Shoot Up or Put Up

Diabetics. And beer.

Tim:

I awoke this morning with a slight hangover, but still flush with the wild success of Shoot Up’s first ever meet up / piss up.

As advertised in those articles down the page, my esteemed co-writer Alison along with her husband Geoff ventured north of the border and braved the cold, rain and general misery to come and stay with us for the weekend and to help host Shoot Up’s planned sober, quiet and reflective meet up.

Fueled with a heady combination of mulled wine and tapas we arrived in Au Bar to really meet our first ever real-life real readers (to whom we’re not related). We quickly established that, contrary to popular belief, people you meet via the Internet are not all escaped serial killers and we settled down to a great evening of beer, wine and diabetes chat (there was also some extensive discussion about zombies, but that’s another story).

Swapping tips and experiences was extremely useful and I was really pleased to see how many lovely diabetics Edinburgh has! Hurrah! The next meet up is already being planned so watch this space!

Alison:

They came! Real people who read our blog out of choice rather than family obligation. And they were lovely. Intelligent, entertaining, fun people. We spent several happy hours drinking beer and meandering through life’s important topics – how great but chilly it is to ride the Christmas ferris wheel in the lovely city of Edinburgh; how just because Edinburgh apparently has the best diabetes care in Scotland the fact that it isn’t delivering against some of the guidelines means there’s plenty of room for improvement; how Tim has learnt to live with the fact that Katie has taken a bit of a shine to comedian Russell Howard; why our British readers seem much more reluctant than our American readers to comment on our blog;  and how to transpose music for an E flat tenor horn - at which point Tim and I were completely lost.

Pharmacist Simon thanked us diabetic types for being such a reliable income stream for professional drug pushers like him but despite much encouragement we couldn’t get him to reveal how many diabetic patients he needs to be able to afford a nice yacht.

Thanks to Tim and Katie for their wonderful hospitality – anyone who has a warm pair of slippers and a glass of port waiting for us after a long journey gets 5 stars from me!

I suspect further Edinburgh meet ups will be on the horizon, but we’re also pondering heading south to sunny Liverpool for the next meet up – could we tempt you to that?

Just a reminder (as if you would have forgotten!) that your soaraway Shoot Up is having a pub night out this Saturday 28th November. We will be in Au Bar (101 Shandwick Place, Edinburgh, EH2 4SD – map here) from 7pm onwards.

I’ll be there with my esteemed co-writer, our respective spouses, my pharmacist (for some reason) and a whole bunch of other members of the pancreatically-challenged hoards. What could possibly be more fun?

All are very welcome to come along, chat about all things diabetes and drink high-carb beer! For identification purposes there are pictures of Alison and me here – but we’ll be the table easily identifiable by the people sitting at it injecting stuff. If you need any further details feel free to drop me an email at tim@shootuporputup.co.uk. See you there! (And just because you’re in another country or continent is no excuse for non-attendance…)

Nothing to do with diabetes. Disgraceful!

As well as writing your soaraway Shoot Up I read a lot of other diabetic blogs. Generally they’re interesting, insightful and useful; however it really gets my goat when people use their platforms to promote some other service or product that is entirely unrelated to the topic of their blog. Frankly, it’s unprofessional, amateurish and downright dishonest – it cheats dutiful readers.

With this in mind, therefore, I’m not going to use your soaraway Shoot Up to promote my wife’s handbag business stripykat. The fact that each handbag is handmade & unique and that they are incredibly good value for money and ideal for Christmas gifts is neither here nor there.

I also refuse to mention that stripykat has been featured in British Vogue or that Katie is one of only twenty Scottish designers currently displaying their products in the National Museum of Scotland’s renowned “Gifted” exhibition.

Only the shoddiest of blogs would go onto say that stripykat also sells a great selection of unique iPod & MP3 holders and camera cases in addition to hairbands and scarves, which are great accessories that will beautifully set off your favourite outfit.

It would also be deeply unprincipled to say that stripykat ships worldwide (that includes you USA!) for only GBP£5.00 and securely accepts payments via PayPal in your local currency.

No, I’m not going to do that – it would be wrong. Move along there, nothing to see.

I recently did an interview for a diabetes magazine (yes, another magazine – we’re getting really big now in diabetes celebrity circles; such as they are). And I was asked what single development would make life easier for me as a member of the pancreatically-challenged hoard.

I did think about a new pancreas grown from stem cells, but I just don’t think science is advanced enough to come up with a proper cure for diabetes in my lifetime (or what I expect my lifetime to be – obviously even I don’t know how long I’m going to live). When you think about it, science has had 90-odd years since Banting & Best successfully stopped killing dogs and discovered insulin to come up with a complete cure. Although there have been leaps and bounds forward since then, science hasn’t even yet managed to come up with a long acting insulin that actually delivers consistently and smoothly for a full 24 hours (yes, we’re talking about you lantus). So I’m afraid that I think cures are still a long way off.

So I side-stepped the question by answering that incremental improvements to existing systems actually make life a lot easier for people with wonky pancreases. Take for example blood glucose meters. I’m a huge fan of Abbott’s FreeStyle Lite as it uses a tiny sample, is stupidly quick to process your result and is just generally well designed and thought out.

When you compare this to the medieval instruments of torture that were used not that long ago for measuring BG you can see that the world has moved on enormously and checking your BG is now ludicrously easy and relatively pain free. Given that a Good Diabetic will check their BG 4, 5 or 6 (or more) times a day such seemingly small changes to meters make a huge difference to the quality of our lives.

Similarly, faster acting insulins would be hugely beneficial. Humalog is pretty good stuff, but I still have to stick it in about 20 minutes before breakfast to avoid a massive post-port and pheasant peak (there’s nothing like a good, well-matured roast pheasant and a flagon of port for a good start to the day. The sort of breakfast empires were built upon, God be my witness!).

Anyway, so that’s what I’m hoping for the future – not a cure – but lots of little incremental improvements. Each one might not be wildly noticeable by itself, but cumulatively they’ll make a huge difference to our everyday, mundane, shuffling lives.

I had my swine flu jab on Saturday (affectionately known round here as the pig poke!).

I wasn’t planning to write about it as I didn’t think I’d have anything more to say than Tim’s wildy entertaining piece had already covered.  

Sadly the English experience hasn’t been quite as good as the Scottish one this time round. I spent a thoroughly tedious 90 minutes sitting with hundreds of other people on Saturday morning as a group of very stressed looking NHS staff herded us through the system to be poked.

While I’m in awe of the NHS finally recognising that I have a job and that delivering healthcare on a Saturday is a great idea, I do question the benefit of it in this case when I was pretty much the only person in the building young enough to have a job.

After a perfectly painless poke I was unable to resist rebelling against the system and scandalously skipped my 10 minutes “recovery time”. I felt I’d probably contracted enough germs already, without sitting in an over heated room for ten more minutes listening to people whinge about how much they hate injections.

I read on the interweb that some bloke called Tim in Scotland had his jab and it had no effect on his diabetes. This proves that everything you read on the interweb is rubbish. Six hours after my jab I headed skywards and stayed there for 24 hours before starting to decline. Now the diabetes is back at normal levels but my arm is killing me. Apart from that, I’m remarkably unscathed.

So, what do we learn from this tale? Don’t believe everything you read on the interweb and if you want a pump, come to north west England, if you want a speedily efficient swine flu jab, Edinburgh is the place to be.

Just to massage our already massive egos (mine is somewhere in size between Jupiter and Saturn) your soaraway Shoot Up got a mention in quality diabetes periodical Sweet. I’ve reproduced a badly scanned copy below for your fun and pleasure. Some of what the article says is actually true, so enjoy.

Unprocessed bacon sandwiches, yesterday

For those that care (and I know you’re few and far between) I had my swine ‘flu jab last night. It was as much fun as any vaccine injection I’ve had before and I now have a mildly aching arm this morning. But that’s as far as the side effects go. Oink! Again I was impressed with how well organised my local surgery was – in and out in three minutes. So compared to the utter misery of actually getting ‘flu a slightly sore arm and a few minutes of my time is a tiny price to pay.

That vaccines can be created so quickly and dealt out so efficiently is of great comfort in the, perhaps unlikely (but not impossible) event of worldwide zombie infestation. I think you’ll agree that all of us have wondered at some point what would happen in the event of the undead rising up from their foetid graves and roaming the earth trying to sate their hunger for spicy brains. Currently the only known cure for the infected is, of course, to remove the head or destroy the brain – with a cricket bat, fire-axe, lawnmower or any other blunt instrument that comes to hand.

One would hope that should such an outbreak occur the nation’s best scientists (presuming that they themselves hadn’t been bitten, infected and transformed into one of the untold legions of undead) would be able to come up with a vaccine pretty quickly and my local surgery would be efficiently dolling out the cure to the local populace within a month or so of the first cases being reported.

We all know that diabetes is, to be honest, a bit of pain. But compared to zombification and brainlessly lurching after humans with a view to consuming their living flesh (do you get vegetarian zombies I wonder?) we diabetics have it easy. I think this important point should have been a major feature of World Diabetes Day – I suppose there’s always next year…

Swine flu - these guys started it!

Later today, you’ll be thrilled to hear, I’m off to the doctors to go and get my swine flu jab. I mentioned in my earlier post about seasonal flu that last year I did manage to successfully contract flu (proper flu I mean, not “man flu”; no, honestly) and I vowed never to miss a vaccination again. The sweats, weakness, aching, misery, despond and despair caused by flu were just far too horrible to contemplate ever having again.

So I’m therefore looking forward to an injection given by someone else for once (ohh, luxury!) and a slightly aching arm. This is clearly more than fair recompense from protection from the oinking disease.

When I was a small child, many, many years ago I would occasionally have philosophical moments (well, as much as a seven year old can have philosophical moments) and wonder what the future would be like. Say in 2009. Hovercars would be pretty cool, entire meals in a pill would be great but, even then, I thought the traditional silver space suit would be perhaps a little impractical and perhaps somewhat dull.

Sadly, none of the things I imagined have come to fruition – we don’t holiday on the moon or travel through time like Doctor Who (which is probably a good thing, given the scrapes that can result from inadvertently opening worm holes in fourth dimensional black holes and messing with the space-time continuum (apparently)). So maybe we’re just living in a stagnant technological backwater of the early 21st century with little to show for the last 25 years.

Then I thought about swine flu for a moment. Back in April swine flu was a brand new strain of influenza that hadn’t been seen before. Now, by November, that new strain has been isolated, genetically sequenced, a vaccine has been engineered, thoroughly tested and is available in my local surgery. When I think for a moment about that I’m utterly amazed. That vaccinations can be made available to the public within 6 months of them turning up on the virus-scene is utterly flabbergasting.

Similarly with diabetes, in merely 90 years we’ve moved from the single option of slow, unpleasant death (never ideal) to having a choice of a whole range of artificially engineered insulins which work extremely well and give us pancreatically-challenged hoards pretty much a normal life. Similarly blood testing equipment and other accessories having moved on massively in recent years – tiny blood samples, three second results and so on. It’s genuinely amazing.

We might not live on the moon, like I imagined at 7, but – by crikey- when you think about it for a minute we’re living in the future right now. Cool!

I’ve been reviewing my insulin history over the last 26 years and it appears that while I’m able to sustain a reasonably long relationship with an insulin brand, I have been a bit of an insulin tart over the years swapping to the latest thing when it’s caught my eye.

When I was diagnosed, back in the dark ages, Eli Lilly were the big thing in insulin. They’d just brought out this new stuff called human insulin. In the dark ages most people used animal insulin, produced by boiling up dead cows and pigs, running the resultant broth through an insulin extraction machine then bottling it. (Here, I must admit that the finer details of this description may be a little inaccurate and I acknowledge the process was probably a little more refined than this, likely using microscopes and stuff.)

Anyway, human insulin was the next big thing and my consultant was very excited that Lilly’s Soluble and Isophane human insulins were on his prescription pad. At the time they seemed fine, they kept me alive which was better than my own body could manage so they were a good thing. Looking back, they were pretty crude. The long acting liked to peak and fall like a rollercoaster and the short acting needed to be injected six weeks in advance of you thinking about eating.

It was the best we could find though, so we stuck with it. My promiscuity started early when aged 9 I jumped ship and moved to NovoNordisk. They’d brought out a marvellous new invention – the NovoPen. Instead of using a syringe twice a day, you could now use a super sexy metal pen to inject with four times a day – it came with Actrapid, a faster, shorter acting insulin you injected just 2 weeks before your anticipated meal. This was intergalactic type progress!

Actrapid’s long acting partner was Ultratard, still with plenty of ups and downs but it also had the additional quirk of only lasting about 18 hours when you actually needed it for 24. Nice.

About 10 years ago the world really changed. A new thing called insulin glargine arrived. And being the insulin tart that I am, I went for it. Sanofi-Aventis became my new best friends with their 24 hour lasting, flat as a pancake Lantus. Marvellous stuff, so much better than that nasty Ultratard although personally the no peaks/no dips thing didn’t really work for me, I found it liked to rocket about 6 hours after I’d injected it, but perhaps that was just me.

The best thing was still to come though. A properly fast acting insulin. Despite my long term relationships with other drug companies, it seems I still held a torch for my first love, Lilly. That smouldering torch was ignited again when they brought out Humalog. You could inject and then eat pretty much straight away (well 20-30 mins but who’s counting?). And it didn’t last for hours on end causing hypos 5 hours after meals like some of it’s predecessors.

I’ve used Humalog for at least 6 years now and we get on just fine. But am I being complacent in this relationship, have I just got all comfy with Humalog and taken myself off the insulin dating scene because we’re lazily snuggled up on the sofa together? There’s plenty more fish in the sea, should I be setting up a date with the slightly newer Apidra or NovoRapid/Novolog? They claim to work a little bit faster and possibly for a shorter duration, but is it enough to be worth the hassle of getting to know a new insulin?

At the moment I think I’m settled in front of the fire in my slippers with my Humalog, not because it’s earth-shatteringly fabulous, but because it’s doing what I need it to do.

Are there any Apridra/NovoRapid/Novolog lovers out there who can convince me it’s worth getting back on the dating scene?

And while Tim is tinkering and tippling his way through WDD, I thought I’d follow Cherise’s lead and go blue in time for the Diabetes UK North West Family Event today.