I've restarted the blog so that I could include more information, most specifically about Type 2 diabetes, since I'm now a Type 1 AND Type 2 diabetic. Didn't know that was possible? Neither did I! Come find out what's going on at the new blog!
Click this sentence to be taken to the new blog, "Hey! I'm Diabetesing Here: The Revenge!"
It's been a hot second, hasn't it? I essentially ran out of things to discuss. I'm not a doctor, so I'm not going to come rushing back here "With the latest news in diabetes treatments and technologies!" But it's once again time to check in because something old and new is happening.
Go ahead, Rob. Confuse what few readers you have.
I'll start with the old stuff, which involves my diabetic neuropathy. This is some BAD juju. My nervous system is in such rough shape that I can no longer accurately tell what my blood sugar is without a meter. It wasn't as though I could guess a number and have the glucometer confirm it, but I could at least say when I felt high, low, or normal. Now...? I'll feel hyperglycemic when I'm actually normal. I'll feel hypoglycemic when I'm running a bit high. And apparently I've gone as low as 54 without feeling it.
That, my friends, is a dangerous way to live.
For several years, I've griped about how Medicare doesn't cover CGM's. Continuous Glucose Monitors. It was so stupid. Here was a piece of technology that could help us diabetics know at a glance what our blood sugars are before, during, and after meals, which could lead to tighter control, and they refused to pay for it...
...until March of 2022. I found this out when I'd finally lost my patience with not knowing what my blood sugar was doing. This is when my glucometer came back with a reading of 54, and until I saw the number, I had no idea I was that low!
Part of my problem with monitoring my sugars was the fact that the prescription for my testing supplies read that I should check "four times daily." That meant, at the most, I could only check four times a day because insurance wouldn't allow for extra tests. I was determined to send a message to my PCP through the patient portal saying that I needed a new prescription that would allow for testing up to eight times a day.
While typing out my message, I got curious. Off to Google I went to ask, "Does Medicare cover CGM's?" I felt I already knew the answer. "No. Beg all you want, peasant! We only pay for technologies that are around five steps behind anything people would consider 'modern'." So imagine my shock when I discovered that CGM's have been covered since March of 2022!
If I had two feet, I'd have danced a jig!
My message to my PCP was changed to "I need a CGM yesterday!" He agreed. And while he and my pharmacy were jumping through bureaucratic hoops, I learned that I would still need the supplies to test manually eight times a day, just to make sure the CGM was working properly. I would swiftly learn it's just a wee bit more complicated than that.
So now that I have a CGM stuck to me, here's how testing goes:
The thing to keep in mind is that BOTH devices aren't 100% accurate. There's always a miniscule +/- variable that we mere mortals can't calculate. We have to operate on the assumption that the meter is closer to the right number, and therefore we need to "teach" the CGM to close the gap when it reads a wide difference between results.
Now for some confusion... because what would my life be without confusion, right?
I kind of cheated when I sat down to learn how to use my sparkly new CGM. I went to YouTube, found the manufacturer's channel, and watched a few "how to" videos. The video on calibration said to calibrate the receiver every 12 hours. That seemed... wrong. If it was going to have such a wide discrepancy every time I manually checked my glucose, shouldn't I calibrate at that time?
It's my philosophy that "smart technologies" are very smart at all. Do the wrong thing at the wrong time and you could confuse whatever device it is that's supposedly "smart." Without insurance, my CGM costs over $550 for three sensors, one transmitter, and one receiver, so I was afraid I'd break something and wind up having to scrounge up the money to replace it... which is why I called up their customer service line to ask if I calibrated every time I checked my glucose manually, would it... ummm... blow up?!
The simple answer? No. In fact, the CGM seems to be more accurate every time I calibrate it. After four days of correcting the receiver, there's been less and less of a gap.
Going from most recent to most distant, my last four A1c's have been 6.8, 6.5, 6.5, and 6.4. My PCP is starting to think I'm a unicorn, in that he's simply not accustomed to seeing a diabetic consistently stay between 6.0 and 7.0. Why bring those up? Because if I followed how I felt without knowing what my blood sugar actually IS, my A1c's would turn to garbage. Allow me to give an example:
Sitting here, watching a movie or writing a thing, and suddenly I'll think I'm feeling low. That's when I'd reach for something to bring my blood sugar up. I wasn't allowed to check my glucose between meals due to insurance restrictions, so I'd blindly treat what I believe is hypoglycemia. Yesterday, I started feeling low, but now I had the benefit of pressing a button on my CGM receiver, and... Hmmm... It says my glucose is 144. Is that right? Check manually, since now I can check eight times a day. My meter says I'm at 130. I would have eaten something to raise my blood sugar when it it was completely unnecessary! If I did that too often, my A1c would come back indicating that I was losing control of my diabetes.
Also, do you remember my entries that included the Somogyi Effect? Well, now the CGM's alarm sounds when my blood sugar dips in the middle of the night. Unfortunately, the device isn't as fast as I'd like it, so its alarm will go off repeatedly while I'm treating my hypoglycemia. I wish there was a way to teach it patience. Like, "Dude, cool pits. I'm working on it. How about you learn how to alert me when my sugar's reaching a normal level?" Alas, I fear I'm asking too much.
So, my friends, we've reached the conclusion of this latest adventure. This is usually the part where I put a picture of a beautiful woman and claim that she's my wife. Alas, todays human female is FAR TOO YOUNG. Take a look...
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For reasons beyond my understanding, my Facebook feed will throw suggestions at me, trying to catch my interest. Their suggestions are usually WAY off. Then one fine day, FB suggested little Faye, here. What captured my attention immediately was her massive wealth of hair! There's just so much of it! It's crazy! As I understand it, her hair has never been cut. Trimmed, perhaps, but never outright cut. So she's been growing that mane since birth! She's youngest and smallest of some youth acting/dancing troupe. (Apparently she's 10 years old and about 4' 6".) She has an Instagram account if you want to learn more about her. Just don't be weird about it, okay?
Still, I can't end my post with stuff about a little girl with enough hair to play Medusa in the MCU. How about bringing back a classic?
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Hey, I sent her the divorce papers! "Jane Douglas, Somewhere in the U.K., possibly near London." Since she hasn't sent them back, I'm assuming she wants to remain married to the walking, talking wreckage that is me. If she wants out, she can send me her exact address. 😁
Does that sound absurd? It should, because it is. And I've done it. Multiple times.
Like today. I wrote about the Somogyi Effect and how I thought I had a handle on it. Yeah, not so much. The good fasting blood sugars are rarer than the ones that are utter garbage. This morning, I woke with a glucose of 403. FOUR HUNDRED AND THREE! You must be thinking, "What on Earth did you eat last night, Rob? An entire chocolate cake?!?" No, my evening snack was a couple of microwave chimichangas, a total of four carbs on a diabetic exchange diet. (Not to be confused with 4 grams of carbs.) My glucose at the time was 126, so I took only enough insulin to cover the meal. My thinking was that if I tried to add just a little more insulin to bring my glucose closer to an idyllic 100 that I'd be risking the slingshot effect of a Somogyi. For all of my careful thinking, I got a fasting glucose of 403.
I had - past tense - a podiatry appointment this morning. I'd just seen my podiatrist nearly two weeks ago, but was still experiencing a bit of pain. When you have advanced Diabetic Neuropathy, a "bit of pain" could be an indicator that something is very wrong. Mind you, the pain has diminished since I called to make the appointment, but I was still going to get it checked out. Better safer than sorrier.
The problem is that I can't go to a doctor's appointment when my blood sugar is so high. I need to monitor it. Take extra insulin if necessary. Be around food in case I overcompensate with my dosing. If I had a Continuous Glucose Monitor (or CGM), this would be less of a concern, as I'd know what my glucose was doing with the application of an app on my phone. But Medicare doesn't cover CGM's. As a result, I called in sick to a doctor's appointment.
The greatest culprit when it comes to missing medical appointments has been my Diabetic Neuropathy. The burning sensation in my skin would make it impossible to wear clothing, since contact with even the softest material would make me want to cry. This wouldn't be a problem if I could just go where I needed to go without a stitch of clothing on, but not only are there laws against that, but no one - and I mean NO ONE! - wants to see me naked.
I sincerely wish people would leave comments to let me know if these lessons and stories are getting through to them. I see some people are reading these meandering musings of mine, but I have no idea what effect I'm having. And no one who's read my last entry has donated to my GoFundMe. (Please, if you can't give, share the link. The sooner I meet that goal, the sooner I can stop worrying about this.)
Anyway, we're nearing the end of my post and I haven't posted a picture of my new wife.
That, my friends, is English actress Jenna Coleman. As I did when "married" to Jane Douglas, I sent divorce papers to Jenna so that she might escape her relationship with me. It's only fair, right? Alas, an address of "Somewhere in England" probably won't reach her, so she and I will remain a wedded couple... until some other beauty catches my eye and I declare that one my bride. What can I say? I'm capricious.
Until my next post, whenever that may be.
"Woooow! Rob came back and wrote a post. We thought he died or something."
Not quite yet. I was recently talking with a friend about how it's miraculous that I'm still alive. I mean, around a decade ago, I was on the phone with an old friend, and after telling him all of the crap that had been going on in my life at the time, he said, and I quote, "It's amazing you haven't committed suicide already."
That's what I get for dialing in to a discount therapy session with Pep Talks-R-Us.
This blog post is so I can share my GoFundMe page. This is, in a way, a continuation of my post about my dental issues, except that I'm now asking for financial aid to get dentures.
I'm sure I've discussed this before, but diabetes control is about balance. Diet, exercise, and medication need to be balanced carefully... except that exercise for me is next to impossible. The strength in my hands is negligible due to atrophying muscles. The bones in my remaining foot have fused, and continue to fuse, creating an appendage that's not terribly useful. Without exercise, I have to maintain control with insulin and diet, and diet is going to be EXTREMELY difficult to maintain without teeth.
By the way, my last post mentioned two teeth that don't move when nudged. I actually tried to convince the dentist that if I could keep those two teeth, my future dentures would TECHNICALLY be partials, which would be cheaper. However, the gums are receding around those teeth just as much as everywhere else, putting them at risk for serious gum infections.
Remember my post on 10 November 2022? No? Well, of the four teeth I had removed around that time, one had broken off, leaving fragments behind. Infection had set it. SERIOUS infection. It was so badly infected that the dentist couldn't numb the site. When he went to grab what was left of the tooth still embedded in my gums, A LOT of pus came bubbling out of the sides. It was a real mess.
So all of my teeth need to go. But because diet and medication are the only two things allowing me to maintain control of my diabetes, I NEED teeth.
For all of the times I've had to beg for financial aid, this is the first time that it's not an emergency. The extractions will begin on 9 May 2023, and that's just the beginning. There'll be another two or three extraction sessions after that. And that means there's plenty of time to reach my goal of...
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Yeah. Sure. That's a perfectly reasonable goal. All I need is one million people to donate $1.00 and I'll be all set.
Seriously, I set the goal at $1,600.00 because that's what it will actually cost. But if there's a millionaire out there willing to throw money at me, I won't complain.
Clicking on this sentence will bring up my GFM page. (Yeah, I linked it twice. Desperate times, desperate measures, etc.) What I'm actually asking for is maybe $5.00 a month for the next six months or so, which should help me meet my goal. If you can't afford to help, just share the page with friends and family. Every little bit helps. And although I'm not in a rush, the sooner I meet my goal, the sooner I can stop worrying about it.
That's it, folks. I came to my blog to plead for help. And if I manage to think of a diabetes topic I haven't already discussed, I'll come back to post about it.
If you go waaaaay back to November of 2022, you'll see a post, "Dentist!" It was quite the experience, and I decided I'd had enough of these oral adventures. It was time to see the dentist regularly. I could at least bite things with my front teeth and chew on the right side of my mouth; I should try to keep the teeth that remained. Thus, after that agonizing visit, I scheduled a cleaning.
But in case you haven't been paying attention to my stories, "Life is what happens while you're busy making other plans." That John Lennon quote fit my "cleaning" visit to a tee. Y'see, there's been quite the build-up of calculus around my front teeth. Yes, calculus. "It's not just math!" Calculus is hardened deposits of plaque.
Okay, let's back up. When my left foot was amputated, I went six months without taking even minimal care of my teeth. I was so overwhelmed by my struggle with all of the other forms of bodily maintenance that my teeth were ignored. That's when the plaque started building up. Once it had a foothold... (A foothold in my mouth? Weird.) Once it had a foothold, the plaque continued to build-up, even when I started brushing regularly again.
Following so far? Good. Because now we have to add other complications to the scenario.
I didn't need a professional to see the rather extreme situation in my front teeth. My gums had been pushed way down, with a lot of calculus at the base of the teeth. Even with that hardened substance's presence, my teeth could be wiggled with just a gentle nudge. Which led me to ask, "If you clean away the calculus, will my teeth just fall out?"
Y'know, it's a little sad when the dental assistant working with you gets excited that YOU reached a conclusion before they could mention it. The dentist was proud, too. And the answer was, "Yes." I asked if they could at least clear away the calculus that would lead to painful gingivitis, and they said my teeth would likely fall out if they did that little bit.
So what? It's a tooth. If it looks like the plan is going to be a complete removal of all teeth, what's the big deal if some fall out?
Oh, nothing special. Just an increased risk of infection because - you guessed it - diabetes.
By the way, that was the plan we discussed. My gums had seriously receded, even where there was no calculus. All but two of my teeth moved when nudged. Things can get caught in teeth that are as loose as mine. Those things can lead to infection, and often do. I have to lose the teeth. All of them.
This news coming on the heels of the EMG results has knocked me flat mentally. Well, not just this, because Dunder Klutz here stumbled after a shower, and my foot smashed into the rather sharp corner of a shelving unit in my apartment. To be specific, it was the inside of my foot, where a particularly large callus resides. Well, resided - past tense. I didn't think much of that collision... until I spotted the blood stains in my carpet. Seems that after my shower had softened that callus, the impact sheered it off, leaving me with a bloody mess of a wound.
So... Very little muscle left in my hands... Serious wound on my foot that I didn't feel, thanks to diabetic neuropathy... I have to lose all of my teeth... Yeah, I'm feeling the weight of existence more than usual. What's more, I'm going to need dentures and I can't afford them. So what if I'm a diabetic that needs to eat? I could live on mashed potatoes and peanut butter, right? I'm going to have to beg and plead with friends to help me get prosthetic choppers, since Medicare doesn't offer dental insurance.
~as sarcastically as possible~ Life is just grand.
Let's change the subject entirely. Remember when I advertised the scantily clad young woman? Well, this isn't her:
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This gorgeous young woman is Rachel, or Keet, as she often says very quickly at the start of her videos. I think she's only 17 at the moment, but I could be wrong. She has a rather serious case of Tourette's Syndrome. Her tics can be quite entertaining because her voice pitches up when she experiences echolalia. She sounds adorable! But she's suffering. She has no control over the sudden movements or outbursts. She posted a video that was only a small portion of a four-hour tic attack. If you want to follow her, then I'll link to her TikTok. But behave. She's underage. She's been bullied. She's been accused of faking. She'll continue to experience these things from a variety of jerks for the rest of her life. Don't be a part of that. Listen to what she has to say and bask in her beauty. Don't be mean or creepy.
Probably more than me, anyway.
Yes, it's been a minute since I've written here. I blew a mental gasket, followed by the realization that I'd run out of things to discuss. I mean, it's a blog about diabetes. To come here and rant about politics or religion would be inappropriate. "In my next post, I'll tell you about my favorite science fiction novels." Not what this blog was created for.
Yesterday, 28 February 2023. however, brought something old/new to my life: confirmation of how bad my neuropathy really is.
Now I know it's been bad. In the last decade, I've gone from calling it "diabetic neuropathy" to "advance diabetic neuropathy." That's because of the diagnosis of Charcot foot. It takes a lot of nerve damage for bones to start drifting, suffer minor dislocations, develop microfractures, and eventually start fusing together. For some reason, knowing all of that didn't upset me all that much. It was an inconvenience. It sucked. But it had next to no emotional impact.
Yesterday was different. I went for a test called an EMG, also known as an Electromyography. Oh, if you're not taking care of your diabetes, get ready for this bundle of fun! They place a few sensors in various spots, and then send a pulse of electricity through specific points to measure the nerve and muscle responses. The test has two parts. The first is when they deliver little jolts through the surface of your skin. The second involves inserting a needle to measure electrical activity in various muscles.
The doctor and nurse would say late in my visit that I was their most fun patient. I tried joking about everything. For example, the doctor was Muslim and I was brought up Jewish, so when she had to deliver a particularly painful jolt several times, I blurted, "This is because I'm Jewish, isn't it!" And during the surface shocks, when the nurse was getting no responses, I had a whole shtick about the doctor berating her about wasting time by running the test on a corpse. "Living patient is in room two. Dead person room one. Go test living patient." (I used a Russian accent. I don't know why.)
Those lack of responses... When the nurse had to turn the electrode all the way up and was barely getting a response... I may have been making jokes, but jolting a nerve that hard and seeing a flatline was bad news. I'd had this test in the past and can't recall it ever hurting. I believe they use microvolts. When cranked to 100 and shocking the nerve several times, only to see nothing on the graph was disheartening.
Usually when I go have tests like this, I'm out the door when they're done and I get the results some time later. Not this time. The doctor was able to tell me that, yes, I do have carpal tunnel in my right wrist. Whether or not I'd benefit from surgery would depend on an orthopedic consult. As for my diabetic neuropathy... It's bad. Very bad. The doctor said, "There's almost no muscle left," but then immediately corrected herself, "Well, there's very little muscle left. You obviously still have enough to move your fingers."
You obviously still have enough to move your fingers.
There's some Stephen King levels of horror in that statement. Have you seen The Shawshank Redemption or read Rita Hayworth and the Shawshank Redemption? Those don't seem like horror stories, do they. You have to consider the author. King often seeks to find the worst fears a person could think of and use those fears as the basis for stories. Imagine being in the wrong place at the wrong time, with circumstantial evidence stacked against you, and because the shock of events has caused you to shut down emotionally, you seem cold and uncaring during the murder trial. A murder you DID NOT commit. You're found guilty and shipped off to prison, where you're promised three hot meals a day, a bed, and a whole lot of new friends you'd run away from if you had the opportunity. That's terrifying. That's what "Stephen King levels of horror" means.
You obviously still have enough to move your fingers.
Imagine the alternative. "You don't have enough muscle to move your fingers properly anymore." To an extent, I'm already there. Holding out my hand, fingers straight and held together, you'd notice that my pinkies and ring fingers on both hands can't close the space between fingers completely. When I struggle to try to make them do what I want, the fingers tremble feebly, refusing to do what my brain is telling them to do.
Dead muscles. Immobility. The muscles have atrophied, not because I was inactive, but because my brain couldn't stay in touch with my muscles.
The doctor DID compliment me for taking steps some time ago to find a fun way of working my hands as a form of physical therapy. I bought 460 2x4 Lego bricks for somewhere around $30. Almost every day, I take apart the last thing I made and build a new thing. Think there isn't much to be built with only one type of brick? Let's take a look.
You might be wrong.
So that's about all I have for the moment. This realization of exactly how screwed my hands are has been emotionally draining. And until I think of something more to say, or someone actually asks me a question about diabetes, this blog will return to it's suspended animation.
