Philip - Interview 15
More about me...
Nine years ago, Philip had a heart attack (not his first) and was taken to hospital. On his second day in hospital, doctors told confirmed he had had a heart attack, and also that he had type 2 diabetes, and would need insulin. Philip didn't recognise the symptoms of diabetes that he had been getting, but now looking back he remembers that he had felt tired and thirsty and needed to visit the loo more often. Also, he had hurt his shin, and it didn't heal as quickly as it would have done in the past.
A few days after leaving hospital, Philip saw a nurse who showed him how to manage his insulin injections. Philip liked the way the nurse involved his wife because having someone close by who has shared information has been useful. If he missed anything, his wife has always remembered; she has also remembered to ask questions when he forgot.
Philip is very active in a local support group that gets speakers such as podiatrists, and eye specialists. He is also part of a discussion group at the hospital which includes doctors as well as patients talking about how best to handle diabetes-related issues. He also took part in an Expert Patient course, and found it very helpful. Philip's diet has not changed much since being diagnosed with diabetes, but he eats only at fixed times because this helps him regulate his insulin dosage better. He regularly goes fly fishing and enjoys it very much.
Philip checks his blood to avoid possible problems from a change of routine.
Philip felt constantly thirsty on holiday and put it down to being too hot.
But how would you describe the symptoms that you have, apart from the slow healing? Did you have'?
Oh yes, I wanted to drink a lot. I was passing a lot of water and what I didn't realise then I was also passing some sediment in the water as well. I thought it was from the toilet cistern itself. Not from me. I didn't realise that. And my wife had remarked on it, and said, 'There's something funny there in there cistern,' you know. But you don't realise those things. You don't look for them. Unless you are primed to look for them. I don't think you would. And I think that most people that I have spoken to who have got diabetes they had exactly the same problem, they didn't recognise the symptoms prior to' I think if you have got a family where the diabetes is inherent in the family, I think people might recognise the symptoms then, but if you haven't I think it would be fairly difficult. It is only when you become unwell more often or not that you, you're diagnosed.
Philip describes how he feels 'light' when his levels are too low.
How do you know then? How do you know when you're about to '?
I get a light feeling, a funny feeling. I can't really explain the feeling. It's you know when I say a distant feeling. You' 'Lightness'. I always think if you've had... a number of drinks and you are starting to go 'light' - you're not drunk, but you're starting to, things aren't quite as sharp as they should be - and it comes on quite... I know when I am coming into that point between 4 and 3, or 3 and 4 whichever way. I know then that I am going low. I have been low. I have been down to 2.8 but that has been for other reasons, you know when I have gone down, it' s a, not getting my meal on time and that type of thing but you can't always cater for. You try to sort of look at all emergencies that could possibly have and try to cater for them. But you can't always, there have got to be times when you can't. And in 10 years, 9 years, I think, I've done pretty well.
Philip says that it is impossible to fool the HbA1c test.
So you know it's you have got, if you go every 12 months of course it means that you can do what you like for 9 months and then the other 3 months you have got to be careful, but you don't do that, because it is really about 12 weeks that they can look back on when they look back at the HbA1c. But if you're sensible you wouldn't try to - well you've got to look after yourself.
Philip sticks to a particular routine with his insulin but says other kinds of routine may work...
So is your insulin, I mean the level that you take is that sort of fixed, you don't change it that much?
I don't change it that much at all. I have 26 of a morning, 18 of an evening before my evening meal and that seems to suit my lifestyle. If I am more active, if I'm going to be active, I tend to may take a little Mars Bar or something, have a chew at that. And that will raise my blood sugars to counteract the effect of the exercise that I am doing. So once again it's coming back to this self-management. To be able to look ahead and say [to yourself] 'Well' I'm going to be doing that, I'm doing this, I'll have that before I do it, and that'll balance me out while I'm doing it'.
These are suggestions that people have made you know over the years, and it suits me.
And I think everybody is an individual as far as that goes. And each person has got to adjust their regime to themselves, not to what other people are doing. They've got to adjust it for themselves I think. Trying to tell people, 'Well you should do this and you should do that, and you should do that, like I do' - that's wrong. I think there's only one person who should tell you what to do and that is the doctor, or the clinic staff.
I think you should recognise your symptoms, be able to recognise when you are going low - particularly when you are going low - look at what you are doing if you are driving and things like that; what precautions should you take if you are driving any distance. I think all these things come under your self-management. You've got to plot it ahead. You've got to look ahead at what you are going to do, how you are going to do it. You've got to be able to analyse I think your feelings to a certain degree, what's happening to you. And carry on with your normal life.