Wednesday, June 21, 2006

The Good, the Bad, the Ugly

Walked over to the hospital and went over my numbers again with Dr. S. (the best part about this whole experience is probably that the hospital is within walking distance).

He'd put me on a one long-lasting Lantus shot every morning, then two or three more shots as needed every day before meals. First, the Lantus was too low, and I had really high sugar. Then the Lantus was too high, so I was bottoming out all the time and getting shaky and had to eat more to keep my sugar on track. So he cut the Lantus back a little, and cut my noonday shot out. Now I'm running a little too high again (over 200) in the evening.

So, I have two choices: add a small noonday shot back in, adjusted for the effect of the Lantus later, so I'd be up to four shots a day again; or, try a mixture of high and medium lasting insulins (premixed) and only take two shots a day, period.

I said, well, fuck it, let's try the two shots.

Well, OK, I did not use the word "fuck," however. My doctor is this older, skinny little Indian man with a long white beard, hooked nose, bushy eyebrows, and a tendency to smack his lips before and after he speaks. He always looks terribly serious. He has no bedside manner, and while he was with me, he took a call from some hysterical-sounding woman. From his end, this is what I heard: "Oh, he's fine, he's doing well.... yes, I think so... Then don't let him go out... Just don't let him go out. He's just going to go out and rape some woman... if he says he's going out looking for women, that's what he's going to do... Then go with him when he goes out... no, no, he's not serious... then let him go out for five minutes, OK?"

Don't ask me what that's about. I have no freaking idea.

So anyway, despite the lack of bedside manner, the guy absolutely knows his shit. I feel comfortable that he knows what the hell he's doing, and I trust his judgement. Which is what you really need in a doctor. I'm forthright enough to ask the questions I need to ask despite his gruff manner, so it works for me.

I love my Lantus, but I almost always say "yes" to new things. If you don't say "yes" you'll never know if the other stuff would have worked better than what you're currently using. So I'll risk a week or two of the "new" not working so great... At least then I'll *know*. And there's the possibility that it'll work *perfectly* and I'll have found the exact right fit. And a couple weeks of glaring at my sugar levels again is worth that.

The cost of this new medication, and a new, more compact glucose meter with a faster testing time?



Speaking of health expenses, I also went and sorted out my hospital bill. I couldn't understand why it said I owed only $3300 of the $27,000 because it didn't say who the hell had paid the other $23,000.

"Oh, it's a contract the hospital has with your insurance company," the billing woman told me.

"Does that mean they paid it?"

"The hospital has a contract with the insurance company. You wouldn't understand."

"Uh-huh. OK, back up again, then. Did they pay it?"

"It means you only owe the $3300 if your insurance doesn't pay it."

"What about the other $23K?"

"Oh, don't worry about that."

"But... has my insurance paid it?"

"It's a contract the hospital has with --"

"OK, OK. Does that mean I don't ever have to pay the $23K no matter what my insurance says?"

"Exactly. All you'll ever be obligated to pay is the $3300, if your insurance won't pay that," she said, and grinned. "I bet you had a heart attack when you got that bill."

"Not really," I said, "I just laughed."

I was also ready to laugh when Dr. S. put me on the scale. I had already steeled myself for the numbers. Was I already over 190 again? Was my body totally freaking out and out of control and everything was going to explode and go to hell?

I stepped on the scale -


I've only gained 7 pounds since I got sick.

I assumed I'd put on twice that.

They say people with a history of eating disorders tend to suffer from that whole body dimorphism thing, where they think they're bigger than they actually are. Seven pounds is a really fucking healthy amount of weight to put on, thanks. 183 is a perfect weight for me, and I'd love to stay there, but shit happens, I know. Maybe my body will surprise me. I don't know that I've ever felt all that in control of my body. So getting diabetes really isn't changing much of anything, as far as altering my perception of self.

I always felt like there was something fundamentally broken with all of my systems.

After blowing money on medical supplies, I went to the local used bookstore where I have store credit and bought some Conan novels.

Because when all else in life is incredibly frustrating and out of whack and your endocrinologist is advising hysterical women on how to keep rapists off the street, there's always Conan novels.

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