Isolation

Featured

We’re all in this boat together. Like it or not!

During this coronavirus I have been pretty much contributing very little or better said, nothing, to the blogosphere about the pandemic, and how it is affecting my life, or for that matter, how it affecting anybody or anything.

It’s not that I don’t have anything to contribute to the conversation. It is that this thing is a really, really big deal, and I don’t want to diminish its importance to anyone by failing to reflect just how important it really is, to me, and to the world around me.

To those out there who believe that the government is overstating the dangers of Covid 19, and they can cheerfully go on about their business without changing anything, well, thanks for less than nothing, since your ignorance may already be having a serious effect on the lives and well being of thousands of people, some right in your own neighbourhoods, some physically a long ways away. Like maybe even in other countries or even continents.

Like it or not, failing to self isolate yourself is reckless endangerment, and potentially, mass suicide/murder.

Canada’s Healthy Minister Patty Hajdu

You see, normally I’m a skeptic when it comes to government health warnings, and generally dismiss most as merely propaganda to serve the interests of an overbearing nanny state.. Not this time, not now and not ever. This virus kills people, lots of people, including people like me, with immune deficits that mean infection will mean a ferocious battle for my very life.

If I’m really lucky, most people in my own area, Vancouver, British Columbia and Metro Vancouver will have been helping the Provincial and Federal governments by isolating themselves at home as much as is humanly possible, and help slow the disease so that by the time I get it, there will still be hospital resources available, and I’ll get whatever it is I need from medical treatment whether it includes Intensive Care, Respirators or other devices. Hopefully there won’t be so many of us sick at one time that the system simply collapses after being overwhelming by the demand created by our citizens being unwilling to do what it takes to flatten the curves, or plank it.

Because isolating ourselves doesn’t necessarily mean that people like me who are vulnerable in the extreme won’t get it. It might, if I get incredibly lucky, and it passes me by. But most scientists believe that eventually this virus will infect somewhere between 50 and 70% of people in the world. The only real question is whether or not society can slow down the spread to give medical professionals and researchers the time to effect solutions that will reduce the numbers of us that are going to die as a direct result of the Covid 19 pandemic.

Even if everybody does everything right, and socially isolate themselves, a lot of people are going to die from this disease. No matter what we do this is true. All ordinary people can do is take whatever precautions are available to allow treatment by skilled professionals to those of us who catch this damn thing, under circumstances that increase the odds of finding an effective treatment and a vaccine that stops it dead in its tracks.

Neither of these is guaranteed, but we have a hell of a lot better chance if we all follow the best advice. Stay at home and socially isolate yourselves. Help our front line defensive workers, like nurses, doctors, researchers survive and get their work done for all of us.

Don’t be stupid. Wake up. Sometimes you just have to listen, and do whatever the hell somebody who knows a lot more than do you, tell you. Now.

Certainties

There are only two certainties in life. Death. And, Oh Ya, that other thing, whatever it is. I think maybe it’s called extreme anxiety.

For a lot of us right now, one of the biggest anxieties is about whether or not you or someone you love is going to get the coronavirus and die a horrible painful death. Can you imagine if you carried that level of anxiety about your health with you every day of your life?

This is precisely how I and many other people with serious chronic illness or pain live every day.

Waking up to a good day, when I’m not in so much pain, or simply in less pain, would be a good reason to celebrate. Or so you would think, but it isn’t necessarily so. If I’m not in serious pain right now, I’m probably super anxious about when it will start up again, since it’s seldom very long until the next session. Can you imagine being so fearful of your next bout of pain that you can’t ever be rid of the sense of dread that hangs over you.

And people who come in contact with me try to cheer me up by saying something like, “Don’t worry it, it can’t last forever, can it?” “Just get over it, you’re too obsessed with it.” As if I, someone with serious chronic pain wouldn’t part with anything I have to make it go away. And, well, yes, it can bloody well last forever, well, at least until I die from it, or some other condition that doesn’t happen to hurt, right now.

If I seem focused on feeling sorry for myself, just leave me alone. If you just can’t provide some comfort to me, exactly as I need it right now, then please get out of my face. I hardly need you to tell me to cheer up. And if you can’t handle it to see me suffering in pain, then just don’t. Leave. Piss off.

For me, and a lot of people with chronic pain, the coronavirus is just more thing to worry about, and make me more anxious about everything I have to do, everybody I have to see, and also more fearful about being able to obtain the bare necessities of life.

As if there isn’t enough to stress out about already, without the Damned Tsunami Pandemic, sweeping over the whole world.

To someone with a serious disease and chronic pain, death isn’t the scariest thing, it’s just the most certain.

Bella Luna – I’ll miss you.

Bella Luna, our German Shepard last summer on the Fraser River near Fort Langley.

I’m going to miss her, Bella Luna, our beautiful thirteen year old German Shepard, who we lost today to old age, after she reached a point where she could no longer walk without falling down every couple of minutes. Climbing stairs, or getting into or out of the car had become difficult lately, and she was periodically losing control of her bowels.

Clearly it was time, as she’s been near the end for a few months. As long as she appeared to be enjoying her life, and not in too much pain, we were happy to accommodate her in her final days, and celebrate the four years or so she had lived with us. But it was time when she was no longer able to get around comfortably, and it became painful to watch.

I could tell that she was happy, despite everything, which made it even more difficult to make the decision. She had lost mobile and muscle mass in her hind quarter, but she still looked so happy to greet us both, that we felt the pull of her love and friendship in our lives. But it would have been unkind to let her continue to suffer. Saying goodbye was agony, and I wept when I left her with the vet. I couldn’t bear to be there with her when she was put to sleep. I hope that she just went to sleep, without any more pain.

The funny thing about how emotional I feel about having to say goodbye is that I never really wanted a dog, once I had a family with kids. There were too many allergies among our children for us to bring a dog home, so the only way we ended up with a dog is that she was already in the family with my adult daughter, who became unable to care for her when her health declined and entered care. Bella was pretty emotionally fragile when she came to us, but she’d had good care for along time, before it became too much for our daughter to handle it.

So Bella was our accidental member of the family. Kath complained about the dog, frequently, but I could tell that she loved her, as much as Bella thrived under her care. She and I both spent a lot of time with Bella, although Kath was really her mistress while she lived in our home. Kath fed her, and was with Bella almost every all day. I only saw Bella at night after work, and pretty much spent the evenings with her, and walked her after dark. Kath has restricted vision so night time walks were tough for her.

Bella was always so present for Kath and less so for me, but she was constantly aware of our slightest movement, and her ears would perk up when either of us said anything, or got up out of our chairs. She pestered both of us for treats, and challenged us to take her out, all the time. She was a delicious nuisance. I’d grumble a little bit when I had to take her out, or feed. I’ll admit that giving her a bath was a highlight, as she really enjoyed having me wash here and rub her down after. She was wide aware and alert, and you could tell that she was always paying attention to whatever was going on around her.

She was a real member of the family, and I’ll miss her a lot. She really left only love and good memories behind. Damn.

It hurts.

Judgement Day

I was listening to a CBC podcast the other night, and there were a couple of people talking about their feelings about various famous authors and musicians. The conversation was really about whether or not our judgements about the behaviour of artists should influence how we feel about their art, and if we should decide to like or not like their art because we don’t agree with the conduct, opinions or morality of the artist.

I listened with some interest because the commentators were both people who identify themselves as lgbtqia2s (https://www.mic.com/articles/28093/lgbtqia-a-beginner-s-guide-to-the-great-alphabet-soup-of-queer-identity) and one of them also identified theirself as a gay black non-binary person. My immediate reaction to their conversation was curiosity because although I don’t identify myself as a member of a minority, generally, I do still identify as a person who has lived my life on the outside of established social, cultural and religious communities in which I live.

My political opinions are progressive within the Canadian meaning of that word meaning that I tend to share and support the politics of liberal leaning parties, and instinctively tend to feel sympathetic and supportive of anyone who self identifies as an outsider, whether as result of ethnicity, race, gender, ethical, sexual and religious views, appearance, etcetera. Which generally means that I’m somewhat judgemental about other people who I perceive as judgemental against all those people I’ve previously mentioned. So I’m inclined to be pretty judgemental about myself, since I know perfectly well that my own behaviour over my life has failed at times to live up to my own ethical, moral and social standards.

So the questions being raised are important to me. Is it safe for me to listen to music I like or even love, if it has been created or performed by someone I judge to have behaved badly? Say, like Michael Jackson, who now appears to have been a pedophile. Should we erase all of our collective memories of his music and dance, and never moonwalk again? Should we ban any mentions about Sir John A. MacDonald, who, in addition to being a drunk, a racist about first nations peoples and their rights, an outright unapologetic sexist. The fact that our nation exists because this man, and other similarly flawed men founded it continues to be true, even if I don’t like it. History is made by flawed men and women. Music is sung by creepy assholes. Great classical art was drawn by perverts we wouldn’t allow in our living rooms.

Should we hide the Mona Lisa, because her painter was a narrow minded bigot who was probably gay but denied homesexuality over and over again to gain social acceptability, not to mention contracts that paid for his work and allowed him to survive in times we can barely imagine.

I found it fascinating that these two commentators came to the conclusion that excluding people from your life because they happen to have been flawed, made terrible mistakes in their relationships, or even committed heinous crimes, should not necessarily mean that you deny the value and beauty of their art as fruit of the poison tree. Doing so would deny human beings the ability to grow, to make amends and try to do and be better than their worst selves. Doing so could remove the incentive for people to change and reflect on their worst behaviours, and thereby learn something.

Should I forever hate my father because of what he inflicted on me as a child, even in the certainty that he committed himself to looking after my younger sister for most of his life after she became a quadriplegic in her early twenties. He did bad things when he was younger, but did amazing things that made her life possible when it had become impossible. So I try to hate the behaviour I judge offensive and admire his enormous contributions to my sister. So I will never forget either, but I judge him to have been a deeply flawed man who showed the capacity for love. I love my father, but see him clearly for all that he was in his life, not just those things that harmed others but also those things he did that contributed.

Which is how I think we should look at historical and living people alike. We should make every effort to be our better selves, no matter how damaged we are or have been in our pasts. We should be as transparent as we can be, without expecting it of others. Fight for equality, justice and freedom, but make allowance for human frailty, both for ourselves and for others.

Another brick in the wall

Life is sometimes simply getting through the day. No matter how much I would like to face each day with hope or happiness, sometimes I struggle with everything that going on in my world, or not going on.

The past ten days it’s been hard to muster up the energy to write my blog. It’s not that I don’t have anything to say, but rather than I’ve always been of the belief that if I don’t have anything good to say, then it may be better not to say anything at all. Nobody wants to hear from a downer or a constant complainer.

Let’s face it. It hasn’t been a great week or two.

One of my favorite cousins died. He was one of my favorites because although we didn’t really know each other all that well, he was someone with similar interests to mine, particularly researching and growing the family tree. I’ll miss his quiet thoughtfulness and good ideas.

This past week has seen an explosion in the new coronavirus spreading out from Hunan, China. In a blog post I wrote last year about global warming, and why it isn’t the most important thing in the world, I didn’t mention pandemics, but this could just as easily become one, and it could kill millions around the world before it runs its course. Scary.

Trump was acquitted in Congress. This blog is not generally explicitly political about US politics or politics outside of Canada at all. To me his acquittal demonstrates with certainty that a person doesn’t have to be a quality human being to get ahead in life. He lies, lies and lies some more, and his followers, which include almost every Republican in the US, doesn’t care whatsoever.

Sometimes life is just getting through the day.

Kobe died. Along with his daughter and eight others. In a helicopter crash. Being famous and mostly a good person is not guarantee of anything either. Certainly, Kobe is a inspiration to millions of kids, and this won’t change that. Still it sucks.

And to top it all off I’ve had this bloody flu all week and still feel the pits. My car broke down. And I’m still distressed about the state of my relationship with my NP. Life would have been so much simpler if I had been conventional, instead of not. My partner would have been so much happier. I don’t know if that would have been true for me, or not. But I’m still the man I have always been, and although I’ve followed the more difficult path, I’m not actually sure that there was any other possible path for me.

So, in summary. I hope the next week or two things improve, especially my attitude. I’m going to work a little harder at counting my blessings, and let go of my current miasma.

Eat right. Live better.

How should we be assessing the risk for someone who has just developed diabetes? What causes beta cell failure?

There is no going back. Damage to your nerves by neuropathy is a one way street. Start treating your diabetes while you still can prevent the worst of it.

Check out Professor Shaheen.s Tutorials in Medicine for a better understand about the science of diabetes.

The journey into becoming a diabetic is one that most of us join without knowing the consequences of what we’re doing. There are a lot opinions out there, even among doctors, as to what actually “causes” diabetes, but pretty much everyone I read knows that diabetes is highly related to obesity and carbohydrate overconsumption. And when I was diagnosed, more than twenty years ago, the information I was given was faulty and at the very least incomplete.

Professor Shaheen’s Tutorials in Medicine https://internalmedicine.blog/

What no one ever said was that if I continued to eat what I thought of as a “normal” amount of carbohydrates and sugar every day, by the time I retired my life would be severely circumscribed, with many symptoms of diabetes and other metabolic syndrome related diseases causing continuing pain, physical exhaustion and emotional distress. I also suffer from chronic fatigue and despite having lost some weight, am still fighting the good fight doing intermittent fasting three days a week for 36 hours.

So what should I have been taught as a younger person, that might have protected me from getting full blown diabetes and other metabolic syndrome diseases.

Eat less carbohydrates. A lot less. On my current low carb high fat diet I keep my carbs below 150 grams a day. Eat even less added sugar. I try not to eat anything with added sugars, and when I do offend I eat very small portions of any sweet at all. Mind you, my appetite for sweet things has pretty much disappeared since I started avoiding them. Stay away from booze. Period. Lots of doctors and dieticians say that a one or two drinks a day is okay. I don’t believe them. Alcohol does similar things to the liver as carbohydrates, without the redeeming quality of providing me with any energy.

Always seek to reduce the amount of starch and sugar, and fill up on natural food if you are going to eat carbs. Eat fruit in season, in your area, and don’t overindulge even in fruit and vegetables.

Try not to get depressed because you can’t have any “real” food. Try to redefine what constitutes a meal, and understand that the meat and vegetables are really enough.

Struggling with Type 2 Diabetes

I have been afflicted with Type 2 Diabetes for more than twenty-five years. Perhaps even longer, since my partner reports that she saw symptoms of it even in my late twenties and early thirties. But despite diagnosis in the 1990’s by my doctors, and a referral to an endocrinologist who worked out of St. Paul’s hospital at the same time, the seriousness of the disease and its potential consequences were not really taken into account until relatively recently, when some of the symptoms started to become more pronounced.

Photo by PhotoMIX Ltd. on Pexels.com

Truthfully, until the summer of last year, I didn’t really feel like it was even possible to have any real impact on my diabetes. After being put on insulin, nearly fifteen years ago, with steady weight gain and gradually increasing problems related to my diabetes, I think I didn’t really believe there was anything I could do about the decline in my health, and probable premature death from diabetes related conditions and disease.

On my birthday last year, my middle son gave me a copy of a book by Dr. Jason Fung, on which I have written a lot in this blog in the past. Reading his book, The Diabetic Code, taught me that I need not be doomed to continual decline as a result of diabetes, but in fact could take control of my lifestyle, and thereby forestal future declines in my health, and even, perhaps, recaptures some of the vigor of my earlier years.

From July until the present I have been working towards a better life. I’ve lost a bit of weight, about 30 pounds down from my weight last summer, although I’m back up 10 pounds more or less since November, as a result of failing to maintain my lifestyle changes over the Christmas break.

Starting last night I am back to doing my intermittent fasting for three days a week, thirty-six hours for each day. During November I went from strictly obeying the fasting hours, and not eating anything, to eating Keto foods which are not supposed to break the fast. Whatever I thought I was doing, what was really happening was that my fasts became shorter and far less effective.

Fasting now until I reach my net goal of reaching 15 BMI during the current calendar years is my objective, for now, until I get my weight down from 222 pounds down to 167 pounds for a total weight loss of 55 pounds over the next 12 months. It doesn’t sound too daunting, having to lose between four and five pounds a month to reach my goal. But of course my goal isn’t really so much about losing weight as it is about gaining control over my blood glucose levels, and wrestling my metabolic syndrome to a point where my health doesn’t continue to decline, or lead to ever more serious consequences of my diabetes.

It is discouraging losing weight by changing your lifestyle, in many different ways, but intermittent fasting and eating a low carb diet is probably the least difficult method. All it requires of me is to pay attention to what I eat when I’m not fasting, and to fast long enough and for enough days, to ensure that my liver gets a reboot, during this process. Even when I reach my targeted goal it will not be the end of managing my carbohydrate and sugar intake. A healthy lifestyle for a diabetic (or former diabetic, which is what I’m trying to achieve) should be one that avoids carbohydrate and sugar in one’s diet, on a day to day basis.

Of course, all people need some carbohydrate and sugar in their diets, but it should always be extremely limited since it has proved to be so problematic to long term health. I’m recommitting to changing my lifestyle to a healthier and strong future. This recommitment includes reasserting my plan to get out and walk an average of 4,000 or more steps, at least four or five days out of the week. With serious neuropathy in my feet this isn’t always easy, but it is nonetheless critically important, to build and maintain a healthy cardiovascular system.

It’s currently two o’clock in the afternoon, and I haven’t eaten anything since about eight o’clock last night. My next meal will be tomorrow morning about eight o’clock, when I’ll have breakfast. My next fast will start tomorrow after dinner, at about eight o’clock tomorrow night, and will continue until 8:00 am on Thursday morning.

Hang in there with me, folks. I may not be changing the world, but I’m certainly changing my world.

2000 Followers

Sometime today I had my 2000th reader Follow me on WordPress and 750th Follower on social media outside of WordPress. Wow! Thank you to everyone who has followed this blog, as well as to the many people who have responded to my blog with numerous “Likes” and even more views. 2750 Followers as of today’s date.

Blog Statistics January 1st, 2019 to January 15, 2020

Pied Piper fable is a curious analogy to a 21st Century blogger on health and lifestyle.
  • TOTAL POSTS 60
  • TOTAL COMMENTS 472
  • AVG COMMENTS PER POST 8
  • TOTAL LIKES 4,194
  • AVG LIKES PER POST 70
  • TOTAL WORDS 44,081
  • AVG WORDS PER POST 734.68

When I first started writing this blog in 2011 I expect to have only a very few followers, likes and views, and didn’t really take blogging all that seriously until spring of last year, when I started to blog about the health challenges I am currently facing, as well as about various strategies related to a lot of different issues. Still, it is currently focussed around health issues, with a subtext running through about the story of my family and my romantic relationships.

So my blog is being read by a lot of you, and I really appreciate your genuine responses and comments over the past year. You’ve given me a lot to digest, and have made me feel both heartbroken, from time to time, and inspired, from other letters and comments. Your courage at facing real physical and emotional health problems inspires me to continue with this blog. If the information the blog conveyed gives anyone comfort knowing that they are not alone, or inspiration to take action to improve their situation, or simply education that allows them to understand someone with these problems, then I have done a service.

I am a true believer in the concept, “Tu Um Est”, which roughly means, It is Up to You! which is the motto of my undergraduate university, The University of British Columbia. I’m also a strong believer in lifelong learning, and acknowledge that while knowledge and information are purely temporary, changing moment by moment in ways we can’t even begin to anticipate, learning is an abiding, persistent process resulting in our constant evolution as human beings.

2750 Followers of Rain Coast Review.  Thank you for reading me, and responding with so many messages and Likes.

This blog celebrates these processes, and are in themselves evidence of constant change in my understanding of life today. Diseases thought to be incurable are now cured on an everyday basis. Things we thought were immutable truths have been proved false, or, if not totally false, incomplete. As I write into the future I will continue to seek out new ways to improve the quality of my life, through sharing the wisdom of others, passing on the things I’m learning as I go, and hopefully continue to illuminate and educate my followers, casual viewers, and fellow readers.

Once again. Thank You. It is humbling to realize that people appreciate what I’m writing, and are kind enough to say so.

Pain Mastery Institute is shut down

The Pain Mastery Institute, which I’ve been blogging about for a couple of months, is shutting down due to financial considerations.

The Pain Mastery Institute, which I’ve been blogging about for a couple of months, is shutting down due to financial considerations. Their courses have been useful to me but not nearly as useful as if they had survived long enough for me to get through the whole program.

The main thing I learned from the courses is that much of what is available for mastering chronic pain is drawn by observed people as they take actions or make decisions which assist them in managing their pain, or ameliorating the amount and intensity of pain.

While the course is gone, and the Institute website shut down, this doesn’t mean that I’m abandoning my pursuit of effective pain management strategies. So keep watch for my blog because I will coming back with a new approach soon.

Update on Intermittent Fasting

Starting on Monday this week I began a five day fast, which so far has been a bit frustrating and challenging. The second day and the third day I found myself absolutely starving, which is odd because up until now, fasting for three days a week, 36 hours, I have never been really hungry.

It takes a bit of a different strategy for longer fasts, like a five days on, four days off, but I’m learning and will be putting together a new primer based on somewhat longer fasts.

Boing 737 crashed after being shot down near Tehran

This has been a really sad and horrific week for me, and for many Canadians. 147 Canadian residents and citizens were killed this week by an airline shot out of the sky by Iran, either by mistake or by design. Either way, we have all lost so much and I can’t really even begin to make any sense of it. I am just sick over it, and I didn’t know anyone personally on the plane, although I do know some family members.

The Prime Minister of Canada has been highly visible in his demands for accountability for this disaster, both from Iran and the United States governments, who put into play the violent altercation that led to these deaths, whether by misadventure or by malice.

I don’t know whether to rage or to cry, or both. I’m not expecting any closure any time soon. Iran is virtually certain to lie through their teeth on this, and Trump will do no better. This is a terrible tragedy for everyone involved in the flight, and all of their country mourns their loss.

A New Years Resolution

Starting today, January 6, 2020 It is my stated intention to achieve a BMI goal of 25% during the current calendar year.

Later in the afternoon

I started working on my blog earlier this afternoon, but was interrupted by a request from a family member for a ride from Burnaby, where I currently work, home to Langley. But I’m back at it now, and would like to upgrade my resolution to include a little more detail about this pledge, seemingly coming out of the blue.

I started doing intermittent fasting in July last summer, and promptly lost 35 pounds before the end of November, fasting for three days a week, 36 hours each on Monday, Wednesday and Friday. Pretty good results although most of the weight was lost in the first 60 days, and only a small amount during the last 60 days. In the last month I’ve pretty much given back ten pounds or so, depending on the time of day I weight myself.

Until Christmas holidays began I didn’t miss a single fasting day in my schedule, although I did start to cheat a little by eating Keto friendly pepperoni sticks and cheddar cheese sticks after a minimum of 24 hours into my fast. Checking my glucose levels shows me that the advisors are correct, and eating those two things, even combined, doesn’t raise my blood sugar at all, or not does having a handful of nuts. However, it does seem to have a negative effect on weight loss so I am going back to a more strict interpretation of fasting, which is eating nothing during the scheduled period.

During the holidays I broke the fast program only on two days, except for the cheating I’ve already mentioned, but my weight fluctuated from 209 back up to 222 and then down again to 216 and then back to 222. It’s amazing to think that I could regain basically 12 or 13 pounds, even attempting to keep my carbs down and no sugar to speak of at all, except for Christmas Dinner. Losing weight and keeping it off is a challenge, that’s for sure.

In addition, because I stalled quite a while before I started to cheat a little, I’m going to increase the length of my fasting period from a three day a week fast, alternative days during the week, to fasting for five days on and then four days off. My current plan, which I started implementing today with Day 1 of my first 5 Day Fast, is designed to kick start my weight loss again, so lose the next 25 to 35 pounds and get a lot closer to my goal of a BMI of 25, which as I said at the beginning of this blog, is my goal for 2020. I’m going to run with this schedule until my weight takes the next step down, past my previous barrier of about 209 pounds where I bounced back up to 222 over the Christmas holidays. .

My weight this morning when I weighed myself was 222.8 so a 25 pound weight loss would get my weight under 200 lbs, for the first time in a pretty long time. At 200 pounds my BMI will be about 31.2 instead of the current 34.8 (222 lbs) or 38.4 (245 lbs) when I started the program in July 2019.

Over the next few days I am going to re-read Dr. Jason Fung’s book the Diabetes Code, and also review his book on intermittent fasting. My own endocrinologist, Dr. Kang at VGH isn’t planning to see me again until about May so I hope my weight is down substantially by then, and my A1C levels at least down to 6.0, but we’ll see about that.

This plan to reduce my BMI to <25 and my weight to <160 is highly purposeful, in that I am attempting to do on my own what Dr, Fung achieves with his patients, a dramatic reduction in obesity and blood sugar levels. In the meantime I’ll continue to take my course in Pain Mastery from the Institute, and report back to my faithful readers my progress and challenges both in my fight against diabetes, and my battle to manage my chronic pain.