Shoot Up or Put Up

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!

Generic pictorial filler

Well, it’s that time of year again – today was time for my seven-month review at which I’m poked, prodded and vampiric amounts of blood removed from my arm for analysis. My feet were jabbed and I was blinded by the flashes of the retino-eye-camera-blindy-thing-whatsit (I’m sure it’s got a slightly more formal name).

Anyway all that aside, the figure we care about is, of course, the A1C – the roughly three month average of how good, or bad, a diabetic you’ve been. This time, mine was 6.3 – down from 6.5 in March. And all done on MDI – none of this pump malarkey. As Alan Partridge would say, “Back of the net!” Top right hand corner! I give you permission to bask in the glowing glory of my personal A1C magnificence!

While I was there, I also had a chat with the doc about my peaky mornings (I start at about 5, put in 8 units of humalog 20 minutes before a small breakfast and still end up at 13 two hours later). So we’re having a crack at using the slightly newish Apidra -  which is made by the same chaps as everyone second favourite long-acting insulin Lantus.

Apparently Apidra kicks in a bit quicker than Humalog (which is pretty quick in itself) so it might be useful for trimming the top off the morning peak. Anyway, I’m going to give it a go and see what happens. Rest assured, beloved readers, I’ll report back with the results in due course.

You'll just feel a little scratch

Well it’s that time of year again, the time of year when I usually ignore my letter from my doctor reminding me to go and get my winter ‘flu jab.

But not this year, oh no. No, this year I’ll definitely be subjecting myself to the joys of a slightly achy arm for the day. I’m not particularly worried about swine ‘flu (oink), as from what I can see it doesn’t seem to be much worse than usual seasonal ‘flu. I suspect it’s been, perhaps, blown a little out of proportion. After all the British press absolutely loves a health scare – especially rancid rag The Daily Mail, which seems to be made up of little else. If I’m wrong, however, please feel free to crow over my cooling corpse saying “we told you so…”

Anyway, I’m just terrified of the usual plain old common or garden ‘flu. Why? Because last year I actually got it and I have to say that it was far from being a week-long chucklefest. I picked it up at a family birthday in France from my brother – yeah, thanks Ben – and on the return trip spent a merry afternoon in Gatwick airport waiting for connecting flight  steadily feeling more and more awful (and, coincidently, probably passing on said ‘flu to 30,000 passers-by who were flying to every corner of the world – go me!)

The next five days or so were spent in bed, sweating, shaking, coughing, spluttering, checking my BG every hour, injecting extra insulin and generally wishing I was dead. Everything hurt and I could hardly summon the mental energy to get up and do something as simple as visit the bathroom (I did eventually go, you’ll be pleased to hear). It was the second most miserable five day period I’ve ever had. The first most miserable was the last time I had ‘flu – at boarding school in Northern Ireland. What fun that was!

So, never wishing to experience the misery of proper ‘flu again (man flu’s fine – I can deal with / put that on any day) I’m ignoring the inevitable health scares concerning vaccines and I’ll be at my doctor’s next Saturday at the front of the queue for the jab.

I have to confess that despite all that, I probably would have ignored the doctor’s reminder as usual. But after consistently disregarding her advice to “go and get your bloody ‘flu jab” last year, Katie very sensibly just made an appointment for me yesterday. I have been told.

It appears my expectations of my own diabetes don’t always match other peoples’ expectations.

I went for my annual torture session at the opticians recently. The “sit there while I shine a bright light into your dilated pupils until you cry” appointment. OK, its not that bad really, it just feels wrong that I go into the opticians with perfect vision and come out unable to read a computer screen for several hours.

Anyway, I have a couple of small bleeds in my right eye that have been there for about 5 years. We’re keeping an eye on them (can you believe I wrote that?) and so far they’re stable and not too much of a concern.

The optician, ophthalmologist and I all agree they don’t need treatment at the moment and the best course of action is to maintain great control to prevent them from getting worse.

The interesting bit is the attitude of the optician depending on who I see. With Mr A we assess there’s been no change and agree that continuing good control and regular monitoring is the way forward.

Last year I saw Mr B. He said similar things but his attitude was completely different. He said retinopathy is to be expected as I’ve had diabetes for 25 years. STOP RIGHT THERE. That may be factually correct but let me manage your expectations. That might be an acceptable statement if I was diagnosed aged 65 and am now approaching 90. But I’m not. I’m 30.

You need to understand, I’m not in denial. I know complications are a possibility. But I believe mental attitude is a big factor with diabetes – if I see complications as inevitable then I won’t view a small bleed as a wake up call to tighten my control, I’ll just see it as one of those things that happens and won’t take the necessary action. With that approach what state am I going to be in at the relatively young age of 54 when I’ll have had diabetes for 50 years?

I’m not dreaming, I know this is doable, I know people who’ve lived with diabetes for over 60 years. They’re fit, healthy and pretty much unblemished by the experience.

So I find myself having to help my health care advisors by managing their expectations of my diabetes. I have high expectations when it comes to my diabetes. I’m not aiming for ok or average, I’m aiming for great because I have a life to lead and diabetes will not be the thing that stops me. Please revise your expectations accordingly.