Shoot Up or Put Up

So old you have to pee on them

Recently I suffered an unwelcome visit from a mild throat infection. I mention this not to get sympathy (because I know I’ll get Sweet FA from you lot) but because it really messed up my blood glucose levels.

Despite being hobbled by MDI, I tend to keep my blood glucose in the single figures (go me!) but with the introduction to my throat of a whole bunch of bacteria or virii (or whatever the plural of virus is) I just couldn’t maintain this happy medium. So I spent a good part of last week testing and injecting, testing and injecting. It got so bad that over a morning I had to shove in 14 units to cover off a small bowl of cereal and glass of orange juice. The Diabetic Gods were not smiling on me that day.

Anyway, with all this testing of my highly-sugary blood my faithful meter kept reminding to “CHECK KETONES”. Usually whenever my meter orders me to “CHECK KETONES” I ignore it. Firstly, I don’t take orders from no one, see; and secondly I’ve never really understood the point in checking for ketones.

If, say, my BG is particularly high I know this because my meter tells me so (and I feel crap, of course). I then duly correct the high by shoving in an appropriate amount of humalog. My BG then comes back down to normal and I get back to humdrum day-to-day stuff – like organising coups in backward African states and international jewel theft, that sort of thing.

If, however, my BG was high and I checked my ketones and I discovered I was indeed producing a low level of ketonic-goodness I would, uhm, do exactly what I was going to do anyway and shove in some humalog and wait for normality to return. Given I’m just doing the same thing, why bother testing for ketones? As an aside, it’s obvious though that if things go really out of goose and my BG is high for days on end, then perhaps ketones, DKA and all that stuff are much more important and work testing for.

Anyway, getting to the subject of this article, after being prompted by my meter 300-or-so times to “CHECK KETONES” I thought, just this once, I would treat myself and check them. It was clearly a quiet evening.

So I dug out my faithful Abbott Optium Xceed, found some ketone strips in the very back of diabetic supplies drawer and prepared to test. Imagine my crushing disappointment when the meter reported an error, prompting me to check the “use by” date on the strips. June 2007. Oops!

Given I was diagnosed at the end of 2005, this packet must have been at most two years old at their expiry date (I suspect they were younger than that as they were the new type of ketone strip that Abbott now do). I understand that strips and what-not will, in time, degrade and it’s probably best not to use them after that time; but a shelf life of only two years or so for something that must be pretty stable? Surely that’s a little suspect? (Please note, I haven’t actually done the slightest bit of research on this fact; it might be the case that test strips are more volatile and unstable than a dodgy nuclear warhead and that Big Pharma has struggled valiantly for years to tame test strip chemicals to last as incredibly long as two years. But I suspect not).

Anyway, in conclusion, this all meant I couldn’t test my ketones the other night. I could blame Big Pharma for evilly building obsolescence into its products; but, really, I blame myself for not checking the use by dates on my spare strips for the last two years. D’oh!

Urgh. Ugly

One of the many wonderful features of diabetes is the sheer, damned boredom of it all. Diabetes is generally about the day to day uneventful plod of checking our blood glucose and balancing carbohydrate and insulin intake. While there are sometimes the exciting peaks and troughs of extreme hypoglycemia and hyperglycemia – which do, admittedly, add a certain frisson of excitement to the daily toil – generally not much of any interest happens.

The one glimmer of interest that appears briefly through the fog of general boredom is the gadgets. In my limited experience, it’s common among diabetics, especially of those within a certain demographic (I’m essentially talking men in their 20-30s here), to have an ongoing obsession in the latest shiny stuff marketed to the pancreatically-challenged hoards by our favourite friendly pharmaceutical conglomerates.

A great example of this is the hype concerning the new Bayer Contour USB glucose meter within the blogosphere (I really hate that word – it creates an air of an important, unified community of useful social commentators; which, of course, we all know doesn’t actually exist; most blogs – especially this one – are made up of an ill-informed, soupy conglomeration of poorly written rants and miss-enlightened opinions that no sane person cares about. But I digress).

Anyway, lots of people have been burbling on about how they’re looking forward to Bayer’s new funky colour screened wondrousness arriving on the market for our joyous consumption. All this goes to prove my point – us diabetics love our gadgets and shiny things.

So, with this in mind, why are the insulin pens us pump-challenged people depend on so damned ugly?

For example, I was idly examining my lantus-enabled AutoPen 24 earlier today and noted its vile, tacky cheap plastic feel. It really is a horrible pen – like something you would win in a disappointing set of Christmas crackers. Similarly, my Lilly HumaPen “Luxura” which I use on a daily basis to squirt humalog into my stomach is hardly as luxurious as the name implies. If, to use an tenuous analogy here, luxury is defined as the Presidential Suite of the five star Balmoral hotel in the heart of Edinburgh then the so-called “Luxura” pen is a threadbare, slightly sticky carpeted, one star Travel Tavern situated near a busy junction on the Norwich bypass. Not so good.

Over the next ten years I’ll stick in just under 15,000 injections (unless I finally get my pump, but that’s another story). So please, beloved pharmaceutical companies, please can you come up with a pen which looks great, works well and helps to stave away the horrendous boredom of diabetes!

Nectar of the gods!

By Samantha

The dreaded hypo’s are back. Uh-oh. Man the barricades. When I have bad hypos, I turn into something like the monster from the black lagoon, all growly, pale and nasty. And over the past week or so, I’ve been having some rather nasty ones in the vein of at least two a day whereupon my poor other half has to pour copious amounts of apple juice down my throat.

Yesterday, we decided to go shopping. And the supermarket we decided on was about a half hour walk away. Fifteen minutes down the road, I start noticing some weirdness going on with my eyes. Then the legs start shaking and the words start slurring.

“I dunt feel fery well…”

I’m trying to get my point across to my other half in the middle of a very busy street. Things are blurry and the world is spinning, and he laughs at me for a moment before making me sit on a wall and making me check my blood sugar.

“Oh dear…I think you need some sugar”

With eyes that seem to be making the world jump around and have a crazy party, I see the number on my meter. 1.6mmol/L. And silly little hypo me starts panicking and, with what must have been rather funny for any passers-by, I tip my handbag all over the pavement. My purse starts rolling away, my gloves flop uselessly on the pavement and various receipts start flying away. In my lack of sugar state, I’m trying to find myself some glucotabs. And I can’t. There is nothing in my handbag.

And then, to make matters just that tad more embarrassing. I start crying. My poor other half helps me put my things back in my handbag before helping me to my feet. Something is muttered about always making sure I have something on me, how come this time I don’t. So our next mission, should we choose to accept it, is to find me some juice. I’m muttering all the way to co-op about wanting juice.

“I want some juice. I need it. I’m soooooooooo hungrrryyyyyyyy”

It earns me yet more funny looks, but I stumble on with a grin. And then, I magically find some chocolate in my coat pocket. And it’s good chocolate, half a bar of Thorntons milk chocolate. It’s thrown in my mouth with the fervour of someone who hasn’t eaten in days. And then the hunger starts. My tummy rumbles so loud that my other half looks at me with raised eyebrows, “Hungry honey?”

I fall into Co-Op, and mutter something to the employee stood at the counter “I need juice. Where’s your juice?”

He points me in the right direction. And I see the biggest drinkable bottle of juice in history. It’s huge. And it’s shining at me, like gold. DRINK ME. DRIIINNNKKK MEEEE. So I grab it, and in the process end up knocking half of the other bottles over with a crash. But I don’t care; I rush over to the counter, drop a pound on the side and start chugging that sweet, sweet orange juice. The cashier is looking at me funny, and I grin at him.

“Diabetic” I say with a goofy grin, “Hypo diabetic. Not good. Need juice”

He just smiles and nods and I go back outside. The world is coming into focus by now; after all I’ve just polished off 500ml of orange juice. And that’s when I start feeling like a prat.

“Seriously…how much did I embarrass myself there?” I ask my other half.

He just looks at me with a grin and shrugs, no answer given. It’s probably best for him not to tell me I think, as we make our way around to the supermarket, where I still want to eat everything.

—————

Samantha is Type One and regularly blogs at http://www.talkingbloodglucose.com/

And lo! the scales fell from my eyes

During the summer last year we went round to some friends of ours for a dinner party. Yes, a dinner party – now that I have reached my thirties, I no longer have the desire to frequent sweaty nightclubs of a Saturday night, downing expensive, sticky drinks and being much, much too close to the dripping unwashed masses.

So being unrelenting and incurably middle class, I now spend Saturday nights with friends, supping fine wines and discussing the issues of the day (I say that, but this particular dinner party ended up being somewhat rowdy, with broken glasses and minor chaos – we eventually left our host in the early hours with an uncontrollable bout of booze-induced hiccups).

Anyway, I digress. I bring up the whole dinner-party thing because I noticed on that particular evening that our host had a rather fancy-pants set of scales which gave you the various nutritional values of whatever you happened to be weighing. I saw that it did carbohydrates and duly lodged this diabetic-friendly piece of information away in the recesses of my brain.

So it came to pass that when our crappy set of TESCO scales gave up the ghost (thanks TESCO – that was £12 well spent, I think not) I finally fulfilled my ambition and purchased a set of said fancy-pants scales.

As I think I’ve mentioned before, I religiously carb count. I mean religiously in that I strictly carb count about as frequently as I attend church (once on Christmas Eve and the occasional wedding). Most of the time I fly solo and make an educated guess for carb contents and insulin doses. But every once in a while I properly check and log everything for a week or so – sort of like a diabetes refresher course – to check I’m doing things well.

It’s therefore when I’m doing a periodic refresher that these scales really come into their own. Can’t be bothered to work out the carb content of your glass of breakfast orange juice? Easy – just bung the glass on the fancy scales, hit 878 (the code for orange juice), fill up with orange and hey presto! up comes the carb content for that exact amount of fruity juicy goodness. Yum!

Using the internal memory, you can quickly tot up the total carb content of your entire breakfast (which is usually, for me, a pint of heavy claret and a whole roast pheasant and trimmings) and log and inject accordingly.

So while not entirely world-shattering, my new fancy-pants scales are actually quite good with helping me to carb count. More importantly, they look really cool. So – in summary – they’re probably a worthwhile spend of £36. If you care, my Salter “Nutri-weigh Slim” electronic scale can be found on the John Lewis web site; if you don’t care, what technology-of-the-future do you use to help carb count?

Here at ShootUp we believe a healthy dose of cynicism is as important a part of living well with diabetes as insulin, carb counting and a balanced helping of optimism. 

I’ve already admitted the cardinal sin of not being excited about a cure and questioned whether the sexiness of finding a cure distracts us from providing decent care today.  Now it seems that there are more super cynical Brits around.

Fellow Brit Caroline is a little underwhelmed by the hype around the artificial pancreas. I’ve been meaning to write an article about the issues facing the artificial pancreas for a while, but this one is a really well thought out look at the reality of the situation that I certainly couldn’t improve on. Enjoy!

Just out of reach

By Samantha

Today, I go into battle. Excuse me while I suit up…and the somewhat serious nature of this post…

Since deciding that an Insulin Pump would be the best option for me, I seem to have had nothing but trouble from various people in the diabetes specialist world. As some you may know from reading my own blog, I have recently come out of a few years of huge diabetes rebellion which has culminated in the onset of peripheral nueropathy. Not very nice I can tell you. And since getting my backside into gear, my blood sugar levels have been all over the place. We’re talking constant hypos (three or four a day usually), which I don’t often feel, as well as huge highs. And all of this is despite carb counting.

I have been arguing with specialists for months now about getting a pump. And my fantastic nursing team have been brilliant about it, pushing my notes forward to various professors and big cheeses.

Then the phone call this morning came. It was my nurse, and she told me that the big cheese had said under no circumstance would I be eligable for a pump. He reckons my latest HbA1C is too good, and I’m too well controlled. Funny that…despite phoning up my nurses in a panic because of various factors and them knowing the factors that have contributed to my wanting a pump. Funny, that despite having massive blood sugar issues, and massive problems with the restrictions of MDI’s, that they still feel it necessary to refuse this flat out.

HbA1C is not the be all and end all of starting on insulin pump therapy surely? Surely there are other factors involved such as the way the diabetes affects the person in question’s lifestyle? Such as, oh I don’t know? Deblitating hypos? It just seems funny that a supposedly brilliant team has immediately jumped on the HbA1C thing, rather than considering all the options.

A total kick in the teeth. And one I’m not going to give up easily I can tell you. Someone fetch me a giant stick so I can keep hitting my specialist with it til he relents!

My fight starts now. It’s going to be a long and hard battle, and many lives may be lost along the way. But I’m certainly not going to give up on this one. The emails to various people in the know have been started, and a full on daily diary of blood sugar issues and whatnot has been started too. My weapon of choice? One fully loaded novopen 4…kapow! Take that specialist team!

But my question for you guys is thus: have any of you had to put up with such things getting hold of a pump? And also, do you have any advice?

—————

Samantha is Type One and regularly blogs at http://www.talkingbloodglucose.com/

Before we get on to the main article suggested by the intentionally provocative headline, first things first – happy New Year to all our beloved readers. I hope you all had a lovely Christmas (or equivalent winter-based festival) and a fab Hogmanay. I certainly did; hurrah!

Anyway, avid reader Rachel brought my attention to this article in the Express newspaper about insulin syringes and airport security. For our non-UK readers who might not know of it, the Express, in my humble opinion, is a worthless rag with horrible, ill-researched journalism (if you can call it that) that results in a paper that is barely worth using to line the cat’s litter tray.

Essentially the jist of the story is that following the Christmas Day bomb scare thing a journalist (if you can call him that) apparently “evaded security” by taking a insulin pen through the security checks at Schiphol airport. After successfully getting airside, the scaremongering article notes that said journalist could then have used the insulin filled pen to…uhm…uhm…not do very much. Oh. Perhaps that’s why security ignored his small vial of insulin in the first place.

I’ve written about airport security before and I’ve never had any problem with taking insulin, needles, finger-pokers and what-not through airports. I never bother telling anyone I have a bag full of insulin and I’ve never been stopped. My concealed pistol has, however, been slightly more problematic. With talk of security being beefed-up (including not allowing passengers access to hand-luggage during the last hour of flights, etc.) I wonder if the pancreatically-challenged hoards might have problems in future?

I suspect we probably won’t – after all there’s not much you can actually do with a syringe – a few small vials of insulin and a couple of packets of test strips could hardly pose a security threat. So I think the Express’ article completely missed the point in two major ways. Firstly, the baddie on Christmas Day also had a load of explosives strapped in his undies – surely that being missed is a little more of an issue than a syringe. And secondly it’s worth noting that not all terrorist attacks happen on planes. The London 7/7 and Madrid attacks were carried out on trains and buses but there’s no talk of security scans on the number 44 bus to Balerno. In other words a determined terrorist will always get through no matter what levels of security are imposed – so why take it out on us innocent diabetics?

Anyway, I’d be interested to hear if any of our readers have had any issues with security since Christmas Day (or indeed, ever). And finally, can any of you diabetic geeks work out what brand of insulin the reporter has in the pictures - I can’t. Answers in the comments below!

Welcome to 2010.  A brand new year, a fresh start. And a shiny new lancet in my finger pricker. I’m not reknowned for remembering to change my lancets but I always make the effort to start the new year with a sharp new dagger to spear my finger.

Happy new lancet to you all!