Honey Tales

Bee Charmer

Not one person who has seen Fried Green Tomatoes will think of anything else but Idgie’s love for Ruth and how she wanted to impress her by getting a honeycomb directly from the hive.

“You’re just a bee charmer, Idgie Threadgoode.

That’s what you are, a bee charmer.”

Honey in Birth

Honey has a great supply of natural sugars and most midwives had honey of some sort on hand, whether in the Honey Bear…

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…or Honey Sticks.

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…or some Honey Lollipops.

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If a woman’s energy was waning, a couple of spoonfuls of honey or 2 or 3 sticks, could perk her back up for awhile more… even if she was unable to eat or drink much else, honey was a great pick-me-up.

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Honey has antimicrobial properties, it is a hydrogen peroxide thing, and there is a lot of research showing honey, Manuka Honey in particular, used on infections can help heal the wound quicker… and without the risk of medication interactions/allergies. Honey is often used on diabetic ulcers, it being more effective than many other treatments.

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New Use for Honey (for me)

So, I kind of knew this, but when I was an intern midwife in San Diego, I got to see the range of what home birth midwives do with honey.

Mind you, by the time I was interning as a midwife in San Diego, I had been in birth for over 20 years and had gone to hundreds of births in hospitals, birth centers and at home. Over the years, I would see things done I had never heard of before, but could usually be shown the research about it.

Honey was often used in the way I mentioned above; for energy.

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So when a woman’s perineum tore at birth and said she did not want to be sutured, I was pretty shocked (every woman who had ever torn in my experience was sutured, it wasn’t ever a consideration not to be). When the midwives acted as if this was a normal thing, choosing no stitches, I was baffled. When they pulled out the plastic Honey Bear and grabbed a spoon from the family utensil drawer, I blinked.

Honey was spread onto the back of the spoon, the woman’s legs opened a bit and the honey “painted” on the tear, all the while the “antibiotic” properties of honey explained. She was instructed to keep her legs together except to put more honey on it.

I’m not kidding.

I still cannot find medical research showing honey’s aid in normal healing of a perineal or vulvar tear; it remains a midwife’s tale that it does anything at all. (This is different than an infected wound, where the research is copious.) Many midwives, myself included, believe it was keeping the legs together that did much more to heal the tear than the honey.

Medical Grade Honey

But, if it did do something, wouldn’t you want Medical Grade Honey (MGH) slathered on your open wound instead of honey the family is using in their morning tea? In fact, research shows that regular table honey has potentially pathogenic organisms compared to MGH.

I mean new parents know to never give their infants honey because they might have spores of a bacterium called Clostridium botulinum. Wouldn’t that follow that it might not be the best thing for a perineum?

Here is a medical grade honey-gauze that might have been an okay thing for an open wound.

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Or perhaps a tube only used only on your body and no one else’s?

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Honeycombs

I remember when my dad (whom I am missing so very much lately) would bring us miel (honey) in the comb from the Cuban store. I loved biting into the wax, feeling the honey ooze out of the tiny openings, then chewing the wax like gum. I wonder if my kids have ever had that experience.

Miel. One of the best Spanish words in existence.

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A Recent Conversation

“I had some cereal and some honey.”

That’s what he said.

“You put honey in cereal? With milk? That’s pretty gross.”

“No, cereal without milk and honey separate.”

“You were spooning honey into your mouth?”

“No I was using a fork and dipping it into the honey and eating it.”

Now I was really on high alert.

“You are telling me that you put a fork into the honey, suck the honey off… then put the fork back into the honey and do it again?”

“Uh, yeah. Why?”

“You are telling me you double, triple and quadruple dip your fork into a communal honey jar?”

“I never thought of it that way before. It never occurred to me.”

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Maybe, knowing what I do now about honey’s medicinal properties, it might not be the grossest thing after all.

(Happy Birthday!)

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Diabetes Discourse: Kidneys

I’ve had Type 2 Diabetes for 21 years now, on insulin for about 18 months. I take 40 units of Lantus once a day and 10 units of Novolog 3 times a day. I am also on 500 mg Metformin.

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I’ve had pyelonephritis (kidney infection) several times, the first hospitalization for it when I was 18-years old. There have been other stays in the hospital for IV antibiotics as well, but it’s been a few years.

During that interim, I was diagnosed with Stage 3 kidney disease. A visit to the nephrologist was awesome, his telling me to not worry too much about it as long as I kept my Blood Glucoses (BGs) under control.

Off and on, labs have shown no kidney stress at all, yet others would, once again, state the Stage 3 kidney disease. My last couple of years’ labs have been pretty good, so I had put the issue on the back burner.

Until today.

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Back Pain

I’ve been having back pain, often a tell-tale sign of “pyelo” (a kidney infection), but was passing it off as… back pain! My urge to pee has been really weird and my not peeing often should have flagged what was happening sooner. It just has been so long since I’ve had any kidney issues, I missed the early signs.

Before I got these labs taken 2 days ago, I thought I’d kicked the pyelo on my own, without antibiotics. Now I am not so sure.

Lab Results

I got a call from the NP’s office that my kidney labs are way off and the upcoming surgery I am scheduled for on February 2 (to have my gallbladder removed… to be discussed separately) might have to be delayed. I go this morning to discuss my labs and have them repeated stat.

It’s scary, these kidney issues. I don’t want to have dialysis… Stage 4 of kidney disease.

I’ll update as I know more.

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Diabetic Discourse: Needles

I’ve been on insulin for a year now.

At first, I was on the kind you keep in the refrigerator and draw up in a syringe with a needle. Good lord, those are pain in the ass.

Not having one clue of all the options, my Insurance Liaison asked if I would rather have pens. I asked what the difference was and she said, “They don’t need to be refrigerated.”

SOLD!

Insulin Pens

I got the pens and loved them right away.

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I keep them in my top drawer with all my pens.

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See the insulin pens? Wayyyy at the bottom.

I am on both Lantus (long-acting insulin) and NovoLog (more immediate insulin), so poke myself 4 times a day.

Now, as a midwife, I know to draw up solutions with one needle, then change needles and use that new one for the injection. Pushing the needle through the rubber at the top of the vial flattens the tip slightly and when you put that in the leg or arm, it hurts more.

But when I use the lancet on my finger to test my blood glucose before giving myself insulin…

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… I (lazily) use and re-use them. They are annoying to change  (4-6 times a day), so it’s just easier to leave it in the mechanism each time. I know, I know… beyond the lazy factor, not too sanitary, either. Especially when I am supposed to be worrying about infections. (I hear you! CHANGE THE LANCETS!)

So when I got the needles for the pens, I thought, “I can be lazy with these needles, too.”

And I was.

Changing Needles

The one thing  with the pens that was different from the refrigerated insulin was the injections freakin’ hurt! It wasn’t unusual to bleed a little after the injection and I also got plenty of bruises.

I don’t recall the reasoning behind it, but a couple of weeks ago, I changed the needle after each injection. Was I experimenting? I have no idea. But let me tell you, when I began changing the needle each time…

… the pain upon injection vanished! The bleeding and bruises? Gone.

What a dork I was re-using the needles.

Clearly, with each stab into my flesh, it flattened those really thin needles enough to damage the skin and tissue.

My Take-Away

Don’t be lazy. Change the dang needle!

Skin Infections (Ugh)

(Rehashing of some stuff, I know.)

Itch, Itch, Scratch, Scratch

I had an iron infusion on October 11th. I receive Solu-Medrol (a steroid) beforehand, but as it wore off over the next day, I began itching. Now, this was my 6th infusion… my first allergic reaction.

I began scratching. And scratching. I took 50 mg. Benadryl. Then 30 min later, another 50 mg. I kept itching. I was using my sharp nails, digging into my skin. I couldn’t reach my back, so used scissors to get the itchies there. Some of this was in the middle of the night; the part with the scissors, I was awake and sitting up.

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Then I went to lay down again and saw a couple of (big) blobs of blood on the sheet and thought, “I probably should go to the hospital!” So I did.

ER Visit

It had to have been one of the most crowded times I’d ever been at this hospital (where they practically know me by name). They couldn’t even get me into a room for over an hour. I was bleeding all over by that point.

The doc came in quickly (yay!) and they gave me a Bolus of Benadryl, some IV Pepcid (which apparently has an anti-itch property) and a nice bag of Solu-Medrol.

It took about 10 minutes when the itching on my arms, legs, hands, belly and feet stopped feeling like I had bugs crawling out of my skin, but my back and head and face kept up almost unabated.

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I got off the table, IV still in place, and poked around the room looking for something long and sharp to scratch with. Not one damn thing. Fuck. I sat on the bed and rubbed back and forth, back and forth… and clawed at my face and head some more.

When the IV was done, I was detached, given Rx’s for prednisone, Pepcid and told to take lots of Benadryl. I went home and scratched with the scissors until I fell asleep from so much Benadryl.

It took 2 more days for the itching to chill out. I was so thankful when it did.

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Residual Issues

Now we are almost 4 weeks out and many of my scratches are still open, two gaping and not doing well at all. The Endo yesterday didn’t seem surprised considering my BGs have been so crazy with all the prednisone I have taken over the last month.

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The wound on my belly is the worst and she used a silver nitrate stick to help with wound healing, then the nurse dressed it. She did the same on my right upper arm… silver nitrate, then dressed. She said she wants to see it in a week and we will decide on antibiotics… holding off on those because 1) I am getting more and more allergic to medications (which at the moment are: Penicillin, Codeine, Azo, Flagyl and whatever was in the iron infusion) 2) they will give me yeast and fuck with my BGs some more. We will try topical first.

The Endo also said I have to see Podiatry for the Neuropathy in my feet. I have a call in to my Primary Care Provider (PCP) for that. And just have to suck it up with the diarrhea at the moment. I will ask my PCP for help beyond Immodium and Lomotil.

I go to the Hematologist tomorrow… am supposed to have an iron infusion, but we’ll see what the plan is for someone allergic to it.

Argh! I am so tired of being allergic to stuff!

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Diabetic Neuropathy Begins

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Legacy of Diabetes

I’ve had Type 2 Diabetes since I was 34-years old… for 22 years now. My entire Cuban family had diabetes as well; skinny, fat and inbetween. My entire life, I watched my pot-bellied relatives manipulate their insulin so they could eat and drink whatever they wanted. I watched as they lost their eyesight, had heart attacks, then had feet and hands cut off from infections. My grandfather died before I was born from complications of diabetes. My grandmother, aunt, uncle all died from diabetic complications. It seems I am next on the list.

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Added Challenges

My Blood Glucoses (BGs) are almost impossible to control. I have been having to take steroids (SoluMedrol & prednisone) because of several allergic reactions lately. (One reaction was to Azo… the other to the 6th iron infusion I had… that one sent me into the hospital because I was scratching myself bloody and using scissors to scratch my back… also bloody.)

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My diet is comprised of almost all carbs for a variety of medical reasons, including dental. Exercise is impossible. I am destined (doomed?) to using insulin to get my BGs under control.

Doctor Visits

Whenever I see doctors, they ask if my feet are numb, tingling or hurt. I have said no for many years. Now, however, they are beginning to hurt more and I realize the pre-pain feeling I’ve had has been like a tight sock on my right foot. Now, at night, there is distinct pain.

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I’ve never read about Diabetic Neuropathy before today and now I am scared.

Besides the foot pain, I also have what seems to be untreatable diarrhea. Taking 30 Imodium a day does nothing to quell the issue. Lomotil doesn’t do a thing either. The GI Doc said I need to get the Endo to help. I see the Endo on Monday. Hope they are able to give me something else. It is distressing, always having to dash to the toilet… pretty challenging trying to work.

I have some Cymbalta from when I was rx’d it for depression and read that was one good medication for the neuropathy. Hopefully, someone will rx it (or something else) to help with the pain.

One More Medical Problem

I have an ongoing list of medical crap I am dealing with, all because of being fat. My fat life is (quite literally) piling on the complications.

All my fault.

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Fat Girl Whining

I’m fat. Really fat. Over 300 pounds fat.

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I also have Diabetes and have to see an Endocrinologist every few months. Endocrinologists take care of fat people. A lot of fat people. There has not been a time when I’ve sat in an Endo’s office that there were no less than 4 really fat people. I just left the Endo’s office (and I love the people there) and need to vent for a second.

Chairs

How can an office that caters to fat people not have chairs without arms on them? How?! The first time in there, I asked for a chair without arms and they brought out one of the bench chairs (that still had arms on it). Fine. They brought it in the exam room with me, too. Nice.

Today, the bench was there… with someone already in it. So I had to cram my fat butt into one of the tiny chairs… with the arms going INWARD instead of out! What the crap?

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I spoke with the office manager who said she’d already put a work order in for more benches and asked me to answer to survey I’ll get in my email with a comment about the chairs.

We’ll see how long that takes.

Blood Pressure Cuffs

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For fuck’s sake, I thought I had finished complaining about medical people taking my blood pressure incorrectly/painfully 2 decades ago.

  • Dealing with a stupid ER nurse using medical tape to try and keep the wrong size cuff on my arm, the tape splitting and the nurse huffing off to get his supervisor
  • Having too small cuffs bruising me dozens of times
  • Having large cuffs bruising me because I have really big upper arms with batwings

I thought I’d come up with a solution by insisting they use the cuff on my forearm. Techs and nurses balked at first, but for the last 5 years, it has been a matter-of-course to take my BP that way.

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Then today, the nurse came at me with a thigh cuff, easily twice as large as the large-sized cuff. I asked her to please take it on my lower arm and she said they had just had training saying it was required to take it on the upper arm because doing it on the forearm is “quite inaccurate.” I grudgingly said she could try, but if it hurt, I would cry.

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The cuff goes on and begins tightening. And tightening. And tightening even more. I said, “It hurts, take it off,” and it stopped pumping up so I said I’d sit still. Then it began tightening again and I nearly hollered, “GET IT OFF.” She did, charting, “Patient refuses BP.” I corrected her: I am more than glad to have my BP done, but on my forearm. She shrugged and left the room.

After my appointment with the Endo (which went really well), I asked how we were going to resolve this BP issue and she said it was “policy” and she would ask what to do. I said, “Patient requests forearm blood pressure,” please put that in my chart. She did.

Fat Anger

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We (our country) is fat… and getting fatter. What is wrong with healthcare providers that they do not make concessions for us? I’ve been writing about this since 1987!!! This is ridiculous.

Not accommodating fat people is yet another way to discriminate and intimidate fat folks. Healthcare providers not doing so prevents far too many people from obtaining care at all, care that can keep them healthier… and for you fat haters, even help fat folks lose some weight (if they want to or are able to).

Over the years, in the courts, this accommodating for “morbidly obese” people has been argued. The general consensus is now that fat falls under the American With Disabilities Act. One more thing on our side.

Please Speak Up!

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Many fat people in our society sit in these tiny chairs, put up with exam tables that do not go up and down and never ask for accommodations for their size. I speak up whenever I can, but I cannot do it alone.

Thinner/Smaller friends and family, please “see” things how we do. If you see people squished into chairs, quietly talk to the office manager, explaining how difficult the chairs are for fat people. Say you have a family member or friend (which I am!) or partner that won’t say anything, but that they get bruises every visit. If you work in an office, restaurant or anywhere people need to sit, please advocate for us to get the proper seating for fat folks.

Special mention to servers: PLEASE STOP SEATING FAT PEOPLE IN BOOTHS (unless they ask to be put in one specifically). It is humiliating to try and squish ourselves into the tight tight space at a booth.

And if anyone thinks the small chairs and small spaces are going to force us to lose weight, you are woefully incorrect. Fat-Haters, rue the day this issue is yours or someone’s you love.

Thanks for listening. Rant over.

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painter: Igor-Grabar