Wednesday, 5 October 2011

An update: Decision made, and the Perfect gift for a Geek

It's about time I updated my blog.
I've been trying for a while now, but I never seem to be able to sit down and bash out a whole post the way I want, and to be able to share everything I want that's on my mind. That pesky thing called time, crazy schedules, and that thing about falling asleep at my desk when i finally squeeze in a moment to try write, after I've gotten through all the other stuff I need to do that day, have made blogging a bit tricky for me lately..
So here's me trying out a new strategy to see if it works: shorter posts, probably less depth and detail (aargh. But I like details :/)ok, fewer details, and I'm gonna try bash them out in brief moments that I have in the middle of everything else. Like this post, written while sitting in the tissue culture lab, waiting for the centrifuge to finish spinning so I can carry on with the next step of washing my supervisor's blood, and then waiting for reagents to thaw  ( enough detail? Maybe just enough to be cryptic ;P ) it helps that I get to do this on my brand spanking new and oh so pretty and shiny iPad :)

So, some brief things ( a list!...type thing.. Does two points count as a list?)

1) I'm a  huge huge geek. I'm a lab geek, an art/ photography/ anything visual geek, a book geek, and a science and techno geek. So it shouldn't be too hard to picture the huge geeky smile I had one my face the whole of Friday evening (and the whole weekend, and whenever I think about it, like now) when I was given a beautifully sleek and sexy black iPad2, preloaded with a bunch of useful and awesome science apps, journal readers and lab -assistant apps, photography and photojournalism apps, reading apps, and some health and diabetes apps. And some web comic apps, because what's a geek without xkcd? This is such such such an awesome gift, I'm instantly attached to it and working out how to integrate it into my daily workings, to feed my productivity, and my geeky brain. I love it. And the amazingly thoughtful, supportive and *ahem* spontaneous geek who gave it to me :)

2) Decision made: I've chosen my pump. Actually I chose it three weeks ago, but y'know (see above comment on lack of time to keep thins blog updated). So, after trying out the accucheck spirit pump, and the glucometer/remote/bolus calculator for the combo pump for a few weeks (the big "NOT FOR HUMAN USE" on the combo pump they lent me was a bit of a deterrent for actually using the whole combo pump system), I was able to test drive the medtronic veo pump (only the pump, not the sensors, so no cgms or lgs for me to try) for about a month. I do still want to post a detailed comparison between the two systems, mostly because my admittedly not-so- in-depth googling sessions weren't able to turn anything recent or with the information I wanted. In the meantime I'll just say that as pretty as the remote for the combo pump is, the fact that the veo offers the cgms integrated with it kinda made this one a no- brainer for me. Add in the fact that i also get the security of low glucose suspend, and that I actually just like the menus and set up for the medtronic pump, and, well, I'm going with the veo. Woop! I'm excited :)
2.2?) My medical aid continues to amaze me. The only paperwork I've had to deal with has been one form for medtronic, with my medical aid details, my a dress and what colour our pump I want, and a form to the postal pharmacy with my details. No letters,  no justifications or motivations, no requests for payment, nothing. And they're covering everything! Ok, well, not everything- i have a copayment of 4% for the pump and transmitter *gasp*, and they're covering the infusion sets and sensors each month. Compared to the paper trail I had to run through just to get my old medical aid to cover half my insulin?  This is awesome.

I've got an appointment for this Friday morning to get my pump and the cgm sensors and transmitter set up. We get the elite sensors here, much to my relief. I curious/ nervous/ excited to see how cgm goes.

Tuesday, 9 August 2011

disjointed points on some impressions on pumping

Well, so much for my “few short posts” that I had said I’d try put up by yesterday- they just didn’t happen. Instead it’s gonna be a few short and not-necessarily-related points (paragraphs?) today, because it was three weeks of pumping for me, and I feel like marking it.
  •  i love the fact that i’m not sticking a needle into myself 6-10ish times a day.
  • It’s taking me some getting used to inserting the cannulas- a) I have to psych myself  up to get it in smooth and straight and not get any  “hesitation punctures”, b) I’ve had to find a pump site that works- iks-nay on the stomach; I’ve always hated stomach shots, and it’s really not all that comfortable with my dancing. I tried the back of my hips- this seems to be working the best, bar one site that felt like it was pinching a nerve in my lower back after two days in. I was keen to give pump sites in my legs a go- thighs have always been my preferred spot for shots. Well, that and my arms, but I’m not itching to try an arm site anytime soon. Anyway, I’m neither skinny nor large, but you would think that after nigh on 20 years of injections, I would at least have enough scar tissue, if not actual fat, to fit a 10mm cannula into my thigh. Seems it keeps poking into the beefy dancer’s muscles in my thighs (i tried twice). Heh, first time I’ve ever complained about not having enough fat on my thighs.
  •  I’m seriously impressed by the stickiness of the pump site’s patch thingy. I’ve got the pump tubing caught on a clothes horse, a branch, a drawer handle, other people. It’s been yanked. The pump has fallen out of my pocket/wherever else I’ve tucked it (I’m still working out what to do with pump when go to the bathroom). The site, so far, stays in. Impressive.
  • I’m a snacker- I nibble on stuff between meals- not exactly great for bg’s. which means I love love love the fact that, with the pump, I can microbolus for the liitle bits I nibble on during the day.
  • That said, my dosing is a nightmare now. That hugely changed I:C ratio I started off with, that was working so beautifully? Not so much working that well anymore- even with meals I meticulously count carbs for, so I don’t think it’s the carb counts being off. Basals have been messing me around a bit too- so now I’m actually doing a series of fasts to test the basal rates. And once I’ve got the basals right, I’ll work out what’s happening with my bolus doses. Yes, I know that it would probably have been easier to do it this way first. But I actually had to push my doctor and nurse educator to let me do this now.
  • I may have been a bit slow on the uptake on this, but it’s august- my three month waiting period with my new medical aid is officially over. Woop! And I now get to choose a pump of my own (I’m guessing roche will wnt the loaned- spirit I’m on back sometime). I’m still deliberating, and may just post a list of pro’s and cons for each system here sometime/soon. I could really do with any advice any has regarding the accu-chek spirit combo system, vs the Medtronic VEO system- re both the pump and the CGMS.
  • Incidently august is my favourite month. I think it probably hails back to the august school holidays I always had, plus august is the end of winter and start of spring. I love it not so much the seasons in particular as for the change in the season.
  •  I think that’s all I’ve got for now.

Thursday, 4 August 2011

2.47 weeks of pumping: losing some old friends, and gaining new constant companions

So, I thought about writing a post after one week of pumping, and then after two weeks, but both of those time points whooshed past in a blur. So I’m aiming to do a few short posts between now and next week sometime, to make sure the three week mark doesn’t fly by unnoticed as well.

So first up: Besides the obvious change of having a pump attached to me all the time, and working out where on/in/under my clothes to put it, there’s been another change in what gets carried around with me.

A sample of the basic contents of my bag, pre-pumping:

I present you with: my oversized wallet, lipbalm, sugarfree gum, glucometer, lantus and humalog pens with pouch, and a small supply of sweets incase of low BG (circled).

Basic bag contents, now that I’m on a pump:

Note the absence of my old friends the insulin pens.  Instead, I now have: a log book and pen, spare infusion set and alcohol wipe, spare bottle of test strips, and (circled) the monster load of low BG supplies.

My initial basal rates were a little on the over-enthusiastic side. Which meant the lows were frequent, sneaky and frustrating during the first week or so of pumping. Basal rates have since been tweaked, but as you can see, I may still be a bit paranoid of those lows coming back. At least with all that sugar on me I will be prepared! My paranoia also extends in the other direction, to highs and DKA. So I’m carrying a spare cannula around everywhere. No kinked sets yet, but I’m ready and waiting…

Thursday, 28 July 2011

Some hairbrained experiments 90 years ago mean 20 years- and counting- of life for me today.

I’m technically a day late to mark this anniversary, but I figure the discovery is big enough that I can post this anyway.

Yesterday marked the 90th anniversary of the discovery of insulin. According to the story goes back a little further than that- back to the 19 century, when they discovered that removal of the pancreas caused diabetes (relax, they worked this out with dogs, not humans. That said, try clearing that with an ethics committee today… o.0), and the identification of the beta-cells (with a then-unknown function) of the pancreas by a medical student, Paul Langerhans. And it was really in 1920 Dr Frederick Banting got the funky idea of starving the pancreases of dogs, and trying to extract whatever the pancreas produces when it’s not ptoducing digestive juices. But it was in 1921 that he actually began his experiments, under the not-too-enthusiastic supervision of Professor John Macleod, with the assistance of Charles Best.  

And today we can say that Banting and Best discovered insulin. 90 years ago they discovered a molecule, a simple protein, that, when they returned it to diabetic dogs, reversed the symptoms of diabetes. And when they injected it into sick and dying diabetes patients, it was like literally injecting life back into them. Before this discovery, diabetes was a death sentence via starvation of the body’s cells and DKA, which equates to pickling of the body due to acidification of the blood. Insulin changed that, for millions of diabetics, myself included.

Because of insulin, I’ve had life for the past 20 years. Because of insulin, I can hope and dream. I can travel, I can work, I can study. I can love and laugh. I can eat, yes, eat. I can eat whatever I want. I can be an ordinary 20 something-year old, and choose for myself to strive for the extraordinary. Thank you Lord for Insulin. Thank you for Banting and Best, and their stubbornness to keep working on something everyone else thought was silly.

Insulin pens and glucometers and test strips and insulin pumps and such gadgets make living with diabetes easier (ok, sometimes frustrating). But ultimately, it’s the insulin that makes for living with diabetes at all.

Insulin is NOT A CURE. But it keeps me, and millions like me, physically alive.

I’m alive. I have a life to pour out in love and worship and service, and finding a way, my way, to bring life to others. Thanks to my God, and thanks to insulin.


I’m alive and kicking with type one diabetes because 90 years ago insulin was discovered. But so many others with the same disease are dying everyday, simply because of geography- where they are born-, poverty and politics make insulin unavailable for them. In many third world and developing countries, insulin, a protein discovered in 1921, and which is easily and cheaply produced with modern technology, is inaccessible to those who need it to survive. 

Please click on the “I agree” banner on the right of my blog (you have to scroll down a little) to support the International Diabetes Federation’s efforts to change this. You can find out more on the page the link takes you to.

Also, watch this video:

and check out the Life for a Child program to find out what is being done, and where they need help.

Sunday, 24 July 2011

A warm fuzzy moment of appreciation for friends

The past few days, I’ve had a few opportunities to realize that I really have some awesome people in my life.

My work environment is pretty casual, and a lot of us get along very well, so it’s a friendly place. A couple of the people at work were privy to my medical aid freak-out, and most of them have listened to me go on about medical aids, and medication, and more recently, me wanting to get an insulin pump. So many of them have shared in my enthusiasm and excitement this week that I’m finally on a pump, and everyone has been really curious about it and wanted to see it, and see the pump site and asked lots of questions about how it works (I still have the enthusiasm of a new pumper to answer all these questions. No doubt in a week or two I’ll be over it a little). And they’ve been really supportive and understanding when I’ve been less than fully functional thanks to low blood sugars. At one stage I even had one of them running round finding me fruit juice while I sat feeling rather useless, struggling to get my blood sugar up. I’m normally stubborn and independent and refuse to be helped, but this week that stuff has really meant a lot to me.

I was invited to supper with two recently married friends on Thursday night- something which is always a treat! The wife, a doctor, is almost as excited about me having a pump as I am! Which makes me more excited, which makes her more excited, which makes me… ok, you get it. It was cool being able to chat about it, among other stuff, and thoroughly enjoyed  their company over a good mealJ

I met up with a dear old friend after work on Friday- old as in we’ve known each other since we were 3 or 4 years old, not old as in aged and wrinkly. She’s known me longer than anyone else, bar family, and has seen me through the ups and downs of life so far- D and all. We’re pretty different, but so similar at the same time, and I love our friendship, because even though we don’t get to see each other nearly as often as I would like, whenever we meet up we can chat as if we saw each other yesterday. D has always been accepted as part of what makes me me, so, with a few curious questions, my new robotic pancreas was quickly accepted as part of me and adding to my quirkiness, and we quickly settled down into catching up. An evening of good company, good conversation, and loads of laughter, over some chocolate martini’s, was just what I needed after a slightly frantic, frustrating and draining week.

Not to mention the people who have shared in my excitement and enthusiasm for taking more control of my diabetes, and getting a pump, even if it has had to be from a distance (many phone calls and facebook comments)- every bit of support counts and I appreciate it so much.

Diabetes runs 24/7, and mostly it feels like I’m running the show on my own. I know most of these people don’t really “get” diabetes, and have no idea what it’s like to bear the load of the disease all the time, 24/7/365. Which is ok, I don’t expect them to. Besides, I don’t make that much of a thing about it for them to probably even realize that there’s that much that they’re not “getting”. But even despite all of that, they’re willing to share in my good times, and offer support and encouragement through the tumultuous times.  And it helps me realize that I have some amazing friends, each of them a blessing for which I’m grateful.

My friends are awesome.

Wednesday, 20 July 2011

Semi-officially a pumper


I has a pump. (kinda)

As of 14h30 on monday afternoon, I’m a pumper.

It’s only semi-official. My medical aid will technically only start paying for stuff like a pump from next month, so in the meantime I’m lucky enough to be able to have a “trial run” with the Accu-Check Spirit. It’s a pretty basic pump, without all the bells and whistles of newer models. But for now I can use it to work out my basal rates and get used to pumping, and next month I should be able to officially get my own fancy-shmancy one. 
[on that note; the roche-rep who set up the Spirit did a pretty good sales pitch to me on the Accu Check Spirit Combo system. It looks really good; I like the idea of the glucometer-remote and some other details sound good, but it doesn’t have the integrated CGMS option. So now I’m feeling a bit torn between the Accu-Check Combo and the Medtronic VEO systems- any chance anyone is willing to offer some pointers/ opinions on these two? I’ve got a few weeks at least to decide, but I’m a slow one for decisions, so deliberating starts…now.]

Pumping so far? Well, I’m impressed that inserting the cannula wasn’t as painful or uncomfortable as I thought it might be- actually, it barely hurt at all.

 But this did:

I practiced putting in two cannulas; one manually, and one with the LinkAssist inserter device. I'm definitely not a fan of the inserter- the suspense before you press the button is horrible! But seeing as I’d inserted two, I connected the pump to the one I’d done myself, and pulled the other one out. And it was a gusher. Thankfully not a sprayer at least, but apparently it had caught a capillary, and as you can see, the bleeding was a little prolific. And yes, that monster of a bruise is pretty darn sore.

Otherwise, honestly, I’m finding pumping a bit weird (a need-to-get-my-head-around-this-and-get-used-to-it weird, not a bad weird). Even though I’ve read up on it obsessively, it’s weird to suddenly be connected to one, and have to pay attention to this little machine to dose my insulin. An everytime 10:30 rolls around I have this thought- oh! Need to take my lantus now… oh, no, wait, I don’t anymore... 
But this I can get used to.

The biggest change seems to be in the actual insulin doses I need. I know that you usually have a slightly smaller total daily dose on a pump than on MDI, but the change seems HUGE. The nurse/educator worked out a starting basal rate for me, which on paper looks really small, but i’m bouncing around between 2 and 8 mmol most of the time- except twice when I overcorrected for lows (semi-deliberately, when I’ve just wanted to get my BG above 5mmol, darn it). But this, I’ve been told is also a part of the normal adjustment process, it’ll take time to work out the basal rates I need. The weirdest thing for me is the change in my insulin: carb ratio and insulin sensitivity factor- the nurse worked out values for each that are literally half and double what I was working with on MDI, respectively. That’s such a huge difference, I was certain she was wrong… but so far they seem to be working. It’s really weird for me, I can’t help but wonder if such a big change is normal? How can I be using so little insulin?

Despite all the lows, I braved my dance class last night, and survived, although I had to stop after an hour- when I took a break to check my BG I was hovering around 4.1 mmol, and couldn’t raise it, even with a box of juice. But I’m glad I could go, and didn’t actually go low during it. I did work out that a stomach pump site isn’t all that comfortable with all the bends and twists of dancing, so at my next site change (technically my 1st site change I guess) I’ll give someplace else, like my leg, a shot try.

I still feel a bit like I’m in a type of pumping limbo- knowing that I’m not going to be on this specific pump for all that long (hopefully), and knowing that whichever system I choose to go with eventually will have a bunch of extra stuff for me to use, more buttons for me to play with, and more functions for me to get used to. But so far so good, and even if I have to endure a bunch of lows during this adjustment process, it’s nice change from sticking a needle into myself 6 or 7 (or 8 or 9 or...)  times a day.

Semi-officially pumping is still pumping.
And I know it’s a change for the better J

Monday, 11 July 2011

MIA and dreaming of the future

I’ve been rather MIA lately- not just from the internet and this blog but from a lot of real life too- a lot of the past month or so I’ve spent hermitizing  in my apartment, with my work and studies and thoughts and…work. The past two and a half weeks in particular, I feel like I’ve been a little ball of stress. Those few people I have been around in this time have had to put up with me being tired, grumpy, emotional, and sometimes all-out weepy (sorry guys). They’ve mostly been really helpful and supportive (thanks guys). And I think the rest of the time they’ve just stayed out of my way. 
It’s all work/studies related. I’m trying to do my Masters, it’s a research/ dissertation based degree. And I’m meant to be finishing at the end of this year. Except that, after over 12months of trouble-shooting, and with four months left to go, the research part isn’t really going all that well. So now’s the time to reassess all the work, and pick a direction to try and pull the little bits that have worked into something that could work as a MSc, and build on that. Hence the stress, and grumpyness, and absent-ness. I guess perhaps the final year of a Master’s isn’t the smartest time to start a blog. But I’ll do what I can with it all.

And not everything in the past month has been study related. At some stage I’ll blog about the following:

-I got to take a long weekend and go down to Durban to visit two of my favourite people. It was a desperately needed break in the middle of the stress, and included some great adventures. And I got to take some awesome photo’s, which I hope to post when I post that blog post.

- I had a once-in-a-life-time kind of opportunity to tag along with some doctors to a missions hospital in one of the more isolated areas of South Africa. a) a beautiful part of the country, b)super interesting to see how stuff works (and what doesn’t work) in places like that. More thoughts shall be shared when this post happens

- That insulin pump that I wrote about? The one I was meant to get about a month ago? It too has gone MIA- it’s apparently attached to someone in Botswana or Namibia or something. I can only assume it’s a long story. In the meantime I’d kinda given up on getting a pump before my waiting period on my medical aid ended- which is actually at the end of this month, woop woop! But then I got a call from the Roche rep last Thursday saying she’s managed to organize another pump for me, which is super cool of her. So im meant to be getting that in exactly a week. Really. I’ll try keep you, um, posted.

-when I’m stressed and bogged down with work my mind clings to a myriad other ideas and concepts and possibities, to try keep me from turning into a complete zombi. Currently I’m toying with ideas about photography, travels I want to take next year when my degree is done, world music influences, local political issues and graffiti, pacman- yes, the game, and dexter- yes, the series… No doubt some of these, and others, will work themselves into future posts.

I kinda miss people, and sleep, and being able to find outlets for my ideas and what ever else goes on in my head. For now I just have to put up with putting my head down and working my way through the rest of the year. I’ll be sociable when I can, I’ll write when I can. I’ll sleep...yeah, when I can. Somehow i need to squeeze some exercise routine back in there too. And everything else just has to be put on the shelf in the back of my head in anticipation of this magical time called “next year” when I can take it down and play with it. sigh.

Thursday, 9 June 2011

Stupid doctors. Stupid needles. Stupid drugs.

This post has nothing to do with diabetes. I just need to rant.

Someone I love very dearly got a needle-stick injury on Monday while assisting in stitching up a patient after delivering a baby. This patient is HIV+ positive. The needle was in the other doctor’s hands.

Stupid doctor.

Stupid needle.

Now this person has to take anti-retrovirals to stop him becoming HIV+. I’m grateful he can take the drugs. I’m grateful they’re available, and they can protect him from this stupid, horrible disease.

But they’re making him so sick. They’re wrecking havoc with his body, his stomach, his head.  I can’t call him because he’s too busy puking.

Stupid drugs.

And he’s in a city on the other side of the country. So I can’t be there. I can’t do anything to help. I can’t fetch him water, or nausea pills or anything.

And I feel so useless, and so frustrated and so angry!

And I’m not even the one who’s sick.

Stupid doctors. Stupid needles. Stupid drugs. Stupid, stupid virus.

I hate this.

Wednesday, 8 June 2011

Is that a Real Low? or do you just want chocolate?

One of the best things about this country is the weather.  After spending two months in Paris in the middle of winter last year, I have a huge appreciation for our beautifully sunny, temperate and (mostly) non-soggy winters. (Although I do sometimes wish there was somewhere we could go to make snow angels!)

Take this winter for example- April and May felt like extensions of summer, with autumn and chilly nights slowly creeping into the mix at the end of May.

But not these past two weeks - it feels like winter has hit us in full force with waves of cold fronts, icy wind, and today; rain.

I’m not that upset about suddenly having to pile on the layers. I do, however, have a complaint to file with whoever decided to crank the winter up to freezing without letting us adjust to the cooler temperatures first.

You see, while I know that it’s just a cold front, that it will pass soon, and that we’re only about two months away from spring anyway; my body is not taking this sudden change so calmly. It is apparently concerned for our continued survival, and has shifted to “stockpiling” mode. You know, that mode where you’re suddenly always hungry and craving rich stews and starchy meals and soups and cookies and chocolate and anything else that might help, just incase of hibernation?  (Or is this just me?) So, even though I’m eating just what I normally would (or even a little bit more), and I know that this is enough,  my body insists on telling me its starving. One hour after a meal.

You’re lying, body! I know it! See that empty lunch box? That, right there, is proof that you have been fed. Now stop being silly and get back to work.

Except... that starving signal tends to come in the form of that hole-in-the-stomach kind of shaky feeling. Yup, that exact same one I get when I’m starting to feel low, just minus the fuzzy-head feeling. And I get a little freaked out, walking around the whole time feeling like I’m almost low. And I’m wasting so many test strips; testing to make sure I’m really not low, and finding out I’m 7.5 mmol/L (about 130 mg/dl) or something similar. 

The problem is, more than once in the past few days, I’ve stubbornly walked around with this fake-low feeling, only to test after a few hours and see a real low staring back at me from the glucometer screen. Darn it.

So, dear body, here’s the deal: how about you stop telling that you’re low and want chocolate, when you’re clearly not; and I’ll be able to more easily make sure I give you sugar when you really do need it? Ok? 

Sunday, 5 June 2011

Victories in progress

Now that I’ve got the bulk of my medical aid story of my chest, I can give an update on that D-doc appointment I went to on Monday. Overall it wasn’t too shabby...

The last time I went there, it had been such a long since my previous appointment that the nurse/assistant/receptionist lady gave me an evil look and a talking-to about my Diabetes (I guess I deserved it). This time she greeted me with a smile, to my relief. Strange how something small like that can make a difference. And I didn’t mind the two hour wait to see Dr S that much- I took the opportunity to get stuck into the Solzhenitsyn book I found at the flea-market a while back (I have a soft spot for old Russian literature, I’m not sure why).

Just as in my last few appointments, the first thing Dr S asked was if she could put me on a pump yet. It was so good to be able to answer “Yes! At least, I think so, but not yet. I have to wait 2 more months.” 
I told her about switching medical aids and we had a good rant about BM (she’s not much of a fan either. It turns out I’m not the only patient, or doctor, that they mess around).

We worked through all the questions I had. I’ve been struggling with slow absorption and prolonged action of my Humalog, which isn’t all that helpful when the point of being on rapid acting insulin is that it’s meant to in and out of your system in 2-3hours. Working with Dr S’s theory that I may have built up an antibody response to the Humalog from being on it for so long (about 10 years I think), she’s given me a pen of Apidra to try out. So I’ve been rocking Apidra since Wednesday (and by rocking I mean bouncing between highs and lows and more lows as I try to work out the insulin:carb ratios and correction ratios and all that. I know they’re meant to be the same as with Humalog, but I also know that for a lot of people they aren’t) and I think I’m starting to get the hang of it. It definitely works faster, which is what I was looking for. 

My Lantus has been knocking me for a six with night-time lows a lot lately. I can blame my increased exercise levels for that,  but after decreasing the dose by 3 units, I’ve been stuck with what else do to about it. Other than snacking more at night, apparently not much. At least, not until I get a pump and can fine-tune a night-time basal rate. Great :/

On the topic of my increased exercise – it’s worked!! Along with the carb counting and all that I wrote about last week, it’s brought my HbA1c down! Ok, only by 0.6%, but it’s the first time my HbA1C has been below 8% in, well, quite a long time. It’s still needs work, but I’m counting this as a victory in progress J

I’ve saved the best bit (ok, maybe not the best- the A1c drop is pretty darn cool for me- but this is the bit I’m the most excited about) for last. Half way through the rant about BM, Dr S’s eyes lit up. She told me about a patient who had an old pump she hasn’t been using since she’s upgraded last year. This patient had lent the old pump to another patient to use while she was pregnant, but this patient couldn’t keep using it now, because her medical aid (BM. grrr.) wouldn’t pay for the infusion sets. So what this boiled down to was that, if I could get my shiny new medical aid to pay for the infusion sets, I could use this spare pump, while I stick out the last two months of my waiting period. woohoo!

So I left the appointment armed with a prescription for infusion sets. I called DH on Tuesday morning, e-mailed them the prescription, and waited. I got an e-mail bright and early on Wednesday- DH has agreed to pay for the infusion sets! After my experience with BM, this is nearly unbelievable for me. DH has an obligation to cover my insulin and tests strips, as part of Prescribed Minimum Benefits for my diabetes. And from all my prescriptions, they can clearly tell that I’m on MDI and not a pump. So as far as I can work out, they have no obligation to cover infusion sets if I’m not on a pump yet. These supplies aren’t “essential” to me, not at this stage, yet. But they’re paying for them anyway. 
WOW. I have an urge to go get “I heart DH” stickers printed.

So now all I’m waiting for is that other patient to drop of the spare pump at Dr S’s practice, and for the rep who does the pump training to get back from Switzerland, so I can learn how to use it.  Both should be done by the middle of this week. I’m so stoked- I should be on a pump within a week or so!

The spare pump I'll be getting now is the Accu-check Spirit. I’ve got mixed feelings about this detail- I’ve heard less-than-great reviews about it. And, it’s not the pump I ultimately want- I’m super keen on the Medtronic Veo, it seems to be considered more reliable, and it has the option for integrated CGMS. But, seriously, any pump that anyone is willing to give me is better than no pump, so I’m not going to complain. I can get working with the Spirit for now, and if I want to switch to the Veo in a few months, I should be able to do so. And of course, the Spirit can be passed on to whoever else needs it.

I’m super-grateful, and super excited for all this. And constantly amazed at how things seem to just be falling into place now. More victories in progress. 

Soli Deo Gloria.
Because, even if we tend to forget it, ultimately it’s all up to Him.

Saturday, 4 June 2011

The Medical Aid Rage

Medical aids have taken up a lot of my time, thoughts, money and energy lately. On the one hand, I’m ok with this, because I think it’s pushed me to find a better solution to the problem, and somewhere in the process stuff has settled in my own head about my health care. On the other hand I am definitely not ok with it, because, ultimately, I suspect all medical aid schemes of being devious, sneaky money-draining leeches, and I vaguely resent that I’m forced to admit that I need them, even if that is the case. 

Here follows the previously alluded-to tale of my medical aid rage, of why even the mention of my former medical aid raises all my hackles and I have to resist the urge to hiss and snarl, and of how, ultimately I think I’m in a better place because of it all. 
It's a bit of a long story, but bear with me.

[a note: as much as I would dearly love to name and shame, I’m going to rather refer to the medical schemes, new and old, by initials. Mainly because I’m still trying to sort through issues with the old one, which may involve me taking them to legal bodies. And I don’t want to risk stuff written here making those processes unnecessarily complicated. That said, the initials used correlate to the scheme’s actual names, so if you really want to know, just match them up with a list of South African medical aid schemes]

I joined a medical aid for the first time in my life in April 2008. The choice to go with BM seemed pretty straight forward- they were considered one of the top schemes in the country, and they had a good-looking plan option specially for students and young adults. Plus, according to the pamphlet and their advisors, this plan was the only one where medication for chronic conditions was covered “in full”, as opposed to out of the medical savings account as with their other plan options. Well, sounds good; I was in the final year of my undergraduate degree, and Type 1 Diabetes definitely counts as chronic, so it sounded like this plan would have me covered. Awesome.

Or not.

After the standard one-year waiting period on any claims for known preexisting condition (ie, my Diabetes), I could finally start trying to get BM to pay for my D-meds and other care. With very few exceptions the operators at the BM call centre, and those at the call centre of the network they subcontracted half of my plan management to, were at best unhelpful, uninformed and uncommunicative; at worst they were just down right rude and insensitive. It took me another year and a half of being placed on hold and being shunted between different departments and different call centers, before I finally worked out which call centre to call for which claims, which forms I needed to fill out, where to get them from, who had to fill them out, and where to send them. Getting necessary information out of these people was worse than trying to get blood out of my lancet-tormented fingertips.

I finally managed to get all the necessary paperwork done to register for BM’s “Chronic Patient List” in January this year. I had to get my GP (not my D-doc, but my GP. They would only accept papers from the GP, even if he wasn’t the prescribing doctor. Go figure) to request funding for my test strips and each of the insulins I use (Humalog and Lantus), specifying the amount I use per day. BM funds medication according to a chronic medicine formulary, which specifies the drug name, but not amounts. He also had to write a motivation as to why I needed to use Lantus instead of Protophane, as the only long acting insulins on the formulary were Protophane and Protophane mixes.

I had no feedback from BM about my forms until I finally called them in March, when I needed to go buy more insulin and I wanted to find out if they would pay for it at last. That call ranks as one of the most unpleasant phone calls I’ve ever had. After the usual shunting and being on hold, I was finally put through to a very rude woman who rattled off what they would and would not pay for:
            -1x 5ml vial of Humalog per month.
            -30 syringes and needles to use with the Humalog
            -1 box of 50 test strips every two months.
            -They would not pay for my Lantus at all.

Wait… 5ml vial of humalog? But I don’t use vials. I haven’t used vials since I was 4 or 5 years old. I use the cartridges that fit into the pens.  I know my GP specified that I use the cartridges. I can’t use the vials, I’m on the run too much, they’re not easily portable, they’re inconvenient and impractical, I’ll mess up my dosing and get infections. Besides that, by my calculations I need closer to 10ml a month, double what you’ve just stated. And the syringes? You know those are single-use only right? So, you’re giving me enough syringes to inject myself once a day?  Are you aware that as a Type 1 Diabetic I have to inject myself every time I eat  (besides my basal lantus shot once a day). That’s at least three times a day! Not to mention that the last time my mother tried to buy syringes for me- we were having a bit of an emergency- she was accused of using drugs and supplying her children with drugs! Are you serious?

-No, they didn’t care. That was what BM would pay for, and that’s all they would pay for.

Ok, so what about the Lantus? Why isn’t that on the list?

The lady informed me that BM would only consider funding non-formulary drugs if they were provided with a valid clinical motivation as to why the patient couldn’t use what was on the formulary.

If the fact that Protophane is a flipping old drug, has an irregular action profile; and causes hypos and hypers all over the place, AND the fact that I was on protophane when I was younger; my BGs were a nightmare to stabilize, and I have been much more stable since I started using Lantus 8 years ago- if all that is not a valid clinical reason for me to not use Protophane, then please tell me what is!

Apparently as far as BM is concerned, if I am not allergic to one of the components in the drug, and have never been hospitalized from an adverse reaction, such as a severe hypo, while on the drug, then they don’t see why I can’t use the drug.

(Seriously, BM, you'll wait for a patient to be hospitalized before letting them try a different drug??)

And the test strips?! 50 every two months? That allows me to test my blood glucose levels less than once a day. What the--?? What medical professional would ever recommend that anyone with diabetes test their blood sugar less than once a day? The minimum I’ve ever been told is 3-4 times a day. In practice I’m testing 6-8 times a day.

They wouldn’t budge. According to their formulary, a box of 50 test strips every 8 weeks was all they would cover.  In their opinion, if the patient’s Diabetes was stable, that’s all the patient should need. Oh, wait, if the patient is sick the patient’s doctor can write a letter motivating for them to provide 50 strips every 6 weeks, until the patient is feeling better.

(It was round about at this point that I started wondering if BM are actually trying to kill people.)

I’m a non-confrontational person. I keep calm. I don’t freak out. I meekly thanked the unhelpful lady for her time, hung up the phone, put my head down on my desk and groaned- “Oh, GOD.” I think the girl at the desk next to me thought someone had died. She made the mistake of trying to put her arm around me. At which point I exploded.

I burst into tears of rage, jumped out of the chair, screamed (yes, screamed. in the communal office. at work.) “I EFFING HATE THEM!!” I then sheepishly apologized for my language, and stumbled out the office through the fury-tears.. Not my proudest moment. But that's how much they got to me.

I’m not sure I’ve ever been quite so angry in my life. I couldn’t breathe properly. I couldn’t speak for a while. I couldn’t function properly for the rest of the day. I kept on running over it again and again in my mind.  I was furious. Furious at the way the woman had spoken to me. Furious at their refusal to accommodate personalized medication regimes. Furious that they expected me to downgrade to antiquated technology and old drugs that are known to be inadequate, and even then, they wouldn't pay for all the insulin I needed. I was furious that I'd never been told any of this before. Furious at having been ripped off for so long, and furious that it took me so long to realize that I really was being royally screwed over.  

This is the day that I snapped. This is the day I declared war. I just refused to take it anymore.  As of this day, I decided, I would not give them another cent of my money.  I know that I could have appealed to BM, I could have done the paperwork, made the phone calls, and tried to fight it. But I had had enough of BM. I could have looked at upgrading to a better plan with BM, but after putting up with being given the run around for 2 and half years, if I never had to deal with BM again it would be too soon.

This is how I saw it: I refused to submit myself to their outdated and inadequate excuse of a diabetes treatment regimen. Not when, in these times, there’s such amazing newer treatment technology out there.  I know my D- control hasn’t been great the past couple of years, but it sure as heck isn’t going to get better on Protophane and testing 0.83 times a day. No, sticking to BM’s plan was not an option.

I did some math:
If I added up what I paid to BM each month, plus what I then forked out for my medication myself, it came to about R2000 a month.  So, technically, that’s up to R2000 that I can pay to another scheme, and get them to pay for my meds and test strips, and maybe, just maybe, even an insulin pump. (Take that, BM, with your vials and 0.83 tests a day!)

I did some research:
I found out that there are some insanely expensive medical aids out there. But, working online and offline, I managed to hear from a couple of people with diabetes who were using insulin pumps.  I asked about which scheme they were on, and how it worked. And one name consistently came up- DH medical scheme. And, as it turns out, their lowest plan through which they’ll pay for a pump is just over what I can afford. Darn it. But this really is the best option. This needs to be done. I want to do this.
So, while other people my age are saving up for cars, or houses, or overseas trips, I’m forking out over a quarter of my monthly salary to a medical aid. And I’m back to relying on my parents a little for help, and trying to reassess the rest of my monthly budget. But, from May 1 this year, I’m a member of DH.  And it feels gooood.

Well, so far, so good. Their response to all my queries has been lightning fast.  I’m technically in a three-month waiting period for making claims, because I’ve changed medical aids mid-year. But they’ve approved all my requests for them to pay for my D-meds and medical supplies in the meantime. They’re even paying for that D-doc appointment I went to on Monday.  Stuff is falling into place. I may even get to start on a pump sooner than I thought! I hate the paper work all this is taking (I hate admin in general), but on the other hand I do a happy dance in the office whenever I get another e-mail saying they’ve approved something.

The only loose end in this story is BM. Even though I’ve made multiple phone calls, and sent them multiple e-mails requesting my membership to be cancelled, they won’t let me go until the end of June. They consider it a two-month notice period. I consider it a further attempt to leach me of whatever money they can while they can. And seeing as it’s illegal to be a member of more than one medical aid scheme at a time, I’m fighting this tooth and nail. Something’s gotta give, and this time I refuse to let it be me.

And just because I’m not appealing against BM’s decisions doesn’t mean I’m not fighting them. I declared war, remember? See, here in South Africa we have a law, the Medical Schemes Act, which established the Council for Medical Schemes (CMS). This council is the key regulatory body for all our medical aid schemes, supervising what the schemes can and cannot get away with, and what they are legally required to do. One of the key functions of the CMS has been to lay out a list of Prescribed Minimum Benefits (PMBs); medical conditions or situations which medical aids are legally obligated to pay for, always. PMBs include medical emergencies, as well as a list of chronic conditions for which medication is essential for survival. Diabetes is a PMB. All medical schemes have to cover it. Depending on the level of the benefit plan, they can provide more or less cover, but even the lowest plan has to make provision for meeting a minimum standard of care, as outlined by the CMS.  One problem with this system is that some of the guidelines for minimum care are a little fuzzy, and some medical aids are taking liberties with their interpretations of the guidelines.

So the question is: was BM completely out of line in blatantly not meeting these minimum requirements? Or were they just applying a very loose interpretation of the guidelines? Or, is it perhaps that the guidelines provided by CMS are just completely inadequate? Either way, it needs to be fixed. I declared war against BM for this. In reality, I can’t really do much to them. Except that I can take them to the CMS. If BM isn’t meeting the guidelines, I’ll fight them. If the guidelines are inadequate, I’ll fight the CMS to change them. Either way, the next time an unwitting and undefended PWD finds themselves in BM’s clutches, BM should be forced to pay for them. They shouldn’t be allowed to do this again.

I’m still furious about BM. But I’m so relieved to be getting rid of them. And I’m grateful for the changes that have, and are, and will still, come about because of this. Deciding to proactively fight a medical aid has overflowed into me proactively fighting my diabetes, which is probably the more significant decision. And it’s triggered a domino effect of actions and decisions that look set to give me the better tools to do this.

This is good. This is exciting. For this, I am grateful.

Monday, 30 May 2011

pre-doctor's appointment... excitement?

I have my appointment with my diabetes doctor tomorrow. I’d call her my endo, but she’s not, she’s a GP with special interest in Diabetes. I guess I should find an endocrinologist at some stage, but they’re in a little short supply in my city. And really, for now, the GP with special interest (lets call her Dr S) works- I like her, she’s got a load of experience, a good rep, and a really well equipped practice. Anyway, I digress.

I’m always nervous before doctor appointments (ok, not for my normal colds-and-fu GP, just all other doctors). Especially with diabetes, I’m nervous about what the doc has to say, if I get good news or bad, if I get a telling off for doing a bad job, or encouragement for trying. And then, there are the blood tests. It’s not the test that scares me (needles aren’t really a thing when you’re sticking one into yourself up to 12 times a day). It’s the results that make me nervous. The waiting for them, and finally getting them forwarded from the doctor.

I haven’t had my HbA1c checked since I last saw Dr S. That was august last year. Yes, I know that that’s way too long ago to have had my check up. The thing is, besides being lazy and broke, when I’m struggling to see any difference in my BG control, I struggle to motivate myself to spend time and money on an appointment where I’ll probably be told the same things, get the same blood test results, and feel even more useless about my diabetes management. Hence, I put off making this appointment until two months ago.

But this time, it feels like it could be different. Even though I’m not sure if there has been much change in my BGs since last year, I have to remind myself that stuff has been falling into place more for me; I have been putting at least a little bit more work into this disease. It still feels like my sugars are all over the place, but maybe, just maybe, I’ll see the effect of my efforts in my HbA1c. Hey, even a little drop would be encouraging.

The bigger thing about this appointment for me is that, for once, I’m actually excited about it. I’m still fostering my recently-acquired raging will to take this stupid diabetes on. The past month, especially, has seen me gathering information about what’s out there in diabetes developments land, and what is actually going on with my own diabetes. I may not have a pattern worked out yet, but I have the data. And a whole lot of questions about it- what can be changed, how to tackle different trends that crop up every so often, and what the heck to do when what should normally work doesn’t seem to work at all.
PLUS, I’m super excited to chat to Dr S about me getting an insulin pump and CGMS. She’s been asking for years if she can put me on a pump yet. For mostly financial reasons (my family doesn’t have much spare cash for such expensive equipment, and there was no chance this side of eternity that my (now old) medical aid was going to cover it), plus a fair amount of hard-headed stupidity for my part, a pump was never really a possibility. That’s changed- my new medical aid was selected specifically because they have a history of paying for these things. This might actually happen, and I’m so super stoked. It’s probably going to take a few months to make this a reality, but at least tomorrow I get to pull Dr S on board with this plan, and hopefully get the ball rolling so this can happen as soon as possible.
Excitement J

Sunday, 29 May 2011

Something Snapped

Since finally starting this blog last week, I’ve been itching for a chance to get writing. I have a huge urge to just blurt out everything in my head before I lose the thoughts, or get cold feet. But the days have been long and full this week, keeping me in the lab, or in meetings, and just generally busy with work stuff (and today, some weekend stuff), and hence away from this blog. Technically, I should be working on image-processing right now… nah, it can wait a while…

Last week I mentioned that I have stories that need telling. The tricky part for me is to work out where to start, and how to tell them, and how to say what needs to be said, without telling you my whole life story (or at least not all in one go).  I know that this this post needs to be about where I stand with diabetes now. I guess part of this is some sort of continuation of “introducing myself”. Knowing where I am and where I’ve been gives readers a context within which to read future writings.  But this post is also largely me wanting to mark where I am now, to place some stones beside this diabetes path to show the point where stuff changed. I want to document it, first for myself, and then to publish it, so that I cannot ignore it. And hopefully so that people will hold me accountable to it, and help me with it.

[I’ve written and rewritten this piece at least three times trying to work out what I want to say, and how I want to say it. Its been tending towards a long rambling  “life-story” type piece, complete with awkward childhood, D-parent-child tension, stupid student days and self-pity. Exactly what I keep trying to avoid.
So here’s another attempt, I’ll try to keep this one short(er) and simpl(er).]

Diabetes has been a part of my life since I was three years old. That’s 21 years. I’ll spare you the childhood memories and anecdotes. Not that they’re not there; I have a bunch of thoughts and memories that have been dredged up from the muds of time. But I’ll keep them for other posts.

I’ve spent a large portion of these 21 years treating diabetes like an unwelcome and inconsiderate house-guest. Sure, I’d do the minimum for it- finger sticks and insulin shots, just to keep it going, because, well, that keeps me going.  But other than that diabetes has not been allowed any significant place in my life. Diabetes has been relegated to the back room, where I would appreciate it if it stayed, quiet and unobtrusive. The problem is it seldom stays there- it sneaks up on me with lows, and jumps out screaming highs, and invades quiet moments with threats of the future. My version of blood glucose “control” can sometimes look like a crazy ping-pong game, and all I want to do is keep the numbers bouncing around between the two slightly-broader-than-medically-suggested limits, so that I can get on with my life. Because I have refused to let diabetes get in the way of me doing what I want to do, eating what I want to eat, when I want it, going where I want to go, and basically just rampaging through life on whatever mission of mine I am on at that point in time. 

Try as I might- and there have been times when I really, really have tried- I just haven’t been able to find and keep the motivation and discipline to tame this guest of mine. Even though I’ve known its bad, known its stupid and foolish, known that it will inevitably catch up with me (sheez, I’ve studied biochemistry, I know how this story goes), I haven’t been able to get myself to do anything other than lock up the guilt and depression in the back and keep doing the bare minimum while I blunder blindly on, with this guest of mine tagging along.

Two months ago, something snapped. It was during another painful and frustrating phone call with my medical aid. During this call I finally realized just how badly I was being ripped-off by them. And I lost it. Not while I was on the phone, just in my head… Ok, and in real life, once I’d put the phone down. This stuff is a story for another post all on its own, but the point is that in the losing it, in the freaking out, in making the decision to look for a new medical aid- one that would actually pay for stuff, maybe even *gasp* pay for an insulin pump- something happened. When whatever it was that snapped, snapped, something else clicked into place. As I started looking around at all the different medical aid options, and treatment options, trying to match them up, and as I came across more and more material about diabetes, suddenly it felt like I finally “got” how this thing was meant to work. No, I didn’t miraculously work out how to perfectly stabilize my blood sugars. But it felt like for the first time, I actually understood how the mess of all the different aspects of this disease and its control are meant to fit together. Yes, I know I’d studied it before, and do technically “know” all the biology.  But suddenly I “got it”. I don’t know how else to put it, it just suddenly clicked in my brain. And with it, and because of it, because I finally “got it”, another thing clicked into place-- a sudden raging will and focus to get this darn disease under control.

These aren’t the first things that clicked. I think over the past year or so, some of the pieces have been slowly settling into place in my head. I’d been wanting to try tackle this diabetes, I just hadn’t known where to start. With a lot of support and encouragement, and the odd kick in the butt, from my rather awesome boyfriend, I started taking dance classes again in august last year, for the first time in 5 years. I also started running in between the classes. The exercise had a huge impact on my BGs- I suddenly had a whole lot of hypos to deal with! It was a good start. I took myself off to my diabetes doctor and had all the blood work done, for the first time in two years. I went back to the dietician and relearned carb counting.  All this has helped- carb counting makes bolusing for meals less like a shot in the dark (mind the pun). The exercise is another weapon against blood sugar, and one that I’ve seen become more effective the more I use it.  But I’ve still been struggling. I’ll be the first to admit that my efforts are still inconsistent, and sometimes it feels like nothing works anyway.

But since the medical aid freak-out, since what ever snapped, snapped and what ever clicked, clicked, I have a raging will, and a mild obsession, to get whatever I need, and do whatever I can, to make this work. Somehow, by waging war on my medical aid (yes, I do promise to post about this in more detail another time), my clicking-snapping mind made the leap and now I’m waging war on my diabetes too. I’ve changed medical aid. I’ve done my research. I desperately want an insulin pump and a CGMS (now to just get my doctor and medical aid to agree to it). I’m testing my blood sugar near-compulsively.  I’m even logging my numbers and shots and meals (ok, not every day, I’m still working on this one. But hey, it’s a start right?)! I’m trying to look at different parts of my control- different times of day, different meals, different activities, etc, as little science experiments (no, I haven’t read Ginger’s book, sorry. I do freely confess to getting the idea from the title of it though). Heck, I work in a lab. I do experiments all the time. If that’s what it takes to work this disease out, I can do experiments! (This also technically changes the horrible log-book into a lab book, filled with all sorts of scientific data and notes. And this appeals to my nerdy side and makes it more bearable :) )

This is war. No more creepy-house-guest diabetes.  As much as I wish it wasn’t so, I know diabetes holds rights to a permanent position in my life. And by waging this war, I’ve up-graded it to a more prominent and visible space, where it occupies more of my time and thoughts. But it can stay there only with my permission, as a controlled and subdued medical condition, not some lurking terror of the future that I’m constantly aware is trailing right behind me.

Whatever it takes. It's war.
This time, this is going to happen.

Monday, 23 May 2011

a minor rant

a rather full and busy weekend, including a fun run/walk, family birthday brunch, shopping, meals out, late nights, late night movies with popcorn et al, and some thesis proof-reading. and, in all that, relatively stable bg's- besides one nearly-low, and a random high of 13 (mmol) late last night. Cue today: maybe it was the unusually early start, maybe it was sleep yet-to-be-caught-up-on, the experiment planning, or the, um, way the wind wind was blowing? either way, three lows (two before lunch) and ensuing rebound highs, tell me that i've been riding the glucoaster. and i'd like to get off now please. unimpressed. i'm gonna blame it on monday and go get some sleep now.

Friday, 20 May 2011

A Start...

So, a little while ago, I was obsessively trawling the interwebs for useful diabetes and insulin pumping related information (not the dry and sterile stuff you find on the medical sites, but actual helpful information, such as other people’s opinions and experiences) to help me in some decisions I’ve been trying to make. And I came across a blog. By someone with diabetes. And he was blogging about diabetes, and his insulin pump. Awesome, more-or-less just what I was looking for. And he included a link to this other diabetes blog. Which had links to other blogs, which had links to other blogs, which had links… all about diabetes, and life, and life with diabetes!
At first my reaction was along the lines of “What the-??? These people are blogging about diabetes??? Why??? What on earth could people possibly have to say about diabetes? Why not, you know, just shove it on the back seat, tell it to keep quiet, and just get on with life?”  Cos, well, that’s what I’ve been trying to do for the last 20 odd years.  But it turned out to be really cool to read about other people’s experiences with diabetes, the fears, problems, survivals, how incredibly funny living with diabetes can actually be, and to be able to completely relate!
And then the reading may have turned into something approaching a mild obsession. I may have drowned my Google reader with D-blog subscriptions. I may have become a lurker (and been appreciative to discover that there was even such a term for me, lurking on all these D-blog sitesJ).  And I noticed that, just in reading these blogs, and seeing the support everyone offers each other, I’ve found loads of information and I’ve been encouraged, and hugely helped in the small steps I’ve been taking recently to actually, well, try take better care of my diabetes. And I’ve become more open and outspoken about it- answering people’s questions, and standing up to fight for (about? over? against?) it when necessary. And that has been really cool. And I think I want to be a part of something like that. I want to be a member of this community, online, and offline…

And so… here is this blog.
It’s a little bit daunting to me to be honest- I have a tendency to start stuff, with loads of enthusiasm, only to let it fizzle and die in a corner shortly afterwards. But, lets look at it as an experiment. And a tool. An experiment- to see if I can actually write anything worth reading, that people may actually want to read, with anything approaching regularity.  A tool- for me to be able to connect with other people with diabetes (I don’t actually know any other PWDs, I’m hungry for communication) and to add my voice to the others out there, telling their stories and sharing their lives (and I do have some specific stories that need telling; like the war I’m currently waging against my soon-to-be-previous medical aid, and my hopefully-imminent-and-exciting transition from MDI to a pump). And, because, despite my trawlings through D-blog land, I have come across very, very few  D-blogs from South Africa (two not-very-active-ones, to be precise). No, this is not Caron’s South African D-blog to the rescue! But maybe I can start something on this side, or at least be a hit that crops up when other PWDs in this part of the world google for the relevant support they’re looking for.  And finally, this blog is an experiment AND a tool because, to be honest, I need the accountability. I’m working hard at getting my diabetic-act together. But, given my previously mentioned tendency to start with a bang and fade rather quickly, I’m scared this fades too. Hopefully by putting myself out there, and making a thing out of my diabetes care, I’ll be more motivated to sustain it. So, for all my ramblings, this isn’t just me saying I want in on the D-blog party. I need this blog.

Um, other than that, I’m not too sure what I’m going for with this. I’ll make it up as I go along. Life on a learning curve, right? And sure, as much as I need to write about diabetes, that’s not all (by along shot) that goes on in my life, or in my head. So no doubt topics will vary occasionally. I may even post photos.

For now, please please comment! Say hi, or something- let me know you were here! Despite my long ramble (sorry), I’m a little shy, and perhaps a little socially inept. This is me putting myself out there, instead of just lurking. But besides this I have no clue how to start conversations. Can I leave that up to you?
… oO

A Preamble...

The time between me deciding to start a blog, and starting this blog was significantly lengthened by me being unable to decide on a name for it. (I wasn’t actually even planning to start this blog this evening, but it’s not like I was being productive at getting anything else done, so I’m just gonna do it, and then hopefully I can stop obsessing and get back to work. That or I’ll compulsively post writings on it. One of the two). So I’m going with life on a learning curve, the one I thought of 2 weeks ago, and keep coming back to. At least for now. 
I guess any life has an in-built learning curve. But heck, I’m a 23 year old, post-graduate student doing biological research, trying to work out how real life is meant to work, and how to get diabetes to settle down and fit into this picture- so, most days, this feels like a pretty steep curve to me. I think I’m ok with that. I like learning. I want to keep learning (I’ll keep telling myself this).
[um, no special meaning for the background of this blog. It’s a pretty picture. I like birds. I like the colours; black and grey. I also like red, but have yet to work out how to fit it in on this layout...]