What's new pussy cat? Whooooooah ooooh aaah ooooh!

Well hello there! My, my things have changed in my life since the last time I took up the pen, metaphorically speaking at least.

So what's happened? In terms of things that have happened, things can be grouped into several categories; university, work and health. So let's start at the top.

 University

As for uni, too much isn't happening on that front. I have finished my year but I have to resit an assignment which is something of a pain in the arse but it needs to be done. I just wish I'd got it right the first time around. I've had to drop out of my elective module for health reasons which will become more apparent when I discuss them in more depth later on.

Work

Well, at last I have some paid work. Hip, hip hooo bloody ray. I can now earn a few things and start turning what is a decidedly Grecian financial situation into something more usual. My first pay cheque rolls in on Friday. It's already promised elsewhere but  at least I shall have it.
I also now work for a rather large voluntary movement which is well known world wide for it's humanitarian aide. Love it.

Health

This is where we enter slightly sticky ground. In terms of diabetes things are doing ok, even though I am in a little of a rough patch that needs a bit of tweaking to sort out. Now for the main event.
Since my last blog, I've had a lot of fun. As you may recall, I did take anti depressants for a little while to help me through a pretty crappy time of my life. I've been clear of them about three months now which is rather nice. However, since I came off them I had some rather unpleasant abouts of palpitations. For those of a non medical mind, these are defined as an awareness of one's own heart beating. A pretty wide definition but one none the less. I saw my GP who is absolutely lovely. We did an ECG. From the GP's ECG it turns out I have something called Wolff Parkinson White Syndrome. This is a pre excitation syndrome resulting from an accessory pathway. I won't explain it all as I am sure that you are all able to find the Arrhythmia Alliance's website and it has a good deal of information about this.
About a week after this diagnosis, I ended up in A&E which wasn't a pleasant experience to be honest with you. The last time I was an inpatient was in 1999. Things have changed a lot since then. The end of it was is that I scared the living daylights out the charge nurse with a BP of 175/95 and a heart rate of 130 - 140 when I was being triaged. What ED thought is that I didn't have Wolff Parkinson White. Odd to say the least.
I've since been seen by a cardiologist who has said that yes, I do have it. I will get around to uploading a picture of my ECG when I can, no promises. The plan is for a procedure called Electrophysiological Studies (EP Studies) with a view to an ablation. More information on the Arrhythmia Alliance's website. The trouble is, that I will be the first pumper that this particular hospital will have ablated. I can't wear a pump into a cath lab as X-rays are used to guide the placement of a catheter. I feel a sliding scale coming along. However, my consultant hasn't mentioned anything about this so I shall have to go to him and sort this out. Watch this space.

Overall it's been an interesting few months. More to come and more interesting things to come as well.

Here I am! Rock you like a hurricaaaaaaaane!

So here I am, checking in again after an emotional post a few weeks ago. It's been fun folks!

What have I been up to then? Well essentially university which has caused various nervous break downs due to having to prepare and give an assessed presentation on cancer recurrences with a case study. Stress central. I've also had to re arrange a placement as university assigned me a daft one which would have been impossible. So I am now in an environment that I am enjoying but is vastly different to what I am used to. Being able to give one to one care and do a proper job is fantastic. More on that at a later date. 

Having taken citalopram ( a selective serotonin re-uptake inhibtor, an anti depressant) for the better part of a year I decided that as I was running our of medication it was a reasonably good time to come off the damn things. Yes, since I came off them I have been having my moments, as you know from my last post. However, slightly more worrying were the palpitations and dizziness that have been and gone over the past two weeks but have since come back this evening. I did go to the GP who I am rather fond of as she is absolutely lovely and tends to give me what I ask for, you might see why I like her. Back to the palpitations, I have had them every so often which I first associated to the withdrawal from the citalopram. That said I have seen the GP about this. My heart sounds are clear, I've had a listen as well just to satisfy my own curiosity. I have however got to go for an ECG on Monday which will be interesting. I've asked that I get a copy sent to me and the GP is happy to do that. That'll come up on here when I get it. 

On a diabetes related note, I found a box of silhouette sets I didn't know I had in a drawer. Result!

Emotions

Those of you that know me will know that I am not one to readily expose my emotions. In fact I am somewhat reticent to for many reasons. Here is me doing something that I usually don't really do. I want some form of catharsis. 

Many of us know the numbers. Chances are, you are that one in four. One in four persons with diabetes will develop depression to some extent. I am that one in four. The twenty five percent. I am the depressive in the room. 
I suppose that I might as well start from the beginning, the beginnings of my mental health issues that is. 
This post will upset. I don't care about that. For me this is the catharsis that I need.

Three years ago this month I lost my Dad in a particularly traumatic manner. Well, I won't try and hide it. My Father killed himself in a park near  where I worked and where I have many fond childhood memories of. I suppose this is where the over bearing theme of the past three years originates from. To say that the eighth of April 2010 was a bad day is something of an understatement.

Over the next eight or so months I struggled on. Partners both helped and hindered during this time. I was also unemployed for two of those months which didn't do great things for my mental health. I dropped out of my first university course. I found a job. I found a girlfriend. The girlfriend left me. The day to day rigors of diabetes. The day to day rigors of twenty first century life. All took their toll. I am still counting the cost.

In September of 2011 I started a new life here in Oxford. I started the life of a student nurse. My chosen career is something that I can only look back on in happiness. Although there have been many ups and downs through the past two years, I wouldn't change it. I am truly fortunate in having found something that makes me so very happy and that I also happen to get paid for when I qualify. Nearly two thirds of the way through the course, I am scared that I will soon be solely responsible and accountable for many things. The foil for this is that I love and enjoy every moment of my job. 

Diabetes has always played quite a part. I started pumping on the twelfth of April 2010. I don't regret starting to do this then. At the time it gave me something to focus on and direct energy into. To keep me busy and not too think too much. What does rankle somewhat is that I am now attached to a machine to keep me alive. Every minute of every hour of every day of every week of every month of every year. If there is something that does an exceptionally good job of telling you that you have a broken body part yet counters this by helping me keep what nature has challenged me with in decent check then this is a good thing. I have my ups and downs. I suppose every diabetic has these. I would suppose that I have these more so given the somewhat traumatic events of this month three years ago. 

A lot has changed since I started to use a pump. My weight has shot up. I was about seventy five kilos when I started pumping and I am now ninety five kilos. Quite the change. My body has stretch marks in all the usual places that weren't there three years ago. My mind has been to some very dark places that I never thought I would find myself in three years ago. My stomach is a patchwork of scars from where I have used various infusion sets. It is a canvas of haematomas from sets that have gone bad or went in badly and hurt like hell. It has bald patches where the infusion sets have torn hair from me. 

I am not the happy go lucky young lad that I was three years ago. I am a world weary cynical twenty two year old who is somewhat suspicious of humanity. I haven't really let people close to me in the past three years. Only lately have I started to let people back close to me. You know who you are if you're reading this. An air has blown into my heart these past three years. I have been down a happy highway yet I cannot go there again. There is a land of lost content within me. I see it shining plain. No matter how much I try, I still see it. I still wish I was there. Despite all the good that has happened in the mire of crap that I have had to deal with over the past three years I still yearn for that place where I cannot go again. 

I am a slave to numbers. Blood glucose readings. Basal rates. Bank balance. Exam and assignment results. HbA1c. Average pre meal blood glucose. Post meal blood glucose. You will learn by the numbers that I will teach you. Most of the numbers are to do with diabetes. Something I didn't ask for. Something I was lumbered with. I play the game that it brings me to. I play it not for a season's fame. Not for a ribboned blazer. I play it so I can pass on the torch that burns on as brightly when it was tossed to me. I try to do this no matter how charged with punishments the scroll. No matter what comes against me. I still have to carry on. Because I have no choice but to. I cannot win this game. I can only draw it. Diabetes seems to have it in for me. Deep within me there is something that has clapped a hand upon my shoulder and sent me into bat in the dimming light. To play the game. To keep me going. Whatever this reserve is, I am grateful for it. It keeps me going. It rallies my ranks of wearied mind and body parts. It gets me out of bed to face the day.

Mental and emotional health are quite something. We know the numbers. I am the twenty five percent. I resent the way that diabetes has helped to take those away from me. I hate that of all my memories diabetes has been present the longest. I cannot recall life without it. I know no different . It has taken much from me. It continues to take. 

But I carry on. I carry on because deep within me is something that rallies me. Something that makes me carry the torch. To hold it with pride and carry on. Today hasn't been a good day. Tomorrow may well be better. I just have to take things one day at a time I suppose. I carry on because I know nothing else other than dogged determination. The drive to see me through is still there. I will see everything through. I will not fall by the wayside. I will stay even with the challenges of diabetes and my other mental health troubles. Today has been a low point. Tomorrow will be a bit higher.

Back seats

So, as you can probably guess, diabetes and I are once again strangers. I've decided to let it take a back seat in my life again. As you wonderfully astute readers will have observed, I am a student nurse. This means I spend a bit of my time on placement. Well, a fair bit of my time. Diabetes often takes a back seat when I'm working, unless I am hypo or in urgent need of a set change. My job comes first and I love it. I often experiment with temporary basal rates. Usually what seems to work is a a temporary basal of approximately fifty five percent. When I eat I tend to have a large meal and give a slow bolus over an hour and a half or so. That does work in the short term. In the long term however, it means that I delay a hypo until later in the shift or for when I get home. I'm currently working out how much I can reasonably reduce the bolus so I can get the correct balance simply because diabetes is a life of compromise.
Like I said, I do love my job and frankly I relish every day, well most days that is. On this placement which is a private surgical ward I am less busy than I am within the NHS which I have now fallen even deeper in love with I still get on my feet and make things to do because I cannot abide being idle and sitting on my arse end. Therefore I make work for myself. I can also take my time doing things which I might not necessarily have had in the NHS. That said, please, please send me back to the NHS.
So diabetes has taken a back seat. Yes I am struggling a little bit with it at the moment thanks to being back on shift work and season related changes but it's nothing too dramatic. I'll stand by for a bollocking from my consultant but hey, she's a decent old bird so she will understand. I think I might also see the shrink that is attached to my team as well, I think it's about time because I am getting more than a little tired and apathetic towards my diabetes. I suppose that this is just an occupational hazard at the end of the day. I reckon all diabetics go through ups and downs in relation to their mental health. Statistics would have me believe that diabetics have a raised chance of acquiring depression, one in four diabetics also have depression if memory serves. Ah well. Let's see how this goes.
Interestingly, I have yet to meet my new DSN, despite being under this team for about a year. I know, I'm a terrible slacker but I think I'd best get on with it sooner or later. I suppose I'd better get my arse in gear and actually touch base with this lady.
Before my wonderful dementia (I hasten to add I am self diagnosing therefore to be taken with a pinch of salt, well bucket of salt) one of my modules at university takes you through the journey and experiences of a patient. It takes into account the anatomy and physiology, pathophysiology and the current evidence based treatments for it. The next module I believe may well cover diabetes so I have offered my services to the leader of the current module to do the patient based part of it as we have had some wonderful people with the conditions being lectured upon come to share their experiences. Most notable was an HIV positive woman who was wonderful. We all loved her and felt humbled by her. Maybe I'll be able to do the same. Who knows.

Until the next time dear proletariat!

Up date!

So my module leader got back to me and my email. He said they'd be greatful for my experiences. I'm more than happy to share. 

Rememberance

As it's now November the nation's minds begin to turn towards those who gave their lives in service of their country. Many British servicemen have made the ultimate sacrifice for my country over the years. Please bear with me, I do have a point. 
In nineteen seventeen Frederick Banting graduated from his medical school in Toronto. As many will know, the First World War was raging at this time. Banting was immediately called up to serve his country, Canada, who made a massive contribution as part of the Commonwealth Forces.
As a young medical officer Banting saw and dealt with the horrific realities of war. Something that my generation will not have to deal with on a similar scale. For heroic actions despite being wounded himself Captain Frederick Banting was awarded the Military Cross for his bravery. Here's the citation which gives the details of his heroism:

Military Cross - Deed of Action

 

Captain Frederick Grant Banting

13^th Field Ambulance, Canadian Army Medical Corps.

 

Near Haynecourt on September 28^th, 1918, when the medical officer of the 46^th Canadian Battalion was wounded, he immediately proceeded forward through intense shell fire to reach the battalion. Several of his men were wounded and he, neglecting his own safety, stopped to attend to them. While doing this he was wounded himself and was sent out notwithstanding his plea to be left at the front. His energy and pluck were of a very high order.

 

Canada Gazette, Vol. 53, Part I, 1919: July-September. Supplement, p. 13

 

Now to many people who live with type one diabetes such as myself, Frederick Banting is a hero for his life saving discoveries. Please remember that there is always another side to a person. Here is Banting's relatively unknown heroism.

 Lest we forget.

 

 

In Flanders fields the poppies blow
      Between the crosses, row on row,
   That mark our place; and in the sky
   The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
   Loved and were loved, and now we lie
         In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
   The torch; be yours to hold it high.
   If ye break faith with us who die
We shall not sleep, though poppies grow
         In Flanders fields.

 John McCrae 1872 - 1918  

 

I'll be home for the summer...

So I'm back at my Mum's for the summer. This means many things. No I am not going to be slobbing around and simply sunning myself. Funds do not allow this despite due to the economic circumstances this country finds itself in meaning that there's bugger all work going. So instead I am making myself useful at home. My project for the moment is sorting out the garden which is a bit of a tall order but I'll get there.

Due to summer temperatures and such like I am having to alter my basals quite dramatically. My total basal dose is no 28.85 units in twenty four hours. This is because I have been hypoing massively and constantly due to heat and working hard in the back garden (back yard for your septics that may read this). I've worked out the temporary basal that I need and that's about 10% for the duration of the gardening and a bit of time after it. I also leave a little off the meal bolus I have before and I give that over a half hour to an hour so that it isn't all in my system at once and that means I don't drop like bat out of hell. I have been doing through enough glucose to keep the manufacturers in business singlehanded.

Other than that it's chill out, try not to let the diabetes kill me and enjoy life. At the last look in July my HbA1c was a wonderful 6.5%, however this is due to a few too many little hypos but still, given my line of work that is inevitable to be honest with you. On a work note, I saw and participated in my first cardiac arrest. That half hour or so will stick with me forever.

Until the next time, well, whenever I next remember the password to this place!

Injections

I had a bit of a struggle remembering my password to get onto this place. Time to blow the dust off the damn thing.

So as you all may gather, I am a student nurse. This means that I get to give injections. Yes, lots of injections. The usual poison of choice being deltaparin, a heparin based anti coagulant used in DVT prophylaxis.
Despite having been injecting myself in a bid to stay alive for the past fifteen years it feels rather bizarre to be harpooning people on a regular basis. Be that a sub cutaneous injection or an intramuscular one. For those of you that don't know what those are, go and look them up.

It is a rather strange and taboo feeling that I've had to over come since starting my nursing degree because it is quite normal to me to give myself an injection but to give someone else an injection? This isn't what I am used to. Then again, many people are not used to the reverse of that situation. Strange eh? IM injections though aren't bad at all. I quite enjoy them. I have two to my name. That's due to many medications that used to be given as an IM medication being now given intravenously.

Not really the priority at the moment I must say.

Well yes, congratulations for working out quite how I feel about diabetes at this moment in time. As I say, it's not what I'd call my priority. I've got bigger things to worry about. There's far too much going on outside of diabetes for me to really give a damn about it. Yes I am keeping an eye on it but not too closely. Things are working well with the pump and all that. I've had my blood results back from the clinic I attended a few months ago and all is well on that front. I'm quite happy with it. My albumin was a little on the higher end of normal but none the less it was in range so I'm not worried at all.
So why am I not exactly giving diabetes my full attentiong you might ask? Simple really. I have exams to prepare for and assignments to do for my university. These take priority. Thankfully there is nothing to do with diabetes in these things that I have to do. Also I don't want to give diabetes my full and undivided attention. If I do that, it has won. It'd have me by the short and curlies. I suppose this is me exercising a greater degree of contol other than ensuring that my BMs are spot on and such like. I'm quite happy to bumble around at the moment safe in the knowledge that I don't have to be a slave to diabetes. I don't want to burn out is the simple thing.
At the end of the day, the diabetes is behaving itself and I am getting on with my life surprisingly enough. I suppose it's just to show that unlike some schools of thought would suggest, diabetes does not have to become your life. Frankly I couldn't think of anything worse.

Update time of the month.

What's new pussy cat? No, I won't impersonate Tom Jones. I cannot sink that low, oh wait, I have. Balls.

So, in theory I am on holiday from university at the moment, however, I've stayed on a little to crack on with an assignment. I love it as it's on cardiology. I'd hate to have to do another on diabetes again. Something that really gets me and bugs me every time I have to deal with it in a professional capacity. Thankfully this essay is one I'm really getting my teeth into and fascinates me. What's more is it doesn't have the same impact upon me in terms of emotion and such like.

In terms of diabetes I've had a little of a rough patch for reasons that I can't fathom. A few entertainingly high BMs and multiple cannula changes combined with correcting by a syringe. Things are now back on track thankfully. I'm sure my time on placement and the raised number of hypos, albeit minor ones has helped balance out the highs. Essentially I'm just plodding on and making the odd minor change to my basals. I think a little weightloss that has happened over the past few months has helped render me a little more sensitive to insulin and caused the need for a reduction in the amount of basal insulin that I require. Quite nice that.

Summer. Well, it is only April but we've had a fair old bit of sunshine. This brings with it the joys of making seasonal adjustments to my insulin regime. If memory serves, the logic behind becoming more sensitive to insulin when it's warm is that the heat causes vasodilation (expansion of the blood vessels) to bring blood nearer the surface to disperse heat by evaporating sweat. This also seems to increase the rate at which insulin is absorbed and used by the body resulting in a few more hypos. Something easily ironed out with my pump. Thank God for technology.

Overall it's going nicely here. I can't whinge. Too much.

Bugger!

So the first set that I put in my arm about an hour ago went tits up. Yeah, not quite planned. It turned into an intramuscular infusion as opposed to a sub cutaneous one that it needs to be. I have another one in now. This time in my right arm. I was kindly aided in the insertion of the set by my trusty Spencer Wells artery clamps which are very good at helping you reach the flab on the back of your arms that you just can't get to with fingers. Who said bingo wings aren't useful? Let's see how this bastard thing does.

A link to a little about my trusty Spencer Wells :

http://www.sciencemuseum.org.uk/broughttolife/objects/display.aspx?id=5515

Infusion sets and boldness.

I have just put in a new set. I put it in my arm. I've heard of people doing this before but I've never quite worked up the courage to do it myself until now that is.

Anatomically speaking it's in the flab around the deltoid/tricep muscles. I don't think the layer of flab is quite as deep as I thought it was as it's little uncomfy but nothing too bad. I need to give my belly a break which I've been using non stop for nearly two years now.

I shall post when I take the thing out of my arm.

Putting the damn thing in was a bit tricky. I am quite used to doing these things with two hands. One hand was quite something else. I think you really need three arms or another person to do it if you want it done quickly and effectively rather than the fifteen minute battle I had to get the thing just where I wanted it. At least it is now in and well, it's a case of watch and see what happens. More when I see it.

The set is a Medtronic Sure T with a six millimetre cannula with an eighty centimetre tube. Not bad at all really.

A cause for celebration?

Given that I use a message board for diabetics I seem to read a lot of things, if I don't post much on there as well, I have very little worth reading.

One that sort of got me a little irritated was the thread about the Joslin medal schemes and such like awards for "long service". Link at the end of this.

I can't quite put my finger on why having a medal for fifty years of diabetes irritates me. I suppose it's effectively rewarding something that has taken a fair chunk from me. I can understand the fact that through the past years I've had to deal with something that I didn't get any say in other than take the medication or die. What I don't need is a reminder to say how long I've dealt with that crap. The less it intrudes into my life the better I say.

I deal with it enough on my own, my diabetes but anything other than dealing with my own diabetes is a little bit on the side of hard. Given that I am a student nurse, I see a lot of diabetes and it's consequences, both good and bad. I don't want to celebrate something that has come close to killing me and endangering my life. It's as if I were ceding ground to an enemy, taunting it, red rag to a bull sort of thing, tempting fate. Coming away complication free and healthy is reward enough. I don't seek praise for living with this. I don't want it either frankly. Having someone bestow a medal upon me is, the way that I see it, effectively a pat on the head and saying "who's a brave boy." Praise will be due on the day a cure is found for everyone that has made it that far. I doubt that I'll be around when a cure comes along. The standard excuse is "in ten years there'll be a cure." My arse.
At the end of the day I didn't get the choice of whether or not diabetes came into my life. I don't want to celebrate that I've had something forced upon me that has made me change my life, has take so much and will continue to take from me for the rest of my life. I will cling to whatever vestiges of control that I can. Diabetes take and will take more than enough from me. I don't want to stop and stare. I want to move on with life and enjoy it with minimal intrusion from diabetes. I won't give anything to it. I won't let it win. I acknowledge that I have this and I must control this to stay in decent shape. However, if I stop and celebrate it I let it win a little victory. It's like being burgled and then when Her Majesty's Constables have nicked the scrote who turned you over you invite them over to tea and give them the run of your house with you sat blindfolded on the sofa.

In the fell clutch of circumstance

I have not winced nor cried aloud.

Under the bludgeonings of chance

My head is bloodied yet unbow'd.

Link:

http://www.diabetessupport.co.uk/boards/showthread.php?t=4170

All I want for Christmas...

So what is it I want for Christmas this fine year? A functioning pancreas would be a little too much to ask of modern medicine. That said, I can ask for a CGM. Despite the NHS hating funding such things (adults with CGM funding are like rocking horse shit) I am going to badger my new consultant for one when I meet him next year. This will enable me to use the function that a Medtronic Veo equipped with sensors calls low glucose suspend. Do your reading. This'll make my life much easier, especially managing my diabetes as a student nurse. I am currently on placement. Although I am not doing badly in terms of managing my diabetes, I could be doing a lot better. Simple. Too many hypos for my liking. Oh well, I shall wait and see once I have booked the appointment with the new chap who is meant to be quite good.

Also what I don't want is to be a diabetes specialist nurse. In all honesty I don't want to devote myself to diabetes any more than I have to. I deal enough with diabetes in my role as a student nurse on acute general medicine in my hospital. I can't face dealing with it any more than I am already. I know we need more DSNs but I can't be one of them. I need time out of diabetes. I dish out insulins, other diabetes drugs such as Metformin and well, I don't like to have any more input than that and perhaps making suggestions. I don't want to deal with it every second. It'd drive me even madder than I already am. I do use my knowledge to benefit my patients though. I won't waste it. I just don't want diabetes on the brain 24/7.

Assignment related blues

So I am now a student. What's scarier than me in fact being a student is that I am a student nurse. Yes, run for the hills. I am now vaguely responsible for health related things. I say again, run for the hills.

Now when anyone goes to university the first assignment that is set can be something of a daunting prospect regardless of what you are studying. When I tried my hand at a degree in Biomedical Sciences the first essay and lab report caused a lot of stress and such like. Now I'm training as a nurse my first proper assignment is causing a little bit more than that. This first assignment is on diabetes. Yes, diabetes. Not exactly what I wanted to do it on but I have to so I carry on and read all the things I need to then write the essay. I thought I had a handle on my diabetes and the psychological side of things. Believe you me, diabetes isn't just a case of taking the insulin, checking your blood glucose and carrying on. Far, far from it. Diabetes manages to seep into everything that you do. For example, whenever I leave my flat I am never without my BG meter and testing supplies, glucose tablets and well, my pump which seems to go everywhere with me. You can't just leave diabetes in the key rack it would seem. When I go for a day at university I end up with the usual BG kit, glucose related stuff. I also end up taking a vial of insulin and syringe should my pump go Pete Tong and the stuff to change sets with. Sufficient to say that this gets to me from time to time. I'd love to have a chance to walk out of the door and not to worry about anything diabetes related. Not to have a pump in my pocket, no BG meter and glucose tablets... Enough of that. Back to the topic.

Yes, my first assignment is a series of questions and miniature essays on diabetes. Both type one and type two. Now this would be very interesting for me were I not diabetic. Given that I am it's a bit depressing. Although it is the cold hard facts of diabetes that we are studying it is damn depressing learning from a book what can and has gone wrong with my body. The statistics make for damning reading. The complications. Sitting down and looking at pictures of ulcerated feet. Charcot's foot. DKA. Effects of diabetes on pregnancies if poorly controlled. The intimacies of a buggered pancreas. The mood swings. Highs and lows in blood glucose.

I suppose that I wouldn't be a fully functioning human if I didn't get a little upset by all this. However, this just brings back memories of the scare stories that I was told as a small child in an effort to get my to look after myself. Back then they didn't mean a thing. Now, at the ripe old age of twenty one, they do mean something. The possibilities of what can go wrong are just scary. Knowing full well what can and probably will happen if I don't put in the effort now. Knowledge is power apparently. This stuff has the power to scare me shitless.

Doing this damn assignment has reinforced how diabetes seeps into everything that I do. I live, sleep, eat and breathe diabetes. This is just to stay alive and hope that through hard work now I do not develop complications when I am older. This takes a toll. I can deal, just about, with this. Now being obliged to study this in a bit of depth is my bridge too far. It makes you think about everything. I live a normal life, I am lucky. However, I have my own sword of Damocles. All I can do is let it out, purge myself of the feeling that this brings up. Try and work it all out. I'm still doing that. Diabetes doesn't sleep like me, neither do the emotions that it awakens.

I draw my strength from many sources. At the moment I have a poem written out on a piece of card that is stuck to the shelf over my desk:

Out of the night that covers me,

Black as the pit from pole to pole,

I thank whatever gods maybe,

For my unconquerable soul.

In the fell clutch of circumstance

I have not winced nor cried aloud.

Under the bludgeonings of chance

My head is bloodied yet unbow'd.

Beyond this place of wrath and tears,

Looms but the horror of the shade.

And yet the menace of the years

finds and shall find me unafraid.

It matters not how straight the gate,

How charged with punishments the scroll,

I am the master of my fate:

I am the Captain of my soul.

W.E. Henley - Invictus

Long time no see!

It's been a while since I last posted on here. Things have been a little manic to say the least. In September I helped my Mum move house so I was packing boxes and the like. Then unpacking them. The joys. Excellent effects on my BGs as I spent a lot of time hypo. Oh well, a lower HbA1c... Cynical but true. A week after moving house in my home town, I moved to university. A case of find the boxes that I'd packed the week before, unpack them then repack then. What a bugger.

So, I am now at university. Horror of horrors, I am a student nurse. Yes, you heard me, a student nurse. I wear a white tunic with turquoise epaulettes and black trousers. Just so you all know what I look like and can run when you see me. Hang on... If you see me you might not be able to run. Well, you can run but you can't hide mwhahahaha!

I managed to survive fresher's week relatively unscathed. Thankfully I have been to university before so I had a good idea of what was coming my way and therefore could work that to my advantage. University is great fun. That said, the first assignment is on diabetes. Yes, diabetes. I am not best pleased. I really don't want to do two and a half thousand words on poxy diabetes. I live with it all day, every day. I don't want to spend any more time dealing with that. However, I must remain professional as I will be facing diabetes a lot as a professional so I must learn and be able to apply that knowledge. I have insider knowledge which helps but also hinders me. Damn broken pancreas. I suppose it's time to rise above it and get cracking with it all.

I am due to start placement in two weeks. For any student nurse in my position, that's to say awaiting the start of their first placement, I am naturally bloody terrified. I am lucky in the fact I have worked as an HCA and sort of am prepared for the challenges of hospital life. I also know what will be coming towards me in terms of diabetes. Given I used to work on a rather busy trauma and orthopaedic unit a change would be nice, a slower pace with more time to care and, of course, a lessened impact on my diabetes. Overall, university is a damn good place.

This weekend, I went to something called Friends For Life. I went last year. In essence this is a gathering of parents of children with diabetes, adults like me with diabetes a few nutters are thrown into the mix too. The children/teenagers are taken care of during the day by a team of wonderfully dedicated staff, many of whom have diabetes themselves. Many of them are about my age and have also grown up with this crappy disease. The adults wander around a series of talks about diabetes given by a wide variety of experts in the field. This year we were very fortunate in having Fiona Campbell and Pete Hindmarsh who are wonderful paediatric endocrinologists who work in various parts of the country. I just wish I'd been one of their patients when I was a kid (that sounds wrong given that I'm only twenty one) as the care that their patients, and not just the children themselves receive. My paediatric care was abysmal. I shall say no more on that matter as we will be here all night. I may also develop murderous rampages. Ragnar Hanas was also there. He is a leading endocrinologist in Sweden and he really knows his stuff. He has been playing with diabetes since long before I was born. It is amazing to hear what it's like from the other side so to speak.

I also attended a talk about technology in diabetes given by INPUT which is a charity designed to improve access to insulin pumps across the UK. Granted that it was very good advice, however it was a bit dry. I can't win them all I suppose!

The best talk that I attended by any stretch of the imagination was Jo Soloweicyzk's talk about teenagers with diabetes. It's my annual kick up the arse/morale booster from a man who has been playing this game for fifty years. Yes, fifty. I think I'll listen to him any day of the week. I shall remain in contact with Jo as he is simply fabulous. You really need to see him to believe him.

I suppose the reason that I go to this thing is to provide some reassurance to the parents that their children, whatever their age, will be fine when growing up. To be asked those questions that if you haven't grown up with diabetes you won't know the answer to. The fun of going to university. The risks of drinking like a fish. How to advise their kids on how to deal with booze. My advice is simple. Teach them what alcohol is when they're you, that's either a glass of wine with a meal or something like that. A beer or two with Dad whilst watching the rugby. Note to parents, this is not an excuse to hark back to your youth, taking your children clubbing is frowned upon apparently. I can't see why... Please, don't let them go to university and the like without a clue of what booze can do. A&E is a scary place to be. Especially on Friday night. The diabetes also complicates things. The trolleys aren't that comfortable either. Life is a rollercoaster, just having an idea of what you're getting onto means that you are going to be safer. Like Elliot Joslin said, the diabetic who knows the most lives the longest. Joslin was around when insulin was first discovered and was a leading endocrinologist whose principles still ring true today. It's also very nice for me to give something back to the diabetes community, at the end of the day I am a resource and it'd be a shame to let it go to waste.

At FFL there are also various companies who sponsor the event. Medtronic, Animas, Lifescan/One Touch, Roche, various charities and diabetes related businesses. I've bagged myself a free new BG meter called the One Touch Verio Pro. There will be a review coming along when I get a day to trial it. I had an interesting conversation with the Animas team about their latest and greatest toy the Vibe. Cue dirty laughter here. Fnar fnar. I will post more on that as and when I get it.

Overall FFL for me is the fun side of diabetes. I can set aside whatever troubles I have with it and go and enjoy myself for a weekend (the breakfasts are also a very good reason for me to go) and meet like minded nutters. It's also nice to give something that I never had as a child growing up with diabetes. It give me a huge sense of satisfaction. It's also an excuse for me to dance very badly at the halloween bash they hold. This year I was a doctor. Yes, scrubs, stethoscope, the works. Here's until next year FFL!

I've been lazy and camping...

So my last post was the first of last month. Look who's been a bloody idle one eh?

Nothing too dramatic to report really. I've left my job so I can go to university in a little over three weeks from now. My nursing degree starts on the nineteenth of next month. This is strange. I'll be a student again.
As for the diabetes, well, things have been a bit interesting. I've had a hatful of dodgy cannulas. I seem to have a knack for finding the viens in my abdomen, that or my cannulas have the idea that heading for a vein is the best thing to do. A few days ago I had that happen twice in a row. I was not best pleased to say the least. There are things that need looking at. For example I need to see if I'm either hypoing and rebounding which is sending me high at about eleven in the morning or whether it's my insulin to carbs ratio that needs checking. Looks like I'll have to get myself in order for a three in the morning until midday basal test. Yawn. I had things rather nice up until a few days ago.
Camping. Yes, camping. I've done a bit in my time but this one was different. It was with my Mum and sisters. We were living in a caravan for a week. Diabetes wise I was pretty good despite large amounts of food consumed. The one real issue was a failed set that went tits up in the early hours. I didn't spot that until later in the evening. Not a great idea. Other than that it all went well.
Normally at this time of year I start to get letters inviting me to attend a review clinic at the hospital where I'm treated. Sadly I've a very strong feeling that I'll get those letters when I've moved to university and thus won't be able to attend. It is a bit of a trek from Oxford to Eastbourne and back. Let alone the cost of the train fare. Oh well, I'll call them again on Tuesday as Monday is a bank holiday. Sort out something. More news on that when I get it.
Humalog. Yes I like it. The new poison is very much welcome. It's not overly different but the psychological difference that the change has made is quite something. That and it's acutally easy to draw up a reservoir for my pump from the humalog vials.
That's all for now folks. I'll post more sooner or later.

Tom

A promised update

So, a few weeks ago I started using Humalog as opposed to my usual Novorapid. Since I started using it there have been alot of things going on. After a nice little bit of a few weeks of things going all sweetly things have now gone a little sour. It's irritating that since I got back from a nice two week holiday where things were pretty good (if with it's off patches) it's all gone tits up. Over the past few days I've had massively uncontrollable bloods. Highs that I've not seen the like of since my pump went out of comission more than four months ago. The like of these highs has been something spectacular.
Now I don't get upset about the occasional high. Far from it. However this time is different. I've been getting upset about it all. I can't find any reason for the highs that I've been getting. I feel fine and I'm totally well. As a result I've got to run a temporary basal of a hundred and forty percent and loads of corrections to maintaint decent control. It's really getting to me. I'm just so fed up with it all. I want out. End of moan.

A fraught few days

A few days ago I started to use Humalog instead of my usual poison, Novorapid. It's been a bizarre few days. On the Humalog start day (H day) I woke up to a fifteen point something or other. Not a pleasant way to start the day. I was obliged to correct my BG and leave it a little while until things were back in order. The second day was one with near perfect BGs. Yesterday was the first day at work on Humalog. A very nice day. I suppose the success were more attributable to me getting the temporary basals right. Then again, Humalog does feel like it is a more forgiving insulin than Novorapid was. My insulin to carbohydrate ratio is the same. It doesn't seem like I need to tinker with that as yet. Thankfully.
Today hasn't been too bad. Well, It could be worse. I was fine when I woke up at three this morning (BG of 7.5) but when I awoke a few hours later (ok I got up at ten) I had a 12.7 which was something of an irritation as I've been going to bed on decent levels and waking up very close to the level I went to sleep on. Secondly I thought my pump was going to pack in. Fortunately it hasn't packed up. After a bolus not going too well because the pump was giving off very unpleasant sounds I phoned Medtronic. After a rather panicky conversation with the lovely woman at the end of the phone it has been found that all is well. I've just changed cannula and gorged on ice cream. I can't be arsed with testing my BG for a while now. I just want to get today over with! That and I just want to forget diabetes again. Some bloody chance.

What's your poison?

All ready for the morning...

A little while, when I last saw my DSN (see post The King is dead, long live the King) ago the decision was made for me to switch from Novorapid to Humalog. I picked up the first vial of that today. Tomorrow is the big day as I've got enough in my current tank to last me until tomorrow morning.
It'd be fair to say that I'm a little nervous of this change to Humalog. I suppose the change is a good thing. At the time the decision was made I was having a rough time of it on the Novorapid. True to form, things are now behaving prior to the big switch. I'm more scared of having to make changes that I suppose will be needed with a new insulin. Just as things were getting good.
I'll make the change tomorrow morning. New reservoir, new set and, most important of all, new insulin. I suppose I'd best start with a completely fresh everything really. I'll be using a Sure T set as well, those just don't fail unless you're really, really special. I've yet to meet someone whose skin has caused a steel cannula to kink.
What the more shrewd amongst you may notice is that I've filled up a reservoir. The change is more than twelve hours away. I always pre fill my reservoirs as I find that I get fewer bubbles left in them if I leave them to stand and the bubbles dissapate. It's like leaving a pint stood at the bar for too long, all the fizz goes. Not desired in beer but most certainly desire in my pump reservoirs.
I'll put something else up after a few days on my new poison. This'll be interesting as I wonder how long it'll take for the dregs of the Novorapid to get out of my system and for the patterns of the Humalog to make themselves known.

I had a good day yesterday!

Yesterday I had a day when my BGs were pretty much perfect. I'm still trying to work out how I did it but more on that later as here are the scores:

09:44 - 6.7
10:25 - 6.5
14:16 - 8.5
20:23 - 6.2
23:15 - 5.0
23:45 - 4.8

I'll be buggered if I know how I managed to do that so here's what I did in the day.

Woke up at quarter to ten then went back to sleep until half ten. Massive breakfast of beans on toast smothered in cheese. Arse around and watch TV.
Quarter past two I ate lunch. Two rather large sandwiches and a monstrously sweet cup of tea. I used a take on the super bolus way of doing things. I gave my usual bolus for the carbs that I had plus a small correction to take things down then I put on a temporary basal for an hour and let it roll. I wandered into town to go shopping after that. It's not usually a BG friendly activity as I tend to get rather stressed and fed up with shopping after all of five minutes. I managed to waste a few hours and eventually (after much swearing and moaning) but eventually got what I wanted. Then I went to the pub and chilled with a few friends who I used to live with last year. a few pints of the great Sussex relaxation aid Harvey's Sussex Bitter. God I could live on that stuff.
In my last post I moaned about how things just weren't going overly well. I suppose I just needed to kick back and live life without diabetes being at the helm. I suppose the point that I'm trying to make is that whatever we do to stop diabetes from getting to be the forefront of everything it still manages to get there from time to time. That's when we need to step back and take a miniature holiday from the D. Well, I say a holiday I mean taking it easy for a little and doing anything to take the D from the front of my mind. I reccomend a few pints of the aforementioned Sussex relaxant. Does the job everytime especially if you choose to take it in the sun and beautiful surroundings of a pub garden. Always needed.