Sunday, 29 December 2013

Top 20 of 2013


I've given up on writing a new intro for this post as last year's is fine so I've lazily lifted it and reposted here...

So below is my Top 20 of 2013.  A few words before you continue...

You won't agree with me.  Some of you will think I'm pretentious for including a raft of songs you've never heard of.  Some of you will think I'm too 'mainstream' in my choices.  Some of you will think this is a massive exercise in showing off.  And that's fine.  My opinion is no better or worse than yours and my choices are no more or less valid than yours would be.  This is just my opinion - you might not like it but I can't help that.  But before you grumble to yourself or tell me I'm an idiot, try and do this yourself.

The "rules" are simple - any song that has been released (as a single, on an album or even as demo/give-away) is eligible to be included.  Pick 20 that represent your favourite and don't include more than one per artist.   I added a rule of my own where I'd limit myself to maximum one choice where collaborations had occurred.  So for example, both Arctic Monkeys and Alex Turner individually made the 2011 Longlist but I would limit myself to a choice from one.  This is only to add variety.  You can find the Top 20 of 2011 and the Top 20 of 2012 by following the links.

The list presented below is given as Track name - Artist (Album).  They are not ranked in order of preference or greatness but rather the order in which I personally think they make a good playlist.  I'd love to hear what you think so get involved in the comments or tweet me @BroooOwl and tag your posts #top20of2013

1.  Jubilee Street - Nick Cave & The Bad Seeds (Push The Sky Away)   There are a few albums from this year where picking one song above the others is a really tough ask, and the latest offering from Nick Cave is one of those albums.  This was one of my early favourites and so just edged it, but Mermaids or Higgs Boson Blues could have edged it.  Great tune to start things off.

2.  Picasso Baby - Jay Z (Magna Carter Holy Grail)   Probably one of those tracks/artists that you either love or hate which is a perfectly reasonable point of view.  I think MCHG is a pretty solid album but I particularly love this one.  If you have the time to spare, watching this YouTube video where Jay Z talks about music as art is well worth 11 minutes of your time

3.  Diane Young - Vampire Weekend (Modern Vampires of the City)   Vampire Weekend are one of those bands that I love for a multitude of reasons (off the wall lyrics, unique sound, incredible vocals) and whilst there new album didn't quite hit the same heights for me as the previous two, this is incredibly catchy

4.  Best Of Friends - Palma Violets (180)   Guitar music at some of its best, great music and catchy lyrics you can't help but sing at the top of your voice.  A great summer tune to have blaring out in the car with all the windows down.

5. Love SpellsBleached (Ride Your Heart)   I can't remember where I heard about Bleached from but this album is one of the catchiest I've heard all year.  This is another one where there are a bucket-load of summery songs to go through.  It's all very familiar sounding music but that's definitely not a bad thing.  Love Spells is my favourite off the album.

6.  Falling - Haim (Days Are Gone)   I'd venture that it's likely you've only not come across Haim if you've been living under a rock or something similar this year.  A rare album where the Hit Parade and I agree - a belter from start to finish.  I could have probably picked any track to make the final 20, but this is my favourite.

7.  Please Don't Say You Love Me - Gabrielle Aplin (English Rain)   I picked this up fairly late in the year but I struggle to get this tune out of my head once I've listened to it (and not in a bad way).  I also really liked November from the album so if you like this, I'd check that out too.

8.  Strong - London Grammar (If You Wait)   Another album I didn't get round to until about November time for some reason or other.  I watched them perform on Later... on BBC2 and was immediately sucked in.  Strong has an odd blend of a Florence & The Machine mixed with Massive Attack that's a bit too difficult to explain.  Definitely one of my favourite tracks of the year without a doubt.

9.  Color Yr Lights In - The Besnard Lakes (Until In Excess, Imperceptible UFO)   A strange one this.  Most of the album can pass you by quite easily unless you're specifically listening to it and doing nothing else.  The first time I listened to it, I was preoccupied with other things until this track came on, when I stopped everything.  It's probably a good album to have on late at night, but this song is really good.

10.  Pink Rabbits - The National (Trouble Will Find Me)   This is definitely in my top 5 albums of the year - it's brilliant from start to finish quite frankly.  Pink Rabbits is basically some of the best lyrics you can imagine, stitched together with some wonderful piano (which I can't seem to learn).  I can't urge you strongly enough to listen to this one.

11.  Waiting On The Doorstep - Filthy Boy (Smile That Won't Go Down)  I'll be up front and say that this is what you'd class as a but of a "comedy" song which normally wouldn't get a look in on a list such as this.  The problem is that this is so funny and catchy that you'd can't help yourself.  I wouldn't necessarily recommend it for children but give it a listen - I'll say nothing more so I don't spoil it.

12.  Van Der Graff - Courteeners (Anna)  Anna is (in my humble opinion) a much improved effort compared to the Falcon album of 2010 which is a good start.  Sadly it does tail off a little after the first half for me but the opening tracks are Liam Fray at his best.  Van Der Graff's lyric about "splitting up like the A57" is fantastic and I do love this song. 

13.  So Good At Being In Trouble - Unknown Mortal Orchestra (II)   I heard this very early on in the year and I've played it for just about everyone I've talked to about music since.  The album is good too but there's something so funky about this track that I really love - soulful and laid back is how I'd best describe it.

14.  You Can't Judge A Book By It's Cover - The Strypes (Snapshot)   If you like raucous guitar music then The Strypes are definitely for you.  The album has a bit of a 1950s feel to it in places which is frankly wonderful.  Again, I struggled to pick a track for the shortlist but this one is pretty simple, and simple is often the best.  Great song.

15.  Cut Copy Me - Petula Clark (Lost In You)   It came as a bit of a surprise to me that Petula Clark was still recording anything to be honest.  The album is a.... bit of an assortment I think.  Hearing an 81 year old covering Gnarls Barkley isn't an everyday occurrence (and not something I'd necessarily recommend) but Cut Copy Me is fantastic.  Next To You is also a great track (and sounds oddly like a Eurovision entry) and also worth a listen.

16.  Breakfast At Sylvia's - Skint & Demoralised (The Bit Between The Teeth)   It greatly saddened me to hear that Skint & Demoralised won't be recording albums after this, the third and final installment.  I think the third album is the best they recorded and whilst Breakfast At Sylvia's may not technically be the best track on the album (the sheer passion and honesty in Amores Perros probably takes that title), I do love it and it's one of my all time favourite Skint & Demoralised songs.

17.  Happy To Stay - the Michael Ainsley Band (Cyclone)   I've seen the Michael Ainsley Band a few times this year, doing support at local venues in Wakefield.  They've got a pretty catchy repertoire which is no bad thing either.  Happy To Stay reminds me a little of some early Green Day (not sure if that's what they were going for but it's nothing but a compliment).  A great song to jump around to.

18.  Further Away (Romance Police) - Lissie (Back To Forever)   Lissie's album is quite frankly brilliant and it's matched by her live performance.  I saw her in Manchester this year and I've rarely seen anyone perform with as much passion as she did.  The title track to this album is exceptional but it's just edged out by this.  The guitar solo reminds me of Fleetwood Mac (though I'm sure someone would tell me I'm mistaken)

19.  Better Than That - Miles Kane (Don't Forget Who You Are)   Another entry for anthemic guitar music which is no bad thing.  This album has some absolute belters on it but this one stands out just above the others for me.  The lyric "Maybe it's the time and place / Or maybe it's your stupid face / That's turning me on" is a particular favourite of mine.

20.  Snap Out Of It - Arctic Monkeys (AM)   Another year and another Arctic Monkeys track on the shortlist.  I think this year it'd be difficult to accuse me of local bias as AM is, by general consensus, the album of 2013.  I'll save my gushing praise and let you read any of the reviews (or better, just listen to it!) before you make your mind up.  As with Nick Cave and a few others, it was almost impossible to pick a favourite off AM.  I was mostly torn between No 1 Party Anthem and this tune, but because I sing this one with my daughter, I've decided to pick this.  Definitely the toughest choice of the whole shortlist.

As with last year, there's some music I've been disappointed in and some other good albums that didn't make the cut.  Kurt Vile's new album fell a little short of my expectations following the debut offering of Smoke Ring For My Halo in 2011.  Don't get me wrong, it's not bad, but I just maybe expected too much.  Kanye West's album grew on me the more I listened to it, but still fell a little short for me.    Daughter missed the final 20 by a short length, as did Yeah Yeah Yeahs with Sacrilige.  And for some pop whimsy, check out Cody Simpson's La Da Dee (from Cloudy With A Chance of Meatballs 2).

The "award" for my Album of the Year this year goes to Arctic Monkeys.  AM is a superb LP in my opinion.   This is the link to the Google search for "AM Review" - pick one at random and read it.  And then listen to the album again and again and again.

I've added another new category for 2013 which is Live Performance Of The Year.  If I'd not been criminally ill on the night of the AM gig (something I don't like to talk about), I suspect Arctic Monkeys would have been walking away with this one too.  As it happens, seeing Nick Cave & The Bad Seeds at Manchester Apollo completely blew me away so I think they win hands down.  You must try and see them if you get chance,

If you made it this far, then thanks for reading.  Hopefully you'll find something new you've not heard before.



Saturday, 7 December 2013

Peer Support

There should be little doubt that living with diabetes can sometimes be difficult to the point of making you feel overwhelmed.

Having a good support network is key to helping you manage the times where you feel like you're not sure where to turn or what to do for the best.  Many of us are fortunate enough to have a group of close friends or a supportive family to help us when we need it; to listen to our problems and offer a sympathetic ear.

Some people are a little less fortunate or may even feel worried or embarrassed about revealing a particular problem or concern to someone they have a close relationship with.  In these cases, Peer Support can be an effective tool for people with diabetes.

Peer Support is an incredibly valuable service that's run on a purely volunteer basis aimed at providing anyone affected by diabetes, whether it's you with the condition or you're a parent or carer for someone with diabetes.  All volunteers go through training provided by Diabetes UK to ensure they're able to listen to whatever you have to say and provided support, advice or guidance wherever possible.  Anyone can get in contact via phone or e-mail and you can read more about it on the Peer Support page

Recently I've become involved, along with another volunteer Louise, in a new strand of localised Peer Support that is being piloted by Diabetes UK.  The overall aim is to be able to offer the same Peer Support service described above, but also offer informal support in a more social environment on a group or face to face basis within our own local areas.

Louise and I are offering Peer Support through a number of different mediums (Twitter, Facebook, and via a shared blog) as well as looking to utilise the Diabetes UK forums if at all possible.  That support will be open to anyone who feels like they need to get something off their chest, just needs someone to listen or simply needs pointing in the right direction for some support or advice.

On a local level, we're hoping we can promote the service by getting local doctors and healthcare professionals on board and by asking our diabetes specialist teams to make sure everyone in hospital clinics knows what we have to offer.  As interest hopefully grows, we'll be looking to arrange informal meetings for people to get to know each other.

Our new Peer Support work hasn't been going very long but it's starting to gather momentum and the more we can spread the word, the more we'll be able to help people affected by diabetes with anything they might need.

Louise and I aren't experts with years of medical training, but we do have a wealth of experience in living with diabetes and know that sometimes, having someone who's able to listen will do you the world of good.

If you want to find out more about what we're hoping to achieve, please visit our Peer Support Blog which also details how to get in touch with us by e-mail.

You can also connect with us in the following ways:

Andy (Sheffield area)

Twitter:  @AndyPeerSupport

Louise (South East)

Twitter:  @LouPeerSupport

If you've got something that's been troubling you then please consider using Peer Support as a means of unburdening yourself.  We use the hashtag #talktosomeone on Twitter so if you need help, support or advice then do Talk To Someone.

Important: All Peer Support volunteers have been through training and checks to ensure you're always discussing any issues in a safe environment.  Your details will be kept confidential at all times.

Friday, 6 December 2013

Top 20 of 2013 - The Longlist


Its that time of year where I start reviewing the new music I've listened to over the past year.

If you're not too familiar with the approach, you can see the 2011 Longlist and 2011 Shortlist posts by clicking the links.  The 2012 Longlist and 2012 Shortlist are also here if you fancy reading!  Basically anything which has been released since Jan 1st 2012 is eligible.  I've narrowed down about 45 albums and EPs to a Long list of about 90 tracks.  I'll then go through and select a Top 20 of 2013.

It's a good way to review the year and find some new music along the way.  Hope you enjoy.



Artist Album Track
About Group Between The Walls Walk On By
About Group Between The Walls All Is Not Lost
About Group Between The Walls Untitled
Arctic Monkeys AM No 1 Party Anthem
Arctic Monkeys AM Snap Out Of It
Arctic Monkeys AM Arabella
Arctic Monkeys AM One For The Road
Bleached Ride Your Heart Looking For A Fight
Bleached Ride Your Heart Outta My Mind
Bleached Ride Your Heart Dead In Your Head
Bleached Ride Your Heart Love Spells
Bromheads Choro Winnebago
Charlie Boyer & The Voyeurs Clarietta Things We Be
Courteeners Anna Are You In Love With A Notion?
Courteeners Anna Van Der Graff
Courteeners Anna Marquee
Daughter If You Leave Youth
Daughter If You Leave Still
Dutch Uncles Out Of Touch In The Wild God Boy
Esben & The Witch Wash the Sins Not Only the Face Shimmering
Esben & The Witch Wash the Sins Not Only the Face Deathwaltz
Everything Everything Arc Kemosabe
Filthy Boy Smile That Won't Go Down Waiting On The Doorstep
Filthy Boy Smile That Won't Go Down That Life
Filthy Boy Smile That Won't Go Down Charm Of The Dangerous Minx
Gabriel Bruce Love In Arms Greedy Little Heart
Gabriel Bruce Love In Arms Zoe
Gabrielle Aplin English Rain Please Don't Say You Love Me
Gabrielle Aplin English Rain Alive
Gabrielle Aplin English Rain November
Girls Names The New Life Pittura Infamante
Girls Names The New Life Drawing Lines
Haim Days Are Gone Falling
Haim Days Are Gone If I Could Change Your Mind
Haim Days Are Gone Forever
Jay Z Magna Carter Holy Grail Picasso Baby
Jay Z Magna Carter Holy Grail Holy Grail
Jay Z Magna Carter Holy Grail Part II (On The Run)
Joe Gideon & The Shark Freakish Snake Candy
Joe Gideon & The Shark Freakish You, The Pole And The Rastafarian
Kanye West Yeezus Bound 2
Kurt Vile Wakin in a Pretty Daze KV Crimes
Lissie Back To Forever Back To Forever
Lissie Back To Forever The Habit
Lissie Back To Forever I Don't Wanna Go To Work
Lissie Back To Forever Further Away (Romace Police)
London Grammar If You Wait Strong
London Grammar If You Wait Darling Are You Gonna Leave Me
Mazzy Star Seasons Of Your Day Flying Low
Michael Ainsley Band Cyclone Happy To Stay
Miles Kane Don't Forget Who You Are Better Than That
Miles Kane Don't Forget Who You Are Taking Over
Miles Kane Don't Forget Who You Are Don't Forget Who You Are
Neko Case The Worse Things Get, The Harder I Fight, The Harder I Fight, The More I Love You Night Still Comes
Neko Case The Worse Things Get, The Harder I Fight, The Harder I Fight, The More I Love You Local Girl
Nick Cave & The Bad Seeds Push The Sky Away Jubilee Street
Nick Cave & The Bad Seeds Push The Sky Away Higgs Boson Blues
Nick Cave & The Bad Seeds Push The Sky Away Mermaids
Nick Cave & The Bad Seeds Push The Sky Away We Real Cool
Palma Violets 180 Best Of Friends
Palma Violets 180 Step Up For the Cools Cats
Parquet Courts Tally All the Things That You Broke You've Got Me Wonderin' Now
Petula Clark Lost In You Cut Copy Me
Petula Clark Lost In You Next To You
Public Service Broadcasting Inform Educate Entertain Spitfire
Public Service Broadcasting Inform Educate Entertain Theme From PSB
Public Service Broadcasting Inform Educate Entertain Night Mail
Serafina Steer The Moths Are Real Lady Fortune
Serafina Steer The Moths Are Real Disco Compliation
Skint & Demoralised The Bit Between The Teeth Amores Perros
Skint & Demoralised The Bit Between The Teeth Breakfast at Sylvia's
Skint & Demoralised The Bit Between The Teeth When Saturday Comes
Stereophonics Graffiti On The Train Indian Summer
The Besnard Lakes Until In Excess, Imperceptile UFO Color Yr Lights In
The Julie Ruin Run Fast Just My Kind
The Julie Ruin Run Fast Party City
The National Trouble Will Find Me Pink Rabbits
The National Trouble Will Find Me Hard To Find
The National Trouble Will Find Me I Should Live In Salt
The Strypes Snapshot Blue Collar Jane
The Strypes Snapshot You Can't Judge A Book By Its Cover
The Strypes Snapshot Hometown Girls
Unknown Mortal Orchestra II So Good At Being In Trouble
Vampire Weekend Modern Vampires of the City Diane Young
Vampire Weekend Modern Vampires of the City Obvious Bicycle
Vampire Weekend Modern Vampires of the City Unbelievers
Yeah Yeah Yeahs Mosquito Sacrilige

Wednesday, 13 November 2013

Divided and United

This blog was first published on the Diabetes UK Blog site in November 2013

Despite being a member of a "club" along with about 4 million other people in the UK, having diabetes is a very individual thing.  The intricacies of the treatment varies from person to person (think insulin to carb ratios) and some will have symptoms that others don't (e.g. hypo awareness).

How we each manage our own conditions, and everything else that comes with it, is a very personal thing to us.  The people we interact with and discuss our daily highs and lows (pun not intended) is also an individual thing.  Some choose to talk openly to the #doc (diabetic online community), others attend local meetings and some may only share with their nearest and dearest.

Despite the myriad individual things that set us all apart from other diabetics, I recently realised that there are a lot of things that do unite us.  I think it probably helps to remember when we're having a bad day that there's someone else who's been through the same things we have, and that should make us feel a little less alone in the universe.  What follows is a list of things that I think we've all done or experienced at some point in our diabetic journey (the list is a little Type 1 specific as I'm speaking from experience, but I've tried to include the Type 2 ones I've discussed with others)

  • Being told "you can't eat that" or "should you be having that?!"  
  • Testing your BG only to get a reading in the 20s that you can't possibly explain
  • ...and conversely, getting a low BG reading when you have no hypo symptoms
  • Writing down your insulin dose in a diary but forgetting to actually administer the dose (really hoping that's not just me!)
  • Waking up in the middle of the night and losing an hour of precious sleep to deal with a hypo
  • Hearing that you have the "naughty" type of diabetes (something I've heard said to Type 2s a few times!)
  • Concocting an elaborate excuse ahead of annual review time to explain a wayward HbA1c
  • Having a particularly bad day where you end up saying "sod it, I'm having chocolate"
  • Stacking insulin doses so you end up with low blood sugar
  • Having a BG reading that's either so high or so low that you do a double take on your meter
  • Wasting a test strip because you don't get quite enough blood on the end
  • Being slightly irritable and having someone tell you to test your BG because they think your sugars are too high/low
  • Getting blood on your clothes after a bolus injection or a cannula change
It's obviously not a comprehensive list but hopefully it does illustrate that whilst we have our own individual plans for dealing with our diabetes, there are some moments we all share.

It can be hard to feel like you're always in control of every aspect of your diabetic life and it can be quite easy to feel like you're the only person in the world who is struggling with something.  Hopefully you might recognise a few of the things from the list above and realise that while we're all individual, we're also all united by the same things that diabetes forces upon us every day.

Can you think of any I've missed?

World Diabetes Day

Tomorrow (Thursday 14th November 2013) is World Diabetes Day (WDD for the sake of my typing).  It's going to be the first time I've "celebrated" it and I've been thinking about what it really means to me.

The short answer is "I don't know".  I've been diabetic for 12 years now and truth be told, I've only known about WDD for a couple of years despite it having been running since 1991.  Those with curious minds can visit the International Diabetes Federation website to find out a bit more about it and the significance the date holds.

Obviously I'm all for anything that helps promote awareness of diabetes and the various difficulties it brings.  There's without doubt a certain stigma that comes with it as many people are unaware of the different "types" of diabetes and the different causes/effects of each.  Again, I'm not going to shove the information down your throat, but Diabetes UK have a pretty quick and effective guide to Type 1 and Type 2 diabetes if you're interested.

I've done a fair amount of work over the last 12-18 months to help fundraise and awareness on behalf of Diabetes UK (thanks to everyone who's supported me in those ventures) but I'm still unsure of the best way to "mark" the day, or whether I need to mark it at all.

I've got some great friends within the Diabetic Online Community (#doc) as well as some great relationships I've formed with people I've met via hospital courses or through my local Voluntary Group.  I'm sure tomorrow will be like many others in a lot of respects in that I'll experience a few highs and lows (physically, metaphorically and blood glucosely) and that I'll chat some of the same nonsense I always do.

After a little contemplation, I decided that I'll rock up to work in a blue shirt and tie (repping the IDF colours) and that I'll try and "live tweet" my day as a Type 1 diabetic.  I'll post my blood glucose readings, my meals, my carb calculations and some of the emotional responses that a "typical" day with diabetes can elicit.  (There's a lot of talk around the associated mental health problems people with diabetes can face that you may not be aware of).

If you want a snapshot into the world of a diabetic, or might know someone else who'd be interested, you can follow me on Twitter at @BroomOwl I'll do my best to tag my posts with #WDD and #DILOD (Day In the Life of a Diabetic) depending on character limits and all that.

I suppose tomorrow will be a chance to reflect and be thankful that whilst having diabetes can suck some of the time, I'm lucky to be alive in a time where modern medicine means I've got a pretty decent shot of living with it for years to come.


Wednesday, 16 October 2013

Tightrope Walking

I'm just back from my annual review and felt compelled to write a just-for-me blog for the first time in a long time.  What follows is pretty much a "stream of consciousness" affair (though I'll be scanning it to make sure it makes sense).  It might feel like a mish-mash of previous blogs I've written, so for any regular viewers out there, apologies in advance.  By the end, I'll hopefully have done a decent job at articulating my inner voice.

Thanks for reading.

In the last couple of years, I've started to look forward to my annual review rather than dread it in the same way a school boy who's forgotten his homework again.

Gone are the days where I'd spend hours thinking up excuses for why my weight, blood pressure, HbA1c and any other measure you care to mention were all going in the wrong direction.  Now I'm in a place where I feel educated enough to spend one of my bi-annual 15 minute slots, discussing my diabetes, any of my problems or concerns and feeling like part of a conversation instead of a lecture.  This is, of course, a good thing.

However, what I can't seem to shake is that feeling of despondency as I trudge through a maze of hospital corridors out into the rain and back to my car.

Once upon a time, I'd leave feeling guilt ridden and angry at myself.  It got to a point where a consultant pulled out a graph and said "If you don't change what you're doing, this [pointing at said graph] is when your kidneys will start failing".  I wondered what the point was.  Why was anyone wasting their time on me if I couldn't be bothered to look after myself?

Now it's a different story.  Today I left feeling frustrated because I was convinced I'd finally cracked it and that it'd be a bit of a chat, usual questions and checks and I'd be on my way.  Not so.  Today my consultant (who is without doubt, bloody wonderful), looked at the download from my BG meter and gave that intake of breath through clenched teeth that consultants do and said "look at all these low readings.  I'm worried you'll lose your hypo awareness".

Now before I continue to wallow in my hole of momentary self pity, I will say that, of course, she's right.  That is a concern, and losing my hypo awareness is one of my biggest diabetes fears.  Basically anything you can prefix with "losing" scares me.

Back to my hole... living with diabetes is tough.  Not some of the time - ALL of the time.  I've had it 12 years and it still kicks my ass.  I guess my consultant has a privileged view in some sense as she can look at 3 months worth of data and see the patterns quite easily.  I write my BG levels down but I've got a bit lazy at looking for patterns I suppose.

The thing is, high numbers worry me.  I know that a lot of high numbers will start to eat away at me and if I can't make them go away I'll feel like I can't look after myself and I'll give up.  I've done it before and it didn't work out well.  I'm always more likely to go slightly over on my insulin calculations to err on the side of caution because I know it's less likely to lead to a high reading later on.  I'd rather have a low reading than a high one (to which my consultant nodded along sympathetically).

I've previously likened having diabetes to walking on a tightrope.  Managing it needs a lot of skill and concentration and you need to consider what you're doing all the time.  If you lose focus you start to wobble and if you wobble too much you'll lose control completely.

It's easy to cry "no fair" but life isn't fair and I'm not 13 years old any more so I'm not taking that option.  I'll keep doing what I've always done - live and learn.  There's no silver bullet to make any of these problems go away and so I'll refine my own care and keep working at understanding how my body reacts to this enigmatic disease.  As I've said before, diabetes isn't who I am, it's just one small part of me.  Sometimes it needs more attention than others but if I'll carry on working to keep the disruption to a minimum.

Friday, 11 October 2013

Mental Strength

This blog was first posted on the Diabetes UK blog site

When discussing diabetes, it can be quite easy to revert to familiar topics depending on who you speak to. Talking to other people with diabetes can lead to trading war stories about particularly unpleasant hypos or serious hospital stays as well as what type of therapy they use to manage their condition. Talking to people who don't have first hand experience of diabetes can turn into a discussion about being type-aware or explaining (for what may feel like the millionth time) that yes, you can have a biscuit/chocolate/piece of cake without needing serious medical attention.

What doesn't get possibly as much discussion are the mental aspects of having diabetes. I'm by no means an expert but I think it's important to make time to give these 'hidden' aspects as much consideration as other factors.

I think it can be quite easy to bypass how you feel about having diabetes because living with it becomes such a normal part of your day, you don't necessarily stop to think about it.

What prompted me to consider this quite recently was the set of forms I received as part of my REPOSE 6 month follow up. The premise is quite simple - you're faced with a number of statements and asked to score them on a scale of 1-5 based on your experiences over the last 4 weeks (e.g. very likely to very unlikely, extremely important to totally unimportant etc.)

That sort of process in itself isn't anything new, but what it does offer is a chance to reflect on those moments when you might have felt sad, angry or frustrated and not consciously understood the reason why.

Some of the questions are quite generic and deal with how you rate your quality of life overall, how you feel on a daily basis and so on. Others ask you to consider how living with the specifics of diabetes affects your relationships with the people around you and your day to day activities or future ambitions.

Whilst I wouldn't dream to speak definitively for anyone else, I'm sure that at some point, many people with diabetes have experienced some sense of anger or frustration that relates to their condition and I know I certainly have. What I don't tend to do is reflect on those feelings and either rationalise them or find someone who can help me with them.

If I were to ask you how much you feel burdened about having to think about your nutrition or how frustrating you find the fact that others don't understand your treatment, you might not give them too much thought. Hopefully for the vast majority of people, such things really aren't factors in your day to day life. However, for some people, struggling through on new regime of insulin therapy or coming to terms with a recent diagnosis can leave them feeling stranded and alone.

Whether you've been diabetic for 12 weeks for 12 years, you're bound to go through difficult times at some stage and but it's being able to manage them that is important.

My lowest point came after about seven years after my diagnosis (I'll have been a fully paid up member of the T1 club for 12 years in October). I got to a point where testing my BG and seeing constantly high numbers would make me feel depressed so I stopped testing regularly. I don't mean that I'd test once a day, I'd be lucky if I tested once a week. As a result my HbA1c rose steadily and I was going to 6 monthly hospital reviews armed with more and more constructive excuses and promises that things would be different next time. I'd be economical with the truth with my family because I felt ashamed I wasn't looking after myself when really I didn't want to admit that I either felt too exhausted to do it, or I couldn't remember how. This continued for about 18 months before I eventually came clean and with the help of my wonderful wife, I started to get things back on track.

I'm incredibly lucky that I have a very supportive family and a great relationship with my specialist team that helps me through the tougher times. There's also a lot of other support out there in various other guises. The Diabetes UK Peer Support Scheme is designed to put you in touch with someone to talk to about living with diabetes, whether you live with it yourself, or look after someone who does. There's also a growing online community of people with diabetes who can listen and help you.

Filling in my 6 monthly review forms has been a cathartic experience and a reminder that whilst things might feel good today, I've also experienced some serious low points and managed to come through them relatively unscathed.   If I'd had to fill in the same forms a few weeks after getting my insulin pump, I know for a fact that the answers to some questions would have been markedly different but being able to reach out for support to the right people at the right time has made me stronger.

Diabetes Week

This blog was first posted on the Diabetes UK blog site as part of Diabetes Week

It's already well documented that living with diabetes can be a frustrating and challenging experience.  I remember thinking when I was diagnosed with Type 1 in 2001 that it was so fundamentally life changing that I wasn't sure I'd ever be able to cope with it.

One of my first thoughts was of a boy who went to my primary school who had diabetes as that was probably my only exposure to someone who lived with the condition.  I remembered that had carried a vial of insulin and a large hypodermic needle around with him all the time.  That memory convinced me I was doomed, that I'd never be able to manage.

Being here 12 years later to write this blog isn't a tribute to my own incredible ability to overcome the impossible, but a real testament to the power of research into treating diabetes and improving the lives of millions of people.

Recently I became involved in a clinical trial called REPOSE (or The Relative Effectiveness of Pumps over MDI and Structured Education for Type-1 diabetes).  The aim of the study is to determine whether an insulin pump provides additional benefit to people with Type 1 diabetes versus Multiple Daily Injections.   All participants, regardless of the treatment type they are assigned, also complete a DAFNE course to ensure that structured education is provided.

Whilst a recent report showed that the UK is lagging behind the rest of Europe and the US in terms of insulin pump usage in treating Type 1 diabetes, there have been no trials in adults that compare how well patient fare between MDI and pump therapy when combined with structured education.  It's important that research like this is carried out to be able to

Annual Review

This blog was first posted on the Diabetes UK blog site

The date of my Annual Review being marked on the calendar has, in the past, struck fear into me on more than one occasion.  I've previously likened it to some sort of 'confession', and I've spent time preparing my excuses for the results that are inevitably not within target.

It wasn't uncommon for me to 'blame' a variety of things for why I'd not quite got round to an improved HbA1c or lost a few pounds.  A new job, moving house, my daughter being born or just "being really busy at work" all got used at one point or another.

I went through a significant period of time where testing my BG was as a rare occurrence and unsurprisingly, my overall control suffered quite badly as a result.  I used to frantically try and cram months of eating right and testing my BG regularly into a week before my clinic appointment.  I'm sure you can guess how well that worked out. 

The thing is, in actual fact, I think that in all bar one or two of my annual/six-month reviews over the last 12 years, my consultants (and specialist team in general) have always been great with me.  They were sympathetic, ready to listen and helpful in a way that didn't feel like I was being lectured.

I guess at the time, I never really appreciated why that was.  I took it to mean that they just generally understood that it was a bit tough sometimes (especially when you're younger) and that they knew I was trying.  To a degree I think a lot of that was true, but really, in hindsight, it was because there is only so much they can do.  The ultimate responsibility lies with me as I'm the only one with any power to change anything.

Of course, any annual review or clinic appointment wouldn't be complete without a sometimes baffling array of numbers, some of which make perfect sense to you, some of which don't.  I don't know how it works in other places, but in Sheffield, I get an A4 summary of my results that includes a 12 month rolling period so I can see how well (or not) I'm doing.

As I've got older I've started to pay more attention to the figures beyond my HbA1c, particularly my blood pressure and my cholesterol.  At one point I was close to being diagnosed with high blood pressure as every clinic appointment showed some high numbers.  I got given a BP monitor to wear for 24 hours which showed that it was only high when I was at clinic - I'm not sure if that's a common problem for some people but it was good to find out it was just clinic that kept putting me on edge!

I know that getting older means that it'll get a little more difficult to keep all the numbers closer to target and that I'll have to work a little harder to do so.  But I know what I need to do and sometimes that's half the battle.

The important thing is to make sure you don't struggle on by yourself if it ever feels overwhelming.  There are so many different ways to get the support you need, including talking to your specialist team, calling the Diabetes UK Careline or engaging with one of the several online communities dedicated to helping people with diabetes.  Being able to talk to someone about how you feel when you have diabetes shouldn't just be a 6 monthly occurrence.

Thankfully my most recent appointment was one where I felt I could talk about my successes over the last few months rather than having to invent yet another excuse.  Hopefully that's also the case for the majority of you too.

Tuesday, 30 April 2013

Revisiting REPOSE

This blog first appeared on the Diabetes UK blog site on 30th April 2013

It's been nearly three months since I started using my insulin pump as part of the REPOSE trial I'm taking part in, and I thought it was about time I did a bit of an update on how things are going.

I think the first thing to say is that whilst it's only been three months, it feels like a lifetime - and in a good way too.  You might recall that I was somewhat apprehensive about making the switch to a pump, a natural reaction to changing the way I've looked after myself for the last 10 years.  I'm happy to say that, at the moment, those fears were misplaced.

That's not to say that the transition was an overnight success, or that I've not had a few wobbles, but overall I feel like I've had a real, noticeable improvement in how I've felt which can't be a bad thing.

It's hard to say what exactly the cause of that is.  It would be easy to attribute it to the pump because that's the most obvious change, but there are a lot of other smaller changes I've made since I've been on the study which have probably had an effect.

Obviously I've attended a DAFNE course which, as I mentioned in a previous blog was an incredible experience and allowed me the time and opportunity to learn about some of the key things I'd either never been told, or had long since forgotten.  It was also really good to meet other people with type 1 and share some experiences.

I've also been recording my blood glucose levels, carbohydrate portions and insulin doses in a daily diary - something I've not done since I was diagnosed nearly 12 years ago.  I think that must be having some kind of effect as it lets me see the patterns over a few days rather than relying on memory which I've always done in the past.   A knock-on effect of that is that I'm testing my blood glucose more frequently than I ever have - from the dark days of a couple times a week a few years ago to at least five times a day now.  I take my testing kit with me everywhere now and that's certainly something I've never done before.

Having the pump gives me the ability to control my basal insulin more effectively and working through that process has been a real eye opener.  I wasn't previously aware of the "dawn phenomenon" (where your blood sugar can rise as you wake up) and going through periods of carb-free eating to understand what my basal levels should be showed me just how differently my body reacts to insulin at different times of the day.  Discovering I need to double my basal doses throughout most of the morning, just to stay level was a bit of a shock!

Whilst I do feel very comfortable with the pump (sometimes I genuinely forget I'm wearing it and panic that I've left the house without my insulin), I think it's worth looking at a couple of the 'negative' aspects of it as well.

Being wired up to something 24/7 is a constant reminder that you have type 1 diabetes (I joked recently that I'm effectively battery operated these days).  Whilst it's not something that particularly bothers me most of the time, it does make it a little harder to forget on the occasions that you'd like to.

On a daily injection regimen, there was always a small chance that you might inject somewhere that might mean the insulin didn't work as effectively as it should, but it was unlikely that would happen for every injection in a given day.  With the pump, as you place the cannula for three days a time, if you hit an ineffective injection site, all your insulin goes through there for a few days (unless of course, you notice, and change the cannula).  You also run the risk of the cannula not being inserted properly but that's possibly a story for another time.

The overall aim of the REPOSE study is to determine whether insulin pump therapy is more effective at treating people with type 1 diabetes.  Whilst I think it's a quite early to make any definitive statement, I know that so far I feel like it's had a positive effect on me so far and hopefully that will continue into the future.