Patience and humor go a long way when dealing with someone whose cognitive memory declines day by day. Confusion is a growing sign as  the diseases of dementia progresses. That’s a  big problem when the patient is also Type 2 Diabetic.

My husband takes insulin four times a day to keep his blood sugar level at bay. He’s followed the same routine for ten years. The formula is simple. Fifteen minutes before all three meals, he takes a sugar count using a blood glucose meter with testing strips. Recently, he forgot which end of  the strip to insert into the meter. Fortunately, when his mind goes blank, he asks for help.

Once the strip is correctly inserted, he has to stab the tip of his finger with a lancet device (a fat pen-shaped object with a tiny needle).  When a bubble of blood comes out, he puts his butchered finger on the tip of the strip. The blood is soaked up and measured. A number appears on the cell phone-size screen.

Ideally, the reading should be between 90 and 130 for a diabetic. His readings  are more apt to range from 150 to 180, but the doctor says not to worry. He prescribes how much short-term and long- term insulin Frank shoots into his belly.  A chart gives custom-designed directions: thirteen units before breakfast and lunch, eighteen before dinner and and forty units (long-acting) to get him through the night. He keeps a record but sometimes forgets to write down the number.

Now for the frightening part. He's starting to draw a blank on the procedure. A week ago, he opened the half-closed door to the room where I write and stepped in,  embarrassed.

"Shari, I can’t remember how my machine works." 

Three days later, he barges in again.  "I forgot how to  get  blood from my finger."

Tonight, he interrupts, this time holding a needle filled with insulin. "I forgot what I do with this."

I ask, "What was your reading?"

"I haven’t taken it."

"C’mon, I’ll help you."

We walk to the bathroom. I point out for the second time today, the third time this week, the lancet lying next to the meter.

"Use this to get  blood."

He does so. (All fingers on his left hand have permanent blue spots from the four times a day 'ouch'.)

The reading tonight is excellent—128. We had a light supper, and he didn’t eat any sweets later.

"So I take 128 units of Lantus (insulin) now," he says.

"No, you take forty."

"I do not," he shouts. "I take the number on the meter."

"You take forty every night,"  I snap back.

"I never take forty," he snarls. "Who’s the dumb one now?"

I take him to the chart posted on the door and show him where Dr. Shah wrote the nightime number in big letters.  He grumbles but sees that I’m right. I pick up the lancing device.

"I’m going to label this. Maybe that'll help."

"Don’t put marker on it!"  He’s still surly. I'm just worried and yes, a little annoyed. Time to inject (no pun intended) a little humor into the situation.
       
 I'll get you for this, my big darling.

"I’ll use marker on masking tape," I assure him.

Two minutes later, I hand him the lancet. A wide piece of tape straddles the side.  I wrote a single word in obnoxious black marker.

He looks at my handiwork. I expected a laugh, but he waved me away.  A  sure sign that  all is not right in his new world.

Heaving a martryed sigh, I take the lancet back to the bathroom and set it next to the meter. Maybe tomorrow morning, he'll get my black humor.

The lancet is labeled "PRICK".