Shoot Up or Put Up

I’m back. Sorry it’s been a while, there’s been a lot going on and I have shamefully neglected the blog. I did have a lovely holiday though, sailing on the Turkish coast. As ever, I learnt a few new (and not so new) pearls of wisdom about holidays with diabetes: 

Lots of boats

• Diabetes junk and I will never get along. No matter how many times I travel, I still get irritated by the amount of diabetes junk I have to carry. It seems doubly irritating when I realise not only is my hand luggage weighed down by diabetes junk, but I’m also carrying round a redundant organ in the shape of a pancreas that isn’t pulling it’s weight  
• Insulin pumps survive a dunking in sea water perfectly well when you accidentally fall out of a dinghy whilst trying to get back onto your boat. A quick rinse in fresh water and it was good as new.  
• I get a bit scared when a storm blows up, we’re still an hour away from where we want to get to and the waves are crashing over the boat. At this point, as you head downstairs to pull out the life jackets and harnesses, it’s not ideal for the boat to plunge down a wave and bounce you across the boat, catching your pump tubing as you fly and ripping out your infusion set.   Once the husband was securely harnessed to the wheel I decided an hour without insulin would be preferable to trying to change an infusion set at sea in a gale. And no, the super quick infusion set removal didn’t hurt at all, but the bruise from crashing into the side of the boat was very impressive.  
• Sods law will always prevail. It’s 8am, we’re in a lovely little Turkish harbour. I’m in the cabin with my diabetes junk spread all over the place as I change my infusion set. The husband is on the loo. At that point I hear a lot of shouting as people try to tell us that some idiot has managed to pull up our anchor as they were leaving. Ten minutes later, all would have been fine. But no, all hell has to break loose when Captain Pugwash is on the loo and the crew is playing at being a pancreas.  
• Other sailors will always think your pump is some interesting boat gadget they’ve not seen before and will be hugely disappointed to learn it’s a life support system for the pancreatically challenged rather than a super dooper at sea navigation aid.  
• And finally, no matter how securely you clip the pump to your bikini bottoms, on a fortnight’s holiday on a boat you will catch the damn thing on a rope at least twice and kneecap yourself.  

 Other than that though, the diabetes was pretty plain sailing.

Caroline’s forum post  about the volume of diabetes junk she lugs around every day made me wonder if I’m a bit of a lightweight. I have a graduated approach to the amount I carry, which increases disproportionately depending on whether or not pyjamas are involved. In brief, my theory is pj=3dj. That is to say, a pair of pyjamas (pj) leads to a minimum threefold increase in the amount of diabetes junk (dj) carried.

If I’m popping out for a couple of hours I take my pump and fruit pastilles. That’s it. Although if I’m in the car there will always be more fruit pastilles, a spare syringe and a decrepit cereal bar tucked away somewhere just in case.

If I have my handbag with me, there’ll be more fruit pastilles plus a syringe tucked away inside in case of emergencies and a spare battery in my purse. If I’m lucky there might also be another bruised and battered cereal bar somewhere.

If I’m going out for the day, I’ll have my blood meter too. Despite previous experiences  proving that life can be a bit of a nightmare when you pull your infusion set out hundreds of miles from home, I still don’t carry a spare (I know, I know, but it happens so rarely and as long as I’ll be home before bed I can cope with a syringe).

Now, here’s where it gets a bit strange. My minimalist approach to daytime trips disappears completely if I’m sleeping anywhere other than in my own bed. If I pack my pyjamas, I also pack my diabetes junk bag with all the diabetes goodies you could ever wish for:

• 2 x infusion sets & infusion set inserter
• Pump reservoir
• Pump batteries
• CGM sensor, inserter & transmitter
• Stickies to keep the CGM transmitter attached to my back
• Insulin
• Spare blood test strips
• Spare lancets – I have no idea why when I only change them on bank holidays and very special occasions.
• Glucagon (although until recently it was out of date)
• Glucogel
• Syringes

At our first ShootUp meetup I discovered that I seem to travel very light during the day compared to others. But what I really want to know is does the pj/dj formula work for everyone, or is it unusual to have such a large swing in diabete junk volume depending on whether pyjamas are involved?

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!

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!

It’s been a while folks what with work being a bit manic and then the husband and I heading off to South Africa for a marvellous holiday, but I’m back! 

And what pearl of wisdom did I discover during my little break? Diabetes can be an excellent way of attracting leopards.

We’d had a great game drive, we’d seen elephants and rhino, lots of impala and a dung beetle but no luck with the leopard. Our ranger radioed the lodge to let them know we’d be back in 10 mins for breakfast. I decided to be a good diabetic and bolus for breakfast immediately so it had a little time to start working.

I’d delivered 6 units of insulin when the call came over the radio – a leopard had been spotted about 5 minutes from us. This was too good an opportunity to miss, breakfast was cancelled and we set off through the bush to track the leopard. I cancelled the rest of my bolus, had a couple of fruit pastilles and spent the most amazing hour following a leopard as it wandered through the bush.

The moral of the story? If you really want to see something on safari, give up all hope and bolus for breakfast. The chance to cause a hypo is too good for any self respecting leopard to miss and they appear almost immediately!

We’re just back from a fantastic fortnight sailing around the beautiful Aegean Sea. We were around the islands where Mamma Mia was filmed so the poor husband is still recovering from being tunelessly serenaded with Abba tunes most days by yours truly! Reading through the comments it looks like Tim’s had plenty of company while I’ve been away but I know that you must have been waiting impatiently for me to answer the questions I posed before I went away.

The wait is over, here we go.

• Disappointingly Greek beer has a greater impact on blood sugars than Croatian beer. I don’t know what the Croatians do to their beer to make it so diabetes friendly but I needed about a unit a glass to cope with the Greek stuff.
• I’m proud (and slightly surprised) to say there was no full on diabetes tantrum prior to departure, but I did allow myself the luxury of a little diabetes grumble whilst packing the seven tonnes of junk needed for a fortnight’s diabetes care.
• And the answer you’ve all been waiting for, how many pump related sailing injuries did I endure? Drum roll please…just the one bruised knee from catching the pump on the rope that hoists the main sail and one infusion set ripped out whilst mooring one evening. Other injuries included a bit of a rash on my back from using extra strong sticking plaster to keep my sensor attached amidst salt water, sweat and sun block and a nasty bruised toe from a slight collision with the anchor. Other than that, I’m remarkably unscathed.

The pump provided hours of entertainment when people spotted it clipped to my bikini. Guesses as to what it was ranged from a personal GPS system so that I could be located if I fell overboard to a camera; a compass; a portable VHF radio and a pedometer! I almost felt like I was disappointing them when I told them it was a boring old insulin pump.

Haute cuisine - French style

You’ll all have noted from her earlier post that that Alison and her hubby are off sailing for a fortnight. Well, not one to be left out, I’m also on holiday for the next six days in the sunny south of France – staying with my folks who live an hour north of Toulouse.

Unlike Alison, I don’t have any queries about my diabetes as I have no intention of doing anything other than sitting the shade, reading The Oxford Book of Modern Science Writing and drinking cold white wine from the Loire valley.

So you lot are going to be cruelly abandoned for the next few days. Feel free to use the forum to continue the cheery banter amongst yourselves. Behave yourselves and enjoy!

The husband and I are off on our jollies for a couple of weeks, so I’ll leave you in the slightly scary but very entertaining care of Tim.

We’re going sailing in Greece which should be fabulous. Sailing is always an interesting diabetes challenge. I find I have to plan my insulin alongside the weather forecast. No wind? Increase insulin in preparation for a day of sunbathing and reading. A good breeze blowing? Reduce insulin and get ready to pull those ropes.

Other important questions preying on my mind include:

• What impact will Greek beer have on blood sugars? Last year Croatian beer proved to be marvellous in having very little impact, fingers crossed the Greek stuff is just as good.
• Will we get to the airport without me having a tantrum about how much diabetes junk I have to carry in my hand luggage? I’d say this is very unlikely.
• And the big one. In the next 2 weeks how many times will I catch my pump on a rope and say something rude when the pump swings round and hits me on the knee? Place your bets now ladies and gentleman, the answer will be published upon my return.

Bon voyage!

In the immortal words of Sir Cliff Richard OBE:

We’re all going on a summer holiday
No more worries for a week or two
Fun and laughter on a summer holiday
No more worries for me and you
For a week or two

Yes, I’m leaving all you lovely readers to the tender mercies of Alison, while Katie and I disappear off to the United States of America for two-and-a-half week’s holiday.

Among other places I’ll be spending a week in sunny Manhattan. Just remember, my American chums, that if it wasn’t for the British, New York would still be New Amsterdam and you’d all be speaking Dutch. Ha!

Holland is of course a wonderful place and the Dutch a liberal, enlightened and intelligent nation with a cracking selection of beers. So, in reflection, sorry about that New Yorkers – if you’d stuck with the Dutch, life would have been so much better. I apologise.

Anyway, if I’m not shot by airport security for trying to smuggle small capsules of liquid and needles into the country in my hand-luggage and don’t succumb to swine fever, I’ll see you all back here in few weeks. Ta ta!

We’re back from our long weekend in Venice, it was all the things they tell you in the guide books – romantic, beautiful, lots of bridges, water, gondolas etc and one thing they don’t tell you – carb heavy.

I’ve thought for years that as well as eating low GI foods reducing the number of carbs I eat gives me better control. When I got my CGMS the data showed that I had much better readings when I ate fewer carbs. This is of course logical, if you’re trying to cope with a massive plate of pasta the margin for error in insulin dosing is far greater than if you’re eating a small green salad. This isn’t rocket science.

I do keep an eye on how many carbs I eat and reduce them wherever I can and overall I do ok. But it’s not easy. I like food that contains carbs. And I now think it is physically impossible to have a low carb weekend in Italy – all that fresh pasta, risotto, pizza, ice cream, tiramisu (yes I know they do delicious grilled fish and marvellous salads and I tried, believe me, but they really do specialise in scrumptious carbs!).

I find pizza in the UK to be the root of all diabetes evil so I rarely eat it. Its high carb and also high fat so it’s absorbed quite slowly into my system. I need buckets of insulin to deal with the carbs but not straight away because the fat slows down how quickly those carbs get in. Since I’ve got the pump, I’ve mastered the dual wave bolus which allows me to put some insulin in at the start of the meal and stagger the rest of it over the next few hours. Bingo, pizza without the immediate low or hours later high.

Thankfully proper Italian pizzas have an incredibly thin base so middle of the night highs following pizza for dinner weren’t a problem last weekend. The first one did catch me out though after I was a bit gung ho with the insulin guessing and it appears I needed half a bucket less than I’d thought. And that brings me to the final great thing about Italy – there’s a very tasty ice cream stall on every corner just waiting to help you deal with that low.