Four decades of red shoe regrets, resolved

I've had a love hate relationship with red shoes for so many years ... stalking them, loving them, lusting for them, even buying them again and again, only to find myself unable to wear them because they're just way too red. There are at least three pairs stashed away right now in a box in the garage that I've never worn, even though part of me still loves looking at them. I even get them out to try on every once in awhile.

Anyway. Today I break my long blog silence to announce that the curse has been lifted: I've found some red shoes that I love, that I can actually wear. Check 'em out!

OK, so maybe they're not the height of fashion ... I actually worried as I was ordering them that they might look like clown shoes, or children's shoes. But they don't (well, maybe a tiny bit, but in a good way). I'm happy with them. They're red enough to be red, without being TOO red. I love the slight platform, the soft thick leather, the comfortable strap. And you can't tell from this picture but they're very wide across the toes, just like my feet. I plan to wear them all summer.

What else? I still think about blogging every day, but so much of what I think of saying seems kind of unnecessary to say. That's a spell that seems to have been broken lately too – my decades-long compulsion to document my experiences, rather than simply living them. I think that practice helped me, more than anything else I've done, to learn how to really inhabit my own life. Writing it all down – and paying close attention to myself, so I can be accurate in my account – has taught me to love it all. I read something the other day that rang true to me:

The great Japanese film director Akira Kurosawa once said, "An artist is someone who never averts his eyes." In 1923, the Great Kanto earthquake killed 100,000 people and destroyed Tokyo. Kurosawa was just 13 years old and walked amongst the devastation of human and animal corpses. When he tried to turn away, his older brother instructed him not to avert his eyes. As a result, Kurosawa came to believe that looking at the whole of life was a way to defeat fear.

That's a big part of what I've been doing until lately with this blog, and with journaling in general. Learning to defeat my fears. I can't say they're totally defeated, or that I expect them ever to be, but I do feel safe in my life and in the world right now, and that makes me feel generous and strong, like I have more to offer than this inward-turning exploration of my own ego. I guess that's why I'm not writing much right now. I'm feeling more like expressing myself in other ways.

While I'm quoting people, here's another quote I've been meditating on for awhile, that I feel I've finally internalized to the point where it's truly how I see the world. I have it on a little card on the refrigerator and have been painting it in calligraphy on little cards to leave around town ... just for fun, and maybe to share the blessing it's been to me:

Hm, what else? It does seem like a long time since I've written anything down. Just for utilitarian purposes, I'll go ahead and document some highlights, in no particular order.

1. I'm about half way done winding down with the antidepressants. They did their job for me again, and I'm grateful. Once again however they did cause me to gain weight – about 20 lbs since August – and that is not good for me. Actually, I don't think they directly caused the weight gain; what seems to have happened (again) is that they make me sleepy and hungry, and hungry specifically for carbohydrates, so that it's very hard to exercise and eat like I know I should. So I'm weaning myself off them and forcing myself to do what I need to, even though I really, really don't feel like it.

2. The job is still going great. I don't think it's possible to overstate how much I love it. This, too, I think, is a huge part of why I'm feeling so good these days.

3. Not that everything is perfect. I don't feel like cataloguing everything I don't like, though. It's all just normal stuff, no different than what most people have to deal with in one way or another.

4. We found out last week that Tater has diabetes insipidus. It isn't the same thing as diabetes mellitus ("sugar" diabetes – the kind I have) – it's caused by a deficiency of a different hormone, and isn't life-threatening; it mainly just means his kidneys can't concentrate urine properly so he needs to drink a ton of water, and pee a lot (that's how I realized something was going on; he was just drinking soooo much water). We're starting him on a medication that should help. Other than that, he's still doing great, enjoying his food, toys and walks, and even inviting Bea to wrestle with him every once in awhile, just like a big puppy. He'll be 13 on June 1.

5. Bea is just a wonderful, wonderful little dog. We're doing an agility class together, and she's also evolved into a major ball hound. That's fun for both of us and makes it easy to exercise her – I just throw the ball for her for 20 minutes a couple of times a day and that about does it for her.

6. I think I am officially turning into the nutty middle-aged dog lady. And I'm pretty much OK with that.

7. My latest obsession is finding the perfect underwear to wear under summer dresses. I'm pretty sure I'm going to have to figure out how to make it myself, and I have a plan. It's based on a pair of ladies' old-fashioned silk combination underwear from the 20s that I found at a vintage shop a few years ago, and is basically a full slip with a camisole top and a long-ish split skirt at the bottom, and possibly some kind of drop flap at the crotch (this is the part I'm still working out, how the crotch needs to work in combination with the longer legs. The piece I have is more like tap pants on the bottom, but I wanted something that will work better on a bike). The goal is to create something that is loose, cool and comfortable, with no clinging waist band or straps to fall down, and with two legs so you can ride a bike without worrying about the whole thing flying up over your head.

8. We've been putting up birdhouses all over the property this spring and as of this weekend we have over 90% occupancy.

9. My early morning yoga experiment lasted exactly one day, at which point I pulled a muscle in my back (in an un-yoga-related incident) and was out of commission for almost two weeks. By that time I'd basically given up on the whole idea of my spring practice period, and decided to just do what I can, when I can. I'm still going to my class at the gym and practicing a little bit at home each day. I want to do more and when I can, I will!

10. The early rising thing was not a total loss, however. I'm learning how to go to bed earlier and gradually it's getting easier to wake up earlier without such a struggle. Part of the problem, I've realized recently, is Mr. A's schedule – he's up between 3 and 4 a.m. every week day, and even though I sleep in my own room, with ear plugs, I always seem to wake up at least partially whenever he's up and about. Synchronizing my sleep schedule with his, at least a little, has helped some; instead of going to bed at 11 or 12, I've been trying to be asleep no later than 10 p.m., which gives me a chance to get into and out of one good solid cycle before he wakes me up at 3. It's not a perfect solution but I think it's better than before.

11. I got through the whole winter without knitting a single thing and am now getting involved in summer sweaters, and tiny little pink sandals for newborn babies in Japan. This is not just any baby, but the baby of my first true love from high school, who's lived there for almost a decade now and is having a daughter in just a couple of weeks with his adorable Japanese wife. Apparently nobody does baby showers or shares baby clothes over there, so they are having to outfit the entire enterprise alone ... Except, they're not really alone – I'm crocheting furiously .... Wishing I had had the time and inclination to do more of this kind of thing when my own nieces and nephews were being born, but I guess better late than never.

12. Speaking of family, I've been more homesick for my brothers and sisters and parents over the last several months than at any other time I can remember since I left home at 18. I'm not sure why. I just love them so much, and miss them so much, and wonder sometimes why I'm still living out here so far away ... except that I love my family here – Mr. A and the dogs, and my friends – and I love my job, and the landscape, and the plants and trees and beautiful clean fresh air ..... Anyway, I'll be traveling to Utah at least once or twice this summer, and possibly to a few other places too. Looking very, very forward to that.

P.S. One more thing – I'm on the lookout for an extremely wide-brimmed straw hat, for gardening. The biggest one I have right now is about 18" across and I would love to have one that is at least two feet across, or even wider. Almost like a parasol for the head! Oh wait – maybe this? I'm actually picturing something more a little rougher, more rustic ... Let me know if you see something like that, won't you?

Clarity (a brief moment of)

So one of the possibilities I've been reading about is becoming a Certified Diabetes Educator. I just keep coming back to it ... As much as I try to tell myself it would make more sense to get an RN, just as a way to qualify for a more stable kind of job than I've had until now, my heart really isn't in it. Visions of bedpans, etc.

However. Certification as an RN might be the fastest way to open a door to something that does interest me – it's one way to meet the discipline requirement to sit for the CDE exam. I could also do it by becoming an occupational therapist or dietician, or by getting an MSW or a master's in nutrition or health education. I'm interested in all of those things (there are also other options that don't interest me at all – optometrist, podiatrist, etc.). But I think the RN is the shortest program, and possibly the cheapest. Not that I think it would necessarily be all that easy, assuming I could even get into a program.

My first choice of paths here – what appeals most to my heart and soul – would be to do the MSW, then the practice experience required to sit for the exam, then to work in a clinical setting (not a private practice) with diabetic clients on both physical and mental/emotional health issues. How the hell long would that take? How would I pay for it? Am I really smart enough to do that? Am I healthy enough? Do I have the stamina? Would I be able to find a job when I was done?

This is where I realize the RN is probably not the best way. Because ultimately, even as a CDE, I would still be working in the discipline I'd chosen, and I don't really want to work as a nurse. I need to be honest with myself about this. I don't want to be a nurse. I want to be a health educator or some kind of therapist. I think. Maybe. Unless it's all just too exhausting.

Still ... I do feel like I need to make a change. Today I read this article, written by one of my clients. It's exactly the kind of thing I used to write for a living and reading it confirmed that I have absolutely zero interest in pursuing that kind of work again, ever. Less than zero interest – negative interest. Infinity negative. I just don't think I could do it again. And I don't have much enthusiasm for design work anymore, either. Good to feel clear about that, too, I suppose.

Ugh. It's the middle of the night, and I can't sleep. Maybe it's just because I'm not doing that well right now, but the thought of scrapping my last 25 years of professional experience (such as it is) to start over from scratch in a completely unrelated field ... I guess I need to think of it as "exciting," and it is, but also: it just kind of freaks me out.

But – the reason I wanted to write it down tonight is because I've been thinking about what feels good when I let my mind consider every possibility, and this is what feels good to me tonight. A teacher I kind of like has this saying, "What is inclusive of how." I've been keeping that in mind too. Because anything that is going to happen, has to start with the "what." The vision. Not that is has to be 100% clear and complete before anything can begin ... I'm expecting that like any other living thing, the vision will evolve as I nurture it and start taking steps to make it happen.

There's also that other metaphor, the one about walking in the dark – the flashlight only reaches far enough to show you the next little bit of the path ahead, but if you just keep moving, you can get all the way there like that.

Anyway. Right now I'm concentrating on developing an informed, actionable and energizing vision of what I want to be doing over the next 5, 10 and 25 years, with faith that this will make it easier to work out the specifics of "how."

And now that I've emptied the contents of my brain into this post, I'm going to go see if I can get a little sleep before the sun comes up.

This is what chronic illness looks like

[From last week] Just a brief note while I'm waiting for Obama to start his healthcare speech to Congress ....

I really want something good to come of this. My insurance doubled last year, and this year it's going up 41%. I damn near cut off my thumb last weekend and had a few scary moments contemplating whether I could actually afford to go to the emergency room .. though thankfully it turned out that wasn't really necessary.

Lately I'm having some trouble with a healthcare concern that seems kind of stupid: I'm just really, really exhausted all the time. I don't know why I should be. I eat well and carefully, I exercise at least an hour every day, I get plenty of sleep, I take my vitamins, I don't smoke and very rarely drink, no drugs, no dangerous or unwholesome habits or proclivities ... I'm not even eating sugar anymore.

And yet I feel like crap. Unless I'm actually on my bike or exercising in some other way, I can hardly keep my eyes open. I can't seem to focus on my work, either; in fact I recently had to give up a small freelance copyediting job because I just couldn't seem to get my head together enough to finish it. I couldn't concentrate, and I was too embarrassed to tell the client what the problem was ... there was no specific deadline so I just let it drift  ... and today I got an email asking how it was going and decided to tell her I just can't do it right now. [to be continued ....]

It's so easy for me to blame myself for being lazy or stupid or a worthless, terrible person. But thinking of it right now, even if those things were true – this little project was so small and so easy there isn't any reason for me to have dropped the ball this way if I were just being lazy. I should've been able to just jump in there and bang it out in a couple of hours. But every time I looked at the pages ... I just couldn't.

So what's going on? Is it hormonal? Seasonal? Environmental? Do I have some kind of allergy? Or is it something more nefarious than that? Cancer can make people feel tired ... and so can about a half million other life-threatening diseases.

Maybe I'm just anemic again. But I've been taking my iron supplement religiously for a couple of years now ....

The other possibility that comes to mind, the one I really don't want to think about at all, is that I may be heading into another depression. This desperate exhaustion and inability to concentrate are so familiar to me ... and this morning, for no apparent reason, I woke up all flooded with fear and adrenaline and spent 40 minutes sobbing my guts out before I finally remembered I still had a bottle of Xanax lying around somewhere, and nibbled a few crumbs off the end of one just to get myself together enough to go to work. Then spent the rest of the day trying to stay awake, since that drug does take the edge off the anxiety but makes me so sleepy I can hardly function.

So damn. Now that I actually describe what's been going on it does seem pretty clear. I must be getting sick again.

I've been through it before, and so far it hasn't killed me. I think the worst part of it is that I feel so guilty about not being as functional and energetic as I would like to be. It's funny to me that despite my own experience with this stupid condition over the last 16-17 years – which you'd think would be enough to convince me it's just as real as my boss's herniated disk or another friend's congestive heart failure, or my own diabetes, all of which can be seen and measured and proven to exist – I still very often find myself secretly agreeing with the masses and leagues of "healthy" people who don't quite believe depression is an actual illness, but think it's more just a failure of will or character in a person who really just doesn't care to work as hard at being happy as everyone else does. I know feelings of guilt and worthlessness are symptoms in their own right ...

Anyway. Blah blah blah. Just like the herniated disk or the damaged heart muscle, my mind's tendency to freeze up under stress is just part of how my body seems to be composed. Sometimes, it forces me to slow my life way, way down whether I want to or not.

I'm sick of thinking about it, and sick of feeling ashamed of it. It sucks, being shaky and exhausted all the time. And knowing that so many people probably see me as a lazy, boring loser and a disappointment, because despite my supposed talents and capabilities, I never seem to really accomplish much.

This is stupid. I know it's the depression talking. I might not be able to turn it off inside my own head but that doesn't mean I need to broadcast it all over the internet.

Mainly, I just wanted to write it down as a record of what's going on for me this fall. And as a reminder to be kind to other people, no matter what ... because you can never really know what someone else is going through, even if everything looks OK.

Back to healthcare reform, though ... I don't know how any kind of healthcare reform would really help me with my particular problem, because right now the most commonly prescribed treatment still seems to be antidepressant drugs, and those have caused almost as many problems for me as they've solved. It's been years since I've taken any, and I don't really want to start them again. Still, it would be nice to know that if I did start seriously losing it, I could just go see someone without having to worry about how I was going to pay for it.

Ugh. So boring. SO boring, it makes me want to shut down this blog. Still, at times in the past I've received email from people thanking me for writing, letting me know it's helped them to read about my experiences, that they feel better knowing there's someone else out there who's coming out the other side of the same thing they're still stuck in the middle of. And it's made me feel better, knowing there are sympathetic strangers sending me good wishes.

I've been writing this blog (under several different titles) for just a few months short of ten years now. Maybe it IS time to start thinking about shutting it down. Or at least making it private again.

Or not. Just rambling now.

I guess the other connection with healthcare is that I can really see, when things get like this for me – and thank god it usually doesn't last very long – that I'm just not contributing to the world, or even just to my own experience and enjoyment of it, nearly – not NEARLY – as much as I would like to. And it makes me wonder what we all lose by not supporting the highest level of health possible for everyone around us – what might be brought forth by some of the people who are suffering even more than I do, for long periods of time or even for all their lives. What would they do, who would they be, if they were feeling well enough to really thrive?

There's this romantic idea afloat that illness, especially certain kinds of mental illness, can bring out the best in people. Beethoven created his best work after he lost his hearing. How many other geniuses of art, literature, music, science – are bipolar, schizophrenic, depressed, Asperger's? I'm sure it's true that some people rise above their struggles to do great work. But if my own experience is anything to go by, there are also plenty of people who are held down and held back from their best work, because it's all they can do just to get through every day.

My opinion is that getting through every day is a beautiful and important thing to do with one's life. It's all there really is, for anyone. But still ... sometimes I feel myself really yearning for just a little bit more. And it hurts when I just ...  can't .... reach it.

Numbers

Did I already post this? The best part is the little dance he does at :40.

So! Once again it's time for an update on My Wondrous Diabetic Journey. The latest news is that I've had two different A1C tests done in the last few weeks, from two different labs, just to see how close the results would be, and they were actually very close. I took both tests on the same day. The one from the walk-in clinic at the pharmacy cost $36 and gave a result of 5.5, and the mail-in one from Walmart cost $9 and gave a result of 5.6. Both numbers are within normal, non-diabetic range, which makes me happy even though A1C is not the only measure of how well I'm doing blood-sugar-wise. Still, it's good to know that at least by that measure I'm doing great.

It's also good to know that both tests come back so close, because that indicates they're both reasonably accurate, which means I don't have to worry anymore about whether I'm risking my health by trying to save a few bucks on a cheaper and possibly less accurate test. Now that my insurance sucks I'm starting to realize I may have been too hard on Walmart all these years ... Not that it makes up for all of their other questionable business practices, but I am sincerely grateful for their $4 prescription program and now this $9 A1C test (compared with $70 for the prescription at my regular pharmacy, and $125 or so for the A1C at the hospital lab). They also have a $8 glucometer with strips that cost about 40 cents each, as compared with my OneTouch Ultra 2 meter, which costs $65, with strips anywhere between $1 and $1.20 each.

OneTouch is actually one of the most expensive testing systems there is, but the Ultra 2 was the first meter I ever had and I've become strangely attached to it, even almost superstitiously, fetishistically attached. It's the magical device that helped me calm down and get my numbers in check when I was so scared I thought I might die ... So for now I'm sticking with it and looking for reliable discount suppliers online that offer strips (usually in institutional, educational and non-U.S. English packaging) for 30-45% off retail. The last supplier I bought from sent strips that were only a month away from their expiration date. Not good. Today I ordered from a different company that guarantees an expiration date of September 2010; hopefully they'll deliver on that because the price was really good – 50 strips for $30, including shipping – about 60 cents per strip.

I use anywhere between 1 and 5 or more strips a day, depending on what's going on. Normally I only test once a day, first thing in the morning. Lately I've been having some inexplicably high numbers, so I've been testing more, trying to figure out what's going on ... although it seems sort of pointless to keep accumulating results from almost-expired strips, because I don't really trust the numbers I'm getting from them. As soon as this new box arrives I'll toss the rest of this old batch.

So anyway. It's been awhile since I talked about the Beetis, but it's still here. And I'm still OK.

P.S. Has anyone noticed that Blogger has started getting all buggy with the code lately? Like making one paragraph a different color than all the others, for no apparent reason – or inserting random inconsistent spacing between paragraphs ... I'm seriously thinking about moving to Wordpress one of these days. I just set up a blog there for a client and am kind of enamored of all the cool features .....

Technical difficulties ... maybe?

Last Friday I went to the "low-cost health screening clinic" at my pharmacy to have a new A1C done. Now that I'm basically uninsured (unless something catastrophic happens and I spend more than my deductible), clinics like this are a godsend. I had called the hospital lab where I've had all of my blood work done until now, and found out that for the two tests I wanted done it would cost me about $235 – out of pocket, non-reimbursable, though it would count toward my deductible IF I was very careful to demand that only lab techs from the official list were allowed to touch my sample.

At the pharmacy's low-cost clinic I paid $65 for the same tests. I was happy with all of my results – A1C safely in the middle of the non-diabetic range, and all my lipids are awesome. I'm assuming my insurance will not count the receipt toward my deductible, since the lab that did the testing is not on the list. But since I don't expect to meet the deductible anyway I'm figuring anything I can do to save a few bucks is probably good.

Except. Tonight I'm wondering ... How do you know the test is good? I wonder what results I would've gotten if I'd had the same tests done at my usual lab. The company is approved by various agencies and organizations, and the tests they run are not bogus – I trust them, I think – but really, how can I be sure? When my life depends on keeping these numbers within a certain range, I hate to think I might be settling for less than accurate information just to save a little money.

I hadn't actually thought about it until tonight, when I got home from a dinner of wor wonton soup (preceded by way too much leftover Christmas toffee from a tin someone brought in to my office today) and tested, expecting the number to be high, and was surprised to see 85 on the little screen. I always love seeing that great number, but I knew it couldn't be accurate, so I tested again and got 87. Suspicious, I pulled out one of my other meters, from a different manufacturer, and tested 165. That was more what I would have expected to see. A second test on that meter showed 156. Close enough.

Then I started wondering – was it the meter, or the strips? I tested a strip from the same bottle using a different meter from the same manufacturer (yeah, I have a bunch of different meters – lots of companies give them to people for free so you have to keep buying their brand of strips) and got 95. So maybe it was the strips? I did a test with the control solution and got 127, which doesn't really tell you much except that the strip is within range for that lot number – which doesn't mean a lot because the range is so wide. Finally, I did another test with my original meter, using strips from a new box – and got about the same result, 87.

So now I'm feeling paranoid about my meter. I've had it almost two years – is it starting to crap out? Probably I will try to figure out what's going on by testing a few more times later tonight, but I hesitate to do all the testing I'd like to, because the strips cost about a buck apiece.

Times like this make me realize why chronic conditions are considered so stressful, even if they're not causing any immediate problems. I feel like I always have to be thinking about my blood – seriously, always! I think about it at least once every hour, every hour I'm awake. If it goes high, like it was this morning (because I have a cold and PMS right now), I worry about nerve damage and heart attacks and obsess about exercising and testing every 20 minutes until it comes down again. If it's low, I feel safe and happy and proud of myself and entitled to relax a bit, at least until the next test.

Lately I find myself thinking a lot about what my life might be like if I live to be old. It's a strange feeling to realize that being diabetic is going to be part of my life for as long as I'm here – it's never going to go away, and I'm never really going to be able to relax and forget about it, and even with the best and most scrupulous self-care it's still likely to get worse as I get older, because that's just how it seems to work with most people.

In a way, I figure – who cares? Everybody dies of something, and the fact that I have this condition doesn't necessarily mean I'm going to die from it. There are a million different ways I could die that have nothing to do with being diabetic. A cheerful thought!

So I'm trying not to get too heavy and morbid about it, but at the same time, I do want to take care of myself as well as I can on the off chance that I do end up living to be old, after all. Which is why the meter is important, because it's the only tool I really have to help me keep track of how my efforts are working, or not working.

In other news: I spent a really great few days with some old friends last weekend, reconnecting over snacks and the Superbowl. It was the first football game I've ever watched from start to finish, and it turned out to be a good one, even though my team (chosen at random because their pants had better stripes than the other team) did not win. The whole weekend was a blessing I'm still basking in. It made me happy to remember again some of the reasons I love these friends so much and how grateful I am to know them – some of them for more than half my life.

A new tool

I had a weird day today. Everything was normal until lunch, which I later realized contained around 40 grams of carbs – almost twice as much as I'd thought. My BG shot way, way up and stayed high for over an hour, then dropped over a hundred points in about 25 minutes. It continued to drop for another hour after that, to the point where I found myself scrounging around the office for leftover Christmas candy to get me high enough to ride home without crashing.

In the end I found and consumed three stale mini truffles (for a total of 7.5 grams of carb, according to the box) and rode only as far as the grocery store, where I roamed the aisles in a stupor, in search of something more appropriate than candy to get me the rest of the way home. That was when I ran into my friend J., a fellow diabetic and one of my personal heroes, a wonderful writer and editor and all-around talented, smart, funny and compassionate person who reached into her bag and commanded, "Eat these."

Well! I was in no condition to argue. I gulped them down. As I chewed she explained that each tab has 4 grams of glucose – no fat or protein (like in chocolate) to get in the way of absorption, which is what you need when you've got to get back to your senses as quickly as possible.

I knew about the tabs but always thought they were only for people with Type 1, whose blood glucose can drop low enough to kill them. That's not the situation with Type 2, at least not with me, because my pancreas still works. Well, sort of. What happens when my BG goes too low* is that my liver goes on red alert and starts pouring glucose back in (although it's actually a little more complicated than that – you can read more about it here), resulting in a sort of boomerang effect – most unpleasant, and supposedly very destructive to nerves and capillaries and other crucial body parts.

Now that I've tried the tabs I can't believe I never used them before. I'm still stunned at how effective they were, and how fast. Within just a few minutes I was feeling totally back to normal. It's cool to know there's such an easy way to raise my BG by a predictable amount in a predictable amount of time – definitely a cool tool to add to my "wellness toolbox."

* Someone wanted to know what it's like to be low. To me, it feels kind of like watching tv in the middle of the night with the sound off. Spacey, dreamy, easily distracted ... hard to concentrate, impossible to engage. I stood in the snack aisle for several minutes staring at the cookies I knew I wanted, and couldn't make myself decide to reach out and pick them up and put them in my basket. It's easy to understand how people who are really crashing could be mistaken for drunk – a good reason to wear medical ID, just in case.

Have you ever wondered if you too might have glucose metabolism issues? If so, I strongly encourage you to stop worrying and find out for sure. This company is doing a promotion right now where they'll send you a free meter and 60 test strips (that's a lot of strips, by the way) – so click the link and get a meter, and do the test. It's easy. Do it first thing in the morning, before you eat or drink anything. Wash and dry your hands, and then test. Normal is around 85. If it's much higher than about 100 you probably ought to talk to your doctor. If it's over 140, you definitely need to go in.

Really, though, if you have serious concerns about whether you might be diabetic, you really ought to talk to your doctor anyway. Just make an appointment and get in there and find out. It's scary to hear that the answer is yes. But the earlier you know, the sooner you can start working on getting it controlled.

The reason I bring this up is because ever since I was diagnosed with diabetes, I've been surprised at the number of people who've confided to me how scared they are that they might be diabetic, too. I don't know what people want me to say to that. Am I supposed to reassure them? "Oh, never! You look GREAT! I'm SURE that YOU couldn't possibly have it." (Most people still seem to believe that diabetes happens as some kind of punishment for getting fat.) Do they want my permission to Not face their fears and live in denial while they possibly suffer irreparable but mostly totally avoidable damage to their organs, nerves and capillaries?

I've offered to help people test their blood sugars and interpret their results, and never once has anyone taken me up on it. Mostly, I guess, they either don't really want to know, or would rather handle it privately. I can't blame them for that. I felt the same way.

The point is, if you're really worried – stop it. Find out what's going on, and then deal with it. It can be done.

[steps off soap box]

Still diabetic!

Once again the Christmas miracle failed to occur. I am still diabetic.

We spent the day at Mr. A's sister's yesterday with all his family. Throughout the day I stayed pretty aware of what I was eating, but toward the end of the afternoon the pies appeared, and that was when I sort of decided, well, it's Christmas, and I know for a fact that these pies are delicious, and one day of higher blood sugars is not going to kill me. So I went ahead and had a whole slice of pumpkin, and several bites of an amazing cinnamon apple pie that his mother had made.

Eighty minutes later, back at home, I decided to test, just to see. 153. Not great, but not terrible. I kept thinking of something I had read, about how even a non-diabetic person's blood glucose will spike fairly high after eating a lot of carbohydrate – it can go as high as the 180s – and that an occasional high number is not necessarily anything to freak out about.

So it occurred to me, since Mr. A had been eating pie at the same time as I was eating it, and had eaten even more of it than I had, that it would be interesting to test his blood sugar and see how high he had gone. Somehow I was expecting that he would also test at 153, and all my pie-eating would be vindicated – because if a non-diabetic person tests the same as me after eating a bunch of pie, then I must be not really all that bad off.

Of course he did not test 153. He tested normal. Which is about what I should have expected for a non-diabetic person – he would have spiked at the same time as me, 40 minutes or so earlier, and then his pancreas would kick out a bunch of insulin and he would very quickly be brought back down to a safe level. Whereas with me, either my pancreas isn't able to blast that much insulin anymore, or it's blasting away and my body's not able to respond to it anymore. Or some combination of the two.

So blah. I should emphasize again that 153 isn't a really dangerous high, and I'm not beating myself up over eating dessert or letting my glucose go over 120 or anything else. But comparing my 90-minute levels with Mr. A's was kind of a wakeup call, a reminder: I really am diabetic, even on Christmas, and every day, and it's okay to take a day off on occasion but over the long haul I really cannot afford to slack off on carb-counting or nutrition or portion size or exercise or anything else.

What's the big deal, really? Right now, probably it is no big deal. But the damage is cumulative. A couple of weeks ago a diabetic friend told me she'd been googling images of "diabetic feet" and those images really shocked her into getting back on track. I took a look, and I've been haunted by those images ever since. (A warning – if you decide to look, be prepared. These pictures are gruesome and disturbing and not easy to forget.)

So anyway. Back in the saddle.

Sick-o-meter

You know those days when you think you might be about to come down with something, but you can't quite tell? You feel sort of tired, but maybe that was just because you stayed up too late the night before. Or maybe had a little too much cheese – that could be why your head feels a little stuffy. Should you stay home from work and try to nip it in the bud? Or is there really anything the matter at all?

If you're diabetic, there's an easy way to answer this question. Test. I've found that if I'm starting to get sick, my blood glucose first thing in the morning (FBG, or fasting blood glucose – typically the lowest number of the day for me) will be as much as 30 points higher than usual. That's how I knew on Monday that I really was starting a cold, and was able to call in sick with a clear conscience.

When I was growing up we did not stay home from school unless we were practically on death's door, and I've always retained the fear of being seen as a faker if I claim to be too sick to go to work. It's weirdly gratifying to be able to "prove" that I really am fighting an infection. And taking the day off to sleep and drink tea and sleep some more made all the difference. Yesterday and today I forced myself to stay in bed all morning as well, since I don't have to work until the afternoon, and that has helped a lot too. A cold of the type that usually takes about a week to work its way out of my system is already about finished, and today I feel well enough to ride my bike to work (the sun is out, it's only three miles, and I may call Mr. A for a ride home depending on how I feel by the end of the day).

In other news, we finally replaced the faulty big front burner on the stove, and I keep burning things on it. I had gotten used to the old one, which took forever to heat up and never really did get as hot as it was supposed to. Someday I would love to replace the whole stove with one that runs on propane – which is the next best thing to gas, if you live someplace where gas is not available, like we do. I hate, hate cooking on an electric stove. This one is not original to the house but it's from the same era, and the main thing I do like about it is its color – dark avocado green. I don't think they make them that color anymore, unfortunately.

The first house I lived in out here was way out in the mountains and it didn't have a furnace or gas lines – the heat was a big wood stove, and we cooked on propane. I loved it. This house does have baseboard heaters, which smell and are inefficient ... so I've been loving the wood stove we installed at the end of the summer. Chopping and hauling wood is not as romantic as some people might try to describe it, but it is kind of a satisfying routine and wood heat is just the best. I don't know why 70 degrees of electric heat should feel different from 70 degrees of wood heat, but it does – maybe it's the humidity? With wood, the heat seems to penetrate my body more. It radiates off everything – the fireplace bricks, the furniture, the walls, everything.

The one thing I had forgotten about is the dust. Heating solely with wood produces a lot of ash that invisibly filters into the air every time you open the stove. Dusting is one of my least favorite household chores, and I'm finding I have to do it a lot more often now than I did before – twice a day right around the stove, and at least once a day in the rest of the room. I'm wondering if there might be some kind of air filter that could help keep the air a little cleaner; must look into that.

Unpopular opinion

On one of the diabetes message boards I read people have been talking about a news report of a car accident in which a diabetic man had a blood sugar low while driving and ended up crashing his car into some people, killing one person. No charges were filed – it was considered an accident.

And just now I read another post from someone on a totally different topic, complaining about how his insurance declined to cover him for a continuous glucose monitor (this is a device you wear all the time that sounds an alarm if your glucose goes below a certain level). He said that just last night he went low while driving and ended up 100 feet down an embankment, in a river.

I don't want to piss anyone off on that board, so I didn't respond to that ... But here in my own private blog I just have to say it: I just don't think people should be allowed to drive if they're susceptible to that kind of unexpected low. That includes anyone who crashes suddenly and without warning, or who can't tell when they're crashing. This is called hypoglycemia unawareness and it's not all that uncommon, especially in people who've had the disease for a long time.

My diabetes is Type 2, which for me (though not for every T2) means that I don't have life-threatening lows and hopefully never will, unless my pancreas really does crap out completely someday. So maybe it's easy for me to say that a certain kind of diabetic shouldn't be allowed to drive ... since I'm not that type of diabetic myself.

Still – it makes me so mad to see certain people on that board getting all indignant and demanding to be treated "like a normal person" when it comes to driving and other high-risk activities, when clearly we are by definition NOT normal – we're diabetic. And if someone's diabetes means they run a regular risk of passing out or going into a seizure with no warning, then I'm sorry but please get real – a person in that condition should not be allowed to drive, ever.

It does suck that not being able to drive is such a huge handicap in this place and time ... I know it isn't a small thing to take away someone's license.

I guess this feels very real and scary to me because I almost never drive myself, which means that when I'm out there getting from point A to point B it's pretty much always just me – no seatbelt, no airbag, no crumple zone, no metal safety cage. Every time I ride I try to maintain a constant awareness of what's going on around me, just in case someone should suddenly drift onto the shoulder and take me out, or broadside me, or cut me off without warning, or force me into traffic or into a ditch ... There are so many careless drivers out there. If I ended up dead because some diabetic idiot is too stubborn to admit he can't tell when he's about to have a low – I would be so pissed!

About the CGM – I do agree with those folks that this should be considered standard equipment for any diabetic who can use one, and who wants one. No question at all. That, I consider a reasonable accommodation.

Thinking about all this makes me feel very tired and sort of depressed about being diabetic. That fact is always on the edges of my attention anyway; it's not something I ever really forget. At the same time, though, I don't think of it as necessarily a very bad thing, or even something that's especially hard to deal with. I have to remember to take my one small pill each day, and I have to make sure I don't eat more than about 75 grams of carbohydrate a day, and I have to exercise one hour or more every day. Other than that, it hasn't affected my life much at all.

But reading about all these other people's experiences ... it's scary to get a look at some of the things that could happen to me over the years, even if I do everything "right" – whatever that is. Not a reason to stop trying, but maybe a good reason to take a break from those message boards for awhile. I think I remember reading somewhere that it is not strictly necessary or required to scare myself to death every single day of my life.

More numbers

Last night on my way home from work I stopped at the pharmacy to pick up the last prescription refills that will be paid for by my insurance. I asked the pharmacist how much they would've been if I were paying for them out-of-pocket and found out it's even more than I thought. Today, I paid $45. If I refill the same prescriptions next month, it will cost me a whopping $385. That's more than an 800% increase, folks.

An eight HUNDRED percent increase.

The most expensive part of that by far is the test strips for my meter, which I'm pretty sure I can find online for less than the pharmacy charges. How often to test is a matter of much debate in the T2 community, but I like to test at least three or four times a day, or even more than that if something unusual is going on (new food, I get sick, etc.). With my current insurance, it's been costing me about 7 cents per test; with the new insurance, it will be anywhere between about 65 cents and $1.50 per test.

The result, of course, is that I'll be cutting way back on my testing. If I scale back to just one test a day I can make this latest refill last through the end of the year, and then the next time I buy them, at least the cost will go toward my deductible. For me, this is probably okay. For someone who needs to test a lot to keep from crashing and dying, it could be a real hardship.

All I keep thinking is, I'm so glad I'm not really sick! Although I guess if I were, that's about the only time I would get anything out of this new insurance .... Or at least that's what they've told us. Hopefully I will remain lucky enough never to have to jump through those particular hoops.

In other news, I have a new nephew, born yesterday. No name yet but I saw the pictures and he is, as you would expect, adorable. I'll meet him in October when I go back to Utah for my dad's 70th birthday party.

An enormous beret

Well, I've kept my eyes peeled all week and have not seen anyone to inspire a fashion photo this week, so instead I offer this: the biggest beret I've ever seen, perched atop a big hairdo I suspect is pretty fancy once she takes the hat off.

Soon it will be chilly and cold again – beret weather – and I am so ready. I had a meeting halfway up the mountain this morning, followed by work, followed by shopping and a party on the opposite side of the valley and finally a long ride back to the base of the mountain (home) in the dark – a good 20 miles by the end of the day, and most of it was hot as hell. I actually set a personal record for most sponge baths taken in public restrooms in a single day. There's definitely an art to getting clean in one of those places without actually touching anything – a critical skill because who knows who's been in there, you know, Touching Things.

Except the restroom at my office, in which case I know exactly who's been in there. Not that that makes me feel any better.

Anyway – I had a good time at the party and even allowed myself to have one bite of an exceptionally fudgy brownie, knowing I would work off at least a few of the carbs during my half-hour ride home. I also had six 1.5" square crackers with pâté, a big plate of salad and about a half a glass of white wine. I'll be curious to see what my blood sugar is like in the morning.

Six point one

That's my new A1C. I had the blood drawn for labs on Monday and actually rode over to the hospital during lunch today to get the results in person – couldn't wait til my doctor's appointment next week to find out.

This is not a terrible number, but it's not great, either. It isn't as good as the last one, which was 5.7. It depends on what chart you look at, but according to MY lab (every lab is a little different), an A1C of 6.1 corresponds to an average blood glucose over the last three months of around 126 mg/dL. The number appears with a little "H" next to it on the lab report, indicating this number is "high." Yeah, I know! I get it! I'm a fat pig and a lazy ass and I'm killing my pancreas with miniature toast triangles and tiny little teaspoonfuls of ice cream.

I may be exaggerating a bit there. Then again, maybe not. Prolonged exposure to blood glucose over about 120 mg/dL destroys the beta cells that produce insulin in the pancreas (not to mention doing damage all throughout the body), so an average of 126* definitely requires taking some action. I'm just hoping it's gone up because I've been slacking off, and not because my pancreas is actually losing its ability to make insulin. I'm not ready to start taking injections yet.

Well, one crisis at a time. Not that this even exactly constitutes a crisis; maybe just a red flag. Or even a yellow one. In any case, the plan for now is to knuckle back down and see if I can get it back into the low 5's again by the end of the year when I can re-test.

* People on a forum I post to have assured me this is not necessarily as bad as it sounds – a brief but very high spike after eating something particularly carby can skew your average somewhat, etc. Still, I'm willing to forego the occasional hash browns and greasy-spoon breakfast if it means I get to keep my feet when I'm old.

Also, forgot to mention

Because of all the upcoming changes in my insurance, I've been going to a lot of doctor's appointments lately. At the end of this month we go from a $20 copay to a $2000 deductible per calendar year ... which basically means all I have now is "catastrophic" coverage – all of my usual healthcare expenses will now be paid out of pocket. Kind of a ripoff, but under the circumstances I'm just glad to have any kind of coverage at all.

Anyway, I just wanted to record the fact that in the last couple of weeks I've seen the dentist, podiatrist, ophthalmologist and dermatologist for complete checkups and screenings, and have been given a clean bill of health (although the dour hygienist at my dentist's office always scolds me for not going in more often, which I hate – both the going in, and the scolding). So that's good. My feet show no signs of nerve damage, my eyes are exactly the same as a year ago (also good), and I have no periodontal disease, suspicious moles, or any other signs of imminent decay. Good to know.

The last appointment before my coverage is dropped will be with my regular doctor, a week from Monday. That means that THIS Monday I have to go to the lab and have all my blood work done again, so we can review it at my appointment. I really should have done this at the beginning of the summer but I spent the whole spring dealing with panic attacks and was afraid to find out what all that adrenaline and cortisol had done to my blood sugar, so decided to give myself a couple more months to try to get it back down again, in order to not have a higher A1C on my chart again.

Thinking of this just now I'm realizing how silly that was, putting it off. If I hadn't been so anxious and freaked out maybe I would have realized that that was actually a GREAT time to have an A1C done, because then I would be able to know what that kind of stress really does to my blood, instead of just guessing. Plus, if I'd done it in June, I could still have had another one now.

It's funny to see how easily I can still slip into that trap of wanting to look away from the things I'm afraid of, despite all my soapboxing about how important it is to always face up to the Truth, no matter how scary. The result is that now instead of having about eight months worth of information about what my blood has been doing, I will have only three months. I won't be able to find out what really happens when that anxiety hits, until three months after it's happened again.

Which hopefully it won't. I always hope I'll never have to deal with it again, even though I know that's probably not very realistic. I was actually thinking this week about some of the things I've done over the last six months or so to avoid having to interact with people, and it suddenly became clear that I'm still not quite over this latest hurdle. So I'm doing some things now to try and address that.

One thing I've done is started being a little more active again on some of the diabetes forums that helped me so much when I was first diagnosed. In fact, I even outed this blog on one of them today – in a very unassuming (I hope) way, not really promoting it, but putting a link and a brief explanation on my profile page so people can find it if they want to read about my "excellent diabetes adventure."

Why would I do that, when it's so important to me to stay anonymous and not make waves or draw attention to myself, especially among people I don't really know? Part of it is because I know I really need to stop indulging every single urge I have to hide, and make an effort to engage more every once in awhile. A more important part is because I started reading posts from people who have just found out they're diabetic, and started remembering how I felt and what I did at the very beginning, and I thought it really might be helpful or reassuring for some of those people to be able to read about my experience. So I just put it out there.

Now time for bed. There is a full pint of banana split Häagen-Dazs® in the freezer and if I don't get out of here right now I might do something I will regret.

World Diabetes Day: Nov. 14

I'm just loading this graphic here until I have time to add it to my sidebar. Find out more about the campaign here.

Being diabetic is kind of kicking my ass right now and I would love to think there might be a way to fix it someday – preferably soon!

P.S. Since I'm on the topic, here's something funny: Beet the Beetis! Or maybe it's only funny to diabetics. The star of the game, in case you're not familiar, is the infamous Wilford Brimley. You know – the diabeetus guy. Pay attention around :36, when he does a crazy little dance in front of the fireplace:



Gotta love this guy ... he has the 'beetis, and still eats oatmeal every day!

Health care

Yesterday at work we had a meeting to discuss changes to our healthcare coverage. One of the results of the layoffs that have been happening since the beginning of the year is that the company is no longer big enough to qualify for the same coverage plans we had before. There are three new options available, with an effective date of October 1. So I'm spending my holiday weekend carefully poring over the stacks of literature I brought home, hoping to be able to extract enough meaningful information to make the best choice.

Losing my health insurance, or no longer being able to afford it, has been one of my greatest fears since I found out I'm diabetic. I sat in the meeting for two hours, feeling like my solar plexus was on fire, wanting to scream or cry. The "plan representative" was chipper as hell, extolling the benefits of the HSA PPO option (the one I will probably end up choosing) over our current HMO, which we can choose to continue – at four times our current cost. She was grinning so hard it looked like her face must hurt. But she was pretty much the only one in the room with a smile on her face. Everyone else looked anxious, concerned, confused.

Well, such is life in a sinking ship. I'm a smart enough cookie and a pretty good swimmer, and am determined to stay on board as long as I can, for reasons that still seem like good ones, at least for now. As an example, in addition to the cost of looking for a new job and getting to and from it once I find it, there's also the daily exercise time I will have to come up with if I'm no longer able to use my bike-to-work time to keep my BG under control. Plus, I still like some of the work I'm doing, and I really like most of the people I'm working with. And of course there's also the access to healthcare – even if it's expensive, the coverage I'm able to buy through my work is still better than what I would be able to buy for myself, assuming I could even find a company that would take me at all. Legally, they don't have to. Even though right now, despite my "pre-existing condition," I'm still pretty healthy.

During the meeting I sat next to a friend from another department whose 24-year-old fiance has been diagnosed with a rare form of cancer. For the last year they've been desperately fighting to get him the treatment he needs. It's inconceivably expensive: he hasn't been able to work, sometimes he needs care at home, and just one of his bone marrow treatments costs upwards of $16,000 a month.

She feels like screaming and/or crying quite a lot, too, she told me. At least it appears he will be eligible to come onto our plan as a spouse, as long as there's no more than a 62-day gap in coverage after his COBRA benefits expire. That was a huge relief to everyone in the room except the plan representative, who was probably the only person there who didn't know the background to that particular question about pre-existing conditions.

All of my issues seem pretty workable when I think of what they're going through. So I've decided to try not to worry so much about it. Even if I someday do lose my coverage and lose control of my diabetes – which seems pretty unlikely, though anything's possible – what would that really mean? Maybe I'd go blind, or have to have my feet or legs amputated. Maybe my kidneys would fail. Eventually I would probably have a heart attack and die.

But I'm going to die someday anyway. This fact has been on my mind a lot lately, for some reason. Maybe it's the change in seasons; summer feels like it's winding down early this year. I've been working late on a deadline for several weeks, drinking way too much caffeine, and not sleeping well – and the other night I woke up around 4 a.m. and couldn't stop thinking that someday I will be dead. It seemed like a stupid thing to think about, but all the same I suddenly found myself crying tears of real self-pity. I kept picturing the face of my friend K. who died in her sleep a few weeks ago of heart trouble probably related to her own poorly-controlled diabetes. She was 72 and so funny and happy and creative and alive – with her big red laughing mouth and fabulous jewelry and her dashing new white-haired boyfriend – it's hard to imagine that she really won't be around anymore. And someday, I won't either.

Now that I think of it I guess it wasn't so strange that I should wake up crying. I've been working so much I still haven't really had time to just sit with the knowledge that K. is gone.

I know no good can come from dwelling on my own death, or worrying about anything that might happen to me between now and then, or afterwards, either, for that matter. Right now I do still have access to healthcare. So I'll just make the best decision I can, keep doing what I can to stay healthy, and focus on enjoying the life I have – instead of worrying about things that haven't even happened yet, and maybe never will.

When you're a chronic worrier like I am – though I'm feeling more justified recently in starting to think of myself as a recovering chronic worrier – sometimes it's good to remind yourself that worrying is always optional. Thoughts do have a way of coming to mind ... but I can choose not to entertain them when they do.

P.S. Here is a link to the article that inspired this long and tedious discourse, in case you're wondering how I get started on these things ....

P.S.S. Speaking of anxiety ... I just added up some of the figures from the plan summaries and it's looking like my out-of-pocket cost for even the cheapest option is almost twice what I'm paying now, and the coverage isn't as good. I think I'm going to go throw up now.

For your (diabetic) reading pleasure

Posting this way doesn't let me embed the links, but you should still be able to read the URLs:

http://diabetesupdate.blogspot.com/2008/08/is-diabetes-eating-disorder.html

http://diabetesupdate.blogspot.com/2008/08/is-diabetes-eating-disorder-take-two.html

I'll say again that this site is the best source I've found anywhere for useful information on diabetes. She's the person who helped me move from terror and despair toward hope and empowerment (in fact, she quoted from one of my emails to her on the back of her book!).

I haven't written about my health issues for awhile and that's because I get tired of thinking about them and can't imagine that others would find them interesting. These posts of Janet's, especially the second one, have piqued my interest again though – especially her description in paragraph three of the supposedly "obsessive" food-related behaviors diabetics engage in. I do everything on that list and more. It's really kind of exhausting, if I give myself time to stop and think about it.

On the other hand, as with so many other things in life (everything in life, maybe) most of how I feel about it seems to depend on how I choose to think about it, and even more importantly, what I actually DO about it. This is where meditation practice really helps – if for no other reason than that it's helped me see how fluid and insubstantial thoughts really are, even – or maybe even especially – the ones that seem most Serious, Important or even Urgent. In fact, regardless of their content, they're all still just thoughts. And as the saying goes, I try not to believe everything I think.

Just do what needs to be done, even if it looks obsessive and kind of crazy to people who don't understand.

There are a lot of people who don't understand.

I could go on and on (and on) about this, and maybe sometime I will.

Stalking the yellow slingback

I finally came up with a decent stealth fashion photo, just in time for my birthday, which is today. Catching sight of this woman was actually kind of a thrill, because she's really beautifully and I'm going to guess even possibly kind of stylishly dressed – something of a rarity in this little farm and tourist town. This combination of gray and bright, chrome yellow is supposedly kind of hot right now, or so I have read. (Note the New York Times on the table here ... apparently some people around here do try to keep track of the rest of the world.)

Here's a close-up of the sandals. Not a style I would ever wear myself – any of it, actually – because it's too sort of ... I don't know, flimsy and refined, undoubtedly well-made but not meant to be sturdy, durable or even probably very comfortable. Plus, my feet are too wide and too important to me to wear strappy, thin-soled sandals.

Thinking of feet ... the other night I woke up in the middle of the night to get a glass of water and as I was stepping around the Jeeps (snoring away in the middle of the doorway – his new way of protecting me, since he can no longer hear a thing) I smacked my little toe hard against the bottom of the doorframe. It turned black and when I trimmed the broken nail it was all bloody underneath, and it occurred to me – a stubbed toe always hurts, but if I don't take care of my blood sugar this is exactly the kind of injury that could lead to my having a toe, foot or leg amputated. Like, within days.

I've read about this online in the diabetes forums; certain writers are super vigilant about reminding us newer diabetics to take rigorous care of our feet. So I put a pair of Crocs next to the bed and vowed never to get up again without immediately putting them on. They may not be as cute as a pair of bright yellow strappy slingbacks, but you can't wear slingbacks anyway if you've just had your feet chopped off.

Anyway. Rather a sobering thought at 3:43 in the morning.

I have been struggling a bit with my health issues again lately, first as part of my spring anxiety series and now just ... I don't know why, but it just seems to kind of go on for no apparent reason. My morning sugars have been back down where I like them to be for a couple of weeks now but I'm finding myself having to work very hard to keep them there.

The biggest problem is hunger – I just feel like I'm starving, all the time, even after I've just eaten a totally adequate meal. Now that I know this is a symptom of my condition, and not an indication that I need to eat something, you'd think it would somehow be easier to reign it in and ignore the urge to indulge. But it isn't. Hunger is such a primal, visceral, urgent experience – you feel like your very existence is in peril. At least that's how it feels to me.

So I'm experimenting again with different things I can eat lots of, that won't cause me to gain weight or blow my blood sugar goals. Water is at the top of my list, along with celery, leafy greens (without dressing), and all kinds of non-starchy vegetables plus fish, chicken and the occasional spoonful of peanut butter or ice cream, just for morale.

I'm supposed to have a new A1C in the next few weeks and I'm a little afraid to find out what it's going to be. I feel sure it will have gone up since my last one. But maybe it won't be as bad as I thought. And even if it is, it's always better to know, right? Then at least I can adjust my program to try to bring it back down again.

In other news, today is also my last day of work before my vacation, and a friend from work is throwing me a little party at her house tonight. While I do celebrate my birthday, I almost never have an actual party, so that will be something special.

P.S. I should probably mention that the podiatrist has pronounced my feet in excellent condition, and my smashed toe was completely healed within a few days. So no worries there, for now – just a cheery thought for the future!

New study

I don't have time to write a lot about this, but I've been reading about a new study that links diabetes and depression in some new and interesting ways.

... Golden, an endocrinologist, suspects that depression might cause physiological changes that predispose people to diabetes. Depression raises levels of stress hormones such as cortisol as well as other molecules that lead to inflammation; these chemicals in turn contribute to diabetes.

Depression plays a role in several chronic physical conditions besides diabetes. For years, scientists have known that depression is associated with higher rates of heart disease, stroke, osteoporosis and perhaps dementia. Stress hormones and inflammatory molecules play a role in all of those diseases. (more...)

Did I write about this already? Since I've been dealing with this latest bout of anxiety or depression or whatever it is, my morning glucose readings have consistently been 10-20 points higher than usual. True, I'm also not exercising as much as I was before, and I have gained back about eight of the pounds I lost last year (@*&#$). But now, rather than blaming myself for being a loser and a jerk and a terrible weak loser of a jerk, etc., I'm entertaining the possibility that hmm, maybe my body (not just my reprehensible character) really does have something to do with it – all on its own – and maybe it might be possible to NOT beat myself up so much when things like this start to happen.

This is not to say that I'm letting myself off the hook for losing more weight and getting my numbers back down where they should be. Just because there's a "real, verifiable reason" why I tend toward depression, weight gain, high blood glucose, etc. – that doesn't mean it's okay to just give up and let it take over my life.

It does mean it might be harder for me to control these things than it is for the average person who doesn't have this condition. It also means ... well, I can't say it makes me happy to see my morning glucose numbers rising, but it is somehow validating to have this bit of "proof" that the way I've been feeling is not just all in my head. Knowing that it's not all my own fault somehow makes it easier to keep trying.

As one of my favorite rabble-rousers said lo these many years ago: "The victory is in the struggle."

Keep on keeping on!

His face will not be seen again

Some of you who've been reading this for awhile may remember a character I know I've mentioned once or twice – a man about town I used to refer to as "the Sweater," because he was always sweating. I just found out he died this week. He was two years younger than me.

This is not someone I was close to, or even knew very well. But I did know him, and I always hated how ambivalent I felt about him. On the one hand, he was interesting – and there's a sad shortage of what I would call "interesting" people in this town, people who would catch my attention in a crowd, whom I would watch and think about possibly getting to know. He did a lot of volunteering, like I do, and always seemed to be around, at any public event and even at weird private functions where I wouldn't expect to see anyone I knew. He also had a certain rough kind of charm, despite the sweating and the cigars. He was intelligent and unconventional and accomplished (in some things). He seemed like someone who might have become a friend.

But he never did. He had a creepy, drunken, angry and out of control side that always seemed to come to the forefront of any conversation or interaction I had with him, and usually sooner (rather than later). We might start out talking about dogs, and then dog breeding, and then suddenly he would have turned it into a leering inquisition into my reproductive status, and whether I might be interested in "mating" sometime.

It didn't take many of those conversations before I started avoiding him.

Over the last year or so though I had started feeling weird about that. Enough time had passed since he'd offended me that I started seeing him as neutral again, instead of as an icky, unpredictable oddball best steered clear of. Also, his health was clearly deteriorating. He was always out of breath, and sweating more than ever. He'd always been fat, but suddenly he was really fat – so fat his skin looked tight and shiny, as if it might split right open – so fat his arms always seemed to be floating out to his sides. His feet and legs (always in shorts) were starting to look dark and burned, maybe from the sun, or maybe from some kind of skin condition. Actually, after all the reading I did about diabetes last year I was assuming it was a sign of nerve damage or necrobiosis lipoidica (look it up); certainly his feet and lower legs looked ripe for amputation, even though he was still using them to walk around on.

Anyway, all of these factors combined to soften my attitude toward him, and the few times I saw him I did say hi, and even used his name, which seemed to please him. But I still kept my distance. I didn't want to take a chance at having my day disrupted by some off-color remark.

A few weeks ago I was with a friend at the cafe near my office when he sauntered by on his tight, swollen legs and worn-down flip-flops. I knew he'd been in jail for awhile, and was now living in his car with several large dogs. "I'm worried about him," I said. "He's going to die if he doesn't start taking better care of himself."

And now he has died, and I feel strangely guilty for not feeling something more than just plain old sad. I wish I hadn't predicted his death out loud, even though his decline was obvious to anyone who cared to see.

It's strange to think I won't be seeing him around anymore. He's been a strong and visible presence in town for as long as I've lived here.

And what could I have done for him, other than what I did, which was to say hello and smile and assert myself, even if it was only lightly, as a friendly presence in his life? You can't tell people what to do, how to take care of themselves. We all do the best we can. Acceptance and support are what helps people heal – or maybe not even heal, but just live. Not criticism, contempt or unsolicited advice.

Still. It makes me want to try a little harder to extend myself to people around me, who could maybe use an encouraging word from time to time. Really, who couldn't?

Liver and onions and beer, oh my!

I've been having so many random and (to me) very interesting thoughts lately, I've decided just to do a sort of round-up of the ridiculous today. And since Blogger now seems to be accepting photo uploads again, you're in luck – there are pictures!

1. Liver and onions Every once in awhile when Mr. A is away for several days I take advantage of the opportunity to stink up the house with one of my favorite meals: liver and onions. He thinks it's disgusting, but I – and the dogs – beg (yes, they literally beg) to differ. It's delicious! I get the regular beef liver, not the pale and insipid-looking calves' liver, which lacks the requisite deeply, bloody and oh-so-livery flavor we love.

Tonight while enjoying this classic dish (if liver and onions can be called a dish, and why can't it? It can!) I realized one reason why people might not realize how glorious it really is. The name is all wrong. If you make it like the name says – plain old liver, with plain old onions – it really is nothing special. What it should be called instead is "liver and onions and ketchup." It's the ketchup that makes it magic. Add on top of that a cold non-alcoholic lite beer, drunk straight from the bottle, and you have a meal fit for kings, dogs and frequently anemic red-haired and carb-restricted diabetics with a few pounds left to lose. (No onions for the dogs, of course – onions are toxic to canines!)

2. Summer reading. Someone asked what I've been reading lately and so I will report that I'm back to Alice Munro, whose oeuvre I still haven't exhausted even though I guess she's not putting out much new material lately (or possibly at all). Right now I'm reading a story collection called "The Love of a Good Woman," which contains the following very arresting paragraph:

There are people who carry decency and optimism around with them, who seem to cleanse every atmosphere they settle in, and you can't tell such people things, it is too disruptive ... It used to be older people who claimed this protection from you, but now it seemed more and more to be younger people, and someone like Eve had to try not to reveal how she was stranded in between. Her whole life liable to be seen as some sort of unseemly thrashing around, a radical mistake.

At this point in the story the main character, Eve, has just returned her young grandchildren to her daughter after an afternoon of unintentional adventures during which what started out as a light-hearted and spontaneous turn off the road came very close (or felt like it might be about to come very close) to going horribly, hideously wrong. The sense of uneasiness, of having escaped something without being quite clear exactly what it was, the nebulous guilt and wondering if the grandchildren will mention it to their mother ....

Oh blah. You just have to read it. "Her whole life liable to be seen as some sort of unseemly thrashing around ..." A feeling, a vague worry I know so well.

3. TV yoga. I just learned that our cable package includes an on-demand channel that has a dozen or so occasionally updated yoga and Pilates programs you can watch whenever you want. Most of them are only about ten minutes long, so I've been stringing them together into nice little custom workouts of varying lengths, to be performed on either end of my dogwalks, bike rides and other forms of exercise. I'm enjoying this very much.

4. More gardening. I got a sweet 100 tomato, a sugar baby watermelon and more of those tiny delicious Alpine strawberry plants. It's going to be a delicious summer.

5. Dog shave. I gave Tater a day off on Saturday to rest and recover from his trauma at the vet, and then on Sunday we gave him a bath and shaved him down. We took a whole shopping bag full of hair off him and he looks great – sleek, sweet and slippery as a seal. We found several foxtails already worked halfway under his skin, so our timing was perfect. Plus, every hair that ended up in that bag is a hair that will not end up on the floor. Or in my bed. Or between the pages of books, or on my t-shirt, or in the soup, or in any other place. Hooray! I do love his long silky beautiful hair (it was one of the reasons I picked him, and our next dog will have the same kind of hair – I'm addicted to it!), but it's nice for a few months out of the year to have a little break from cleaning it up all the time.

So here he is before the haircut, hiding next to the picnic table. Click for the big picture; you can actually see cookie we bribed him with, and the whites of his eyes as he glances at me over his shoulder as if to say, "Do we really have to do this TODAY?"

And here's the after, with a pile of hair and a pair of scissors included for scale. It really is a great big pile of hair, right?

6. American Idol. Speaking of addiction – I got hooked on this show last year totally by chance, and this year I've been mesmerized by it all over again. It's on in the background right now (I can't stand to actually watch the whole thing, I just love to follow the action) and in just a few minutes, maybe even before I finish writing this post, they will announce the winner for this year. It's been especially interesting to me this year because there were two Mormon contestants, and now it looks like one of them is going to win. If he does, I wonder what he'll do in two years when it's time to go on his mission?

7. Blueberry season. Just as in winter there is a time when I start checking the produce aisle almost every day to see if the satsumas are in yet, in summer there's a time when I start looking for local blueberries. Well, today was the day! They're back, and they're only a buck and change for the little package – not eight dollars like the ones from Chile were just a couple of months ago (not that I ever buy berries out of season, of course – that would be so un-green of me).

8. Silver clogs. Another obsession I haven't quite decided to satisfy yet ... I'm still just fantasizing over pictures online.

For example, these. I love the little flowers and have been intensely tempted to get them even though the closest they have to my size is about two sizes too big. Maybe with socks ...?

Or these. I love the high heel, and the fact that the strap can be worn in two different positions – over the top, or back behind the heel. Plus, they're Swedish!

I have to give props to Julie here as the fabulous person who got me started on the metallic clogs thing, with this picture (the second one down – click it for the big version in which the shoes are clearly visible) in one of her Monday fashion posts. I highly recommend these posts if you're not already aware of them; we chicks-in-the-sticks really rely on our friends on the ground in hip places to keep us informed of what's being worn in the upper echelons of real street fashion and Writermama never fails to deliver in this regard. Thanks, Julie!

Realistically, silver shoes are something I will probably end up Not getting. I know myself well enough to know that if I did get them, that would be about all I'd do with them – get them, but not wear them. Silver is a color I love to look at, but not to wear. Those second ones come in metallic bronze so I might get those, though my worry is that they'll be 1) too narrow, 2) too uncomfortable, or 3) both.

Still, that's what returns are for, right?