The cruellest month is transitioning to the merriest one

[pameladean]

The pandemic isn't over, but the one-year mark came in with a lot of changes. Now that the first year is done, I regret not keeping a pandemic diary, as so many people did. But I have to say, to a far greater extent than I anticipated, the entire situation did a very bad number on my brain.

Once I was fully vaccinated I went in for lab work for the first time since June of 202, when my doctor begged me to do so before the anticipated surge in cases after the protests of the police murder of George Floyd. There was no surge, mercifully, which has not stopped right-wing bots and trolls from whining in perpetuity about how nobody complains about protests even though they obviously spread the virus.

My doctor had had me send her blood pressure and blood sugar numbers taken at home for a week or so in February, and then told me she would like to increase my metformin dosage. I agreed. This has been more annoying than I anticipated. I need to take metformin with food lest it wreak havoc on my digestion. The extra 500 mg is supposed to be taken with breakfast, while I retain the practice of taking 1000 mg with dinner. Medical directions of this sort always think people eat breakfast at 8 a.m. and dinner at 6 p.m., and they think bedtime is eleven p.m. at the latest. My schedule is nothing like that, and in particular meals tend to be crammed into a smaller percentage of the day than in the idyllic regular dreams of the people who write directions for the ingestion of medications.

In addition to eating it late, I also don't eat very much breakfast, since I have never since puberty been hungry until several hours after I get up. Now I'm eating twice as much as I want in the morning, which isn't much fun and also involves preparing twice as much. I used to eat a cup of soy yogurt, which was sufficient to cushion the effect of four blood pressure medications, an acid-reflux medication, and a different diabetes medication. Now I have to, horrors, make toast or oatmeal or something. In the morning. Not only am I not hungry when I wake up, my brain also, even when it was working well, did not really come online for an hour or two either. So I'm eating a larger breakfast than I want earlier than I want, which ends up pushing lunch further out. I usually have breakfast around 1 p.m. if I'm lucky, and lunch around five or six. Dinner is very late for a number of reasons having nothing to do with metformin, but it is not late enough to put twelve or usually even ten hours between breakfast and itself. So I'm perpetually flailing about the kitchen at 2 a.m. trying to find something substantial enough that I also actually want to eat in order to take the metformin.

Despite all these complaints, the new dosage is working and my A1c is down to 6.0. (This test measures the percentage of red blood cells that have glucose attached to them. A result of 6.0 is "pre-diabetes" in normal people but very good news in a diabetic; it's quite a bit below the point at which nasty complications tend to show up.)

Other lab work was fine too, except that, since she'd increased my metformin, my doctor ordered a vitamin B12 test, and I turned up borderline deficient. A remarkable number of symptoms that I had put down to pandemic stress, and that I have seen listed as symptoms of pandemic stress in any number of articles, turn out to be possible effects of B12 deficiency.

I've been taking B12 supplements for a couple of weeks and they are starting to have an effect on my energy levels and on the sweetness of my temper. We'll see about the higher cognition, I guess. My doctor thinks the deficiency is caused by the metformin, but I think it may have begun earlier than that, since I just generally eat somewhat weirdly.

Eric came over today for a short masked, distanced visit in the back yard. There might be one more of those, and then we can meet as in the before times. My brother will be fully vaccinated as of May 19th, and then anybody in my household who wishes can go see him and my mother and sit indoors unmasked and not have to yell all the time.

Eric had a complicated hierarchy of errands that had already been slightly derailed, if one can derail a hierarchy; so the visit was even shorter than anticipated. I stayed in the yard, hunting down all the peonies, which I'd been meaning to check on for several days. Raphael and I went for a long walk yesterday and started seeing the red alien shoots of emerging peonies everywhere, bringing ours tardily to mind. I am usually peering at their locations as soon as the sow is gone. Mine are in fact all up, even the unfortunate one that is being shaded out and wants moving. I watered them all. There were also a number of mystery plants that I'd been puzzling over for some days. They look a  little but not enough like daylilies, and while daylilies will pop up wherever they can, they don't usually jump long distances; these plants were not that close to any daylilies. One in the front finally offered up a bulb, and I remembered that I'd succumbed to a good deal on mixed giant alliums last fall. So that will be a nice surprise when they bloom. I watered those, too.

We have five flourishing green daffodil plants and one lone, extremely tenacious daffodil flower, which remained unmoved by snow, frost, and comparative drought. I should feed all of them. Most of the rest of the yard is either emerging creeping bellflower (argh), rampant scilla, non-native sedges, a bit of stubborn grass, and volunteer trees, largely box elder, hackberry, mulberry, Siberian (or possibly Chinese) elm, Norway maple, and green ash. There is one lilac bush, a volunteer from seed of the neighbor's ancient, lightning-struck, but still persisting bush. Eric said he was glad we had gotten a scion of that lilac before the neighbors put up a six-foot board fence, and I am of the same mind.

The other thing that Raphael and I saw on our walk was a glorious abundance of species tulips. I ended up ordering three different kinds for next year.

In addition to having energy and regaining such sweetness of temper as I can be said to have possessed, I've begun to be able to work on my Zeno's Novel in a more efficient fashion. I hope I may post here more often, a pandemic aftermath diary, perhaps, though when I think of India, and of all the people I'm worried about because they haven't been able to be vaccinated yet, I don't think we are in any aftermath just yet.

I've read every post in my circle all this time and have really appreciated every one of them, and the persistence of everyone's existence.

Pamela

Edited to correct previously-invisible typos.

Comments

[sovay]

But I have to say, to a far greater extent than I anticipated, the entire situation did a very bad number on my brain.

*hugs*

I am glad you and your brain are still here and you have all my sympathies on the breakfast situation; I taught myself to eat immediately on waking for reasons of medication (I learned about rice cakes) and I still hate it. Glad that the B12 is helping, too.

[pameladean]

Immediately on waking, yikes, I salute you! I have to take an H2 blocker as soon as I am upright, and then wait ten to sixty minutes before ingesting anything else, ideally 60 but that depends on when I need to be combobulated. A solid hour is not enough to really make me want to eat, but it's better than immediately. I should look into rice cakes. They don't have to be toasted.
*hugs*
P.

[halfmoon_mollie1]

it would be wonderful if you could find the time to post more often! I enjoy hearing from you.

[pameladean]

Aw, thanks. It's less time than activation energy, so we can hope. P.

[dreamshark]

I'm glad to hear that you are feeling better.

[pameladean]

Thank you! P.

[kore]

I am really, really grateful and happy you're still here, and have been here.

I guess I wound up with a really patchy "pandemic diary" but I also just really snapped around Jan or Feb when it seemed like we wouldn't be getting vaccines until "some time off in the future," and that turned out to be just the extra bit of stress my psyche couldn't take. (One thing the record tells me is that people haven't been really serious about, or adhering to, lockdowns for a lot longer than they think. A huge part of the population -- about half at least -- failed amazingly at the "stay inside, wear a mask if you go out" bit, which is fucking amazing.)

I have NEVER been hungry right after I get up, in fact if people try to make me eat anything other than coffee and MAYBE a piece of toast 2-3 hours after I wake up, I'll be sick. I don't start getting really hungry until at least past 11, and by the same token, I really start perking up past 10 PM. I don't think I regularly ate three meals a day even when I was a kid living at home with my parents! Medications and food are another part of treating chronic illnesess that really needs to be fixed.

[pameladean]

Right back at you! I guess your pandemic diary is probably patchy by your usual standards, but it's quite dense by mine!

I'm still so dismayed at how, next to the heroism displayed by so many people, so many others just couldn't be bothered to inconvenience themselves in any way.

"Medications and food are another part of treating chronic illnesess that really needs to be fixed." Yes, yes, a hundred times yes. Taking people who are already having trouble doing things and providing them with a rigid schedule to do more things on and then, mostly, blaming us if we can't, is not the way to go on!

P.

[bibliofile]

I dunno, don't our DW posts count in part as a pandemic diary?

Yay for feeling better, strategies for coping with medication, and posting when you can.

[jjhunter]

I've read every post in my circle all this time and have really appreciated every one of them, and the persistence of everyone's existence.

Very much likewise. And I have treasured every one of your comments.

[pameladean]

Oh, thank you, that's good to know! Formal poetry of that kind proved unexpectedly difficult, but I really liked having the opportunity.

P.

[sraun]

Talk to your doctor about the Metformin scheduling? Irene & I are 2000 mg with dinner, which is working well for us. If you explain what your typical eating pattern is, I'd bet she'd be willing to help you find something that works better.

[pameladean]

I think her recommendation was based on what times of day the high sugars happened, but it can't hurt to drop her a note; thanks. I don't really have much idea of how other people take metformin.

P.

[sartorias]

Glad to see you posting. Picturing those lilacs and tulips!

[pameladean]

The lilacs aren't blooming yet, but I'll try to thread the labyrinth of DW's image-posting directions to put up some photos when they do.

P.

[sartorias]

Yes! Thank you!

[graydon]

There is this wretched biochemical sense in which stress and B12 deficiency are nigh-indistinguishable. I'm glad to hear you're getting supplements and hope the specific, general, and overall brain-trend remains positive a long while.

I've been trying to think of things as entering the "stop digging" phase of metaphorical holes. Everybody hasn't put their metaphorical shovel down, but the rate at which things are getting worse is generally decreasing. I'd like things to be getting better, but must suppose that getting worse less fast is necessary as a transitory condition approaching getting better.

[pameladean]

Given what B12's role in the body is, I guess a deficiency of it IS stress, in a more direct way than some other deficiencies.

Thank you for the idea of being in the "stop digging" phase. That's useful.

P.

[graydon]

You're welcome!

I have been finding it challenging to avoid contemplating the specific logistics of performing bog-sacrifices. (I mean, no, that won't help directly, but with sufficient selectivity of the sacrifices I'd think one could reach 95% confidence of a resulting improvement.) So I've been trying to remind myself that we're very much at the "persuade everyone to put their shovels down" stage of being stuck in a pit.

[lcohen]

if i had to try to fit meds around two different meals, i'd be in serious trouble trying to figure out how to make that work, exactly, so i empathize greatly!

i always appreciate when you post and i appreciate your comments when i do so. i hope that you feel more you-ish, whether due to abatement of the pandemic, or increase of B12, or simply that the winter of our discontent is turning somewhat to an adequate if not glorious summer.

[pameladean]

Thank you! When I was first getting diabetes education, the nurses were fond of saying, "Diabetes likes regularity." My silent response was, "Diabetes can bite me," which of course goes both ways; but a regular schedule of anything you can name is not going to be the way a significant number of people live their lives, for a myriad of reasons.

"More you-ish" is a very good phrase indeed. Also I'm giggling over "made adequate summer by these sons of York."

P.

[nineweaving]

So very glad to hear that spring has come for you, on the earth and in your spirits.

Nine

[minoanmiss]

I am always delighted when you comment on my nattering. :)

Adventures in metformin, whee. If you must have a starchy component to your breakfast, would crackers work? Some kind that you like by themselves? I think 4-6 would have about the same mass as a slice of toast, depending on size, nd instead of prep you can just pull them from the package.

I also can't eat breakfast right upon getting up, so I have my first metformin with my lunch (which is usually crackers and cheese when I'm in the office). I am about to find out my current A1C so we'll see if that plan is working!

[pameladean]

Something that didn't have to be toasted first would certainly be an improvement. Sovay mentioned rice cakes, and I could also check into mildly fancy crackers.

How far apart do you take your metformin, if you don't mind saying? I may be being unnecessarily draconian about timing.

P.

[minoanmiss]

6 hours or so between lunch and dinner, on average.

[graydon]

Something that didn't have to be toasted first would certainly be an improvement.

Finnish ration crisp rye bread has a long shelf life, a flavour, and nutritional value. Also a complete lack of preservatives. (The useful property of not becoming less chewable when frozen is hopefully of less interest!)

That source sells a much smaller quantity than a case, though the case is of course less expensive per the each. And maybe where you are someone local makes something similar. (At least if the thought of rye flavours doesn't give you horrilipations!)

[mrissa]

Things keep happening, and instead of keeping a pandemic diary about it all I write poems somewhere between an hour and a month afterwards, which is, as timekeeping systems go, a mess. No one has ever constructed a poetclock, and with good reason.

[pameladean]

NOW I WANT A POETCLOCK.

I was about to add that poetry is better than timekeeping in any case, but sadly I don't think that's true. Fortunately we don't have to do without either.

P.

[oursin]

It's lovely to hear from you, and glad you are fully vaccinated and getting medical attention for other issues. Even if there is indeed this weird assumption about How People Live Their Lives according to a standard timetable.

[pameladean]

Medical attention with a scheduling fetish is better than none at all, certainly.

P.

[ljgeoff]

It's always good to read a post of yours. I also find the medication noodling interesting.

Would you happen to know what this little beauty is?

[pameladean]

I always read other people's medication noodling with great fascination.

Those flowers are almost what you said -- they are called spring beauty. They have little grasslike leaves that are completely occluded by those great spotted ones, which are the leaves of trout lilies. Spring beauty is one of my favorite ephemerals, but I haven't seen any yet this year. Next week, I hope!

P.

[athenais]

What an excellent catch-up. I'm sorry the medication means you have to eat more breakfast and earlier. I mean it, I'm really sorry. I, too, do not want food upon arising, nor do I normally get going before 8AM, so I don't really want to eat before 10AM. And then we don't eat at 6pm, that'd be way too soon. Too much food too late at night and I sleep poorly. Who are these strangers who have such regulated stomachs?

I sat in a coffeehouse today and drank my coffee without a mask, the first time since February 2020. And it was glorious. I am so thrilled about going to see my stepmom next month and not needing to worry about being masked in her home.

[pameladean]

While I wouldn't wish an inability to eat upon arising on anybody, it's really cheering to know there are so many of us. It's a pity we aren't catered to, that's what.

I'm so delighted for your coffeehouse experience and the upcoming trip!

P.

[asakiyume]

I never thought of that before: how the merriest month follows the cruelest one. A good reward for surviving, I guess!

There is one lilac bush, a volunteer from seed of the neighbor's ancient, lightning-struck, but still persisting bush. --It makes me think in some wonder how different plants and animals are. I saw a tree on my walk, it had been broken at its base and fallen over, only connected to the stump by the a thin shaving of a connection, and yet that was enough: the lying-down tree had put out blossoms and baby leaves, as if this catastrophic blow was just a change in orientation, nothing more.

That's very heartening to hear about the B12 supplements. I like hearing about simple treatments that seem to help people.

[guppiecat]

It occurs to me that your schedule (such as it is) is more aligned to how Europeans live than Americans, so I am wondering if the guidance from European doctors might not align better to your lifestyle.

Not that I know of an "ask a European doctor" service or anything, but it did cross my mind.

Also, for what it's worth, I tend not to eat breakfast either.