Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!
Friday, August 6, 2021
Quack, Quack!
Thursday, July 29, 2021
The Path To Pumping - Pt.1
It must've been during one of the last Diabetes appointments for me at my old clinic, before I threw my toys from the pram and transferred all my care to my GP, because the memory of the event is very hazy. The numbers weren't looking great, I wasn't feeling great, volunteers were wandering around and making small talk - which added to my tension and it was waiting room temperatures in there.
"We could try you on a pump"
Have something attached to my stomach? 24 hours a day!? The idea was dismissed by me immediately and probably not in the kindest of tones to that HCP. What an idiot.
Here we are, probably 20 years later, and I would crawl through fire to trial an insulin pump. In fact, what I've agreed to do might feel like crawling through fire but I'm going into this with an open mind, a clean slate, no judgements... at least none that I'll verbalise until it's over.
I got pump-curious after meeting so many #GBDoc folk, hearing their stories and wondering if that might work for me. I've carefully listened to their joys and woes and after many tweets and many messages I decided to make some noise about it to my consultant. We'd spoken about it in 2019 but my A1c was great, I wasn't really struggling with anything which might make pumping a priority and I felt the appointment time would be better served by bringing up Libre access. So it proved, although Libre funding wasn't straightforward and took some intervention by Prof. Partha Kar to make it happen.
This time! There will be no name dropping, string pulling or threats (just kidding). I'm going through the process as an ordinary Diabetic. I am, after all, an ordinary Diabetic as I've mentioned many times. I'll create a blog for each step of the process in moving from MDI to pumping, you'll hear about everything and this is Part 1.
The conversation with my consultant went exactly how I want every appointment to go. I know that I'm doing alright, I'm getting by, and once that had been confirmed I brought up the subject. I know it's not a case of ask and you shall receive with the NHS. The money pot is not an endless one and criteria has to be met and I think that's fair enough. I'm not here to abuse the system. I genuinely think pumping could take my T1D management to the best place it could be and here is why:
- Dawn phenomenon
- Impaired hypo awareness
- Injection burnout
- MDI & CGM (or Flash) use has reached it's limits in improving my Diabetes management
and a quick look at the details for those four points? Sure, okay.
There is only one Phenomenal Dawn and that's @MoodWife. Dawn Phenomenonononon is really annoying and has begun happening to me more frequently despite Basal changes and tweaks. It's affecting my Time In Range and increasing my average blood glucose level and, of course, my HbA1c.
My hypo awareness is cancelled. In the last 5 years, I've gone from feeling hypo at 6mmol (when my BGs were too high) to feeling hypo at 4mmol (Yay!) to feeling hypo-ish at 3mmol and only having the strong feels when the number is low 2mmol. Worrying stuff, right? I'm glad I'm CGM'd up to the eyeballs and that I have alerts for falling BG otherwise you may have seen dramatic images of me in hospital. My hypos tend to happen when I'm asleep and my alarms usually wake me. However! sometimes they don't until things are very urgent. Worrying stuff again, right? My overnight BGs are a mess and it would be wonderful to have a pump provide more stability.
I inject at least 7 (SEVEN!) times per day. That can rise to 10 if things are really bouncy! and I'm becoming increasingly tired of the burden of it all. The idea of changing a canula twice in six days, compared to possibly 60 injections in that time, sits very pretty in my mind. That would represent a huge decrease in my Diabetes burden and a better QoL.
My overall management of my condition is very good. "You have very good control", said my consultant. I know, I'm kind of a big thing. I have many leather-bound books and my apartment smells of rich mahogany. 60% of the time, it works every time... I'll stop with the Anchorman stuff now (watch the movie and think of me). I know that I'm doing alright but I know it could be better. It can't be better with my current therapy. That can only happen via technology or I will likely suffer from burnout by trying any harder.
So, those points were put across and! it seems I'm good to go... good to go to DAFNE. Remember earlier when I mentioned crawling through fire? That's right! It's DAFNE time. Deep breaths. I know that it's been a great thing for many of you and in the interests of peace and ticking a box and being an ordinary Diabetic, I'm going to go through with it. And that's where I am, right now. I'm waiting for the call from the DAFNE lady, who I really hope is called Daphne, to begin the training process. When that happens I will publish Part 2. I bet you couldn't be more on the edge of your seat.
Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!
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Sunday, July 18, 2021
Representation
Diabetes in the public eye has to be a great thing, right? A diverse representation of all types of people can only reduce division, hate and normalise disabilities, including Diabetes.
Coronation Street got the Type 1 ball rolling a few weeks ago and last week Pixar joined the Diabetes party with a character in their Turning Red movie, seemingly wearing Diabetes devices. Both great things for Diabetics, particularly the Coronation St character as it appears they'll be focusing on the condition more than the Pixar movie's passing nod towards it. I hope the Coronation St character will be allowed to develop in the coming years and the difficulties of living with T1D are brought to the public attention, at least the public who still watch that particular soap opera.
Beyond the recent TV and movie rep', I've been thinking about others who have proudly acknowledged that they have Diabetes. In the mid and late 1980s, as a young boy, my only "Celebrity Diabetic" was Gary Mabbutt. Gary played for Spurs and was capped by England and he is still well known in Diabetic circles today, particularly football fans. That was it, for me. I'm sure there were others but Diabetes was a much less visible condition beyond the Diabetes clinic at the hospital.
Technology has made Diabetes a visible, talked about thing. It's forced the hand of Diabetics to become that bit more public about their condition. A pump, CGM or even a small Libre disc are physical signs which are often hard to hide compared to the sneaky finger pricks and injections, done covertly or behind closed bathroom doors. Perhaps we have more to thank technology for than simply improving the management of our condition? It's out there! WE are out there!
Not everybody uses technology, of course (despite what you might see on social media). Perhaps some will still hide it because years of conditioning can take a long time to overcome. So, representation is important in other ways. Representation by the masses (our peers) is increasing and I believe that is the most important way to have Diabetes seen by the general public, a general public which still struggles to understand types and which holds ideas of Diabetes, that are ignorant and harmful, firmly in their minds.
How you represent is individual to you, your life and your comfort zone. I speak and write about it in various places and I choose to do so using what I consider to be an effective method. Your methods might be different, of course. What is important to you in regards to Diabetes is almost certain to be different to me and others, too. A brief look through Twitter will reveal a variety of subjects, pushed as hugely important and they may indeed be that to a minority which could include you, or other aspects of Diabetes might be higher on your agenda of importance. What is important for us all is to talk about Diabetes, type if you wish, specific things relating to it if you wish, openly.
Social media is an easy place to air views and share your experiences. It's an easy place to represent D. If that's your comfort zone then embrace it and go to town! It can have a surprising, positive, effect. I'm astounded at the positive comments which have been sent my way in the last couple of years since growing a social media presence. All I do is share my experiences and views while engaging with my peers.
We don't always agree, either! and that's an important part of life, too. To accept that others have their views and opinions on their own condition and health and subjects relating to it. It's important to not turn those times into arguments, to not bully or name-call or reduce yourself. The people who do that are not helping to represent. Using aggressive, "industrial" language does not help to represent - Do you want your children to read frequent use of the F word? Your choice, of course! I'm far from a prude and I have certainly used foul language and a harsh "tone" before. Within Diabetes, I try to keep it family friendly. That's not because I'm focused on engaging with families. It's because it's much harder to alienate or offend anybody of any age when the language is PG and the tone is soft.
I encourage everybody living with Diabetes to share their views. Talking about it is great representation for your peers and yourself. It's normal to have a health condition or a disability. Don't hide.
Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!
Thursday, July 15, 2021
The Cost of Hypos
Do you remember the "sugar tax" of a few years ago? Our favourite sugary drinks, the life-saving drinks which we used to treat hypos, suddenly became less sweet. Lucozade, Ribena, Vimto and the other teeth rotters became less attractive or pointless if you wanted to treat a low blood sugar. Lucozade clung on to a good chunk of its glucose but it was still much reduced, meaning more would need to be consumed (and bought) to treat a hypo than before the days of the sugar tax.
Today, news reports have highlighted that an independent review of the food that we eat should be subjected to further taxes, specifically sugary and salty food, and vegetables should be prescribed on the NHS.
The story is here if you'd like to read through it.
That story aside, it has made me wonder what the cost of hypos are. I don't mean the physical exhaustion, stress and anxiety. I'm talking cash, moolah, filthy lucre. Just how much does a hypo cost? In an ideal world, nothing. Gluco Gels are available on prescription and assuming you only need 30g of carbs (3 x 10g tubes of glucose) to treat your hypos per month (my allowance) then you're golden, hypos will cost you nothing as a Type 1 Diabetic. Meanwhile, back in the real world, here are my hypo stats for 2021 so far:
At the half way point of the year (183 days, 26 weeks) I'd had a grand total of 74 low blood glucose events. That's just under 3 per week. Of course, that fluctuates depending on a seemingly infinite number of variables but let's assume an average of 3 per week, rather than the days before CGM alerts when my hypo numbers were almost double that amount.
Hypo treatments and their costs will vary. I don't eat and drink the same thing in the same amounts for each hypo. So, what's the most common treat for me? Squashies and Lucozade! Let's do some pricing up:
4 x 330ml bottles of Lucozade are £2.70 (68p per bottle)
1 x packet of Squashies is £1.00
I conservatively estimate that I will drink half a bottle of Lucozade and eat around a quarter of a packet of Squashies for a hypo. Again, that will vary depending on many things but as an average I think that's a reasonably conservative amount. An average hypo is costing me:
34p in Lucozade
25p in Squashies
59p is no big deal, right?
3 hypos per week, though. Alright, £1.77 per week.
Oh, £92.04 per year.
I've had T1D for almost 37 years. £3,405.48
Perhaps I'll still be here in another 37 years. £6,810.96
Remember that my hypo frequency was once double what it currently is? Yikes!
Suddenly hypos are starting to look like expensive events, over the course of my life. I could probably buy a weeks' groceries for what I spend treating a hypo over a year. And now a proposed extra sugar tax of 15% - 25%?
I know that my hypo events are a tiny number compared to some. I wonder how much your hypos are costing you? and do you agree with the proposed new sugar and salt tax? Let me know.
Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!
Saturday, July 10, 2021
Size Matters
It's not what you're thinking, let's get that clear right away. Although! I am referring to little things in this blog, at least in regards to Diabetes. Those little things which we might be guilty of neglecting, ignoring or putting on the back-burner for another day. I've certainly done those things for various aspects of my Type 1 Diabetes.
Recently, it occurred to me that the little things can get neglected by others. Specifically, our healthcare professionals. I'm a firm believer that the majority of HCPs go into the profession with the very best of intentions and that they carry those intentions throughout their professional lives. Perhaps, with experience, shortcuts are used and without any problems arising from doing something to save time, to allow for a break, deal with a clinic which is overflowing and full of patients, etc. An HCP might repeat the practice because it's a small thing, nothing bad happened. Those of us who have been employed may have done similar things. Perhaps the job was stressful, you needed a break or you just really hated your boss! So, you cut some corners, reduced your load.
Yesterday, I tweeted the image below:
Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!
Thursday, July 1, 2021
Death & Taxes
Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!
Thursday, June 24, 2021
Confessions Of A Diabetic
Please forgive me Diabetes for I have sinned against you. Have you ever been to a confessional? I haven't and I suspect if I did it might be a case of "Are you sitting comfortably? Then I'll begin!"
T1D comes with advice from the professionals for living healthily and rightly so! Once upon a time, that advice came in the form of strict rules. "You will eat at X O'clock, inject at X O'clock, wake up when we tell you to and pee in a very small tube for us four times a year". Things have improved, of course, and now I only need to pee in a very small tube twice a year.
With rules, comes rule breaking or maybe rule bending. And so, today, I present to you some stories of my own rule breaking and bending for your consideration. They are all going to be Diabetes related, of course and all suitable for family viewing although I encourage you, reader to not copy any of the below or think that because that bloke from the Internet got away with it then you will too. Are we clear? Super! Let's begin.
My rule breaking began at an early stage. Oh, lancets were being changed, carbs counted and injections given on time (at that stage) but at school things went very differently. Please check out Hobnobs in Hiding for some tales of my schooldays with T1D.
Following education, with a job, money in my pocket and a Fiesta Popular Plus on the the drive, the world was my oyster! Diabetes had to tag along despite me generally ignoring it and refusing to answer it's calls. Those were the days of parties, drinking, pubs, clubs, girlfriends and things were great! Of course they were. I think most people refer to their late teens and early twenties as great times. I'm no exception although I do feel incredibly lucky.
Shall we begin with hypos? I once made a video which described my worst ever hypo and it's still true to this day. Following a weekend of excess, I woke for work, showered, injected (twice per day mixed insulin jabs at this point), jumped into my car and headed off to work, no finger prick. I didn't need to take finger pricks, I hadn't for years at that stage, I could feel when I was low. Yeah, right! Yawning, tired, a bit hazy? Absolutely, it'd been a long weekend and I was looking forward to getting to work for a rest. However, yawning, tired and hazy are also strong hypo symptoms for me. Then the sweating began and I opened a window. Then the shaking... the shaking... oh no! I'm hypo. I grabbed my bag (still driving at this stage) and opened juice box after juice box. Because of my ignorance of T1D and the frequent hypos that I was coping with, I used to carry several with me in the car to take to work. I was probably 5 minutes from my place of work when the flashing lights began. I'd stopped the car and took it out of gear. Engine still running, I reached for what must've been my third or four juice box and then nothing. Black. I woke up in hospital, tried to punch a doctor and then started crying.
I'm lucky because I'd stopped my car in a busy place where police would often drive by. One spotted me with smoke bellowing from my car's exhaust. At that stage I was having a seizure and had planted my foot on the accelerator. There were seconds between that happening and me stopping the car, even fewer seconds between that and me taking the car out of gear. The police officer dragged me from the car, ripping my blood soaked shirt open in the process. I don't know if he was expecting to perform CPR or was just clumsy. Blood soaked? Oh, yes, I had bitten my tongue during the seizure and things got a little red for that lovely white shirt. I'm lucky. I spent the next week at home, recovering from that incident which could've quite easily killed me or many innocent others. Diabetes, on that occasion, had had enough of being ignored. My behaviour changed, I began testing my BG before driving and ate a breakfast. I took all my Diabetes stuff to work and confessed my condition to my incredibly kind and understanding boss, who hadn't seen or heard from me in a week.
Hypers were more frequent... I think! That's because, as you've just read, I wasn't taking any finger pricks. I don't remember getting any test strips or lancets on a prescription for several years! I wonder if my GP thought that I was cured? I was getting my insulin pens and needles and that was it. Remarkably, I was never unwell because of high blood glucose, no DKA, no frequent need for the toilet or raging thirsts. I would love to see my BG results from those days but suspect they would reflect my extremely infrequent HbA1c tests which were often around 9 - 10%.
How many HbA1c tests did I submit to? After passing out, following one when I was 11 years old, I have memories of three others over the course of the next decade. I didn't have time for blood draws and the ensuing bollocking from my then DSN. I was young! I was a roarer! a rogerer! a gorger and a puker! (You'll understand that if you've ever watched Blackadder).
My DSN gave up trying to convince me to have an A1c. Instead, she relied on my detailed blood glucose diaries. Never in the course of human history had so many lies been written in one book, it was like a Tory manifesto! Of course, she couldn't question why I was always between 4mmol and 8mmol, solidly for a month because I wasn't letting them take an A1c from me! Those works of fiction kept me in their good books for years. Little wonder that I gained some success as a poker player in later life.
"How was your appointment?" family would sometimes ask. Oh, you know, fine considering I hadn't been and was eating a bacon sandwich in the Cafe instead. Nothing tastes as a good as a bacon sandwich when you should be getting strips torn off you by an angry DSN. Yum!
Life changes. I grew up, kind of, eventually and with family comes greater responsibility. Today, I check my BG all the time! I wear a CGM and finger prick to calibrate it. I go to my appointments. I don't lie to my HCPs. My A1c is between 6 and 7% and I will submit to as many blood draws as I'm asked for.
My blog is for my thoughts and brief tales relating to Diabetes. I have a larger collection of notes and stories which aren't necessarily family friendly. Confessions Uncut, if you will, which might make an interesting book. Should I write it?
In the meantime, if you relate or have a confession then tell me everything, my child in the comments below or Tweet me!
Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!