In Case of Overdose...

I've been out of the hospital for exactly a month now.

I was admitted around 5 AM on September 30th for an intentional insulin overdose.

 I took my total daily dose in one go, waited 30 minutes, and was about to inject another day's worth when I freaked out and did the only thing that made sense: asked Twitter what to do. I didn't know if it was something I could fix by chugging a lot of juice and monitoring it on my own. When I thought I'd gotten over the worst of it (blood sugar was 90), I got a call from my university's police department. Someone had anonymously reported from my Twitter that I was suicidal and in danger. I talked to the woman on the phone, declined help, and hung up. Five minutes later there were two cars from the city police sitting outside my parents' house at 3:30 in the morning. The police wouldn't go away until I let the paramedics check me over. Their meter read my blood sugar at 30, but the paramedics didn't quite believe it because I was coherent. After a recheck came back at 33, they believed it.

Fast forward half an hour. Three policemen and two paramedics are in my house, and there's a fire truck outside for some reason. The police dispatched to my house have had training in speaking to suicidal individuals, and are going on the word of the paramedics that I should really be going to the Emergency Room. By this point my parents are awake and the police are working to convince my mother to at least get me checked in the ER. So we went to the ER. I was drinking juice the whole way there.

When I checked into the ER around 5 AM, my blood sugar was 73, but quickly plummeted to around 40. I was given a Coke and IV glucose. The orders were written that I Was supposed to have my blood glucose levels checked every hour. Every hour they stuck my finger and gave me a can of coke every time I was below 90. The cans of Coke they give out in the hospital are 7.5 ounces. By my (and my bored caretaker's) best estimate, I had around one liter of Coke.

Finally, about 12 hours after my admission, my BG was >90 for two hours in a row. By this time, though, the nice doctors in the ER had transferred me upstairs and filed a 1013 on me (in the state of Georgia, a 1013 hold is basically a psych hold because I was considered a danger to myself). I was going to be stuck in the hospital for 48 hours to experience one of my worst fears: not having control over my diabetes management.

After ensuring my BG was stable above 90, the doctors did not want to give me any insulin at all, but gave me dinner, which I refused because they wouldn't give me insulin. A few hours after celebrating a BG of 110, they were looking for room in the ICU because they don't do insulin  drips on the main  floor and my BG was >450. Giving IV doses of Regular insulin eventually brought me under 450 (and kept me out of the ICU).

My usual dose of Lantus, when I'm on it, is 60 units. It's fairly large, I know. The doctors on staff did not want to give me more than 5 units that first night, and I fought my way up to 30 the next day. To this day I have no idea what the hell they did for my mealtime doses. They seemed like random numbers to me. In any case, I tried to avoid the carbs and pretend I wasn't hungry. After my initial lows, I didn't drop under 200 until I went home.

For some reason, health care folks seem to think my insulin pump is a problem. I went through this same thing last year when I was being treated or suicidal ideation. It's like they think I'd use my pump to give myself a ton of insulin? It'd be so much easier to use a syringe or a pen, in my opinion. Maybe they think it's a trigger? In any case, the doctors at the hospital (both the general doctor and the psych doctor) did not want me to have my pump back, but wanted me to go back on pens for a while. After discussing it with my parents, we talked to my doctor as a team and convinced him that using my pump is ultimately what's best for my health.

One of the most infuriating things about this whole ordeal is that the entire time I was in the hospital, they would not let me call my endocrinologist. At the same time they wouldn't trust what I said about my own treatment, which is fair given the reason I was in there in the first place. When I went to my endocrinology visit the next week I was told that the hospital I was in was the worst for diabetes care.

 At any rate, please don't worry about me. I'm at home with my supportive family. I have friends to talk to. I have a new therapist and she seems like a good fit. It's going to take some time, but I'm slowly getting over this hurdle and getting ready for the next.

It's taken me a month to get this blog post out because suicide is something that's hard to talk about. My hope is that by talking about it, I can help reduce some of the stigma around talking about it.

The Post I Didn't Want to Write

I didn't want to write this post. I really didn't, and I'm worrying about pressing "publish" on it this time. I've written it several times over in the last few months. I just feel like I can't get back to regular diabetes blogging without letting this skeleton out of my closet.

I know this is a diabetes blog, but I have talked here about my depression before. (You can check the "labels" section in my sidebar.) I've always said that the easiest way to reduce stigma around something is to get people to talk openly about it. So I need to talk about some personal things now. I need people to understand. I'll be sharing this blog post with everyone I know online and in person, so excuse me if parts are a little vague. Feel free to shoot me a message if you have questions.

Some background: I have had depression for a long time. I'm 26 and at least half of my life has been covered by this dark cloud. The first time I had to see a counselor for depression, I was 13 years old. I fought against taking antidepressants until I was 19 and couldn't cope on my own anymore.

This past fall (2015) was a particularly bad one for some reason. My brain decided that it wasn't enough to just be depressed. I'd always had the occasional suicidal thought, but my brain needed to ramp things up. I couldn't stop thinking about killing myself. Everything became a plan to end it all. To top it all off, I'm usually attached to enough insulin to get that job done.

One morning was particularly bad for some reason, so I called into work and told them I wouldn't be in. Then I called my psychiatrist and told her what was going on. She told me I needed to come into her office, so that's exactly what I did.

I ended up spending time as an inpatient at a psychiatric hospital. After the inpatient stay I transferred to an outpatient program where we (the patients) spent time working on things like mindfulness, reflection, and various ways to cope with out maladaptive behaviors, be they drinking, drugging, cutting, or just being flat out depressed. I met a lot of cool people and was working hard at this program, but I was not getting any better. I ended up needing to spend more time on the inpatient unit because I was still very suicidal and the staff felt it was in my best interest to not be at home. Additionally, my psychiatrist thought it was a good time for me to take a break from my pump because he was afraid I was going to use it to hurt myself. I did write about taking a brief pump break, but I don't really remember doing it. Why?

Electroconvulsive Therapy. ECT. Even in psych hospitals it carries a bit of taboo. I was mentally in a dark place with no options left. I'd tried many, many drug therapies to no avail. I'd spent weeks in treatment at a psych hospital. Nothing was helping me and I was constantly suicidal, so I agreed to undergo ECT treatment.

Over four weeks I had a total of 12 treatments. It didn't hurt and I don't remember much of it. The main side effect of ECT is memory loss around the time of treatments. I don't remember most of December or early January except that I was pumpless and hopeless, yet optimistic this treatment would work. Did it work for me? Mostly. The visceral need to be dead is gone, and that is a huge relief to me. ECT did pretty much nothing for my mood. I'm still working with doctors to find a good pharmaceutical aid for that one. I'm seeing a therapist. I know that eventually something has got to work. It has to, and I'm not giving up until I find what works for me.

Thank you for reading this far. It seriously has taken me months to decide to hit the "publish" button on this.

Foot Update!!

A friendly warning: there is a picture of my stitched foot in this post. 

I had my foot surgery a few weeks ago. When I got home from the surgery, my dog wouldn't leave me alone for a few days. Everything went fine with the surgery, and they put me in a sexy, sexy post-surgical boot. A few days after surgery, my foot was quite swollen, and my toes looked like Vienna sausages.

The pain meds were... an experience. I was prescribed Vicodin, which I thought I had taken before. Well, I have never taken Vicodin before, and it makes me really, really nauseated. I mean, to the point of almost vomiting in my boyfriends car (thankfully I didn't). That being said, taking Vicodin and an anti-emetic every four hours did nothing to the accuracy of my CGM numbers. So at least it had that going for it.

In addition to the lovely drugs, my doctor prescribed this neat little machine for me. It circulates really cool water around my sore foot and squeezes on my other leg to prevent DVT. I really only used it for the first few days after surgery, and now it's sitting in my living room. I really do need to call the guy to return it.





I went back to the podiatrist yesterday, almost three weeks post-op. I was told that my foot looks good and is healing quickly. Yay foot! The doctor took my stitches out, manipulated my foot for a bit, and then bandaged it back up.I haven't been allowed to get my foot wet since the surgery, so that means it hasn't been washed since before the surgery. That's why my doctor's initials are s till on my foot. Also, the smell! I won't even get started on that....

I still have some swelling and bruising in my foot, as well as some pain and stiffness. You know what, though? I'll take it for now. I have at least another week in the sexy gray boot before I can start slipping back into my dancing shoes. Right now I'm still walking like a slow poke, but I should be back to normal-ish soon. 

My Bone of Contention

This is my sore foot that has been bothering me for about a year now. I've been seeing doctors since January, trying to get some relief. I've tried physical therapy, ice, rest, steroid injections, topical creams, shoe inserts and pads... I've tried everything. The problem? A super high arch combined with an exostosis (extra bone growth) which rubbed against my shoes, causing persistent tendinitis. Then, over the months, the rubbing caused a cyst to form under the tendon in my foot. Now, I'm not an artist, or a doctor, but I'm going to try explaining this the best I can.

 The pink squiggle is the tendon that is irritated. The yellow lump is my new cyst (which I can feel and move under my skin. Kinda yucky).  The red line is where the surgeon is going to go in and shave my bone down. Yeah, shave. Hopefully the shaving will alleviate the pressure on my tendon and prevent the cyst from returning. 

I've already gotten my prescriptions for after the surgery. Ibuprofen, antibiotics, and Vicodin. Does anyone out there know if the acetaminophen in Vicodin is going to mess with my Dexcom numbers? I've tried Google, but the results are inconclusive.

I had my pre-op appointment this week, where they told me to not take any insulin at all the day of surgery. Um, that sounds like a terrible idea. Surgery is at noon. So I called my endo's office, who told me I should let my surgeon handle my insulin, until I told them what the surgeon wanted me to do. I'm still waiting on official word from my endo as to what I should do. 

I'll be posting an update eventually as to how everything went with my insulin needs and how the Vicodin affected my Dexcom readings, if at all. 

Putting my Best (or worst) Foot Forward

I went to the podiatrist today for the first time in my life. I'm 24, and I've been having foot problems for a while now, at least since January. I've tried resting, icing, wrapping, and it helps in the short term, but the day I stop doing these things my pain returns. I went to my primary doctor again earlier this week for the pain. The last time I was in, Dr. Dumbass told me to come back if it kept hurting. It did, so I went back. Thankfully, I got to see my regular doctor instead of the idiot I got last time. Anyway, he wanted to send me to physical therapy for my foot to try strengthening muscles and gain support. I asked him how we can treat something if we don't know what, exactly, the problem is. So he referred me to a podiatrist.

Now, being a diabetic, I get a little nervous when I start thinking about my feet. Every time I'm in the endo's office, I get a clean bill of health on my feet. They look good; strong pulse, no nerve damage, etc. It doesn't stop my worry though. We've all heard about the foot problems associated with diabetes. I was nervous going in. To my surprise, he didn't mention my diabetes once. Woo!

I had my foot X-rayed while standing.

Everything is normal, except for my high arches. I was given some orthotic inserts to bake in the oven and shove into my shoes. Done and done. For now, I hate them, but hopefully they'll help. I hope my problem was something this simple and it resolves soon.