Category: Diabetes

Step Into Healthier Feet…

If you haven’t guessed, I enjoy my pun-based titles. Most posts I write will have some play on words relating to the content. Half the fun is in doing so. But anyway, yesterday I wrote on the importance of proper oral hygiene and how it relates to Diabetes. I’ve said it before and I can easily repeat now, Type-1 Diabetes has this nasty habit of affecting just about every aspect of the human body. From possible vision problems to compromised organs, it’s no wonder that people living with Type-1 Diabetes run into so many issues and complications. Tack on the fact that fluctuating blood sugars will often sap one’s energy and will, and you have an easy recipe for disaster where it relates to one’s health. And your feet are no exception. Proper foot health is a very real concern t=for someone living with Type-1 Diabetes. And today, we’re going to explore those problems. Walk with me… (see what I did there?)

Your feet are an important part of your body. Seems like a pretty obvious statement, right? After all, isn’t EVERY part of your body important? Well, that’s a matter of opinion… Just ask your tonsils or your appendix. But I digress… Your feet are essentially your means of locomotion, allowing you to walk, run, stand and if you happen to study the martial arts like me, kick, block and defend yourself. The loss of one’s feet would present fairly specific challenges that would make all around daily life a serious challenge. This is why it always makes me so sad when I hear that someone’s Type-1 Diabetes has gotten bad enough that they had to have their foot and/or feet amputated. In fact, it’s a Diabetic aspect that I’ve often seen referenced in comedy circles, right up there with quoting Wilfred Brimley. But all jokes, or attempted jokes aside, what are the issues that lead to this outcome? And what can someone with type-1 Diabetes do to properly prevent them?

According to an article posted by the Cleveland Clinic, “People with diabetes are at an increased risk of foot conditions and complications if they have diabetes-related neuropathy and/or poor circulation. Diabetes-related neuropathy happens when you experience nerve damage due to persistently high blood sugar (hyperglycemia). It most commonly affects your feet.” One of the reasons that these aspects tend to affect the feet, is also because it’s an extremity, where blood circulation will already be at its lowest. For this reason, neuropathy will set in much easier than in other areas of the body. The article goes on to indicate that these issues can be caused and snowball due to a number of different aspects, including sores or blisters that go unnoticed and are allowed to become infected. Since folks with Type-1 Diabetes have a weaker immune system, they’re at a higher risk of infection.

And the damage caused to the feet’s blood vessels can make the healing process take far longer. This increases the risk of the infection spreading into other areas of the body, leading to gangrene, which can lead to the amputation that seems to be the trademark of an uncontrolled Diabetic. Some of the prevailing conditions that can lead to foot complications include but are not limited to:

  • Cuts, ulcers, burns and blisters that don’t heal.
  • Dry, cracked skin.
  • Corns and calluses.
  • Fungal infections or ingrown toenails.
  • Hammertoes and bunions.

It can be pretty difficult for someone, especially if one is not a health care professional, to notice and identify some of the issues with one’s feet. But some of the symptoms that one should be on the look out for may include persistent sores, calluses or or blisters, bleeding without injury, infected skin or pus, foul smell, persistent aching or pain in the feet and/or ankles, swelling or skin discoloration. If you start to notice any of these issues, you may wish to consult your doctor or medical professional. Consistent symptoms may be an indicator of an issue that will require medical attention.

So, it’s fair enough o say that folks with Diabetes have this complication, but what causes it? Typically, foot issues are caused by neuropathy or poor circulation. Lessened circulation will also contribute to the difficulty in healing wounds on the feet. Uncontrolled blood sugars, like in every other scenario, take the driver’s seat in how healthy your feet will be, since consistently high blood sugars will cause nerve damage in the legs and feet, leading to consistent aching and pain, even when there’s nothing visible to be seen. Like with everything else medically-related in life, every person is different and symptoms may persist in different ways for each person. What’s important is to ensure you’re taking proper steps to care for your feet to avoid these issues.

What can you do to prevent some of these issues? Well, the preventative steps will seem somewhat obvious but you’d be surprised at how many people seem to overlook them. First and foremost, control your damn blood sugars! That should be obvious for a variety of important reasons, not only foot health. But least of all, you should be checking your feet on a daily basis. Since Diabetics may have lessened sensation in the feet, wounds and blisters may not always be felt. I sit down to put on socks and shoes every morning, and perform a cursory check of both feet to ensure I don’t have wounds that I may have incurred that I wasn’t aware of. You want to ensure that your footwear and socks fit properly, not too tightly, and are in good condition and clean. The clean part relates to your socks, which some people have a propensity for re-wearing socks for more than a day. This is a bad idea, given the potential bacteria you may be introducing into cuts or sores from extended wearing of socks. Change ‘em up on a daily basis and make sure they aren’t too tight, limiting an already limited blood flow.

Make sure your shoes fit well, are comfortable and don’t exert pressure or tightness against any areas of your feet. The insoles of your shoes should be in good condition and prevent rubbing against your feet to cause blisters. Wash your feet daily. I mean, you should be doing that regardless but keeping your feet clean and properly moisturized are important steps to maintaining proper foot health. Consistent exercise to help maintain blood flow can also be important. You should avoid ripping off calluses or corns yourself, or walking around bare-footed (as much as I love doing this). All it takes is one step on your kid’s LEGO block to cause a wound that will trigger a negative chain of foot-related events that you won’t want to deal with. Last but not least, trim your toenails properly and make sure there are no sharp edges or ingrown nails.

Diabetes Canada has a great checklist that covers a lot of this. You can access it here. A lot of what’s described above should be things that you’re doing regardless. Proper exercise, controlling blood sugars and daily cleaning and washing being among the most prominent. So, while it may seem tedious to be doing so much to maintain proper foot health, it’s really just an inclusion to what you should already be doing to stay healthy. Type-1 Diabetes is a life-long condition; one that will eventually do me in, I’m sure. But I have no intention of making it easy or going down without a fight. This is why it’s so important to maintain these bodily systems and ensure your feet are there to carry you around for the foreseeable future. Food for thought… ☯️

Put A Smile Into Your Health…

This feels like one of those posts where I should clarify that I’m not a doctor or health professional, and I base the content of my posts on personal experience and my own, independent research that I find online. So, read at your own leisure but take it for grain of salt until you can consult your own healthcare professional. There it is. Now, on with the post… For most of our lives, we’ve been told to brush our teeth. This seems like a pretty common and obvious hygiene practice, and is societally expected among other things like wearing deodorant and showering. But in the busy hustle of life, brushing one’s teeth can be one of the most easily overlooked hygiene practices, even in the western world. In looking up information for this post, which was triggered by my wife and children attending scheduled dental visits, it was difficult to find anything definitive on the origins of brushing one’s teeth. The one common theme among the varying sources I read, is that the practice is actually several thousands of years old, with people using “chew sticks,” which are twigs or branches taken from certain trees. These wooden pieces would fray once snapped, making a small, makeshift brush.

Prior to that, ancient humans ate a diet mostly consisting of plants and fruits, and this high-fiber diet would promote proper oral hygiene, eliminating the need to brush. But things have changed since then, which probably explains why I ALWAYS get that one strand of meat stuck in that same spot, every time I eat a strip loin. Bloody hell… But I digress… It wouldn’t be until the early decades of the twentieth century that the modern day toothbrush would make an appearance and daily brushing became not only the norm but the expected societal standard to make sure your breath won’t stop a clock. But some of the practices and the understanding we have behind proper oral hygiene has changed over recent decades. As a child, I was essentially told to brush my teeth three times a day; after each meal but certainly upon waking and before bed. Sometimes, because snacking is a must, brushing a fourth time happened. As a child, I had no dental issues but yet I always had the dental hygienist bitching at me to brush more or floss better. The constant nagging made it so that I developed a sincere dislike for the dentist’s office as a child.

When I was younger, the premise was simple. If you don’t brush your teeth, you’ll get cavities and lose your teeth. Full stop. That was the concern. Your breath will smell bad and your teeth will fall out. If you want to successfully eat independently for years to come, make sure you keep brushing and flossing. Pretty simple premise and makes a lot of sense. On the surface. But research over the past couple decades have peeled back the onion, or the proverbial gum line if you will, and have shown that there is a lot more inherent risk to poor oral hygiene than simply losing one’s teeth. Not only have connections been made to things like gum disease and periodontitis, but since the gums have connections to your circulatory system, there are also implications for heart and organ health, Diabetes complications and allowing increased bacterial strains entering the bloodstream and infecting you in various ways. Imagine getting a heart attack or having a stroke because you didn’t brush your teeth?

According to an article posted by the Mayo Clinic, “Like other areas of the body, the mouth is full of germs. Those germs are mostly harmless. But the mouth is the entry to the digestive tract. […] The mouth also is the entry to the organs that allow breathing, called the respiratory tracts. So sometimes germs in the mouth can lead to disease throughout the body.” SO, the bottom line is that your mouth is an open, easy access for germs and bacteria to access other areas and systems within your body. The article goes on to say, “Most often the body’s defenses and good oral care keep germs under control. Good oral care includes daily brushing and flossing. Without good oral hygiene, germs can reach levels that might lead to infections, such as tooth decay and gum disease.” This means that poor oral hygiene or not brushing your teeth enough can contribute to far, far more serious issues than simply just your teeth falling out.

What does this mean for me and my fellow Type-1 Diabetics? Well, the reality is that as a Diabetic, my body’s immune system is basically there but not doing its job, making my body’s immune system far more susceptible to infections and less capable of fighting them effectively. This means that if some of the nasty that percolates in the ol’ mouth makes its way into my system, the results can be far more dire than for the average joe. This makes proper oral hygiene and teeth brushing all the more important for me. The article does describe issues for Diabetics, as follows, “Diabetes makes the body less able to fight infection. So diabetes can put the gums at risk. Gum disease seems to happen more often and be more serious in people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels. Regular dental care can improve diabetes control.”

Imagine your blood sugars being off because you don’t brush your teeth enough? This can be a real possibility. Although I’ve always done my best to try and stay consistent with brushing my teeth, I don’t always have time to run floss and there are busy days at work where I can admit that I don’t get to brushing for an actual day. I’ve been wondering if, over the past couple of years, this may have contributed to my bronchitis and pneumonia issues that I’ve faced, since the Mayo Clinic’s article does explain that some germs can make their way into the lungs and contribute to pneumonia and other respiratory issues. So, this may be a possibility. I can guarantee that I’ve upped my game in this area. It’s a bit difficult to rationalize losing weight, exercising, eating well and monitoring/controlling my blood sugars with a fine tooth comb to help combat the symptoms of my condition, yet something as simple as consistent oral hygiene gets ignored.

So, what is consistent oral hygiene, and how much should you be doing? The prevailing thought these days is that you should be brushing your teeth a minimum of twice a day. This is done for about two minutes each session, using a soft-bristled toothbrush to prevent irritating and damaging your gum line. During my son’s most recent dental visit, it was recommended that if you can only brush your teeth once during the day, it should be right before bed. This makes sense, as it ensures that you’re not allowing food remnants and bacteria to sit and do as they will all night while sleeping. Flossing daily, using floss or a “water flosser” is important, as there will always be food remnants between teeth that won’t be removed by brushing. I, myself, have a water pick, which is interesting and a different means of flossing one’s teeth. It apparently has the benefit of getting at more areas and cleaning between the teeth better than traditional floss, IF you can get the hang of it. While I stick to traditional floss, when I take the extra time to use the water flosser, I usually end up making a mess more than anything else.

Be sure to replace your toothbrush ever three to four months. This is, I’m certain, the one aspect people seem to overlook the most. While you should replace your toothbrush as soon as it begins to become worn or the bristles start to flare out away from the center of the brush, most people will usually hold on to a brush for far longer than they should. Keep in mind that this bad boy is being ground into the area of the mouth containing food particles and bacteria, and there’s no easy and effective way to clean one’s toothbrush. Oh sure, there are UV trays that apparently disinfect and clean toothbrushes. I don’t know how effective these are or if they actually work, but it’s likely more cost effective to just splurge on a two-dollar toothbrush every few months than paying for some gimmicky device to clean it. Avoiding things that stain your teeth, like red wine and/or tobacco products is recommended. Even though we all dislike being in the magic chair and trying to answer questions with someone’s fingers and dental tools in one’s mouth, yearly dental visits at minimum should be considered, since dental professionals will have the tools and ability to clean areas that you may not get access to, from home.

They also have the ability to help with the removal of dental plaque and provide fluoride and other treatments to help with overall oral health. Don’t forget that dentists are medical professionals and will have the ability to assess and treat potential dental conditions or gum disease, which, based on what I described above, becomes critically important. Not only to preventing all the nasty stuff like heart conditions and stroke that the article describes, but also to help with proper Diabetes and blood sugar control. And given that I’ve caught pneumonia and bronchitis for the past two years that have seen me hacking and on meds for a couple of months a shot, I’ll be paying significantly deeper attention to my proper oral hygiene. All other things aside, I plan on sticking around for decades to come. I’d like to do it with my teeth intact. Nothing sucks more than trying to eat a steak through a straw. Food for thought… ☯️

Making Type-1 Diabetes my B%&ch…

Anyone who’s read a number of my blog posts will know that it’s pretty clear that Type-1 Diabetes carries a number of complications that can make a person’s life a living hell. The routine stuff, for the most part, has become so routine for me over the past four and half decades that I’m ABLE to call it routine. But there’s no arguing that T1D basically affects absolutely EVERYTHING in one’s life and has an influence on everything I do, from working, sleeping, eating and even my relationships. More on that last one some other time, but the bottom line is that with the exception of organ failure or amputation, I’ve seen it all, done it all and have suffered through it all. By virtue of this, Diabetes has yet to throw something at me that I haven’t met head on and overcome. This was a solemn promise I made to myself in my early teens, when I realized I would need to take my own health in hand in order to live into adulthood.

About ten years ago, a slightly different kind of Diabetic complication landed on my plate. As a matter of routine, I had a yearly ophthalmologist appointment to clear my eyes. This was generally done at the request of the Force, to ensure my vision was clear. I had a particular doctor that I had been seeing for almost five years at this point, so I was a bit surprised when I was met with his partner in the eye clinic, instead. He explained that some patient files had been passed to him as my previous doctor was moving on to different projects. Okay, fair enough. I’ve never been a big fan of changing doctors or even changing meds, when it’s happened. In my experience, doing so almost always results in “rocking the boat,” and basically fucking up the nice, healthy balance I maintain in my life. But it would turn out that this one change would not only lead to the identification of this complication but would lead to its treatment.

During this exam, I was asked if I had noticed my vision blurring. Being a police officer in the field with Diabetes made this a difficult question to answer, given that shift work, fatigue and fluctuating blood sugars would all affect my vision. But as it turned out, I had developed a condition known as Diabetic Macular Edema. For those of you who haven’t read my previous posts, Diabetic Macular Edema is a condition where fluid begins building up behind the back of the eye, around the macula, which is what controls how your vision focuses. When this fluids builds up, it causes swelling at the back of the eye that can lead to all sorts of vision and eyesight complications. The link to a HealthLine post above will provide further context, but this condition usually occurs as the result of poorly controlled or high blood sugars, something that I had in abundance before I took my health in hand. There are a few treatments, including but not limited to laser treatments for the retinopathy aspect (which I’ve had) and injectable medications that teat the swelling, which was what was needed next.

I’m not gonna lie here, folks… I’m usually pretty good at acting like a tough guy, shuffling off scary stuff and ignoring pain. And up to that point, I have had needles in just about every area of my body. Except my fucking eyes! For what was probably the first time in my life, I was frightened of what would come next. Based on the doctor’s explanation, I needed these injections to maintain my eyesight. But I couldn’t ignore the thought of a needle sliding into a part of my body that wasn’t meant to be pierced. I mean, conceptually, NO part of the human body is “meant” to be pierced… But getting a needle in the eyes is something that up to that point, I had only seen in horror movies. One can see how this might have fed my anxiety. Setting my fears aside, I made the appointment, booked the time off work and booked my very first hotel room in the city, since my wife and I had just recently had our first child and she couldn’t join me. I would need to stay in the city overnight since I would be effectively blind, as it relates to operating a vehicle, especially after dark.

That first appointment came with a slew of stress and anxiety, which did nothing to help some of the pre-procedure tests I needed. Did you know that heart rate and stress affects your eye pressure? I sure found out. My vision was a touch below normal, even with normal blood sugars and my prescription glasses on, which prompted further confirmation that I needed this treatment. Once I was in the chair for the injections, the doctor walked me through the steps and proceeded to put eye clamps in to keep my eyesight open. Ever seen the movie “Clockwork Orange?” That messed up scene where they clamp his eyesight open and force him to watch stuff? Picture that, but without the psychological torture. The worst part is that you’re awake, your eyes can move and in fact, you NEED to move them in order to look in a specific direction to allow the doctor to inject into the white part of your eyes. All that build-up and anxiety for it all to be over in about thirty seconds. Reminds me of my teens (if you know, you know). But all jokes aside, it was painful, no question.

What followed was a blur (literally) of booking the next appointment and stumbling my way back across a public park to my hotel. I stretched out on the bed with all the lights closed and tried to nap intermittently as the freezing drops wore off and the full extent of the pain kicked in. For hours after, I could see shapes, colors and general outlines, allowing me to make my way down to the quaint, Irish pub located on the ground floor. I spent my evening there, nursing my pain with the only type of “painkiller” I had available. This had been the routine for the past decade. Now, it’s become such a routine that the sting is almost imperceptible. If it weren’t; for the loss of vision keeping me from driving, I wouldn’t even need to stay in the city afterwards. But in the beginning, i had to get the injections every four weeks and in most cases, some of the swelling had returned by that fourth week. Over time, with better controlled blood sugars (I had recently started pumping therapy around this time), consistent exercise and keeping a firm grip on the reins of my health, those periods began to stretch. Every five weeks, then six, seven and so on. With every new, longer interval, I felt a small twinge of personal victory.

My last appointment was a 14-week interval. It took a long time to get me to that point and it was the longest I’ve gone without getting the injections. Given some recent headaches and blurriness, I fully expected to go in to my appointment with the announcement that some swelling had returned and we needed to claw me back to 13 weeks. But lo and behold, my scans were completely clean. No swelling at all. My doctor opted to push me all the way to 16 weeks, which is the longest interval possible on this medication. If I can make it to 16 weeks without any swelling returning, we’ll be re-assessing my treatment and deciding if I’ll stay at 16 weeks indefinitely, or if I’ll come off the injections entirely, with scheduled follow-ups to ensure the swelling doesn’t return. Needless to say and right before the holidays, this makes for one of the best Christmas gifts I could imagine getting.

The bottom line and despite that this is good news, the point of today’s post is to illustrate that when one takes heir own health in hand, in tandem with properly trained medical practitioners, they can make a significant difference in the maintenance of one’s health and the potential outcome of certain treatments. While I fully admit that there are things that simply can’t be healed or treated, there’s a lot that can and it’s important to give yourself and your body the best fighting chance to be in good health and live a happy life. For myself, and as much as I’ve been enjoying my little Irish pub, I’ll certainly look forward to a break from traveling and being away from home overnight. And, you know, getting fuckin’ needles in my eyes… Food for thought… ☯️

Off Warranty, And Lacking Replacement Parts…

I’m sure many of you can relate… It’s early morning. Your soft alarm goes off and you groggily click it off. You yawn and stretch and roll slightly, feeling creaks and pops in your joints that you don’t recall being there before. You make your way out of bed and slowly walk to the shower, noticing the chill on the morning soaking through to your bones. Once under the shower head, you let the warm water revive some articulation and relieve some of the aches from the previous day. You slowly trudge through your morning routine with the same amount of speed as a sloth trying to climb a tree. Sound somewhat familiar?

I often look back fondly at my twenties and remember the almost surreal ability I had to train for absolute hours on end, sweating and core temp skyrocketing… Performing line after line of full contact shadow boxing up the length of the dojo, doing dozens of katas, one after another, staying on my knuckles for 20 minutes at a time or in a horse stance for half an hour without missing a beat… This was usually followed by grabbing a shower and hitting the town, either for a game of pool with friends or a quiet coffee and soup at the local coffee shop while making my way through the latest book in the “Wheel of Time” series. The speed, reflexes and ability to recover I maintained was almost supernatural, despite being Type-1 Diabetic AND despite my blood sugars never being quite as well balanced as they are today. By the light, times have changed…

In the past couple of years, I’ve come to acknowledge a couple of hard truths; that I can’t maintain fitness to the level I did twenty years ago, which should go without saying, and, it takes me far, far longer to recover. While the stubborn part of me would love to knuckle down and say “Hell no, we won’t go,” and keep pushing just as hard as I always have, that’s just not a fair reality for me anymore. I recognize that I’m saying this while simultaneously remembering that Sensei is in his 70’s and easily puts me to shame, in the physical activity department. But I digress… The point is, I’ve grown older and as we grow older, the body’s ability to heal and recover effectively begins to diminish. This is why adults will often complain about the cracks and pops they never noticed there before. None of this has been quite as obvious as it has been for me, over the past few months.

AT some point earlier in the year, and I can’t recall exactly when, I started to notice a twinge in my right shoulder. It was subtle, at first. A bit of difficulty scrubbing my back using that hand, or a slight pain when I would reach a high cupboard. I chalked it up to having slept wrong or just tired muscles. MOST workouts were reasonable uninterrupted as a result. But over the course of a couple of months, the pain worsened and mobility in my right arm depended, to the point where I actually ordered a shoulder brace for some of those more extreme workouts. As an aside, the shoulder brace I found was one designed specifically with sports and martial arts in mind. It’s made by a company called Anaconda Fightwear, and their stuff is pretty good. If you’re interested in a braces for almost any of your joints, you can check out their website here. My shoulder brace has been a life saver, especially when I’m performing a lot of the circle blocks or techniques that I need through karate.

Once I recognized the need for external support just to do the things I’d been doing for decades, I started to contemplate the usual; appointment with the chiropractor, massage therapist, acupuncturist, etc. Anything more extreme or medical would come as a second step. But as is often the case in adult life, time passed and busy schedules dominated and I didn’t get to the chiropractor until about three months ago. Now, chiropractic medicine gets a bad rap from a lot of people. Some of this is born out of fear of having one’s joints (especially the neck) cracked. Some of it is because of one-offs where someone with something pre-existing may have had it aggravated by a chiropractic adjustment. Whatever the case, I’ve yet to have a chiropractor’s visit where I don’t feel better afterwards. The first time I went to the chiropractor was back in 2010. The relief that flowed through me after my adjustment almost brought me to tears. But once I again, I digress…

My point is, my shoulder was examined and it was determined that I may have weakened muscles in the shoulder that are limiting my mobility. Not an uncommon thing for a decades-long martial artist who is getting up there in age. Although not yet what one might consider a senior, my body’s ability to heal is less than it was, even a few years ago, so here we are. The solution? A set of simple body movement exercises to try and build back some strength in the stabilizing muscles of the shoulder. That lasted all of a couple of weeks. Towards the end, the exercises themselves became too painful and I needed to find an alternative. Going back to the chiropractor a few weeks ago, a deeper, more extensive examination of my shoulder was done. It was determined that I had a condition called “frozen shoulder.”

So, what the hell is frozen shoulder? Well, according to an article by the Mayo Clinic, whose web link I’ve conveniently lost, frozen shoulder, also called “adhesive capsulitis,” is a condition where the connective muscles and tissues in the shoulder thicken and tighten around the shoulder joint, causing limited range of motion and pain. While it’s not exceptionally rare, people over 40 and who have certain conditions like, oh, say, DIABETES, are at higher risk. Great. Thanks, T1D! One more issue on the checklist. The treatment is pretty simple; movement. yes, you read that right. Range-of-motion exercises, working the shoulder and on occasion, some pain-numbing medications injected into the joints. But, it does take years for it to completely recover. The article goes on. To explain that it’s unusual for frozen shoulder to come back to the same shoulder, so I guess THAT’S good.

Why do they call it “frozen shoulder?” As described in the article from Mayo, which I managed to find here, it hits in three stages:

  • Freezing stage. Any movement of the shoulder causes pain, and the shoulder’s ability to move becomes limited. This stage lasts from 2 to 9 months.
  • Frozen stage. Pain might lessen during this stage. However, the shoulder becomes stiffer. Using it becomes more difficult. This stage lasts from 4 to 12 months.
  • Thawing stage. The shoulder’s ability to move begins to improve. This stage lasts from 5 to 24 months.

When looked at from this perspective, it paints a long, bleak picture of recovery. While this falls under the category of “this could be worse,” y’all know just how much I love hearing THAT. If you do the math on this, I’m looking at nearly four years to recover, bearing in mind that everyone is different. The good news is that I appear to have passed the freezing stage. After that initial chiropractor visit and the subsequent working of the joint and the pain it accompanied, I head a couple of weeks of limited mobility in the shoulder and neck that saw me walking around like a fucking robot. You don’t realize just how much you need the supportive muscles in your neck until you can’t use them. Sitting, lying down and even rolling over in your sleep becomes an extremely painful prospect. And when every movement during the night jolts you awake in pain, your rest goes to shit, so your recovery is lengthened even further. But i seem to have a fair mobility back in most areas, with only a bit of limited mobility in the shoulder with very little pain. Looks like I’m at the frozen stage. Yay.

Growing older is a part of life. There’s no getting away from it or getting out of it. That’s why it is so critically important to maintain one’s physical fitness, nutrition and getting proper rest. That will go a long way towards ensuring that you can ride off into the sunset with some reasonable constitution left, as opposed to a lump of scarred, immobile old man crankiness. I mean, let’s be honest, I’m still ticking that very last box with the crankiness but that’s a whole different thing. Next week, I’ll be starting a form of vibrational shock therapy that will help to break up any potential scar tissue and potentially help with the healing process. While I’m looking forward to it, as one would expect, I’m not a fan of the whole “shock” aspect. But I’m sure it’ll be fine. Stay tuned for updates as this treatment progresses. In the meantime, I take solace in the fact that even while having had Type-1 Diabetes for 43 years at this point, my organs are in great health, my blood sugars are phenomenal and even my eye injections have been spaced out to fourteen weeks. Not too shabby. I’d say I’m doing quite well. ☯️

Routines Good, Habits Bad…

People live their daily lives based on their habits and routines. One may be inclined to wonder “what’s the difference?” Well, there are some integral differences that can drive whether what you’re doing is helpful to yourself or not. A habit is loosely defiined as something you do without thought. For example, picking your nose or chewing your nails would be a habit. Making a point to work out for thirty minutes every day after work would be a routine. I’m using pretty one-sided examples to illustrate my point. But ultimately, habits don’t generally become part of one’s routine, although if you perform your routines with enough focus and intention, they will eventually become habit. This can be the difference between bad habits and good.

Something Sensei had explained to me over the summer during my last visit resonated and stuck with me. In his 70’s, Sensei still very much reflects the man I always knew him to be. He wakes in the morning and engages in routines that promote his continued health and ability to remain independent and moving. This includes proper nutrition, fitness and exercising, including but not limited to cycling, house work and of course, consistent karate training. He’s never really lapsed in that department and he is still at a stage where he would be effective against opponents several decades his junior. He can do this because he uses discipline and intent to ensure he maintains his routines, and while they may have become habit, they’re not without effort. After all, the human body, much like water, tends to take the path of least resistance.

Habits can be bad because they often bring you to a slump in your daily routine. AND they can be much harder to stop, once you have them. Routines are the opposite. They take effort and sheer force of will to start and maintain, but once they become habit, they can still be difficult to maintain, since they require effort. Habits usually do not. Some simple examples. Every Tuesday and Thursday when work finishes, you and a few of your work colleagues tend to hit up a local pub for a couple of pints. You end up eating some bar food, maybe some wings or fries, followed by making your way home. Since you’re full and carbo-loaded, you’ll likely slump down on the couch and binge-watch a few episodes of your favorite show then make your way to bed for a quasi-deep, alcohol-assisted sleep. This is an easy habit, easy to get into and with little or no excuse on the person’s behalf to prevent of refuse to participate.

Now, let’s look at a routine. Let’s say you decide to take it upon yourself to wake up an hour earlier on a given morning and go running. You work up a good sweat, get a few miles in and get your heart pumping first thing in the morning. You get home, cold but sweaty, and work your way through your list of pre-work items, including but not limited to showering, dressing and packing a lunch for the day. You leave the house and hit the ground running. You feel energized, motivated and decide that this will be the new routine. Then, your day ends. You get home from work, struggle through your evening meal, maybe take care of the dishes, spend a bit of time with the spouse and kids before falling into a deep, exhausted sleep. While you may have initially hoped to make the routine of that morning a standing one, the following morning has you feeling groggy, tired, cold and wanting nothing more than to stay in bed for the added hour where it’s warm, comfortable and you don’t have to do anything. You decide that since you went running yesterday, you can likely take a “break day,” and hit it hard the following morning. You skip the routine you intentionally began. It’s all downhill from here.

The discipline and effort that’s required to maintain any good routine doesn’t come easily. And since the human body prefers to take it slow and easy, it’s much, much easier to skip things and just relax than it is to stick with any measurable routine. The thing about routines, is that even once you’ve gotten into it enough to make it a habit, it only takes once or twice to skip it, omit it from your day or decide not to do it, for it to break the routine and have to start all over. And the irony is that the same amount of discipline and effort will be required to start it up again, even if you’ve been there before. Which sucks. This is why you want to ensure you maintain those routines and avoid skipping days, negating your routines and allowing apathy to seep in are detrimental to one’s overall health. Like being able to get up in the morning and hit the ground running? Enjoy having reasonable energy levels and flexibility? Being able to continue doing all the things you enjoy doing, even in old age? Then you need to stick to your routines. Break your bad habits but foster your healthy routines. As Sensei has often told me, only you can manage your health. Food for thought… ☯️

You Only Did Thirty Minutes…?

Look, working out is hard. It is. Even if you’re one of those freaks who absolutely LOVES their 5 a.m. run through the neighborhood, the effort and discipline required to haul your sleepy ass out of bed and make it out the door into the morning chill is usually more than what the average person can put up with. And I should know; I absolutely LOVE karate, but finding the time, will and balanced blood sugars to get through a couple of hours, twice a week, in order to stay consistent is tough. That’s why one sometimes needs to take baby steps. Habitually, and for the most part, my wife and I are quite adept at carrying out brief, 30-minute workout circuits together. While it might not sound like a lot, for the purposes of a workout, 30 minutes allows us to get our cardiovascular efforts in, break a significant sweat together and gain that tell-tale ache in our muscles of a job well done. This begs the question; are we doing enough?

According to an article by the Mayo Clinic, the average person should aim to get at least 150 minutes of moderate aerobic activity a weekor 75 minutes of vigorous aerobic activity a week. This total can be spread out into smaller chunks throughout the week. So, we’re talking about a workout that gets your heart pumping. The article goes on to say that you should “Do strength training exercises for all major muscle groups at least two times a week. One set of each exercise is enough for health and fitness benefits. Use a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions.” Further, it specifies that “As a general goal, aim for at least 30 minutes of moderate physical activity every day.” Okay, perfect! This means that the 30-minutes allows us circuit workouts that my wife and I hammer out together on the weekends meet the mark and is all we need, right? Well, maybe not…

If you’re carrying on your fitness activities with the end goal of losing weight , keeping the weight off or achieving specific fitness goals, this minimalist approach may not be adequate. And sitting for prolonged periods of time can be horrendous on your overall fitness and goals. This should be pretty intuitive but you’d be surprised, and I’m guilty of this myself, how much time people spend on their ass, either working, binging television or in their leisure activities. I lose count of how much time I spend sitting when I’m out to coffee with friends or binge-watching new episodes of Grey’s Anatomy with my wife. Not so great for fitness goals and can actually aggravate or undo some of the fitness achievements you’ve reached. But that isn’t the goal of today’s post. Today’s post is about length and frequency of working out. So, let’s get to the important question: Are my current 30-minute workouts worth it?

The short answer is yes. As most leading health practitioners and fitness experts will tell you, any activity is better than no activity. Another obstacle/hurdle, at least for me, is the fact that as I get older, the energy levels and ability to maintain the same level of fitness as I did even just five years ago, has altered significantly. Sensei would likely cuff me on the back of the head if he reads this, considering that in his seventies, he is very much the image of fitness. More so than someone at my age or younger. Frankly, he puts most people to shame. That being said, ensuring I reach that couple of hours’ total throughout the week CAN be challenging. My body’s propensity for letting the blood sugar drop about twenty minutes before I get home certainly doesn’t help matters. This leads to more evenings than not, where I find myself wolfing down food when I get home as opposed to taking the half hour needed to burn some calories and get a sweat on. The struggle is real…

At the end of the day, all of this starts with you. Unlike most people, I don’t subscribe to the thought that one needs to be motivated in order to workout. That is a whole lot of nonsensical bullshit, right there! You need to be disciplined. Period. Start. Do something. Only do ten minutes of running in your backyard? Good for you. Twenty minutes of doing some weight reps? Fantastic. An hour of wrestling and rolling around on the floor with your kids? Even better. Develop and maintain the discipline to do SOMETHING. Once that discipline is in place, the motivation will follow. It can’t happen in the other direction. That’s an important detail, and most people fail to understand this. For me, going back to the days of 2-hour karate workouts several times a week are likely dead and gone. Type-1 Diabetes and my overall age and health just won’t allow it any longer. If I tried, I likely wouldn’t have the energy and ability to deal with, you know… work, kids, life… But I can guarantee that I’m going to keep pushing workouts and exercise. As often as I can, for as long as I can. They’ll have to pull my cold, dead corpse away from the mats because my health is important, as it supports everything else. So, take care of yours, as well. Unless you’re healthy and capable, you’ll find yourself unable to do any of the other things in life that may be important. Food for thought… ☯️

Why Carbs?

You know, having discovered carb counting back in 2014 when I was first introduced to insulin pump therapy, I realized that I had spent my entire youth misunderstanding the body’s relationship with sugar, carbohydrates and what they really mean for someone living with Diabetes. When I was a child and known to have “Juvenile Diabetes,” the basic rule was simple; take your shot and don’t eat any sugar. This led to significant errors on my parents’ part. Hungry? Have a slice of bread. There’s no sugar in bread. Thirsty, have a glass of milk. There’s no sugar in milk. It resulted in a number of years where my health was in decline, my blood sugars were rampantly out of control and had me live through a number of Diabetic comas. Not fun. But it was the early 1980’s and my parents, light bless them, did the best they could with the limited information we were given. Even when the health care system was “better,” there were still significant gaps that could have cost me my life early on. If not for the several times my brother woke and ran to my parents to wake them, I likely would have died before reaching my teens. Which is what they expected of me back then. But I digress…

Pump therapy introduced me to the concept of carb counting. So, let’s start with the basics, for those who may not be aware. Carbs, or carbohydrates, are macronutrients found in most food that your body breaks down to use as a primary source of fuel. For the most part, you NEED carbs, even though your favorite celebrity may tell you that you should go carb-free. Complex carbohydrates can include simple carbs, which are usually the ones that act fastest if you need to increase your blood sugars, or complex carbs, which need to be broken down by the body first, which is why they don’t make an ideal blood sugars treatment. This can includes breads and crackers and such. And this also includes fiber, which is included in the carb total on your food label but should be substrates from the carbs you calculate for, as they don’t affect blood sugars. The other main sources of fuel are protein and fat. If your body has no carbs available for fuel, it will begin burning stored fat for energy, which is why some folks believe in fasting and going carb free. All caught up? Good. Moving on.

Since learning to carb count, I’ve altered my mindset when it comes to food. For the most part, the trend in the western world is to add carbs to carbs, when eating a meal. Think about it. When was the last time you went out to your local restaurant for a meal? If it was a burger joint, you likely would have had a burger and fries. The carbohydrates in the burger are paired up with the carbohydrates in the fries, leading to a massive amount of unnecessary carbs within one meal. The second aspect is that since these are all complex carbs, bolusing for the correct amount of carbs will likely cause your blood sugars to drop significantly before your body has a chance to break those complex carbs down into usable energy. Then you end up piling fast-acting carbs on top to, you know, keep from dying… The result usually ends up being that your blood sugars will skyrocket. Even trendier and “full meal” restaurants seem to pile on the carbs. Have a side with your meal? Sure, why not? Potatoes, fries, rice… They’re all an unnecessary and unneeded carb added to the total count of your meal.

Most of this stemmed from the need for restaurants to portray the concept of getting bang for one’s buck, by ensuring full plates or meals. Since most sides are made from something lenticular and cheap, it’s a no-brained, from the business’ perspective. From the perspective of a Type-1 Diabetic who needs to calculate everything, it can be complicated and complicating. And no, that’s not a typo; I mean both. The inherent problem is that a portion of crabs that you yourself didn’t measure out can be extremely difficult to bolus for. A pile of mashed potatoes can quickly turn into bolusing too much or too little for what you’re getting, on top of being a complex carbs within that will take forever to break down. And unfortunately, while salads and veggies are options that would eliminate that problem, most vegetable, especially the high-fiber ones, are fillers that will make you feel fuller, faster. While this is not an inherently bad thing, it sucks when you pay a small fortune for a delicious meal where you might get to full from vegetables to enjoy the main. Plus, I’m one of those “I’m not paying for food that my food eats” people.

When eating out at any dining establishment, have a closer look at your meal and consider the pros and cons. Maybe a particular location has those seasoned, crispy fries that you really like and makes it definitely worth the added insulin. Or maybe, just maybe, you can just enjoy the burger, skip the fires and NOT deal with the added blood sugar issues or bolusing that ensues. Not least of which is the added fullness and bloating from overeating. You don’t have to be an Ozempic user to recognize how to keep your meals reasonable and portions smaller and more manageable. You just need to give a fuck about your health. Food for thought… ☯️

Give Yourself A Break…

Type-1 Diabetes is a beast of a condition to manage. I don’t think that should really be a secret to anyone who has it but to the undiagnosed general public, many seem to think that all it involves is taking the occasional insulin shot, testing your blood sugar and NOT eating sugar. In truth, managing Type-1 Diabetes is a life-long journey (although some would call it a battle) that requires constant monitoring and being on one’s guard. For myself, I was diagnosed at the tender age of 4 years old. Some would throw out a few token “aww’s” at that but realistically, I was too young to really know any different. It was likely easier for me than it would have been, had I gotten diagnosed into my teens the way some friends of mine have. I grew up learning how to manage Diabetes and never had the opportunity to develop “bad habits” that might have made control more difficult in my later years.

But for the folks who are not Diabetic and may not have a family member who is, there is a lot that goes on in the day-to-day steps to control my Diabetes and ensure I don’t lose my eyesight, have an organ fail or have limbs amputated due to poor control. And those are just some of the more knowable potential outcomes. The lesser known and visible side effects are things like ketoacidosis. I had a friend who hosted a guest in her home who was Type-1 Diabetic. He spent the weekend there and the following morning, she and her husband were curious at the fact that he was sleeping in so late. They knocked at the door and inquired when he would be getting up. She remembered him responding “Do I have to,” to which she indicated no and let him go back to sleep. An hour or two later, they were concerned enough that they decided they had to wake him. He had unfortunately locked the door and they had to break their way into the room. He had gone into a Diabetic coma and died. This is the darker side of the condition that people don’t recognize when they’re busy making jokes about “Diabeetus” and thinking it’s because just eat too much sugar or candy. But I digress…

Here are some of the things that I need to stay on constant guard about, when managing my Type-1 Diabetes on a day-to-day basis. This is the stuff that most people don’t realize and that aren’t visible to anyone who isn’t immediately in my household. This list is not exhaustive but is definitely part of my daily routine, which is likely why I’m always exhausted and need several cups of coffee. But here we go:

  • Extra and non-Diabetic Medications: This one is a particular sore point for me. Besides insulin injections, I have daily medications I need to take. In early 2010, a regularly scheduled doctor’s visit resulted in being prescribed statins, which are apparently a required staple of grown adults with Type-1 Diabetes to help control cholesterol levels, and Ramipril, which is used to control overall blood pressure and heart health. On top of that, although I came off of this one a few months ago, is a medication called Ezetemibe, which also used for cholesterol control. Although, since starting to use Ozempic in late 2023, I no longer need the Ezetemibe since my cholesterol is essentially a non-concern. Oh yeah, I take weekly Ozempic injections to help blood pressure and kidney health.
  • Frequent Blood Sugar Testing: I’m pretty lucky to be on a modern insulin pump. Prior to 2014, I was testing my blood sugars up to ten times a day on average. The problem with that is the inconvenience of having to blood let one of your fingertips when you’re feeling off, no matter where you are or what you’re doing. Flying blind and assuming your blood sugar levels can be dangerous and detrimental to your health. It’s even more inconvenient if you’re on a flight, in a restaurant or in a work meeting where you need to excuse yourself. Even worse was during the dating phase where you’d need to test your blood or worse, if things were heating up and getting physical and you had to ensure your blood sugars were okay to “proceed.” Thankfully, that part of my life is over.
  • Constantly Carrying a Man-Purse: What I’ve learned over time and especially in the past year or so, is that I can never take anything for granted. Stepping out of the house to run an errand while thinking “I’ll only be fifteen minutes,” can turn into a medical emergency pretty fuckin’ quick.! Just at the start of this summer, my blood sugars were normal and I had to run to a local mall to pick up one item. The mall is a literal five-minute drive away from the house. It should have been quick, easy and without concern. Once at the mall, my pump started loudly blaring at me. My blood had dropped to 3.4 mmol/L. What should have been a quick, ten or fifteen minute trip turned into forty minutes of sitting on a bench, sipping on a Coke and waiting for my blood sugars to rise enough for me to safely (and legally) drive home. These days, I always carry a small shoulder sling that contains a glucometre, a small first aid kit, wipes and hand sanitizer and at least one (although usually several) bags of non-perishable fast-acting carbs. Which brings me to my next point…
  • Keeping family Members from Being Concerned: They say it takes a village and in most circumstances, they would be right. One of my mother’s greatest concerns over the years would be that I would find myself alone as an adult and have to deal with the pitfalls of Diabetes alone. This can be inherently dangerous, since slipping into a serious Diabetic episode when I have no one to help can be deadly. But when I look at that scenario with the trip to the mall, one of the first things I did was text my wife. Not only to let her know I would be a while longer than expected but in the event I found myself in greater medical distress, I had to be prepared to have her assist me in some way, or at least know to go to the hospital to find me if something happened. It can be somewhat exhausting for family, especially considering it isn’t a condition they have themselves. That’s why it’s incredibly important NOT to get testy when they ask if you’ve tested your blood, or eaten enough, or remembered to take your pill. If you have family members that are invested enough to give a shit about your health, you need to soak that shit up and be grateful. Like I said, it takes a village.
  • Near Constant Adapting To Changing Conditions: Probably the toughest and most annoying aspect outside of taking insulin or testing your blood sugars, is having to adapt to plans depending on what your body is doing. Sure, everyone does this. Ever had to cancel plans with friends because you had the runs and couldn’t leave your house? Picture that, but on a daily basis. I’ve lost count of how many times I’ve had to cancel coffee or hangouts with friends because I was ill due to blood sugars or my compromised immune system had me dealing with yet another common illnesses that most people would shrug off. Don’t even get me started on wanting to get a workout in but my low blood sugar fucks my night. Or, speaking of fucking up one’s night, imagine wanting to get physical with your significant other, but your blood sugars are too high or too low to allow you to perform as required. Not fun.
  • Traveling Becomes a Burden: Honestly, this has become WORSE since starting on an insulin pump. Travel becomes tedious, especially if I should be leaving the province or country. I have to calculate and plan out my insulin intake, use of supplies and alternatives in the event I run out of something at my destination. Will I be able to find what I need? Will I be covered for it, outside of my home Province or while I suddenly find myself paying a significant amount of money out-of-pocket? If a given pharmacy in the area doesn’t carry what I need, can I do without or will I be sacrificing a portion of my trip traveling elsewhere to find what I need? Just two years ago, my continuous glucose monitor expired and the one I had packed for the week failed on installation. My local pharmacies not only had no idea what I was talking about when I tried to purchase more, but I had no means of ordering any. I had to run the pump without CGM for the remainder of my trip.

While some of these can be chalked up to basic inconvenience, some of them can lead to significant issues or even become life-threatening. You know how you always read about these folks who get harassed for parking in a handicap space but don’t “look” disabled? Picture that, with everything but not limited to, everything I listed above. Managing and living with Type-1 Diabetes requires a daily grind where you can never let your foot off the gas. And people often wonder why I’m always exhausted and binging caffeine like it’s going out of style. Don’t eat sugar? Sure. Take daily insulin shots? Absolutely. But trust me when I say that while it could always be worse, Type-1 Diabetes, at least when it’s properly controlled, is a far cry from an easy walk in the park. Food for thought… ☯️

Not All That Glitters…

Ah, Shakespeare… I never read much of his stuff through school the way many others might have. Apparently, French schools in Northern New Brunswick took issue with using English literature as a base for learning. No idea if it’s still the same today, but back when I was a student, they died on the hill that they would only refer to French-origin authors. But I digress… Despite the title, today’s topic isn’t about Shakespeare. It’s about Diabetes. Specifically, the benefits and pitfalls of an insulin pump and some of the unseen difficulties that people may not be aware of, when they see someone rockin’ an insulin pump on my hip. I recently had a couple of teenagers walk past me in a retail store and they actually asked me if I was wearing a pager? First, I was surprised they knew what a pager was. Now, I’m just disappointed that they asked, considering the tubing that juts out from the top. But anyway, moving on…

I’ve been on pump therapy for a little over ten years now, and am enjoying my third insulin pump from the same supplier. Each more advanced than the previous, my first pump was a glorified syringe; providing a basal rate throughout the day and not delivering insulin unless I manually inputted carbs for as bolus. I still had to finger prick several times a day and maintain direct, hands-on control of all aspects of my Diabetes (which one likely should anyway). When the concept of continuous glucose monitoring was brought up, I was recommended the Freestyle Libre. Referred to as “the poor man’s CGM,” it wouldn’t tether or communicate with any pump, but a simple phone app would allow you to get your interstitial fluid reading at any time. The down fall to this is that it didn’t maintain levels for you or adjust your pump, so total manual intervention was still required. But it was still a step forward from constant finger pricks.

My second pump came with a tethered CGM, which now allowed me to have communication between the pump and the CGM for direct adjustments and insulin blouses, based on what my blood sugars were at, at the time of my meal. It was a significant step forward and prevented constant finger pricks every time I ate something. Which was nice. The third pump, which is the one I’m on now, not only has a tethered CGM but uses a platform called SmartGuard, which communicates and makes micro adjustments to my blood sugars every five minutes, depending on my blood sugar levels, insulin sensitivity at certain times of day, and different carb ratios for different meals and times of the day. These adjustments, performed by the pump itself without my intervention, have significantly improved my time in range, providing better overall blood sugar control, less extremes high’s and low’s and a happier, less grumpy me (although only marginally less grumpy).

So, here comes the dark side of pumps… I’ve always written that life rarely cares about one’s plans. The only stronger advocate for this effect is Type-1 Diabetes. At the end of the day, you can do everything inherently right and still have issues. Such examples happen frequently for me, despite how closely I watch my levels and take care of myself. After all, just about ANYTHING can affect blood sugars, including things like mood, temperature and climate and just about anything else you can possibly think of. And no matter how nice a trinket the insulin pump may be, or how diligently you work towards controlling your condition, something will always come along to throw a monkey wrench into the mix.

If you look at the image above, it shows a steady decline in blood sugars levels. This is from the app on my phone that monitors my pump functions, so that I don’t have to constantly remove the pump from my belt to look at it. This decline in blood sugars carried on for a couple of hours. If you look closely, you’ll note that the pump initially trie dot adjust by cutting off my basal flow shortly after the noon hour to compensate for the downward trend. Although sitting around 8.0 mmol/L isn’t a terrible level, the downward trend is what can be a concern. Once I dipped below 4.0 mmol/L, I slipped below proper range. I’ll point out that during this time period, I was at a science Centre with my family. I wasn’t engaged in stressful activity, I wasn’t exerting myself and I spent most of the visit sitting. It starts to take an upward trend shortly after the 2 o’clock hour. This is after spending over forty minutes eating an entire bag of Skittles (the large, 170g bag; not the individual 61g sachet).

It took another half hour or so for me to start to feel normal and to be able to function within what I needed to walk around, interact with my kids and get us home. It’s a not-so-frequent occurrence but it does happen; even with something as technologically amazing as the insulin pump. But low’s aren’t the only issue. Lingering high’s can also cause significant issues. High blood sugars can lead to nasty secondary issues like ketoacidosis, where your blood slowly turns acidic. Not fun. But the overall shitty feeling you have while dealing with either extreme high’s or low’s more than just suck; they can potentially endanger your life. The previous day to the scenario above, I had a blood sugar level in the mid-teens, which lingered for a significant portion of the day.

If you look at the image above, the tiny red slice accounts for the period below range I suffered while out with my family. The huge yellow portion is the approximate fourteen-and-a-half hours that my blood sugars were high. This led to a night with barely any sleep, frequent urination, constant adjustment bonuses to compensate, both manual and pump-programmed, and wondering at what point I should start to consider phoning an ambulance. Nice, eh? The icing on the cake is I ate nothing heavily sugared, drank plenty of water and fluids and didn’t do anything that should have elicited this spike. But for some reason, it happened, it lasted and it lingered. I had to deal with it during the period of the day that a reasonable person should be sleeping and getting the required rest for the day that would follow. It sucks, but such is the life of a Type-1 Diabetic. It sometimes has no rhyme or reason and just fucks with your day without warning.

This is all the more reason to be properly prepared at all times. In that extreme low scenario when I was out with my family, if I hadn’t packed my shoulder sling with some fast-acting carbs and other Diabetic necessities, I might have found myself in a difficult situation. And this is the where the “not all that glitters is gold,” comment comes in. The insulin pump is an amazing tool for Diabetes therapy. But that’s all it is; a tool. A technologically-advanced tool that makes my life ten times easier than it was two decades ago, mind you. But a tool nonetheless. And as handy and pretty as it is, it still falls to the person behind the pump to ensure proper blood sugars levels are controlled and health is maintained. Diabetes has come a long way, since I was diagnosed all the way back in 1982. I can say with sincere honesty that I can’t wait to see what the next decade will bring. After all, there’s nowhere to go but up. Stay healthy. ☯️

When Customer Service Still Exists… (Above & Beyond)

We live in a world of entitlement and immediate gratification. Most people these days are of the opinion that they owed everything, are entitled to everything and assume they’re always right. I see a lot of that. Cue a British retail mogul named Selfridge, who coined the phrase “the customer is always right…” In the early 20th Century, Selfridge coined this slogan, but the part that modern people seem to forget, is that the slogan actually reads, “the customer is always right in matters of taste.” This slogan was meant to emphasize that customers should always have their preferences catered to, rather than lose the sale. Somehow, over the decades that followed, it got shortened to “the customer is always right,” and customers the world over have used this as a weapon to assume businesses should bend over backwards to provide things the customer either hasn’t paid for, or isn’t entitled to. The flip side to that coin, is the degradation of customer service in modern retail. More and more, it seems that getting decent service and correct orders in almost any industry is a dead art; businesses preferring to assume customers should just take their chances and suck it up if it’s wrong, rather than actually try to do it right.

It’s a bit of a cynical view, I admit. But it comes from a place of experience and knowledge. I’ve worked in retail industries often over the past three decades, despite my policing career, and I’ve seen the damage from both sides. This is why, when good service is provided, especially good service that goes above and beyond, I believe that is should not only be recognized but thoroughly congratulated. So, here’s the background. I was diagnosed as Type-1 Diabetic when I was four years old. As of two days go, that means that I’ve been Type-1 for 43 years. I’ve been around the block, as far as dealing with every possible situation Diabetes can throw at me, including ketoacidosis, comas, frequent dehydration, eye issues (hence my eye injections) and kidney issues. I’m among the lucky ones, as I’ve worked and fought hard to maintain myself and my health, preventing some of the more serious complications of Type-1, such as organ failure and, well… death. So believe me when I say that I try and do everything right and control my condition with an almost surgeon-like precision.

Whenever I travel, whenever I leave the house, really, I always make a point of bringing along certain necessities with me. This usually includes nasal spray, hand sanitizer, a portable first aid kit, a glucometer, and last but not least, fast-acting carbohydrates, like Skittles or Swedish Berries. This is done almost without exception since, even on a short car ride, my blood can suddenly drop for little to no reason and I can find myself stuck in traffic with no means of treating a low. It’s almost reflexive at this point, having done so for most of my adult life. Which is why the situation that happened last Thursday night came as a bit of a shock… I travelled to Saskatoon for my scheduled eye injections. I do these at 13-week intervals now, which is a marked improvement from the 4-week intervals I started at. Once again, a testament to how the body can heal itself from many conditions if you take care of yourself and give it the tools it needs. I travelled to the city Thursday morning and checked into my hotel room without issue. I walked over to the hospital about mid-afternoon and got checked into for my procedure. Getting through the process can take a couple of hours but the procedure itself is only about ten minutes. Modern medicine, go figure.

That evening, I enjoyed a solitary meal at the Irish pub located on the ground floor of my hotel. Everything went fine and I made my way back up to my room to binge-watch some Netflix and go to sleep. I awoke a couple of hours later to my insulin pump blaring an alarm at me. It appeared that I was suffering a low. Not just a low, but I got the dreaded “Below 2.8mmol/L” message, which meant that my low blood sugar was basically at a life-threatening level. The only thing I can figure is that I had over-bolused for my meal and the additional insulin hadn’t caught up to me until then. Yet another reason why it’s never a good idea to eat so close to bedtime. Accustomed to treating late-night lows, I staggered over to my backpack and rummaged through, trying to wrap my fingers around the live-saving gummies or Skittles I expected to find. Only, I found nothing… The candies I usually so meticulously packed in every bag whenever I left the house were nowhere to be found. Panic began to set in. I considered downing the little sugar packet included with my coffee station but quickly dismissed the idea, since it would have very little effect and I would still be in trouble. With little other choice and quickly losing sense of my faculties, I did the only thing I COULD do; I grabbed my room key and debit card and stumbled out of my room to seek help.

I made my way to the ground floor and remembered the bank of vending machines to my left. I walked over and struggled to see clearly, both from the blood sugar and from my recent eye injections, to figure out if one of the machines took debit. I felt the minutes melting away, so I walked up to the counter and asked the front clerk for help. I managed to mumble out that I was Type-1 Diabetic and was having a low episode and needed his help. Although I have been staying at this hotel for over ten years, I didn’t recognize this man, which likely makes sense as I’m usually sleeping during the over night. This man guided me over to the lobby couch, sat me down and hustled into the restaurant’s kitchen and got me a cup of straight Coke. He handed it to me and watched me as I drank it readily. He got me a refill once I had finished the first cup and carried on from the reception desk, while keeping a clear eye on me. After about ten minutes, my blood sugars started to climb back to a level where I could at least start to see properly and feel a sense of coherence again. He asked me how I was feeling, to which I replied that I was coming around. The clarity of my voice must have encouraged him, compared to what I had initially mumbled.

I slowly walked over to the vending machines and I was able to find one machine that took debit, so I got myself a bottle of Coke to bring back to the room, in the event I dropped again or if I needed a little bit extra. I was sure to thank this gentleman before getting on the elevator. My blood rose to over 4.0 mmol/L before I finally fell back asleep, which isn’t phenomenal but was a clear sign it was climbing and my pump would wake me if it dropped again. I woke up the next morning feeling as though I had been hit by a freight train. I felt like an absolute inexperienced idiot. Not only did I have one of the worst lows in recent memory, I ad to do it while I was away from home and on the one occasion where I somehow forgot to pack some carbs for the trip. I know how the latter happened but I won’t bore you with the reasoning. The bottom line is that when it comes to my health, there is no valid excuse. If anything, I should have checked my back when I arrived and unpacked. At least then, I would have had the opportunity to buy something for the room ahead of time and I could have avoided the whole thing.

As I started sipping my morning caffeine, the reality of the situation started to sink in. The severity of the low and the situation I was in, alone in a hotel room, no sugary products to consume and slowly losing cognitive capacity, this could have gone from bad to extremely worse in very short order, had I not made my way downstairs and if my mystery clerk hadn’t assisted me. Although he may not have been fully aware of just how serious a state I was in, and he may not recognize that he may have potentially saved my life (or at the very least, saved me from an ambulance ride), he rose to the occasion and helped me without hesitation. He could have done what many would have done, and what I’ve been subjected to in the past, where security could have been called, accused me of being intoxicated, etc. After all, incoherent, stumbling man on shorts and bare-footed, mumbling something about an episode; many would have acted differently. But not this man. This man stepped up and gave me the help I needed to allow me to help myself. For me, that’s customer service that goes above and beyond what one would usually hope to find.

When I checked out of my room that morning, I asked the front desk clerk who the gentleman working overnight was called. As I asked, I reached over to the bank of business cards on the desk and grabbed one for the General Manager. I think the clerk took this as a bad sign and asked me if something had happened. I said that yeah, something had happened. This man possibly saved my damn life and I wanted his name so her could be recognized. She told me her name was Greg, and was happy to hear that he was able to help. I’ll be sending a note to their General Manager recognizing this man and what he did for me last Thursday. He showed the kind of attention and assistance that everyone in the service industry should be able to provide for their guests/customers. And I should dare say that customer service like that doesn’t belong on the night shift. Hat’s off to you, Greg! You’re an example to others. Keep up the good work!

For myself, this was a sobering reminder that my condition follows me wherever I go. It doesn’t take days off, doesn’t stay behind when I travel and won’t give me an inch for the mile. By virtue of that, it’s all the more reason for me to be vigilant in preparing for any outing, trip or travel. After all, I can’t always assume that in the event of an emergency, Greg will be there to save the day. Sugary food for thought… ☯️