Stuart - Interview 12

Age at interview: 60

Age at diagnosis: 55

Brief Outline: Stuart was diagnosed with diabetes five years ago. Currently he controls his diabetes by diet alone and takes no medication.

Background: Stuart is a taxi driver and is married with two adult children aged 28 and 30. Ethnic background/Nationality: White British.

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About five years before the interview, Stuart had a series of nosebleeds and when they were investigated it was discovered he had high blood pressure and also type 2 diabetes. He felt shocked and angry because he felt healthy and believed he had a good lifestyle. In 2004, he and his family moved up to Scotland and registered with a new GP, where they carried out a set of routine tests. These new tests cast some doubt about the diagnosis of diabetes, and it was suggested that he might have glucose intolerance instead. Stuart felt quite pleased to hear this, but when they changed their GP practice again (moved from temporary accommodation to their current house), the original diagnosis of type 2 diabetes was re-confirmed after a blood test. 

After the diagnosis, Stuart changed his diet, although he believes that he ate quite healthily anyway, and started to routinely eat a healthy breakfast. He used to go to the gym regularly, but after moving to Scotland he has found that difficult. However, he has taken up golf and also does weights at home. Stuart also changed occupations when he moved to Scotland and is now a taxi driver. He feels that his new job is very sedentary and makes exercise during the day difficult. 

Stuart has never experienced any of the symptoms of type 2 diabetes and is not on any medication. He thinks that sometimes this may cause him to deny that he even has diabetes, but he is well aware of his condition and does his best to live a healthy life.

Stuart was diagnosed when he was having treatment for persistent nosebleeds.

So if you could tell me about your life with type 2 diabetes?

Well I've been trying to try and think when I was first diagnosed, and I think it must have been round about 2002, maybe 2001. It came as a bit of a shock, I have to say. It came about because I had had some nosebleeds. And I'd been to the hospital and been to the GP with these nosebleeds and it was discovered that, that I'd got raised blood pressure. 

But at the same time the doctor undertook a range of tests and to my horror he came back and said that there was indications of diabetes there, but that a few months previously, twelve months previously perhaps, it wouldn't have been diagnosed. Because they'd actually just lowered the threshold I think for the tests and for the results and I would have been sort of forgotten about, if you like, if, unless they'd changed these readings. And they'd done that I think in order to try and identify as many people with type 2 diabetes in order to get the planned services for the future and start treatment early, so that some of the other problems weren't, maybe didn't, didn't occur. 

I was quite surprised and quite shocked and a little upset when I was told, because you know I'd been very healthy, very fit, you know nothing wrong. I'd had no illnesses or anything in the past. So it came as a bit of a shock and a surprise. And I suppose I was, I was a little bit angry too that somebody had told me this and, 'How dare they tell me I'd got this illness and, when I'm so fit and healthy and felt absolutely fine.' I mean even with the nosebleeds there'd been no other indication of anything, anything wrong. So, you know, I had a very fit and healthy lifestyle. 

Stuart felt anger, shock and disbelief at the diagnosis because he'd always been healthy and fit.

It came as a bit of a shock, I have to say. It came about because I had had some nosebleeds. And I'd been to the hospital and been to the GP with these nosebleeds and it was discovered that, that I'd got raised blood pressure. But at the same time the doctor undertook a range of tests and to my horror he came back and said that there was indications of diabetes there, but that a few months previously, twelve months previously perhaps, it wouldn't have been diagnosed. Because they'd actually just lowered the threshold I think for, for the tests and for the results and I would have been sort of forgotten about, if you like, if, unless they'd changed these readings. And they'd done that I think in order to try and identify as many people with type 2 diabetes in order to get the planned services for the future in Br-, and start treatment early, so that some of the other problems weren't, maybe didn't occur.

I was quite surprised and quite shocked and a little upset when I was told, because, you know, I'd been very healthy, very fit, you know, nothing wrong. I'd had no illnesses or anything in the past. So it came as a bit of a shock and a surprise. And I suppose I was, I was a little bit angry too that somebody had told me this and, 'How dare they tell me I'd got this illness and, when I'm so fit and healthy and felt absolutely fine.' I mean even with the nosebleeds I, there'd been no other indication of anything wrong. So, you know, I had a very fit and healthy lifestyle. 
 

Stuart drives a taxi for a living and feels it hasn't helped with his diabetes.

Well, taxi driving really isn't, perhaps isn't terribly compatible with somebody that's trying to eat well and sort of exercise. It's a lot of sitting around for a start. And, like I say, I take a good breakfast before I go. And then I'm very careful at lunchtime with what I eat. I usually get a sandwich, and occasionally a packet of crisps. But try not, I've always got some fruit in the car that, that I can sort of snack on if I need to snack. Or I particularly like some small raw carrots and there's usually a pack of those in as well to nibble on. So I'm not eating sort of chocolate bars and things like that in between. But the diet is absolutely okay.

But it's the exercise part that suffers in taxi driving because I can't wander too far from the car, and I can't sort of get out for a walk at a quiet period because I've got to be close to the radio. So it is difficult. So therefore exercise in an evening, going out for a walk is important. Although I don't do that very often. But I do in a morning do sit-ups and I've got some weights at home that I use, just for 20 minutes each morning. So I'll do some sit-ups and some weights just to, you know, try and exercise a little bit. But it's the cardiovascular stuff that I miss out on.

Stuart goes to the GP for routine checkups and also sees a chiropodist and dietician.

At the six-monthly check I go and see the, the practice nurse, who has an interest in diabetes. And she takes the blood, she takes the measurements, and the weight and the height, and various other bits and pieces of test and asks the questions. And then at the twelve-monthly check, which is in my case towards the end of the year, we do the same thing. And once the results come back I then have to go and see the doctor, who interprets the results, if you like, and, and will then make a decision whether some other course of treatment ought to take place or whether we're quite happy to go along for the next twelve months.

And in the interim, if it's felt necessary, we'd go, I'd go and see the chiropodist. The dietician I've seen once. But, you know, she was saying that, you know, because of what, the way we eat, then she couldn't really improve a lot on, on that. So I don't see her very often. And we have an annual eye test, eye check, just to make sure everything's behaving as it should do at the back of the eyes.

So I think, I think I'm fairly well looked after. I mean my particular GPs' surgery, I can get an appointment the same day, and I could wander up and sit down and wait and see a doctor. So there isn't a problem accessing either the doctors or the nurses up there. So I do know that if I had any concerns or wanted to know something, then quite easily I could get that information. And if I wanted something of a more general nature, then I could perhaps have a look on the Internet and see whether I could find anything out. But there, there hasn't been an occasion to do that as yet.

Stuart says he has a 'series of excuses' of not taking as much exercise as he should at the moment.

I'm told I'm doing everything right, apart from, from the exercise bit, which I need to address.

And do you think' Do you have a plan at the moment?

I have a series of excuses why perhaps I'm not doing as well as I should. And one, the big one at the moment is the, is the fact that my daughter's getting married next month. And sort of a lot of time is taken up with, with helping her to plan and to get things organised and get the, all the wedding stationery out the way and various things. So that's an excuse. It's not a reason. And we always - I think it's the human animal - decide that we're going to do these things, '[I'll] start tomorrow.' But you know, tomorrow never comes. And I am aware that it needs to be done, and that it will, it does take a long time with me to, for these things to sink in. And maybe once, once I've started, then, yes, we can carry on. As I say, the golf is a good way of, of exercising and it's a good way, the way that I enjoy. Because I, you know, just, just walking is boring to me. So if there's a purpose behind it, then, yes, I might, I might exercise more frequently.

Stuart describes his discomfort with the idea of diabetes as a physical imperfection.

But I don't like having it, I don't like having diabetes. And, but I'm sure there are lots of people that don't like, like having the conditions that they've got. But we come to terms with it and start to, to get on with life and deal with it as best we can.

Is that because it's a label of an illness? Or is it, is it specifically diabetes?

I think, like I said before, it's an imperfection, if you like in some ways. And that, you know, not ever having had any real conditions before, only sort of minor bits and pieces, then suddenly I'm told that my body's not working perhaps in the way it should do. So it's, therefore things aren't, you know, perfect. I think that, I don't like that. You know, I am a little bit maybe, I wouldn't say perfectionist, but I like things to be right. And, you know, if things aren't right, then, you know, I don't like it.

And then it's the same sort of internal, if you internalise that and, you know, make it part of your body, if you like, then if it's not working properly, then it's not right. And I don't like that idea, I have to say. I'm not particularly frightened about the progressive nature of it. It's just concern about having got it and having had it in the first place. And that might sound, sound very strange, but, because I don't maybe look too far in the future. I don't know.

If it's going to happen, if I've done a lot of what I can to stop the progression, if you like, or to make things less progressive, and if it still happens then we have to accept that, you know, it is part of the illness and that. If I'd not paid any attention to my diet and, and not started to look after myself a bit better than I was doing maybe, and, and it got worse, then I would be left feeling that, you know, I'd let myself down, I'd let my family down and let, and let my friends down. So it was for my benefit that we changed the diet and sort of the lifestyle and everything, but it also has a major impact on the family.