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

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 - 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 - 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