Thursday, 11 February 2016

A focus on foot health







**Disclaimer - This is a guest blog by Solesee**



When your feet ache it’s usually a signal that you probably need to rest them.  However, the alarm bells should start ringing when you can’t actually feel any pain in your feet or toes.   In this instance your feet and toes could be affected by what is known as “Peripheral Neuropathy”.  This condition, caused by a number of different health issues, affects the feet and could be responsible for reducing your lifespan without you even knowing anything about it.  Although there are a number of health issues that cause peripheral neuropathy to occur, this blog post is going to focus on how it affects diabetics.

So what is Peripheral Neuropathy?
Let’s start by looking at the definition of the individual words:
Peripheral is defined as on the edge or at the ending as in the term ‘on the periphery of…’. As far as you body is concerned this means the feet, toes and tips of your fingers.
Neuropathy is defined as a disease or a dysfunction of one or more peripheral nerves.  Anything that affects the nerves usually causes a weakness or numbness to occur.
Therefore, in layman’s terms, peripheral neuropathy is classed as a condition that causes damage to the nerves in your feet and other extremities of the body, resulting in a loss of sensation or feeling.   This can manifest itself in many ways: a tingling feeling; muscle weakness; shooting or stabbing pains at random points; loss of balance; or complete numbness.

How does peripheral neuropathy affect people with diabetes?
So what does this mean for you, as a diabetic, in relation to your feet?  How much about the importance of foot care been explained to you in detail?  The key thing is that if you have peripheral neuropathy there will be certain spots under your feet that you may not be able to feel.   The result of this, more importantly, is that you may not notice whether or not you have hurt your foot.  Putting the fact that you’ve diabetes into the mix, brings the added complication that wounds you do get are slower to heal than somebody without diabetes. But how would that happen, you may be thinking.  All I need to say is blisters due to a shoe rubbing your heel, a small stone that has got into your shoe and is now stuck between the bottom of your foot and your shoe and, a personal favourite of mine, walking across a hot sandy beach on holiday.  There are many causes of wounds on your feet, and sadly as a diabetic they’re much more difficult to treat.

Should I care about peripheral neuropathy?
Let’s be fair.  Most people tend to neglect their feet at some point.  Daily we push them into (often ill-fitting) shoes, some of which rub and pinch our feet.  When was the last time you clipped your toenails?  You are not alone as most people leave it until absolutely necessary. As we don’t tend to wear shoes around the house we stub our toes on chairs, tables, etc. Think about the general forces that you inflict on them – your whole body weight for a start. This weight is too much to be counterbalanced by the cushioning in most people’s shoes.  Not surprising when you consider that your big toe alone takes 40-60% of your body weight.  Still surprised that your feet sometimes hurt?  Well if this happens to you it’s a warning that maybe something is not quite right.

But hang on, what if I have peripheral neuropathy?  Doesn’t this mean that I can’t feel the pain that most people feel?  Yes.  This simple warning system is not there for you.  This means it now needs replacing.  Your body is good at counteracting a deficiency in your senses.  If touch and feeling is taken away, you can switch to using one of your other senses – your eyes.  You should be looking under your feet on a regular basis.  If you don’t it might be too late by the time that you do.  Any rubbing shoe or simply even dry skin can cause the skin to crack, creating a small wound, which might already be infected.   And you wouldn’t know this if you haven’t looked at your feet.  Infections can be very painful and take a long time to heal properly, especially in a diabetic as blood flow to the feet may be reduced.  If the infection has spread too far it can lead to amputation of the infected limb.  If that wasn’t bad enough an amputation can also take ages to heal, possibly resulting in multiple amputations.  Statistics show that once a person with diabetes has an amputation, the risks of morbidity are higher than in a person without diabetes.  Don’t let this happen to you.


Tuesday, 9 February 2016

It's okay to be selfish



I’ve realised recently that it’s okay to occasionally be selfish. 

I’ve realised that saying yes isn’t always a good thing and that by occasionally saying no I’m taking better care of myself. 

I’ve realised that the activities I enjoy can be difficult to get pleasure from if I don't think about my own needs as well as others.

I’ve realised that comparing myself to others is destructive and can impact on me physically and emotionally. 

I've realised that I have value and worth, but others can take advantage of that because they realise it too. 

I’ve realised that I don’t need to follow the crowd to fit in and be accepted by others. 

I’ve realised that there are signs that I may need extra support and that turning my back on those signs can lead to a downward spiral. 

I’ve realised that people can’t be changed and that I don’t have to do something that someone else wouldn’t do for me. 

I’ve realised that it’s okay to ask “why” and not to accept everything I’m told. 

I’ve realised that I’m entitled to challenge and question anything that will impact on my life. 

I’ve realised that almost everything I do influences or is influenced by my diabetes, which means that by occasionally being selfish is in fact being kind to myself. 


Sunday, 24 January 2016

Diabetes Care - What Works




**Disclaimer** This blog is about methods that work for me and my diabetes, in my clinic setting, with the team that provides my care. We all have very different care, funding, time, management techniques, preferences etc, so this blog is from my personal experience and musings.


I’m conscious that when I’m asked to present at conferences, training sessions, lectures or write for journals and other publications, many of the requests I receive are about what went wrong with my diabetes and my care. When I deliver a presentation I always ensure that whoever is listening understands that what happened was in my past and is not my present or future. A great deal has changed in my T1D care over the last 4 years and I have a lot to be thankful for. Spending much of my time engaging with patients and carers and discussing their experiences has been a real eye opener as to just how well my care is delivered, and looking back I can see just how much has changed to make that happen. I don’t know the ins and outs of how those changes came about but, as a patient, I can see and feel that whatever was done has worked well indeed.

This blog is about what works.


Email

Email is not a new concept, dare I say it’s even a bit old fashioned in some ways, but it is a very effective method of communication in health care when I need a non-urgent question answering and I don’t have the time to keep phoning my diabetes clinic in an attempt to reach my consultant. I know that he may not be near a phone when I’m free to make or take a call; instead he can reply to an email as and when he picks it up, send a few lines to reply (or even a simple “yes” or “no”) and that’s it, my question is answered and my mind is put at ease. I think it’s very important to understand that there are boundaries and expectations from both sides however. I wouldn’t email any of my team at 3am on a Saturday morning and expect to have a reply within an hour; a Monday morning or afternoon reply is a much more realistic expectation. Similarly, I know that if I’m in a situation when I’m very unwell and need advice straight away then email isn’t the best method of communication. However, in the right situation it has proven to be very effective for me, providing flexibility and a different method of access to my HCPs, sharable information (e.g. blood glucose data) and HbA1c results and importantly it helps to build a trusting relationship between my HCPs and I. Personally I find some topics much easier to approach over email than on the phone or face-to-face and this allows for further conversations to develop in person if I so wish.

Text

Much like email, I have been provided with my consultant and my diabetes specialist nurse’s mobile phone numbers for certain situations. This came about when I started using my insulin pump and I was provided with these numbers in case I found myself in a situation that was not an emergency but could not wait until the next day or after the weekend to be resolved. I realise that providing patients with mobile phone numbers requires a lot of trust and as patients we are advised of situations which would warrant a phone call or a text. As with email, I know there are boundaries and I would not abuse the privilege of being given my HCPs phone number. This is a method of communication that I haven’t had to use, however I was very grateful to have an extra safety net in the first few weeks of using my insulin pump as it can be an uncertain time for new users.

ADHOC

ADHOC appointments are brilliant for me with my hectic schedule and never knowing whether I’m coming, going or just been! Often at the end of my appointment my consultant will arrange our next one there and then rather than waiting for me to be sent a letter with a time/date which isn’t convenient. He will tell me when he’s available and he books me in there and then, followed up by an email to confirm the time and date. Although I do have my regular 6-12 monthly appointment booked via normal means, if I have an issue that I need to discuss which can’t wait for that amount of time, or he feels that it is necessary for me to be seen more frequently, then he will arrange this between the two of us. I very much appreciate how flexible he is to meet my needs and I find that even a quick 5-10 minute appointment is far more effective than waiting for my annual review or being put onto a long waiting list to see one of his team.

Respect

This is so very important to me – respect is a two way street in my appointments. I have a great deal of respect for my team and I know that is reciprocated. We value each other’s opinions, skills and strengths and we are all honest about our weaknesses. We are all human after all and I can’t expect them to have the answer every time, but what makes the difference is when someone says “I don’t know but I will find out for you”. I imagine that is very difficult to do as a HCP (I know I’ve been in that situation myself before) and when it comes to something as important as my diabetes, I respect the fact that they don’t take a wild guess or leave me with no answer at all. I look up to my team because I know that they have worked very hard to implement the changes that myself and other patients have needed. I hear so often from other patients outside of our local area that they don’t feel valued or listened to and it makes me realise how different my team is to many out there. That’s not to say that there aren’t other forward thinking and proactive teams; I know there are some great HCPs leading diabetes care with us.

No duplications

I'm unsure of when or why it happened but a few years ago I stopped receiving letters from my GP to have my HbA1c done at the surgery. I have my blood taken at the hospital after my appointments and I used to find it very frustrating that I would then be requested to have it repeated by my GP. I honestly don’t mind where I get it done, as long as it is only done once and as long as the result is shared between my GP and consultant (which it now is). Perhaps this is where the issue comes in… how easy is sharing of information between the two? I’m more than happy for my results to be share and discussed if it means that I’m not having my veins poked and prodded more than it is necessary. This goes for any test that I need. One thing I will say is that having all of my tests done consistently in one area would be a benefit to me. I find that although I have my blood taken at the hospital I am then required to have my other health care essentials completed at the GP surgery, sometimes going home with urine bottles to bring back at a later date (which I admit to forgetting about), then going off to have my eyes tested at a later date. With all of my other appointments and commitments I would prefer to get everything done and out of the way in one go.  

Up to date info

This isn’t as much of a big deal to me at the moment as I am quite proactive in knowing who does what and when they do it when it comes to my care, but it is important for those times when I need to quickly find a phone number, or check the day of a certain clinic. I know which nurse assists in running which clinic and I know which consultant has a special interest in __________ (fill in the blank) aspect of diabetes, however if I wasn’t so nosey I could find clear and up to date information available on my hospital’s website. This, I imagine, is very useful for people who have been newly diagnosed or have just moved to the area.

Willingness to try new ideas

In a way this ties in with respect but I find my team are more than happy for me to try different technology or methods to manage my diabetes. An example is when the Freestyle Libre came onto the market – I was amongst a group of 6 patients in the UK to be the first to use it and my consultant was more than happy to assist me with this in order to get the best outcomes from the technology. This included me emailing him data (at his request, I must add) for him to review before I met him. A year or so later I was asked to trial the new MiniMed 640G insulin pump which required him to assist me should I need help. He was more than happy to learn about this new insulin pump, as was my DSN, in order to see how it could benefit me. When it comes to my diet I do tend to intermittently try low carb and I’m aware that not many HCPs advocate this to their patients. He talked me through the pros and cons and accepted that it was something I would like to try after helping me to make an informed decision; he then supported me with following that decision through. It leaves me feeling like I can have open and honest conversations with him about my diabetes whilst helping me to feel more in control of the decisions I make. This is valuable as it builds my confidence but also maintains a good relationship between the two of us.

Partnership and team work

Last but by no means least, my consultant, DSN, dietician and I are able to work together as a team to improve our outcomes. I say “our outcomes” as I am very aware that my results equal their results. We each have targets that we want to reach or maintain and I feel that this is very much a team effort. In all honesty I wouldn’t want to take on diabetes with anyone other than my consultant but there have been times when barriers have gotten in the way. The biggest barrier being myself. There have been periods of struggles when I’ve become frustrated with my diabetes, with my management and results, and there have been times when I have let this become an obstacle between us. However, those times are thankfully rare and I overcome them because I have such a supportive team alongside me. Not behind me or in front, but alongside me. Everything that I have mentioned in this blog is in place for the benefit of patients and whilst it may also make the jobs of our HCPs easier, ultimately they have made changes for their patients. 


Ninjabetic x 

Monday, 18 January 2016

Creating new T1 Diabetes models of care




The weekend just gone was very special for me and one that I will remember as the first time that I have ever felt truly positive about change in Type 1 Diabetes care. 

I was invited to attend an inaugural meeting in which patients with T1D, carers, Health Care Professionals (HCPs) and commissioners would come together to develop ideas to improve the care that patients receive throughout the UK. It was an honour to be asked and to be amongst some of the best in the world of diabetes. The group included many people that I had met before through my diabetes work and I can honestly say that if anyone was going to make waves in T1D care, it was this group.

First up we had patient and parent presentations to set the scene regarding what we needed to change, move away from, embrace, improve and continue developing further. Kev did a excellent job of talking to us about being a “diabetes dad” and describing his daughter Amy’s time with T1. He articulately discussed his experience as a parent, the tools that himself and Amy use to successfully manage her T1 and what they had and hadn't benefited from in terms of the care Amy has received. Before this talk I hadn't heard Kev present before but he did so in a way that captured the audience and made us all think about how some aspects of children’s and young people’s care need to improve.

Next up was little old me, and I won’t talk too much about my journey as so many of you know it inside out, but what I really wanted to get across to the room were two key points; that change is happening in health care with regards to digital and online education and support, and HCPs need to embrace that change. Also, in terms of education (which was my main focus), it is lacking in many areas and it is so very important that from day 1 of diagnosis we take away some education. Reflecting back on my experience, I was on a dose of 100 units of insulin per day, from the age of 16-25. For these 9 years I was told to take 20 units of fast acting insulin for every meal I had, no matter what that meal was, and 40 units of long acting insulin at night. I knew nothing of carb counting, correction doses or even how dangerous insulin could be. Is it any wonder that I stopped taking my insulin because of the crashing hypos I was experiencing from those doses.

We then heard from Jens who described the lack of transparency in his care and the complicated system that he found himself up against. It was very interesting to listen to someone who had challenged the system and the people in it and to hear that there was very little interest in making improvements. Jens, if you didn’t know, if the founder of Diabetes Care Finder, which (when it’s up and running) will allow people to find the diabetes care that they need, read patient reviews, review the services that they attend and ultimately make decisions that are best for them about where their care is delivered. Jens is a real innovator and Diabetes Care Finder could be a big game changer for patients with diabetes. 

And last but certainly not least we saw Mike inflate a balloon and make a rude noise with it! True story! Mike wowed me with his experience of working as a lay member to create the NICE T1 Diabetes Guidelines. I was impressed to learn that the process involves a monthly meeting for 5 years - now that takes some real dedication. Developing NICE guidelines is something that I don’t have much knowledge on so it was interesting to hear Mike educate the room as to just what goes in to creating these guidelines and why he decided to do this. In the past I will admit that I have been too quick to judge based on what I see in front of me but I must say, I don’t think I could have done what Mike has. When we, as patients, all have such individual needs it must be an incredibly difficult task to undertake, so I have a lot of respect to Mike for stepping up to the challenge!

So as far as patients and carers go, we had a really insightful session which would guide the HCPs later in the day with regards to developing ideas for new models of care.

After a quick break we heard from the legends, Professor SimonHeller and Dr Fiona Campbell who gave an overview of how diabetes care has developed over the years, but recognising that it isn’t where it should be. They highlighted that it isn’t as advanced in capturing technology in the way that it should and that the reality is that we don't just need to keep up but we need to stay ahead. Prof Heller asked the question “Which condition demands more of an individual that Type 1 Diabetes?” There was silence in the room as we all knew just how much input is needed from patients and carers to manage T1D on a daily basis.

Up next was what Partha described as “the fun bit”. And it was fun indeed! The HCPs split into 4 groups, each with a scenario (including a pot of gold) and were asked to develop a possible model of care which was then pitched to a panel of commissioners and a patient representative (Roz Davies). The groups were allowed to select patients to join their groups in order to probe us further about the care that we receive and any suggestions we had for improvements. Ideas developed, I sat back and listened as the HCPs challenged each other and forced each other to think outside the box. I was impressed at their passion drive and determination. I could see genuine excitement in their eyes as within around 45 minutes their ideas were looking promising. As I said before, this was an incredible group of people and it was reassuring to know that we have these people fighting our corner in the world of Type 1 Diabetes. I just wish everyone could have been there to hear what was said throughout the day.

One of the main points that I have taken away from the meeting, which seems incredibly obvious now, is that I tend to live in my own little bubble in which insulin pumps, CGM and access to specialists as and when I need them are the norm for me. The meeting reminded me that there are many more people with different needs; those who choose not to use pumps and CGM and those who aren’t able to; those who receive very little support and education and for whom access is hard to come by; people in nursing homes or those who are house bound or those who are in prison or are homeless... This is why we need options for patients and more than we have at the moment. If a patient would prefer to be seen within the community then can we make that happen for them? Should they have to see a specialist? If someone needs to be seen in secondary care how can we ensure they are seen within an appropriate time frame? What needs to change to make hat happen? If patients would like to have all of their 15 health care essential checks delivered in one place then what can we do to provide that? The fact is that we need flexibility in what patients are offered, we need choice and most importantly we need services that people are going to use and get good outcomes from.

I won’t go into details about the final proposals but I must say that they were all very promising. Please keep watching Partha’s blog for more details as he has promised to do a write up for you all but trust me when I say they were creative, forward thinking, innovative and patient centered. I have been to a lot of meetings which have promised to improve T1D care and not one of them has followed up with their plans. Not one has made the effort to cover so many aspects of the patient journey in order to influence change. A quote from Dr Pratik Choudhary (which I have pinched from Roz’s blog – sorry Roz) is something to think about… "Current practice kills at least 30% more people by the age of 50 than best practice should achieve."

It’s time to do better.



Ninjabetic

You can catch up on the weekends tweets by searching #TalkT1 on twitter and on my storify archive here




Wednesday, 16 December 2015

December Favourites








I promise one day I will film my monthly favourites and put them on my youtube channel, but until then...

My first December favourite is this foot care Christmas gift set by Baylis and Harding. Yes, as you can see, I have bought myself a Christmas present, but only because I wanted to try something new on my feet and it cost the same amount as my usual Neutrogena foot lotion (but this has extra goodies included)! So in this gift set you will find a manderine and grapefruit foot lotion with vitamins A, B and C, scented foot soak crystals also with vit A, B and C and a pair of super soft, fluffy, white socks. With diabetes it's important that we look after our feet, check them every day and keep them well moisturised to prevent any breaks, cracks and dry skin which could cause problems. As I mentioned, I usually use Neutrogena foot lotion but I love the Baylis and Harding hand washes and thought I'd give these products a try instead. I added the bath crystals to warm water and soaked my feet for 10 minutes, dried them well and applied the lotion (being careful not to put any between my toes) and then I slept with the socks on over night while the lotion got to work. The result - silky soft feet with a fruity scent and the gift set didn't break the bank! You can get this gift set in Asda for only £5 in their Christmas gift section. 


Next up is this diabetes alert bracelet by Kirsty. I actually won this a few months ago in a competition and it was the first ever medical alert that I'd had. Obviously it's important for people to know that we have diabetes just in case there is an emergency situation, but most medical alerts don't look so great. Kirsty, however, has a lovely selection of not only jewellery but other diabetes accessories too. They're affordable, they look good and they would make great stocking fillers, birthday presents or just a nice treat! Check out Kirtsy's website at Diabetic Jewellery to see her full range and prices. 


Now, I've raved about the Hid-In range before on my blog and youtube channel, and as these really are one of my favourite diabetes products of all time I thought I'd give them another mention. Katie, the lady who designs the Hid-In range, has type 1 diabetes herself and knows just how hard it can be to stash away insulin pumps inside clothes. She has come up with a whole range of attractive and discreet ways for insulin pump users to wear their pumps in a comfortable and fashionable way. From the range I have a pair of pocket panties, which have a pocket in the front for my pump, and I also have a body band which I can wear with any outfit. Something I also love is that Katie can customise the body bands to match your favourite underwear! Again, this would make a great Christmas stocking filler and I'd definitely recommend the products. Katie also has designs for men too, so guys... get hold of a pair of pocket pants or a body band for your pumps too! Take a look at the range on Katies website and check out her brand new kit bags too!


Moving on to blood glucose testing and for the last few months I've been loving this little duo by Nipro Diabetes Care. I was sent a whole bunch of their blood glucose meters to try out and this one has to be my favourite so far. Not only is it pink (it also comes in blue) but it is a 2 in 1 meter, combining the meter with the pot of test strips, therefore saving that vital bit of space in your bag or pocket and making testing that little bit easier. Something else, which I don't currently have, is that it also comes with a matching pink or blue jacket (yes a jacket) that fits over the test strip pot and has a sleeve for a finger pricker! I love how simple this design is, how easy it is to test my blood sugars with it and, obviously, I love that it's pink! Check out the Nipro range on their website


Time to get diabetes appy! Here are two apps for carb counting that I'd like to recommend for any time of year, not just Christmas, and those are Carbs and Cals and Cook and Count. The first, Carbs and Cals, I've used for the last 3 years and I also have the book (it was a freebie with my accu-chek combo meter) and I've found it so useful, especially when I'm eating out and I'm unsure of the carb count. It's a great little app that doesn't use much space on my phone and it's really easy for me to use. The second app, Cook and Count, is designed by Deborah who's son has Type 1 diabetes. This is a fantastic app for home cooking - It allows you to select all sorts of ingredients (as well as add your own), add measurements and calculate your total carb count for a whole dish or per portion. It also allows you to take pictures of your food and store your favourite recipes to look back on later to quickly view the carb count. Both of these apps will make carb counting at Christmas a whole lot easier! Check out Carbs and Cals and Cook and Count on the app and play stores. 



Aaaaaand finally! This isn't a diabetes product but in a way it's related so I thought I'd throw it into my December favourites... A few wonderful products from the Simple skin range. So during the winter my skin tends to suffer for a number of reasons - cold weather, stress, drinking more alcohol than I usually would and eating slightly less healthy food, but I've noticed that when my blood sugars are running high (which they have been in the last month or so) my skin becomes really dry and dehydrated and needs an extra boost. I'm loving the Simple range at the moment because it's just so simple! Micellar cleansing water is everywhere at the moment and it's not only a great make-up remover but also good for hydrating skin. I usually remove my make-up with Simple cleansing skin wipes, cleanse and exfoliate with Nivia products, then use the micellar water on a cotton wool pad, use the eye roller for a refreshing wake-me-up, apply a Olay moisturiser and finish off with the Simple beauty balm. It seems like a lot but my skin needs it in the winter and when it's so dry and dehydrated I can really see the difference. Take a look at the Simple range on their website and find out more about what their products can do for your skin. 


Merry Christmas everyone!

Laura x 

                                                        

Wednesday, 25 November 2015

Caring for a career



This blog post is very different from my usual topic, however it is a message that I wanted to get out there, and what better place then here. As many of you will know I am a final year student nurse. I am thoroughly enjoying my training and I feel very lucky to be able to do it. However, had it not been for the NHS Bursary I would not have been able to do my nursing degree as I have a student loan to repay from a previous degree. Today it was announced that student nurses will no longer be supported by the NHS Bursary and will need to take out a loan. This will potentially mean up to £30,000 (or more depending on location) of debt for students who's starting salary is £21,478. Take into consideration that many nurses, like myself, have previous degree loans to repay, and many have families to support, it raises the question; how many will get into so much debt for a nurses salary...?

As a student nurse I have spent the last three years between University lectures and clinical placements, showing my dedication and passion for the nursing profession. I have given up my job, my salary and my financial security to retrain and complete a three year adult nursing degree. I have cared for and supporting my patients in the best way that I possibly can, always putting others before my own needs, whilst maintaining my ongoing education. I have worked long unpaid hours in order to gain experience, knowledge and understanding in my new profession. I have stayed far past the end of my shift when wards were understaffed, I have worked without breaks in order to provide care, I have done everything possible to ensure that I am being the best student nurse that I can be, so that I will one day be the best nurse that I can be. Not only that but as a student nurse my time spent studying is longer than most degree students. When others have gone home for summer holidays and Christmas, my nurse colleagues and I are still diligently attending University and clinical placements.

Being a student nurse is physically and emotionally demanding – we undertake clinical practice for 8-12 weeks at a time alongside studying to further our knowledge, writing essays, undertaking drugs exams, working and caring for our families To me the decision to remove the NHS Bursary shows very little respect for our future nurses and a complete lack of understanding into how it will affect an already damaged NHS. The government has made mistakes and is trying desperately to claw back some money, however student nurses will be paying for those mistakes. It raises many questions such as how many nurses will be able to train without a bursary? Will the government raise the salary of nurses (who when qualified start on £21,478 per year) to enable them to repay student loans? How will student nurses who are undertaking a very emotionally demanding degree cope with the financial burden that a student loan entails? And as mentioned for some, repaying previous loans and/or raising families? And what will be the knock on effect should training places not be filled?


Many student nurses rely on the NHS bursary to support them through their degree. We become highly skilled, professional and committed individuals who bring excellent values and beliefs to the NHS and we do so because we care. Our strict University screening process ensure that students who apply to study nursing are doing so because we want to make a difference, because we have the qualities that will allow us to become caring and compassionate professionals. These qualities are then assessed throughout our degree, allowing us to build upon our skills, transforming us into proud nurses who you would want to care for your nearest and dearest. When we apply to become nurses we do not do so because we want to earn huge salaries at the end of it. We know that is not going to be our reality. We accept that we will be on an average wage, however the NHS bursary helps us to prepare for that. Now that this has been withdrawn how many caring and compassionate people will be able to train to become a nurse? Personally I couldn’t have afforded to train without the financial support that I have received from my NHS bursary and I am very grateful for that. I wish that our future nurses would be given the same opportunity that I have had – the opportunity that allows them to care for a career. 


Monday, 23 November 2015

Dear Doctor




Dear Doctor,

I don’t know if you’ll remember me, we met 13 years ago in your GP surgery. You were the first Health Care Professional that I had spoken to in the UK following my diagnosis in Paris. You had a kind face and you were friendly and welcoming. You introduced me to a nurse who would help you to help me, and together we would try to work out this messy and menacing illness called Type 1 Diabetes. We used to talk, though not for long, about this thing called insulin. I didn’t understand it, even weeks after being taught how to inject, but I didn’t know how to tell you that. I was young and nervous, you were confident and decisive. I was worried that I would sound silly, immature and like I couldn’t cope. You presumed I knew what it all meant, maybe you thought that someone else had told me first, but I was very much in the dark. I wish now that I hadn’t been so fearful, so apprehensive and stubborn; I wish that both of us had asked “do you understand?” but neither did. I assumed that one day I would be informed, you assumed from day one that I was knowledgeable. We were both wrong. Things didn’t work out between us and I moved to a different team, but I wasn’t fearful anymore about not understanding. Lack of knowledge had caused me to become fearless. 


Dear Doctor,

I don’t know if you’ll remember me but we met 6 years ago in the Emergency Eye Department. You noticed something that your colleague didn’t and for that I am very grateful. You reassured me that I would be taken care of and that I shouldn’t worry. I was alone, it was late and I began to cry. You held my hand as a nurse cannulated me. You told me that I would be admitted to a ward for further investigations and you made a promise that you would visit me once I had settled in. I didn’t expect to see you the next day, on a Saturday, but you stopped by to say hello. A few hours later you came back. You sat on my bed and told me that a scan had showed a shadow. Whatever that shadow was it was pressing on my brain and your team would need to investigate. You saw tears in my eyes and told me to be brave. I took a deep breath and stayed strong for what seemed like the first time in years. I wouldn't have been strong without you there. When we met again you explained the procedure. The thought of it scared me but there was no one else that I would have wanted to operate on me. I was very pleased to have met you.


Dear Doctor,

I don’t know if you’ll remember me but we met 2 years ago in Accident and Emergency. You were the person who was sat at the nurse’s station when I came in with high blood glucose, high ketones and vomiting. It wasn’t until an over hour later that we met, when you pushed yourself away from the desk to my bed on one of those backless seats with wheels. You didn’t even stand up to walk over to me. You had a clipboard in your hand and you put your feet up on the side of my bed, balancing the board on your thighs to write notes. You looked at me and said the words “so you’re my DKA?”. No. I was not your DKA. I was your patient, with a name that was written down in front of you and you didn’t have the decency to call me by it. You didn’t speak to me, but to my mother, as if I wasn’t there. You wheeled yourself back to the desk then stood, picked up your coffee cup and walked away. I was pleased to not see you again after that.


Dear Doctor,


I know you will remember me, I’m still under your care. I’m one of the patients who takes up far too much of your precious time, but you would never tell me that. You always smile, you always ask, you always go the extra mile. You are the kindest, most caring and supportive Doctor I have had the privilege of meeting. You understand what I’m saying when I can’t articulate it myself. You know my diabetes inside out; you know just what I need, what I fear, what I think and feel. I can’t rate you highly enough as you have changed me for the better. I talk about you so highly amongst my peers and with professionals too; the way you always have the right answer, it seems like magic to me, I wish I had that magic too. But often, as you know, diabetes can be tough. It gets too much, it’s unbearable at times, and when that happens I turn and run. I’m not running from you, I’m running from it. You know I’ll come back one day and I know that you’ll be there when I do. But now is not the right time. It’s me, it’s not you. 



Laura x 

Sunday, 22 November 2015





My monthly article for The Diabetes Times is about understanding the reasons behind insulin restriction, omission and diabulimia. Please click this link to read it. I would love to hear your thoughts on this, so please comment here or find me on twitter (@ninjabetic1) or on facebook (ninjabetics) to let me know what you think. 


        




Laura x 


Wednesday, 18 November 2015

November 2015 Favourites



Here are some of my favourite diabetes things that I've been using this month. I should really have made this into a video but maybe this will work for now... Please let me know what your favourite diabetes things are! 


First up are these cute pump cases and body straps from Pump Cases. They were sent to me to try out and I'm loving them! Another small blog with more detail will follow soon. The guy who makes them has a whole selection of colours and designs on his website and these 2 caught my eye. The pink paisley is really pretty and eye catching and the black Eiffel Tower case not only looks good but has a handy clip too. Not only are they great designs (I like my pump to be well dressed) but they're a pretty good price too (around the £8-£10 mark)! Check out Pump Cases website and facebook page


 


A bit of a strange one but I love this bread! I've always been a thick sliced white bread kinda gal and nothing could change my mind. OMG door step bread is simply the best!! However, my blood sugars didn't seem to agree that it was the best kind around, so I thought I'd give this a go instead. It's called Burgen and it has 11 grams of carbs per slice. Compare that to my previous 22 (sometimes more!) grams per slice and there's a pretty decent carb saving there. I've actually been eating this for a few months now and haven't had thick white bread since I made the swap. It tastes good, only costs £1 per loaf (in Asda), my blood sugars love it and I've lost a bit of weight since swapping too. Plus it has seeds which give it a great texture. 




Another foodie fav are these sugar free Hartley's jelly pots which have 1 gram (ish) of carbs per pot. They're not exactly an autumn/winter dessert but they satisfy my sweet tooth (which is getting out of control) and I don't need to take insulin for them due to the low carb count! Great stuff! I got these in Asda and they were 5 for £2 :) They're great for lunch boxes (even my grown-up lunch box). 




Many of you will know that I have absolutely fallen head over heels in love with my new diabetes gadget, Dee-Dee Dexcom. I know it's not new to many people but it's new to me and I'm in a whole new world of diabetes control. Seriously, in the 13 years that I've had diabetes my control has never been this good. It's easy to use, pain free to insert, has great graphs/charts when uploaded and keeps my attention focused on getting better results. This is a lot more that I can say about this, but do follow me on twitter (@ninjabetic1) and facebook (ninjabetics) for more updates. I would rave about this CGM all day if I could!




My final product to rave about is this first aid tee-tree gel from the Jason range. I was actually sent a bottle of this by a friend 2 years ago and it worked wonders for soothing my angry cannula sites, so I bought another. It's about £2.50 - £3.50 online, so not too pricey, and it lasts absolutely ages as you only need a tiny amount. I find that when I take my insulin pump cannulas out, even after 2 days, I'm left with an angry red lump which can be very sore and itchy! After cleaning the old site I dab a bit of this on it and it instantly feels soothed. I'd definitely recommend trying this if you have angry skin after you take out a pump cannula (or even if this happens when you inject). It smells good too! 




Ninjabetic x 

Friday, 13 November 2015

We are the world in world diabetes day #insulin4all





Everyone with diabetes deserves to live long, healthy and happy lives! Insulin, test strips, blood glucose meters etc should not be a luxury, they should be available to anyone who needs them. We need to support people and advocate for them until they are provided with what they need to manage their diabetes! 

That is why I am supporting T1International's World Diabetes Day campaign, #Insulin4All.

Please upload your selfie to T1Internationsl's tumblr page and show your support too! This campagin brings people with diabetes from around the world together in order to advocate for better access to insulin, test strips and other diabetes supplies. Take a look at their website and see the good work that Elizabeth and her team have been doing for the last few years - They are amazing people and they need your help to raise awareness for the fact that many people around the world are suffering from complications and dying due to lack of access to diabetes supplies. 

Have a great World Diabetes Day everyone and don't forget to support this cause.

Ninjabetic x 


t1international Tumblr
t1international Twitter
t1internationalfacebook

Tuesday, 3 November 2015

Type 1 Diabetes… A day in the life #DiabetesAwarenessMonth








7:00am – Mr T’s alarm wakes me up. Wait until he gets up then stretch out in bed.

8:00am – Get out of bed as Mr T leaves for work. Test blood sugars (4.1). Drink a little Lucozade.

8:05am - Look over Dexcom history for that night. 

8:10am – Get degus out of cage. Feed overexcited, squeaky degus. Leave degus eating and make a cup of tea.

8:30am – Play with degus whilst doing hair and make-up. Gambit degu eats my mascara.

9:00am – Check blood sugars (on Dexcom) 5.0. Make poached eggs and toast. Count carbs (22 grams) and take insulin (extended bolus 30 minutes).

10:30am – Leave for work training session. Make mental note to get petrol and order more glucose test strips. Test glucose before driving.

11:00am – Arrive at training session. Check glucose (7.5). Regret not bringing a travel mug of tea. Turn off alarms on Dexcom but keep within reach.

11:30am – Really regret not bring tea. Stomach starts to make strange “gastroparesis” noises. Pray that I’m not going to start feeling nauseous.

12:00pm – Test glucose. Drive to Asda. Spend money that I don’t have on beauty products that I don’t need. Debate in head whether or not to buy more salad. Decide not to as stomach can’t digest salad. Realise I forgot carrier bags. 

1pm – Count carbs in soup (12 grams of carbs). Soup tastes cheap and nasty because it’s cheap and nasty. Take insulin (standard bolus). Drink tea. Make more tea.

2pm – Reply to lots of emails. Drink tea. Realise I didn’t turn Dexcom alerts back on.

4pm – Study, study, facebook, study, twitter, study. Quickly check Dexcom

6:30pm – Tidy bathroom cupboard. Throw away all beauty products that have been covered in sticky goo. Check on degus and feed them. Check glucose is still in range.

7:30pm – Tidy clothes (get all tidying done before starting placement next week). Realise that 46 t-shirts may be excessive. Throw no t-shirts away. Make more tea.

8:00 – Have a hypo before dinner. Eat jelly babies then remember that they don’t work anymore. Drink Lucozade.

8:20pm – Count carbs for dinner (70 grams of carbs). Extend insulin by 1 hour. Watch Archer with Mr T.

9:00pm - Study a bit more. 

9:30 – Get degus out of cage for exercise. Reply to more emails whilst stopping degus from eating the walls.

10:00 – Wake up on degus floor after “shutting my eyes for a minute”. Degus have gone back into cage on their own.

11:00 - Change insulin in pump. Remember that I shouldn’t do that before bed. Test glucose (8.2). Get into bed.

11:10 Have chat with Mr T. Decide to keep alarms on Dexcom during the night after Mr T confirms that they don’t wake him. Check glucose on Dexcom one more time.

11:30 Remember that Lucozade is in kitchen. Go to find it and put it near bed.