Newly diagnosed and very overwhelmed

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Ravensrapture

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My cat Grizzly was just diagnosed on Monday. His blood sugar was 300-330. Since my schedule is crazy working 2 jobs and with money being tight, we started him on the pills (glipizide) 1/2 pill 2x a day. They also recommended the Hill prescription w/d dry food. I bought a small bag to mix in with his other food Hills Science Diet active longevity dry food. I am wondering should I take the prescription stuff back, finish up the stuff I currently have by mixing it with the wet food and slowly transition him over to just the wet food? What is the best for me to use? Right now, I feed them in the same bowl 1 Cup of dry food a day. Between them, it does not get finished. What is a good feeding schedule? Morning and Supper? Is it ok for them to graze? I've never used wet food before so I'm not sure what the best way to handle it is. I have another cat who is 15 and she has early stages of renal failure. I'm sure this would be best for her (kitty) also? I am very overwhelmed with all the information out there. It seems like I should be checking his sugar levels - how do I do that, how often and what is the best one to use? I am so scared and did I mention overwhelmed? I would appreciate any advice you can give.
 
I understand the "overwhelmed". I was the day I first posted here. All I can tell you is that it WILL get better. For you and for Grizzly.
There's a lot to address in your post, but what I'll chime in with before I have to hit the hay is this. Eventually, you will no longer be feeding dry food to him. Dry food and diabetes don't mix. If you can, bring back the Hill's dry and get your money back. If you have to mix dry in to try to get him to an all-wet diet, use what you still have. Just don't take a long time transitioning him (and all your cats) to a diet of low-carb canned food. Don't spend money on vet prescribed food either. There are foods available from the grocery store that are cheaper and better for all of your kitties. There is a list on the board that everyone here uses and someone will link you to it soon.

I find a 12 hour meal schedule works for me, but it will depend on the "glipizide" schedule - how often do you dose him, how long does the effect last. I use PZI insulin, and it is a once-per-twelve-hours drug. You might end up using insulin instead. I'll let someone familiar with that form of treatment address that, because I wouldn't want to advise you on something I don't know anything about.

If you are interested in home testing for blood glucose, that's what just about everyone here does. You can request a "newbie kit" which will set you up with the basic supplies to start. That is something you would do at least twice a day, before feeding and before dosing. There are lots of youtube videos that will show you how it's done, and you could even get a member of the group to visit and show you how to do it if any live in your area. Let us know where you are located. Or, they could at least phone you and walk you through it the first time or two. The people here are incredible, and go to great lengths to make you feel less overwhelmed or scared. All you have to do is ask.

I really have to crash though, but I am sure that others will be by soon to add to this. I got to get up for the 6am test and feed routine!
Welcome to the group, take a few deep breaths, and just remember that you and grizzly will get through this thing.
Carl in SC
 
Carl is right. It doesn't have to be expensive or difficult to treat a diabetic cat. It is a lot easier than other diseases cats could have. We have a protocol that has been very successful getting cats to regulation and in some cats, remission.

We feed wet lo carb food (8-10% carbs) Most of us feed Fancy Feast, Merrick, Wellness or Friskies. Here is the food chart: Janet and Binky’s chart Mixing wet and dry for a while is probably a good idea while their tummies get used to it.

We use insulin. Lantus, Levemir and PZI are the most popular here. Glipizide is generally thought to tax the pancreas rather than support it. This is from a vet hospital site: Glipizide acts by increasing the pancreas’ secretion of insulin and it is possible that a level of adequate control can be achieved by maximizing the pancreas’ secretion in this way. There is some capacity for side effects (15% of cats taking this medication will get an upset stomach) plus the majority of cats will not be controlled with this medication alone. Glipizide is often used as a last resort (i.e. when it is not possible to give insulin injections) as increasing the pancreas’ insulin secretion, it also increases the pancreas’ amyloid build up (which is what probably caused the diabetes in the first place).

As Carl said, we also hometest to make sure we see how the insulin is working. Here is how we do it: Video for hometesting

Keep reading and asking questions. We would love to help you help Grizzly. (Can't wait to see a picture with that name.....)
 
Hi and welcome to FDMB. We all understand how you are feeling, we were once there also. But I can assure you that Feline Diabetes is a very manageable even with a busy schedule.

First thing I would like to tell you is to consider changing to insulin instead of glipizide. Glip does not work well at all to control diabetes in cats and also can cause other health issues such as liver problems. Insulin works better and can even be given on a crazy schedule. Even though it is recommended that you give insulin on a 12/12 schedule, you can give insulin if it has been at least 10 hours since the previous shot, however, you will need to also learn to hometest to make sure that your cat's BG levels are in a safe range to give insulin. Hometesting means using a human glucose meter to test your cat's blood to get a reading. For newbies we recommend not giving insulin unless the BG level is 200 or higher. You will test before every shot. Besides knowing if it is safe to give insulin, another advantage of hometesting is that it eliminates the need to take your cat to the vet just to be tested. You can use any brand of meter, but if cost is an issue, I recommend the Walmart Relion brand meters. Their test strips are about $39 for 100 and one of the most economical meters to use. They are great meters. If you get one, I suggest either the Relion Micro or Confirm, they require less blood to test.

Food: Stop feeding your cat that prescription food. It is not effective for diabetes, especially the dry food. You can take the prescription food back even if it is open and your vet will give you a refund. Better foods are canned food and many of us feed our cats either Friskies or Fancy Feast. My cats even like the Walmart Special Kitty brand and it does not have any negative affect on Ricky's BG levels. I feed my cats twice a day and if any is left over I just leave the bowls out so they can finish it later. Since one of your cats has renal problems (CRF), I recommend the Friskies Special Diet canned foods, all flavors except the Chicken and Gravy if you feed both cats the same food. The Chicken & Gravy is higher in carbs so it will cause the BG levels in your diabetic cats to spike. My cat Witn had both CRF and diabetes and the Special Diet foods kept both her BG levels and kidney values stable for several years before I lost her at the age of 19.

Start reading the info on this site and ask all questions you may have. We have all been where you are now and are hear to help.
 
Thanks so far for your comments. I will be taking that food back and getting wet.

By the way, I'm Kris and I live in WI. I have no idea how to post pictures so I can put grizzly and kitty on here for you to see but would love to show them off.

Thanks.
 
Lots of great advice already given, and I am sure you are busy reading tons of useful stuff, so I won't overwhelm you further.
Just wanted to say Hi and Welcome to our little corner of the world. This is an amazing place with lots of folks willing to offer help in all kinds of way.
Feel feel to ask any questions you have. We love to help

Angela & Callie Mae
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make sure you read the food chart. link above post. special kitty from walmart ok, the pate kind (as inall foods mentioned) turkey and giblets, super supper and mixed grill. fish varieties also but we try to limit the amount we give.
fancy feast classics, friskies, nine lives and of course there are more expensive brands, which i forget the names of cause they are soooo out of my budget. I feed raw (home made) and special kitty and all are doing well
 
Not going to overwhelm you further....Just stopping by to say Welcome to the Family! Since you are already getting great advice. Just keep reading and asking questions as they pop into your head, someone will be around to answer them. :-D

Mel, Maxwell, Musette & The Fur Gang
 
I know it's overwhelming in the beginning. I promise that it gets easier! You're in the right place to help your Grizzly!
 
Welcome aboard. Talking about being overwhelmed. I was a mess when my Simba was diagnosed on 4/25/11. I didn't think I was going to make it. All I did was cry, not eat or sleep, but I reliazed my little Simba needed my help. I took him for a 2nd opinion on 6/13/11 since I was not happy with my previous vet, who was my vet for 20 yrs. The 2nd opinion strongly recommended Simba coming off of dry food and the importance of doing hometesting.

Simba came off dry food on 6/13/11 and I started doing hometesting, which I thought he would freak out, but he's been so good with me pricking of his ears, better than given him the insulin injection..

Both my cats now ONLY eat "Classic Fancy Feast" wet food. Simba's B/S levels dropped dramatically since on wet food. Simba has not had insulin in six weeks. I thought this was going to be a long life insulin depended diabetic kitty. I truly believe taking him off dry food and doing hometesting is what saved his life.

I work full time 8am to 5:30pm. I feed both my boys 1/4 can wet food at 4:30am and the other 1/4 can at 7am just before I go to work. I was worried that they would not have food to eat through out the day, so I decided to freeze 1/4 can for each cat and take it out of the freezer just before I leave to go to work. When I get home that frozen food is gone; therefore at least they get something to eat while I'm at work. I feed them again 1/4 can wet food when I get home at 6pm and again before I go to be at 10pm, so they get about 2 1/2 to 3 cans a day total. My vet said wet food is more filling than dry.

Yes, it sure can be so overhelming with so much to learn, so much information to digest, but please believe me; in time it does get so much easier. I'm still very new with Feline Diabetes, but if I can do this so can you.
 
Hi Kris,

You've gotten very good advice about ditching the dry (especially the w/d, that's about the worst food you can feed a diabetic cat) and the glipzide. I'm also going to add more emphasis to definitely starting insulin instead of glipzide. As others has mentioned, glipzide works by forcing the pancreas to work even harder, where what you want to do with a diabetic cat is let the pancreas rest so it will heal and start producing insulin normally again. It's only if the pancreas can heal that the cat will go into remission. Glipzide will only make things better in the short term, but eventually burn out the pancreas completely.

Check out page 4 of the diabetes treatment guidelines for the American Animal Hospital Association: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

Oral hypoglycemic drugs, combined with diet change, are only indicated if owner refuses insulin therapy or is considering euthanasia. These agents are not considered appropriate for long-term use.
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I would urge you towards a slow acting human insulin like Lantus. Studies have been shown that 80+% of newly diagnosed cats go into remission with the combination of Lantus, a wet, low-carb diet, and tight regulation via home-testing. http://www.ncbi.nlm.nih.gov/pubmed/19592286 My own cat went into remission almost a year ago and was completely diet controlled following this route. He's back on insulin now because he had some very traumatic dental surgery with complications, but he's on the road back to remission and will likely go off insulin again soon.

I also wanted to assure you that you can do the treatment with a full schedule. I work two jobs and go to grad school, so I was in a panic when Bandit was diagnosed. Eventually I got into a routine that worked, though. I tested at least three times a day, once before each insulin shot, and then once when the insulin peaked (when his Blood Glucose reached it's lowest number) six hours after his evening shot. Since his shots were at 7am/7pm, that meant I was getting this test at 1am, so I would go to bed at 11pm, set my alarm for 1am, do the test and go right back to bed. Yes, it was a bit of a pain in the butt, but it was worth it to do that for a while to have him go off insulin completely. Once a week I did a curve on the weekend when I didn't have to work during the day. If I was going to be gone and I wanted to make sure he had food, I set out an auto feeder with frozen wet food in it. If you have more than one cat, and any of them are gobblers, you'll want to get 1 meter for each cat. I have this one and I love it: http://www.amazon.com/Automatic-Fee...DTJA/ref=sr_1_2?ie=UTF8&qid=1311606200&sr=8-2 It has a compartment to put an ice pack in it to keep the wet food cold, but I find it easier just to freeze it and pop the frozen food in.

Once you get used to testing and giving the shots, it's very easy and only takes a few seconds for each one. You can definitely do this! Once you get that testing data things are so much easier and less expensive.
 
Hi Kris, and, of course, you too, sweet Grizzly -- love that name!!!

Where in WI are you? No specifics, just give us a town. We have sugar-cat friendly people there who might be close enough to show the home testing ropes...

Giz wouldn't even be in the same room with W/D. She did like DM however. Ironically, it was the only cat food, she actually ate. Go figure... Initially it was canned and dry DM. Soon, sadly, her tastes changed and she'd only eat DM dry (got 1/4 cup twice a day). I basically subsidized with everything and anything in my fridge and/or pantry. Then I broke out my George Foreman grill (a Christmas gift from my sister 1-1/2 years before) and started grilling chicken, steak (whatever was on sale), and pork chops (she preferred boneless center cut...). Grilling might be one way to go for both Grizzly and Kitty. Meat is high quality protein which Kitty needs and very low carb which Grizzly needs. I know money's tight. Work the sales... Properly cooked and stored, one chicken breast, a small piece of steak, and a pork chop can last about 5 days per cat. Unless, of course, you decide to sample any or all because you realize your cat is eating better than you are... Then, figure 4 days...

I free-fed Giz then, and Nikki now, by the way. A grazer's a grazer, after all... It's also a peace of mind thing for me. I like knowing food is available when I'm not home...

Can you tell I was a train wreck when Giz was diagnosed? Actually took her used syringes into the kitchen and practiced shooting air into a hot pad that bore a remarkable resemblance to her scruff when tented... Took about two weeks to stop shaking and realize I had developed a very swift, smooth, and confident delivery.

Speaking of shooting insulin -- and, how's that for a segue?! Please ditch the Glip. It's truly not good for a sugar cat in the long or even short run. Think Lantus, Levemir, or PZI/ProZinc in terms of insulin. I know that money is tight for you, Kris. For me, too... There are groups around who may be able to help you with both insulin and supplies. For insulin, you'll need a prescription. DCIN (look for one of their posts here) and IMOM.org if you qualify. Nikki is DCIN sponsored, for which I'm eternally grateful... I can't pay them back with money yet, so I donate my design skills. Helps me deal with needing help... Without their support, I couldn't keep Nikki who is a wondrous, albeit quirky sugar cat, who decided to rescue me a little over three years ago. Nikki and I have discovered a shared fondness for quirky... Also check the Supply Closet forum here as supplies sometimes become available for either free or the cost of shipping. Please, ditch the Glip.

Ravensrapture said:
I have no idea how to post pictures so I can put grizzly and kitty on here for you to see but would love to show them off.
Click to expand...
The simplest way would be to hit the "Upload attachment" thingy kind of to the left and under the "Save draft", "Preview", and "Submit" buttons. You'll have to browse your computer to find the photos we all want to see. If you want an avatar, just PM me (click that little button under Nikki's pic on the right side) and send me a photo. I have Photoshop and can resize/crop for you and send it back. Then, you'll have to do that whole upload/browse deal somewhere in your user profile. We'll figure it out...

The FDMB was my first message board experience, Kris. I'm beyond shocked they still let me post. Maybe it's because of Giz, who became a bit of a legend here. Maybe it's because we danced for four years. Maybe it's because this stupid spider showed up in my bathroom three days straight and I named it Charlotte -- which was the moment I realized I was ready to love again -- and, Giz, with her ultimate sense of irony and humor, sent Nikki to rescue me. Well, at least Nikki eats canned cat food!

I'd like to think they still let me post because it allows me to pay it forward. It is most interesting and rewarding dancing with a sugar cat...

Welcome to the place you never wanted to be; but, will be blessed for having found. Trust me.

Love and countless encouraging hugs for you, Grizzly (!), and Kitty,
Deb and Nikki -- and, Giz, forever dancing in my heart...
 
Welcome! Not long ago I was in your shoes. I quickly found this site and the message boards and learned alot. Cedric was on Lantus because that is what my vet felt would get him into remission (and guess, what, it did). We took the Lantus for about a month and still got consistant numbers (see his spreadsheet below). I had been thinking of reducing his grain free, high protien low carb dry food in mid-May and then forgot to give it to him 5/19. That was the last day he had it and his numbers dropped. His last insulin injection was the night of 5/21. He has had normal range numbers since 5/22, usually about 60s (I did not test him last night like I meant to, I was wiped from a long day at my p/t job). I still try to test him every other day, but with my A/C problems last week..... :-|

Note I changed his diet to all grain free, high protien low carb food. Mostly wellness & blue buffalo widerness canned and the Wilderness dry (which he doesn't get anymore). Much more expensive than the fancy feast I was giving him before with his blue buffalo weight management dry (which did NOTHING to help him lose weight, highest weight was 18.2 lbs). I have found a local pet food store that has a nice variety of grain free, etc canned food. I usually buy 5.5 can (which is a day of 4 small meals) and they run about $1.49-1.69. I did buy some of the FF classic in an emergency, but I was hesitant to give it to him, because he wa eating all kinds of FF before his dx. Well, he's fine on the FF. his numbers only rise when I give him tuna from the bummble bee pouch. :lol:

I work 2 jobs (that's 7 days a week of work) and I bought my first home in March. We had been living in that house (a townhouse, so he gets more exercise) a week before his dx. money is tight here too. I have learned to work around it.

I wanted to post something that my longtime friends with 2 now 3 of their 4 cats with renial failure. I asked them to send me some info for a friend of mine who's oldest of 4 has just been dx'd with this. I want to share it w/u for some help. Please note that they do feed some dry to their 4, but none of their cats are FD:

Hi Jesse,

Nimbus & Trisket both have "chronic renal failure".

Every morning each cat gets a 1200mg Fish Oil capsule, some NatureMade
Potassium Gluconate (Trisket a whole 550mg tablet & Nimbus a half
tablet), and each gets 1/2 of a 5mg Benazepril (this is human blood
pressure medicine that is also sometimes prescribed for kidney issues
but that is only beneficial in cats for kidney issues). Both the Fish
Oil & Potassium Gluconate are found in the "human" vitamin & supplements
section of a drug store.

They also eat special Kidney Diet food prescribed by the vet & purchased
on-line through VetCentric. They both used to eat Royal Canin KD dry &
Trisket Royal Canin KD canned. They prefer that the "renal cats" eat
canned but Nimbus only eats dry food so we leave a bowl of the KD dry
food out for both of them. Then Trisket developed a high calcium level
in his blood tests & the research of specialist vet we started to take
Trisket to learned vets were having good results with the calcium level
issue by switching from KD to SO. So Trisket now eats Royal Canin SO
both dry & wet. The regular vet would prefer that Nimbus eat the KD dry
food instead of the SO dry food so sometimes we lock Trisket up in one
of the upstairs rooms & we switch out the bowl of food that Nimbus has
access to with the KD food.

They also say Mewberry has early stage renal problems. So we have been
feeding him Friskies Special Diet canned cat food that can be found on
the cat food shelf at grocery or pet stores. For the past year we have
had Mewberry & Rufus confined to our bedroom where they get fed
separately from Trisket & Nimbus. It is a challenge to have Rufus &
Mewberry eat their own food but I finally developed a procedure that
works most of the time. I feed Mewberry his special food first, then I
feed Rufus her Fancy Feast and sit there until she has had her fill.
Then I take the Fancy feast away but leave Mewberry's Friskies Special
Diet out. Otherwise Mewberry happily gobbles up the raminder of the
Fancy Feast. Later in the day I get the Fancy Feast out again for Rufus
to eat & Mewberry to finish off. Mewberry has not yet been prescribed
any drugs or special order foods as his renal issues are not as severe.

Wish Wanda luck with her cat kidney issues. Nimbus & Trisket have had
this for several years. The vet explained that when a cat dies of old
age it is normally from untreated renal problems.

Doug
 
Hi Kris and welcome to the best place you never wanted to be. Kit was diag about 2 weeks ago and I was a complete mess. I will tell you that you and Grizzly will be ok and things WILL get better. My vet initally put Kit on glipizide and the same prescription food as your vet did. I did my own research and decided myself that I didn't want to keep Kit on the glip. I have to strongly agree with everyone else here that said "ditch the glip." Kit and I are still getting in a rhythm of giving shots, but it is getting much easier.
We also use the ReliOn Confirm that most people have mentioned. You can get the meter at Walmart, it comes with a lancet pen. It's like 9 bucks and the test strips and lancets are the cheapest I've found. If you decide to go the insulin route, which I hope you do, I will tell you not to buy your syringes from your vet. They are WAY over priced. You can get them at Walmart too. 100 for 15 bucks, that'll last you for 50 days (compared to the 100 for 40 bucks at your vets office, OUCH!). When you get to that point, anyone here can tell you what you need to buy. Also, if you have a petsmart around you, they have a brand, Sophistacats, that is fairly cheap, about 38 cents a can for 5.5 oz. I'm not sure about the Special Kitty price at Walmart, so I'm not sure how it compares. Kit refused to eat the Fancy Feast, you will just have to see what your Grizzly likes. It's important to remember Every Cat Is Different. Most people recommend not feeding more than 3 servings of fish a week (mercury) and they say liver is addicting, so you may want to try and limit that too. I spent HOURS reading cat food lables my first few days, but the Binky's list that Sue and Oliver already mentioned, is very helpful.
When you do start home testing, make sure you have some low carb treats to give Grizzly. Even if you don't get blood, even if you mess up. He still gets a treat and you still get a treat. Whatever he likes, as long as it's low carb. Your treat doesn't have to be low carb though :)
It's important that you remember to breathe. It will get easier. It will be okay. Welcome to our sugarcat family.

Terri & Kit
 
Thanks. Luckily my part-time 2nd job is at PetSmart here in La Crosse. I spend a lot of time now reading labels while I'm working but still get confused. I bought the relion confirm - thanks for all your suggestions- and found it to be very reasonable. I am happy to report the first test went great, first prick got the sample and neither one of us got upset. He hardly flinched. I have not put him on insulin yet but we did ditch the glipizide. I am trying to find a vet around the area that is knowlegable in feline diabetes and am waiting for one to call me back tomorrow. I am nervous on putting him on insulin for fear he will never get off of it. My sister had a sugar cat a long time ago and it was bad. Poor C-A-T practically begged for her insulin and was sooo sick her skin even started to fall off.(shortly after she passed away in her arms) I just don't want that to happen to us.
 
Don't be afraid to go on insulin, sometimes it's just what their bodies' need for just a short while. I'm not saying this will happen for you, but it has happened with other cats. My Sebastian was on 6 units BID of PZI, and once I started testing before I shot, and only feeding low-carb wet food, he went OTJ within a few weeks. I was completely freaked out at the thought of giving him insulin, but I did it for a while and was committed to doing it for as long as my cat would need it. It's been since 6/21/11 that he's had a shot, and he's back to his old bad-boy self, defeating the mighty mousey toy and tormenting his sister. Every cat is different, but some do come off insulin once they are on it. I was extremely lucky, and we may still be in a honeymoon phase, but it is great. We still use the ReliOn daily and his numbers haven't been over 70 for over a week.

Hang in there, you can even convert a vet. We went back after 3 weeks and our vet said to keep on home-testing and to feed him as I saw fit. You know what's best for your kitty, and you can do this!

Everyone here on this site are amazing, they can help get you through all this.


Jeanne and Sebastian (sugar cat) and Sabrina (blind kitty)
 
Ravensrapture said:
Thanks. Luckily my part-time 2nd job is at PetSmart here in La Crosse.
Click to expand...

I am guessing that your PetSmart doesn't have a Bainfield Vet in it? At least Pet Smart sells stuff like Wellness, Bluebuffalo Wilderness, etc so you can start your baby on "better" food for the conditions. And you better be getting an employee discount! :-D
 
Ravensrapture said:
I am nervous on putting him on insulin for fear he will never get off of it. My sister had a sugar cat a long time ago and it was bad. Poor C-A-T practically begged for her insulin and was sooo sick her skin even started to fall off.(shortly after she passed away in her arms) I just don't want that to happen to us.
Click to expand...

I've never heard of insulin causing addiction or leprosy in cats, so something else was going on with your friend's cat. Insulin is not a drug, it's a hormone, so it can't do anything other than what it was meant to do in a body, which is to regulate blood sugar content. The only side effect insulin has is that sometimes it can cause blood sugar to drop too low if too much is given, or if the cat suddenly needs less insulin (like if dry food is suddenly removed from its diet). But like with people, you can easily prevent a hypoglycemic incident by home testing before each shot, and by grabbing a few tests throughout the day. Also, if you get a slow acting insulin like Lantus, Levemir, or PZI/Prozinc, there are dosing protocols that make these types of incidents very rare. Take a look at the article I posted up above. Studies have show that giving insulin can be very safe if the right insulin and dosing guidelines are used.

It happens, but very rarely will a cat go into remission based on diet change alone. Most cats need insulin for a little while in order for their pancreas to heal. If you take a look at that article I linked to (and I have the full text if you ever want to print it out for your or a new vet), 80+% of newly diagnosed diabetic cats go into remission with a combination of Lantus (glargine), low carb wet food, and the Lantus dosing guidlines we use here via home testing. The sooner a cat starts insulin therapy, the sooner and more likely he will go into remission.

I know this to be personally true. My Bandit was on Lantus for about a year and he went into remission. The only side effect we ever had was him feeling so much better because his blood sugar was in a normal range. He had a very traumatic experience about a month ago (complications from dental surgery) that caused him to need insulin again, but because I started treatment immediately he is already about to go into remission a second time.

I hope I'm not sounding pushy, but I really wanted to emphasize that it's better to start treatment sooner than later. The longer your cat hangs out with high blood sugar, the harder it will be to achieve regulation (normal blood sugar with insulin) and then remission (normal blood sugar without insulin).

You are off to such a great start hometesting and changing diet! I really don't want you to be afraid to take the next step, too. Everything seems so scary at first, but once you start treatment you're all like "Why was I worrying about everything before? This is soooo not as hard as I thought it would be. In fact, it's pretty easy."
 
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