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 nobelprize.org 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.

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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


TADAAA!


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.