song That Never Ends, but it's unrelated to this post.

Time passes, and eventually they/we learn to sing Show Me the Way to Go Home. Oh, but summer camp taught us an even better alternative! Murphy's Saloon, also know as Give a Cheer! 

Give a cheer, give a cheer

For the men who drink the beer

In the cellar of Murphy's Saloon!

They are brave, they are bold

For the whiskey they can hold

In the cellar of Murphy's Saloon!

Well it's drink, drink, drink,

'Till you vomit in the sink!

Yell out your order loud and clear:

MORE BEER!

Well it's more, more, more

'Till you pass out on the floor

In the cellar of Murphy's Saloon!

Apparently, the lyrics are regional, but there's nothing quite like a bus full of teens and tweens singing at the top of their lungs about something they know absolutely NOTHING about!

"Hey, Rob...? This is entertaining and all, but does this have anything to do with diabetes?"

The songs? No. The subject of alcohol? Yes.

There are things about the diabetic diet that can drive a dietician to the brink of madness. Two that I can think of immediately. The first is pizza. Between the variable size of slices, to the mystery of how much sugar might have been used when making the sauce, it makes it next to impossible to calculate carb content. The other thing... well, things, plural... are alcoholic beverages.

Drinks for growed-ups contain the perfect combination of substances to make your body scream, "WHAT'S HAPPENING?!?" If your beverage of choice is beer, it's going to have basic carbs. If you prefer mixed drinks, as I do, then they're going to have sugar. Mind you, I now have only one ounce of booze twice a year - once on my birthday and once on New Year's. But there was a time when I wouldn't turn down a well made Long Island Iced Tea. Gods above and below! You can barely make out the taste of alcohol in one made to perfection. I met one bartender whose secret ingredient was powdered lemonade mix. It was a delicious way to get soused. And the sugar in that lemonade mix probably did horrible things to me that the alcohol politely numbed.

Yeah, the sugar/carbs in various adult beverages drive a diabetic's blood sugar upward. If you're out at a bar, you can't exactly ask the bartender to slap a label of the nutritional value of your drink of choice, so you can't really guess at what dose of insulin you should take to cover your night out.

Besides, alcohol lowers the blood sugar.

Yup. The capricious Fates have decided that having a few drinks with your friends raises and lowers your blood sugar simultaneously. Fun, right?

My years of experience have taught me that it's usually the sugar that wins the glucose tug-of-war, but my best advice...? Don't drink. I don't mean "Don't drink EVER!" Save it for special occasions, just as you would a massive slab of seven layer German chocolate cake. 

Twice a year, I settle down with a single ounce of Irish Mist on the rocks, and I sip it so slowly that the melted ice usually winds up dominating the glass. I rarely finish drinking it. When I was younger, however, I could knock back my drinks like I was on a mission to kill myself that very night. Peach or peppermint schnapps made me the go-to guy at several parties. "Oh, you wanna get smashed faster? Go ask Rob for some of his stash." There was one night when my friends and I bought a bottle of Mescal simply because Van Halen sang about it in their song Cabo Wabo. I wish digital cameras were a thing back then! "We drink Mescal right from the bottle... A salt-shake, a little lick of lime... Mmmm!" They sang it, we did it, and the faces we made as we swallowed what must surely have been gasoline would have made for some interesting tales later in life.

Here it is, later in life, and I can't help but wonder what kind of damage I did during that relatively short period of partying, my blood glucose bouncing up and down from moment to moment. Mind you, I wasn't an alcoholic. Booze was rarely a part of our regular gatherings... which was good, because I wasn't a happy drunk. Some people get happy or violent. I got depressed. It's why I can't even recall the last time I was drunk.

What my friends and I DID do regularly... is a topic for a different day. 

That brings this bit of suggested diabetes management to a close. As with everything else I discuss, what I have to say is a matter of "should" versus "shouldn't." I won't say "you can't" because, as it turns out, I have no way of stopping you from doing anything. And if you doubt what I'm saying or are experiencing outright denial, you can always consult your doctor.

And now, in case any of you are cat lovers...

😉