Friday, May 19, 2006

Another thought

From the past. Prompted by the Cargill advertisement on MSNBC for sugar-free chocolate.
It must have been 1992 or 1993. I was at a support group meeting and a dietician had been invited to answer questions. A study had just been released that suggested diabetics could consume up to 25g of sugar a day with no ill effects so a lot of the questions naturally concerned this matter and whether this represented one or two Belgian chocolates. At some point the dietician got a little cross we weren't heeding her mantra of lean meat, brown bread, green apples and she totally lost it.
She screamed that the study should never have been released, that we would never be able to eat just one chocolate (diabetics apparently have no self-control) and we would all end up getting horrible complications.
We've come a long way from those days. Genuine Belgian praline anyone?

Wednesday, May 17, 2006

21st Celebration

Twenty-one years since the diagnosis and I'm in kind of a reflective mood. I'm thinking about what has improved during the intervening years, what's actually worse and what could do with a huge upgrade.
In 1985 Type 1 diabetes was called Juvenile Diabetes or Insulin Dependent Diabetes (IDD) and pork and beef insulin was still being prescribed. But a growing number of people were taking the new "human" insulin, many of whom I seem to recall, blamed it for loss of hypo warning signs. When I was diagnosed, I was more concerned that the human insulin didn't come from actual humans, and when I was reassured that it was manufactured, that I got that rather than animal insulin (I was a recovering vegetarian at that time).
I was taught to use a syringe and told I could either mix the basal Ultratard with the bolus Actrapid or shoot it on its own before bedtime. As I was so befuddled I couldn't cope with mixing the stuff (hugely complicated), I opted for four rather than three shots a day. A little while later I discovered the diabetic nurse (that's the nurse who worked with diabetics and who had juvenile diabetes) used a Novopen and I had to have one. Before I left the office, please.
There was some sort of deal with the purchase of a special meter, buy one get a Novopen free (plus ├ža change, plus c'est la meme chose), so I got a cool Novopen, and I loved it. Everyone thought it was a real pen and people were upset when I told them they could not borrow it. Still it was three shots of Actrapid and one of Ultratard and though I've changed insulins I'm still shooting up at least four times a day. This definitely needs improving.
Eventually the Novopen was replaced by Novopen II, nasty, plasticky beige but with one great feature: you could take your shot and the number remained displayed until you used the pen again. So if you were on a sliding scale and were the forgetful type you could see if you had taken your shot or not. In those days I had to take the shot 30 mins before a meal and I could forget a lot of things in that half-hour. Unfortunately the plastic locking mechanism wasn't very sturdy and the pens broke easily. A few years later and U-40 insulin became U-100 and I had to swap to a Novopen III. That was upgraded and it no longer showed the last number dialed, so I now had to remember if I had had a shot or not. Definitely worse.
Now I have disposable Humalog pens. They are so ugly, much bigger than they need be and no-one is going to mistake them for a Bic. Plus, I feel I'm using up the earth's resources at an alarming rate. What happens to all that plastic?
As for meters, I'm on my fourth. I loved my Glucoscan II so much. It had a huge display, 30 second wait compared to 60 seconds of other meters, it was simple to use, and was slim. It sat in a vinyl wallet, strips on one side in their foil packages, meter, lancets and sticker on the other side. Looked great, worked great.
When it finally died, my parents bought be the AccuCheck meter and I hated that machine with a passion. It was truly the worst designed meter I have ever seen, the size of a brick and an unappetizing generic grey colour. The strips came in a tube and I could never get the top off. I either had to ask someone to help or I wrestle it off with a knife and end up with strips all over the floor and, once or twice, a nasty gash to my finger. It was also so complicated and gave so many false readings I went out and bought myself a new One Touch Ultra.
The improvement here was a five second wait for results and it was tiny. But it didn't do much else. Then the big upgrade to One Touch UltraSmart. I know I've complained about this meter elsewhere, largely because it isn't Mac compatible but there is the facility to record insulin intake and carbs, fats, protein; it gives weekly, monthly and three-monthly averages, it even lets you record doctors' appointments.
What I'd like now is a meter that has a better screen, that comes with a keyboard so I can type in additional information and that wirelessly interfaces with my Mac. Manufacturers are you listening?
I remember the endocrinologist coming to see me while I was in the hospital and telling me two things: it was the best time in history to be diagnosed with diabetes and that there would be a cure within the next ten to twenty years. Well, I think he may have been right on the first one, and a lot of things have got better, especially the advocacy and activism and support of other people with diabetes but as for the second, I'm celebrating twenty-one relatively healthy years living with diabetes but I don't see that a cure is any nearer now than it was then.

Wednesday, May 10, 2006

The grass is always greener

Ok, it's time for my periodical whine about living in the USA. This time it has been brought about by an email from the US Government telling us that our application for a green card has been received at the Texas office and they will let us know if it has been approved in 400-450 days. As our visa runs out in 49 days we will be stuck waiting for an annual extension visa and unable to travel during that time. Rats.
It's at this time that I start making a pro/con list for living in the US.
On the pro side my worse half has a job here, on the con side I can't officially work until our green card is granted. On the pro side the weather is much better here, on the con: the healthcare system sucks. Big time. Example, sweetie had to go to the emergency room after a work related accident. After a four hour wait he got four stitches, a tetanus shot and a week later a bill for $500. We have health insurance, we are supposed to have a $50 copay. No one asked my husband for it and as he was bleeding freely, he probably didn't think of it. Anway it was a work related incident so he should have to pay $0. Two phone calls to the billing dept of the hospital confirmed that his copay was $0, and he thought it was finished. A week later another bill for $500. followed by a bill for $49:95, a letter from the insurance company to say they had paid $475 and another letter asking him to confirm it was he who had been treated. All that administrative work for what reason? Aaaagh.
And one more con: my doctor in Belgium used to write a scip for spa treatments. Very therapeutic. Apparently that doesn't happen here but I could get unlimited Nexium, Paxil and Ambien. Hum.

Monday, May 08, 2006

(Almost) all good news

So it's official, changing injection sites does have a profound and positive effect on blood sugar readings.
I had an appointment with the endocrinologist last week and finally, having played phone tag for a few days, I got the results of my blood work. A1c levels are waaaaaaaay down, and this despite the fact that I am taking less insulin. The only thing I really altered was where I stick the needle and I am truly amazed at the change it's made.
I only stopped exclusive stomach injecting at the end of March, so I'm hoping for an even better number next time. My OneTouch UltraSmart meter tells me averages for 7, 14, 28, 60 and 90 days; and the averages for 7, 14 and 28 days are two-thirds of the 60 and 90 day readings.
The only bad news, which I got at the appointment, is that I put on 2 lbs. This didn't seem to worry the endo unduly but is a source of great grief for me as I have gained six pounds since December. So much for "I'm a diabetic and I can eat whatever I want". And to add insult to injury, because we are both watching what we eat, my dearly beloved has lost a corresponding amount in the same period. Bah!