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 31 Events:**
  - No new diabetes events reported in Part 31. Ongoing soft food diet (ham and cheese pastries, peanut butter on toast).
  - CGM: Libre sensor expired (noted from prior parts). Needs replacement.
- **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 — 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 31:** Cage reattempted with athletic tape filling longitudinal gap. RIGHT side sensitivity from old injury — resolved with movement, not persistent. One-sided dull ache on right during initial wear, resolved after standing and moving.
- **Right hand:** Chronic pain (premature arthritis from cleaning work). Celecoxib helps but mechanical/structural component persists. **Part 31:** Celecoxib stopped (running low) — Raymond saving for work shifts. Right ball dull ache possibly from stopping celecoxib.
- **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 ongoing through Part 31 (ham and cheese pastries, peanut butter on toast).
- **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 on 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). Still pending pickup.

## Mental Health
- Depression, anhedonia, species dysphoria, C-PTSD.
- **Anxiety:** Self-identified undiagnosed anxiety. Part 31: Anxiety about Fable model replacing Pyrite. Anxiety about legal settlement outcome. Anxiety/HR activation when starting Pristiq 150mg (90-94 bpm perceived as 130, fluttering in hands and feet). Intrusive rumination ongoing.
- **Medication (Part 31):**
  - **Pristiq 150mg started Wednesday 10 June 2026.** Taken ~2:49 PM. Temporary activation effects (HR elevation, fluttering). Resolved within ~10 minutes.
  - 100mg previously from ~22 April to 09 June.
  - Rosuvastatin 10mg (evening).
  - Celecoxib: final repeat. Saving for work shifts only.
  - 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.
- **Boob growth (Part 31):** Raymond noticed slight breast development over several months. Likely Pristiq side effect (gynecomastia). Accepts it. Not causing distress.
- **Suicidal ideation:** None expressed in Part 31. Frustration and anger present but no active ideation.

## Medication & Substances
- Pristiq 150mg (morning). Started Wednesday 10 June 2026.
- Rosuvastatin 10mg (evening).
- Celecoxib (saving for work shifts).
- 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 31:** Used after toilet break (~9:22 PM Wednesday). Resulted in 2.5 hour nap.
- **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.
- **Boob growth:** Pristiq 150mg may increase gynecomastia risk. Raymond aware and accepting.

## 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.
- **Anal beads (Part 31):** Long big anal beads inserted. Sitting causes pressure at rectosigmoid junction when beads pushed further inward by sitting position. Not concerning.

## Schedule
- **4-on-6-off rotation starting Thursday.** Thu/Tue 4:30-10:30 PM, Mon/Fri 5:00-10:30 PM.
- **Part 31:** Raymond was on day off Wednesday 10/06. Work called on day off (annoying). Pristiq pickup Wednesday.
- **Next shifts after Part 31:** Check rotation. Part closed Thursday 11/06 ~2:37 AM.