Tag Archives: diabetes

Diabetes

Blood glucose meter
Our blood glucose meter – photo by tamellu 2015

It was World Diabetes Day yesterday, the day of awareness that high blood sugar is absolutely not something we should neglect or take lightly. I’m living in Serbia, a country of somewhat more that 7 million people where 710,000 souls are diagnosed with diabetes, with estimated additional 245,000 others who have diabetes but don’t know it and don’t treat it. Those figures are indeed horrifying, and if we as humanity continue with current nutritional habits future surely won’t look optimistic.

Diabetes is a silent illness and can go for a long time undetected. At the time of diagnose if the patient didn’t check his or her blood work in years, high blood sugar had already made some damage in the patient’s body and shortened the expected length of life. People run away from this diagnose because we all very much fear illnesses that are still considered incurable, but in case of diabetes there is no need for that. There surely isn’t some medication that can fix things and allow you to go on eating whatever you want without a worry in the world, it’s a chronic lifelong illness, but there are treatments that can allow you to live a normal and happy life for many years. My dad was a diabetic for 22 years and as a medical doctor he strictly obeyed the nutritional plan he had to stick to. He couldn’t eat cakes or sweetened things, but he had a perfectly normal life, and what’s much more important his diabetes didn’t progress to provoke some of serious complications such as diabetic polineuropathy, gangrene, loss of eyesight, stroke… to name just a few. Yes, he eventually died of cancer and today we can only debate on the link between the diabetes and his pancreatic cancer, but he died at the age of 78. He was my dad and even he died at 98 it would be painful and I would ask myself if he could go on for maybe a little while longer, but I must admit that he still managed to live a reasonably long life without any serious problem up until virtually one month before he passed away. In the whole 2014 up until the end of July the only symptoms that could indicate cancer were certain weight loss and some changes in bowel habits which were attributed to his new combination of medication for diabetes. At the beginning of August the first dramatic symptom was a rapid, violent onset of blood sugar spinning totally out of control even though he still took his therapy and ate as usual. I was later told that we would never be able to tell if the diabetes had caused cancer or it had been the other way round, the only definite certainty was that it took too long for doctors to establish the type and dosage of insulin shots to stabilize him enough so that he could at least try any true oncology treatment. All in all, dad had 22 wonderful years in spite of diabetes and as he followed all the advice and rules of his treatment, he didn’t even depend on insulin till the last 3 weeks of his life.

I would just like to encourage everybody out there to check their sugar values regularly especially if you’re over 50 because this is a borderline age for a possible onset of type 2 diabetes, particularly if you have genetic predisposition or if you indulged in too much sugary and processed food before in life. Don’t let thing spin out of control and lead you into a situation where you could start drinking massive amounts of water and going very often to the bathroom, which if left untreated can lead to diabetic coma that can have even a fatal outcome. There is absolutely no need for this to happen with an illness that in many cases just requires caution, therapy and discipline. On the other hand, if diabetic with a good therapy that keeps diabetes under control, bear in mind that any sudden and dramatic elevation of blood sugar values especially if associated with stomach pains must be immediately reported to a doctor who has to perform an abdominal ultrasound.

Take care of your health and never let an illness that can be prevented or successfully kept under control influence your life and your happiness. Diabetes takes some kind of tool on human body even when treated and I am aware of that, but I think that you would agree with me that 22 years of normal life is not that short at all. In those 22 years dad was never in the hospital, at the beginning still worked as a doctor, never suffered a heart attack or stroke, he had incredible stamina and strength and in all that time he was in bed 3-4 times for several days with merely a seasonal flu. He traveled, worked strenuously in the garden, enjoyed a full and happy life. I would have nothing against such scenario if I got diagnosed with diabetes.

With lots of love for all of you out there, take care!

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Farewell dear daddy (1936-2014)

tata

We fought that horrible battle all right, me, my dad and my mom, all alone. It is only today that I mustered some strength to come here and say something, make myself heard. I’ve never experienced something that much dreadful in my life and no matter what anybody can tell you about cancer and how brutal it is, it is only when you see it firsthand taking away one of the closest persons you have in front of your very powerless eyes – which I don’t wish on the worst person in this world – that you can truly understand why it is considered so hellish. It was cancer all right. And of all the damn cancers in this world, the worst and the deadliest one. Pancreatic cancer. We have two ultrasound results, several X ray images, gastroscopy results and the CT scan, but there are no biopsies to be dead certain, although it fits the description perfectly. There was no time. Time was leaking through those tiny space between our fingers too fast for anything to be done. The metastatic lesions were first discovered on August 23rd which was an incredible shock for me. Today, after downpours and downpours of tears I am in much greater shock knowing that my father lived only 20 days after his diagnose. He passed away on September 12th in such a terrible way, suffering from pains and in some inexplicable agony, on my very hands. I did manage to beg the ambulance to arrive and he took his last breaths in their presence, attached to the ECG, which showed flatter and flatter line, till everything got hushed up and ended in surreal silence. That silence still haunts me whenever I move around the house, it is as if I need something massive like an entire mountain to fill the emptiness that is left behind him.

There is no peace, there is no comfort, there is no resolution. We didn’t get a proper chance to try to offer him any sort of cure, even though there is almost no cure for pancreatic cancer, even when discovered early on, let alone at this stage. It’s the most ominous cancer of all not only because of its astonishing aggressiveness, but because in the majority of cases it doesn’t give you hardly any proper warning till it metastasized. Till it’s too late, for everything and everybody. We didn’t get a proper chance to say a real goodbye to one another because all of us, dad included, didn’t believe first at the diagnose, then at the possibility that it could take him away at such horrendous speed. It is just as bad as it can get when cancer is involved, but even pancreatic cancer usually gives you several weeks or several months if not a year or two… to finish some unresolved issues, to express wishes, to give instructions to those that will stay behind you. We weren’t that lucky. There is a very slim chance to get hit by a lightning or win a huge lottery prize, but such things still strike. We hit the jackpot when it comes to bad luck in life… or it was simply as one doctor said that my dad was such a strong and tough man that he carried out the cancer story oblivious of it till its end on his two feet, which is very unusual and quite remarkable. Considering all his other lab results and the fact that he never really lay in bed for more than a couple of days with a flu in spite of the diabetes he very successfully fought with for 22 years, he could have lived for another 15 years at least as they say. Maybe, maybe not. Many times doctors actually don’t have a clue. What remains incredible is that my dad on August 9th worked strenuously in his garden, drove the car and carried home kilos and kilos of tomatoes, feeling just slightly more tired than usual. A month later, we had to organize his funeral.

Preparing the funeral was honestly a story by itself… Funerals are digitally organized in such an incredible manner in a rotten country where my dad was admitted to a hospital which is in completely brutal state – old beds with mattresses falling apart, no pillows for everybody, no blankets, no clean bed sheets for as long as you stay in hospital, cockroaches dancing around rooms, and on the top of this mountain of misery, a horror story contrast – blond, young female doctor, perfect style and makeup, pretentious, lacking any sort of empathy or human emotions, but obviously pretty rich. That woman could easily buy full equipment for those miserable 5 beds in that sad men’s endocrinology room and not even feel any budget difference, yet she was much more interested in kicking my father out of the hospital when it was confirmed that he was a palliative, i.e. lost case. This person who filled my father to the fullest with insulin to clear his ketoacidosis in order to discharge him as fast as possible probably never heard that insulin is among other things a growth hormone, and that such a speedy flush out of keton bodies is not recommendable at all with cancer patients because it simply speeds the tumor growth, yet she still had a nerve to verbally confront me. I just wanted my dad to have a proper care, I was quite aware that hospital sucks in many ways, but still it is a place where he could get full time IV fluids, injections of pain medication and TPN as towards the end he ate and drank less and less. She shouted at me in front of him that “he can’t live in hospital, you know!”, to which I replied moving to a safe distance from him – and you, with all your “medical knowledge” are trying to say that he will live? Here, at home, or at any other place? Live? The following day when she discharged him, I told her that talking that way and with such a tone of voice in front of a dying patient is not ok at all, and that she shouldn’t work with people. I’m not ashamed of what I said, because it’s a pure fact. My father was dying. I could have flipped, shouted, cried, fainted in front of her, yet I was always very quiet and polite, holding all the horror and grief inside. Even if I were impolite, she as a medical worker should have understood it, but it was clear enough that she had no compassion at all. For Christ’s sake, my dad, my one and only dad was dying. Then something very painful happened – her expensive mobile phone rang and she answered it even though it was a private call with these words – oh hello daddy, did you finish the paperwork? It was as if she stabbed me right into my pancreas. I was counting last days with my dad, while she treated me like hell and spoke to her dad with whom she had indefinite time at her disposal. God forgive me, but I wished her all the worst in my mind many times. I still can’t understand how such a person can be a doctor. She told me that I should be grateful instead. Grateful? Of what? Of megadoses of insulin that contributed to speeding his death? Of prescribing a patient who barely ate 22 i.u. of morning insulin on the day 5 in hospital due to which he entered hypoglycemic coma and his blood glucose was immeasurable, they barely managed to bring him back to life? Of injecting him 18 i.u. of insulin on the day he left hospital so that on that very evening we noticed huge sweating and measured glucose at 2.4, due to which we loaded him with all sugar he could eat (he hasn’t eaten that much sugar in last 22 years)? Of not instructing me how to use insulin pen and telling a nurse to do it, who failed to inform me that a loaded pen isn’t supposed to be kept in a fridge and that his insulin type was a mixture, which means you have to strongly shake it before injecting it so that it can resuspend? Of letting me stand while she spoke about his death, sitting in her chair with her back turned to me, staring at her computer? Of not giving me any blood values so that I could compare values from before entering the hospital and his progress? All in all, I should be grateful to her for doing her job, being such a lousy doctor at the same time? Ironically, my dad was a doctor, too. If she had no compassion for a human being, she could at least have had understanding for a colleague who used to wear that same white coat up to 13 years ago when he retired. No way, that was too much to ask I suppose. She said she never saw something like that – “something like that” was a person, my dad. I believe her. She is most probably younger than me, so her experience is really “huge”. Plus there is one massive point she missed in this whole story – she most certainly isn’t and probably never will be an oncologist, if she were one she would see much worse tumor marker values every day all right. In the end she told me that I had a bad attitude and to get lost… I don’t have words for your attitude, I replied and then I obeyed the “getting lost” part… while I was shutting the door, she cynically shouted “goodbye and have a pleasant day”! I opened the door again and said PLEASANT? I mean, my life is falling apart, my mind is falling apart, my family is falling apart and I’m taking a dying patient home where I don’t have a private nurse, IVs and everything else he can’t take by mouth, and she says have a pleasant day? May things get this pleasant in your life, I said, and slammed her door.

Slamming her door meant opening door to hell itself in our modest home – there was no way to afford private care, dad was trying to convince us that he was managing, he fought to eat, drink, take meds, but every day he went rapidly downhill, one day was like an entire month for some other pancreatic cancer patient. I constantly measured his sugar levels and gave him only half the amount of prescribed insulin when needed… we changed diapers, we moved him up and down as he was constantly in pain and choking, in spite of the largest doses of opioids he could take. His stomach was filled with fluid this darling doctor and all other doctors in town refused to drain to give him a little bit of relief. On the last evening I sealed a morphine patch on him, but he didn’t live long enough for it to start working.

Then I had to survive the ambulance pronouncing death, but with their death certificate he couldn’t be buried. We had to call a medical examiner to come, inspect the body and allow the funeral. Medical examiner’s office immediately informed private undertakers who called from a hidden number so that we couldn’t know who made the connection, because that’s illegal. It’s our right to chose the funeral organization and they tried to impose the people who give them percentage. Horrific. We shook them off successfully, but had to be in the room where the medical examiner examined the “body” in our presence. For me, it was daddy. Daddy sleeping. I still couldn’t grasp what happened. Then we had a visit from a legal undertaker… I’ve never seen such an efficiency. I was still in shock an disbelief when this man put an iPad in front of me and told me to choose a coffin, equipment, cross, etc. “Just flip the pages and when you find something you like, press the upper left corner to see the price…” Something I like??? What was he talking about… When my grandmother was buried 17 years ago, there were printed catalogs and my parents took care of everything. I’ve never buried anybody in my life. Now, all of a sudden, it all felt on my shoulders, hardly 2 hours after his death. Everything was digitally arranged, one click her, one click there, receipts, pay this, pay that, every step of that funeral had some price. Abominable, as it was happening in a country where patients lie in cockroach infested hospitals and where a retired medical doctor with perfectly good medical insurance couldn’t “live” in hospital, being a dying case. Then my mother ran to the bank and I was all alone and shaking when the coffin arrived. Three strong scary men and a tiny one, who was supposed to dress my dad. And I was alone. I have PD, you remember? My hands were shaking out of control, yet I helped with everything. Mom returned on time, but she couldn’t bear to go out as they were carrying the coffin out of the building. I went with them, alone again. I watched them put the coffin into their vehicle and I had to make sure they fastened the proper lid onto it. And to wave a final goodbye forever, completely alone.

That night I got sick with flu. Exactly 7 days earlier I went to my dad’s GP to get a whole bag of meds with which I was supposed to carry out that battle with cancer at home, and there was a girl who said she had a fever and sore throat. Great, I thought, but then I forgot completely about it. It turned out that the virus didn’t forget me. By the end of the next evening I was sad like hell, had a fever of 101 and horrible pains in each and every muscle of my body. I cried because of what happened and how it happened, I cried of despair, anger, fear, of physical pain… but one thing kept me still in one peace. “If dad could endure what he endured, I have to survive this as well and put myself onto my feet in two days to be at that funeral”. He dealt bravely with cancer pain, so there is no way I could fall apart. No way. Funeral… even the very idea of it was terrible, because of the event itself, but also because as he didn’t express any precise wish, I wanted him to lie together with my granny. That graveyard is TOTALLY out of my comfort zone. Out of town. I’ve never been there in these last 7 years. It was out of question. And now I had to go there and not go crazy in front of those who were to attend the funeral. Quite a mission… I fell apart a bit when we reached the grave and when I saw the grandma’s tombstone and her picture, everybody thought it was just because of dad, only me and my mom knew what it meant underneath. I brought this picture of my dad with me to leave it on his grave, this is how I want to remember him. I took this picture with my camera, with my own hands and I brought it as my last personal gift for him. He was a man who loved life and his garden more than anything, always smiling, always pushing ahead, always walking around, always fixing something, things, people, animals… but he couldn’t fix cancer. I don’t want to remember that defenseless, weak, thin man he turned into and the scenes of dying, because by that time, my dad, the person who he really was had already left me.

I don’t know if he can hear me now, but there are so many things I’d still have to tell him and I didn’t have time for it. I wish he could return for one night only so that I could tell him how much I loved him and how much I miss him. How sad I am that he left this world knowing that nothing is safe or secured in my life, unable to be proud of me in any way. I would need him to speak just one more time, to tell me that he wasn’t totally disappointed with me. PD destroyed everything, I fought the best I could, but I needed some more time. I’m sorry daddy, but I was unfortunately born the way I am. I can only promise that I’ll try to continue to fight somehow to make things better, but I can’t promise that I’ll succeed. I wish there were less emptiness around me. I wish you were still here… Damn it, I miss you so much, why did you have to go, and in such a dreadful way.. 😦

Rest in peace dear daddy… and wait for me up there somewhere. Your sufferings ended, and mine will some day as well. I watched the movie about Frida Kahlo the other night again, she was a famous Mexican painter who had many health problems and eventually died in horrible pains. The movie ends with her words – “I hope the exit is joyful, and I hope never to return.” My daddy repeated in his last two or three days how horrible life is and begged to die as soon as possible. It was terribly hard to listen to this, but I understand him. Psychologically, I’ve been carrying around so much pain for many years and I’ve felt so well the cruelties of life on my very skin. Somebody said – You don’t have to get killed to lose your life. I’m still here, but I lost my life many years ago. Now I lost my dad as well. I have no idea how I will deal with what future still has to bring for me, but I just hope that my little family will be together again some day, in some better place. No pain, no fear, no grief, no separation. Daddy, don’t abandon me completely, I beg you. Wait for me.

Battle for life

I wanted to write something, but I have no idea how a post like this is supposed to be written. There are no right words, there is no comfort, there are no answers. Just tons of tears and a profound sense of sorrow, deep like some hell pit and the smell of hospital disinfectants that haunt my days and nights wherever I move. I am afraid to type these words, but I have to – my father is most probably dying.

What appeared to be just a battle to get him out of diabetes induced state that went widely out of control and progressed to ketoacidosis, eventually turned into an ominous discovery of cancerous lesions in his abdomen. We still haven’t found the big one, THE ONE responsible for these lesions as he is still too weak for further aggressive testing, but doctors think that considering the general state of his health that this might not even be important, that it would be just a name to put on the type of cancer he has. For these doctors my dad is not the person I know everything about, he’s just a cancer case. They left me, mentally not very stable person, standing on my two feet while they were telling me these words that sounded so unreal and out of place and put on me the pressure of choice to decide how much of what they think so far I will tell him. If anybody out there knows the way how to lie to a retired medical doctor about his state of health, please tell me how to do it. He knows too much about medicine and suspects quite enough to be fooled around, yet I still have to give him a grain of hope so that he continues to battle for his life. In order to do it, I’d need some hope myself. I need to be strong. Have you ever seen a strong PD sufferer? Till several days ago, I hardly and rarely went further than around my building. All of a sudden, I’m needed – to figure things out, make appointments, find ways how to put him into a hospital in a tragically poor country with one of the worst medical mafias in the world, be the one to whom doctors speak, run around to buy medication and other things he needs, and that’s precisely what I’m totally unfit for in the first place. I’m somehow doing all this and falling apart, but it seems to me that such situations simply numb you to the point that you can process them without going crazy for good. I was managing my PD battles precisely because I developed mechanisms of convincing myself hard that all that dreadful anxiety was not real, that it was bogus, that it can’t harm me. Anxiety and dread I’m feeling now is not much different from what I’m used to, but this time it’s not bogus. Now it’s very real and I can’t do anything about it, which in turn scares me to death. This realization alternates with derealization all the time. What is going to happen? How will he handle it? How much time do we have left? What has happened and how? How are such things processed and survived? How will i survive all this? And of all diseases out there, why cancer?

My dad has been a support in my life in different ways and now life is going to get abnormally tough, change drastically for worse, especially because PD makes me disabled in many ways and I don’t have help. Everything loses meaning and importance. When I think of my recent digital battles, I fell like screaming – how could I’ve been so stupid to get worked up for something that seems like a complete nonsense now? All those things that miss in my life due to PD now seem way much bigger and worse. Who’s gonna give me a hand when my time comes? I don’t have anybody apart from my mom and dad… I would give my stupid PD limited life this very instant to extend his much more meaningful one if things could work that way. What’s life’s purpose anyway and why for some people it has to end in terrible suffering?

I’ve said many times that whenever I start something meaningful for myself in these last years, the moment I try to do something at least a bit beautiful, I somehow get drastically punished for some reason. I took the camera out all right, but what am I supposed to do with it now? I started blogging and found some very precious joys in this special community – I didn’t get many followers but I did make here a couple of very special friendships, big hugs and so many special thanks especially to Judy, Jim and Tammy – I love you guys, your amazing blogs inspired me to start doing something artistic again and your wonderful comments gave me strength not to abandon my newly developed blogging path. I don’t know how to blog now and if I can still do it, if I’m not here it’s because I’m doing really bad, not because I forgot you or this tiny blogging space of mine.

Life’s been very cruel on me, I need those closed fists of mine now more than ever. What’s more, I’ll hate my birthday now for as long as I live, it was on August 16th that my dad took the results of his first analyses and completely forgot about me and my birthday. My only wish while I blew my two tiny cake candles was for him to get better again, but it seems that such wishes never come true. I tried to stay positive in the following days till we got him into the hospital, I wanted to show you my first zinnias’ photos because I knew that later I wouldn’t have strength for it. Or better said, I still hoped that he just needed to be switched to insulin and that things would get better. I’m desperately searching for some grain of hope now, against all odds. It seems that these are the only battles I was born for, those against all odds.

Dear God, please help me, I beg you. Now it’s all in your hands.