Everybody loves Frio!

If you have type 1 diabetes and need to keep insulin cool, then you will undoubtedly have heard of Frio.  When travelling New Zealand at the beginning of the year my Extra Large Frio case became my best friend for keeping my meds in happy holiday mode.

When Frio UK contacted me to ask me to take a look at some new products I was glad to because, frankly, I heart their products.

Here's what I thought!

Check out their shop here.

If you have any questions about their products feel free to drop me an email at anna@insulinindependent.com.

Lazy Diabetesing / Survival Mode

Two weeks ago we, as a family, welcomed my little girl into our lives. Having seen my unwavering efforts to keep blood sugar hikes and spikes at bay during pregnancy, I was whole-heartedly congratulated on a job well done by my family members (aka, 'the help').  Inside, I congratulated myself too. It was a slog, but I did it.

Throughout pregnancy, my aim was to keep my diabetes as balanced as possible, without becoming a massive control freak and giving birth to one stressed-out neurotic little kiddo. But after 9 months with an HbA1c in the low 6s, healthy squishy bits and a full term pregnancy, it felt like the challenge (war?) had been won. Two weeks on, it has dawned on me that the challenge (war?) is only just starting. 

Immediately after she was born, I smugly looked at my CGM trend thinking how very much I had 'this'. My nice steady line with occasional above 10 mmol spike painted the picture of a mother absolutely nailing post-birth blood sugars. Two weeks on, and even my CGM trend arrow is trying to show me where I went wrong. 

My once 'never away from my side' receiver now shows a sorry trend of gaps and spikes. The gaps telling the story of it having been left in another room, far from anywhere conceivably useful. The spikes sharing its tale of alarms smothered into silence at the bottom of a nappy changing bag - often rummaged around in, but never for the CGM. The weathered tally gear case shows its age, and the precious upper and lower alarm limits set beautifully at 4 and 7.5mmol (target numbers for pregnancy) now stand at 4 and 13mmol, because I had to turn off the alarms which have been the electronic nag in my life since February 2015. The battery uncharged for the third time in this week. A sorry tale it tells. 

Am I lazy diabetesing? Well, no. Right now I'm adjusting to a new normal beyond anything I could have imagined. My kid is amazing, but in a world where only last night Jamie and I celebrated sleeping in the same bed for the first time in two weeks, there is no room for diabetes 'perfection', if there even is such a thing. If there is, it probably holidays with the 'compliant diabetic' and the 'optimal control' gang. 

Right now I'm living day-to-day, in survival mode. And while I thank my situation daily to be able to use a pump and CGM, right now, as I learn tricks of the trade for getting dressed AND having a shower in one day through a fog of sleep deprivation and survival naps, my diabetes has to just tick by on autopilot. My pump means I always have insulin when I leave the house, and my Dexcom is the safetynet of blood sugar mayhem. Anything in between 'way too high' and 'plummeting like fuck' is pretty much OK. 

The time will come when I have the headspace to basal test between breastfeeds, and prepare blood sugar friendly foods between vomitted-on outfit changes. For now, I'll stick with survival mode 

And on we must go. 

Diabetes and Pregnancy: The End Game

Today is the first day of diabetes awareness month, centering around November 14th, World Diabetes Day.  As the days of the month turn over like pages of a book, social media fills up with information, opinion, blog posts, product launches and events.  For me, November has always been about educating, advocating, empowering and de-stigmatising a condition that affects millions around the world.  This year, it represents that little bit more because today, November 1st, 2015, my little girl turns one week old.

November this year represents both a new chapter in my life entitled 'motherhood', and a new chapter in my diabetes life of being a mother, with diabetes.  As I learn about the fun and foibles of being a mother - of breast-feeding and explosive nappies, of pram construction and bedtime routines (or total lack of them, if my little one week old is anything to go by) - I also now have to do so alongside learning how to manage my diabetes with this new beautiful person in my life - one who needs me to be on my game around the clock.  Learning how to prioritise when a hungry baby demands a feed after I've bolused for my dinner, or how to manage the blood sugar drops of breast-feeding or of remembering to check my blood sugars when my CGM alarms rather than treat the hypo it says I'm having because I'm just too tired from a bad night's sleep.  How will I treat a hypo when baby needs a feed?  And how will I keep my HbA1c from drifting as my focus is pulled in a direction other than my diabetes?  Time only will tell.

This year November and beyond is about learning how to do diabetes all over again.  It is about resilience and re-educating.  It is about finding balance, and about using the technology I have at my disposal to make diabetes a big enough priority in my life that the control and quality of life I enjoy so much aren't sacrificed, without leaving my child thinking diabetes is number one.  It isn't. But in many ways diabetes was easier to manage during pregnancy because it was all I had to do.  If my levels were wacky, a short walk could bring them down swiftly, and appointments were no issue to attend because it was just me to worry about.  Now, there is another person - one who cannot reason or wait -  whom I need to think about first.  

Pregnancy was without a doubt the most challenging period in the time I've had diabetes, made up of equal parts determination, joy, frustration and fear.  But the end result of careful planning, resilience and keeping my eye on the pot of gold at the end of the rainbow was a healthy baby girl, all 7 pounds 11 ounce of her.  Only this pot of gold isn't the stuff of myth, she is very much here.

Happy Diabetes Awareness month people.  Let's make this a good one!

Pregnancy and diabetes weeks 13 - 24: Trimester two

When I first fell pregnant it felt as though the magic 12-week mark, when we could more 'safely' announce to the world that we were expecting, was light-years away.  Managing my secret 'pregnancy diabetes' around colleagues and friends was tricky, but strangely exciting, like an affair with none of the sordid details.  By day I carried on in my job, exercise routine and social circle as usual.  By night I would sneak away to hospital appointments to discuss growing babies, bellies and basal rates. Bat-Anna and her new double life were in full swing.

But with the 12 week mark now upon us, we got to announce to the world that we two were to become three, and that the extra tummy 'pooch' (attractive, much?) and enormous(er) cahunas I was lugging around with me came with purpose.  We got to see our little growing bun, now less kidney-bean shaped and looking just like a little person, and were re-assured that we had passed the first round of testing for congenital birth defects.  At this point some of the many clinicians I was seeing would tell me I could stop taking my increased (5mg prescription strength) dose of folic acid.  Some however told me to carry on for a while, so I did, right until 20 weeks.

During the whole pregnancy the first three weeks of the second trimester on the sail into the unknown were the most easy-going.  Insulin sensitivity drifted off, giving a well-earned rest from the 45 minute hypos brought on by the final days of the first trimester, and now knowing there was a healthy kicking baby on board, life seemed to go back to normal.  My new normal, anyway. At about 12 weeks the placenta starts to function for itself, and the change in not only symptoms of pregnancy like spontaneous day-sleeping and ravenous carb-mania, but also the more predictable blood sugars, made for a veritable day off.

At the point we started to tell people was the first time I really started to feel pregnant, seeing as bat-shit crazy blood sugars are often all in a day's work for us D-champions, so even though I knew the hypo marathons were baby-related I had to repeatedly remind myself that's why.  But at week 15 the first flutters started to happen and my growing waistline and pride in becoming a parent was matched  only by the growing insulin resistance which started to hit me at around week 18.

By week 20 I was raising my insulin at certain times of day (between 2am and 5am) three to four times weekly, as my dawn phenomenon (when I am already most resistant to insulin) went into overdrive.  I would often have to notch up my overnight rates every 2-3 days, trying my best to leave a day in between to monitor my efforts.  FYI, if you can resist upping them daily you deserve a medal - one I will personally craft for you, but its worth it when you don't have to deal with monster hypos from over correction.  It was around this time that I truly saw the value of my Animas Vibe pump and Dexcom CGM into their own, because despite being 4.5 months pregnant not once had I had to wake my self up at night to try basal testing (the world's most futile during-pregnancy task) because my beloved Dexcom was all over that shit.  

Yayyyyy, my blood sugar today is perf.....oh. Ok

It was around this time of pregnancy that I also learned to make peace with the odd highs and lows. While traveling with my baby-daddy in New Zealand I had worn out the asphalt in many a campsite by walking at un-Godly hours through the guilt that a blood sugar of 12 or 13 mmol would give me in the pit of my stomach.  But the 20 week 'anomoly scan' had shown me that my body and overall

good control had so far given me a healthy, perfect baby, untouched by the blasted condition I carried around with me.  Some days I nailed blood sugars and insulin resistance, others I 'failed' miserably (or so I felt).  Some days were a bizarre mix of good and bad.  But every day was a day on the countdown.  I earned to tell myself that every day - be it good or bad - was a day I nailed.  And if I wasn't aware of my hard work paying off in the steady HbA1c and healthy scans I was pulling in, then the first true 'kicks' my kid gave me at 22 weeks, were all the sign I needed, because my kid clearly had something to say on the matter.

The second trimester was tough, in ways completely different to those in trimester one.  Instead of  being pro-active in my preparation for pregnancy, keeping secrets, dealing with insulin sensitivity and hoping to reach that 12 week mark safely, I had to learn how to be reactive, flexible, self-forgiving and most of all, to enjoy it.  Any time I needed a reminder of why I was trying so hard in my day-to-day life I just looked at those moving images of Baby McP, and any crappy day was forgiven.

I was now two thirds of the way through baking my bun and my daily mantra of 'test-change-review-repeat' felt a little like an annoying 2013 rave song, but kept me sane when the words 'routine' became a thing of the past, now replaced with 'constant change'.  The second tri certainly did a superb job of keeping me on my toes, but my new normal was somehow, working out just fine, one day at a time.

Pump failure: pregnancy panics and the cocoon of the DOC

It took me a good six months to trust the technology after switching from injections to insulin pump.  And at first there were a great deal of bumbling involuntary midnight cannula changes, kinky moments and at times I was sure my equipment was trying to kill me .  But slowly and surely as my HbA1cs came down, my hours of valuable sleep went up and my quality of life started to soar, it wasn't long before I would have made for the mountains beyond Rio if the NHS had tried to take my pump back.  It was mine: managed by me, and part of me.  

Fast forward five years and with the introduction of Continuous Glucose Monitoring (CGM) into my life and a growing baby in my belly, and the idea of coming off my technology, even briefly, gives me the shivers.  Granted, I dream of the day when I'm no longer tethered and catching my go-go gadget pancreas on door handles or unsuspecting strangers I stand a little too close to, but my choice to remain on a tubed pump indefinitely is based on five good years of a happier, healthier me.  And my choice to use an Animas Vibe which can integrate the Dexcom CGM I use, as well as being waterproof, is a decision I've never looked back on.  

But I still like to moan.  I am British, after all.  Diabetes, particularly during pregnancy, is extremely tiring.  There is no time to burn out because the kicking, wriggling bundle of joy in my belly means there is no taking my eye off my diabetes - well before and beyond the nine months that little hitch-hiker is mooching its free ride.

"I'm almost looking forward to the burnout after baby is born", I joked, bobbing around the swimming pool with my best friend of 22 years.  "I might even take a pump break.  I'm so tired of having to change the reservoir so often now that insulin resistance is in full swing." I said, not so jokingly.

Be careful what you wish for.

Three hours later and with a slightly watery reservoir change having taken place halfway though our spa day, my pump was making some pretty freaky noises.  The kind of noises a distress call from Wall-E might sound like if someone tampered with his electrics.  Noises which I instinctively knew would make for a long and worrisome night.

Driving home I un-hooked my pump, because the semi-permanent not-very-rhythmic vibrating it seemed to be favouring, teamed with the intermittent squawking gave me little faith that I wanted to be connected to a malfunctioning pump with a full reservoir of insulin.  As I reached my home I dashed inside and dialed the number for Animas, knowing that at 5:45pm it would be the support team over the pond in the states I needed to speak with.

While on hold I took a photo snapshot of my basals profiles (which thanks to insulin resistance are barely recognisable and certainly not memorable since the last trimester of pregnancy kicked in), just in case my pump died all together.  This was my best move that night, given that five minutes later while running some checks on the pump, the buttons gave up all together meaning the basal menu was firmly out of bounds. After a few checks and the inevitable diagnosis that my pump was kaput, and the Animas team had fired off an email to the UK office that I would need a replacement ASAP. Awesome.

But that was really the easy part.  Now I just needed - while 7 months pregnant and with diminshing leels of insulin in my system - to figure out how the hell to make the transition back to injections.  I had, of course, ordered in some spares of my pre-pump insulins Lantus and Lispro when I fell pregnant, knowing that this day may come, but remembering what the hell kind of pattern I was in, when to take the background insulin and how long it might take or that insulin to kick in, felt overwhelming. My last (unsuccessful) pump break had been 4 years earlier and had seen me back on my pump within 8 short hours, so my track record for this kind of manouevre was not good.  Ordinarily I would have just fumbled my way through, but with each swift kick to the inside of my abdomen, I was reminded why this would not be the ideal time to experience my first adult diabetes-related hospitalisation. It was not a time for 'winging it' or making mistakes.

I quickly took to social media as fast as my fingers could type, because having called my clinic a good two hours after they had closed their doors I'd found no-one there to speak to for advice, unsurprisingly.  It was then that I started to panic.  And it was then that the cocoon of the Diabetes Online Community came to life.

Within an hour of frantically typing out my garbled requests for advice I had friends from Devon offering me spare pumps and 'strangers' (whom I feel connected to in indescribable ways) wishing me well.    An hour after that diabetes nurses were offering me advice on what to watch out for and when to test.  An hour after that I was tweeting messages to one of the lead specialists at my home clinic.  An hour after that I was texting my very own consultant for help after a fellow blogger offered me their number, having read about my situation online.  And an hour after that I had administered the insulins I needed and was settling in for bed, feeling secure with the advice I'd received, and that the remaining CGM technology I had going strong would help me keep an eye on my levels overnight

I woke up 2-3 hourly during the night, and managed levels of 8-9mmol throughout.  Higher than I would have wanted, but acceptable considering the back-story.  The next morning the inevitable rise started as the Lantus still had to take effect (having learnt on SoMe that it can take up to a week to become truly stable!), and the two-hourly injections weren't quite keeping me where they should.  But, five hours into the day and after a desperate call to Animas were I firmly played the pregnancy 'card' (cheeky, yes.  Shameful, I don't really care...) and begged them to get the replacement to me that day, and my new pump had arrived. Thankfully, they did.  They probably heard from the wobble in my voice that of all days to go the extra mile, today would be one that truly counted to one very tired and frought person.

The next three days were a roller-coaster of results from the initial highs to the eventual too-much-insulin-sticking-around lows, but my pump was back on, and the baby playing bongos on my kidneys was telling me it was worth it.

Without the DOC I would have muddled through somehow.  But that was how I spent my childhood and teen years, before Social Media became a part of the arsenal I use to manage diabetes; I muddled through.  Since the DOC emerged, and at times like this, it helped me feel safe, secure, empowered and in my time of need, cocooned.  And for that it is worth its weight in gold.

Judged.

Blood test measurements, and certainly my reactions to them, are loaded with emotion.  My results are just that - mine; personal, meaningful, emotive, and loaded with context.  And having someone I don't know look over them with a judging eye from their tower of objective reasoning makes those emotions rise up in me.  They shouldn't, because I know as well as the next person that any result I see is 'just a number' and that I should only ever treat them as a snapshot of information at that moment, at that time. But taking a step back is hard when your life is littered with words like 'balance', 'control, 'good' and 'bad'.

 

My 29 years with the condition have taught me that diabetes is one of the most complex science experiments in the world.  Why?  Because our experiment is happening in 'real life' and countless factors are constantly at play.  I know that how much sleep I have, what I ate for dinner last night and how hot or cold the weather is, for example, all play a role in impacting my blood sugars.   And pregnancy has opened up a pandora's box of reasons filed under 'other' which can affect my blood sugar control.  My usual diabetes pump team, who have spent 6 years working with me to help me achieve the level of control I am happy with know this, and are usually the ones reminding me not to concentrate too much on the results above or below where I would like them. They are the masters of patting me on the back and giving me some positive perspective. 

 

A few days ago I attended my first maternity diabetes clinic appointment.  Until now I've been attending usual maternity appointments with my wonderful midwife, and have seen my usual beloved pump team for the rest of my diabetes management every 2-3 weeks.  But now that I have reached the 25 week milestone in my pregnancy, my care is transferred down to what I call the 'warehouse'.  My hospital is a verylarge hospital on the South Coast of England, with an enormous amount of speciailist departments and thousands of women coming from across the county to manage their pregnancies and give birth to their children. Because of these numbers, it can come across as sheer pandemonium when the unit is full of large waddling ladies being hearded from scan department to generic health check areas.  Seeing the same person twice, other than the familiar faces of the diabetes team, is a rarity.

 

As I sat down in the specialist registrar's office having never met her before, and whipped out my weathered and paint-chipped blood glucose meter, placing it on her desk for her to see, I was fairly happy that I had been doing all I could to manage my diabetes during the notorious second trimester of pregnancy, when insulin resistance and reduction in mobility means my blood sugars have been a little more 'rollercoaster' than I would have liked.  

 

As she scrolled through my meter, her eyebrows raising intermittently as she let out little puzzled breaths, asking me what arrows meant and whether or not certain blood sugar results felt a certain way, I was getting little read on what she was thinking, but was starting to feel protective of the numbers she held in her hands.  I was starting to feel judged. 

 

"Are you aware of the targets in pregnancy?" she asked, not looking at me.

 

"Yes.  5.5mmol before a meal and 7.5mmol after." I replied, a little perturbed considering the 5.3mmol currently trending on my CGM.

 

"I often just use the meter at the extremes because my CGM tells me what I am doing the rest of the time." I said, trying to explain myself, my guard now firmly up. She looked at my bag where the CGM was poking out of the top, clearly in such regular use that packing it away in a zip-pocket was pointless.  I could tell she didn’t really understand what a CGM was.

 

As the questions rolled I clocked my husband shifting in his seat, also getting uncomfortable about the loaded questions from the stranger flicking through my numbers .  To add a little context, my baby is currently measuring in the 50th percentile for growth, meaning if you took 100 babies, mine would be perfectly smack bang in the middle for growth; not too big, not too small.  My A1c is still in the mid 6s even with the second trimester mayhem, and my CGM trace shows an 80% in target spectrum of blood sugars. The 'out of range' figures are also neither drastic, nor regular. Baby is kicking away hourly and I've been feeling amazing, diabetically speaking and otherwise.  I do not need to explain myself.

 

With a few more comments fired about being too low a little too often, and trying not to rebound from them, Jamie and I were shuffled back out of the office and seated back in the warehouse for our scan, a moment we'd been both excited and anxious about.  But now we were a little more focussed on whether I really was doing OK or not, considering the registrar had just carried out what felt like brain surgery on my last 2 week's results. 

I've come to learn that being subjective about people's responses to my numbers is not one of my strong points, and that I need to let certain things go.  But as we took our seats and exchanged knowing glances, Jamie managed to sum up how I felt in one word.

 

"Judged", he scoffed.

 

"It's not just me then", I replied, glad that my husband 'gets it' and was ready to jump to my defence given that he has seen first hand how hard a job pregnancy has been at times. I've tried to avoid being the over-sensitive pregnamonster, but picking apart remarks I take the wrong way because of beasty hormones, over ones with genuine carelessness or malice, can be tough. But seeing that Jamie has also picked up on the tone and the questioning made me feel better. Like I wasn't the crazy emotional one.

 

With that, we rolled the comments off our backs and chose to start focusing on seeing the baby again, and on celebrating the excellent blood pressure and clear urine analysis I'd already been told about that day.  But with my blood test meter now firmly back in my bag, locked away for my eyes only, I was reminded of the sharp sense of privacy-invasion that exposing my results for the 'panel' makes me feel.  Everything is under scrutiny when you are pregnant, and those whiley hormones have a habit of making you even more sensitive to anything which looks vaguely like criticism. The fact that in three months there won’t be a team of people ready to assess and evaluate my every blood sugar is an idea I grow more fond of each day.

 

Three months, and counting.

Pregnancy weeks 9-12: kidney-bean babies and leveling out

So at 9 weeks it's finally sunk in; we're having a baby-kid. It's a strange feeling, knowing you are pregnant but not really having tangible proof of that, other than the crazy sore breasts, insane lethargy and incessant crying at TV adverts with mistreated dancing animals.  I've donated a shit lot of money to charity during this stage of pregnancy.  Be warned.

I must have looked at that pregnancy test a millions times, but it wasn't until I saw the kidney-bean-with-ears shape on that first early scan, that I really 'felt' pregnant. There doesn't seem to be a 'standard' approach to scanning mums with D early, but ours was scheduled at 9 weeks, and offered estimated dates of conception and due date, and basic checks that everything looked OK.  Not that I would have had a clue because to me the image on the screen could have been anything, but seeing the flutters of the primitive heart flicking away on the screen was a pretty special moment, and made the many hypos and achey worn-out feet worth every single moment.

After donating more of my best blood cells to the hospital's store of my personal supply, now quite possibly needing its own wing of the hospital, we've been told all looks good with the growing kidney-bean, and that my HbA1c was holding steady just above 6%.  This, along with the fact that I'm learning how to manage the 45-minute hypos, means things have started to feel a little more normal again in life.  I'm packing away the carbs with the gusto of a famished post-hibernation grizzly bear, and if I ever start to waver or feel a little overwhelmed with the task ahead, I look at the photos of the bean, and remember why I'm doing this.

As a result of the first scan and midwife appointment, I'm now also in a regular routine of seeing my diabetes team every 2 weeks for them to look over my results, make suggestions and work with me towards achieving blood sugar levels as close to 5-7mmol as possible.  Some days this feels like a mammoth task, but keeping their email addresses to hand and dropping them a line if I am ever struggling has helped me enormously in feeling like any issues are addressed straight away.

Things I've noticed in the final parts of the first trimester:

~ I've become more sensitive to insulin, and more accepting of carbs.  Rarely rising above 9 mmol even after the most carbilicious meals mean the final parts of this trimester have left me feeling like life is leveling out, just a little.

~ Hypos still take a long time to recover from and some hit in 'stealth-mode', with little warning.  If you don't use CGM, I would highly recommend increasing blood tests if you haven't already, because the tiredness and general overwhelming need to be completely horizontal, if awake at all, in early pregnancy means those hypos-in-cloaking-devices can knock you for six.

~Blood tests still suck.

Pregnancy: weeks 5-8 (boob-ache and bolus-mayhem)

By now if the constant boob-ache and total lethargy hadn't given me reason to suspect I was packin' a baby down there, the five pregnancy tests sealed the deal.  I was one of those horrendous secretly-thrilled people filed under 'lucky bastard' who didn't suffer any sickness (yet), but, before you virtually strike me in the blog-face or permanently unsubscribe from my posts, I have taken to spontaneous day-sleeping.

Spontaneous day-sleeping is a marvellous condition which makes it all but impossible to keep the pregnancy a secret, and works wonders for your relationship when every film we watch together ends in me snoring or falling asleep immediately after the opening credits. Sex, has all but gone into hynernation, because I'm asleep all the time, and there are laws against one-way loving. Jamie, is thrilled.

Diabetes-wise, these weeks weren't too crazy of a time after the first 4 weeks other than some pretty striking hypos which seemed to take 45 minutes or more to recover from. Having been away travelling there was still a whole heap of late-night campsite-tramping and wicked post-meal hypos needing lots of fruit-juice glugging.

During these weeks you may well be going along to your maternity clinic for your first blood tests (these don't get any easier, even with a kiddo on board) and some information on how your care will take shape over the next few months.

Below are some of the things I noticed over these last few weeks.

~I've been religiously using gentle walks to budge down blood sugars when I know I have enough insulin on board but that my post-meal spike is going up just a little faster than I would like.  A quick 15 minute walk around the block once or twice is enough to bring me back into range, and the beauty of walking is that even when lethargy-face hits, it's not such a big ask to go walking for 15 minutes.

~On the plus side, carbs, which I was convinced had reached the end of their sweet life during pregnancy, are back in full force. With some cleverly timed bolusing, I've been enjoying meals with 70, 80 or even 90g carbs.

~ pregnancy gives you 'hunger-rage'. You'll know it when you see it, and you'll probably consider strangling any stray cows eating unattended in a field if hunger-rage strikes. Because you will be THAT hungry. 

~Blood tests still suck arse.

~For some reason my blood sugars have become increasingly more difficult to bring up after a hypo.  Initially I made the horrible mistake of treating hypos twice, because after 30 minutes I was still in the 3s at a stable pace. Be warned, treating twice is a false economy, because you'll most likely spike twice as hard and twice as fast when you recover.

Insulin pump end of days: The Animas 2020, IR 1200 and IR 1250

With all the hype around the Vibe insulin pump in recent years it would be easy to forget about the the Animas 2020 insulin pump, which was a complete favourite across the diabetes community and at one time the most exciting pump on the technology landscape.  Many still wear one because they love it so much.  But for those people still using an Animas 2020 insulin pump (and the IR 1250 and IR1200) this New Year's Eve will signal the close of a chapter on their current insulin pump choice, because the software these pumps uses will no longer be functioning after 31st December 2015.

This has come about because of memory limitations of the technology at the time the platform was created, but as these products are no longer manufactured by Animas they are focusing their efforts on creating the next generation of products in order to provide patients with better solutions and sheckshy new technology.

After 31st December 2015 the pump will no longer function, and will generate a 'Call Service' alarm.

In order to avoid any disruption to insulin pump usage, it is really important that you contact Animas UK as soon as possible, who will offer a replacement Vibe pump, if eligible.  No additional warranty will come with the new pump.

If you use a 2020, IR 1250 or IR 1200 please contact Animas on:

Customer Service

0800 055 6606 (for UK)

1800 812 715 (for IE)

A belated look back at the Animas weekend 2015

Somehow life has run away with me in recent weeks, but finding time to review the Animas weekend which took place back at Loughbourough University in May 2015 and give a little look at the photos from the weekend has been a 'must-do' for quite some time.  

Two years ago Sir Steve Redgrave said this about the journey he had been on since meeting Dr Ian Gallen after his diabetes diagnosis, and then going on to win his fifth Olympic Gold medal after his guidance and advice:

When I was diagnosed with diabetes and thought that my sporting career would have to come to an end I was absolutely devastated.  But with the support of Ian Gallen and his team, I was given the confidence to carry on with rowing and I was able to stay at the same level that I was at before having the condition; going on to win gold at the Sydney Olympics 2000.  I came up with the quote "diabetes has to live with me not me live with diabetes."  And that has stayed with me ever since in whatever I do in life. 
Steve

Want to find out more information for next year, so you can come along and be immersed in a weekend of fun, surrounded by people with type 1 all wanting to learn more about sport and the effect it has on diabetes, then email sportsday@its.jnj.com.

And check out the video montage of this year's exploits.

Enjoy!

InPuT's virtual flash mob: The best kind of Sunday lunch get together

My passion for the work InPuT do is no secret.  Having witnessed first-hand the power of patients being given the knowledge, support and talking points needed to poke their consultants with a big technology-accessing stick, means I will always understand just how much they are needed in the diabetes landscape of the UK.  Just recently I had the pleasure of attending the Animas weekend and having spoken to several people trying - with limited success - to access technology which could improve their lives, I know just how much that need continues.

I've also seen first-hand how carefully InPuT spend the money they get. In a world where charities come under fire all too often for big business-like spending and abhorrent expense account-rinsing, InPuTs fresh and frugal attitude to spending is the antidote.  Encouraging the use public transport and relying heavily on the support of volunteers and part-time multi-skilled staff, their main aim is always to help people access appropriate diabetes medical technology.  And here's to not forgetting that they are the only charity in the UK doing this.

If everyone in the UK who uses an insulin pump donated just £1 a year, InPuT would have the money to continue their work in the UK.  If everyone who used some form of medical technology did so, they would be able to do even more.  So how can we give back to one of the lesser-known but truly needed charities? Well this Sunday we have the chance!

Rather than asking you to interrupt your usual basal dosing of money to the charities you support on a regular basis, InPuT's donation is just a quick bolus of support.  This Sunday, on the 151st day of the year (because NICE guidance TA 151 refers to the provision of access to pump technology, of course!), everybody is going to get 'together' for Sunday lunch, and in a virtual flash mob of support, will bolus just £5 to InPuT by texting 'INPU31 £5' to 70070.  

I've been 'pumping' now for 5 years, so this year I will bolus my £1 per year to InPuT as a tiny - but enormously appreciated - 'thank you' for the work they do.  Because I know how important it is that they have the funding they need.  So, I ask this:

Have you benefited from the work InPuT do?

Do you know someone desperate to access technology who InPuT could help?

Did you find out about InPuT after your own battle with accessing technology?

Do you want to help other people access a pump or CGM?

Do you want to be involved in a frankly fantastic event?

Could you spare just £5?

If you answered 'yes' to any of those questions, I will see you at lunch!

Pregnancy: weeks 1 - 4

OK, so we didn't even find out we were having a baby until week 4 of pregnancy, when the hormone HCG was finally at high enough levels in my body to be detected on a pregnancy test but, we'd been planning starting a family for quite a while. And while it may not be time to add safety locks and baby-proof unit edging to all our furniture just yet, there were a number of things I learned can help along the early weeks of pregnancy nicely.

Considering 2 of the 40 weeks we are pregnant aren't even really pregnancy, there wasn't much of a change in anything in the first 4 weeks of pregnancy.  But I had been honing my basal patterns significantly and trying to convince my blood sugars - through diet, exercise and lots of deliberating over insulin dosages - to run a much smoother pattern over that 4 weeks.  You know, just in case.  I basal tested  to within and inch of my life, and re-read my already dog-eared copy of Gary Scheiner's Think Like a Pancreas, now defaced with scribbled notes in the margin and corners of the most important pages folded down.  His chapter on basal testing particularly helped me get much better patterns before we eventually did 'the baby dance'.  This also helped me nudge my recently rising HbA1c from a happy 7.4% to a 6.2% in the first weeks of pregnancy.  The general guidance is people with diabetes should aim to get it below 6.5%.  That may seem impossible, but it's funny how the motivation of a baby can help...

I also started to get back out there and use gentle low-intensity exercise like a stroll to nudge blood sugars down if they started creeping out of my comfort zone. Not only did this bring me down faster, but any gentle exercise is arguably good during pregnancy - although the advice I was given was not to start trying anything too intense if you didn't already do it.  Well...if it's doctor's orders... But by walking to the shop here and there after a meal, I managed in those early days to keep BGs generally under 10mmol after meals (180 mg/dl).

I also took a pre-natal vitamin and an increased (5 milligram - prescription strength) folic acid tablet daily for several months before we tried.  Whether or not the sales pitch of helping with conception is true, I will never know.  Perhaps we were just irritatingly lucky to fall first time.  Perhaps the daily vitamin had something to do with it.  But the folic acid is vital. Folic acid helps reduce the risk of birth defects and the good thing is any extra you don't need the body kicks out - so you don't need to worry about taking 'too much'.

Finally, I also learned that I had to stop freaking out about high blood sugar levels. I spent the first week after finding out we were expecting crying like a total lunatic every time my blood sugars rose too high. This wasn't fun, or necessary. You're partner doesn't want to be looking at you like you're a crazy person having just taken on the beautiful, but HUGE, news about his growing family. The only time high blood sugar levels are dangerous is for PROLONGED, UNTREATED highs. Just do your best to bring them down as soon as possible. And stop freaking out your partner.  Says the crazy lady who writes this blog, now much wrinklier and grey-haired than she was a few short weeks ago.

Weeks 1 - 4 of pregnancy really didn't bring anything more than I was already managing, and even the fabled tell-tale low blood sugars in early pregnancy didn't creep in until after this time.  But there are still 36 to go...who knows what else is around the corner.

D-Blog week: I can...

D-Blog week is the brainchild of Bittersweet Diabetes, and as it turns six years old. it provides another opportunity to hear from blogger voices across the world simultaneously.  I love that two people will see a completely different challenge from the same topic, and today's is sure to be a good 'un.  Today's topic is....I can...

When I was 12 years old I told someone who was asking me about diabetes, "Don't worry about me, there will be a cure in five years." I'd heard it spouted by Diabetes UK and blindly, fell for the line.  At the time very little was known about stem cells or even the causes of type 1, insulin pumps weren't yet routinely used in the UK, and CGM had yet to be invented.  Why I believed this wild claim with so very limited technological support for it ever happening, I will lay firmly at the feet of hope.  I hoped.  My God, I hoped.

 

By 22 that hope was all but lost, as I plunged into months of the worst burnout I have to this day experienced. My DSN, a fantastic woman called Sue Craddock, to whom I owe a great deal as she steered me back on track with careful words and constant support, referred to it as 're-diagnosis', due to the severity with which the reality of diabetes was smacking me in the gut.  "Please take me into hospital, I can't do this." I begged, after testing my blood and discovering I was 22 mmol before even having made it out of my pyjamas.  There was no cure.  It would never happen. It was lies.

 

By 32 another decade on and wiser, older, happily pregnant and still taming the diabetes beast as best I can, things have changed direction yet again.  Now, the technological advances and better understanding of the sheer complexity of diabetes has brought into the diabetes world a new term: Artificial Pancreas (AP).  While the AP isn't a 'cure' at all, if we're honest - it is a new ray of hope. The idea of a closed-loop system which could manage blood sugars on our behalf, and in most situations, is to me a dream come true.  I often ask when is 'good', good enough, because as a community we still hold on hope to stem cell research and islet transplantation, these were the hopes I'd clung to at 12, and those which had let me down by 22.  I still hope they will happen, but I don't let myself dream of days away from this life, quite the way I used to. 

 

But with the AP, tangible evidence is released almost daily in the form of human clinical trials, showing the literal steps which are taking place, bringing us ever closer to one of the most important technological breakthroughs since the discovery of insulin.  And at last, I can see a different future.  I can see that while a 'cure' might not be around the corner, if ever, there will be a time when I can sit with my friends from the diabetes community and enjoy a meal, day out or even just conversation, without our diabetes loudly interrupting our lives.

 

I can.

The newest chapter: a future not lived in fear

Just a few years ago I sat down with my then fiancé, Jamie, and told him there was a good chance I might not be able to have children. It wasn't that I was unable. I was, and still am, completely sure that diabetes doesn't affect fertility per se, although complications undoubtedly play a role in decision-making. My inability was something quite different: it was fear. I was mentally and emotionally infertile through fear, and the idea of having a baby with diabetes was crippling. I had no reason to think I had any physical reason I might not start a family, but the many horror stories I'd heard about people with diabetes having babies left me unable to dare think about starting a family. It was a fear of the guilt if I wasn't able to manage my blood sugars during pregnancy. It was fear that once we'd started down the journey of parenthood, there was no going back and I allowed that fear to dictate my future. 

I sit here tonight writing this post in a place light-years from where I was then. Tonight, I sit here with a smile etched permanently into the curves of my face, ecstatic in the knowledge that my 13 week-old baby is growing - no, thriving - in my belly. 

How did I get here? From a place so convinced it was not an option for me? 

My new, wonderful normal, one not frozen by fear of diabetes, but in fact thriving with it,was because I found a community of people with diabetes, more fierce and powerful than any force I've come across, and that's what got me to this place. That, and the support of a husband who never once made becoming a parent a condition of our love.

I found a community of people who changed my fear, self-doubt and total lack of diabetes confidence, into a fierce desire to say 'eff you' to the journey that diabetes would bring. I found a community of people who said, "You can, and you will". They shared with me their stories of hope and made me realise that the fears I'd been holding on to by reading one too many horror stories were not just misguided, they were just plain wrong! 

Piece by piece the last 5 years of blogging have shown me, and my husband and father-to-be Jamie, that when it comes to having a baby we can, and we are. 

IThe next chapter - one with undertones of excitement, hope and still a healthy touch of ohgodhowthehelldoyouraiseakid? - is well and truly under way. 

It gives me such enormous pleasure to introduce you to, Baby Presswell. 

Careless Words: stock letters and diagnoses

Until three days ago I'd never heard of Diabetic Maculopathy.  I'd heard of Diabetic Retinopathy, having worked my backside off over the space of four years to keep my emerging retinopathy at bay by adopting life with an insulin pump, CGM, and lower GI diet.  But diabetic maculopathy was a term I'd never come across.  That was, before seeing it in the cold stock letter I now held in my shaking hand.  

"Your recent eye test showed evidence of diabetic maculopathy.  Diabetic maculopathy is a condition where there are changes to the blood vessels on the macula, the central part of the retina at the back of your eye."

It continued...

"It is important you attend this appointment to protect your eyesight.  The following can help reduce your risk of developing sight-threatening diabetic retinopathy in the future:

• Aim to control your blood sugar levels as well as possible.
• Make sure your blood pressure is monitored regularly
• Go for regular diabetic checks."

After finishing my silent 'fuck you very much' head-rant about the control of my blood sugars (6.2% HbA1c), my blood pressure (102/60), and my regular diabetes appointments (minimum of 8 per year), I turned to  Dr. Google, having had no real explanation about what this letter - and new diagnosis - really meant.  My unsteady hands uncovered more and move information I could have lived a lifetime without knowing.  

I learned about the loss of central vision and inability to recognise faces. I read about injections to they eyeballs and about laser treatment ending in the loss of peripheral vision.  I imagined how this might all affect me. And I'm not ashamed to say that I wallowed in my post-diagnosis fog of confusion for several days.

Over the next three days I received that same letter three times, due to some kind of unwelcome admin error.

The fourth letter, from the specialist eye consultant within the actual eye department at the hospital I attend (as opposed to the community eye clinic where I have the eye tests done) told a somewhat different tale. 

"The retinal photography and OCT scans done when you were recently seen in the diabetic eye clinic showed there are changes related to your diabetes.  You do not need treatment at this time."

It continued...

"We will be sending you an appointment for repeat photographs and OCT scan in approximately three months."

This new letter made no mention of maculopathy, and gave no indication of any level of urgency to be seen.  Had I received only this letter, I would have been spared the many days - and two further letters - of worry and stress.  I would not have heard of the term maculopathy until a point at which I would have seen a professional face to face; a time when I can pose questions

As my good friend and shoulder-to-turn-to-after-that-letter, Laura, recently said, complications aren't just physical.  The psychological impact of being diagnosed with another condition, one which may impact your quality of life enormously, is not a dialogue appropriate for a stock letter.  The person selecting the drop-down options on my letter, while running through their daily work to-do list, probably had no idea of the impact it would have on me, or that the universal, impersonal stock letter using terms like 'sight-threatening' and 'treatment options' was a new and concerning diagnosis . They probably had no idea of the work, and money, I put into trying to manage this condition, and they probably have no idea that a driving license is key for my job, or that losing it could change the face of my career markedly.  They probably wouldn't know of my hopes that children may form part of my future, and that not recognising their faces, or that of my husband, is devastating to me.

The careless words used in the initial letter(sss...), which equated to a diagnosis of a sight-threatening condition, left a usually level-headed diabetic, perfectly familiar with complications in the past, in a significant amount of distress.  And yet, the follow-up information painted a somewhat different, less frightening picture.  I do still have some changes in my eyes; changes which need further assessment and monitoring.  But complications themselves I can live with, when I am armed with correct information and a feeling of control.  I have lived with retinopathy for years, and muclopathy is just a variation of this.  I can live with that.  I have always been the sort of person who responded best to knowledge about my condition, rather than threats of what may come. But I don't cope well when half-truths are delivered in such a careless and scare-mongering way.

My response to the NHS stock letter-gate is sealed and in the post. And normal life can resume.

Roads

For as long as I can remember, a brisk 20-minute pulse-raising pavement pounding could lower my blood glucose more quickly than any shot of insulin could match. I can budge myself from 'horribly high' to a 'perfect plateu' in a matter of minutes, and once I stop walking, the bloods stop dropping as if by magic. 

We found out only three short (but wonderful) days ago that I was pregnant and together, somehow, we would be raising a baby and fumbling our way through the beginnings of parenthood in just 8 more teeny-tiny months. 

Since deciding to try for a baby, the walking game has been a regular occurrence, and since finding out about the pregnancy, it feels as though I haven't stopped walking since.  Whenever my blood sugars creep too far out of my comfort zone, I can be found pacing up and down campsites and gravel tracks in the most remote parts of New Zealand at most times of day, in all conceivable weathers. Our car journeys have taken many a detour so as to find a stretch of road I can walk up and down safely until my blood glucose creep back down to safe levels. Luckily, New Zealand is bang on target for remote, barely-travelled roads. Sometimes Jamie walks besides me, sometimes he waits at the end with a water-bottle and testing kit for the 15-minute check-in. But we always do it together.

For the most part my blood glucose levels have been good, but the rumours I'd heard about insulin sensitivity leave me baffled as I have all but removed carbs from both breakfast and lunch in an attempt to cut down some of my four to five daily walks. The one good piece of news is that by the end of this pregnancy I should have a rear-end like everyone's favourite 'diabetic', Halle Berry. 

Step-by-step and walk-after-walk we work at ironing out the blood sugar conundrums currently going on in this hormonally hijacked body of mine. We basal test; we experiment with food; we evaluate; we tweak. And we walk. And we realise that our jobs don't begin in eight little months. They are well under way right now. And protecting our little growing hitch-hiker, currently no bigger than a poppy seed, has become priority number one. 

We walk, because it feels better than pumping my body full of insulin and waiting for it to take effect. We walk, because the 'give it another 20 minutes' mindset of old is no longer good enough when a little-person is depending on me taking action now. We walk because this is the path we've chosen.

And walk it we must.

The timing was perfect

Even though detailing life with diabetes through a blog can seem to the outside world as though I'm writing my very own Dear Deidre column, it's really about finding and connecting with others living with this sometimes bizarre way of life. Hard done by, I am not. 

The occasions when I do feel the 'woe is me' attitude creeping in are rare; usually somewhere in the midst of deepest burnt-out from managing a life-long chronic condition, when no amount of effort seems to land me on the right side of 'optimal' blood sugar range, and no amount of dedication seems to pay off. But a swift and forgiveable wallow in self-pity, subsequent kick up the rear-end and reminder that too long in full wallow mode is what will most likely lead to complications beyond emotional ones, and I'm back on track. 

The Wholemeal Cafe in Takaka, Golden Bay was our pit-stop on today's adventure down under, and the array of glorious-smelling cakes, tasty-looking treats and scrumptious-seeming drinks (think organic Wilky Wonka's warehouse) were beckoning. It was a delight to behold.

I'd already enjoyed three coffees that morning and having eaten lunch and being in a humid part of New Zealand's North Island, all I could dream of at that moment was a cool glass of something delicious.

I scoured the backs of bottles and grilled the server for carb counts, hoping to find just one I could sip on to quench my thirst. 

53g per serving.

35g per serving. 

28g per serving. 

47g per serving. 

Nothing. 

For one reason or another, mainly a slip of 1.5% in my last HbA1c, I've been trying to claw back something which looks like control. Although people with diabetes can eat anything they want (ask me if I'm allowed that; I dare you), there are times when I wholly feel that I shouldn't if I really want to see the results I look for. Insulin works in covering most foods well, but juices it does not. And I didn't want a post-drink spike ruining my day and rendering me useless through fatigue as my body tries to rid itself of the unecessary sugar floating around my blood stream. 

After five minutes of trying to find some kind of middle-ground, I sat at the table with my chilled tap-water, feeling very sorry for myself that guava-orange, apple-mango and black currant delight were not on the menu for me tonight. 

Begrudgingly I took out my CGM to check where I was at. 

Ta-da! 

As if by magic my diabetes decided to play ball, and my current blood sugar of 3.2mmol and falling meant any one of the juices on offer were mine for the taking, and the gentle fall meant I didn't need to gulp it down in a confused and sweaty mess. I could take my time with this.

My sparkling blood orange delight went down just perfectly. And in a moment unlike that of the Shawshank Redemption workers in the 'rooftop at sunset' scene, I had a little happy grin on my face treating this hypo. 

Anna 1, Diabetes 0. 

Just one more...

"Just one more look!"

I insist, as we round the corner of yet another beautiful backdrop, stopping at scenic viewpoints to soak up every last inch of this beautiful isle.

"Just one more go!"

I beg, as we zip-lining,swim, kayak, luge and hot-pool our way through our days. 

"Just one more shot!"

I plead, as the camera gets put away after a hard day's work, capturing the whirlwind adventure we find ourselves in.

"Just one more day!" 

It feels like that's all I've been saying since arriving on the shores of New Zealand to fulfill my dream of traveling to the other side of the world.  Never quite happy with the days we had.

Just.  One.  More.  Day.

All too often I forget - shamefully so - that there are corners of the world where children don't wish to travel.  They care not for kayaking or zip-lining.  Fine cuisine and locally made wine are things of an alien world.  What they want - what they need - is insulin.  Without insulin, they die.  Without enough insulin, they can expect to live in suffering.

Two years ago, a group of bloggers in America decided to set out to raise money on Valentine's Day, for children who may not see another, and the outcome was incredible

Just $5 can buy enough insulin to keep a child alive for a month, through the International Diabetes Federation's Life for a Child programme, which provides life-saving insulin to the far corners of the developing world.

What if

What if, instead of giving 12 red roses on Valentine's Day this year, you gave 11 plus the gift of having given a child 'life' for a month.  

What if, instead of giving 12 red roses, which may wilt and die in less days than there are flowers in your posy, you gave a child 'life' for a year, and your lover's vase stood empty?

What if every person in the world who could afford it, gave a child life for a month?

The International Diabetes Federation's Life for a Child scheme provides insulin to children in parts of the developing world where children don't have the luxury of ticking a box on a prescription form and kicking up a fuss if it is not delivered in 48 hours. 

By donating just $5 to Life for a Child, the cost of just one rose, you could save a life.  

Just one more day needn't be a dream.

Control Freaky

This picture gives me the shivers. Not the butter compartment, well-known as the des res living accommodation of insulin, but the fact that this butter compartment is in a communal refrigerator of a public campsite inhabited by up to 100 people at any one time. 

I'm a self-confessed control freak about most things - no doubt a result of 28 years of having words like 'control', 'in-range' and 'compliant' (*shudders*) a part of my lexicon since diagnosis. But I'm especially control freaky about my diabetes. I feel safer that way. Anything I don't have control over with regards to my blood sugars, medications - even complications, unnerves me. 

In England, leaving your insulin at the whim of any would-be trouble-maker is a big no-no,  and I would rather leave my car open with a sat nav on display and a large sign saying 'take me', than leave my insulin out for the taking. 

That said, I am currently at the beginning of a eight-week trip around New Zealand, and while my Frio case is doing a good job at stopping my insulin from warming up, it doesn't feel as though it is keeping 'refrigerated' exactly. With its chemical stability comprised after 28 days, and my trip lasting 65, I am trying to keep mu insulin in as good a condition as possible and trying to keep it refrigerated. This means embracing the public fridge now and then, come what may. 

Let's hope New Zealand lives up to its name of being a safe place. And let's hope leaving my insulin on display is the turning over of a new relaxed leaf for me. 

Although there is a chance that the total control freak in me may also have 2 bottles stashed in my emergency, 'goes everywhere with me' travel bag, and one more cheeky bottle hidden in my handbag. I'm also insured up to the hilt and have an app which shows me all the nearest hospitals and doctor surgeries. You know, just in case. 

Loans without interest

If Charlie has one cannula which lasts two days, a bottle of insulin which lasts 10 and a bottle of 50 test strips, how quickly will Charlie travel 15 miles on a train travelling at 60 miles per hour?

I finally understand the point of those seemingly inane classroom maths quizzes.

As we plan for the big trip, and the possibility of Armageddon, my brain turns to mush at the mind-melting mathematics I have to do in order to make sure I have all the equipment, insulin and general diabetes paraphernalia I am going to need to successfully navigate my way across the other side of the world for just two short months.  As I do so, it reminds me how vital each link in the diabetes armour I wear really is: without cannulas, the tubing is pointless; without tubing, the insulin is redundant; without the insulin, I can expect only to get to know the hospitals of New Zealand. If any one piece of this equipment fails, the rest is rendered obsolete.

But above all, none of the equipment has any use at all if my pump pops its little Animas-shaped clogs while down under.  Animas, like many pump companies, offer a loan pump service if you are going away for a while.  As I ticked the final boxes on my checklist of travelling to-dos, I called them up and ordered my loan pump.  I'd already ordered my pump insurance (mainly because loan pumps are covered on this ample policy), but on the off-chance that something should happen, I wanted to make sure I could just switch pumps and carry on enjoying the trip of a lifetime.

Once again Animas' customer service impressed me when they agreed to let me use a loan pump for two months, as opposed to the couple of weeks they normally offer one.  They did have to check this amount of time would be OK, and carried and a couple of checks to make sure their stocks were high enough to ensure other customers could also use a loan pump if needing to, but my spare pump, in New Zealand pink (other countries are available), arrived today, shiny and boxed up ready to go on a journey of its own.

It is worth remembering if you are going away to check that your pump company does offer this kind of service, and that an extended trip won't be a problem.  I'm also taking pens, insulin and needles with me just in case, but having this little safety-net on board while I'm away makes me feel even more safe while honeymooning in an unfamiliar land.  Thank you, Animas.

Finding balance...

Sometimes life can move at 100 miles per hour.  At least, if I'm not keeping a close eye on things, I can easily let it.  With a fast-paced job and a love of the outdoors, I find myself moving, speaking and filling up my calendar at the speed of light.  And while those fun and frolics bring a certain aspect of joy to my life, the aftermath of repeated late nights, early mornings, lengthy days and not enough breaths in between, are hard to bury forever.

It's no secret to me that adrenaline and cortisol have their effects on my insulin resistance, and even the briefest bout of stress can have me notching up the basal levels on my pump 10%, 20% or 30% at a time in order to keep the diabetes beast under control.  And even though I can hide the effects of stress with a flexible approach to insulin for a while, the shallow breaths, bad skin and broken sleep give away what my body is trying to tell me, and it shouldn't need to scream before I listen. But finding balance can be a challenge.  Especially when the demands of life seem to be pulling me in more directions than I can navigate simultaneously.

Earlier this year a friend of my family reached out to me and told me about her work as a Craniosacral Therapist (CST).  My mother, who goes as often as she can, had told me about her 'wonderful sessions' with Louise, and the contented smile on her face and air of peace about her after she returned from therapy intrigued me more.  I'd already started exploring the idea of meditation, and had long known that when I get stressed one of the best (and quickest) ways to get things back on track was to strip back my diet and eat simplified basic meals.  The idea that I could find a new way to find some balance, had me taking Louise up on the offer of trying a few sessions, to see what effects it might have on my blood sugars and general well-being.

CST is designed to address a range of issues from emotional to physical, by creating a space within which to recognise the body's manifestations of what is wrong, and allow it the time, and peace, to heal.  It grew from osteopathy, but was developed by a practitioner who found that he gained the best results from his patients not by manipulating joints with force, but by using very light touch to relax his patients.  While relaxed, the therapist and patient can then work together to identify where in the body they feel pain or discomfort, and focus on addressing that using those light touches and guided sessions.

My sessions with Louise started with a conversation about my experiences of illness, pain, injuries and even birth! Because CST aims to address the person as a whole, not just the symptoms you show up with.  Perhaps unsurprisingly, diabetes played a significant role in this conversation, because the condition itself can leave lasting effects on the body, and the emotional demands of managing a long term chronic condition can leave me twisted up with the worry and weight of the constant grind.

Once Louise had an idea of the kinds of stressors that were, and are, in my life, we moved into the session.  Lying face-up on a table similar to massage table, the first part of the session was about 'settling down'.  This involves taking deep breaths while lying in a comfortable, peaceful room, and focussing on where in my body I felt good, and where I felt bad.  What became immediately noticeable to me during my first session was that my feet found it almost impossible to rest.  Constant twitching, fiddling and intense awareness of the light touches Louise was making, or bothered by the touch of the blanket on them.  It became clear to us both that my busy head was mirrored by my busy feet.  Over the next few weeks we concentrated on mastering the settling techniques, and focussed on relaxing my feet and legs.  By session 5, my legs had the most incredible sensation of relaxed 'heaviness' during the session, and that feeling of busyness and urgency had faded away.  

We worked on several symptoms over the next few weeks, from a tight chest to headaches and emotional stress, and each time I learned more about how to listen to what was going on in my body, and how to focus on allowing the space to breathe and focus on well-being.  But most of all, I found out how to stop...and take a breath... in a way which had escaped me until I tried Craniosacral Therapy.

Craniosacral therapy is now part of the way I do diabetes.  Sessions cost from £40 so aren't something I can afford every month.  But when life gets a little busy and I forget to take a breath, it's a tool I use to bring me back to the beginning; a great place to start from again. In the same way that stripping back my diet helps me find due North diabetically, CST helps me set my emotional and physical compass back in the right direction.  I've also since used the techniques from the sessions in calming me down on a turbulent flight, and on stressful days in the office when I'm feeling overwhelmed by the every-which-way instructions directions and demands of worklife around me.

In some cases Craniosacral Therapy can be prescribed on the NHS and while they won't recommend a specific therapist, they will recommend CST as a therapy for people dealing with emotional, psychological and physical complaints.  It is ideal during pregnancy and even with babies, or people struggling with fertility.  Out of interest it is since my sessions with Louise that I have fallen into a regular monthly routine - somthing I had never done in my life as an adult female. 

You can find more info here, for anyone who wants to explore the idea of a holistic approach to finding balance, and I could not recommend Louise highly enough.