Shoot Up or Put Up

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by Alison

The terrible smell

10 July, 2012 in Living with diabetes, Mildly amusing

After yet another diabetes related bed sheet incident I am now starting to think that diabetes and sheets are simply incompatible bedfellows. This time there was no visible problem, no massacre-like blood stains or mysterious slime. Oh no, this time it was the smell. Thankfully not the smell of my toes rotting off or my kidneys frying, but stil not a fragrance I like to have around the house.

I’m sitting on my bed (which I’d only changed the day before) getting ready to change my infusion set. I have no concerns about blood spots getting on the sheets because the set I’m removing is on the top of my thigh. If I remove a set from my buttocks while sitting on the cream duvet, I can almost guarantee it’ll bleed and leave tiny red marks on the duvet. But my mind is clear of such concerns today.

I fill the reservoir with insulin and squirt a bit back into the bottle to remove some air bubbles. Then I draw a bit more insulin into the reservoir to make sure it’s full. Then I get a bit carried away and pull the plunger completely out of reservoir, emptying 300 units of insulin all over me and the bed in the process.

I don’t tend to notice the smell of insulin any more. Apparently 300 units is enough to cure my olfactory fatigue. I can confirm that it stinks. I finish the set change and naively mop up the insulin thinking that’ll sort the problem. Afterall, despite probably being enough to kill 4 ShootUp readers should we split it between us and inject it all at once, 300 units isn’t really very much. It’s just a few spoonfuls.  

Having washed my hands, I return to the cleaned up bedroom. The smell is overpowering and showing no sign of abating. I strip the bed and resign myself to having to wash the sheets. I also change my clothes. I carry on with my day, but there’s a lingering smell wherever I go. Even with clean clothes on, I still stink. I take a shower. I start planning what we can have for dinner that’ll overpower the insulin smell – curry and garlic perhaps?

The husband comes in. By now the house is full of wet washing because the British summer monsoon is raging outside. But that doesn’t really matter, because there’s no hope of smelling the washing over the overwhelming stench of insulin. From the way the husband recoiled as he crossed the front doorstep, I guess the smell is still pretty powerful. We open all the windows and go to the pub.

Thankfully the smell seems to have gone now, but I’ve learned my lesson. From now on all insulin will be stored in a safe box in the garden shed and only used when wearing full safety gear.

First insulin injection given 90 years ago today

11 January, 2012 in news

This dog was interested to read that the first ever insulin injection was given 90 years ago today on 11 January 1922. Made from extract of boiled cow and ultimately causing an allergic reaction in the human guinea pig, it was a good start, but it’s pleasing to see they’ve refined things a bit over the years.

They say insulin revolutionised diabetes treatment, but that feels like a bit of an understatement.

Today seems like a good day to celebrate having merely a chronic condition, rather than an inevitably terminal one.

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by lizz

Human insulin, pork insulin and me

26 April, 2011 in Living with diabetes

My hypo warning signs disappeared with the advent of ‘human’ insulin. My change from pork to human was accompanied by a spanking new insulin pump, one of the first, and the fact that it caused extremely severe hypos here, there and everywhere was lauded as wonderful news by my diabetes nurse – I was so much better controlled now!

Pork insulin is real insulin obtained from the pancreases of pigs slaughtered for meat. Insulin is a protein made up of two amino acid chains, joined and ‘folded’ into a particular shape.

Pork insulin differs only slightly from human insulin, by one terminal on one of the amino acid chains.

‘Human’ insulin is made in vats by genetically modified bacteria or yeast cells. The two chains are made separately and chemically combined. But they will not function as insulin until they are ‘folded’ by a secret procedure. After folding, it is identical to real human insulin.

I have no idea why ‘human’ insulin does not agree with me, but can only conclude that the fault lies somewhere in its manufacture – unfolded chains perhaps?

My consultant had – through ignorance presumably – also kept me on long-acting Ultratard. Ultratard was a long-acting insulin injected for basal last thing at night. This prolonged my very severe hypos, and along with other issues, eventually forced me to give the pump up after a year of trying.

I was then moved to a new, shiny Novopen and a new blood-testing machine. By then I was used to the hypos and didn’t connect them with my move to human insulin.

My problems were not a worry to anyone other than me until I wanted children. At which point, after a hypo that saw me into hospital, they kept me in to try and ‘balance’ me. My consultant at the time couldn’t manage it and while he was at a conference another consultant ‘stole’ me and tried himself.

It took six weeks and no exercise but at last I stopped swinging quite so violently and was allowed home with folic acid to try for a family. Once pregnant (this was an IVF baby) I stayed on the sofa for nine months. I had another baby 5 years later and managed by being very careful, but also, my control became a lot easier whilst pregnant.

Then I was changed to another human insulin – Humalog – and experienced other symptoms. Two of my fingers suddenly wouldn’t bend – then wouldn’t straighten. I could no longer do the lotus position or get my leg behind my head (not a pressing problem, I admit) because one of my ligaments wouldn’t stretch. My hypos became much more severe and frequent.

So I was started on an insulin pump – a Minimed 507 with Humalog. I think the continuous supply exacerbated things – my fingers almost seized up. The pain was much worse. I was getting pains in muscles. I was suffering memory loss and felt tired. In the end I looked up these symptoms and found the Insulin Dependent Diabetes Trust– and changed to using pork insulin in the pump.*

What a difference! Within DAYS I was thinking more clearly, my body (and this is the only way I can describe it) felt ‘calmer’. I slept better. My hypos decreased (from 10 a day to about three) and weren’t as severe, I wasn’t irritable all the time, the pains disappeared and in three weeks my fingers freed up and I could move them. They are still fine.

I now have an utterly wonderful team at hospital, and excellent care I can’t fault. A pump, with tiny doses, and pork insulin, a team who listen, the possibility of CGM on the horizon and my little trained alert dog, Lola, all of which now keep me as controlled as I am ever likely to be! A far cry from being thrown out of a ward because my blood sugars were uncontrollable as a teenager – I was trying, honest, I was not eating sweets! Or being told by a consultant that my tiny doses were ‘homeopathic’ and I should eat more! I often wonder if anyone else had similar problems with getting health care officials to believe them. Have you?

*Advice on symptoms possibly related to human insulin is available from http://www.iddt.org/

Avatar of Alison

by Alison

Identifying the perfect piece of flesh

2 February, 2011 in Kit & equipment, Living with diabetes

The thing about injections and infusion sets is there are so many options and such a vast selection of flesh to put them in it’s hard to know where to start. 

I started young with the whole injection business and with that came a picture of a man/woman/android complete with grids on each injectable area. Each thigh and buttock was divided into 8 squares, the same for the stomach and a grid of 6 on each arm. Then as you injected in each place you coloured in the corresponding square on your man/woman/android. When the picture was complete, thrillingly you got…another picture to start again on. That was my first lesson in quite how monotonous this diabetes thing can be. 

But, aside from the repeated disappointment it did set me off on a lifetime of site rotation which is no bad thing. When I stopped using the pictures I did rebel and have been doing so ever since…without the motivation of having some squares to colour in I stopped injecting in my arms. I’ve never liked it; I only did it so I could complete the picture and move on to the next man. 

Infusion sets are a bit harder than injections because wherever you choose to stick it, you need to be happy you can live with it there for 3 days. My favourite spot is my lower back. It’s the quiet little cul-de-sac of the body. It’s out the way so I don’t see it if I look in the mirror and there really isn’t much activity or passing traffic to tangle with the set and tubing. It’s perfect. It’s also my favourite spot for CGM sensors so they usually get priority there and infusion sets are relegated to the thigh or buttock. Either is fine but it did take a while to stop me pulling the thing out every time I pulled my pants down. In the early days of thigh/buttock exploration so many toilet trips ended in much cursing and irritation. 

The stomach seems to be the spot where most people start with infusion sets. I venture there every now and again for a bit of variety but it’s my second favourite sensor spot so I do like to save it for them. 

I use Quicksets on my back, thighs and buttocks and they work really well for me. For my stomach I prefer Silhouettes. While I may be an insulin tart, when it comes to infusion sets I’m quite the young innocent. I found two that work really well for me and I’ve stuck with them. 

The final piece of the butchered human injection/infusion set site puzzle is arms. I don’t do arms. At all. Ever. I’ve reached a level of maturity where not even the satisfaction of being able to move on to another picture would make me do arms. Maybe if I was offered diamonds or holidays, or a significant amount of cold hard cash for a fully coloured in virtual person I would consider it, but for now, arms are safe. 

What about you? Where do you put yours?