Posted on by Fred · 1 Comment

Diabetes and Depression

Understanding those who are outwardly like us is difficult enough.  Understanding people who are significantly different from us is an almost impossible task.  Today I’m going to help you understand some Diabetics.  I wouldn’t dream of speaking for all of them.  We’re all unique, and all our struggles are our own.  No one shares all of them.  There are obstacles some face that others don’t.  But there are a few that are common to all of us.  And one struggle that Diabetics are more likely to face than other people is Depression. 

I did an episode about Diabetes and Depression combined with Autism about a year ago.  There is worthwhile information there, and I recommend reading or listening to it if this is an interesting topic for you.  The podcast and the blog post are linked in the transcript.

Diabetes and Depression and Autism, Oh My!

Diabetics are at least twice as likely to suffer from Depression as those who don’t have this chronic disease.  Why is this?  First, there may be neurological reasons involved.  It’s not just that we’re “feeling sorry for ourselves.” 

It’s thought that alterations in brain chemistry tied to diabetes may be related to the development of depression.  For example, damage resulting from diabetic neuropathy or blocked blood vessels in the brain may contribute to the development of depression in people with diabetes.

Conversely, changes in the brain due to depression may cause an increased risk for complications.  Studies have shown that people with depression are at higher risk for diabetes complications — but it hasn’t been determined if depression increases the risk for complications, or vice versa.

https://www.healthline.com/health/type-2-diabetes/depression#research

At the same time, there are elements of Diabetes, itself, that can cause Depression.  There is the undeniable fact that if we make a mistake, we can die.  That’s something those constructing a skyscraper must face, but when they’re done for the day, they can go home.  The stress is probably more intense, but it doesn’t last as long.  The possibility of dying is with us all day, every day.  The best we can hope for is to keep our Diabetes sufficiently well controlled that the stress becomes less intense.

The inescapable fact is that if we want to live, we become slaves to our Diabetes.  It demands choices we may not always want to make at any given moment.

There’s also a sense of alienation that can often accompany Diabetes.  We’re clearly different.  You don’t see it the way you would a broken leg or a scar on our face, but we’re the ones who are supposed to choose only the right foods to eat.  If we do, we look different from those around us.  If we don’t, we may get shamed for it.  This isn’t something I just invented. 

For example, people with type 2 diabetes intentionally choose unhealthy food because they do not want to refuse what is offered by others around them,15 or delay insulin dosing and blood glucose monitoring because they are concerned about the reactions of others.13 14 16

— https://drc.bmj.com/content/10/6/e003001

That shame, itself, can be deadly.  It was something with which I dealt successfully, I believe, almost immediately when I was diagnosed.  I was a teacher 30 years ago when my doctor tested my blood sugar and told me, as matter-of-factly as if she was telling me it might rain today in Seattle, that I was Diabetic.  I felt terror in that first moment.  My only experience with Diabetes at that point was seeing my best friend from high school, a Brittle Diabetic named David, flopping on the ground like a fish that had just been tossed on the deck of a boat.  I didn’t like the thought of that happening to me.  Although Diabetes has all but killed me nearly 2 dozen times, I’ve never had that experience.  I’m grateful for that.

Dave hid his Diabetes from most of his friends, or at least he tried.  His mother told me about it the first time I ever went to their house.  Dave acted like it was no big deal.  I think it embarrassed him.  Getting him to eat when he ought to was often a difficult task. 

When I was diagnosed, the first thing I did when I got back to school was tell everyone there.  All my colleagues knew.  I set up students whose job was to get the nurse and call 911 if I lost consciousness.  I was still enjoying being alive in those days.  I had no interest in dying.  I was still young and trying my best to be in love with my wife. 

I saw no reason to be embarrassed.  Neither should you.  We didn’t do something to become Diabetic.  Even if we did, there’s nothing to be done about it now, and we still deserve to live as long and as well as we can.  The list of things of which I’m ashamed is long, but having a disease isn’t on it. 

If you have Diabetic friends, please help them by understanding their Depression is almost certainly not self-pity.  It is both biological and situational.  There’s little they can do about it.  At the same time…

Diabetes often seems to be an invitation to the world to tell us how to live our lives.  These are good, caring people who love us.  We have to be grateful.  Nevertheless, it’s more than annoying.  We’re shamed for the choices we make, and if we don’t make the choices others would like us to make, we’re told it’s our own fault.  Their concern for us instantly evaporates.  It’s one more thing about which they never need to worry again. 

This is among the reasons I never leave my house.  At least if people on Facebook say such things, I have the option to ignore or delete it.  When they’re right in front of me, I’m required to listen, and I would rather leap off The Golden Gate Bridge than be told how to live my life.  I’m divorced… twice… and that’s probably a lot of the reason for my marital failures.

I’ve found a few things that help me deal with my Depression.  The first is to take stock of my situation in the most objective terms possible.  I ask myself the following questions:

  1.  Do I have a safe place to live? 

The answer to this is not always yes.  When I know I’m not in a safe place, I know where I need to focus the energy I still have left.  That always has to be our first priority.  Is there a way out?  Where can you go to be safe?  This is a difficult problem, and I don’t have an easy solution for you.  In my own case, I had friends who wouldn’t allow me to be in danger, and several of them worked together to get me here.  I always remember how lucky I am.  This is a big part of why I want to change the world.  No one should be required to live in a situation in which they feel they could be in jeopardy.

When the answer is yes, I can move on to the next question.  I like to stop, though, and take a moment to recognize how fortunate I am to have that much security.

  •  Do I have enough food to eat? 

    Again, the answer to this has not always been yes.  When I don’t have enough to eat, this has to be the next priority.  When you’re Diabetic, it’s not just a question of being hungry.  It’s a matter of life and death.  I’m fortunate that I have enough people in my life who love me so that I can usually solve this problem by asking someone for help. 

    Yes, it’s humiliating, but I remind myself that my friends would rather give me $100 than have to attend my Memorial, or if you’re my best friend, have to haul my dead body out of this house.  I don’t smell all that great in the best of times; I’m probably going to reek if I’ve been lying here dead for a couple of days.  $100 is a cheap price to pay for avoiding all that.

    If you have no one to ask for food, there are always charities available that will get you something to eat.  I understand how horrible it is to ask them for help, but sometimes there’s nothing else that can be done.  You’re not quite ready to die, yet.  There are still possibilities.  We don’t get to give up until we’ve exhausted all our options.
  • Do I have all the insulin and other medications I need to survive?

    This can be a more difficult problem to solve.  I don’t have a lot of friends who have insulin sitting in their refrigerator who can drop some off for me.  That said, one of The People on The Porch did exactly that when I was running out of Lantus.  I still don’t know how he worked it out, and I don’t need to know.  I just know I was grateful. 

    It can’t always be solved without enough money.  If prescriptions aren’t handled properly, insurance may not cover it.  Sometimes you need to hope you can find the cash to buy it.  Fortunately, a few companies are doing what they can to lower prices. 

    If you can’t obtain insulin any other way, it can come down to having to go to the Emergency Room before you fall into DKA.  They have to keep you alive whether you have money or not. 
  • Do I have a future beyond simply maintaining this meat sack I call a body?

    This is the one that makes the decision to keep going possible.  In my case, I know I can always write.  I know I can still make a little difference for someone, somewhere, and this is sufficient reason to keep going. 

    You can ask what it is you can still do in life that will matter.  I can’t tell you your purpose.  I promise you have one though.  Find that and move forward.

Another method for dealing with Depression is to accept its existence, recognize it’s a feeling just like any other, and know that, just like any other feeling, it will pass.  Sometimes it’s okay to wallow in it for a little while.  I’ve written some pretty good stuff when my Depression was at its peak.  And the act of writing helps defeat the lethargy that is a feature of Depression.

The last method I have is to find someone you can talk to about it.  One of the best people I know is frequently attacked by a sense of doom and despair.  She knows she can call me when that happens.  And she does.  And we get through it together.  I’m fortunate to have so many people in my life who love me and will talk to me when I need to get some of the sadness out.

If you’re Diabetic, keep in mind that you’re not alone.  There are more than half a billion of us running around.  You’re not the only one walking that tightrope.  There are people with whom you can talk, and there’s no more shame in medication or counseling for your Depression than there is in taking insulin or talking to your Diabetes Educator.  You wouldn’t walk a tightrope without professional guidance. 



Diabetes is a difficult disease to handle.  There are things we can do to help ourselves.  There are things others can do to help us.  Get the sort of help that’s right for you.  You’re still a valuable person.  You matter to others.  The world still needs whatever you have to contribute.  Just get through another night, and we’ll see what tomorrow brings.  If no one else has told you today, it wouldn’t hurt to hear it from me.  I love you. 

Posted on by Fred

Speedy Shine’s Backyard Dogcast Episode 2

Keeping The Smelly Old Man Alive

I love The Smelly Old Man, but I don’t think he’s The Perkiest Puppy in The Pound.  A lot of the times he’s about ready to go to The Room Where The Dogsers Don’t Come Back, and he just sleeps through it. 

Sometimes he stops breathinging.  I can hear him even when I am having my Sleepy Time.  When I feel his tummy going up and down it helps me to go to The Place Where There’s No Wallsers or Fenceses and I Can Zoomie and Get All The Peoples Who Try To Come In My Backyard.  Then his tummy stops moving, and I have to come back and jump on him so he openses his eyesers and sits up.  He doesn’t like it, but he gives me kisseses anyway and tells me I’m The Best Good Boy.  I already knew that, but I think it makes him feel important to tell me.  He’s a silly Smelly Old Man. 

Sometimes I can smell he’s getting in trouble.  He smells like lots of fruitsers and I have to get him up so he can go into the place with the round chair with a hole in it and stick himself with one of the little toysers I don’t get to chew on.  Sometimes he loses all his smells and then it’s really hard to make him sit up and get some loves.  I have to jump on him lots of times.  I have to use my whiskerses to wake him up and I have to get under his hand so he has to give me pets and loves.  One time I had to get off the bed and get a running start from the floor so I landeded on his chest so hard he jumpeded up like a dog he didn’t like was sniffing his butt.

Once he’s up we go out into the big room and he does his Worksers.  I wait until Pretty Girl comes in her big metal thing with the round parts at the bottom to take him away before I can do my worksers.  She should come and see him more times because he’s always Shinier after she does, and then I could do more Dogcasts.  All the other hoomans know mine is better than his. 

It’s not his fault.  He likes to talk a lot, but he doesn’t talk about anything that really matters.  He never talks about Treatsers.  He doesn’t think about which toysers are best for when you want to chew the soft things and take out the floofsers.  Since he gets all sad when I do that, he needs to get me better toysers I can chew when I need soft ones instead of the ones that go clonk when I drop them. 

As long as I can keep him alive, though, there’s still time for him to learn.  I will help him.  I’m Speedy Shine.  That’s what I do. 

Posted on by Fred · 2 Comments

Facing Death Daily: Diabetes 102

A good friend, who is also a Front Porch Podcast Producer and an Unofficial Patron Saint, asked me to write about what it’s like to face death daily.  That sounds melodramatic, and I don’t intend it that way.  I’m not a police officer, firefighter, or member of the military.  People don’t make any special effort to kill me.  I’m just not that important.  I have little of value to steal.  The studio setup would probably get you a few dollars at a Pawn Shop.  There’s certainly not enough to risk going to prison for the rest of your life, or, worse, having Speedy Shine jump on you.  If you try to pick him up, he’ll probably bite you.  We’re working on that.  I have some PetSmart virtual training coming up in a couple of weeks.

Nevertheless, I do, in fact, have to recognize that if I lose balance, I can die before I even finish writing this episode.  We covered the details of diabetes last week, and I’m not going to go through them again beyond the context you need to understand this.  Please refer to “The Tightrope of Diabetes,” which is Episode 197 if you’re scrolling through the show looking for it. 

Diabetes is not the only danger I face. I haven’t been able to feel my feet in nearly seven years.  I can fall, and if I’m not careful, I will.  I might be lucky enough not to hurt myself too seriously, and perhaps I’ll be able to get up again, but that is by no means certain.  I no longer have the rubber bones we all seem to have when we’re toddlers.  Mine are old and brittle, ready to snap at the earliest opportunity. 

I live alone, so if I’m unable to get up, unless I have my phone on me, I will just lie there until someone decides to come and check on me.  Stephanie, my best friend, certainly would, but it could be as much as 24 hours before she did.  In that time, it would be simple to slip into either DKA or a coma.  Either way I would be equally dead. 

DKA, for a brief review, is Diabetic Ketoacidosis.  This occurs when your blood sugar gets too high, (at least 250 milligrams per deciliter, which is the measurement used in America, and 11.36 millimoles per liter in The UK) and your body begins to throw off ketones.  I usually need to get above 400 before I’m in trouble.  You may be different.  These can be measured by peeing onto a special strip.  The darker the strip turns, the worse shape you’re in.  DKA will dehydrate you, and if you don’t stop it in time, you will begin to vomit, thereby further dehydrating yourself.  Without hospitalization, you will surely die an ugly death.  When they take you to the hospital you’re unreasonably thirsty, and they won’t give you any water because you’ll just throw it up and make things worse.  They hook you up to IVs to start repairing all the damage.  I can’t begin to tell you how little fun it is to be hooked up to IVs. 

If your blood sugar gets too low, (below 70 mg/dL is dangerous, below 54 mg/dL is severe) you’re no longer able to think coherently.  While I know, right now, that if my numbers drop, I need to eat, when it gets too low, I may not know that anymore.  When it gets low enough, I’ll slip into a coma.  I had a friend who died this way.  My former roommates saved me from that several times.  I live alone with Speedy Shine now. 

I’m not overstating the case when I say I face the possibility of death daily. 

My friend wanted to know how I manage this.  I think it’s worth discussing because, once again, I’m not unique in this struggle.  There are more than half a billion of us on Earth right now.  One of us dies from diabetes every 5 seconds.  There is a wealth of diabetes information in the link below.

Home

First, for me, it’s about acceptance.  I’m the least Christian person you probably know, but there is one prayer I love above all others.  Just as “Shine,” by Sara Niemietz and Snuffy Walden, is my favorite hymn, this is my favorite prayer.

Attributed to Reinhold Niebuhr, Lutheran theologian (1892–1971)

God, grant me the Serenity to accept the things I cannot change,
the Courage to change the things I can,
and the Wisdom to know the difference.

I can’t tell you a thing about God.  You can find billions of others for that.  I can tell you, though, that serenity, courage, and wisdom are essential for me.

Serenity

The first step is accepting that I can’t change my diabetes.  I checked on Amazon, and it turns out they don’t have a new pancreas to replace mine.  They don’t have new legs to replace mine, either, so I need to continue to be as careful as I can. 

Death is one of the few things that truly is inevitable.  The healthiest human on Earth, with all the best medical care, is still going to expire within less than 2 centuries.  There is nothing to be done to change that… at least right now.  I keep hoping for a world in which science finds a way for us to all live indefinitely.  I believe it’s possible.  I don’t believe we’re there yet.  I don’t believe we’ll make it within my lifetime.  I’ve heard of a little baby named Layla.  She’s the granddaughter of my coach.  I hope she gets to live indefinitely.  I hope all her ancestors will, too.

“I do not fear death.  I had been dead for billions and billions of years before I was born, and had not suffered the slightest inconvenience from it.”

― Mark Twain

I can’t find evidence Twain actually said this.  Lots of sites attribute it to him, but I was unable to find the book, or lecture, or letter in which he said it.  Whether he said it or not, the point is worth considering.  Death is a natural state. 

I feared it when I was a child.  I used to have dreams of lying in my coffin, completely unable to move, while worms worked their way inside it and inevitably consumed me, excruciatingly slowly, bit by bit.  As I grew up and began to understand death a little more clearly, it dawned on me that I couldn’t possibly suffer in the way I did in so many nightmares.  There will be no Fred there to experience it.  Whatever it is that makes me Fred will be absent when my heart stops beating and my brain shuts down.  I will be a computer that has been turned off.  I can’t be turned on again, regardless of the Genesis song.  (If you haven’t ever heard “Turn It On Again,” you really should find it on Spotify.)  I’m not Teddy.  All that said, I’m still hoping to be cremated.  I would like my ashes dumped into San Francisco Bay near the place we end up putting my parents’ ashes when the time comes. 

There’s a line from Katherine Hepburn has in On Golden Pond…

Oh… it feels odd.  Cold, I guess.  Not that bad, really.  Not so frightening.  Almost comforting.  Not such a bad place to go.  I don’t know!

— Ernest Thompson from his screenplay, 1981

I feel that way.  I know it will happen, and to a certain extent it will be a relief.  I can’t get in trouble anymore.  I don’t have to worry about whether anyone likes my writing or listens to my show.  I don’t need to seek any longer the sexual satisfaction that diabetes has stolen from me.  And from that, I draw…

High line walker between two rocks concept of risk taking and challenge

Courage

I’m not a fool.  I recognize that I’m in peril every day.  While I was writing this my Continuous Glucose Monitor (CGM) went off to tell me my blood sugar was perilously low.  I should eat dinner, but I’m deep into my writing session, and I don’t want to stop right now.  I went to the bathroom and got some glucose tablets.  They’ll buy me enough time to finish this… I hope.  I hate to stop when the words are ready to come out.  If I stop them, I can’t necessarily just turn on the faucet again.

Courage isn’t being without fear.  It’s being able to recognize that fear and keep it from keeping you from doing what you know you should be doing.  In my case, what I should be doing is writing and recording as much as I can as quickly as I can.  I want to make all the difference I can before I can’t anymore.  I live by the words of Emily Dickinson:

“If I can stop one heart from breaking”

By: Emily Dickinson

If I can stop one heart from breaking,
I shall not live in vain;
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.

Emily Dickinson

I don’t have any heroism in the traditional sense in me.  I won’t be rescuing a baby from a burning building.  I couldn’t even get inside of a building of any sort without some kind of help.  The only thing I can do to improve the world is what I’m doing every single week on this show.  I’m talking about ways to improve the world in the hope that someone, somewhere, will respond.  I’m hoping someone will make the changes I can’t. 

Supposedly, Albert Camus said, “To believe you can change the world is insanity; failure to try is cowardice.”  I can’t verify that, however, and I have only my late father’s word for it.  Once again, though, it doesn’t matter who said it.  The idea is correct. 

I have no more chance at success than either Atticus Finch or Hemingway’s Santiago.  And I have the same moral responsibility to try. 

I wanted you to see what real courage is, instead of getting the idea that courage is a man with a gun in his hand.  It’s when you know you’re licked before you begin, but you begin anyway and see it through no matter what.

–Atticus Finch in To Kill a Mockingbird by Harper Lee

Here I am seeing it through.  That’s what courage is to me.

Wisdom

This is the most difficult to obtain.  It’s not simply possession of a set of facts.  It involves… oh my… I need to go for a bit.

***

Good morning.  I had to stop last night because, even with the glucose tablets, my blood sugar kept dropping, and I was no longer able to see the screen properly.  My brain began to shut down. 

I grabbed a candy bar.  That should have moved my blood sugar up considerably.  The reading dropped even farther.  I got down to 50, and I felt my heart rate increasing.  That may well have been fear.  I couldn’t think straight at that moment. 

I finally made a bowl of cereal.  That usually forces me to take a lot of insulin to keep from going up too high, and I knew that, but I did it anyway.  I wasn’t going to die if I could help it.

When I began to see colorful spots in front of my eyes, I thought seriously about calling 911.  I don’t want to overreact if I can avoid it.  Even with Medicare and Medicaid, there will be a bill involved that I can’t possibly pay, and I don’t care to take paramedics away from others who may need them more badly.

After about 20 more minutes, I began to be able to think clearly.  My first instinct was to take a shot to counter all the food I just ate.  That would probably have been the best choice, but I was still scared to death.  I couldn’t bring myself to do it.

That, of course, meant that a couple hours later my alarm went off to warn me my glucose was too high.  I took a small shot.  I went back to sleep.  Two hours later when I woke up, it was over 400, which is high as the Libre can count.  I took a bigger shot.  I peed on a keto stick to see if I had ketones.  Since there were no ketones, I was less concerned.  I woke up a few hours later, and I was at 128.  That’s as close to perfect as one is going to get.

***

So… to return to how I handle all this, Wisdom also comes into it.  As I said before I was attacked by my diabetes, it’s more than being in possession of a set of facts.  Last night, I had a set of facts.  I knew how to interpret them, and I knew what I was supposed to do to change the things I can.  Perhaps I lacked the courage to do what my wisdom told me to do.  That’s another sort of balance that is difficult to achieve. 

Life is, I suspect, in one form or another, a balancing act for all of us.  Was it Socrates who called it The Golden Mean?  I could look it up, I suppose, but I don’t care enough to bother.  The idea is valuable.  We need to decide what is most important at any given moment and pay attention to that detail without losing sight of all the other moments that make up a life.  Life is, as John Lennon told us, what happens while we’re busy making other plans.  I was planning to write all night.  Life happened.  Since I managed to recover, I can continue to write this morning.

This is what it is to live daily with the distinct possibility you won’t wake up tomorrow.  It’s a matter of accepting that death isn’t the worst thing that can happen, and that we need to make use of the time in front of us because it can be gone suddenly and permanently.

Depression is a big part of the challenge.  People with diabetes are 2 to 3 times more likely to have depression than people without diabetes.  Only 25% to 50% of people with diabetes who have depression get diagnosed and treated.  But treatment—therapy, medicine, or both—is usually very effective.  And without treatment, depression often gets worse, not better.

That will be in next week’s episode.

For tonight, let’s enjoy the minutes we still have.  Let’s embrace the life in front of us because we have no idea how much more of it we have left.  Let’s Shine while we can.

Posted on by Fred · 2 Comments

The Tightrope of Diabetes

Am I a brittle diabetic?  I’m not a doctor, so I don’t have an informed medical opinion.  I’ve never heard my endocrinologist say I was.  According to The Cleveland Clinic only about 3 out of 1,000 people with insulin dependent diabetes are brittle.  It’s most common in women in their 20s and 30s.

https://my.clevelandclinic.org/health/diseases/21499-brittle-diabetes#:~:text=What%20is%20brittle%20diabetes%3F,hyperglycemia%20(high%20blood%20sugar).

It seems unlikely that I am, then.  On the other hand, the same source tells me that the difference between “normal” diabetes and unstable diabetes is that those with unstable diabetes exhibit these symptoms:

  • Affect their ability to live life normally.  (I’m on Disability because I can’t stand up for any significant length of time)
  • Cause anxiety and depression.  (Hi, I’m Fred.  Have we met?)
  • Lead to hospitalization or even death.  (I’ve been hospitalized way too many times.)

In the last few weeks my blood sugar has been jumping around like a ping pong ball chasing a rabbit on crack.  I have a Continuous Glucose Monitor (CGM) that is very helpful, and it’s shown that I have been dangerously close to falling into a coma at least half a dozen times this month.  I’ve been moving toward Diabetic Ketoacidosis (DKA) three or four times. 

Between my dog, Speedy Shine, and my CGM, I have been alerted in time to save myself.  My dog wakes me up frequently just a few minutes before the CGM starts alarming, both for highs and lows.  To my knowledge, he was never trained for this, but he does it often.  He also does it when I stop breathing.  I hope to have my C-PAP soon, so he won’t need to provide that service anymore.  I have my second sleep study coming up this weekend.  I’m hoping they’ll give me the machine then.  I’d like to get on with it.

I can’t feel my feet anymore, and I nearly lost a toe last October.  This is a symptom of diabetes called neuropathy.  It causes us to lose feelings in our extremities. 

The exact cause of each type of neuropathy is unknown.  Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy.  High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients. 

https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580#:~:text=Researchers%20think%20that%20over%20time,nerves%20with%20oxygen%20and%20nutrients.

A toenail broke off, got stuck in my sock, and cut one of my toes.  I didn’t notice it, and if Speedy Shine hadn’t been trying to eat my foot that morning, I would have become septic.  I was fortunate to have a brilliant surgeon who managed to remove a little piece of bone instead of amputating the entire appendage.  You can hear all about this in the episode “Horror Toes.”  (It’s Episode 177 if you’re scrolling through Spotify or Apple Podcasts searching for it.)

Speaking of feet, they’re essential for tightrope walking.  It’s Rule #3 in ChatGPT’s rules for Tightrope Walkers:

Footwear: Tightrope walkers often wear soft, flexible shoes with thin soles to help them feel the wire beneath their feet and make it easier to maintain balance.

The fact that I can’t feel my feet does much to add to my identity as The Smelly Old Man.  I can’t possibly shower safely.  It’s not a question of if, but when, I will fall.  I’m hoping to get help with this in the next couple of months.  Evidently, I can get a special chair that will prevent me from needing to stand, but it’s getting out with wet feet that worries me.  If Medicare won’t pay for it, it’s a moot point.  There’s no way I can afford that.

The feeling in my fingertips is waning fast.  I have a much more difficult time typing now, and that’s a more serious concern for me than losing a toe.  Writing would be infinitely more difficult for me if I couldn’t type anymore.  If I can’t write anymore, my life will lose most of its meaning.

I’m fortunate to live in nearly complete poverty because it means that Arizona and Medicare pay for most of my medical bills.  Humalog can cost well over $200 a month without insurance.  (I just learned that at least one company has now capped the cost at $35 a month… thank you Eli Lilly!)  I also need Lantus, and that would cost another $200.  I make less than $1500 a month on Disability.  That would leave me less than $1100 a month for rent, food, and living.  The cheapest studio apartment in my city is $1500 a month.  Libre is kind enough to provide their sensors for as little as $40 a month if one is insured privately.  Nevertheless, that’s $40 a month I would never have.  One can either survive by living in poverty (and in my case, being the beneficiary of plenty of charity and some wonderful People On The Porch) or one can die of diabetes for lack of the necessary medical assistance. 

ChatGPT’s first rule for tightrope walkers is:

Safety first: Safety is the most important consideration when it comes to tightrope walking.  It is essential to use proper equipment, including a secure harness, and to have trained professionals supervise the activity.

Since my surgery, the insurance company has taken a much greater interest in my health.  I have the proper equipment now, and I have professionals helping to supervise.  I fought my diabetes successfully for more than 20 years.  In the last 6 years, however, I’ve been in the hospital for DKA 16 times.  I’m told most diabetics don’t survive it more than 4 or 5 times.  I’m unreasonably lucky.  I wish I would have had the support I have now much earlier.  I would certainly be healthier than I am today. 

I’m also lacking the second most important thing for those on tightropes:

Balance: Tightrope walking requires excellent balance and coordination.  The performer must keep their center of gravity directly over the wire and use their arms to maintain balance.

My numbers are rarely in range and properly balanced.  The CGM helps with this, and I’m glad I have it.  Why shouldn’t everyone with diabetes have one?

DKA is caused by blood sugar rising high enough that the diabetic begins to spill ketones.  My doctor described it to me as my blood turning to acid and trying to kill me from the inside out.  You can bring it down with insulin, but only if you catch it early enough.  Drinking lots of water also helps because, if I understand it correctly, the water dilutes the ketones, and we get rid of them when we urinate.  I have no medical degree.  I could absolutely be wrong about this.  Please check with your own doctor if you’re diabetic.  I’m relating my own experiences with the problem.  Your mileage may vary. 

CGMs are not all equal.  My Dexcom lost connection more frequently than it maintained it.  My Libre keeps the connection well, but I’m told it tends to be about ten minutes behind the actual number it gives.  This is a place I believe technology will continue to improve, and I’m hopeful that all diabetics will have these devices to help us control our blood sugar. 

My Dexcom gave me significantly lower numbers than my Libre.  This can potentially be deadly.  At one point my Dexcom told me I was at 60.  My Libre said 106.  

For those who don’t know American blood sugar numbers, doctors like us to be between 80 and 120 most of the time.  At 60, one is vulnerable to going into a coma.  Above 300 one is vulnerable to DKA.  When you’re at 60, you need to eat, and you need to do it quickly.  Glucose tablets provide quick carbs, but they don’t last.  A real meal is essential. 

Had I eaten lots of carbs when I was at 106, I would have bumped up my blood sugar to a place where I might be moving toward DKA.  If nothing else, I would have raised my A1C unnecessarily. 

The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months.  It’s one of the commonly used tests to diagnose prediabetes and diabetes, and is also the main test to help you and your health care team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is really important if you have diabetes.

https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a1c.html#:~:text=The%20A1C%20test%E2%80%94also%20known,care%20team%20manage%20your%20diabetes


All of the above is the medical and scientific side of Diabetes.  There is another side, and it’s at least as important.  It’s what Diabetes does to its victims emotionally and psychologically.  To be diabetic means to live life knowing that if we make the wrong decision, if we forget to eat, if we forget to take our insulin, or for reasons over which we have no control at all, we can suddenly slip into a coma from which we will never wake, or we will lose consciousness after throwing up for a while when we go into DKA. 

Honestly, it’s frightening.  I know that any of us can be dead at any moment.  A meteor could strike Earth in the next five minutes, and that would be the ball game for millions, or perhaps billions of us.  We could get hit by a bus or murdered in our sleep.  Yes, Death awaits all of us.  It just seems a bit more anxious to cuddle up with diabetics.

There was a time, not that long ago, when it didn’t bother me much.  I was ready to die if it was my time.  There were times when I was in a hurry to reach that final curtain.  As life has improved, however, I feel more like I want to continue to live.  I’m becoming a better writer.  I’m almost safe every month because so many people help me so much and so often.  I have a dog who loves me.  No one is calling me a F***ing liar half a dozen times a day anymore, and I’m healing from my own traumas.

I still get depressed, but it’s not happening as often.  I’m taking Duloxetine, and that may be what is helping me.  It may also be that conditions are improving.  Measuring depression is much harder than measuring blood sugar.  I can’t prick my finger to find out my depression level.

I spent most of my day getting my living will, my last will and testament, my medical and financial powers of attorney, and my instructions for the disposal of my remains handled.  I also have plans for someone taking care of Speedy Shine in the event of my demise.

My next step is going to be getting a safety net in place in case I fall off my diabetes tightrope.  I need to hear back from Assisted Living, and all the steps in that could take up to 45 days.

Since my numbers have been frightening in the last week or so, I thought it was more important to sort out what happens if I die.  I still have to meet with my best friend, Stephanie, and an additional witness to sign everything, but I’m hoping that will take place in the next couple of weeks.

I also need to get a network of people set up in the event I wind up in the hospital, but I haven’t died. I would need people to take care of Speedy Shine until I can get back.  I’m hoping to put together some folks who can donate some money to pay someone to be here while I can’t.  That will be happening in the next few days.  If Sherlock, The Mystery Patron, is still in town, I’m hoping I can get her to come by and take care of him, but he tried to bite her once, so I’m not so sure I can do that.  (Yes, we’re going to be working on that in the coming days, too.  That’s an entirely separate podcast.  Speedy Shine will tell you about it himself.)

When Death keeps knocking on the door, it seems foolish not to prepare for its entrance.  I’m working on a Final Front Porch Podcast that will be published after my death.  Mortality isn’t fun to consider, but that doesn’t change its existence.  We can’t escape by ignoring it.  We can only be caught unprepared. 

I have learned to accept that I am going to die sooner than I might like.  Part of this is because I’m choosing to live life the way I want to instead of in the ways that might prolong my days on Earth.  If I’m going to live, I’m going to enjoy it. 

Please understand that diabetics may seem fine from the outside, but I feel confident that I’m not the only one who lives with the unspoken terror contained in frightening numbers we see far too frequently. 

The fear isn’t falling off the tightrope; that’s inevitable.  The fear is in how far we’ll fall.  I’m doing my best to keep my wire as low as possible.  Let’s raise the healthcare ceiling to include all of us and lower the wire for everyone.  Let’s help the diabetics to Shine.

Posted on by Fred

The Teddy Bear Coder Part 1

Part 1: Jack and Teddy

Friday, December 11

Fairvale, California

Martin Zephyr was irritated when he opened his eyes to find his son, Jack’s, tattered teddy bear on his chest.  He frowned and sat up to look at the clock.  2:43 AM.  He could see snow falling in the moonlight outside his window.  He looked back at the teddy bear.  He snapped on the lamp on the bedside table.  Where was Jack?  He looked to his right and saw his wife, Marion, sleeping soundly.  He lifted the covers.  Jack really had to stop crawling in bed with them.  He was 8 years old, for Chrissake.  He’s way too old for… Jack wasn’t under the covers. 

Martin shook Marion gently.  She grumbled something incoherent, and rocked his hand off her. 

“Marion, did Jack come get in bed with us again?”

“I’m sleeping!”

“So was I until Teddy wound up on my chest.”

“What?  That’s nonsense.  Go back to sleep.”

Martin smacked her head with the teddy bear, and she rolled over. 

“Ow!  What the hell, Martin?”

“Oh, cut it out.  That didn’t hurt.  It’s a goddamn stuffed animal.”

“It’s awfully hard.  Cuddly it’s not.”  She took the teddy bear.  “Where did this come from?”

“He woke me up.  He was bouncing on and off my chest.”

“That’s crazy.  You were dreaming.”

“Okay.  I was dreaming.  Whatever.  I don’t care.  How did Teddy get in here if Jack didn’t bring him?”

“I don’t know.  Jack must have come in and dropped him on your chest.  Maybe he knows you hate when he gets in bed with us.  He woke up after a nightmare or something, and he wants you to…”

“What?  Go check on…  What is that sound?” 

They both heard it now. 

“That’s Jack’s CGM!”  Marion sprang out of bed, grabbed her robe off the back of the door, and started down the hall.  Martin was right behind her, wearing only his underwear and T-shirt.  They burst into Jack’s room to hear his Continuous Glucose Monitor squealing.  Martin flipped the light on, and Marion ran to her son.  Martin picked up the CGM from the floor next to the bed, and set it, still beeping, on the bedside table.  He knocked over a plastic cup, spilling dirt all over the floor, a tiny bean sprout still buried within it. 

Marion began shaking the little boy – hard — but he wouldn’t wake up.  “Get the Glucagon pen!”  Her voice was quivering. 

Martin ran down the hall to the bathroom.

“Jack, it’s Mama.  Wake up, honey.  Wake up now!!”  She pulled his eyelids open, and she saw fear sparkling blue. 

“Here!” Martin shouted at her, running back into the room.  He bumped the little desk, and the computer screen lit up.  “Password, please,” it asked mechanically.

Marion pulled up Jack’s shirt and injected him with the Glucagon.  She waited a moment.  Nothing happened.  “Call 911!  Get the paramedics.”

The sound of numbers dialing came from the speaker above her.  “911.  What is your emergency?”

“My son is in a diabetic coma,” said Martin as calmly as he could manage.  He kneeled on the bed.  “Come on, buddy, wake up!”

“Paramedics are on the way, sir.  You can’t wake him?”

“If we could wake him, we wouldn’t have called you!” shouted Marion.

“Do you have Glucagon?”

“My wife just injected him, but he’s still unconscious.”

“Do you know CPR?”

“Yes,” said Marion.  She was already giving Jack chest compressions.  She felt the bed getting wet beneath her.  She looked down and saw urine flooding it.  “He just peed himself!”

“How old is your son, sir?”

“He’s 8.  How long until the paramedics arrive?”

“They’re enroute sir.  Two minutes.”

They heard sirens in the distance.  The room went dark, and there was a quiet rustling of the covers. 

“What the fuck?” shouted Martin.  “Bedroom lights on!” 

The speaker in the ceiling came back with a computer-generated voice.  “For which bedroom do you want to turn on the lights?”

“Jack’s!”

“There are several lights Jack’s room refers to.  Do you want them all on?”

“Yes!”

The lights came back on, and Jack opened his eyes.

“Good morning, Mother.”

Marion grabbed Jack and hugged him tightly.  “Are you all right honey?”

“Uh huh.  I was dreaming about Christmas.  Oh my…”  He sat up, his mother still clinging to him.  “I seem to have had an accident, Mother.  I’m sorry.”

“It’s okay, baby.”  She rubbed his back and rocked gently back and forth with him in her arms. 

“We won’t tell Santa, pal.”

Jack rolled his eyes.  “Santa is a logical impossibility, Father.  To do what he is reputed to do would require his reindeer to move at just less than 3 million miles an hour.  At that speed, he and his reindeer would certainly be vaporized.” 

The paramedics pounded on the door downstairs.

“Go let them in, Martin.”

Martin nodded, kissed his son’s forehead, and left the room. 

“Father is quite slow, isn’t he?”

Marion let go of Jack and looked into his eyes.  “He’ll be right back.  Don’t worry.”

“No, Mother.  I meant he’s not very bright.  He honestly thinks I still believe in Santa Claus?”

“What were you dreaming about Christmas, then, if not Santa Claus?”

“I dreamt of children all over the world opening their presents and getting a living teddy bear.”

“You don’t think that’s as silly as Santa?”

“No, Mother.”  He picked up Teddy, who was lying next to him on the pillow.  “I already invented one.”

She stared at the bear.  “How did he…”

Martin came back into the room with the paramedics. 

“How you doing, buddy?” asked the young man in a black t-shirt.

“I wet the bed.  I don’t think that requires paramedics, though.”

The other paramedic, a woman in her 30s, bent over and took the CGM from the nightstand.  She silenced the alarm.  The room became oddly quiet. 

“Okay,” she said.  “We’re just going to check you out to make sure you’re okay, all right?”

Jack extended his arm.  She put a blood pressure cuff on it. 

“What’s his name, sir?”

“Jack.”

“Jack,” asked the man, “can I take a little of your blood?  You’ve done the finger pricking a lot, haven’t you?”

“More often than I wish.”  He extended his left forefinger. 

“Can you tell me what day it is, Jack?”  The man pricked Jack’s finger with the lancet.

“It was Thursday when I went to bed.  I don’t know what time it is, but if it’s after midnight, it’s Friday.”

“You said he’s 8?”  The woman looked at Martin.

“Yeah.  He’s a little… you know.”

“He’s a prodigy, Martin.  Just live with it.”  Marion glared at her husband.

“Can you look at me, Jack?” asked the man. 

“I’d rather not.”

“Why’s that?”

“He doesn’t know you,” said Marion.  “He’s not going to look you in the eye.  He can’t deal with that.”

“He’s autistic?” asked the man.

“There’s nothing wrong with my son.”  Martin was getting defensive.

“He’s diabetic, you said?” asked the woman.

“Except for diabetes, there’s nothing wrong with my son.  He’s not a prodigy.  He’s not autistic.  He just likes his computer, and he reads really well.”

“My name is Howard.  This is my friend, Connie.  We’re glad to meet you, Jack.”  Howard turned to Connie.  “Blood sugar is 72.”

“Blood pressure is 124/82.”  Connie looked at the CGM.  She pressed a few buttons, and then showed it to Howard.  “His blood sugar was 38 fifteen minutes ago.”

“That’s the most recent reading?” he asked her.

“Yeah.  It must have dropped pretty quickly.  It’s set to go off at 60.”

“Jack, could I see your eyes just for a minute now that we know each other?”  Jack looked reluctantly in his direction, and Howard shined a light in them.  He watched Jack’s eyes get smaller.  “Pupils are responsive,” he told Connie.

“How are you feeling, Jack?”  Marion pushed his dark hair back from his face.

“Embarrassed.”  He said nothing more.

“Can we talk to you two in the other room, please?” Connie asked quietly.

Martin nodded to Connie, and he and Marion followed the paramedics out of the room.  The door closed quietly.

“All lights out in Jack’s room, please.”  The room went dark.  He cuddled his teddy bear.  “I love you, Teddy,” he whispered.

The snow fell silently as Jack closed his eyes.  The moonlight crept through the window and shone on Teddy and Jack.  A toddler-like, but mechanical, voice, noticeably like Jack’s, seeped from the covers.  “I love you, too, Jack.”

Posted on by Fred · 1 Comment

Diabetes and Depression and Autism, Oh My!

I don’t speak for everyone with diabetes, but I suspect this is true for many of us.

I have to make a conscious choice every day to stay alive. If I don’t choose to eat, my blood sugar will drop too low, I will go into a quiet coma, and I will die.  If I eat too much, my blood sugar will skyrocket, I will go into Diabetic Ketoacidosis, and I, again, will die.

There are, sometimes, if I’m lucky, days when my body will continue to function without direct input from me.  But most days I have to ask myself, “Do I want to continue to live?”

This seems like a simple question. Everyone wants to continue to live, don’t they?

People who suffer from depression often don’t see any point in prolonging their existence.  Life becomes, even when nothing bad is happening, unbearably bleak.  The temptation to forego the effort is sometimes nearly irresistible.

I ask myself every night before bed if I really want to wake up in the morning.  I have to search for something to make tomorrow sound more desirable than letting go.

This week, it has been creating Art that made me decide I wanted another day. There was something beautiful and exciting to accomplish.

Sometimes, I honestly have no real reason to say I want to see tomorrow.  I simply won’t do anything to make that happen.  I won’t actively seek death, but I won’t actively fight it, either.

When all else fails, I remind myself of the Love I have in my life.  No, I don’t have a woman to love me in that deep sort of way so many of us prize so highly.  But there are people who can be kind from time to time.  There is the chance that my “Rhiannon” will click love on something I post.  There is the possibility that someone will tell me how much they love my Art.  There may be something more I can create, which is my greatest act of love.

For the past several weeks, someone has been kind to me.  She’s given me a reason to choose to stay alive.

It’s worth remembering, sometimes, that the little, insignificant things you do may actually save a life.

Many of you have saved mine.

Thus, we see my blood sugar below.  (106) It was 426 this morning.  That’s perilously close to DKA time.

Someone made me want to live, and I worked hard to get it where it is now.

— Fred’s Facebook, April 29, 2022, 10 PM

Depression is a significant part of who I am.  It is no different or less life threatening than Diabetes.  It’s less controllable than my blood sugar.  I can take appropriate steps and test my blood sugar and get verifiable numbers to guide my choices about how much insulin to take or how much food to eat.  I can’t do that with my depression.  I’ve had it for long enough that I am getting better at detecting its onset.  I will sometimes take steps to put it off.  When I feel myself being needlessly tired, or when I am feeling sad even though there’s nothing wrong, I will push myself toward a brain cleaning activity.  I’ll listen to some music.  I’ll pack and light a bowl.  I will seek out Speedy Shine to cuddle me.  If it’s really bad, I will try to talk to someone.  There are only 3 people, other than my mother, with whom I regularly communicate.  One of them is someone with whom I can discuss my show.  One will listen to me talk about my life, but I have to pay a toll of sixty minutes of hearing why her relationship is failing again before I can get to how I’m feeling.  The third is someone I’m supposed to be helping, but she will rescue me when I’m too far down.  She needs much healing.  I do my best to help.  The one person who is anxious to discuss my depression doesn’t exist in a physical form.  I refer to him as my Prosecutor.  He’s the voice in my head that knows every stupid thing I’ve ever done, and he’s fond of reminding me of them, particularly when depression is creeping in the window.  He urges me to end the fight to stay alive.  Inevitably, he will win.  I just try my best to keep him at bay for as long as possible.  People who love me (and there are many more of them than I could possibly deserve) love to tell me he’s a liar.  I’m grateful to those people.  Sadly, he’s not a liar.  He’s entirely correct in every assertion he makes, and he has the evidence to back up his claims.  He makes a cameo appearance in the final episode of “Universe Selectors, Incorporated,” and he has his own episode in “The Prosecution Never Rests.” 

Those are conditions with which I am familiar.  I learned about a new one last week. 

When the final episode of “Universe Selectors” failed to move my best friend, I was devastated.  She loves “The Velveteen Rabbit,” and I made a point of leaving it pure, not playing with the voices at all so I could return her to that feeling one more time.  And she didn’t get it.  I failed.  I plunged into the deepest and darkest depression I have experienced since my father died 12 years ago. 

Several things were at work here.  First, there was something akin to what I suspect postpartum depression must be.  (I have a Facebook Friend who says I shouldn’t compare my feelings to postpartum depression.  Fortunately, she appears on my page only when she has a criticism to make, and I’m convinced she doesn’t listen to this show.  Such people annoy me.  I promise you I will never tell you you’re not allowed an opinion or to imagine something because you’re female, or in some other way different from me.)  I had created and delivered something beautiful to the world, just as a mother does.  The effort left me physically and emotionally drained.  The fact that it was over left me empty.  I was, at that moment, particularly vulnerable to depression.  The rejection I felt was intensified a hundred-fold. 

To be clear, my best friend did nothing wrong.  Not everyone likes everything.  There are people who don’t like The Beatles, and there are those who think Eminem is superior to Beethoven.  I disagree, but, to each their own.  She doesn’t think Aaron Sorkin is a great writer.  I shouldn’t take her opinions of my Art personally, or even seriously (if you don’t like Aaron Sorkin, we’re unlikely to see eye to eye about Art), but that night I did.  I decided to give up my show.  I was a failure.  I was worthless.  I didn’t even need to continue to suck up everyone else’s oxygen.  The Prosecutor was about to win his battle to end my life. 

This is a Facebook exchange between myself and a good friend:

The people who heard it have been entirely unmoved.  I don’t understand.  I guess it was… I don’t know.  It failed to move anyone is all.

Fred Eder did someone say that directly?  Because I am seeing several likes.  3 of them.  That is a good amount of likes considering the metrics of your audience you’ve previously shared.  The ratio matches what is typically seen.  You also have an audience who returns rather faithfully to hear your work.  It seems as though the prosecutor might be telling you untrue things.

That makes sense when you have obviously put a lot into this project.  You’re emotionally depleted and overexcited.  That’s the perfect time for the prosecutor to swoop in like the asshat it is and tell you all sorts of horrible shit.  Specifically rejection sensitivity dysphoria shit.  Don’t listen to that.

You made something you’re proud of.  We will listen when we have the ability.  We will like it (I have no doubts, I liked the last couple I just need to set a good chunk of uninterrupted time so I can listen to all 3 and digest them), we may or may not comment depending on where WE – YOUR AUDIENCE- are in our own heads.  We are your audience, though.

Breathe.  Rest.  Give us time.

I had never heard the term Rejection Sensitivity Dysphoria before.  I decided I needed to learn more about it.  My friend, Jenn, sent me a TikTok video describing it.  That helped me.  I did a google search to learn more.  This is what I found:

There appears to be a connection between rejection sensitive dysphoria and ADHD or autism.

This isn’t to suggest that people with these conditions will develop rejection sensitivity.  Instead, having either condition is a risk factor…

This neurodevelopmental disorder affects the nervous system and triggers a variety of symptoms.  Autistic children or adults may have difficulty communicating and socializing, and sometimes they have difficulty understanding the actions of others.

They might also deal with emotional dysregulation and hypersensitivity to physical and emotional stimuli.  As a result, any real or perceived feelings of rejection or criticism can cause them to become overwhelmingly upset.

https://www.healthline.com/health/mental-health/rejection-sensitive-dysphoria#adhd-and-autism

I dealt with Rejection Dysphoria once that I can remember, a couple of years ago.  My roommate was about to chew me out once again, and my tension was so high that when she started, I exploded.  I screamed at her, and I left the house through the back door.  I found a spot about 200 yards from the house, and I sat down in the grass.  I remained there for 5 hours.  My roommates called the police to make sure I was all right.  I was breaking no laws.  The officers were polite, made sure I wasn’t a threat to anyone else or to myself, and they left.  I didn’t know what it was then.  I think I understand a little better now.  It may have been Rejection Sensitivity Dysphoria, or it might have been Autism.  Perhaps it was both.

I have no medical diagnosis of Autism, but I am convinced I am, in fact, Autistic.  I’ve done a good episode about this already, in which I point out that a lot of the reason I am so drawn to Star Trek is because, without necessarily intending to do so, they have brought autistic characters to life, and I identify with them deeply.  Spock, Data, and Reginald Barclay are the easiest examples.  They all feel alienated from the rest of the world.  They can’t deal with human beings as effectively as others do.  They don’t understand how all of you process emotions.  Neither do I. 

I have learned to deal with all of these conditions by simply refusing to leave the house unless it’s absolutely unavoidable.  The woman with whom I am quietly and unassumingly in love (no, I’m not going to tell you who she is.  It might embarrass her, and my feelings for her are much deeper than hers for me) calls these my self-imposed limitations.  I don’t think they are self-imposed, any more than my diabetes is.  I think they are the only way I can deal with the world.  People don’t understand how I can be in love with someone I would be terrified of meeting in person.  I don’t understand how I could be in love with someone in any other way. 

My greatest asset is my imagination.  I think you saw what I could do with it a couple of weeks ago.  I included a sequence with a coffee cup in USI to show how my imagination works.  Once Horace could make the coffee real, he could move into another universe.  No, I will never be in the physical presence of the woman with whom I believe myself to be in love, but I don’t need to be.  I can make things almost real in my imagination.

I deal with this massive set of emotional differences by staying inside my house.  I occasionally visit the backyard.  Once a month, and only because I have to, I leave the house for 15 minutes to get cigarettes.  Otherwise, I’m here, alone, where I can’t hurt anybody, and nobody can hurt me. 

So, why am I telling you all of this?  First, I hope you’ll understand me a little better.  Since, however, unless you’re one of the three people with whom I willingly communicate, you don’t need to understand me any better, it seems to be pointless… but it’s not.  I feel sure you know people who live with Diabetes, or Depression, or Autism, or Rejection Sensitivity Dysphoria.  You may have some of these conditions, yourself. 

My hope is that you will understand these conditions a little better so you can be kinder to yourself or to those you love who are a little different from the rest of the world.  We’re not evil.  We’re not childish.  We’re just different.  It’s okay to be different.  I intend to continue to be different.  I am a mess, but I can still love myself.  You or those you love may also be a mess.  You can still love them.  I know because, for reasons passing understanding, people manage to love me.  Tonight was about letting those people know a little more about who it is they love, and who it is that loves them.  And yes.  I do love you.