Monday, March 14, 2011

Adding Insulin.

I love this picture of Jim, doing a Russian pose.

As I sat in the waiting room at the hospital clinic, waiting my turn, a man walked in wearing very silly clothing, balancing a plate on a stick.

He looked over at me and said, “I LOVE THAT BOOK!”

He was referring to “The Island at the Center of the World” by Russell Shorto, a book I cannot put down. It’s a history of early Dutch Manhattan, one that was lost for a very long time due to the fact that the English were at war with the Dutch and they wanted to make it seem as if they invented the United States -- and one that is still be translated from stacks and stacks of old Dutch documents uncovered in recent years.

I was a bit startled by the attention, but the invader went back to twirling the plate on the stick. He was very funny. I whipped out my video camera, but he said he did not want to be posted on the Net. However, I could shoot it just to prove to my friends that I was seeing what I was seeing.

I learned later that he is the clown for the pediatric clinic, and the four women who man the front desk at the clinic love it when he drops by. Usually, the clinic is filled to capacity with people, waiting their turn to see a doctor.

The moment of lunacy and joy is welcome in a place where most people are feeling sick or scared of doctors and institutions.

I have been to this place when it was packed to capacity and tensions are high as people wait for their turn. The women behind the desk all stay very cool and manage to do coordinate everything really efficiently, with equipment that I don’t believe is the latest in high tech design.

When my name got called -- after a waiting period to get my blood tests from my primary clinic -- I met with a very attractive. young female Asian intern (?) who took my health stats and asked a bunch of questions, like what medications do I take.

I hate this question. The list is long and I can never remember the names of everything, not to mention the dosages. I had a list in my wallet, but it wasn’t there.

“There’s the little blue one for blood pressure, but it used to be a different color. It’s a generic”. Or is that the thyroid pill? Actually, they’re both blue and so is one of my diabetic pills.

It can be very confusing to be a walking chemical experiment.

Eventually, after she took some vitals and asked a few questions, “What do you take THAT for??” a rather hurried middle aged doctor came in, but he got a phone call, so he turned me over to a more senior doctor who I immediately fell in love with.

I mean, right out of central casting. He had bushy eyebrows and a kindly crinkle in his face.

She looked down at her notes and began reporting, “The patient is 57, has AIDS, diabetes and...”

He listened to the list and started peppering her with questions. She was clearly trying to maintain control as he corrected her assumptions, or questioned her recommendations, all part of the game.

It was an episode of HOUSE!

The sum of it all was that I was maxed out on pills, that my A1C was now over 9, and too high, and that it was time to start me on insulin injections, news I was prepared for, but not really excited about.

“Start with 10 units. One shot every evening before bed. Test your blood in the morning. We need to get it under 120. Do it for three days, get the average. If it’s still too high, increase the dose by 3 units. And do this every three days until you get it under 120.”

I think my mind started to wander at bit at this moment, though I was concentrating really hard and even repeating instructions back to them, verbatim. Mouth moving. Mind in Miami, thinking about New World Waking and how the rehearsals are going.

10 units. 120. Three days. Three units more. Come back on Friday and a nurse will teach you how to do the injections. This was Wednesday.

On Friday, the nurse strapped this pin cushion to her leg. She took the demonstration injection pen -- I hadn’t needed to bring mine along, though I had it with me -- and dialed it up to 10, then 50 and 100 to show me how easy it is to get the proper dosage.

She handed the pen to me. When you roll it, the numbers fly by and it sticks out more from the end of the pen. It was kind of fun, to tell you the truth. I had this feeling, suddenly, of being more in control of my blood sugars.  

Someone asked me how I keep up such a good face -- and the answer is I don’t think about it. It just is. Also, there is always someone worse off, and I should be grateful for what I do have.

Like Japan, just now, with a tsunami and earthquake. Nuclear plants collapsing. Christ, the entire earth was thrown off its axis.

The images of tidal waves and the reports of thousands of dead. It makes all the stuff in the Middle East seem kind of stupid. In Japan, the earth buckles -- and over in the MIddle East, all the problems are man made.

Those types of problems -- the type that have to do with how human beings treat each other, and who has the most power, money and influence -- can be changed in an instant if, suddenly, everyone just stopped, took a look around, sat across from a table, and came to a mutually and collectively fair agreement.

Peace with justice. Justice with peace.

In fact, in this book about Manhattan, we’ve arrived at one of the moments that changed the course of human history, was when a philosopher named Grotius suddenly put out the idea that man’s natural state of nature was peace, not war. Until then, the author states, everyone in history just assumed that you had to always be at war with someone, always in alliance with some against another.

This was also how the Indian nations around this area functioned. If you signed an agreement for a piece of land, you could live on it, and their tribe could hunt on it, but you had signed yourself up as an ally against whichever this Indian tribe deemed as “enemy.”

For the first time, Europeans sat around a table, decided to end all their wars, which they did, kind of, and went on their merry way.

We know, of course, that that agreement did not end War. But it did prove that reasonable people, if prodded, and with a little faith, can stop shooting each other, at least for a little while. And they can do it by just making the decision to stop. A change of mind.

In Japan right now, they cannot fix things by changing their minds.

And now I realized I’ve gone far afield, but there is a point.

I told Mark Janas, yesterday morning in the cab as we were zipping down to Bay Ridge, where I sing in Mark’s choir at Christchurch Episcopal, that I remembered telling the POZ Magazine reporter, Degen Penner, that I felt sometimes like an old tire being reinflated.

After three days, my morning blood sugar has been testing in the 160 - 180 range. So, last night I dialed up to 13 and tried again.


Hm. I wonder if I should raise the unit level more quickly?

This is on 57th street, but since we're going to Brooklyn...
Jersey looks beautiful this morning, the sun hitting the buildings as it rises.
I want to have a show here some day.
Times Square, going to Christopher Street. I took the 3 train.
We stopped here at 14th Street. I changed to the 1.
Now, I'm back at the Starbucks, sitting in the window.
...reading my book, waiting for Mark and James.
Our choir robes are in these closets.
I think these robes are for a different congregation that meets here.
Mark Janas and Fr. Jeff meet to look through the music.
Lent has started and now the music changes a bit.
There I am looking down at the music.
Flagg Court. Where Jim grew up, across the street from the church.
On the way back home, we walk to the subway on 3rd. We pass these row houses.
Not the biggest front yard in the world, but you work with what you have.
And down into the subway back to Manhattan.


Anonymous said...

Steve, a big hug and many thanks to you for the place in your big heart from which these written gifts emerge, allowing us to reflect and think about what's truly important in our lives.

Unknown said...

To answer your question--NO, do not go more quickly. Give your body time to adjust to each change! Take it from a person who usually goes too quickly changing medicine doses...

Laura Morefield said...

I hear you about carrying around a list of your meds. I have multiple copies that I sling about with abandon.

And then when it changes, I get "around" to updating it so sometimes it's not always current.

Glad you're feeling some agency aborning in your blood sugar counts.

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