From: lydick@SOL1.GPS.CALTECH.EDU (Speaker-to-Minerals)
Newsgroups: alt.callahans
Subject: On the razor's edge, or:  Hyperglycemia or Hypoglycemia, that is the question
Date: 28 Sep 92 05:02:36 GMT
Reply-To: lydick@SOL1.GPS.CALTECH.EDU
Organization: HST Wide Field/Planetary Camera
NNTP-Posting-Host: sol1.gps.caltech.edu

StM curses (anybody who might be offended should do whatever's necessary to
skip the next screen, or, if you've got a bit of self-control, you might just
ignore it)

SHITPISSCUNTFUCKMOTHERFUCKERCOCKSUCKERTITSCHROWLANYGODTHATMIGHTEXIST

Ok, now that I've said the seven words you can't (according to George Carlan)
say on television and given the anglicized version of the Kzin equivalent of
TANJ (remember, we Kzinti ARE somewhat agressive), let me get to the matter at
hand.

A while back, I asked the group for help.  In particular, I admitted that I was
somewhat suicidal;  I pointed out a means of suicide; and I pointed out that I
valued the peace of mind of my fellow Callahanians enough that, given you knew
about that means of suicide, it was now closed to me.

I screwed up royally by doing that.  Well, it seemed like a good idea at the
time.  But now I'm back on insulin.  This post is the first part of a
description of what I face if I *DON'T* take insulin regularly.  There will be
a second post detailing what happened *AFTER* my ulcer started bleeding.  The
post will be at least somewhat humorous.  But please feel free to skip both
part 1 and part 2 of this series if you've got a weak stomach (pun intended; 
after all, this IS Callahan's place).  The second part will describe my stay in
a hospital, and might be interesting to fellow Callahanians, in that most of
what you've heard about hospitals has been written either by:
	1)  Doctors (there was a best-seller about this topic a few months ago)
or
	2)  People who are afraid to argue with doctors.
My experience may be rather uncommon:  That of a well-informed layman who's
willing to question everything that goes on, but who realizes that he can't
simply order the staff about.  Actually, I got on well with the hospital staff.
Anyway, here's the long and the short of how I ended up in hospital (it may not 
be very coherent, but neither was I at the time).

To recap:  I pointed out that, in my refrigerator, I had a vial of insulin.  I
pointed out that a diabetic could easily OD on insulin and it would be
considered an accident.  I told you that I was no longer insulin-dependent.

The first is true (though it's now a NEW bottle of insulin).  The second is
still true (I came closer than my doctor would like this afternoon).  The third
is no longer true.  Or, in the words of my doctor (Rhonda Kamoku):  "The
honeymoon's over."

Yes, I am back on insulin, on doctor's orders.  Let's open an X-window on the
week or so starting on August 11 (those of you who don't care or who are TOO
empathic should skip the rest of this post;  Kitten:  Even if you skip the rest
of the post, please e-mail me for a description of my acute hypoglycemic
episode;  it might help us both (or at least one of us) to compare notes:

August 11:  Carl, at about noon, checks his serum glucose level.  It's about
100 mg/dL.  That's fine (normal range is 80-120 mg/dL).  He's been checking it
more often (until a couple of weeks ago, he'd been checking only before
breakfast and before retiring;  now he's checking it before lunch and dinner
as well) since some job stress (*NOT* his boss's fault!  Carl's a workaholic
and took on a MAJOR workload that his boss didn't even have a clue about,
though it *WAS* related to Carl's job; details on request) had increased the
variance of his blood sugar levels.  For the last couple of days, the variance
also seems to have come down to reasonable levels (~20 mg/dL).  Nevertheless,
Carl has a talk with his boss, Jim Westphal.  Now, it turns out that Jim hired
Carl when Carl's previous boss fired Carl for being unreliable (though, since
both jobs were with Caltech, technically Carl was never fired;  turns out, as
best I can tell, that, in this case, TWSJ [there WAS some justice], but I could
be wrong, or just prejudiced).  Carl, who's been diagnosed as a diabetic since
Jim hired him, notices that the symptoms he's seeing now under somewhat severe
job stress (three different people whose needs Carl considers it his job to
meet have, in the course of two weeks, told Carl about problems that it's going
to take about 5 man-weeks to solve, and it's important that ALL these problems
be solved NOW!) are IDENTICAL to the problems he had when he was fired from his
previous job (though the stress under the previous job was about twice what
he's experiencing now), and points out to Jim that he is, as best he can tell,
physiologically incapable of performing his job as he sees it (i.e., Carl
submits a resignation).

Jim refuses the resignation (well, that's not a REAL big surprize;  the first
thing he said to Carl after hiring him was, and I quote, "If you're not having
fun, *I* must be doing something wrong" [now, that's the kind of boss to have,
unless, like me, you're bothered by working for someone who's *TOO* forgiving])
and has a meeting with Carl to figure out how to reduce the stress to levels
that won't cause Carl medical problems.  They reached an agreement.  First of
all, nobody else in the WF/PC group any longer had the right to ask for help
from Carl;  it's now a privilege.  Second, Carl now has explicit permission to
bump things up to Jim (prior to this, Carl would only bump decisions up to Jim
that he decided [frequently after hours or days of consideration] were beyond
his competence [boy, was this one rare!  Gives you an idea of Carl's opinion of
himself] or authority [boy, was this one common!  Gives you an idea of Carl's
opinion of others' opinions of Carl];  now, any time Carl can't make a snap
decision, Jim's to be talked to [well, except for right now, when he's out of
town;  <Hey, DJ, I think the group would like to know that the *OTHER* DJ (if
that's not a good nickname for my boss, I don't know what is) is up to at the
moment;  could I borrow Linda and Robbie (I've got specific reasons for wanting
both of them, and the Bar-bee-que is *GUARANTEED* inedible) to report on my
boss's current project?> <was that enough levels of inclusion for y'all?>])
whenever Carl finds that making the decision puts too much stress on him. 
Third, Jim now has instructions to order Carl to go home if he's got reason to
believe Carl's been at work for more than 16 hours in a row (I think my record,
while working for Jim, is 65 hours;  for Harvey, my previous boss, I might've
managed 81).

Anyway, the upshot is, Jim and Carl agreed on a stress reduction program. 
Somehow, they forgot to include mother nature.  

August 12:  Carl starts to come down with a summer cold.  Serum glucose still
normal.

August 13:  The summer cold gets worse.  Carl starts to lose his apptite; 
serum glucose still normal;

August 14:  The cold peaks.  Carl has *NO* appetite.  He makes the mistake of
not eating.  Serum glucose at 12:00:  ~100mg/dL.  Sounds fine, doesn't it?  But,
you see, Carl's body was figuring out at this point that it could metabolize
fats and proteins (since Carl hadn't given it any sugar to feed on).

20:00  Carl experiences nausea.

22:00  Carl begins vomiting.  At least once every five minutes

August 15: 10:00:  Carl's HMO opens (about 15 miles away), and, still vomiting,
Carl decides he might be in trouble.  He checks his blood glucose level:  287.
That's *NOT* good.  Carl doesn't quite realize just now far from good that IS
(of course, when your serum glucose level is that high, you're not expected to
understand much of anything;  that's half the problem) He calls his nearest
friend who owns a car.  The phone's busy.  BUMMER!

But, Carl has an inspiration:  He calls the nearest BAR!  (did any of you think
that Callahans was REALLY all that special?  It's not.  You can find bars VERY
much like it anyplace you go.  The only special thing about Callahans is that
you don't have to show up a dozen times before you become a regular [I'm
willing to debate this issue;  if any of you disagree with what I've said,
please begin a separate thread with a subject of "Is Callahans unique?"]. 
Well, actually, it's a bar and restaraunt.  The manager (Eleno) answers:
(Debra is the bartender);  (Carl's apartment is owned by the bar's owner); 
(for any history buffs out there, the section of Colorado Blvd. AND Huntington
Drive involved is Rte. 66)
	Eleno:	Amigo's; can I help you?
	Carl:	Could I speak to the bartender please?
	Eleno:	Certainly, Carl
	Debra:	Amigo's; can I help you?
	Carl:	Hi, Debra.  I hate to be a pest, but I need a ride to Arcadia;
		It's an emergency;  is there anybody there who might be willing
		to takee me?
	Debra:	Uh, Carl, there's nobody here yet.  Let me talk to Eleno.
	Eleno:	Carl?  I'll meet you at your apartment in 5 minutes.
	Carl:	You know how to find it?
	Eleno:	Sure
5 minutes later Eleno drives up to Carl's apartment.  Carl gets in Eleno's car.
	Eleno:	Where are we going?
	Carl:	Cigna Health Center, on Huntington, in Arcadia;  the best way
		I know to get there is just go east on Colorado Blvd.
(some discussion of freeways and/or just driving east on Huntington drive from
San Marino follows.  The upshot is that the *ONLY* way Carl knows to get to the
health center is "drive east on Colorado until you hit Huntington.  Keep going
'til you see the AAA sign.  That's where we're going" (I never claimed that
Carl was compos mentis at this point!).

Eleno notices that Carl isn't his normal self, and considers the difference to
be serious enough to be important.
	Eleno:	Carl, if I see a police car, should I ask them to provide an
		escort?
	Carl:	No, I don't think it's that much of an emergency
They arrive at the health center.  Carl has already diagnosed his problem
(yeah, I know, that's not unusual, but it turns our Carl was RIGHT!).  Carl
walks up to the urgent care desk and says:
	"Hello.  Here's my card.  I'm a diabetic, and I think I've gone
	 ketotic."
The receptionise, of course, doesn't have the vaguest idea what Carl's talking
about.  When Carl mentions diziness and shortness of breath, however, she perks
up (obviously, Carl's having a HEART ATTACK!  Right!).  Carl gets quick
attention.  He repeats his description of his problem, almost verbatim, to the
nurse, who asks "Have you ever been in ketoacidosis before?."  Carl answers,
somewhat testily, "Not as far as I know, and I'm NOT NOW.  I said KETOSIS, not
KETOACIDOSIS!"  The nurse walks off in a huff.  It later turns out that Carl
was right:  he was ketotic, but not suffering from ketoacidosis (Ketotic:  His
uring and his sweat contained a hell of a lot more ketones [mainly acetone]
than is normal;  ketoacidosis requires that the blood be similarly affected,
and that the pH of the blood be lower than normal.  They weren't.  Most medical
personnel *HATE* it when a patient knows what's going on."
	Anyway, Carl gets admited, and gets an injection to relieve the nausea.
Doesn't help.  He keeps puking anyway.  Dry heaves.  For a while.  Oops. 
Eventually, this viscous purple stuff comes up.  A doctor comes by and looks
upset about it.  Carl doesn't understand.  Until about 5 minutes later, when a
*LOT* (say about a pint, or, for the stuff we're talking about, a UNIT) of dark
purple non-viscous liquid (looks like coffee grounds except for color) comes
up.  One of the less discreet people in the vicinity lets it slip that what has
just issed from Carl's innards is commonly known as "blood."
	*To be continued (hey, at least you know that the hero survives)*
From: daq@hpfcso.FC.HP.COM (Doug Quarnstrom)
Date: Thu, 1 Oct 1992 22:19:49 GMT
Subject: Re: Speaker for the Dead
Organization: Hewlett-Packard, Fort Collins, CO, USA