Unfelt Hypos - enjoy them!

One evening, a few years ago, I was at home watching "The Mask" with Jim Carrey and Cameron Diaz. It was around 8:30PM and earlier on I had eaten my eveing meal - what it consisted of I cannot recall. As I continued to watch the film, I saw that 8:30 had become 9PM, and knowing I would soon be taking my night-time injection, I wanted to check my blood sugar level so that I would know just how much insulin to inject.

So, still keeping one eye on the film, I stabbed myself, exsanguinated my as-yet-never-to-play-guitar digit, and awaited the result from my glucometer. Within 30 seconds I was surprised - somewhat pleasantly, I might add - to be informed by my now-friendly digital machine that I was "Low". I say surprised because I didn't feel any different than if I had registered a 6 or even a 12. To put it another way, I felt absolutely fine.

There was no hunger, no trembling, no shakes, no sweaty palms. There was no panic-induced dash to get something to eat, no need for help, no inability to focus, not even an increased heart-rate - even watching Cameron Diaz, who could do that to most men!! (Maybe there was something wrong with me.....). In fact, I continued to watch the remainder of the film, unhindered by any hypo symptoms whatsoever. It wasn't until we were rewinding the tape (yes, it was a while ago!) did I even remember that about an hour previously I had been informed by my glucometer that I needed something to make my blood sugars rise. However, at this point I still felt fine, so more out of curiosity than necessity I checked my blood sugars again.

This time, the reading was 7.4mmol/l (155mg in America and parts of Europe).

How had this happened?

Why had this happened?

Why didn't I feel low?

Well, at the time that this particular incident occurred, I had had Type 1 Diabetes for about 20 years. In those 20 years, I had had umpteen hypos, most of which I had felt the strength of. However, one effect of having to go through these numerous attacks on my body was that having had so many hypos, my body had built up an 'immunity' of sorts, a certain tolerance for them. My body could 'handle' them without having to inform my mind that I was having a hypo.

I had grown used to them.

It's true. Many people who have had diabetes for a lengthy period of time (or even for not that long) have either had or will experience this phenomenon. In fact, it is quite common among those of us with Type 1 Diabetes, even if it isn't always widely known.

If we are unaware that we are unaware, these can pose a threat to us. We could be going along one minute, feeling fine, only to be looking dazedly around us wondering what's going on the next.

Because I am aware that unfelt hypos exist out there, I find it useful to check my blood sugars frequently, not because I want to be a goody-two-shoes, endocrinologist's lick-arse, but because I don't particularly want to have to be dragged from within yet another hypo with a syringe in my arm or leg, or worse, having to try to get myself out from a particularly strong brand of hypoglycaemia.

This is the main disadvantage of building up an immunity to lows - not even knowing that we are low (at times). However, there are certain benefits. One is the fact that we can actually taste the food we put into our mouths, and actually might even get the chance to enjoy the flavour of chocolate or ice-cream or whatever it is that we use to remedy the situation. There is also the added bonus that we may actually retain some dignity by just going about our business of fixing what is not quite right without having to beg or plead or grunt for help from those around us, not all of whom know what to do (or even want to help). We don't have to make embarrassing spectacles of ourselves in a quest just to get a drink of milk or juice into us, and we can feel relaxed as the potion quietly and efficeintly does its job.

As someone once said to me: "Enjoy your hypos!" I think I know now what he meant.

Antiquated Care Methods

So, having worked a few shifts at this place I now call my job, I have noticed and questioned some of thier policies, in particular their attitude towards treating people with diabetes.

As a lot of the people in care here do not have their full facaulties available to them, they often either can't or won't eat full meals - including those with diabetes, both Type 1 and Type 2. When it comes to mealtimes, they just inject them with X amount of insulin and then expect them to eat accordingly - even if they cannot or will not. I asked why they don't just give them their meal, then see what they have eaten, and then inject the insulin in accordance with what they have eaten, instead of eatin according to the amount injected. I think it makes sense, but I think that it may involve making too many changes to the routine of the staff, not necessarily to the residents. Oh, the thoughts of it.......

The attitude of some - not all, I must add - of caregivers to residents in there, from the point of view of diabetes at least, really highlights the antiquated treatment methods which are being administered. The sad thing is that it does not have to be like this. Surely it is in everyone's interest to give insulin according to need, as opposed to give food according to insulin administered. It would lead to less hypos for a start, and they would probably save on their insulin costs too in the long run. But the disruption to the staff............

This bothers me. For one, it is the 21st century, not the 18th, but the thinking behind this way of treating people comes from the point of view of the medic, not the person receiving care. Surely these facilities were built to care for the resident/patient with support from the medic. not run according to the desires of the medic, with the resident/patient coming as an afterthought, or esle there for the benefit of the carer? I wonder how long it will be before the resident/patient comes to the forefront of the equation? Until then, we'll just have to keep on making our point, whether it is subtly, quietly, forcefully or un-ignorgably. If we don't, these methods will just continue.

Working Nights at the New Job

Okay..... so I've begun to work nights, and initially my bloods were all over the place - just like my insulin amounts. I started on Monday night with a 25 (yes, a 25!) but I managed to reduce it to a 9 by the end of the shift. I don't know whether this very elevated reading was down to overeating (don't think so), nerves (possibly) or the erratic sleep pattern (possibly) or even a combination of the aforementioned factors (probably). However, it was a very uncomfortable me who began work that night, and a slightly more comfortable me who finished at 7 the following morning.

These night shifts have been really disrupting my sleeping patterns, though, and this also could be playing a part in my bloods ghosting around, going wherever they want (except too low, thankfully). I don't like it. I don't like the fact that I have to do these nights, as my bloods are all over the place, but I'm not sure whether to say anything to my employer, for a number of reasons. If I say anything to them about the job affecting my bloods, would they use that as an excuse to let me go, bearing in mind that I am still on probation and therefore I can be let go without reason during this period. Also, I don't want to hide behind my diabetes, and it would be really easy to say "Oh! It's having an adverse effect on my bloods, therefore I can't do it!" and use that as an excuse not to do the nightshift - welcome as it might seem to me.

There's also the stress. We have been given a bare minimum of exposure to this particular role, and tonight they are3 expecting me to go in and look after all of these people on my own, with very little experience. I can't see the sense of this, as they are willing to pay people overtime, but when I was orientating, I was in a team of 2, and things worked much better. It was also a better way of getting the experience while working with an experienced colleague who could answer questions and point you in the right direction. Tonight will be different. I have to go in, on my own, and look after these people for 8 hours. The stress of that alone is enough to cause my bloods to fly up, which I will have to deal with later on, I'm sure.

Dilemmas, dilemmas.............. I know I have to go to work. My kids, wife and family are depending on me, as am I, and the job involves taking care of people, which also appeals to me, ut can I do it to the expected degree? I pray God will guide and direct me, and also help me to control my bloods so that I am physically and emotionally capable of doing what is required of me properly.

Nightshift

Hello all

I have just started a new job at a nursing home. This work is all year round, with no such thing as 'holidays' in the eyes of those who run it or who live there....... a bit like Type 1 Diabetes, I suppose. Anyway, tonight I have to work the nightshift - 11PM to 7AM. I'm wondering what to do with my insulin dose.

In the past when I worked nights (which was never too often) I found that my blood sugars tended to misbehave and become erratic, no matter how hard I tried to keep them in the so-called 'correct' range. I remember also having a discussion with a dietitian about how I seemed to be able to take more insulin in the mornings and eat less without nosediving into a hypo, compared with if i took the same amount of insulin later in the day, where I would have to eat more just to avoid the hypo. She told me it had to do with hormones - not that I know much about them, but it makes me wonder if I do spend the whole night awake, will my body think it is still in day-time, and how will it react?

I was thinking of not taking my nighttime insulin, and instead just going on my quick-acting, just to see how I get on. This is all new to me, and I have to say I'm not looking forward to it. Nor do I want to hide behind my diabetes and let it dictate to me that I cannot do this - attractive as it may seem to someone who would like to work more regular hours. There must be some n urses or doctors or anyone else out there with Type 1 Diabetes who have to work night shifts - any ideas or advice for me? It would be greatly appreciated.

For now I think I'll just try to go on the short-acting, and see where it takes me. I'm comparing it to a trans-atlantic flight, where you travel east from Canada to Ireland - you lose a night's sleep, and just get back into the swing of things - but then again, you on ly do that once, you don't have to repeat the process later that week - if you do, you tend to travel back from where you came, not forwards again.

I'm confused, a bit scared, but I'll have to do something.

Thanks

John

Online Group for Long-Term Type 1s

Yesterday I was contacted by a Type 1 who has had diabetes for 24 years. She lives in Iowa. Her idea - which I think is an excellent one - is to start a group for people who have had Type 1 Diabetes for longer than (for example) 15 years. She says that most of the groups online seem to cater for those who have been newly diagnosed, which is fine, but that none of them cater to those among us who have had it for a long time. Having it for longer can present different issues than to those who are just diagnosed. For a start, we tend to be older, and they tell us that you are more at risk of developing complications the longer you have it.

I have to say I'm blessed - I've had it 34 years, and no major organs have been affected. I've had laser treatment on my eyes, which was successful, and in fact my eyesight is as good as anyone's. I've never needed glasses. However, that's not to say I won't develop complications later. For the first 32 years of my life I was an extremely physically active person - I swam competitively, I played football (soccer), judo, and went hill walking on many weekends. In between this I was also just out running and doing circuit training - well, it beats watching television - and i think that has really benefitted me. But now, I've moved country, I am married with 2 boys, and my woek schedule along with my responsibilities as a father and a husband do not always allow me the freedom to be as active as I once was. I too face the possibility of complications as I grow older, and as I heard someone say recently, "an ounce of prevention is worth a pound of cure". Hear hear.

So, what would we discuss in this group for those who have had Type 1 Diabetes for, say, 15 or more years? Complications and their prevention, definitely. Insurance issues, probably. Experiences, anecdotes, ideas - well, hopefully. From my own life, I know that when I first heard other people with diabetes telling stories that could just have easily have had me at the central role, I knew then that I was not alone with this condition. No longer was I isolated, the fear and frustration began to dissipate. The joy of being in with this crowd of knowledgeable, caring, and fighting-the-same-issues-I-was people just lifted me emotionally and spiritually no end. It was magnificent! I remember the absolute joy of that weekend, and the huge let-down of having to say goodbye to all of these people at the end of the weekend seminar. This was in the days before the prevalence of such tools as the internet.

Now, however, we do have the internet at our disposal, there sitting, waiting, willing to work for us. If used properly, this wonderful tool can offer lifelines, an online support group of sorts, and hope to many people who might otherwise not be able to avail of it. It's there, it's available, it's easy to use. Why don't we?

Check back later for more details about website etc., but be sure this will happen, and if want it to, it can happen for YOU!

This blog is beginning to work....

Hello all

Just after I had written about the desire to create a community of Type 1s, what did I get only a Facebook message looking for me to join a group on that site. Great idea, and a good start to something which could gain momentum if we capitalize on the opportunity quickly. So, c'mon all you Type 1s out there, get on board and let's change how the world looks at Type 1, and also let's support each other. It's much needed, can cost next to nothing, and will help us all both in the long and short term.