Raj - Interview 06

Age at interview: 42
Age at diagnosis: 41
Brief Outline: Raj was diagnosed when he was 41 when he was having routine tests for a blood disorder (polycythemia) that he has had for the last six years. He takes metformin and pioglitazone for his diabetes.
Background: Raj is a process operator and is married with two children aged 19 and 13. Ethnic background/Nationality: Asian

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Raj was diagnosed a year ago. He recalls that he had been losing weight, feeling tired and having pain in his legs. For the past 5 or 6 years he has been living with polycythaemia (a blood disorder, the overproduction of red blood cells) and it was during regular tests to monitor polycythaemia that diabetes was diagnosed. Now that he has diabetes, Raj feels that his risk of heart, kidney and other problems is increased. 

Raj feels much more tired than before and is extremely careful about his diet and lifestyle. He may play cricket or football with his kids, but feels exhausted after a short time. He still enjoys working, but again feels very tired by the time he gets home. Although his friends know that he has diabetes and accommodate his dietary needs, he finds that sometimes he misses being able to eat and drink the same things as them. 

Because of polycythaemia, he sees the GP every 2 months. He takes metformin (4 tablets/ day) and pioglitazone (1 tablet/day). He checks his blood glucose once every 2-3 days and feels that he can recognise when his blood glucose is getting too low or too high. 

Raj's wife and children have been a huge source of support for him. His wife cooks special food for him, and makes sure that he eats lots of fruit and vegetables. Raj works on shifts that change every week, so he takes a packed meal to work to avoid missing mealtimes.


Raj feels more energetic since he has been more careful about when he eats.

And by changing your diet, do you feel any different?

I do feel a difference. I do feel a lot more energetic and that sort of thing, because I think the sugar levels are being controlled. And the thing is before I used to eat any time, whenever I feel like it, but now I've got a timing on everything, what time I have to eat and what sort of things I have to eat. I have to make sure [and] by doing that, controlling my diet and everything, that has made a lot of difference to me. So I do feel a lot more energetic what I used to be and feel a lot more healthier.

What do you mean by timing?

Timing because there are certain things like before I didn't used to have any breakfast or anything like that. You know, I used to eat in the evening or, you know, afternoon, whenever I feel like it. But now I know being a diabetic person I have to have breakfast, only certain food. And then I have to have a certain time my lunch and dinner, just to make sure my diet is all controlled. Not like, you know, when I feel like it I eat it. Because if I do that, my sugar levels go high or low, either way. Just with being a balanced diet, I know I'm going to have breakfast in the morning, that will keep my sugar level right till lunchtime. When I have, at lunchtime they'll keep me there. And with taking the medicine, that will help me a lot as well. Because the thing is that the medicine I'm taking in the morning and the evening, that keeps the sugar level balanced, you know. If I eat say any time my food or something like that, that will affect the sugar level a lot. Because if I, say if I eat at 10 o'clock or something like that, you know, instead of breakfast or something like that and the timing between the, my breakfast and my lunch is very short, that sort of things, that will affect all my sugar level. Because by 10 o'clock my sugar level will be down. If I have food at that time, obviously I'll be hungry, I'll eat a bit more, and that makes my sugar level a lot more higher. So I have to make sure my timing and my, all my food and everything is right, you know, all balanced out.


Raj who also has a blood disorder (polycythemia) sees his GP every 3 months and finds it reassuring.

And how often do you see your GP now?

Well, mostly I, now I go to, every three months. If I need to go before or if I think I don't feel that well or there is something, I need to change any medicines, I can go any time. That's not a problem. They say to me like, 'Just give us a phone call and you'll be straight in, you know. That's not a problem at all, you know.' And they are always there to help me out. Nurses, doctor, they've been fantastic. I couldn't complain about them, you know. The way they done the things, they've done all, the thorough tests and everything. It's not only the diabetes, related, other things as well. They check everything to make sure everything else is okay.

What do you mean?

It's all the other tests, you know, related with the diabetes, like my kidneys, you know. They check, you know, my blood is flowing into the, my veins properly, that sort of thing. You know, like they check my feet, that sort of things, and make sure all my nerves and everything is fine, you know, and that sort of things, you know. They're always there, and the things like they always either phone me or just send me the letter, 'Right. You need to come over here to get it checked and everything, to make sure your health is okay.' So they're always supportive in that way.


Raj still checks his levels and records them for his GP because he may need more medication.

And do you ever check your blood sugar yourself?

I do. Every couple of days I check my sugar level and make sure that's right. As I got all the instruments and everything provided by my GP. And I check at home and everything's fine and it's all controlled now.

But you mentioned before that they're going to change the treatment?

They're just going to add another tablet, you know, that's what they're saying. And most probably I'll, they said to me, I have to go tomorrow to see my GP, and they are going to decide, you know, what sort of tablets they're going to add it on, just to make sure. Because the thing, what they want, they want my sugar level to be below 7. Which is, at the moment sometimes it's 7 and sometimes can go a bit higher, which, they're not happy with that. So that's what they going, they're trying to do, just to make sure it's below 7. Yes, there is, sometimes there is below 7. But they want it all the time to be controlled. And so that's why they're going to put me on the medicine.

And do you, do you note it down when you take your blood sugar reading?

I do. Well, when you're, it all started when I found around being diabetic. About the first six months I used to check my blood sugar every day and I used to write it down and everything. So just to make sure when I go back to see my GP to show them the results and how everything, how everything is working out. So they can see how was my blood sugar and how they can decide, you know, how, what sort of medicines I'm going to have it, that sort of things.

And now it's not every day?

No, it's not every day. Every two or three days, something like that, you know. When I, if I feel can, I should check it, I'll check it, you know. Because I know myself, you know, if it's going to be right or not, because from your own body you know whether it's going to be right or not. If you feel it's going to be a bit high, then most probably I'll check it, you know, or if it's going to be a bit low. But when it's right, you know, you feel in yourself everything is fine, you don't bother with that.


Raj has polycythemia as well as diabetes and sometimes feels too tired to cope with the demands...


But now both things are combined, the risk has got a lot more greater what it used to be. Before it was clotting, anything like that, you know, something like that, my heart, thing, but in, with the diabetes my chances of the risk is triple now in all aspects. My heart, my brain, my liver, kidneys, everything. So I have to be extra careful, and my lifestyle is now totally different what I used to be. Sometimes I do feel physical limitation, that things I want to do. My mind says, “Yes, I'll do it” but my body doesn't respond. Yes, there's a physical limitation, which I find is really hard, especially when you want to play with the kids - you know children they want to play football, cricket things like that - and you do play, but the thing is I just play for five minutes, ten minutes, and after that you're really exhausted you know. So you can't do the things with the children what you used to do. And if we do go out as a family, something like that, or any activities, I have to be more careful what I can do, what I can't do it. So it has affected my lifestyle a lot.

And work-wise; I do go to work, I do enjoy the work, but when I do it, when I come home I do feel I'm really tired because of the work I'm doing. But before that [diabetes] I used to do so many hours a week, that didn't used to bother me at all, and I used to be a fine, active person all the time. I used to like to go out, everything, but now things have changed a lot. It's not the same as what it used to be.

And do you think it's because of the combined effect?

I think so, because my polycythaemia, when my blood level goes high, I do feel really tired, really tired, really lethargic, all I want to do is sleep. And being the diabetes on top of that, I have to make sure my diet, if my diet is not right, or my sugar level is either going up or down, that is a factor as well. So I think both have combined. And because of that it is, I find it a lot more difficult to cope with the things sometimes what I used to before.

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