I can't believe it's been so long since I last posted here! It seems the muse has deserted me and I haven't had any inspiration for new poems. I have therefore decided that, starting tomorrow, I will pick a random diabetes-related story from the day's news and write a poem about it. Not expecting any masterpieces, but at least it should get me back in the swing of things - I've been far too neglectful of my blog!
One of the forum’s members related the unusual tale of trying to inject her small daughter, but no insulin was being delivered. She changed the insulin – no luck, changed the pen, no luck – then realised it was because the needle had no hole! Clearly a lancet who had been frightened by the folk tales of other lancets who told him that lancets rarely get changed – not at all like the official ‘single-use’ line he had been taught – and perhaps that’s how he ended up in a needle box…
Congratulations lancets all! You’ve all achieved a pass,
And now it’s time for you to leave the Lancing Duties class!
So follow me, you’ll be assigned to boxes at the gate –
Just keep in line and you’ll be fine, don’t push, not long to wait!
‘I’m scared, I’m not sure I should go, for though I passed the course,
And though I’d only do it once – could I draw blood by force?’
‘Just once? You’re joking! You’ll find out it’s six times every day,
And every day for several weeks before you’re thrown away!’
‘Are you sure? How awful! I think I may hang back
And lurk here in the shadows – they won’t miss one in a pack…
I’ll mingle with the needles, for surely they’re used less
And don’t conclude their useful life a blunt and bloodied mess!’
‘Oh my! I’ve been selected after months within this box,
In the darkness of this drawer with the underpants and socks!
It’s up to me to do my best and pierce this person’s skin
And deliver up a dialled dose of clean fresh insulin!’
Oh no! But wait! But it’s too late, I didn’t think this through!
I have no hole! It can’t get out! Whatever shall I do?
If only I’d stuck to my task, I’d surely have succeeded –
A lancet’s not a needle, for a needle’s hole is needed!
Research is very important in the field of diabetes, and there are some very important and practical discoveries being made all the time that help to make my life easier and safer – and maybe one day I’ll be rid of this disease completely thanks to the wonderful work done by the world’s scientists. However, every now and then I come across reports of research that, to me, seems totally worthless, and I wonder how on earth they get funding for it! A recent example was the ‘discovery’ that people with Type 2 diabetes got better blood sugar readings when they replaced a breakfast muffin with a scoop of mixed nuts. No sh*t Sherlock! Blood sugar levels are raised primarily by the carbohydrate we consume. Muffins contain carbohydrate, nuts contain relatively few carbohydrates, ergo muffins are more likely to raise your blood sugar levels! What is the point of testing such obvious theories when the real puzzles about diabetes need vital money?
I’m pleased to announce without further ado
Our findings, which I’m sure will all astound you!
For fifteen long years at considerable expense
We’ve tested our theories, now they seem to make sense!
We discovered diabetics, when their levels are high,
Feel grumpy and thirsty, and we think we know why!
It’s because it’s not normal to be in that state –
So keep levels normal if you don’t want that fate!
And in one of our tests we discovered that bread
Increased the blood glucose, so eat bacon instead!
An historic observation, I am sure you’ll agree,
And all thanks to the money allocated to me!
And thirty nine subjects who consumed only jam
For a week and a day, then replaced it with ham,
Found their levels would rise when they ate something sweet,
But their levels were fine if they ate only meat!
And our insulin study is a fantastic success!
We gave some subjects lots and some others much less –
If we gave them too much, they collapsed on the floor,
But giving them too little showed that they needed more!
So we hope you are pleased that you funded our tests,
Such groundbreaking results – I can see you’re impressed!
And all this achieved – as cheap as it sounds –
For the paltry little sum of two million pounds!
Yet another ‘miracle cure’ for diabetes, this time consisting of drinking plain old water. The catch with this one though, is the quantity you have to consume – half your body weight in ounces per day! Now, I’m not sure that that means if you weigh 200 pounds you drink 100 ounces, or that you drink 100 pounds in one ounce gulps. Given the nature of these miracle cures, let’s assume the latter…in which case I have only one thing to say – hyponatremia!
Who’s next please? Come up here, and stand on the scales
For the guaranteed cure that, to date, never fails!
Most doctors dismiss this, as daft as that sounds –
Ah! I see you weigh in at just four hundred pounds!
That’s 180 kilos (sounds much less, don’t you think?)
So that’s just 90 litres a day you must drink!
If you start in the morning and imbibe all day long,
You’ll be cured in a fortnight – what on earth could go wrong?
I’ll admit there’s a chance that you may get confused,
And your brain cells might swell – but it’s not like they’re used!
For most people who come here and believe in this cure
Wouldn’t notice if they left with a few billion fewer!
And you may lose your appetite and become very sick,
And the headaches and convulsions may come on very quick,
And you may feel quite dizzy, or become comatose –
But it’s over a week since we’ve had one of those!
I have just about recovered from my 1,000 mile round trip this weekend to visit members of our forum based in Scotland at the Glasgow Meet. Sadly, due to last-minute technical problems (The Doctor was off in another time stream saving the universe from a trans-dimensional duck infestation), Megabus were offering a Tardis replacement bus service, so my journey, instead of being instantaneous, entailed leaving home at 7 pm on Friday evening, travelling by train to London, then an 8 hour coach journey to Glasgow overnight!
Sadly, the Tardis was out of commision
A journey of 1,000 miles, there and back!
Unfortunately, I wasn’t able to sleep much overnight, as I had hoped, and as the dawn light broke I found myself speeding through Cumbria heading towards the Scottish border. I knew when we had reached it when I started spotting the newly-born lambs with their distinctive tartan fleeces, and heard the unmistakable mating calls of the wild haggis ringing out even above the noise of the engine and my fellow passengers snoring. I guess you need to be up that early to catch a glimpse of these shy creatures in the wild.
Quick! The clock is running!
Arriving in Glasgow, at Buchanan Street Bus Station, I headed down the hill to Glasgow Central where I hoped to get an invigorating shower, which proved to be the case. I spent a little while afterwards listening to the wonderful voice of the station announcer and watching the crowds rush hither and thither, all clad in their weekend sports and casual kilts, some with lively sporrans yapping and snapping at the smell of a Sassenach. Thankfully, I was swiftly brought under the protection of Hazel and Carol who were able to keep the agitated beasts at bay.
Being highly civilised, cultured people, Hazel suggested breakfast at The Willow Tea Rooms, where the décor was designed by the great Charles Rennie Mackintosh who no doubt regularly partook of a full cooked breakfast here daily before embarking on some more world-famous designing.
Carol and Hazel, my protectors!
All set up for the day, we made our way to the meeting venue, the Counting House pub. And so commenced a day in the company of lots of fantastic people, some of whom I had met before, but many I had not. It was great to meet new friends and renew old aquaintances (someone should write a song about that…). As usual in the presence of fellow diabetics my blood sugar levels soared to unheard of heights – I really must get some kind of shielding to protect me from this, it happens every time and I have experienced most of my highest readings over the past three years in the company of two or more fellow diabetics! This time the upper figure appeared to be 15.3, much to the enjoyment of Hazel who insisted on documentary evidence of her wonderfully in-range 4.8 alongside my carb-counting calamity. Thankfully this gradually reduced to single figures over the course of the day as I judiciously exchanged my preference for Old Growler bitter to the more diabes-friendly lager.
Diabetes Osmosis as I absorb the glucose emanating from my fellow diabetics.
I wasn’t the only person who had come from afar. Donald had come from Aberdeen, Rachel from Edinburgh and Emma from somewhere I can’t quite remember, but a long way anyway! Angie had even used the cover of visiting her family to fly up from Cambridge so she could attend, although to make the ruse convincing she had agreed to spend two weeks with them…! Vickie arrived, looking nothing like her avatar, and we were joined by Jim, Fiona and Carol’s other half and father. Splendid company and we had animated discussions putting the world to rights whilst we contemplated the crowds outside in the square being bombarded by raindrops the size of footballs (or a ‘light shower’ as it is described in these parts).
Hazel and Emma
Vickie and Jim
Donald and Carol
Sassenach and Carol
Rachel and Fiona
As the guests departed and hunger pangs began, many hours after breakfast and with nothing but liquid in between, I decided to opt for the tourist’s meal of prime Heeland Haggis, neeps and tatties. Lovingly prepared from farm-assured and ethically-reared organic haggis, with sumptuous Tayside neeps and Lanarkshire tatties, the meal was a culinary triumph. I also managed to bolus for it correctly, as my levels were at 5.4 before bed!
Haggis, Neeps and Tatties
And so, to bed. Hazel and Carol shepherded me through the throngs of bagpipe playing sword dancers Flinging on every street corner to my hotel, a comfortable and very reasonably-priced establishement with no lift and a vertiginous spiral staircase to the top floor where my room was situated. And no lift. Fortunately, I hadn’t overdone it on the beer so I survived the ascent unscathed and settled in to watch the final of ‘So You Think You Can Dance’ and contemplate the day. My contemplations continued long into the night as I was entertained at frequent intervals by the merry, traditional songs of the native population, with the odd car alarm to punctuate the silence in between the songs. I was so tired I slept anyway though, and woke early, consumed a fine Scottish breakfast and went walkabout in the city before catching my ten-hour coach and two hour train home!
Haven’t done a post about my running for a while, partly because it seems to have been very hit and miss this year. Had a poor month in February, great month in March, lazy again in April, and really starting to get back into it in May. Things have changed from my March regime though, principally the fact that, as the day begins much earlier I have been getting up at around 5:15, thus generally getting my run in before 8:00. As I now need to eat and inject before going for a run, and allow time for the food to digest and the insulin to start peaking, I usually step out around 90 minutes after eating. All well and good, but what I consequently have to deal with is that my regular lunchtime is now around 7 hours after my breakfast, a long time to go without food or further injections.
So, I have been trying a little experiment over the past few days. On the first occasion, a few days ago, I decided that I would eat some toast and inject a small amount of insulin to cover it, shortly after completing my run. The result? Hypos all the way through to lunchtime! On the next occasion I decided to see what would happen if I ate the toast but didn’t inject for it. Result? My level prior to eating was 6.8 mmol/l (122 mg/dl) and by lunchtime it was 5.7 mmol/l (103 mg/dl) – I didn’t need any insulin for that toast! I have just repeated the experiment today, after a much shorter run. I was 7.0 mmol/l (126 mg/dl) after the run, ate some toast, and then was 5.2 mmol/l (94 mg/dl) before lunch! So the scenario with me seems to be:
1) Eat nothing for breakfast, levels normally creep up to the 7s/8s by lunchtime.
2) Eat breakfast, no run, levels usually in 5s/6s by lunchtime
3) Eat breakfast, go for run but eat nothing after, levels in 7s/8s by lunchtime
4) Eat breakfast, go for run and have toast afterwards, levels in low 5s!
There are lots of natural remedies that can help people with diabetes maintain good blood glucose levels, although their efficacy is often difficult to prove, and relying on them can be potentially dangerous. One such remedy is bitter melon, or bitter gourd, and the majority of advocates of this recommend eating the fruit or seeds, or taking the active ingredients in a supplement.
However, in the wacky world of diabetes, there’s always one stand-out fruitloop who puts forward a bizarre slant of their own, and offering a cure. Bitter melon is no exception. I won’t publicise the site that suggests this, but the method is as follows:
“Take half kg of bitter gourd in a big container and stand in it with clean feet. Then crush the bittergourds with your feet continuously. Then you will start to get the bitter taste of bittergourd in your tongue. Getting the taste of bittergourd without eating, is in itself a miracle. Do this daily for about 7 days. Then check your blood sugar level. When you do this ‘exercise’ regularly remain assured that your blood glucose level will remain in control.”
So, let us imagine then a specialised Cure Centre, run by a hard-nosed and officious instructor who will, for a fee, ensure you comply with the demands of the cure…
Keep your knees up number three! I want to see you sweat!
If you put in the work then this will cure you, don’t you fret!
And number five – I’m watching you! Stop paddling around!
I should be hearing squelching, but I hardly hear a sound!
Excuse me, are you Norman? I’m here about the cure.
I thought I’d found the right address, but now I’m not so sure!
No, you’re not mistaken, have you got your receipt?
Ah yes, that seems in order, now let me see your feet!
Cubicle number four is free, it just needs swilling out,
So go and get your swimsuit on and I’ll give you a shout!
I’m sorry? I don’t follow you – don’t I get a pill?
Don’t be so ridiculous! Now, in here if you will…
Now, on the rail behind you, suspended from a cord
You’ll find a row of melons, also known as bitter gourd.
Nut them with your forehead and split them on the ground,
And then get those legs pumping, and your feet stomping around!
I’ll make sure you keep working, so there’ll be no slacking off –
I want to see your melons pulverised inside that trough!
If you make the effort and maintain a good technique,
Then I can guarantee you – you’ll be cured within a week!
Regular readers may remember the enterprising Supermarket Manager, Mr Worsnip, who initiated the first ever ‘Diabetic’s Day’ where diabetics were invited to come and shop in his store with free meters, insulin and jelly babies laid on to get them through their visit (see Supermarkets of the Future). Sadly, it has been uncovered that the store was operating subtle and hidden marketing techniques to try and induce extra, impulsive purchases of unnecessary luxury items. The most dangerous of these was the alteration of the frequency of the store’s fluorescent lights which, it turned out, were set at just the exact wavelength to trigger severe hypoglycaemia in the oblivious diabetics!
I am convinced that this is the reason why I have suffered so many hypos on my shopping trips to the local Tescos – and why I do not suffer the same fate in Waitrose or the Co-operative! Clearly, Tescos must be using the same techniques as Mr Worsnip to try and shift those piles of Ferrero Rocher outside of the Christmas season!
Mr Worsnip, you are charged that you did subliminally induce
A diabetic’s hypo, without warning or excuse!
We have gathered all the evidence, and are ready to proceed,
So tell me Mr Counsel, how does the defendant plead?
Not guilty, Your Honour, however could he know
That this frequency of light waves could make a diabetic low?
It was only his intention to try and sell more Shredded Wheat,
And not send people hypo, and falling at his feet!
And if you please, Your Honour, I’d also like to say
Mr Worsnip started Diabetic Supermarket Day!
He laid on entertainment and honey roasted ham,
And heavily discounted all his diabetic jam!
Would such a man endanger diabetics in his store?
The thought is so distressing that it hurts him to the core!
Head office had insisted that the lights were safe to use,
It’s they who should be standing here – them you should accuse!
Mr Worsnip, with his knowledge of the diabetic state
Should have stood his ground and not complied, but alas now it’s too late!
His greed for selling Shredded Wheat overcame his commonsense,
So, without ado, that’s enough from you! Let sentencing commence!
I ran my meter readings through my computer software yesterday and was astonished to see that every reading bar one was within my target range of between 4 and 7 mmol/l (72 - 126 mg/dl)! Only one hypo all week! Heavens, I must be cured! (If it wasn't for all that jabbing with needles I still have to do...!) So, probably one of my favourite diabetes pictures since diagnosis.
I was pretty appalled to read a post from one of our forum members this morning in which she explained how dreadfully her daughter had been spoken to when she went to have a foot injury examined at the minor injuries unit. The nurse gave the daughter (only 16 and not long diagnosed) a lecture with dire warnings about false legs and amputations! Where do they get these people from? It’s almost as if there is a special school where such people are trained to be as tactless and ignorant as possible – hopefully not all students at that school comply with their training!
Hello, I’m your instructor for the diabetes course,
I’ll teach you how to make them weep and tremble with remorse!
And if I ever hear of patients leaving with a smile,
That’s immediate suspension –no ifs, no buts, no trial!
I’ve got a few scenarios, and I’d like you to explain
How badly you would handle them, and inflict the greatest pain!
Nurse Jenkins, you look dubious, so I think I’ll start with you –
Your patient says she’s hurt her foot, so tell me what you’d do.
‘Well, first I’d put her at her ease, and say it’s very good
She decided that she’d see me just as early as she could.
And then I would examine her as gently as can be,
And reassure her, if I can, that it’s infection-free.’
No, NO!!!!! You have to frighten her, and make the poor girl fear
Her foot’s already gangrenous and won’t survive the year!
Castigate and bully her, until the poor girl cries
And thinks that there’s no hope for her, no matter how she tries!
‘I’m sorry, I won’t do it! That’s surely not the way!
A patient needs encouragement to get them through the day!
So you can take your course and stick it where the Sun don’t shine –
I’ll treat the patients my way, and I’m sure I’ll do just fine!
I have really enjoyed participating in Diabetes Blog Week 2011, and it's been wonderful reading everyone's contributions! Many thanks to Karen for organising it, and to Emma for reminding me it was about to happen! I hope people have enjoyed my poems, it's been really lovely to hear all your comments! So, what have I learned?
Basal, bolus, MDI, pancreas, pen and pump,
That lipohypertrophy is a way of saying ‘lump’,
A plethora of ‘-opathies’ affecting eyes and feet,
That there’s no carbs to talk about in any type of meat,
And macula, that’s vernacular for the bit that helps me see
The thirty one guage needle on the pen in front of me…
And how does all that glucose get in each and every cell,
And answering the question of just how does Lantus smell?
That cake is not forbidden, and some chocolate is OK,
Accepting there’s no cure as yet, and ‘it’ won’t go away,
But what I’ve learned beyond all this, a priceless thing for me,
Is I don’t need to feel alone – I have the D.O.C!
Who would have thought that something as life-changing and devastating as being diagnosed with a chronic, incurable disease could actually also produce changes for the good? Apart from the fact that it really made me sit up and take notice of my overall health and the way it was potentially heading, it also turned out to be an extremely rich source of inspiration for my poetry! Now, you may have noticed that my poems tend not to be the chest-beating, soul-searching and angst-ridden litanies of gloom and despair. I’ve tried that sort of stuff and I just can’t do it. No, I prefer to spot an absurdity or situation that can be given a humorous twist because I firmly believe that if you don’t laugh, you’ll cry.
On the whole I’ve been pretty lucky with my diabetes. My levels are very good as a rule, HbA1c has been in the 5% club since about 6 months after diagnosis, and I was diagnosed late in life, aged 49, so I haven’t had to spend decades with it as yet (although I’m looking forward to my Joslin Medal and Alan Nabarro Medal for 50 years with diabetes when I reach 99…
So, not a lot to complain about, and I try not to, being fully aware of the struggles that others have in comparison to my relatively cushy ride. But that doesn’t mean it doesn’t bother or upset me, or ruin my routines or plans, probably made worse by the fact that I had several decades of carefree spontaneity prior to diagnosis. There’s no escape, and sometimes that gets me down. I do try and bear in mind that things could be far worse though, and try and look on the bright side and inject a little humour (see what I did there? Groan!) with my poems, which I hope will lighten the burden for others from time to time.
So, 10 things? How about…
One, you never leave me,
Two, you’re always there,
Three, you’re so demanding,
Four, you never care,
Five, you’re so erratic,
Six, you’re timing’s bad,
Seven, sometimes dramatic,
Eight, you make me mad!
And if you haven’t worked out
What I’d pick for Nine and Ten,
Then please go back to Number One
And read the list again!
Just go! Vamos! And sling your hook!
For you’re not wanted here!
Vacate my life and let me be,
And let me drink my beer!
I haven’t been diagnosed that long, just about three years now, and am glad to say that I have been able to manage my diabetes well without any real disasters or howlers. When I was first diagnosed I remember getting home from the hospital and going through my cupboards, clearing out everything I thought I could no longer eat – honey, sugar, biscuits, treacle, puddings, ice cream, chocolate – I remember being surprised at how much stuff I had that was now forbidden to me, especially since I had never considered myself to have a particularly sweet tooth.
As time went on though, and I learned more about carbohydrate and things like the glycaemic index and glycaemic loading diet, I realised that I shouldn’t deny myself the occasional treat. Happily, weight was never an issue for me, and I quickly got back into my running, so could afford extra calories when the whim took me. I learned that nothing was forbidden to me, as long as it was in moderation, and taking care to consume ‘fast’ sugar items as part of a meal so I would lower the overall GI and have less of a spike in blood sugar levels.
However, sooner or later every person with diabetes will encounter someone who isn’t diabetic, yet knows far more than you about what is and what isn’t allowed. Obviously, in their minds, anything sweet will probably kill you almost instantly, so they take it upon themselves to safeguard your welfare by issuing horrified warnings should you absent-mindedly raise a slice of cake to your mouth. Before your lips can close around the moist and heavenly delicacy, their stern insistence that ‘you shouldn’t be eating that!’ suddenly hits home and you realise how close you came to an almost certain early demise. Thank goodness for the Diabetes Police!
My goodness! How stupid! I’ve been such a fool!
I’m embarrassed and my face has turned red!
How could I have forgotten the One Golden Rule?
I must have gone out of my head!
Of course! You’re correct! Why couldn’t I see
That the cake that I almost consumed
Represented such danger, for it’s poison to me!
Oh forgive me! May I leave the room?
I feel such an idiot, my head hangs in shame,
For the consequences might have been so severe,
If I woke from the coma, then who would they blame?
All due to my ignorance, I fear!
Oh thanks for your warning, so grateful to you!
I am blessed by the interest you take!
If it wasn’t for you, I may not have pulled through
My mistake in digesting that cake!
One of the good habits I got into as soon as I left hospital was recording everything related to my diabetes management down in my diabetes diary. Ostensibly just for recording blood glucose levels and insulin doses, I quickly developed my own shorthand so I could easily record all the new elements that I learned were part and parcel of the management of this disease. I started recording the time of my insulin doses so I could avoid ‘stacking’ – having an injection before the previous one had worked through my system. I also recorded the type of food I had eaten so I could refer back and see how my dose calculation had performed when eating the meal again. My activities – mostly running, interspersed with Gay Gasper – so I could see the effect on my insulin sensitivity. Plus lots of other little things that might be of use to improve my blood glucose management, or perhaps to help me identify possible causes when everything seems to go haywire for no apparent reason. I’d never remember all this stuff, no matter how good my memory is, so the diary is an essential tool in keeping me safe from the dreaded complications.
I’d urge everyone to make friends with their diaries! Diabetes is about so much more than the readings stored on your meter, especially if you are on insulin, but also if you’re not, in order to spot those patterns emerging that might throw some light on why you went high after eating those profiteroles…
Dear Diary, have you noticed how good a boy I’ve been?
Just flick through all your pages and you’ll see just what I mean!
For every day, in every way, I’ve laid the numbers down,
The ones that make my heart content, the ones that make me frown.
For only by recording them can I see the reasons why
This morning I was far too low, that evening far too high!
And more – it’s not just fingerpricks and insulin amounts,
But food, my mood, and exercise, for every factor counts,
And when something confuses me, or I just get the urge,
I see the problem clearly in the patterns that emerge!
So thank you my dear Diary, you’re worth so much to me,
And I’ll attend you every day – oh yes, I will! You’ll see!
I’m the Admin for a diabetes support forum. Although the forum has only been going less than three years, we are now in excess of a quarter of a million posts from thousands of people. If there is one thing I learned early on in my involvement with the forum, it is that everyone’s story is different. Even two Type 1s of similar age and length of diagnosis will have very different experiences to relate, whether it is their reaction to different types of food, their ability to control their levels, their reactions to exercise, and the reactions of the people around them to their condition and how they handle it – the bottom line is, we are all different. By responding to each other’s cares and concerns, triumphs and troughs, we can help each other build up strategies to cope with those aspects of diabetes that have had us stumped, maybe for many years. There is no substitute for this knowledge and shared experience, no teacher or text book can teach it, there are no simple rules applying to all, except perhaps the need for insulin, whether from pump, pancreas or pen, to process glucose and keep our levels in range. So who do I admire the most? Every single one of you!
Hundreds of people, thousands of posts,
Which one should I pick from these? Which one means the most?
The parent, child or pensioner? Perhaps the anxious wife?
Or the person who refuses to let it rule their life?
The people running marathons, or those who walk a mile?
The people fighting deep despair? The ones who make me smile?
So many different lives to lead, so many tales to tell,
From happy Pumping Paradise to needle-phobic hell…
All ages, colours, sex and creed, the bald, brunette or blonde,
Tall and small and thin and fat, we share a common bond.
So many newly-diagnosed – if only there were fewer,
And maybe one day, not far off, we celebrate the Cure!