June 19, 2006


This morning at work I was feeling a trifle low, so I went digging in my bag for my piece-of-crap meter. It wasn’t there.

Hmm. I reviewed my steps that morning. Had the meter gone into my bag? I couldn’t be sure. I looked in the bag again, ferreting through its many pockets. No meter, piece of crap or otherwise.

Well, for crying out loud.

I’ve done this before, of course. I’ve left my meter at home, at work, in an airport. (I have a backup at home, none at the office. Foggy, peculiar Violet in action.)

I’d never been in a situation where I felt low and couldn’t test. The most straightforward solution--consume a lot of carbs--would probably leave me over 300 by the time I got home or obtained another meter. So I tried to assess my lowness by feel. It wasn’t a bad one, at least not yet. Just a little shaky. Reminded me of when I get symptomatic in the 70s.

I ate two Milk Duds (4 g). That was all I had in the box. I ate one glucose tablet (4 g). I contemplated going to the fridge for juice. Decided to wait.

A few minutes later, I felt normal again. Then I felt a little nauseated. Maybe I hadn’t been low after all, in which case I should take some insulin. No, no. Foolishness.

Online, I researched the NIP formulary. Hardly any brands of test strips are approved. I decided to buy a One Touch Ultra Smart. Looked for coupons online. No luck.

I spent the next two hours feeling sorry for myself (well, also working a bit). Meters aren’t cheap. I know better than to go out without my meter. Stupid diabetes. Stupid forgetfulness. Stupid everything.

Finally, I dragged my ass down to Walgreens. The meter of choice happened to be not only in stock, but hugely on sale. It only cost $30, plus $26 for test strips. Maybe NIP will reimburse me, though I don't have a prescription yet.

The OTUS is clearly much better than the piece of crap, with many customizable features that I will probably never use. POC will become my office backup.

I tested at 105. Phew.

June 2, 2006

Observed on the F train

Yesterday, while hanging on to a pole during the subway ride to work, I noticed a shiny-eyed young fellow in a business suit watching me with a rather animated expression on his face.

I am not, to place this event in context, of an appearance or personality that generally attracts the attention of men on trains. I have my charms, I think, but they are the subtle, quiet kind. I move through the world relatively unnoticed most of the time.

I glanced away from Mr. Bright Eyes, then back again. He looked away quickly. Caught!

A moment later, it happened again.

Hmm, I mused. Perhaps this is not such a bad hair day as I’d thought. Or maybe the Cymbalta has already added a mood-disorder-treatment-in-progress glow to my countenance.

Then I realized that the man wasn’t looking at me. He was looking at Nellie.

When I wear a dress, I usually stash my pump in a thigh pouch I got from Minimed, which has an elasticky band with an adjustable Velcro closure. But I have a few dresses that are cut such that I can conceal the pump in the side of my bra, under the strappy part that goes around the ribcage. It’s easy to pull out (in private) for dosing, and when I’m standing, sitting, or lying down, my arm covers the pump, rendering it almost invisible.

When I am hanging on to a subway pole high above my head, however, I appear to have an absurd rectangular attachment bulging under my clothing, inches to the right of my not-quite-so-bulging breasts. It was this protrusion that had caught the eye of my observer. He was trying to figure out what the hell it was.

Realizing this, I felt a little mortified at my vanity. Foggy, peculiar Violet has an admirer! Ahem. Not.

Some of you, I know, would have taken the opportunity to educate Mr. Bright Eyes as to the nature of Nellie. I’m not so bold. However, for the sake of pride, I did refrain from switching arms to conceal the pump. (Actually, the persons surrounding me were so closely packed in that I couldn’t switch arms, making it expedient to decide that I wouldn’t even if I could. So there, Mr. Bright Eyes.)

On the plus side, this small adventure made me realize how completely accustomed I’ve become to wearing the pump. I used to be very focused on concealing it from people to avoid just the sort of attention I received from my subway companion, but it’s so much less of a Thing now that, apparently, I’m able to forget it completely--at least on a train full of way too many humans and way too few seats. This may symbolize a form of progress. Or it may just be another example of what it’s like to be Foggy, Peculiar Violet, who also forgot to put on her medical ID bracelet yesterday and nearly took twice the correct insulin dose with her dinner due to misreading the nutritional info on a box...

June 1, 2006


I feel pretty sheepish now about Dr. Two-Fifty's moniker. I really ought to make it a policy to meet the docs before I take the gloves off in the naming process. Dr. Two-Fifty, had I met her first, would be properly named something spirited and optimistic (such as Dr. Pluck), for reasons I'll explain below. But for the sake of continuity, Dr. Two-Fifty she shall remain.

The waiting room of Dr. Two-Fifty's office is filled with flowers. There are six vases full. (It's a large waiting room.) It smells a little like a funeral home, but it looks very nice. Dr. Two-Fifty emerges to greet me. She is smiley, quirkily dressed (for a shrink working in a hospital, anyway), and has a firm handshake.

She spends an hour with me, during which we cover my recent life history (egads), discuss the workings of insulin pumps (with which she was not familiar), factor in family-related issues, and talk about drugs. Particularly the latter, of course, since that's why I am there. Dr. Two-Fifty feels very confident that I am experiencing a biological depression. She has a lot of interest in prescribing Cymbalta for me. Three things point that direction: the clear compatibility with diabetes; the fact that it's a chemical cousin of Effexor, which Mrs. Violet (my mom) has used with great success, meaning that it might work for me as well; and the possibility of side benefits with a (non-diabetes-related) pain condition I've had for many years. Cymbalta is good for unhappy nerves of all sorts--it's used for diabetic neuropathic pain as well as depression--so it might be soothing to more of Violet than just the brain.

Ah, but then there is the problem of the NIP drug formulary, which, as noted below, classifies Cymbalta as a "step" drug. I bring out the formulary list of brain meds and show it Dr. Two-Fifty.

She wrinkles her nose. "What does 'step' mean?" she asks.

"It means that before they would approve Cymbalta, you would have to tell them that we tried other meds and they didn't work."

"Outrageous," Dr. Two-Fifty declares. "Well, that's no problem. I can do that."

"You can?"

"Sure. It'll take a few phone calls, so you probably wouldn't get the prescription for a few days, that's all."

I am impressed. This must be what part of those two hundred-fifty dollars are for.

Then I have a small light-bulb moment. It is 7 PM on May 31. The NIP insurance goes into effect at midnight on--yes--June 1. All I need to do is get the prescription filled tonight, assuming GOI (Gentle Old Insurance) will approve Cymbalta. Then I will have my pills. And NIP is supposed to honor all transferring prescriptions as long as the doc says it's okay.

Moments later, Dr. Two-Fifty is googling Walgreens. We find a 24-hour pharmacy 4 blocks away, and off I go.

I took the first dose this morning, GOI having been quite cooperative. I miss them already. Cymbalta is a small capsule the color of canned peas. (Ouch. I was hoping for purple.) I'm starting on half the usual starting dose, as Dr. Two-Fifty believes a gradual transition is much more comfortable and safe. I hope that doesn't mean it will take longer to work (if it works at all), but of course it might. Meanwhile, I have the satisfaction of thwarting NIP, which has improved my current mood considerably. A good start.