1000 miles, 1000k - January Progress

Well, it was an ambitious task I set myself, to complete 1000 miles and 1000 kilometres before 2010 is through, and although I have made a start I am way behind schedule already! I should have been able to foresee that January is not the best month to commence such a project. The kilometres are fine, as they are done indoors on my exercise bike, but unfortunately I have made no impact whatsoever on the running. I have a plethora of excuses, the principal one being the lack of clement weather. Cold, icy, wet, windy for much of the month. At one time, in my younger years, I would not have shrunk from the challenge. I used to go running in the Peak District in shorts and t-shirt, through all manner of terrible conditions. Once you get going you heat up very quickly, so it’s not as bad or masochistic as it looks. These days however, I don’t have the motivation, nor do I want to risk life and limb on slippery park paths.

So, the mileage portion of the challenge has reduced by…2 miles! In theory, I need to do just over 83 miles each and every month to achieve the target, so I am now 81 miles behind. The kilometres have gone slightly better – a lot better, actually, since I have almost achieved my monthly target there. I have completed 76k out of the required 83. Of course, a kilometre is only six tenths of a mile, so it is an easier taks all round. But it is so BORING!!! I expended a total of 2730 calories whilst doing this.

Next month is shorter by three days, so my task is particularly hard. I need to get my ass into gear and go for it!

Pharma-Dalai-Lama

One of the problems of suffering from a chronic, medicated illness is the need for regular trips to the pharmacy to get prescriptions fulfilled. It’s a problem because, often, our life-sustaining medications and supplies appear to be regarded as luxuries and non-essentials by many of those charged with providing them in a timely manner. Personally, I have experienced nothing but grief in the past six months or more, trying to get the things I need to keep me functioning day-by-day, and this has been principally due to the inability of my local pharmacy to fulfil their promises.

The pharmacy is situated right next door to my GP surgery, so it is logical that this is where I should go to collect my supplies – me, and thousands of other patients. As a consequence, they are always extremely busy, and efficiency appears severely lacking. I have had to return on numerous occasions to collect missing items – often more than once when the items have still not arrived by, or even after, the promised date and time. Recently, I was promised a solution to the missing item and waiting problems. I could leave my prescription with the pharmacy, instead of taking it to the surgery, they would ensure the items were in stock and get the prescription signed by the GP, and I could return three days later to pick it up with no wait.

Unfortunately, this has not worked at all. On the last two occasions since this new procedure was initiated I have had items missing and had to return, or had to wait forty minutes because the order had not been filled. I feel I have no choice but to take my business elsewhere – I would rather a forty minute walk to a more efficient pharmacy tan a forty minute wait for items haven’t been ordered. Unfortunately, my experience has been repeated by many, many people up and down the country.

So what’s the title of this post about then? Well, on the diabetes support forum we have a member who actually works in a pharmacy, albeit a hospital one not serving the general public. Rachel T is able to give us the story from her side of the fence, giving us the lowdown on availability, problems encountered with suppliers, use of certain drugs and their substitutes – in short, a mine of information and a great perspective on how things operate from her point of view., and always conveyed with great humour You then realise that it’s not the counter staff at your local pharmacy that are generally at fault, but often the management structure, or supply lines, or many other things, and this can reduce the ire you emanate to a degree. So, the following poem is dedicated to Rachel T, with many thanks for her input and, above all, her friendship!

She’s our pharma-dalai-lama
And she blesses us with karma
We’re so glad she’s not a farmer
That’s our lovely Rachel T!
Should we have prescription dramas,
She’ll explain and make us calmer,
Though our stories do alarm her,
Just how poor service can be!

Her careful explanations
To our diabetic nation
Fill us all with admiration
For she understands our plight!
She delivers her perspective
Which will make us more reflective
And we temper our invective
At the next prescription fight!

Mild or Severe?

There used to be a time when there was only one kind of diabetes. In the pre-insulin days, diabetes would manifest itself as acute, usually in young people who lost weight rapidly and slipped into coma, or age-onset, which was generally perceived as milder since survival might endure for many years. At that time the different causes of the disease were not clearly known – lack of insulin would cause the acute symptoms, whereas a gradual decline would be due to resistance to insulin action.

Somewhere along the line, the descriptive terms ‘mild’ and ‘severe’ crept in. These terms distinguished those who were in DKA, coma, going blind, kidney failure, amputations from those who showed few outer signs of the disease and were able to manage their condition to some extent by dietary and other lifestyle modifications. These latter cases would succumb eventually to the more dreadful complications, just as their ‘severe’ counterparts had.

In recent times, the adjectives have been used to describe a distinction between Type 1 and Type 2 – with Type 2 often falling into the ‘mild’ category as it may be treated by diet and lifestyle changes in many cases, or with tablets rather than insulin injections. This is nonsense – both types require vigilance and present different and, in my view, equally difficult challenges.

The terms ‘severe’ and ‘mild’ persist to this day in some medical practises or publications, but I think they are very misleading. People with diabetes have diabetes. All forms of diabetes are ‘severe’, since all can lead to awful consequences if they are not properly treated and managed. This is a life, limb and sight threatening,disease and no-one diagnosed with it should be misled into complacency by being told that theirs is ‘not so bad’. Nor, in my opinion, should people be told they don’t need to test, to find out how dietary and activity changes affect their levels so that they can achieve the best possible control. There’s an argument used that knowing how things are going might lead to depression at the sight of an occasional high reading – what nonsense! People need to be able to learn how to use these readings to adapt and enhance their chances of staying free of complications. It is criminal to deny anyone who wishes to test the means to do so – once a year HbA1c tests are an additional tool, not a substitute!

Whatever your Type of diabetes, and whatever your stage, you must never think that it needs little consideration because ‘yours is not so bad’.


Now, calm down, you’ve no need to worry my dear,
I can tell you right now that you’ve little to fear,
For you’re much better off than a lot of them here,
Diabetes for some folk can be classed as severe!

What then is the difference, for I see you have filed
My details and blood test under ‘Diabetes, mild’?
I was wondering if maybe you might have compiled
Some simple distinctions – pretend I’m a child…

Well, if it’s mild, then we’ll see you perhaps once a year,
To see if you’ve gone blind, and that your urine is clear,
But if it’s severe, and if you were to cough,
Then there’s every chance that your foot might fall off!

Thank goodness it’s mild then, and I won’t need to test,
For knowing my levels might make me distressed…
I’m happier not knowing, until the day that I’m here
And you tell me I’ve caught the type that’s severe!

My diabetes is due to expire…

I wish someone had told me earlier – my diabetes is due to expire in three years, three months and a few days. In the whirlwind that ensued after my diagnosis, with seemingly hundreds of visits to doctors and clinics of all varieties, I filled out a form which would grant me exemption from prescription charges due to the fact that I had diabetes that required medication, chiefly in the form of insulin. That wondrous substance, isolated by Drs. Banting, Best, Collip and Macleod and celebrating the 88th year of its first human trial yesterday, is not something that I must inject for the remainder of my life!

How so, you ask? Well, what I hadn’t realised was that the charge exemption form was valid for only five years, at which point a new form would be issued asking you to confirm that ‘you still have the condition declared on your original application’. Result! All I need to do is tick the box that says ‘No’ and I will no longer have diabetes!

Of course, I still have diabetes you fools! Unless I have somehow missed the earth-shattering news that a cure has been found for the disease affecting over 300 million people worldwide, which seems a little unlikely, I still have diabetes. Ah well, we can but hope!



My diabetes is due to expire,
I’ve got about three years remaining,
For my friend got a letter that implied she’d get better,
And we all found it most entertaining!

Bureaucracy dictates that our diabetic fates
Lie in answering just one simple question,
‘Since last you applied, please confirm or deny
Can your pancreas cope with glucose ingestion?’

Could it be, all along, that the doctors are wrong,
And diabetes is not a lifetime affliction?
Tick the right box – you’re cured, that’s one diabetic fewer,
And you won’t need those horrid prescriptions!

It’s a ‘no’ then from me – I am diabetes-free,
And I’m off to the pub for some drinking!
And I’ll eat what I like with no fear of a spike!
Dr Banting, what on earth were you thinking?

No Smoking please!

Tonight at 9 p.m. will mark the 15th anniversary of my stopping smoking – quite possibly the best thing I ever did for my health! It was at about ten past the hour when I smoked my final cigarette and I haven’t had one since. For the first few weeks I wanted one. For the following two years I walked closely behind people who were smoking in the street so I could suck in some of their smoke. Now, fifteen years on I can’t stand to be anywhere near cigarette smoke, and I know that I will never smoke again.

I had my first cigarette about 40 years ago. Someone at school had been selling them and I bought a couple to try out. I smoked them in the half-built bungalow directly next to our house and they made me feel extremely sick and dizzy. Like most children, though, I persevered, and a couple of years later I used to share a packet of five Park Drive down in the park with my friend Richard, where we tried to look cool and pretended we had girlfriends. Most of my friends around that time smoked, as did most of their parents. Soon I had progressed to ten Embassy Regal a week, and eventually that became twenty, thirty a week…by the time I was a student at University I was smoking sometimes as many as forty a day. At that time, cigarettes were around 40p for a packet of twenty.

As I progressed through my twenties, I started running marathons – still smoking, but far fewer, and feeling like I wanted to stop. I succeeded once for eighteen months, but then ‘just had one’, and was soon back puffing at full strength. I tried nicotine patches, but as they decreased in strength, I simply supplemented my cravings by smoking!

What finally helped me succeed was a programme on Channel 4 on the 7th January 1995. The programme featured a man called Allen Carr, who had devised a method to help people stop smoking the ‘Easy Way’. In it, he held seminars with some long-term smokers, and I was very impressed to hear their testimonials at the end of the programme, extolling the technique’s virtues and praising its success. Intrigued, I went to the bookshop the following morning and bought the book, ‘The Easy Way to Stop Smoking, by Allen Carr’. It was a short book, and I had finished reading it by 9 p.m. the following day. Whilst reading the book, I found I had become increasingly excited about stopping and couldn’t wait, so I smoked my final cigarette – and that was it!

Run the clock forward thirteen and a half years, and I was waiting in a hospital operating room to have an angiogram to examine the state of my arteries, after my recent diagnosis of diabetes and suspected heart attack. Thankfully, my arteries were declared ‘pristine’, and I attribute this entirely to the fact that I stopped smoking all those years before and had gone from strength to strength with my running. Had I continued smoking I would have been in much worse health, and with the prospect of having to stop smoking at a time I would no doubt have found extremely difficult.

So thank you Allen, you most probably saved my life, or at least extended it by many years!

My Glorious Graph!

Despite the excesses of the festive season, I was very pleased when I uploaded my blood glucose meter readings to my computer and brought up the graph for the past month. In 150 tests, I have stayed within my target range of 4-7 mmol/l (millimoles per litre) for 70% of the time. I’ve had a few lows – down as low as 2.2 on one occasion – but nothing I couldn’t handle. A lot of the higher readings are, in effect, ‘false’ readings, as they were taken before and after exercise when I would hope for a slightly raised level before embarking on activity. The main thing is that I have been successfully matching my insulin to my food intake.

In the past month, I have had only two readings in double figures – one of 10 exactly, and one of 10.7. The latter was taken after a lunchtime drink and would therefore have been influenced by the alcohol which can ‘spike’ you fast, then drop you low. I’m very lucky, I think. I know of many people who get highs of 15, even 20 and above, on a daily basis no matter how hard they try. The body doesn’t like these highs – a non-diabetic person would rarely show a level outside of the tight 3.5-6.5 mmol/l range, due to the exquisite fine-tuning of their endocrine systems. For a diabetic it’s a constant battle and a perennial worry, but thankfully I seem to be doing OK – long may it continue!



Now this may sound peculiar, and it may make you laugh,
But just take a look at my glorious graph!
It shows my blood glucose over the previous four weeks,
And there’s hardly a difference between the troughs and the peaks!

The band that’s in yellow would be perfect control –
The desirable range, four to seven millimoles.
A fully-working pancreas would achieve this with ease,
For a non-diabetic it is really a breeze!

But if you’re like me and your pancreas broke,
Your graph will look different to the non-diabetic folk,
And you might expect high points of fifteen or more,,
Or lows below two that drop right through the floor.

Ah! But this graph is glorious, and I’ll tell you for why,
For if you look closely, it will soon strike your eye.
See if you can point out the only time when
My levels exceeded a value of ten!

So I ‘m happy to look at this graph, on the whole,
For although it’s not perfect I’m achieving my goal,
And it justifies consumption of a few pints of beer –
Let’s hope it remains so for the rest of the year!

Sno-botic!

Well, this awful snow has been preventing me from going out for a run, or even a walk in the park, so I thought I should make some use of it. I therefore present Sno-botic, a diabotic that may not survive the next warm spell!!

Materials:

Snow, formed in a Novofine 6mm needles box

4 x ramipril capsules for mouth

2 x omeprazole for eyes

3 x omeprazole for buttons

2 x novorapid insulin pen cartridges for arms

1 x Accuchek multiclix lancet for nose

When is a stomach bug not a stomach bug?

When it’s diabetic ketoacidosis of course! I was just browsing through my old emails when I came across this one that I sent out to my friends who had been asking after me. Interesting for me to read this from the perspective of 18 months experience of dealing with diabetes, so I thought I would include it in my blog:

When is a stomach bug not a stomach bug?

When it’s diabetic ketoacidosis of course! After losing 17 pounds in just over two days, I thought it prudent to seek the help of healthcare professionals, and a jolly good job I did too as I discovered that you don’t just ‘get better’ from this condition as it’s potentially more lethal than a stella/Stolichnaya cocktail with krepkaya chaser. Boy, I’ve never felt so ill! The good news was that I had my appetite back within 24 hours and regained the weight I’d lost (through ‘gross dehydration’) within 3 days. The bad news was that I had a heart attack and found out that I’m Type 1 diabetic and will be ‘shooting up’ for the rest of my life or until they find a cure…

There is more good news though. I had an angiogram after the heart attack (which was not dramatic at all – very minor, and I didn’t know I’d had it!), and this showed that I have a very healthy heart and am positively encouraged to continue with my running. Plus, thanks to the diabetes, I’ll have to make sure I have a very healthy diet from now on if I’m to avoid the possible complications, but that’s no bad thing. I’ve been surprised to learn that I can eat anything a non-diabetic can eat – no special requirements, just low-fat, low-sugar etc. – what you should all be eating!

It seems like I was in there for months, with so many tests and procedures etc. I literally lost count on the number of attempted piercings I received. But I’m happy to say that I was quite overwhelmed by the superlative quality of care I got from every level – doctors, nurses, the ladies who make the tea – they were all absolutely brilliant and it’s quite humbling to see how hard they work, in 12 hour shifts, for considerably less than ooh, I don’t know – people in the financial services sector?

Anyway, I’m back home now and trying to get used to the scary machines I have to use! Thanks to everyone for their good wishes. In truth, I probably haven’t felt this healthy for months!
Think I might have to give the Beer Festival a miss this weekend though…
Cheers.
Alan

1000 miles, 1000 kilometres

First post for 2010 and therefore traditional to include some of my ambitions for the year ahead! My main objective is to stop being so lazy and get more active – I was shocked and embarrassed to realise that I haven’t actually been out for a run since 8th December, and that was only a short one. The weather has been partly to blame, but in truth I have simply been feeling unmotivated. I need to get a couple of races sorted out for this year to give me a goal.

I looked back over the past couple of years at the details of my running as recorded by my Garmin Forerunner. 2008 was quite a poor year, unsurprisingly so since I was diagnosed with Type 1 diabetes in May that year. Because of various medications and some anomalous ECG readings I wasn’t allowed to even attempt running, or even walk very fast, for about three months after diagnosis. In total for that year I recorded a total of 190.5 miles running.

This past year I have had less of an excuse, although I have found it difficult getting used to running with diabetes, and the fact that it can no longer be as spontaneous as it was. I have to check blood sugar levels, eat, wait for an hour or two, check levels again, go for run, check again. I used to just get up, have a cup of tea and then go out – it would wake me up for the day – but now it has to be planned and there’s always the chance that my levels will be too high or two low for me to start a planned run, which can be enormously frustrating! I managed to improve on the 2008 total, but not by a huge amount, just an extra 43 miles. At one time I would have run that in a week, easily.

I have attempted to use my exercise bike on occasions, but it is very boring – I prefer to be out an about. I bought the bike to help rehabilitate myself after breaking my femur. However, that was over five years ago, and in that time I have cycled a total of 1024 kilometres.

This year, then, I aim to improve on all this, and picking a nice arbitrary figure I hope to clock 1000 miles on the Garmin and 1000 kilometres on the bike! I think this is achievable as it’s an average of just under three miles and three kilometres a day – some days I would hope to do much more.

So, this morning was today’s first effort towards my goal! But, unfortunately, there has been a very hard frost overnight, and although the day is beautiful and sunny with clear blue skies and only a whisper of wind, it is not a day for running. It isn’t that I’m too soft to run in cold weather – the run always warms you up rapidly – but the memory of broken limbs and the fear of slipping, especially on those shaded spots where the weak heat of the winter sun has yet to cast a warming glance. Instead, I wrapped myself up and went for a walk through the park, just to get some miles on the clock. Two miles, to be exact! Ah well, it’s a start – only 998 to go!