A few brief notes on overseas travel:
1. I always worry about security issues when I take my pump and supplies through new airports. Nellie and I navigated the airports of Rome, Bologna, and Brussels without disruption.
2. That said, for the first time ever, I was asked to produce documentation of my need to carry diabetes supplies. This was in the Brussels airport, pre-boarding for my flight to return to the U.S. I had my endo's letter with me, and it was accepted without question. (The agent was also willing to accept something called a "health card," whatever that is.) The letter was briefly taken from me, and I was told that it would be shown to the pilot. It was returned to me within a few minutes and I was allowed to board.
3. The same agent asked me in a rather pointed way, "You are carrying only the supplies you need for this flight, correct?" She was tipping me off as to what to say, it seemed: she practically winked at me as she spoke.
I was carrying a lot more than that, of course--to be specific, my entire stash of leftover pump supplies and backup syringes from a week-long trip. Nobody in their right mind would board an overseas flight with exactly 8 hours worth of supplies and no more. Imagine if the plane were diverted or had mechanical problems or who knows what. I bring all my supplies in my carry-on, period.
I answered, "I'm carrying what I need plus backup in case my pump has problems." Technically true, depending on how broadly one defines "problem."
That worked for the agent.
4. Had I followed the advice of Dr. Reassurance (see post below) on adjusting the pump clock for the 6- to 7-hour time change--she said to simply update the time when I arrived and watch for trouble, my body would catch right up--I would have had serious lows.
Insulin needs are indeed closely related to physical activity, so it makes sense that over a period of a few days the body would adjust to a time zone change. But I hadn't wanted to make such a drastic change all at once because it would have placed my highest basals, which are more than double the lowest, right smack in the middle of the period when my body was expecting the lowest dose. It seemed moronic to blithely change the time on a delicately calibrated medical device without making ANY compensation for the fact that my body, for the first couple days, was pretty sure it was 11 PM even though the actual local time was 6 AM.
One of my pump resources, SMART PUMPING (published by the ADA), recommends that for a time zone change longer than a couple hours, you should adjust the pump clock by 1.5 per DAY until you're caught up to local time. That made a lot more sense. In the end, I took a sort of middle road and made up my own adjusted basal regimen with the main premise being that I really couldn't handle a major low on this business trip. I allowed myself to run slightly high until I felt very confident that my body had decided to catch up to local time.
I also had to adjust for my different insulin-to-carb ratios throughout the day, a topic not addressed in any of my books. I went a conservative route here too, using my lunchtime ratio for both breakfast and lunch (instead of taking significantly more insulin at breakfast as I normally would). As far as I could tell, over 7 days my meal ratios NEVER normalized to local time. Again, had I reset the pump clock per the advice of Dr. Reassurance, I would have seriously screwed myself.
Hmm, a very practical post for Violet. I'll navel-gaze more next time so that you can all feel confident the real Violet hasn't been kidnapped by aliens and replaced with a stoic number cruncher...
April 13, 2006
March 12, 2006
Ruminations, month 18
Well, I'm trying to think about coming back here. It's not feeling great.
I'm bored and angry and eye-rollingly apathetic, almost simultaneously (though I realize that isn't quite possible), with having diabetes. Somehow the idea of participating in my online D-existence feels like acquiescence--which is in another person's parlance simply "healthy adjustment" to reality, but there you are. I'd like a few months or a year of denial, thanks.
The zillion finger sticks a day: mind-numbing. The set changes, hauling crap around everywhere I go, crunching tablets on the subway, feeling guilty about keeping shoddy records: yawn, yawn, ennui. I don't mean to sound pathetic or self-pitying: what I'd really like to feel is neither, but just normal.
That said, I also know I should be grateful for a little boredom. Nonboredom for the diabetic typically means loss of control, complications, hypo unawareness, or some charming combination thereof. Boredom means your life is not currently, immediately threatened. Huzzah.
Another reason I'm cranky, a perhaps less boring one, is that I'm getting ready to go overseas for the first time--for business, alas, rather than pleasure--and I'm more than a little anxious about the D ramifications of the six-time-zone change combined with an intense work schedule. My new endo, Dr. Reassurance (she's a separate post), says all I need to do is reset the pump's clock and expect a bad day while I adjust. Um. Okay. That seems weird somehow. I need to research this further during the next, eek, 12 days. I'm so sick of diabetes that for the first time since dx I am entirely behind the curve in researching how to take of it and myself. Normally I am all over this kind of shit.
Anyhow, the tests and suchlike (hmm, I initially typed "sucklike," heh heh) from January turned out mostly okay, and the follow-ups to the not-quite-okay one turned out okay too. So I still don't really know what's been up, but the meds are continuing to help me overall. This is a good thing.
I feel like I've veered off the trajectory of the hegemonic narrative, to borrow some English grad student BS lingo, of the adult-onset diabetic. Shouldn't I be well on my way, at this point, to sunshiney gratitude for the gifts my disease has brought, as dissected in numerous posts across the blogosphere a few months back? Shouldn't I be philosophically wry, in a charming, admiration-invoking way, about how much worse off I could be, and also how if I'd been born a century ago I would already be dead? Well: I do have times when I feel philosophical in a positive sense, but right now it seems mainly clear that the whole business of having a chronic disease Just Never Goes Away and is Terminally Tiresome. Which makes inhabiting this online world, as full of grace and support as it often is, in some ways very sad for me. I would like to be less centered on diabetes, not more, and I don't know how to balance that with the positive aspects of writing here and allowing myself to care about others who are writing their stories as well.
I'm bored and angry and eye-rollingly apathetic, almost simultaneously (though I realize that isn't quite possible), with having diabetes. Somehow the idea of participating in my online D-existence feels like acquiescence--which is in another person's parlance simply "healthy adjustment" to reality, but there you are. I'd like a few months or a year of denial, thanks.
The zillion finger sticks a day: mind-numbing. The set changes, hauling crap around everywhere I go, crunching tablets on the subway, feeling guilty about keeping shoddy records: yawn, yawn, ennui. I don't mean to sound pathetic or self-pitying: what I'd really like to feel is neither, but just normal.
That said, I also know I should be grateful for a little boredom. Nonboredom for the diabetic typically means loss of control, complications, hypo unawareness, or some charming combination thereof. Boredom means your life is not currently, immediately threatened. Huzzah.
Another reason I'm cranky, a perhaps less boring one, is that I'm getting ready to go overseas for the first time--for business, alas, rather than pleasure--and I'm more than a little anxious about the D ramifications of the six-time-zone change combined with an intense work schedule. My new endo, Dr. Reassurance (she's a separate post), says all I need to do is reset the pump's clock and expect a bad day while I adjust. Um. Okay. That seems weird somehow. I need to research this further during the next, eek, 12 days. I'm so sick of diabetes that for the first time since dx I am entirely behind the curve in researching how to take of it and myself. Normally I am all over this kind of shit.
Anyhow, the tests and suchlike (hmm, I initially typed "sucklike," heh heh) from January turned out mostly okay, and the follow-ups to the not-quite-okay one turned out okay too. So I still don't really know what's been up, but the meds are continuing to help me overall. This is a good thing.
I feel like I've veered off the trajectory of the hegemonic narrative, to borrow some English grad student BS lingo, of the adult-onset diabetic. Shouldn't I be well on my way, at this point, to sunshiney gratitude for the gifts my disease has brought, as dissected in numerous posts across the blogosphere a few months back? Shouldn't I be philosophically wry, in a charming, admiration-invoking way, about how much worse off I could be, and also how if I'd been born a century ago I would already be dead? Well: I do have times when I feel philosophical in a positive sense, but right now it seems mainly clear that the whole business of having a chronic disease Just Never Goes Away and is Terminally Tiresome. Which makes inhabiting this online world, as full of grace and support as it often is, in some ways very sad for me. I would like to be less centered on diabetes, not more, and I don't know how to balance that with the positive aspects of writing here and allowing myself to care about others who are writing their stories as well.
January 11, 2006
Six points for Dr. Bruce
The reception area of Dr. Unknown is shabby: carpet worn through, paint chipped and filthy. A sign requests my patience during a time of building-wide renovation.
BAM BAM BAM BAM BAM BAM BAM. RAT A TAT A TAT A TAT A TAT. BAM BAM BAM BAM BAM BAM.
Along with my other symptoms, I now have a headache. Wait, didn't I already have a headache? Yes, yes I did.
I've arrived early in anticipation of filling out numerous forms. There is only one, with four lines, plus a privacy disclosure.
BAM BAM BAM BAM BAM BAM BAM. RAT A TAT A TAT A TAT A TAT. BAM BAM BAM BAM BAM BAM.
Dr. Unknown's receptionists, an ethnically diverse triad of chattiness, are discussing the romantic misfortunes of one of their group. "What you need to do," one advises, "is get your OWN apartment, your OWN condo, and tell him to..."
BAM BAM BAM BAM BAM BAM BAM. RAT A TAT A TAT A TAT A TAT. BAM BAM BAM BAM BAM BAM.
The triad is interrupted not only by the hammering above but by a male voice. They address the speaker as Bruce.
Bruce, I recall, is the first name of Dr. Unknown. Hmm. First-name basis with the desk staff? Chalk up one for him. And for the triad, for that matter.
I wait a while longer. Dr. Bruce personally fetches the patient ahead of me. And then he fetches me. "Ms. Violet?" he inquires and shakes my hand.
Another point for Dr. Bruce.
We go to his office, a crowded but neat room featuring pictures of his family, a teddy bear, various physicians manuals, a Monet print, a book about Tibetan healing, and a volume of Margaret Bourke-White's photographs.
We talk for a long time about why I'm there. He asks questions and takes notes. He doesn't rush me. My history raises no eyebrows: he is familiar with an adult getting type 1 diabetes, he understands my obscure gynecological problems, and he seems to know insulin pumps, too. I grudgingly award him another point.
He suggests that there may be various explanations for my symptoms, not only fibromyalgia, and that we will keep open minds for the time being.
Then there is an exam. Dr. Bruce takes my blood pressure himself. Is his nurse absent? Or is he just incredibly self-sufficient? I've never seen a doctor do the "nurse" stuff. He seems very natural about it. Okay, one more point.
Dr. Bruce: 4. Anti-Dr. Bruce: 0.
After the exam, we return to his office and talk further. He explains that fibromyalgia is not a hasty diagnosis. First we must rule out other possibilities, of which there are many. He will do scads of bloodwork to this end. I shouldn't be frightened, but one of things he'll check for is lupus. He doesn't think I have lupus, but as it's an autoimmune disease that can cause symptoms like mine, he would be remiss in not checking. But he really thinks I have a virus, something that will go away as I heal over the next few weeks. Many viruses, he says, can cause muscle and joint pain and terrible fatigue. One is parvovirus, which usually strikes kids, but in adults can cause symptoms much like mine. The bloodwork might tell us, or might not. Time will also tell us a lot. If I still feel this way in 6 months, he will be more inclined to consider fibromyalgia.
I'm cranky. He's making sense. But I'm supposed to sit around and feel like crap until he decides I've been sick long enough to be diagnosed? I am on the verge of subtracting a point.
"Of course," Dr. Bruce continues, "what you probably want is to feel better right away. We can address that."
Oh.
Dr. Bruce prescribes a muscle relaxant for bedtime, which will help me fall sleep and should assist with the problem of pain awakening me. I will also take an anti-inflammatory twice a day for pain. There's one that's prescribed more often than the one he's giving me, he says, but it can affect blood sugar, so we don't want to use it.
Two more points.
I am to call next week and report on how I feel. He'll tell me about the bloodwork and we'll decide what to do next. Unless something of concern shows up, in which case he will call me first.
I fill my prescriptions, return home, and google parvovirus. Hmm. Could be. Not sure. Meanwhile, the drugs do help. I had less pain last night. It was hard to fall asleep, but once I did I slept almost all the way through the night for the first time in weeks. This morning I'm feeling pretty good, some small pains but not much. A huge improvement.
Woo hoo. Woo hoo hoo!
BAM BAM BAM BAM BAM BAM BAM. RAT A TAT A TAT A TAT A TAT. BAM BAM BAM BAM BAM BAM.
Along with my other symptoms, I now have a headache. Wait, didn't I already have a headache? Yes, yes I did.
I've arrived early in anticipation of filling out numerous forms. There is only one, with four lines, plus a privacy disclosure.
BAM BAM BAM BAM BAM BAM BAM. RAT A TAT A TAT A TAT A TAT. BAM BAM BAM BAM BAM BAM.
Dr. Unknown's receptionists, an ethnically diverse triad of chattiness, are discussing the romantic misfortunes of one of their group. "What you need to do," one advises, "is get your OWN apartment, your OWN condo, and tell him to..."
BAM BAM BAM BAM BAM BAM BAM. RAT A TAT A TAT A TAT A TAT. BAM BAM BAM BAM BAM BAM.
The triad is interrupted not only by the hammering above but by a male voice. They address the speaker as Bruce.
Bruce, I recall, is the first name of Dr. Unknown. Hmm. First-name basis with the desk staff? Chalk up one for him. And for the triad, for that matter.
I wait a while longer. Dr. Bruce personally fetches the patient ahead of me. And then he fetches me. "Ms. Violet?" he inquires and shakes my hand.
Another point for Dr. Bruce.
We go to his office, a crowded but neat room featuring pictures of his family, a teddy bear, various physicians manuals, a Monet print, a book about Tibetan healing, and a volume of Margaret Bourke-White's photographs.
We talk for a long time about why I'm there. He asks questions and takes notes. He doesn't rush me. My history raises no eyebrows: he is familiar with an adult getting type 1 diabetes, he understands my obscure gynecological problems, and he seems to know insulin pumps, too. I grudgingly award him another point.
He suggests that there may be various explanations for my symptoms, not only fibromyalgia, and that we will keep open minds for the time being.
Then there is an exam. Dr. Bruce takes my blood pressure himself. Is his nurse absent? Or is he just incredibly self-sufficient? I've never seen a doctor do the "nurse" stuff. He seems very natural about it. Okay, one more point.
Dr. Bruce: 4. Anti-Dr. Bruce: 0.
After the exam, we return to his office and talk further. He explains that fibromyalgia is not a hasty diagnosis. First we must rule out other possibilities, of which there are many. He will do scads of bloodwork to this end. I shouldn't be frightened, but one of things he'll check for is lupus. He doesn't think I have lupus, but as it's an autoimmune disease that can cause symptoms like mine, he would be remiss in not checking. But he really thinks I have a virus, something that will go away as I heal over the next few weeks. Many viruses, he says, can cause muscle and joint pain and terrible fatigue. One is parvovirus, which usually strikes kids, but in adults can cause symptoms much like mine. The bloodwork might tell us, or might not. Time will also tell us a lot. If I still feel this way in 6 months, he will be more inclined to consider fibromyalgia.
I'm cranky. He's making sense. But I'm supposed to sit around and feel like crap until he decides I've been sick long enough to be diagnosed? I am on the verge of subtracting a point.
"Of course," Dr. Bruce continues, "what you probably want is to feel better right away. We can address that."
Oh.
Dr. Bruce prescribes a muscle relaxant for bedtime, which will help me fall sleep and should assist with the problem of pain awakening me. I will also take an anti-inflammatory twice a day for pain. There's one that's prescribed more often than the one he's giving me, he says, but it can affect blood sugar, so we don't want to use it.
Two more points.
I am to call next week and report on how I feel. He'll tell me about the bloodwork and we'll decide what to do next. Unless something of concern shows up, in which case he will call me first.
I fill my prescriptions, return home, and google parvovirus. Hmm. Could be. Not sure. Meanwhile, the drugs do help. I had less pain last night. It was hard to fall asleep, but once I did I slept almost all the way through the night for the first time in weeks. This morning I'm feeling pretty good, some small pains but not much. A huge improvement.
Woo hoo. Woo hoo hoo!
January 8, 2006
Stree, or where I've been
1. Really tired. Tireder than tired. Grocery-shopping-leads-to-mandatory-napping tired. Missing-out-on-going-to-bookstore-with-Animegirl-because-too-tired tired.
2. Really sore. Freakishly sore in muscles not being used and some I didn’t know I had. Bizarrely sore in joints that don’t look swollen. Made sore by slicing chicken and by doing nothing at all. Sore enough to lose sleep, worsening #1.
3. Really fuzzy in the head. Unable to concentrate for large chunks of the day. Language-related cognitive errors, e.g., typing the wrong words in memos, such as publishing interesting when my brain was thinking publishing industry. Awkward lapses for an editor, these are.
4. Really anxious about the above, too focused on every bodily sensation. Doing my hypochondriac, excessive researching thing. Full of theories. Current frontrunner is fibromyalgia, which my mom has and which fits my current situation almost exactly in terms of symptoms.
5. Spinning wildly from #4 to an unknown future in which my hopes and plans for work and family are cast into doubt by yet another decline in health.
As all this has been going on for several weeks, I’ve broken down and sought medical intervention at last. Oh good, a new opportunity to be disdained and patronized by health-care professionals! Tuesday I’m seeing a rheumatologist. I can only hope this encounter will lead to numerous suspenseful bloodlettings, diagnostic screenings involving machinery, and multiple follow-up appointments before I’m told nothing is wrong me with
Whoops. I’ll leave that in as a demonstration of #3. Hell, at least I caught it before I hit the “publish” button. I know--everybody does stuff like that all the time. My brain just doesn’t feel like itself. Language is supposed to be my safe area.
Anyhoo…before I’m told nothing is wrong with me that a laboratory can find.
The idea that I may have another chronic medical problem is a little too much for me right now. Maybe it’s all stree. Whoops, I meant stress. Ahem. (What’s stree? Stress induced and/or experienced by a tree?) But I don’t think stress all by itself is supposed to effing hurt this much.
My current goal, energy permitting, is to detail Whatever May Come in the most sardonic possible tone for your amusement and mine. Oh, and to not be ill. That would be cool too.
2. Really sore. Freakishly sore in muscles not being used and some I didn’t know I had. Bizarrely sore in joints that don’t look swollen. Made sore by slicing chicken and by doing nothing at all. Sore enough to lose sleep, worsening #1.
3. Really fuzzy in the head. Unable to concentrate for large chunks of the day. Language-related cognitive errors, e.g., typing the wrong words in memos, such as publishing interesting when my brain was thinking publishing industry. Awkward lapses for an editor, these are.
4. Really anxious about the above, too focused on every bodily sensation. Doing my hypochondriac, excessive researching thing. Full of theories. Current frontrunner is fibromyalgia, which my mom has and which fits my current situation almost exactly in terms of symptoms.
5. Spinning wildly from #4 to an unknown future in which my hopes and plans for work and family are cast into doubt by yet another decline in health.
As all this has been going on for several weeks, I’ve broken down and sought medical intervention at last. Oh good, a new opportunity to be disdained and patronized by health-care professionals! Tuesday I’m seeing a rheumatologist. I can only hope this encounter will lead to numerous suspenseful bloodlettings, diagnostic screenings involving machinery, and multiple follow-up appointments before I’m told nothing is wrong me with
Whoops. I’ll leave that in as a demonstration of #3. Hell, at least I caught it before I hit the “publish” button. I know--everybody does stuff like that all the time. My brain just doesn’t feel like itself. Language is supposed to be my safe area.
Anyhoo…before I’m told nothing is wrong with me that a laboratory can find.
The idea that I may have another chronic medical problem is a little too much for me right now. Maybe it’s all stree. Whoops, I meant stress. Ahem. (What’s stree? Stress induced and/or experienced by a tree?) But I don’t think stress all by itself is supposed to effing hurt this much.
My current goal, energy permitting, is to detail Whatever May Come in the most sardonic possible tone for your amusement and mine. Oh, and to not be ill. That would be cool too.
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