August 2015 - Type 1 Writes

My Week on Diabetes Autopilot

August 31, 2015 by Frank Leave a Comment

I went to give my insulin dose after lunch. I dialled it up and stuck it where it needed to go. As I put my insulin pen away, I stopped and tried to think about what I’d done. How many units had I given myself? What did I have for lunch? Less than a minute had passed, and I couldn’t even remember.

I’ve been stuck on diabetes autopilot, and that routine has been on repeat every day in the past week. A fairly busy week, mind you. I’ve had to shake off a cold without any sick leave because of my responsibilities at work. I’ve had to wake up an hour earlier. Despite my best efforts, my body refused to fall asleep an hour earlier at night. And after imagining all the possibilities of an earlier finish, the reality has been falling asleep on the couch in the afternoons.

It was morning tea time on Friday morning. I was having my usual apple and Muesli bar. My blood sugar was 13.1, thanks to the cappuccino with 1 sugar I’d had earlier. Driven by my urge to bring it back down, I grabbed my insulin pen and quickly jabbed in 5 units. Normally, being on my feet at work would cover the apple. Meanwhile the muesli bar was a nut and seed variety, and had a lot less carbs than the ones I normally eat. I wasn’t thinking straight that morning. I’d already set myself up for a hypo, I just couldn’t see it yet.

Half an hour later, I was beginning to feel exhausted as I carried out my work. I wanted nothing more than to sit down somewhere. I was constantly sighing and loudly exhaling air from my mouth. I was nodding along when others were speaking, lacking the energy to talk back to them. I felt warmer and sweatier than normal. I didn’t have to go and check my blood sugar, I already knew that I was hypo.

I grabbed a muesli bar from the stash in my locker (this one had 24g of carbs) and walked back out into my work area. There was only one person around at the time, who knows that I have diabetes, but I still felt rude for eating in front of her. “Have you not gone for morning tea yet, Frank?” she asked me. “No, I’m just low and need some sugar,” I replied. “Oh, of course you do!”

I knew that the hypo was fixed, but those feelings of exhaustion just wouldn’t go away. And there was just something about coming off of a bad hypo that made me crave those carbs and sugar even more. So I decided to head off for an early lunch and grabbed a Supershake, a Cheese and Bacon Roll, a block of Lindt chocolate and a Jam Donut doused in sugar (I know, not your model diabetic!).

In that moment as I sat there in the staff room, those carbs had never tasted better. That rich cheese and salty bacon hit the savoury spot on my tongue perfectly. The sugar on top of that donut stuck to my fingers and my face, and I felt high. Drowning it down in that thick, chocolatey supershake was heaven on earth. And after a few squares of chocolate, I’d finally had enough.

I went easy on the insulin dose, because I knew I’d be on my feet for another 2 hours. By the time I got home, I was a lovely 21.3. I gave another 10 units, and then decided to play the waiting game. I was 17.4 an hour later, 14.9 after that, and 11.9 by dinnertime.

I have no explanation to offer. It was just one of those days. Thank God it was Friday, because I really needed some rest.

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Be Realistic, But Don’t Settle for Satisfactory

August 28, 2015 by Frank 4 Comments

How do you feel about a hba1c target of 6.5%? Chatter among the #DOC this week has been circling the new NICE (National Institute for Health and Care Excellence) guidelines for people with diabetes in the UK. I initially felt quite reactive to this like many others on social media, however some rational thinking has softened my view.

In Australia, I’ve always been told that I should strive for a hba1c of between 6 and 7%. That hasn’t changed in the 5 years that I’ve lived with diabetes. During that time, my hba1c has plummeted due to frequent hypoglycemia, it has gone up due to burnouts and it’s also fallen within the satisfactory range. And I can tell you from experience that a satisfactory hba1c level is extremely difficult to maintain while trying to live an active and ever changing life.

My main concern about this suggested target is that each and every person with diabetes is different. And we all have our own unique circumstances surrounding our diabetes. There are children, teenagers and adults living with diabetes. Some of us are newly diagnosed, while others have been living with it for several years. Some of us have a parent or carer to help us manage diabetes, while others do it on their own. Some of us are content with where we are at, while others are fine tuning and making room for improvement.

So, in that respect, a stock standard number for the masses is certainly not a one size fits all approach. That number will be easily achieveable for some, and completely unrealistic for others. That number is going to set some up for success after success, and others up for repeated failure. And while a number is a great means of motivation and goal setting, it isn’t always a true reflection of the hard work and effort we’ve put in to managing our diabetes.

On the other side of the argument, Mike at Everyday Ups and Downs points out that the lower target is a way of encouraging us not to settle for something satisfactory. I’ve been really excited at seeing borderline acceptable hba1c levels in the past, only to be told by doctor’s that it should be lower. My response at the time was more than dismissive, but looking back at it today, I finally get it. I should strive for a lower number if it’s a realistic goal for me, as it will further reduce my risk of complications in the future.

Mike also suggests the 6.5% target is a way of making doctors more comfortable with seeing lower hba1c numbers in patients. It’s news to me, but apparently some non-hypoglycemic patients are told that their hba1c levels are too low. Crazy!

So, what do I think of all of this? Don’t pay too much attention to what’s in the media or to others. Set your own goals that cater to you and your diabetes situation. Make them realistic. Have a team of people around to cheer you along. Take some time to relish an achievement, and then move the goalpost a little further back. And remember that nothing is impossible if you put your mind to it.

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A Whole New World of #DOC on TuDiabetes

August 27, 2015 by Frank 1 Comment

Does the DOC ever end? I’ve joined TuDiabetes recently, where I have discovered a whole new world of People With Diabetes to connect with. I’d heard of the name before, but I had no idea what it was. And it wasn’t until a prompt from my friend Rick at RADiabetes a few weeks back that I decided to join.

The biggest drawcard of TuDiabetes for me would have to be the forums, which are filled with lively, supportive discussions relating to almost anything I can think of. Chances are that if you have a question, there is probably already a discussion going on about it over on TuDiabetes. And while I’m hardly qualified to give advice, here are a few words of encouragement I’ve left in the forums recently.

In response to feelings of weakness and self defeat:

“Firstly, don’t compare yourself to others. You are your own unique, wonderful person. I’m sure that those other T1Ds have their own struggles. You probably just don’t see them, or they don’t show it in public. If anybody said diabetes was easy all of the time, they’d be lying. Secondly, don’t think of those setbacks as defeat. Think of it as knowledge you’ve gained that you can apply to the situation next time to ensure you won’t have a setback again.”

In response to not feeling human (which actually inspired last week’s post A Letter to My 17 Year Old Classmates):

“I was diagnosed a week out from my 18th birthday. Everyone else was out drinking, doing Shisha, living off Red Bull and generally abusing their bodies. And yet I was the good, sensible guy who ended up with diabetes. I get it.

Unfortunately, having diabetes means constantly having to field questions about why you’re not having cake or why you look so miserable. There’s no point in setting boundaries, because people aren’t going to remember. My best advice would be to come up with a strategy to deal with these questions, such as politely declining the cake, or politely telling the in laws you don’t feel like talking about diabetes today. Don’t let it bother you, because we all get those “stupid questions” all the time. And they only do it because they care (I know, I have a hard time believing it sometimes too!)

Finally, don’t be too hard on yourself. Diabetes is ALWAYS changing, and sometimes diabetes is more to blame when things go wrong.”

Another big drawcard of TuDiabetes is the interviews and other interactive activities which I can live stream from my computer if I so wish to. Sadly, the majority of these events happen while I’m fast asleep in the early hours of the morning! Ditto for the chat feature, which is pretty much like Facebook chat. I have my own profile page, which displays my latest activity. There are also diabetes resources and fact sheets at my disposal too.

I know what you’re thinking – another social network? My thoughts exactly. Blogging and Twitter take up a lot of my DOC time, so I only check into TuDiabetes occasionally. However, many people do get their source of DOC support from TuDiabetes, and perhaps you will too.

You can sign up for TuDiabetes at www.tudiabetes.org.

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My Lousy, Flu-Ridden Friday

August 26, 2015 by Frank 3 Comments

My Friday had gotten off to a terrible start. I’d had very little sleep thanks to a wonderful cold, and it wasn’t until 5am that my drowsiness finally overpowered my congestion. My alarm went off at 5.30am, and I angrily hit the snooze button for another half an hour. By 6am, I knew that I had to get up.

Thankfully, nothing crazy was happening blood sugar level wise and there was no signs of ketones. But I felt absolutely terrible. It was cold, grey and raining outside. And I wanted nothing more than to call in sick to work and stay in bed. I knew that nobody would really think I was just chucking a sickie a day out from the weekend. I knew that I would easily have been able to guilt them with diabetes excuses if I really had to.

But I knew that we are always short staffed on Fridays, and I felt guilty for my workmate who would be left on his own if I didn’t go in. I also had to grab the key off of him as it would be my responsibility to open up next week. And being a day out from the weekend, I knew I might be asked for a doctor’s certificate if I didn’t go in. So, against all stupidity, I decided to get up, shower off all traces of Vicks that I’d rubbed on my chest through the night, and went to work.

For most of the day I was quiet. I was short. I didn’t feel like talking. I gave one word, unenthusiastic, I-don’t-really-give-a-shit-answers. People asked me what was wrong. I felt guilty sneezing and blowing my nose in front of others, despite doing my best to do it over in the corner. The day seemed to absolutely drag as I watched the rain pour from the miserable grey sky outside.

Honestly, my biggest regret of the day was that people had to see my shitty, flu induced mood. I felt so guilty and so embarassed that people had to see me like that. I don’t like to bring my problems to work and dump them on others. I go to work with diabetes every single day. I never let it interfere with what I have to get done. I never use it as an excuse to get out of something. I test, inject, correct and treat hypos in private. I rarely complain about it. And my colleagues always forget that I have diabetes whenever I bring it up in conversation in the staff room. And in a weird way, I’m kind of proud of the fact that I don’t make diabetes anyone else’s problem.

So why couldn’t I keep it together on Friday? Why was an innocent cold the thing that brought my world crashing down? I guess I was pissed that I guilted myself into going in. I guess I was pissed that I didn’t stay home in the first place. And I guess I was pissed that I didn’t take the time to look after myself.

And as it turned out, going home at lunchtime to look after myself was the best decision I made all day.

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My #OzDOC Story

August 25, 2015 by Frank 4 Comments

When I first started this blog a few months ago, I felt rather lost. I’d had Twitter for some time, although I thought it was absolutely stupid. I didn’t really see the point of following people I didn’t know. I felt so out of place trying to find diabetes stuff to tweet, which at the time didn’t sound even remotely interesting. And I felt like a desperate idiot tweeting my blog posts with every popular hashtag that I could think of.

Then one day, I stumbled upon somebody’s retweet from this Twitter account called the Oz Diabetes Online Community. It’s a Twitter chat for people with or affected by diabetes here in Australia. For one hour every Tuesday night, we introduce ourselves and answer a series of questions around a set topic of the week. We’ve talked about things like germs, exercise, team work, a cure and National Diabetes Week, to name a few. The best part about it is that anyone can see the chat just by typing #OzDOC into your Twitter search bar, and you don’t have to join in until you are ready.

Ever since then, OzDOC has been the place to be on a Tuesday night. OzDOC really got me started in the Twitterverse and the Diabetes Online Community, and helped me to feel less like a stranger. They are an amazing, friendly, welcoming, supportive and inspirational group of people. They were among the first of the #DOC friends that I made. Although I don’t know any of them in real life, they certainly have come to feel a little like family. And I don’t think I’ve missed a single chat since I first found it.

I feel extremely empowered having a space to share my experiences in managing diabetes, and I take a lot of inspiration from the other wonderful people there too. I love that we can all have a good laugh at ourselves, not to mention our fierce comptition for the wittiest tweet of the night. Having a wonderful community like OzDOC helps me to feel a little less alone with my diabetes. And while I love that the Diabetes Online Community connects me with people from all over the world, OzDOC helps me to feel a little more at home with my diabetes here in Australia.

Have a think about what you share about your diabetes with the people in your life, and what you choose to keep to yourself. Then join in by following #OzDOC on Twitter from 8.30pm Tonight AEST (GMT+10). Hope to see you there! (I’m guest co-moderating this week).

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