Baby Steps.

My gorgeous godson and I.

In the past, when it comes to my diabetes care, I have always wanted to run before I'd learnt to walk. After I was diagnosed, I wanted to learn everything I possibly could to be able to lead a "normal" life. I remember wanting to learn how to carb count really early on, and being told not yet. This didn't sit well with me, so I went away and taught myself! I wanted to learn it all! I did a lot of reading on diabetes. I'm one of those people that likes to know what they're up against.

Over the last three years, I have learnt that learning everything at once and striving for "perfection" is not the way to do it. You need to take things slow, one thing at a time: baby steps. This is a new concept for me: I don't do baby steps. I tell everyone else to take baby steps, but I don't. I know what I want to achieve with regard to my diabetes care and eating habits, and I want to achieve it now. But I know that this mindset is only going to leave me back where I started. So, it's time to walk my talk. I need to get all the fundamentals in place to help get to my final goal, and the only way to do this is with baby steps. 

I'm bolusing again properly, although my carb counting skills are rusty. I'm eating breakfast everyday, which is good as it sets me up for the rest of the day. My averages are slowly coming down, which I am very happy about! It's my eating habits throughout the rest of the day that need to be worked on. I snack a lot, and that needs to stop. And I need to cook proper dinners, not just pasta and a sauce. I also want to find another outlet that's not comfort eating after a bad day. A lot of targets, I know, but this is where the concept of 'baby steps' comes in. I've got to take it one day at a time, and not beat myself up after "bad" days. I know it's not going to be easy, but I am determined and motivated, and that, along with the wise words of a good friend of mine, will keep me going.

Language Barrier.

Palacio Real, Madrid.

I'm a language student, French and Spanish being the two languages I study. As you can imagine, it is challenging enough to switch between the two when it comes to everyday conversation. When I first arrived in Alcalá, I was very stressed; I had moved straight from Toulouse to Madrid, was living in a hotel, and had no permanent accommodation set up (stressful situation to be in). Coming straight from Toulouse meant I had been surrounded by the French language, and suddenly I was expected to communicate in Spanish, a language that I had not spoken in about seven months. 

Somehow, I managed to sort out accommodation. My Spanish-English and French-English dictionaries were a great help! I went to register at the university and I remember walking in feeling quite confident...then the person I was talking to turned round and said "Ah, vous etes francaise?" ["Ah, you are French?"]. Cue minor meltdown on my part. I explained that I was English, but had been living in France and was now here in Spain for the second semester. He then understood my meltdown. Again, somehow I managed to get through registration and after that it was Spanish as much as possible. It took me ages to stop talking French, but I think I'm just about there now. 

Now, explaining something as vocab specific as diabetes in Spanish has proven a challenge, as I've mentioned in this previous post. Factor in alcohol and trying to explain diabetes and you are asking for trouble! I went out at the weekend with some friends, one American and two Spanish. When I'm drinking alcohol, I like to stay on top of my blood sugar levels, so I test frequently. I took out my blood testing kit, and tried to do a test discretely under the table, but what I was doing did not go unnoticed and questions were asked. 

I was trying to explain that when my blood sugar drops, I have to eat or drink something sugary, and that I always carry sweets in my bag. In Spanish, the word for sweets is golosinas. Now, I ask you please to remember the fact that I had been drinking! I said I have gasolinas in my bag. Gasolina definitely means petrol! I did not have petrol in my bag! I was so embarrassed! And things just went from bad to worse! Again, remember that alcohol had been consumed! I then proceeded to say "estoy muy embarazada". Embarazada does not mean embarrassed. It means pregnant. So after my first language mix-up, I then said I was very pregnant! Not embarassed, pregnant! 

So...what have I learnt from this? Golosinas and gasolina are two very different things, embarazada does not mean 'embarrassed'! (The word I was actually looking for was avergonzada (avergonzado if you're male)) and to just not talk in Spanish after alcohol has been consumed! 

Tapas.

Tapas in Alcalá.

I don't understand how Spanish people with diabetes do it! Bolusing for tapas is such a challenge! Where I am in Alcalá, tapas is very much the norm. It's not like in the capital where you'll find restaurants, it's primarily tapas bars here. Not only is it promarily tapas bars, but even if you don't want a tapa, it comes free with whatever drink you order. Like I'm gonna turn down what is essentially free food! But this does leave me with two significant diabetes-dilemas!

1. Given that Carbs and Cals and other similar books I've got are generally focused upon "normal meals" (spaghetti bolognaise, lasagne, roast dinners, stir fry etc) I have no idea where to even start with working out the carbohydrate content of tapas!
2. If I'm going out for the night, and I'm going to be getting a tapa with every drink, what do I do? Do I take an estimated dose and then correct at the end? Do I bolus for each tapa separately (really not ideal!), do I just correct at the end of the night knowing that I'm going to be drinking?

Really, it would be easier if I just avoided tapas, and had them as like one-off "treats". But that's easier said than done. I finish class, and it's the norm to go and get a drink and a tapa. I don't want to be going back to my flat to eat a proper lunch! But at the same time, I don't want to be dealing with the crappy sugar levels all the time! 

This week, I have decided that I am going to try and avoid tapas. I need to get back on track with my diabetes and build up my confidence with it all once more, and tapas aren't going to help me. That, and next week I have family coming to visit, and they're going to want tapas, so I need a "good" week before they arrive.

However, I am determined to be a tapas-bolusing-master by the time I leave Spain! Practice makes perfect, right?!

"But You Don't Look Diabetic..."

Spot the non-diabetic, anyone?!

This is something I hear a lot...doesn't mean it gets any less annoying though! Diabetes is one of those things that the world only sees when I check my blood sugar or do an insulin injection. It's invisible: there are no physical markers that say to the world "I have diabetes!" But when people learn that I am diabetic and then say to me "but you don't look diabetic..." I always find myself wondering what they expect someone with diabetes to look like. So, for the first time ever, I asked! I was curious to know what a diabetic should apparently 'look like'! The response I received was something along the lines of "well you're not old, and you're not fat." 

Deep breaths, count to ten, regret asking the question, you know the drill.

I'm not old and I'm not fat, therefore I don't look like I have diabetes. Is that a compliment?! I swear diabetes is a subject covered in GCSE Biology class, and you're taught that it's autoimmune and stuff like that. I mean, don't get me wrong, I was no expert in diabetes prior to my diagnosis (and I'm still no expert), but I knew it didn't just occur in old people and those that are overweight. Ok, GCSE Biology was some years ago, but even so! 

There's a lot of emphasis put on type 2 diabetes, because of it's link with both age and weight. And it's good that people know about type 2, as it's something that, with some good, healthy lifestyle choices, you can reduce your risk of developping. But that also means that there is a lack of education and awareness when it comes to type 1, as well as the other type of diabetes such as type 1.5; in the eyes of the general public we all get "grouped together". There have been numerous times when someone has found out that I am diabetic and they've turned round and said "my [insert relative here] has diabetes too...you can just take a tablet once a day and you're fine..." (If only it were that simple!) Another comment I had recently was "you have to do that because you parents gave you too much sugar when you were younger!" Safe to say I was not amused with that comment! Not only was there a lack of understanding about what type 1 diabetes is, but it was also just plain rude!  

But in the words of a friend, I'm going to keep calm, smile at their ignorance and continue raising awareness.

Happy 21st Birthday, Lizzie!

There are no photos of us together...I was bored!

Today is the lovely Lizzie's 21st birthday. Lizzie and I have become very good friends over the last few years, so today's post is in honour of her!

Now, as I've mentioned before, Lizzie can only be described as my diabetic best friend. She is incredible. I talk to her more or less everyday. She keeps me focused, listens to me rant, offers advice and is just bloody brilliant. Together we set up SDUK which is doing really well, and I just can't imagine not knowing her. She was also a huge help when my housemate was going through diagnosis! And believe it or not, we've only met in person once, and that was last summer when our first words were something along the lines of "is it appropriate to hug?! We haven't met, but at the same time we know each other...hug feels appropriate...I'm going ahead with the hug!" (I kid you not!)

So, today's post is going to be a list - 21 reasons I love Lizzie in honour of her 21st birthday! Enjoy!

 1. She loves Starbucks just as much as I do! (It was a given this was going to be my #1!)

2. She also love Nandos just as much as I do! (Again, a fairly obvious #2!)

3. She puts up with my moaning about diabetes.

4. She laughed at the fact I referred to her as sugar.

5. Since number 4 happened, she also calls me sugar (it's now a 'thing'!)

6. She's as tiny as I am (no one likes being the short girl with lots of tall friends!)

7. She was absolutely brilliant when it came to answering my questions about type 1.5.

8. She goes through phases of texting me everyday to tell me what her sugar levels have been like!

9. She stands her ground when it comes to her diabetes care.

10. She agreed to joining together to set up SDUK, which is now almost a year old and still gets used!

11. She's a Brownie leader.

12. She got crazy excited when I sent her a postcard from Toulouse!

13. She gets as excited as I do over new diabetes-related gadgets (Novopen Echo springs to mind!)

14. She is more or less always available to talk (last night she went out for her 21st, but she was still responding to whatsapp messages, silly girl!)

15. She provided me with blood sugar logging templates to help me get back on track.

16. She is very open and honest, despite having only met me once!

17. She introduced me to M&S pink grapefruit and lemonade drink. And it's diet! (At least I'm pretty sure it was her!)

18. She got me into blogging. I saw how much it helped her and figured I'd give it a go.

19. She dies her hair red and I love it!

20. She doesn't let anything hold her back.

21. She's just genreally an absolute angel, and I can't imagine not having her around!

Happy 21st birthday, sugar! I hope you have an amazing day and I will see you again very soon! xxx

Happy World Thinking Day!

At Brownies.

February 22nd marks World Thinking Day amongst all those involved in Guiding and Scouting around the globe. It's actually the birthday of both Lord and Lady Baden-Powell, the founders of the Scouting and Guiding movements, and it is a day where groups all over the world think about their "brothers" and "sisters" within the two movements. This year's themes were "Together we can save children's lives" and "Every mother's life and health is precious". 

This links with another campaign that has been running throughout February, and I think it links in very well with this year's Thinking Day themes, and therefore a good time to write about it.

Spare a rose, Save a child - Life for a Child.

This concept is genius, in my opinion! All that was asked of people this Valentine's Day was to buy one less rose for their loved one and donate the cost of that rose to this cause to help supply children less well-off with insulin. So simple, yet so great! Diabetes can affect anyone and we all know that without appropriate treatment, particularly in type 1 diabetics, the consequences are fatal. Being from the UK means I have access to the NHS, a free healthcare system, and having type 1 diabetes also means that I get free prescriptions, so I don't pay a penny for my insulin, needles, test strips etc. Yes, there are problems with the NHS, but nonetheless, it grants me access to free healthcare, something I am very grateful for. 

All the money raised from this campaign goes straight to Life for a Child, a charity linked with the International Diabetes Federation, and all money donated goes towards providing children with insulin, blood testing kits and education programmes to help them live life with diabetes. 

A worthy cause if you ask me!

Explaining Diabetes...En Español?!

Casa Cervantes, Alcalá de Henares.

Anyone that knows me knows that I can explain diabetes fairly well...in English. No one in France ever asked me about my diabetes, so I didn't have problems there when it came to the language barrier. But after my hypo in the my local supermarket a couple of days ago, I decided it was time to seriously drill some vocab into my brain. Now, my diabetes-related vocabulary in Spanish goes as far as:

Soy diabetica ('diabatico' if you're male) : I'm diabetic.

Tengo diabetes : I have diabetes.

La insulina : Insulin.

That's it! So, trying to explain diabetes proved very difficult, as you can imagine, particularly when already in a hypo state! This is really a post for my friend, Bethaney, as she is spending part of her year abroad in Spain (fingers crossed for Granada!) but I guess it's handy for anyone visiting Spain. I have found out relevant diabetes vocabulary! It took a lot of google-searching and reading of the Spanish equivalent of Diabetes UK (La Fundación Para La Diabetes - website here if you're interested)

Las agujas : Needles.

Inyectar : To inject.

Una inyección : An injection.

La glucosa : Glucose.

El azucar : Sugar.

Los hidratos de carbono : Carbohydrates.

El autoanáliso : Self-testing. 

El nivel de azucar : Sugar level.

El nivel de glucosa : Sugar level.

La hipoglucemia : Hypoglycaemia.

Normoglucemia : Normal sugar levels.

La hiperglucemia : Hyperglucaemia.

El páncreas : Pancreas.

La descompensación diabetica : DKA.

La glucagón : Glucagon.

There's actually a fairly detailed list of words and definitions you can read if you click here. However, I have no idea how to translate "blood testing kit" into Spanish! If anyone can tell me how to say that in Spanish, it would be very much appreciated!

Beat The Hypo?!

Yum!

Now, if we are all honest with ourselves, I'm sure at one stage or another in our diabetic lives we have found ourselves playing a little game of what I'm now calling "Beat the Hypo". Well, I'd like to think I'm not the only person in the world to have decided to play this game, anyway! Here are the results of when I played yesterday on my way back from teaching:

Hypo 1, Vicki 0.

I made it 3/4 of the way home, and then hypo-ed good and proper! It was horrific! I was in the middle of my local supermarket and I managed to find fruit juice cartons. I was fumbling around for what felt like hours trying to get a carton out of the packet, and started drinking extremley quickly, as well as trying to check my blood to establish just how low I was (2.8mmol/l). At this point, security was approaching me, and in my hypo state, had to try to remember as much vocab as I could in order to explain that I had diabetes and was hypo. 

Turns out I didn't need to, as when he saw me holding my blood testing kit, and then the juice cartons he knew exactly what was happening and actually stayed with me to make sure I didn't keel over! He told me that his Mum had type 2, so knew what a hypo was and that I was having one when he walked over. It's not often you bump into someone that knows exactly what's going on!

Familiarity.

Home away from home.

With all the recent talk of getting back on track and support systems and everything else, I’ve found myself really missing my family and friends! So, yesterday afternoon I sought out familiarity, and went into Madrid to go grab...a Starbucks! Yes, that was how I delt with my homesickness! Starbucks: a place where the carbs in the chocolate chip muffin I ate are exactly the same as the carbs in the chocolate chip muffins in England have (around 63g of carbs, if you're wondering); where I can get my standard grande, skinny, decaf latte and know it is going to taste amazing; where I feel like I’m at “home” even when I’m not at home (Starbucks is my preferred coffee shop, that is all!)

I know that the feeling will pass, but it doesn’t make it any easier now. I skyped one of my housemates at the weekend and it was so, so good to properly catch up with her. We skyped for a good three hours, and I’m pretty sure if she didn’t have work to do and it wasn’t around 3am Spanish time, we could have kept on going! Oh, where would we be without modern technology, eh?!

Year abroad is great, don’t get me wrong! I am incredibly grateful for having the opportunity to live and study abroad, not only in one country, but in two. I’ve been able to spend 4 months living in France, and I will end up living in Spain for about 5 months by the time I've finished my exams here! Pretty amazing if you ask me! And the travelling opportunites I've had, and will have, are incredible: lived in Toulouse, visited Bordeaux and Clermont Ferrand, lived in Alcalá de Henares, visited Madrid, plan on visiting Granada, Alicante, Salamanca. I've really caught the travelling-bug and I'm loving it. But then I miss the stability of having a permanent home. I'm pretty much living out of a suitcase, and no where has been home for more than 6 months. That's hard. I like stability, and for that reason I am very glad the year abroad is just that: a year. 

I can't wait to see what the next few months bring (hopefully stable sugar levels are up there!) but I also can't wait to get back to the UK, back to Norwich, back home, where I have my friends and family, the diabetes clinic (never missed spending time at the diabetes clinic until now!), and just a general feeling of permanence. 

Life In A Day.

Guadalajara, Spain.

Life In A Day is a movie-documentary that I am now recommending to everybody! A friend recommended it to me, and when she first explained the concept, I was confused by how it was going to be put together, but I thought it was so incredibly well done. I laughed, cried, smiled, felt heart-broken: it really was an emotional rollercoaster, and a real eye-opener.

Basically, it is a series of video clips that people took and then sent in. The one thing they have in common is that they were all filmed on the same day: July 24th, 2010. The clips come from countless different people, spanning 190 different countries, so the clips you see vary greatly, as you can imagine!

It put a lot of things into perspective for me. I like to think that, on the whole, I am generally a happy person. Like everyone, I have my down days, but I think that more that 75% of the time, I am in a happy mood. Recently, I have had major diabetes problems: I went back down that omitting insulin route and it was just generally not a good time for me. But watching something like Life In A Day really made me realise just how lucky I am for everything I have. For a start, I have access to a free healthcare system and prescriptions, meaning I can actually stay alive! Then there's my actual family, my chosen family, my friends. I think I can say, in actual fact, I have it quite easy! Yes, there will come a time when, once again, diabetes will beat me. But, in keeping with my last two posts, I need to make more of an effort to remember the good and the words of encouragement of those around me. And if that fails, then I'm pretty sure re-watching this movie-documentary will do the trick! 

Click here to watch Life In A Day on Youtube.

Words of Encouragement.

My words of encouragement.

The power of words continue to amaze me. The way that, when strung together correctly, they can make people smile, move them to tears, sometimes hurt, and other times give you exactly what you need to get going again (the language student in me shining through massively right now!) About a year ago, I read a book called The Happiness Project by Gretchen Ruben. Now, I was very sceptical about this. With regard to happiness, I agree with the quote "happiness is a mood, not a destination, and it is not permanent - it comes and goes", and Ruben's idea, to me, suggests that happiness is destination. Nonetheless, I did read her book; I was intregued. Happiness is a very personal thing, and I was interested to read what she wrote. It was one of those books that I took notes from, and I was really surprised by how much I actually took from her writings. For example, I very much agree with her concept of having a "list of rules" by which you live by. Whether you realise it or not, almost everyone has little "mottos" that they abide by no matter what. As well, there were some things she mentioned that I do believe help to cultivate a happy mood, such as maintaining good relationships with family and friends, clearing the clutter (personally, mess makes me miserable), taking time out for you etc etc. They were all things I tried to do anyway.

But there was one piece of advice of hers that I took and acted upon, and I think it's the one that has been the most reliable source of happiness for me. In her book, Ruben suggests creating a "happy box": somewhere you can keep some photos and...well...anything that makes you happy. When you have a bad day, it's always there waiting to make you smile. I created a "happy box" to take away on my year abroad with me. Inside this box I usually keep photos (but they are currently up on my noticeboard), birthday and Christmas cards from my friend Ellen (she always writes essays in them, but they are on display) and pictures from my Godson (also on display in my room).

However, the items that never leave this box and come with me everywhere are the letters written to me over the past two years from two of the girls I lived with at uni. It seems that no matter how bad I think things have been, their words always manage to cheer me up and help me remember the good, something I spoke about in yesterday's post:

"This is a message to keep you smiling and let you know you're loved..."

"The places you go, things you do, people you meet that remind you of the goodness and wonder you share this world with. So if you ever loose sight of the magic in the world, read this and smile..."

"Together our 'family' will get through anything; it's what we do best..."

"She's a lady...woooo woooo woooo...she's a lady..." [you had to be there!]

"Tomorrow will be a new day, the sun will rise and what seemed overwhelming becomes something you've survived..."

"If life were easy, it'd be boring. There'd be no need for vodka, no need for girls night and no need to appreciate life..."

"The darkest days unite us, bring us together in A&E, together in the LCR, together in a bed with baileys and lettuce..." [again...you had to be there!]

It's these words, which I was reminded of after a skype date with a friend yesterday, along with constant texts from my best friend and friends from the SDUK facebook group that keep me going. Another friend posted on Facebook the following quote: "Friendship...has no survival value; rather it is one of those things that give value to survive." And I believe this to be true. It's a lot easier to get up and "fight" everyday when you know you're doing it for other people as well as yourself. 

Remembering The Good.

Group Lizzie and I started.

In my first post here, I mentioned that I have mixed feelings when it comes to diabetes: there are times I hate it, but then I remember everything I've gained from it, and that leaves me feeling confused about how I should feel about it all. This has always been one of downfalls: remaining grounded and remembering the good when diabetes gets difficult.

When diabetes gets difficult, I start wishing for my old life. The one where I didn't have to carb count and time my meals, prick my finger numerous times a day to make sure my bloods are in check, treat hypos, correct hypers. Being diagnosed at 17 means I still remember not having to care. I had the luxury of being able to do what I wanted when I wanted. At times like these, diabetes wins, because I let those thoughts take over and I let my diabetes control go completely. It doesn't just slip, it 100% goes to shit. 

What I actually need to do is stop letting diabetes win. Because when I actually sit down and think properly about it, more good has come of me having diabetes than bad. Yes, I have to do injections and sugar test and count my carbs. But I've also entered into this "other world" where I have had the opportunity to meet so many new people. When I was first diagnosed, I knew no other diabetics. No one in my family had diabetes, none of my friends knew anyone with diabetes. I felt so alone, so I sought out online support. I first joined the Diabetes Support forum, and from there I was introduced to Circle D. It was also through the forum that I met, whom I like to refer to as my diabetic best friend, Lizzie. Both being at university meant we had similar experiences and needed advice on many of the same topics! Realising how much we relied onto each other, we went on to start up some online support for students called Student Diabetics UK, where, once again, I have had the opportunity to get to know so many other students, and hopefully we'll be able to have our first meet over the summer (Lizzie, are you reading this?! Let's make this happen!)

See! So much good has come of my diabetes. Yet I fail to hold onto that! So I'm writing it here, in the hope that when shit hits the fan again (which it will), I'll be able to look at this and be reminded of all the good I've experienced over the last three years or so. 

DWED.

The unseen eating disorder.

Seeing as today marks the end of National Eating Disorders Awareness Week 2013, I figured I'd write about something very close to my heart: DWED, more formally known as Diabetics With Eating Disorders. 

Most people have heard of anorexia and bulimia and, what I believe is referred to as EDNOS (Eating Disorders Not Otherwise Specified - N.B. I am not a medical professional, full disclaimer here!) But what about diabulimia? The unseen eating disorder. Someone suffering from diabulimia will deliberately give themselves less insulin, or not take any at all, in order to loose weight. This weight loss occurs because when glucose levels in the body are to high and there is a lack of insulin to help convert the glucose into glycogen, the glucose is then lost through your urine, meaning the calories are lost too. Your body's response to this is to start to burn fat stores and muscles for energy, and then produces a by-product know as ketones. Ketones are highly acidic and are very dangerous. People with diabetes can end up in diabetic ketoacidosis (DKA) and this can be fatal if left untreated. 

Insulin omission is something I personally have been through. Twice now, actually (not my proudest moments, but they happened nonetheless). Not only that, but I have friends who have been through it and some who are still going through it. For me, it never started out as a weight-related issue, but more like a diabetes burnout, and along side that came the weight loss. It wasn't until people started complimenting me on the weight loss that it then escalated. But whatever the cause, the consequences are the same.

At the moment,  DWED are campaigning hard to get diabulimia more widely recognised here in the UK. You can find out more about the charity and see what they've been getting up to by visiting their website here.  It's a great charity where all the volunteers are committed to what they do, and maybe, at some point in the future, I will have the chance to join that team of volunteers.

(All information regarding DWED on this page has been adapted from the DWED website.)

Routine.

My fairly empty timetable!

It is no secret that, for me, when it comes to diabetes care and eating in general, I need a routine. If I have a routine then everything else just seems to full into place. I've now sorted my timetable and I know when I'm teaching English, so now I have no excuse when it comes to establishing a routine. I've been in Alcalá for almost 4 weeks now, so I think now is a good time to get into one.

First, I need to go to bed at a similar time every night. According to my Think Like A Pancreas book (my bible, as mentioned before) "lack of sleep can cause an increase in stress hormone production and may cause a rise in blood sugar levels. It also tends to increase appetite and can lead to insulin resistance and weight gain, particularly when normal sleep hours are spent in a sedentary state (watching TV, etc)." This is good news, as I love sleep, but I need to start sleeping at normal-person times, not falling asleep in the early hours of the morning and waking after midday!

In keeping with this, I need to get up at a similar time everyday too, more than anything just to have a decent breakfast. If I eat breakfast, I tend not to snack during the day; if I miss breakfast, then it's pretty horrific and I just graze all day, loose count of how much I've eaten, don't inject because I don't know how much insulin to take...it's for the best that I eat breakfast!

Exercise! Okay, here in Alcalá, I walk everywhere: to class, home for lunch, to class again, home for the evening. But I want to do more. It's not like Toulouse here, where I used to run along the canal, and the gym here is so expensive, so I can't afford that. Walking everywhere will do for now. This might change in a months time though. It'll be when I'm back in England that I step up the level of exercise I do, particularly when I'm back at uni where the gym is pay-as-you-go and classes are cheap! 

I also need one day a week "for me". One day a week where I can let the routine 'slip' a little. I already know that this day will be a Sunday. My friend and I meet for breakfast in town, but it's a late breakfast, so I get a bit of a lay-in and I listen to my lovely friend on the Union radio station, Livewire in the afternoon. That's it. So I have the rest of the day to do what I want, whether it be uni work, laundry, tidy my room, watch movies, pick up a book, skype, whatever. But it's a day when I haven't got to be anywhere other than breakfast in the morning.

Insulin.

Stocked up!

I have been taking insulin (albeit on and off) for the last three years, more or less. But other than helping to control my sugar levels and that it's a hormone, I wouldn't be able to tell you much more about it. Until now, that is! This Think Like A Pancreas book has very much become my bible to diabetes! (Again, I reiterate that I have not been paid to promote this book. Just, being on year abroad and not having access to my healthcare team/DSN, it's all I've got right now :) ).

I'm on a basal-bolus insulin regime. I knew that. This basically involves me taking two different types of insulin: a slow-acting (basal) insulin (Levemir in my case) and a rapid-acting (bolus) insulin (Novorapid). The whole point of this insulin regime is to try to mimic what my pancreas would do if it did it's job properly (you just can't find the cells these days!) I take my Levemir at 9.30pm every night, and lasts approximately 24 hours (so if I were to not eat anything or inject any rapid-acting insulin, my blood sugars should remain steady. Should being the key word here!) I then take my Novorapid with any food that contains carbohydrate that I eat (N.B. like the last time I mentioned this book, this is just a summary of what I've read, and please remember I am not a medical professional, full disclaimer here!)

What I didn't know: 

• If your basal dose isn't right, none of your other doses will be either.
• There's a horribly complicated formula for calculating boluses: The bolus dose = (food dose + corrections dose - insulin on-board) x activity adjustment I can safely say I will never be using this to calculate my injections! Give me the insulin to carb ratio any day!
• Spacing meals and snacks at least a few hours apart is important so that the bolus insulin can return your blood sugar level back to normal before you eat and raise it again.
• The timing of a bolus injection is actually essential. For foods with a high glycemic index (GI), you need to bolus well before eating, with moderate GI foods, soon before eating and with low GI foods, after eating. 
• Linking in with above, the pre-meal blood sugar reading is also important when deciding when to take the bolus injection. 

There's a hell of a lot more to this that what I realised! But what gets to me more than anything is the fact that I'm reading this all for myself now, three years after my diagnosis. Where was this education when I was diagnosed? Or in the years after my diagnosis as I adapted to living with type one? Because, a lot of what I've read seems pretty essential to me! Ok, moan over!

Keeping Track.

TGI Fridays, Madrid.

Time to get back into the routine of keeping sugar logs. I used to have log books, but they never served me well, so I'm thinking computer logs are the way to go. I've dug out templates that my friend Lizzie sent me when I first left for my year abroad. I'm not the most computer literate person, so using her template is definitely easier. That, and she also has a column to log what food she eats, something that I also feel would be useful in order for me to get my eating back under control again too. I'm also hoping it's going to eventually help me get back into carb counting. 

In keeping with this, I've also been thinking about targets; what levels I should be aiming for. For a non-diabetic, levels pre-meal are usually between 3.5 - 5.5 mmol/l and less than 8 mmol/l two hours after meals. Targets for people with diabetes are very similar. According to NICE (2004), people with type 1 should be aiming for a pre-meal level between 4 - 7 mmol/l and a post-meal level of less than 9 mmol/l (Information taken from the Diabetes UK website). However, given how...lapsed...my diabetes care has been, I think achieving these desired levels will be too difficult. 

The NICE targets are future targets, for sure, but not ones I want to be aiming for right now. Right now, I just need "average" control back, then we can work on well controlled! Having emailed my DSN, we've decided that my pre-meal targets can be between 4 - 10 mmol/l and I need to be aiming for post-meal targets of less than 11 mmol/l. Seems fair to me. It will also allow my body some time to adjust to running "normal" levels again before we get to tightly controlled, which is where I want to be at the end of this. But after almost three years of being tightly controlled and then 'burning out', I feel that this time round I need to take smaller steps; get the fundamentals in place and hopefully see more long-term effects. That's the plan, anyway! Let's see how long it lasts for!

Think Like A Pancreas.

Time to 'Think Like a Pancreas'.

It's time to go back to basics; time to re-educate myself on diabetes care and everything else. How? With my new Kindle-read Think Like A Pancreas by Gary Scheiner. I downloaded this this morning and have been reading it all day. It's actually quite refreshing to read a book about diabetes written by a type one diabetic. I remember doing a lot of reading when I was first diagnosed, but I don't think I actually read anything written by another type one.

For the moment, I have just been reading the chapters that are going to give me the knowledge I need just to get back on track. When I'm back on track, I'll then read the more detailled stuff. It is often said that knowledge is power, and this is very much the case right now. The more I read Scheiner's book, the more in control I feel about everything. And, like I've said, it definitely helps that he writes from his own experiences. 

So, I've been taking notes as I read (knowledge is power, remember!) and this is what I've taken from the book so far (N.B. All information is below is a summary of what I took from the book "Think Like A Pancreas". I'm also going to take the time to mention here that I have not been paid to advertise this book; it's just my opinion of it. And whilst I'm mentioning stuff, I'm also gonna point you in the direction of my disclaimer --> click here!):

• First off, Scheiner was diagnosed in his hometown Sugarland, Texas. Not relevant to  my diabetes care, but hilariously ironic!
• That crappy blood sugars affect your body a lot. I'm not just talking the lack of energy and ability to concentrate, but it also affects your skin and gums, your mood and actually helps to reduce your appetite. 
• Something that I found particularly interesting was that "high glucose levels can make us impatient, irritable and generally negative" - I've had a very negative attitude towards my diabetes care recently, and it turns out my crappy blood sugars have just heightened that sentiment.
• That although my diabetes is autoimmune and there's nothing I could have done to prevent it from happening, chances are there was still a trigger. Scheiner states that "viruses, major stress, environmental toxins, exposure to certain foods at a young age and genetic markers have been proposed as potential triggers."
• There are actually six types of diabetes! Six! Type 1, type 2, gestational, LADA, MODY, neonatal.
• Diabetes management relies upon three interlinked criteria: tools, skills and attitude. And you need to have all three. The best tools and the expertise to use it just isn't going to cut it if you don't have the right attitude. 
• Record keeping is essential. At the start, it needs to be daily, but once control has been fine-tuned, written record keeping can be done periodically, like one week a month or when levels start slipping.
• Linking in with record keeping, it's important to know what to look for when you have your results written out. Scheiner suggests focusing on overall average glucose, standard deviations (the amount of variability in your readings - yes, I did have to look up what it was, and apparently lower is better!), and the percentage of readings that are above, below and within your target range. 

But the most important nugget of information I took from my reading so far is the following:

"Over the course of your life with diabetes, there will be countless setback. When they occur, do not give up. It really helps to live your diabetes life one day at a time. You can't change the past, so don't worry about what you did - or didn't do - yesterday. And you certainly can't live tomorrow until tomorrow. Every day represents an opportunity for a fresh start."

This is something I can very much relate to, and it is going to be what I keep on coming back to as I get back on track with everything, and I look forward to learning more about my diabetes care. 

Take II.

Vicki's Notebook take two. Why? Because I feel like I need a fresh start. 

Alcalá de Henares.

I'm halfway through my year abroad and have got myself into the worst situation. the following demons have come back to haunt me:

Insulin omission.

Binge eating.

Not eating at all. 

Not a great combination when you're diabetic. But there you have it. 

Not only have these demons come back to haunt me, but, like I've said, I'm also on my year abroad, which is why it's more important than ever that I get these under control. Because I don't want to remember my year abroad as the year the issues came back. I am happy, however, for it to be known as the year the issues came back and I got them under control properly! Even if there are setbacks along the way, which there will be.   

My best friend has just left Madrid having come to visit me this weekend. We talked things through and I did a massive cry, something I definitely needed, and here we are. A good friend once told me that I need to have a "conversation with myself" in order to clear my head, and she is right (she's always right - I hate that!) So here I am. Starting afresh. And in order to do that, I need to let go of some stuff.

Over the last two to three years, I've actually been holding onto a lot of anger when it comes to my diabetes. Well, that needs to stop now. This is something I am going to have for the rest of my life, and if I don't let go of the anger I have towards it, I am going to end up falling into the same routine time and time again, and I don't want that. I need to focus on long-term goals in order to stay on top of this as much as possible.  I'm not saying my aim here is to be perfect 24/7, because it's not, and I know that that is pretty impossible. But I need to stop falling back into this whole not taking my injections routine. It's not healthy and boy do I feel crap for it! 

But, first of all, I need to vent. And I don't know if writing here is the way to do it, but it's a start and it allows me to organise my thoughts. 

Diabetes is a bitch. It's something that I am reminded of 24 hours a day, 7 days a week. I hate it. I can do everything right, and still it throws me hypos or hypers to keep me on my toes. Being female also means that time of the month throws me more curveballs. My injection sites get sore, my fingertips bruised from sugar testing and the flipping test strips get everywhere (I swear they grow legs and move about my room!) 

And that's just the physical side of it. That's actually the part I can probably handle the best. My biggest issue is the psychological side of it. Diabetes has this huge control over my emotions, and it shouldn't. Well, I shouldn't let it. But it does. Those numbers that I see of my testing kit have the power to make me cry one day to then doing a happy dance the next. It's ridiculous, but they do. That's the first thing that needs to stop. Bad days that reduce me to tears are allowed, but that daily influence those readings have over me...that's got to stop. 

As for food...well...given that I have to watch what I eat and count carbs and everything else, it's no wonder my issues with food came about. But they too need to go do one! Because being a type 1 diabetic and having issues with food really isn't the best combination!

As you can see, there's a lot of hate there. But here's the killer. I have hatred for something that has actually brought a lot of good to my life. The fucker of a health problem has actually allowed me to enter into this whole other world where I have had the priviledge of meeting so many lovely people, some of whom have become very close friends over the last three years. What am I meant to do with that?!?! Where does that leave me, other than feeling very confused about how I should feel about it. No diabetes would mean no Lizzie. No Daisy. No Alice. No Circle D. No SDUK. You see, confusing! 

But either way, I need to let it all go and get things back on track so I can start fuctioning like a normal human being once again. Because I can't go on like this. I feel awful. I look awful. It just needs to stop. I want my life back. I want to be in control again. I want to feel happier more often.

Right now, I feel very lost. It's almost like I've forgotten what to do and I feel like I need to go back to basics with everything in order to get it back. I know that it's bad that I'm not taking my injections. I know what the potential consequences are. And I know I need to get back on track. Writing this has helped (knew I referred to this as my diabetes therapy for a reason!) At the same time as writing this, I re-read some posts from my first blog from when I went through this before. It reminded me that I got through this before and I can do it again. I just need to remember that it's not gonna be a quick and easy process. I need to put the work in and I'm not gonna see results straight away. But a weekend with my best friend, chats with my friends Stateside, pouring my heart out to my DSN via email and writing this has left me in a clearer headspace and I actually feel like I am able to sort this out. I haven't worked out how I'm going to tackle this yet, but my head feels clearer, and I believe now I'm in the right headspace to sort this out. I'll figure out logistics later!