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!

There are certain things in life that only those of us who are pancreatically challenged will ever have the pleasure of doing. Having a heated debate about whether or not you lick your finger after doing a blood test is one of those things. Said debate over at Diabetes Mine got me thinking.

I lick. I’ve always licked. It has never occurred to me to do anything with the left over blood on the end of my finger other than to lick it (or occasionally spread it round my sheets)

I’ve been licking for almost 27 years now and so far no horrific consequences have befallen me despite the gallons of blood I must have swallowed. Here’s where it gets disappointing. My thinking went along the lines of – 27 years with diabetes, guestimate an average of 5 blood tests a day, a lick each time, I’m virtually a vampire I’ve ingested so much of my own blood.

If we assume a blood test takes on average 1 microlitre of blood for the machine and another 3 microlitres left on the finger for licking purposes, that gives us a starting point.

I’ve had diabetes for almost 27 years or 9,862 days to the nearest year (including leap years – thank you pedantic husband).

Work on an average of 5 blood tests a day, every day and that gives you 49,310 blood tests since my pancreas packed in (which in itself I think is a pretty impressive number).

If I lick 3 microlitres per blood test that means I’ve ingested 147,930 microlitres of blood over the years.

Sadly, it takes a million microlitres to make a litre which means after 27 years of committed licking I’ve only managed to ingest 148ml of my own blood. That’s about the size of one of those small cans of diet coke you get on a plane.

What is it with diabetes and size? I thought I took insulin by the gallon but then discovered it takes less than a teaspoonful per day to keep me alive.

Now I’ve discovered that all those hard years of testing and licking would barely sustain a mosquito on a diet.

If I was a vampire I’d have starved to death by now.

Note: The numbers in this article are a stab in the dark. I’m really not that interested whether they’re 100% accurate or not. I’ve already had a tedious discussion with the husband about rounding up and down, decimal places and how much blood I lick versus what goes onto the test strip. I’m starting to wish I’d never started this. Please just be amazed by the scale rather than finicky about the maths

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.

We’re off to Disneyworld in a couple of weeks for a bit of much needed Disney magic. Amidst the excitement it did set me thinking. What would diabetes be like if it was managed by Disney, that all encompassing factory of magical happiness?

If Disney did diabetes…

• My pump would wake me up in the morning with a cheery blast of Zip-a-de-doo-dah
• I wouldn’t be high, I’d be magically elevated
• I wouldn’t be hypo, I’d be having a magical moment
• You’d no longer experience that horrid time in limbo when you’re sitting on the floor waiting for the sweat to subside and the sugar to kick in after a hypo. Oh no, that time would be filled with amazing fireworks displays, beautifully choreographed to classic Disney tunes.
• Insulin would be measured in fairy drops, not units
• I’d have to fight with a certain mouse named Mickey to get to a nice low carb cheese snack
• As a motivator to maintain glucose levels within target range, any results out of range will trigger my meter to play “It’s a small world” on a loop until it gets a result within range. (This way lies madness me thinks!)
• HbA1c results would be delivered via the medium of dance – a good result gets you Mickey and Minnie surrounded by hundreds of dancing showgirls. A less than favourable result is delivered by a screeching Cruella de Ville.
• Snow White would lend me one of her dwarves to carry my diabetes junk round for me (I’m not fussy which dwarf, although I’m pretty good at being Grumpy and Dopey myself so it’s probably best she lends me one of the other 5)
• When I’m having a bad diabetes day and the world is getting me down, a meerkat/warthog dancing combo would appear and serenade me with an uplifting rendition of Hakuna Matata
• The whole thing would be even more expensive than it already is, but somehow you’d feel it was worth the money

Any more suggestions? Have a nice day!

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!

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!

Me vs my grandad. Yesterday

Christmas. It’s a time for family, a time for sharing things, a time for complete overindulgence. But in my family its also time for the dreaded blood sugar wars. You see, both of my grandparents are diabetic. They’re Type II, both on insulin (and my grandmother with an insulin pump) and I have to say, my grandfather absolutely adores to try and beat me in the blood sugar stakes! And usually he wins.

“What’s your sugars Sam?” he asks every morning, only for me to look at him and say something along the lines of “7.2…” or “6.3” or as it was the other morning, “15.2…” And every morning I get a grin, “I beat you. Mine is x.x”. And every single morning I growl at him and tell him how much I dislike him and his good blood sugar levels.

It usually ends up with a lot of stick beating, handbags at dawn and of course the age old favourite of a renactment of the battle of Hastings. I kid you not, it’s that bad. It happens every Christmas without fail. The blood sugar wars, whereupon I lose in a not-so-valiant way, give up and end up eating chocolate cake. The only problem with this however is that the sugars go through the roof, and I end up being laughed at by granddad, who has a much better level than me. Never mind, eh?

I have to say, I had the last laugh after Christmas dinner, when granddad’s sugars were higher than mine. I was a humble 5.6 whereas he was up at 8.something or other. Excellent! It’s all in good fun though. It wouldn’t be Christmas without a bit of friendly diabeticesque rivalry in the Morris household! It has to be done, when the majority of people in said house are pancreatically challenged!

Although I have to say, it gets rather confusing when my grandmother has the same blood glucose machine as me…I wondered why my levels were coming out reading 100 or more. Silly French system!

Though this got me wondering, do any of you have blood sugar wars? Or play swap the numberwang? Maybe that’s just me then…

I hope you all had a fantastic Christmas and have a brilliant New Year!!!!!