Tuesday, April 03, 2012

Meditations on melancholia

I am not, by nature, a cup-half-empty kind of guy.

My general reaction to unpleasantness is a combination of "stiff upper lip, old boy" and a pause to smell the flowers before powering through whatever unpleasantness has reared its' ugly head.

Coupled with this attitude is a state of general physical health that apparently has to be experienced to be believed, along with an immune system aggressive enough -- to borrow a phrase from Ambulance Driver -- to attack squirrels in the back-yard.

I have literally been told, on more than one occasion, by a doctor, "I don't know what the hell you brought back from Nigeria, but it seems to be clearing up."

Heh.

Diabetes is the first major hitch in my get-along that I've ever experienced.

When I was diagnosed, my doctor sat down and asked if I had any questions. I really didn't, so he looked me in the eye and said, "Your death certificate is going to read: Complications of diabetes. That's a fact. However, we can get another thirty or forty good years."

It appears that I may have locked in on the first part of that sentence and ignored the last part.

Sigh.

I have done extraordinarily well. My HbA1C levels have been consistently better than expected. My doctor wants my A1c to be at or below 6.9 -- and it's been between 4.8 and 5.6.

However, getting the old blood sugar down that low has required some fairly significant life-style changes. Stress and pain, I have discovered, tack on a decent 100 points to my blood sugar ... and me with a job that is nothing if not stressful, and the occasional pain is unavoidable.

Pizza and rice -- two foods that have been staples of my diet in the past -- elevate my blood-sugar all out of proportion to what they should, damn it.

Last week, I was checking my blood sugar at work. Normally, I do this in a closed office, or in a quiet corner somewhere, but there was a fairly major fur-ball hanging-fire, so I was doing it on the Ops Desk in Central Control.

One of my rookie officers happened to see me doing so, and was obviously squicked-out about the whole finger-stick thing; the stress had run my blood-sugar too damned high; I really wanted a medium pizza; and I was suddenly heartily sick-and-tired of being diabetic, of the responsibilities of rank, with the whole kit-and-kaboodle.

The icing on the cup-cake was when one of my best subordinates walked up and handed me a two-week notice of resignation.

Have you ever seriously thought of crawling into a dark room, shutting the door and staying there?

My officer apologised for the resignation, but explained that the officer's spouse was going to be dead in less than a year because of a medical condition, and that my officer was determined to spend as much time with the spouse as possible before the end.

The officer then shook my hand, thanked me for being me, and calmly reported that part of the fur-ball had been dealt with and what were my orders as far as the rest?

After work that evening, I walked out to my pick-up, looked up at the moon and said, "I get the point. I'll pull my thumb out."

So I can't have pizza. Or a sandwich whenever I want. Rice is right out. So what? Assuming I don't zag when zigging is the right answer, I've got as many good years ahead of me as I have behind me.

I can think.

I can talk.

This morning I woke up above ground.

You know what? Everything else is just gravy.

LawDog

37 comments:

That Guy said...

Great post. All it takes is some perspective to show us we don't have it too bad.

Luis said...

Right on, baby, right on. I needed to hear that today.

Monkeywrangler said...

Dawg, I wish you could sit down and chat with my Type 2 insulin dependent better half. You two'd have fun...

You can checkout his blog if you like though. He's at formerfatguydiary.blogspot.com . There's also a very good book I can recommend--Not Dead Yet, by Phil Southerland. He was at one point, the youngest ever diagnosed type 1 diabetic. Diagnosis at 7months old...

--Vic303
And yes, every day you wake up on the green side of the grass is better than the alternative!

Anonymous said...

My father has, finally, gotten his type II under control - and feels much, much better.

The main thing he's done, is not consume any kind of grain, at all. He eats fruit, vegetables, etc, but does not touch grain.

Also, get your testosterone levels checked (T is part of your body's system to process blood glucose - your vet should know this, and your doc should know that type II diabetics usually have low testosterone levels.)

Peter said...

Oh, yeah.

I've got a long catalog of medical and physical problems myself, as you know. They don't make life any easier or more comfortable . . . but I'm still alive and kicking. Many folks who've been through what I've been through are either dead, or alive but not kicking - they're in wheelchairs.

Basically, if no-one's shooting at me, it's still a good day.

;-)

Phillip said...

Glad to hear you're getting back in control. Those kinds of diagnoses are hard to take, but it sounds like you've worked through the rough part and you'll be doing better from here on out.

I try to keep the same attitude you do, but sometimes it's hard to do. I fell off a 40 foot cliff in 2007, and due to the injuries I still have recurring chronic pain. It also seems to have messed up a bunch of metabolic processes, which we're still getting a handle on. But when it gets me down, I try to remember the answer I gave when I woke up in the hospital bed when people asked how I was: "I'm alive! I fell off a 40 foot cliff and I'm alive! I'm doing GREAT!"

Heh... Just remember, if you beat the diabetes like you did the Nigerian bug, you'll be strapped to a table for research. But do your best to keep it under control, and handle things like pizza and rice the same way others do cake or ice cream. Have a little bit of it figured into a dietary budget (make a menu) so that you can plan other things to reduce the impact.

I love seeing a new post come up in my feed reader from you, because I know it's either going to be funny, inspirational, both, or have some other value. This one... definitely reminds me to be happy for what I do have and to try to work on my attitude, and that's something I've been having a problem with lately. Thanks.

Well Seasoned Fool said...

Condolences to your officer and his wife with the terminal illness.

Anonymous said...

Sorry to hear that. Take it for what it worth, but slow-carb/low-carb diet is something to consider. No bread, pasta, rice, potatoes or any other starches based foods. Fruits are pretty bad too.

Beans/legumes/veggies for filler, any meat/fish/eggs/bacon for protein. As a side effect bad cholesterol will probably go down too.

Best part - one day a week you knock yourself out on any bad stuff.

KCSteve said...

My ever-indulgent wife found a diabetic 'pizza' recipie that's better than it sounds.

Basically you use a whole wheat pita as the crust and limit your toppings to reasonably friendly bits.

And yeah, I figure any day that starts off with "I woke up" and does not continue with 'in a pool of...' is pretty good.

Don't get to eat all the things I want when and how I want but I haven't lost any body parts yet so I'll go with it.

Foo Bar said...

I'm in much the same situation as you LD. did you get the massive weight gain from the Diabeties Meds?

I get a lot of "how are things?" from people about my health stuff. my response it "they could be worse"

I said that to a client of mine. she was feeling crappy. found out what they though was a spot on her lung. open her up to remove a small part and ended up pulling all of one lung and part of the other.

4 months later she died leaving a 12 year old daughter.

yah. things could be worse. I'm upright and ambulatory. I have a loving wife. I have guns in the closet and fishing license in my wallet

it could be worse.

The Lost Goat said...

Fool, I'm just guessing, but I'd bet a small body part that officer is female. Something about the carefully gender neutral wording ... and the percentage chance on who quits their job with a sick spouse.

Anonymous said...

I'm afraid this might not fit well into the tone of the post, but someone needs to say this:

"Have you ever seriously thought of crawling into a dark room, shutting the door and staying there?"

Those are generally called Monday mornings. Congratulations, now you know how us ordinary mortals feel. ;)

Anonymous said...

'Dog, My sympathies on the loss of pizza. I am in the same boat. At least you have a more compassionate sawbones than I. When I saw my Dr. last year, I had gone in for a feeling of just overall weariness and 'off-ness'. When the call came from the doctor's office saying that I "needed to make an appointment", I realized something was amiss.
With very little preamble, the conversation started, "So, basically, you're a huge diabetic."

Apparently, my physician learned his bedside manners from Atilla the Hun...

Anonymous said...

Lawdog, my late Father had type 2 diabetes.

We found that the Houston Eatzi's sourdough bread did not shoot his blood sugar up. There is an Eatzi's in Dallas I believe and hopefully they still have their own bread.

Dad would check his BS at night and see if he could have little bit of bread and jelly. Most of the time he could.

Enjoy your blog, stay healthy. Jesse J. South Texas

armedandsafe said...

Dog, I don't have diabetes. I do, however, have hypoglycemia, which is just the opposite of diabetes. When I eat a bite of food, the gland wakes up and floods a full load of insulin into my blood stream. Can you say "low blood sugar crash?" So, my diet problem is exactly the opposite of yours, but the symptoms and results of falling off of it are identical to yours.

Hang in there, lad. You will find a diet regimine which suits your tastes as well as your blood sugar control needs. It just won't contain as much "gravy" as you used to like, but it's still gravy.

Marty said...

A heart attack will kill you. So will cancer, and myriad other diseases. The difference between most of them and diabetes is that diabetes kills you slow.

Having hit my 50's, fear of Type II diabetes is the main reason I've committed to getting into better shape. Lost 30 lbs in the last couple months and am almost at goal weight. Now, the trick will be to keep it off...

Steve said...

Crap happens. And, good for you.

Low T, hypoglycemic and celiac disease.

All discovered in the last few years. So, I really have to watch what I eat, but I get to eat like a Hobbit (ten meals a day, when they can get them).

Plus, I have an expensive HRT.

But, I have a loving wife and kids, most of the rest of my health, and so long as I'm careful with my diet and make sure I eat before doing anything stressful (or getting behind the wheel), things work pretty well.

And I'm still on the upper side of the daisies.

Alisa said...

Perspective is everythng, isn't it? What's the proverb - "I wept because I had no shoes, until I met a man who had no feet." As stubborn as you are, I'd venture you'll outdo your doc's prediction by a goodly number of years. Goddess knows I intend to. :)

tanksoldier said...

Adult-onset Type I diabetes is the main reason I had to leave the Army. I was 35. Complete life changer, one that I still haven't completely come to grips with all these years later. All you can do is keep on keeping on.
You're such an inspiration online, I can't imagine what you're like in person. I've often wish I could work with or for you, just for the funny stories if nothing else, and I'm sure your co-workers and subordinates feel the same.

maddmedc said...

There.
Done that.
Was told that a year ago.
A1C from 13 to 5.9
Weight to much to damn near where I want to be..
Once a day oral med.
Feeling fine..
Except I had to give up my see-food diet of course..
Sigh I count every damn carb I eat..
It ain't easy...but the MBWITW (Most Beautiful Wife In The World)beat cancer and I have Sons whose kids I want to know..
Life...Hang in there...

Anonymous said...

Dog,
Keep up the good attitude.
Doc was hacked at my weight 186 and A1c 7.2 and shipped me off to the diabetic counselor. We tweaked the daily carbs/calories a few times. As I was starved at dinner we wacked the main meals down to 45 grams of carbs and I have a 30 grams of carb afternoon snack that I can live with. Thankfully I can have bread and it doesn't screw up my blood sugar. after about a year I'm 165 and A1c is under 6 (5. not much IIRC I was so happy I didn't care at that point) Note I can eat bread but I walk 2 miles one day and 30 min or so of calisthenics the next that was mainly getting rid of the pounds the diet of <1800 calories daily got rid of a lot of fat. My best guess based on dim memories was in college I ate about 5 times a day after college I ate on a clock (it's dinner lets eat) instead of when I was hungry that probably started the battle of the bulge.

I'm off all the meds but will be testing my blood sugar probably forever. That's ok, I've got a lot of stuff to live for and yet to do.

vis pizza, try spinach alfredo pizza it's great and doesn't screw up my numbers like the tomato/marinara sauces do. All the peppers I used to love now detest my numbers.

Keep that stiff upper lip going.

re:
quote

"Have you ever seriously thought of crawling into a dark room, shutting the door and staying there?"

for about .00003 seconds after the doc said diabetic,

but I have too much yet to do, then it was time to pull on the big boy pants and get cracking

The oddest part of all the eat/don't eat is that I can eat a large hamburger/cheesburger and an unsweetened Ice tea and it doesn't blow my numbers up at all.

touch one fry boy, and it's in orbit.

woerm/THR

Anonymous said...

I feel your pain, LawDog.

Diabetes is an IMPERIAL pain. Thanks for reminding me to, as you so succinctly put it, pull my thumb out.

But it's still a pain.
Ulises from CA

Unknown said...

Hey Dog....

Last year my endocrinologist asked me if I had ever been castrated. The only possible reply to such a question is "I think I would remember something like that."

It turns out that us males in our 50's are supposed to have 375 to 450 mg per decaliter of blood. Girls have 75-125 mg and pregnant girls can get to 200. Body builders and extreme athletes can get to 800 or even 1000.

My level is 34.

I just missed it by a decimal place and change.

Testosterone is famous for its effect on male sexual behavior; but let me promise you that it has quite a range of effects. It is also used by the body for healing after exercise and/or STRESS. It helps you sleep better. It is widely known as a neurotransmitter, and the lack of this hormone can mimic depression.

I was on an antidepressant for YEARS until this diagnosis was made. When I started testosterone therapy, I was able to go off the anti-depressant.

Internal Medicine doctors do not check for this hormone unless asked. However, Endocrinologists do check for it. I recommend an appointment with your friendly neighborhood endocrinologist ASAP to check for this, and about a dozen other chemicals that you and I know nothing about.

God bless you Dog.

Unknown said...

lsonave kshier

Rabbit said...

I have (well, had) two first cousins who were insulin dependent diabetics. The younger did quite well on a diet higher in proteins, and has been on an insulin pump nearly since they became available. She's dealt with it for 40 odd years now and is in overall reasonably good health. Her brother was not well controlled with either ultralente (NPH/Humulin) or regular insulin and while a diet of primarily carbohydrates kept his numbers closer to normal, he could swing from 140 to >600 in a matter of 90 minutes or so. He had other complicating medical conditions which contributed, but even with extremely close professional monitoring and dosing it was difficult to maintain a level anywhere close to normal.

Islet cell transplants are becoming more common. It may be something to look into.

Regards,
Rabbit

Gaffer said...

Attitude is everything...and you have the right attitude. With you lady keeping you on the best path you will do well.

Tam said...

I'm not one for cheesy internet hugs, but you can have one anyway. :)

Anonymous said...

Re. crawling into a dark room and shutting the door - Yup. Family history of depression, combined with receding prospects for employment in my field and a few other wild cards sent me down a hole a few weeks ago. As you say, I'm not pushing up crabgrass, most of me works to normal tolerances, and we got rain yesterday. Hang in there, Dog, sir.

LittleRed1

Library-Gryffon said...

You're not crawling into a hole, you're regrouping!

The grain-free lifestyle really isn't as hard as it sounds; I've been wheat/rye/barley free (mostly) for a decade, and in January I cut the rest of the grains and almost all of the other starches out. My blood pressure is back to normal instead of "normal for your age", I've lost some weight around the middle, I seem to have fewer grey roots, and the stomach doesn't demand a prilosec every morning. Those benefits along with less arthritis pain (I can *tell* if I've had too many refined carbs by how much things hurt in the morning), and fewer migraines are more than worth giving up pizza, pasta, and honey glazed donuts.

Though making a "crust" of a thin layer of ground grass-fed beef, baking it till done, and then adding pizza toppings worked out pretty good.

Bernard Brandt said...

Dear LawDog:

I rather approve of your existence. I find the world a more interesting place with you in it. I would like this state of affairs to continue.

Because of my interest in your survival, I suggest that you might want to look at the following website:

http://www.deathtodiabetes.com

As 'a word to the wise is sufficient', I will leave it at that.

Will said...

For those hypoglycemic:

Try a very low dosage of Fluoxetine (Prozac).
Dissolve a capsule in a measured amount of water. Start with 500mcg (micrograms) a day. Take this for a week, then increase the dosage by 50% for a week.

Evaluate results:
A) Does it seem that you are experiencing less blood sugar swings? Less sensitive to food intake times/types/amounts?

B)Encountered side effects of the medication?

If no to (B), consider increasing the dosage in regular steps until you get (A), or hit (B).

This is an off-label use of the medication. It is known to affect blood sugar levels, but not understood, IIRC. I stumbled on it nearly 20 yrs ago. I encountered side-effects at 750mcg, and reduced to 666mcg/day (30 spoonfulls/20mg capsule), which works well for me.

Note: Tablets will work. Cheap generics vary in quality, you may have to up the dosage to get a useful amount of the med.

MAKE SURE YOU ENERGETICALLY SHAKE THE CONTAINER PRIOR TO EACH USE!, (no matter which form you use).

It's possible this may also help diabetics, but I have no feedback on that application.

Will said...

Forgot to add,
Prior to this, I was setting an alarm to get up in the middle of the night to eat something.

Otherwise I was waking up as a zombie in the morning, stumbling around for several hours until I got myself together.

Firehand said...

Do what I do anymore: get the pizza, just eat the toppings. I'm not diabetic, but it's gotten so that much bread of any kind makes me feel stuffed for hours.

Or do the toppings pick up some of the troublesome elements from the crust?

Anonymous said...

Interesting post.

I recognize some of the symptoms others have mentioned (zombie in the morning, pain, feeling bad after eating some foods,..) and have diabetes in the family. I've never been checked. It may be time.


My sympathies to your officer and their family.

John Severson said...

Hang in there 'Dog. The world is a better place with you in it.

Jennifer said...

Hmm. And now I must figure out a diabetic friendly pizza recipe. Pretty sure lumpia is on the good list though ;)

Eqwatz said...

Make sure that you have your teeth and gums thoroughly checked; there isn't necessarily any pain with an abscess or gum problem.
I had a rotten tooth which abscessed and created a blood infection. I turned into candied fruit; my blood sugar was over 500 (I'm a dental coward.)
With a tooth extraction and 10 days of anti-biotic and my blood sugar was 100-120; this was after 20 hour fast, and then tested 1/2 hour after chugging a glucose drink.
Infections which reach the blood will give you crazy high blood sugar and cholesterol--it can be as stupid as an ingrown toenail or bone infection from stepping on a nail or thorn.