Gareth - Interview 24

Age at interview: 61

Age at diagnosis: 50

Brief Outline: Gareth was diagnosed 11 years ago. At first he was prescribed tablets, but is now taking insulin which he prefers.

Background: Gareth is a retired paramedic and is married with 2 grown up children.

More about me...

Gareth's diabetes was diagnosed in 1996. He was working as a paramedic and so knew the signs and symptoms, but didn't recognise them in himself. Looking back, he remembers that he had been feeling thirsty and needing the toilet frequently but said that it never clicked that he might have diabetes.

Gareth had a very dramatic episode leading up to the diagnosis. He and his family were scheduled to go on holiday, and though he had been ill for a few days beforehand and hadn't eaten much. When they had boarded the plane and were about to take off, Gareth started sweating profusely and looked very ill. His wife stopped the flight and Gareth was taken to a doctor. 

After he was diagnosed with diabetes Gareth was put on gliclazide and metformin. He was still working as a paramedic, which included driving the ambulance at high speed and working long hours. As time went on, the medication dosage was increased to the maximum amount. Then Gareth had a back injury which forced him to give up work. It was at this point that Gareth transferred from oral medication to insulin, and he says that insulin has improved his quality of life. Gareth follows a routine which includes keeping fit and going to the gym regularly which helps him manage his diabetes.

As a paramedic Gareth was well aware of diabetes symptoms but never made the connection for himself.

Well I was first diagnosed with diabetes in 1996, or there or thereabouts. And came as a bit of a shock really. Although I, I mean, the job that I was doing as a paramedic, I knew all the signs and symptoms of diabetes, I didn't recognise them in myself. Like drinking excessively, going to the toilet, and so on and so forth. And this was something which I thought was just one of those things, getting old, getting to around the 50 mark. So it did come as a bit of a shock. 

How I found out that I was a diabetic, we were going to America on holiday, and we went to Heathrow. 

So we got on to the, get to the airport, walk around, get onto the plane, and sat right at the very back of the plane. The food was, the fumes if you like, the food, the smell of the food, the smell of fuel, 'cause we could still smell the fuel because the engines were at the back, and all of a sudden then I starting sweating profusely, and, it was just as if somebody had put a tap on my body and just switched it on and it was just dripping off. And my wife said am I all right? And we were at the, actually, we were at the end of the runway just ready to start to taxi off, and obviously I was in hypo and I passed out. So my wife, so she tells me, jumped up, said, 'Stop the plane.' And they stopped the plane. Which was a bit melodramatic, so it was quite good. So she stopped everything at Heathrow, which is funny, [laughs] now [laughs]. 

We walked around Heathrow. We went to the, another desk. There was this girl who was from the airline and we arranged for another flight out, about three hours after our original flight, but we had to go via New York. So, which was an added bonus, so we were going to New York to go to Boston. So this is what we done. I had a marvellous flight over from Heathrow. My wife had a terrible flight, because she sat up watching me all the time. Wondering everything, nudging me and things like this. But that was it. 

So as the holiday progressed I got really better because I was eating. I was, and, and no symptoms of diabetes at all. But when we came back just to satisfy my wife. She said, 'You have got to go see the doctor', so I arranged to see the doctor, but I, before going to see the doctor, I had done an ECG on myself in Casualty and I checked it out and there was nothing on there, 'cause I could, could read an ECG quite well. And there were no peaks or troughs or anything like that. PIS was okay and everything. So I go up to see the doctor. I take a copy of my ECG up and he said, 'Oh there is nothing wrong with that at all. But to shut her up we'll do a blood test.' So I said, 'Right you are.' So he took blood and I took it up to the hospital and lo and behold he was ringing me within an hour to go back up to see him, because my blood sugars were something like about 26 or something like that. Twenty-, 26. So that's my introduction to diabetes.

Gareth doesn't always want to be monitored or to take so many tablets but knows he must.

You've got to make sure that your blood pressures are okay. And then of course if you've got raised blood pressure you are liable to have a stroke and so on, and things like this. So you keep monitoring that. You have got to be monitored for those type of things at the surgery, and cholesterol is the other thing as well, because these are the negatives that go with the diabetes.

You got to make sure that they are okay. I went to the doctors last year or the year before and my cholesterol, he said good cholesterol is, sorry my bad cholesterol is down and my good cholesterol needs to come up. So, you end up having a tablet, to maintain your cholesterols down and then you have got a tablet then to react to get your good cholesterols up. So, you know, it seems silly to me, but you can understand' I can understand the difference after it had been explained to me why it has got to happen. And yet, because my cholesterol isn't exceptionally high, but they want it within certain bounds you've got to take these tablets.

So that's the negative side of diabetes really, as you've got other things that you've got to monitor. And you've got to keep monitoring them and try not to miss your appointments with your doctors and things like this, because you've just got to keep going on these things. That is the way I have found it. That has benefited me. Sometimes you go there, and you don't want to be, 'Oh here he is again, you know, with his Mac coming in to have his tablets', but you've got to go.

That is another negative is you have got to go regularly to get it, your medication. I'm fortunate, I can get mine for about three months at a time. But I need a suitcase sometimes to come from the chemist [laughs]. You know you get a few tablets, you are taking loads of tablets isn't it, you know you are going to have a nice little carrier bag full to come away from' People think you are buying presents.

Gareth takes higher doses of insulin now than he did before and advises newly diagnosed diabetics...

I take 42 units [of insulin] in the morning, and 44 at night, which is quite high. Its' That's the one that suits me at this moment. It keeps my sugars level.

Has it changed over the years?

Oh yes. When I first started on insulin I was on something like about 10/10, just to find out, it's like everything you titrate isn't it? People might not know what titrate is - you find the level of the medication that you need to keep your diabetes in control. So I started going up and then of course my sugar was rising slightly, so I increased it with telling people what I'm doing and also with the consultation with a nurse or a doctor. And I'm on this level now.

I was finding that if I was taking more units in the morning, I found that my levels the following morning would risen, so this is why I take a high dosage in the evening - two more in the evening to counteract that - so I take 44 in the evening just before my evening meal - because that is normally your biggest meal. And then, in the morning, I just take say 42, and then I'm right for the day.

The people have to take insulin or tablets at various times in the day, more than twice, so if you were logging it, [write] it down [on the] log when you're taking your tablets and what time you're taking them, and also whenever you take your reading, what time you take your readings. So if you have to go to the doctor, he can see the peaks and troughs of whatever you've got. Its important that you record when you are newly-diagnosed and I'm not saying that you shouldn't do it after, but it's more imperative that you take it when you are newly-diagnosed, so that they can see how you're reacting with your treatment.

Gareth used to be a paramedic and so knows the difference between hypos and hypers. He says a...

But I mean as a paramedic had you ever attended to somebody else who might be having a hypo?

Yeah. I have been to people who have been hyper and hypo. So I knew the difference of them and yeah, the glucagon and things like this, the drugs that you use. And 50% dextrose which is ideal you know, because it's, that's a wake-me-up drug which is fantastic. So I know, how things react on, with certain things, how much sugar you can get in and the forms of what people do. Because a lot of people say that you should have ready like glucagon to inject, but the first thing is orally and so I knew everything that, the treatments that should go with the condition. Which I didn't know I had [laughs].

So you knew all that at that time as well?

Yeah. I did yes. So you know. You know, you pick up things, but there we are, because you always remember you go to casualty especially with somebody with diabetes who is in a hypo and one of the sisters here used to say, 'Go and get a Mars Bar for them.' And you know it is only simple things like that but you remember, or a sugary drink. You know, to try to get them to drink it, milk is another thing, which you try and do. Marie biscuits. So, you know you tend to prepare yourself. Afterwards I was prepared for it, you know, I always had something like that. And make sure that you, I make sure that I eat fairly regularly at times, you know within a certain times. Not exactly heavy meals. But may, I have a little something to eat before I got to bed in the night because when you are at rest sometimes you don't want to go want to go hypo in the middle of the night, and you have got to experience being hypo as well. Because it's really, ah it is something different. It is like walking on eggshells. Its you are sort of like getting a little bit risen, it is just surprising and'

There is no pain with it, it is just that you feel that you're in a different part, you are just rising, in my experience that is, you know, but the eggshells, and you know, you start to know how, what you're having and how it was coming about, so you know, even in the, you wake up in the night sometimes, you know, very rarely happens to me, but I have woke up in the night and I've had to get up. I know I am sweating, and so I come down and make myself a piece of toast or some bread or have a drink, biscuit etc. anything, just so that it is quite then. And you, but it's like walking as I say it is walking on eggshells, you know, you know your know your feet are going there, but you know you can't really feel it.

Gareth does not worry about 'what if's' that may happen in the future but says he will deal with...

Well what about, some people might experience a bit of depression?

I haven't, I personally haven't. That might well have, my wife might have thought I had been in depressions, but I haven't had anything on that lines at all. I am not really that type of person. I know depression can affect you at any time, but it hasn't with me. My outlook on life is fairly good. I'm not one of these people that say, 'What if?' I say, 'If it happens then I react to it. I don't want to react before it happens' sort of thing. So I've been fortunate in not being depressed. I've' No I've never been depressed. As I said earlier on if I have to take tablets which I have to, for the rest of my life, I'm quite prepared to do it. Some people think that is a chore, but it is not to me. It just giving me quality and I've never, not that I haven't got time to be depressed I suppose, but I should say I never am depressed. I might get a bit depressed if were was to lose at rugby but that is about it, that is my depression, but that is short-lived down anyway because it is only a game.

While working as a paramedic, Gareth always made sure he had food or money with him, so that he...

I was working yeah, and even know I made sure I had sandwiches if I was going out like, because you never can tell in Ambulance Service like we done at times, I'd go to work in [town] and we ended up going to [city]. Taking a transfer so, you know, you always had to be ready to go, and you know, so there was a couple of things I always made sure, is that I had i.e. a biscuit or something like that, to go with and also that I had money. Because I always had money, just in case I had to buy some food whatever we got. Because if you went to [city], you're talking about three hour journey, so you know you need to eat. Even in the middle of the night you needed to eat because it wasn't just one to five. You could go at any time.

And there were times when we would come to the end of the shift and we had a red call, and the red call was a transfer to London, and you've got to go, so instead of working say, as it was eight or twelve hour shifts then, you'd be there working twelve, sixteen hours. And whilst it's not right, but these were the conditions that you had to work in because you couldn't get anybody else to take them, because everybody else was working at the same type of shift and you would have to go, especially if somebody needed a child going up to Great Ormond Street or anything like this, or somebody going for a liver transplant, you had to go with it, and you can't say, 'Oh I can't go. I've got to have something to eat.' You had to get up and go straightaway.
 

Gareth checks there is bread to eat at restaurants before he takes his insulin.

Okay. So if we talk a little bit about your social life.

Yeah.

And how, if diabetes has any effect on your social life?

No. Diabetes hasn't affected me. I if we go out for a meal as long as I take my tablets or my insulin at the right time I'm a, okay. If we go to a dinner dance, or if we go where there's a meal concerned, you know I got to make sure that if I take my insulin, I don't like to take my insulin at the table or anywhere, I don't think it's, sometimes it's right. Because some don't accept the fact that you are putting a needle into your body. I don't upset anybody in that respect. If I am on a table where people know I am, I just do it then, and they don't mind, but I would make sure that there is a bread roll on the table because you never know the length of time that people take to serve if we are at a dinner, and towards the end of the rugby season I go to a number of dinners and I make sure that there is, I mean there is always bread, there before I have my injection. So you know I watch out on that.

And what about going to people's houses for dinner. I mean would you, would you kind of mention that you were diabetic or '?

No I wouldn't, I wouldn't do that. I just wouldn't, some of the things, if we say for instance, if they got a sweet out and there was a trifle there, I would have some of that, you know, and I am not, regimental in everything that I, I wouldn't upset anybody, I don't tell them anything except no sugar if they had a meringue or stuff like that, I wouldn't, really, it really depends how much it was, how much, if the portion they'd give you. You know, I'd have a little taste perhaps, but no, I don't, I wouldn't put it as a negative. I think certain things, you know I will admit I cheat, in, in some little things, like once a week perhaps, it used to be novel, and we used to go out on Sunday and stop at a local pub and I would have a cheese cake for lunch at the end, but that is just about it in general really. No and I don't think, no my sugars haven't changed, they might rise a little bit, but very, very little so I tend to look after that.

As long as, and it would be a negative if I was going out in anybody's house, I would say 'I can't have that, I can't have this'. I think it'd be wrong, if somebody, if I have been invited to somebody's house and they put a meal for me, more often or not I'd have to, I would eat it, not as if I would have to eat it, I would eat it and enjoy it, and just to be social, but not, if there was a sweet meringue, a sweet dessert, I would say, 'Oh I'll cheese and biscuits or something like that'. And it does happen. If I go, whenever we go away and things like this, instead of having the sweet trolley I would have a cheese and biscuits which is quite nice. Cheese and biscuit and a celery stick [laughs].