The “badness” of hypos

So common theme – child faints at school and the staff ask did you eat breakfast. Why?

Because hypoglycemia is common. Common things happen commonly. Kids especially have brains that “chow” sugar. In other words a child’s brain is glucose hungry and thus the need to feed food that keeps blood glucose levels constant, not spiking and dipping, but a constant availability of glucose for all cells but brain hungry cells especially.

How much more so is the problem in a type 1 diabetic whose “automatic” controls and back up systems have failed altogether.

Hypos -ARE BAD!

Hypoglycmia – low sugar is really bad for you and for this reason the bodies alarm bells go off properly when your sugars are dropping or go very low and the possible end result is loss of consciousness or death.

YEs, death.

So when I write motivation after motivation as if my words have magic power and attempt to explain to a fellow colleague who should know these things and have to re-explain why multiples hypos are BAD. That’s what I mean they are bad in so many ways but the death way really pertinent.

The only real way to get good “time in range” in type 1 diabetes is with a pump and an accurate CGMS – continuous glucose monitoring.

In my opinion this should be standard care. Before the funders have apoplexy. It saves lives, it saves complications and many downstream costs. But that’s just my opinion.

But mostly if I had a type 1 child I would not be able to rest easy without such a system. Finish and klaar.

2020 – a new year for diabetes

I really like the sound of 2020 and we are at the cusp of really exciting things especially for type 1 diabetes and closed loop technology. Eventually.

Yes it has taken quite long to get here partly because it is a really big and honourus challenge going closed loop. But seeing as 2020 has 2 loops that’s double the looping chance of looping becoming more sustainable.

That thought also makes me super happy. Mainly so that patients who previously had to prick fingers 6-10 x a day and inject 4-6 times a day can now really focus on what the rest of us focus on – living life unencumbered.

So let it be the year of accurate CGMS and flawless looping.

Wound healing

Diabetic leg ulcer – we took it from first photo to second in 5 weeks – controlling sugars and using laser (bioflex)laser ….0832898351 2 QUarry road @the ELlenbird Hilton

2020 a great year to come…

It’s a round number, it’s an even number, it’s balanced and it already feels great !

HEre’s to a wonderful and blessed 2020.

Goals : see more diabetes patients who are uncontrolled and help them gain control and extend their lives with quality.

In the shortterm a little probono trip to Zithulele hospital to do cataract surgeries : sutureless extracaps …Yay!

May your year be a wonderful one.

 

Tango, times and tis the season soon to be the new year :) tango the fastest growing art form in the world :)

The Tango is a dance, it is much like life. There is a tension between partners and to dance well together there must be enough traction and count-traction to enable almost a perfect leaning into one another not too little and not too much, just enough to “know” where each other is and for each partner to be able to subtly sign to the other a move, subtle, gentle, moving a feather but it moves willingly.

It’s beautiful really and how all communication should be – in tune, harmonious.

For this reason when you really tango it is a healing dance.

It touches places that other things in life don’t reach the tango does.

The posture is one of leaning, much like the Song of Solomon leaning in of lovers. And yet the tango can be danced with any partner. It is not so much about sex as it is about intimacy and respect of the heart space.

The invitation to move a certain way is made by either partner and it is gentle and a hint. The actual movement can be accepted or an attempt be made to change it and this is a conversation of connectedness and respect. A little bit flirtatious as times but very proper. Passionate sometimes. But boundaries are strict. Or shall we say firm.

The relationship is also much like Christ in history and people at large. If you don’t lean in you will not be privy to the mystery. And the leaning is not a depending. It is more of a deep understanding once you can get there. It can take a while. Or it can just never happen for you or a massive wide door can open. And I am not advocating religion here at all, more a deep understanding of life at large.

Choice is the key and moving to a beat is the learned dance. Life is short, tango rather.

Touch me on my tango 😉

 

 

 

 

 

 

South african princesses and princes …

We are an amazing country despite all the trials and tribulations, the load shedding, life shedding, corruption breeding filth, rises our spirit in many forms : rugby world cup and a true price of a leader, multiple other wins this year and now a princess : genuine, herself, real, true, hardy and beautiful inside and out -it shines for all the world to see.

We have so many : Yvonne Chaka Chaka, Karen Zoid, Johnny Clegg, Madiba, Ben Gaunt, you and me …a rainbow of endless hope, joy and most of all feistiness.

Be inspired by these average south african humans who elevate us and cheer us each individually on in this day, a new day and a bright future – south africa OUR land.

A friday kind of poem

An AFrican Feast

The sun sets golden

the harvested hay bales fill

the amber air with hues

of hazelnut

dust

it’s rich , it’s amber coloured

temperature too

you can drink the amarula in

you can spiral tranquil lose

yourself within

the ivory carved moon rises east- an AFrican Feast

Libre flash monitoring – “freeing” you up to live life (technology permitting )

What is flash monitoring ? Well it’s a button you wear on your upper arm (under normal sleeves) and use your phone (many compatible android and iphones) to swipe across the button and voila- a sugar reading. It then records on a graph on your phone.

We have come a long way since 1922 when without insulin type 1 patients essentially died. Crass but the truth sadly. And here we are in 2019 and we do not even have to rely on finger pricks. Yay! Progress and science and so much of happiness all around.

Flash monitoring does have a lag, and that is quite individual. Safe to say the “real time” sugar is ahead ie the flash is behind real time but the trend remains the same – I hope that makes sense. The beauty is being able to see where you have come from and are headed towards. So, if you are heading down you can snack or watch and wait depending on the circumstances : ie food, exercise, illness and same for heading up. And you can flash in 5 minutes to see.

So I very much advise against knee-jerk reaction to the blood sugar on flash monitoring but rather watching and waiting and “learning” from experiences of exercise and cake eating etc. As for adjustments in insulin doses and timing of insulin and what does what. For example stress affects certain people in one way and others in another and the beauty of the flash is that you get to learn what your body does and adjust to that.

In the UK this device is now relatively largely widespread and with great great results of way better control, time in range and very importantly better quality of life for type 1 patients. It is being funded by the NHS at large thanks to the Diabetes warrior doctors who have literally “gone to war” to get this funded.

In south africa we battle “the funders” to do what actually benefits them downstream but happy to say that I do feel that progress is being made in this arena too. Our “war” also slowly slowly being won for the betterment of both funder and patients.

Flash monitoring – glucose readings regularly not requiring finger sticks/pricks – accurate, timeous and life changing – allowing patients to live full lives rather than survive.

#abbottlibreflash a multitasking device that adds value at every level

Walk for diabetes awareness 16 nov 8am 3km on saturday (2 days after the 14th-which is world diabetes day) …:)

We are walking on saturday 16 november for diabetes awareness at 8 am for 3 km from the cascades parking lot in pmb. Call 0832898351 for info you may need.

It’s FREE and you will receive a FREE water bottle. 🙂

We will walk in the forest weather permitting 🙂 see you tomorrow 🙂 🙂

What is aesthetics?

An Art form I believe.

Botox has both a good and a bad name. It can be used well and poorly. It is a toxin, botulinum toxin that paralysis muscles that are tending to overwork and create wrinkles. A small dose of botox is called baby botox and renders a very natural subtle youthening look smoothing out fine lines and divets in the ageing forhead.

Filler works like a charm in the cheek zone to lift : jowls, marrionette lines and generally also a youthening effect. Filler also really does wonders for very thin lips and uneven lips or if you really are wanting a pout.

So yes it does make you younger but if you do it in small doses it is subtle and smoothing and just very pretty.

And an art.

http://www.myinnatehealth.co.za/aesthetics.html

November is BLUE #diabetesawareness

Sugars are sticky

Sugars are icky when low or high

november is blue but we are not blue

because there is a solution for many of the problems

sugars …SOLVE them make them stay tight in range

Diabetes type 2 and diabesity …yes there is a link but fat shaming is a shame :(

Why is it that there is so much emotion and sentiment around diabetes. Even recently on some american programme there was “fat shaming” in conjunction with diabetes type 2 and yes there is a fair amount of “blaming” patients regarding their diabetes and a sentiment that diabetics just shovel food down their throats.

This is not the truth and couldn’t be further from it.

There is a really big difference between type 2 and type 1 and for some reason often the type 1’s who generally get labelled “the bad kind of diabetics” get accused of “causing ” their condition – which really is pure ignorance.

Then add to the confusion the diabesity/obesity epidemic that plagues us and you get even more confusion.

One would think though that journalists/tv folk would empower themselves with knowledge.

Anyway the long and the short boils down to what I often say – a relative (type 2) or absolute (type 1) lack of the hormone insulin – which takes a glucose molecule (much needed by the cells (all of them)) into the cell.

It is true that lifestyle is a risk factor for type 2 diabetes, however it is not the only risk factor. Age above 40, genetics, demographic as well as a whole host of other things like stress and medications are risk factors too.

It’s not simply you eat too much therefore you get diabetes type 2.

Also every one of us is actually at risk as we are all going to be over the age of 40 one day and that in itself is an independant risk factor and the analogy I like to use is that the pancreas is like a part in a car – and parts get worn and torn.

So next time you think of fat shaming, think again. Think about things just a bit more deeply. Subcutaneous may be deep but it isn’t always shallow…

 

New therapies …for dyspareunia -hope @#PRP

If you suffer from “dyspar” dyspareunia you know exactly how debilitating it is and the knock on effect to other areas of your life. The causes are mulitiple and include psychological aspects which cause as well as perpetuate a cycle that once it starts is quite hard to terminate.

Up to now there is not much to offer in treatment, a quick google search will tell you : lubricants, try to identify and treat the root cause, warm baths etc 🙂

Platelet rich plasma is your own plasma that is full of rejuvinating healing properties, ie is fully compatible with you, safe, and a potential answer to a difficult to solve problem. At the very least it is worth trying if you are suffering.

There is some research using PRP in tendon injuries but less so for it’s many other uses. In practice it works. In america it is known as an “o” shot, in south africa it is called a “v” shot. It essentially is a “re-juvination” of skin, glands and tissues helping to increase blood supply and functionality. Helping with incontinence, dyspareunia, and desire. The proof really is in the results seen by therapists using it and their very satisfied customers many of whom are very happy to share their experience of it on you tube and social media.

Incontinence and dsypareunia affect up to 47% of women and barring surgery for the former up to now there was little hope. This is a safe option with an immediate efffect. It is one of the few “therapies” around that allows increased lubrication as well as rejuvination of the glands responsible for this, increases blood supply for healing of tissues as well as blood supply to the elusive g spot.

Life is better when all your body parts are happy 😉 happy wife, happy life 🙂

London, closed loop and life :)

The Kings’s College London type 1 diabetes clinic is a world class unit that delivers care to patients lucky enough to live in the area as well as beyond (on a referral basis). It is a humble prefab building in the great metropolis of King’s College and home to a team of health care professionals who embody team. I was priviledged to attend a course there last week in London.

Call me a nerd but a 2 day learning experience is a great great highlight in my life.

I have always embraced the team approach to diabetes and these guys rock at it. From resident pschologist as part of the team to mulit-disciplinary meetings across the team there is not actually a level of care that functions outside of a “team”. And the patients benefit from this approach.

The learning more specifically last week was focused on learning from the medtronic 670 g “closed loop” patients and how amazingly well the algorythm can perform and what a “miracle” way of delivering insulin this is for a lot a patients. How we can apply lessons to our other patients in terms of how best to use insulin and information.

Technology certainly is both exciting as well as exceptionally clever as regards type 1 diabetes and being a part of this revolution so to speak is something I am extremely grateful for.

Thank you again to Medtronic, to King’s College and to everyone who made this learning possible.

Learning is life and life is learning and it’s all actually a circle…

 

Perspective, plain site…

Life is a rollercoaster chocolate box that dishes one out a random mix of stuff and sometimes pulls back from you entirely and leaves one confused and bemused.

However at least with age one gains a little more perspective and the ability (as a woman) to control (albeit not entirely) one’s emotions. And this is like pure gold. The ability to step back (so to speak figuratively) and “cognitively” digest things and “prepare” a cold clever response that may well be unexpected and certainly perplexes the individual perpetuating the patriachy.

The rollercoaster is often a fixed item over which control is not had. However it seems that later on in life one is able to “hover” above the chaos for milliseconds that are little bursts of miracle moments.

Plain site also becomes a more plain. Which seems crazy but somehow the blinders of youth really do just that and as the time and clock tick the site improves – at least the sight of the soul 🙂

And for this I am grateful 🙂

NHI and what is to come…because it IS coming!

The NHI will certainly be coming whether or not it is yet another train smash as we have experienced with every state run institution or not. Will it be a better south africa ? That remains to be seen.

What is unequivocal is that it is coming and it WILL be implemented. Does that make me want to run away. Yes, yes and yes. Am I going to ? No, no and no. I have personal reasons for staying but I do believe that we also need better health care for the majority and NHI may well aid in a small way to some kind of “fairness” when in the past there has been gaping holes of “unfairness”.

I would like to start a new movement of positivity and seeing the opportunities in south africa.

Face it, there is no perfect place in the world. People are the problem. And they are everywhere. However there are also unique wonderful people who are everywhere.

Also in this place we call home with wide aching gaps there are opportunities for both financial prosperity as well as kindness prosperity – which is all we go to the grave with.

So will NHI be a challenge. Yes it will. Does it mean the end of health care for the wealthy or relatively wealthy (bear in mind there are folk who survive out here each month on R1000 a month). No, I hope not. Is there opportunity to assess this situation and find a new way regarding the epic challenges that face us like diabetes, hypertension and the complications thereof ? Yes. I believe necessity is the mother of invention and as health care practioners it is yet another to re-evaluate and use our God given brains to come up with a palatable solution.

Kindness is one of the few things we take with us. And death is a certain guarantee.

So let’s start there and move outward as the ripples on the sea when a stone skips over the surface. South african’s are adaptable at large and we are able to see and do the positive, come with me.

Basal Iq -it’s here and yay of yayness

plerTandem t slim have basal Iq on offer. It has arrived. The great wonderful benefit of the algorithym is that it has very simple rules and is robust in it’s ability to prevent lows suspend insulin and recommence as soon as the trend picks up.

One of the biggest conundrums with insulin is not enough results in high sugars and too much even just a little too much results in lows and no two days are ever the same for diabetics.

This new offering offers a solution.

And if you know what lows feel like and do to your functioning you will recognise the benefit. For longterm health this is a huge benefit. All the new trials confirm that TIR – time in range is what saves : eyes, limbs, kidneys, hearts and brains.

Thanks to ethitech for bringing this to market.

Yay yay yay for patients.

Basal IQ – I can’t wait :) it’s sooo exciting

T slim will be coming to market with a product called basal IQ which is to say “smart basal insulin” that is delivered in acute “communication” with a sensor of glucose readings to as to keep sugars “in range” tightly with no lows, hypos or highs/spikes.

Anyone who has actually felt the feeling of a sugar of 2 mmol/l or 15 mmol/l will know how “kak” it feels. Add to this how bad it is for your brain and organs at large and the era of this kind of wonderful advent becomes like Christmas in July !

It’s revolutionary, it’s brain saving. It’s limb saving. It’s heart saving.

I can almost not contain my excitement at the delight of this arriving.

Watch this space #tslim #dexcomG6 #happinessatsugarcontrol

Clever basal insulin is the way forward.

 

 

670G medtronic – a lesson for all diabetic practioners in a very good way :):)

The new 670G medtronic pump is truely a wonderful amazing device.

What suprised me more than anything else is what an absolute pearl of a lesson it is in terms of how insulins work and the daily awful grind and variability of being a type 1.

Honestly congratulations to this development team, you have come up with a genius product. Genius!

It expertly and simply solves for so many of the dilemmas type 1’s face daily. And in a safe and perfect way.

Truely a product that answers so many of the questions that we have up to now not solved.

Thank you thank you thank you.

THe MARD was my biggest happiness on the sensor – 8.7- wow-Yay!

So many reasons that in my opinion as many type1 patients should get onto this technology in terms of cost saving in the long run for med aid schemes and longevity with quality for patients both old and young.

I nominate it for product of the year.

Problems it solves for :

1.) daily variability (automatic adjustments according to blood glucose)

2.) hypoglycemia – on a downward trend of sugar readings it keeps decreasing insulin as to prevent a low and then eventually suspending insulin so as to prevent the low from happnening, as soon as the sugar trends up it resumes insulin and keeps adjusting

3.) high sugars – on an upward trend it increases insulin (up to a preset SAFE) level with alarms and alerts so as to prevent the high sugar

4.) variability immediately improves as does TIME IN RANGE

5.) multiple layered safety catches in case of problems

 

A tigress and her cubs …zoo wonderfulness

We were priveledged to go to the johannesburg zoo last week and walk around. Man we were treated to royalty.

The tigress and her “bred in captivity” cubs were on show and it was spectacular beyond belief. I have never seen a tigress before and the degree of royalty, beauty, bestiality and just sheer grandiosity blew my mind completely.

How anyone could ever harm such a creature is the reason we are so screwed up. It’s beyond me completely.

The cubs kept biting her on the bottom and she kept swotting them with her half a human size paw. And then on occasion wrestling them into submission. The lesson for me was the tranquility with which she “mothered”. Unperturbed, calm, serene, firm and yet gentle.

I was in awe and it made me think about life in a way that I had not prior to this experience.

Nature is like an unwinding perfect spiral ever increasing in grandiosity and simple splendour with an innate perfection built into it and then we come along -the human race and stuff it up like 150%.

Sometimes one needs to just take a walk on the “wild side” at the zoo 🙂 and think beyond our own pathetic existence and circumstance.

Monday from the heart of a mom :)

Yet another Monday. For moms it’s a little toughie a Monday. The similar same routine starts all over again. Please get dressed, please eat your cereal, please wash your face. Please brush your hair or allow me to do it without the mammoth effort of actually shooting a mammoth with a bow and arrow.

If you are lucky enough to actually make it to the car with all the “shit” kids need for one day all in one piece you breathe a very deep long sigh of relief. The first of the week of many.

Is it this hard ? Ask a mom today?

The week is bound to be filled with at least 3 activities a day on average – that’s just the curricular school ones. In between running a small business which happens to be a GP one (so there are a few extra challenges daily there too), making sure everyone eats everyday, attending all the ” one should really be there” activities at the various schools, complying with stuff like UIF, VAT and other 3 letter word stuff that actually also take up time, effort, brain power and most of all MONEY. One is expected to make money, enough to pay all the folk who work for you too as well as all those government funds.

Come around 4 pm I am physically mentally and spiritually tapped and tanked. It is at this precarious mentally fragile point in the day that my night job begins.

A round of homework, attempting to feed children healthy food. Navigating until the moment of literally falling into bed in a collapsed state of near coma. ONly to wake up on tuesday and repeat.

Don’t get me wrong I love my girls and would not swop them for the world. However I FEEL collectively we have lost the plot a little in this life thing. I honestly feel it could be another way. The rushing the pushing the striving the activities the money chasing.

…

LIfe could be should be slower, lingering and enjoying moments. Not feeling like you are literally living on the N1, at that pace that the GP number plates drive, constantly driving right up your bumper aggressively pushing.

We only get one and we only get one “childhood” period with our children.

We need to learn to desire with all our heart to linger. To chill. To enjoy. To communicate without words in a space that is spiritually serene.

Or have I lost it properly now ? I think not.

 

Continous monitoring and it’s influence on control – a huge wonderful impact

If I could pick only one thing for all my type1s and type 2 s on insulin to have in their armamentarium of goodies it would be access to continous monitoring for sooo many reasons.

1.) they learn from it and figure out which foods spike them

2.) they learn what drops them and how quickly and how to rectify this, ie how long the rescue takes to kick in so to speak

3.) they are able to see that if they inject insulin correctly at the correct time that it actually controls the sugar

4.) they can see what a “missed” dose does to the sugar

and I could honestly go on to 100 things …

REcently prices have literally plumetted on these devices making them more and more accessible.

THe next question to ask is : ? accuracy.

It is imperative that the device have the lowest MARD possible.

All this means is that the reading you see on the device is actually a TRUE reading.

Sluce. Kapish. Simple

Accurate is everyting .

So pick up something in your armementarium today for YOUR control 🙂

Accuracy data from ADA 2019 hot off the press praising CGMs’s at large 🙂

The data backs up the average clinician’s gut feel that seeing is the answer.

An African feast …an amarula sunset

The sun sets golden

The harvested grass bales fill

the amber air with hues

of hazy hazelnut

dust

it’s amber coloured temperature

too

you can drink the amarula in

you can spiral tranquil lose yourself

within

The ivory carved moon rises east

An african feast …

Basmati rice is NOT a carb ???? …. what is a carb?

A few times a week I harp on about carbs and carb portions to patients. And as many I get them saying to me I don’t eat carbs doctor I only eat basmati rice 🙂

WEll now hey! So the level of understanding of what a carb actually is : carbohydrate.

noun : any of a large group of organic compounds occurring in foods and living tissues and including sugars, starch, and cellulose. They contain hydrogen and oxygen in the same ratio as water (2:1) and typically can be broken down.

At the end of the day anything that once broken down by stomache acid and enzymes becomes a glucose molecule. It’s quite a vast food group. And it includes more than bread 🙂

Vegetables too have carbs in them. The only thing that does not essentially is a protein : fish, red meat, chicken, ostrich meat, crocodile meat etc.

And some veg has almost no carb value to it. For example green beans and kale :). Something like a carrot or peas have carbs too 🙂

If you are diabetic anything from : ice-cream to basmati rice that breaks down to a glucose, sucrose, fructose molecule of sorts is a carb.

That’s why we count carbs. To match the “perfect” amount of insulin and timing to the amount of “carb” ingested.

🙂

My favourite tool is : myfatsecret which is south african based and essentially a key tool in carb counting.

It’s not that you CAN not eat CARBS it is that you need to match the insulin to the carb. Ie you should be injecting an amount of insulin to “mop up” the carbohydrate value.

Carbs, carbs, carbs

“Soul”it ude …https://www.solitude.org.za

This last weekend I had the joy and priveledge of going to a creative retreat at solitude in the dargle near Howick. What a soul re-juvenation 🙂

One’s own journey is a precious thing, one’s own creative journey in my opinion even more precious, like precious on steroids 🙂

What I discovered on my very excited to share return was that one’s personal journey is not as relevatory to others as it was to one’s self.

Lesson learnt 🙂

For me it was cathartic, connecting to myself, releasing in a high release way as well as calming, coo-ing almost in the best way possible, rocking in a hammock kind of gentleness, presence and preciousness.

We did all sorts of “arty” things not for creation sake but more for the journey sake and connecting to one’s inner child. The wisdom that was downloaded to each of us was profound, gentle and powerful. Sometimes the simple in life is the key. And happiness is an elusive gift just within our reach.

 

“Low class” -what does that mean?In 2019???

To my great shock I was accused of being “low class” yesterday. What does that mean buddy?

As far as I am aware it must hark back to the good old colonial british empire days? Like lady “downton abbey” and co looking down their royal blue blood noses at the “help”?

Yes I sound bitter. I am bitter. And I am reeling from a label that jerked the body inside the clothes.

Is this referring to a financial status? a way of behaving – like some bubblegum blowing teenager with a cockney accent? Even that in my opinion is a horrific “classification” of another PERSON.

Is is referring to a “bad” blood line with not enough “royalty” in it ? Or is it simply a person born badly by lineage who also has mannerisms (like farting) that do not FIT into “high” class society?

I am sorry, are we not in 2019? Did I miss a beat? Have women not got the vote largely in the world and even almost allowed to drive in saudia arabia?

Comments like that are what is wrong with society at large. Rather than celebrating “diversity” and “hybrid vigour” one chooses to spit and from such high ground and cause divisiveness.

Low-class : adjective : of low inferior standard, quality or a social class, cambridge dictionary adds -and the least money.

Pity you can’t take ” money” to the grave one day and that true love and joy do remain. The “richness” of being free to treat even a poor person with love and dignity is in my opinion high class. The attitude that one human is better than another is low class and sad really.

Funny how the world is upside for some. Luckily not for all.

Diversity is great and humans have greatness within them. Don’t let the bastards get you down.

Even the Simpsons seem confused 🙂

Diabetes and what we CAN do…

1.) Eat healthily and cut portions in half, we all eat to much, yes that includes YOU

2.) exercise at least 3 x a week – you will benefit mentally and physically and here is a money back guarantee – if you do this and you do not benefit email me and i will pay you – drleethegp@gmail.com (must include concrete proof of exercise 30min 3x a week)3.) Cut out simple carbs – gone done and dusted (like most of the game of thrones characters -assassinate them)

4.) have your sugar checked every now and then

5.) Don’t assume that overweight people have diabetes and vice verse and don’t criticise you never know people’s situation.

No sign of the log curve relenting, so think on this : if you continue as you currently are you are at risk, eat better, exercise and test your sugars randomly throughout your life and YOU have a chance of defying the log curve, else don’t say I didn’t warn you 🙂

 

The battles we face daily …diabetes and the funders :) yeeha!

So we all know we are currently experiencing an epidemic that is about to “tidal wave” africa in terms of diabetes. And we know that world wide despite logarythmic increases over at least the last 10 years there is no stopping the tide. We love food and no exercise too much.

So we also know that the more this happens the less health wealth and happiness for society and the more sick folk get the more it costs the medical aids – so then with tears in my eyes and a brain between my ears why is it that we have a daily fight with funders to do what is right for patients and saves them hugely downstream costs ?????

To me it’s a no-brainer. I dont know.

I have been accused of being a dilly woman and yes I am a woman doctor – that does not bode well to start in the patriachy. And yes my dress sense is a bit quirky. And yes my mouth she speaks way too easily for the patriachy once again. BUT, really all I want is the best for my patients short term, long term, longevity with quality wise which adds up to a societal knock on downstream. So whilst quirky all I am actually fighting for is the greater good ????

The funders and generally brushed with a giant sweep of a brush at large seem to slowly be waking up to the multiple facts staring them down like a gun barrel as this is a very large challenge to them to. How does one solve these dilemmas as still stay top 5 profitable in south africa ??;) 😉 😉 ah em …

Just saying, there are better ways to tackle this tsunami…

I met an amazing academic yet pracitical medical advisor the other day, and my suggestion is that other medical aids follow suite – yes have your acturial scientists who make you the top JSE company when a med aid is supposed to be a med aid not a top achiever, but combine it with some sense so that you can stay there cos right now your tactic aint going to work for you on the long game.

 

Philosophy on a wednesday …

It’s wednesday, the middle of the week. This week it feels like it could be friday already in terms of the meters of steps taken and strides and tides and rolling blackout brain (personally).

I think you know what I mean, we all have those weeks where the challenges mount and seem insurmountable.

Life, what is it?  we are born, we live and poof we die.

I sure do hope that it might make sense in the ether up there one day because down here in the hum drum mill it is a fascinating concept to contemplate meaning.

Emotion is a given to human “ness” and yet to some it is almost a negligible blip on the radar. The spectrum as such of emotion is large. Some humans have it in chunks (like me) and some have just the babiest dose of it. And yet it seems to inch it’s way into the puzzle that is life and sometimes do more harm than good.

For someone (like me) who wears their veritable heart on their sleeve this life can be intensely hard. Overwhelming. Can lead to a sense of drowning.

It also is one of those things that you can’t really control the button on (like volume which you can control). It just bears it’s own innate pulse onto one. The highs and lows rumble tumble and exhaust. Each day churning up some new emotions and some old. Each day like crashing sets of waves pummel.

For some the line is still, static, blip “less”.

Figuring each other out in this life is a conundrum.

Blip

chip on shoulder with a grip

emotion, sea ocean, full

ongoing tides that one can’t always ride

or hide

from

spirals and pulses

round and linear

grip and go, wing and toe

longing for a still breeze, a flat dam, a peace, a knowing and less churning/burning

but without emotion where would we be?

The highs the lows the heels the toes.:)

 

Diabetes and you and me …

When you overload a cart the horses take strain. Much the same with the human body. Each cell requires a few things : amino acids, glucose molecules, and a whole host of other complicated yet simple molecules.

Each cell in the body essentially respirates, breathes in so to speak glucose and oxygen and breathes out ATP and CO2 in order to function, much like the lungs and the opposite of what trees do.

Simple yet complex.

If you overload the system with glucose molecules they will simply be stored as fat for a rainy day and also overwhelm and flood the system with stickiness.

That is what diabetes is in the type 2 sense of the word, flooding the system and causing a sticky mess.

Type 1 however is an initial lack of the key that takes the glucose into the cell and forcing the cell to respirate anaerobically which leads to death without the rescue molecule insulin.

Starving in a sea of plenty is type 1.

Drowning in a sticky mess is type 2.

The ebb and flow of the cell works in harmony if the correct diet is maintained and goes horribly out of whack with an overload or under-dose of glucose molecule flow to the cell.

 

Type 2 Diabetes – what is that?

Are you fatigued and have blurry vision ? Have  you had your sugars checked.

You may be one of the many people who are living with an undiagnosed illness that is causing a train wreck in your blood vessels at large from head to toe.

It’s easy, simple and could be life saving.

One finger prick could save your life. The truth of the matter is that at least 1/3 of patients have had diabetes for 10 years BEFORE it is diagnosed. Have yourself tested today.

Semantics and sperm and Gigantics

Words, wordsmiths, gaslights and gobsmacking delights.

Semantics rhymes with pedantics and that’s pretty much how I feel about that.

Sperm : the yin and the yang can not exist without each other, so the sperm be a very critical element in the recipe for a child. The world can only go on with the birth of babies, it’s imperative to survival.

The truth of life though, what is that, the crux of the matter. That’s the giant question. Some folk ignore this their entire life and press on with the daily grind.

mmmm ….

Words, gnirps, Esio Trot and epis glott…

little folk and big folk – who is so bespoke…

“hybrid” Closing the loop …how divine :)

If you have an intact pancreas you already have a closed loop. That is to say you eat food and your pancreas automatically releases the perfect amount of insulin to “match” the carbohydrate you have just eaten so that the glucose molecule can travel easily into the cell, all cells require glucose for metabolism.

However if you are reading this and you are a type 1 diabetic you do not have B cells that are functioning and this is great news for you – a closed loop. It is in essence : an artificial intelligent pancreas.

It is here and for that we rejoice. It is not the full monty but at this stage each step is a win and this is a big big win. The algorithms get more and more accurate and detailed as time and data increase.

From march 2019 the alogrythms to close the loop will be available to all and anyone in the world.

For more info : 0832898351 Romae for a booking

It’s here and that is awesome. It’s hybrid and it’s not at its full potential as yet however it it more than we have had up to now and for that we rejoice.

February the month of love …more than just the heart even at the start

Is it love that makes the world go around. I watch tv programmes and movies that make me think that a huge deep motivator of many decisions, actions and directions lives take has a lot to do with LOVE, the big love, the small love, the emotionally wrecked love. But love.

Emotion? The real deal deep stuff love ? What is that even ???

It appears to me across colour, context, race, culture the absolute unspoken language is one innately known. Deep within. Written in expressions. Felt without touch.

Profound.

The effect of love gone wrong on health is as profound.

Both physically as well as psychologically.

Love can be a tonic if it is pure and love can be poison if it is gone awry.

Health is your wealth and determines your quality of life and so love is a thing that needs deep introspection and worth spending time determining who it’s recipient be. All spiritual writings muse on this.

Let February 2019 be a month of health and wellness regarding the big LOVE.

A simple poem about love

love, weave, dove, leave

longstay, home way, keen to know the longtime love way

peace, joy, pure heart ploy

woven into our souls a golden thread that doesn’t tread but only weaves gently

and peacefully and tenderly

can you twine it with another

shoo the trust that that requires

should it break the two both break

what a risk that makes

shakes, aches.

But oh! the joy of a twine that shines and finds growth mutually …

The Diabetic Educator …for a friday read :):)

What does an educator do? Diabetes is a multisystem disease affecting most organs in the body. Managing diabetes holistically in a team means each member focuses on their area of expertise.

For the educator this is explaining how insulins work, how the different oral meds work, what sugars should and could be at different times of the day, dangers of hypos and highs, how to inject, how to test etc in the newly diagnosed.

One very important aspect is setting goals around targets like A1c as well as variability, post meal values etc as well as any other goals regarding diabetes like exercise, staving off burn out and depression and a whole host of possible goals.

The educator in many respects is a co-ordinator or conductor of the processes and aids very much with direction and the trajectory of the diabetic path.

This critical role actually can make the difference in getting to target as well as staying at target which translates to less health expenditure downstream as well as healthier functioning patients with quality of life.

Educators are core to diabetes management top of the range.

Diabetes and CDE and Discovery 2019

This year from around next week, the various options excluding keycare of discovery will join the CDE family. Why this is exciting is that CDE has always provided comprehensive holistic care to diabetic patients and by managing a disease like this in a team approach it is simply put better managed.

What that means “downstream” so to speak is less cost to med aid, better health to patient. Greater longevity with more quality.

We are super excited at this development and though teething problems will certainly occur the benefits will outweigh the initial stumbles.

THe swtich over for diabetics on discovery is automatic you don’t have to do anything. Ok so top 2 plans nil to do, other plans register on health ID it seems with your GP/doctor. 🙂

Multi-disciplinary team approach to all diseases is a good way forward.

 

Today is a new day…

Chronic illness like diabetes especially type 1 diabetes where your life depends on testing your sugars and injecting insulin can become fatiguing to say the least. The drain and strain of this burden gets you down no matter how positive the patient and the family.

But what can be done?

I have a few tips for diabetes and other chronic disease burnout :

1.) Every day is a new day, forget the past, forgive yourself for the mistakes, highs lows etc and begin afresh almost like today is the first day

2.) Give yourself a mental break, have a week off mentally of driving strict control

3.) “allow” yourself to cheat now and again making sure you do it safely-ie inject to cover the carbs accurately

4.) See a psychologist or a life coach or similar profession regularly through state or privately – you owe it to yourself.

5.) Take anti-depressants where indicated, don’t feel guilt about it, if it has been prescribed to you for burnout, depression take them.

6.) Get together with other type1’s or people with a similar diagnosis both for sharing the good tips and debriefing about the bad stuff, no-one can commiserate like someone going through the same thing.

 

FEel free to add your tips 🙂 Today is a new day! Indeed

Discovery and CDE

So this year all Discovery patients(excluding keycare) with diabetes will be covered on the CDE programme. This is super exciting.

What is CDE ?

Cardiovascular Diabetes and education – the brain child of Dr LArry Distiller which has been running for many years across south africa out of Houghton Johannesburg. It is a programme by which diabetes is managed holistically and by a team of professionals each focusing on an area of speciality : feet, eyes, diet, exercise, medication etc.

What makes it great for control of diabetes and general wellness is that all members talk the same language in terms of diabetes management and work towards a goal of control individualised for each patient.

For any queries phone : Romae 0832898351 or email drleesecretary@gmail.com or drleethegp@gmail.com

The CDE programme runs according to international and national guidelines to give the best outcomes longterm, that means looking to have less heart attacks, less amputations, less renal failure and dialysis, less hospital admissions for diabetes due to better control and the programme achieves it year after year.

Reasons our country is great …

1.) app of the year and its success story – well done MTN

2.) Jordan Peterson’s book – 12 rules for living and the impact it could have on us if we applied it 🙂

3.) a world widely connected and the availability of gems to all

4.) Gareth Cliff and his vision and content and joy bringing en masse

feel free to add to my list

End of year madness … or is it gladness?

Another year 2018 has come and gone in the literal blink of an eye. I find myself looking back aghast at 8 years gone by in a jack flash. So much joy and so much agony. A kaleidoscope really. A train smash storm born delight. So much and yet so little.

Life is a lesson if nothing else. And I guess right now I am just terrified that I have too little time left here, now, deep in the poison garden to borrow some words from one of my favourite poems ever ever.

To recap 2018, it started with a transkei soul filler in January at Zithulele and interestingly in november topped off with a similar soul collide. I do love it when souls collide, slip and slide and joy errupts.

February the month of love seemed full of long hard days of work and figuring out pain.

March and easter arrived too soon, a lovely camping trip with friends in the cobham berg marked the kind of first quarter’s end and did a lot to boost the love tank.

April, well a month of decisions and immense pain one I shall sooner forget.

May, my birthday month had some snippets of great support by friends and reflection.

June and July the winter of the year, also just seem to full of work. But a wonderful wonderful time in the snowy mountains learning to ski, putting a hole in a sump and finding treasures in Barkley East of all places as well as the most exquisite mountains – the guardians in Elliot of even more strange and wonderful and undiscovered unrecognised places.

August was yesterday more great work. September the air filled with spores and pollen, we sneezed and bloomed. October too.

November and here we are December!

Shoo, looking back I am excited to look forward. Right now it’s hard to lift my foot even 10 cm and I feel that a good hibernate sleep of 2 weeks would not be enough. But I vow to be back in Jan2019 rejuvenated, joyous and full of brimming life for the little bit of time (hopefully at least 50 years) that I have left :):)

At this time o’ joy – I shall be joyous

2020 vision – what is your response? South africa …

There is a goal to eradicate blindness by cataract by the year 2020. Perfect vision is 20/20 or 6/6. A world health organisation WHO initiative from 1999 that aims to address multiple issues around vision and avoidable blindness it has taken off beautifully in some parts of the world and yet is sadly lacking in others.

Interesting to me the case of the eastern cape government, happy to jump on the band wagon of an NGO like Grace Vision and “claim” it’s successes but not even vaguely interested in helping fund a very worthy and well run cause.

I used to work in the government sector for 8 years. There is every single excuse not to work thought up by the staff nursing and other -like not enough staff (they require 4 nurses in order to operate), out of stock of something, too hot, too cold etc etc. Possibly some vaguely plausible but almost always overcomeable with will.

I find it sad that as humans when we are part of a big machine like government sector the vast majority of us default to the lowest energy setting.

Challenge to government health sector – partner with the NGO’s financially and see the gain/win and delight of YOUR people – the people of south africa.

WEll done mediclinic!

A chicken in the clinic …

I spent last week doing cataract surgery MCSIS at Zithulele hospital and more specifically Grace Vision (NGO). This is an amazing NGO doing phenomenal work in a very rural and poor community. They have managed since inception to alleviate blindness in their immediate vicinity.

THis means that according to the world 2020 vision target they have already done in by 2018 !!

That is simply amazing and unheard of in this part of the world – the eastern cape.

But then Zithulele at large is not your average place either.

Run by inspirted staff at large it’s a place of many miracles daily. Zithulele is a government hospital just off the road to coffee bay, transkei, which has managed things that few such institutions have been able to through sheer hard work and lots of prayer and mindful action.

Tell the truth or at least don’t lie …

We are all spiritual beings and have intrinsic innate plumb lines.

We all also have unbearable ignorance in us. There is actually much to navigate in this life. And choices present themselves and when they do the choices potentially direct or re-direct the rest of our lives.

So really we actually do have some control over the path.

I guess what I am trying to say is that life is as simple or as complicated as you choose to make it and within us lies a lot of intrinsic value as well as rubbish and we somehow have to sift out the rubbish and learn to trust the truth the internal plumbline that longs to direct our hearts and souls in a direction of fulfilment.

And to this end, we can really only be true to self if we are willing to be honest.

We celebrated world diabetes day this past wednesday and Diabetes in essence, especially type 1 offers and real deal opportunity for a whole family to get honest about a lot. A curse in essence which sometimes turns into a blessing in relation to facing challenges and rising in a dignified way above them.

In daily confronting a disease like diabetes that challenges you to eat healthily and responsibly, inject correctly, pre-empt highs and lows and at the same time fight the chronic disease fatigue.

The irony is if you manage your diabetes well you outlive the rest of the population due to preventing things like heart disease etc. I wish it were so simple with our psyche. Diabetes is a special challenge to the psyche and so many patients battle this daily and win.

 

 

 

 

 

 

Fear can be overcome by humour, there is indeed no other way…

Of two choices you can be certain – to choose love or to choose fear. What do you choose?

One of the best ways to combat fear is humour – Pieter-Dirk Uys said this in an interview with Gareth Cliff on Cliff central …http://cliffcentral.com/ – an awesome place to find cool pod casts.

Another thing that struck me is how as humans when there is a big internal fear of big feelings like for example homosexuality or being abused etc, that we someone turn our focus to self-loathing. That shadow self, the “unacceptability” thereof then turns into a great fear and we operate frozen out of contempt for this. This is not healthy.

Another thing I learnt yesterday is that depression is fear turned inward, internalised.

Not a good thing.

And yet there is freedom, there is joy, there is dancing.

IN humour, in letting go, in acceptance of self. In naming the emotion and confronting the fear in a gentle accepting way. Sitting in the mud with it. Alongside it.

We are complex individuals who crave, long for and desire connection. Empathy is the key to that connection. Without empathy connection is nearly impossible. Empathy.

 

 

 

 

Mental health …the big taboo

Tell someone you have breast cancer at the very least they have sympathy for you. Tell someone you have broken your arm they will say I am so sorry. However let it be : depression, or drug addiction or any mental dis”order” shoo but the judgement, the “look” and the opposite of support.

Like a sausage, by and large every time.

Even amongst colleagues. Even amongst loved ones.

Why? Why such stigma, such judgement, such vile poison?

Are we afraid? Is it fear? Is it selfish?

I don’t know, I only know the reaction is sad.

We are all physical, emotional and spiritual beings who battle multiple fronts on any given day. We all have spots in all of these areas. And yet in the strangest way we are all connected. And deeply so. Believe it or not. Your choice. But the truth is we are.

Think on this today. Perhaps you have such a person in your life. It would mean the world to them to even just be accepted by you.

Halloween …

What is halloween?

It is a festival that started more than 2000 years ago, this is before Christ. They were pagans in what we know as England today – celts.

It is a festival marking the end of the harvest season and has a long history.

I was trying to figure out why it is so offensive to the christian religion but even after researching I am confused.

If we really think back to 2000 years ago, and that is hard to comprehend. Life as we know it was very very different. They were as we call it pagans but really they were just trying to survive and using the sun, wind and stars to get them through the year.

As with all of these traditions like father Christmas and the easter bunny – do children really know the significance of the holidays we celebrate?

What does halloween mean for children – sweets, pumpkins, trick or treating, dress up. They certainly don’t channel anything.

I actually find it quite interesting that as humans in 2018 we still have followed a lot of customs from more than 2000 years ago, fairly “religiously”.

My personal feeling is that it is what you model daily, preach without words that has the biggest impact.

Also perhaps I am cooked in the head but “broad minded ness” in my book includes exposure to things rather than hiding them under a mushroom however this is just my personal opinion.

 

Scraps of affirmation…

Peter and John went to pray one day, they met an old man on the way ay ay, silver and gold have I none said he, but such as I have give I unto thee. Rise up and walk.

Yesterday I was privileged to listen to a sermon on this very encounter. The man in the story did not have faith for healing. He had faith for what he had encountered for many years -scraps. Scraps of money, time, affirmation, food.

And yet that day he was healed. Leaping and jumping and praising God.

So much of many of our lives are lived much like this. Hoping for scraps. And really that is not what we were destined for.

There is so much more.

We have a mindset sometimes that we lock into for years and years. And then all of a sudden sometimes the light breaks in. And we can see.

And there is a time of feasting.

Being lame is innate to my name, Claudius – the lame one. Wounded healer.

What an absolute joy and jump to be able to gift healing in the physical sense. And sometimes even the emotional.

But true healing is a much deeper process that requires divinity.

And the amazing thing is that it IS available. And also one does not have to be ok with scraps, now put that in your peace pipe and take a long hard inhale.

Claudius was a very interesting fellow, conquered Britannia – the UK basically. To sojourn from Rome to Britannia in those days was quite a sojourn.

 

The aqueduct of sylvius…

Oh my word the brain is just so absolutely fascinating and phenomenal.

I had to explain the brain’s mop up operations to a patient today and was suddenly struck by wonder …

This extremely intricate system “cycles” cerebrospinal fluid 3-4 x a day. I had never really thought about this before. One learns neuroanatomy in second year and it is really just all part of a web of knowledge about the body that has never been debated philosophically before (by myself I mean).

“The windings of the brain (which I first learnt of Franciscus Sylvius, a great anatomist) if you diligently examine the matter you shall find to descend a good depth and that the brain doth gape on each side, over and above that same middle division made by the Sickle, with a winding clift, which begins in the forepart, about the roots of the Eyes, whence according to the bones of the temples, it goes back above the root of the spinal marrow, and divides the upper part of the brain from the lower part.” -written by Caspar/Thomas Batholinus from a book F Sylvius neuroanatomical work.

How beautifully described. I am in awe just of the description. And that is how they communicated in those days 1500’s – with care and deliberation.

Much similar to the brain’s care and deliberation of itself.

A slow wash 4 times a day : fluid formed by choroid plexus within the lateral ventricles which then feeds through the system into the third ventricle via the aqueduct to the 4th then via 3 small foramina into the subarachnoid space and spinal column.

The brain bathing itself, soothing itself, slowly like a water feature – tranquil and clean and clear.

We have much to learn about self care from this amazing washing lesson by the brain. WE are generally our own worst enemy. Learn from your brain and cleanse, dream, bath today.

The aqueduct 🙂 one of my favourite parts of anatomy.

 

 

Roaring 20s party …

So we are throwing a fund raiser towards the cause of Shap Shap cinemas – can be found on Facebook … doing a wonderfully good job in terms of a lot of community education at large.

We are going to dance, party and just have a lot of fun. WE have DJ Queen G who is phenomenal playing, food from Copperfields which is delectable, a cash bar. And all of the money raised goes straight to Shap Shap.

I heard about these amazing individuals/NGO listening to Gareth Cliff during his interview with them last year.

Please support us, this is a tangible way to turn our SA around – just do it man, pay for a ticket. Dress up is optional and I guess so is dancing but will be encouraged 🙂

Life is short, times are tough, have fun and support change.

Diabetes type 1 is no one’s fault, don’t be ignorant

Daily I hear very interesting “lies” about diabetes. I heard a classic last week. Someone’s mom who had had a stroke was told her mom has the kind of diabetes that CAN NOT be controlled. God’s truth!!!

Another common lie is that this is a disease “you do to yourself” i.e. you behave/eat in a certain way and your “punishment” is diabetes. Well I am afraid that is NOT TRUE.

Especially in type 1 diabetes. This scourge has been with us for a long time. However up until the 1920’s there was no “cure” or “treatment” so to speak i.e. you generally died from it. And the consequence being the “genes” or genetic inheritance died with that. Since the 1920 s we have had insulin and now one can live very “normally” yes ~I said normally with type 1 diabetes. Yes it involves checking sugars and injecting insulin but other than that you can eat mostly what you would like to and get on with life as you would like to.

So to the diabetes that can not be cured I say : Lord have mercy. There is so much lack of knowledge especially in public sector about diabetes. That added to the corruption. Ie meters, strips, insulin being sold on the black market meant for the poorest of the poor free as part of a the dismal service being provided is a scourge.

Any form of diabetes can be treated and controlled. Is it easy ? No but is it do-able even for the poorest of the poor. YES!!!

There is so much corruption in this country and it always affects the poor more. Let’s at grass roots level tackle this with the power of words, peace, and the truth. Join us to contribute to both awareness and funds for shap shap doing this very task daily excellently : roarin 20s party 27 oct 2018 …see Facebook drleethegp and shap shap