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Duncan - Interview 27

Age at interview: 63
Age at diagnosis: 61
Brief Outline: Diagnosed 2 years ago. Duncan takes metformin, gliclazide, simvastatin, atenolol, ramipril and amlodipine. He has had neuropathy in his feet since 2006 and expects to receive laser eye treatment soon.
Background: Duncan is a retired teacher and careers advisor who is single with no children. Ethnic background/Nationality: White British.

More about me...

Duncan's diagnosis of diabetes happened when he was in hospital being treated for Miller Fisher syndrome. As a former chemistry teacher, Duncan understood the facts of diabetes though with hindsight he feels he may have given the impression of knowing more than he really did. His current work as a careers advisor means he works away from home a great deal which makes it difficult for him to keep his weight under control. He does not check his blood glucose levels regularly, nor has he been encouraged to do so by his GP.

When he was working as a teacher, he probably drank too much, and he's glad that at least diabetes has helped him solve that problem - he no longer drinks at all. Food is a problem for him though; partly because he dislikes vegetables and bland meals and partly because he lives alone and often buys ready-made meals from the supermarket. He used to lead an extremely active life, coaching rugby at school, leading expeditions and was also in the Territorial Army. He has always considered himself fit and healthy, but acknowledges that too many takeaways and alcohol were bad for him.

He feels his diabetes is under reasonable control, though metformin does not agree with him. In February 2006 his left foot became infected without him being aware. He was treated in hospital for 6 weeks, but he became quite depressed and wanted to go home. Though his foot has healed, he has to wear special boots and tries to keep the weight off his feet as much as possible. He cannot walk far because his foot could flare up again. Being unable to walk much has affected his social life, his holidays and his retirement plans. Duncan is also waiting for laser treatment on his eyes, though he hopes it won't be too serious. He remains very optimistic, enjoys the company of old friends and is determined that diabetes is not going to dictate how he spends the rest of his life.

 

Duncan thinks he may have had diabetes for years before being diagnosed because he was overweight...

Duncan thinks he may have had diabetes for years before being diagnosed because he was overweight...

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I wasn't all that surprised by the diabetes certainly, or by the high blood pressure I suppose because I was doing, I mean I am probably about as overweight now, as I was then. And I drank far too much. So I, and I knew the symptoms, I had seen them on the back of buses, on advertising shows, you know, sort of tired, going to the loo, etc. And I didn't think any of them were so bad that I had actually gone to my GP. But I hadn't been to my GP for about eight years. So I could have had diabetes for eight years before it was diagnosed. But I didn't get the lethargy particularly, I was still capable of doing sort of fifteen hour days, so I wasn't really aware of it. But as I say when they told me I wasn't surprised. If that makes sense?

 

Duncan thinks that his old habits of eating lots of takeaways and heavy drinking may have caused...

Duncan thinks that his old habits of eating lots of takeaways and heavy drinking may have caused...

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I mean you get annoyed sometimes. And also I think I am probably helped by the fact that it is my fault in a way. I mean I am not saying it's entirely my fault, but one of the reasons I ate too many take-home Chinese and too many bottles of wine, was being coming home at half eight in the evening after a long day's teaching I probably felt I needed it. So I mean to that extent may be it wasn't entirely my fault.

But I knew I used to teach alcohol awareness at school, so I couldn't say I didn't know that I was drinking too much, and I couldn't say I didn't know that not taking enough exercise was bad for me. So to that extent, I may be don't feel as miserable as I would do, if I had been struck down by something that I had been responsible for.

And if I, I mean it sounds pretty bad to say that if I did sort of pop off tomorrow then, because I had eaten or drunk or whatever too much for sixty one years, then at least I had sixty one good years. So to that extent I am not too bothered.

 

Duncan explains that he doesn't want diabetes to dominate his life and so takes a 'broad-brush'...

Duncan explains that he doesn't want diabetes to dominate his life and so takes a 'broad-brush'...

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Well I mean to start with I was just incredibly careful. I mean when I was in hospital I didn't have much appetite anyway. I sort of cut out sugar pretty well completely. The trouble is I don't like vegetables all that much, so I eat quite a lot of fruit. The trouble is when I'm working, it does get, it just gets very difficult. I mean whenever I am staying in the Travel Lodge I have their sort of breakfast box which is cornflakes, I mean it's alright, not that bad, but I often end up eating in Little Chefs which is usually chips with everything.

So, I mean I don't know' back here I try and do everything Marks and Spencer's just down the road, which does lots of good healthy food. So I try the 5-a-day, although I quite often don't manage it, sometimes I manage considerably more than that. So to that extent I'm certainly not perfect and I manage. My friend with diabetes said you can have a doughnut occasionally as long as you view it as a special treat, and so I mean I tend to do that - more than I should I expect.

You know I know I ought to be counting calories all the time, and this, that and the other and making sure, but I just do it in a very broad-brush way and as I say I tried to eats lots of' Drink fruit juice, although fruit juice has got fruit sugar. It just gets' You know as I say I'm just not prepared to make myself miserable and let my life be taken over by diabetes to the extent that I spend all the day planning meals.

I mean I've got a diabetic cookbook and that sort of thing, but again, you know its' I... most of the things I get are prepared but luckily Marks and Spencer's have now started doing the good 'nutritionally balanced meals', which' I had one last night, roast pork and vegetables, it was very you know easy - four minutes in the microwave - and it was actually was lots of vegetables, and whatever. I think it probably was' It certainly looked healthy from what they said on the packet.

 

Duncan prefers not to check his glucose levels every day. The strips are too expensive and also...

Duncan prefers not to check his glucose levels every day. The strips are too expensive and also...

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Once every six months or so. I mean it's left to me to make the appointment. I think they would probably remind me if I left it too long. I mean, when I first came out of hospital after the Miller-Fisher knowing I was diabetic, I went straight to the shop and bought myself a blood sugar meter and because they'd been monitoring me four times a day, well no, certainly every meal so more often and I thought it was quite important. But the trouble is test strips are '30 for a set of fifty and I just after a bit, it just got too expensive, by the time I'd... And the GP and the diabetic nurse said, 'You don't want to do that. You will get worried or something by it if you'' And so I just gave up.

I mean I didn't see why I mean I wasn't prepared to keep spending money for something ' and I mean I was, I just tested myself every morning and I mean for weeks, I was just on, pretty much exactly the same every morning. And I thought well if the nurse and the doctor say I don't need to do it, I'm not going to keep spending '30 every couple of weeks just to do this. So in a way, I would be' I've still got the meter, I suppose I ought to kind of get another drum of strips, calibrate them up and just occasionally test myself just to be on the safe side. I've got a blood pressure monitor that I use occasionally just to check, but again that usually' Always seems to come up okay.

 

Duncan believes there should be a greater awareness of how careful people with neuropathy need to...

Duncan believes there should be a greater awareness of how careful people with neuropathy need to...

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Well the main thing, which we haven't mentioned yet, is that I did get very bad foot ulcers, and that was one thing that I wished I had had more emphasis on from, well me reading it, but also from the system. I mean I knew that you lose a bit of sensation in your peripheries and after I came out of hospital I went to a private podiatrist who ran filaments all over my feet and made it clear that I actually hadn't got much sensation in my feet. I can feel obviously when I am treading on them - they're not numb - but I don't get any major sensation. And as a result, because I didn't realise just how careful I should be I picked up a couple of bad ulcers. I don't know when the one on my left foot came but on my right heel I think I had a bad cracked insole in a shoe and I walked quite a long distance on it, and it got so badly infected that as soon as I went to the podiatrist, he put me straight into hospital. And I spent six weeks in there you know, just mostly, I pretty well discharged myself in the end, because I was just lying in bed, waiting for ten minutes of treatment every day. 

But it took, that happened in end of January after I'd been diagnosed'So that's a year and a half ago. But I thought everything was going well. You know, I came out of hospital, my vision got right. I started driving again and then about a few weeks after that my, this heel infection came in, and that actually didn't heal over until August. That pretty well put me off. I had no work - I had to miss working. I had to miss my summer work for the university invigilating. I couldn't do any careers advice, so basically most of that eight months I was sitting in this chair or something like it, with my feet up staring at day-time television which was pretty boring. 

Luckily thanks to the podiatrist and the care I mean that got better. But I have been told that I can't, I will never be able to walk any distance on my feet again for the fear of it going. I've got NHS boots which seem to protect it, but after, I had a' Last Christmas I did a bit more invigilation which involved one what would have been a minor walk in the days of my youth, just about a mile, and the heel broke down again and it was another three months before that healed over.

 

Duncan has no problem working and driving for long hours but his neuropathy means that walking to...

Duncan has no problem working and driving for long hours but his neuropathy means that walking to...

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It has affected my future plans. I mean I still' My job as a careers advisor, I mean I still do it. You know, I mean, possibly, I don't know, I did five days last week, five days the week before that, although I found that a bit much. But I think that is more that - you know probably thirty years ago I would have found interviewing eight people a day, and writing out reports for five days a week probably a bit much - I don't think that has got anything to do with diabetes. I mean the week before I had to, I was suddenly called to go and help out at Dover and I had to get up at four in the morning, leave at five, drive round the motorway 150 miles to Dover, work for five hours and drive back and I didn't have any trouble with that - so to that extent it is okay.

But it's just that walking any distance is'Well, I don't know whether it is because I haven't been walking much because of my feet, but now walking much is difficult anyway. So it has had a big effect in that respect. It has certainly had a big affect on my future plans. It probably hasn't affected day to day all that much. I mean the main thing was when I couldn't drive for periods, because I mean [the village] is a bit, sorry this place is a bit isolated, but you know there are buses I managed perfectly ok, but I... Distance would be difficult... To go any great distance without it being a hassle, and I do rely on my car.

 

Duncan was looking forward to an active retirement but now can't walk for pleasure because of...

Duncan was looking forward to an active retirement but now can't walk for pleasure because of...

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Well the main thing, which we haven't mentioned yet, is that I did get very bad foot ulcers, and that was one thing that I wished I had had more emphasis on from, well me reading it, but also from the system. I mean I knew that you lose a bit of sensation in your peripheries and after I came out of hospital I went to a private podiatrist who ran filaments all over my feet and made it clear that I actually hadn't got much sensation in my feet. I can feel obviously when I am treading on them - they're not numb - but I don't get any major sensation. And as a result, because I didn't realise just how careful I should be I picked up a couple of bad ulcers. I don't know when the one on my left foot came, but on my right heel I think I had a bad cracked insole in a shoe and I walked quite a long distance on it, and it got so badly infected that as soon as I went to the podiatrist, he put me straight into hospital.

And I spent six weeks in there you know, just mostly, I pretty well discharged myself in the end, because I was just lying in bed, waiting for ten minutes of treatment every day. But it took, that happened in end of January after I'd been diagnosed' So that's a year and a half ago. But I thought everything was going well. You know, I came out of hospital, my vision got right. I started driving again and then about a few weeks after that my, this heel infection came in, and that actually didn't heal over until August.

That pretty well put me off. I had no work - I had to miss working. I had to miss my summer work for the university invigilating. I couldn't do any careers advice, so basically most of that eight months I was sitting in this chair or something like it, with my feet up staring at day-time television which was pretty boring.

Luckily thanks to the podiatrist and the care I mean that got better. But I have been told that I can't, I will never be able to walk any distance on my feet again for the fear of it going. I've got NHS boots which seem to protect it, but after, I had a' Last Christmas I did a bit more invigilation which involved one what would have been a minor walk in the days of my youth, just about a mile, and the heel broke down again and it was another three months before that healed over.

So given the fact that most of the things I intended to do in my retirement involved going up to Scotland, and climbing some of the mountains I've never climbed (because I was up there with cadets so I was responsible for, or going to museums and travelling and that sort of thing) and I can't really do that now. So it has had a major effect, its completely binned all my retirements plans and really makes most things quite difficult.

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