"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.

Cheaters Never Prosper

Yeah, yeah. It's a cliché. I'm sure we can all think of someone who cheated and prospered plenty, primarily because they were never caught. However, when it comes to diabetes, cheating on your diet without taking the proper precautions will eventually catch up to you.

I mentioned last post that I learned how to cheat on my diet right under the noses of the people responsible for making sure that I didn't cheat. The analytics of my blog have taken a dive and no one has commented, so I figured I'd just make my way through the list. But not necessarily in order. No, that wouldn't be any fun. I'm still just going to go with whatever I'm in the mood to write until someone makes a suggestion otherwise. So nyah! 😛

Back in the before times, when cell phones were an impossible dream and video games could only be found in arcades, my father became a member of The Suburban Players. This was a community theater group that would put on productions just a few short steps upward from high school quality. They may not have been the best shows ever performed, but they had fun.

In 1977, the musical they chose was Mame. The show has a character named Patrick Dennis. Patrick is 10 years old in the first act and an adult in the second act. And you'll never guess who was 10 years old that year!

That's right! It was me! (I made it really difficult to guess, didn't I?)

Me and a dozen other kids auditioned for the role. In the race for the role, I placed second, (making me the first loser). I was disappointed, but I was also 10, so it wasn't the end of the world.

And then the director and producer of the group realized that the kid they'd cast was actually a giant. They'd given the supporting role of Agnes to a sweet woman who was about 5' 2". In the very first scene, the characters of Agnes and Patrick are supposed to be lost in New York, and they pause for a musical number... as one does when lost in Manhattan. But the boy who got the role of Patrick was growing like a weed. He was already about four inches taller than Agnes and still growing.

So guess who replaced him! (Yeah, I'm terrible at setting up a mystery.)

For three months, every Monday, Tuesday, and Wednesday evening was rehearsal. Blocking, singing, and choreography. Ummm... When I use the word "choreography," I'm using the word VERY loosely. As a group, the Suburban Players could sing and act. But dance...? Not to save their lives! Me included! After those three months, it was showtime.

Totally unrelated to diabetes care, but entertaining... The most flattering compliment about my performance came during these rehearsals, and this compliment wasn't given with words, but with actions. The role of Mame was played by a woman named Marian. The character was supposed to perform in a show within the show and do so badly that she gets fired after her first performance. That's when adorable little me, carrying a bouquet of roses, stepped into the scene to lift her spirits with the song, My Best Girl. Every time - EVERY SINGLE TIME! - Marian would start to cry because she thought it was so sweet. And there was out director, Marty, shouting at her, "MARIAN, STOP CRYING! WE CAN'T AFFORD WATERPROOF MAKEUP!" 🤣

[/boasting]

As mentioned previously, I was taking only two injections a day. It was a mix of NPH (Neutral Protamine Hagedorn) and Regular insulin. What made it "regular?" No idea. I just know it was called "Regular." I took a larger dose during the day to cover the majority of my meals - breakfast, lunch, and afternoon snack - and a smaller dose to cover dinner and evening snack. For the record, the evening dose was about half the size of the morning dose.

Opening night, I was an uncontrolled ball of nerves. I'd been singing in front of the cast for months, but now I'd be performing in front of 300 strangers. ~ Gulp! ~ In my nervousness, I accidentally took my larger morning dose at night. And in case you've forgotten, being extra active makes insulin work harder. Even if I wasn't going to sing and dance, the adrenaline pumping through me would be enough to keep my blood racing through the night.

As luck would have it, one of our cast members was a pediatrician by day. My parents consulted him about what should be done to counter my accidental insulin overdose, to which he suggested - brace yourself - Twinkies. There wasn't time to feed me an entire meal to counter the higher insulin dose, so he recommended I just down a couple of Twinkies as a shortcut.

Can you see what just happened? Yes? No? Maybe?

I - a diabetic for three years up to that point - had been taught to absolutely hate my disease with every fiber of my being by the incubator and two years at a summer camp full of tyrants... had just learned that the "threat" of hypoglycemia warranted an opportunity to "legally cheat" on my diet. And because there was no way to instantly verify this back in the day, my minders had to take my word for it. Remember, this was still the time of urine tests, which were notoriously unreliable in terms of blood glucose management. Home blood testing was still years away. As far as 10-year-old me was concerned, I'd been granted carte blanche to eat whatever I wanted, whenever I wanted. It's really not the kind of thing you want to teach a less than emotionally stable diabetic.

Technically, that was the beginning of me pushing the boundaries of my diet off a proverbial cliff. This was the foundation to many of my hospitalizations, as mentioned in my post from 25 July 2022. By then, of course, I didn't have to lie to people around me. I could take my allowance money and buy the garbage I shouldn't have been eating without anyone being the wiser.

There's a different philosophy toward diabetic diets now. "Take enough insulin to cover your terrible eating habits." You don't have to lie and sneak around. Just be honest with yourself AND your doctor. They might not be happy with what you eat, but knowing you're actually paying attention to your blood sugars and adjusting your insulin doses accordingly will keep them from berating you. I'm still not a doctor, but I AM a diabetic whose Hgb A1c has been between 6.0 and 7.0 for the last eight years, with the last one being 6.5. So just as I said near the start... nyah! 😛

Okay. Here we go. Beautiful young woman... scantily clad... aaaaand GO!

Oh, great. I try to share a picture

of a beautiful, scantily clad woman

and wind up sharing a Link instead.

To My Type 2 Diabetics

Welcome. You're late to the diabetes party, but you're welcome here. (Your club card and membership jacket are in the mail. 😉) Especially because a lot of the nightmarish scenarios I've discussed are sometimes the inciting incidents that get you diagnosed with diabetes in the first place! You could be a diabetic for years, your beleaguered pancreas coughing up just enough insulin to keep you alive. You've chalked up all of the fatigue and general malaise you've been feeling as you simply getting older. 

And then one day you find yourself hospitalized with a seriously infected wound on your lower leg or foot. You tell the doctors that your feet and legs have had some weird pains for years, but, again, you thought it was aging. This wound...? You didn't even feel it when you got it. But that kind of thing happens all the time to people, right?

Yes... to diabetic people.

You've been alive for decades, doing whatever it is you do, following a diet that's somewhere between that of an adult and a seven-year-old. Yes, you had a perfectly balanced meal for dinner last night. But now that you're an adult and can do whatever you want without your parents yelling at you, an entire seven layer German chocolate cake for breakfast this morning was perfectly reasonable in your mind.

Suddenly you're being told that the dietary habits you've developed for oh so many years have to be radically changed, and this... THIS is uncalled for! "Radically change my diet?!? I REFUSE!" 

I get it. I really do. Because if you go back to my 13 July 2022 post, Diabetes: The Revenge!, you'll see that I reacted badly when the remainder of my life was explained to me at age seven. I was a child with the dietary habits of a child. I even had messy, childlike rituals for some of junk food. The two I recall most clearly were Hershey's with Almonds and Yodels, which was one of the many confections from Drake's Cakes. 

The Yodels were cakes rolled with a layer of cream and coated in chocolate. My ritual involved peeling off the exterior layer of chocolate with my teeth, carefully unrolling the cake so I could lick out all of the cream, and finally dunk the remaining cake in milk.

The Hershey's with Almonds was artistry in terms of the mess I could make. I'd break off a piece and hold onto it long enough for it to melt in my hand. I would then lick the chocolatey disaster from my palm and spit out the almonds into my "clean" hand. This would continue until the chocolate was gone and I had a tiny handful of almonds, which I'd then devour while humming tunelessly, but happily.

I know. Gross. But this was what I did between ages five and six! If I was still doing that at 55, your concern would be warranted. Now I just eat the almonds along with the chocolate I lick off my hand.

I'M KIDDING! Yeesh.

My point is that I was so blindly enraged when I was told that all of my junk food had to be cut from my life at age seven, that I can fully empathize with how much more difficult that dietary change must be with decades of life piled up behind you.

There's a reason why I'm bringing this up today. Y'see, yesterday I was visited by one of the building maintenance men, Max. (Not his real name.) He's a Type 2 diabetic. He'd recently told me his Hgb A1c was 13.0. 13.0!!! And when he arrived yesterday - 

"Rob? Quick question. What the heck is an Hgb A1c?" 

Oops. How on Earth did I let that one slip by? No idea, but I'll start by pointing out that I may well be labeling it the wrong thing. When I look it up, it's "HbA1c." But somewhere early in my self-education, I learned it as "Hgb A1c," so that's how I'll be writing it in my posts. Note: I'll use both for my posting labels.

A hemoglobin A1c is a blood test that measures your glucose average for the prior three months. As a diabetic, your target is between 6.0 and 7.0. Thanks to my vigilance in controlling my diabetes, I haven't had a result above 7.0 for nearly eight consecutive years. My most recent result was 6.5. So when I tell you Max had a 13.0, it means his average daily blood sugars have been 350.

An A1c chart clipped from some of the

finest Interwebs.

Through our conversation yesterday, I learned that he'd had a Snicker's bar just before coming to my apartment. Although I made it humorous, I was pretty angry that he was thumbing his nose at the very idea of managing his diabetes. He takes two daily doses of a 24-hour insulin, but he doesn't cover his meals with short-acting insulin - it hasn't been prescribed to him - and he doesn't check his sugars before meals. Let's look at another A1c chart to get some perspective on Max's 13.0.

Suicidal! This chart says Max's 13.0

qualifies him as being suicidal!!!

What I told Max yesterday is the same thing I tell every diabetic under such poor control. I AM NOT A DOCTOR! TALK TO THE DOCTOR HELPING YOU CONTROL YOUR DIABETES! Because all I can do is express an opinion. Mind you, it's an opinion backed by 48 years of personal experience, but it's only an opinion nonetheless. What's more, I only know how to take care of MY diabetes. I wouldn't even dare to guess at the precise needs of another diabetic.

I can say this much: Max needs to be checking his glucose and taking a short-acting insulin per meal. How much is between him and his doctor, but I suggested that if he's not going to adjust his diet, he should at least learn to take enough insulin to cover the garbage he wants to eat.

Look, this blog serves two purposes. It let's me vent about my diabetes while simultaneously teaching other diabetics about about their illness the best way a layman can. It's why I stress that I AM NOT A DOCTOR. (See? I did it again.) You need to be talking to the person helping you manage your diabetes to refine your personal care. I've encountered too many Type 2's who simply don't care that they're diabetics and are casually dismissive when I try to explain the dangers of not caring. And if you're one of those kinda of people...? Well, I'd essentially consider you a 13.0, too.

Yes, I indirectly referred to you as being suicidal. Prove me wrong.

And now, no more dilly-dallying, the beautiful young woman, scantily clad...

OMG! That's her! The one I've

been trying to share! But she's

thoroughly clad, not scantily clad.

Well, maybe some day soon, right?

Balance in All Things... Except That One Time

I'm sure you have your own opinion to this question, but do you know what the worst thing is about living with diabetes? It's a pain in the butt. Type 1, Type 2, it doesn't matter. Diabetes maintenance is annoying. You have to watch your glucose levels. You have to take the proper amount of insulin so you don't go too high or too low. You have to include physical activity to give your medications a leg up doing their jobs.

Keeping an eye on your blood sugars comes in one of two forms these days. Either you're poking your fingers several times a day or you're wearing a Continuous Glucose Monitor, or CGM. If you have a CGM, then the arduous task of checking your sugar is looking at an app on your phone. You poor thing. Do you want a hug to help you cope? 😛 If you're poking your fingers, it's a horrific ordeal that takes five minutes if you drag it out. FIVE WHOLE MINUTES! If you maintain this lackadaisical pace, you could use up 24 hours in 72 days! (That's if you're checking four times a day, which you should.)

Calculating your insulin dose depends on your current glucose levels. At this point, nearly every diabetic on insulin is on a sliding scale to adjust their doses per meal. Personally, I take a proactive approach. I don't just take insulin to cover what my glucose level IS, but what it WILL BE. I look up how many grams of carbohydrates are in my upcoming meal and add enough insulin to cover it all. Yes, poor, beleaguered diabetic. You would have to do... MATH! Oh, the humanity!

I will not, however, tell you how much I take for each meal. I'm extremely insulin resistant, so when I tell anyone who understands such dosing how much I take per meal, they look at me like I've grown a second head.

Exercise is probably the most bothersome part of diabetes maintenance, especially as we grow older. Remember that time we ran around when we were five years old? Yeah, it turns out that that wasn't enough to last a lifetime. That sit-up I did back in '87? Still not enough. The thing is that you don't have to have an entire workout regimen. Just be active. Don't grow roots on the couch all day, every day and you should be okay. Stand up and shake out your arms, maybe do a few leg-lifts, stretch your back by twisting side to side. Just 60 seconds worth of getting the blood pumping. That little bit can go a long way. Of course, if you can get an actual workout in, that's much better. It'll have benefits that will last for decades.

Yes, decades. When I was a teenager, I cycled everywhere! And occasionally, when I had no destination, I'd ride my bike for hours on end simply because I could. Several decades later, I could impress my physicians by tightening up my quads. The muscle definition was still there despite the onset of various diabetes complications.

Doing all of the above...? It's a bother. You have to stop whatever your doing so you can diabetes for a few minutes. (Yeah, I used "diabetes" as a verb. You got a problem with that?) It's not like... oh, I dunno... asthma, where an attack will forcibly bring your life to a halt. Depending on the severity, an asthma attack can mean a puff on an inhaler or being rushed to a hospital. But wait! I can step it up. Cancer! Now there's a disease that will ruin your day if ever there was one.

I'm not discounting the seriousness of diabetes. It requires your attention so you can function. But it's not a HUGE time investment, and a little perspective helps you to realize the difference between a disease that's a pain in the butt and one where your life perpetually hangs in the balance. 

But diabetes definitely has its instantaneous dangers.

Throughout this blog, I've harped on high blood sugars and the complications they can bring. But what about going in the other direction? What about hypoglycemia? Well, my friends, I have a story for that, too.

Starting at age six, I knew girls were more interesting than comic books. Alas, for all of my interest, I was never brave enough to ask a girl out. My first kiss came along when I was 13, but I wouldn't have my first "official" girlfriend until I was 16. This is her:

What do you mean that Yang Xiao Long from RWBY? That's my girlfriend from 39 years ago! Why, yes, as a matter of fact, she WAS animated and with a weaponized cyborg arm, thank you very much!

Okay, maybe not. But I had my first girlfriend, perfectly average as she was, and I had me a date with her one night. Hoo-boy, was I excited! I was so worked up that I had no appetite whatsoever... but I did take my evening dose of insulin. (I was only taking two injections a day back then. For any other diabetic dinosaurs out there, it was a mix of Regular and NPH.) (No, not Neil Patrick Harris. He was never a type of insulin... as far as I know.) At her house, we had about an hour alone together. We fooled around like a pair of thoroughly inexperienced, hormone-driven teenagers. That meant my cardiovascular system was working overtime.

All of that activity, a fixed dose of insulin, and no fuel for my body.

I mentioned that cycling was my jam back then. To get myself started, I'd put my left foot on the pedal, push off the ground with the right, swing my right leg over the bicycle, take my hands off the handlebars while sitting up, and ride, ride, ride. That was certainly my plan as I left my girlfriend's house that evening... except that when I sat up to ride no-handed, the world went dark.

When I fully regained consciousness, I was alone in an ER treatment room. My face hurt a great deal. There were fluorescent lights above me and an IV in my arm. I immediately did what came naturally and screamed, "DAD!!!" Mind you, I had no idea if he was there, but he was who I called for. Lo and behold, my father was there. I was admitted to the hospital for a few days of observation. It was only when I got out that everything was pieced together with the help of a number of people.

When I mounted my bike, I made it all of 30 feet from the girlfriend's house when I blacked out. I was found in a puddle of blood by some 18-year-old kid walking his dog. Because I'd made no effort to stop my collapse to the ground, I'd landed on my face. It wasn't pretty. There was scabbing between my upper lip and nose, along the bridge of my nose, and my cheek. The kid brought me to his house, and these were his exact words to his mother: "Hey, Mom! Look what I found! Can I keep him?"

As I understand it, his 13-year-old sister was wearing a mud-mask of some kind and was absolutely freaking out about being seen by a stranger. Honestly, she could have been wearing a gorilla costume and I wouldn't have known.

I was sat in the kitchen while they dialed 9-1-1. Emergency services sent two cop cars, two fire trucks, and an ambulance. (That'd be two pair in a game of Poker.) These trained professionals all stood around, getting the story from the family, and staring at me in bafflement. The consensus was that I was high on drugs, since I was conscious, but unresponsive to their questions. I just kept saying that I needed to call my closest friend at the time, Bambi. (Yes, that was really her name.)

The 13-year-old girl eventually pointed out the Medic Alert bracelet I was wearing. I'm sorry, but HOW MANY TRAINED EMERGENCY PROFESSIONALS WERE THERE?!? The bracelet had my address and a phone number to call in cases of emergencies.

Things moved along nicely after that. The ambulance brought me home. I sat on the stairs with a towel filled with ice against my face. The paramedics had recommended that I be brought to a hospital. Before leaving the house, I told my father that I wanted a moment to gather my bearings. I stated my full name, my date of birth, my Social Security number, and the fact that I had two brothers, one of whom was adopted.

And that's what I repeated the entire way to the hospital. Because we were going to the hospital where my endocrinologist worked, it was a 30 minute drive. My dad - bless him - endured my repeated rambling the whole way.

I went to thank the family that helped me that night, and as they filled me in on what happened, I had only the most vague recollections of what happened. It was like remembering everything through a heavy mental fog. I still don't understand how I was conscious and unconscious simultaneously. I was awake, but completely unaware of my surroundings.

If I knew then what I know now, I would have skipped that evening dose of insulin or taken it and forced myself to eat something that fateful night. As I've stated, diabetes is a pain in the butt, requiring a constant balance between diet, exercise, and medication. Hypoglycemia hits a lot faster than hyperglycemia and is possibly more dangerous. The brain needs sugar as much as it needs oxygen. Without fuel, the brain would stop working. When that happens, everything else stops working.

And that brings another exciting post to a close, my tiny audience. But as I end it... Do we feel lucky? Can we get the scantily clad young woman?

Oh, so close! It's a

scantily clad mannequin.

Diabetic Neuropathy: Charcot Infested Waters

Welcome back! In this post, I'm going to talk about my favorite complication of a complication of diabetes. This one is so special that it gets a name that doesn't include the word "diabetic." Diabetic retinopathy? Diabetic neuropathy? Diabetic nephropathy? Amateurs compared to CHARCOT FOOT! "Charcot" is pronounced "shark-oh." Hence my punny title. Delving a wee bit deeper into medical technobabble, it's also called Charcot arthropathy. 

This post is going to be a real treat, as you'll finally get to see what truly lurks inside me, your charming, humorous, and handsome author.

Charcot foot is a condition that's considered an advanced form of diabetic neuropathy. It's also another one of those diabetes complications that have theories about its cause, but no solid facts. (It's why doctors "practice medicine." When they finally get it all figured out, they'll probably stop practicing and go pro.) The way I describe it is thus: Because the brain has stopped talking to the soft tissues in your extremities, they stop doing their jobs, resulting in the bones of your foot starting to drift, suffering microfractures and dislocations. 

Within two years of my diagnosis of Charcot foot, the arches of my right foot had completely collapsed, and my left foot was turning into a deformed mess that wouldn't support my weight without significant discomfort. 

I endured Charcot reconstructive surgery on my left foot TWICE! The first time, four screws were put through the bones of my ankle to help them fuse together. Fused bones don't drift or experience those miniscule fractures... or so we could hope. This surgery took four hours. Basically, the doctor had to open up the entire ankle to see what he was doing, and then drill those screws into place. Post-op was three solid months of absolutely ZERO weight-bearing on my left foot, and another three months of only partial weight-bearing.

Oh! I forgot something about the surgery! Not sure how I managed to forget this aspect, seeing as how it was so impactful, but IT FREAKIN' HURT! Medical professionals like to ask, "On a scale of 1 to 10, how would you rate your pain?" When asked during my post-op hospital stay, I wanted to scream back, "IT'S A THOUSAND! DON'T BRING MORPHINE! BRING CYANIDE!" 

My doctor was impressed with how well I healed afterward, and the bones of my ankle were fusing nicely... until he noticed that the metacarpals - the long bones of the foot - in my left foot were starting to drift outward. He wanted to go back in, remove the screws, and install three long bolts in an effort to get my entire foot to fuse.

This, my friends, is where I uphold my promise from earlier. I present to you... the real me:

Profile of my left foot post-op.

Top down, angled view post-op.

The nurse said something during a follow-up visit with the surgeon that I found a bit unnerving. "It's fascinating being able to see everything in a foot by using just a bright light." The way you can kind of see the bones of your fingers with a flashlight, she could see inside my entire foot.

My adventures with my left foot would continue, but that's yet another one of my stories that will have to wait. For now, we'll move on to my right foot. I lucked out. My surgeon had initially wanted to reconstruct it, too, but the bones eventually fused on their own and the foot was stable. I'll even show you!

This is obviously not my

foot. I simply wanted

you to see what a normal

foot should look like.

The mess that is my

right foot. You don't even

need to be a doctor to

see the difference!

My right foot becoming deformed did two things. It caused my Achilles tendon to constrict, requiring surgery to lengthen it. While not making my right foot completely mobile, it did double my range of motion. Charcot foot also altered my shoe size from 10.5 down to 7.5.

More podiatric adventures await, dear reader! Thrills! Chills! Spills! No, really. I once took a messy fall when I kinda sorta forgot I was disabled. But those tales are for the future! For now, I leave you with the beautiful, scantily clad young woman!

Hmmm... This one seems to be wearing a mirror.

Diabetic Neuropathy: These SFX Are Not CGI

Wow. You came back after that last post?! I'm a little surprised, what with its "fun" subject matter. Permanent nerve damage probably doesn't seem as scary as going blind because it starts off with pain, and humans start hurting themselves almost immediately in life. Trust me. At some point during your toddlerhood, you took a header that had you wailing. Because we deal with pain from early on, maybe you think you'll be able to cope with the pain of diabetic neuropathy. And who knows? Maybe you can.

There are other things, however, that you'll eventually be unable to deal with due to their increasing severity. These things happen slowly, so you don't notice them until they've become a problem... and they're just going to get worse.

"Ummm..., Rob? You said this blog would infuse humor into all of the bad news. You're not being particularly funny today."

Okay, I'll tell a joke.

A chicken and an egg are lying in bed, with the former smoking a cigarette. The chicken then looks over at the egg and says, "Well, I guess we answered that question."

If you don't get it, you're too young to have it explained.

Now back to our regularly scheduled doom, gloom, and misery.

On the off chance you've forgotten the function of the nervous system, it's the lines of communication that connect everything in the body to the brain. Some of the things the brain does don't require thought. Those are the autonomic functions I mentioned last post. Your heart beating, breathing, etc. Then there are the things you do consciously. Writing, playing video games, calling your arms dealer to demand why the latest shipment of guns is late.

Oh... Is that last one just me? My bad.

Now try to imagine your body performing autonomic and conscious functions together. When you think to reach for the TV remote, you don't activate each muscle individually. The brain automatically handles all of the fiddly little details that allow you to perform your chosen task.

Because diabetic neuropathy wreaks havoc on the nervous system, however, some of those neurological messages won't reach their final destination as swiftly as they should. And sometimes, as a bonus, they don't reach that destination at all. Fear not! Medical science has devised a way of testing for this! Ready for this mouthful? It's called a electromyography, also known by the much shorter "EMG." It measures muscle response to electrical stimulation of the muscle. Like almost everything else pertaining to diabetes, it involves a needle. The technician gets the needle into the target muscle, sends a little electrical pulse through it, and the equipment measures response time... if there IS a response. One technician couldn't get a response out of me, so she called the doctor in and he poked around with the needle until he simply gave up.

Good times. Good times.

If you're not reading into this, I'm leading you to the conclusion that your muscles will start to suffer from atrophication. Muscles atrophy - decrease in size and waste away - from inactivity. You might be able to prolong the life of various muscles with a moderate exercise routine, but once you've started to lose the muscle mass, it's usually all down hill from there.

Loss of muscle mass in your feet can lead to falls that result in injury. Loss of muscle mass in your hands can lead to a weakened grip and cause a loss of motor control - just a fancy way of saying you'd lose control over hand movements.

Now I tried to look for pictures to show you, but I couldn't adjust my search parameters well enough to find what I wanted. So after a bit of struggling - okay, A LOT of struggling - I took pictures of both of my hands. Because of the angle at which I had to hold my hands, they look a lot more wrinkly than they actually are. Without further ado, my hands:

Left hand.

Right hand.

I am, believe it or not, trying to do something very specific in both pictures. Discounting my thumbs, I'm struggling to bring my fingers together. They should all be tight against one another, but I can't do that unless I curve my fingers. It's that loss of motor control I mentioned. In some circles, this is known as diabetic hand syndrome. 

Now for another hand pic. Try to maintain control as I bring back my sexy right hand.

For your enjoyment,

I circled the problem area.

See that area I circled? There should be a thick cluster of muscles there. After a mere 10 years of diabetic neuropathy, medical professionals could see the beginning of muscle atrophy. With over 25 years between me and my diabetic neuropathy diagnosis, laymen can see how that area where muscle should exist is now little more than webbing.

Heavy stuff, right? Let's lighten up the mood with another joke before I go on.

A guy walks into a psychiatrist's office with a duck on his head. The psychiatrist asks, "Can I help you?" And the duck says, "Yeah, get this guy off my butt."

Next on our exciting list of things diabetic neuropathy can do to you is diabetic gastroparesis. I mentioned last post how digesting food is one of the autonomic functions of the body. Diabetic neuropathy can mess that up, leading to such exciting symptoms as nausea, abdominal bloating, feeling full after only a few bites of food, acid reflux, and vomiting undigested food you ate hours ago.

I've experienced symptoms of gastroparesis. I once had such bad acid reflux that I thought I was having a heart attack. Because I was brought to the ER with a complaint of chest pain, they did an entire cardiac workup on me without ever considering that my problem might have been digestive. The ER doctor shrugged after all tests came back negative and sent me home. Acid reflux never entered his mind.

Oh, I have another good one! This involves another autonomic function. It's called orthostasis. When you stand up, the blood vessels in your legs constrict to stop your blood from rushing into your legs. Diabetic neuropathy can lead to orthostatic hypotension, which is a significant delay in constriction of those lower blood vessels. As a result, you become lightheaded and dizzy. Oh, your body eventually catches up and regulates your blood pressure appropriately, but by then it's a question of whether or not you've collapsed from the improper amount of blood in your head.

Much of what I've discussed thus far probably isn't relatable. Muscle weakness? An inability to digest food? Bah! Unimportant hogwash!

Fine. I'll give you a reason to be afraid. This is the part where I go into full Adult Mode, so I'll be straying from what I've tried to do thus far, and that's to keep this blog family friendly.

Erectile dysfunction. Men know it and fear it. Women know it and smirk. (Laugh while you can, ladies. I'll get to you shortly.) Several of my posts have mentioned microvascular damage. No one really thinks about it until it's pointed out, but men becoming erect is a result of increased blood flow to the groin. Thanks to damaged nerves to go along with the vascular issues, your one-eyed trouser snake doesn't even know when it's time to wake up.

"Silly Rob. They got pills for that. I'm not worried." While I nod sagaciously at your well-made argument, let me also point out that many of those pills have side effects that distract from the fun you're hoping to have. The increased blood flow provided by Viagra can make you feel feverish. Cialis can cause severe muscle aches. These are only a couple of side effects, (aside from the four-hour time limit before you should contact a healthcare professional).

To the feminine gigglers I hear on the sidelines, you also get to experience sexual dysfunction. Men will forever be jealous of a woman's capacity for multiple orgasms without the required refractory period. (That's our time to "reload," gentlemen.) Well, ladies, how would you feel if you went from the ability to have many orgasms to... oh, I dunno... ZERO.

Obviously, I can't speak from experience about that last one. I just know that it exists. Truthfully, I don't know if your team also has a pill to address the issue, so talk to your doctor if you want to know more.

There's one other aspect of diabetic neuropathy I want to discuss, but I'm going to save that for another post because it's HUGE! The kind of thing that's impossible to ignore. You'll LOVE it! 😉

I've shared enough pictures this post, so I'll end with one final joke to help you decompress.

A duck and an egg are lying in bed, with the former smoking a cigarette. The duck then looks around with rising panic and says, "I think I'm in the wrong joke!"

Diabetic Neuropathy: YOU ARE NOT PREPARED!

For those unfamiliar with the line, "YOU ARE NOT PREPARED!", you should watch the trailer for World of Warcraft: Burning Crusade. The way Illidan shouts the line at the end is exactly how I'd say it when warning diabetics about diabetic neuropathy. There's no way I can explain this complication of diabetes and discuss my experiences with it in one post. This condition, which is permanent nerve damage, has been the bane of my existence for almost 25 years, and can be YOURS for the low, low price of neglecting your diabetes!

Do you know what causes diabetic neuropathy? "You just said it, Rob. Neglecting my diabetes." Yeah, okay. I get that. But do you know its specific pathogenesis? "It's patho-hoozi-whatsis?" The specific physiological changes that cause disease. For example, when I discussed diabetic retinopathy - diabetic eye disease - I talked about vascular damage and neovascularization. So I'll ask again: Do you know what causes diabetic neuropathy? "No, Rob. I do not. But you're going to tell us, right?"

Ummm... No, I'm not. Because the reality is that no one can. There are a great many working theories about what causes it, but no one really KNOWS. Here's one of them. 

Take notes. There'll be a test later.

Through the scientific processes of voodoo and mysticism, the body converts glucose (regular old sugar) into fructose (sugar from fruits), which it then converts into sorbitol (sugar alcohol). Why does the body do all of that? Well, I'll tell you... 

...that I'm STILL not a doctor, so I'm explaining this the best a layman can!

Somehow, some way, the sorbitol winds up in the nervous system. The sorbitol and the neurochemicals that make your nervous system function are just about the same size, so only one can squeeze through the neuropathways. Think "Three Stooges Syndrome" from The Simpsons. When the proper chemicals go through, all is well. When sorbitol goes through, it damages the nerves.

I guess I should toss the other theories at you while I'm here. Telling you to research it on your own might be pushing it. I mean, somehow you wound up here, reading this blog, and that was a miracle unto itself. Left to your own devices, you might decide neuropathy is caused by Bill Gates and 5G network towers.

Before you jump off that ideological bridge, diabetic neuropathy has been around a lot longer than Bill Gates and 5G.

Okay, the next theory is the typical microvascular disease. High blood sugars alter the shape of the smallest blood vessels, causing them to narrow. Inadequate blood flow starves the nerves of oxygen. (To starve a body part of oxygen is medically known as hypoxia.) Oxygen-deprived nerves break down and never properly recover because the blood vessels feeding it oxygen are permanently damaged.

The last theory I have to share is very similar. High blood sugars alter the structure of the nerves themselves, causing them to malfunction.

"Hang on, Rob. Theories two and three are the same thing, aren't they?" Yes and no. Theory two involves sugar damaging the blood vessels. Theory three involves sugar damaging the nerves directly. The problem is that science has yet to figure out a way to see these events as they're happening. By the time researchers are able to examine ruined blood vessels and nerves, it's after the fact.

Try to imagine a house that's been burned to the ground. The fire marshal says that the fire started in the garage, where there was the following: a natural gas leak, a stove turned all the way up with a pan of oil on it, and a faulty electrical outlet. So what started the fire? Did a spark from the outlet ignite the natural gas? Did the oil in the pan get hot enough to combust? Did that outlet release a spark inside the walls, which in turn started burning? Here's a brain twister: What if all three happened simultaneously?

It's very similar to diabetic neuropathy. Scientists know it exists, they just don't know what "started the fire."

"Ummm... Rob? Why was there a stove in the garage?" Really? That was your takeaway from that example? 🤨

This is the part where I rail against the way diabetics are taught about its complications. It's always the same simplistic warning: "You could lose a foot." The problem is that they never explain HOW it can happen. Well, dear reader, you'll be unhappy to know that I'm going to tell you.

It starts with pain. Diabetic neuropathy provides two exciting types. One is a burning sensation in the skin. The other is what's been described as a sudden sharp electric pain. The best part is that you'll experience both, sometimes simultaneously. Now you might be thinking, That's not so bad. I've had little burns and sharp pains before. I'll live. Oh, no doubt that you'll live. Except that these pains are your nerves screaming at you that they're not functioning properly. And here's some bonuses... The burning sensation can be so bad that silk touching your skin could cause you extreme pain. That sharp electric pain...? Yeah, I had one of those last for a week; just one specific spot feeling like someone has jammed a sewing needle into me.

By the way, for the sharp pains, I once referred to them as "pain seizures" and a pain specialist REALLY liked the phrase. And one of the reasons he probably liked it so much is because diabetic neuropathy is often treated with anti-seizure medications. I have a story about that one, but it'll have to wait. Let's focus on one thing at a time.

So there's pain. It tends to start in the extremities. For a majority of people, that means the feet and lower legs. Once neuropathy has advanced enough, you'll start experiencing numbness the the affected areas. That's not good news. It means the nerve endings have died. You could smash your foot into the leg of a table and the only way you'd know is that the impact registered with nerves that are still active deeper inside you.

This it where the loss of a foot can happen. Let's say you DO smash your foot into something and the skin gets broken. You have no idea how bad the damage is until later, when you decide to take off your socks. Surprise! The sock is soaked in blood! As you peel it off, you feel nothing as the scab, still clinging to the sock, gets ripped away. Around the now-freshly bleeding would is skin that's an angry red and warm to the touch. Congratulations. It's infected.

If you're one of those diabetics who hates doctors and think you can treat such a wound on their own, you might well be on the path to amputation. Cleaning the wound and using topical antibiotics probably aren't enough. The infection can go deep! Deep into other tissues, like muscles, bones, and tendons. That's when you'll feel it, when it reaches those still-functioning nerves. Such serious infections could lead to septicemia - blood poisoning - and gangrene - tissue death. It's at this point that amputation becomes a requirement because a part of your body has already died! There's no saving it.

I think it's time to bring this post to a close. I still have a lot more to say about diabetic neuropathy, but I've been so serious and, if I'm honest, angry, for a while. I'm angry because I know the end stages of diabetic neuropathy can be avoided, but almost no one listens. "Experience is the best teacher." Not in this case. By the time you're experiencing an amputation, you've got an entirely new set of lessons to learn... like how reliant you were on having two feet until you lost one.

Okay, let's decompress. Let's all relax and look at the beautiful... No, wait. Every time I promise to show you the woman, something else appears. So this time I'll promise something diabetes-related and maybe we'll get lucky.

Diabetes Fight Club.

Perfect. And with kids, no less!

Never was the cry of "phrasing!" more appropriate.

DKA: It Wasn't My Fault!

I can officially count THREE times when I lost control of my diabetes and it wasn't anything that I did to cause it. One story is boring. The second is wall-to-wall stupid. The third is a bit amusing. 

First Story

This one's short. I was 24 and wound up in DKA because. That's it. My answer is officially, "Because." When my physician asked me what happened, I told him that I honestly had no explanation whatsoever. We collectively shrugged our shoulders and hoped it would never happen again.

Second Story

Well, it did. I was 38. By that time, I was using "The Poor Man's Insulin Pump." That means I was taking a dose of insulin for each meal. I should have been checking my glucose before each meal, but I wasn't mentally there yet. To my credit, I was at least taking enough of an averaged dose to cover the food I ingested.

I was going to be out and about in the world to get a new pair of glasses, so I packed up some alcohol swabs and my insulin, and then rode on a couple of buses for two hours. When I reached my destination - an establishment that promised glasses in an hour - I had my eye exam, then walked the half-mile to the mall.

It was only after I'd eaten some lunch that I remembered to take my insulin. Hey, it happens. And I've heard people ask with shocked incredulousness, "How do you forget to take your insulin?!?" Their assumption is that something I do regularly would be impossible to forget. I counter with a question of my own: "Haven't you ever rushed out of the house and forgotten to brush your teeth?" When they try to point out that the insulin scenario is more dangerous, I offer the counterpoint that they're both daily rituals that can be overlooked when we're preoccupied.

Were you paying attention when I listed the supplies I brought with me? Alcohol swabs and my insulin. NO SYRINGES! 

Well, no problem, right? I would just go pick up my glasses and hop on the next bus heading home... except that I'd treated myself to the damned orange chicken at Panda Express for lunch.

I'll go into detail about how I take my insulin doses one of these days, but back then, because I wasn't actively calculating my dose per meal, I would be taking just enough to cover a meal that might be a little... sweeter than usual. And orange chicken definitely qualified as "sweeter." Additionally, there was no 24-hour insulin covering me on those off-hours back then.

By the time I reached the optometrist, I could feel my glucose levels rising. I was going to be in trouble if I didn't take some insulin soon. But I still had hours to ride two different buses to get home, so I got my new glasses and skedaddled.

With about 20 minutes before the bus arrived, I walked across the street to a sports bar for a drink. No, not a drink-drink. Just a drink. I was starting to experience the early signs of polydipsia, excessive thirst, so I ordered the largest Diet Coke they had to go. When it was served, I took a HUGE gulp of it and thought, Ummm... that... That didn't taste right. I asked the bartender if he'd given me a Diet Coke, and he replied, "No, that was regular Coke."

Yet another moment of inattentiveness helped that day go from bad to worse. If he'd given me the drink as I'd ordered it the first time, maybe I would have avoided the hospital. Maybe. Alas, as I boarded the first bus, I knew that was impossible.

Reaching my final stop, I still had half a mile to walk to get back to where I was living. While not the most strenuous activity, being active without any insulin to correct my metabolism was only helping all of the building poison do more damage to me. By the time I walked through the front door, I could barely stand. My housemates took one look at me and asked if I was okay. All I could mutter was, "Hospital." Why I didn't say, "Ambulance," is a mystery. One of them drove me to the hospital, where I finally vomited for all of the nice doctors and nurses, thereby proving to them that I was officially in DKA.

That's when I learned a new thing. It had been 14 years since I was last in DKA, so I didn't know that an insulin IV drip now meant being put in the ICU. Why? Because insulin in the veins as opposed to subcutaneous, (just beneath the skin), works at least 100% more potently. THIS IS NOT AN ENDORSEMENT TO TRY THIS AT HOME!!! IT'S EXTREMELY DANGEROUS!!! There's a reason why they administer this treatment in an ICU, where you can be continuously monitored by nurses. If for whatever reason you rapidly swing from high to low blood sugar, they have the knowledge and tools to counteract it... especially if you wind up losing consciousness. I really can't be any clearer. DON'T ADMINISTER INSULIN INTRAVENOUSLY AT HOME!!! 

When I could finally think straight, I explained how I wound up in DKA and we could both see how this case was a kind of comedy of errors.

And speaking of comedy...

Third Story

When I was 16, I started developing post-auricular inclusion cysts. Think of them as mountainous mutant pimples that never come to a head, and keep growing until they get so soft that they explode. Well, kind of. It's not like I'd be walking around school when they'd go off like volcanos. They'd usually burst if I rolled over onto them while sleeping. I'd wake with a small, bloody mess to clean up, and then life would go on.

Except when one of them decided to become extremely infected. Very red. Very tender. And since I haven't mentioned it previously, diabetes and infections are like a mix of steak-flavoring and Jell-O!

Okay, let's pause a moment and learn a thing or two, shall we? The body is chock full of autonomic functions. These are things that don't require conscious thought. Breathing. Blinking. Digesting. You get the idea. When we experience stress, we naturally go into fight or flight mode, even if it's a situation that requires neither fight nor flight. Case in point: pain. Let's imagine you suddenly burn yourself. Reflexes - another autonomic function - have you pull away from the heat source immediately, while naturally produced steroids are pumped into your bloodstream. Those steroids are packed to bursting with everything you need to fight or flee. This includes lots of sugar to energize you.

I'm only using pain as an example. Any form of stress can release those steroids. And in the case of my cyst, the stressor was infection. My body needed energy to fight the infection, so it fed me naturally occurring chemicals that I can't process without insulin! Yeesh! You'd think my body would've learned by that point!

The infection was bad enough that I lost complete control of my diabetes without putting any effort into it. I took my insulin, followed my diet, and still wound up hospitalized.

From the time I was brought to the ER to day seven of my hospitalization, I told everyone that needed to know about the giant, painful cyst behind my right ear. No one - and I mean NO ONE - was paying attention to that complaint. They simply chalked up my visit to the usual Rob antics, like not taking insulin and eating garbage.

In the background of this visit, my endocrinologist went on vacation, leaving a different doctor in charge... and then he also went on vacation, leaving a resident in charge of my care. Residency is an important part of a doctor's training, where they learn to fine-tune their considerable education. Alas, the resident I was left with wasn't the sharpest tool on the tree. (Yeah, I mixed metaphors. What are you gonna do about it?)

Seven days of being monitored and my glucose levels continued to fluctuate between 200 and 300. This was not how I usually responded to treatment. By day seven, they were usually ready to send me home. And because they couldn't wrangle my sugars, I earned a visit from the arrogant turd of a doctor left to care for me. He walked into my room, stood intimidatingly at the end of my bed, and demanded to know how I was cheating on my diet. There was no alternative in his mind. I had to be sneaking in some kind of candy or other junk food to maintain a consistently high blood sugar.

I was actually insulted. I mean, yes, I absolutely cheated on my diet egregiously, but never when I was in the hospital. And this doctor being so monumentally cocksure was offensive.

So, of course, I confessed. "The only extra thing I've had is soft pretzels with mustard." Plenty of extra carbs to raise the blood sugar there, right?

Dr. Know-It-All had a pen and notepad out in the blink of an eye. Now he wanted details. Who was bringing me... soft pretzels with mustard, was it? Yeah! When were they bringing it to me? How were they getting past the nurses station with extra food for me? He would have those answers immediately or I'd be confined to my room!

That's when I held up the book I was reading: Soft Pretzels with Mustard by comedian David Brenner.

He stared incredulously at me, getting red with rage. He was so mad that he couldn't find the words to tell me off. He simply stomped his way out of the room.

A few minutes later, a smiling nurse came in. She obviously found my cheekiness amusing. Thinking on it now, it's entirely possible that that intern's arrogance was something the nurses had to deal with daily, so him getting burned by some 16-year-old punk was exactly what she thought he deserved. This time, instead of instantly being accused, she ASKED if I was cheating.

For the umpteenth time, I explained about the incredibly large and painful cyst behind my ear. And for the first time during that hospital visit, someone looked at it. The cyst was warm, red, and so soft that it might well have popped that very night. But a surgeon was called up. He numbed the site, drained the cyst, and prescribed antibiotics. And wouldn't you know it? My blood sugars came under control two days later!

The cysts became an adventure all on their own, resulting in four different surgical procedures. But those aren't diabetes related, so you don't get to hear about them unless you ask nicely. 😛

Another blog post completed. I'm gonna try again. I know it seems impossible to confuse pictures so easily, but mine is a strange existence that defies explanation. And now... the beautiful, scantily clad young woman!

Oh, come on! That's just cruel!

DKA Revisited - This Time It's Personal

Get comfortable, tiny audience, as Rob, the World's Least Well-Known Diabetic spins his very personal tale of psychological woe and chronic illness. Perhaps a favorite alcoholic beverage might help... although if you're a diabetic, I really don't recommend it. Diabetes and booze go together about as well as a peanut butter and mustard sandwich.

I was taught to hate my diabetes from the start. Because I was around the incubator more than my father, everything pertaining to taking care of myself was conveyed by way of screaming. I couldn't get a urine sample going before a meal? I got screamed at. I was too scared to inject my own insulin? I got screamed at. Commenting that the orange juice she bought to treat hypoglycemia tasted bad because it was in weird metal cans? Wanna guess? That's right! I got screamed at!

On that last one... We usually had an entire carton of orange juice in the fridge, but I was required to use the cans because they were exactly 6 fluid oz. (About 29.5 ml. for anyone reading from across the pond.) From some unknown source, the incubator thought that was the limit on how much orange juice should be used to treat low blood sugar. When I asked if she could at least buy apple juice instead... Do I really need to write it at this point?

At age eight, I was sent to a sleepaway camp for diabetics. (I won't name them to avoid libel.) The day was structured with periods called "more actives" and "less actives." The former meant some kind of sports activity. The latter meant doing something relaxing. Urine tests, insulin doses, and meals were neatly mixed into the schedule.

What follows is only one example of several incidents that I experienced.

The morning went like this: Wake up --> morning urine test --> insulin --> breakfast --> less active (usually policing our cabin) --> more active... which was tennis in this specific instance. I didn't know how to play tennis. I didn't want to know how to play tennis. Thus, I refused to play tennis. Instead of suggesting some other activity to get the blood moving, I got screamed at. So it was like I hadn't left home at all... except that they added an extra cruel twist. Because I refused to be active, I was denied lunch.

After making it crystal clear that I never wanted to go back to that camp for the remainder of my life, I was sent back the next summer.

It was on my second visit to that "diabetic penitentiary" that I learned to perform my own injections. It was "spare tire day," meaning we were to inject our stomachs. The nurse handed me my syringe, pointed across the infirmary, and said, "I have to go help that kid. Good luck." And she walked away.

After wrestling with the very idea of giving myself an injection at all, I finally asked if the nurse would allow me take it in my leg. With her approval, I then sat there and stared at the syringe. It wasn’t a syringe at all to my nine-year-old eyes. In my head, the tiny needle was a Scottish claymore, five feet in length and honed to the sharpness of a baseball bat. They wanted me to jab that vicious blade into my tender young flesh?!? They had to be insane!

There was a radio playing in the background. I swabbed the injection site with alcohol and sat with the syringe paused over my leg. I was so afraid that I felt paralyzed with fear. Thankfully, instinct took over. I started bouncing my hand to the beat of a familiar tune on the radio. One-two-three-BAM! The needle sank into my leg and I depressed the plunger... a little too quickly, causing me to feel the insulin going in, which was... icky.

But it was done. Achievement unlocked: Shots, shots, shots, shots-shots! (No, I will not link the song. This is supposed to be a family friendly blog. 😉 ) I would use that rhythm method of injecting myself for years to come.

Things were different when I was 10. I was sent all the way up to Massachusetts to spend time at Camp Joslin. (Remember Elliot P. Joslin? He was the doctor who thought diabetes was visually appealing... the wacko.) At this camp, they taught diabetics to live WITH diabetes, which would have been an excellent lesson for me... had I not spent 2.75 years learning to hate diabetes with every fiber of my being.

I could fill several posts with all of the abuse I endured at home from the incubator and how my father wasn't around enough to defend me and my brothers from her, but it all boils down to this: anywhere else was better than the house I grew up in.

A couple of months before my 13th birthday, I got extremely sick. It was all of the symptoms of diabetic ketoacidosis, but I was hospitalized under the diagnosis of a severe stomach virus. Two weeks later, I apparently caught it again. And as the summer moved on, I got it again... and again... and again... For the record, as far as I know, there's no such thing as a chronic stomach virus. Chronic infections? Yes. Chronic diseases? Yes. Chronic viruses? Nope. Even herpes, which IS viral, takes some time off every now and again.

Hospitalizations guaranteed me plenty of positive attention from someone – anyone! Initially, I would be pleased when my parents would come to visit me, but that novelty became worn out in short order. The incubator would come into the room, take the television remote from me, flip to her soap operas, sit and watch while knitting. She would say very little to me. When her shows were over, she would pack up and leave with a minimal goodbye. My father would rarely show up at all. He was too busy or too tired to make the trip to the hospital. The rest of my family didn’t live close enough to come to see me. I was a teenager, so most of my friends didn’t drive yet.

After a while, no one would come to visit at all. I was left alone.

Well, not quite. I would take comfort in the company of the hospital staff. I would also go from room to room, visiting other patients and their visitors. The hospital is where I went to socialize.

Think about that for a moment. I would induce DKA so I could get away from my unhappy home and to make friends. Quite twistedly, I have fond memories of being hospitalized! And that, my miniscule audience, is clearly a sign of mental illness.

Since this was back in the 80's, mental illness still carried a heavy stigma. Today, mental illness is recognized and acknowledged as a genuine problem. Mental illness is mental illness, which mental illness mental illness mental illness. (I was already using the phrase too much, so I decided to run wild with it.)

The reality is that physical illness comes with mental illness. Even if you're in perfect health, a bad head cold will make you feel emotionally down. Now imagine the condition is chronic. Diabetes. Asthma. Colitis. Migraine headaches. The list goes on and on, and they all come with varying degrees of depression. And if the condition is terminal...? I'm not qualified to discuss that, but I can only imagine how bad it would be.

As it is, I can tell you how bad depression is from my own perspective. I've been officially diagnosed with severe recurrent depression and PTSD, with the incubator contributing generously to both. The best description I've ever heard to describe depression: Imagine you're lying in bed, and in the middle of your bedroom floor is a magic wand that will fix everything that's wrong with your life. All you have to do is pick it up and wave it around a bit. Depression saps you of the will and energy to even roll onto the floor, pick up the incredibly light wand, and give it a few casual waves.

Those diagnoses of mental illness came later in my life. During my teens, while other kids were delving into drugs and alcohol, I was getting into Twizzlers. It was my way of self-medicating. Y'see, that's what addicts are often doing. They're treating their illnesses with that which makes them feel good, or at least helps them forget why they're miserable. Me? I went to the hospital for a week or so, where I was treated well and was able to forget my miserable home life.

Why tell you all of this? Because there's always an underlying reason why a diabetic would allow themselves to become so violently ill. My reason was an unhappy home. And if you're a diabetic who's often losing control, you need to ask yourself that big introspective question: Why?

Between the ages of 13 and 20, I was hospitalized countless times. I know it's over 50, but I officially lost count after I turned 16. And every one of those hospitalizations did more and more long-term damage to my body without me noticing. I would learn much later what I'd done to myself.

So... We feeling good? Everyone bright-eyed, bushy-tailed, and happier than clams?

No?! NO?!? Fine. I'll improve everyone's day with that picture of the beautiful, scantily clad woman I mentioned last post.

Well, okay. I could've sworn I clicked on the

beautiful young woman, but my ninja penguin

showed up instead. He's the one I send out

to handle... problems.