Twilight

 

Sunset in Chiba-2

Last month, my family and I buried our father. His journey towards the end of his life reinforced lessons I learned from my mother’s final struggle with cancer and death nearly 19 years ago.

We are born. We live. We die.

That is a reality that we all share. But a lot of people I know talk about living and not so much about dying. Unless they talk about death in a religious or philosophical context, death is taboo, or at least is an uncomfortable topic. The mention of death is dismissed as morbid, rather than the liberating exercise that it could be. Many discuss quality of life – whether and how often they should exercise, what they should and should not eat, how they should avoid stress, and what job will not strangle their soul – yet stay away from talk of death. But no talk about life is complete without considering how one approaches the end.

Of course we don’t know when and how we will actually leave this world. But we can think about certain eventualities and how we and more importantly our family will deal with them. Do I have life insurance and is it sufficient? Do I have a will? In addition, we should also seriously ponder upon three other important questions.

The first is “What is our will?” If an accident results in us going into a vegetative state, what should our loved ones do? Do they keep us going even if we will forever be plugged into machines? Do they authorize surgeries just to keep our bodies going for one or two weeks longer? Do they donate our organs? Do they let us continue to exist even after we are reduced to less than the shell of the person we were?

The second is “Who decides for us if and when we become unable to do so?” This is especially important if you are in a relationship but are not married. You do not want your long-time partner shut out by family members for any reason. Please have the necessary legal documents to make sure your chosen representative, and no one else, is authorized to represent you.

The third is “How do we deal with serious illness?” Should we be faced with a serious medical condition, such as a terminal illness, what do we do? Do we undergo chemo, a series of surgeries, or experimental drugs or therapy? Do we waste valuable time and resources depriving ourselves of proper food and nutrients to follow a grueling detox program because some pseudo-science alternative medical entity tells us so, as my father had done out of desperation? Instead of being in a hospital, do we prefer to spend our last days in a beautiful, peaceful environment?

These are some of the things we should not be afraid to ask while we have the mental, physical and emotional objectivity and capacity. Once we are seriously sick, we become less objective and may clutch at straws in the false hope of prolonging our existence. If, due to bad circumstances, we end up in a coma, we certainly will not be in any position to make any decision.

By the way, I’m not saying we should not fight for our health and our life. We must fight. But at some point the nature of that fight changes, and we should be ready to accept and prepare ourselves and our loved ones for the inevitable. Instead of dying a shrunken, tired individual whose last weeks are spent in fear, pain, and suffering, we can choose to spend those weeks leaving behind better memories, ticking off the last things on our bucket list, or simply enjoying the sunset.

More importantly, by being prepared, we hope that we can spare our loved ones the difficulty of second-guessing us and the guilt that that may produce. No one wants to be seen as callous or unfeeling even if the most difficult decision to make is the right one. No one wants to do the right thing only to be riddled with guilt and self-doubt. Indecision, family wrangling (which thankfully my family did not face), fear, guilt, even shame – these are not the legacies with which you wish to burden the ones you love.

Bureaucrats!

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Every time something works, someone will come along to mess it up.

This morning, I visited my endo for my quarterly checkup. Everything is fine, except for one tiny change in our arrangement which my endo announced at the end of the consultation. Apparently, the National Health Insurance (probably thanks to a bored bureaucrat or more likely a group of bored bureaucrats) has decided that effective April 1 doctors cannot issue a script for more than 60 days’ supply of medicine. Previously, my endo regularly issued 90 days’ worth of metformin (plus 10 days’ allowance in case I need to reschedule my checkup due to any unforeseen event), which covered my needs until my next quarterly A1C bloodwork and checkup. It worked perfectly. With the recent change, however, my script will no longer match my quarterly A1c check and I will be required to pay extra visits to my endo just to pick up meds.

Why? Why? Why? I’m sure that in the larger scheme of things there is a reason for the new restriction. But, I’m also sure that whoever thought of this new scheme did not consider the fact that it is a big inconvenience to a lot of patients.

My doctor and I discussed our options.

Option One, in two months, I’ll pick up one month’s supply of medicine and go back one month later for my A1C checkup and to pick up my next two months’ supply. Repeat.

Option Two, in two months, I’ll pick up two months’ supply of meds and go back two months later for my A1C test and the next two months’ supply. Repeat.

Either option demands that I visit my endo the same number of times. But with Option One, I can maintain my quarterly A1C tests, whereas with Option Two I will have only three A1C tests a year, with a total of three months that are not covered by any A1C check. I suppose it’s Option One for me.

Some of you may be thinking, “What’s the problem? It’s just four extra visits to the doctor’s a year to pick up medicine.” Of course, if I had all the time in the world, the extra journeys to the doctor’s is not an issue. But, like most people, I don’t have that luxury, and I’m willing to bet, neither do those bureaucrats should it be their turn to be the patient.

Kickstarting the Year of the Monkey

The Year of the Sheep was not my year. sheep-152371_1280It was generally disappointing, depressing and discouraging all around. Early on, there was a troubling occurrence at work. I failed in my attempt to do another marathon. My father’s health worsened, which was compounded by his desperate experiment with a pseudo-medical quack institution. Although I don’t express it aloud, my father’s health weighed heavily on my mind. All these things contributed to an almost yearlong cohabitation with depression. I lost interest in things I cared about and loved the most, even singing and music in general, something which I could not imagine ever happening. I didn’t care, an attitude which extended to my own health. I stopped self-monitoring my blood glucose; I loosened up a lot on my diet; I did a lot more sitting than exercising. I went through big chunks of evenings and weekends doing, and thinking of, nothing. I had been mostly coasting along in the trough.

But, by some miracle, I’m emerging from this almost dark hole I found myself in. This was triggered by my experience on New Year’s Eve. I was at a club, where more than three-quarters of the people who paid to get in spent their time sitting down, looking bored or taking endless selfies, and burying their faces and typing away on their mobile phones or tablets, probably sharing their “grand” time at the club. I wondered, Why pay to get in if you’re just going to sit down, especially on New Year’s Eve? To those addicted to selfies, really, how much more narcissistic can you be? (A lot more apparently.) There were a few people who at least talked to each other, danced, or bobbed their heads with the music (I can still see this elderly Chinese woman, obviously a tourist, who had no mobile phone, thoroughly enjoying club music). But generally, all I could see were the tops of people’s heads over their lit phones. I found the scene so pathetic that I suddenly felt good. At least, even with me down a hole, I can say that I had a life. As 2016 waltzed in, I resolved to get that life back.monkey-152685_1280

I began by going for my quarterly bloodwork. My A1c was slightly over 6%. While I was anticipating a far worse number, I have not been out of the 5% club in seven years. So, despite the fact that I have not been a good Type 2 diabetic, I was slightly crestfallen with my A1c. My endo looked at me kindly and told me not to worry. But at the same time he warned me sternly to watch my carbs and increased my metformin dosage to (in his words) “help you return to your previous levels”. He then reminded me once again to watch my carbs, and to lose the small  amount of weight I gained in the previous three months.

I’ve returned to exercising, with walks and skiing.  Last weekend, the ski slopes punished me for my lamentable lack of fitness. Not only did I ache all over after skiing, I had no stamina while taking on the slopes. That’s all the reminder I needed to work on getting my fitness back this year.

I have started pricking my fingers again to check my blood glucose. I stopped self-monitoring long enough for my fingers to forget how painful it can be, even with very slim lancets. I’ll just have to keep wincing until I get used to the discomfort of self-monitoring, which doesn’t take long.

I’ve started reverting to my previous way of eating. Basically that means forgoing rice, noodles and pasta which found a way of becoming a staple in my diet last year. I have also requested my generous office roommate to stop tempting me with chocolate covered wafers and cookies, and he has kindly agreed.

As you can see, I’m well on the way to getting my diabetic life back on track. No matter how miserable 2015 was for me, I relearned some important lessons. Life will throw me a curveball; it may do so one at a time, but sometimes three, four or more at the same time. When that happens, I know I can count on family, friends (online and offline), work (yes, work and not vacation) and more importantly my husband to get me through. I’m never ever alone, and all the difficulties will eventually pass. I just have to hang in there. Most importantly, I have to have faith in myself. That’s something that many probably have difficulty remembering during difficult times; I know I have. But however difficult you think life could be, if you can weather the challenges, life will reward you and you come out a winner.

It’s just the start of the year but I have a great feeling about this year. I was born in the Year of the Monkey, and I’m a Monkey, so this is definitely my year. I don’t go for superstitions; however, after a dismal 2015, the Year of the Monkey cannot go anywhere but up.

 

 

 

 

 

 

 

 

 

 

Changing attitude?

men-311308_1280A couple of weeks ago, on a boat ride with strangers, I noticed one of the passengers brought with him no-sugar happoshu or low-malt beer. The passenger was a Caucasian male in his late 20s or early 30s. I asked if I could check the food label as I wanted to see if the beer was no-carb as well. As he handed the can to me, he volunteered that he was drinking no-sugar beer because he is pre-diabetic. I was taken aback by this disclosure because he was not embarrassed about his condition, unlike other non-Japanese Type 2 diabetic or pre-diabetic individuals I’ve met. In fact, it seemed to me that he was more embarrassed by the fact that he was drinking no-sugar beer than he was by the diagnosis, and that his condition was a poor excuse for not drinking regular, proper, beer. Continue reading

A new chink in my diet

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Rice bowl.

When it comes to food, I consider myself lucky in that I have no allergy or intolerance, apart from lactose. Of course, being diabetic, I have to minimize, if not avoid, carbohydrates (especially simple carbs) to have better control of my blood glucose. That said, I can choose to indulge if and when I wish; of course, with full knowledge of its effects. This is the case with rice. I generally do not eat rice because rice of all sorts, white, brown, red, polished and unpolished, raises my blood glucose really really quickly. But now I have to avoid rice for another reason. It seems that I have developed an intolerance for it.  Continue reading

Singing may be detrimental to my diabetes

spaghetti-31784_1280I had recently performed in a summer recital which my teacher mounts annually for her students. Although preparing for the recital can be stressful, I look forward to performing every year. This year, I was especially excited because I would be singing a really famous Italian aria which for years my husband had been asking me to learn. My excitement spilled over to what I would wear, what make-up I would use, and even to what color I would paint my nails. I actually had my nails done, something I’d never even bothered to do in the past recitals. I wanted to look my best. Continue reading

Being Large

weight-loss-494284_1280I’ve been doing some retail therapy lately and been so thrilled to be able to buy decent tops in Tokyo. A few years ago, even after my weight loss, my choices of blouses in Japan were limited to a handful. These days, though, I have found more shops carrying wonderful Large size tops. What I find remarkable is the fact that I’m now comfortable asking, “Do you have this in Large?” Continue reading

So What!

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My peaceful hiatus from the online diabetes community was disturbed by the uproar started by the misleading, ill-informed and insensitive tweet by the CEO of Crossfit and the equally misleading, ill-informed and insensitive responses to that tweet from certain members of the diabetes community. For those who are not aware, let me summarize. The inconsiderate and ignorant CEO tweeted the image “Coca-Cola Open Diabetes” which clearly insinuated that sugar causes diabetes and that therefore those who drink too much Coke (or have too many sugary things) brought diabetes upon themselves. This tweet drew indignation from the diabetes community. Sadly, the indignation included the equally inconsiderate and ignorant response “Learn the difference between Type 1 and Type 2” from an alarmingly large number of Type 1 diabetics (represented by a pop music personality) or their parents.

Like many, I was incensed with the Coke-related tweet. Continue reading

D Blogging

Note: Day 6 of DBlogWeek. If you have been blogging for a while, what is your favorite sentence or blogpost that you have ever written?  Is it diabetes related or just life related?  If you are a new blogger and don’t have a favorite yet, tell us what motivated you to start sharing your story by writing a blog?  (Thank you Laddie of Test Guess and Go for suggesting this topic. I don’t think I’ve ever written anything that I can say is my all time favorite. Often I read someone else’s article, essay, novel, blog post, or interview, and I think “Man, I wish I had written or said that!” It took me a while to garner enough courage to blog. Envy and frustration made me do it. cloud-709095_1280 Continue reading

Lunch

Note: Day 5 DBlogWeek. Taking a cue from Adam Brown’s recent post, write a post documenting what you eat in a day!  Feel free to add links to recommended recipes/shops/whatever.  Make it an ideal day or a come-as-you-are day – no judgments either way.  (Thank you, Katy of  Bigfoot Child Have Diabetes for this topic.)

Pardon me for deviating from the topic but I thought this DBlogWeek prompt would be an apt opportunity to answer a question I often receive from friends and strangers, diabetic or not: What do I eat for lunch? I get this question because I live and work in Tokyo, where rice and noodles are among its staples. Since I do not bring my own lunch to the office, many wonder how I manage. Actually, it is not that difficult to find suitable dishes and restaurants in Tokyo, which is among the world’s top food meccas. In most cases, rice is either served in a separate bowl or placed at the bottom of the bowl (as in rice bowls). Instead of describing food options, which I’ve done before (here), I’ll let you see for yourselves some of the reasonably priced choices available at restaurants and food courts near my office.

Western

Another Garb lunchGarb lunchLunch salad

 

 

 

Chinese

Chinese pork dishMabodofuChinese lunch

 

 

 

 

Japanese

Negitorodon

Rice bowl – the rice is separated by dried seaweed

Japanese lunch

Oyakodon

Chicken and egg rice bowl – the rice is under a layer of cooked egg

 

 

 

 

 

 

Bento

Thai bentoBeef bentoSalad bento