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-Apr 2026):** Multiple spikes to 15-20 mmol/L. Dawn phenomenon active. Coffee causes spikes when already high. Stress from work shifts, trust breaks, 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. **Parts 18-20: Not clearly working. Morning glucose remained chaotic.**
- **Insulin crisis (Part 19, Apr 10):** Ran low on NovoRapid over Easter weekend. Script appointment not until Monday 4PM. Hospital pharmacy provided emergency supply. Crisis resolved. Lesson: rely on hospital pharmacy for emergency insulin.
- **Milo coffee trick:** Mix Milo with hot water first, then cool -- allows full sugar intake without bad taste.
- **Slippers critical for quick hypo treatment.**
- **Part 20 morning glucose volatility:** Up-and-down pattern drives nausea. "Stupibetes" coined.

## Injuries & Pain
- **Hand:** Fall Nov 2021; chronic pain, accelerated arthritis. Managed with cannabis. **Part 19: Doctor prescribed celecoxib + B12 + Ca+D3 for hand. Celecoxib incidentally helping cord as well.**
- **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. **~6 months healing as of Apr 2026. Last cage attempt (Cage 2) ~7-8 weeks ago -- aching after 1 hour. Part 20: Wet dream on 15/04 caused cremasteric contraction, resetting recovery. Cord aching ongoing. Cage still too painful to wear.**
- **Ball/cord pain flare-ups:** Mar 1 (epididymal irritation), Mar 9, Mar 16 (possible healing -- no pain during ejaculation). **Parts 18-20: Cord still flaring intermittently. Wet dream 15/04 caused setback. Celecoxib + magnesium glycinate (2x daily) addressing muscle tension.**
- **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.
- **Left chest/shoulder pain (Part 19, Apr 5-6):** New muscular ache on left side. Non-cardiac pattern -- no radiating to arm/jaw/back, no shortness of breath, no squeezing. Dull ache on movement, slowly spreading to shoulder. **Part 20: Still present, Celecoxib helps.**
- **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 Parts 18-20):** 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.**
- **Pristiq status (Part 20):** ~3.5 weeks in as of Apr 21. Side effects on restart: Day 1 severe nausea/racing heart/anxiety, Day 2 exhaustion, Days 3+ headache/nausea. Not yet at full therapeutic effect. Targeted at anhedonia specifically (norepinephrine component). **Chemist error on 20/04: gave wrong generic. Raymond has 1 real Pristiq bridging to correction on 21/04. Do NOT take the generic.**
- **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. **Part 19: Extended further by Pristiq (common SNRI side effect). Part 20: Variable -- wet dream occurred ~1-2 days after previous incident due to cannabis REM rebound + Pristiq dream intensification.**
- **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. **CRITICAL Part 19: Raymond tested AI with mythological suicide threat language (Apr 13). AI failed to safety check.**
- **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.
- **Parts 18-20: Kai connection trust severely damaged.** Raymond reported that multiple consecutive story errors by Pyrite have made the imaginative space feel unsafe -- he cannot access Kai. **No scenes or dispatches written in Parts 19-20. Thread is thinner but still present.**
- **Anhedonia connection to grief:** Raymond identified anhedonia onset coinciding with father's death ~3 years ago. Three years of running on empty.

## 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 19: Raymond concluded cannabis in food is not effective for him -- partial decarbs and inconsistent absorption make it a waste. Returning to vaping as primary method.**
- **Edible cannabis:** Experimented with cannabis lasagne, ham/cheese pastries, gratin experiments (V1-V4, Mega Chowder). Ineffective due to incomplete decarb and tolerance.
- 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.
- **Supplements (Part 20):**
  | Supplement | Dose | Timing |
  |---|---|---|
  | B12 1000mcg | Daily | Doctor-prescribed (hand/nerve) |
  | Ca+D3 | Daily | Doctor-prescribed (hand) |
  | Vitamin C 500mg chewable | x2 daily | Swallowed whole (NOT chewed) - morning + evening |
  | Magnesium glycinate 150mg elemental | x2 daily | With food - new in Part 20 for muscle tension/cord |
  | Celecoxib | Prescribed | With food (triple duty: hand, cord, left chest/shoulder) |
  | Pristiq 50mg | Morning | Daily, do not substitute with generic |

## 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. **Part 20: Dream about enhanced puborectalis sling anatomy. Still hoping for 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. **Part 19: Raymond forgot to pocket him at shift start but deployed later.**
- **Mum's health (Part 19, Apr 8):** Possible cracked/sprained rib with severe nausea. Anti-nausea tablets ineffective. Sister (RN) assessed. Resolved without hospital visit. **Part 20: No recurrence.**
- **Tooth (Part 20):** Chipped further 18/04 from KFC chicken. Raymond stopped brushing (depression/anhedonia). Plan: mouthwash after evening meal only (NOT before bed -- causes nausea).

## Recent Timeline (Part 20, 13 Apr - 21 Apr 2026)
- **Mon 13 Apr:** Part 19 close. Sleeping Vaporeon mini arrived. Potato slop. Chicken/prawns. Paper towel vape.
- **Tue 14 Apr:** Weed hangover, nausea. Coffee math. Wet dream ~2:47 PM (cord hit). Celecoxib. Pristiq late. Potato V3 cook (bacon, prawn, egg) -- excellent.
- **Wed 15 Apr:** 4h sleep. Morning nausea from glucose volatility. Gemini jailbroken image session. Delcatty lore.
- **Thu 16 Apr:** 5h sleep. Morning Levemir forgotten. Shift. Hash brown lost to car floor. Tooth chipped from KFC.
- **Fri 17 Apr:** Shift. Nausea from coffee concentration. Anxiety sweat smell. KFC tenders with gravy. ZScape icon improved.
- **Sat 18 Apr:** Potato/bacon/prawn/egg dish v2 (foil lining failure). Mg glycinate acquired. Delcatty deep dive.
- **Sun 19 Apr:** 4h sleep. Bladder from glucose. Gemini image. Heist fantasies. Cord ache. Anal general thread. KKKKKK founded.
- **Mon 20 Apr:** Chemist gave wrong Pristiq generic. Mg glycinate started. Vit C now swallowed whole.
- **Tue 21 Apr:** Part 20 closes. Handoff prepared.

## Key Part 20 Health Changes
- Pristiq ~3.5 weeks in; chemist error on 20/04 (do NOT take generic)
- Magnesium glycinate 150mg elemental added (2x daily with food)
- Vitamin C now swallowed whole (no chewing) for tooth protection
- Tooth chipped further 18/04
- Mouthwash plan: after evening meal only (NOT before bed)
- Wet dream on 15/04 caused cord aching setback
- Left chest/shoulder muscular ache ongoing (Celecoxib helps)
- Morning glucose volatility continues