It has been nine months since I had my second stroke.  I like to think I'm doing rather well, but then something will happen that brings me right back to the beginning.  I had a laundry list of things that were seeming rather "off", so I went to see the doctor last Tuesday.  It turns out that the blood pressure medication that I'm on causes swelling in the lower extremities, which means my ankles look like grapefruits.  I'm on a calcium channel blocker called Verapamil, which was chosen not only because of its benefits for blood pressure, but because it helps prevent migraines.  If I can have one med that does two things, that's better than two meds, right?

Except maybe not so much.

So, I'm back to compression hose, but now I have to wear the high compression hose, and there just aren't many cute options out there for high compression hose.  Well.  Unless I want to spend about $50 per pair, and I'm not exactly on a champagne budget, here.

I got new meds for my allergies, so I've switched that this week.  I was having some pain in my left shoulder, and it turns out that I've got a frozen shoulder.  I'm in the first stage (freezing), where it's painful, and then there will be the actual frozen stage, where I'll lose mobility, and then finally the thawing stage, where it will all magically get better.  In about 1.5 to 3 years.

So.  Physical therapy.  And I've been told it's going to hurt a lot.  A frozen shoulder happens frequently in white women, pushing 40, with diabetes, who have had a recent stroke.  Look at that....I fit all the categories.  What basically happens is that adhesions form in the capsule around the shoulder joint, causing thickening and inflammation of the capsule and limiting room for movement.  The only solution is to tear those adhesions and then allow the rest of the stages to unfold--hopefully in a smaller amount of time.  The medical name for a frozen shoulder is Adhesive Capsulitis.  Back in December, I fell getting out of the shower, and I thought this all resulted from that--and partially it might have, but partially it's from the stroke, too.  So my doctor thinks that what really happened is that the frozen shoulder is masking a potential rotator cuff injury.  I'll do six weeks of physical therapy, and then go back and see her--if it's not any better, then I'll go in for an MRI to see if I potentially need surgery.

My life is a total party.  Non-stop.

I really need to get back into the swing of writing in here regularly.  Anyway...

I'm doing well.  A couple months ago, I fell getting out of the shower, and kind of screwed up my left shoulder, so I need to get that looked at.  Otherwise, though, I think I am likely as well as I'm going to get.  Which isn't to say that I'm back to 100%, because I'm not.  I think it was somewhat irrational for me to assume I would be.  Although I'd like to get all the way back to my old self, I have to accept that there will be lasting consequences to a neurological event like a stroke.  In truth, it's fairly amazing that I'm as well as I am.  So, I will always have a leg and a hand that don't respond the way they used to, I will still walk with a limp when I'm tired.  But, I am here, and ALL I have is a limp when I'm tired and weak limbs.  That's no small thing.

Oh, and one more thing.

Meet Gwendolyn, my insulin pump/bionic pancreas.  Isn't she lovely?  I'm learning that a lot of people don't know much about insulin pumps.  In fact, almost everyone assumes that it required surgery and the installation of a permanent port.

It did not.  It's composed of about five parts.  There's the pump, then there's a reservoir that holds the insulin, and an infusion set, which consists of the tube that connects the pump to my body, and a cannula with attached adhesive that goes into (and tapes on to) any site I want to put it on, usually somewhere on my abdomen.  And then there's the sensor (which has a filament that goes into my body) that attaches to a transmitter (that sticks on my body) that comprise the Continuous Glucose Monitor (CGM).  The pump and the transmitter are permanent appliances, the sensor and infusion set are disposable.  When I have it on (which is any time I'm not in the shower), it looks like this:

And when I do shower, all I do is twist a piece on the infusion set and it and the pump come off, leaving just the cannula and my sensor and transmitter.  The pump clips onto my waistband, or in my pocket or into my bra if I want to wear a dress.

Every three days, I change the infusion set.  Every six days I change my sensor.  The sensor checks my blood sugar (well, not really.  It checks the sugar level in my interstitial fluid, which isn't really the same thing, but for the sake of argument, let's pretend it is.) every five minutes, and I check with my meter before meals and before bed.  My meter wirelessly connects to my pump, which also wirelessly connects with my sensor.  SO, checking with my meter helps calibrate my sensor for more accurate readings.

It sounds complicated, huh?  It's actually MUCH easier to deal with than needles and pens.  At meals, the pump helps calculate the dose I need to take to correct my blood sugar, if it's high, and also how much I need to take for the amount of carbs I'll be eating.  And then it gives met dose.  In addition, every hour, I get a pre-determined amount of fast-acting insulin--mine is 1.8 units.

To understand why, you need to know a little biology.  And it's like this--your pancreas is around to secrete insulin when you need it (in response to higher levels of glucose in  your system) or glucagon (which prompts your liver to release glucose when there's not enough).  So, my pump replaces one part of that--the insulin.  I can still have blood sugar lows that I'll need to treat, but having a pump and a CGM sensor and transmitter, my pump can tell when I'm getting low, alert me, and prompt me to check to see if my meter agrees that I'm low, and then treat appropriately.

It's a pretty elegant system.  And it's already helping--I've only had it for about a month.  Actually, it's been exactly a month since I put my first set and sensor on.  And I don't know what my A1C was before (I didn't get orders to check it), but I know it's better now.  If I had to guess, I'd say 7.  It was 11 when I had my stroke, so that's a great improvement!  I'd like to get down to a 5 or 6, but I think that will come with time.

Anyway.  Gwen (when I'm happy with her, she's Gwen.  When she wakes me up at 3 AM, I have other names for her.) is a thing.  And now you know more about her than Eric does, which is an entirely other thing.  But, she's another tool in my arsenal that will keep me from  having another stroke.  And that's all that matters.