Interview 12

Age at interview: 19

Age at diagnosis: 14

Brief Outline: Insulin injections turned out to be less of a problem than he originally anticipated. He does not mind injecting at all. He is on Lantus and NovoRapid and says that he likes the flexibility of his new insulin regime. Says that the secret is to be patient, to learn how to control diabetes and then to live life normally. The information given by doctors, nurses and dieticians has really helped him to maintain good diabetes control.

Background: Lives with mother and siblings. Works full-time in the retailing industry. He walks to work.

After his diagnosis he became a bit shy and lacking in confidence.

And how much did you know about diabetes at that point?

Before, I knew nothing about diabetes. I'd heard of it and heard that people had to inject everyday, but I didn't know what it was that they were injecting or how diet was controlled and stuff. I'd heard about a few footballers and sort of celebrities and stuff with diabetes. But'

And how did you feel at that stage, having developed this thing called diabetes?

Kind of strange, yeah, because I haven't known anybody close, or anything, who'd had it before, so it was all kind of new, but I wasn't worried, like, at all. It hadn't - it knocked my confidence slightly for a while, not noticeably, but when I look back on things I realise that had I not had diabetes I might have been a bit more confident, and now, sort of five years on really, it's not that factor at all. I just sort of - in a way it doesn't bother me that much. Sometimes I nearly forget injections, because I don't worry about it. Injections is just one little thing to me, so it's no kind of problem.

You said that it affected your confidence a little bit?

Yeah.

Can you tell me more about it?

Just meeting new people, stuff like that. I wouldn't be very forthright and outgoing too much, and also I play a lot of sport and I used to be very vocal on the pitch and stuff - playing football, and I'd be a little bit quieter and just generally things like that. Just, I became a bit more quiet as a person really, than I was before. But I've probably regained all that confidence now, but for the first two years it was a bit - yeah - a lot quieter.

He thought the injections were going to be a lot worse than they actually turned out to be.

What happened in the hospital?

I was given insulin for the first time - injected didn't really bother me. I've never been bothered by injections really. It didn't hurt. I thought it was going to be a lot worse than it actually was. And then I didn't - my first thoughts as well it's going to be a big deal, it was going to be quite frightening. I didn't know how I was going to cope. As soon as it started I thought there's no problem here. What is three or four injections a day? It's not really stunting my life at all or anything like that, and yeah, I was just having my insulin, and just waiting really, because the consultants etc were on holiday, that I couldn't really do anything, so I was just waiting round the hospital, and it was a kind of surreal experience, feeling very well, not actually feeling anything was wrong with me, but having to sit in the hospital. So it was a bit annoying, but it had to be done.

He wishes his doctors would share information about him so that consultations could progress a...

It's, can be a bit repetitive at times. Quite a few times I've been there I've got frustrated, because three months before I've had exactly the same conversation, but because it's been different doctors' So I've gone there and they've said this and I've gone away and yeah, do all that. Come back and they've said exactly the same things to me that they said three months ago. So I progress myself in getting better sugar levels, but then they haven't really consulted with the other ones so - you've always got to bring them up to speed. So they always ask you questions, and it's annoying really, because you've told them how you feel what your sugar levels were the last time, what your diet is and stuff like that to one doctor, and then three months later you have to say it all again to another doctor. So I feel clinic can be a waste of time sometimes, but like other times the last occasion I went I spoke with the dietician, and she explained to me how different carbohydrates have got different different values. So rice is - a plateful of rice has got a lot more carbohydrate than a plateful of mashed potato, for example. So that was that was really useful to me. So at times like that it's been good, but other times it can be just - I feel it's a waste of my time, sometimes.

It is because you don't see the same doctor?

Yeah, that's one problem, because you don't see the same doctor every time. You can see - all the time I've been going to clinic, over four and a half years, I've probably seen about seven different doctors. Yeah.

So the continuity' they don't know who you are, basically?

No, they've got a file on me that everything is put into, but they don't - well, I think they don't always check up on their patients before they look at it. Because, well, like I said, they always ask me the same information. But the dietician, she's very good. She often has a chat with me just to see how I'm getting on, and that's very useful, because like she's showing me how rice has got more carbohydrate than mashed potato, now when I do inject after I have a meal, I know if I've had curry, with rice, that I need more insulin then, and that's actually helped my sugar levels.

What would you improve regarding the consultation at the diabetes clinic?

Better - I think they need to talk to each other more because like I was saying quite often I get asked the same stuff by different doctors and I don't feel there's any progress there, so I think they need to, before they see the patient they need to sort of check the file over and say oh we discussed this last time so the issue doesn't have to be raised this time, things like that, so' I'm okay with them, but I think they need to talk to each other a bit better, because sometimes I think the information - certain things could be, like we could move on and talk about new subjects and stuff, but we are talking about the same stuff all the time, and also it would speed things up because people don't like going to clinic, obviously, and sometimes the process can, sort of, take two hours, with the waiting as well and stuff like that, so' I just think yeah they need to talk to each other a bit more.

Says that he is most likely to have a hypo when he is tired but that he and his mum know what to...

Have you had any hypos?

Yeah. I've had a few times when I've quite often I've been tired. I've had a few late nights and stuff, and over the course of two or three weeks, and then I've done an activity, and it's really drained me, and I've come in and sat down and started to sweat. Just constantly sweat, and - where it's really sort of frightened my mum, because I've not done anything, and I've come in and I've started sweating, really bad. And then my head started to sway side to side, and my vision was going a bit funny. And so that's happened about twice, and my mum's just given me a bit of fruit juice and like a chocolate biscuit, and then I've had a sort of sandwich about ten minutes later, and after half an hour you're just back to normal again. It's almost like your batteries are going flat, in a sense. So as soon as you put new ones in you're fine to go. It's quite a strange feeling because you don't feel any pain or anything. You just feel you want to go to sleep, but actually it can cause some trouble, it can be, so two times I've needed my mum, she's been there. But other times I've felt low, not bad, and I know if I don't do anything about it will get bad. I've just gone to the cupboard and got a snack or a drink and I've been fine again.

He's never had any problems with his friends who have always supported him.

Well. I've never had any problems. My friends have always accepted me they're a good bunch of people. They're - just because I was different to them, they didn't treat me any differently. I was always treated the same and quite often they'd kind of forget, in a way, because I never had any problems. So they'd say, 'Oh do you want to stay round so and so's house', and I'd say 'Yeah, I'll take my insulin with me', and stuff like that - and they'd say, 'Oh, sorry', but yeah. But I've never had any problems. I've stayed with a lot of my family members and they've been really good, and they sort of worry too much really because they know I've got diabetes. My nan, she always used to make sure I was all right all the time, and I was like, 'Yeah, I'm okay', [laughs] but yeah, yeah, they've been brilliant.

He has a diet high in carbohydrates because his job is very active and he plays football once a...

And about your diet, tell me about - because diet is really important?

Yeah. I have a high carbohydrate diet, full of carbohydrates. My job - I'm very active, so I need a lot of carbohydrates to keep me going through the day, and also a lot of protein. I tend to - I don't eat enough fruit. I should eat more fruit. I only really eat apples and grapes, whereas - I don't really like oranges and bananas, but I wish I could eat them, but I don't like them, so I tend not to. So fruit's probably the one area where I could improve my diet quite a lot. I'm quite good with vegetables - I eat varied sorts of vegetables, so I get a good source of vitamins but yeah, not enough fruit. That's - I could eat more fruit.

And you are a sporty person?

Yeah, yeah.

Did you learn that you need to have more carbohydrates?

Yeah, that's what they told me, that although you don't produce insulin - because your body doesn't produce it, when you inject insulin it just keeps on going, so if you're doing an activity where you're using a lot of energy, your insulin won't stop, if your energy is increasing. So they told me that if I had a football match to have a sandwich or something - a carbohydrate snack beforehand, just to give me a little bit of a boost, and then I've carried on sort of playing football and that, and then to have a lucozade drink, or energy drink, just like they say on the bottle, sort of, before during and after sport, just little sips all the time, and then once I'd finished an activity then again just have a little sandwich or carbohydrate snack, to stop me going low, maybe an hour after my activity has finished. Yeah, but normally for me, quite often if I've played football it would be in the afternoon, so I'd have lunch afterwards. Or at night, then I'd have my dinner, so I was always close to having food. I'd never play a match and then go a long period without eating.

Yeah, it was good, yeah. I've always tended to have good control as well, so my HbA1C results have always been quite good. Recently I've had a few high ones but I have had a HbA1C of 7.1 before - mostly they're around 8 - 8 - 8.1., like that. Recently I've had one that was 9.2. I was going a bit off, off the boil slightly.

How did it make you feel?

Just a bit sort of angry with myself, because I know that I was sort of letting my diet slip. I was having more sugary things and stuff. I knew I shouldn't have done, but I was jut going through a period where I got lazy really. So my HbA1C went up, but now I'm in the process of getting it back down. I know - I know I can get it back down, so it's no real problem.

He drank too much once and ended up in hospital in a coma which frightened everyone including him.

Have your mum or your dad been anxious at some point?

There was the one time when I went to a party and I drank too much, and mum rushed me off to hospital, because from one moment I was quite fine, and then I was rejecting all food Mum was trying to put into me. My sugar was going really low, so she rushed me off to the hospital, and I went in intensive care, and I was on a sugar drip for about two hours which is - I didn't really know what was going on, because my body was going low, so I 've hardly got any memories of it at all, apart from sort of waking up. But yeah, that's the only bad time I've had, really. And then my mum, everybody, friends, were really good, because they saw what happened. Not so much my friends, but my mum did, and then it was like a wake up call, because she said to me that I caused that problem myself, whereas some people were genuinely hurt and needed attention and I was kind of wasting time, in a sense, because although I needed to be treated, it was my own doing that got me there, whereas other people, genuinely hurt in an accident or something needed attention and I was taking up their space, in a sense. So I've never had an incident like that again. So' it's always sort of - I think everybody needs a little warning like that, sometimes, because I'd got to that stage where I'd got a bit lethargic. I was sort of going along thinking that I was sort of invincible, in a sense, because everything was going so well, the control and stuff, so I sort of pushed the boundaries of alcohol a bit, and suffered the consequences.

He explains the plan he followed for his injections during a long flight to New Zealand and was...

Yeah. I was quite lucky. I played hockey at school, and we got the opportunity to go on a mixed hockey tour to Australia and New Zealand. We went in July 2003. First of all we spent a week in New Zealand, which is fantastic. We went to the South Island, to Christchurch spent a couple of days in Christchurch, and then went an hour south to place called Ashburton, and we were there for sort of two - two days, and then we went to Wellington, and then we flew out to Australia. It was their winter so it was very cold, but it was a very nice country, New Zealand.

And how did you manage your diabetes? 

Oh yeah'

What changes you had to do, what you had to pack?

The most difficult part was the flight itself, because we went with Air New Zealand, and they fly the opposite way to everybody else. They fly via Los Angeles, so it's actually a longer flight. So going backwards through time, as well was a bit difficult. But what I did was I halved my insulin and then kept my watch on British time so every twelve hours I gave half my Lantus, which at that point, I think, was 24 units Lantus - so I was doing 12 units every twelve hours, basically, to cover the flight. I still had my watch on British time, so when I got to New Zealand, I did it every 24 hours from that point. So, with the time difference, instead of having my Lantus at ten o'clock, eleven o'clock at night, which I was previously, I think I was having it at eight o'clock in the morning. Yeah, but it was still on British time, and that meant that all through the trip I was just having it in the morning, but then my sugar levels and everything were fine. No problems at all with it. And then on the plane of course you get meals sort of every four hours, and they're always quite little, so during the course of the flight I probably injected six times with NovoRapid but they were all little portions, so it was sort of eight units here, eight units there'.

Okay, so obviously you talked to your doctor before you went and he sort of told you - he or she told you'?

Yeah, they sort of set a plan, and said, 'It's best to do it this way'. I stuck to the plan and it worked out fine. I didn't think it was going to work out that well, as it did. I was really pleased when it worked out really well.

Just learn to be patient because when you are starting to managed your diabetes your blood...

Yeah, just be patient, really, because what I've found is sometimes you think your sugar levels are going to be good, and they can be a bit higher than normal, and I used to get frustrated when I was younger, because I used to want perfect levels all the time, but yeah, you've just got to learn to be patient and if you go low, don't panic, stuff like that, just self managing it. You've just got to take your time, get to know it better, stuff like that, and then once you're okay with everything then just lead a normal life and just get on with it really, that's what I try to do.

And what about asking questions to the health professionals?

Yeah they're always there to help so if you have a question you might as well use them and ask them, because they tend to have all the answers, so, yeah.

Probably not to worry about it if they - if you get asked to change your insulin regime to do it because it's only going to benefit you, and I mean every time I got asked I've always changed regime - I've changed three times, I think. I've had three different styles, and everything's a challenge, and I sort of relish challenges really. Yeah just to get on with it and not let it rule your life. You just have to make allowances and stuff, so, don't rule your life by your condition. Sort of live your life and then adapt it to the diabetes.