Grace

A few nights ago I recalled a memory from middle and high school (7-12th grade). The advanced placement biology class dissected cats each year, and after finishing their autopsies, would weave through the hallways with the cats in their metal pans, singing Amazing Grace. It happened every year–all six years I attended. Rumor is that a parent complained and that it doesn’t happen anymore. So I attempted to capture the memory in a poem.

grace: cathedral high school’s annual
advanced placement biology cat dissection

the sour of formaldehyde trailed
from your wet bengal tails
dripping to the granite floors.

your tortoiseshell
torn through with a shallow scalpel
two seniors to a group
clumsily locating your lungs
and subdividing your uterus to find
two kittens sleeping
like baoding balls.

can you hear it?
footsteps.
the swish of the latex lab coats.
you’re deflated in flat metal pans
but surely you must hear it.

heavy oak doors propped
with students gathering at the opening.
we sing, too.
how sweet the sound.

Rupp at the lead with
an open hymnal.
he looks over the arch of his glasses
at his parade.

we’re saying a prayer for you.

not asking for anything.
you were an overpopulation, and
no one wanted you alive.

they can only
intone your form, manner, and motion.
they can only
chant thanks that your
corpse taught them the puzzle of
our insides.

you still look as though,
if you slid from the basin,
that you would land
on all four feet.

Too Far

A new online diabetic friend, Sophie, posted that yesterday was her one year diagnosis anniversary. It was a rough day, and it got me thinking about my upcoming appointment with PA J (Dr. K’s physician’s assistant).

I know my a1c is going to go up. Last time it was the lowest it had ever been, at 6.9. However, this was an artificially low number. Over the course of a month or so, I had been increasing my insulin rather than decreasing it. I did this through decreasing the number in my insulin to carb ratio as well as by decreasing the number in my correction factor. For some reason, my brain was thinking, “decrease number = decrease in insulin.” Well, it was a stupid mistake. Decreasing the number in either your insulin to carb to ratio or your correction factor actually increases the amount of insulin you receive.

Long story short, I was experiencing extreme lows nearly everyday. This drove down my a1c number in the long run, but wasn’t healthy or safe. I figured out my error with PA J, and I have had far fewer lows in the last three months. That means that the a1c is probably going back up. My guess is she’ll come in at about 7.3.

When I have upcoming endocrinology appointments, I get to thinking about all of my past failures and how all the chips are going to fall in the future. I should have googled what was in those brownies. And that frozen yogurt. And everything I ate that I estimated for. Will I go blind? Will I have neuropathy? Is it all my fault? Is it all under my control?

The answers are all yes and no to some degree. The only principle that remains true is that I try to manage my health the best I can on any given day. Some days are much more regimented than others, but it is not to say that the less than perfect or terrible days are terrible ever for a lack of trying.

Fresh

Almost all of my things are in boxes or bins for the short move to my new one bedroom apartment one suburb over. With help from mamabird and daddy, and other friends, I hope to have everything moved on Tuesday, and be unpacked by the end of the week.

I will very much miss my current place. It’s so open. My master bedroom is huge. But there is a lot of unused space here. The living room is cavernous, but almost never filled with people. The guest room is great, but people stay over less than once a month.

My new place is smaller, and more expensive (since I will not have a room mate with which to split the cost). It is on the main floor, however, with a walk out to grass. This will make Nico very happy. It doesn’t much like bounding up or down the two flights of stairs at our current place. He usually waits to be carried up (which I call giving him a transport). It’s a dog friendly complex with an off leash dog park on the grounds, so I hope we meet other dogs and humans with which to be friends.

Transitions are only as bad as they last. Soon I will be at home at the new place, and onto the next hill to overcome.

Organize

I was diagnosed with Generalized Anxiety Disorder when I was 16 years old. Prior to being diagnosed and treated I developed (what I thought) were pretty good ways to cope with the constant feeling of nervousness. My main strategy was telling my mom everything I was nervous about at about 9:00pm every evening, while laying on the living room floor. Another was sleeping (Note: I didn’t, and don’t currently, sleep because I am feeling nervous, I just sometimes sleep when I feel nervous because I usually wake up feeling better). Now that my anxiety is controlled, I find that when I’m feeling stress or nerves within the realm of normal, that my coping strategy involves cleaning and/or organizing things.

I can’t say if it’s an effective or healthy strategy, but I sure get a lot of stuff done. I’m also usually able to fall asleep, or continue on with my day afterward. The behavior definitely falls on the mild spectrum of an obsessive compulsive tendency, as I use it as a means to relieve anxious feelings. I will admit that sometimes I wish I didn’t feel compelled to clean and organize, but that I’d much rather put things in order than have a relenting compulsion related to El Caminos.

Ketones

I hadn’t thought a lot about ketones until a week ago when they hit with a vengeance. Ketones are a yucky thing produced when blood sugars are high for a prolonged period of time. They are the bodies reaction to the high blood sugar. You can have different levels of ketones in your system, depending on how high the blood sugar has been and how your body decides to react to it. The ketone test describes the amounts as: none, trace, small, medium, and large.

Whenever my blood sugar has run high, I have simply corrected until it came down. Correction doses are doses of insulin only to bring the blood sugar down (not as a part of eating something with carbohydrates in it). In the past, my blood sugar has usually come down pretty predictably. I’ve only tested for ketones once or twice before in my 7-year tenure as type I diabetic. And those two tests were just to see what happened. Both tests came out ‘none.’

On the Sunday before Memorial day, I was running between 300-450 all day. I was at home and munching on treats all afternoon, so I assumed I wasn’t giving myself enough insulin to cover what I was eating. Each time I’d test, a high number would appear on the screen. I felt okay, so I just kept eating and correcting assuming it would eventually make it’s way back into my desired range (between 80-120).

I tested before bed that evening and it came back as 350. I corrected one last time before bed, which freaked me out a little as I was risking going low while sleeping, but I figured if I didn’t give myself a correction dose, I’d wake up with a blood sugar of 1 billion. In the middle of the night I woke up feeling like a train had hit me. I was very nauseated. I tested again at 1:00am and was at 370. The (pretty large) correction dose had done nothing. In fact, my sugar was higher than it was before the dose. I started flipping out.

I am a part of some diabetic groups on Facebook. A favorite is called I Hate Diabetes (Type 1). A rather aptly named group, most people come with questions, concerns, and to complain heavily about the disease. I’ve read various posts about people experiencing ketones and ketoacidosis. Mostly stories of them having to go for a stint in the hospital. Thus, when my blood sugars weren’t coming down, I knew I had ketones.

I tested my ketone levels and they came back as “moderate.” It was the darkest color I had ever seen on the test, and started dreading a visit to the hospital. I looked up treatment for moderate ketones. Half the websites said: GO TO THE HOSPITAL. The other half said: drink lots of water, keep giving large correction doses, and keep testing blood sugar and ketones until they both come down. Water flushes ketones out of the system. Such a simple, but powerful treatment to a yucky thing.

So I made my first post to I Hate Diabetes and described my situation. The consensus among members and fellow T1Ds was similar to my Google results: half said GO TO THE HOSPITAL. The other half said treat it yourself for a couple hours and if it’s still terrible THEN GO TO THE HOSPITAL.

Over the course of 2 hours, I drank about 7 glasses of water, tested my blood sugar 10 times, and tested for ketones 5 times. I gave myself approximately 40 units of insulin to correct the high blood sugars. That’s a TON of insulin. For a Thanksgiving meal, I have given myself 25 from a pen at most. My insulin pump won’t let me give a single dose of more than 20 (you’ve got to split it up into 2 separate doses to bypass it). Basically, it’s a ton of insulin. Even 10 units of insulin given to a non-diabetic could kill them.

I started feeling better once I was at 120 with trace ketones. At 3:30am, I flopped down in bed–exhausted from the ordeal. After only one minute, my mouth started watering and I knew I was going to throw up. I leaped out of bed and dashed to the bathroom where I had the most violent and glorious vomits of my life. They broke blood vessels all around my eyes; the ‘gin blossoms’ lasting three days. After ralphing, I finally felt just right. So I passed out a second time–making it until morning.

And then I woke up low.

144

“144.”
“Ah, I was like 306.”
“I’m recovering from a low.”
“How low?”
“60.”
“You felt it at 60?”
“Not always, but this time.”
“Lucky, what’d you eat?”
“Three Twix bars.”
“So you’re 144 and on the way up.”
“Yeah, see you at 306.”

Rabbits

I like reading the spam comments that my blog collects. I understand that they are generated by taking random pieces of text aggregated from millions of websites, and spit out to be as novel as possible so as not to get flagged as spam.

I find some of the comments to be surreal. So I started making poetry out of various comments. No changes have been made to grammar of phrasing. Only spaces, punctuation, and a title have been added.

rabbits
can you find anything that
could punch holes in it?
you can build up your village
and live a peaceful existence.

rabbits like to sit on their hay
and chew on it while they rest.
a selection of cards for both
experienced and novice
collector.

Leave A Message

Last night, Beth and I went to see Eric Whitacre at Orchestra Hall. On the way there, I saw Al Franken getting out of his car in downtown Minneapolis. I immediately smiled and waved; it was that excited 6-year-old-whole-arm-hand-flapping kind of wave. He cracked a smile and waved back at me (although much more casually).

The concert was pretty much perfect, save for my pod and PDM beeping THREE TIMES DURING THE SHOW. The first time, it beeped to tell me that it was one hour until pod expiration. The second time, to tell me it had hit the 62-hour expiration. We were seated in the back, but it was still an audible beeping to those around me. It’s not just one beep, it’s a rhythm (beep-beep beep-beep, beep-beep beep-beep). To top it off, the actual PDM emits a sustained beep when you turn it on to silence the pod from beeping. Normally it’s not a problem, but in the middle of a classical music concert, I felt very embarrassed.

The third time it beeped, it was warning me that my pod had 20 units left in it. By that third notification during the concert, I was exasperated. I considered ripping it off and tossing it into a garbage can outside. On further consideration, I realized that someone might think a beeping item with electronics in a public trash can was a bomb–something. So I left it on, and prayed that it wouldn’t beep anymore after the third disruption.

I have the PDM set to vibrate only, but some notifications will always beep, even when set on vibration. I wish OmniPod could make a silent feature available, but I suppose there are some people who absolutely need every one of those reminders.

I’m at home now listening to a recording of The River Cam, and hoping that the next time I see Eric Whitacre, that I remember to put on a completely new pod before showtime.