Mental health awareness week

As its mental health awareness week I wanted to share a little something I experienced recently and wondered what other people thought.

If you are a health care professional (HCP) can you be unwell? Sounds like a bizarre question, huh? Anyone can be unwell, right?

I’ve never really worried about being unwell. I mean, I literally hate feeling unwell, but I have never felt the need to worry about seeking medical advice and attention. This recent experience has left me feeling otherwise.

So here’s the scenario. I am unwell with an infection, which has impacted on my blood sugars and caused me to become more unwell than what I would have done without type 1 diabetes. A huge shock I know, I was unwell!

It was just ONE comment, a passing comment made by a HCP. There was no malice, in fact, they were very kind. But this one comment has stayed with me. It’s got me thinking, what do other HCP’s think when a fellow HCP becomes unwell? Are you shocked?

‘….it did make me laugh, a diabetes nurse unwell with diabetes…’

Just a simple comment carrying so much meaning and feelings. Feelings of guilt. Feelings of embarrassment. I really should avoid getting sick. But is that real life? I had much better things planned than having my arse kicked by a nasty virus.

Throughout our lives many of us will encounter multiple viruses, coughs, colds, infections, a decline in our emotional well-being, a mental health problem, minor injuries, stress and much more. It’s pretty much part of life. We are living longer therefore may be exposed to more illness than ever before. Some of us may develop chronic conditions, acute medical emergencies, be involved in life changing accidents or have a terminal illness. There are many factors that can contribute to this, but each and every one of us, regardless of our own profession should never be made to feel that you cannot be unwell. As much as I, and many others like to believe, we’re really not invincible! Well apart from superheroes, but we all know they are not real………

Is it really a big deal that a person with a medical condition becomes unwell which impacts their medical condition which in turn causes them to become more unwell? And then they have to seek medical advice or medical attention. Isn’t that what we want people to do. To get medical intervention when needed? Isn’t this what we advise others, our family, our friends, our patients to do. So what messages are we actually giving each other, to our colleagues? Because the message I felt I was given was that a diabetes nurse cannot be unwell with diabetes.

So just a thought. Can a mental health nurse have depression? Can a Podiatrist have dry and cracked heels? Can a dentist have a tooth abscess? What about our GP colleagues, I guess they should NEVER become unwell, imagine that! A GP with a chest infection. A GP with a cold. A GP with migraines, pain, infection, illness, long term conditions.

Is it really a huge issue if someone within a particular speciality became unwell with their own condition?

So, for mental health awareness week, we really need to look after each other. Not make people feel guilty for being unwell. Not shame them for being unwell with a condition that they may have a speciality role in. Because if this is what we really think, then I suppose we all need to hand each other a rather large roll of bubble wrap to keep ourselves safe and closed off from reality.

So next time you think, that Dr, nurse, health care assistant is unwell again, ‘tut tut,’ consider how you would feel. You would want to seek advice, support and intervention if required from your fellow colleagues without feeling shamed. Just imagine how you would feel if someone said just that one comment……

Type 1 challenge

For diabetes awareness month I thought I would set my colleagues, who do not have diabetes, a little challenge, to live with type 1 diabetes (T1D) for 5-7days.  I was unsure who would want to participate and also wondered how I would actually really feel knowing others had access to my live continuous glucose monitor (CGM) data.

Surprisingly quite a few of my colleagues were interested in taking part and I limited it to 4 participants, all senior diabetes specialist nurses (DSN).

I sent details of the challenge to them so they were aware of what they were voluntary taking part in, including potential alerts whilst sleeping, and emphasised that if at any time taking part was causing them additional stress or ill health they needed to withdraw from the challenge.

The rules: Test blood glucose (BG) before eating, driving, exercise and any other time they felt it may be necessary.  They would use my live CGM readings to make decisions; if about to drive and BG shows 4.4mmol/l, they would need to treat accordingly to drive.  Of course my actual BG would not change due to decisions they made, it was allowing the opportunity to respond to the numbers like I have to.

‘You will need to check BG with every meal and carbohydrate snack/drink. You will be required to carb count and calculate your insulin dose, including any corrections you may need with the BGL reading presented to you’.

Living with T1D requires continuous decision making throughout the day and those living with T1D often feel the burden of self-management.  Having interruptions, making decisions, counting carbs, adjusting insulin and factoring in day to day life can have a negative impact on the person living with T1D. This in turn can impact self-management and how the person with T1D responds to their own BG readings.

Many health care professionals have limited understanding into living with T1D and therefore may become upset, frustrated or at a loss with how they can help.  They may lack insight of the day to day interruptions and understanding why injections or BG testing can be forgotten, or why some do not bring their meter to clinic.  For me, sharing data is the same as giving someone access to my bank account.  They can see what I have been doing, my eating habits, if I have missed insulin doses, forgot to test my BG, and may draw on their own conclusions as to why I have had a high or low BG.

Aim: To enable a greater understanding of living with T1D, 24/7, and gain insight into potential issues faced

The challenge: Initially I was extremely nervous to be sharing my CGM data with my colleagues.   Whilst I know they are very understanding, there is always that feeling of being judged.

What if my BG is consistently high? What if they disapproved of my carbohydrate intake? What if they kept having to treat a hypo, if it interrupted their sleep or working day? What if they thought I was a ‘bad’ diabetic and shouldn’t be a diabetes nurse?

But, what if they gained a little more insight of living with T1D? What if it helped them to pause and reflect during a consultation?

For the record, I am so very impressed at their level of compassion towards those living with diabetes, so at no point did I feel that they needed to improve this.  Agreeing to take part in this just shows the type of people they are; always wanting to support others and look for ways in which we can all enhance our skills and knowledge to support those living with diabetes.

The day before the challenge started I sent a little message to the group;

‘Good morning. Unfortunately your latest blood results confirm you have T1D….please start injections tomorrow as per the information sent…please carry your preferred hypo treatment…test BG before driving as per DVLA guidelines…’

Day 1: This was exciting and scary all at once.  All the ‘what if’s.’

I was off work and needed to go into the city center, a little shopping trip. My CGM alerted me to a potential low after showering and the first message came through, ‘thank goodness I’m not driving, I’ve just had a banana.’  Not long after this I was alerted to a hypo which required everyone to take fast acting glucose, regardless of where they were.

Later that day I had another hypo along with messages ‘are you ok…eat something sweet…’ Two hours later another alert followed by messages, ‘are you ok, you’re dropping again.’ 3 hypos in 1 day! I hadn’t had a hypo in weeks, to be hit with 3.            Did my body do this on purpose to throw some excitement into this challenge? I hope not! Please don’t say I’m entering ‘hypo season,’ how embarrassing!                                 The third hypo that day really got me, of course I said I was ok, but I did worry when I started to feel ‘weightless.’

Wow, what a crazy first day. It wasn’t until later when I realised how exhausted I felt. I was so pleased I was off work the following day.

Day 2: I forgot to bolus as was on the phone sorting an imminent house move. Of course this caused a raised BG and plenty of alerts.

My colleague advised that she had missed a lunch time dry injection, as was in a meeting and had a dress on, so injected once in the car.  A great insight into the difficulties faced, some that may not have been considered.

Days 3-7: These days were pretty uneventful, a few meal spikes and overnight highs, alarming throughout the night.  One of my colleagues advised she got up early hours in the morning to take a correction.  This involved going downstairs & working out how much insulin she would need along with giving a dry injection.

Reflection: This challenge has been a learning curve for all involved, including myself.  I realise how I have become comfortable with letting my BG run higher, even though I have a CGM to alert of hypos.

During my time as a student nurse I had to join a new team for each placement and always worried about having a hypo, so would try and keep my BG higher.                          I imagine, although I have settled in my new role, there is still a fear of having a hypo in front of others.

My colleagues really are awesome! They respected the fact that I live with T1D 24/7 and apologised for ‘checking in’ with me if my BG was going low or high.  I did not mind receiving messages from them, it was actually really kind of them.

The care and compassion they showed throughout this challenge were admirable. I would highly recommend for other health care professionals to take part in a similar challenge.

 

Reflections from 2 participants

Having worked as a HCP in diabetes for 17 years I hoped I had a small insight to what it might be like living with diabetes, having tried to support people with the condition, listening to them explain what it is like and the struggles they face as well as the positive side of diabetes.

There is an awful lot of remember if you have Type 1 diabetes and you have to think about everything before you do it.  Suddenly what you are eating becomes ‘how many carbs are in that, how much insulin do I need, is a correction dose required?’

The first day of this challenge the CGM alarmed three times due to hypos.  This was a real reality check into what it can be like to have hypos and having to treat them.  My teeth felt horrible after all the sugar.  During one of the alerts, I was driving and needed to pull over as the alarm would not stop.  These all added extra time out of my day which I didn’t really have. But this is how it really is and made me think, this is real for my colleague and other people with T1D.

BG testing: One night I worked late and jumped in my car to drive home and realised half way home I hadn’t tested my BG level.  I did this the following day too!  It made me realise how easy it is to miss this test because of life being busy.  It may only takes a few minutes, but it’s those few extra minutes when you are busy or tired.  I advise people all the time to check their BG before driving, and now understand how easy it can be to miss this vital test.  What if I had been too low to drive in addition to being tired?

Injections: This was not too bad but I did reuse needles a few times which became uncomfortable, so I ensured I changed them every time.  There were several times towards the end of the week, the weekend mainly where I tend to graze more, and forgot to inject before eating.  I injected in front of colleagues in research, one was a new colleague, so that was interesting explaining what I was doing.  I also injected in a room with people with T1D, but no one was watching.  I explained to them the challenge I was taking part in.  I was nervous though, doing the injection in this group, as I did not want to make light of what they live with day in and out.

CGM: I liked being able to see what your BG levels are doing and can understand why people would want to use this.  I think, if I had T1D and did not have such device, I would be checking my BG levels a lot and would probably not sleep well.  Fascinating seeing BG levels at the touch of a button. I wouldn’t want to have diabetes and insulin without this software as it makes management so much easier. I t enabled planning; i.e. if BG is falling, glucose can be taken to prevent further drop

This experience has heightened my awareness of all the extras you have to take into account when you have T1D and that you can never really switch of from it.  There is a lot of stuff to carry around and always have with you.  I do think it might stop me doing things, but I hope not.  It really is part of who you are.

I have only had a very tiny insight this week into the condition, I will never truly know what it is like and how hard it can be.

Thank you to my colleague for sharing her BG levels with us and for helping us understand a little more of what it is like to live with T1D.  I hope it will help me be a better DSN.

Thank you to my colleagues who kindly took part in this challenge.  You really are amazing!

Five year diaversary

Five years ago on this day my life changed forever. Wow, five whole years!

Whilst I would give my right hand to not have type 1 diabetes, actually I probably wouldn’t, I don’t think I would change a thing. I used to believe my life changed in a negative way, but I was so wrong! Without my diagnosis I would not be where I am now.

In these five years I have achieved things I never thought possible. Some things I had little interest in before are now part of my life.

I’ve met some amazing people in the last five years, many of who are really close friends. Many have helped encourage and support me to achieve amazing things. Many have been by my side, listened to me & offered words of wisdom. Many who have believed in me and worked alongside me to help others. This is something I am most grateful for, the friendships gained. Something I never want to change.

If only I could have seen the positives of my diagnosis I may have felt less afraid. I may have realised I had nothing to worry about because it will just become part of my life. Yet five years ago this did not seem possible. The day to day management of type 1 seemed impossible at times. It still does sometimes.

Five years ago I feared for my future, I feared day to day life of managing such a complex condition. Don’t get me wrong, there are so many days where I struggle and wonder why I can’t just take a set insulin dose, or a pill and get the same result day to day. I wonder why diabetes sucks all of my brain power into thinking about counting, about numbers, about ratios, when to eat, am I safe, am I well, can I do this right now. Each day I manage to have these thoughts, in silence without many knowing what is going on. People assuming I am tired due to a late night or just lack of sleep. Whilst both of those are true reasons, 99.9% of the time this is related to my diabetes. Sometimes I feel so exhausted that trying to get through another day with smiling and being positive seems near impossible, but as always I realise it’s not. The effects of high blood sugars, and low blood sugars can really take it out of me, yet somehow I manage to go on and get through the day when all I really want is to rest, to sleep & re-charge. I put on my ‘big girl pants’ and get ready to take on the day, rise to new challenges and keep moving forward. That’s all I really can do. Because if I choose not to keep going I may miss out on future experiences, miss out on meeting new friends, miss out on becoming a stronger me.

I regularly meet others at the start of their journey, learning how to manage life with diabetes, diabetes and living. Whilst I can empathise and reassure them that their journey will get better, it will eventually all slot into place, I realise that it’s their own personal journey they have to experience. I can only hope that others get at least one positive experience throughout their journey, preferably a handful more.

Five years ago today my life changed forever. Type 1 diabetes chose me to live with. I choose to take it with me on every new adventure and show that I won’t be stopped. I may need to work harder and think differently and regularly cry on the inside.

BUT. I. WILL. NOT. BE. STOPPED

 

Whirlwinds and living

 

 

Wow, what a busy few months. Sorry to have neglected this page, but I’m finally back! I have been so so busy, and really should have made more time. Saying that, any spare time I had was spent trying to sleep, catch up or just, well, live!

If I am honest, I am uncertain if I will continue to blog. I can’t say I missed it, which makes me wonder if it really is for me. I feel so exposed when sharing my thoughts and feelings, along with experiences. Yet is this selfish? If my experiences can help encourage someone else to leap into a world of believing and achieving, then surely I should try to help? I will surely figure this out whilst my crazy life begins to settle, ever so very slightly.

So, where have I been? Nowhere! I have been submerged in a life of exams, essays, placements, working, studying, sleeping, working, dreaming and how can I forget trying to manage this arse of a long term condition DIABETES. Like seriously if life wasn’t crazy enough, diabetes nearly tipped me over the edge. There have been times when even saying or hearing that word made my ears bleed, my throat dry up and my face turn bright red. Spoiler alert*no marvel comic action hero scene actually happens. I DO NOT turn into the hulk. Although, sometimes I felt like I would literally self-combust at any given moment, especially while writing my dissertation. I cannot even describe what I was going through. Yet I manged to get through it and somehow achieve a very high first for my dissertation! Hope you’re giving me an air high five now?! If not do it! YEAH…. It felt good right?

Actually, I have been somewhere. Que a slightly, ever so proud, big headed Kelly moment…..I cycled again. That’s right, amidst all of the crazy hectic life of mine, I somehow managed to fit in a cheeky relaxing bike ride in France again. OK, relaxing isn’t quite the word that describes what actually happened, 65miles in one day of tremendous mountains, blazing sunshine and a near death experience….that should set the scene for you! (Yes I am slightly (extremely) exaggerating).

This month I would have been managing my diabetes for two years with my side kick Penny, aka my portable pancreas aka my insulin pump. What a whirlwind it has been, time has literally flown! We have a love hate relationship, and at times I feel we just hate each other more than we really should. Yet, when I actually think about, it was never really going to be easy. I was fairly new to diabetes when I started to use a pump, a mere one year into studying at university. A new environment with new stresses which would continue to change throughout my studies with increasing placement commitment, long hours, pressure and exams. I know I like a challenge, but jeez this has to be the biggest challenge ever! And just when I think I understand how to manage blood glucose levels when working, eating, drinking, sleeping, exercising, socialising, it all changes and I have to start again. No matter how much I think I know, I always feel I know very little. This is probably the most frustrating thing about type 1, for me. I long for some regularity, instead of having to constantly learn new techniques and adapt my life, medication and mind-set just to stay well and ultimately alive. It’s this frustration that makes it hard for me to manage. I like to be in control, as I’m sure everyone else does. When I can’t even manage my own health and well-being, no matter how hard I try, the frustration kicks in. I then don’t want to put any more of my time and effort into diabetes, if everything I am doing isn’t working. For me, I need to focus on what is important at the time, and if diabetes tries to get in the way I turn a little crazy. I can totally blame hyperglycaemia for this though….right?

I have changed so much over the last few years. Somehow I have grown in confidence. I have been able share my fears and concerns which in turn has helped me become more confident. I have my amazing friends and health care specialists to thank for this. Without them I really don’t know if I would be half the person I am today.

There are the days where others tell me how much they admire me, and how inspirational I am. As much as it’s very lovely to hear I get a little overwhelmed with it. I don’t really understand. How can I be inspirational? I wouldn’t tell someone else how inspiring they are for riding their bike (ok, we did cycle a looonnngg way! Check it out – Ouistreham to Bayeux), or for swimming in the sea. But having diabetes, everything I do seems to be an achievement. I don’t want to sound ungrateful, because I’m really not. I love how kind everyone is, but inspirational….come on. Inspirational is the likes of Roddy Riddle, walking over 300miles in freezing conditions, putting his own well-being at risk. Crazy yes, but inspirational! Inspirational is my close family friend, who is trying to live each day and watch her young children grow whilst arse face Cancer is trying to kill her each day. That’s inspiration right there for you!

Right now I am learning to enjoy living again.  Remembering who Kelly really is and brining fun and laughter back into my life.  With everyday life continuing to grind me down, I’m learning to push back up.  To work through the difficult times and continue to accept the help I so desperately need.  Because life really is crazy and can change within a fraction of a second…..

So whilst I ponder over blogging and eating freshly baked banana loaf, I will continue to remain upbeat, help others and plan the next adventure including coastal steering, and most importantly a new diabetes mission! To be continued………??

Ouistreham to Bayeux

Following our amazing charity bike ride, London to Paris, in September 2016, the ladies and I wanted to continue our cycling adventures. Being out on the bike, cycling through picturesque villages bought a smile to my face and for once I felt I could actually do something good for my mind, body and soul (cheesy I know!). So of course, I wanted to help arrange another bike ride. Originally we looked at cycling in Holland, yet with it being a pain in the arse getting out of the UK with our bikes, France was the best option. Who wouldn’t want to cycle in France anyway, they have fantastic cycle routes and the best croissants!

Since the charity ride last year I haven’t really cycled much. The pressures of uni really got to me, and I had no time or energy for anything other than studying and writing my dissertation. Yet I needed to start getting out on the bike again, it’s not as simple as getting used to being back on the saddle I had more important things to learn AGAIN. In case you didn’t already know, my blog name gives it away, I had to remember how to manage those pesky blood sugars before, during and after cycling. Let the hard work commence!

In between studying, exams, dissertation writing, going to uni, going to work and trying to live I managed to fit in a few rides with some of the girls. To begin with I felt like a newbie on the saddle, yet after a few long distances rides I remembered how much fun it was to be back on the roads with lots of laughter. With time I soon built up my confidence and began to master managing my blood sugars just like I had before.

‘I can do this, right?’ I mean, I cycled over 200 miles to Paris last year, I can totally do this. But the anxiety began to creep in. The what if’s. What if I can’t cycle far? What if I hold everyone one up? What if I have a hypo, like a bad one and need help? What if I need the others to help me with my diabetes? I know I did not need to worry, I was with some amazingly supportive friends, but I don’t want to hold others back and ruin their experience.

Two weeks or so before our planned trip my blood sugars began to start dropping, quite suddenly. Many of which I had no warning. Maybe the change in weather caused this? I made multiple insulin adjustments yet these did not help at all. At times I reduced my basal by 60-80%, and reduce my bolus yet still have hypos. I couldn’t seem to stop the hypos, no matter what I tried they just kept attacking me. Those who have hypos will understand how frustrating and tiring low blood sugars can be, and quite frankly it can really get you down (literally!) The day before we were due to head to France I woke tired from multiple hypos and felt there was no way I could cycle right now. Not only was I exhausted, I knew cycling would make my blood sugars even lower. Given the amount of hypos I had already faced, I started to worry that cycling may actually contribute to me needing emergency treatment for a low blood glucose. This scared me so much. I didn’t want this to happen, especially not in another country, potentially in the middle of nowhere. I knew I would be with the best people, a group of very knowledgeable and experienced diabetes specialist who could look after me if required, but I really didn’t want them to have to do this. This is meant to be a relaxing cycle break for us all. It would be selfish of me to even consider going. I had made my mind up. It was safer for me to stay at home. Safe in my bubble. If I didn’t cycle I wouldn’t increase my chances of passing out. A quick message to the crew and a sigh of relief. Yet the response I got bought a tear to my eye:

“We started this together, we will finish together”

I got the impression that not going wasn’t really an option! I needed to ‘man up’ and take each moment of the ride as it comes.

Saturday 3^rd June 2016

6.15am: After a fab night dancing away and 3 hours sleep Lauren messaged me to say she was on her way! I had only just got out of the shower…..I needed to be ready and outside within ten minutes. Challenge accepted!

Once parked, Lauren and I cycled 3 miles to Portsmouth Ferry, where the others were waiting for us. Although all were tired, we were excited and smiling as usual. Boarding the ferry bought back memories of the charity ride, I knew I made the right choice to come. I couldn’t let diabetes ruin the fun!

The ferry journey was fun, I wouldn’t expect it to be anything other than laughter throughout! Croissants, costume change, balloon models, quiz by Rusty Cutter, glitter tattoos and armed with our new mascot Pierre, we were ready to take to the roads! We also met some veterans, and some lovely chaps who knew friends of ours, and were heading out for the D-Day event in Bayeux.

 

We arrived in Ouistreham at 3pm to discover a fabulous cycle route to our next destination. Apparently this route was here last year too. Instead we choose to cycle through campsites, onto the motorway and goodness knows where. Who would have known it really didn’t need to be so dramatic, if only we had found this route! The sun was beaming down, we were on our way and on schedule to arrive at our hotel by 7.30pm. At one point our route took us off road, it felt like miles through the trees and bumpy gravel. No problem, I had my new snake skin tyres, I was NOT going to get a puncture! With many photo stops, toilet breaks and hypos along the way we finally reached our destination an hour after we had planned. Did you actually just say you can’t find the key to our room! No worries, we don’t mind waiting a few minutes, a few minutes more…..like seriously how long!

Today’s ride was fuelled by 1 large bag of jelly babies, a handful of gluco-tabs, 2 sports gels & -80% basal insulin.

After a lovely/random meal, and toasting Sarah’s birthday, it was time to rest our tired body’s.

Due to all the low blood sugars, the ladies I shared a room with were a little worried and wanted me to go through my dexcom alarms, have fast acting glucose near me and maybe some reassurance? “It’s ok, I do this every day.” I put the dex alarm on vibrate, so it would only alarm if 3.1 or below, I didn’t want to wake everyone, and explained to Sarah (who I was sharing a rather large comfy bed with) that I keep quite still so no need to worry about me trying to snuggle up with her. At one point in the night I woke really cold, but didn’t want to get up to find the blanket. I am sure Amanda had the blanket, and I didn’t want to wake everyone. Little did I know I already had, and boy did they let me know in the morning! Turns out the dex vibrated to alert a high blood glucose and rising. It did NOT alarm Amanda! Therefore I slept through this. I was also grinding my teeth, talking in my sleep ‘pass the jam Sarah’, and also snuggled into Sarah. How freaking embarrassing! I felt awful, they had not slept well because of me. Well apart from Paula, who was oblivious to it all. Maybe if you passed me the jam Sarah, I would have been ok?!?

Sunday 4^th June 2017

After breakfast, an outfit change and photo shoot, we were ready to set off to our next destination 40-50miles to Bayeux. I felt confident that my blood glucose would remain slightly higher today due to the overnight spike, and hoped to reduce or even avoid hypos.

Many photo stops, we had all day to relax and enjoy this picturesque, extremely uphill ride. Seriously how many hills! After luckily finding an open shop, we secured our baguettes onto the bikes and set off to find somewhere to stop for lunch. The hills had put us a little behind schedule, but not to worry we were halfway there and it was a lovely sunny day. Maybe we will aim to arrive in Bayeux between 4-5pm. Still giving us plenty of time to get to the beach and enjoy the D-Day fireworks and celebrations.

 

STOP! Did that sign actually just say 36km?? Amanda gave me a little smile and told me to ignore the signs, it was the route number. For the next hour Amanda continually told me to stop asking how many miles, ignore the signs and keep pedalling. I knew something wasn’t right, those signs definitely meant km, not the route number. Throughout we all managed to laugh about the distance we had to still cycle. A quick call to Valerie, our accommodation host, advising we will be there for 7pm. A stop to ask a local if we could fill our bottles with water and friendly tanks beeping as they passed us heading toward Bayeux, I felt positive we would soon arrive. Yet it soon became clear we would not get to Bayeux until 8pm. Why oh why did we have 17miles left to cycle, yet now have even further to go?!? I was starting to flake, like everyone, and began feeling really ‘cranky.’ I couldn’t see the funny side anymore and just wanted to give up. Literally who makes hills this steep which go on forever?!? I was so hot and could feel a sweat coming over me. Oh, hello hypo! I had tried so hard to avoid this all day by eating cereal bars and having jelly babies and gels before getting to a blood glucose of 5. How on earth did this just happen. I felt angry, my legs felt like lead but I didn’t want to stop, we were running late already. After eating at least 12 jelly babies my BG began to rise, slipping out of the 2’s and into the 3’s. I nearly even made it to 4. I still felt cranky and everything felt even more difficult, but I was determined to keep going. Just keep cycling, just keep cycling……

I knew I was struggling as the distance between the group and I began to widen. I felt really hot and had the awful hypo sweat come over me. No, please not again. I was back in the low 3’s with the arrow heading down. I got the impression that everyone started to realise something was wrong, and I found that someone would hang back with me. I reassured when I could, saying I was ok and that my BG will soon rise, but I didn’t want to talk anymore. The bike felt heavy, I felt like my arms were struggling to hold me up. ‘I’m ok, just five more minutes. I do feel woozy though, I feel odd.’ I started to struggle to get the words out, it was easier to stay quiet. Keep your head down and keep pedalling, we are nearly there! Amanda was talking to me, I haven’t a clue what she said, but with a dex reading of 2.2 and a downward arrow I heard her shout STOP to everyone. It was time to take a quick break, treat the low and get moving. Yet I couldn’t get off my bike. If I just stand here for a while I will be ok. I need this gel but I cant seem to swallow. I know what I need to do, but I cant seem to do it. I need to sit on the floor. No one look at me, I think I’m going to fall. I can’t tell you this though as I can’t seem to say what I want to say. Just keep your head down, sit down Kels, it will pass. No thank you, I don’t want bread. I wouldn’t be able to chew it. Everything looks a bit blurry, I feel awful. Please don’t pass out. For someone who has never fainted I was petrified of this happening, and even more so of embarrassing myself. I remember trying to think where the glucagon injection was, but literally couldn’t think. I wanted to tell the others to get it, but I couldn’t find the words, so I just sat quietly politely saying ‘no thank you’ when food was offered. What felt like forever trying to suck out the last of the sports gel, with the sound of me swallowing exaggerated in my head along with my heartbeat, I eventually started to feel more awake. I could speak, I’m ready, lets go!

That has to be the worst hypo I have experienced. Although I felt scared, I felt safe knowing that my friends would look after me, if only I had told them where the glucagon was though (lesson learned!).

We eventually arrived at our accommodation at 8.45pm. What a lovely place too.

Quick shower and outfit change, we headed for a nice meal and a few beers. What a looooonnnggggg day!!

Monday 5^th June 2017

With no dex alarms, everyone slept really well. As soon as Amanda stepped out of bed the laughter started! Check out the tan lines!

After a quick trip to Bayeux tapestry, photo stops and croissants, it was time to get back on the bike and head to the ferry.

Cycling through some lovely Poppy fields, we bumped into a group of men (some very fine looking men). Some on a tandem bike, pink tassles, pink baskets and heading for the same ferry. I’m going with them! But oh no, some people, mention no names, wanted to be sensible and go the bike route. Amanda and I tried hard to persuade them, but they went into parent mode and there was no way we were going to win this one. OK, it was Sarah & Paula! Sorry, but this is something I will always remind them of, you will find out why later!

 

We found somewhere on the beach to have lunch and I was determined to make use of the bikini I bought along. After some persuasion, Amanda, Maggie & Sarah also agreed to make a quick dash into the sea (although Sarah decided to stay in her cycle gear….next time ay!) For the first time since I have had Penny the pump, I felt ready to take her in the water. Yet all the DSN’s with me suggested not to. I was starting to see a change in them, little worries of how I used to be. Maybe being with me and pretty much living diabetes with me, they had started to take on the worries I had/have? I decided against taking Penny for a dip, just in case!

With 45mins to get to the ferry, we had plenty of time to cycle at a nice pace. Hang on a minute, this ride reminds me of somewhere we have been before. London! Yep, stop at every traffic light. It was getting really cloudy and dark and we were running out of time. Does anyone else feel that we thrive on pressure?!? As we cycled onto the ferry the rain started. Luck had been on our side throughout this weekend. All we needed to do now was find a nice spot to sit and relax on our way home.

So we bumped into the group of guys again, who showed us where we could sit and relax on recliners. We never saw these before, because we danced the night away! After a game of hide and seek, putting on face cards and staring at other passengers – Lauren was very good at this, we giggled all the way home. We also established that the guys were footballers, 2 of which played for saints – one being the goalie. Note to Sarah & Paula – trust me next time when I say we are joining a group of men

We arrived to gale force winds, rain and experienced nearly being blown off of the boat. I always wanted to rein act ET, I should have just let the wind take me up, up and up!

 

 

 

 

 

 

I can safely say we are already planning our next cycle trip away. I have a feeling this will be an ongoing journey. Literally love each and everyone of my cycling friends and can’t wait for our next adventure!

It’s a cycle 2 days in a row kinda weekend 3rd & 4th September 2016

Wow what a weekend. Just sat here now, my brain completely wired, full on awake. Yet earlier today I looked like I had not slept for days. Completely and utterly exhausted.

So who thinks this cycling malarkey is easy?!? Well, I shall let you into a little secret….come closer, I don’t want anyone else to hear…. “it’s not.” Didn’t hear me? “It’s not!!” Yet it is most certainly the best thing I have ever committed to.

So as you all know, yes I will bleat on again, having type 1 diabetes makes exercise sooooooo much harder. Just when I think I have figured out how to keep my blood glucose levels (BG) fairly stable before, during and after a bike ride, my body decides to chuck in a curve ball. This has not stopped me though. Actually it has made me a more confident and determined little soul. I blaaadddyyy love cycling!

O.K back to this weekend. Two days cycling quite a large distance for me.

Saturday consisted of crazy Donkey’s and horses chasing me. I soon realised they were after my banana and not actually trying to eat me (even though Amanda was sure we were Donkey dessert!)

Of course we reached the crazy beast of a hill. Like literally this is a struggle to walk up, I stomp up on my tippy toes whilst Amanda just keeps cycling. That lady is totally determined. I just look at this 25% incline and get off immediately. Total respect to you Mrs Pamplemousse. Although you really do need to work on staying on your bike and quit toppling over, you really will damage those parts you keep telling me about.

Then there was the near slide under the lorries wheel experience. No exaggeration! I have never been so scared in my life, well not that I remember. Just as we were enjoying the downhill country road, a few blind bends and ‘Mr I have all this Hay on my truck so will take up your side of the road without slowing down,’ decides to just appear. Like seriously calm the freak down lad. What’s the rush? Jeeeeeeezzzzzzzz. In a blink of a moment BRAKES, stay still, stop wobbling, throw yourself into the gravel and bushes, chuck your leg down and lean to the side… AVOID THOSE WHEELS. Phew, we made it. I honestly do not know how I managed to stay on my bike, same can be said for Lauren with poor Amanda watching in horror. Those few seconds really shook me, more than I thought as the following day going downhill or around sharp bends I was hyper aware of everything and super cautious.

44miles later, the furthest we had gone. Amazing ladies! Totally shattered the rest of the day though.

 

Sunday.

I DO NOT WANT TO GET UP. Snooze alarm…..grrrrrr…get up! You HAVE to do this.

As soon as we take off I remember I’m with hills Sarah & hills Kev. Oh man, Sunday should be a duvet day. The saddle is causing some discomfort today, my legs are burning but this soon eases. I CAN do this! Who am I kidding, here comes a hill, and another, and another. It’s up, up and up we go. Literally just up! Totally the worst hill ever. FACT! I hate this route, I hate hills, I hate everything. My legs hurt badly, they feel really heavy. I can’t do this, I’m not doing this, I need to get off. It hurts to walk. Just get back on Kelly, sort it out! Oh no I’m going to be sick. oh no I have to stop. Please don’t be sick. One of my new warning signs of my BG dropping really quickly, nausea. Like the no time to even think nausea, it’s just going to happen. OK, you’ve got this. Test bg just to check and have a few sweeties. NO WAY. I’m hypo. No wonder my legs feel really heavy and I hate everything. Stop thinking and start eating. This nausea though. Down the juice, down the juice. Keep going, all will be fine in a few minutes. Just keep cycling, ignore the blurred vision, the mammoth sweat. DO NOT BE SICK. Phew no vomit, and finally at the top of this ridiculous hill ever.

OMG. Literally how many more hills today. Look at the sunflowers. I’m back in my happy place. I love cycling. I love this route. I love everyone. I CAN do this.

Arrrggghhhhh seriously enough of the hills. This is feeling ridiculously hard. I’m sure my tyres are even screaming at me. Wait, they are. I have a puncture, my tyre is flat. A lesson in removing tyres, changing inner tube. Team work, thanks team! Let’s go…..REALLY do we need any more hills. Hang on is that a bike, that’s a head…..there’s a guy laying in the bushes! Whoah calm down fella, no time for hide and seek on these bends. Luckily he had a soft landing and all was well. A few seconds earlier would have been a different story for a few of us approaching his path!

Lets go. I’m feeling tired. I feel angry. I’ve had enough. I want to get home. I want to get off. I want to stop. CAN WE JUST GET HOME. How many more hills. I feel sick….oh no here we go again. Jelly babies are your friend, keep going. And breathe. I’m happy again. Bloody hypos!

I have just cycled two days in a row! Go me. Can I get a whoop whoop

A whole lotta learning, training and perseverance

As much as I would love to include every detail of changes I made to my eating and insulin regime, you can breathe a sigh of relief as I wont bore you with that.  It’s been a massive whirlwind from the very start and I seriously cannot even remember all of the changes I made and when.  What I do know though, is with careful planning and getting to learn how exercise impacts on your own diabetes, BG levels can be managed very effectively.  I’m not saying it’s easy, far from it.  What I am saying is stick with it.  You CAN achieve anything you want to.  Nothing is impossible.  What I have achieved is proof that anything is possible!

“You is kind, you is smart, you is important.”

So, I knew I had to practice riding my bike. Getting used to a road bike would be hard. Firstly I was scared of cycling on roads.  There are far too many cars.  On reflection though, it’s the blooming pedestrians you need to look out for! Apparently it’s ok to just stroll in front of me as I am cycling 20mph downhill towards you and your buggy. Grrrrr.  Lucky for them, and for me, I have the reflexes of a cat. A ninja cat actually! A cycling ninja cat.

Enough of the crazy cat stuff. Back to training.

Being on a road bike felt so much different to my teenage mountain bikes. I had to balance on these teeny wheels. I don’t feel safe! Curly handlebars too, aka drop down. So much to learn about this bike. Why so many gears?!?  I’ve now learned that gears are my best friend when hitting the road and those blooming hills!!  However the bike was the least of my worries, although I made out many of times it was the only thing I was worried about. I lied.  The big D was my real concern.

My insulin pump team had arranged an exercise with diabetes workshop which I signed up to.  I was really excited to be joining and knew I would learn a lot.  It was so important for me to attend, however I now wonder if it was the right time?  I had been feeling really down and frustrated about my diabetes and from what I can remember had also been unwell.  Team this with exam and essay stress, managing my diabetes had moved down my list of priorities. Yet I knew this was extremely important and I had to really focus on making safe and appropriate changes to my insulin ratios along with the amount of carbohydrate I needed to consume. I knew it would be hard, I really did, but sitting in the first session it dawned on me how hard it could be.

01/02/16 Exercise & pump workshop

The day had finally arrived.  I was really excited to start learning how to manage my diabetes during exercise.  Although I was quite nervous.  I did not know my dietitian, Penny, that well and hadn’t a clue who I would meet on the day.  I knew it was a small group and believed it would be people with similar exercise interests.  I knew how important it was for me to start learning what I needed to eat, when I needed to eat, what I needed to reduce insulin wise along with the timings.  I knew how crucial it would be to ensure I kept within safe blood glucose (BG) levels.  I knew the importance of this but I couldn’t cope with all the information.  It was just too much to absorb.  All I could focus on was the amount of carbohydrate I needed to consume prior, during and after exercise. Then there was the BG testing through the night if I exercised after a certain time, and of course eat some more.  Eat, eat & eat. That’s all I heard.  I’m certain the session had more to it, but all I could focus on was the fact I would be coming back from this bike ride at least two stone heavier, maybe even double the size I started with.  Yes, I know this could not happen in a few days, but it’s how I felt.

I can’t do this.  I can’t eat this much.  If I need to keep testing in the night how will I sleep? This is ridiculous.  I’m never going to manage this. I can’t do this.  I’m NOT doing this. Will people stop talking about Golf! Why is everyone playing Golf?

I’m cycling to Paris.

No. No I’m not!

I can’t be here, I need to leave.  Oh no, don’t cry. You never cry, well not in front of others.  DO. NOT. CRY.  I can’t breathe. Get out now.

Cue the fight or flight response. “Sorry I have to leave, I thought the session finished at 4pm?” A little lie never hurt anyone right?

Through teary eyes I drove home.  I could not see properly, could not breathe properly.  I was a full on blubbering mess.  It was at this point I really began to fear this crazy challenge.  It’s just too much for me right now.  Irrational Kelly arose and I began to wonder how to tell everyone I would not be coming. I didn’t want encouraging messages. I just wanted to say, sorry but count me out of this.

A call from my DSN, June, within an hour of me leaving, (turns out I don’t hide my emotions too well even when I’m not talking). I had managed to discuss my worries and arrange a 1:1 with my Penny.

Here is the link to a small blog I wrote at the time of this minor blip.

Taking some time

It all seems a bit of a blur now, but as you have already seen I didn’t change my mind, back out of it.  Thank goodness I didn’t!

My first bike ride, the very first time I took my pearly white bike out, we cycled 27miles! I had been out the night before so had very little sleep, was ever so slightly (OK quite) hung over.  Poor Lauren and I had not even cycled before (only short rides). Yet we managed it.  We certainly showed we are tough cookies.  I must admit though it hurt to sit down for a few days, even walking was a challenge! If we could manage this I knew we could do it.

I just needed to learn how to manage my BG.

 

Our first group ride 01/04/16 – a somewhat hung over & tired Kelly

 

 

Pearly white handle bars

 

Learning how to manage my BG took a lot of trial and error, perseverance and determination.  I had to remain focused and committed throughout and ensure that I engaged with June & Penny as much as possible (sorry, I know I took up so much time!)

Many a hypo’s were had, which at times felt very deflating.  Knowing I had tried so hard to avoid them.  Then there were the hypo’s that appeared 12hrs/48hrs/72hrs post exercise. To start with I thought, yay you’ve nailed this, then the crazy hypo would appear 72hrs post bike ride.  These hypo’s were often ones that happened quickly, no symptoms until I just felt a little uneasy and nauseous. Test – 2.1. WHAT!

Then there was the overwhelming feeling of nausea. During a bike ride with Amanda I thought I was going to be sick, even thought ‘I don’t actually have time to stop.’

This isn’t a graph from cycling, unless I sleep cycle?!?

Through the use of a Libre I soon established that this was a symptom of rapidly dropping BG levels.  This happened to me on a few occasions, mainly when cycling uphill.  One of the group training rides we cycled up this mammoth hill. Like literally, it went on forever.  Honestly!  I actually thought I was cycling to the clouds until the feeling of nausea appeared. BAM! ‘Stop Kelly, Stop. Where are the bushes. Do not vom on yourself.’  I didn’t want Maggie to see me being sick so told her to go on.  I knew I wouldn’t be hypo as I have always caught the drop.  But not this time. 3.5 and dropping. Thank goodness Maggie stayed back with me. Slightly embarrassing but Maggie reassured me that we are doing this as a group and will stop as a group.

 

 

Looking back, all these lovely comments really helped me and also showed me the type of person it takes to not only be a great DSN but a truly kind and caring friend.

 

With all the challenges faced I still managed to persevere and started to learn what I needed to eat and how to adjust insulin to avoid major impacts on my BG. Wearing a Libre at times really helped me see patterns, the impact exercise had during and after and establish how many jelly babies were needed to keep me going during long distance rides. This also helped my DSN & dietitian to suggest changes in food consumption and insulin levels. As a team I must say I was starting to feel safe and ready to do this.

I met with Penny many of times. Each meeting Penny would write everything down for me including how much carbohydrate to have before, during and after a planned bike ride. How much protein to have to aid muscle repair. What times to eat. How much to reduce my insulin by. These little notes helped as I could look back and remind myself what to do. All of a sudden it didn’t seem so over whelming. I finally started to absorb everything Penny was telling me. I had this. I can do this. I just needed to remember to eat more! Thanks to Amanda, aka Bruce, I was always prompted to eat cereal bars during our bike rides even if I was reluctant to do so.

A few weeks before setting off to Paris I went for a bike ride with some of the group. My BG remained stable throughout. I had nailed it! Yet by the time I had driven home my BG had spiked and was on its way up. This is something I had never experienced before. My BG had always dropped low. What do I do?? Again this was a different challenge and with my new confident exercise and diabetes management I found a way to start working with the high BG.

 

Within 6 months I had managed 20 long distance bike rides and approx. 10 short distance ones to and from work. 20 really isn’t that much but it turns out it was enough to get me from London to Paris!

 

Where it all began – 07/11/2015

I remember heading back from the Diabetes Quality In care awards in October 2015 and discussing with Laura how I would like to do a charity bike ride. Laura suggested we should meet up, she only lives two minutes away from me, and go out on our bikes. My response “I don’t actually have a bike.” There goes that idea!

But I still wanted to do a charity bike ride, it would be a challenge.  I do love a challenge! I sent a little email out, not really expecting much interest.  What harm would it do asking some local diabetes health care professionals?  The likelihood is that most will say no, some will agree but actually not commit and therefore within a year I would still be sat pondering what to do

HOW. WRONG. I. WAS!!

Email sent 07/11/2015 – “I am arranging a charity bike ride next year, hopefully London to Paris (or something similar). This will be self-organised……Would anyone in your team be up for the challenge?!? ….”

After a few emails, a group of us who were keen to take part met on 7/12/15 in a local pub to go through the plan.  I must admit I was unsure if they really wanted to do this and doubted how dedicated they really were.  I also didn’t know some of them. Those I did know, I didn’t know that well (poor grammar, but c’mon I’ve just cycled to Paris!)

Before I knew it Christmas had passed and it was time to book the ferry to Dieppe. Cabins were being booked quickly and I was worried we would not have anywhere to sleep apart from the floor, maybe out on deck? The thought of sleeping out on deck though…..nope STOP thinking! There were approx. 11 of us who had agreed to take part, so I envisaged 6-8 of us booking onto the ferry. Wrong again! After a very panicky morning, I spoke with a lovely lady who managed to release a further fifteen foot passenger/bike spaces and the panic was over.  Wow, 14 of us booked onto the ferry!

Is this actually happening, for real?? I have to go through with this now, I’ve paid for my ferry journey from Newhaven to Dieppe.

It seems so easy. London to Paris here we come!

Yet the reality of it all began to dawn on me.  The whole point of this charity event is to CYCLE to Paris. I didn’t even own a bike. *Poor student alert!* I couldn’t even afford a decent bike.  Luckily for me I received a rather large refund by a utility company which meant I could buy a half decent bike. Yay!  Let the bike shopping commence. So many to choose from.  All the pretty ones are out of my price range or not suitable for what I needed.  Luckily Kev provided much advice and help and steered me away from the pretty, non practical bikes.

Why can’t I have these Kev, why?!?

 

Finally in March 2015 I became the owner of this beaut.

Practical and light.  Added bonus, I love the colours! Many thanks to Cycle world in Romsey for selling to me at a discounted price after establishing what the bike was for.

Now the bike crisis was adverted it was time to start cycling. I. DON’T. HAVE. TIME. Like seriously how can I fit in cycling on top of essays, exams, placement, working, living…yes living. Wow I really do need to block time out in my diary. I have plenty of time though. 6 months is plenty of time!

Hang on, I think I have forgot something? I’m sure there is something I really need to work hard on, just to keep me safe and well. Just to make sure I can actually mange this bike ride. Yep, I’ve got it. That will be the type 1 diabetes. It was time to start learning about managing my diabetes with exercise. The impact exercise has on me (totally unfit). The impact it has on my blood sugars. The impact my blood sugars will have on me. What food I need to eat and drink. Foods to avoid/minimise.

Oh man, did someone say this will be easy!?!

 

Frio visits Croatia

The lovely team at Frio sent me some products to try which I took along with me for my little adventure to Omis, Croatia. A stunning fishing village. Yet we had not planned for the cold and wet weather! That certainly did not stop us from having the most amazing time. I love these ladies so much and look forward to our next adventure, maybe with a new addition too 😉

I had used a frio wallet when I travelled to Cyprus and loved it so much I knew I would be making further purchases. So was super excited to be able to try the new products. Unfortunately I was unable to put these to full use due to the lack of sunshine. However our last day the sun was shining and we even managed to watch the dolphins elegantly jumping out of the water making their way past our amazed faces. The gorgeous Frio tagged along to the beach with us.

So what is Frio? Frio products help to keep medications cool. For me this is a must have for my insulin. I am hoping I can use these when summer arrives. Oh wait, it is British summer time now right? Maybe these little beauties will get full use next summer? Unless anyone wants to take me on holiday, just somewhere hot and luxurious….I will await replies (or even set up a separate email? I’m sure I will be inundated with offers…….)

O.K. Getting back to Frio.

Aztec mini

This product is light and compact, the perfect companion, cool and trendy, for my insulin pump to hideaway and sunbathe next to me. My insulin pump fits nicely in this small zipped purse. I am hoping that when I do manage to hay a lay in the sunshine. It was also handy to pop my inhaler in here too (not with the insulin pump)

Medications and cosmetics cool wrap

I literally love polka dots. Spots & stripes, my fave! So instantly fell in love with this wrap. The FRIO Wrap was able to hold spare pens, test strips and other essentials. Perfect travelling companion. Looking forward to be able to use this when I head to my next sunny destination. I also used this to pop some make up products in, lip gloss of course!

The wrap has 12 sections in total, 6 on each side, of varying sizes to be able to hold different items. An absolute must have!

Medication purse

 

Did I mention I love polka dots? This will be ideal to take out during the day with insulin products, or other items that need to be kept cool. Not only is it ideal for medication, my phone, bank cards and make up fitted nicely in here.

 

Final verdict: WINNER!

Frio website http://friouk.com/

Twitter – @FrioUKLtd

Disclaimer – I was not asked to write a blog about these products. I was provided them to review and offer feedback. All views of these products are my own views.

 

L2P training 12/06/16

London to Paris (L2P) training

NB. The information regarding dietary intake and insulin ratio’s are personalised for me and should not be followed by others.  All advice and changes to insulin and dietary intake must be provided by your health care professional.

27.5mile ride planned for 1.30pm.  A polite request to Mr weather man …..please hold the rain until we get home…PLEASE

Aim – to maintain a nice steady blood glucose level. Yeah right, when does that ever happen! Oh, hang on…it once did…back when my pancreas was fully operational.        OK so the real aim is to prevent or even reduce the number of hypos during and post bike ride.

Plan

My actual plan

12pm – 2xtoast, 2xeggs = 38g

Normal bolus (forgot to reduce!)

Temporary basal rate (TBR) 70%, (30% reduction of normal basal insulin), for 5hours. This should cover the ride and ….ops, will need to extend to cover 2hours post cycle. Will do this once I’m home.

Things to take. 2 water bottles, 1x500ml water. 1x500ml isotonic sports drink (1/3^rd of the drink every hour will help….but I don’t have any more space for another bottle!). 250ml juice carton. 130g bag jelly babies. 1 banana. Think I may get myself a little (large!) basket to carry everything I need!

Due to repeated hypos this week, 3-5 a day, I think it may be wise to take glucagon injection JUST IN CASE. Being in the new forest It could take a while to get help if needed, or even have any phone reception, and as much as I love Donkeys I’m not sure they will be able to help me!

Must remember to have extra carbs before ride!

Must remember to eat carbs after ride. 50g carbs. 20g protein.

Must remember a snack pre bed ….do I bolus for this? I’m sure I do. I think I do. Oh sod it I will and just hope for the best.

Must remember to reduce basal overnight. Previous ride, same route, caused multiple night hypos which resulted in lack of sleep and a very tired and cranky Kelly.

Breakfast following day – reduce bolus by 30%. Cancel TBR

End result………

To be continued………