Heart Broken

Yeah, yeah. "Heartbroken" is one word. Since I make an effort to choose my words with care, (although you'd never know it with some of my typos), I'm not writing about a failed relationship. In fact, I'm not really talking about my heart in this post, but my vascular system. Still, it's a cardiologist who oversees my "heart" disease, making the post's title appropriate. So nyah! 😛

It was probably about 10 years or so ago when I was prescribed my first bottle of nitroglycerin, (commonly called "nitro" to save on syllables). Yes, I'm one of millions of people walking around - "hopping around" in my case - with what is supposed to be an unstable explosive compound in my pocket. Well, kinda. Through some kind of pharmacological voodoo, the compound is rendered harmless in terms of explosions and such.

The reason it was given to me was because I was experiencing an occasional tightening sensation in my chest. Nitro is a vasodilator. If you've ever had your pupils dilated, then think of nitro doing that, but to blood. However, my symptoms were so infrequent that my past PCPs never thought it important enough to recommend I see a cardiologist.

And then the frequency started to increase.

There were other factors besides symptoms that pushed me to see a specialist. First and foremost is my family's history with cardiovascular disease. My paternal grandfather died from a sudden heart attack at 65. (Might have been age 60, but that's because one memory collided with another and the math did strange things inside my head.) My father was in his 60's when he had to have a triple bypass and mitral valve replacement. My brother, two years younger than me, tore his ascending aorta while he was... ummm... Well, he and his wife were alone, and... uhhh... Y'know, doing married couple stuff. As I understand it, his condition should have been fatal. By some miracle, he lived. So, yeah. The men in my family didn't have a good history when it came to cardiovascular health.

Another reason was that I was 50 when I asked my PCP to refer me to a heart doctor. The big 5-0 is when you should really start paying more attention to the possibility of a number of illnesses, including heart disease. Doctors can perform basic tests to monitor for such conditions.

Finally, just in case you didn't already think of it, I wanted a heart doc because I'm a diabetic. A lack of glucose control can force the restructuring of existing blood vessels, so heart disease is almost inevitable for diabetics. Almost. 

The thing that my brain latched on to was that doctors and nurses kept referring to the tightening sensation in my chest as "pain." Silly me, I would try to correct them that pain hurts, and this didn't hurt. It just felt uncomfortable and worrying. Eventually I recalled heart attack victims describing that it felt like an elephant was sitting on their chest, so... Yeah, I guess it really was a kind of pain.

My newly acquired cardiologist ordered some tests, including a stress test. This is where they usually force the patient to be active briefly, and then record how the cardiovascular system handles it. I, however, had to be the difficult patient, what with me dealing with the giant hole in my foot. The stress on my heart had to be chemically induced, and... it did not feel good. It was unnatural to be sitting still, engaging in next to nothing except conversation with the technician doing the test, when suddenly my whole body was flushed with blood, my heart pounding away. 

The result of the tests indicated that heart disease was indeed settling in, but my doctor believed it could be managed with medications. He put me on a cocktail of four different medications and scheduled a follow-up appointment.

On my next visit, I still wasn't feeling quite right, so he increased one of the medications.

Rinse and repeat for the next visit, with the same medication increased.

At that point, I felt okay. Reaching for a nitro tablet became a rare occurrence.

Then COVID-19 decided to enter all of our lives. I had the pandemic trifecta of pre-existing illnesses that would make for miserable circumstances if I should catch it. Diabetes, overweight, and cardiovascular disease. By some miracle, I didn't catch it. But the stress of its very existence started doing that thing to my chest again. So when I called the cardiologist to let him know what was going on, he deemed it time for us to do an angiogram so he could see what was going on inside me with his own eyes.

I knew the basics. He'd go in through an artery and have a look around. What I did NOT know was that his exploration would be broadcast onto a huge TV screen right there in the catheter lab and that I'd be pumped full of blood thinners. They gave me a bit of sedation so mild that I didn't really feel its effect at all.

Here's what we learned. Keep in mind that he didn't name the arteries, only calling them "the first, second, and third." 

The first was in good shape. Not GREAT shape, just good shape. 

The second required the placement of a stent. This involved him sending in a balloon surrounded by a metal mesh and positioning it where a blockage was forming. He inflated the balloon, widening the artery and supporting that widening with the mesh. How the stent stays in place is something of a mystery to me, but it stops that artery from narrowing again. This part of the procedure meant I'd be on blood thinners for the next year while new arterial tissue grew over the stent.

The third artery... Ohhh, that third artery. Totally, completely, 100% blocked. He even had me look at the screen so I could see him bumping the wire probe uselessly against the blockage. But while that blockage was forming, my body took the initiative and tried to effect its own repairs. I have collateral arterial growth that bypasses the blockage. However, this isn't the good news it sounds like. Do you remember, even vaguely, when I talked about neovascularization in my diabetic retinopathy post? Like the new blood vessels in the eye, the new arteries aren't as good as the original equipment. In fact, when the doc was starting to explain the collateral arterial growth, I asked, "Like neovascularization in diabetic retinopathy?" To which he replied, "Exactly."

This procedure should have been an in-and-out experience, but I just had to be the troublesome patient. My blood refused to clot, so I kept bleeding from the hole in my wrist where he'd entered my vascular system. I was kept overnight, with nurses checking on my leaky wrist every two hours.

If you're ever hospitalized, remember that you're not there to rest; you're there to get well. And if that means a nurse interrupting your sleep every two hours, so be it.

So that's my tale of how I was officially diagnosed with diabetic heart disease. What makes this different from regular heart disease? I'm a diabetic. That's it. It's probably not REALLY diabetic heart disease, but the fact that I'm a diabetic means the word "diabetic" is likely to be thrown in front of every diagnosis I receive.

Before I go, this...

You didn't think I'd be serious,

at the end, did you?

Showing a Little Leg

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

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

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

The initial wound.

After 10 days of wound care.

After 20 days of wound care.

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

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

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

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

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

Posting Schedule Derailed

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

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

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

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

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

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

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

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

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

Mmm... Yummy brake pads! 💖

Every Post Could Be My Last

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

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

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

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

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

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

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

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

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

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

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

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

My FRIENDS made that choice.

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

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

Silver linings, people. 😉

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

This is Monica Barbaro,

AKA "Phoenix" in

Top Gun: Maverick.

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

We're All DOOOOOMED! But Not Really.

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

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

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

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

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

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

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

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

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

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

Or become a cyborg. Because cyborgs are cool.

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

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

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

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

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

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

And now...

This... will take too long.

Hang on...

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

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

A Little Update

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

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

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

What it looked like the day after

it happened.

A week and a half later.

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

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

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

Please Like, Subscribe, and Comment Below

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

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

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

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

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

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

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

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

Nothing. 

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

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

Now it's just a matter of someone

convincing me to post a pic of her

in lingerie. 😉

Taking a few days off

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

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

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

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

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

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

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

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

My Poor, Beleaguered Psyche

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

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

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

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

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

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

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

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

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

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

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

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

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

I looked it up and found this among

the images. Seems legit.

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

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

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

Clara from Doctor Who? You're all

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

Wait a minute!

Disaster Supplements

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

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

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

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

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

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

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

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

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

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