Wasim - Interview 22

Age at interview: 29

Age at diagnosis: 28

Brief Outline: Diagnosed a year ago after emergency admission to hospital. Wasim is on insulin (NovoRapid during the day and Lantus at night).

Background: Wasim works in financial services and is married with 1 son and 2 step-daughters. Ethnic background/Nationality: British Asian.

More about me...

Wasim's diabetes was diagnosed in October 2006. He was fasting during Ramadan and had decided to start his fast days with high energy drinks instead of a proper meal. He went into a deep sleep and was saved by a friend who recognised that Wasim was extremely unwell and took him to hospital. His blood glucose levels were extremely high and he was told he should have been in a coma. He was put on insulin immediately and now takes short-acting NovoRapid during the day and longer-acting Lantus at night. He feels he is managing well and that he has 'taken ownership' of his diabetes.

Wasim has a very sweet-tooth and loves fizzy drinks, cordials (fruit squash), chocolate, asian desserts and sweets, but he knows he can only have these things in moderation and on what he calls 'cheat' days. He has found dieting and losing weight quite difficult, and knows that his dislike of sport and exercise makes it more difficult for him to lose weight. Since his diagnosis he has tried to walk more and if the weather is good he generally gets off the bus early to have a longer walk to and from his office.

He receives all his diabetes care through the hospital and he hardly ever sees his GP. Wasim is under the impression that his GP practice has no specialist clinic for patients with diabetes and certainly no specialist diabetes nurse. So far, Wasim is satisfied with the care and advice he receives from his consultant and the nurses at his local hospital, but would like stronger links between his GP and the hospital. He gets most of his information from the hospital, and has also searched the web using general search terms like 'diabetes' and 'insulin' rather than looking for specific websites dedicated to diabetes.

Wasim's family is very important to him and he wants to continue to manage his diabetes properly so that he can look after his son as he grows up. Wasim hopes that if he continues to get his blood glucose levels down and maintains good control he may be able to take oral medication one day rather than insulin.

Wasim realised how serious diabetes was when he was still in hospital and felt too weak to lift...

So, you know, I could hear them talking and I'm saying, 'What's the matter?'. Well it's supposed to be between 4 and 7. So I said, and they said, that what's puzzling them is that after 60, apparently, 'You're supposed to be in a coma, but I think it's because you're quite a built, stocky lad that you've managed to keep on going for this long'. So straight onto insulin, potassium and saline drips, you know, a mixture of them, and I was in hospital, basically, for a period, a full period of a week. And' It would have been longer if it hadn't been for the fact that I took ownership of how they were help, teaching me to take the injections, you know, use different sites and trying to basically, get myself fixed and back out. Because I was conscious I was still in a trading period - I think I was just conscious about getting back to work.

I suppose it didn't really hit home until the first night when my son came up to the hospital that I'm in, and I couldn't even pick him up because I was that drained. I couldn't literally lift anything. I don't like showing emotion but at that point it was, it was pretty gut-wrenching and' I, felt like if I've got to do it, I've got to do it at least for my son. You know I've got to be quiet not selfish this time so, that's how I found out basically it was first time ever.

Wasim thinks it would be difficult to get the support he needs from his GP and prefers being...

Now, I know more about it - still probably don't know doesn't as much as probably could do - but it's been a constant learning curve because there's always' I mean in the whole process of me coming from hospital to home, there's been bits missed out that I've had to pick up on. You know, there's the support while you're at hospital, fantastic, look after you, brilliant. The transitional phases... They're the bits where it gets a bit messy, you know, it's where one's passing the beacon to the other but the other one is not really ready for it or they're not fully aware of the situation. 

Do you mean by that when you left hospital, it was a question of getting your notes to your GP?

I think that was faxed over. But I think the phrase that came to mind for me was that they were 'winging it'. They were basically going on the fly, they were basically, you know, looking at it as it came and, you know. To be fair ever since I've left the hospital, I've only ever seen my GP at my surgery once. See, he only does two sessions a week, in the afternoons or mornings and, and, you know, it's hard when you've got work commitments to try and take the time off. I mean my work's been really supportive they've, whenever there's been an annual check up thing, or the need, you know, then they'll give me time off to do it. So they're really supportive. 

But obviously in terms of the surgery everything I've really had information wise, I've had fantastic support from the diabetes specialist nurse at the hospital, you know, at the clinic, they're the ones that have been the most helpful, if ever I've had any queries they've got like an answering machine service, they get back to you. 

But you say you're not really getting on going regular check ups at the GPs?

Oh no.

Why is that?

I think from what I read, and what I understand of the whole system, you can choose where you want to have your treatment for, and even though. I don't know whether or not this is something that's... and based on what I've read and what I perceive about everything at the moment, the doctor's purely registered us so they get some sort of funding because I'm a diabetic patient under their care. Yet I'm not seen by them, I'm seen by the hospital. The only other things that I've really had are the you know the retinopathy scan when they check whether or not you're getting the glaucoma. I had one of those letters from the NHS Trust, went to one of these walk-in centres where they have a mobile unit, but everything else has been through the hospital.

Wasim would prefer to get his information from the internet and for it to be aimed more...

I would have liked the hospital to have there own website or microsite, which would of maybe had links to where the useful information sources are. And where you can gain support, useful telephone numbers, you know, because it's easier to mislay a piece of paper, to lose a file, or maybe lose numbers. Basically, have case studies on it, but you know show how people of different ages are dealing with this, or different stages of your life, how you could be coping with certain issues that you might be facing. What predominantly happens to people on the main then. Again, you know, not taking the ideas from others but basically, linking to the right sources. So someone may have already produced a website on healthy eating recipes, you know, how to I don't know' Minor exercise routines that aren't too you know, too much for somebody to detest maybe [laughs].

You know, as well mainly getting the viewpoint of someone younger. I mean, for instance, just going back to what you were saying in terms of exercise, one thing that, it's not much, but it is something, is there's the games console the Nintendo Wii, you know, it's interactive, you're up there, shaking around, burning calories, more so than you would be than if you just sit down tapping away at a game pad. 

So you know, there's little things which build up into a big thing. You know, there's stuff, you could be that kind of person or you could be somebody who's, you know, you can have those kind of lifestyle options or you can lifestyle option where you've got people who'll go to the gym, you know, go do the treadmills and whatnot.

Wasim believes attitude makes a big difference and he prefers to focus on staying positive.

I've read about it [depression], but I think it's a bit too harsh for me to say, I don't know if it would be too harsh for me to say - you choose your attitude in life. You know, if you let things get to you then things will get to you - if you choose to look at more to the positive even if when there are negatives that are blatantly you know, taking you down, I think you have something like you say a goal to aim for, something more positive to look out for.

It can you know, if somebody, I can understand why somebody would think it's it was depressing, because if it is, if they're not managing it correctly, or they've not been given the support correctly, and that the support network's not in place and they're not aware of their options, they're not aware that you know they can still lead a normal life then I suppose, yeah, people could get depressed about it.

But it's again it's your own choice of how you feel, you know, you could choose to in the morning to get up and have a good day, you could choose to get up in the morning and have a miserable day. I think, well one thing I've been taught over the years as well, especially being from a sales background, is that you don't let those around you affect you, or if there is what you call a 'mood hoover', you know, somebody who sucks the mood out of the rest of the people. You try to change their attitude so that they become more positive. So it's the focus is just to just stay positive all the time.

Wasim says he's never been keen on exercise and thinks he's probably become quite lazy.

I'm not a [laughs] okay. Exercise has not been a big part of my life I'd be the first to admit it's not. Laziness is one, commitment issues. I did try when I was younger I'd say, how old, sixteen. Sixteen' I went and joined one of the health clubs in [city] paid, even paid a subscription to it that's how committed I was to trying to do it. Went with a friend from work now, beforehand she took me to Thorntons and we had chocolate and I thought you know what, toffee sorry, and I thought, 'You know what' Okay, fair enough, we're going to burn this off when we get there.'

So I had a really good session we did the track, we went swimming, we even did the fat blubby test where they pinch you. I'm obviously embarrassed because I'm a bit on the, and she's saying 'Oh look at me'' and you know [laughs]. But afterwards she takes me to blooming Pizza Hut doesn't she [laughs]. So I thought to myself, 'You know what...' I said to her, 'If this is what's going to happen every time I can't do it. There's no point, I'm going to put more on that I am losing.'

Did try obviously some sports in my life. Used to be part of an amateur badminton club in [name of town] nearby. I stopped when I married, moved away from there. We used to play cricket in my holidays as well. Used to play that with, you know, my best friend and other people from the college. And that's it.

I'm very conscious about me, me at me at pools. Thinking if I jump in the water, they'll all jump out kind of thing so it's, you know, the only, like the last time I went swimming was when I went to Florida in 2003. I made sure I'd worn one of those, you know the no-sleeves but like a those kind of things, I made sure I had that on when I went swimming I was just, I don't want people to laugh at me or something.

Before that, it was when I was a child, a very young child, there was a private swimming school and I just got my width and my certificates from there and then that was it. So no exercise is not'

I keep being asked by family members, do I want to go to the gym with them and things and it's a) through laziness, b) through family you know. Sometimes it's my turn to look after the baby. Finding, you know, the commitment and the time. Because it by the time you have time off so I, at the moment, my days off are Wednesdays, I'm' I think the word is shattered [laughs]. I'm, I am actually just want to lay back, you know, have a snooze maybe catch up on some of the [TV] programmes that I'd missed.

Wasim has tried to work out for himself why he was diagnosed with type 2 as opposed to type 1...

Okay, so you had your treatment in hospital. Now who, you say you went onto insulin straightaway?

They weren't sure at first, they weren't sure whether or not I was a type 1 or type 2, and to be fair from everything I read from the Diabetes UK stuff and research that's been passed to me by family members etc. and stuff I've done on my own, there's no sort of in-between stage like a 1.5 or something. You know, it's either a 1 or a 2, and if they never sure, they'll always stick you as a 2, just to be safe, rather than go on the cautious side.