a week of travail (3)

Friday turned out to be my last day; I'd at least heard that correctly. What I next needed to know was when I'd be getting my "education" so I could have an idea as to when I'd be leaving. Also: there's one important stat that I've forgotten to talk about this entire time: my pulse-ox. A pulse oximeter is a device that slips onto and shines a light through your fingertip, registering not only your blood flow but, more importantly, how oxygen-rich your blood is. It normally goes on an index finger, but I've had it on my middle finger, ring finger, etc.—whichever digit happens to be available at the time. Pulse-ox was definitely one of the numbers the staff was curious about; it's measured as a percent, with 97-100% being good to excellent. Start slipping down to the 92-95% range, and you're probably having a bit of difficulty breathing. I don't know what my pulse-ox was at home when I felt as if I were drowning, but at the hospital, I was around 92%. As long as I didn't exert myself, that range was fairly tolerable for me, but the moment I tried to walk any distance or lift something that would've been easy to lift had I been healthy, I'd feel the tight, invisible hand around my heart and lungs. By the end of my stay, my pulse-ox floated up from 92-ish to about 97-ish. Good enough to let me go, but they did put me on oxygen for a spell on Thursday.

At some point Thursday night, with my roommate having changed from the difficult old man to the introvert, I elected to blast my fan and take a shower. My hospital top had been changed because I'd been sweating so much, but my crotch and entire pants area was redolent with the stink of being unwashed for several days. I didn't shower, but I did the equivalent of having a sponge bath: I used the smart toilet's bidet function, along with some soap, to wash my nether regions. With no towel, I used toilet paper to dab myself mostly dry, then hand-washed my hair and my armpits. My torso was still covered with electronic sensors, so I couldn't do anything about that (by which I really mean that I didn't ask), but after washing my filthiest body parts, I felt some measure of renewal. Couldn't do anything about my underwear, alas.

Now, though, it was Friday morning. I had my breakfast at close to 8 a.m., and I heard that I'd be seeing a doctor (they used the Korean honorific term for professor to describe her—교수님/gyosunim) at around 10:30 a.m., and that I'd be let out soon after. Nice.

I texted my boss (he lives in Suwon, a satellite city south of Seoul) and told him not to bother coming; I'd be done early, and I'd see myself out. The order of events was: get the electronic readers taken off me, see the professor about my education (which I realized would be mostly about my new insulin pen), put my regular clothes back on, walk down the hall to pay my undoubtedly expensive bill, then get the hell outta there. 10:30 rolled around; my chest was free of those sensors although there was still some residual sticker gum leaving goopy traceries on my skin. I got into a wheelchair and was rolled to the elevators. Because I'd been lodged on the 16th floor, pretty much everything except ultrasound was beneath me (ultrasound was also on the 16th). We took the elevator down to 2 and rolled out. I was taken to the Diabetes Education Wing, and within a few minutes, I was greeted by a middle-aged, female doctor who, like almost all of the other docs, immediately asked me whether I could speak Korean.* My noncommittal "A little" allows them to permit themselves the luxury of speaking in full-speed Korean; I catch a healthy percentage of what they say and can guess a lot via visual cues (pointing, gestures, things they write for my benefit), and thus the lecture began.

It was indeed mostly about the insulin pens that would be a part of my life over the next few months. (I don't really need them, just as I don't need the drug metformin despite a prescription for it; you'll see a post on this point later this evening that argues that insulin and metformin only make my problem worse.) But we did go over things like diet (they have ridiculously lax carb standards). I had the chance to practice using the insulin pen on a sort of rubber ball held inside a mount to keep it from rolling; the ball simulated flesh. It took me three practice runs before the doc was satisfied, and she gave me a set of books and pamphlets on diabetes for my edification as I left. I did manage to ask some questions before going, though, and I learned that (1) my problem was definitely not related to COVID,** (2) the insulin shots—which I'd made clear I hated—wouldn't be a permanent thing, but a lot of that was up to me, and (3) repair of my heart would be a matter of following the meds schedule, dieting strictly, and exercising more and more. This did leave me a bit confused, though, because I would've thought the road to recovery for someone supposedly on the brink of death would be a lot less blasé and a lot more specific and strict. Such does not seem to be the case: take zee pills, do zee injections, diet, and exercise without over-straining. No one said I had to worry about being a ticking time bomb who would collapse at any time—no one but that self-righteous doctor at the beginning. So I feel as if I'm in about the same place as I was three years previous. I know that the Newcastle diet had me losing a ton of weight over three months (about 28 kg or 62 pounds), my HbA1c score went down to 5.7 (practically non-diabetic), and my aggressive walking had helped my heart and lungs. Add stairs to that, diet more strictly this time, and that's a winning formula. With many thoughts swimming in my head, I was rolled back to the 16th floor.

Once back on 16, I eagerly changed into the clothes I'd been admitted in the previous Monday evening; a nurse explained the bill-paying and meds-receiving procedure; it all seemed simple enough. My final bill was W1,427,470, less than half my bill from three years ago. I'd stayed at the hospital for less time, and I'd had fewer tests done on me. They had my citizen's ID number, which in theory is linked to my national insurance policy, so I assume insurance played a role in the calculation of price. The place to pay was also on the 16th floor (I wonder whether there's a cashier on every residential floor; they certainly want your money). I was handed some final paperwork that included the dates for my next appearances at the hospital: at the end of this month and on May 24.

Final self-assessment: my pulse was still a bit high, as was my blood sugar, but my blood pressure had been brought under control, and my pulse-ox was near optimal. I had also lost a few kilos. I was still weak and not able to walk long distance, and hefting my Costco bag full of things (it was the boss's Costco bag) was a bit of a chore. Since I'd been given a few weeks' worth of meds, there was no need for me to visit a pharmacy, but I did need to visit a medical-supply store to pick up a constant glucose monitor (in the US, and apparently also in South Korea, there's no longer a need for a prescription to buy this machine). I still haven't done that, but I will do so tomorrow (Tuesday) morning. The CGM tracks your blood-sugar levels all day long; you fasten it onto your shoulder right at the deltoid; it has tiny needles that barely pierce the skin. The moment you eat something, your blood sugar rises, and your body spikes insulin to bring the sugar back down. Insulin isn't the healthiest hormone: it reduces your blood-sugar levels, but it also primes your body to store fat. The object of the game, according to every expert I watch, is to minimize insulin spikes. This is why intermittent fasting and regular fasting are key; if you eat nothing, you have no spikes to worry about.

Having paid up and with no immediate obligations, I took the elevator down and walked out the main entrance, walked across the access roads to the taxi stand, and got myself a cab back to my place, about a kilometer down the street. It would be nice to think that all of this was over, but you and I both know it's not: the hospital will be back to monitoring me, and I'll have to watch for my frequent lapses of will and my post hoc rationalizations, not to mention my diet and exercise regimes. I got healthy once before, though, so I know I can do it again. The question is how to keep the benefits once I earn them.

Welcome to the rest of my life.

__________

*There was one flummoxed female doc who came up to me and gave a speech about something or other in competent but somewhat broken English. When she left, one of the nurses who had witnessed the information dump smiled from behind her mask and chirped, "She didn't know you spoke Korean!" I told the nurse I was, if anything, relieved to get that information in English. Medical Korean is still mostly beyond me. I learn terms as the need arises, but I'm always behind.

**I was left to wonder, though, how I could have been strong enough, pre-COVID, to do 1.25 staircases, then suddenly left weak with heart failure. Maybe I'll ask the next time I'm at the hospital in a couple of weeks.

It was a relief to walk up to my apartment's side entrance.

Spring is here.

insulin pens

tiny black dots = pinpricks from blood-sugar sampling