Interview 04

Age at interview: 18

Age at diagnosis: 18

Brief Outline: Diagnosed in August 2005. Her insulin regime consists of three injections of NovoRapid before each meal and in the evening before bed is Insulatart. She uses cartridges with pen injectors. The fact that she was diagnosed with having diabetes still upset her but says that everybody; her mother, friends, GP and the care team at the hospital have all been very supportive.

Background: This is her first year at university and she is studying media and communication. She will be living in student accommodation during the week and at home with her Mum at the weekend. Ethnicity: Portuguese.

She describes being in hospital, her high blood glucose levels and what it was like to be given...

I was in there for about an hour in that room and then I got taken up to a different part of the hospital where there was other patients but it was a ward like an emergency sort of ward. So there was only like six patients there. And I was on a bed and stuff. And then they put me on the drip, and on an insulin. They didn't inject insulin into me they just. It was like on this machine where the drip was.

On a drip?

Yeah.

And the insulin was going in through there as well. Because when I first came into the hospital my sugar level was 27 and it's meant to be between four and seven. So it was very high. I stayed in hospital for around four days. I then, later on that day I got moved to a different ward which was like just a diabetic ward. And I stayed there for a few days. And then I had a dietician come in to talk to me and I had several consultants and nurses come in to speak to me. 

Can you explain in a little bit more detail how they gave you the insulin?

Yeah. They put a needle like in my arm but firstly they done lots of blood tests as well and stuff in the meantime. But the insulin they put a drip in my arm and then there was this machine underneath the drip and it was like a big sort of plastic needle with white liquid which was the insulin. And that was going through another tube but it was all connected to my arm and I think that was the insulin that was being put into my body.

Were they explaining to you what they were doing at the time?

They weren't very communicative really at the hospital. I didn't find very, I had to ask most of the questions. They didn't, a lot of times they didn't really tell me what was going on and stuff.

So you remember what type of questions you asked?

Yeah I just said basically what they were doing. They said they were putting insulin on there. And then after a while I'd have to start taking the insulin by myself, injecting myself, in my belly and on my legs and stuff.

Remembers how upset she was on the adult ward when she realised that an older patient had had her...

They said I could, you know, get heart, heart problems and problems with seeing things and stuff. And yeah.

That scared you?

Yes it scared me quite a lot especially when I was at the hospital because there was this other patient I think she was bit by a mosquito on her leg and where it got infected and stuff they had to cut her leg off. And yeah that sort of scared me a bit. And then there was another patient she didn't have one toe obviously because she probably hurt it and when you've got diabetes it takes such a long time to heal that they had to cut it off as well.

So basically you were in an adult ward?

Yeah. Well it was a big ward but I was at the end and it was all like older people. It was all people over 50 so they were all quite, you know, unwell so it was very shocking going straight into that seeing what would happen to me in the future? What could happen. I think I should have been put, you know, on maybe a children's, not a children's ward but a more teenage ward because it was quite scary seeing that. And that's why I think I got even more upset about the whole thing because I saw how other people were looking and that could happen to me if I don't look after myself and stuff.

If I'm just going there for appointments it doesn't bother me. It's if I'm actually staying in hospital. I think when you get in it's a very big shock to see all those old people like that. I think they should have places for younger people with diabetes.
 

She found that nurses working on different shifts didn't communicate with each other very well.

Well at the hospital itself I thought the communication was very poor between the nurses and between each other really. You know you have different shifts of nurses, different nurses coming to see you and stuff and some of them. Like when I was coming home I had wait about two hours to get all my medications and then this nurse, she just gave me an insulin pen and it had someone else's name on it. And she can't, that's just out of, you know. You can't do that because it's got someone else's needle in there. And if I hadn't have looked I would have injected, you know, I think it's terrible communication at the hospital on the wards but the diabetic centre in the hospital is very good and efficient. It's just the actual communication on the ward and maybe, I don't know. They're not very, communicative like between each other.

She has been recently diagnosed and says that she discusses fears and concerns with her mother...

How have they responded?

They've been very supportive both at the hospital and my GP. They provide a lot of help. If I want to talk to people and if I'm upset they're very supportive. They're not cold or anything. They're very, yeah, they're great actually, they're very nice. And…

So it seems to be that apart from the the care team you also talk to your GP and you are in touch with him?

Yeah, yeah. And I have to go and get all my medication for when I go to university. So I had to go and see him last week and get all of my insulin and my strips and stuff from him.

And so he has been responding, he has been supportive?

Yeah very supportive. And he said even though I'll be studying away from home he said whenever I come back if I need to talk to anyone or if I need to see him to just make an appointment or something. So it's been quite, yeah he's been quite supportive. 

Do you have any fears or concerns about the future as far as your diabetes is concerned?

Just scared that, you know, about when you get cuts and stuff on your feet and legs that I have to cut them off, amputate them. That scares me quite a lot and things that can get in, heart problems and eye problems and stuff. Yeah it all sort of scares me a bit.

Who do you talk to about these fears?

Just my friends and my mum if I'm feeling down or something or my GP as well. He is…

You have talked, discussed with him about this?

Yeah. Well I've been upset if I have, you know, an appointment with him I've just cried or told him what's wrong and he's been quite supportive and he like. They just say basically if you control it you shouldn't get these problems. It just has to be, you know, well controlled, the diabetes.

She was recently diagnosed and does her glucose tests and records the results as advised by her...

And how many times a day do you check your blood sugars?

My blood sugar level, I check it three times a day. I check it as, when I wake up. I check two hours after my lunch and two hours after dinner.

Do there is anything difficult or unpleasant about checking your blood sugar levels?

No sometimes if I do it in the same finger, if I, you know, prick the same finger sometimes it will hurt a bit but it's not really unpleasant. It doesn't hurt very much. At the start it did because I wasn't used to the feeling but now I'm used to the feeling it doesn't hurt me.

And you record your results of the blood sugar tests?

Yes I record it in a, a book that I have so before breakfast and two hours after lunch and two hours after dinner I record it. And so my doctors can compare every day and then so I know what it's like, how my level is and if I need to alter my insulin levels etc. And they help me to do that at the hospital.

Thinking about your hypoglycaemia episodes because you said that you had quite a few?

Yes at the beginning when I first came out of hospital I got taught what a hypo was. And I think three or four days later I had one. And it was at home. I started feeling quite shaky. My legs were quite shaky. I started sweating a bit on my back and on like my face and stuff. So what I done is I took three Lucozade tablets and ten minutes later I checked it again and it was a bit higher, my level, so I had a sandwich. And then for about a week I had one nearly every day. Not like terrible ones just a bit of shakiness and sweatiness. But then when I went back to the hospital they, I think they put down my insulin so it was. I wasn't getting any, I haven't had any hypos since.

After diagnosis she experienced hypos everyday for a week. She went back to the hospital and her...

Thinking about your hypoglycaemia episodes because you said that you had had quite a few?

Yes at the beginning when I first came out of hospital I got taught what a hypo was. And I think three or four days later I had one. And it was at home. I started feeling quite shaky. My legs were quite shaky. I started sweating a bit on my back and on like my face and stuff. So what I done is I took three Lucozade tablets and ten minutes later I checked it again and it was a bit higher, my level, so I had a sandwich. And then for about a week I had one nearly every day. Not like terrible ones just a bit of shakiness and sweatiness. But then when I went back to the hospital they, I think they put down my insulin so it was. I wasn't getting any, I haven't had any hypos since.

She is newly diagnosed and explains which factors she had noticed affect her blood glucose level,...

It just concerns me because sometimes, you know, my sugar level might be high and then suddenly the next day or a few hours later it's quite low. And that worries me because that difference of sugar level in the body can. Obviously it's not good for your body so it worries me like what can happen if it's really high one day and then really low, you know, a few hours later. That sort of worries me. But I think it's just at the beginning stage where my body's, you know, getting used to the insulin and the whole new, you know, diabetes and injections and stuff.

That's the explanation that has been given to you by doctors or?

Yeah. It's my body's take, is going to take time, you know, to get to the right level because it's a new thing and I'm going off to uni so I'm a bit nervous. And also like in women when you have your period your sugar level is higher as well. So all this'

Have you noticed that already?

Yeah, yeah I noticed that. But I just, I was a bit scared because I didn't know why it was a bit higher and then I asked the doctor and they said a few days before you get your period your sugar level can either be high or lower. So that was quite comforting because now I know for the future.

You just need to, with me as being a student I get quite nervous or stressed when I have exams and stuff and they say you have to be very careful because you know your sugar level can get high at those sort of times. So I've been trying to control my emotions and trying to not get upset or stressed about things as much because I know it can alter, you know, my sugar levels. 

So, at some points you feel kind of positive and have positive thoughts and feelings and at other times when you are under stress you might sort of feel down?

Yeah you sort of break down a bit, yeah. And especially if you have a lot on your mind and there's other things going on in your life, even in your social life or if you have an argument with someone.

I just think if there's other parts, if there's other problems of your life, you know, if you do have an argument you feel nervous and you might cry or something and that completely messes up your sugar levels. I don't know why it does it but. Because when I've been upset or upset with my boyfriend or something it does, it just goes out of control. The levels get high or they can get very low as well. So it's something just to try and not think about things just relax and, you know, try not to get into arguments and stuff. 

And if anyone in your life is, you know, stressing you out just get rid of them. You know, that's what I think. Just take them out of your life [laugh]. It's easier that way.

Says that her relationship with her mum was good before her diagnosis but now it is even better....

How has your mum reacted to the news of you?

She was very sad, like very upset and stuff and all our family that are in Portugal she phoned them and she was crying, explaining the situation but I think now she's getting more, you know, used to the idea. And she's very fussy over me though. She like makes my food and doesn't put any salt in it. Makes everything how it should be and yes she's just been very supportive. She's tried not to show her emotions really in front of me so that I don't get upset and stuff.

Ah but do you talk to her?

Yeah I talk to her about how I feel. Yeah. And she's, like if I'm crying she'll just comfort me and say 'Oh don't worry there's worse things, you could have cancer or you could, you know, die or something'. So it's not something that, you know. If treated well you can live a long time, you know. Diabetes isn't something where you can just die suddenly because of it. If you know how to treat it you can live like a normal, a normal life really. So she's just been encouraging me to do what I want and to not let the diabetes hold me back really. 

You have always had a good relationship with your mum sort of communicate?

Yeah but it's got much better now that I've got the diabetes. That has brought us closer together I think because she's been there 110% for me. She's always there for me to talk to and, you know, and she's been more, like she hasn't stressed me out or anything. She's been understanding. So it's really good to have someone like that around to keep you strong.
 

Keep positive and do control your diabetes. And when you feel depressed do make sure that you...

What would be your advice to other teenagers or young people about managing their diabetes or about their attitude to diabetes?

Just keep positive and think that there's millions of people out there that have the same thing. You're not alone. Just make sure you do everything properly because if you do it properly from now it will prevent you from, you know, getting worse things one day. And make sure that if you do feel down talk to someone because it's bad if you keep your feelings in because I find that. If I talk like I'll feel better afterwards. And basically don't let it stop you from going out or from doing anything. You can still study. You can still do what you want to do. Go to parties and stuff. It's not, it doesn't have, you don't have to. It doesn't control your life. You have to control the diabetes. So it's just part of your life, it's not your, your life doesn't revolve around it. So it's just something that you have to remember but apart from that don't let it take over your life. That's what I think.

I think when you have bad days it is good to talk to people be it your mum, your friends, your boyfriend or girlfriend. Because if you don't I think if you hold it in it just gets worse and worse for yourself and you just start feeling down and depressed and that's not a good thing. So I think you should talk to people about your problems.

Have there been episodes in which you have felt depressed?

Yeah definitely, especially when there's other things going on in your life everything just seems like such a big problem and it all just gets on top of you and you break down. But you have to come back up really and just smile and just get on with it.