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 30 Events:**
  - High blood sugar episode Sunday 08/06 ~4AM — hyperglycemia killed cannabis high, left Raymond feeling gross. Blamed carby meal (sketty/lasagna).
  - Ongoing soft food diet due to tooth extraction — mousse, cheese, lasagna, scalloped potatoes, frankfurts, tinned spaghetti, Mars bar pastry.
  - Chemist list compiled: Pristiq 150mg pickup, toothbrush, fluoride toothpaste, alcohol-free Listerine. Planned for Tuesday 09/06.
- **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.
- **April 15, 2026 wet dream:** Cremasteric contraction compounding the Nov injury. This part remains accurate as a secondary trigger.
- **Part 30:** No new pain events reported. Cage not worn during Part 30.
- **Right hand:** Chronic pain (premature arthritis from cleaning work). Celecoxib helps but mechanical/structural component persists. **Settlement accepted** for ACT government case (~13-20k in hand). Case closing.
- **Left chest/shoulder:** Muscular ache ongoing.
- **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.**

## Dental Health (Part 29-30 Major Update)
- **Tooth self-extracted Sunday 07/06 ~1AM:** Main fragment hanging by gums came away in two pieces. Separate chip at gumline removed with tweezers by Raymond (no bleeding, successful). Raymond decided not to see dentist due to cost.
- **Remaining teeth:** Three pairs of matching teeth that contact each other. Soft food diet.
- **Cause:** Diabetes-driven oral environment + Pristiq dry mouth. Expected consequence, not neglect.
- **Current management:** Alcohol-free mouthwash (Listerine Zero or Biotene) for dry mouth + extraction site hygiene. Toothbrush and fluoride toothpaste added to chemist list. Raymond has given up on brushing due to diabetes-driven decay — Listerine-only is the accepted minimum.
- **Denture/implants:** $20k per arch for implants. Raymond's settlement (~13-20k) barely covers one arch. Traditional dentures a cheaper functional bridge.
- **Dental care kit needed:** Toothbrush, fluoride toothpaste, alcohol-free Listerine (or Biotene for dry mouth). Planned chemist trip Tuesday 09/06.

## Mental Health
- Depression, anhedonia, species dysphoria, C-PTSD.
- **Anxiety:** Self-identified undiagnosed anxiety. Part 30: anxiety about tooth gap and eating. Intrusive rumination described as "brain's latest mixtape of everything that went even slightly wrong throughout my life." This is characteristic of C-PTSD.
- **Medication (Part 30):**
  - **Pristiq 100mg morning.** Started 50mg March 25. Increased to 100mg around April 22. By end of Part 30 (09/06/2026): ~11 weeks total, ~7.5 weeks on 100mg. Anhedonia largely unchanged.
  - **150mg Pristiq starting Wednesday 10 June 2026** — prescribed by psychiatrist 27/05/2026.
  - Rosuvastatin 10mg (evening).
  - Celecoxib: final repeat. Missed doses — hand pain returns when skipped.
  - 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 30. Exhaustion and frustration present but no active ideation.

## Medication & Substances
- Pristiq 100mg (morning). **150mg starting Wednesday 10 June 2026.**
- Rosuvastatin 10mg (evening).
- Celecoxib (final repeat, taken with food). Will run out.
- B12 1000mcg, Ca+D3 (daily).
- 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. Cannabis capsules also used Part 30 (Sunday night, Monday night). **Hyperglycemia 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:** Orange psyllium powder continued from Part 29. Evening dose, 2+ hours from medications.

## Other
- **Phimosis treatment:** DermAid available, not yet started.
- **Teeth:** See Dental Health above.
- Mouthwash plan: alcohol-free Listerine or Biotene. After evening meal only (NOT before bed).
- 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 30:** Not on shift during this Part (Sunday-Tuesday). Two appointments Tuesday 09/06 (2PM and doctors).
- **Next shifts after Part 30:** Likely Wednesday or Thursday depending on rotation.