Thursday, June 08, 2017

what if I stopped?

I consider, from to time, whether I should continue to do all the things doctors prescribe for my multiple health issues. Test my glucose six times a day Inject one unit of fast-acting insulin for every 8 carbs I eat (so become adept at carb counting). Also, inject baseline insulin at bedrom and upon rising to give my body a baseline of insulin above and beyond the fast-acting stuff. So that's 8 to 10 injections a day.  Plus my joints hurt. Sometimes I hurt so much I can't think.  I do have, at long last, an appointment with a pain specialist on Monday. I got the referral and made the appointment back in early March and mid-June was her first opening. As I wait, I have no painkiller. Sometimes I hurt so much that I fantasize discovering some magical way to crawl out of my all-over aching.  Over the weekend, so weakened by pain and unable to ignore it as I usually can, I took an ibuprofen. My cardiologist -- yeah, I have heart failure, common for diabetics and my dad and maternal grandmother had heart issues with their diabetes -- insists ibuprofen is unsafe for women over fifty. I had the 400 mg ibuprofen tabs in the house. I haven't used any ibuprofen since I developed heart failure but on Sataurday, I was in so much pain I took one. It was an emotional stress to cave in and take it even as my body slowly hurt less. It still hurt but less. And my left knee:  I've been telling my primary for well over a year that something is wrong with my left knee and she doesn't exactly dismiss what I say but she doesn't offer any help for it. My left knee has gotten so bad I can barely walk. Very painful walking combined with heart failure leaves me deeply fatigued all the time. While in Canada recently, I was able to use (for free!) a mobility scooter at Ottawa's National Gallery of Art. That scooter showed me I could move through the world.

Shortly after my return to Bay Area, with only a cane and no scooter, I very painfully forced myself over to SF MOMA so I could see the Diebenkorn/Matisse show. The lines were as long as lines for art have ever, ever been. I had to stand for almost two hours, slowly moving forward. In excrutiating pain. Not just my knee. My hips, oh lordy, my hips screamed. I cheated. I walked to the head of any head-of-line I could see. I couldn't see them all because the endless lines snaked up and down room after room. And I kept thinking "if I had that scooter, I could sit while I wait".

I get nagged by doctors to exercise. I have been a consistent lap swimmer all my life. In the past year or so, I have swum less and less because the walk uphill to my pool got to be too much. One doc told me "well, if you can't swim, walk". Fuck her. I didn't say fuck you to her but I wanted to. If I can't walk two blocks on a slight incline to swim, how the fuck am I supposed to walk a couple miles a day to give my heart a workout?

And eating.  I eat a fairly ascetic diet. Lots of dark leafy greens, meaning I have one serious salad daily. I do one protein shake for brekkie, using plain organic whey, raw cacoa powder, ginger, tumeric and cinnamon. This is not a very satisfying breakfast but when I was traveling and didn't get in those spices, whew, I really felt it, esp. the missing tumeric (curcumin).  I eat almost nothing but vegies. I do have wild salmon with braised spinach a couple times a week. I enjoy blueberries, which are very low in carbs.  I am so very careful about what I eat but as most fat women would tell you, almost no one believes a fat woman when she describes eating healthfully but does not lose weight.

Doctors who nag me about my weight muust know about studies showing that once fat cells exist, they are very very very tough to starve. It takes a starvation diet to be slim.

Last week, I have my biannual food doctor exam. Diabetics get annual food exams but my feet are in good shape so far so my foot doc has me come in every two years.  She was warm and friendly and spent a little time with me. I mentioned how frustrating it is to be hounded by several docs to lose weigh and she, bless her, gave me some ease by saying "Some people, many people, are just not born to be thin. It runs in families."  I was so relieved. My dad's mother, his sisters (my aunts) were all about my size once they hit forty or so. And my maternal grandmother was never slender. I never heard anyone criticize my female relatives for being fat. They were who they were. And loved as they were. I remember my Aunt Mary crash dieting for her eldest daughter's wedding and I remember her quickly returning to her normal size after the wedding. I remember feeling sad that Aunt Mary thought she had to starve herself for one party. None of her family would have cared if she was a size sixteen for the wedding.

So, I am juggling type one diabetes, heart failure, atrial fibrillation, very painful and overall arthritis pain, a bad knee, chronic, deep fatigue.

And I ask:  why do I bother? Would it be so bad if I just stopped taking care of my diabetes, stopped taking all my heart meds, stopped pressuring myself to eat less and less, stop berating myself when I don't do a good aerobic workout daily?  Why not just accept what has been given to me, which is ill health, and just escalate my demise?

Right now, I am not, at all, suicidal. Thank goddess. Some folks might not understand that when someone is drowning in suicidal obsessing, it is very very emotionally painful. So thank goddess I am not suicidal these days.

I just did a little experiment. I ran out of my fast acting novolog two days before a Monday doc appointment. Then my doc called in sick, which is perfectly fine. She retires soon and she gets to be sick. But her head nurse wouldn't give me my novolo. So I went without it for a few days until I could see another nurse, show her all my meds and explain what I needed. That sissified head nurse yelled at me, telling me I should have requested the refille two weeks before the refill ran out. Duh. I needed to change my scripts and I can only do that when I actually see my doc so I did the right thing I got an appointment. It wasn't my fault my doc was sick that day.

I felt very sick those days I had no novolog. Then I tried to push on and not use novolog even when I got more.  It's a catch 22. Sure I can skip insulin. And, hey, I'd lose weight. I lost over 20 pounds in five days in a hospital in February because the ninny hospitalist wouldn't give me insulin. what kind of a doctor withholds insulin fro a type one?  I lost 28 pounds in five days. So for a few days, feeling scolded by that head nurse guy and steadily questioning why humans don't just accept what life sends their way.

I mean, do we really need health care? Maybe we should all surrender to our fates?

And in my case, no one loves me.  I don't even have anyone to put down to contact if I die so, for sure, no one would care if I checked out a little sooner rather than later.

So I went six days without properly dosing my insulin. But I am spoiled. I feel really sick when I don't use insulin and I don't like feeling sick. So I am back on the sauce, the insulin. I still feel lousy. It will likely take a few days for me to catch up. But catch up to what?  It's not like I ever actually feel well.

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