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.