Shoot Up or Put Up

Clubbing - Belgian style

Last weekend I met up with two old school friends in the party capital of Europe, uhm, Brussels. While it may have a reputation for bureaucracy and dreary boringness, Brussels does actually have a great night-life, so soon after arriving we went out to hit the pubs and bars of the capital of the EU. Woo!

After sampling some (by “some”, I mean “quite a lot of”) cherry wine in a bar that used to be brothel, we headed off to Les Halles Saint-Gery and the famous club night “Stop Suffering and Start Dancing” which was being held in large, sweaty, crowded, smoky nightclub. As always when clubbing I had the issue of what to do with my insulin while I partied like it was 1999.

As I’ve mentioned before I carry all my diabetic kit around in one of a variety of funky man-bags. But the problem is you can’t check said bag into the cloakroom as you’ll inevitably need to test your blood glucose or inject at some point between arriving at midnight and leaving at 4am. So the only obvious solution was to head onto the dance floor, bag in tow.

So if you happened to be at Les Halles Saint-Gery last Saturday night and some git in the very centre of the dance floor, who danced like some sort of escaped lunatic (and was accompanied by a ginger monster and bearded freak*) kept bashing you with a brown leather Visconti bag then I can only apologise profusely. I’m sorry, I really am, but I had no other choice.

While dancing like a loon I was inevitably burning off calories (and producing my own bodyweight in sweat – yum!) leading to the obvious risk and tedium of sorting out a hypo. So I duly checked my BG (the strip light on the Freestyle Lite proved very useful for testing in a club that was seemingly only lit with flashing strobes). I was pleased to see that appeared to have created a perfect equilibrium between the energy I was using up and the carbs in the beer I was glugging down all night.

Who would have thought it? A bottle of Satan beer (yes, it is called that. If you can find it, try it as it’s very nice. Though at 8% it is rather strong…) every hour perfectly balances an hour of dancing like a maniac.

That beer can be put to this use is, I think, a very important discovery. So I will be applying to Diabetes UK for funding to conduct a great deal of further research. Naturally we will need plentiful supplies of beer and night clubs with good music. Any diabetic volunteers want to help out?

* It’s worth noting that Dave (said “ginger monster”) is the person who came up with the name of this blog and, indeed, the very tasteful sub-title. For this he deserves credit. It’s also worth nothing that Mat (said “bearded freak”) has contributed nothing.

Generic diabetes-related pictorial filler

If, for some weird, inexplicable and entirely hypothetical reason you were given a choice of which chronic illness you had to be inflicted with, diabetes might actually be somewhere at the top of your list.

None of us wanted to become pancreatically-challenged and I daresay if a cure arrived tomorrow (it won’t, by the way (and even if it did, it wouldn’t be available on the NHS)) we would all jump at the chance of finally being shot of diabetes once and for all. But, while it’s undoubtedly a pain, it’s a lot better than other, inferior, chronic illnesses because:

•   It’s under our control. Very generally speaking, the better we look after ourselves the better our quality of life and the fewer bad consequences we’ll suffer when we’re ancient. We do actually have a lot of control over our chronic illness. It’s not as if we expect to find ourselves writhing and foaming on the floor at utterly random times, or regaining consciousness in a seedy motel room 300 miles from home with no idea how we got there, á la Fight Club.

•    Short term problems are easy to treat. Obviously extreme highs and lows can lead to a spell in hospital but these are very rare. If our blood glucose goes too high we can shove in more insulin. If our blood glucose goes too low we simply guzzle down a pile of cakes, fruit pastilles or other delicious, sugary delicacies. Minor problems can be quickly and easily treated ourselves.

•   We only need occasional hospital visits. Everyone, without exception, hates hospitals. But I only have to go up to my local hospital for a thorough check up every 7 months and it takes about an hour or so. Frequent visits to the doctor and long, painful treatments are not required.

•   It probably won’t kill us. With well managed diabetes we can expect to live out our three score years and ten. Diabetics don’t tend to die young. I don’t know about you but I think this is actually quite a Good Thing.

•    It’s actually quite healthy. Aside from the whole pancreas-not-working thing, diabetes is pretty good for you as we’re encouraged to have a healthy diet and exercise a reasonable amount. The fact that life is easier if we do these things is quite a good incentive for actually doing them.

•   There’s not much blood. We might get a few bruises and our finger tips might be ravaged, but diabetes involves seeing only tiny amounts of blood for testing, etc. – and most of our blood stays within us. This is definitely a Good Thing. Try eating lunch and reading blogs about haemophilia (with lots of photos, of course) and you’ll know what I mean. We’re lucky!

•    It’s inconspicuous. Unless you tell them most people will not know you are diabetic as there are no outward signs you have it. This allows us to be as open, or as private, as we like about our diabetes. Some people like to only tell their partners or a few close friends that they’re pancreatically-challenged, while others delight in injecting in full view in crowded nightclubs. So at least we have the choice how we deal with it.

So there you have it. Diabetes might be a complete drag at times, but compared to other chronic illnesses it’s a walk in the park. Thanks my non-working pancreas chum!

Shelly's new motor-yacht

Just two short bloglettes today for your enjoyment. Firstly, some of you may be vaguely aware that as well as running a top quality blog, we also have a forum at http://forum.shootuporputup.co.uk. The Shoot Up forum quietly ticks along and to be harsh, but fair, not a great deal happens over there. Personally, I quite like it because I’ve configured the forum so flashing emoticons, pictures and inane signatures can’t be displayed – bliss!

Anyway, while there are infinitely better diabetes forums out there - http://www.diabetessupport.co.uk is a good example – occasionally the soaraway Shoot Up forum has a few gems of goodness. A case in point as a long running thread at http://forum.shootuporputup.co.uk/topic.php?id=2 describing how we were diagnosed with diabetes and memories of that fateful, heart-sinking day when we discovered we were a member of pancreatically-challenged club. Anyway, it’s a good read if you ignore my stupid comments about spies and stuff on the first page.

Secondly, our chum Shelly at Circle D has blatantly asked us to plug her new eBook “Living with Diabetes 24 hours a Day – A Personal Journey” which is available here. As we’re hoping that Shelly will invite us on one the yachts she’ll inevitably buy with the profits, we’re more than happy to give her said plug.

Shelly also runs Circle D and organises diabetes-related socials down in sunny Kent and she is a font of diabetes knowledge and support – so check out her site and buy her book, so she can become the colossus of the diabetes world that she richly deserves to be! Rrraaaagh!

http://circledrocks.co.uk/

I recently had cause to look at my fingers. Not a high octane thrilling experience, I’m sure you’ll all agree. But I did notice the array of tiny dots caused by the last zillion, or so, blood tests that my poor, ravaged fingers have had to endure. While I can never take a break from diabetes, I thought that my mangled fingers could do with a rest and so I decided to give alternate site testing a go.

My first meter, along with the myriad that I’ve used since, came with the obligatory finger poker. Said finger poker came with an alternate clear bit to shove on the end for what the guidebook described as “alternate site testing”. “How thrilling”, I thought, as I chucked the apparently useless bit into the bin.

However, last week I dug through the rancid, rotting fish bones in the bottom of my bin and pulled out said clear finger poker bit and gave it a go. Incidentally I’m not really sure why finger pokers have a clear end bit for alternate site testing. Answers below if you have any idea.

Anyway, back to the article; with my poker ready to poke I started with my palm. The first thing I noticed, pretty quickly, was that it hurt. Quite a lot. Maybe my crusted fingertips are so covered in scar tissue that I can no longer feel anything through them – not even a sharpened piece of metal being thrust into them. (Bang goes a career in delicate eye surgery). But, whatever, it seemed more painful than the fingertips.

I also noticed that a bleeding palm is quite difficult to give a squeeze to get that little extra bit of blood out as you do with your fingertips. As a result I failed to fill up three test strips and my meter moodily displayed its nagging “You haven’t put enough blood on, eejit!” message (I have a very rude meter).

The palm being a failure, I then moved on to inflict some misery on my forearms. The fatal flaw with my arms is that they’re quite hairy. Not exactly the matted fur of a gorilla, but certainly enough hair to be going on with. Said hair just made things trickier but, bravely, I persisted.

Much like the palm, the arm isn’t very squeezable and so getting that all important extra drop of blood out was quite difficult. So I increased the depth gauge on the poker until I could swear I could hear the lancet scraping against bone every time I attacked myself.

Finally the mission was accomplished and I managed an alternate site reading. However, I then observed, with mild revulsion, how much your arms actually bleed after being stabbed with a full-depth lancet. After my five or six attempts I looked like I had enjoyed a jolly evening of self-harm but, hey, at least I had my reading.

So will I continue to alternate site test? Probably not. It generally seemed like a pain in the arse and wasn’t very successful. However, because of the post-test self-harming-look I might save the arm-tests for Hallowe’en parties.

I know you’ve also been waiting for weeks in eager anticipation of our latest poll results. Well, dear readers, wait no more!

Last time we asked how involved you got in diabetes politics. In other words, if you don’t like something about your diabetes care what do you do about it?

Apparently not a lot. With the majority (56%) noting that they got angry but didn’t, in fact, actually do anything about it. From this I guess we can conclude that the majority of diabetics are frustrated passive-aggressive balls of misery. Hurrah!

However, a sizeable number of firebrands actively chase their MPs, health boards and so on to try and force complacent health providers to improve their care. A smaller minority of 12% (whom I suspect is just Alison voting multiple times!) cared enough to note that they would be prepared to start riots, set fire to things and generally cause a nuisance (I suppose violent insurrection is quite a nuisance) to make changes to diabetic health provision.

Finally, the smallest minority (4%) just didn’t give a toss, evidently preferring to vegetate on their sofas instead of actively looking after their health. And, as they say, why not?

The new poll is all about how often you think about your diabetes on a daily basis. Are you obsessive compulsive about it or downright negligent? Click over to the right to register your vote!

Those results in full:

I get cross, but don’t actually do anything – 56%
I’ve written to my MP about diabetes – 28%
Rrragh! Man the barricades! -12 %
Meh, diabetes issues? Who cares? – 4%

As I write this I’m still gently suffering from my hangover resulting from the Shoot Up night out yesterday. I have a sneaking suspicion that one of the glasses of merlot I consumed was off, hence feeling slightly off-key today. However, it’s nothing a gallon of water and two paracetamol won’t cure.

Anyway, self-inflicted misery aside, yet again we had a thoroughly good turnout of Edinburgh’s pancreatically-challenged hoards. While I carefully brought my camera with me I stupidly neglected to take a single photo, so you’ll just have to take my word for it that a good time was had by all.

Given that Edinburgh-based diabetics clearly enjoy a pint or two, I’m planning the next night out for sometime in late March / early April or thereabouts. So keep an eye on events calendar down there (*points down the right of your screen*) for times and dates!

As a result of wildly popular demand, the next Shoot Up night out is scheduled for Saturday 13 February. Taking place in the heart of sunny Edinburgh, we plan to  eat food in a restaurant – to behave like civilised people [update: someone neglected to book a table in time - Valentine's weekend busy, who'da thought it? Duh! So forget the restaurant bit] – and then proceed to the pub – to behave like un-house-trained animals.

If the thought of sharing breathing space with a bunch of diabetics appeals to you (and I bet it does) then head over to our Facebook page for all the gory details:

http://www.facebook.com/event.php?eid=270821976326&ref=ts

As always, everyone welcome – this includes partners, non-diabetics, fans of the blog, stalkers, etc. See you there!

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!

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?