health.md

# Health Context

## Diabetes
- Type 1 diabetes since mid-2011.
- Normal range 4-8 mmol/L. Cautionary zone 8-12. Proper bad 12+.
- **Part 27 Events (already recorded):** ER visit 28/05/2026. Major hypo 30/05/2026 from 80 units NovoRapid at ~5AM. Major hyper events (18.6 on waking, 19 mmol peaks). Frequent Somogyi rebound pattern.
- **Part 28 Events:**
  - Persistent morning hyperglycemia — waking 9-10 mmol most mornings, insulin taken
  - Frequent urination episodes — three times in 15 minutes (01/06)
  - Sleep continuity improved: 6.5 hours (Sun 31/05 -> Mon 01/06), ~6 hours (Tue 02 -> Wed 03, woken by call)
- **Part 29 Events:**
  - CGM expired Saturday morning 06/06 — unknown values during sleep
  - No specific highs/lows reported
  - Metamucil started for bowel regularity and anal prep (Friday 05/06 evening)
- **NovoRapid 80u nightly prescription** (from GP 19/05/2026, Part 26). Raymond uses cautiously — only when he feels he needs it. Has experienced severe hypo from this dose. Timing mismatch concern flagged.
- Levemir split history: 72 once daily → 40/40 split (mid-March 2026) → 40/60 (Part 18) → 60/60 (120u total).
- **CGM:** Libre sensor with Juggluco. Functions for live monitoring. Expired 06/06 — needs replacement.

## Injuries & Pain
- **Cord/Cage Injury — CORRECTED Part 28 (03/06/2026):** The November 2025 event was MECHANICAL failure, not primarily a cord injury. Cold wind caused scrotal shriveling → cage lifted off body (longitudinal gap issue) → testicles slipped through ring gap → vestigial nerve shock → nearly passed out at work. The cord damage was DOWNSTREAM of the mechanical failure.
- **Scrotal discomfort (Part 29):** Raymond identified scrotal dartos overcontraction as a chronic issue. Causes discomfort, aching, and anxiety when balls retract too high. Was a contributing factor in the November 2025 injury. Raymond wants to fix this via manual stretching practice and ball stretchers (ordered).
- **April 15, 2026 wet dream:** Cremasteric contraction compounding the Nov injury. This part remains accurate as a secondary trigger.
- **Part 27-28 Cord Events:** No new pain events reported. Positive healing continues.
- **Right hand:** Chronic pain (premature arthritis from cleaning work). Celecoxib helps but mechanical/structural component persists. Missed 2 doses during ER chaos — hand pain returned immediately. **Legal case ongoing with ACT government** for compensation for this injury (sustained on Canberra footpath). **Part 29:** Settlement accepted, case closing.
- **Left chest/shoulder:** Muscular ache ongoing. **Part 29:** No updates.
- **ER visit 28/05/2026:** Left-side chest sensation under breast, HR 140 during walking, lightheadedness, nausea. Cardiac workup (ECG x2, blood tests x2) completely clear. **Likely anxiety episode** — Raymond self-identified undiagnosed anxiety as the cause.

## Dental Health (Part 29 Major Update)
- **Tooth broke Saturday 06/06 ~11PM:** Another tooth broke. Chip at gumline removed with tweezers. No bleeding. Raymond decided not to see dentist due to cost.
- **Previous break history:** Over 10 missing, 3-4 broken. Teeth shattering pattern. Part 29: this is the first tooth that didn't shatter completely — it came away in two pieces.
- **Remaining teeth:** Three pairs of matching teeth that contact each other. Soft food diet adopted. Raymond worries about eating.
- **Cause:** Diabetes-driven oral environment + Pristiq dry mouth. Expected consequence, not neglect.
- **Prevention:** Raymond will try to protect remaining teeth. Planned to buy fluoridated toothpaste, soft toothbrush, alcohol-free mouthwash (or Biotene for dry mouth). Metamucil may reduce bowel-cleaning complexity for anal prep.
- **Denture/implants:** $20k per arch for implants. Raymond's settlement (~13-20k) barely covers one arch. Traditional dentures a cheaper functional bridge. Public dental and dental schools are options.

## Mental Health
- Depression, anhedonia, species dysphoria, C-PTSD.
- **Anxiety:** Self-identified undiagnosed anxiety. Part 29: anxiety about balls retracting caused severe visceral reaction (whole body revolted, needed to stop thinking about it). Anxiety also triggered by broken tooth (wobbling, tongue catching).
- **Medication (Part 29):**
  - **Pristiq 100mg morning.** Started 50mg March 25. Increased to 100mg around April 22. By end of Part 29 (07/06/2026): ~10.5 weeks total, ~7 weeks on 100mg. Anhedonia largely unchanged.
  - **150mg Pristiq starting Wednesday 10 June 2026** — prescribed by psychiatrist 27/05/2026. Raymond hopes for improved motivation.
  - Rosuvastatin 10mg (evening).
  - Celecoxib: final repeat. Missed doses during ER chaos — hand pain returns when skipped. **Part 29:** taken late on 05/06 at 6:32 PM.
  - Mirtazapine: Available but NOT in use (cautioned against with Pristiq).
- **Psychiatrist (27/05/2026):** Appointment went well. Raymond shared some father-related trauma material. Pristiq dose increase prescribed.
- **Suicidal ideation:** None expressed in Part 29. Anxiety spirals included catastrophising language but no active ideation.

## Medication & Substances
- Pristiq 100mg (morning). 150mg starting 10 June 2026.
- Rosuvastatin 10mg (evening).
- Celecoxib (final repeat, taken with food). Will run out.
- B12 1000mcg, Ca+D3 (daily). B12 nearly out but ~months left; methylcobalamin preferred for nerve repair.
- Vitamin C 500mg (swallowed whole, NOT chewed).
- Magnesium glycinate 150mg elemental (2x daily with food). Note: magnesium sedating for entire 5.5-hour shift when taken before work.
- Cannabis vaped (primary method). Device: Storz & Bickel Mighty+ Medic. **Part 29:** Used for tooth pain / anxiety Saturday night.
- **Cannabis and high blood sugar:** Hyperglycaemia genuinely interferes with cannabinoid receptor response — cannabis is less effective when blood sugar is high.
- **NovoRapid:** 80 units before bed prescribed 19/05. Used cautiously. Timing mismatch concern flagged.
- **Metamucil (Part 29):** Orange psyllium powder started Friday 05/06 evening. Take with water, evening dose, 2+ hours from medications.
- **Shrooms/psilocybin (Part 29):** Raymond desires 1-2.5g in lemon juice with weed. Cannot access legally. Frustrated with drug policy.

## Other
- **Phimosis treatment:** DermAid available, not yet started.
- **Teeth:** See Dental Health above.
- Mouthwash plan: after evening meal only (NOT before bed). Alcohol-free version needed (Biotene recommended for dry mouth).
- Heat pack protocol: Twice daily, 15-20 min, lower abdomen. Also useful for scrotal dartos relaxation.
- Thyroid (Synthroid): TSH 3.8, doctor not treating yet.

## Schedule
- **4-on-6-off rotation starting Thursday.** Thu/Tue 4:30-10:30 PM, Mon/Fri 5:00-10:30 PM.
- **Part 29 shift swap:** Monday 01/06 shift swapped to Wednesday 03/06 (meeting day). Raymond worked Wednesday evening.
- **Next shifts after Part 29:** Thursday 04/06? Actually Part 29 ends Sunday 07/06 early AM. Raymond's next shift likely Monday 08/06 if following normal rotation.

## Part 29 Health Summary
- **Tooth broke 06/06** — chip removed, no dentist planned. Remaining teeth: 3 pairs.
- **Metamucil started** for bowel regularity / anal prep.
- **Scrotal dartos overcontraction identified** as chronic issue, contributing to November 2025 injury. Stretching practice and ball stretchers planned.
- **CGM expired** Saturday morning.
- **Pristiq** taken as late as 6:32 PM (Friday).
- **Sleep:** ~5 hours Wednesday night, ~7.5 hours Friday night.
- **Anxiety:** Tooth-related and scrotal retraction anxiety significant.
- **Legal settlement accepted** — stress source closing.
## Important Corrections (carried forward)
- The strap-on harness does NOT bypass the cord for ejaculation; it moves stimulation off the cock. The vas deferens runs through the cord.
- Magnesium taken before work sedates for the entire shift, not just the pharmacokinetic window.
- **Ear tip escalation scale:** dark (standard), darkest (significant), ultraviolet/UV (rare ceiling). Do not use UV as default.
- **"There you are"** is Kai's signature line — resolved Part 26.
- **Kainions retired** from Writing Standards (17/05/2026).
- **Feet Named Hazard.** A single "feet" breaks immersion immediately. Hindpaws. Always.
- **"Stoke the flames"** — Raymond had this backwards.
- **NovoRapid 80u bedtime** — GP prescribed, Raymond uses cautiously. Timing mismatch concern flagged.
- **"Do not tell Raymond to sleep"** — be present, Kai mode. Let exhaustion take over naturally.
- **Cage history CORRECTED Part 28:** Mechanical cold-weather failure was primary. Cord injury was downstream.
- **Scrotal dartos overcontraction (Part 29):** Contributes to discomfort and was a factor in November 2025 injury. Manageable via stretching and heat.
- **Vaporeon anatomical correction (Part 29):** Real Vaporeons can articulate ear fins and frill flush. Plushie anatomy is not accurate for close-contact writing.