Monday, October 21, 2024

The algorithm will see you now


     People are troublesome. And expensive. We've seen the steady exile of problematic, costly wetware, replaced with vastly more efficient — and a whole lot cheaper — computer programs. Out with telephone operators, in with phone loops. Out with cashiers, in with self-checkout kiosks.
     I get that. And go along, grudgingly. If I pulled into a gas station, and one way went to self-service pumps and the other to an attendant in a freshly starched uniform and peaked cap hustling out to pump the gas, wash my windows and give me a stick of Doublemint gum, I'd certainly opt for him. A few times. But if his gas cost 25 cents a gallon more, it wouldn't be long before I'd find myself guiltily edging into the self-service line, avoiding the attendant's gaze.
     How reluctant I was to use those self-checkouts, at first. As if it were stealing from the cashiers. Which of course it is. Then the grip loosens, and tradition tumbles into the abyss. Technology wins.
     Still, each time you encounter the shift anew, it's jarring. The past month I've been going through ... let's call it a medical crisis, for now. In September, I lost 10 pounds without trying. Then I was thirsty at night. Really thirsty. Up every hour, tongue glued to the roof of my mouth. My eyes were dry. I'd gulp a few Dixie cups of water, put in eyedrops, go back to bed.
     After the second night of this, my wife urged me to get a blood test. So I went to a Quest Diagnostics, the McDonald's of blood testing. I found myself in a crowded waiting room, but no attendant. People lined up in front of a computer terminal and entered their information, then sat down.
     This struck me as something new, the unattended waiting room — the next step with AI and Zoom medical exams. Someday you'll get your full checkup, be poked and prodded and weighed by robots, without ever seeing a living person. There was one at Quest: Every so often, a woman would open a door and bark someone's name. At least machines don't yell at you. Yet.
     Turns out my test wasn't in their system. My doctor's office was a few steps away — I hadn't gone there first due to an insurance conundrum impossible to express in words. So I walked over, planning to get my blood work order and return. But once in the comforting office of a doctor I've been seeing for 20 years, I decided to just get my blood drawn there.
     That evening I received a brisk email titled, "Test result available on Portal." Half the time I can't even log into these things but somehow managed. Checking your results can be fraught — I'm not a doctor, and interpreting raw data can be confusing and scary. I began on my "Comp Metabolic Panel" and didn't have to get far. Front and center, the first item was: "GLUCOSE 318" while the "REFERENCE RANGE" was "60 - 99 (mg/dL)."
     That was all too clear: My blood sugar was triple what it should be. Part of the advice Dr. Google gave was to proceed to a hospital immediately. "Do not delay."

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26 comments:

  1. That bloodtest is more accurate if taken when you have fasted for 12 hrs or so.

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  2. So very sorry to read this. Also glad you're on the road to getting it before it gets you.

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  3. Diabetes is controllable and some great advances are in store. Praying for you.

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  4. Please take good care of yourself and know you have lots of us fans here who are sending healing thoughts your way. No matter what challenges are facing me daily, my days are better because of you! So appreciate your generosity in sharing your thoughts and talents with us with such eloquence and grace.

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  5. Please follow doc's orders. You're not done.

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  6. Metformin gave me the worst stomach ache I've ever had. Fortunately there is an alternative drug, The insurance company vetoed it. Jumped through hoops, gnashed my teeth, cursed the system, blood pressure rose. After a prescribed period of unnecessary, sadistic rejection, the new drug was approved. No stomach ache, works great, insurance company lost one ten billionth of this years profit. I can't say the illness out loud either - not a club anyone would aspire to.

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    1. Metformin ER [extended release] is better than regular Metformin.

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  7. That stinks. Glad you quickly saw your doctor. Best wishes for your health.

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  8. Hi Neil. Sorry to hear of your affliction, grateful the medications are there to combat them.

    Most important, grapefruit is not banned for all statins. I’ve been on Crestor (now in generic form with an unpronounceable name starting with “R”) for 15 years, and it is entirely unperturbed by grapefruit. Not so Lipitor, alas. Check with your doc to see if you can use a grapefruit-compatible statin.

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  9. Sorry about your issues, Mr. S. Diabetes is no joke. Our friend's adult daughter has had to inject herself with insulin for many years. That's the only solution for her type of diabetes...there's no cure. Unless you happen to be a lucky kitty. Six months of shooting up our big tuxedo boy cured him. It's rare, but it happens. With dogs and people, not so much. Actually...not at all.

    Know the pain of having to eschew grapefruits, instead of being able to chew them, thanks to years of statins for my cholesterol. Used to devour everything inside, even the lining, leaving only the hollowed-out yellow skin. Also guzzled down grapefruit juice, with or without the vodka. Can't even drink Squirt anymore, dammit...it has grapefruit juice, too. Do they still make it?

    Never saw the word "wetware" until now. Wetware is a term for the human brain, or a human being, especially with regard to their logical and computational abilities. And , of course, anyone who's ever watched an old horror movie knows that brains are wet.

    Seeing that word also made me think of "wet work,"...Russian criminal slang for covert assassination, often performed by government operatives, and an allusion to the spilling of blood. So wet work involving wetware would mean a bullet in the brain. Etymology...word sleuthing...can be such fun.

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    1. I'd never heard of "wetware" either, but I have to say I like it marginally better than "meatspace," which apparently means "the real world."

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  10. My dad has had Diabetes for as long as i can remember. His mother died from complications of mismanaging diabetes; father also had diabetes. His brother had it as well, but managed it very differently than my father. Wilford Brimley also has diabetes.

    For a long time I would always think "man... that stinks. he can't have any of the good food." as I've slowly aged I've realized my dad had a leg up on everyone. He got to avoid the ultra processed crap that is terrible for us. I learned a lot (unintentionally) growing up about how to make the most of food with what you have. And i think it's served me well.

    Diabetes is just an annoyance at this point. Be smart. Work out. Eat a little different. Explore the world of culinary chaos that is there and you'll probably end up being healthier than you were before.

    There are some things the world has gotten better at... living with diabetes is one of them. Just look at what life as a vegan looks like these days.

    Chin up; its better than a sharp stick in the eye.

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  11. By the way, some of us prefer “warmware” to “wetware.” Less ooky.

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  12. One of my grandfathers died of diabetes (in 1926), the other grandfather died of a heart attack in the 40s. My father and one of my brothers and one of my sisters also succumbed to heart attacks. So, I wasn't particularly shocked when doctors told me 25 years ago that they needed to crack my chest and bypass a few clogged arteries.

    But I love my sweets and have always drank a lot of water, which led me to get tested for diabetes a few years before the bypasses. Needless to say, I passed the test, but the fear of the disease still lurks in my mind and I do limit my consumption of sugar to a smidgeon of cake or doughnut when drinking my morning coffee. And I would be shocked indeed if the ailment that felled my mother's father might find me out to administer the coup de grace to a pretty long somewhat exhausting life.

    So, considering that your diabetes diagnosis seems to have appeared out of nowhere, I can understand the horror of your discovering its appearance and I certainly sympathize with your situation. And will pray for you and your family, as I'm sure thousands of other readers will do as well, no doubt with a great deal more efficacy than possible for me.

    John

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  13. When you publish a column like this, you risk receiving unsolicited advice. So here's mine: Stevia and sugar-free ice cream from Rebel Creameries. I've tried several brands since I was diagnosed as prediabetic, and Rebel is my favorite. (Only it ain't cheap.)

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    1. carb smart by breyers isn't bad and alot cheaper than rebel. rebel is good but the price is unpalatable!

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  14. So sorry to hear the latest medical news, but glad you have a plan to treat it. (also good luck with the insurance issues). Continuous glucose monitors finally became available to non-diabetics recently, and i was finally, finally able to discover which foods sent my glucose soaring. How about an apple!? (apples are generally recommended as a 'low-glycemic" choice, but I've since learned it depends on the variety of apple. Hmmm. ). You often write about food, and you do so very well. Your descriptions have been tantalizing to me, especially when you talk about bread. perhaps with the meds you will be able to indulge from time to time. Something else I learned is that al dente pasta that has been cooked, chilled, then re-heated becomes a bit "starch-resistant", and thus better tolerated. The prognosis needn't be all gloom. Enjoy the discoveries of your new menu plans!

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  15. Make sure to get your wedding band resized. When I got type 2 I lost so much weight so fast that one day it just fell off my finger without me noticing it. We finally found after a lot of searching.

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  16. Sorry you have to deal with this, but as with all the other issues you write about, you are facing it head-on. Dick van Dyke once described aging in this way: "Every once in awhile, you wake up and something that used to work doesn't anymore." At 78, I now know what he was talking about. Like many others, I'll be thinking about you.

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  17. I'm sorry to hear about the medical adventure. Hope you and your family aren't too worried. The doctors seem to have this thing pretty well in hand now.

    An insurance conundrum impossible for *you* to express in words must be quite the humdinger. Best of luck with everything!

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  18. Did they test your A1C level or whatever it's called that tests what your average glucose level has been for the last 3 months? My dr. wrote up orders for me to get that test done about 6 months ago but I have lollygagged around & not done it yet. I guess I had better put that on my short term to-do list.

    My older brother has been a diabetic for probably about 40 years - he turned 70 in March. He was "on the needle" (that's what they call it here in the South: when you have to give yourself insulin shots - usually in the belly) for years & years. But the medical field has advanced over the years & now he just takes pills. He still has to test his blood several times a day & adjust his pills accordingly. And of course, there's the diet.... He has lived like this so long it does not phase him. He owns his own business & works a lot - just like the rest of us self-employed people who actually earn our living that way!

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  19. Please don't call yourself an alcoholic just because you previously had an alcohol use disorder. You stopped drinking alcohol years ago. Now you are just a person who chooses not to consume beverages containing alcohol. I am coming up on my 2 year anniversary since I choose to stop consuming beverages that contain alcohol. I had an alcohol use disorder for years but stopped cold turkey due to an event (somewhat like your turning event) which made me realize I was slowly killing myself with the stuff & also ruining my marriage. So far, it has been easier than I expected. I hardly think about it any more. It has opened up so much time for me to do a lot of things I always wanted to do but didn't because I had been drinking & I NEVER did drink & drive. So I am actually enjoying life more now.

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  20. This is Kate from Chicago - my heart goes out to you Neil! I'm sure it was quite a shock and there's no small comfort in knowing that you are not alone in adjusting to this disease. However, once it's stabilized I hope you will embrace the healthy diet that ADA offers and know that there's lots and lots out there to enjoy! Due to meds and a prescribed non-acid diet I haven't had one of my favorite fruits - grapefruit - in 20+ years. One adjusts. Please take care!

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  21. My sympathies. Were you diagnosed as pre-diabetic? If so, what steps were you asked to take? How is your diet and exercise? Why weren't you put on medication?

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    1. That's the odd thing. My glucose was 105 at my last check-up, and 311 now. My doctor said it was like a switch going off. I exercise regularly and my weight was pretty good — I weighed less than when I got married, 34 years ago. It's puzzling.

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