One year of diabetes --- by the numbers

Today marks the one year anniversary of Isabella’s diabetes diagnosis. We’ve gone through a lot in the past year, that cat and I. She has shown enormous patience and adaptability (plus a good measure of her usual snarkiness) and I have learned to let go of the idea that I can bend this disease (or this cat) to my will.

The past year breaks down like this:

739 injections (plus 16 more from the pet sitter). Miraculously, I’ve only been bitten a couple times – when I tried to shoot without having Isabella’s face firmly planted in a food bowl. Every once in a while I forget who I’m dealing with, but she reminds me.

773 blood glucose tests (requiring far more ear pokes!). Oh, the horrors Isabella endured. One day I chased her frantically around the house with a lancet and the meter. If anyone had witnessed that, the cat would have been removed from my care and I would be under psychiatric observation.

3 vials of insulin (we’re working on number four). The first one cost $150. The second and third, about $100 each. Number four? $41. Yippee!

2 fur shots. That’s not bad, actually. Shots, I can handle. It’s all the other stuff that’s a crap shoot.

Highest blood sugar reading: 487 (July 19th). That’s even higher than the vet’s reading when she was diagnosed. I’m doing a great job, aren’t I??

Lowest: 38 (September 3rd). Isabella does this just to show she can. Or to highlight my incompetence, one or the other.

6 vet appointments. I’ve already tallied up those costs. Let’s not revisit that just now.

2 vets. The first one, I firmly believe, thinks I’m a complete nut case. The current vet may share that opinion, but she hides it better.

1000+ cans of cat food (for both cats). How many of you carry a teeny, tiny shortened version of Janet’s food list with you at all times? I deleted the brands that cost too much and the varieties too high in carbs, eliminated extraneous columns, printed the resulting much-smaller list doubled-sided, and shrunk it down so it fits in my wallet. You’ve all done that, right? It’s not just me?

1 time Isabella yanked the strip out of the meter with her teeth. Now I can say for sure that kitty saliva on a test strip causes an error message on the meter. I’m going to start charging her for the strips when she pulls stunts that wreck a test strip. It’s coming out of her college fund.

One year. In the early days I was convinced I could get Isabella regulated and off insulin. Now I’m only convinced that I don’t know what I’m doing. Sometimes I’m discouraged, sometimes realistic, sometimes resigned. A month ago my cousin asked Isabella’s age. When I told him twelve, he replied “She could live for years.”

If I do my kitty pancreas routine adequately, she will. Yep, she will.

Let’s play … JEOPARDY!

What has Isabella’s diabetes done for me lately? Well, it’s turned me into a cesspool of trivia, for one thing. I can spout off facts about things most people never give any thought to. Useful? Maybe not. But in my fantasy life, all that minutia could translate into big bucks, given the right situation.

Such as … say, an appearance on a certain game show?

(Cue theme music.)

Alex Trebec: Good morning. Today’s contestants are a homemaker from Memphis, Tennessee, a writer from Chicago, Illinois, and the owner of a diabetic cat, from San Jose, California. Welcome everyone. Now, let’s play JEOPARDY. Writer will start us off.

Writer: I’d like “Pancreas Facts” for $100

Alex: The answer is: “The hormone that lowers blood sugar levels.” Cat Owner?

Cat Owner: What is insulin?

Alex: Correct for $100. Your choice of category?

Cat Owner: I’ll take “Neurology” for $400.

Alex: The answer is: “The neurologically-active form of a common vitamin, sometimes used in mega-doses to treat neuropathy.” Cat Owner, you’re first on the buzzer.

Cat Owner: What is Methyl B-12?

Alex: That’s right! You’ve got $500 and you can choose the next category.

Cat Owner: OK, let’s try “Diet Fads” for $500

Alex: The answer is “This popular low-carb diet has been adapted as a species-appropriate diet for felines.” Homemaker, you’re first.

Homemaker: What is The Zone?

Alex: Nooo, I’m sorry. You’ve moved into negative territory. Cat Owner?

Cat Owner: What is Atkins, or “catkins?”

Alex: Right again! You’re firmly in the lead with $1000. And we have time for one more question. Cat Owner, the category, please.

Cat Owner: Let’s go back to “Pancreas Facts” for $500

Alex: And it’s a Daily Double. Cat Owner, you can wager up to $1000.

Cat Owner: Let’s make it a true Daily Double, Alex. I’ll bet the whole $1000.

Alex: And the answer is: “These clusters of cells scattered throughout the pancreas are responsible for the organ’s endocrine functions.”

Cat Owner: What are … Islets of Langerhans?

Alex: Correct! Congratulations, Cat Owner. Your winning total is $2000 and you’ll be invited back for our Tournament of Champions in the spring. Writer, Homemaker, you had a formidable opponent today, and I thank you for playing.

(Camera fades as musical theme plays.)

How do you define “others?”

I got a consumer survey in the mail yesterday. I’m a sucker for surveys. Those guys call on the phone? I’ll talk to them. Survey in the mail? I’ll complete it and return it. I’m the perfect target for marketing people who want data.

I opened the survey and searched carefully though all the bits of paper in the envelope, Sometimes there’s cash in there, as an incentive. No greenbacks in this one, just vague promises of “valuable coupons” and a chance to win $500. I know it’s dodgy, but like I said, I’m a sucker for this stuff.

Settling in at the kitchen table, I spread the survey form open in front of me. Then, damn it, went in search of my reading glasses. OK. They want to know if I buy various types of products (Air freshener? Denture cream?) and how often. Sometimes, the folks behind this want to know about specific brands. All in all, it’s a bunch of check boxes and not too much strain on my brain. I grab a pen.

Isabella, sensing that my attention had shifted away from her, hopped up on the table to rectify that. She laid full out on the survey. Purrs. Head butts. Annoyance! I worked around her as best I could until even she didn’t care what I paid attention to and she left.

Oh – look there! Does anyone in the household suffer from diabetes? There’s a column for “you” and a column for “others in house.” I check “others.” What type of diabetes? Well, Isabella is probably Type II, but if I’m going to get coupons in the mail, I don’t want them to be for stuff like glipizide, so I check Type I. I indicate that she takes insulin “2 or more times per day” and uses a meter “Other” than AccuCheck or OneTouch. Sweet. Bring on the money-saving coupons! How about a lifetime supply of strips? Oh yeah, I’d switch meter brands in a heartbeat for a lifetime supply of strips.

Finishing up, I fill out a bit of demographic information. I’m single, no kids, and I live alone. Uh oh. Do you suppose the folks at Survey Central will notice the discrepancy? I live alone, and yet “others” have diabetes. Can’t go back and change it, I used a pen. Next question: Do I have pets? Ah! Yes, indeed. I check “cat” confident that if I’m ever called before the Survey Ethics Committee I can point out that my cat is an “other” in my household.

Done. I seal the survey in the return envelope and put it out for the morning mail. Now I’m just hoping for some free strips.

Nagged into action

My cat is a nag.

I’m sure most cats are nags. Wanting to go out. Wanting to get fed. Wanting a belly rub. Isabella is a nag in those ways (except the belly rubs; she’ll take you out if you touch her belly. Casey is the belly-rub beggar around here.) and in one other way: she nags at me for her tests and shots.

The routine is to feed, then test and give insulin in the morning before work and in the afternoon when I get home. In the morning (after I’ve been nagged out of bed) I shower while the cats are eating. By the time I’m done, they’re done and Isabella is ready. Since I’ve got to go to work, I stay pretty much on schedule.

In the afternoon, though, I have to entertain myself while the cats eat. I open the mail, check email, change clothes, and lots of times I get distracted and delayed. Delays annoy my cat.

Yesterday I poked about doing this and that, then used the bathroom. As I sat on the toilet, Isabella came in and gave me a look. No noise, no meows, just a look. She conveyed her displeasure with my dawdling as effectively as a pointed glance at a wristwatch. Never mind the hundred times I’ve waited to test her while she cleaned her butt; heaven forbid I should clean my own.

Things being what they are, I apologized to Isabella and hurried to get the testing supplies and insulin ready.

She’s scary when she’s annoyed.

Diabetes Resume

I’ll bet you never realized caring for a diabetic cat has the same resume-building potential of a grad school education. Well, think about it. There are myriad high-level skills required to keep a furry diabetic going from day to day, and every one of them can be translated into a well-paying job. Just look at this list:

Budget Management: Isabella’s diagnosis meant all sorts of new entries on the Expense side of the household balance sheet, without corresponding increases on the Income side. One year later, I’ve still got the house, the creditors aren’t calling, and both cats are thriving. Is it such a stretch to think this sort of budgetary finesse could be applied to a job as the budget manager for, say, a small city or a Fortune 500 company?
Potential Salary: in 2006, the Budget Director for the City of San Jose earned just shy of $197,000.

Data Management and Interpretation: You’ve read about my spreadsheets. All those numbers and trends play a large part in the day-to-day decision making involved in feline diabetes care. Who else uses numbers and trends for daily decisions? That’s right – a stockbroker. Do I hear Dean Whitter calling?
Potential Salary: $131,290 is what those at the top of the middle 50% earn.

Diplomacy: Although I alone deal with Isabella’s diabetes on a day-to-day basis, I definitely need a knowledgeable veterinarian. Luckily, I’ve found one. Like all relationships, though, there are times when I don’t agree completely with the vet’s opinions (on, say, food) or suggestions (for lab tests). That’s where a healthy dose of tact comes into play. I’ve got to be able to disagree, ask questions, and make my own suggestions and maintain collaborative relationship. It can be tricky, but not, I imagine, any more tricky than the work done by the diplomats of the US Foreign Service.
Potential Salary: Senior Foreign Service officials earn $100,000.

Drug Delivery: I’m not talking about dark-alley felonies. Rather, I refer to the skill of safely inserting exogenous insulin into a creature with teeth and claws. It’s all about timing and distraction. I imagine it’s not unlike getting meds into a patient housed in a hospital for the criminally insane. On second thought – maybe that skill is best left off the resume…

Specialty Cleaning: It isn’t one of my favorite parts of kitty diabetes, but let’s face it: the disease involves a certain exposure to, ahem, bodily fluids. First, there’s the blood. Several times a day I perforate my cat to make her bleed. Sometimes the blood is easily contained, sometimes it gets flung far and wide. Then there’s the urine: it needs to be occasionally captured and tested for ketones. The capturing requires a certain intimacy with the cat; the testing, a certain intimacy with the urine. And then there’s the vomit. All cats puke; diabetic ones just seem to puke more, and they like to puke in the middle – middle of the night, middle of the floor, middle of the bed, etc. As Isabella’s personal handmaiden, I get to mop up all those fluids. Often. And that, I believe, qualifies me for a well-paid job as a crime-scene cleaning specialist.
Potential salary: Per the website HowStuffWorks.com “it's possible to reach six figures in a big city with a lot of violent deaths and meth labs” Cool.

So, if I ever get tired of my current job, I’ve got a few other options to explore, courtesy of my cat’s lazy pancreas.