Overthinking

Depression is a wretched thing. Some days I feel okay, others it takes almost nothing at all to reduce me to a blubbering mess. Sometimes it isn't even days, it's just hey this moment I'm David* Banner and the next I'm the Hulk.  In my case it's probably mostly the grieving process at work, but I've been noticing for a while now that my moods have been swinging a lot more than they used to. At least I don't turn green...

Writing used to be cathartic and now it's just a chore. Let's see how this goes.

I'm not depressed because of my diabetes. That's just life. I saw an article a day ago about a ten year old girl who had passed away at a sleepover because her blood sugar had dropped. This was something my parents were always afraid would happen, which is why I didn't spend the night at anyone's house until I was much older than ten, and even then my little sister had to come along. I had friends whose parents didn't want me to stay over because of the diabetes. As a kid I never even considered this was a thing. I had no sense of mortality. Now, I do. But even now whenever I start listing the things that are stressing me out, my diabetes isn't one of the top contenders. In fact, it's usually an after thought.

Speaking of thought, I'm an over thinker. Every comic you've ever seen where someone is lying awake at night staring at the ceiling thinking about everything is me. I lie awake and I think. I can't not think. I don't know how to stop. Even when I'm asleep I'm thinking. I know this because I wake up a lot at night, and when I do I'm already in the middle of a thought...or more likely, a string of them. And not even a string...it's more like...a cloud. A brain cloud.

Lately, I just feel like my mind is spiraling out of control. I forget what I go into rooms for, can't keep track of my list of things to do, and generally walk around not sure what is going on, where I'm going, what is happening, or if I'll ever regain control of my life.

Weird thing is, I'm actually in control of most of my life. I just don't feel like it. Which kind of brings us back to depression, because I don't feel like doing anything, really, a lot of the time. I'd say I'm just lazy but I've always been lazy and this is...different.

My doctor put me on an anti-depressant, but that backfired in an epic, almost Michael Bay type way. I haven't been sick like that in a long while. It actually kind of depressed me more that this wasn't going to be an option. I've survived this long without them, though, so it really isn't that big of a loss. 

I guess the point here is that it's always something, as Gilda Radner would say, and the something may always be diabetes in the back ground but it's certainly not in the foreground most of the time. For example, the number one thing that wakes me up at night is actually my insulin pump beeping incessantly. But I never think to actually look at the screen to see why it's beeping- I just pound on the buttons until it mercifully stops beeping, at least for a little while. The diabetes is so much a part of who I am that it hardly even registers on my radar anymore. And that's kind of ironic, when you think about it. The one thing I should be thinking about, considering I think about everything all the time, and I just don't.

My theme song.

*Yes, I know in the comics and the MCU movies his name is Bruce. Bill Bixby was David and that's canon in my head so don't make me angry. You wouldn't like me when I'm angry. 

Oscar the Grouch

My favorite Sesame Street character is Oscar the Grouch. I don't have an over zealous love of trash, but I can be a grump. (Incidentally, did you know Caroll Spinney, the same puppeteer who performs Oscar, is also Big Bird, and has been both character since the show launched in 1969? No wonder he has four Daytime Emmy Awards. He deserves more!)

Everyone should read his book, by the way. 

I have noticed that I seem to create a lot of the stuff Oscar covets, though, particularly of the "medical" kind.

Test strips alone are a lot. (Four finger sticks a day times an average of 30 days a month is 120 strips, plus packaging.) And little bloody tissues take up a bunch of space. (Also times at least four- more when my pump is trying to get into Automode, but that's a different blog.) And don't even get me started on the sensor and pump set packing.

Too late.

On July 1st I started to collect all of the diabetes related trash that I created in a gallon zip lock bag, just to see how much of keeping me alive was polluting the planet. Halfway through the month I needed a new bag, and there have been a few things (mostly bloody tissues) that I have forgotten to stash and threw away. By the end of July I had two very full gallon zip lock bags full of medical garbage. If I'm really honest I was expecting more.

Sesame Street and Oscar © Sesame Workshop

But then I started to think about the math. If I fill up two one-gallon bags each month, that's 24 gallons of trash every year that I throw away. I can recycle the boxes that the pump supplies come in, but the rest of it has to hit the landfill. 24 gallons of trash doesn't seem like that much over the course of a year...but then you figure I've been on the pump for about fourteen, and have had sensors for the last six, at least, and before that I was using syringes four times a day...so let's even guess just a gallon a month for that...

I've probably thrown out 240+ gallons of diabetes trash at least since I started on the pump, and maybe 300 gallons of trash before that. Honestly, it's probably more like 450 gallons, because 4 shots a day and two different types of insulin instead of the one, plus extra blood tests, and therefore extra lancets means it was probably closer to 1.5 gallons of trash instead of just one. That's 690+ gallons of diabetes related trash over my lifetime.

If you figure that a standard size drag it down to the curb trash can is about 32-35 gallons, that means I have filled at least between nineteen and twenty-one (and a half) trash cans with needles, bloody tissues, test strips, pump containers, used alcohol wipes, and various other sundries.

Then take into account that there are over 30 million people living in the US with diabetes, but only about 1.5 million of them have Type I , and that's more math than I am willing to do at any given time. That's a lot of trash.

We need a damn cure, people. I don't even think Oscar the Grouch would want to touch this stuff.

John Lennon Said it Best

And it also goes on, regardless of the void that you're now living with.

Three days after Dad passed away I was sitting in pump training. I probably could have cancelled it and put it off for later, but Dad would not have been happy with me for not taking care of myself. I was also out of sensors for the other pump and the new one had been sitting in my linen closet for months, after all.

The new pump I'm on is again a Medtronic. For the most part it's business as usual- I had no problem putting it on and getting it going. It uses the same insulin reservoir, the same insertion settings, and for the most part is very familiar.

Except that it's totally a different thing.

Old pump

New Pump...pay no attention to that high blood sugar.

This new pump has different "modes."  Straight up just on and monitoring your blood glucose (BG) is called manual mode. Letting the pump actually act kind of like a real pancreas is Auto Mode.

Wait, what?

This is some high tech Batman stuff I'm talkin' about here. For one thing, in "manual mode" it has safeguards that will stop the pump from giving you insulin when it notices your blood sugar dropping. As long as the continuous blood glucose sensor is working, this is a game changer.  My other pump would alert me to lows but just keep on trucking along until I either dealt with it or ended up in a coma. And the sensor itself is pretty damn accurate, which is a miracle for Medtronic.

It has to be accurate, because of the whole reason to get this pump. Auto Mode. Auto mode is basically the pump automatically deciding how much insulin I need based on previously gathered sensor data, current sensor glucose readings, and (this is the scariest part) what I input into the device.

Give myself insulin before I eat?

Count my carbs?

What madness is this?

Actually, if I can keep myself in the habit of doing those things, we may see some significant improvement in my next a1c. I had a pretty scary low the other night because I mis-counted the carbs, and today I'm riding high for the same reason, but otherwise since I started using the auto mode on Tuesday I've been pretty steady between 70-160.

I will say this, though, (since you know it's rare I have no complaints)- the new pump is a needy little wretch. I've been checking my blood sugar more than average. More than I think I have since I started on CGM in the first place. (And yes, I know this is a really stupid thing to be complaining about because it's status quo for all diabetics that we get the finger stick several times a day.)

There are other things about it that kind of annoy me. It takes several more clicks to do things now, like silence it or give a bolus. Whereas before a blind person could use the pump now there is a lock on it that requires sight to bypass, so that sucks. And then there's this-

Apparently the adhesives for the old pump gave people a lot of problems, like allergies, so Medtronic changed them. Now there are two redesigned adhesive tapes they insist we use, and the result, at least on my skin, is the above. Itchy, red, painful...it's pretty awful. And of course, once I get it off I'm putting a new one on, and it's a big radius on those things. I've been constantly overlapping that tape on top of already irritated skin. 

Fortunately, the other tape came in packets of ten, even though there were only five sensors in the box. I have tons of them left over, so in spite of the request to use their "new and improved" tape, I'll keep on keepin' on with the old ones until they stop making them so that my stomach looks like I've got horrible rashes all over it. 

Complaints aside, I have high hopes for this thing. If it really can help me regulate my blood sugars better then that's only a good thing. I'm not getting any younger and even though the retina specialist I saw this morning said the pictures of my retinas were "excellent" and that I should keep up the good work, getting things closer to normal is the goal. And maybe this time with this pump things will be just that much easier over all. It's not like I can really control this disease, but guiding it might be an obtainable goal.

I hate this blog

Seems like the only time I ever make time to come in here and do this anymore is when I have a major complaint or I'm grieving. And this sucks because this is the latter.

My father passed away last night after a months long battle with multiple infections that he kept picking up at rehabilitation facilities. Had he not had multiple myeloma (read: cancer) this may not have happened, but he did so here we are. The thing we were all focused on was getting him back on his feet after the broken hip in December, then getting over this infection, then that infection, then this other infection...all the while the cancer, which couldn't be treated until all this other crap was taken care of, was in the background silently making it harder and harder for Dad to fight back. He'd been on life support for two weeks and there was nothing more we, or he, could do. So last night we said good-bye while John Coltrane played him out in style.

I've known for a while that this was coming, but the little girl in me kept hoping that my Daddy was going to surprise everyone and pull through. That they were going to get the ventilator out of his throat and he was going to start breathing normally, that today they'd try to ease off on the pain reliever and he'd start to stir, and that after a couple days he'd be up and talking to us. I wanted so much for that to happen. But it didn't.

My Dad wasn't the easiest person to live with. He was very quiet, and spoke very little. His use of the silent treatment wouldn't seem like much considering this, but it was pretty pronounced. He was a jazz musician and didn't have a whole lot of appreciation for music that was played the same way twice (or the music I played over and over in my room!) But he was always there for me, and he always wanted what was best for me, and he loved me and I knew it. He certainly loved my son, maybe a little bit because they looked so much alike.

What can I say that I haven't said before? This sucks. It's awful. I'm broken-hearted for so many reasons. I don't know that I ever really got to know my father- he was a private person even with family.  I just scanned my Google Photos and there are so few where my Dad is the main focus of the picture. Most of the time he was just in the background, watching what was going on. I wish I had more pictures of my Dad, but the truth is being in the background was kind of how he was- always there, quietly observing, chiming in when he felt the need to which wasn't that often.

I think that's what makes this the hardest. My Dad was in (the first) rehab for his broken limb last Christmas. It was weird him not being there. The conversation level wasn't much different. The food wasn't much different. The number of presents and laughs wasn't different. But what was different is that Dad wasn't there in the background, just being there. That steadfast presence I always felt was gone. And now he's really gone and it doesn't seem real at all.

Dad wasn't big into sports like most dads. Father's Day cards were always a challenge because he never fit that stereotypical Dad mold. The thing that I really associate with my Dad is music. He played woodwinds (like, all of them), and composed, and arranged, and conducted. He gifted us his old turntable and speakers and receiver. The speakers were built for him back in the 1950's or something, and are so big I could still fit inside of one. I told him we were thinking about buying a piano and he said, "Just take ours." (To be fair, I'm pretty sure the upright was my Mom's and the baby grand we sold over 25 years ago was my Dad's, so he gave us my Mom's piano.) The books and magazines he read were all about music. He spent hours watching YouTube videos of jazz players. He was a professional musician from the time he was 15 years old. When I see musical notes, I think of my Dad.

I'm still in the numbness phase. Lots of memories floating up to the top of my consciousness. Lots of wishing I'd wake up already because my Daddy can't be gone. Lots of wishing I could hug him again and tell him I love him.

Welcome to Adulting. Sorry, no refunds.

Current state of mind:

Not to bore anyone with details, though, if you're reading a blog about diabetes perhaps details don't bore you, but since my last blog I have been "in the process" of getting a new pump. I'll wait while you check the date on my last blog. For those of you who wouldn't bother to do that, it was in October.

OCTOBER.

Much has happened since then. And, as Inigo Montoya once said,

My husband and I spent most of last year fostering a child that we had initially planned to adopt. That did not work out and in November the child was moved into another foster home. We also permanently closed our foster care licence because we are sure of what our family unit consists of now: us, our son, and our pup Rosabel.

In December my Dad fell, broke his leg, and has since been in and out of care dealing with issues stemming from this. It has been incredibly hard on my Mom and I feel guilty for not being more help to her.

In January my hubby had neck surgery and he is still recovering from this ongoing ordeal.

Throughout all of this, Rosabel has become increasingly less mobile because of her knee issues, and pretty soon we'll have to start researching wheelchairs for her with purchasing in mind.

Our son has restarted behavioral therapy because while he is a brilliant and loving child, his favorite word is no, he has his sensory issues, and he has got to learn how to listen before my patience is used up and all words come out as screams.

Interspersed between all of this I have been receiving bits and pieces of "new pump" materials.

• Waaay back in August, at least, Medtronic started to call me about getting a new pump because the warranty on the one that I am (still) using expired.
• At some point I told them to ahead and submit it to insurance- provided they understood I was only okay with this as long as it was 100% covered. So far I haven't gotten a bill.
• A new glucometer arrived first, because the ones I have don't "speak" with the new pump. Got this at some point in December, I think.
• The actual new pump arrived- definitely in December, because we were out of town and even though it was supposed to be signed for the UPS driver just left it in front of my house. This has been sitting unopened in my bathroom linen cupboard since it arrived.
• Less than two weeks ago I got the transmitter for the CGM. I think it was actually last Monday that I picked it up from the UPS store. It looks exactly like the old one with the exception that it has a little "G" on it.

I should probably add in here that somewhere toward the beginning of this I was told that all of the supplies for this amazing new pump that was completely covered by my insurance are coming from Puerto Rico, so there might be a delay in getting them because when this all started they'd just been hit with a hurricane, the fallout from which they are still suffering. At the time, though, it was estimated I'd be up and running by January, February at the latest.

 

So today I called Medtronic to see what was going on. After four attempts and being hung up on twice, I finally reached what my grandfather would have referred to as "a real live person" and after a few minutes of explanation I asked, "When are the sensors going to be available?"

"Oh, they're available now. We just don't have an order for you."

"...Can I put them on order?"

I have a person who is supposed to be in charge of my account, setting up training, and yadda yadda. I didn't ask for how long the sensors have been available, because it may have upset me even more. Regardless, they are now in processing- not exactly on order, because they have yet to be run through my insurance, and I'm guessing they still need to contact my doctor to have a prescription written for them since they asked for the office contact information. So we'll see when/if they arrive, and whether or not they will actually be covered by my insurance.

Frankly, I haven't been doing a stellar job of taking care of myself, and I could be doing better but I've been using all the drama in my life as a crutch as to why I haven't been. I've also been using that as a crutch as to why I haven't been following through with the physical therapy I'm supposed to be in for the arm pain I've been having for almost a year now (it's not shoulder pain, but I am definitely feeling it in the muscle below my shoulder. My range of motion has been limited of late.) I have a doctor's appointment in two weeks wherein I'm sure I'll get an earful, but I think the thing that is either going to really motivate me or have me throw my hands up in surrender is my next birthday. It's a big one and I'm not one hundred percent sure how I got here so fast. It just feels like yesterday that I was listening to Alanis on the radio and deciding which classes I was going to take my first semester in college. Where the heck did my 20's and 30's go?

Is it? Or is it a coincidence? I don't know anymore.