Bribes de confinement 2 [fr]

Bien au chaud dans mon petit cocon, je me sens libre comme jamais. Les autres et leurs besoins se sont évaporés, les miens petit à petit montrent quelques feuilles. 

Dans ce monde arrêté, moi aussi je peux m’arrêter. Enfin. La chape d’attentes s’est envolée. Le besoin désespéré de rester dans le train, aussi.

J’essaie de ne pas trop penser à l’injustice contre laquelle je ne peux rien, à la douleur qui traverse tant d’autres et qui m’épargne jusqu’ici. J’écoute ma respiration, j’essaie de tout oublier. 

Liberté mon privilège, que j’essaie de goûter avant que la culpabilité ne t’emporte.

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Letting Go [en]

For pretty much all my life, I have struggled with how I react to people being wrong. “Wrong” meaning, here, “wrong according to my beliefs/knowledge“. The frontier between beliefs and knowledge is murky, and we would all fancy our beliefs to be knowledge, but in some cases we can more or less agree on what is belief and what is knowledge.

I have a really hard time with people who are wrong. Wrong, of course, as described above. I have my beliefs and values, and do my best to accept that not everybody shares them. I don’t believe in any god, some people do. That’s fine, as long as beliefs are not construed as facts or knowledge.

When debating, I have very little tolerance for the “well, it’s my point of view/opinion” argument – systematically offered as a justification for something that was initially presented as fact. You can have opinions and beliefs, but if you present them as facts in a debate, prepare for them to be challenged. But as I said above, the frontier is sometimes murky, particularly as seen “from the inside”, and that is where trouble lies.

Take vaccines. I’m taking that example because it’s easy. I believe things about them. I consider those beliefs pretty rational as they are, to the best of my efforts, based in science. So I know they are safe, I know they work, I know they do not generally offer 100% protection, I know there can be a tiny risk of bad reaction, I know they have helped eradicate some illnesses and control others so they do not rip through society like Covid-19, I have a decent understanding of how a vaccine is built, how and why it works. So, of course, I think that people who believe different things about vaccines, like that they are harmful or even dangerous, are wrong. The problem is that in their “web of belief” (read the book, it’s wonderful), their beliefs are perfectly rational and therefore, knowledge.

We could say that each side of the argument here sees their belief as knowledge, and the other’s as belief.

Faced with somebody who believes something that contradicts something I know, my initial impulse is to explain to them that they are wrong. Because who doesn’t want to be right? I bet you can see how that strategy doesn’t really work out well.

So, over time, I have learned to bite my tongue, accept that what people believe (including myself, though I hate the idea) is never going to be completely objectively rational, and remember that nobody (first of all me) likes being told they are wrong. The tongue-biting is more or less successful, depending on the topic in question, my mental state, and who is facing me.

The current pandemic has given me a golden opportunity to work on not only my tongue-biting, but acceptance of differing viewpoints. Accepting that people see things differently doesn’t mean I believe every point of view is equivalent. Quite the contrary. It’s more about accepting that people will believe what they believe, that they aren’t rational (me neither, though I try my best to be), and that it is normal and OK.

I do my best to share accurate information. I’m not perfect or blameless, but I try to exercise critical judgment and be a reliable source of information for those who choose to dip into my brain, though facebook, this blog, or conversation. I also try to correct erroneous information, and that is where things get slippery. It goes from setting the record straight when people share obvious hoaxes or urban legends (generally by instant messenger), providing critical sources when others share scientifically wobbly information (hydroxychloroquine) or scare themselves needlessly (what use masks really serve, disinfecting groceries). And I’ve had to learn to back off. To keep the peace, to preserve relationships that I otherwise value, and also to preserve my sanity and inner peace.

One milestone was when I realised it was useless trying to tell people who were convinced a certain French scientist had found the miracle cure for Covid-19 that the scientific evidence for it was flaky at best, dishonest at worst. People are scared and will believe what helps them. We tend to want to ignore the emotional dimension of our beliefs, but it’s there, and much more powerful than our rational brain (as anybody who has ever tried to reason through emotions knows).

Some people are more comfortable dealing with uncertainty than others. Some people understand logical fallacies and cognitive bias better than others, and are more or less able to apply that knowledge to the construction of their beliefs (critical distance). But we all have emotions and they colour what we are likely to accept as fact or not, whether we like it or not.

So I tried to drop hydroxychloroquine. That meant I had to accept that (according to my knowledge) false information was going to do the rounds, in my social circle, that people were going to have false hopes, and spread misinformation, and I wasn’t going to do anything about it. Not an easy thing to let go of. I feel like I’m skirting responsibility. My therapist would certainly tell me that fixing other people’s beliefs is not my responsibility…

I’ve been doing the same thing for some time now with people who believe vaccines aren’t safe or efficient. I know facts don’t change people’s minds. Worse, debate reinforces beliefs. I know! But I don’t really believe it, and keep on wanting to try. So I bite my tongue, remember that for the person facing me their belief is perfectly rational, remind myself that telling them they are wrong or debating them will not change their belief, and try and get on with my life. But for vaccines in particular, I seethe, because these beliefs have an impact on actually lives and public health. And I have to say I dread them moment when we will finally have a vaccine against SARS-CoV-2, and people will refuse to use it. It’s going to be a tough exercice in emotion management for me.

Anyway, I’ve reached a point now where I try to provide the information I feel is the best for those who want it, and I’m getting better at feeling OK that somebody I value or appreciate believes something I think is plain wrong – without trying to change their mind about it. I’m getting better at identifying the point where a discussion stops being an exchange of ideas in the search of truth or satisfaction of genuine curiosity, and starts being a standoff between two people with firm beliefs, each trying to shove theirs upon the other.

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Bribes de confinement 1 [fr]

Les jours avancent comme une douce brume, glissent les uns sur les autres et les uns sous les autres, s’embrassant langoureusement, et moi au milieu je me laisse porter, bercer même, dans la douce chaleur du soleil d’avril. 

Mon nid est fait de fleurs qui n’ont pas compris l’hiver, de lianes folles qui ne savent plus où grimper, d’années de vie qui se cachent dans tous les recoins. Deux chats m’accompagnent de leur présence ensommeillée. Tout est paisible, ici, dedans comme dehors.

Il n’y a plus d’attente, car le temps a perdu son sens. Il y a juste le chant des oiseaux et le silence du ciel, dans ce monde sans hommes qui m’observe, immobile et patient. 

Alors je me contente d’être. Être dans ces jours dont je ne sais plus le nom mais qui m’enrobent de leur sérénité, dans cet espace infini qui est le mien, et ce corps qui n’est que moi. 

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Feline Diabetes: My Advice for Diabetic Cats [en]

After 2.5 years of dealing daily with feline diabetes (and over two years of managing a French support group), I thought I’d put together an English version of what my best advice for diabetic cat owners is so far, as most of what I’ve written on the subject is in French.

Things to know

I’m starting with this as a sort of FAQ/TL;DR:

  • upto 84% of remissions within six months of diagnosis using Lantus/Levemir and home monitoring (injections do not have to be for life)
  • Lantus/Levemir are far superior to Caninsulin/Prozinc
  • home monitoring makes a huge difference in quality of regulation and reduction of risks, as well as chances of remission
  • a diabetic cat can be well-regulated and lead a normal life
  • FreeStyle Libre continuous glucose monitors can be used successfully on cats
  • a normal human glucose meter can be used for monitoring, pet meters to not add significant value to the monitoring
  • diabetic ketoacidosis kills more cats than hypoglycemia – at a bare minimum have urine dipsticks to monitor ketones in urine
  • inject twice a day at regular times, and prefer syringes over pens (you can draw insulin from the pen with the syringe)
  • inject a constant dose of insulin (no fiddling with the dose at each injection), and adjust the dose progressively according to the lowest glucose value reached with the previous dose
  • a decently regulated diabetic cat can miss a dose of insulin now and again if necessary
  • a diabetic cat can be fed wet, dry, raw, whatever you want; less carbs and more protein is good, therapeutic “vet” diets are fine; free-feeding dry therapeutic food has huge advantages with Lantus/Levemir
  • never change a cat’s diet without close monitoring if it is under insulin

Getting started

If your cat has just been diagnosed, you’re probably in shock and afraid to lose him or her. The first thing I’d like to tell you is that feline diabetes is a very manageable disease, and that there is no reason for a well-managed diabetic cat to die from diabetes.

The second is that the treatment for diabetes is insulin injections (no way around that), and you will get over your fear of doing them if that is an issue for you. And it does not have to be “for life”. A 2009 study has shown that with the right treatment protocol (Lantus/Levemir insulin and serious home monitoring), upto 84% of newly diagnosed cats (less than six months since diagnosis) could achieve remission. Remission means the diabetic cat doesn’t need insulin injections anymore.

I have seen cats in critical condition upon diagnosis, skin on bones or diabetic ketoacidosis (more on that later), with other illnesses, go on to not only survive but thrive and reach remission. It’s work, of course, but it’s worth it. I have seen owners who were panicked by needles and blood go on to not only give insulin injections without a second thought, but also monitor blood glucose at home multiple times a day, with a little blood prick on the edge of the ear (the cat usually minds way less than the human doing it!)

A well-managed diabetic cat can have normal quality of life and live out the rest of his cat years with no major consequences.

Insulin

Insulin is a hormone secreted by the pancreas. Its job in the body is to make glucose from the bloodstream enter the cells (glucose is fuel/energy for the cells). Diabetes is due to an issue either in insulin production (poor pancreas is sick or damaged and can’t do its job correctly), or what is called “insulin resistance”, meaning that something in the body prevents the insulin from doing its job correctly. The insulin is there but it can’t get the glucose into the cells. This insulin resistance then exhausts the pancreas as it tries to keep up, in vain. Common causes of insulin resistance are obesity, illnesses like acromegaly, or (note the vicious circle) high blood glucose.

To manage diabetes, we are going to give the body extra insulin to help it along and help feed the cells. Insulin is a fragile molecule, and it doesn’t survive going through the stomach, so it has to be injected. The needles used to inject insulin just under the skin are tiny, and cats barely feel the injection once you get the hang of it.

There are four different insulins that are commonly prescribed for cats: Levemir, Lantus, Prozinc and Caninsulin (called Vetsulin in the US). Levemir and Lantus give by far much better results than Prozinc or Caninsulin. With them, cats are easier to regulate, get a better quality regulation, and a higher chance of remission. Remission and correct regulation are possible with Prozinc and Caninsulin, but less likely and more tricky. On the French group, we often help owners discuss switching insulins (French document) with their vet.

If you can get Levemir or Lantus, go for it. Prozinc is better than Caninsulin, but Lantus and Levemir are in a whole other category. If you have a human insulin like NPH or Insulatard, it’s going to behave similarly to Caninsulin. Tresiba (a new, long-lasting human insulin) seems to behave like Lantus and Levemir.

Whatever insulin you are using, you want to inject twice a day, 12 hours apart. With Lantus or Levemir, it’s really 12 hours – give or take 15 minutes. With Caninsulin and Prozinc there is more flexibility (even a couple of hours), but you’ll get better results with regular injection times.

You also want to inject the same dose of insulin continuously. Varying doses or skipping injections regularly make regulation difficult. The best dosing methods involve injecting the same dose of insulin for some time, then evaluating how that dose is performing through blood glucose measurements, and then adjusting the dose by a small increment, and reevaluating again, and so on.

Using syringes rather than pens allows for more precise dosing and also makes the injection itself faster for the cat.

Home monitoring

Home monitoring is the key to managing diabetes well. It’s even more important than the choice of insulin. With a glucose meter, you can easily check your cat’s blood glucose. Regular measurements will help keep your cat safe (both from hypoglycemia and from the consequences of bad regulation) and give you precious information to adjust the insulin dose (with instructions from your vet or by following a time-tested dosing protocol). This will give your cat the maximum chance of remission and, even if you don’t reach remission, the best regulation possible, and therefore the best quality of life and health.

If you can, I highly recommend using a FreeStyle Libre continuous glucose monitor for your cat. The monitor is attached to the cat’s skin with a sticker. It lasts upto 14 days and each time you scan it (with your cellphone or a dedicated reader) you get the last 8 hours of readings (4 readings per hour). This means you never miss any information on how the blood glucose is evolving, and you can relax about when to check it. It’s also a great solution if you’re away from home a lot, need to board your cat or have somebody looking after him or her that cannot do “ear prick” tests, or if your cat is hard to test (I’ve had one, I know some cats can be impossible). Here is a video demonstrating how to apply the FreeStyle Libre sensor, and providing some explanations. (See on Facebook.) Many owners apply the sensor themselves at home.

One thing you should absolutely be monitoring, whether you monitor glucose or not, is ketones. An unregulated diabetic cat can develop ketones (if his cells are starving so much that he starts metabolising fats to get energy). Ketones accumulate in the blood and the cat ends up developing diabetic ketoacidosis, a deadly complication. Cats with DKA (diabetic ketoacidosis) can be treated and saved, but in my experience many vets are not equipped to manage it, as it requires 24/7 intensive care for a number of days. I have seen way more cats die from ketones and DKA than from hypoglycemia.

Keeping an eye open for early traces of ketones is therefore absolutely necessary, both for your cat’s life and your bank account. It can be done in two ways: either with a glucose meter which also measures ketones, or with urine dipsticks (photo below). If you’re not monitoring blood glucose, get the urine sticks. They have colour codes which will also tell you how much glucose is in the urine, a precious indication if you’re not monitoring blood glucose. If you are monitoring blood glucose, then a meter is a better choice, because it is more precise, and you do not need to wait for the cat to pee. If your cat has already had ketones or DKA, she or he has a one in three chance of developing ketones again. In that case too, you really should have a meter. (Note that the FreeStyle Libre reader also doubles as a glucose and ketone meter.)

So, if you’re not monitoring blood glucose, the absolute minimum you should be doing is monitoring glucose and ketones in urine, if not daily, at least a few times a week.

If for some reason you cannot monitor blood glucose or install a FreeStyle Libre, you can monitor water intake, weight (weekly), amount of food eaten (if free-feeding), and general clinical signs like play, purring, grooming, habits, etc.

You will want some kind of notebook or spreadsheet to track your monitoring, whatever form it takes. A shared online spreadsheet using Google Sheets is a great solution (see below).

Support

Don’t do this alone. Managing feline diabetes is a marathon, and can feel overwhelming at first. Your vet cannot give you the day-to-day support you will get from an online support group, where you will benefit from the experience of those who have gone through what you are going through now, and (often) 24/7 support, either for technical questions or simply to cheer you up or hold your hand.

If you speak French, join the group I manage on Facebook, Diabète félin: apprendre à gérer son chat diabétique (groupe de soutien). If you speak German, join the Diabetes-Katzen Forum (where the tight regulation protocol published by Roomp and Rand in 2009 was developed). If you are an English-speaker, join the FDMB (Feline Diabetes Message Board).

Of course there are both cultural and “technical” differences between these support communities, in addition to language. So the advice you will get will not be exactly the same. Here are a few key points on where the views you will find in the French community (therefore mine) differ from those you will find on the FDMB (as this is an English article):

  • In the French group we do not insist on feeding a wet food diet even if tight glycemic control is desired, our experience being that it is perfectly possible on dry food, and we have a good opinion of therapeutic (ie, “diabetic/veterinary”) diets over commercial ones.
  • We recommend starting insulin first, and worrying about diet later, rather than postponing the start of insulin therapy to put in place a diet change.
  • When glucose values are high we increase insulin at an accelerated rate, depending on how much monitoring the caregiver can provide (in line with discussions I have had on the German forum).
  • We encourage the use of FreeStyle Libre continuous glucose monitors whenever possible, as they offer less stressful monitoring for owners. The continuous monitoring allows for more assertive dosing decisions as there is no uncertainty regarding past glucose values.
  • Our management of low glycemic values (50 mg/dl and below on a human meter) is slightly more relaxed than on the FDMB, more in line with the German site. Same for dose reductions, as long as there is sufficient monitoring and owner experience.
  • We don’t give a lot of importance to removing food 2 hours prior to pre-shot glucose tests, and are OK with free feeding.

Food

Food is one arm of diabetes treatment. Feeding a cat a diet with less carbs is going to help bring blood glucose numbers down. But beware: less carbs is not the only thing that counts. The overall quality of protein in the food is important, and some therapeutic diets are formulated to help keep the blood glucose stable (the whole question of which carbs).

This is where my advice strays from the lot of what you will find online. On the French group we have very good experiences with dry diabetes-formulated therapeutic food, in particular Hill’s m/d. The huge advantage of dry food is that you can free-feed the cat (use a food silo – the cat should never see the bottom of the bowl, and shouldn’t know the human is the food distributor). Of course, if you have a cat who likes wet food, that is fine too. Do what works best for your cat and you.

If for some reason or another you need to give your cat another diet (food intolerances or other illness that requires a special diet), it is still possible to get its diabetes regulated. It will just probably require more insulin. Remember that the goal is not to give as little insulin as possible: it is to keep the blood glucose low and stable.

If you are giving Caninsulin or Prozinc, you’ll want to make sure your cat eats a reasonably good meal just before or around injection time, and has the same amount and kind of food over each 12-hour period following an insulin injection.

If on Levemir or Lantus, nibbling throughout the day works fine (total free-feeding). We have seen cats that were very bouncy and hard to regulate on very low-carb wet food become much easier to regulate (with more insulin, but who cares?) and less bouncy on a free-fed dry therapeutic diet.

For some cats, of course, reducing carbs to the max will allow them to be diet-regulated and go off insulin. But pay very close attention to the quality of the food in question – quality is not just about carbs, ingredients (or lack of certain ingredients), or form (wet/dry/raw). It is about nutriments.

I don’t recommend changing the diet before starting insulin. A diet change can bring along a host of problems and with a diabetic cat, you want to start insulin as soon as possible and get clinical improvement quickly. If and when you change food:

  1. do it progressively, over a week
  2. monitor blood glucose levels closely, as they might drop and you might have to reduce the insulin dose

Never change the diet of a cat that is on insulin without close monitoring. It can go into hypoglycemia and die.

Constraints

Having a diabetic cat comes with a certain number of constraints, the most obvious of which is being there twice a day 12 hours apart for insulin injections, every day.

However:

  • Prozinc and Caninsulin allow flexibility in injection times, up to a few hours, as long as blood glucose is high enough at injection time
  • A well-regulated cat can skip and injection now and then
  • With Lantus or Levemir, if you can’t inject at the normal time, injecting approximately 6 hours after what would have been injection time (give or take a few hours) and skipping the next injection mitigates the “damage” due to the skipped injection
  • It is possible to find (or train) pet-sitters to give injections
  • Some diabetic cat owners take their cat with them on holiday
  • Some places will board diabetic cats
  • If you are not there to monitor blood glucose (the person replacing you will do injections but not monitor glucose) consider putting a FreeStyle Libre continuous blood glucose monitor on your cat.

Many cats reach remission, which means an end to injections. Some cats are so well-regulated that although they don’t reach remission, they can move down to one injection a day (Lantus/Levemir) and skip injections regularly.

Financially: to make a budget, do not look at sticker prices, but calculate how much insulin, food, strips etc. will cost for a month. Dry food is cheaper than wet food, for equal quality. Not all insulin is the same price. Regarding test strips, in Canada the One Drop unlimited subscription is really the cheapest option. In France, we calculated that the One Drop is cheaper if you’re using 5 strips a day or more on average. Do the math for your country! In France, it costs less than 100€/month to give your diabetic cat 5-star treatment. Generally, home monitoring costs less than doing curves at the vet, and decreases the chances you will need to spend a lot of money on an emergency.

Risks and caution

Most people are afraid of hypoglycemia. It is indeed a risk that comes with insulin therapy, but if you are home monitoring, increasing the insulin dose gradually, following safety guidelines and avoiding brutal diet changes, the risk is very small. Having access to food further decreases this risk.

Most serious hypoglycemic episodes I have witnessed or heard of occur after a diet change with no monitoring, large dose increases with insufficient data to justify them, or long periods of injecting the same dose with no monitoring.

What people are unfortunately not afraid of enough is diabetic ketoacidosis, probably because it is a complicated word and “ketones” (despite the popularity of “keto” diets) are not part of our everyday vocabulary or life experience.

I have seen more cats than I can remember die from diabetic ketoacidosis. This is in particular a danger for newly diagnosed cats or badly regulated cats. The absolute first thing one needs to be doing with a diabetic cat is checking urine for traces of ketones.

It is often recommended to skip the insulin dose if the cat is not eating. This advice can be dangerous, as one of the first visible symptoms of ketones will be loss of appetite. Skipping insulin for a cat with ketones will make the situation worse and things have a high chance of spiralling out of control. This is why at the bare minimum glucose and ketone urine checks should be made. On the other hand, injecting a full dose of insulin on a fasting cat who is normally well-regulated can be disastrous too (hypoglycemia).

High doses of insulin are not dangerous as of themselves, and some cats need them. The only risk of “too much insulin” is hypoglycemia, so if you are monitoring to stay safe on that side, there is no reason to be worried about the number of units you are injecting – considered you reached that number progressively and with adequate monitoring.

If you are injecting Lantus or Levemir, injection time is very important (give or take 15 minutes). Injecting less than 12h after the previous injection can lead to hypoglycemia.

What if I don’t treat my cat’s diabetes ?

Not treating a diabetic cat shouldn’t be an option. If it is lucky, the cat will waste away to be just skin and bones, starving and drinking like a fish the whole time. It is not comfortable. If it is not lucky it will start producing ketones and die of diabetic ketoacidosis.

If your cat is diabetic, it needs insulin. What I describe in this article is my “best advice”, but if the alternative is no treatment, then anything is better than nothing – even one injection a day with scarce monitoring.

Many people don’t believe they will be capable of caring for a diabetic cat, be it for needles, constraints, or finances. But trust me, solutions are found, and many people caring very well for their diabetic cat today didn’t think they would be capable of doing it when they got the diagnosis.

Diabetes can really be very well managed, so it’s absolutely worth giving your diabetic cat a chance at life.

My vet doesn’t agree

The advantage of online support groups is that we have the luxury of paying attention to just one illness, whereas a vet has to know everything on everything – and for more than one species. Feline diabetes is a very niche condition, and vets are generally not very familiar with it, and dread it – cat owner reactions tend to range from panic, despair, to asking for euthanasia.

So, vets are generalists, but people in feline diabetes support groups have probably read more on feline diabetes and followed more diabetic cats than most vets, though of course their knowledge on anything outside that field is certainly going to be lacking.

Vets tend to have an approach to treating feline diabetes that makes it as easy as possible on the owner: no home monitoring, just injections, drop the cat off every now and again to check blood glucose (a curve, or in some cases, a single spot test). The consequence is that they aim for an improvement of clinical signs: the cat stops losing weight, stops eating as if it were starving and drinking like a fish, doesn’t go into DKA or hypoglycemia. With home monitoring, however, we can do much better, and aim for remission or great blood glucose regulation, rather than just a stabilisation of clinical signs.

Also, vets, like other medical professionals, are often faced with people who have “found information online”. 99% of the time, the information in question is crap. So, don’t assume your vet is going to take seriously your “online research” on feline diabetes, even if you can see that it is solid.

Links and conclusion

I’ll probably add to this article as I remember things I have forgotten to include. I hope you found some useful information here! To finish, here are links to some recent publications on feline diabetes if you want to read more.

Photo: Quintus and Oscar, my two diabetic boys (one in remission, the other with a FreeStyle Libre)

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La normalité reprend ses droits [fr]

L’habituel commence gentiment à reprendre ses droits. Le temps reste mou; hier j’étais convaincue qu’on était samedi, au point que quand une personne que je devais voir lundi m’a dit “à demain!” j’étais à deux doigts de la rectifier. La sensation de crise aiguë m’a quittée. J’ai trié mes tupperware.

Mes objectifs quotidiens sont modestes: m’installer pour lire mon roman, finir ma journée assez tôt pour regarder ma série, faire des boulettes de viande avec le kg de viande hâchée que j’ai achetée en action à la Migros. Et, la normalité revenant au galop, je procrastine. Bref, je me retrouve face aux mêmes challenges qu’il y a 2 mois, qu’il y a deux ans.

Je fais partie des grands privilégiés de cette crise, vu que je peux me payer le luxe de me débattre avec mes difficultés habituelles.

Ce qui n’est pas habituel, par contre, c’est que je me trouve extrêmement irritable. Je pars au quart de tour. Alors que d’habitude j’arrive à garder une saine distance émotionnelle par rapport aux choses qui ont tendance à m’énerver (les gens “qui font faux”, “qui ont tort”, “qui réfléchissent pas”, bref, vous voyez le schéma, c’est pas très glorieux), maintenant c’est un peu comme si je n’avais plus de fusible pour ça. Un effet de bord du confinement, rien d’anormal, mais c’est ennuyeux. La solution est assez simple, heureusement. Dormir assez (j’ai le luxe de pouvoir), sortir et bouger assez (idem), garder un rythme au quotidien (plus difficile). Et limiter un peu les contacts sociaux.

Je suis clairement sortie de ma phase “tout lire, tout apprendre” au sujet de coronavirus. Maintenant, ça m’ennuie même un peu. Je crois avoir fait le tour, j’attends surtout que la science avance (mais ça, ça sert à rien d’être au taquet dessus chaque jour), les décisions au niveau politique ont été faites et je me doute bien de ce qui nous attend, encore des semaines ou des mois de la même chose. Sur Vaud les chiffres commencent à se stabiliser, ce qui veut dire que la courbe grimpe moins raide, alors on tient bon, on pense fort à ceux qui sont au front, on évite de prendre des risques ou d’en faire courir à autrui, et on attend. Je suis consciente que c’est facile pour moi de dire ça, je n’ai que ça à faire, de toute façon, attendre, pas d’urgence.

J’ai fait des semis. Je suis allée chercher du levain, qui bulle à côté de celui que je tente de démarrer ici. J’essaie de me mettre chaque matin au soleil sur mon balcon, avec les chats. J’essaie de manger correctement, ni trop ni trop peu.

A ce propos, j’ai installé MyFitnessPal. Alors c’est très bien, la base de données de nourriture est super (on y trouve même les brownies de la Migros), on peut scanner les codes-barres… Mais le problème est que même si je me suis dit que j’allais juste noter ce que je mange pour prendre meilleure conscience de où sont les calories (je n’ai jamais fait de régime de ma vie, donc je suis assez peu au fait de la densité énergétique de ce que je mange), je me retrouve à regarder cet objectif total journalier et à me stresser pour essayer de l’atteindre. Et ça, c’est pas le but. Alors j’ai changé mon fusil d’épaule: je rentre les choses mangées le soir, après-coup. Et j’arrête d’essayer de faire attention – juste manger raisonnablement, comme je fais d’habitude (et comme je ne l’ai pas fait cette dernière année…).

Je trouve difficile de ne pas me mettre de pression, de façon générale. Tant pis si je ne “profite” pas de cette période. Ça aussi, c’est pas le but. Le but c’est de vivre. Et c’est pas si facile.

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Mes top tips pour les courses en temps de pandémie [fr]

Histoire d’éviter les crises cardiaques, cette photo date du 16 mars 2020

Par les temps qui courent, faire les courses pour plusieurs personnes quand on y va (seule ou seul!) c’est une bonne idée. Ça permet aux personnes à risque d’éviter une sortie, ça fait une personne de moins qui se balade dans le magasin, bref, les courses groupées ont la cote.

Deux petits “trucs” pour vous simplifier la vie:

  1. Utilisez Google Keep pour les listes de courses. On peut y faire une liste avec des petites cases à cocher, et partager cette liste avec qui on veut. La personne peut mettre à jour sa liste quand elle veut, et on a toujours accès à la dernière version à jour. Quand on fait les achats, on coche, et les achats cochés disparaissent de la liste. Super pratique!
  2. Demandez aux personnes pour qui vous faites les courses de vous envoyer un bonne photo du code-barres de leur Cumulus (ou Supercard, ou…) et utilisez-les pour prendre autant de scanners que de personnes. Cela permet de scanner séparément, de faire des tickets de caisse séparés, et d’éviter (littéralement!) des comptes d’épicerie une fois les courses faites.

Sinon, pour les personnes que mes “pratiques d’hygiène” intéresseraient:

  • Je me lave les mains avant de partir de chez moi, je les désinfecte à l’entrée du magasin avec le désinfectant fourni, je passe aux WC les laver après avoir chargé la voiture, je les lave en arrivant chez moi, et encore une fois après avoir rangé mes courses.
  • Je ne désinfecte pas mes courses.
  • Je ne porte pas de gants. Le virus s’accroche mieux et survit plus longtemps sur les gants que sur la peau, et il ne peut pas rentrer dans le corps via la peau.
  • Je ne porte pas de masque. Dans un contexte où nous manquons de masques, il faut les laisser en priorité aux soignants, qui de par leur métier, ne peuvent respecter la distanciation sociale dans leur travail, et sont en contact avec des personnes malades ou particulièrement vulnérables (hôpitaux, EMS, soins à domicile), et aux personnes malades (pour éviter de contaminer autrui ou de faire paniquer l’assemblée en toussant). Ce serait différent si nous avions un stock de masques suffisant pour couvrir toute la population, en plus des soignants.
  • Je scanne et je paie avec Twint.
  • Je fais les courses une fois par semaine au max pour limiter mon exposition.

Pour terminer, un tuyau “rangement”: pour vos denrées non périssables, si vous fonctionnez comme moi un peu aux stocks, rangez-les par année de date de péremption (un étage pour 2019 et avant – oui vous pouvez sans autres manger une conserve “périmée”, un autre pour 2020, puis pour 2021, et 2022 et plus ça peut aller dans le placard du couloir ou la réserve de la cave). Ça vous aidera à utiliser les aliments les plus anciens en premier.

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La texture du confinement [fr]

Ce qui a changé, c’est la texture du temps qui passe. Ce n’est plus un temps qui me file entre les doigts et que je cherche désespérément à retenir. C’est un temps bien plus immobile, qui ressemble un peu à celui du premier mois après mon opération, où il n’y a pas grand chose d’autre à faire que d’attendre qu’il passe, en tentant de vivre agréablement son quotidien. C’est un temps sombre, et au bout il y aura de la lumière, donc ce sera bien, après, mieux, probablement, mais si, un jour, plus tard.

C’est un peu le temps de l’attente, l’attente peu agréable d’un futur qui va nous en libérer.

Et dans ce temps un peu étrange, bizarrement, je me trouve fort capable de vivre.

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Un jour ordinaire de confinement [fr]

Aujourd’hui, j’ai réorganisé mon armoire à épices (j’en ai beaucoup), et j’ai pleuré en écoutant Joan Baez chanter “Hello in There” (une chanson qui m’émeut toujours en temps normal), dédiée à son ami John Prine, chanteur que j’ai découvert via une interview de Terry Gross dans Fresh Air, qui est dans un état critique, victime du Covid-19.

On est tous en deuil, sous une forme ou une autre, même sans avoir perdu personne. On est en deuil de notre normalité, de notre vie d’avant qui ne sera jamais plus, de notre liberté, de notre sécurité physique soudainement compromise, de notre quotidien avec les enfants à l’école et le travail au bureau, des nos rencontres avec nos proches et nos amis, d’un avenir dont on ne sais plus précisément de quoi il sera fait.

L’état de stupeur, le sentiment d’irréalité, le temps qui passe lentement, la perte de conscience du jour qu’on est, le déni à divers degrés, l’incapacité de se concentrer, de bien fonctionner… tout ça c’est du deuil.

Adieu le monde qu’on tenait pour acquis. Adieu aussi, le sentiment de sécurité qu’on avait ici, vivant dans un pays ultra privilégié, de ne pas courir grand risque de choper une saleté de maladie qui pourrait nous terrasser.

J’ai l’impression d’être le jour de la Moisson dans les Hunger Games. On attend tous, plus ou moins tétanisés, de savoir où le couperet va tomber. Chaque semaine qui passe, le bilan s’alourdit, les personnes touchées se rapprochent. La grande majorité, sans gravité, heureusement. Mais pas toutes.

Ça commence à me faire peur. Mon déni commence à fléchir. La réalité rentre, insensiblement. Mais fermement.

Alors j’ai pleuré en pensant à John Prine, à Joan Baez qui chante pour un ami qu’elle risque de perdre, à tous les autres proches ou lointain qui sont touchés ou le seront. Je me recentre sur mon petit canton, ma petite ville, ma petite personne, en espérant très fort qu’on s’en tirera le moins mal possible.

J’essaie de ne pas trop penser au reste du monde, à l’Italie, à l’Inde, parce que juste là c’est trop dur.

Alors je vais aller me promener dans mon voisinage désert, parce que même si “je refuse de me réjouir“, cela ne veut absolument pas dire que je suis incapable de voir et de prendre plaisir au positif.

Et demain, je rangerai mon armoire à thés.

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Je refuse de me réjouir [fr]

Je refuse de me réjouir. Je refuse de me réjouir de l’air plus clair, des animaux plus libres, du silence et du calme, du rythme de vie moins frénétique, des changements que vit notre société, des remises en question de nos décisions politiques.

Je refuse de me réjouir de ce “positif” que l’on paie de tant d’angoisse, de détresse, et de mort.

Nous sommes en crise. Evidemment, en crise, il y a des changements radicaux. Evidemment, le soleil continue à briller à travers les nuages, et il y a des bonnes choses à regarder pour nous aider à supporter la réalité du monde.

Mais comment peut-on se réjouir de la baisse de la pollution alors que des économies entières sont mises à genoux, des populations entières sont paralysées, les morts se comptent (pour le moment encore) en dizaines de milliers? Il faut aimer bien peu l’humanité pour se réjouir ainsi du désastre qui nous frappe.

Oui, résolvons les problèmes du monde en stoppant toute l’industrie, en plongeant dans la récession tête la première! Les gens qui tiennent ce genre de discours “positif” comprennent-ils vers quoi nous nous dirigeons? C’est bien une planète plus verte, je suis à 100% pour, mais quel prix sommes-nous prêts à payer? Faisons mourir de faim et de maladie les gens, ralentissons l’économie, ça fera moins de monde sur notre planète et moins d’émissions, c’est super.

Alors non, je refuse de me réjouir. Je trouve ça indécent.

Quand l’immeuble qui me bouchait la vue brûle et s’effondre, je ne vais pas crier de joie parce que je revois enfin les montagnes.

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Ça fait combien de temps, déjà? [fr]

Cette semaine j’ai passé plus de temps hors ligne, et c’est bien. Depuis hier, facebook me gonfle un peu. Je pense que j’ai fait le tour de ce que j’avais besoin de savoir pour ma tranquillité d’esprit. Je pense que cette histoire va durer, je ne porterai pas de gants dans les magasins, les masques oui ça sert mais si toute la population en porte, sinon de grâce laissez-les aus soignants et ne les gaspillez pas pour vous protéger en faisant vos courses (restez à distance des gens plutôt), la chloroquine j’attends sagement de voir les résultats de vraies études, restez chez vous, confinement, isolement…

En fait je me rends compte que je ne suis pas trop mal dans cette période de distanciation sociale, pour le moment. Moins de contact, ça me convient, on dirait.

Donc facebook me gonfle: le confinement et la réalité de l’épidémie ce n’est plus nouveau. La chloroquine et Raoult me sortent par les oreilles. La paranoïa autour de la contamination des surfaces aussi. Les grands cris à plus de sévérité, plus de masques, plus de tests… allô le principe de réalité, les gens? Les gens qui obsèdent sur des chiffres qui ne veulent pas forcément dire grand chose. Les témoignages de patients et de soignants. Les articles plus ou moins complotistes et plus ou moins fumeux. Alors moi aussi je fais l’épidémiologiste et la politicienne de salon, j’en ai conscience, mais je crois que j’ai plus ou moins dit ce que j’avais à dire, et je commence à me répéter, et j’en ai marre.

Hier j’ai rangé mes réserves alimentaires. J’ai toujours des réserves en temps normal. Je dis souvent en rigolant que je tiens un mois facile avec ce qui est dans les armoires et le congel. En voyant l’épidémie arriver, je me suis simplement assurée que mes réserves étaient à jour. Et hier, en rangeant, j’ai trouvé des tas de vieilles conserves (c’est pas grave hein ça tient des années), et je me suis dit que ce serait peut-être intelligent de les ranger par date et non par sorte. Donc j’ai un rayon “2019 et avant”, un rayon 2020, un 2021, et un 2022 et après. A différents endroits. Alors bien sûr s’il me faut une boîte de thon et que la seule que j’ai est bonne jusqu’en 2022, je vais la prendre. Mais comme ça je peux facilement regarder d’abord dans la pile 2019, puis 2020, puis 2021… Même si ça se garde des années, autant commencer avec les plus vieilles.

J’entends des récits de personnes qui galèrent avec le télétravail. J’imagine bien que c’est pas simple pour tout le monde (surtout avec des enfants dans les pattes). Je vais faire un petit Live sur facebook tout à l’heure avec quelques conseils (plus de 10 ans à mon compte… je vous promets qu’on apprend des choses). Peut-être je ferai un article, aussi, on verra.

Cette semaine a passé plus vite que les précédentes. Je me dis que c’est bon signe, ça veut dire que le choc se dissipe, que je m’habitue. Ma peur de tomber malade ou de perdre des proches augmente, par contre (indicateur qui va dans le même sens: le choc/déni se relâche). Je connais des personnes malades, personne gravement à ma connaissance, et je connais des gens qui ont perdu des connaissances. Ça se rapproche.

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