Wednesday, 22 December 2010

I was watching television the other day...

Not surprising really that as I've been out of a job for a little while now. Thankfully that's soon to come to an end.
Channel Four is a channel that is well known for misrepresenting persons and generally talking out of it's arse. What I speak of is yet another example of this, in relation to diabetes. Like their series that goes by the name of The Hospital. That's another subject all together. However, news team gets hold of a medical report and the words "NHS", "funding", "diabetes", "millions" and "wasted" come into the equation I generally assume that they are skewing things and not looking at the bigger picture. This is one such as case.
Channel Four has gotten hold of a report generated by a doctor (the doctor in question, after writing this, no longer merits the title of Doctor as they have disgraced their profession and become a slave to the accountants) claims that the NHS is spending far more than is necessary on the modern insulins on which many depend. It also claims that they are far less effective than the older Human insulins.
Now it is true that the modern insulins (analogues such as Novorapid, Humalog and Apidra; then the long acting insulins such as Levemir and Lantus) do cost more than the older Human insulins. However, it is not as true that they are less effective than the older ones. Far from it. They are effective if they are well used and if patients are taught essential skills such as Carbohydrate Counting. The older human insulins do not need as much skill to use. This smacks of bimodal insulins that I first started on in nineteen ninety six when I was diagnosed. The issue is that the NHS furnishes diabetics such as myself with lovely insulins that are the cutting edge in their field yet it does not educate us in their use. If there is education in carbohydrate counting that is structured (such as DAFNE and SADIE) or determined diabetics who learn the skills of their own accord. Some are given a scant education and generally left to get on with it. This was the approach first taken with me. However, at the age of seventeen I was something of a rather precocious young man with little understanding of what I was doing in relation to my diabetes nor any real will to learn new skills. After all I had been doing much the same thing without any ill effects (or so I perceived it then) for many years. The first approach at learning to carb count did not work in my case. I simply let it slide and conveniently forget about it until it was mentioned at any appointment and then fobbed off my team with excuses or told them that I didn't want to and just let it go. Then I was offered a place on a course of a similar nature to DAFNE. I took it. I haven't looked back since. What I like to envisage is a system in which all diabetics are taught to carb count as soon as is possible. Perhaps the system should be modelled on the Finnish one where all diabetics are hospitalised for a week upon diagnosis to learn the skills of carb counting.
Now back to the point, the NHS could save much money by putting all type ones onto human insulins, mixes and the like. However, these would only save on drugs costs. The cost for complications, emergency hospital admissions would be much higher than they are. The fact is that bimodal insulins and the older insulins don't really work as well and are simply out dated. The treatments available with them just aren't as good as what's available with the modern insulins. They do not offer as tight control or as good quality of life. Ultimately a few pounds saved by using older insulins and older means of control would eventually have to be spent on treating complications. That and much more money than that saved on cheaper and less effective medicines.
What got to me even more is that the report once more began to focus on type two as opposed to type one. It gets me that the small minority of type ones from the many thousands of diabetics within the country are all tarred with the same brush. Again that's another issue. What I really want to see is a report that shows all the type ones like myself who make damn good use of their insulins and care for themselves. Not the ones that don't care and allow themselves to be hospitalised or do not seek to improve their own care. Enough on this now. I'm going to write a letter to someone.

Monday, 20 December 2010

The novelty has worn off.

Well, it's been a little over eight months since I started pumping on the eight of April this year. Alot has happened since then. However, I'm here to talk about the pumping side of that.
Like I said I've been pumping eight months. After that time the novelty of it has really worn off and the thrills are really gone now. I'm no longer excited about bolusing or changing sets and the like anymore. It's all become a mundane reality, as much a part of my every day life as my injections were when I was on them.
Pumping is most certainly much harder work than injections was. The amount of effort required is somewhat greater than what I needed on MDI. On the flipside the rewards are much greater than they could have been on MDI. I know pre pump I had decent control on MDI. Now on a pump it's not all the easy good control that it once was. I was very lucky when I started pumping that my basals seldom deviated from one unit an hour over the day. I only had three different basal rates then. That worked for a while until things got complicated. Now I've got seven different basal rates which have had alot of hard work go into them. Then there's bolusing. It's a more complex affair than simply giving an injection ever was. There are so many options that can be taken and it does take alot of work to work out what suits what best. Now I'm doing my utmost not to whine as this has been of great benefit to me.
It has been alot of hard work for me these past few months. Especially now as I've got my basals sorted out but they seem to need to change every few weeks which is a right pain in the arse. There's always alot to take into account with pumping and there are a fair few things that can go wrong with it. I've had a dose of cannula fails and taken a fair while to work out what was going wrong. On the reverse I have now found the cannula that works for me. I've tailored the basals that seem to now work for me.
I did know when I embarked upon the pumping trail was that it would be much harder work than MDI had ever been. That was, to begin with, tempered by the novelties of pumping. Now it's all begining to seem like alot of hard work. I do try to remind myself that pumping is the right way for me to go and that it offers me alot more than MDI ever could have. The pumping has paid off. I've been able to maintain an HbA1c which has been consistantly in the seven percent area since I started pumping. The highest since starting pumping was 7.6% or 60 mmol/mol in new money. The lowest was 7.1%. I suppose I did let myself go a little after a few months of pumping and now I'm in the process of bringing myself back into line after a momentary lapse or a phase of laissez faire.
What am I trying to say then? Well, ultimately I've got to the stage where pumping is no longer fun and is more hard work than anything else. It's just another means of getting insulin into it. However the results are worth it. I am becoming more apathetic to pumping and diabetes in general though.

Sunday, 19 December 2010

We don't need no education

We don't need no education,
we don't need no thought control,
no dark sarcasm in the classroom,
hey teacher! Leave them kids alone!
all in all it's just another brick in the wall,
all in all you're just another brick in the wall.

Apologies of Pink Floyd. A momentary laps of reason on my part. Spot the other Pink Floyd reference in that one.

Well education is the name of the game. More precisely the education of type ones like myself. Type ones are expected to regulate their blood glucose levels by the use of insulin. We're expected to learn how to adjust doses and that sort of thing. There are a lucky few like myself who have been on a purpose built course to educate type ones in the use of their insulins. It's called carbohyrate counting. Some are left to learn by distance under a little supervision from their diabetes team after a back of a fag packet briefing on the subject. This was tried with me and had sod all success. The problem is that there are very few courses that run for type ones. There is the DAFNE (Dose Adjustment For Normal Eating) course which is a nationwide programme and is run by many hospitals. Some hospitals have their own local equivalents. The one I did was called SADIE (Skills fo Adjusting Diet and Insulin, Eastbourne.) However, there simply isn't enough to go around and the waiting lists are huge.
This is a real shame as the increased amount of education in the type one community would save the NHS much money in terms of hospital emergency admissions and complications because the education would give people the keys to better control. I say it'd save money but I do have to bear in mind the old saying that "you can take a horse to water but you can't make it drink". It's a shame as there are people who just don't look after themselves despite the condition that they live with.
Now when I was diagnosed it was a question of two injection a day. If I recall correctly the main education was how to treat a hypo, keep meals a set times and have snacks in the mid morning and mid afternoon. Then I went onto rudimentary MDI which gave mildly better control but still we weren't taught how to alter doses nor were we really given the education we needed to make adjustments to my basal insulins. This carried on for years. It's a sad thing as if I weren't as lucky as I have been I could have fallen victim to a series of complications by now. It was only in 2009 after thirteen years of type one that I learned to carb count. This did my control so much good.
Since I learned to carb count many things have happened to me. First and foremost in diabetes is that I now use an insulin pump. For the first time in fourteen years of being type one I have since been able to achieve and maintain an HbA1c below eight percent. This never happened in the days of MDI. Granted there have been fluctuations in that but I have done things that I have never been able to do before in the terms of controlling my diabetes.
I think that's all I wanted to say. I'll probably find something else later on and then write another post about it.

Sooon to come on here will be a guest post by a friend of mine whose daughter is three and is type one. She also uses a pump. I'll put it up as soon as I get it.

Tuesday, 14 December 2010

A numbers game... Or is it?

Some people seem to think that having diabetes, in particular type one means that you play a numbers game for your entire life. I don't really think this is so.
Now granted alot of us try to get as good a set of numbers every day as we can. That doesn't mean that we wake up and the first thought of the day is "oooh, I'll aim to get perfect BG's today and will test so much". Far from it. Yes I do test my BG when I awake just to see where I am but also it may be a while until I eat. If I'm higher than I'd like to be when I wake I'll put in a correction and wait for the BG to drop enough for me to be comfortable enough with it to eat. I suppose this is a case of rolling with the punches.
I do test alot. I don't do this for the sole reason of perfecting my control all day, every day. I do this because I use a pump and the pump is only as good as it's user. The more tests you do the more data you have to work with and it makes things easier to sort out. I also can't really trust the way that I feel as much as others can so I'd rather test.
Back to perfectionism. I do admit that at times I am something of a perfectionist as far as my diabetes goes. However, I feel that this only applies when things are going a little wrong as I want to get things sorted as quickly as I can so that I can be back on track as soon as is possible.
The perfectionism isn't my sole objective in life. I do put alot into my diabetes however it's not because I want to see near perfect numbers every day of my life. Far from it. That would be a nice thing but it won't happen. The reason I put alot of work into my diabetes is because I don't want to fall prey to a variety of complications that can come about as a result of poor control.
What kind of conclusion must I come to then? Well based on what I've written above and how I'm feeling at the moment the perfectionism isn't my goal, it isn't something that is always at the forefront of my mind. I don't live to be the master of my diabetes and to get perfect control. This would take my entire life over, stop me having fun and ultimately, to gain perfect control you'd have to isolate yourself in a laboratory and remove all fun and things that can interfere with the diabetes from your life. The trouble is that there are so many things that can interfere with diabetes that it'd be impossible to remove all of them. Diabetes isn't about making your control so perfect that no one could tell the difference between your BG's and that of a non diabetic. It's about finding the balance between good control and having a fun and fulfilling life. Someone else has put this much better than I can ever hope to. When I was at Friends For Life in October this year one of the organisers said a few words to round it off. It was based on his daughter who has been diabetic for many years. He said " we don't live to be diabetic, we live to dance on the beach." That says much what I want to in a much more eloquent way than I ever could.

Tuesday, 7 December 2010

I was on the internet recently and found this...

Whilst having a browse on Youtube (as you do) I happened upon a video about changing the infusion set as I do on a regular basis. This was a little different as it was filmed by some parents of a young lad no more than a year or two old (link at end of post, if I remember) and I was struck by emotion. Something that doesn't usually happen with blokes in general.
When I was in my early teens I recall my Father saying that if he could, he would have diabetes instead of me. Now that I use the Children With Diabetes (link to website at the bottom of the post) mailing list I can begin to understand a little of what they and my old man must have felt and continue to feel.
It's one thing to have grown up being diabetic and not knowing anything different but to be the parent of a diabetic child? That's something I can't even begin to comprehend if I'm honest with you all. One can suppose that there is the feeling that what is your perfect child has been spoiled by something that you can't influence, the emotion of the knowledge that your child will now have something that cannot be cured, only controlled but even so there's still the risk that you won't get away Scot free, the pain that they don't understand what's happening other than your parents are coming at you with a very large metal pointy thing and inflict pain upon you and that they'll grow up with something that they won't be able to shake but with which you'll have to deal with until they're at an age when they can take it over for themselves.
So what's the point of this post you may be asking yourselves (yes, you dear literate proletariat) I suppose this is me raising a glass (both metaphorically and physically) to the parents who are absolute saints and wonderful in the way that they deal with their children's illness. I salute you.
I only wish that this kind of support had been available to my folks when I had been diagnosed as this would have been of such great benefit to them. This is my toast to you, the parents of children with diabetes who are such a resource to one another, such a comfort to one another in times of hardship and many more occaisions and things like that.

So, what caveat must I add to this? Well, ultimately I am so very grateful for the tireless effort put in by my parents into something the stresses of which I cannot comprehend or even begin to imagine. I am lucky in the way that I am the diabetic and don't have to go through what the parents have. I say lucky, it's a Catch 22 situation and one I'd rather not be in but the situation I find myself in I must make the most of.

Here there be links:

Sunday, 5 December 2010

The joys of putting in a cannula

Now, in the UK there are many diabetics, only a small fraction of those are type one such as I. Forgive me as I cannot remember the statistics (then again it wasn't a strength of mine at university!) but I do remember this one; out of all the type ones in the UK only a miniscule four percent use an insulin pump. I'm one of the lucky few. [For he who today sheds his blood with me will be my brother. We happy few, we band of brothers. Shakespeare, Henry V)] Excuse the novelty that is me quoting things and doing so in what is probably a none too accurate fashion!
This four percent will know what a pain in the arse it is to change a cannula on a regular basis. Mine generally last about three days before things start to go Pete Tong. After about threee days boluses begin to loose their effectiveness and after meals I generally begin to shoot up into double figures so then I need to change. That aside there is the choice of cannula. This is quite something as to different pumpers different cannulas mean different things - comfort, convenience of insertion and foot print upon the body. There are many more things that people take into consideration but those are the main ones for me.
Having tried a variety of Medtronic's cannulas (cannulae?) since I began pumping a little under eight months. Those would be Quick Sets, Mios and last but by no means least, the Silhouettes. Out of all of these I currently use the Silhouettes and I love them. I won't go into the reasons why at this point in time, a later post will come about this.
Back to the original point of the post, changing cannulas. Today was the day of a cannula change as the reservoir for my pump (1.8 ml, about 175 units of the lovelyt Novorapid) lasts roughly three days if I don't binge on carbs or need many corrections. I thought that today I would try a new site. It's not far from the ones that I usually use which are about an inch or two from my belly button which is found amidst hairs on my fledgling beer gut. I thought I would move it more near my hips as at the time my considerable love handles seemed adequate to house the lovely cannula.
I tried twice. I failed twice before retreating back to the more normal areas. Now in retrospect I should have gone in at a more shallow angle. The blurb that Medtronic dispenses with each box of cannulas (something I fail to read at every occaision) says that I should by rights go in at an angle of approximately twenty to thirty degress. I go in at about forty to forty five degrees. Perhaps that was too deep an angle for the flab that was available on the love handles. It seems so. The sites were bloody agony to touch, not something I am used to as I have a considerable amount of padding with which to work. I don't really know anything else other than those two factors that caused such pain. I suppose you learn something new everyday when you pump.
Here endeth the lesson.

Tuesday, 30 November 2010

All the small things

As the title says there is more to life with diabetes than just checking your BG and taking insulin and whatever other types of medication you may be on. First there are the mental aspects of it which I don't want to go into at the moment. Here I want to talk about all the small things, the little innocuous things that to someone without diabetes would have no consequence but to folk like me they can become a little bit more sinister.
Needing to go for a wee. Well as innocent as it may sound this can mean one thing for a diabetic, that they have a high BG, generally over 10 mmol/l. This is caused by the kidneys dumping excess glucose into the urine when BG exceeds 10 mmol/l, this is called the renal threshold. So then, waking up in the middle of the night or in the small hours with a desperate urge to use the toilet usually results in a BG. Sometimes it comes back to be in the right range of numbers. Sometimes it comes back to be just over what I want to be so I correct. Sometimes it comes out as being far from where I want it to be. For insulin pumpers such as me this can mean a variety of things. Chief amongst these things is a cannula fail which is a right nasty bugger to deal with but somehow it's even worse at night when you've just woken up and it's the kind of time you're a little groggy from being woken up and you're in that twilight zone between fully functional awake and the fine state of slumber you were in previously. This makes everything that little bit harder. The resulting cannula change becomes more complex for what was once a relatively simple procedure. There are other reasons for waking up high in the small hours and one of them is being human. We can carb count to a very high degree of accuracy but sometimes it just doesn't work and you get it wrong. Simple but hugely irritating.
Being thirsty. Normal solution drink. If diabetic reach for testing kit, insert strip into meter, prick finger with finger stabber and apply blood then wait for the score. If you're lucky it comes back fine so you then go and grab a drink of your choice. If you're unlucky and the BG's come back high well, the reason you're thirsty is because of the renal threshold trying to wash glucose out of your body in the urine. Once again a usually small and innocent thing becoming somewhat more sinister.
Being tired. Yes. Another symptom of hyperglycaemia. If it's completely inexplicable after a restful night's sleep then it precipitates a blood test. Normally fatigue is a symptom of hyperglycaemia or sometimes it can be related to a hypo.
Shaky legs. It may well be that you've just been for a fine jog but when you've got up off the sofa if you're a bit of a slob at the moment like I am it can mean one thing only to me. A hypo and then comes the resulting blood test. Granted each diabetic has a variety of hypo symptoms that make it patently clear to that induvidual that they are hypo but they do follow broad guidelines.

That's the end of a somewhat disjointed blog post. I suppose what I wanted to get across is that any day to day thing which means nothing more than what it first appears to be to someone who doesn't have diabetes.

Sunday, 28 November 2010

The joys of basal testing.

Basal testing.

Two words that strike fear into the hearts of most pumpers. Especially me. Generally these mean forgoing all food and subsisting on water for a period of several hours and testing at least on the hour every hour. For me I test every half hour. This is just for in the day. Should you wish to do the same at night an alarm clock is needed and the results can be interpreted the next day once the jaded tiredness has worn off.
Not so for me. Give that yesterday I wanted to basal test in the small hours I thought it'd be a simple matter of setting a few alarms on my phone and waking up and testing when they went off. No such luck. Diabetes never makes anything easy nor does my body it seems.
So, the original plan was to start at three in the morning and work my way forward until about seven testing every hour. The three o'clock test went fine. The trouble came after it. The trouble was in the form of me not being able to get back to sleep after the first test. After half an hour of tossing and turning in my pit I decided to abandon any notion that sleep was going to come. After that decision was made I then decided to stay up and test every half hour. I managed to do so until half past ten, some seven and a half hours later on. The results were wonderful and highlighted an interesting pattern as you will see now:
03:00 - 6.5
03:30 - 6.2
04:00 - 5.2
04:30 - 5.2
05:00 - 4.9 Note, this is where it starts to get interesting. How long can I last until I hypo?
05:30 - 4.7
06:00 - 4.7
06:30 - 5.1 Doth the dawn phenomenon rear it's ugly head? I think so!
07:00 - 5.7
07:30 - 6.3
08:00 - 5.8
08:30 - 5.9
09:00 - 5.6
09:30 - 6.4
10:00 - 6.1
10:30 - 6.4

Now I know I can be a bit of a perfectionist but the drop that occurs between 03:00 and 05:30 is a little worrying. Having had a few hypos at about the 05:00 mark that have woken me up this seems to fit the pattern should I have gone to bed on a slightly low BG of about 5 mmol/L the night before. Then there's the rise that happens between 05:30 and 07:30. I do suspect that there is a little bit of dawn phenomenon occuring there. On that note, I have made changes to suit both of the trends that came up in my basal test. Tomorrow I intend to have a repeat performance to see if the changes have been to my good. I also intend to basal test until about midday to see if there is any rise after 09:00 until 12:00 as I've had a fair few days when I've tested pre lunch (usually between 12:00 and 13:30) and have been above ten.

Fingers crossed about tomorrow's basal test. I'll do a post after I've done it. I also need to basal test in the late afternoon/early evening to see what effect the early darkness has had on me.

Friday, 26 November 2010

Two for the price of one...

Like it says, two issues for the price of one tonight.

As winter has arrived the nights draw in early and by about four it's darker. Now to anyone else this probably wouldn't have much of an impact on their life. For me as a diabetic the effects are quite interesting.
What I've noticed is that at about three or four in the afternoon of an ordinary my BG's have started to rise resulting in higher than average post meal BG's and higher than average pre meal BG's. What is wrong? Personally I think it's that I'm not getting enough basal. This is because I reckon that my body is getting tricked into thinking that it's night This may sound silly but given that it's pitch black by five o'clock. This seems to make my body think it's night and I should be asleep. I'd very much like to spend alot of my time in bed but that's besides the point. The answer is a basal test tomorrow from about two in the afternoon to about six in the evening. I will post the results tomorrow if I remember to do that!

Now the second issue. Given that my partner is also diabetic but under the care of Selly Oak hospital in Birmingham and is going for a pump which her consultant has now said he'll reccommend that she be given funding for it. This means that I've done a little travelling to and from Birmingham as I was at the appointment where she was told she'd be given funding. Ultimately it needs a three and a half hour journey either way. This has the lovely effect of raising my BG's. The worst part for raising the BG's is the part of the journey that I need to make on the London Underground. On my usual basal I find that I can't get my BG's below ten or so. Fortunately they don't go dramatically high. So it seems that I now have to put a temporary basal onto my pump for the length of the journey. It seems that journeying is a stressful event for me. Next time I travel I think I'll be popping on a temporary basal of about a hundred and twenty five percent.

Wednesday, 17 November 2010

A spin off!

Having read a somewhat moving blog by a good acquaintance about doing night time blood glucose checks on his two sons I feel that I should say a little on that subject.
As a young adult with type one (young adult, damn it I hate that term, rant aside let me proceed) night time tests are a necessary evil that can range from a minor inconvenience to a full blown shit storm.
When I do a night time test it's usually at the classic hour of three in the morning. Classic in the fact that this is the time of night at which your blood glucose is lowest. Or so goes the theory. On the lowest level it is a minor irritation as you have to wake up to what seems to be a klaxon going off next to my bed then fumble around looking for the BG kit and going through the motions. Then there's the ensuing result. If it's a nice one that's in range and hasn't budged too much since I went to bed a few hours previously then all is well and I may return to my slumbers without any worries.
The next scenario is if it's a little bit higher then I'd like. Normally I'm woken up by the need to go for a pee the moment my numbers start to go above ten millimoles per litre (the renal threshold for glucose, in English that's the level above which the kidneys throw glucose into the urine to get rid of it). My other half is exceptionally good at spotting this and is very easily woken so I can't get out of bed and do what's necessary without waking her up. If this is following an evening long doughnut binge then I know fullwell that it's self inflicted because as usual, I'll have got the carbs in my doughnuts wrong. Note to self; look at Collins Gem Carb Counter from time to time.
Then there's the final scenario. I'm in the late teens/ early twenties. Then I become decidedly displeased as I wake up with a deep urge to go to the toilet and paradoxically I also awake with a raging thirst. Damned if you do, damned if you don't. Throw in the appropriate correction and hope that the next three or four hours is enough time for the blood glucose to drop in until you wake up.
When I do do my night time tests as a routine at three in the morning it's usually over about a week or as long as I need to spot any trends at that time. If needs be I do tests at different times to help sort things out or to make the image clearer.
There's also another type of night time test. The just got into bed hypo type of test. Normally this can be just enough to wake me at say a three point five millimoles per litre result. From the sublime unto the rediculous in the low twos or even ones which come out of the wood work once in a blue moon. It's not the hypo that bothers me so much more the bout of the munchies that follows the hypo. Sometimes twenty grammes of glucose is enough to sate me and make me feel good enough to head back to sleep. Sometimes I feel the need to eat everything within sight. This goes to such an extent that I have at times been found eating sugar sandwhiches in the small hours. Then there is the realisation that I will then need to bolus for this hypo related binge. That gets me even more than the hypo as I've then got to retrospectively work out the carbs and then the appropriate insulin dose for that. Fortunately I use one unit of Novorapid for every ten grammes of carbohydrate that I eat but even simple division is one hell of an ask in the small hours or a few hours after I've got into bed.
How to round this off then I must ask. Ultimately then night time blood glucose tests are a hassle. The amount of grief they can cause depends on the result that I get or quite often if I do the test or not as I have been well known to turn the alarm off and go back to sleep without doing the test. Damn unpleasant to do at times but a necessary evil. It's a catch twenty two situation as you know you need to do it at times but there are times when it's such a fine balance that it could easily go either way. So then, mixed feelings on my part about night testing. In typically English fashion I must end on an understatement; it's a bit of a bugger.

Sunday, 7 November 2010

Heavens! A review that might be diabetes related...

Well, I have been getting more of the free stuff and exploiting it. This week's free thing is an Accu Chek Mobile blood glucose meter courtesy of my fabulous DSN.
Firstly a little bit of an overview. The Mobile is a blood glucose monitoring system that does not have strips. Yes you heard. It doesn't have strips. It has a cassette thingy inside with what I suppose is the equivalent of the strips on it. The reagents are also in there.
What's good about this is that there isn't any faffing about with the handling of test strips and popping them into a meter then jabbing your finger with a lancet.
This is fantastic. I love the concept.
Now the downsides.
Firstly the noise made by the meter when you fire it up is quite phenomenal. No good if you're trying to sneak a stealth test in there and need it to go unnoticed.
Secondly the size. This is quite something to look at really. When you line it up against my Contour USB in it's pouch with strips and lancets it's roughly the same size. However what can't be done is when I need to break the black USB pouch down into its component parts and stash them in various pockets. That can't be done with the Mobile which makes it rather hard to conceal unless you have rather capacious pockets. I suppose I'd best get my bum bag from my early teens back. That carried everything in it with the one downside of looking like an utter tit. This Mobile is a housebrick and a rather unweildy piece of kit. Not liked.
The Screen is rather large which is a nice thing but then it's only a single colour and is rather lack lustre when compared to the Contour USB.
Then there are the flag options that you get on both the Contour USB and the Mobile. Firstly there is a much wider range of flags on the Contour USB. The Mobile's ones are somewhat limited in comparison.
Turning off. Something that may be trivial but I don't appreciate having to physically turn off the meter after testing. I love the fact that if I take the strip out of a USB then it just turns off. Simple. Not so in the Mobile. You need to manually shut it down after testing or setting the flag on a BG result. Not helpful.
So, in conclusion then I don't really like it. It's a large and bulk meter that isn't as accurate as my own Contour USB. There isn't any software such as the simplistic and easy to understand Glucofacts that comes with the Contour USB. Ultimately it's good for the novelty value that it's a unique concept and the only one of it's kind but when it comes down to using it day in day out in the way that I do it just doesn't cut the mustard really.

Tuesday, 2 November 2010

Friends For Life 2010

Well, from sod all blog related antics over the past few months to quite an explosion now.

Where to begin? Well, Friends For Life is a gathering of diabetic kids and their families. All type one kids. For the kids there was a series of activities depending on their age. For the old and boring adults like me there was a series of lectures/talks about the best ways to deal with diabetes from many folks.

The talks, well, I would have attended Gary Scheiner's "Strike The Spike" talk. Note the would have. I missed out as both my other half and I had failed cannulas. Then Siobhan went two up on me as she had three failed cannulas in one morning. We were looked after by the wonderful Jo Soloweicyzk, a fellow type one who's been type one for forty nine years and is still relatively sane despite that! His talks that we went to were quite something, I even won a quid off him for being able to tell him who discovered insulin.
There was Fiona Campbell who as the Paediatric consultant at Leeds, gave a fascinating talk on hypos.
Gary Scheiner gave several great talks, only one of which I could attend owing to cannula fails and a lack of space in the other.

What was the best thing was being around so many kids and being able to help their parents with the questions that only a yound adult (I hate that term!) with type one could answer.

That and the amounts of free stuff I got my hands on was quite something. The rep from Medtronic who set me up on my pump was there. Despite her being a bit rude it was nice to catch up with her. The Animas folk were brilliant. I got hold of a couple of reservoirs and sets from them that are compatible with my Medtronic Veo. From the Roche folks I got a belt and a pump case usually meant for their Spirit pump but seems to accomodate my pump rather nicely. Then there is the amounts of hypo treatment I've got my hands on. Seriously, I won't need to buy glucose tablets for a long, long time. I warn ye, should you get the option of buying Hypo Fit stuff made by Arctic Medical I wouldn't touch it as it had the habit of attempting to summon the chunks with me last night. I'd also avoid the glucoshots that the folks who organised it had left out for us to help ourselves to. I still have many of them. Pens too. Many, many free pens.


Tuesday, 24 August 2010

Pump associated toys...

Firstly an apology, I've not been doing this for a while for several reasons. Paramount amongst those is my contract of enslavement with my local PCT which employs me when I'm not undermining my university. Secondly is laziness. Enough said.
I think it's safe to say I've been diabetic for long enough because now the colour of my pump cannulas actually does matter! Sad I know but it's now a possibility (and one which I have used) to get hold of coloured cannulas for a Medtronic pump. They're called Mios and I've gone for a load of blue ones. Five months worth to be precise. Each one comes with it's own Quickserter which is really handy as it saves on having to lug around a Quickserter and cannula. They're much less painful when putting them in too. I do like the Mios, they are a rather handy thing to have instead of the Quickset cannulas (of which I still have a few lurking around the place). The main reason I got them was the colour. Yes, the shallow and sad bugger has only got them for that really. If I remember to, I'll put a picture up on here. Not likely but you have been warned haha.
Since begining pumping back in April of this year alot of things have happened. The best one diabetes wise is that my HbA1c has gone from 8.3% pre pump to 7.1% in four months. I have also got how to fill reservoirs actually sussed out (most of the time!) Overall, diabetes life is as good as it gets.

Thank you loyal subjects!

Sunday, 27 June 2010

Some late night ponderings on charitable doings for the future.

Well, last November saw Movember come around. That was growing moustaches for a prostate cancer related charity. I may well be doing the same but splitting the proceeds between a prostate cancer charity but, more importantly for me, JDRF. Me with a 'tache? Sounds wierd no? Oh well, it'll be a laugh and it'll generate a few quids for charity so it's a win win situation.

Thursday, 24 June 2010

Summer has arrived!

Now for those beach bums that are out there this is a very abnormal English summer. It's not raining. No, seriously, it's been sunny all this week. The temperatures have generally been at around twenty five degrees celcius. At work today we couldn't get below twenty five and a half degrees even with the air conditioning on. It must have been hellish outside.

Now, heat increases insulin sensitivity in alot of diabetics. I'm not an exception here. I've had several hypos because of it. The sensitivity increases because a raised body temperature causes something called vasodilation to occur. This is when blood vessels dilate to allow a greater volume of bloody to come into contact with surrounding tissues to disperse and escape the body thus keeping the body temperature at about thirty seven degrees celcius. What this means for insulin is that more of it is absorbed so the potency of what's in your system increases and sometimes results in hypos. Now when you're at work, and, in my case wearing a lab coat in a very warm lab this happens reasonably frequently. I cannot for the life of me work out why this is so. I just suppose that I can get there in the end by it's hellishly frustrating in the mean time. Thinking cynically here, this will help me to lower my HbA1C so it's a case of swings and roundabouts!

Now pasta. A food that I love but one that is a bugger to judge over how long I give my bolus for or for how I arrange my dual wave bolus for. Let's just say the first has been more successful than the second! However, tonight's story is a different one. I forgot to give my bolus for tea. Prior to eating I was at 5.7 mmol/L. I only realised this as I was looking at my pump to see how long it would be until I would have to do a two hours after a meal check. It showed me that my last bolus had been at 15:20 that afternoon for an ice cream that I ate to cool down at work. No bolus given for tea. Instant action of testing bloody glucose. I got a reading of 9.2 mmol/L. Thankfully pasta releases it's carbohydrate very slowly. I was lucky this time, if it had been anything else I reckon that I would have been alot worse off. Moral of the story, something to which I will almost certainly not adhere to is to check if I did actually give my bolus!

Next weekend will be bloody good fun. I am meeting with a group of raving mad folk otherwise known as fellow diabetics in that jewel of the south Brighton. This basically starts out with bloody good intentions but ultimately degenerates into a drinking session with a set of wonderful people. I'm waiting on the hangover and hole in the bank balance.

What I've also done this fine day is to order the forms for my provisional driving liscence. I'm going to be learn to drive this summer. It's high time that I did so. A word of warning, steer clear of the roads and pavements in Eastbourne. I may well be bearing down upon you with great speed in an out of control set of wheels. Look out!

Sunday, 20 June 2010

So it begins....

The holidays from university are here. Now, unlike the majority of other students who work over their holidays I will be working in a field that actually counts towards my degree and eventual HPC registration. This should be interesting. At the moment I am rotating through the four departments of the local hospital pathology laboratory. I'm currently in Histopathology and I've really seen a fair few eye opening things. I won't mention what I've seen on here for two reasons. Primarily patient confidentiality and secondly, decency. There are some rather unpleasant things that surgeons hack out and send to histology to be turned from a lump of meat into a microscope slide. Ultimately this will help with my eventual HPC registration and thus allow me to practise as a Biomedical Scientist in the realm of the beloved NHS. Some doubt my sanity in doing this but the way that i see it is that I have less time after university to faff about in and the learning is all done at a rather gentle pace. Ultimately this way takes a year off my training time after univeristy as I will have all that I need to be HPC registered done within a few months of graduation as opposed to a year or two of graduation. Maybe I'll travel after university or maybe I'll do a few years as a Biomedical Scientist then go into medicine. I really don't know. What I would really like to happen is for me to change the views held by the Army on diabetes and spend twenty five years as an officer. Some hopes but exceptionally slim ones. I'll do a separate blog post about that at a later date.

Saturday, 19 June 2010

The Battle of the Bulge...

No, for those of you that have the misfortune to know me in reality may think that I am blathering on about a certain punch up in the Ardennes over the winter of 1944 - 1945 but more over my university accquired beer belly. Nine months of eating what you want when you want, heavy drinking, laziness and a total lack of exercise other than staggering to a variety of pubs and clubs has, undoubtedly taken its toll. I'm two stone heavier than I was when I went to university. For those that understand the new money of kilogrammes I was seventy kilos before university and having just got back home I am now eighty two kilos. That was a hell of a shock I can tell you.
So what am I going to do about it you may ask. Well, for starters I am back at home. This means healthy eating and much smaller portions than my usual gargantuan university American sized portions. There will be more exercise too, dog walking will become part of my day and I will have to start going to the gym again. Let's not beat about the bush. It's going to be a long and hard journey to drop about ten or so kilos but still, let's just see. Who knows, a somewhat slimmer version of myself may be posting on here in a few months time.
Now for a Big Mac.

Wednesday, 9 June 2010

And he has a new shiny thing!

Beware you unsuspecting readers. I have a shiny new piece of diabetes gadgetry. It's a Bayer Contour USB blood glucose meter. I was given one by my DSN to trial things for them, my DSN who is also diabetic is going to give one a go too. Here's an interim review of the first day. This will have included a basal test aswell. Here's hoping.

Well, where do I begin. I suppose I'd best start with appearances. When you look at it there is a stonking great screen with three little buttons to the right of it. Then there is the cap that covers the USB point which you thump into the computer. The top is glossy black and the rest is a rather dull by comparison matt black. I'd be happier if it was blue though seeing as I got hold of it without paying a penny I'll shut up about that one now. That's the appearance dealt with.
I suppose the next thing to look at is the actual methodology of doing a test with it. It's pretty standard for a BG meter. Shove in test strip, apply blood and wait. However, after the apply blood step you can select if you want to mark the test in a certain way such as with a pre or post meal marker. Nice that. Then the result pops up onto the COLOUR screen after five seconds have elapsed. You then get further options for markers which vary from exercise through to illness and stress. Handy that when your memory is as crappy as mine is.
Then there is the computer related stuff. The charge time is two hours. I know that's a fair while but according to a friend this lasts her two months. After that which is a little of a let down there is the software which comes with it. For this sort of thing I am of the mindset that follows the KISS principle, no not the blood spewing, face painted glam rockers but that of Keep It Simple Stupid. Plain reasoning really as the less there is to be fiddled with or inadvertently changed the less there is to go wrong. It's quite something the Glucofacts software from Bayer. It's easy to use and fires up as soon as you plug in the meter. It's also bloody easy to navigate around and there are options that are simple to change and there is also the option to print the log book out which is lovely. Saves the somewhat lazy me from writing things out on paper or in Excel. This should work rather well with the Carelink software which I use in conjunction with my Medtronic Veo pump. Hopefully I will be able to save things as a PDF file or something similar to send them to my DSN when the mood takes me.
Now for the ancillaries. That would be the finger pricker. To me this comes across as cheap and nasty. In my opinion it's no way near as good as my Accu Chek Multiclix which I use at the moment. It only carries one lancet as opposed to the six carried by the Multiclix. It's a rather loud thing which isn't hard to make ready for use. Then there is the fact that as these things go it's rather painful to use. Much more so than the Multiclix again. Generally a pretty poor finger pricker. Next the test strips. They are rather tiny compaired to what I have previously used. There are pros and cons to this. The con is that they are a little hard to handle when you're trying to put one into the strip housing to test. That said, the fact that they are bloody tiny is the pro as well as the con.
A small word about the screen. It's in colour and rather large which is nice. However, if you are planning on testing outside on a sunny day as I did today be prepared to squint and create shade with your hands for it. Hands which aren't already occupied with lancet and meter. I think we all need to grow third arms for that.

Right, that's it as far as the interim review goes. I have just tested and got a lovel 6.4 mmol/L.

Friday, 28 May 2010

Hello again!

Well, things have happened since my last post. I have recently seen the DSN and had a good chat. At the moment I am trying to sort out my over night basal and that means the dreaded three o'clock in the morning test. What fun. Last night revealed I was at 11.0 mmol/L and I'd gone to sleep on a blood glucose of 8.6 mmol/L. This tells me that changes are needed but I think I need to do a few more of these spurious tests before I make any changes.
A few weeks ago I was having trouble with my post meal readings. That to me suggested that I was not getting enough insulin with my meals. So it's time to change and I have changed from one unit of Novorapid to every ten grammes of carbohydrate to one unit for every seven and a half grammes of carbohydrate and thus far it's been working well.
Summer has arrived. That means changes to insulin regimes which for me are an absolute pain in the arse. It seems, unlike most diabetics, I need more insulin in the heat as opposed to less. Shame that as I want to see how long I can make a reservoir last. The current is about three days but in reality I change every two days as I use alot owing to the fact I eat alot! That and my basal rates use a fair old bit. I like to change cannulas every two days because after that amount of time, depending on where I have put them, they get uncomfortable to have.

Until next time!

Sunday, 23 May 2010

Time to dust off this old tome again...

Well, we haven't quite reached the proportions of what I would imagine a tome to be but it's an intelligent sounding word so I'll run with that for the moment.

It's exam season at university so there is stress by the tonne. Thankfully I have my pump to help deal with this and the temporary basal rate function is quite something. The fact I can also give corrections as and when I need without having to ram a piece of surgical steel into me is quite something too. The bloods have been all over the place since going back to university for several reasons. Firstly there is the odd bout of the lurgie that I have had to contend with; a cold gets around a flat or even a block in halls quicker than a dose of dysentry does the rounds in an African village. Then there is that wonderful substance know as alcohol, arguably the cause and solution to all of life's problems. When I was on MDI I had pretty much sussed how to deal with the effects of a piss up. Now I'm on a pump it's all changed. I can feel a series of nights out on the lash coming up as a series of experiments to determine what is the best way to manage my pump and booze. Note to self: only visit RFC if absolutely essential, you DO NOT want a repeat of the last adventure...
Here's comes the point in time where I've lost my original train of thought. Not something too uncommon for me, it happens all of the time. I have been known to look at my passport before giving my name to someone as I even forget that from time to time. I jest. Ah, just caught onto the original train of thought. Food has something to do with how bizarre my bloods have been. The student diet as I know it (beer, pizza, beer, chips) is not what you'd call diabetic friendly. Oh well, I must do what I can. I think my basals still need a little work as summer has now arrived and that means it's now time to crack out the shorts. When I buy these things now I seem to look for pockets that are now large enough to accomodate my pump and all the other diabetes related crap I lug around with me.
I think I must draw this post to a close as I haven't a bloody inkling of what to write about any more. Well, until the next time we draw this somewhat untouched volume down from the shelves of the interweb!

Monday, 10 May 2010

Almost a month in...

So it's been nearly a month since I started pumping. Only another two days to go but still, I can't be bothered to write this post in two days time as by then I will have forgotten it.
Since I began I've had a fair few trials and tribulations that have included being ill and going back to university. Illness on a pump is easier to manage than on MDI (Multiple Daily Injections) by quite a way. I managed to have a fair few decent bloods despite having the lurgie! Basal rates are the next issue. I am getting closer to the bull now. Just a few more tweaks and basal tests will see me on the home straight as far as the basal goes. It's quite incredible the difference that 0.05 of a unit will make. It's quite the tool this pump and I will be able to achieve much better control with this than I ever could with MDI.
If I didn't mention in my last post, I've had an HbA1C done. In effect that's a long term blood glucose reading to gauge how well I've been looking after myself in the past few months. Pre pump it was 8.3%, after three weeks of pumping it had dropped to 7.8%. Quite the change. I've never been able to get my HbA1C below 8% on MDI. I just never did happen.
Every day I learn a little bit more about pumping and the little tricks you need to use to make everything just so. For one I have had a few issues with bubbles when I've been drawing up my reservoirs. On a wonderful message board ( I use I was given the excellent tip of letting them stand over night before I load them into my pump. The rationale behind this is that the bubbles will, over night, rise to the top of the reservoir and form one larger one which can easily be expelled when you prime the pump. Another tip was to use insulin that had been out for a few hours to get it to room temperature. All nice and easy after a few goes.
For today the BG's have been near perfect. I woke up on a 5.4, then before breakfast got a 4.4, before lunch I was 5.2. I still need to tweak the basal a little, the need for that is demonstrated by the 4.4 at about eight in the morning when I had breakfast. Still, I'm nearly there which is good!
Until next time...

Monday, 3 May 2010

Where I go I do onot know, I only know the places I've been...

Well, I do believe that I have banished the lurgie from my system. Just in time for the visit to my lovely DSN tomorrow. The only reason I know it's gone is because the bloods are back to what I would consider normal. I was awoken at about half four feeling a little bizzare today. Checked the blood, lo and behold I was hypo. A lovelt 2.4 mmol/L to kick of the day with. Treated and in the process I demolished the biscuit box. Then went back to bed and slep until nine ish... When I arose for the second time my blood was at 11.9 mmol/L. Oh bugger. Apart from that and one other hypo the bloods have been quite good this fine day! Been employed at the family home painting my old room and shifting stuff around. What joys.

Now to update the blood glucose diary for the lovley DSN who is also a type one. What's even better is he uses a pump. I even work in the same hospital that I'm treated at so all is pretty fine and dandy at the moment...

Sunday, 2 May 2010

Beware the evils of cheese on toast...

What is says in the title. I had an out break of a craving for cheese on toast just after I got into bed last night. So I gave in a made some. Bloods were 7.8 mmol/L before bed. I woke up at half six this morning with bloods of fifteen. Where's the damn justice?! It's not as if I didn't take insulin for it. Anyhow I corrected and went back to sleep until half ten. Enough time for the insulin to do it's job. When I re emerged I had a blood glucose of 8 mmol/L. Not bad. I've corrected that as I want to get it down to six before I go and stuff my face with a pie at lunch.

I might just go and do some work now...

Saturday, 1 May 2010

The dreaded lurgie!

Well, over the past few days I've had the lurgie. It's brought about massive raises in blood glucoses and some cravings for cheese on toast. Yes, you heard me, cheese on toast. With ketchup. I think I'm over the worst of it and the lurgie is getting to being out of my system. Tonight won't involve staying up until one in the morning to chase down a high blood glucose. That's for two reasons; primarily the last time I looked my blood glucose was near ten millimoles per litre and was dropping. Secondly and, more importantly, I can't be arsed. Oh the joys of living with diabetes. At least things are getting back to normal, well as near normal as I think they can be at the moment. Time to get some shut eye before I head home tomorrow for the bank holiday weekend and hopefully no more lurgie! Roll on home cooking...

What a night...

Well, last night wasn't pleasant. Two hours after stopping snacking (for which I had bolused appropriately) my blood has rocketed to twenty point one millimoles per litre. Disaster. I shot in seven units with my pump and sat up until one in the morning waiting for it to come down. By one I has dropped to nine point two millimoles per litre. Within two hours I was hypo. Oh the joys. So I do my usual thing of destroying the fridge, again I bolus for all the unnecessary stuff I ate. I woke up at eight this morning to a bloods of fifteen millimoles per litre. What fun. So I've jammed in a correction and put on a temporary basal of a hundred and thirty percent. I wish whatever it was would hurry up and get out of my system or get it all over and done with. Maybe I need to change my insulin to carbohydrate ratios. I don't know. This is all really getting to me.


Friday, 30 April 2010

Now Bond, this is your new pancreas, I want you to treat it better than the last one I gave you...

Hello! Long time no speak dear minute readership! Well, I am now live on my pump and have been for just short of three weeks. It's quite wonderful. The first few days were nigh on perfect in terms of blood sugars. Now that any traces of that horrible thing Levemir are out of my system a few changes have been made. I've upped my basal overnight as I've been waking up on blood glucoses of ten millimoles per litre or more. Hopefully a basal rate of one point one units per hour from nine at night to seven in the morning will sort it out. Tomorrow will be the judge of that and the jurors will be the next few days. I hope my nurse doesn't mind that I've upped things without consulting him. Fingers crossed it works though. I can't say how good this thing is at helping me deal with the amounts of stress that I've been under. It's quite something to not have to give injections on a daily basis. I now just get issues with the cannulas and reservoirs to entertain me in the place of injections! I now have funding and that has been cleared with the lovely folk at Medtronic. Tuesday will see me ordering a load of stuff to stock up on for the next few months.
I really can't describe well enough what this means for me. It's given me something to focus on so my life now has a little more purpose than it used to given what's happened over the holidays. It's also given me the tools to use in getting that wonderful thing known as the HbA1C (glycosylated haemoglobin) down below eight percent for the first time in years. I'm sort of dreading the first post pump start HbA1C that I will be getting around next month.

Don't say I didn't warn you that this blog would be a somewhat erratic journal of my diabetes! So far I think this has come true! Here's to the next HbA1C and the next post... Whenever those may be!

Monday, 5 April 2010

All stop for news!

Comrades... Pass the vodka! Welcome to Mother Russia!

Damn it, again, I'm thinking that I'm in another country all together. Well there is certainly news here. First things first, I've got my pump. My shiny new Veo. Well, after today it's not looking as shiny and box fresh as it was. That would be due to a bout of gardening that ended with me leaning on a brick wall to scrape mud from the old booties. I'd quite forgotten that I had my pump around on my back and quite unprotected. I've now got some lovely scrapes and gouges in it. A rather nice one on the middle of the screen. Bugger. One upside is that it was going to happen sooner or later. It now matches it's owner a little better I do believe as it's not so box fresh and looks a bit used and not so clinical now. I like this new look.

As of last Friday I've had a cannula in me. This is the type of one I will be using when I go live in a week. People have asked all the sort of predictable questions such as "can you feel it inside you?" and so forth. The answer is no. I can't feel it and I've certainly forgotten that it was there at times. This morning's run in with the garden wall would certainly demonstrate that I do believe. Quad erat demonstrandum, to those of a non classical bent such as myself that means "which demonstrates the point in hand". Quite a nice expression there I do believe.

I've had to serisouly fight the temptation to go live without the care of my wonderful team so far. I just can't wait to get this all on the go and banish the daily use of the five millimetre surgical steel 31 guage need for a long time. I'm already in love with this thing and quite frankly I really do believe that it's the way forward for me. Hopefully I've got the right kind of mindset and character required to do this. Here's hoping. I do know that things like this don't suit everyone. I would advocate the use of a pump but for some people it just isn't the way to go about managing the old evil Diabetes. Like I've said, for me it's the best thing I think.

Time for a few pictures....

Saturday, 13 March 2010

CGM Day Two...

Well, last time I had this contraption on me I could barely sleep and was obliged to lie in a feotal position on one side. This time I slept like a baby bar waking up at two AM, I still can't work out why so I tested my blood and got a 4.8 mmol/L so I just went back to sleep. I got out of bed at half eight and my blood had only risen to 5.5 mmol/L. That meant breakfast time. So it was a case of a sausage buttie which was wonderful. Two hours later that had pushed my blood up to 10.7 mmol/L but that had just dropped to 6.0 mmol/L prior to lunch. All in all, the day is going well. I can't wait to see what the graphs are going to be for this. Shortly I'll be off out to Sainsburys to get hold of a few pizzas as I'll be interested to see the effects of one of those on my bloods. Sloppy Guiseppes here I come! That and I do need to get some food in for the next few weeks...

Friday, 12 March 2010

CGM Happiness...

Well, as of today I am wired up to a CGM (Constant Glucose Monitor) for the next few days. I unplug from it, so to speak, on Tuesday. That's half an hour out of work then. I've already baptised it with bloods around the 10 - 11 mmol/L mark. Fingers crossed my lunch time correction has sorted it all out for me.

Insertion was achieved using a mechanical device and was virtually painless, this is much better than last time around. Last time, I couldn't even walk a hundred metres with it attached due to a huge itchiness emerging from the site. This time around I've been walkign all over the place and I'm about to pop out to post a card to my Mother.

Wednesday, 3 March 2010

This place is familiar!


Nope, sorry, wrong party conference! I do believe that I have some good news! Despite all the dicking about that I've done with my Levemir doses my HbA1c has only risen by 0.1%. It's now 8.3% and what's even better is my cholesterol has come down to 3.9! Drinking... Mmmm beer. I was out last night and got shit faced rather earlier than everyone else and was thus denied entry in that establishment known to Brighton inhabitants as Coalition... Remind me not to drink on a next to empty stomach again! I do believe I should have had a pizza prior to that one. But hey ho, at least I was up in time to go to my lab class at the satanic hour of nine in the morning!

My new dose of Levemir is currently thirty six units taken at eight in the evening and it bloody well seems to work! For the past few days I've been waking to bloods that are perfectly in range. Now I'm going to ruin that all with a couple of cereal bars....

Sunday, 21 February 2010

Highs and hypos another day in the world of diabetes...

So I went out last night. I had a good old half pound burger and chips on the way home. It was probably rather foolish of me but I did dose for that. I mean I was sober even after four pints and a shot of that confounded thing known as Jaegermeister. I suppose my liver doesn't like me enough to keep chucking out glucose when I need it at the same time as metabolising alcohol. I rolled back in to my flat in halls at two in the morning and was in bed by three. I woke up at seven thirty with a blood glucose of eighteen point nine millimoles per litre. Damn it. So what did I choose to do about it? Well, standard procedure really. I gave seven units of Novorapid. Then I went back to sleep until midday. The joys of being a student. I woke up to a blood glucose of nine millimoles per litre. Not too bad I think. Then I decided to go shopping in the afternoon. I got back after a massive shop (spent only thirty three quid!) and decided to have a pint of apple juice and a few chocolate digestives (dark chocolate I'll have you know.) A few hours later I've had the wonderful thing that's a hypo. I suppose I should be grateful for the fact that I actually felt the damn thing. Two point eight millimoles per litre isn't pleasant. I do belive it's down to the glycaemic index values of what I ate after the shop. I reckon that the insulin hit and took out the rise but after that things just dropped right down and down into hypo. Frustrating is it not? I'll bloody well say so. At this current moment I'm procrastinating about work and munching on my tea. Typical bloody student. I must depart as the episode of Wallander that I have up and running on BBC Iplayer beckons...

Saturday, 20 February 2010

The promised update...

Well don't say I didn't warn you. This is the update that I promised last night. After correcting a blood glucose of fourteen point five millimoles per litre I thought that would be it and it would gracefully sink into the acceptable range. Sod's law being Sod's law dictated otherwise. About an hour and a half after taking the correction I dropped into a hypo. I know a three point nine millimoles per litres isn't a bad one. I just took a fair few glucose tablets and went back to my bed time reading (for those interested it's on the greats of laboratory medicine, yes, I did print a load of things from a rather good website to read) and then promptly turned in for the night. You'd have thought that would have been the end of it wouldn't you? It turned out otherwise. I awoke at two in the morning lathered in sweat and feeling distinctly hypo. Upon testing with my blood machine which has a glow in the dark screen I found my blood glucose to be at two point six millimoles per litre. Not good. Prompt action ensued and I was munching on glucose tablets and toast like there was no tomorrow. I even got creative; for some reason I sprinkled sugar onto my second piece of toast. Who said diabetes doesn't have it's highlights? Devising rather wacky toast related concoctions at two in the morning makes for great fun if you're hypo! That did have consequences which bit me when I woke up this morning. My blood glucose was thirteen point seven millimoles per litre. Not the best thing to start the day on but I suppose that id does beat being hypo, but not by much let me assure you.

Time to be getting on with two things, a piece of coursework and then the odious practise that is reflective learning which I must do alot of over the next few years and possibly my career. Bugger.

Friday, 19 February 2010

PT good for you, good for me!

And so the song goes in that Stanley Kubrick epic that is Full Metal Jacket... My point is that I've just thrown myself into a gym for the first time in a very long time indeed. I thought this would help me get control of my bloods but it seems otherwise. I had a rather sugary cup of tea before walking to the gym as part of my warm up. Before I exercised my blood was 13.0 mmol/L. Afterwards I thoght that getting a level of 10.9 mmol/L was a good effort and that it would either stay around that mark. Seems I was wrong. In the fifteen minutes the bus took to get me home my blood went up to 12.0 mmol/L prior to tea and by fifty minutes ago it was 14.5 mmol/L. Needles to say I am rather miffed. I reckon it's down to one of two things. Firstly, I may still not be getting enough Levemir at night. It's still quite the possibility. Secondly I may have hypo'd and not noticed it. Damn hypo awarness. I've corrected for that but I do believe my bloods are rising. I'll be checking again soon. I'll give a progress update then. Fingers crossed that it's better then.

Friday, 12 February 2010

Bloody silly thing that...

Some of you may know I've been gradually reducing my dose of basal insulin. Well, a few days ago I reached the small dose of twenty two units. It's ended in tears to be frank. Highs over the past couple of days. This evening has really hammered it home, I've got strong ketones. I've just doubled every insulin dose I've just taken and I've chugged three pints of water. Hopefully that'll sort things out. I do feel bloody stupid for all of this. There's no way around it, it's self inflicted because I've been a stubborn fool.


Thursday, 11 February 2010

Further late night musings...

This is somewhat frustrating. I reckon because I was half an hour later on my evening Levemir dose my bloods have gone high as a kite. Well, not that a blood glucose of fourteen point two millimoles per litre is dramatically high but after a day of semi decent bloods it's out of no where. The story is as so thus far. Before tea (comprising one massive steak manwich as my flatmate Max calls it) my blood was five point four. At nine o'clock it was eleven point two. Half an hour ago at eleven it was fourteen point two. I mean I corrected the eleven point two with three units. Did I hypo and this is my body lashing back at me for that? I mean my hypo awarness isn't what you'd call great and it means I miss hypos that are between three and three point nine millimoles per litre. Perhaps that's what happened? I really don't know. Though I am more than happy to put my money on that one. It's hugely frustrating. I've hypo'd once already today and I didn't enjoy it. Twice is not good. I just want to sort things out with this damn basal insulin and not to have to fiddle with things again. I mean seriously, this is getting beyond a joke, I can't do anything right it seems. Not a single damn thing. I really don't know what I can do. I suppose just hope and see how it goes.

Here's hoping...

Tuesday, 9 February 2010

Well fuck me sideways...

What a monumental fuck up. Yes I said a MONUMENTAL FUCK UP. I Mean seriously, this is really getting on my tits. First the absolute dogs breakfast of letting me know when my pump start dates were and about my choice of pump. That's a whole other can of worms which will just get me in a rage tonight. That is not needed at all. Now we have this royal balls up.

The impression I get from the most recent e-mail from my DSN (today no less) is that they want to push me towards getting a Roche Spirit pump. In my opinion this is a wholly inferior device to the Medtronic Veo that I want to con out of my PCT. I get this impression for several reasons. Primarily that they state that Medtronic are not willing to provide the consumeables for me to have a trial period on the pump I want whereas Roche (sputum filled wank socks) are actually willing to provide me with the consumeables. Both companies have provided my team with trial pumps but that's beside the point, what good is one without the gear that goes with it? Still unsure of the answer dear reader? Here's the answer in a nut shell. A pump without consumables is fuck all use to anyone. My team cite their second reason by saying that they have yet to work with Medtronic in starting a patient on a pump. I mean it sounds like they have a serious phobia with this, a phobia almost on a par with Jeremy Clarksons fear of manual labour (though that is brought on by him being bone bloody idle) unlike my team's phobia being brought about, as I see it, by a fear of progress or someone wanting something different. Their third reason is that if I were to have a trial pump (yes, the Spirit made by Roche) it would mean I would have to then apply for the latest version of the Spirit (this one has a blood glucose monitor that doubles as a remote control for the pump) and isn't what I want. I leave the worst until last. My team, yes, this is the team that once stood very highly in my opinion, HAVEN'T EVEN FUCKING WELL APPLIED FOR FUNDING YET!!!! That's the worst part as they've already booked the dates with the Medtronic folks (I now fully expect them to recant that promise) and they've bloody well known I've wanted that model of pump since last bloody year!


I am absolutely disgusted by the conduct of my team and cannot really fathom the thought processes that they had to go through to come to this point.

Friday, 5 February 2010

Time for a colossal moan...

So I'm a student. It doesn't necessarily mean that I'm Gordon Ramsay, at least not in culinary terms. I swear like him on a good day. So last night I had a mild bout of food poisoning. Damn sausages. By consequence my bloods have been all over the place and I had ketones when I woke up. Oh the joys. I ended up phoning the DSN so I could have a quick natter with her about it all. In the end I've sent her my spread sheets. It also turns out the the new DSN I'll be getting when I go onto a pump is also a type one, he's also a pumper. Finally someone who can empathise with me. That should be damn good.

In all, today has been a day of bad bloods and ketones. So much fun for all concerned! Like hell. I also got all of my prescription from my local dealer with nothing left as an owing! That's a rare occaision!

Thursday, 4 February 2010

Basal issues once again...

Is it bloody impossible to find a dose of basal insulin that holds me at the right levels over night? It seems that I am asking far, far too much at the moment. Whatever I do I wake up with my bloods in the teens and It's hugely frustrating. I know from some testing I did a few days ago that my blood glucose drops further into the night from about eleven onwards. I think the one solution is, over the next couple of days, to stay awake until three in the morning. This is to find out if, according to the theory, I am hypoing or dropping too low at the point of the night when blood glucose is lowest. I do believe that I am getting too much insulin. The DSN's advice of increasing until I find something that does work didn't work. I had much the same problem a few years ago and the result was terrible bloods across the board. It seems that my nurse won't believe me. That's due to the fact I don't present with the typical symptoms of low blood glucose over night. I mean there are generic symptoms for something but not everyone presents them in the same way, you catch my drift? I do believe I did hypo last night. Waking up a sweaty mess is not a nice thing to do at two in the morning but yes, it did happen to me last night. If only I'd tested my bloods. If only.

Whinge over for now.

Tuesday, 2 February 2010

Food for thought....

You know when you have moments that really just do leap out and grab you by the throat? Well, I've had something along those lines. I've just watched the Richard Dimbleby Lecture on BBC Iplayer, the perennial curse that destroys the degree aspirations of many first year university students. I digress. The lecture was given by Sir Terry Pratchett a celebrated author as I'm sure you all know. However, what many don't know is that he suffers from a rare form of Alzheimers. The subject of the lecture (that was in the event given by Tony Robinson - someone to just about everyone remains Baldrick - due to the fact that because of Terry Pratchett's form of Alzheimers means that he has trouble reading aloud) was that of assisted suicide, or as Mr Pratchett likes to call it, and I'm with him on this one, assisted death. I don't want to be morbid in this post but the topic does intrigue me and it is a rather fascinating subject and one that is the subject of what are rather ironically dubbed "healthy debates".

I feel the need to make my position on that subject rather clear. For me assisted death should be an option to people who understand clearly that their quality of life would be lesser or would make their life somewhat pointless (apologies for the way that I sound rather callous but these are my feelings on the matter and I'm bloody well not changing them to suit those that disagree with me) or just if their life meant that they could not live per se. My own opinion requires that I give you a scenario. Say that however far down the line it may be I am so ill that my quality of life is so impaired that I cannot carry out basic tasks or I cannot enjoy my life as fully as I could I would much rather slip away with some dignity rather than remain alive hooked up to God knows what. I would rather slip into that great unknown which is death rather than live out death in a hospital bed unable to move or live without medical intervention. Given the fact that I am a type on diabetic - a condition which has a large number of complications that can prove fatal or reduce life expectancy - I am pro assisted death in a manner not too dissimilar to Mr Pratchett's. Should my quality of life deteriorate to such a level that I was unable to care for myself and require vast levels of medication I would much rather take myself in my wheel chair and wheel myself over Beachy Head, a favourite for those bent upon self destruction in England (those that come from London the service from Victoria is hourly and rather good. The expense of a return ticket is thus avoided) I just hope that they have by then installed an arch at the top of the cliffs and a skip at the bottom to make life or the lack of it much easier for all concerned.

I think I must draw this to it's conclusion that assisted death should not be stigmatised as it is. Those seeking a premature end to avoid suffering later on should not be denied the end that they desire. There is in my opinion, nothing nobler than to be allowed to choose the manner of your own end, to meet death and the Grim Reaper on your own terms. Dignity should be considered right unto the end. I do believe that the legal provisions necessary for assisted suicide to be legal should be made.

I make no apologies for being morbid and slightly fatalistic but the purpose of this blog is for me to put across my unadulterated views about many things, not just those related to diabetes. I suppose in abstract this could be seen as related to diabetes. I leave it to you to work out.

Monday, 1 February 2010

Some late night musings...

Well, going by my clock it's one in the morning. What sane induvidual remains out of that wonderful thing called a bed by choice at this time??? If that were the standards by which we judge insanity various genii would be defined as insane. I suppose there has to be a touch of insanity with genius, I mean look at Einstein's hair!

I suppose the point of this post is to whine about insulins. Granted things have come along way since the days of two jabs a day and no glucose monitoring bar the occaisional venous sample sent to the labs or some such but I still like to moan, people should be worried if I stop moaning rather than if I start.
For instance, I would dearly love to meet the pharmacist who developed Levemir. I acknowledge that the art of creating something like that is one that takes many years to master but when you're dependant upon a drug that doesn't do what it says on the tin I suppose one has the right to be somewhat miffed. I would dearly love that my Levemir (which, for various reasons has been the root of alot of my troubles) did last the whole twenty four hours that the manufacturer says it will. I've been on split doses of that insulin. It wasn't pretty to say the least. During the course of my carbohydrate counting course I gradually worked out that the split dose wasn't the way forward. The result was a single dose of levemir. That had things down to a fine point which worked so damn well. Until I went to university that is. I started playing around and this made my life so much harder than it needed to be diabetes wise. I made too many changes over a short space of time without any proper thought, just the desire to see good numbers in the screen of my blood machine. The good news is that things are back on track now though. I'm getting the basal sorted. My nurse's advice of increasing the dose until the numbers got better turns out to be complete bunkum. It seems I was getting too much and I make the loose assumption that this was driving me into a hypo, my pancreas dumped a load of glucagon into my blood stream which caused my liver to dump a load of glucose into my blood stream. This was happening without me noticing sadly so thus went undetected. At least I know what was going wrong and I'm in the process of sorting it out.

My second whinge of the night. Now I've recently bought some weights to help stave off the advance of the student beer belly. It's badly needed. I like a bit of a work out here in my room in halls. The one bugger to this I have discovered is that weights cause my blood to rise sadly. It seems that during weights my body kindly releases adrenaline which has the knock on effect of causing glycogenolysis to occure in my liver. To those who haven't got a clue what that is this is the process by which the liver breaks glycogen - the storage molecule for glucose - into glucose and dumps it into the blood. I suppose this is an evolutionary aide to the fight or flight response of the sympathetic nervous system which would help a caveman to leg it from an angry bison that went by the name of Lunch. What this evolutionary survival aide means is that weights cause my blood glucose to rise, this then leads onto me having to give a correction which annoys me sadly. I admit I want good control but that means lots of jabs. I want to have good control but I want to balance that with my desire to minimise injections. High bloods mean corrections but that's wehn my mind splits into two parts. One says jab to get better control so things won't go wrong at a later date, the other says just leave it to sort itsself out. Hard to choose isn't it? I feel obliged to go for the former of those options. I like my sight. Granted sticking a piece of surgical steel into your abdomen isn't nice but given the possible consequences many years down the line I think I'm willing to do it.

One more thing, for all you dear readers there will be a guest post popping up sooner or later. I'll get around to it when I do.

I get the feeling I've written a right old essay. I hope you've got the patience!

Sunday, 31 January 2010

Hello...My name is Tom and I'm an insulin addict....

Whoops, took myself to the wrong place there I think!
Seriously though I love this wonderous stuff that I am obliged to pump into my system at regular intervals everyday. I haven't heard of a free drug dependency with none of the nasty side effects and such regular health checks...That said I do rather envy smackheads for being so damnably thin! If memory serves me, the first use of insulin to treat Diabetes Mellitus (sounds posh doesn't it!) was eighty eight years ago. Two gentlemen by the names of Banting and Best walked into a ward in a Canadian hospital and administered the first insulin to be extracted from animal pancreases to comatose children who otherwise would have been killed by that friend of us diabetics which goes by the name Diabetic Ketoacidosis or DKA for short. I guess the reason I'm writing about this is because as part of a series of lectures I've had for a Biochemistry module we were obliged to learn about ketone formation; more precisely the circumstances under which they form. In essence they are formed either in the absence of insulin or when starving due to a variety of factors. I suppose what I'm driving at is that even highly educated university lecturers with doctorates to their names are ignorant of the full truth that diabetics are obliged to live with. Now, although I didn't turn up to the aforementioned lecture I did read the notes and revise for the test that I sat on Wednesday. What the lecturer failed to acknowledge is that ketosis occurs in diabetics and it can easily morph into DKA and a trip to A&E where the medics, God forbid, may not know of it. Five years at medical school and you'd sort of expect them to be able to suss out what's playing up ("Doc, my blood pH is going down and my breath smells of pear drops, that's normal isn't it?")
Time to cut to the chase I feel. This is but one example of the ignorance that diabetics such as myself have to deal with on a day to day basis. Sometimes I correct them because I can be bothered, however, most of the time I just simply cannot be bothered to do that because I know that I may aswell be p*ssing into the wind on occaisions. I wonder how may people get like this. Ignorance might well be a never ending path for us diabetics to walk down come rain or shine but some of us get further than others. I'd like to think I'm sort of getting there, eventually that is. Then again ignorance can be compaired to knowledge which is the ever expanding horizon and learning which is the endless march towards it. All in all, I suppose that there are some who will when they stand corrected will bear that in mind. That said, there are sadly those that will remain unchanged no matter what we tell them.
Talking of those induviduals, my bloody know it all aunt starting grilling me at a family get together over the festive season. Normally I'm happy to answer questions about my diabetes but that night something about her was just rubbing my up the wrong way completely. She spotted that I'd jabbed using two different pens at different points in the evening. What I suppose she wanted to know was rather specific. That said, she didn't ask what my two pens had in them and what the difference between the contents of those pens was, all she asked was why I had two pens. Nothing else. My Mum saved me some embarassment by getting me to explain what the difference was. I recall we then went on to talk about insulin pumps and my then anger at my care team for not telling me sooner that because of my choice of pump I would have to wait until April to start on it, not as I then believed January. I think my little sister boldly tried to defend my team, lovely people though they are, they could have damn well told me. I shouldn't have had to ask for that information myself. As I recall that bloody know it all aunt backed out (very wisely in my opinion, seeing as I wasn't really in the mood to tolerate any kind of sh*t from her) of joining in the question and answer session on diabetes chaired by yours truly.

I think that's all of it out of my system for the evening...Maybe...

Rather new and exciting blood glucose monitor....

I've just gone and bought myself a rather new blood glucose monitor a few days ago. It's an Accu Check Aviva Nano. Admittedly, to the uninitiated this will sound to be a rather dull and trivial matter; it is however of something of great importance to diabetics. You see we reckon if we are lumbered with what we are we may as well have some fun along the way. Spending a few quid because I was bored has had some rather good consequences. This Nano is absolutely tiny. I thought it's predecessor the Accu Chek Aviva was small but this thing is half the size. Think the One Touch Ultra but half the length but twice the width.
I love this little thing because it has ways for me to mark out pre meal bloods, post meal bloods and other things. I can also set reminders in the form of alarms on there. It also does averages of the aforementioned blood glucose readings over seven, fourteen, thirty and ninety day periods. There's a photo somewhere in this post, the more knowledgeable of you may just clock onto the fact that I've not yet mastered this joy that is blogging! The reading in the screen of the Nano in the photo is something that at the moment I dream of!

Tomorrow I may well write a piece about the pump I'll be getting my greasy palms on in April. Who knows if I can in all honesty be arsed to write about that tomorrow. Two posts in one day is enough for any man.

Here goes...

Well, that time has come. I've started to blog about living with diabetes. I've sort of been looking for an outlet for my feelings about living with it other than the odd forum that I use and MSN conversations.

I suppose I'd best tell you all a little bit about my life thus far with diabetes so here goes. Back in the dark old days of nineteen ninety six at the age of five I was taken to the GP. I don't know what it was that my parents spotted but, Mum and Dad, it was a bloody good call. I recall peeing into a cup for the Doctor (this man was excellent. My successive GP's are nothing compaired to him.) From what I'm studying at the moment I now know what he did. I'll leave that to your fertile minds to ponder. The next thing I can remember is being in hospital with a nurse coming at me with a bloody great syringe. They got me to doa blood test aswell with, what is by my standards now, a geriatric blood glucose monitor. I have some memories of my Grandfather who was there with me and my mother having to do a blood test first. From that day onwards my life has seemingly rotated around injections of insulin and blood tests. First it started out as two injections a day. Then three. Then four. I'm at the point now of taking as many as I need bar the pre meal insulin and basal insulin. That said, jabs all end on the twelth of April this year as I get my hands on a nice and shiny insulin pump. I'll be getting hold of a brand new Medtronic Veo. For those that know what an insulin pump is I won't bother to explain. For those that don't know JFGI (Just F*cking Google It.)

I feel I need to say a little bit about myself other than the fact that I'm a type one diabetic and have been for fourteen years.

I'm a student studying for a BSc honours degree in Applied Biomedical Science degree in sunny south coast of dear old England. I suppose having diabetes has influenced my choice of degree course but there was something else that contributed to my choice! I suppose the point of this blog is to relate as many of my diabetes related experiences to those in the wider world who can be bothered to read. I love my music and have somewhat eclectic tastes. I go from good old Elgar right the way through to metal by the Swedish metallers Sabaton. Beer in my eyes is better than water but with the D you can't be too careful when substituting the good old water for the amber nectar that is served in a pint glass.

Here's hoping I remember the passwords to get into this for the next post!