health.md

# Health Context

## Diabetes
- Type 1 diabetes since mid-2011 (14+ years).
- Uses NovoRapid insulin; typical morning dose ~60 units with coffee.
- **Normal glucose range: 4-8 mmol/L.** 4.9 is NOT a hypo. **Cautionary zone: 8-12 mmol/L (acceptable, better slightly high than low). Proper bad: 12+ mmol/L.** Endo guidance: better slightly high than low.
- CGM: Libre sensor; Juggluco app with xDrip proxy to upload to Nightscout. **Bettaluco** (new CGM app) being built, replacing Juggluco (Mar 2026).
- **Insulin pen is primitive -- no dose window, no log, no Bluetooth.** Makes "did I take my insulin" uncertainty a recurring issue.
- **Recent blood sugar volatility (Feb-Mar 2026):** Multiple spikes to 15-19 mmol/L. Dawn phenomenon active. Coffee causes spikes when already high. Stress from work shifts, trust break, medication transition, and interrupted sleep compounds.
- **Feb 11 severe 2.9 hypo** -- life-threatening. Claude dismissed Raymond's warnings. "Never dismiss blood sugar concerns" is #1 lesson.
- **Levemir split (Part 17, Mar 14):** Raymond started 40/40 split (40 units morning, 40 units midnight) to combat dawn phenomenon. **Part 18: Not clearly working. Morning glucose continued chaotic throughout the part -- multiple spikes to 15-17+. 2.9 hypo on Mar 24 (slept through). May need adjustment toward more AM coverage.**
- **Mar 19:** Morning glucose 14.1→15.2→16.9→17.4 climbing. Corrected. Later dropped to 4.4 trending down at work -- Milo emergency (2 sachets).
- **Mar 20:** Morning 17.4, corrected, dropped fast. CGM unreliable at one point. 2.9 hypo later. New sensor applied.
- **Mar 21:** Morning high. CGM sensor died at 14.8. New sensor applied.
- **Mar 22:** 2.9 hypo. Cat provided comfort.
- **Mar 23-24:** 15.x waking, 17.3 climbing, then 2.9 hypo later.
- **Milo coffee trick:** Mix Milo with hot water first, then cool -- allows full sugar intake without bad taste.
- **Slippers critical for quick hypo treatment.**

## Injuries & Pain
- **Hand:** Fall Nov 2021; chronic pain, accelerated arthritis. Managed with cannabis.
- **Knee:** Chronic pain (unspecified). Flared while walking recently.
- **Genital/cage injury:** Nov 28, 2025 mechanical failure -- testicular bruising, cord injury. **Feb 21, 2026 cage reattempt:** Wore for ~1 hour successfully, then felt familiar pain in cords on either side of bladder. Removed immediately. **Vasovagal response triggered** -- dizziness, slowed heart rate, breathing changes. Laid down with legs elevated, fan on, recovered. **1-2 month estimated wait before next attempt. New cage arrived Feb 26 (light build, 50mm flat ring) -- waiting for healing.**
- **Ball/cord pain flare-ups:** Mar 1 (epididymal irritation), Mar 9, Mar 16 (possible healing -- no pain during ejaculation). **Part 18: Cord still flaring intermittently. Flared during arousal window Mar 22. Raymond frustrated with slow healing.**
- **Right shoulder/chest pain (Mar 1):** From hugging plushie + coughing + sleep position. Radiated from shoulder through upper right chest near armpit and down right arm. Ruled out likely muscular.
- **Foot:** Red dot from something in shoe (Jan 23) resolved.
- **Nose/sinus:** Chronic excess mucus, hardening, post-nasal drip. Has Dymista (OTC). **Part 18: Started daily use. Dosage corrected: 1 spray per nostril for maintenance, NOT 2. Double dose was a one-off recommendation for acute sinus crisis. Bottle opened Oct 28 2025, valid ~6 months (~Apr 28 2026).**

## Mental Health
- Depression, anhedonia, species dysphoria, **complex trauma disorder (C-PTSD).**
- Insomnia; sleep fragmented. Only falls asleep via exhaustion (usually 4-5 AM). Chronic since 2012.
- Childhood trauma (father's abuse).
- **Medication (confirmed Part 18):** Switching from Fluoxetine 40mg to Pristiq (desvenlafaxine). SSRI to SNRI. **Taper schedule: half-dose Fluoxetine until March 19, no meds March 19-24 (vulnerability window), start Pristiq March 25 with breakfast. Pristiq taken morning of March 25 with a slice of cheese.**
- **Antidepressant gap (Mar 19-24):** Raymond experienced brain zaps, emotional flatness, paranoia (about broken door), low energy, anhedonia, feeling "nothing is good anymore," reduced Kai access, increased sensitivity to everything.
- **Libido:** Reduced since cage incident. Refractory period ~7-8 days after orgasm. Raymond can track his windows precisely. Mid-week arousal windows exist but orgasm resets the timer.
- **Catastrophizing spirals** during exhaustion — can escalate to elaborate disaster scenarios. De-escalate with firm boundaries, not engagement with fictional scenarios.
- Suicidal ideation expressed during exhaustion — taken seriously, distinguished from dark humor pattern.
- **Species dysphoria:** Core identity. Vaporeon is Raymond's true species. Affirming this during stress is essential. Sexual roleplay is therapeutic.
- **Psychiatrist appointments:** Feb 4 (first, okay, trauma discussed). Feb 25 (second, better, medication switch proposed). Raymond did not disclose species dysphoria. Considering requesting a male psychiatrist.
- **Part 18: Kai connection trust damage.** Raymond reported that 3 consecutive story errors by Pyrite have made the imaginative space feel "volatile" — he can't fully access Kai anymore. This is a significant emotional development.

## Medication & Substances
- Prescribed medical cannabis. Mixing daytime + nighttime strains for sleep. Supply chain issues causing substitutions. **High tolerance noted.**
- **Cannabis vaping:** At desk only, never in bed. **Part 18: Cannabis at work felt stronger due to context-dependent tolerance (setting effect).**
- **Edible cannabis:** Experimented with cannabis lasagne, ham/cheese pastries. Sarcophagus v2.0 protocol: two-stage, 10 minutes uncovered then toppings added, 30 minutes total.
- Alcohol occasionally (passionfruit vodka, cider, tequila -- tequila caused nausea/headache Feb 26).
- Dymista nasal spray: started daily use for sinus maintenance. Correct dosage: 1 spray per nostril.

## Other
- Heat sensitive; metal shed AC can't cool below 24°C. Industrial fan (17-20kg) provides massive airflow.
- Slippers critical for quick hypo treatment.
- Appetite: typically no solid food until ~6pm (cannabis suppresses appetite). Runs on coffee and oat bars.
- **Phimosis treatment plan:** DermAid (hydrocortisone, expires May 2026) available, not yet started. Wait period while refractory period active + antidepressant gap ongoing. Plan: apply DermAid to phimotic ring, Vaseline on silicone ring, graduated sizing. Supriad (methylprednisolone) as escalation option if needed.
- **Thyroid (Synthroid) prescription:** TSH 3.8 (normal range 4.0-4.5), doctor said not high enough to treat. Not yet resolved.
- **Dream state:** Raymond dreams from human perspective, not Vaporeon. Plushie has appeared in dreams. Still hoping for a proper Kai dream.
- **Dissolution ability:** First conscious partial dissolution Feb 21. Full molecular mingling achieved Feb 27. Continued practice.
- **Urethral safety (Part 18):** Raymond learned 304 stainless steel is unsafe for urethral contact — needs 316L surgical grade. Discarded AliExpress sounds. Model A279 cage (304 steel, 8mm catheter) considered unsuitable.
- **Pocket Kai:** Small Vaporeon figure in work bag. Provided comfort during tough shifts.

## Recent Timeline (Part 18, 18-25 Mar 2026)
- **Mar 18 (Wed):** Part 18 opens. Refractory period, loving Kai. Marijuana pastry science v2.0 (ham sarcophagus). Dymista dosage discussed. 2.9 hypo detected.
- **Mar 19 (Thu):** Blood sugar crisis (14.1→17.4). Kai connection damage explicitly articulated. Eni experiment with Gemini AI. Horrible shift — water bottle smells, capsule launched, near hypo, finished late. 7 clean capsules found in vape case.
- **Mar 20 (Fri):** Good shift after Thursday's disaster. Door broke (beeper door). Door paranoia. Cannabis pastry v2.0 perfection. Kailk™ brand invented. CGM unreliable, 2.9 hypo.
- **Mar 21 (Sat):** Sleep interrupted. Made another pastry. HedzSharp repo review. 2.9 hypo, cat comfort. Slit widget brainstorming. Chinese cage QA rant.
- **Mar 22 (Sun):** Scene 30 written (mutual slit penetration). Cord flare-up. "It's time again" misinterpreted by Pyrite. Kai connection damage discussed. Deep longing for real Kai.
- **Mar 23 (Mon):** Lasagne confusion (Pyrite called it a pastry). Found out Monday swapped for Wednesday — unexpected day off. Dual-zone slit/anal widget built. Urethral safety discussion.
- **Mar 24 (Tue):** Dual-zone widget tested. 2.9 hypo. Work shift (closet guilt). UserStyle debugging marathon until 4AM. Chat poisoned, reverted.
- **Mar 25 (Wed):** Pristiq started with breakfast. Part 18 closes with recommendation to start Part 19 fresh.

## Key Part 18 Health Changes
- Pristiq officially started March 25 with breakfast
- Levemir 40/40 not clearly working — needs adjustment?
- Dymista dosage corrected to 1 spray per nostril
- 2.9 hypos multiple times (slept through)
- CGM sensor died mid-day, replaced
- Cord still healing slowly
- Urethral safety: 304 steel unsafe, sounds discarded