Thursday, 31 December 2009

New Year!


2009 has been a year where I’ve been rather dominated by diabetes. I’ve been heavily involved in a diabetes support forum, writing diabetes-related poetry and articles here and elsewhere, and of course, dealing with the condition itself day-by-day. I wouldn’t say it has been controlling me, but I think that, in the coming year I need to find a better balance and look for more non-diabetes related activities and interests. I think it has been fairly inevitable that my first full year with the condition has meant a large proportion of my time has been dedicated to understanding it and learning all I can about its past, present and future, but next year I am back in charge!

Bring on the New Year, I can’t wait!
So give a resounding cheer!
I won’t hold back or hesitate,
And I won’t drink too much beer!

Last year my pancreas decided to end
It’s role in my glucose control…
Well, my wiggly organ friend,
Here’s one in your millimoles!

You thought that by this time that I
Would weep and mourn your loss,
But you were wrong and that is why
In THIS body I’m the boss!

I’ll tell you now that only when
You work like days of yore,
Why, then we’ll be good friends again –
In fact I’ll love you more!

Next year will be the year for ME,
I’ll have the upper hand!
Not in the thrall of devil ‘D’
But alive and feeling grand!

Wednesday, 30 December 2009

Diabetes Support Review of the Year 2009, part 3


Diabetes is a serious condition, but we’re not always gloomy and doom-laden! One of the most popular threads over the past year has been Diabetes Support’s own virtual pub, the Glucophage and Glargine. Here all are welcome to order whatever carb-heavy meal they desire, and drink their fill on any tipple that takes their fancy with no effect on their blood glucose levels. Currently standing at over 35,000 views and 4,500 posts it supercedes the earlier ‘one-liner’ threads that proved so popular. Resident DJ Brightontez provides us with an eclectic mix of tunes from dusk till dawn from his (actual) jukebox! The pub will be refurbished when it reaches 10,000 posts…

A fine selection of jokes, from members Einstein and Diabetic Dave in particular, have swelled the Jokes section, formed when the number of jokes began to take over the ‘Off the Subject’ section. Some risqué, some silly, and the occasional one which didn’t quite hit the mark, but humour can often be a very personal thing.

Katie’s ‘Post your pictures’ thread generated a lot of interest – so many people curious to find out what the faces behind the nicknames are really like! Currently running at nearly 4,000 views maybe it’s time to revive it! The London and Southampton forum meets also included pictures which many people have seen and commented on. However, the forum Gallery section hasn’t been as popular as might be expected – I think this may be due to some of the restrictions on adding pictures that many have found, making it difficult to use, and something that perhaps needs to be revised in 2010.


jedward


Diabotics Polly Urea and Gluco Jon pose as Jedward for World Diabetes Day

X-factor has been hotly-debated, with many people appalled at Simon’s decision to keep Jedward in, and disappointment from many that Olly Murs did not win (mostly from the lady members). A poor quality bunch all around this year, not up to the standards of Alexandra Burke and Leona (who’s now so famous she only needs one name!).

Aymes led a concerted campaign to elect her little brother Barnaby as the ‘Face of Kinder’. He didn’t win, but did make it into the top 100 out of 4,500 contestants!

Diabotics, creatures formed from the detritus of diabetes care – test strips, tubs, pill bottles, needle cases, insulin cartridges etc. have proved a hit and another welcome distraction from the downsides of diabetes. First introduced to us by Becca, they’ve provided many an hour of misspent time for some of us making them, and produced some very positive comments for our efforts. It’s particularly nice when children have taken part and created their own – see Kei’s daughter F’s creation Diane Botic below!

Diane Botic



We’ve had a few weddings (not yet between members!), new babies (notably Kati Admin’s little boy Zachary!), and some pregnancies, with lots of advice and support flying around on these subjects too. Some members have stayed and posted for a while, and then moved on. Some people pop in now and then to see what’s going on, or to ask something new that’s cropped up in their lives. We have posters who are very prolific, notably Steff – currently topping the list at around 8,500. I’m guessing she would have made 10,000 in the year if she’d joined in January! Some people have joined and never posted, or even come back after the first day, to our knowledge. Some join and read regularly – there’s a real mix and hopefully however active or long or short a visit, we hope it is helpful. We’ve had a few researchers and students pop in and the occasional professional, but they don’t seem to stay too long. And the odd spammer!

For some reason, there has also been a lot of discussion about the wonderful Kate Bush, lovely women with short haircuts, and a smattering of diabetes-related poetry…!
I’ve learned an awful lot in the past year and I believe I have made many new friends. Hopefully 2010 will continue the success of 2009!

Tuesday, 29 December 2009

Diabetes Support Review of the Year 2009, part 2


One topic that attracted a lot of interest was whether people viewed diabetes as a disability. Opinions varied, some preferring the term ‘condition’ they do not feel they are disabled, but can do pretty much everything that a non-diabetic can do. There is also a feeling that a ‘good’ diabetic who follows a healthy lifestyle and diet is actually fitter and healthier than the general, non-diabetic population as a whole! There is, however, the legal implication of being included in the Disability Act, whereby employers must make reasonable provision for diabetics, allowing them to test, take breaks if necessary to treat hypos, and not discriminate against them.

From another perspective, the issue was raised in a number of threads of the special considerations for children with diabetes, such as should they be allowed to the front of queues at theme parks and what schools should provide for their care. The increased flexibility of treatment regimes and the attempt to gain tighter blood glucose control mean that there may be more testing, injections or the complexity of pumps for schools to monitor. We have some very forthright and active parents on the forum who fight hard to ensure that children get the care and support they need, whilst living as close as possible a normal childhood. These parents have been of great support over the year to those with newly diagnosed children, who are often frightened, confused and overwhelmed by the diagnosis and all it implies.

Another popular theme was my participation in the Great South Run to raise money for JDRF – popular perhaps because of my persistence in attempting to gain sponsorship! The good news is that we raised over £750 for the charity thanks in no small part to the generosity of our members. The other good news is that I finished with all limbs intact!

Several threads have revealed the great diversity of our membership and the circumstances surrounding their diagnosis. In ‘How long diabetic?’ we discovered that we have many members with over 30, 40 and even 50 years of diabetes, with everyone from a few months to a few years in between. This huge breadth of experience means that our members have encountered many changes and different treatment regimes and there is always someone who can offer advice and support. Those recently diagnosed are a great help too, as they bring to light current care practices that some of the longer-diagnosed members may not be aware of, leading to renewed efforts to get up to date and on track.

Other features of the year have been discussions of glucose meters, statins, neuropathy, medical ID, changing needles and lancets, depression, swine flu, appropriate testing for Type 2s, incompetent doctors and pharmacies, metformin, retinopathy exams, podiatrist visits – topics which have often cropped up many times as new people join with new questions. Our adage remains that there are no silly or stupid questions, even the one I asked about nostrils! And of course, something that only people with diabetes can fully understand, the announcements of improvements in HbA1c scores!

Tomorrow, the lighter side of Diabetes Support in 2009!

Monday, 28 December 2009

Diabetes Support Review of the Year 2009, part 1


As you may know, I am an Admin of a Diabetes UK backed support forum, Diabetes Support UK. As the year draws to a close, I thought I would write a review of what has been happening there over the year to give an indication of the topics uppermost in our member's minds with regard to diabetes in all its many incarnations. This is Part 1, as it is turning into a larger task than I first envisaged, so much has been going on!



It’s been a busy time for Diabetes Support’s first full year since inception, so I thought I would write a little review of what’s been happening. Over 5,000 threads have now been added, and we are approaching 1,800 members. Number of posts per month climbed from around 2,800 in January, peaked at over 10,000 in July, and have been between the 7,000-9,000 level in the months since then.

So, what have we all been talking about and reading? I decided not to do a month-by-month review as many threads have run over a period of many months and in some cases are still being added to. Instead, I thought I would write about the threads that have been viewed most often through the year, as these threads represent the ones that most people read, if not actually respond to.

The stand-out thread for number of views is The Pumper’s Thread’, with (currently) over 23,000 views. This thread variously chronicles the experience, joy, despair, pitfalls and superb advice of a number of our members new to the use of insulin pumps, or long-term pumpers offering the benefits of their knowledge and experience (particularly Adrienne – you are a legend!). In some cases, it was about adults new to pumps, in some cases parents with a child on a pump, all supporting each other brilliantly as they got to grips with the complexities of the machines. Prior to the introduction of this thread, a number of people had been diarising their own particular journies, and these separate threads also constitute some of the most read threads. Eventually, it was decided to introduce a sub-forum for pumping so that new members would find it easier to find information and advice about particular problems.

Second on the list for most-viewed thread is the ‘No Carbers/Low Carbers’ thread with over 12,500 views. As on many forums, there is a big debate on the right approach to diabetes management with regard to carbohydrate consumption, and this can often become polarised when enthusiasts for one person’s experience are at odds with another’s. We did experience some conflict on the issue, but I am very happy to say that the vast majority of our members respected the views of others, absorbed the information being given, and applied it to their own particular situation. As always with diabetes, you need to learn about the options and discover what works best for you in balancing your dietary and lifestyle choices with your need to maintain good levels of blood glucose.

I have to take the blame/credit for another of our most-viewed threads ‘Oh bother this blooming basal!’, which started off with me bemoaning the constant and unpredictable changes in my basal insulin requirements as I sought to find a dose that would prevent the threat of night-time hypos whilst keeping my background glucose levels nicely within range. I started the year at twenty units of Lantus, went down as low as six, and am currently of eight.

The next most popular threads, unsurprisingly, contained discussions about food! A very popular thread, added to daily by many members, was ‘What did you Eat Today?’. Here, members wrote up their menus for the day so that all could see what kind of healthy (or otherwise!) options were being consumed and in what quantities. The thread was very successful in introducing everyone to ideas of what they might be able to try, and also where people slipped up and sinned! Which brings me to the next most popular ‘Forgive me, for I have sinned!’ Here people have talked about their little indiscretions and major rebellions in their diets, confessing them to all and in the act informing everyone that it’s OK to have a treat every now and then – don’t beat yourself up about it! We’d all go mad if we weren’t allowed the occasional sin, and as long as we keep in mind the big picture and don’t become complacent, the whole world isn’t going to end because of a few profiteroles!

Member Wallycorker (aka John!) has kept his thread ‘Please support my diabetes petition’ in the limelight and has attracted a lot of attention, and hopefully enough signatures to get it to the point where Number 10 have to respond. It concerns the advice being given to newly-diagnosed people regarding diet and the allocation of test strips on prescription, particularly to Type 2s. This topic has also been discussed many times over the past year in various threads, in particular regarding the restriction of strips by GPs to Type 2s on a regime of diet and exercise. If they are not allowed to test, how do they know how their efforts and diet are affecting them? The Hba1c test can only give a partial answer. The real issue, of course, is cost, as the strips are expensive, but for many they would give improvement in levels, greater flexibility in diet and most importantly with a chronic condition like diabetes, peace of mind.

So what other things have been important to everyone? The forum meets in Southampton and London generated a lot of interest, and were deemed by all attendees as a great success! More meet-ups are planned for 2010, and now that we have a better idea of what works and what doesn’t hopefully they will get even better!

Of course, one of the big topics during the year has been the issue of injecting in public. This issue gained increased attention after the publication of the infamous letter from the retired nurse in Diabetes UK’s own ‘Balance’ magazine, saying how disgusted she was on encountering the practice. Unsurprisingly, there was considerable uproar on the matter, with quite a lot of members objecting to the publication of such a letter in a magazine that diabetics themselves pay for and should therefore find supportive, not offensive. The issue was further inflamed by the subsequent publication of more invective from the nurse in a later edition of Balance. My own ‘Nursing 101’ also gained a good response on the topic!

Part two of the review tomorrow, lots of other subjects discussed over the year!

Friday, 25 December 2009

Bah, humbug!




When the horrid hypo headache hits you hard,
And you want to keep the shakes and sweats at bay,
Then please don’t turn to meat, for you must have something sweet,
And what better sweet to eat on Christmas Day?

Its minty taste’s divine and it’ll set you up just fine,
And make that hypo headache go away,
So don’t you mutter ‘Bah humbug!’, but a hearty ‘Hurrah humbug!’
And let the humble humbug save the day!

A very Merry Christmas to all my readers!

Tuesday, 22 December 2009

Make my Christmas!


When I awake on Christmas Day,
I’m hoping that you’ve gone away,
For though I’ve tried to learn to love you,
There’s many a thing I’d place above you!

Diabetes, I know you care,
You never leave me, you’re always there,
But I would cope if you should go,
Just thought that I should let you know…

We’re very close, that much is true -
At every meal, it’s me and you,
And each night – oh how close you keep!
And never leave me while I sleep…

You could leave me a Christmas gift,
Or just leave, and see my spirits lift!
So how about it, if you could,
Just pack your things and go for good!

I wouldn’t miss you, can’t you see?
It’s over between you and me!
You’re not the friend you think you are,
So sling your hook, and make it far!

Wednesday, 9 December 2009

Dear Santa...


Christmas is notoriously a time for over-indulgence, eating and drinking with abandon and not really worrying too much about the consequences of this once-a-year celebration, as it can all be remedied by the New Year Resolutions that are just around the corner. Last year, however, was my first with diabetes, and for the first time I had to consider carefully what I was going to eat and drink – how much I could safely handle without making myself REALLY ill, and not just a bad stomach ache and sore head the following day.

As I’m on insulin I can, in theory, just calculate the carbohydrate content of my food and drink and dose myself accordingly. However, I’d also have to consider timing of injections, so I wasn’t peaking or dropping low, and I’d also have to consider whether I really wanted to inject the amount of insulin I might need for a day of extreme over-indulgence! It’s at times like this that you really start to realise what a great asset your pancreas was – and no doubt (as in my case), completely unappreciated! So here’s my plea to Santa, for a new, fully working pancreas. Even if it only works for a day, like many Christmas gifts, it would allow me one day free of the shackles of diabetes – and that would certainly be a day to celebrate!



Dear Santa, I’m hoping that you read this list,
For I’m asking for something that lately I’ve missed,
It’s a thing called a pancreas, now I know what it’s for,
It’s something that I’d never thought of before!

I’ve got one that’s broken, and whoever would know
It was my dearest possession, and I do miss it so!
If you brought me a new one, with all working parts,
Then I could eat jellies and trifles and tarts!

I’d have roast potatoes, and parsnips as well,
But I’d lay off the sprouts (because of the smell!)
And after my turkey and cranberry sauce,
Why, then there’s the pudding – with custard of course!

And all through the day I could fill up on treats,
Like mince pies and chocolate and fruit cake and sweets!
With a lovely new pancreas I could drink lots of beer,
Till I couldn’t walk straight, but with no hypo fear!

I know that a pancreas might be hard to find,
And if you can’t get one, I won’t really mind,
Instead, leave some insulin, for my stocks might run low –
A gallon of fast-acting, and a pint of the slow!

Tuesday, 8 December 2009

Injection Disaffection


It’s a common misconception, I think, that being an insulin-dependent diabetic is difficult chiefly because you have to inject yourself several times a day. This is something that most people can relate to, the thought of all those injections and how they must hurt but you have to do them even if you are afraid of needles, and ‘oh, I could never do that!’ I’m sure you get the picture. There are few of us alive today in modern society, of what ever age, who haven’t had to have an injection of some form or another. It may be that the injection hurt, or simply that the anticipation of the pain might even be worse than the actual needle going in. Often, these injections involve rather large needles, and are made into the veins or muscle tissue, which again can make them more painful.

However, insulin injections are quite different. The needles are tiny, usually 6 mm, and the injection is subcutaneous – into fatty tissue rather than a muscle or vein. As you are not injecting deeply, there is rarely contact with nerve endings or blood vessels, just maybe the odd small capillary that might engender a tiny speck of blood. Fingerprick tests to check blood glucose levels are usually far more painful as there are more nerve endings in the fingertips and you are actually trying to produce blood.

So, what is difficult about insulin injections, if it isn’t the pain? The answer is trying to work out every single time just how much you need to inject in order to hit the ‘Goldilocks’ dose – neither too much, nor too little insulin. A healthy pancreas will do all of this without you knowing, and in such finely-tuned amounts that it is impossible to mimic manually by injecting or even with an insulin pump. The insulin starts off at the wrong place too – a healthy pancreas sends most of the insulin it produces directly to the liver for redistribution, an injection will slowly be absorbed through the capillaries directly into the bloodstream. To calculate the dose you need to know precisely how much carbohydrate you are going to eat, and what your resistance to insulin is like at the time of day that you inject. That resistance might be reduced by some previous activity you have undertaken – but by how much? You might also need to consider the speed of digestion of the food you are about to eat, so that you can match the peak of digestion (and consequently blood glucose levels) to the peak of your insulin. There are many, many more factors, but you get my drift.

If you have a healthy pancreas, you cannot comprehend this in the way that a diabetic person does, even if you are very familiar with the concepts and maybe know people close to you with the disease. It is true that a parent will fear for their child if they have diabetes, but that is different to how a comprehending adult will feel. With each injection I feel an anxiety about getting the dose as near to perfect as possible so that my blood glucose levels will fluctuate no more than a non-diabetic person’s would, and thus spare me from the potential awfulness of diabetic complications of the heart, eyes, kidneys, nervous system and limbs. No matter how often I do it, and later find I got it almost right, each injection brings with it this mental distress. This may fade with familiarity, I’m not sure, but for the moment that seems unlikely or at least a long way in the future.



I think that on reflection, my injection disaffection
Is not from when the needle tip goes in,
Or some fearful predilection, or the worry of infection,
For I rarely feel the pinprick break the skin.

No, the pain of the injection is the insulin selection,
And the hundred different things you need to know –
Overlooking one connection in your quest for dose perfection
Could later find you high or find you low.

For each dosage calculation you need flawless information,
If you don’t inject, you can’t really understand,
For you have no real sensation of the fear of complications,
That pervade your life in Diabetes Land!

Monday, 7 December 2009

Diabotic - Accu Chick!


The latest addition to the diabotics range of creatures constructed from the assorted debris and detritus of diabolical diabetes!

Materials:

1 x Accu Chek test strips box
1 x outer needle cover
2 x Novorapid insulin cartridges
4 x inner needle covers
20 x needle tip covers
32 x Accu chek test strips

Sunday, 6 December 2009

The Fight To Survive – Caroline Cox


If you have Type 1 diabetes, and in particular if you are a child with it or the parent of such a child, then this book should be essential reading. It charts the life, and near-death and subsequent recovery of a young girl diagnosed at the age of 11, at a time when insulin therapy was unknown and the only available treatment was a near starvation diet of less than 800 calories a day.

The diet itself was intolerable for most, who could not live with the daily torture of eating far less than their growing bodies required, but in this respect Elizabeth Evans Hughes showed remarkable dedication and willpower, especially for one so young. Caroline Cox builds a vivid picture of Elizabeth’s struggle and her refusal to let the disease and its privations restrict her from living as normal and full a life as possible, and her strength would permit. She sought to remain cheerful and optimistic in her many correspondences with her mother, Antoinette Hughes, and relieve any pressure she could on her family, in particular her father who held some of the highest positions in US political and judicial life.

Intertwined with the story of Elizabeth’s life is the story of the discovery by Banting, Best, Collip and Macleod of the substance that would save her life and completely alter the treatment of diabetes – insulin. This book provides an excellent companion volume to the two other great accounts of the revolutions in diabetes care that have occurred since the early 1920’s: The Discovery of Insulin by Michael Bliss, and Diabetes- The Biography, by Robert Tattersall. Cox’s biography brings a very human and personal perspective to the story of the miracle of insulin and brings home forcefully the dreadful realities before its discovery, and the hope for the future after it was successfully purified and administered.

I have Type 1 diabetes and do not have to endure what Elizabeth and her contemporaries had to endure. With modern treatment I can be confident that the insulin I use is pure and standardised, with a reasonably good prediction of what I need to inject in order to eat a certain meal. Each year new discoveries are being made to refine and improve the lot of the person with diabetes, but none – short of a cure - can surely match the transformation brought by insulin to be able to consume a healthy and varied diet rather than wasting gradually away to nothing.

You will be captivated by Elizabeth’s spirit and courage and left in no doubt that, awful as a diagnosis of diabetes is even now, there was a time when it was almost unbearable. I cannot recommend this book highly enough, I read it from cover to cover in one sitting.

Thursday, 3 December 2009

I'm low, I'm low...


Hypoglycaemia is one of the perils of diabetes, most commonly in those on insulin and trying to keep tight control. Erm, that would be me then! A hypo occurs when the level of glucose in the blood drops too low, usually below 3.5 mmol/l. As glucose is the only form of energy the brain can use, it quite rightly becomes rather distressed when it can’t get enough to function properly and sends out all sorts of signals to let the unfortunate diabetic know that something is wrong.

The odd thing is that, even though I know precisely what is happening, I feel somewhat reluctant to remedy the situation by eating some fast-acting sugar, like jelly babies or a sugary drink. I feel like it’s something really annoying and fight against the feeling, as though I can somehow overcome it through willpower alone, that it is something I must defeat mentally, even though it is a physical condition that needs handling in a physical way. As the person having the hypo I can’t rally say how I might appear to others, but there is much evidence that people become irrational, or appear drunk, sometimes aggressive, and often completely illogical. Not surprising, really, as it is the hypoing brain that is compromised and therefore not best placed to behave in a rational manner.

I know what I need to do to make the feeling go away – eat some sugar! But knowing this does not seem to be enough to make me act immediately, and I’ll sometimes spend quite some time deciding whether I should eat a green jelly baby, which I don’t really like, or a red one, which would be a nice treat and at least I would get some pleasure as a reward for suffering the hypo. But if I always leave the green ones, then there’ll only be green ones left at some indeterminate time in the future when I’m having another hypo and would really like a red one! And I’m arguing out this stupid dilemma whilst all the time I’m trembling and sweating and my heart is racing, and there are hundreds of little black blobs swimming in and out and across my vision.

Just eat the stupid jelly babies!!!!!
I’m low, I’m low and I know that it’s so,
And I wish and I wish that this feeling would go,
For I’m sweaty and shaky from my head to my toes,
From the back of my head to the tip of my nose!

So why don’t I act? Oh, why hesitate?
It’s so inconvenient, I’d rather just wait,
I’ll leave it a minute, it won’t be too late,
Though it seems to be worse now, I’m in quite a state!

I’ve got jelly babies by the side of my chair,
A green one? A red one? I really don’t care,
This darned diabetes is really unfair,
I'm living the dream - or a waking nightmare!

Oh, I can’t write my letters with eyesight like this,
All swimming and jumbled and all gone amiss,
So at last I feel tempted by the sugary kiss
Of a sweet jelly baby, and some sugar rush bliss!

Tuesday, 1 December 2009

Diabetes - the Biography - Robert Tattersall


I thought I would include a review of a book I read recently about the history of diabetes. There appears to be very little written on the subject, despite its importance and the development over the years, particularly the last century.

This is an absorbing and comprehensive account of the history of diabetes encompassing earliest theories, the discovery of insulin and changes in treatment regimes including the very latest advances. It provides a very useful complement to Michael Bliss’ ‘The Discovery of Insulin’, expanding on the progression of treatment since the earliest days of insulin therapy to include chapters on diabetic complications, methods of testing and control, application of drug therapies and the emergence of the patient as primary carer in the management of their diabetes – thus moving the emphasis from physician-led instruction to self-monitoring and flexibility by the individual.
Dr Tattersall builds an easily digested ( and non-spiking!) timeline of the changes in diabetes and its care, beginning with its first recorded descriptions 3,500 years ago through the advances of the nineteenth and twentieth centuries, culminating in current methodologies and advances of the twenty first century. It is an encouraging story of how diabetes has changed from being an almost assured death sentence accompanied by severe and distressing complications to a manageable condition with increasingly sophisticated treatment options, thus promising a much brighter future for those who are being diagnosed in ever-increasing numbers today. A very welcome addition to my library!

Monday, 30 November 2009

The Diabetics of Dingly Dell


Diabetes can be a pretty invisible disease. Generally, people won’t be aware that you have it unless they happen to see you injecting, or testing, or if you have some outward sign such as one of the many complications of diabetes – eye or kidney problems perhaps, or maybe even and amputated limb. At one time diabetics were easy to spot, particularly Type 1 where there is no insulin production. Such people quickly became emaciated, unable to use the energy from their food so their bodies would start processing fat and muscle. Without insulin the levels of ketones would quickly start to rise to dangerous levels leading to coma and death.

The discovery of insulin changed things hugely, and was widely supposed to be a cure. Indeed, the results of administering it were astonishing – people literally ‘came back from the dead’. However, as knowledge of the disease and its treatment became more sophisticated, the full complexity of just what a pancreas achieves for a healthy human being became apparent. It’s not just a case of ‘inject and go’, there are a myriad of factors that need to be considered in calculating each dose, several times each and every day – type and quantity of food, temperature, activity levels, illness, age, stress – the list goes on and on – if the worst effects of the disease are to be minimised.

And then, of course, sometimes it just does not respond as you expect, as it has a hundred times before when you were in the exact same situation, with the same meal, same time of day, after your run in the spring sunshine. This unpredictability can be terribly stressful (which in turn can send levels rocketing!), but most of the time most diabetics will keep it hidden from view. Unless you have diabetes, it is very difficult to understand how it feels to have no escape from this constant low-level fear and frustration. There are worse things to endure in life, it is true, but just because someone appears fit and healthy don’t assume they have it easy.



There’s a place that you’ve probably heard of,
But here’s something you may not know so well –
For amongst all the fairies and pixies you’ll find
The Diabetics of Dingly Dell!

They all appear perfectly normal,
And healthy and active and strong,
But if you think diabetes is easy,
Then think again please, ‘cos you’re wrong!

There once was a time down in Dingly
When prospects for diabetics were poor,
But the discovery of magical insulin
Was hailed all at once as a cure!

But insulin is only a treatment,
Diabetes cannot be ignored,
How much you inject requires deep intellect
If a long life’s to be the reward.

So if you should find yourself visiting
The denizens of Dingly Dell,
Consider the fairies and pixies and gnomes
Might be diabetic as well!

Sunday, 29 November 2009

Where in the World?


I was just taking a look at my blog statistics, in particular the current World Map that identifies where in the world the people reading it are coming from. The map changes as it only stores the last 500 visits, so I have lost some of the Brazilian visitors, and the Hawaiian, and a couple from Australia. Recently I got my first visitor from Moscow, which interested me as I studied Russian at university and have always retained an affinity for that part of the world. There are some people from India, Bangladesh, lots in the UK and Europe, and quite a few in the United States.

They find my blog in a variety of ways – google or bing searches, through links from bulletin boards or the blogrolls of other bloggers, the ‘Next Blog’ option, and recently Twitter and a few this month from NaBloPoMo. The searches are interesting. I was amused to see that one visitor found my blog when using the search request ‘how can jam kill diabetics’ (see poem ‘Diabetic Jam). I’ve had several people reading ‘The Podiatrist who Tickled my Toes’, after searching for ‘podiatry tickling’ or ‘podiatry poem’, and the more conventional ‘diabetes poetry’ and ‘funny poem about diabetes’. There are a lot of very serious poems about diabetes around, but I prefer to keep mine light as a bit of an antidote to the dread forebodings and hand-wringing the disease can engender. I’ll admit that a lot if it is of questionable quality, especially when under the pressures of NaBloPoMo (only one more day to go after today!), so I hope that you will take a little time to look back through the archives and hopefully there will be something to make you smile.

Of course, not all of the visitors have an interest in diabetes as their route here might have been entirely random, but the chances are that many of them will be touched in some way by the disease. Maybe a partner, friend or relative has been diagnosed, or there is some past family history. In 2000, the World Health Organisation (WHO) estimated 171 million worldwide with the disease, with a possible 366 million by 2030. That’s a lot of people, and it really doesn’t matter where in the world you are: Africa 7m (2000) 18m (2030), the Americas 33m (2000) rising to 66m (2030), Europe 33m (2000) 47m (2030), and so on.

This rise in prevalence will place greater and greater pressures on the health services of all countries, where such services exist. In those countries where access to essential care and medication is not freely available there will inevitably be a huge increase in suffering from diabetic complications and the prospect of premature death. I count myself extremely lucky to have been diagnosed with diabetes in a country where my medical needs are catered for without personal cost by the National Health Service. Millions of others around the world do not have money for test strips, oral medications or even insulin, and will therefore almost inevitably succumb to poor control and all the associated risks that entails. My biggest hope is that some of the research currently underway to seek a cure will bear fruit. Maybe in my lifetime people will fail to find any sites where they might learn ‘how to kill diabetics with jam’, because diabetes will only be of historical interest, I hope so!

Saturday, 28 November 2009

Dia-Dalek!

Presenting Dia-Dalek, scourge of Time Lords everywhere! I've been a fan of Doctor Who since the very beginning - back in the William Hartnell days, so the image of a Dalek has always been buried deep in my subconscious. I even got a red Dalek outfit for Christmas when I was about six years old, and went out to exterminate the Thompson brothers from up the road. Sadly, my weaponry was inactive, and they drove me away with their ping-pong guns - curse you Thompson brothers! Apparently, my father and a couple of his friends emerged from the pub down the road after having their lunchtime Christmas pint, saw a red Dalek fighting two ping-pong firing galactipedes, and decided to return to the pub until their sanity returned...

dia-dalek

Dia-Dalek is therefore my crude tribute to these glorious creations - wonderful to see how prominently they are still are in the current storylines, despite numerous extinctions! Dia-Dalek is a diabotic - a creature constructed from the detritus of a diabetic life...as follows:

Materials:
1 x Novofine 6mm needle box
20 x AccuChek test strips
20 x needle tip protectors
1 x needle cap
1 x Lantus cartridge
1 x Multiclix lancet
6 x Candesarten blister packs

...with the rest of the gang...

The Diabotics

Friday, 27 November 2009

Beware the hot water bottle!


I was quite surprised to learn after I had been diagnosed with diabetes that I should now avoid a number of seemingly harmless things, like hot water bottles, foot spas and socks with seams. The problem with these things is that, even with only mild neuropathy, your feet may not be able to detect whether they are being damaged either by heat or by a blister caused by a seam in the sock. Should a wound pass unnoticed and become infected, this could well be the first stage of problems that may, in the worst cases, lad to ulceration and possibly gangrene. Scary stuff indeed! Although I don’t have any neuropathy as far as I’m aware, having had my feet thoroughly checked over by a podiatrist, I have to check my feet each day so that I can be sure of catching any potential problem before it can go too far. Just another little reminder each day that I have diabetes, as if I’m ever likely to forget!


Beware the hot water bottle
That you use to warm up your toes!
For your nerves may not let you know it’s too hot,
And it might just be best if they froze!

Beware the humble foot spa
For it has hidden dangers you see!
You might boil your feet in the excessive heat,
So learn to live life foot spa free!

Beware of the socks that have seams!
They may rub your feet the wrong way,
If a blister’s neglected then it may get infected,
So go seamless with socks I would say!

These things that may once have seemed harmless,
Are things that you now must reject.
Look after your feet and protect them from heat,
And treat them with utmost respect!

Thursday, 26 November 2009

A Northern Ode to Southern Tarts


After living with diabetes now for just about 18 months it’s hard to remember a time when I didn’t have it, or at least have it to worry about. You’re constantly reminded about it, so there’s no real escape. I’ve been lucky though, with generally good levels, just a necessary and unwelcome chore several times a day when I have to make decisions about it. This is expressed extremely well in an article by Catherine Price, which I wish everyone without diabetes could read so they could gain some insight.

So, feeling a little nostalgic today, and that prompted a revisitation of the culture shock on moving from the North to the South of England. I’ve lived in the south of England now for around thirteen years. One thing that drew me here originally was an encounter with a young lady on an Open University summer school – nothing romantic, but she was absolutely delightful company and we corresponded for quite some time afterwards. It opened my eyes to how drab and boring my existence had lately become, in a rut with my job and with a virtually non-existent social life. So, I decided to try for a new job. With no ties I could apply anywhere in the country, and with no preconceptions was happy to go wherever life took me.

I was fortunate enough to find a new job quickly through an old friend of mine and, although the job soon became a bit of a drudge, having made that initial wrench made it easier to move on again. And so, here I find myself now, a broken femur and a chronic life-threatening disease later, reminiscing about how that young lady would jokingly mock my Northern ways and cheekily describe herself as a ‘Young Southern Tart…



I’ve often heard it stated about the Southern Parts
That the whole place is peopled by Young Southern Tarts,
And the one that’s most sought after by Rough Old Northern Men,
Is the one who is a Stunner, by the name of Mary Fenn!

For Southern social circles, fashion gurus in the Town,
Her special wit and wisdom are the source of her renown,
For she never races whippets, nor wears an old cloth cap,
Nor smokes a pipe on Sundays with a goose upon her lap!

But gracious is her nature when faced with those low-born,
Those sad old Northern peasants, that other Tarts would scorn.
This saying is their mantra, which warms them to the core:
‘Her arrival gives us pleasure, and she leaves us wanting more!’

A Northern Man exposes, in the passage of a week,
Such low-born traits and foibles that would make a Tart go weak!
His social interactions with the Southern and refined
Betray his common peasantry and feebleness of mind…

A pickled egg in Sheffield is thought of as a treat,
And the smartest men in Rotherham wear clogs upon their feet,
And the richest men in Barnsley with their fine two-bedroomed houses
Find no difficulty walking with a ferret in their trousers!

When faced with such barbarity, Miss Fenn displays her gifts,
And overcomes with sweet aptitude these trans-cultural shifts.
Her modesty is legend, and her smile will bring good cheer,
And the promise of those lovely lips turn Northern men to beer!

So Northern Man rejoices that the world contains such Tarts,
His pride restored and swelling (along with other parts),
Sing hip hooray for Mary! And hip hooray again!
For the Tart who is a stunner with an equally lovely brain!

Wednesday, 25 November 2009

Don't take away my Pancreas!


Before I was diagnosed with diabetes I had no real idea what the pancreas did or even whether I really needed one. I think this is fairly common amongst the general public. We are used to hearing about our ‘vestigial’ organs that we can function perfectly well without, so are not surprised at the suggestion that maybe another organ can be added to the list.

Since diagnosis, of course, I have learned much more about the functions of a pancreas. Not only does it normally produce insulin and its opposite hormone glucagon, but it also plays an important part in the digestion of our food, producing powerful enzymes for the purpose whenever we eat. We can live without a pancreas, but will then have to take additional medications to help with the digestion of food. I have yet to discover whether a lack of glucagon is something that needs to be remedied – this is the hormone that prompts our liver to release glucose into the blood to raise blood sugar levels, and which therefore has an opposite effect to insulin.

Some people have their pancreas removed due to infection or disease, and this will make them diabetic. Sometimes the pancreas may not be wholly removed, and may continue to function. I know of a child whose pancreas produced so much insulin at birth that her blood sugar levels were continuously falling dangerously low, and she had to have her pancreas removed. However, a small part remained and this will still sporadically produce insulin, making control extremely difficult and unpredictable. Banting and Best also encountered problems when the dogs they were experimenting on had not had their pancreases fully removed.

Pancreas transplants are extremely complex and difficult, chiefly because of the digestive enzymes which, if leaked, can literally eat away at the surrounding tissue. A more likely future appears to be in the field of stem cell research and beta cell transplantation, but this is currently in the early stages.

So, the pancreas is certainly not vestigial! But neither, it appears are those other organs that traditionally have no use – the appendix and the spleen. The appendix is now thought to be a storehouse of ‘good’ bacteria which can be used to replenish the intestines should they become depleted. And the spleen is now thought to be important in aiding the recovery of heart damage after heart attacks by producing white monocytes which aid in the repair. The conclusion? Never mock an organ that seems to have no use!

Who would have thought a pancreas
Was such a complex thing,
And when it fails to function right,
The problems that could bring?

If you have diabetes
Does that mean it has no use?
Like your spleen or your appendix,
Or perhaps the male prepuce?

But no! It’s not just insulin
Our bodies need it for –
There’s glucagon and enzymes,
So it cannot be ignored!

All hail then to the Pancreas!
Hold on to your original!
It may produce no insulin,
But it’s certainly not vestigial!

Monday, 23 November 2009

Diabetic Osmosis!


Something a little strange occured during the London Meet. My blood sugar levels are normally very good, and practically always within range, but on Saturday they were almost invariably high – sometimes even double what I might have normally expected! My only conclusion is that, like fertile women who live together and whose cycles become attuned, my blood sugar levels were equalising with the other diabetics sat around me. The closer they were, the greater the effect. On one occasion when I checked I was 13.9 mmol/l – almost unheard of for me! – the two people sat at either side of me had levels of 20 mmol/l and 26 mmol/l, also higher than they expected. Gradually, as I travelled home my levels began to fall back to more normal levels, and had fully settled in range before bed after I had been alone for a few hours!

Beware the Dark Side, should you meet
With diabetics on the street,
For there’s something, although it’s rare,
Of which you may not be aware!

When diabetics form a group,
Like poultry in a chicken coop,
The sugar in their blood may rise,
So please be warned and worldly-wise!

Should one Type 1 with good control
Be subject to more millimoles,
It seems there’s only one prognosis –
Proximity Diabetic Osmosis!

The sugar seeps from every pore –
Some may get less, some may get more,
But in this diabetic bubble
Meter readings often double!

This all-pervading, unseen force
Will start to fade with time of course,
It’s temporary, so please don’t fear
If diabetics stand too near!

Sunday, 22 November 2009

Megatrain!


As reported in yesterday’s blog post, I went to London yesterday. Astonishingly, the return rail fare was £2 plus 50p booking fee! When I booked it, I couldn’t believe it, and as I said to Katie at Southampton Central, I won’t really believe it until I get back! Well, I’m back and I’m still finding it hard to believe. I booked well in advance, which is important to get the lowest fare. The guard simply checked the reference number I had printed out, let me through the barrier and off we went. The train arrived on time, and contrary to what I was expecting, there weren’t hordes of people fighting to get on – just five other passengers – so we got a seat quite easily. Moreover, we weren’t assigned to a particular carriage – I’d envisaged maybe some kind of rail container vehicle with soiled straw on the floor and no windows, but it was just an ordinary carriage.

As the train departed, the guard informed us that, should we so wish, we could upgrade to First Class for an extra £5. This would be £6 paid for a journey that, if booked on the day, would have cost £58.20. As the train began to fill up, the value became even better, as the guard announced that he was opening First Class to all passengers at no extra cost, so that would have meant a £55.20 journey for £1! We didn’t bother, as by the time we had reached the FC carriage, all seats were likely to have been taken, but this doesn’t detract from the amazing price.

The journey was smooth and comfortable and arrived in London Waterloo on time. Our return journey was equally trouble free, although we had cut it a bit fine and made the train with only a couple of minutes to spare – I hadn’t taken account of Katie’s desire to hug everyone before she left the pub when calculating when we would have to leave!

I will certainly travel on this again. It’s almost worth booking a journey even if you’re unsure whether you can make it, as £2.50 is hardly going to break the bank if it turns out you can’t go. And we got to spend seven hours in London for the price of a pint of JD Wetherspoons beer!

Saturday, 21 November 2009

London!

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Today was the eagerly anticipated meeting of members of diabetes support forum. The plan was to meet up in the British Museum and then find a local watering hole capacious enough to accommodate a crowd of about 15 to 20 diabetics! Katie and I travelled into London together, and walked the mile or so to the British Museum from Waterloo railway station. Thankfully, the weather was clear and sunny, and the views across the Thames on either side of Waterloo Bridge were truly superb, although our initial steps across the bridge had been somewhat blighted by the concrete monstrosity of the Southbank Centre – how could an architect ever have thought that that was beautiful? Hideous!

Southbank Centre

We did get a little lost along the way, but not too far off our route, and managed to find the British Museum without too much drama, although I’m not sure I inspired much confidence in Katie! The arranged meeting place was by the souvenir shop on the west side of the Great Court. I have never been in there before, and was hugely impressed by the magnificent Court. As we were arriving a little later than the others, they had already moved on from the shop, so we wandered round the west side until we came across some tables at which many people were seated. Casting my eye over them, I recognised one of the forum members, Rossi, almost immediately so we made our way across and I introduced myself and Katie. How strange to meet all these people that I had been chatting to on the forum for months, and put faces to nicknames, and names to nicknames!

As it was approaching lunchtime, we decided to forego an exploration of the Museum, and instead set off in search of a pub for some food and drink. Our first choice, The Museum Tavern, proved unsuitable, as it was too small and many of the tables were already taken, so a quick search by Amy was made to find a nearby Wetherspoons – generally large establishments, with a good choice of food and beer at very reasonable prices. We settled on The Shakespeare’s Head, admirably suited to our large party. Wetherspoons are also good pubs for diabetics, since they provide full nutritional data for their food, essential for the carb-counting insulin users amongst us!

shakespeares head

And the rest, as they say, is history! I won’t go into all the conversations we had, as there were too many, but I do know that my voice was starting to go from all the talking as the afternoon drew on! A most enjoyable afternoon spent chatting and imbibing until the time came for Katie and I to leave. Very reluctantly I might add, but it was a condition of our tickets that we had to catch a certain train – which we managed to do by a very slim margin! All in all, a very enjoyable day, meeting some terrific people, and definitely an event to be repeated!


Bad diabetics eating profiteroles!
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Such innocent looking souls!
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Friday, 20 November 2009

Behind the bar, a pewter bucket...


An ex-boss of mine, giant in stature, was also rather partial to a good drink. This was good news when you fancied an extended lunch hour, as you would just invite him along and he would happily stay there and buy the beers for hours! Not sure how I’d cope with that now, as too much beer on a daily basis is not a recommended regime for a diabetic! Back then were more innocent and carefree times, I guess. He had a peculiar method of hiding his bald patch – instead of a ‘comb-over’, he had a ‘comb-forward’ which meant that his hair was quite long at the back and then combed forward to give the appearance of a fringe. This was fine, if a bit ridiculous, but when the wind was blowing in the wrong direction, the hair would rise up and flail about. We concluded that this was his method of communicating his requirements across a crowded bar – a sort of follicle-based semaphore. Here is the Ballad of Dave Y, aka Mad Dog aka ‘The Bend’…

Tiny little baby, ten fingers, ten toes,
Lying still in blissful repose,
Awoke and screamed in baby words
‘That bottle you give me is quite absurd!

How can I grow up big and tough?
That bottle doesn’t hold enough!
There can’t be more than half a gill,
Don’t economise on the milkman’s bill,

If I’m to grow to six feet five
That much will barely keep me alive!’
The parents watched him rant and rave,
Astonished how his hair could wave.
‘We’ll have to order several litres,
Or else they’ll think we’re baby beaters!’

And so the milk began to flow,
And the lad began to grow,
He learnt to walk towards a pub
And lift a pint in his dad’s club.

He went to school, he learned to count,
And drink a rather large amount.
First in pints, then in yards
Without feeling too rough afterwards…

Then at a party down Canklow way
A challenge to meet or a bet to pay:
To drink a barrel down in one…
One deep draught and it was gone.

He travelled far, he travelled wide,
A giant thirst, a drinker’s pride
Offered beer, Mad Dog took it,
Behind the bar, a pewter bucket…

‘I didn’t say that!’ was his chant
‘I wouldn’t say that!’ he would rant
‘I promised nothing!’ he would plea
‘A pint for the lads, a bucket for me!’

Body language so profound
Communicates without a sound.
Wave his hair across the bar,
Follicle language travels far.

‘I’m sorry, you’re wrong!’ the man would snap.
‘What you say is utter crap!’
A bucket deep without an end
This is the man they call The Bend!

Thursday, 19 November 2009

Tickling Dogs




I think that today I should tickle a dog,
Yes, I think that is what I should do!
Or maybe a frog on a gnarly old log,
Perhaps I could tickle that too?

For I need a distraction to take me away,
An escape from my cares and my woes…
For when you live with it day after day,
Diabetes gets right up your nose!

Like having to think about what I can drink,
And several daily injections,
And to stay in the pink and not kick up a stink
About needing blood sugar corrections!

So, what do you say? Maybe just for a day
Diabetes could just let me be,
And leave me to play in an unfettered way,
And a dog might get tickled for free!

Wednesday, 18 November 2009

The Whole Mole!


Blood glucose in the UK and many other parts of the world is measured in millimoles per litre (mmol/l). A mole is the SI unit of measurement, and a millimole is one thousandth of a mole. What we really want to see each time we prick our fingers and take a test, is a reading of between 4-7 millimoles, which is regarded as ‘normal’. It actually represents a tiny amount of glucose per litre of blood, and at normal levels if you were to add that much sugar to a litre of water, you would probably not be able to taste it (Type 1.5 demonstrates this admirably on her blog at Just a Spoonful of Sugar. )

So, how long does it take to get through a whole mole? I invented a (probably entirely non-scientific and spurious) method of calculating it. If we accept that one unit of insulin will lower my blood glucose level by approximately 3 mmol/l, and I take 30 units of insulin per day, then it will take me just over eleven days to get through a whole mole…!

Imagine if, when making that fingerprick hole,
The blood that emerged should contain a whole mole!
It’s highly unlikely, for you’d probably be dead,
And your blood would be glucose, and probably not red!
For each time that we measure we are hoping to see
That most of our blood is entirely mole-free!
Ideally, we’ll find just a whisker or two,
For a nose or a claw would be harmful to you –
That’s too much of a mole to be called ‘good control’,
For it’s thousandths we want, not the whole of the mole!

Tuesday, 17 November 2009

Beware the Iron Gym!


The only sport I do is running. I did use to combine a run with some gym work, but the gym was far too expensive for the number of visits I was making, so I decided to cancel my membership. So, I had to find an alternative way of building up some upper body strength. It’s important in distance running to be reasonably strong in the upper body, as you do have to carry your arms along too, and they can become very tired if not exercised also. Building muscle mass is also helpful to diabetes, as it is more sensitive to insulin than fat and thus will burn glucose more easily.

I’ve had a variety of home gym contraptions over the years, but the latest one that caught my eye was the Iron Gym. It’s a well-engineered piece of kit that can be fitted (and removed) almost instantly to any doorframe, and allows pull-ups to be done using a variety of arm positions. The chap on the advert certainly looked very convincing, so I decided to take the plunge so I could get a body like his!

Good grief! It is much harder than it looks to pull up your entire body weight, especially if, like me, that weight has been steadily increasing over the past year! The first time I tried, I think I managed two chin-ups. But I worked at it and managed to build up to about eight – still not startling, but progress nonetheless! Then, my enthusiasm got the better of me and I felt something ‘go’ in my abdominal muscles, just below my right ribcage. It didn’t feel too bad at the time, but as the days went on the pain and discomfort got worse. It has started to ease now, but this is about three weeks later, so I’ve now returned to my flabby old self!

I was promised some phenomenal
Biceps, triceps and abdominals,
Of the kind that would put Superman to shame!
But it’s not gone quite to plan,
For I’m not a ‘six-pack’ man –
And the Iron Gym’s the thing I have to blame!

Should have taken things more steady,
Realised I wasn’t ready,
But impatience for results just drove me on.
As I dangled in the air
I felt a tummy muscle tear,
Now my hopes of toned-up strength have all but gone!

I would go to any length
For some upper body strength,
But the Iron Gym was just a step too far!
So now I’ll have to rest
Till I’m healed and at my best,
To become a washboard-stomached superstar!

Monday, 16 November 2009

Don’t wire up any plugs today…


Some complete and utter nonsense today!




At the end of the day
As the horses ate hay
And she put out her sandals for work
Came a voice soft and low
‘Twas a voice you may know
From the place where the Tooth fairies lurk.

Sleep softly, she said
On your fine blow-up bed
That inflatable throne of the night!
And dream of the things
That the morning might bring
As the darkness makes way for the light.

So she slept and she dreamed
And she dreamt that it seemed
That a ritual must be performed
At the dawn’s early light,
When all blurry of sight
With a beverage, her bed be adorned…






And on rising she knew
That the first cup of brew
Was not destined to moisten her lips
But should soar in the air
And descend on her lair
With a shriek and a swish of her hips!

‘Be not worried, my dear’
Said the man from IKEA
For the sheets that are now soaked in char –
For delivery is due
Of a bed that is new
And you’ll sleep like a Hollywood star!

Sunday, 15 November 2009

No flu for me!


I had my seasonal flu jab yesterday. The surgery had the task of injecting everyone off to a fine art. When I entered, there was a queue of about five or six people, but by the time the receptionist had checked my name on her list, it was my turn to go in! About fifteen seconds later, it was all done! I remember reading somewhere that GPs get a payment for each patient they inject, something like five or six pounds. Given that the whole procedure took about thirty seconds per person, that’s somewhere in the region of £600 an hour – not a bad rate of pay!

I felt absolutely nothing when injected, although my arm is aching slightly now. I’d much rather have the injection than the real thing. Being diabetic means that my blood sugar control would go haywire if I caught flu, with a quite serious risk of diabetic ketoacidosis (DKA). Since that was what landed me up in hospital at diagnosis, I know exactly what it’s like, and NEVER want to suffer that again!

So, I’ll be off again in a couple of weeks or so for the swine flu jab. Some scaremongering stories have been doing the rounds, but from the more respected sources I have read, the dangers are minimal, and not to be compared with the problems they encountered in the mid-1970s when some Americans died from sde effects from the vaccine being used at the time. There are risks with all sorts of things, and you just have to weigh up the evidence and make an informed decision. After a year of living with diabetes, I no longer take the word of medical staff as sacrosanct – they often can’t agree with each other so you quickly come to realise that you need to be pro-active with your health choices. This is why I stopped taking statins, although the jury is still out on whether I need to keep taking a daily aspirin. Nine drugs down, two to go!

Just roll up your sleeve now,
You won’t feel a thing,
That’s not totally truthful,
Sometimes it can sting!
But having this jab
Will be better for you
Than a serious dose
Of the seasonal flu!
So don’t be a baby,
Just give me your arm,
I’ll inject this dead virus
To keep you from harm…
In a couple of weeks time
We’ll see you again
For your swine flu vaccine -
We don’t know quite when –
Then that’s it for the winter,
We’ll see you next year,
That’s two bad diseases
You no longer need fear!

Saturday, 14 November 2009

Diabetes Support Forum UK

Diabotics Gluco Jon and Polly Urea celebrate World Diabetes Day!
Today is World Diabetes Day. A year ago today, a new forum was launched in the UK, supported by the charity Diabetes UK (although not widely publicised enough still!). Having been diagnosed just a few months before, I had visited a few other forums, but was largely perplexed by their complexity, number of sub-divisions, varieties of diabetes, diet and control methods, plus the sheer number of members and daily postings. So, it was refreshing to encounter a new, home-grown forum that I could get into from the beginning.




Things started expanding rapidly from the start, with between 10 and 40 new members joining every day and introducing themselves. I’d read up a lot on diabetes care since my diagnosis, including studying an Open University course on the subject, so found my self in a position to be able to offer suggestions to the other members in answer to their questions. Plus, I was familiar with the mechanisms of a support forum, having been a moderator on another forum, unrelated to diabetes, for many years. I also had a lot of time on my hands, and an eagerness to learn what I could and discuss experiences with the other members. As a result, after a few months, I was asked to become a Moderator for the forum, to help keep the place ticking over and watch out for any bogus or abusive posts, or simply to steer new members to the appropriate section or give instruction on operating the forum.




The forum grew, and as it was growing, so was a new life in the tummy of the forum’s founder! As a result of her pregnancy, the founder asked if I would take over the administration of the place whilst she took some time of to have, and care for, her baby. Now we are a few months further down the line, having expanded hugely in that time, and with nearly 75,000 posts and 1,676 members! Not all those members post all the time, of course. Some never post, some post for a short while then disappear, yet others have posted thousands of times and then departed. There are new people coming in all the time though, and this keeps the place vibrant and fresh. It’s wonderful to see the transformation in people from frightened, panicking, newly-diagnosed into confident and supportive experts on their own diabetes. Plus, I have learned of the anguish and frustrations presented to parents of diabetic children, who cope with remarkable stoicism and give such tremendous support to one another.




The bond that unites all the members, whatever type their diabetes, or length since diagnosis, or if they are parents, carers, teenagers, pensioners, athletes, makes it a very good place to spend time. There are the realities of diabetes, the terrible complications that can be visited on people, but there is also the great humour of people in the face of adversity, which helps to keep us all going. Next week, a large group of us will be meeting up in London. I am sure that will carry the bond of friendship to new levels, and I’m very much looking forward to it! Pictures, no doubt, will follow!

Friday, 13 November 2009

Motivation


I crawled reluctantly out of my nice warm bed this morning, after spending a fitful night snatching the odd hour of sleep in between listening to the torrents of rain lashing down and overflowing the guttering outside my bedroom window. I was determined to go for a run this morning, chiefly because the weather forecast was for even more dire and dreadful inundations over the coming days, with accompanying gale force winds. If there is one type of weather I hate to run in, it is driving rain whipped into a stinging frenzy by unpredictable and powerful winds.

So, I was quite relieved to see that there appeared to be a lull in the Storm God’s diary which coincided nicely with my excursion round the local park. In fact, in some ways it was far more pleasant for running than in recent days, as the temperature was slightly higher, and the good cloud cover meant no blinding sunshine to blur my route. Even so, it was an effort to get myself out of the door. I went for a run a couple of days ago, and though they didn’t feel too bad, my legs were still a little sore and achy from that run. But, what’s a little ache in comparison to what some people have to endure?

My biggest motivator for some years has been to hold the image of Jane Tomlinson in my mind – no privation I might suffer would ever come close (I hope) to what she had to endure. Jane, for those who do not know of her, was an astonishingly tenacious, wonderful, brave, funny Yorkshirewoman who ran London Marathons, cycled across the USA, cycled from Leeds to Rome, and – in my view her most remarkable achievement – completing the full Ironman Triathlon. There are many tremendous and talented athletes who have achieved such feats, but she is the only person I know of who has achieved all this whilst undergoing treatment for terminal cancer. Jane had been in remission from an earlier diagnosis of breast cancer, when the cancer returned, this time inoperable and with a projected life expectancy of less than two years. She refused to let it defeat her, and began running, building up eventually to be able to run and cycle at a level that would surpass many of her peers, with or without cancer. She raised mllions for charity, raised a beautiful family and continued working until finally succumbing in September 2007 – seven years after her diagnosis.
Jane Tomlinson

In the face of that kind of effort, how can I complain about my lot? She will forever be an inspiration for me and many, many others. If you get the chance to read the story of her life, please do, I guarantee you will moved and inspired.

The Luxury of Time

How Good is That?: The Story of a Reluctant Heroine

You Can't Take it with You

Friday November 13th, 2009
Distance
3.7 miles
Time
35’ 31”
Calories
432
Blood glucose before (1.5 hour)
7.2
Blood glucose after
8.7

Thursday, 12 November 2009

Blood Sugar Blues




I woke up this mornin’
My levels were high…
Feelin’ sluggish and poorly,
Like I felt I might die!
Musta messed up my basal,
Now that ain’t good news!
For it means that all day I’ll have the blood sugar blues!

Oh, the blood sugar blues,
Blood sugar blues, oh my!
When your level’s off the meter,
You wanna lay right down and die!

Thought I’d fix me some coffee,
Put some life in my legs…
Some strong black coffee -
Drink it down to the dregs!
But it ain’t doin’ nuthin’
Don’t feel better, no sir!
That diabetes fairy – put a curse on her!

Oh, the blood sugar blues,
Blood sugar blues, oh my!
When your level’s off the meter,
You wanna lay right down and die!

Wednesday, 11 November 2009

A Long Cold Summer

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I’ve been trying to keep up with my running since completing the Great South Run – if I don’t keep the momentum going now as the days start to get darker and colder, I’ll fail completely when winter really sets in! This is my second winter with diabetes. Last year was horrible, not least because I didn’t really have a summer before it and autumn was particularly bad in this country. My summer was ruined by my diagnosis, of course, but in particular it was the huge number of drugs I was put on. Worst of all were the beta-blockers. I’d had a problem with my heart (myocarditis) when diagnosed and had been restricted to only very light exercise for about two months. This meant I lost much of my fitness from my training for the Stockholm Marathon.

When they finally allowed me to do some gentle running I suffered even more. I didn’t feel I had a problem with my heart, but found that a short run at a very gentle pace would soon have me feeling as though I’d rowed the Atlantic or something. After reading up, I discovered that beta-blockers work by restricting your heart rate to below 100 beats per minute (bpm). As I needed to push my heart up to at least 140 bpm to run comfortably, it meant that my heart was not able to pump the oxygen-carrying blood to my muscles quickly enough, so they became fatigued. The beta blockers also had the effect of making me feel cold ALL the time – even in bright summer sunshine I felt chilled to the bone. I developed chilblains on my toes for the first time in my life.

So, the drugs that were supposed to be saving my life (potentially, by not letting my heart work too hard) were ruining my quality of life. Thankfully, I persuaded the doctors that my heart was fine and could finally get on with my life. If I never have to take those pills again it won’t be soon enough! I found it interesting that, despite all the recommendations I’d had that running – good, sustained, aerobic exercise – was the ideal sport to pursue to gain a healthy heart, I was being stopped from doing it by the very same people who recommended it!

I managed the Great South Run last year, but on very little training so I did feel somewhat dissatisfied. But it was also an achievement to run with diabetes for the first time, so not a wholly unrewarding experience. This year my training was badly disrupted by injury – just little muscle tears, but enough to stop me from training for a while. I didn’t want to miss the event because I had a lot of sponsors. But I was still a little disappointed not to be at my best in the race. It was an improvement on last year, but I’m hoping that next year will be much better. I won’t achieve that without putting in the effort now!

Tuesday, 10 November 2009

Fancy a Ruby, me old China Plate?


I like a good curry, the hotter the better – Chicken Vindaloo is a favourite of mine. Best served with basmati rice which has a relatively low glycaemic index (GI) than other types of rice, but only allowing myself a small portion of naan bread as that does tend to give me a high blood sugar spike. No reason I shouldn’t enjoy a beer with the meal! Alcohol has a sort of topsy-turvy relationship with blood sugar, sending it higher with the extra carbohydrate, but then lower as the liver turns to processing the alcohol rather than releasing glucose. Brandy would have the same effect, although some people find their control is better with spirits than beer.

Estimating the carbs in a plateful of curry can be difficult though, especially if served in a restaurant. As well as an indeterminate quantity of rice, there will also be sugars in the sauce. Generally though, the calculations for my insulin doses are reasonably good, and I always remember to include an extra amount for the sweet treat I indulge in after the savoury meal. Eating sweet things with the meal will help to lower the overall glycaemic load, so the cake or pudding can be eaten with less fear of a sugar spike – another good reason for eating curry!



I’m really looking forward to a nice Ruby Murray,
But I must do a Banting and Best,
For before you indulge in a hot spicy curry,
You must do a blood sugar test!

I’ll work out the size of my grandfather’s nose,
Before a peck of my old speckled hen,
For you must be precise with your insulin dose
When you inject with your insulin pen!

You can choose to be pecked in your Old Auntie Nellie,
Or perhaps in your Old Fife and Drum!
But in public it’s best to inject in your belly,
As your bum may be too much for some!

Would you Adam and Eve that a nice Britney Spears,
Or even a stiff Fine and Dandy,
Can be supped with your meal? (That’s a bottle of beer,
Or a generous helping of brandy!)

You might want to finish your Lilley and Skinner
With a treat like a big Sexton Blake –
With the lowered GI from the rest of your dinner,
There’s no reason you shouldn’t have cake!

Monday, 9 November 2009

The Carrot and the Stick


Some people have recently said on the forum how being told the bare, unpalatable truth about the consequences of poor blood sugar control has really made them sit up and start getting serious about their diabetes. If you let your guard slip then terrible things can creep up on you before you know it. So, sometimes tough love can be what is needed should complacency or rebellion set in. On the other hand, a person might find that encouragement is the key to success, possibly by being given the opportunity to get funding for an insulin pump with all the wonderful flexibility and enhanced control that brings. I feel that, currently, I am driven to keep good control mainly due to the fear of complications. This is not to say that I am in constant dread, but that I have an incentive to do everything by the book to give myself the best chance.

Diabetes nurses, so pleased you could attend,
Your patients will be glad you came – on you they all depend!
Today we’ll learn a technique called the carrot and the stick,
If carrots do not work for you, then the stick might do the trick!

Now, if a patient comes to you and their levels have been poor,
You might suggest a pump for them, describing its allure,
But sometimes a really harsh approach is the one that you should pick –
Frighten them with neuropathy and beat them with that stick!

They must avoid complacency, so keep them on their toes!
A pump might be a carrot dangled right before their nose,
And if you get their hopes up that a pump may soon be theirs,
You’ll be their favourite DSN – a nurse that really cares!

Assess your patient carefully, decide which method’s best,
But make sure that they know that they must inject, record and test,
For minor inconvenience they’ve everything to gain,
Avoiding complications and a life that’s filled with pain.

Sunday, 8 November 2009

Injection Hokey Cokey


I’ve recently changed from using the top of my hips as my injection site to using my tummy. The area on my hips where I was injecting had started to become a little sore, although I did use alternate sides to allow some healing to take place between jabs. It’s very important to rotate your injection sites as injecting too often in one place can lead to the formation of fatty lumps, which may then cause the insulin to be absorbed at unpredictable rates – you may get virtually nothing being absorbed into the bloodstream, and then suddenly get a ‘surge’ which might then present a danger of hypoglycaemia.

You also need to bear in mind that different sites have different absorption rates, so this might be something you need to take into consideration when injecting. Particularly fast will be a limb that is in heavy use, such as the thigh of someone going for a run, so again this must be borne in mind when choosing where to inject. The needles are tiny and rarely hurt, but doing it over 1500 times a year will gradually take its toll, so keep rotating those sites!

You can stick it in your tummy,
You can stick it in your thigh,
But don’t always use the same old place,
And here’s the reason why:
Too often in a single site
Could cause some lumps to form,
Absorption then could be quite poor,
Erratically performed.

Different sites for different tasks,
Please also bear in mind,
Absorption rates will vary
From place to place you’ll find.
The tummy is the quickest,
A plump behind is slow,
And fastest is a limb in use
As runners ought to know.

It’s yet another element
We have to factor in
To calculate four times a day,
Our dose of insulin!