London

I've arrived! It's taken me 2 days to get the internet working but I'm glad to be back online.

Last night, on my second day here, I attended a meet up of North London Young Diabetics. There were 7 of us in total, and we did what all d meet ups seem to be about - eating and drinking! We met at 6pm and left about 9, all of us going our various ways on the tube and bus. It was a lovely evening and no doubt there will be another meet soon.

London, for me, is a big, scary city. I've never lived anywhere this big before! It's also quite exciting, but for the most part all I am at the moment is very nervous about it all.

On Tuesday, I travelled to Southampton to take part in a day's training with JDRF and INPUT. I have quite a lot to say about it, but not much energy right now, so I'll get a proper update on that out soon!

Taxi drivers and visits to A&E

Last night I had a phone call from a friend.

"I've been low all afternoon, and I'm throwing up. Should I go to A&E?"

YES YES YES was my answer to that. "I'll meet you there."

I threw all my crap in my bag and rang out the door. I grabbed some cartons of OJ on the way 'just in case'.

I discovered the bus had left a few minutes before and it would be over 30 minutes wait; I decided to run the first part of the journey (I would have had to catch 2 buses to the hospital). Before doing that I tested:

3.3. "S**t!" Down went the first OJ carton, and a phone call to a taxi rank. The taxi arrived shortly and the taxi driver asked me why I was going to A&E.

"My friend is a type 1 diabetic, he has a low blood sugar level but is throwing up so he can't get his blood sugar levels up - A&E is the safest place for him to be."

verynicetaximan: "Don't they treat you kids with tablets these days, you don't have injections do you?"

Cue a lengthy, slightly hypo discussion about the difference between type 1 and type 2, the medications we can use, and my pump! I even showed him my cannula and the pump itself. I'll give him his due - he took what seemed to be a genuine interest and seemed to keep up with the conversation.

To cut a long story short, after an injection of Metoclopromide - dude was fine. Levels stayed in the 9s and 10s and it's all over now from what I hear.

Motto? Even if things are probably going to turn out okay, when you have type 1 in the frame, there's a big chance they might not. Quote of the day came from the ridiculously stuck up doctor in A&E:

"We see millions of people like you everyday - you have norovirus."
me: "No, you don't see millions of him. He has type 1 diabetes."

edited to clarify: her point was that he was no one special and should go home - my point was that with type 1, he was NOT like everyone else and needed to be taken seriously!

Living with type 1, and living alone with type 1

I mentioned earlier this week that I had had some bad hypos, including a particularly bad night time hypo. I'm not sure if I've publicly stated before, but as I rent a room in a shared house and don't actually know any of the other  people living here, I consider myself to live alone - as I do not know I could rely on the others in an emergency, nor do I know them well enough to want to place my life in their hands.

Which means I am pretty self reliant when it comes to managing what could become emergency situations overnight. I've taken steps, that I have learnt over the years, to ensure I can help myself if I need to.

- always, always, always keep BG testing kit within arm's reach when sleeping. I sleep with my kit in my bed, yo. That way I know exactly where it is and where I need to reach for to grab it.
- always, always, always keep fast acting carbs within arm's reach. Plenty of them. And a choice of them - I can have a hypo where I become very 'picky' over what I want to eat or drink, so I usually have a choice of glucose tablets, juice or Lucozade.
- I have a plan with my mum, if I got to a point where I could no longer help myself. I would ring her and she would get an ambulance sent to me. When I make my move to London, I will also be giving her the numbers of some friends and family in London so she could get in touch with them.

Now, these might not be rocket science or fancy. They aren't complex or time consuming. These few rules I have set with myself (I never sleep without my kit, glucose or a plan) ensure that I can 'cope' with having a hypo over night.

Why do I have them there? Because the horrible truth is, there are eventualities I can barely even begin to think about when it comes to night-time hypos. There are awful stories that don't take much googling to find, about low blood glucose levels over night, and how they end up. Back at the Friends for Life UK 2010 conference, Jeff Hitchcock spoke about why he let his daughter move in with her boyfriend when she was fairly young. He spoke about him never wanting her to sleep alone, in case something happened. We all know what that 'something' is - dead in bed syndrome.

Age 22, I still ring my mum to tell her about the bad hypos I have. My rule number 4: always, always, always know where your support lies, and utilise it.

Video

A few months ago I was interviewed by Birmingham Children's Hospital on living with, and growing up with, type 1. Please excuse my lovely Birmingham accent and the fact I sound so apathetic! How embarrassing!!

Link: http://www.youtube.com/watch?v=ZmG7j-i-Oes

Hypo hamsters

I mentioned in my last post that I've been experiencing more hypos due to having my cannula in my thigh. The problem is almost sorted (working on 50% temp basals and finding out when I need to reduce it even more).

The first night after the cannula change I had one of the worst hypos I've ever had. I went down to 2.4 which really isn't all that low. I mean, it's very low - but I've been lower. This hypo though gave me some of the strongest symptoms I've ever had.

These included

• waking up unable to breathe properly
• standing up to go to the toilet, and falling into my wall
• almost falling off the toilet (amusing imagery but scary at the time)
• shaking like a leaf in a hurricane
• total confusion; writing on a friend's facebook wall asking if I could use ice cream as a hypo treatment (and getting international replies!)
• insane desire to just shut my eyes and go to sleep to get rid of all these feelings - as a child, the one mantra my mum had when I was hypo was 'do NOT go to sleep'
• and the weirdest one: my right eyesight went totally...weird. It was just like looking through a kaleidoscope - as if my eyesight had been chopped up into squares and those squares had moved around so the picture was totally wrong. This lasted for a good 30 mins or so and was really quite frightening to be honest; it scared me thinking about what a low blood glucose can do to the body

After about an hour, I was in good numbers and went back to sleep. I woke up slightly out of range - 10.1 if I remember correctly! - but seriously, with the way I'm known to rebound, I'm happy with a 10.1 after a 2.4.

I called my mum later - we're very close and she's the first person I ring after a bad hypo. I told her about the hypo and she said two things to me - one a bit eerie, and the other just ridiculous.

"I was thinking about you hypoing overnight last night. And for some reason, I took my mobile phone to bed with me, just in case you called me."

- how did she know I had nearly called her when I first tested at 2.4 and was unsure I could treat this myself? She amazes me. I told her she's a bit like a hypo dog...to which she replied the funniest thing I've heard in a while.

Mum: "well, because you can't have a dog [I rent my room!] you should have...a hypo hamster!"

Me: "and what would the hamster do when I go low?!"

Mum: "it would run faster around its wheel!"

I was in tears laughing at this comment. I can just picture a poor little hamster running around the wheel every time I went low! Honestly!

LipohyperWHAT? Experiments, what?

Lipohypertrophy - lumpy/fatty areas caused by injecting insulin repeatedly into the same area (my definition). For over 15 years I injected into my thighs twice daily, meaning I have 2 really nice raised areas. I haven't injected into them for years, literally, and they are still raised, still there.

I usually use my middle areas for my cannulas - tummy, sides, basically anything I can reach easily and is comfortable. I realised I'd been doing this for 4 months straight and everything was starting to look...a bit dot-to-dot.

Yesterday I tried a new site: the lovely raised areas, aka lipohypertrophy, on my thighs. I was really nervous about it - I hadn't tried this site before, I was unsure how much pressure I'd need to apply to break the skin with the inserting needle (I insert my Sils manually), so on so forth.

And what have I found? Since siting the cannula there, I have been hypo several times. I've only just clocked onto it - but since changing, I have been hypo 5 times, in around 30 hours.

My question is now: what do I do with this info? When siting cannulas in my thigh/lipohypertrophy again, should I use a continuously lowered basal, say dropping 5 or 10% at a time? Is it a fluke, a one off? I need to change cannula tomorrow - should I put it in roughly the same area for experimental purposes (I'm a good site rotator normally) and see if I continue to hypo? I have 5 days of the same shifts (7am - 3pm) so it would be a good time to experiment.

Any thoughts or advice would be greatly appreciated! I had always believed/been told that lipohypertrophy would be more likely to send me high due to lack of insulin absorption...the human body is so weird.

In the new year...

I'm hoping 2011 will be a very positive new year. I have my new job going to start in a month or so. I'm hoping to shrug off a little of this burnout.

I've just read an incredibly inspiring blog - Naturally Sweet - about Hayley, a 16 year old girl with type 1. Her blog says it all really. But reading it has started to make things move within - the thought of running support groups for children. Of starting a diabetes awareness foundation. Of summer camp! I need to mull it over, but I feel totally 'pulled' by these thoughts.

2011 is also the year for me to work on my (total lack of) confidence issues. I need to get all of that out my system else I will never move forward!