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...

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.

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.

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.

Tom

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...

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!

RAGE!!!!!!!!!!!

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.

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!

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.

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.

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!