#Diabetes - #Norovirus #Attack Day 2 08:37 30th December 2013

#Diabetes - #Norovirus #Attack Day 2 08:37 30th December 2013 

blood sugar 13.2 nausea subsiding and decided to starve for another day as my body is now breaking down fat and therefore could go hyper causing an escalating increase in sugar and dangerous ketosis ( breaking down fat) I therefore took 8 units of Levemir and 4 units of Humalog drank half a glass of fluid and went back to sleep setting alarm for 11:30. Planning going well and well controlled. alarm set for 3 pm and sleep

#Diabetes - #Norovirus #Attack 30th December 2013 05:36

#Diabetes - #Norovirus #Attack  30th December 2013 05:36

blood test 15 mmol, decided I need to increase the Humalog to 6 units to bring it down to 12 -13 could hold back on the nausea and was sick luckily the fluid I'd taken has dissolved the pills so job done, I then drank some more fluid as the thing to avoid besides hypo is dehydration. I then checked the alarm was 08:15 before going to sleep.

My Diabetes - 30th December 2013 02:30

Blood Test 12.3 feeling aweful lots of hot  flushes trying not to be sick for a few more hours took 4 units of Humalog and set the alarm for 05:30 took 2 more paracetamol, really pleased I'm maintaining the 12 -13, most important thing is to avoid a severe hypo and a stay in hospital.

My Diabetes - Norovirus 29th December 23:40

Knowing that i needed to take my usual collection of Pills and could risk being sick I gave into the nausea and vomited soon after waking, I the  tested my blood after washing my hands and before sterilising  them with alcohol.  My blood sugar was 12.3 and I took all my pills with a little milk along with stugeron hoping it would prevent me throwing up for the next 4 hours or so.

I then took another 4 units of Humalog and 8 units of  Levimir, then I set the alarm clock for 02:30 and went to sleep.

My Diabetes - Norovirus 29th December 2013 21:00

Just after 21:00 I tested my blood sugar after vomiting again, thankfully it had now come up to 13 mili mols which from the past i know is a good level to allow me to control it in 3 hour blocks with just short acting insulin with a risk of serious hypo ( for me),  after testing my blood I took 4 units of Humalog and no carbohydrates.  I then took two paracetamol for the pounding headaches and half a glass of squash and set the alarm.  For 23:30.

My Diabetes - Attack of Norovirus day 1

I tried really hard to avoid Norovirus and as I haven't been out much recently I thought I'd missed it.  Then went to pub a few days ago and yesterday afternoon I realised my sugars were going low so kept topping up with carbos all very weird.  Them 16:00 I had a lie down and some more lucozade. Unfortunately  things just got worse.  At 18:30 29th December 2014 I recognised the nausea and luckily by 18:45 I was being sick.  Now you may think the word luckily is a strange thing to say, but 15 mins later I'd have taken 20 units of Humalog and sickness after that would have been a major problem as I discovered some years ago, unlike the films insulin and no ability to keep anything down is a major problem.

After being sick, it was apparent from the nausea that this wasn't going to be a one off as the nausea came in waves.

I tested my blood and it was 4.4 despite all the extra carbos all day.

So I took 10 grams of carbos and no insulin and went to bed setting the alarm for 2hours
and taking a large glass of water with a little salt in it, blood testing meter and a bottle of lucozade.

Submitting diabetesmentor blogger blog to Bing for the search engine to find it

Hi,

I've just finished a video on how I submitted this blog to Bing so it would appear in the Bing web searches, hopefully it will make it easier to do things.  

picture of the binf webmaster page showing diabetesmentor blog

So if your involved with a good cause and want to ask any questions on setting up your own blog or that of a good cause pages, including ad-sense advertising please feel free to ask. The video is on my fixed1t youtube site.

Malcolm Dixon's fixed1t Bing submission video

Still no comments on any of my blog entries :-(

Regards Malcolm (aka fixed1t)

My Diabetes - How I Became Interested in the Psychology And Physiology of My Hypos part 2

Long before Diabetic Dogs became available, I had a discussion with one of my specialist doctors and nurses about smelling the hypo before it happened and therefore being an early warning system. They look sympathetically at me with that 'well if you think thats true thats fine'.
I was still a student and we were studying the so called 'mystic' branch of psychology called Phenomenological Psychology.  It was joked about being 'mystic' because is a branch of psychology not based on external experiments (how I remember it) but on monitoring internal processes. i.e. how do I feel about this.

My Diabetes - How I Became Interested in the Psychology And Physiology of My Hypos part 1

As a 12 year old, we had an interesting Religious Instruction teacher, who covered not only the biblical teachings, but if we were all attentive and behaved he'd spend some at the end of lessons on what we referred to as weird stuff.  Some Old Testament stories of Ezekiel and his description of the 4 propeller 'Lancaster Bomber' and other weird stories from the popular Astronauts from space guru Enrich Von Daniken. He also told us about dowsing and other old mystic type stuff and we'd bring and bend metal coat hangers and search for hidden copper coins in one of the 32 desks to learn how to dowse.  


He also told us about prophets and indian fakirs and ancient and modern mystics and yogi's. He also had a great old book on meditation and showed us pictures of a yogic masters sitting with his legs crossed balancing on their hands, controlling pain and various bodily functions and explain he warned that these took years to perfect, so don't try them at home.

After I discovered I was very good at finding copper coins in desks, a friend and I went to the library for books on yoga.  After some practise I learned to be able to slow my breathing and heart rate and being a thin child I could easily do the half and full lotus.  I discussed with friends how great it would be if you could learn to control things our bodies body and set about doing it, then some years later I discovered it was a new pseudo science called Bio Feedback.

Years on from this, I found a number of  articles in a number of hobby electronics magazines for Bio-Feedback machines and Galvanic Skin Response meters, so I built a couple.  Using the machine I quickly discovered that I actually could do what I thought I had done as a child, slow my heart and respiration, relax very quickly and deeply and the electronic gismos confirmed I was indeed popping in and out of relaxation at the drop of a hat.

So when I became diabetic whilst studying Behavioural Sciences degree, I knew physiological things were indeed happening to me and the effects on my body and from the psychological perspective also my mind. So I decided to become my very own lab rat. I also discovered there was a branch of Psychology that attempted to gain great insights not by doing experiments but by internal personal observation.  It had fallen into disrepute by being a sort of  'mystic' branch of psychology called Phenomenological Psychology.  

It was shunned about being 'mystic' because is a branch of psychology not based on external experiments (how I remember it) but on monitoring internal processes. i.e. how do I feel about this.  Now I had machine that could review my physiology and feelings, tastes, smells and behaviours I could comment on, so I set about using what tools and observations I could make to understand how my hypos affected me and how to prevent them from overwhelming me and rendering me unconscious.

And what an interesting journey it has been.

TBC

My Diabetes - Can A Diabetic Have A Sex Life? Part 6 Viagra, Cialis & Levitra

There is no point in taking expensive erectile disfunction pills like:

Viagra, Cialis or Levitra
If you are planning to ingest large quantities of alcohol with the romantic meal etc. I don't know why alcohol has such a deleterious effect on these pills, but it does.

Also, as I've mentioned previously alcohol prevents the body from using its own energy stores so their is an increased risk of hypo which again will kill off the effect of the pills.

Learning Points:

• Alcohol and Viagra, Cialis or Levitra don't mix

• If you have to drink, do some test to find the right balance for you

• Make sure you have sufficient carbs 

• Viagra, Cialis or Levitra will make your heart beat faster and burn more carbs

TBC

My Diabetes - Can A Diabetic Have A Sex Life? Part 5

Almost everybody at some stage in their life, has a light to moderate hypo from too much exercise, skipping meals or too much to drink.

• pale skin around the eyes

• cold sweats

• tingling of the lips and tongue

• shaky hands

• unsteady on your feet

• difficulty in concentrating

Learning Point:

• Test your blood sugar before

• Eat sufficient fast acting carbohydrates to ensure you don't go hypo

• If in doubt have a bit extra and adjust for it afterwards

A difficulty for diabetics is that excursion hypo is pretty similar to a insulin hypo and there is nothing that will stop you and your partner quicker than either of you worrying that the sweat and clammy skin are down to an impending hypo. 

TBC

My Diabetes - Can A Diabetic Have A Sex Life? Part 4 Viagra, Cialis & Levitra

So what 'Daddies Little Helpers':

• Viagra

• Cialis ( tadalafil )

• Levitra

• etc

Unless you have taken an appropriate amount of carbohydrate and continue to do so during the exercise session none of these pills will help. They will only increase the blood pressure to nether regions, if you are not hypo, and are engaging actively. 

So before reaching for the pill draw its important to get the planning and the provisions correct.

Learning Points:

• These pills need carbohydrates to work
• These pills take time to work 
• During the 30 mins to 1 hour lead time your blood sugar needs to be higher
• If you frequently have hypos these pills are unlikely to help
• If you frequently have hypos these pills my make it worse
• Plan -- Don't Fail

TBC

My Diabetes - Can A Diabetic Have A Sex Life? Part 3

Ignoring all of the emotional content for the time being, its important that a diabetic views sex as exercise, and like any exercise provisions of the extra carbohydrates is crucial.  So ignoring the biology, one has to seriously decide is this a:

• short sprint with no warm-up (hopefully by mutual consent :-)

• ten minutes warm-up then a short walk

• ten minutes warm-up then a long walk

• twenty minute warm-up and a short walk

• twenty minute warm-up and a long walk

• thirty minute warm-up and short walk

• thirty minute warm-up and long walk

• .....

And then there are the marathons for the younger members who don't have work to go to or kids to take everywhere and do all nighters at the festivals. LOL
Using the sports example each of the scenarios will require different preparation and unless planned well in advance and catered for the outcomes could be good or not so good.

• Try and test your blood fifteen - twenty mins before

• If low I drink a quantity of lucozade beforehand, if high I drink a mouthful.  I'm afraid slow release dry wheat biscuits will not suffice

• I always try to ensure I have a bottle close at hand to top up

• I always had some longer lasting 'biscuit' or cake to eat afterwards to ensure there is no post exercise hypo

• If I start to run out of steam I top up 

My best advise if this is all new to you (don't worry nobody ever told me about sex and diabetes) is to keep a little diary:

Time and Date?

blood sugar before?

carbs taken?

warm up time?

walk or run time?

Did you feel hypo?

What were the symptoms?

Headache?

blood sugar after?

It isn't necessary to do this for a long time, but a pattern will emerge quite quickly.

In fact I'll create a tiny database to go on the iPad/iPhone for people to try out, and I'll make it password protected.

TBC

My Diabetes - Can A Diabetic Have A Sex Life? Part 2

Well it didn't take me more than a few hilariously bad attempts to realise that the Doctors and medical experts obsession with achieving and maintaining a constant low blood sugar was not going to do much for my sex life with the cocktail sausage and the damp squib being but a couple available options without appropriate planning and preparation.

The first thing a diabetic needs is a sensitive and sympathetic partner with a sense of humour and who won't take it personally if there is a bedroom failure. I always smile when people say sex is something to be taken seriously 'really' only with your clothes on.  Otherwise you may as well be mud wrestling with warm white chocolate for the mess it makes and the grunting and the sweating and thats before you've even switch the television off.  LOL

The first thing to consider is that if I have a severe hypo whilst playing at missionaries, then I will become a literal deadweight. The more energetically one goes about such things the more sudden is the decline. I imagine many partners do not take lightly to being squashed, although for others it may be what they are seeking. Now you may have pretended for a few moments in the past that you have become a dead weight, but the real thing is much much heavier and more scary and difficult to move, to breath as any judo enthusiast will tell you and unlike the films people tend not to collapse in convenient positions so they can be easily rolled off.

But I've jumped in at the deep end, as we men have occasionally been accused of doing.  It was deliberate.

TBC

My Diabetes - My Favorite Tipple Lucozade

By far the lifesaver for me over the past 32 years has been the humble glucose energy drink "Lucozade".

It is remarkably fast acting at bringing up my blood sugar and not giving me rampant indigestion and I tend to use it when doing work around the house, garden, sex and crazy sports.

I know all the theories about slow release carbohydrates being better for me, and that I should reduce my insulin to do tasks but it always left me exhausted and feeling hypo.

Not only does the mixture of the insulin and the lucozade enable me to get on and do the most difficult jobs it also changes my muscle shape and tone in an afternoon.  Whereas my partner and others spend weeks at the gym and are often left tired and drained by exercise (they have burnt their reserves of glycogen etc) I am left feeling bulked up and ready for more action.

You may think after consuming 30g+ of lucozade and doing some heavy work that my blood sugar would rise after I stop, it seems sensible.  But it doesn't, the blood sugar stays at a reasonable level as my body goes about repairing, refreshing and building muscle my body and the effect last for days or longer.  But if I laze about it all goes back to being untoned.

Mind you I go through quite a bit of it so tend to buy in bulk packs:

Here is a link for Amazon UK 12 x 330ml pack:

And Amazon USA 24 x 330ml pack:

Thats if you can't pick it up in your local store.

In fact a large percentage of the hypos I had when I first became diabetic were post exercise (of any sort) where I had reduced my insulin only to find I need extra carbs as I was going hypo. Then my blood sugar shot through the roof as I had high carbs and reduced insulin. So I had to take a little insulin and I'd bounce back and forth like a game of hyper & hypo ping-pong.

I've also noticed that maintaining my insulin level but using lucozade, my recovery time post-exercise using the is significantly shorter than my non diabetic friends and as they tend to wilt as I just seem to get more in shape, fitter, stronger and more irritating as I want to continue.

But each to their own, this is just how I deal with it.

TBC

My Diabetes - Coincidence or What? UK Newspaper Article - Why sex is good for you

I was just looking for the statistic that sex is equivalent to athletic exercise when I stumbled across this article in todays UK 'Daily Mail Online'.

The article gives ten reasons why sex is good for normal healthy people.

daily mail newspaper article Why sex good you 28th November 2013


What they didn't realise when researching this is that given a large percentage of the complications caused by or associated with diabetes are circulation related, then sex for diabetics must be even more health giving.  Lets face it, anything which increases your exercise, heart rate, carbohydrate metabolism is in my own personal experience extremely useful especially when a lot of exercise is mind numbing.

Also, depression and loneliness are frequent issues for long term diabetics, so anything which causes the release of the positive hormones and makes you feel good must help and bind you to your loved ones.

I'm not surprised that sex is good, but alas not available on Dr's prescription.

I hope you enjoy the article.

Below are Amazon UK links to one of the 1999 published book mentioned at the end of the article, and to a more recent thesis for those who like to research their topics.

                

And for USA readers, here are the Amazon links

               

I hope this does not offend peoples sensibilities no smut is intended.

TBC

My Diabetes - Can A Diabetic Have A Sex Life? Part 1

As a male diabetic I can tell you Type 1 Diabetes and sex has all the makings of a comedy of errors for a number of physiological reasons and you may as well try walking a tightrope with a blind fold on if you don't make preparations.

As I mentioned in a previous blog, blood pressure and blood sugar are linked and given that a certain crucial part of my male anatomy is literally pumped up by blood pressure, it does take much imagination to realise that if my blood sugar drops then my blood pressure also drops and so does any chance of operating the crucial anatomy.

So if I stoke up on carbohydrates beforehand, I just need a bread role to play hunt the hotdog.  But if I fail to have sufficient carbohydrates it will end in a case of find the cold cocktail sausage. ;-) LOL

Now for non diabetics this isn't an issue, unless they get drunk, because getting drunk on an empty stomach will make you hypo and therefore liable to be playing in cocktail sausage territory.

So before having sex I need a cunning plan.

A sad side effect of this is it takes most of the spontaneity out of the event, because this is the only true case of the business saying:

" If you fail to plan you plan to fail " and your attempts will very much end with a damp squib.

 Arg, but I hear people say, have some extra carbohydrates.  But like with the squash game I regaled you with in a previous blog, if you take loads of carbohydrates and your partner says "sorry I have a headache" then you'll definitely get one too from a very high blood sugar and be up all night peeing honey and figuring out how you can put such a high reading in your diabetic record for the nurse or doctor to comment on.

So what to do?

TBC

My Diabetes - How often do you as a diabetic or the diabetic your with look at their watch?

I have found over the years that it's really important when meeting new people I will be interacting with to let them know I'm diabetic.  It really helps them understand the little 'weird?' behaviours I've developed over the years as just plain common sense.  Question? How often do you as a diabetic or the diabetic your with look at their watch?

For me its very often almost whenever I mention time. So what did I think that those who didn't know I was a diabetic thought I was doing?  I didn't know so  I asked them after telling them I was diabetic, and they said things like, I thought:

• you were a very nervous person
• you were impatient with me or others
• you looked like a junkie waiting for your next fix
• you weren't interested in what I had to say
• it was an ignorant thing to keep doing in public
• if he keeps doing that, I'll ask him if there's somewhere he'd rather be
• you were disrespectful to others, looking at your watch and not listening

It became apparent that without the appropriate background information they were rightly making some serious value judgements based on what they saw, which could have relationship or career limiting consequences.

Having been told this I decided that I would use my watch checking 'tick ;-)' to introduce others to my diabetes without appearing attention seeking or narcissistic.  I generally say something like:

"Sorry before we start can I just say that if you see me keep looking at my watch or the clock on the wall, it isn't because I'm bored, or I want you to shut up, end the meeting and go, its just that I am an insulin dependent diabetic and I need to eat at regular set times".  Interestingly, I find I even look at my watch when telling them or if I mention time in any way past, present or future during any conversation.

Of all of the thousands of people I've told throughout the years most have said "oh thats no problem and thanks for telling us".

I've always felt that trying to hide my diabetes is totally counter-productive if people aren't happy about it, then its their problem, but if they are unhelpful when I told them, they would certainly be no use for me in an emergency.

Learning Points:

• I tell people I am diabetic so they understand that I am different
• I find people are generally nosey and show interest
• I find most people say they know somebody with diabetes, but sadly they say they don't tell people and keep falling over
• I find they appreciate the confidence
• I find that in a business situation it humanises me and the meeting
• I find that people will then disclose issues of their own

TBC

My Diabetes - Film 'Broken' starring Tim Roth ( Most Realistic Diabetic Portrayal I've seen on film)

Nearly every movie I have ever seen with a character with diabetes was awful verging on dangerous.

The typical scenario is some major event is going down e.g. a planes crashes in the desert where the is no water and certainly no carbohydrate,  and everybody is desperately trying to find the insulin to give to the 'hypo' diabetic... argh.. it would kill them quite quickly by hypo seizures, coma etc.

As I say to my friends and colleagues, if you find me in difficultly give me carbohydrates, if I perk up in 15 mins then all is well if I don't then the slightly higher sugar can be dealt with later.  Don't ever give me insulin or let me take it without testing my blood.

Don't the medical advisers to these corporations know anything about diabetes.

Then a month or so ago a close friend who also works with people with disabilities asked me to watch the British film "Broken" as she wanted my opinion.

At last a great film with an almost accurate portrayal of diabetes.

The story is quite simple with the portrayal of 'normal people in normal life' and an 11 year old insulin dependent diabetic girl called 'Skunk' (newcomer Eloise Laurence) who lives with her brother and single parent father (Tim Roth)  in an english cul-de-sac.  Like all of us we don't get to pick our neighbours and Skunk is living next to the school bullies.  Skunk also has a neighbour with a learning disability who she treats with kindness and respect, so what could go wrong?

I found the movie gripping, its portrayal of how normal life is for Skunk despite her diabetes was really positive, and the local boy with other difficulties is no harm to anybody.  But then lies and discrimination from the bullies and ignorance and intolerance cause everything to rapidly spiral out of control with devastating consequences.

I thoroughly recommend this as a film.

Here is what Amazon UK

and Amazon USA

This video deals with some adult themes so you may not be suitable for younger children, so I suggest adults watch it first before showing the kids.

Please let me know what you think if you watch it.

Malcolm

My Diabetes - A Great Night Out Clubbing Ends in Accidental Coma

In the eighties when we were both young students, D was visiting her relatives and I decided to go out on a Friday night drinking and clubbing with a friend.  I promised D that I wouldn't  drink too much and would be careful.

We had a really good night but I got just a little greedy and when offered one of the road I took it.  I got home feeling a little worse for ware, tested my urine which didn't seem too bad, so I took my insulin and had my supper and went to bed.  Then the room began to spin slowly then a little quicker. It wasn't long before I realised that I was going to be sick.

I got up and was sick, and went to lie on the bed and rapidly began to realise I was going hypo, so I went down stairs and drank some lucozade and went back to bed, only to have to visit the bathroom again.  I realised that I was alone and potentially in trouble and repeated the cycle a number of times.  The last thing I remember it was around 3 am and I was sitting on the kitchen floor, so I didn't fall over, and eating a biscuit.

When I woke I was absolutely frozen and shivering violently.  I looked up at the clock and it was around 11 am.  I was a little annoyed with myself for not foreseeing what would happen if I got sick and making plans.  I realised I'd missed my 8am insulin so the whole day would need to start from now, but I was hungry and my head was killing me.

So I decided I'd go over the road and get some fresh bread from the shop and a paper.  I asked the guy for the fresh bread and he said they only had yesterdays, which was a little unusual, and I then started rummaging through the papers.  But as I did so I got increasingly confused as the papers were not the Saturday papers I had expected, they were Sunday papers.

Then it hit me like a brick, on a winters day I had been curled up on the kitchen floor unconscious for over 32 hours in what must have been a coma, luckily the low temperature and the few carbs I had consumed must have reduced my metabolic rate and thankfully I suffered no longer term damage or worse death.
D coming back and finding me dead on the floor would not have been good.

Normally my body would have broken down the glycogen etc in liver and muscles and then the fat, but alcohol inhibits this process from happening until it has been dealt with.

Learning Points

• I realised that my youthful drinking days would have to be moderated
• I realised that a simple night out partying can rapidly develop into a medical emergency if I wasn't careful
• I realised that I was in control of the drinking, the offer of one for the road however kindly offered had to be balanced with the potential outcome
• I learned over the next few months that I didn't need to get blind drunk to have fun
• I realised that after a few drinks, any more I drank did little but to pee my money away
• I realised that the less I drank, the easier it was to get the enjoyment part of it with very small qualities, a cheap night out ;-)
• In deciding to moderate my drinking early in my diabetes,  I had accidentally prevented myself from getting some of the major diabetic complications in later life made worse by excessive drinking with diabetes
• I realised that each day was a new adventure

TBC

My Diabetes - How I Deal With Eating Out

Having explained the difficulties I have experienced with eating out the question is what I have done to try and avoid the pitfalls.  The thing to remember is that its only the carbohydrates that are the issue and have to be taken in balance with my insulin.

If its a night out my partner wants to do with her golf friends that she knows will have no real meal time, then I gracefully decline.  It's nice for the non-diabetics to have a normal mealtime without having to worry about me eating on time.

If I want or need to attend then:

• I eat my carbohydrate allowance as a meal before going out. This is usually something very really simple, fish fingers and oven chips. 
• I then attend the meal and eat everything that doesn't contain carbohydrates in the main course.
• Quite often I get to eat some of the pudding, as it often arrives several hours late and about the right time for my mid evening snack.

As always I carry 3 or 4 biscuit bars (12 - 15 carbs) in my pockets and a bottle of lucozade in the car.  I always carry more carbs than I need for the event so that in the event of a breakdown etc I know I have enough to take me through to the next lunchtime. 

There have been many times when I have been told categorically that the meal will be on time, and that we will be sat down to eat by 7pm only for the fickle finger of fate to step in and mess things up.  So although I often end up paying for a meal I don't get to eat all of, its worth it for my health and my peace of mind.

Learning Points

• Unless I'm cooking the food it may be late
• My urgency has the potential to be an emergency if not planned for
• I don't expect other non-diabetics to understand and even if the do they may not be in control
• I always carry plenty of food and never leave the house without it
• As soon as I get home I test my blood and if its high I taken an extra few units of short acting insulin to bring it back down gracefully

Exercise, Blood Sugar and Blood Pressure

Even before I was diabetic I knew that after a long run, I would look pale round the eyes despite having a red face and my hands would tremor.  This is hypoglycaemia in a non diabetic brought on by my burning of all of the bodies reserves too quickly for my body to break down its fats and other substances in the liver and muscles into usable glucose.

If I was not diabetic my body would reduce its insulin production and releases glucose for the remaining insulin to use when I start to exercise.  Insulin is like a catalyst your body needs it to break down sugars.  However as a diabetic on insulin my insulin level will be constant so if I do anything that requires extra energy, and I need to balance it with extra sugars.

Playing Squash

Before I became diabetic I liked the occasional game of tennis or squash.  I'd arranged to meet somebody, book a court, turn up with a bottle of water and play and afterwards I would have a sweet snack.

As a diabetic I can't do this:

1. To play squash I must either reduce my insulin (to prevent me burning to much carbohydrate), this requires forward planning. 
2. Or I drink a high carbohydrate drink before, during and after the game.

Okay thats seems simple enough, choose 1 or 2.  Unfortunately its not that simple.  In both cases diabetic control depends heavily on the reliability of your partner and the time of day of the game,

In both case if my squash partner doesn't arrive on time then I will have to begin exercising myself, i.e. go for a run in order to make up for the lack of a game.

All of the doctors have always told me to reduce my insulin before sport or heavy work that brings me out in a sweat.  I do this only very very occasionally, the reason is quite simple people are unreliable and get caught in traffic, forget or possibly decide not to bother to play.  I may also decide not to do the heavy work if the weather is too bad.  With little insulin in my blood my sugar will go high, and stay high for a long time.

So I tend to have a small mouthful of lucozade just before a game or heavy work and another just as it progresses.  For squash I am ready, if they don't turn up I have a modest bit of exercise to do, to get my blood sugar down.  If they do turn up i'm ready to play.

I also noted from observation, that with the reduced insulin plan it took me longer to recover and I noticed little in the way of physical benefits.  Whereas taking my normal insulin and topping up with high carbohydrate drinks to exercise, feels like watching a Popeye cartoon with spinach (if you don't know about Popeye type it into youtube).  My muscles swell and become more toned and my recovery time is vastly improved and my stamina lasts for days.

Warning, playing with my insulin level is not for the faint hearted and I acknowledge it can be dangerous, so I always have carbo's in my pockets and check my blood levels before and after sport for the some time.  Also tell the other person what you are planning to do and what to do if you start talking nonsense and falling around.

Learning Point

Reducing my insulin allows me to do exercise without lots of extra carbs

Eating or drinking extra carbs allows you to do extra exercise

Doing neither can lead to hypo if you exercise, or high blood sugar if you don't

TBC

My Diabetes - The Clinic

Despite having some basic understanding of what diabetes was, when I attended the clinic for the first time I had absolutely no idea what was going on.  Urine sample in the box, weigh you, prick the finger, take some blood, photograph the eyes etc

I met the teams specialist diabetic nurse, who was very nice and said if I needed to ask any questions then to come and see her.  I was met the dietician who told me about exchanges and how much carbohydrate I could have and if I had any questions to ask to come and see her.  I then met the consultant who told me how my diabetes was, what insulin he wanted me to take, and to see my doctor to arrange for needles, syringes and insulin.  I then met the nurse again who showed me all the places I could inject.

After over an hour I was going hypo, as my appointment was 13:30 and it was 1 hour late (this is quite often the case due to heavy workload) and now it was 3:30 and I was going hypo.  I hadn't wanted to eat my biscuit at 3pm in front of any of them as I had a chocolate biscuit and they were against chocolate biscuits.

So I nipped into the loo and ate my biscuit.

By the end of the session I didn't know what I knew but I was loaded up with all sorts of diabetic diaries, reagents, leaflets sample and so on.

It was only after I'd left I realised that although lots of people had said if I had any questions to ask, I had no idea what to ask and there wasn't any time in the process to ask.

Learning Point:

• I should have done a little reading on diabetes before attending clinic
• I should have made a list of the kind of things I needed to know 
• I should have written down new things as they were explained to me
• I should have not been afraid to keep asking for clarification
• I should have spoken to some of the other diabetics
• I should have joined the local association
• I should have eaten my biscuit whoever was there, never delay for others

TBC

My Diabetes : Diabetes Does Not Stop Me Having Fun ! Here's Safe Free-fall Flying :-)

Okay enough of the Diabetes management stuff for a few minutes.

One thing I have never let my diabetes do is to prevent me from doing crazy things.  However, given that a vast majority of injuries in fun sports are often caused to people trying to save somebody else who has gotten themselves into difficulty, since I've been diabetic I've tried not to put others at risk for my stupidities.

Free-fall Parachuting is fun but, as we diabetics know if your sick it could be a bit of a problem trying to consume a large amount of glucose in the back of a bobbing light aircraft whilst still throwing up... I haven't done that by the way I just like to plan ahead ;-)

Also, in reality as a newbie the amount of time you actually free-fall for yourself is pretty short, then a lot of dangling.

So here's a great way I got the flying free-fall fun of the wind in my face in a serious vertical Airkix wind tunnel.  Nothing got hurt (not even my pride with the silly hat they made me wear), and if I need to stop, I could just step out of the airflow.

If you have a recently diagnosed young diabetic (or oldie young at heart) who thinks he'll never be able to do anything remotely silly again, I thoroughly recommend it and I've been diabetic for 32 years and it hasn't stopped me.

My Diabetes - Safe Airkix Free-fall Flying Fun

Malcolm

My Diabetes - Angry Diabetic When Eating Out

For me, over the years,  the thing that has been guaranteed to make me edgy and angry is eating out.

I have lost count of the times when we have gone to eat out with friends. colleagues or strangers and it doesn't go to plan. The reasons are really simple for non-diabetics:

• they don't need to worry about when they eat
• they don't need to worry about what they eat
• they don't need to worry about how much they eat
• they don't need to worry if they arrive late
• they usually want to go to the bar for a chat and drink
• they usually want to wait until everybody has arrived before ordering
• they don't need to worry how long they take to ponder the wine list
• they don't worry too much over how long it takes for the food to arrive

It usually goes something like this:

• we make sure those organising the meal out  know I am a diabetic, and we agree a time when we will be sat down and eating, for example 8pm
• we agree that everybody will meet in the bar by 7:30pm
• we agree we will order at the bar and be seated with starters by 8pm

Alas, the reality is often:

• virtually nobody has arrived by 7:30pm 
• by 8pm people are just arriving and are chatting at the bar
• by 8:30pm we are still missing people
• eventually everybody has arrived by 9pm and we go to sit down

As I diabetic I've been in a dilemma for 1 hour, should I eat an extra biscuit whilst waiting for the others or will they be here as they promised.  If I eat and extra biscuit I will have to leave some of the expensive food on my plate or risk having a high blood sugar.

So at 9pm we are seated at the table, then the fun begins:

• Everybody wants to discuss the menu, should I have x, y or z
• Then the huge wine debate breaks out
• before we know it, its 9:30 as we place the orders

The issue we now have is the restaurant which was relatively empty at 8pm with quick kitchen response times is now running flat out with delays.  It's 10pm before the food arrives and I've been getting increasingly annoyed with the situation for the past 2 hours.

Unfortunately those that don't know me most likely think I'm a grumpy person without knowing that if we had one stuck to the plan of 7:30 meet 8pm eat we have all been happy.

Of course due to the extra carbohydrates I've eaten due to the delays and my blood sugar rising naturally as my lunchtime insulin has long since disappeared. When the food arrives I have no idea how much carbohydrate, garlic and other blood sugar changing herbs are in the food.  One thing I can be certain of is my blood will be high by the time I get home. 

Learning Points:

• non-diabetics can eat when they want and there is nothing I can do to change it
• with the best will in the world people get delayed
• some people are naturally always late
• I can never tell how long the restaurant will take to serve me
• I have no idea what the carbohydrate level of the food is

This is a lot of unknowns.  Also, I have had a 32 year joke with Debbie, wherever we sit in a restaurant for some reason I am always the last to be served. LOL  Therefore, if I am invited out to an important meal I have to think very carefully in advance how you are going to deal with the delays.

Luckily as an insulin diabetic, if I test my blood and it is high, I can give myself some extra short acting insulin to bring it back down in a few hours. Then begin my normal routine.

TBC

My Diabetes - Angry Diabetic Syndrome

One of the most common things I hear about diabetics and I have experienced it myself many times is what I will call my 'Angry Diabetic' syndrome.

I liken this to a real life Jackal and Hyde situation.  One minute I am a kind rational person and the next even the most simple thing anger me.

By monitoring my blood glucose and my moods I very quickly noticed there is a direct correlation between my mood, rationality and my blood sugar levels. As the blood sugar drops and the amount of sugars available in my brain also drops.  I become angry, anxious, confused and my higher reasoning functions seem to drop away and I become a like an aggressive animal.

I put this down to the fact that I as a human being are basically a violent animal and we had to be to survive and end up at the top of the food chain.  But realistically the only thing that separates me from other animals is my larger brain(which needs lots of food) and my associated higher functioning centres. When these higher functions get switched off or suppressed due to lack of sugar then then not surprisingly I revert back to a lower animal state.

I liken this to a 'kill to eat' reflex and if you want to see it in action trying taking food away from a very hungry pet.  If they are not too hungry they will let you, but there becomes a point where they will growl and fight you for it.

The thing which is fascinating about this is that moment the blood sugar comes back even slightly up I am immediately calmer and like nothing has happened.

It's not just diabetics who show aggression there blood sugar levels drop.

It's been know for centuries that a hungry army is more violent, aggressive, less rational and more likely to take risks.  Interestingly, after a great battle and plunder there was often a great feast and the soldiers and commanders became less violent and began to behave with some compassion, until the food ran out?

Some years ago european lager companies brought out strong beers with no sugars in them.  Suddenly there was a massive rise in bad behaviour and violence linked to these beers.  Drinking sugar free alcohol and an empty stomach is a sure fire way to make anybody hypoglycaemic,  out of control and aggressive.

From my own experience I noted that violent drinkers had very poor diets preferring to drink alcohol rather than eat.  Most likely causing a very drunken Hyde to visit.

This is certainly an area requiring study.

Learning Point:

1) To avoid Hyde coming out to play and becoming an angry diabetic, I make sure my blood sugars do not drop too low.
2) It appears to me from my monitoring that if I stick to the very low levels of blood sugar demanded by my medical advisers, then I can quickly become Hyde from the simplest mild exertion.
3) If I have low blood sugar and my meal is delayed for whatever reason, then Hyde comes out to play.

For me there is a definite tradeoff of ultra low blood sugar, hypo and anger. With slightly higher blood sugar I remain calm and rational.

It is up to the reader to decide in discussion with your medical team and family what is acceptable and best for you.  I was making my own life and that of Debbie a misery with Hyde outbursts until I found the best levels for me.

TBC

My Diabetes - What did I do to try and avoid diabetic hypos

In reality it is impossible for me to avoid ever having a hypo, the real question is how can I lessen the chance of having a 'severe unexpected hypo' which would require the help from others.  What I quickly realised was that the most important thing to do was to discover 'My Hypo Early Warning Signals' so I could prevent a mild hypo from becoming something much worse.

The way I went about this was to make the conscious decision to become more aware of my internal self and my body. Before I became diabetic I didn't pay that much attention to my body. I knew:

1) If I was tired, I slept.
2) When I was hungry, I ate
3) If I ate bad food, it made my ill
4) If I I ran a long distance, I became stiff
5) If I stubbed my toe, it hurt

These were all the normal things, but I knew I had to go further.

So for a short period I kept a note book and gradually I began to notice things:

1) If I had to get up in the night to go for a pee
  --> my urine test at breakfast showed high sugars
2) If I woke up in the morning with a basketball bladder
  --> my urine test at breakfast showed high sugars
3) If I woke up in the night soaked in a cold sweat
 --> I was experiencing a night hypo and need to drink a high glucose drink
4) If I woke up in the morning with a tiny cold penis
  --> my urine test at breakfast were blue and very low
5) If I had an extremely full bladder and hadn't drank much
  --> my urine test at showed high sugars
6) When I broke out in a cold hypo sweat I smelt a kind of musk on my skin
 --> I was going hypo and needed to eat
7) If the images before my eyes started to get blotchy like looking through cloth
 --> I was going hypo and needed to eat
8) If my lips started to tingle and my chin became cold and numb
 --> I was going hypo and needed to eat
9) If I started to look red face and get a headache
  --> my urine test showed high sugars
10) If my calfs and thighs started to feel like they were full of treacle
  --> my urine test showed high sugars

This observing becomes a form of biofeedback, from evidence and feelings I very quickly became aware of my body and its needs and the signals it gave me when it was in distress.

Learning Point:

If I wanted to be in control of my diabetes, I had to know what it did to me and how those things, felt, tasted and smelled.

The most import thing I learned was:

The hypo is not my enemy trying to cut me down, its a friend warning me that I need to do something to prevent things getting worse.

TBC

My Diabetes - Riding my hypoglycemia 'hypo' bicycle

I view learning to become an Insulin Dependent Diabetic is like learning to ride my first bicycle. When I got my bike I thought I just get on and ride like everybody else, but this is not what happened.  I remember being frustrated that I couldn't ride a bike like my brothers and everybody was giving me advice and telling me how to do it:

sit on the seat and peddle you'll be fine (oops crash)
just peddle and move forward and you'll be fine (oops crash)
try sitting up straight (oops crash)
keep you hands tight on the handle bar grips (oops sideways crash)
going down hill will help you get your balance (oops crash)

Eventually my mother held the back of the seat just enough to stop me leaning too far on one side or the other.  Suddenly I had balance and was peddling and moving forward safe in the knowledge that she was holding me.

Then she shouted out I looked round realise she was no longer holding me (oops crash).  Then over time it became second nature, I can even ride without your hands, then get really cocky.. oops crash.

Controlling my diabetes was like this.  The professionals were very matter of fact.  They said if I:

1) Test my urine for sugars and write it in the diary
2) Inject the prescribed amount of insulin at the set time
3) Ate the right quantity of food
4) Exercise

Then everything would be okay and fine.

I did exactly what I was told to do and some days it worked and my blood sugars were low, and other days my blood sugars were high.  If I took the bus up the long hill to home I would be fine, but if I walked up the hill I'd be shaking like a leaf.

The real question for me was how to square this diabetic circle.  Like all medical instructions they seemed to be very rigid and inflexible.  It may sound incredibly straight forward to a dietician, or a specialist nurse or and doctor but real life is not that straight forward and simple.

TBC

My Diabetes - Coming to terms with my insulin injections

A year before I became diabetic I was drinking with friends and we had been watching a documentary about a child with an incurable genetic illness who survived due to multiple injections per day.  We all announced in the way immortal youngsters do, that if we needed to take injections, we wouldn't bother and we'd just have a massive party until the day we died. LOL

The youthful bravado still makes me smile.  The reality a year later was I was going to have to inject myself with a long acting insulin once a day for the rest of my life and I wasn't happy.  For a number of days I felt pressured and angry, why me? what had I done to deserve this?  Back then could darn socks with the thick reusable needles attached to heavy glass syringes I had, they could really hurt when they started to get blunt injecting with them day after day.

Then as I was going through a doorway I banged my elbow, ouch it hurt and as I went to rub it I thought that hurts more than those damn needles.  Here I was in more pain from banging my elbow than injecting myself with life giving insulin.  But was I thinking, "thats it if I have to bang my elbow again in my life I don't want to go on", of course I wasn't. I gave it a bit of a rub and went about my business.

So next morning I tested my urine and gave myself the jab with less hesitation and thought well its not worth dying over. Also, on the insulin I was beginning to feel well again. Also for the first time in months that I didn't feel I could single handedly drink the local lake dry. It was also great to walk about town not having to look for the next toilet with a bladder the size of a basketball.

Learning Point:

1) I was totally terrified of needles almost didn't join the Army when I heard how many injections I had to have in basic training
2) As an Army medic I saw seriously tough soldiers faint at the sight of a needle so being scared was okay
3) Insulin dramatically improved my life as a diabetic and made me feel well
4) Sixty years earlier I would have died without insulin
5) My 32 extra years since diagnosis have been worth the daily injections

The reality of injecting insulin is I became accustomed to it and it became routine.

TBC

My Diabetes - My First Hypo

My first hypo occurred just over an hour after the nurse left.

As she had not explained the warning signs and symptoms of a hypo and it caught me by surprise.  I had assumed that as my blood sugar was so high it would take ages to come down, but it didn't as I'd been starving myself for days.

I got up to go to the bathroom a felt a little unsteady on my feet.  Then I began to notice, what I have become to realise, are my warning signs of a hypo:

1) A cold sweat was breaking out on my arms and hands
2) The my back and my neck were soaked with this cold sweat
3) My hands were trembling and sweating
4) My lips began to tingle and my chin began to go numb
5) My penis had apparently disappeared to who knows where and was so tiny and cold it was a fiddle to urinate.
6) I began to get more light headed and feel like I was going to faint.
7) When I got back to the room Debbie asked me how I was and I said a bit faint.

Luckily, we were sharing the house with nursing colleagues who took one look at me and said, wow matey your looking very hypo.  One of them ran over to the nearby shop and bought a large bottle of lucozade(high glucose drink) and gave me medium size glass to drink and a 4 bar kitkat which I miraculously place in my mouth and devoured in a few bites.

I felt awful for around 15 minutes, and then suddenly like a switched had been switched back on I was fine, like nothing had happened.

My learning points:

1) Always have at least one bottle of high glucose energy drink or glucose tablets or chocolate with you or within reach.
2) Always make sure that you have appropriate levels of carbohydrate food available before you inject any insulin.
3) If you start to feel faint or dizzy sit down immediately, do not wait to fall over or faint as this could lead to serious injuries or may incapacitate you.
4) Always tell others if you start to feel unwell.

TBC

My Diabetes - The nurse arrived with Insulin

I was advised by the Doctor to go home and that a 'diabetes specialist nurse' would visit me that afternoon and explain all about testing my urine with reagent tablets and how to take insulin.

When she arrived she quickly showed me how to test my urine by placing a quantity of urine in a test tube and dropping in a reagent tablet.  The tablet fizzed violently and the initial blue liquid turned bright orange.  By way of learning curve, I also discovered you should not hold the test tube in your hand as the reaction generates a lot of heat.  Orange I discovered was very bad, it meant large quantities of sugar were still in my urine.

The nurse then drew up a quantity of insulin into a syringe showed me how to pucker up the skin on my thigh and told me to stick the needle in pull back to make sure there was no blood (so I was injecting directly into a vein) and then squeeze in the syringe.  Although as a nurse I had given injections I discovered it was quite different doing it on yourself.

She then wrote some numbers down on a pad for how much Insulin I should inject daily and when to test my urine, then she gave me a note to take to my doctor, and said you might want to eat something if you start to feel hungry. She asked me if I had any questions, and I said no and she left, never to be seen again by me.

My Learning Points:

1) Once I was diagnosed with diabetes, things happened quickly, one minute I was fine, next I was diabetic forever.

2) The professionals I spoke to often assumed that the last professional had fully briefed me and had told you everything I needed to know. In reality they had not as they too had assumed somebody else had already done it.

3) The professionals asked me if I had any questions, but as I'd never had diabetes before I had no idea what questions I needed to ask so answered no.

4) If you take insulin and don't eat then it is a very quick way to get a very low blood sugar commonly known as a hypo.

TBC

My Diabetes - My Diabetic Diagnosis

From 1977 - 1980, I trained as a Registered Mental Nurse, and had come into contact with people with diabetes, I had learned something of the history and I knew a little about the signs and symptoms. In September 1980 I became an undergraduate of Behavioural Sciences at a UK Polytechnic.

The summer of 1981 was warm, and therefore I did not immediately notice that I was drinking more than usual.  However, as the summer turned to Autumn I realised that I was beginning to look thinner than normal after having a flu jab and was drinking a lot.  I'd also found a local store that sold 'Cream Soda' a sweet drink from my youth and had begun drinking it in the summer heat to quell my thirst, but it appeared to make it worse.

By early October I really felt like I was 'dying of thirst' and it came to a head when I was in a local cafe that specialised in very large pots of tea. Shortly after it arrived on the table and without thinking I picked up the milk jug tipped it into the pot and started drinking from the pot. Debbie my partner was with me, and she looked at me and asked what was I doing and was I going to leave any for her?

I looked at the jug, looked at her and said, I have no idea what I am doing but I think I have must have diabetes mellitus.  Suddenly it all made sense.

In the school of nursing we'd been told that in the old days before urine test reagents (tablets), certain nurses and patients would taste a sample of the diabetics urine, and the sweeter it tasted the more severe was the patients hyperglycaemia 'excessive sugar in the urine'.  Knowing this trinket of knowledge, I excused myself and went off to the bathroom placed my finger it my stream of urine and tasted it. It was sweeter than the sweetest Honey and smelt heavily of the sugar puffs breakfast cereal.

I came back to the table and told Debbie I have diabetes. It was a Friday and we went straight to the Polytechnic doctor and told him what had happened and said I have diabetes mellitus.  He was polite but dismissive and said it was most likely an infection or reaction to a recent flu jab.  After some discussion he agreed to take blood or urine sample and said I was to come back the following week, and it was nothing to worry about.

By time we got back home I had urinated an embarrassing number of times and I noticed my legs felt literally like they were filled with treacle and my eyes were a little out of focus.  I said to Debbie, I don't like this I need to flush the sugars out of my bloodstream and so ate very little in the way of carbohydrates over the weekend and drank lots of water.

By Monday I was still urinating a lot, due to the large quantity of water I was drinking.  As I had very little in the way of carbohydrate intake, my urine was tasting less of sugar. When I went into the Behavioural Sciences department there seemed to be a bit of a panic on and asked a member of staff what was going on.  She informed me that they had been looking for me since Friday, that they didn't have my address and the doctor needed to see me urgently.

In the Doctors surgery, he informed me that my blood sugar on the Friday was way past coma levels and he was amazed I hadn't collapsed into coma.  I explained to him that I'd eaten virtually no carbohydrates all weekend, that I'd drank nothing but water and it was a three hike up hill from the surgery to my residence.

He took some more blood and urine, and arrange for a nurse to visit me that afternoon to give me Insulin.

My Learning Points:

1) My excessive urination without excessive drinking was an early warning sign that me kidneys were trying to flush something out of my body.

2) My excessive thirst on a cold day when I hadn't eaten lots of salty things or taken any anti-histamine tablets meant my body needed the fluid.  As my thirst was accompanied by excessive urination then it told indicated to me that I may have diabetes.

3) Tasting my urine is a quick, simple and not at all unpleasant test.  Urine is mostly sterile unless you have urine infection.  Also due to the sensitivity of the tongue to salt and sugar you need only the tiniest amount.  Normally urine is salty and insipid and never sweet if its sweet it shows the presence of sugar.

4) Had I not taken immediate action of reducing my carbohydrates to virtually nothing and drinking water, my blood sugar when have continued to rise causing me serious problems.

5) My prompt action prevented me from needing to be hospitalised with the condition.

TBC