LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Monday, February 10, 2014

Jumper on the ledge

I can’t believe I just taxied right off the fucking runway. One moment I’m headed for the terminal, the next moment we’re off in the grass, my landing gear is mired in the mud, and the plane is stuck fast. I shake my head. How did that happen? Did I pass out? Get distracted? Did the steering fail? Fuck! I advance the twin throttles. Both radial engines spool up with a throaty roar, the airframe vibrates, but we do not move. I throttle back before I shake the silver beauty to pieces. Then I advance just the left throttle. The left engine snarls to life, the plane shakes and groans, but again we do not move. I yank the throttle back to idle. Shit! I sit for a moment, exhale, collect my thoughts, then I key the mike and call the tower. Uh, november triple four six kilo, I, uh, have a little problem here…

Sunlight filters in the window between the slats of the blinds and across my bed, waking me. Crap. I need to call the FAA this morning and explain to them how I taxied off the runway at an unauthorized spot yesterday and got stuck in the mud. Hell of a way to start the day.

I swing my feet to the floor and my eyes fall on the glucometer on my nightstand.

Oh. Wait. I’m not a commercial pilot anymore. It was a dream. Or… or… is the diabetes a dream? As cobwebs dance across my mind, I try to sort it all out. The gleaming plane stuck in the mud seems so real. The world of diabetes and illness seems like a fuzzy, distant dream… and yet… and yet I think what feels real is the dream and what feels like a dream is real. How can that be?

I rub my eyes and see my clothes and stethoscope laid out on the Victorian chair in the corner of the bedroom. Then I remember. I’ve been sick. Very sick. And today I must go back to work. Not at the airport, but at the clinic. The sliver plane off the runway in the mud, so real moments ago, fades as the reality of diabetes and chickenpox crowd in. Silver planes are dreams. Reality is desperate times and desperate people. Sickness and poverty and fights with insurance companies. I have been commanded to return to this reality: It is time. You must return. You must come back to work.

But I do not want to go back to work. I do not feel fit for duty in mind, body, or spirit. But the powers that be are insistent, and my boss—the most brilliant clinician I know—feels that exercising my brain in its old patterns might be just what it takes to get it to start working again. The neurological equivalent of jump-starting a car.

I am so unconvinced that I do not even pack lunch.

Now on the one hand, I’m not terribly sick anymore. I’m no longer contagious. Most of the scabs have fallen off. I’m able to stay awake for most of the day. But on the other hand, I’m not terribly well, either. My mind still does not feel right, and the pain in my gut remains omnipresent—sometimes worse, sometimes better. I feel a mere shadow of my former self. Perhaps the shape is the same, but there’s no contour, no depth. I believe this disease should have killed me but someone dropped the ball. Probably, just like UPS and FedEx, who can never seem to find my house, the Grim Reaper got lost en route. Now I’m in limbo like a lost package that no one knows what to do with. Do we forward this onward or return it to the sender?

I’ve been asked to come into the clinic in the middle of the day and to stay only as long as I feel up to it. I have no patients on the docket. I’m just to catch up on phone messages, emails, and get familiar with the new version of our electronic medical record that was installed in my absence. Without my normal mental powers at my command, I am unable to conjure up an excuse not to comply with the request. But I dearly wish I could.

The sun high in the sky, I drink a cup of coffee and eat a Kind bar. Then I pack a pipe with Black Cavendish, put on my grey wool coat, pull my dusty go-bag off its hook by the door, and step outside.

Climbing back into my jeep after more than a month feels surprisingly “right.” Sort of like putting on a comfortable old pair of shoes. Still, on the drive over to the clinic I can’t shake the feeling that I’m going to my own execution. I don’t want to be doing this. Along with the nagging pressure/pain in my gut, I now have butterflies in my stomach. The devil on my shoulder whispers in my ear: Just drop into the median, do a U-Turn, and turn tail for home. Tell them you tried, but just couldn’t make it. They’ll never know.

Like a jumper on a ledge, I want to, but for some reason I do not. I forge onward.

The day is sunny and bright. Normally the kind of day that’s full of promise. The hour’s commute seems to take forever, but in a good way. After all, I’m in no hurry to get where I’m going.

It has been one month to the day since I last worked. Most of the four weeks off is a fog of sweat-drenched nights, nightmares, ER visits, fear, fatigue, and confusion.

Not exactly a vacation.

I park at the edge of the main parking lot instead of “up back” where employees are supposed to park. I can barely walk and I want to conserve my energy for the day. As I make my way stiffly down the hall to my office, my brain seems mired in molasses. Everything is familiar and yet nothing looks quite right.

My office door is closed tight. I usually leave it open. In my imagination, I briefly envision yellow-and-black crime scene tape sealing it off. I shake off the image and push the door open. The energy-saving motion detector wakes up and turns on the lights for me. I drop my go-bag and car keys on my desk, and as I turn to close the door, I see it.

Something new is waiting for me.

My wall is no longer a sterile blank canvas. It is graced with a painting and a note from my beloved. At some point while I was away, my wife snuck in and hung a painting on the wall. It’s a big painting of a small airplane being engulfed by a fearsome cloud—a wicked swirling blue-grey vortex.

It’s an oddly sinister painting. But I love it at once.

Why? Because the plane is in the sky—where planes belong. It’s not broken down, out of fuel, grounded by fog, or stuck in the mud like the planes that have haunted my chickenpox nightmares for weeks on end. Clearly, this little plane is about to encounter an epic challenge, but it’s flying boldly forward.

I realize at once that this plane and I have a lot in common. Like it, a storm surrounds me and I must fly through it or I must crash in the attempt. I’m not ready for the challenges ahead, but I mentally advance the throttle, bank towards the storm, and fly in.

The first hour is spent getting (slightly painful) welcome-back hugs from my various colleagues.

The second hour is spent trying to get my fucking computer working. We have three different passwords between turning on the stupid laptop and reaching the damn electronic medical record. Each password has to be at least 12 characters in length. Each password has to have at least one capital letter, at least one lower case letter, at least one number, and at least one special character. The same password cannot be used twice, each password expires every three months, and cannot be reused.

I cannot remember any of them.

I sit in front of the blank computer screen and tell myself that even without encephalitis, even without sleep deprivation, even without the wicked cognitive side effects of powerful antivirals, I likely had problems logging in every day.

I tell myself that, but I am not convinced.

The third hour is spent trying to figure out how to do the most basic of operations on the new medical record software that looks nothing like the old. Or maybe it does look like the old and I just don’t remember. Again I find the dream world and the real world converging on me and I’m not sure what is changed versus what I’ve lost. I glance outside my office door, but there’s no sign of Bill Clinton.

The pain in my gut gets worse. A giant knot. I don’t know if it’s the chickenpox damage, the swollen lymph nodes, or just garden-variety fear and stress. Maybe all of the above, but I find myself doubled over at my desk, unable to sit up straight.

One of my nurses pokes her head in the door, “You don’t look so great, you doing OK?”

I’ll live, I reassure her. In fact, at that moment, I wasn’t sure I wanted to.

The fourth hour is spent weeding through month-old voice mails and hoping that most of the people who left me messages have since contacted someone else at the clinic. Three weeks ago, for instance, there was a message from one of my patients: “Please call me right away, I only have one day of insulin left!”

I have 193 emails. Fuck that. Enough is enough. I’m going home.

I’m exhausted. Everything today was a struggle. Even the littlest things took the longest time to accomplish, and still didn’t feel right. It felt more like the first day on the job, not the 2,500th that it really was.

But I made it through the day.

I shut down the computer and looked up at my new painting of the little plane approaching the big vortex. I don’t know if my mind will ever work right again—but somehow this plane flying into the storm gives me hope. It will be a long road, no—a long flight—to recovery. But at least today I’m off the ground.

And now that I’m back “in the sky” again, I wonder if the dreams of broken-down, stranded, and grounded planes will fly away.

Maybe tonight my dreams will take wing.


Anonymous StephenS said...

Loooove that painting. Hope things get better every day forward.

8:04 AM  
Blogger Unknown said...

I also love the painting. I pray each day will get better and the fog will clear!

12:28 PM  
Blogger Bennet said...

Have about a 190 email?

3:56 PM  
Anonymous Albert Kretz said...

Wil, aka, Lee,
Since you are among the first to use a CGM, you may be interested in viewing our efforts on Indiegogo.
Please search for: Continuous Glucose Monitor - Advanced BioSensors-Ohio. We are developing the next-generation, Painless, Micro-needle (1-hair thick), Dermal sensor which is Extremely Easy to Use.
I would appreciate your comments and , if you think this effort worth while, sharing it with your readers.
I appreciate your taking the time to learn about this project and wish you continued success with your own T-1 efforts.
'Keep on Truck'n'
Al Kretz

11:37 PM  

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