Medical update: Minimal side effects so far


It hasn’t been too long since I checked in about my health but, seeing as that was kind of a new beginning, I thought I would report that all is going well – at least as far as I know. I’ll get the results of my blood work-up in a couple of weeks. Most important will be my CD-4 count and my viral load. When last checked the CD-4 needed to come up and the viral load had a fair distance to drop to ‘undetectable’.

The diabetes is going okay with the insulin. I had to actually drop it a little in the evening as I had a few ‘low sugar’ episodes, which are quite unsettling – particularly the one when I woke up in the middle of the night in a panic.

I have fewer HIV-related pills and capsules to take now (5 in the morning, 4 at night). At night I also take my insanity stabilizers which have been working well, too. There was one night of what I thought was hypomania but I managed to stay indoors and out of trouble.

Someone who hadn’t seen me in a few months told me today he thought I had gained weight, indicating that I seemed to be showing a bit of a pot belly. The sad fact is, however, that I am so underweight my tummy only seems big compared to everywhere else. I’m trying to keep my sense of humour about it, comparing my physique with a praying mantas, especially when my woven pack-sack slumps down my back. I don’t actually know if my weight is down or up or if, as it was at the last doctor’s visit, I have simply stopped losing.

As the cooler weather creeps in I’m wishing I could store more food to insulate my bones. In addition to the occasional meal replacement drink I’m trying to bulk up with avocados and cashews. Other suggestions would be most welcome!


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Medical update: My 16 month ‘holiday’ is over


I am back on meds to fight the good fight with HIV. (Don’t worry Medic-Alert, I’ll be emailing you soon.)

With the help of a lot of insulin, steadily increased since I started it July 17, my blood glucose levels are well enough in control that my doctor told me today that “We’re ready” or “It’s time” (I can’t remember which but both apply.)

My viral load is 125,000 and my CD-4 count is 260.

So, in addition to my “head drugs” for bi-polar II (1200 mg Lithium and 15 mg Mirtazapine), another drug for diabetes called Metformin, and Crestor for cholesterol, the HIV rundown is Viramune, Truvada, Prezista and Norvir.

This so-called drug holiday came about as a result of leaving one drug at home when I dashed away during the crisis in Montreal in late April and through May of last year. In order to prevent cross-resistance my doctor told me to go off all meds rather than do it piecemeal. Then when I got home I wasn’t looking after myself very well, to put it mildly, and yet my blood work was still pretty good so my doctor and I agreed to continue with the break. Then my diabetes began to worsen and, after tinkering with Metformin and Glyburide for a while (I was needlessly wary of insulin), I agreed to start insulin in July.

While all of this was going on my psychiatrist was working me up to a more diabetes-friendly combination so it’s been quite a project but I am optimistic that September will bring good health in every respect.

(Judging by the pain in my seat I know I haven’t gained much, if any, more weight.)

Feeling: Optimistic

My diabetes journey has moved on to insulin injections


It was no surprise when, after reviewing my latest blood glucose monitor readings, my HIV specialist prescribed insulin injections. (He’s been working on me about this.) Diet was not doing enough and the pills could only do so much for so long (approximately three years). I had already been to a diabetes clinic at Women’s College Hospital earlier this month so I was preparing the ground for this. I went back there yesterday with my prescription and to learn all about insulin pens, needles, insulin vials, etc. It was a lot of information to take in but very helpful staff, a nurse and dietitian, gave me hand-outs and wrote down very specific instructions as to when to take my shots, when to test, etc.

This morning I laid everything out on the floor in front of my recliner, like the pieces of a model airplane, read the sheets of instructions, and very tentatively prepared for my first injection. (I didn’t inject last evening because I had taken one of the old medications yesterday morning.) For someone who can’t stand to watch as my blood is tested, this went very well. There is no blood to see by poking the needle in and then gently pushing the plunger (pen cap). It went fine but it’s going to take awhile before I can just discreetly slip into a washroom during an evening meal, peel up my shirt and plunk a shot into my side. (We decided the only place I could possibly find enough to pinch for the injection is on either side of my abdomen, parallel with my belly-button. My weight, stretched over a 6’3″ rack of ribs, is only 130 pounds. That’s down ten pounds since the end of April.)

I was a little freaked out yesterday but 24 hours has eased my anxiety somewhat. So three scoops of ice cream for everyone! :)


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Shaking my fist at diabetes


The point was driven home today that diabetes is a bigger threat to me right now than nineteen years of HIV/AIDS.

I’ve heard it before and frankly, despite taking blood glucose-lowering medications, I just haven’t managed to get the crucial numbers under control. 

Things went off the rails this time last year, with Craig’s accident and death, as evidenced no more clearly than by my doctor’s review of my chart – last year’s – today.  I had been expecting results from last week’s blood tests and, without realizing he was reading April 2007 results, my doctor today rhymed off numbers I have not had since…well…last April. 

The expression on his face changed when he had last week’s results faxed over and all I heard, after confirming the news was bad, was Charlie Brown’s teacher giving me the latest readings. 

“Wah-wah-wah…”

I’ll write them down when I see my HIV specialist the week after I get back from Montréal.  He’ll be quite upset, methinks, (although non-judgmental and ever-cordial) and it would not surprise me if he started me on insulin, a threat that has hung over me for a few months.  Ugh!  My doc today suggested I at least try to improve my daily results between now and then.

I have been cooking for myself much more in recent months, thanks to my slow cooker, but I do go overboard with sugar cravings in the evening too close to bedtime.

I hate having to be so mindful of eating.  Eating, especially eating well, has always been a necessary evil at best – and, while I do get some pleasure out of others’ cooking, meal prep for me has mostly been drudgery.  If Ensure or Glucerna could keep me alive I’d be fine with those little cans.

It used to be, with AIDS hanging over my head, I was encouraged to eat whatever I wanted.  That changed a few years ago.  Then since last year, after having to go off my meds during the crisis with Craig (because I hadn’t packed all of them – and to take some without others risked cross-resistance), I’ve only been taking my diabetes meds.  Goodness knows how bad my numbers would have been without those!

Anyway, I am ranting and full of enough self-blame to be able to minimize the impact of any ‘I-told-you-so’ anyone could offer, kindly or otherwise.

I don’t know where I’m going to pinch an inch to take insulin (at 6’3″, 140 lbs. soaking wet)…but, if I don’t cement myself in self-pity first, I will do what I have to do.

The early stability of the HIV, in the first few months of being off those meds, has not lasted.  As much as I feel so much better off them, it’s time to get back on those babies and so if that means taking insulin I guess I’ll have to roll with that.

I see my HIV doc and my shrink on the same day one week after I get back from Montréal. Just the way it worked out :)

P.S. Suspicious as I am of potential spam, I’m pleased to say that I found a very useful article on the rationale for glucose monitoring by following the first comment here to
Amy’s site
.


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This is hypomania at the very least


Pardon me if I piss and moan…

It seems to have started with a headache, a mild migraine I think, which – although not as painful as some I’ve experienced – my vision was quite bad for a couple of days. Pardon the sentence construction.

No, back up. It started when, seemingly out of the blue, I had a voracious appetite for reading books. As behaviour out of whack goes, this was better than it’s been in the past. It seems like a long time since I’ve picked up a book that grabbed me – but two in a row? And then buying all five of the selections for CBC Radio’s Canada Reads next month? (By then I may not want to read ever again.) Far from being ‘bookish’ I usually lack the ability to concentrate on a story, be it fiction or non-fiction.

Anyway, it is Tuesday going on Wednesday. Last Saturday afternoon and evening I read, and then again on Sunday.  Then, as the pages began to run out, I pulled another book off the shelf to think about as I wrapped up the first story. The second book could easily have been finished on Monday were it not for the fact that the headache came on. Even though I withdrew from social obligations due to feeling so crappy, I still managed to be drawn away by an impulse to fiddle with widgets on my blog. That kept me going all night – yes all night, and me with a headache! Morning came – that would be Tuesday, yes – and I had the TV news blaring in the background as I continued to fiddle with the blog. This lasted well into Tuesday evening, plotting everywhere I’ve visited on to a map widget, until an alarm went off inside me and I realized I was hypo-manic – at the very least. So what do I do (besides type without breaking paragraphs)? I download YouTube lectures – and good ones at that – of medical professionals discussing the manifestations of, and treatments for, bipolar disorder. Note to self – this episode is one of those occasions my p.doc. would want to hear about, despite having seen him just last week and feeling, frankly, kind of flat – neither low nor high.

At Christmas I lightheartedly mentioned to Mom that the odds in the gene pool have been against me going much longer without the first signs of heart trouble. She couldn’t hush me fast enough, of course, but it has fascinated me. Not that I haven’t had other things going on – the accident trauma in 2003, for one thing. But tonight I was thinking, maybe I’m the one who – having been treated for one mental health issue or another for most of twenty years – maybe I’m the one who will carry that weight for the remainder of my life. Things along these lines have come along way since my grandfather’s time so there’s plenty of hope for me but I must co-operate. Like taking my night-time meds for example. That would have allowed me to sleep the last two nights. What was resisting it all about? Also, I have got to cut back, if not cut out, caffeine. Even though I honestly think I need it to revive myself the morning after the aforementioned medications I need not – and should not – be drinking one form of caffeine or another until mid-evening. Most meetings I’m at after dinner provide herbal tea options.

So there. That’s my assessment of my disorderly mood to this moment. It’s past pill time and I think I will go to bed now, further distractions filling my mind even as I write that.  Man, I hate being down on myself!


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Feeling well


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I’ll be seeing my HIV specialist at the middle of next week and, regardless of what may be reported from my latest lab work, I am feeling better than I have for a long time. I fully expect that my viral load will have grown some more, perhaps my CD-4 will have dropped some, and who knows where my glucose will be (I am preparing myself for the possibility of needing insulin if only so that we can move on to returning me to my anti-HIV medications.)

Regardless of what my latest blood tests will tell us next week, I am hearing very good feedback from people – in particular people who have not seen me in awhile. Surely I am better than I was around the time of Craig’s death last May. Maybe being six months-plus sober also has something to do with it! I also like to chalk it up to being off so many medications. I do not want to press that for too much longer, however, and I take my specialist at his word that he will most likely be able to knock back my viral load in short order.

I did not intentionally go off my HIV meds but, once I needed to go off them all in order to avoid cross-resistance with others, I settled in to enjoying this time away.

I’m quite literally growing into my beard and am resisting the temptation to trim it too much – I need to cover my hollowed cheeks – until I see how it continues to take shape.

Hopefully, whatever comes following next Wednesday’s appointment, I will continue to feel well and ‘look well’, too.

-
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A Mr. G. day


I’m experiencing a Mr. G. headache today or at least one whose characteristics – terrible pain in my shoulder, neck and head – remind me of my childhood nemesis.

It could be the weather (cloudy, windy and cool) or poor posture (it’s hard to sit comfortably with no butt to sit on) but the locations of these body aches rarely fail to remind me of C.G. and his bullying teaching techniques.  Even if I do not dwell on what happened, with him and in ensuing years, the physical pain awaits release.


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Where have I been?


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I have been neglecting/avoiding my blog lately. I don’t know why other than perhaps the fact that I am supposed to be writing something else, somewhere else and I have not really begun to do so. The solution? Write nothing anywhere of course!

Last week I had my blood tested for the usual things in advance of my visit to the specialist ten days from now. Because I have been off my HIV meds for most of the summer we will get a good picture of where I am now and what old and new meds might be re-started or tried for the first time. Having had such a long break I hope that it will be an easy regimen because, frankly, I like NOT taking all those pills. (Right now I’m just doing the psych and diabetes meds.)

One day at a time, Kenn. Speaking of which, Monday marks two months of sobriety for me so I’ll probably be on a chip run until this time next week!

Meanwhile, I need to get back to the off-blog writing…

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Seeing daylight through layers of secrecy


I am challenging myself to begin an exercise of trust, or at least vulnerability, by chipping through my secrecy.

So thick is my denial that I sometimes don’t even perceive myself as secretive.

This blog, where I have revealed more about myself than many would be comfortable doing, has surely been self-revealing. However my secrecy – read insanity - is not so much about what I’ve done, or what has happened to me, but how I have so often coped mainly by seeking my own counsel.

To believe that this is satisfactory is a big lie, just as it is untrue that I have not had outlets (mostly professional) with whom to release the inevitable heads of steam along the way.

Yet I isolate. My friends think I am doing okay, better than okay even – or do they? Am I the last one to recognize how distressed I am?

There are so many lies about myself that I have believed.

This began early.

Mr. G., C. G., sadistically tormented me as my elementary school’s head teacher – this being the only example to have been put in narrative form – all the more sick because he was a family friend (and a member of our church).

I believed that I was somehow a lesser human being because of the way he pitted my nerdiness against his, and his son’s, athleticism.

“Four Eyes” he called me after the sick, abusive way he tested my eye-sight.

Did I report that to my parents at the time? Not with my childhood belief that adults (and adult friends moreso) stuck together, and he probably knew that. (It’s only in my adulthood that I have taken his name in vain among family members.)

His steady chipping at my self-esteem set me up nicely for coming of age – as I saw it at the time – with strange, much older men in my teenage years.

A few years later, at the hands of someone else, this was sexual abuse and exploitive, at the very least, and with today’s level of kid-proofing I believe I probably would have reported it.

And yet…

In the confusion of realizing that my sexual orientation was not like other boys I carried guilt, shame and self-blame so reporting the perverts did not seem like an option. Those feelings just seemed to confirm what I had been seeing in myself since Mr. G. threw a blanket of abuse and secrecy over me and stole so much of my childhood wonderment.

And then he failed me in math – was it any wonder I could not learn from him? – giving him an extra year for his sadistic pleasure. Equating school with mortal terror it is a miracle I was ever able to get to high school, to say nothing of college.

I drank, and quite heavily, from the earliest opportunities. I had my first black-out that first September at college. When I left home, in the fall of 1977, to go to Niagara College I would not turn eighteen until October 26. That did not stop me from drinking. (Eighteen was still the drinking age back then, although I think it might have been changed to nineteen around that time.) In any case at no time (after high school) was my drinking illegal. This is not to say it was not inappropriate.

I was not conscious of it being a coping mechanism, a way to feel a peace inside that I otherwise could not feel. It just seemed like the thing to do as a college freshman, strange looks, blackouts, and even a warning or two, notwithstanding.

What was I hiding from then? It would be many years before I saw the sexual abuse for what it was. I do not recall feeling latent trauma from elementary school. No, it was the more immediate discomfort of being around complete strangers, new classmates, coupled with the youthful feelings of immortality, awakening sexuality and drinking-as-ritual that found me increasingly fogged under the haze of alcohol.

One of my early solutions, in retrospect, to my being gay was to dive head-long into a fundamentalist church for a couple of years – adding a level of self-hate and unspoken hopes of exorcism.

The drinking continued, off and on, intensifying through my coming out in 1981, through my working days (‘Aren’t all journalists drunks?’ I rationalized), and up to the time I began to try to stop drinking and I tested HIV-positive in 1989.

I need to grow into the idea that what happened to me as a child, and later, does not make me who I am today. It has certainly influenced how I have interacted with the world but I am not merely a sum of past traumas.

Thanks for the comments Jeremy. (This was the conclusion of the original post yesterday.) As alone as we are in our traumatic times I know that I am not alone today in recovery.

I am reading a couple of helpful books. I lie. I wouldn’t be bipolar were I not reading at least three helpful books :)

Tom Wootton’s The Bipolar Advantage (although I have lost interest in it for the moment as I read the two others), The Dual Disorders Recovery Book from Hazelden and Vastly More Than That – Stories of Lesbians & Gay Men In Recovery by Guy Kettelhack, also published by Hazelden.

I am seeing the “cunning, baffling and powerful” in my disease(s).

When I was being treated for acute post-traumatic stress disorder, following my 2003 accident, and thought – once and for all – that I was facing the demons of my sexual abuse, I let myself believe that this was the reason why I drank. With that piece of the puzzle found it seemed to me, thanks to a disease that loves such self-deception, that I could drink again. That is logic only an alcoholic could come up with!

So I did.

After a couple of years of PTSD treatment I began to realize that, while no longer depressed thanks to a sedating anti-depressant, I was manic. I didn’t have that word for it yet, however. To me, Doctor Kenn, it just seemed like a pleasant absence of depression.

Alas it was, so another psychiatrist concluded, bipolar disorder (specifically bipolar II). Nothing to be alarmed about yet, he assured me, just take a different medication.

It worked. Trouble was, however, that it ought not be taken under the influence. I obeyed the guidelines on those occasions when some moderate drinking went late into the evening.

After Craig died, however, and I was doctor and alcoholic I let the bipolar med go for a while. I was sufficiently frightened of mixing it with booze and more than snared by alcoholism again to let any fears of bipolar disorder take a back seat.

Now I see that I can be sober, take my psych meds, and stop the chicken-and-egg debate about the relative severity of each disease – the list of which, of course, also includes HIV and type-2 diabetes!


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A new category – T.M.I.?


Not that this would be the first time I’ve done so but today’s story risks revealing just a little t.m.i. – too much information.

I set out from home late this morning, with my laptop in my backpack, first going to a noon meeting, and then coming to the internet cafe near Maple Leaf Gardens where I can tap into free wireless while downing a couple cups of java.

It was only a matter of a few minutes before a familiar face came in and sat down to do some web-surfing of his own.  This face is on someone who has…er…danced for me a fair bit during some of my manic episodes at a certain club, which I have managed to stay away from since getting back on my bipolar med and abstaining from alcohol (this is Day 16…or 400-plus hours). 

Like some boom-box message from G-d I spotted another such dancer on my way to a meeting last night and quickly took a detour so as to avoid conversation with him.  (I was an especially nice guy, as far as he was concerned, a real special friend, don’tcha know?)

Anyway, seeing the other guy in the cafe today didn’t upset me.  As a matter of fact I could glance over my computer screen and see him typing away, his pleasant smile and physique mine for the viewing without a trip to the bank machine.  I was busy enough answering emails and checking Facebook to prevent myself from bursting into flames of lust.  As if to tempt fate, although not deliberately, I needed to change seats because the sun was making my computer screen difficult to see so I joined him at the opposite end of a long couch (with three cushions it could easily seat four or five people of medium size).  I was listening to my iPod and we were both focused on our respective computers so there were very few words exchanged, culminating in “See ya!’, and a trade of smiles, as he packed up and left a few minutes ago.

Do I know where he was going?  Sure.  Do I know where I could find him this evening?  Of course.  But I am going to a meeting, where I will be seeing my sponsor (and I’m sure she’ll have some feedback for me), and then I will – I am certain – join the meeting crowd at the Baskin-Robbins as I have done all week.  My sobriety needs to continue to include abstinence from the dance club. 

Meanwhile, I have added “T.M.I.?” to my blog tags.  It may be useful to review past posts and see whether this category might be appropriate for some of them, too.

:)

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About face…no, about effacing


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I am “processing”, somewhat, a phone call I received from my beloved Mom last night. Forgive me if it seems morbid – but such topics tend to arise during the grieving process which, of course, the family continues to experience.

Over the weekend, as Craig’s partner visited her in Perth for the first time since Craig’s burial in May, Claude and Mom went to the Scotch Line Cemetery where the remains of Dad and Craig are buried, where Mom and Claude plan to join them in death – whenever that comes – and me, too.

It’s a double plot with, as I understand it, room for two caskets or up to eight cremation urns, more than enough room since we have all been, or will be, cremated when we leave this earthly plain.  And space for two head-stones side by side.

Claude double-checked with Mom about my plans and wondered if I was thinking I would like a head-stone. The plans have been that Mom and Dad would have their stone, as they already do (with the names of all their children on it) and that Craig and Claude would place a stone for themselves beside the first one (where the flowers are in the picture). Claude was wanting to make sure that I was not feeling crowded out, I guess. Up to eight urns…but room for just two head-stones.  (My sisters and their families have plans elsewhere.)

“Oh no!” I told Mom. “My plans have been to be buried in the plot, yes, but I had never contemplated having my own head-stone.”

Then I brought out the effacement (I thank my sponsor for that accurate description) as Mom explained that my name, and the details of my birth and death could go on the back of the stone that she and Dad have (the one with all four of the children’s names on the front).  As a matter of fact that would mean my name would then be visible to anyone coming in from the main gate even if it was facing away (an ‘about face’) from the front of the stone.  A bonus would be that the the old stone school house on the cemetery grounds (a school where my grandmother once taught!) is close enough that it would, at some point of the day, cast a shadow over my name.  Not that I am equating school with shadows…

I joked with Mom that piggy-backing on their stone would be more than satisfactory; that all I really needed was a brick with my name on it planted in the turf.  Then I spoke of myself as “just me”, meaning - among other things I suppose - that Kenn is single.

Despite the fact that I am absolutely sincere in wishing no more than that for my final resting place Mom challenged – and God love her for this – the “just me” thing.

Yet, as I recounted the conversation to my sponsor later, the effacement seemed so natural.

Without being deliberately self-denying, in the Saint Francis of Assisi style, for longer than I can remember I have tried not to claim too much of the planet’s oxygen or terra firma. This is not about being modest, believe me.  And it’s not like I haven’t hoarded material things!  No, it’s more about the way I see myself – probably best left to analysis, or private reflection, deeper than I could possibly blog about – at least for now. You’ve seen glimpses here…distorted views of what I “deserve”, for example.

I like how my sponsor reworded part of A.A.’s first step, which she applied to herself and wondered if it might fit for me, too:

We admitted we were powerless over alcohol; that our lives had become unbearable (as opposed to unmanageable). 

Not that I have been actively suicidal (although I suppose it could be argued that I was passively so).

This followed up on my observation the previous night that “My life was unmanageable…and then I drank.” In other words, despite the unquestionable love and support of my parents and siblings – which has been constant – I was living with all sorts of neuroses and, yes, unreported trauma quite young, long before I ever picked up a drink.  My self-image sucked. 

Therefore alcohol was my solution.

Right…

Believe it or not, articulating this makes me feel better!

Needing some healthy calories


I’m about 130 pounds soaking wet, about 59 kilograms. So I found out when I got weighed at my doctor’s today. The last place where I could possibily lose weight – my feet – now are like detox Reeboks (paper slippers). I swear my left shoe, tied as tight as I can, is still loose.  It would not be a problem were I not 6’2.5″ tall (what’s that, about 190 cm?)

This has far more to do with the events of the last weeks, and my crazy moods, than with HIV. (Fear not *Juanita*.) Besides I have always been thin, probably well below the ideal body mass index, too.

But this is ridiculous.  I should never lose weight, only gain!

I need to eat more. I need to eat healthy. I probably should see a dietitian again. But even if I know what to eat I have an aversion to the kitchen, other than the coffee-maker and the microwave.

It wouldn’t hurt to try a little resistance traning either, except that my repaired forearm and hip/femur can’t take too much.

This is childish.  I am whining.

I do like Wendy’s “Baconator” and I think I’ll go grab one now.

Then maybe a case of “Glucerna” (“Ensure” for diabetics) from the pharmacy.

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