Upsetting the Apple Cart

About 6 weeks ago I posted a blog about my recent experiences with Omnipod, after I had made some enquiries about the demo pod and received a string of long and frustrating episodes of silence.

In this blog, I detailed why my experiences so far with Medtronic had left me very secure in the knowledge that first impressions mean a lot. My first impression of Medtronic was great. My second experience was fantastic. My subsequent experiences, unmatchable. I decided that as I had never experienced an Omnipod, or had any idea of their customer service, I would stay with Medtronic because wires or no wires - I trust them.

Things have become a little confusing.

Around 3 weeks ago, just before Christmas, one of the bods from Omnipod US contacted me to say that he had just received my email (the one I sent them saying how disappointed I was that I had been unable to even obtain a demo kit, let alone have a conversation about the option of switching systems) and that he was extremely disappointed in the service I had received.

I should think so, to be honest.

In the email, he detailed some issues (all plausible) they had been facing with the demo pods and said that he was keen to send me one. His email was friendly but professional and the length of the response and managerial status of the person sending, showed me that my email had not been taken lightly.

Thank you, it was good to get a response, even if a 'little' late.

I explained that as grateful as I was, my time was up on choosing my pump and after having such a shakey start, I felt safer staying with my current company. I may be biased but in truth, Medtronic can do little wrong in my eyes, after helping me squeeze and wriggle my way out of several close scrapes (including sending me equipment at last minute, calling me back in a moment of hyperglycaemic 'fuzz' and walking me through the problems with kinked cannulas). But nevertheless, the previously silent company have now maintained a respectable level of communication, and have never been more than a day away in terms of replies to emails, and on one occasion chased me up on something. Good enough for me, Omnipod.

We continued to exchange emails as the team there seem to be very keen to send me the kit, probably because they know that once I have seen it I will be 'sold'. THIS was the kind of response I was expecting back in August when I sent of my first request.

Anyway, to cut a long story short[ish], after a number of emails and after me trying to explain that it may well be too late, I arrived home tonight to find a package waiting for me. Is it an Olive branch or a sales ploy? Not sure, but either way I knew what it was.

Everyone loves a package at the doorstep, right?

I tried my hardest not to get too excited, knowing that no matter how pretty or tubeless it is, I still stand by my words that I am a little nervous about what level of service I would receive if I had a problem.

Well folks, I am in big trouble. I was expecting something similar to my Medtronic pump, which I always thought was small, but it does have to house an AAA battery, a computer, 3ml of insulin and a host of other parts which make it work so seamlessly -most of the time - so it can only be 'so' small. I have always had a mix of responses to my pump. Some people seem surprised that it is so small, some people shocked at the size.

This, had me shocked. I will take a photo to include in my next post, because I will damn sure be giving this a spin, but to give you an idea, the 'pod' is about three quarters the width of my pump, about three quarters the length of my pump and a little thinner too. Next to an iPhone, it is exactly the same length as the smaller side of of an iPhone, and about a third of the length.

In other words - it is small!

It is currently sat next to me, still encased in it's packaging, because as keen as I am to try it out for size, I am very nervous about liking it too much. I wasn't lying or trying to 'fob off' Omnipod when I told them it was too late, there is a good chance my pump has been purchased, meaning I am too late for the boat this time. I also wasn't lying when I expressed how unsure I was about the whole level of customer service issue. I was, and still am concerned, that I could leave a very wonderful company for one I have yet to be convinced by.

But I am also sat here with the future of insulin pumping beside me. It has no tubing, is small and discrete and no one would have a clue what it was. I wouldn't have to tug on the tubing during the night or worry about bubbles getting in, because according the Omnipod website, the pump primes itself.

It could also be just out of my reach, for at least the next three years.

I am completely torn about what my next step is. I will try it out, because as small as it looks, it IS fixed to the skin, meaning where ever it is, it stays. My current infusion site is fixed, but it is also almost flat against the skin and I know all too well what a hassle it is when I lean against something.

I guess the next 3 days will be a real turning point for me. it will either determine whether or not this pump is the future for me or whether my head - which is with Medtronic - may want to take that risk and go with the Pod system.

Perhaps the customer service was down to that one rep, who to this day appears to be uncontactable by any normal means. Perhaps on the other hand, it is a good insight into what kind of service I cold receive if things went wrong.

Right now my heart says Omnipod, and my head says Medtronic.

That is a hell of a choice to be faced with. And one I thought was done and dusted.

Dear Santa...

I know that you are extremely busy at this time of year, what with it almost being time for you to set off with all those present in tow, weighing down your sled and making your Reindeer huff and puff. How you manage it all in one night has always been beyond me. With 6 billion homes to visit, I imagine you aren’t really too keen on later entries on the request front.

I know that at this time of year it becomes pretty commonplace for everyone to start reeling off their Christmas wishes as if you have all the time in the world. I know you have a sled to oil, a workforce to motivate and presents to wrap. I know you have reindeer to exercise and maps to plot. I bet there are a few more people in the world than last year, so I expect you are mighty busy.

I know that people often contact you about things which are a little out of your remit, like Jamie, who I know has already sent his letter to you asking for a Porsche. Any colour but yellow, as I am frequently reminded. One of these days you could slip a Matchbox version into his stocking, just to keep him quiet.

I know that children are the most important people at Christmas, and that you have to get busy acquiring all those snazzy new electronic toys. I remember the Buzz Lightyear saga, back in the 90s, when parents trampled one another to get the figurines in Toys’r’Us because apparently you had run out. I was too old to care for it really, already in my teens and more concerned with make up, shoes and the Backstreet Boys (yes, I know, but I was 13!), but I still remember the news, and remember thinking how crazy it was that anyone could want something that much. I’m not sure what it is this year, but I bet it is a damn sight more technical than Buzz was!

The thing is, what I want won’t take much to wrap. It doesn’t need bows or pretty paper. I don’t want anything more than the next person, in fact, it is a lot less than a Porsche! Mine won’t breed jealousy, envy or greed. Mine is simple, but it would make my year.

Dear Santa,

I, would like a day off.

Today I woke up high again. I left my breakfast because I wanted to see my sugars come down.

I waited a long time.

Today I did 9 blood tests, most of which were out of range.

Today, I had my third eye appointment of the year, where the drops they put in my eyes make them sting, lose my sight and dappled red.

Today I had every sugar from 6-15.

Today, I felt tired because there is no such thing as a day off.

All I want Santa, is to be able to wake up, brush my matt of a hair into some sort of style, eat my breakfast and get on with my day.

All I want Santa, is to be able to eat a meal - any meal – without first testing my sugars, doing around 3 calculations and taking yet more insulin. Without having to test them again two hours later, no doubt disappointed with what I see.

I would love not to have to worry today. Not to worry about the blood sugars. Not to worry about what cost that mince pie will have, both today and in ten years.

Not to worry full stop.

If I could have one wish from Santa, it would be this. One day off.

Are you listening, and did you get my letter?

Trial by HbA1c

Today was D-Day; it was HbA1c day. Some people seem to be able to sail through A1c blood tests with very little bother at all. They simply don't seem to mind blood tests, and know that the whole process of having blood taken is an integral part of managing diabetes. The results of the tests tell us diabetics and our health care providers, what the status quo is regarding our recent management. If the results are good, we have been able to keep the problems at bay for a little longer. If they are bad, we can take action.

I am not one of those people.

Don't get me wrong, the latter part of that paragraph is all very clear to me. The only reason I continue to put myself through the process of having tubes and tubes of blood taken, is because I KNOW they are the best way of knowing that everything is still OK.

However, to anyone who didn't know better, Anna at the clinic, waiting for her blood test to be done, is actually crack addict gagging for a fix.

I'll paint you a picture; There are about ten people there waiting patiently for their number to come up on the screen. No-one is causing a fuss, no-one is making a scene. Everyone is just there carrying out the wishes of their Doctor - getting their blood drawn . There is however, a girl sat in the corner, wearing baggy clothes (they make her feel more comfortable) and looking like she might throw up everywhere. She is shaking, twitching, sweating a little and looking as though at any minute she may bolt for the door.

This, is me. I have blogged in the past about the way in which I find blood tests thoroughly traumatic. And not just the result, which in the past has hardly been a reason for celebrating but actually, because the whole process makes me want to hurl.

The beauty of being a human is that we have fantastic foresight. We have this brilliant way of being able to predict the outcome if we make one, or even a series, of bad decisions. Granted, animals have a certain degree of foresight, seeing as you can train a dog not to chew the table and my cats have certainly learnt that as fun as it is, scrambling up the curtains, claws and all, will earn them a time out in the other room (their equivalent of the naughty step).

For this reason, we lock out car doors at night, we try to exercise and eat right, we don't shout abuse at our bosses, we don't buy £50,000 cars when we work in a fast food joint and we work late when we have a meeting the next day and need to get our papers straight. We make decisions every day based on our experiences and we use our gift of foresight to do this. For this reason I remain in line at clinic, twitching and shaking, just so that I can get those results, be they good or bad.

But as good as we are, we aren't perfect at realising what will happen in the future. If we were, diabetics would never eat sweets. They wouldn't drink, smoke or skip insulin shots as teenagers. They would do everything by the book. If we were able to use our foresight perfectly, no diabetic would ever get complications. We know that diabetics are ALL at risk of getting one of the many devastating complications that can eventually manifest themselves. And we know that any blood sugars above 'normal' range will cause that damage whether it is just the initial damage, or adding to what is already there. But it can be really hard to imagine what life would be like with those complications, whether or not we know someone who has one and whether or not we read the many books and Internet articles depicting life after the worst has happened.

That is why, when I think about a cure, it would be the lack of blood tests that would be one of the biggest benefits of no longer having this disease. Not for one second do I think that a blood test even compares to the real complications of diabetes. But the fact is, I have NO way of knowing how I would cope with a complication. I can't imagine the feeling if I was diagnosed with a further condition brought on by this disease. I can't say how I would manage day to day. I can't imagine what something like neuropathy feels like. I continue to respect the complications, which is why I wear a pump, why I exercise, why I try to be careful, and why I strive on a daily basis to achieve better control.

But I do know what blood tests 3 times a year feels like. I know how it feels to never win the battle against the test and wuss out in the waiting room. I know what it's like to need to take the day off because I will sporadically try to pass out during the rest of the day, because now and then I make the silly mistake of thinking about the experience I had earlier on.

Because of this and the fact that I have been lucky enough to avoid any complications up until now, the full blood count, HbA1C, triglyceride, cholesterol, thyroid, electrolyte, liver, kidney and creatinine blood tests will be the thing I would most like to wave goodbye to, should there ever be a cure.

Probably seems strange to some, but for me, the a1c is worse than the wearing of a computer, the daily finger blood tests and even the poor sugar days. For some reason, it just is.

What would you cheerily wave goodbye to, on the day this disease got the boot?

Omnipod Vs Medtronic

Looking at the title as a non-pumping diabetic, you would be forgiven for thinking I am going to blog about the next big cinema blockbuster (well, maybe more like minimal-budget-straight-to-DVD horror flick), but in fact this post is about my recent attempt to look into the Omnipod insulin pump.


In November, I received my letter from my specialist to advise me that I have been successful in passing my insulin pump trial and will be continuing with this method of treatment.

I'm not sure there is a word in the English language to describe the feeling - but elated, ecstatic, thrilled and thankful are some of the words that come close. All the hard work has paid off and Maggie (my pump) and I will continue to be partners in crime for the indefinite future, something I [and all my nerve endings] are very pleased about.

Appart from the obvious benefits of completing the pump trial (improved BGs, flexibility, reduced complications, reduction in needle jabs et. cetera et. cetera) the other benefit of getting to this point and finally passing the trial is that I now have a little choice about the kind of pump I can have. I have already blogged enthusiastically about the first day of the trial, when I had attended the hospital to plug into 'The Matrix' for the first time, and saw the Medtronic Paradigm VEO sitting in front of me. I had been aware that my hospital in the past had always used the Accu Chek Spirit, which looks a little like this:

Now generally, most insulin pumps look roughly the same, but I really wasn't taken with this one. I had seen it and held it once in person and for some reason felt it was somewhat 'clunky'. Perhaps this was because I was still unsure about pumps in general and this was the first I had seen up close. But also because I had also done a lot of research into different pumps and had always come back to one; The Medtronic Paradigm VEO. I had looked over it again and again, and was completely sold on the fact that one day, when CGM was more affordable, I would have a pump which was ready and waiting to allow me to join the party. Unfortunately I didn't have the most smooth of rides when I did try the CGM, but it remains an extremely useful tool in managing diabetes, and I stand by my claim that it is something every diabetic should have the option of using - let's hope the NHS catch up! Thankfully, I have found the pump itself thoroughly wonderful, apart from the odd kinked cannula frustration, which frankly seem to be part and parcel of using any Teflon cannula as opposed to steel ones. But the pump itself has been like a best friend to me.

But perhaps the most important thing about my pump, is the people and service behind it. The aftercare, if you will. From the moment I joined the Medtronic clan, I have known nothing but complete support and care from the company and the people behind it. I have had a number of mishaps with the pump, including one which led me to phone Medtronic in America on a Sunday afternoon, while shaken and a little concerned. The customer service I received that day was second to none, so much so that I took the time to send an email to Medtronic telling them just how impressed and grateful I was for their compassion and outstanding service. Not only did I accidentally hang up on the customer service chappy on that Sunday afternoon, thanks to the mild panic going on in my head, but after getting straight back through to another person, it turned out that the original customer service agent had been trying to call me back (from America no less) for the 20 minutes I was on the phone to his replacement.

Medtronic have also sent me skins and a remote control at my request (despite the fact that the only equipment I actually need, is already right here on my hip - these are just for play), and have also sent me a reservoir after I lost my head and forgot to get some spares from my DSN.

I could not sing their praises more highly, and suspect I always will.

But despite the fact that I have felt very safe in the hands of the folk at Medtronic, a new pump recently arrived on our shores, and as I have now passed my trial and have the option to consider another pump before making a choice which will remain with me for the next three years, I wanted to check this pump out.

It is the worlds first tubing free insulin pump and goes by the name of the Omnipod.

Rather than having a 43 inch tube which leads from the pump to the cannula, everything you need to deliver the insulin is contained within that little white 'pod' (on the right hand side). The PDM (Personal Diabetes Manager, on the left) is used to wirelessly send commands to the pod, which then delivers the insulin as and when you ask it to.

This is the diabetic equivalent of Topshop giving away all their most expensive and stylish lines, with a cherry on top. It couldn't be more exciting.

So in August, when I knew my pump trial result was looking good and that the option of a new pump may be on the horizon, I contacted my DSN and asked about perhaps trialling the Omnipod now that the option was there. After hearing that she would consider it providing the cost was not drastically different, I contacted Omnipod. Almost immediately I heard back from their customer service team, to advise that my details had been passed to their rep, and that they would contact me soon. A good sign.

Sure enough, about 2 or 3 days later, I heard back from their rep, who advised that I could have a trial which would be done with my DSN involved.

All was looking good. However, since this time, I have sent off about 4 or 5 unanswered emails, and have been left very concerned about the level of customer service I have received. To this day I have never once been let down by Medtronic, in fact quite the opposite, they have time and time again surpassed my expectations, and have proven themselves invaluable in making the transition onto an insulin pump, which in all honesty wasn't the easiest thing I have ever done and took a lot of adjusting.

The problem is, due to the fact that it is now December, and my rep appears to be very unconcerned that a potential customer (sale) is ready and waiting to join their club, I have been left very concerned about what aftercare Omnipod can offer. What if the pump stops working? What if their cannulas kink? What if it is 3am, I have ketones and am panicking again? Where will my lifeline be then?

I now have to reach the decision of which pump I want by the 25th January 2011, which will be one whole year since I joined the 'pumping crew'.

As a result, I have had to reach the decision that I do not have enough confidence in Omnipod to make that switch. Tubes or no tubes, what underpins any insulin pump lifestyle, is the option of having help at the end of a phone should anything go wrong. And when it comes to it, the insulin pump is nothing more than a computer. It can succeed just as often as a computer and sadly can also fail, just as any computer.

The fact that Medtronic are helpful, contactable 24 hours a day, knowledgeable and apparently prepared to go to many lengths for the benefit of the customer is infinitely more important than how the pump looks, whether or not it has tubing and whether or not it is fashionable.

I would LOVE to have a pump with no tubing, but not at the cost of everything else which makes the pump a success.

I truly hope that people in other parts of the country have had more success with them, and that perhaps my experience was more to do with my local rep, than with the general customer service. For children and unsure adults, the thought of no tubing and what appears to be a small, streamlined and 'sexy' pump may be just what they need to make that swap - something which will save their life, literally. Unfortunately, I remain unconvinced. I wrote to Omnipod advising them that I was sad about the fact I had to reach the decision not to change to their system due to my concerns about their service. Well guess what, I still haven't had a reply - even to that.

I had a good feeling about Medtronic when I first looked into the pump, and on the day I found out I was getting one ... And when I received my pump skins through the post ... And when I got my remote control ... And on the day all my cannulas were kinking ... And when I sent my email to thank them for their service.

For now at least, my faith (and funding!) remains with Medtronic. I don't have anything against Omnipod per se, and perhaps when my warranty on Maggie is up (generally pump users change to a new pump whenever the warranty has expired, to ensure if anything goes wrong they will still have excellent after care), I will try contacting them again, just to see what/if anything has changed. But for now, I remain confident in the knowledge that I am in good hands with Medtronic and that swapping to a 'sexier' pump, could have been the beginning of a very long four years.

Maggie the Medtronic, it's you and me from here on baby.

Food for thought

About a month ago, I discovered a blog. This in itself isn't anything special, seeing as my Internet D travels often lead me to stumble across others people's stories about their diabetes, either by virtue of recommendations, becoming 'friends' with another person with diabetes online, or via the old fashioned way - browsing. This was no different, I happened upon it with a few simple clicks of the mouse. But there was something different about the content of this blog. Instead of talking CGMs, pumps, frustrations and high points like most other blogs I follow, this blog talked about managing type 1 diabetes without the use of insulin. Now, I have seen my fair share of scams, fraudulent claims and tall tales around any number of so-called cures for diabetes and in all honesty, my initial reaction was that this must be another one. Perhaps they are selling another 'cure'. Drink this potion (at the very [un]reasonable cost of £79.99 per 20ml bottle) and you will be free of diabetes. But this was not the case - nowhere was the mention of potions or magic beans.

So I read on with interest - and in truth, a little caution - as I read about a little girl named Kylie. Kylie's parents had suffered the same traumatic news that many other parents across the world have had to come to terms with. My parents did. Maybe yours did, or maybe you are the parent who has had the same devastating news.

"Your child has diabetes."

Just as with many other parents, Kylie's learnt in time that their daughter would rely on daily injections, blood testing and countless appointments with specialists each year. Only this couple were different; they decided very early on that they would try anything and everything to spare their child from this fate. They started researching, reading and experimenting; they toyed and juggled with all kinds of foods, until they pinpointed which foods had the greatest impact on Kylie's BGs. Slowly they started to remove all those foods from her diet, until eventually, Kylie no longer needed injections. This, was the blog that started to change my view of food.

Contrary to my suspicions that this must be a one in a million case, I soon found others online who were also experiencing life without injections. Many were children, but there are also the odd adults here and there. They all had one thing in common; they had caught the disease and started lowering their carbs during the 'honeymoon period', when they're body still had a reasonable percentage of functioning cells. Something I doubt I have. But still I set about contacting as many people as I could, with a little [perhaps naive] hope that maybe one day I too could live without injections. As much as I love my pump and as much as it has changed my life and as much as I sing its praises, I would do almost anything to be free of the daily grind that is in effect, self harming for the purpose of living. But it comes at a price. Carbohydrate is all but a curse word for these families. Anything with carbohydrate, such as oats, potatoes, pasta, whole grains, most dairy and rice is just not possible if you want your blood sugars to stay level. How is it that these people manage it?

One of the immediate discoveries I made, was that all of those who followed these strict low carb, high protein diets, followed a plan by a Dr Bernstein.

Dr Richard Bernstein is a Type 1 diabetic himself. Over his years of living with diabetes, he had begun to suffer a number of complications. And we are not talking 'small' complications like tingly fingers or the odd blurry vision brought on by high sugars. Not that I think those are small per se, but in terms of what can go wrong, these are at the lower end of the scale, for me at least. But Dr Bernstein had neuropathy in both his legs, his sight was all but permanently damaged and most importantly, his kidney problems meant that he had a sell by date of 5 more years on his life - which he discovered through his own research into the condition he had. At this point, Dr Bernstein bought himself a home blood testing kit. Something that you and I take for granted on a daily basis. We read the results and either curse or rejoice. They can now be bought for little more than £10 and sometimes you even get them free. Way back then, before they were available for domestic every day personal use, Dr Bernstein had to enlist the help of his physician wife, and bought himself the 3 lb bulky device which cost hundreds of dollars and was by no means portable. But with this device, Dr Bernstein also embarked on a similar journey to that of Kylie's parents and the many other diabetics who have found a way to control sugars either by diet alone, or by diet and minimal medication, with minimal side effects in terms of hypers and hypos. The problem was, Dr Bernstein at the time wasn't a Doctor. He was an engineer whose claims about controlling diabetes through diet were shrugged or laughed off.

How could this man claim to know anything about diabetes? He may have it, but we have the knowledge of how to treat it.

Well, Dr Bernstein refused to give up here. He subsequently enrolled at medical school and gained the MD after his name that would allow him to finally influence the teachings of the so-called 'experts' of the time and devise his own A-Z guide of how to control BG using diet and finely tuned insulin administration.

Dr Bernstein's method is now one of the most widely advocated methods of treating type 1 diabetes in the US, and would appear to me, to be snowballing at an astounding rate. Thank you Mister Internet, because I for one would never have discovered this for myself without the use of my trusty keyboard and Google search engine.

I have been reading Dr Bernstein's book - 'The Diabetes Solution: The Complete Guide to Normalizing Blood Sugars' for about a week now, and have already learnt so much more than I could ever write in one post. Like the reason behind sudden sharp hypers after a meal when I 'stuffed myself', despite having carb counted to within an inch of reason.

I am now starting to experiment with my own diet, toying here and experimenting there - so far with reasonable success. In my first 4 days, I did not have a single blood sugar over 8.4mmol (151 mg/dl). I have not gone as far as cutting back as much as the book suggests, purely at this time because I am only on chapter 4 and don't know how or what to avoid at this point. I also have to admit, that right now I can't quite get my head around how cutting out whole grains and dairy can be good for anyone. I know that the rules of a healthy diet don't always apply to diabetics, but I have been trained for 24 years to know that low fat, high carbohydrate (without even a single mention of protein!) is the way to go. Without a doubt any change in diet takes some degree of choice and reason, but to cut most food groups out all together is something I am still unsure about.

But for someone whose obituary had all but been written (sorry for the coarse idea, but if you read the book you too would realise how severe some of the complications really were), this person turned their life around and still now at the age of 74, lives a healthy 'normal' life.

The jury is still out for me whether I would be able to fully remove carbs all together (other than those from specific vegetables). I am at present firmly in the school of thought that food is medicine, it is fuel - here for the purpose of keeping our bodies nourished. But I am also in the school of thought that food is medicine, it is our fuel. Confused? Are those not the same thing? Well, I truly believe that sometimes a meal out with friends is the best medicine. Sometimes when you have had a tough day, coming home to a nice 'naughty' dinner or a film with pop corn or ice cream as a treat, outweighs the 'damage' that it can do to all of us in the D club.

However, that being said, if Dr Bernstein managed to not only outlive his 'expiration date' by every 'professional's' opinion, but also reverse most of his complications particularly the more dangerous ones and still to this day manages his condition via insulin and a tailored diet, then why can't I? Is it all that dangerous to cut out certain foods? The fact Dr Bernstein is still walking this planet would suggest not...

I know that I will never be able to come off insulin all together. I know that after having had chronically high sugars for the majority of my teens has probably destroyed every last insulin producing cell I had left. But that is just toughr. Perhaps if I had caught myself in the very early stages of the disease, during the honeymoon period, just as Kylie's parents did, I would have stood a chance. Perhaps if my parents had had the tools I may have now found, it would be a different story. Perhaps today's blog would be about not having to inject, about having perfect sugars, about living without type 1.

Instead, today's blog is all about trying new things. I continue to read Dr Bernstein's book with fascination, sneaking a read at work, while my partner watches cricket or while I'm in the car. I continue to remain open-minded and hopeful.

I continue to travel on my diabetes journey and find new ways to tackle this disease.

So join me if you will as I begin to experiment with my own food regime, and use my experiments as a way to reach your own decisions about your condition. I hope that my future posts will offer some insight and clues as to what may be awry in your own diet. If not, then I am sorry. But if so, feel free to use me as your Guinnea Pig - I plan on doing it anyway!

Posts to follow!

Six things

I found out this evening that it is Universal D-Blog day (really? is there such a thing?) and as part of that all of us in the D-club are bound (not legally) to write about 6 things we want the Universe to know about Diabetes.

I have had a great time reading about all the things other people want the world to know, and many of them I wish I had thought of myself. So I will henceforth list my 6 things, and will attempt not to plagiarise any of the brilliant answers I have read so far.

1) You aren't made to wear an insulin pump, you choose it. OK, I'm in a restaurant with a friend I haven't seen in a while. The time comes to order my nosh and I begin my calculations of what I might need to dose. Anyone who has ever seen an episode of 'Scrubs' should recognise the facial expression, as mine is usually not dissimilar to the expression on 'JDs' face when he drifts off into his dream world. Only in my head, there are no crazy and entertaining fantasies. Instead I am doing something like this: 65 grams of cabs x 1.3 units of insulin (my evening bolus dose) + 1.2 units to correct for high sugars, delivered over 30 minutes equals...... Out comes the pump, and then the questions start. I usually quite enjoy this bit, because I get to talk about this unwelcome stowaway who dictates so much of my life. But if I could tell you the number of times I have had the question "It's got that bad has it." First of all, 'it' doesn't get worse. The complications might but diabetes itself is incapable of morphing into some three headed, blood sucking, red-eyed beast which now forces me to be 'put' on a pump. 'It' carries on for the most part as it always has done. Sometimes it is predictable and almost seems to like you. Sometimes it is in a mood which could only match that of Mariah Carey when she found out they painted her dressing room the wrong shade of white. Second of all, do I really look that bad?? Can you tell the diabetes has got 'worse' just by looking at me. Just for the record, I chose this lifestyle. Because it made my life easier, because it made more sense than blindness, kidney disease and constantly numb/tingling/painful limbs. I chose this because I wanted it.

2) Yes, I am allowed that. OK, to be fair and give credit where credit is due, this one is not technically the fault of the public. If you were to believe the poorly thought out media campaigns advocating a healthy, seed and grass eating lifestyle, for fear of developing the dreaded 'diabetes' (Type 2, TYPE 2, PLEASE, JUST ONCE SPECIFY TYPE 2!), we would all believe that people with diabetes shouldn't go outside, shouldn't eat anything except vegetables and ornamental garden grass with a tasty side order of Quinoa and shouldn't even look at that piece of cake. Granted, there are good choices and not so good choices. But the fact is I carbohydrate count to within an inch of my own life on a daily basis and have done for 12 years. And for that matter - am very good at it. I am good at guessing and I am good at calculating. For that reason, no food is outside the realms of possibility. If I know how and what to inject for it, the sky is the limit. So yes, I can have that!

3) Diabetic equipment gets EVERYWHERE. When my friend moved house about 5 years ago, she actually took the time to contact me to tell me that she had found 37 sterile needle lids on her floor underneath her bed. This is because I spent a substantial amount of time with her, on many a night out, weekend in and girly get together at her abode as a teenager. I had my own toothbrush and toiletry set at her house, because eventually it just didn't make sense to bring my 'stuff' every weekend. But with that also came the fact that for every day I spent there, there were about 6 blood testing strips, 4 needle covers (small flexible plastic lids which you peel off the lid of the needle before using it), sterile wipes, lancets etc etc etc, that all find there way into the thousands of nooks and crannies that a home has to offer. I was also recently on a walk with the same friend, when we sat on a bench and noticed a testing strip placed just next to our feet. Here, Lauren pointed out that I was a bit like the guy in 'The Shawshank Redemption', who empties out his pockets of stones in the exercise yard, only I do it with diabetic equipment on walks in the country. I cannot tell you how many times my cats have come leaping into the living room with any number of needle cases, cannulas and reservoirs which they have managed to find and mistakenly perceive as a play-thing.

4) Blood tests - SUCK! And not in some vampire-esque blood sucking joke way, but in a real way. I hate them. I seem to be able to all but pass out on every occasion,and while doing so freak out every poor bugger in the waiting room, because no matter how many times I have them done, it never gets any easier. I know they are for a good cause. I know I have to have them done. I know the result will paint a very clear picture of how I am faring against this disease. But it makes no odds to me. The twitching, sweating and shaking starts from the minute my DSN hands me the blood form. Even as she writes out my details on the form, I can feel myself squirming. She has seen me turn white on many occasion, but only on blood test day.

5) No two days are the same. This is perhaps one of the most frustrating things about diabetes, and people often laugh (they get shot down straight after) because they think I am kidding when I tell them that your BGs are affected by weather, sleep, time of the month, stress, food you ate yesterday, eating fruit, eating veg, even looking at a danish pastry. OK, OK, the last thing isn't proven, but ask any diabetic with a sense of humour and they would agree, it has been known to happen, it's just never been documented 'officially'. The fact is diabetes is affected by almost anything which affects your body, including external forces like heat, noise, and routine. It really is that mean.

6) Yes, you can have diabetes and still have a sense of humour. I have discovered that all of the things that drove me crazy and made me feel very alone, happen to EVERY SINGLE DIABETIC. And these things are possible to laugh at. I'm not saying laugh at diabetes or take it lightly per se, not by any means, but next time you find a testing strip (or 20 of them) at the bottom of your bag, remember this post and laugh about it.

Taking a break

OK, so I have been performing VERY poorly on the whole updating the blog thing. I guess there are a number of reasons. Firstly, in the past month I have had four family birthdays including J-dizzle hitting the big 3-0, a wedding, a holiday, a surprise party and all the secretive planning that has gone with it. So something kinda had to give. In this case it was the blog. Secondly, for some reason the diabetes has gone a little AWOL this month, with some of the strangest results I have seen. No doubt because of all the weddings and birthdays, which are of course filled with alcohol and cake, two little elements I spend most of my time avoiding.

I decided to allow myself a month off, a vacation - if you will - because the truth is when you manage something like diabetes, there can all too often be times when the blasted condition takes over. On a daily basis I do around 8-10 blood tests, 4 or 5 boluses, numerous calculations, the odd correction and numerous frustrating moments when I get a bit...'sweary' shall we say. Sometimes, to come home after a day of bad bloods, you just don't feel like writing about it. I always wanted this to be an honest blog about what it was really like with a silent (or sometimes not so silent) partner like diabetes lurking behind every corner, but I never intended this to be somewhere to rant and complain. Primarily because anyone reading a few posts may begin to stop reading the words - about what diabetes really entails - and start reading between the lines. Subtext is hard to ignore when the author of the words are angry, impatient and a little burnt out.

So I come back to you refreshed and ready to get on with it, after having had a busy month which has of course resulted in some downright confusing results. I admit that I have had the kind of month when I could have punched diabetes in the head. Problem is, it doesn't have one. So I have come through 'the dark days' ready to tackle this silly thing head on. The most effective way.

Over the past months not a lot has changed in my body; the weight has remained stable (if a little on the 'cuddly' size), my routine hasn't changed, I haven't been anywhere hot, I haven't changed my diet significantly, and yet somehow my blood sugars have been acting like they are having some kind of party in my body, with a more the merrier attitude. Apparently the worse and more frequent they are, the better the party!

I'll go on to explain a few of the ups and downs as I go on, but it certainly feels good to be back!