Conclusions to a Medical Self-Analysis

Part Three

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  • I have a lot of stuff going on.
  • Everything seems to be connected to everything
  • I’m worried about my medications, almost as worried as I am about my health problems for which I’m taking the prescriptions
  • My poor health makes it hard to focus on the various ailments and their causes.
  • I’m tired of being sick and tired.
  • Knowing that I need to make changes, and even being aware of some of the changes I need to make, doesn’t mean that I have the energy or clarity of purpose to stay the course and do what is necessary to improve my health.

It is obvious from reviewing my medications and their various side effects in the context of my various ailments that some of my problems may be made worse or even caused by the side effects of one or more of my medications.

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I missed a couple of my medications when I listed my prescriptions and side-effects, the most important of which is Humulin 70/30 which I take in the morning with breakfast and a dinner, both 60 units each time.

Humulin 70-30 Insulin

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Humulin 70-30 (70% human insulin isophane suspension and 30% human insulin) is a man-made form of a hormone that is produced in the body used to treat diabetes. The most common side effect of Humulin 70-30 is low blood sugar (hypoglycemia). Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, trouble concentrating, confusion, or seizure(convulsions). Other side effects of Humulin 70-30 include: injection site reactions (e.g., pain, redness, irritation), skin thickening or pits at the injection site (lipodystrophy), itching, rash, weight gain, and swelling of your hands and feet.

Tell your doctor if you have serious side effects of Humulin 70-30 including signs of low potassium level in the blood (such as muscle cramps, weakness, irregular heartbeat).

Each patient’s diabetes is different, and the injection schedule and use of Humulin 70-30 is individualized. A doctor determines which insulin to use, how much, and when and how often to inject it. Humulin 70-30 may interact with albuterolclonidine, reserpine, guanethidine, or beta-blockers. Tell your doctor all medications you are taking. Tell your doctor if you are pregnant before using Humulin 70-30. If you are planning pregnancy, discuss a plan for managing your blood sugars with your doctor before you become pregnant. Your doctor may switch the type of insulin you use during pregnancy. This medication does not pass into breast milk. Consult your doctor before breastfeeding. Insulin needs may change while breastfeeding.

Medical Editor: John P. Cunha, DO, FACOEPLast reviewed on RxList 12/9/2016
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The next step is to review the side effects of each medication, and benefits of each, to determine what I should do. At the very least I need to review the interaction of these medications to figure out which of them are making my health worse, and which better.

Already I have some concrete ideas about improving my situation, including getting back into using my CPAP machine, recommitting to losing weight, and concentrate of getting more exercise.

Fibromyalgia and Diabetes

Does insulin resistance cause fibromyalgia?

A newly confirmed link with insulin resistance may radically change the way fibromyalgia and related forms of chronic pain are identified and managed

Date:May 7, 2019 Source:University of Texas Medical Branch at Galveston Summary:Researchers were able to dramatically reduce the pain of fibromyalgia patients with medication that targeted insulin resistance.

I have not been diagnosed with fibromyalgia, at least not yet. However, the development of chronic pain has paralleled my diabetes over the past twenty-five years. For most of these years I have taken metformin or other compounds including metformin, which may have been providing some mitigation of the numerous forms of pain I have battled with over the years.

So, in addition to the pain potentially caused by “dysfunction within the brain’s small blood vessels” caused by insulin resistance, as noted in the report on this study, I think researchers should also study the link between inflammatory diseases and diabetes, to determine any causality, either way. 

Having had a lifetime of inflammatory issues, starting with chronic allergies to a multiplicity of substances, arthritis, tendonitis, asthma among other painful inflammatory symptoms have laid the groundwork for neuropathy and muscular inflammation. The pain in my feet and hands has nearly become disabling from a combination of pain from neuropathy, arthritis and tendonitis.

In the meantime, my medical practitioners have their hands full trying their best to assist me in dealing with the symptoms, as well as with the underlying issues related to diabetes. My muscle and skeletal pain issues are largely untreated while I struggle with diabetes, as an insulin dependant diabetic. 

From this report, among other studies I’ve read, it is clear that there is little that can be done to reduce my experience of chronic pain that does not also improve my A1C levels on an ongoing basis.

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Three things need to change in order for there to be a significant reduction in both – a substantial reduction in my current weight, exacerbated by using insulin, better A1C blood sugar management, which may be a result of changing the form and administration of insulin to a much more intense dose management more closely related to my blood sugar levels and meal times, and a more appropriate combination of reduced caloric intake with a physical exercise regime which focuses as much on increasing flexibility of my skeletal and muscular systems, as on weight loss or caloric output. 

I think, from my own experience, that the cited report offers some valuable clues to fibromialgia, its causes and some potential treatments. But I also think that these relationships are more complicated that they appear on the surface, and may require much more than a magic bullet to help deal with the pain.

I am who I am, and that sucks for us both.

affection close up elegant flower

My wife of thirty-four years and I are on the verge of divorce.  In hindsight, it was always pretty inevitable since we always wanted completely different things from life, and what we wanted depended on our partner being someone completely different than who they are, especially in term of the fundamentals of marriage itself.

It took a very special kind of blindness to last this long, a willingness to overlook a fundamental flaw by pretending that it wasn’t there, but a flaw so deep that once exposed it can never be overlooked again, covered over, repaired or forgiven.

This huge rift between us goes right back to our earliest days, the days when I was married to someone else and she became the mother of my son, born as a result of a brief but torrid relationship which had resulted in his birth, less than 10 months after we first met.

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Nobody would have have thought that such a start propitious.  Having a child out of wedlock wasn’t something that either of us had imagined when we engaged in the obviously dangerous tryst.  But for me it turned out to be less of a moral challenge than it is to her, to this day.  She has never forgiven us for committing seriously immoral conduct, or herself, for that matter, for having slept with a married man.

It makes no difference to her that I was upfront from the beginning.  There was no hidden marriage, or implied statements to the effect that I was single, or almost single.  When she and I met, I had no intention of splitting up with my first wife, nor she with me.

We had an open marriage by mutual choice, arrived at by long discourse and mutual interest in exploring beyond the boundaries of marriage.  My former wife was well aware that I had a number of outside female companions, several of whom we even shared.  The fact is that we did split up within five years, but our open marriage was not the primary source of our going our separate ways.  There were other, far more serious fault lines between us, not the least of which is that we both carried within us the net effects of physical, sexual and psychological abuse as children, most of which we skillfully concealed from each other, but which were the real cause of our breakup.

2016-05-15 13.27.40Our lovers had nothing to do with it.  Well, maybe they did, and maybe my current wife had something to do with it.  Having a baby with another woman put unbelievable pressure on my first marriage, even though I had concealed the existence of the child from my ex.   Maybe this supposedly idyllic and idealistic “open” marriage had more than a little wrong with it.  If everything was so open and above board I would not have hidden such an important thing as having fathered a child with another woman from my ex wife.

We’d actually discussed what we would do if this happened, although we’d both committed to using protection.  We’d mutually agreed that we’d handle it together, and make room in our lives for any such child, and the mother as well.  We’d extend our marriage to include them, for the sake of the child as much as for our own sake, as well.

The truth is that we had both failed to disclose important things from each other along the way, and the baby was simply the last and most significant of those lies between us.

So when my wife and I moved in together, after my ex-wife and I split up, there was a lot of things we should have discussed before getting pregnant with our second child together.   By the time it came around to deciding to get married it was already too late to work out how we were to deal with our mutual expectations of marriage, and what it means exactly to get married.

Front Door

There’s no place like home?

Instead we got married with a simple agreement that since it was unlikely that I would ever be sexually monogamous we would leave the “faithful” out of the marriage vows, but leave in the marriage vows, promises to stay the course, be loyal to each other’s best interests, to look out for the other person’s growth and do anything we could do to be the best partner possible, but not including fidelity.

She believes that I took advantage of her naivete, or alternatively, she really didn’t understand what it mean to live with an unrepentant polygamous man, within vows that didn’t even suggest sexual fidelity or exclusivity.

She says that she didn’t really believe me when I said that I was always likely to have friends and lovers outside of marriage, but that I wouldn’t let those relationships interfere with my relationship with her, or with my responsibilities to my kids.

In hindsight,  I should never have moved in with her after the end of my first marriage, and most certainly shouldn’t have fathered two more children with her.

If she exercised willful blindness about my nature, and my apparent incapacity to live within a conventional marriage, then I also was willfully blind.  I never really understood her feelings on the subject, which she never articulated in so many words, but has demonstrated without a doubt at times over the last thirty four years.

She didn’t ask, mostly, and I didn’t say.  On the few occasions when she did ask about outside activities or relationships, I repeated what we had agreed to at the beginning of our marriage.  We had agreed that we wouldn’t talk about it, I’d keep it away from my home, and I wouldn’t ever be intimate with a friend or close acquaintance of hers.   She said that she didn’t really want to know, and I took her at her word.

I knew that our agreement was tenuous, at best, because over the years I came to understand that the only way she could deal with it was to pretend that it did’t exist, as if I really didn’t have any outside relationships, nor would I want to have any.   She told herself that my refusal to promise to be faithful, or to discuss any variation on the original stance, was a cover-up,  but not for my being unfaithful, but as a face saving device so that I wouldn’t have to acknowledge that I was a changed man.

She knew that my self-image always contained my sense of being independent and free to engage with anyone as a free human being.  She knew that I believed that I could be faithful my promises to her, without having to accept a value system in which I simply don’t believe.

There were moments over the years when this fault line caused difficulties in our relationship,  when she was sure that I was involved with someone.  But since we had no dialogue about it that actually illuminated anything, she stuffed her feelings down and held back from expressing her sense of shame and outrage at my values and my inherent sensuality.

One result was the effective end of our intimate sexual relationship more than a decade ago. Although it was never raised by either of us, my unwillingness to commit to sexual fidelity seemingly made it impossible for her to fully participate in sexual congress.  She submitted to sex rather than made love, a fact that made it less and less attractive to me over the years, and also made it less and less possible, due to my declining sexual performance generally. 

Finally, a year or so ago, it all came out into the light.  Somewhere along the way I had been exposed to a STD, discovered in a routine battery of blood work, which required me to inform any sexual partners so that they could be tested to protect themselves.

The first person I told was my wife, who went immediately into a slow burn which quickly turned into an inferno.

She said that she wanted a divorce.  And sooner rather than later.  Some days I think that she’s changed her mind because we get along so well, and do so many activities together.  And generally we do get along really well, and cooperate in our lives together.  But when I start to think that things maybe will heal over, it explodes out all over again.

From her perspective the only reason we’re not separated right now is that my health and economic situation is so bad that I wouldn’t be able to function on my own.  Up until now it has been true, and without something changing it might be true for years.

My income is from CPP and OAP, for a total of $1380 a month, which when combined with her income, allows us to live a reasonable life.  On my own it would be pretty much impossible, and the situation wouldn’t be much better on her own either.

But things aren’t actually getting better between us, and whatever store of goodwill and affection sustained us for so many years, despite the underlying fault line, is getting pretty thin.

I remember saying a long time ago to a friend that “when one person in a relationship has contempt for the other, the marriage is over, completely over, and no amount of effort can bring back the respect and trust once it is gone.”  This has never been so true, and when I hear the scorn and disrespect in my wife’s voice, I’m scorned right to the core.

I know.  I should have known better.  Even then, I should have done better.  Although, for the life of me, I have no idea how I could have done better, except by changing myself and my values fundamentally to suit her.  Or alternative, persuaded her to adopt my views on life.

01-Ways-to-Help-a-Friend-Dealing-With-Divorce-Nicole-fornabaio-rd.com_-760x506However, it is now far too late, and in her heart she really can’t forgive me for “sleeping around” on her for all those years.  Even if I were to change and be willing to promise to change now, it would not make any difference to her.

She is convinced that I have betrayed her and that I continue to betray her, not for my acts of betrayal, but because I am unrepentant and refuse to apologize for being exactly who I have always said I am, and done exactly as I always said I would.

It is irrelevant to her feelings today that she knew exactly who I was, and what I believed from the first night we met.  I am who I am, and to her, that’s disgusting.

Not much of a foundation for mutual respect.

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Rain Coast

 

 

 

 

 

 

Wonderland?

Sometimes I feel as if I have fallen down the rabbit hole into an alternate universe, one in which I’m no longer a person.  The world has also changed, seemingly irretrievably, into a place without any kind of safety, security, and surety.

Mum used to complain to me, from time to time, when she was retired from teaching, that she felt invisible, of no consequence, and therefore, of no value to anyone, including to herself.  I remember telling her that, of course, she had meaning and value, at least to her children, and that we value her for her wisdom and accumulated life experience.  I believe now that my comments were, at best, well-meaning but false.

Feelings are not facts, although they weigh us down as if they are real.  I am going to be celebrating my sixty-fifth birthday in less than a month.  Supposedly this means that I should be enjoying the opportunity to retire from active working life, and into a pleasant meander down the road of a new journey, not so bound up in ambition or goals.

Instead, I head into retirement with serious complications of diabetes and COPD, chronically exhausted, in constant arthritic and neuropathic pain.  My professional life is in disgrace, and my finances are completely destroyed.  My marriage is a shambles, a mere shadow of meaning and purpose I believed it to be. Whatever self-esteem I once enjoyed has been systematically eroded to the point where I have become self-effacing and ashamed.

Accomplishments once achieved with pride, are now rued as pointless, as they were not sustained, nor followed up with long-term success.  Professional competence and pride in my knowledge and skills are now the pathetic memories of a fallen champion.

I have crashed and burned before, and arose from the ashes to take on new challenges and build a life again. I’m told by professionals that I need to let go of the past, forget my shortcomings, and learn to live with my current life and health circumstances.  In short, I need to refocus on a new future.  Build again a life worth living,  a life into which joy and laughter can once again be a part.

There is still much of value in my life, and turning to those people who continue to befriend me and support me is a part of that future.  Gratitude for what I have now will be a good start.

Still, it is difficult to look around me and see a landscape filled with characters I don’t recognize and don’t think I really want to get to know.  What would be even more helpful would be if I could find a mirror that shows me the man I once thought I was.  The mirrors in Wonderland show me a person I scarcely recognize, and who I really don’t want to be.