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Tuesday, 21 March 2017

JapanDia

A month ago my husband and I celebrated 10 years of getting in each others personal space bubbles, mashing our lips into each others faces, and not making decisions about what we want for dinner together. To celebrate, we booked some of those crazy Jetstar return free travel deals to Sapporo in Japan in February.

We left Brisbane with temperatures of 37°, and arrived to temperatures in Hokkaido of -7°. Cold weather and a 40° temperature swing was a very welcome change. Last time we were in Japan it was so hot that my insulin was only lasting a day and a half before expiring. No such issues this time. 

It was such a different travel experience to what I had had before. Sapporo was absolutely covered in snow (It is in contention with a few other places for snowiest city in the world), at points being built  up at least a metre taller than my husband and I. 



Naturally, once again I had to smuggle diabetes and all of its luggage into my carry-on. I must be getting better at controlling my uninvited travel companion though, because I barely heard a peep from my diabetes in the week I was away. Even on that day that we went to Odori Bisse Sweets and I ate 2 desserts before dinner, then dinner, then dessert again (which you can read about on my travel blog at: http://tonyobyointokyo.blogspot.com.au/). 

Of course there were some small blips. Thankfully, unlike in Europe, Japan doesn't believe in trying to sell sugar-free soft-drink alternatives, so not only did I only have to consume a small amount of a soft-drink to treat my hypos, but hypo treatment was blissfully easy to find.

The Japanese have a slight obsession with making food accessible (you cannot walk more than 200m without coming across a mini-mart stocked with delicious goodies). On one particular night, we went to the Sapporo Beer Museum for dinner when just after arriving, as we were standing in the freezing cold, I was alerted to a hypo by my pump. I could see that there was a long line into the beer museum (and therefore to any possible food inside). Immediately my eyes fell on a quiet bus stop across the road. Nearly buried in the snow was my shining beacon of hope. A vending machine. With an endearing exclamation of 'F***ing Japan' and 100Y later, I was guzzling a freezing cold soft drink. The temperature of the bottle made my lips numb and my throat ache as I swallowed the frigid liquid but at least I had hypo treatment.

Later on once we were inside the beer factory we found a beer marketed towards diabetics. Beer is remarkably cheap in Japan, so yea, that beer is 200Y - roughly $2. You can get full alcoholic beer at their mini-marts (like our 7-11's) for about $1AUD. 




The day after visiting the beer factory I discovered an unexpected plus to having diabetes in Japan. The very last picture on this 'reserved seating' sign on our tram was described as being for people with 'internal organ failures'. If my Type 1 isn't an internal organ failure, I'm not sure what is. So at the very least, if I really wanted to, I could get a seat on crowded public transport (although I would never use it, it was interesting to see).


Seat for a Pancreassasin


There were a few learnings in taking diabetes into such a cold climate. Like how hard it is to calibrate when wearing so many layers. Sometimes the CGM had trouble talking to my pump through my 5 + layers. I usually need more insulin in winter in Australia, but because I used so much more energy to walk in my copious amounts, it all sort of evened out and I barely even had to put on reduced basals.

Having CGM with the suspend before low feature was an absolute gosh-send. Usually my pump was hidden well within my clothes, so I just sort of had to rely on the CGM and  pump to make a few executive decisions about my diabetes management for me. Something about punching holes in my fingers in -7° temps didn't make me feel all that enthusiastic about finger-pricking.




_________________________________________________________________________________
Reasons why I'm hypo:

Its the exact opposite right now. After having an AMAZING week BGL wise, I had my first hypo of the week, unclipped my pump, and forgot to clip it back up. 6 hours, dinner and dessert later....all without insulin....my meter is not a happy chappy. Neither am I. #diabetes fail

Tuesday, 28 February 2017

No Pumps On Board

I don't know if I would call myself a regular airport attendee, but between work and spending money that my bank would rather I didn't on holidays, I have developed a well-versed diabetes travel routine. It doesn't give me optimal control all the time, but I do the best I can. Travel days are always going to be something that throws me, because they throw my body out. Different wake and sleep times, less activity, more sitting and the food routine and diet changes wreck havoc on my best-laid plans.

Travel with a medical condition like diabetes can be scary, exhausting, busy and burdening. Plane journeys are uncomfortable enough without the added feelings of a low or high blood sugar or having airport security fussing over your medical condition.

Before any travel (especially international), I always make sure I am well-stocked with supplies and that they are packed in an easy to reach place on my onboard luggage. I never put any diabetes supplies below in checked luggage because I can't guarantee I will get my bag on the other side or that nothing will happen to my bag (such as sudden temperature changes or rough handling). If I'm travelling international I split my supplies between my husband and myself. I take about 30% more supplies than what I need as a precaution. Last time we went to Japan (In 2013) that 30% extra insulin probably saved me a trip to a pharmacy to get more bottles of life because the heat in Japan was causing my insulin to expire every 1.5 days.

I bought some of those packing cubes a while ago, and I found that the smaller ones are perfect to put all my supplies in. It makes it super easy at security and on the plane/travelling around if everything you need is in one spot.

NO PUMPS ON BOARD: Saw this on my recent flight to Sapporo on the flight safety card. The 'not permitted' symbol seems to include an insulin pump. ???

As well as supplies, my number one recommended thing to take with me is my scripts and a letter from my doctor, explaining what each item that I carry is and what it is used for. I also make sure the doctor's note explains why my pump cant go through any screening such as MRI, CT or X-Ray. I have used this letter in Japan every time without fail as Insulin pumps are not common in Japan. In Sapporo, they were insistent that I turn my back-up pump on to make sure it wasn't an explosive device. I had to unscrew the battery compartment to show them that it wasn't possible for me to turn it on, if there was nothing to power it and then they ran the bomb swab over the pump which was fine. In Cairns I whipped out my trusty letter to avoid the full body scanner, which I went through last time by removing my pump, but was not possible this time because of the newly inserted CGM taped securely to my arm.

I don't usually display my pump, and will normally hide it underneath my jumper, to avoid unnecessary questions from security. The few times that I have had it out, it has caused issues. Luckily, my Medtronic pump does not set off the metal detectors, so hiding the pump beneath my clothes is easy.

For domestic flights, I can take juice or other liquids through security, but for International, I try to stock up on glucose tabs in case of a hypo in the security line. I always buy a sugary drink once through security, but in some countries like Indonesia, they actually make you throw out any liquids before you can board the plane, so anything purchased after clearing security is a waste.

At take-off and landing, I disconnect my pump, otherwise changes in air pressure push extra insulin through my cannula and I get very low, very fast.

Most recently, I have been disobeying the rules regarding transmitter devices on planes, and have kept my CGM on during all my flights for the past year (over 20 flights). The plane hasn't crashed, or lost its course, and my pump hasn't exploded. Its made flying so much easier, especially on long-haul flights, where my husband can now just check my pump to see what my BGLs are doing instead of waking me up. I can also see any problems I am having and fix them up far quicker than if I had the CGM turned off and was only doing manual checks once every 2 or 3 hours. Especially when landing, I can see if I need to have some sugar to avoid a baggage claim low.

All of these preparations means that the biggest issue I have with travelling with diabetes, is that I have diabetes. Today, for example, I got on a plane to Sydney at 9am in the morning. Then I got on the return flight home at 3pm in the afternoon. One flight went well for my diabetes, one flight did not. I did the same thing on both flights. The morning flight went well because I had been able to follow a similar routine to my normal day. I ate breakfast, got on the morning flight (when I would normally be sitting at my desk) and BGLs tracked between 4 - 6. The afternoon flight did not go so well because I had missed my 20 minute lunchtime walk, missed morning tea, delayed lunch by 2 hours, and eaten different food to normal for lunch. If only I could have left diabetes at home by itself for the day.

Tuesday, 7 February 2017

Position Vacant

SCENE ONE

ASHLEIGH staggers into an over-bright boardroom in a workplace office. Furnished with a long board table, and many wheel-footed office chairs. Ashleigh flops into a chair at the far-end of the table. She is sucking on a straw plunged through a juice popper. 'B'sits beside Ashleigh. 12 OTHER COLLEAGUES take seats around the room.

ALL (singing): 
Happy Birthday to you, Happy Birthday to you. 
Happy birthday dear colleague, happy birthday to you.

Ashleigh waits until the singing has stopped and lowers her forehead to the table.

COLLEAGUE 1 (to Ashleigh):
Are you alright?

COLLEAGUE 2:
Are you sick? What happened? Are you ok?

COLLEAGUE 3:
Oh yeah, you don't look too good. Are you right?

Colleagues continue firing questions. Ashleigh makes vague grumbling noises, raises her juice and makes shooing motions with her hands.

B:
She's fine. Just leave her alone. She's just having a
low blood sugar.

COLLEAGUE 3:
Do you need us to get you anything?

COLLEAGUE 1:
Ohhhh, I'll get the Glucagon! Can I give you a shot?

B:
She's got her juice. She'll be fine. Just give her a few minutes.

COLLEAGUE 1:
Why can't we use the Glucagon?

ASHLEIGH (with some energy now):
I have a juice. I just need quiet for a few minutes. You can't use 
the Glucagon unless its an emergency; only if I'm unconscious or 
can't have sugar. 

END SCENE




When you have a self-management  heavy disease like diabetes its important that you have a few people around you like S who are on your side in your day to day life. There's a lot to diabetes.

It takes a lot of time, energy and effort to train a Diabetes side kick. You work at educating them over many months, maybe even years. Slowly feeding information through small conversations or simple statements. Whether you mean to or not with these people, you create a relationship with them that involves some amount of diabetes knowledge download.

So I have people. I have friends who I knew before I was diagnosed, who picked it up as we went along. I have family who I expect a lot of. I have diabuddies who I don't need to explain at all to. I have a work colleague. Change that to had, because S will be finishing up her job with my workplace at the end of this week.

I have to start fending for myself again at work. Its helpful having someone who knows your diabetes in situations like the birthday cake hypo debacle. (Which continued on past the initial hypo. I had people asking me days later if I was 'feeling better yet' which really confused me because I didn't remember taking any sick leave or feeling ill. I had to be reminded of 'the other day in the boardroom at morning tea'.)

Its impossible to spread the knowledge among too many people, so if you can have one or two people that know enough about what is an emergency, what a hypo is and when everyone else should leave you alone and stop talking, then you're doing alright.

Goodbye to my work diabetes look-out. I'll never train another quite like you. Thank you for never talking to me when I'm hypo. not stabbing me unnecessarily with the Glucagon, not judging, bothering to listen to my diabetes natter, and all the jaunts down the road to stock up on juice when I ran out.

Monday, 30 January 2017

PoGo

What did I do in 2016 when I was ignoring my diabetic self?

A lot of exercise.

Pokemon Go was where it was at (ok, its still where I'm at, at least until I find the last 3 non-regional monsters I need to complete my PokeDex collection). I did a lot of walking in the latter half of 2016 trying to hatch distance-based pokemon eggs and find new Pokemons.

It helped to have something to concentrate on as I walked. I have always found exercise to be mind-numbingly boring. Or it made me anxious. PoGo took care of both the boring and the anxiety. I was able to forget how nervous exercise made me (thanks for that, diabetes) when I was concentrating on catching little monsters.

I started off small. I have always walked during my lunch hour, so I increased my single block to 2 or 3 blocks (had to try to get as many PokeStops as possible). Then I started off walking 4km in the afternoon after work, then worked on getting my time down as I got better at catching monsters and not tripping over my own feet. When I had gotten my time down, I added more distance and found a 6km route to walk.

I kept going and as my PokeDex got fuller, I got fitter. My 6km route morphed back into a 4km route when I found an exercise park that I could stop off at and complete a few sets of muscle based exercises. I upped my reps. I stopped catching as much Pokemon and my exercise time ballooned out from around 50 minutes a day to around an hour and a half on weekdays, and over 2 hours per day on weekends.

On weekends I vary my exercise a bit more. I might go for a bike ride, or a longer walk for a few hours. Sundays are Springwood Conservation Park Day, where my husband and I go to do laps. There's a very steep set of stairs followed by a 1.5km circuit that I jog 3 times. The stairs are an absolute killer and going up them 3 times is more than enough to give me the lovely 'going to puke my guts up' feeling that you really want when you're trying to run.

I recently started adding jogging to the mix. At first I was breathless after 100m, but I can now run nearly 2km before I need to stop and walk for 30 seconds before starting up jogging again. Every day I push myself to jog further, even if its just a few meters past where I made it to the day before. The only problem with that is, I cant PoGo and jog very well. So I am just turning on the app and then sticking it in my bag while I jog, so that at least I'm walking my Buddy Pokemon and hatching distance-based eggs.

The plan is to eventually be runnning the full 6km while still adding a stop-off to the exercise park. Or maybe getting a 4th lap of the Springwood Stairs in before I get the shaky 'about to vomit everywehere' feels.

Not everyone understood the appeal of PoGo, but for me its managed to keep me interested and pushing myself to get fitter for over 6 months now. Slowly, but at least I'm getting there, and for the first time in my life I'm actually enjoying exercise. So theres a plus. To everyone who complained that there were too many young people out walking their phones, there's a plus.

Monday, 23 January 2017

I think I had Diabetes in 2016

I think I had diabetes in 2016. I know there were nights that I didn't sleep and days where I slept too much because my blood sugar didn't really do what I had planned for it that day. There were finger-pricks and site changes and pump battery changes. There was blood and insulin and sticky-leftover residue from CGM tape. Diabetes was there. I'm sure of it. I can't tell you what my last A1c is, not because I don't want to, but because I don't remember. If it was better or worse than the one before that, I have no idea. But I am vaguely aware that at a few points along the year I let someone siphon some blood out of my arm to produce some readings that I paid no attention to.

I lost my diabetes voice in 2016. It hung in there for a little while at the start. I just got too tired, too busy, too overwhelmed with life to keep hearing it. "Check Your BG" got swamped by the sounds of my rattling washing machine every Saturday morning. "Change Your Basal Rates" was drowned out by copious amounts of Netflix. "Advocate!" couldn't be heard beneath my new nephew's sweet little coos. I didn't take "Be prepared" along to work with me each day, and found myself completely out of test strips, insulin or both more times than I cared to count. (Thankfully there were people close by who helped me pick up the slack during those moments of complete unpreparedness).

In 2016  I let diabetes 'just be there' quietly in the background. I began to accept that sometimes you can't have perfect control...and that that sometimes might span for a year or more. Life was too busy for diabetes.

I think I need my diabetes voice though. My diabetes needs my diabetes voice. It helps.


















Thursday, 29 December 2016

Company

There's little about the world around you that you pay attention to when your blood sugar is low. A public space can diseappear quickly. People milling about, fast movements, babies crying, gossip amongst friends, or a fantastically coloured dress all cease to exist when you're in the realm of your low. You don't have the concentration to see separate objects, and noise mutes and dulls.

I was low today (thanks, Summer) at my local shopping centre. My foggy brain managed to distinguish an empty table that I could sit at and quietly drink my juice. It was a knockout low. I was glad for the table because breathing was difficult and my legs had gone past jelly stage and seemed to made of vapour; I couldn't imagine how they would support me at all.

As I sat and sculled my juice, a lady in her early 60's motioned to the other chair on my table. I had no idea what she wanted but I just nodded anyway. I didn't care, so long as I could drink my juice. She sat down next to me, plonking her bag heavily onto the floor beside her feet, A plastic cup in front of her. I could smell the coke in the cup, fizzing away.

Minutes passed in silence. I recovered from my hypo. I re-entered the world and began to pay attention to the lady who was had sat down opposite me. Her shoulder-length, slightly greying blonde hair was mussed. Her eyes were tired, and lips were tight as she rubbed them against each other. She was hunched over, and paying no attention to my stares.

In a beautiful moment I understood, as her hands rubbed over her face and she made a soft little groan of discomfort. I had been there with her, moments before, in that closed-off space. She sipped her cup of coke in the same way I drink soft drink when I'm low. When you need to swallow quickly, but the bubbles get up your nose, and the experience is unpleasant. The pursed lips and look of disgust written on a crinkled nose and squinting eyes as you force liquid you don't want into your body.

I stayed and waited. Her back straightened out and her hands ceased their repetitive rubbing of her face to rise up and smooth her hair down. Her eyes opened up, brighter and her the tension had left her cheeks. In silence, I checked my blood sugar. She didn't flinch at the blood that welled up from my finger tip. She offered a smile instead, and asked if I was feeling alright. I nodded and asked her the same. We gathered our things and left in opposite directions.

The whole drive home, I couldn't stop thinking about what a beautiful, surreal encounter it had been. The chance we had had to share that lonely, dark space that a hypo occupies and to feel understood.








Thursday, 8 September 2016

Drink. Eat. Drink. Eat.

I am hollow. Vaguely aware that I have a shell of skin and hair molded into human form. Not strong enough to hold whats supposed to be inside.If there is anything inside; but I can't feel it. I don't feel like my skin is my own. There is nothing to feel when I scratch my nails across my face, trying to stimulate a sense. My chest is empty, even as my heart feels like it's beating too fast, and my lungs are too heavy. I watch my fingers wring together but I am disconnected from any feeling. When I clumsily bang my leg against a table, or a wall, I do not register it, even if I scrape the skin off and bleed. My body doesn't know that its happened. I am numb, in every sense.

In this state, I am not a person anymore. Who I am has left me. What I am has left me.

There's a monster in my body. Controlling me. It's only goal is to feed. The monster gets angry when it's interrupted. I get angry for the monster. I am not me anymore. I am a vessel for the monster, and my body is not my own.

I am simply a pipe connecting my mouth to something that's supposed to be in my stomach. That is all I focus on. How to get liquid down that pipe. I know it must go in my mouth first, but I'm not aware of how this happens.  The air is thick and stale and the liquid I swallow on impulse is tasteless in my mouth. There is a vague and far-off sensation that food is in my mouth, that I am chewing, but it doesn't matter what. That is not the point. The point is to get it down. Drink. Eat. Drink. Eat.

My eyes are unseeing. I stare ahead without taking my surroundings in. I am not sure if they even exist. Everything is flat, and I believe that the landscape around me has been hastily painted on. The doorways are uneven and faces are blurry. I don't always manage to touch the things I am reaching for. I can see darkness in the corners of my vision and I think it is growing. Creeping closer. Maybe this is where the monster lives.

My body doesn't do as its told. I want to run away from this place. The monster in me keeps me captive, it skews my legs and makes my head swim if I try to lumbar away from the path it wants me to take. Even on the path it chooses I still sway, and trip as I feel my way towards what it wants. Drink. Eat. Drink. Eat.

There is cotton in my ears. Words are said but they don't make sense and they aren't important. Too many voices confuse me in this strange place. There is only room enough in my head for one voice. Snarling. Drink. Eat. Drink. Eat.

I can feel the monster in my skin as I feed it. It is stretching through my limbs, pushing against my bones and muscles. Sinews that I had forgotten I had, but feel heavy now as they strain tight beneath my skin, stretched by the monster who is growing. I ache, but I am feeling.

I am feeling and I am fighting back. Sound is exploding into my head as I rip the cotton from my ears. Light is over-bright as I fight my way through the dark and focus my vision. My chest is burning now from the effort of this battle of wills. My breathing is laboured, and I suck fresh air greedily as I fight to determine who will control me. My skin tingles and sweat prickles over my arms as I force the beast from out of body.

I win eventually. It takes me a while to recover. I feel nauseous. My body wants to rid itself of the food the monster fed into it. Every inch of me is tired. My toes are even tired.

I delight in wiggling them, knowing that they are mine. I am human.



_________________________________________________________________________________

Reasons Why I'm Hypo:

This is hypo.

Wednesday, 24 August 2016

Endoscopic Review

There are some rare perks to having Type 1 Diabetes. Being first-in-line for a medical procedure is one of them.

I recently had an endoscopy to check for coeliacs disease and when I first called up to book I was offered a mid-morning appointment. It wouldn't have suited my diabetes at all. I casually dropped the magic 'D' word into my next sentence and I could almost hear the scramble on the other side of the phone to come up with a better time. Within 10 seconds I had been bumped up in priority to the much coveted procedure prime-time at 6.40am.

In the weeks prior to my endoscopy I did all the necessary, glutening myself up and setting appointments with my educator and endo for proper management during the procedure. The nurse at the endoscopy clinic became my new best phone buddy, working through the procedure with me beforehand to make sure that they had a handle on my Type 1 and my insulin pump.

After 4 frustrating weeks of glutening myself, dealing with the pain that came after eating and the resulting hypos, I was cheering when the morning finally rolled around.

My husband dropped me off on his way to work and sat with me until it was time for the procedure. Despite being nervous I was doing well. It made it a lot easier knowing that I was first in and wouldn't have to wait for anything.

Shortly after arrival I was called in to an assessment area where I met the doctor performing the endoscopy and went through a medical check, where they tested BP, my BGL, weight and height, and the details of the last food and drink I had had. To get an endoscopy you fast for 6 or so hours prior, so having the first appointment of the day was really helpful. I had accidentally consumed 4 jellybeans at 3am when I woke up a little low, but they were fine with this. I was asked if I had any questions and the only thing I really cared about was that I would be put out to it as I had read that some people were awake during these procedures. I was assured that because I had ticked the anxiety box on my pre-admission forms that I wouldn't be aware of anything happening to me.

After the assessment I was led through to the op area and set up in a bed where a nurse attached a BP monitor, pulse oximeter and inserted a cannula into the inside of my elbow. I met the anesthetist who once again reassured me I would be out to it. The anesthetist was the one who was in charge of my diabetes during the op, so I took him through the management plan my educator had set up with me. I checked my blood sugar, which was on 12 and rising (which it does every morning until I eat breakfast) so I kept my basal rate on my pump as per normal. I showed the anesthetist where my pump canula was inserted on my hip and the CGM in my arm and taught him that to check my blood sugar he could simply press the middle button and my CGM reading would show up on the pump screen. He was happy to let me self-manage as it was such a short (20 mins max) procedure.

It was as I was explaining the CGM that a second nurse entered stage right to remark on my insulin pump.

"An insulin pump?" She remarked, "What do you need that for?" I thought the answer was pretty obvious but replied that it was to help manage my Type 1 Diabetes as an alternative to injections.
"Ohhhh, so you must have really bad diabetes then if you need that, hey. And you're so young."
The last thing I needed as I was getting ready for a procedure was aggravation like this. I bit my tongue and explained that the pump was just another means of insulin delivery, similar to needles but with less injections and more freedom. She turned her nose up and sniffed that she "would prefer injections, if you ask me, because no-one can see that you have diabetes that way."

I went to reply, but I think the anesthetist either noticed my BP rising or the daggers I was shooting this nurse, because before I could reply he had motioned the other nurse to place a round tube into my mouth and announced that he was going to be putting me out right now.

40 minutes later I was hazily opening my eyes in recovery, feeling lovely and relaxed, wondering how I could get my hands on some anesthesia for home use and trying to avoid the nurse seeing that I was awake so I could just lie there a little while longer. She did eventually notice that I was lying there with one eye crooked open and bustled over to see how I was doing. She checked my BG (which I could already see had remained stable on my CGM) and got me up to have a breakfast of ham sandwiches.

20 minutes later I was being released into my mums care with instructions that I should receive the biopsy results in a few weeks' time.

The procedure was a lot easier than I thought it would be and I was surprised at how well my BGL held steady without any temp basals. The staff were all lovely & professional (minus that one nurse) and the only thing I wish I had been told about before was that its quite common to have sternum pain for up to a week after the endoscopy.


Monday, 18 July 2016

Both Feet on the Ground

This year Diabetes Australia focused on the 4,400 diabetes-related amputations per year, 85% of which are preventable. The campaign was received with mixed results, most likely because it did address an issue that people don't like to think of in relation to themselves or their clients.

I don't think I'm alone in wanting to ignore the more serious side to diabetes - the side where you may develop complications despite your best efforts to train your diabetes to sit and stay on command. I will readily admit that when I first saw that the key messaging was regarding amputations, my instinct to protect my vulnerable diabetes psyche was to ignore diabetes social media for the week. Which I somewhat did. I didn't want those images. Fear of complications is very real, among all people with diabetes, and each person deals with those fears differently. I deal with my fear by trying to maintain good blood glucose control and follow the annual cycle of care to prevent complications.

The problem is, I have to think about complications more than I feel comfortable with, because I follow the annual cycle of care. The current medical system in Australia favors those in the know about their health, and for those with little time or education on how to access various services, it is easy for them to get left behind in their diabetes management and complication prevention. The current onus when it comes to preventative care and measures is on the patient. The patient has to ask to see the podiatrist, they have to remember to see the optometrist, the patients schedules an appointment with the nurse for an updated chronic disease care plan. I don't always remember to include the podiatrist in my ever-rotating list of doctors and I rely on my yearly drivers medical as a reminder to see the optometrist, as just two examples. That's a lot of work that I have to do. A lot of appointments that might fall through the cracks. And a lot of know-how to get the system to work for me.

So I for one am welcoming this years National Diabetes Week messaging around preventable amputations. The campaign worked both to educate health professionals to pursue the annual cycle of care, including regular podiatry checks, and also to educate patients on understanding what sort of checks they should be getting, and when to seek help so that they don't end up with an unnecessary amputation. The messaging this year is as much about starting these conversations with your health professionals so that they can help you to tick off all the boxes relating to complications screening as it is asking you to be aware of your own body. In doing this, it alleviates some of the burdens for me, as a patient.

I have worked so closely with my GP and the practice nurse in regards to my diabetes-related care that they are starting to look through my records without prompting. At appointments they ask to make sure all my checks are up to date - and if they aren't, they then look for someone suitable and schedule an appointment for me so all I have to do is show up and everything else gets looked into. But this was a process, for both of us. I used to have to be the one to follow up and ask, and keep tabs on my out-of-date check ups.

Some of the complaints listed against the amputations campaign this year were in regards to diabetes-related distress linked to fear of amputations and other complications. People are generally afraid of the unknown and amputations and our future with diabetes is often unknown. So what if we try to make the future known? What if we provide patients and doctors alike with the knowledge of what to do in the early stages of the disease, or the early stages of an infection, on what to do to prevent this from ever happening. How much less distressed will people be, knowing that there are things they can do, and do now, to prevent the majority of amputations.

There were complaints that the messaging this year wasn't 'positive enough' and that National Diabetes week should only consistent of 'Girl-Power' style awareness where we show the public that we all have 'D-Power'. I think we're already doing this well enough though. For every diabetic who has ever pushed through a day high, low, yoyoing between both and tired AF, they're showing that we have the D-Power. We've got sportsmen and sportswomen, TV presenters, singers, a prime minister and just everyday people who all show that we with diabetes, we can do anything that we set our mind to. I don't worry about the public perception in regards to this but public perception does need to change where complications are concerned. It's no wonder we get stupid remarks, if we are too afraid to address the issue ourselves.

Why don't we turn a negative complication into a positive message? That won't hurt anyone. Not raising awareness about the risk of amputations and what can be done to prevent them for people who live with diabetes, and their health professionals - that will hurt someone. They might even lose a leg over it.

Friday, 15 July 2016

Pulp Fiction

I added an item to our staff meeting agenda at work the other day, and it had absolutely nothing to do with my job. It was a bit of a selfish agenda item.

At the end of the meeting, when all the staff attending by conference call had logged off, I called attention to my diabetes. Everyone at work knows I have it, my diabetes is not something that I hide. Some understand my diabetes fairly well, some the basics and some I am still working on educating.

I fielded an errant comment only a week ago during a staff birthday morning tea that I wouldn't be able to eat cake next week (now this week) because it would be National Diabetes Week. I am not sure how it being National Diabetes Week prevents me from putting cake in my mouth, but I'm beginning to think the commenter was on to something, because I am super high right now from the cake I did eat today at morning tea. We have lots of cake here. And I have a lot of salads that I don't want for dinner as a result.

Hands Free Hypo.
Conversations continued later that day when I was walking around with a juice box tucked under my chin treating a hypo. I don't usually allow people to see me treating a hypo because I tend to get cranky and I just want to be alone. This was one of those rare times when I allowed other people near me. Naturally, questions were directed to me about hypos, how to treat them, and then if they should/could do anything and if so, when. I went through the usual explanation and ended with instructions that if myself or the other diabetic at work were unconscious, that we should be given Glucagon, and how to give it.






"Like in Pulp Fiction?" someone said, and mimed stabbing a needle into their chest.

Almost, but with a little less 'aggressively stabbing needle to the heart' and more careful insertion into a large muscle

The next day I added a Glucagon demonstration to the staff meeting agenda, which is how, in the middle of National Diabetes Week, I came to be holding a diabetes special of 'Show and Tell' at our staff meeting. Complete with demonstration from a dead (expired) kit I had been hoarding at home.

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Reasons Why I'm Hypo: I rage bolused to get rid of the stubborn post-cake high. Rage bolused kicked in hard.