Month: February 2016

Heatwave

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I felt as though I had just opened the door of a hot oven as I stepped outside of the building where I work yesterday afternoon. Squinting as my eyes adjusted to the bright, early afternoon light, I could feel the sweat on my forehead. I let out a sigh of exhaustion. I instantly felt the burn of the blazing hot, 42 degree sun on my skin as I walked over to my car. I could swear it was hot enough to fry a steak on the burning pavement.

It must have been well over 50 degrees inside my car, which had been parked in the blazing hot sun for 8 hours straight. An uncomfortable burst of hot, dry air blew into my face as I switched on the car, waiting for the air conditioning to kick in and do its thing. I wanted nothing more than to head home, have a cold shower and flop under the air conditioner with some iced coffee. Instead, I had to brace myself for an uncomfortable drive towards the city to see my diabetes educator.

I’d refilled my drink bottle for the third time before I left work, after I’d been skulling down water for much of the day. My blood sugar was 6.2 before I left work. Although the majority of my rapid acting insulin from lunch time had worn off, I slipped a Merryteaser Reindeer chocolate from my leftover Christmas stash into my bag, just in case I needed it. The heat is often unpredictable.

It has never taken so long for my car to cool down once the air conditioning has been cranked up. That car ride to diabetes clinic was absolutely draining. My water bottle was just about empty by the time I pulled down my window to grab a ticket at the entrance to the hospital carpark. I’m not normally one to rove around for a good parking spot, but a spot undercover, and away from that deadly sun was well worth me wasting a few extra minutes. 

As I sat down in the air conditioned waiting room, my meter confirmed a hypo coming on. I pulled my now melted Merryteaser chocolate reindeer, and sucked all of the remaining life from its packet. Just like the world outside feels to me right now. Sucked of all its life, and its glory.

With the mercury set to remain above 40C here in Perth for the next three days, please look after yourself. Stay indoors, keep covered up outside, drink plenty of water, and be prepared for unexpected glucose levels.

I hate Summer. I hate the hot weather. I hate being cooped up indoors. I hate uncomfortable nights of sleep. I hate feeling exhausted and drained. I hate managing diabetes at this time of the year. And I’m very much looking forward to the cooler months of the year.

Join the Australian Diabetes Online Community for our weekly diabetes support chat on Twitter tonight from 8.30pm AEDT by following #OzDOC. 

The “Fill In” Endo

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I’m very protective over my diabetes. I share it with the people I can trust, and I do my best to shield it from people who aren’t going to be supportive. I can thank my very first endocrinologist for that.

Thankfully, the endo I have today is someone I can trust. Each time I go into diabetes clinic, I find myself able to share more and more with her. Which is funny, considering I only go in there twice a year. But still, I feel a certain level of comfort in front of her, that I don’t in front of strangers.

I’d been planning Wednesday’s appointment out in my head for weeks. I had a list of notes and questions in my diary to ask her. I was nervously anticipating my post Christmas hba1c result. Sidenote: I really need to get these done inbetween my 6 monthly appointments, so that I’m not playing guessing games or making excuses to slack off on diabetes management for too long! I knew exactly what I wanted to talk to her about. I even brought along my FreeStyle Insulinx meter and USB cord, ready to share my data with her. For me, that was a massive step, and a big vote of confidence in her.

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So, when a “fill in” endo came over and called me into the office, my guard was immediately up again. That trust was gone. I would have to tread water carefully, but I was willing to give him the benefit of the doubt.

However, he didn’t seem to be very knowledgeable around my questions.

I asked him if I would be able to get an endo’s sign off on the pump without coming in for another appointment. His response went something like “I’m not really sure. I imagine that we would be able to sign it without you coming in. Gwen will be able to tell you.” Gwen, being my fantastic diabetes educator, of course.

I also asked him if I could have a letter exempting me from limits on subsidised test strips. He responded with “I haven’t really heard of such a thing. It might be a better question for Gwen. There is such a thing as too much testing. Most people probably don’t need to be testing more than 4 or 5 times per day.” 

He also wasn’t very encouraging when we talked about my latest hba1c result.

It had gone up by half a point since last time, but it was exactly where I expected it to be after the past few months I’ve had. I expressed my disappointment, and my desire for it to be lower and more stable with a pump. “Your hba1c is around where we’d like to see it. It’s certainly a good range to be aiming for” he replied, suggesting that I didn’t need to be aiming any lower.

All in all, he left me feeling disappointed. I feel like I’ve come so far with my diabetes management. I’m so proud of the attention and interest that I’ve given to my diabetes in this past year. I had shared my perspective around my diabetes to him, looking for some support and some guidance. Yet some of his answers were so vague and wishy washy, that I seriously doubted whether he was an actual endo.

I got the impression that because my chart looked amazing compared to many of his other patients, he didn’t need to give me too much of his time. I’m not a qualified professional myself, yet I can see that there’s room for improvement. There is always room for improvement.

As I walked out of there with a doctor’s certificate dated from the 1990s in hand, I thought to myself thank goodness I’m seeing Gwen on Monday.

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Spare a rose this February, and give life to a child with diabetes in need. Visit sparearose.org.

Spare a Rose, Give Life to a Child With Diabetes

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My blood glucose meter often leaves me in doubt after bedtime tests. Thoughts will begin to race through my head. Did the test strip pick up more sweat than actual blood? Are my hands dry enough? Did any water get in there? How much has it dropped since the last time I tested? No, there’s no way that my BGL can be THAT high!

My head tells me that I’m being silly. But at the same time, my sub conscious tells me I need that second test, just to be sure. I don’t think about those less fortunate people with diabetes often enough. However during these moments of doubt, as I’m turfing a test strip for a fresh one, I often do.

I think about how lucky I am to live in a country where access to test strips is reasonable and affordable. I think about how lucky I am to be able to use test strips like water, if I need to. I think about the comfort and ease of mind I feel because of this life saving tool that I could not possibly live without. I think about how silly some of my rants on this blog must seem in comparison to more serious issues out there in the world.

Lack of access to insulin is the most common cause of death for children with diabetes in many countries around the world. In fact, in some parts of the world, the estimated life expectancy of a child who has just developed diabetes could be less than a year.

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That’s why this February, we in the Diabetes Community are encouraged to Spare a Rose. The premise is simple: buy one less rose this Valentine’s Day, and donate the value of that rose (approximately $6 Australian dollars) to the International Diabetes Federation’s Life For a Child program. The cost of that one rose provides life-saving diabetes supplies, medication, and education that children in developing countries need to stay alive. One rose, one month of life to a child with diabetes. A dozen roses, a year of life for a child with diabetes.

I have donated the gift of life to a child with diabetes. You can make a donation to Life For a Child too. Click here.

I will be taking Spare A Rose printouts into Diabetes Clinic on Monday.

I’ll also be supporting #SpareARose on social media. Grab the Facebook and Twitter covers here!

Spare a Rose, and give Life to a Child with diabetes in need this February. A far more meaningful gift than those corny flowers and pink stuff. Just saying.

Deciding to Switch To An Insulin Pump

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Diabetes has never felt more difficult to manage in these past couple of months. Quite frankly, insulin injections are just feeling like a lot of hard work.

The best results seem to come if I eat similar foods, consume a similar number of carbs and do the same level of activity every day. I can remember my diabetes educator telling me that most people have around 10 to 15 meals they have in rotation. Theoretically, once I knew the correct insulin doses for all of those meals, managing my diabetes should be a piece of cake.

However, that’s not always practical when you’re a human being.

Sometimes I feel hungrier than normal. Sometimes I don’t feel like eating. Other times I go out and I want to eat more than normal. I don’t always eat the same foods together on my dinner plate. Sometimes I’ll indulge if there’s leftover desert in the fridge. Above all, I don’t enjoy eating exactly the same thing each day.

I’d like to think I have a really good understanding of the effects that different foods have on my body. Some foods need a delayed bolus, some need a pre bolus and others need a bolus when I eat them. I have a good idea of the carb content in most of my foods, but I don’t rigorously count or weigh my foods. So, my insulin doses are generally a good old guesstimate.

Usually, guesstimates work well for me. However, I still like to test 2 hours after a meal in case I need to correct a high reading, or to stop a low in its tracks. If I eat something with a higher fat content later in the day, I can expect a spike after bedtime. If I’m eating something that’s digested really slowly, like pasta, ditto. Then there are the Lantus Adjustment Struggles. Will my Lantus dose will be enough, or not enough to match the food I’ve eaten in one day?

I cannot remember the last time that I did not have to endure the Nightly 1am Glucose Checks. I don’t enjoy them, but they are necessary. It’s been a long time since I’ve felt confident that my glucose levels will remain stable through the night. I absolutely hate waking up high. The thought of a blood sugar out of range for the 8 hours I’ve been asleep puts me in a really bad mood. I don’t like starting my day on that note. Night time testing helps a great deal. More often than not I do wake up in range, which makes it all worthwhile.

Which brings me to a big decision. To Pump, or Not to Pump?

Drumrollllllllllll……..

After much deliberation, I’ve decided that I’m going to give the insulin pump a go.

I’m hoping that with the pump’s ability to continuously deliver insulin, some of that work to regulate my levels in the background might be made a little easier. My hba1c level has fluctuated over the years, so I’m hoping that the pump might help me to achieve a little more stability.

Sure, it’s going to be a big learning curve. Sure, the pump is only as smart as the person operating it. Sure, I’m still going to have diabetes after it all…

But I really have nothing to lose. My Private Health Insurance will cover the cost. I’ll have as much support as I need from my diabetes clinic. And I can always go back to injections if I don’t end up liking it.

I’m thinking about the Animas Vibe pump, because of it’s compatibility with the Dexcom CGM which everyone raves about. I’m not really interested in a CGM at the moment, but it’s always nice to have that option for the future. My other options here in Australia are Medtronic and Roche. Opinions anyone?

It was a big decision for me to make, and I’m glad I took the time to think it through. I can’t thank you all enough for your friendly words of advice and support over these last few months.

I’m off to see my diabetes educator next week, and hopefully I can get this looooonnnng process started. Wish me luck!

Wishing one of my readers, C, the best of luck for her pump day today. 

Diabetes Instinct

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“Frank, when you first got diabetes, what were the symptoms?” Mum asked me on the weekend. 

Of course, Mum knows the symptoms of diabetes well enough. But I knew exactly why she was asking. I was actually thinking the exact same thing myself.

“The weight loss was the very first thing, but that was a few weeks before I was diagnosed. I didn’t even notice that until the very end. Then I started to feel a lack of energy, and the thirst, a few days before. Eventually I couldn’t even get out of bed.”

“Were you eating?” (if you want to get Mum worried, just tell her you don’t feel like eating!)

“Yeah I was, up until a couple of days before.”

My sister hasn’t been feeling well. It seems like a bit of a virus that’s been lingering around over this past week or two. 

Of course, I know the symptoms of diabetes all too well. I still remember my own, as though they happened only yesterday. I was certain that this was nothing to worry about. But I could still feel the knots in my stomach, turning. I was anxious, and I could feel myself begin to tremble as we were talking it through. 

That instinct was still there. That instinct of diabetes symptoms will always be there.

I hate this disease. I hate how time consuming it is, I hate how much I have to think about it, and I hate how I feel because of it. There’s only one thing I can think of that would be worse than having diabetes itself. That would be having to see any of the people that I love live with it.

In this very moment, as I am writing this, I realise exactly how all the courageous diabetes parents and families in the world feel.

I realise exactly how my own loved ones feel. When they hear the prick of a lancing device. When they hear the clicks of my insulin pen. When they see me shoving sugar down my throat. When they hear noise coming from my room at 2am in the morning. 

I’m not ashamed of my diabetes.

Diabetes hasn’t held me back from doing anything.

I don’t spend my time worrying about diabetes.

But knowing that my loved ones have to see me live with this disease day in and day out, is far worse than having diabetes itself.