Diabetes is not a myth -so why do we pretend it is???


So funny to me how there is still a lack of acknowledgment as well as a bit of head in the sand when it comes to this massive diabetes epidemic. WE seem to think we are all fairies in a fairy tale and bad things will never happen to us despite our bad behaviour.

We are currently in a pickle. A sticky soup mess of diabetes by the gazillions and yet you see no REAL action. Why?

Confusing really.

Especially problematic to have this many children “suffering” mostly silently from undiagnosed disease.

So much knowledge available and yet so little interest even.

Until the day it hits you or your family. In terms of type 2 especially in children there is so much we can do as well as reverse this if found early. So why are we not going out and actively diagnosing it?

Unfortunately in type 1 in children through no fault of their own, their bodies have attacked their pancreas and essentially killed the pancreas. And without insulin they would die.

More awareness, less scaremongering, less head in the sand, more action. More at least attempt to slow the log curve of growth. Why don’t we at least try to slow the log.

type2 chilrdrentype2kids.jpg

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Comrades – the real joy of south africa


Oh to sit at the half way mark and watch both the beauty of south africa as well as the glory of our people both running and spectating. We are in truth a rainbow nation that deeply cares for each other across colour and culture and language and on comrades this is on display for the whole world to both see and experience. What a spine chilling, tingling and emotional few hours that really filled my tank with pure joy.

I then went and had lunch with my folks and watched some of the live footage on tv. The interview with Bruce Fordyce about Ann Ashworth was so heart rending. They were only expecting/hoping for the last gold medal and on the day she came out guns blazing and surprised even herself. To see his enthusiasm for her race and the joy of what transpired on the day, beautiful.

Our country is amazing and whilst we still have a lot to work through we are actually working through it. We are not pretending there is no elephant in the room. We are tackling daily life in south africa on a daily basis and working for the good of all.

Comrades day is our commitment to that process in action. Proud to be south african. And wow what a lady is our Ann.

 

 

What is a cough and what is a cold?


The definition of a cough : Middle English: of imitative origin; related to Dutch kuchen ‘to cough’ and German keuchen ‘to pant’, Expel air from the lungs with a sudden sharp sound, kuchen : cough, hack, kuch: fit of coughing,.

A cough is a sound we make that has a deeper cause, like a post-nasal drip, a pneumonia or a bronchitis (blockage in the passageways), a problem with the nerve supplying the lining of the lung, asthma, smoking, a lung tumour, gastric reflux etc. So in my humble opinion cough syrup as such is a little bit like using an antibiotic to treat a viral infection. One needs to treat the cause of the cough. Once one gets to the root of the problem and treats that the kuchen will go away.

🙂

What is a cold? A cold usually implies a viral infection of milder intensity that the “flu”. So many people say I have the flu please give me an antibiotic. Well! Antibiotics DO NOT touch viruses for starters and “the flu” is not the common cold or a bacterial infection like a sinusitis or a bronchitis.

Cold viruses :

  • human parainfluenza virus.
  • Human metapneumovirus.
  • coronaviruses adenovirus.
  • human respiratory syncytial virus.
  • enteroviruses.

A virus is a tiny little living thing of genetic material that infects you. It is vastly different to a bacteria.

(yes do not confuse your google search with 27 years of study…)

Cold viruses generally do not kill you.

However the flu viruses of which there are also many amongst them swine flu and the influenza virus CAN kill you. So that is why we have a flu vaccine. It is so that you don’t get one of the virulent viruses that can kill you. Yes you may still get a cold virus or a bacteria (that is not part of the flu vaccine) …but it will NOT KILL you. Get it???

spekboom tours…www.spekboomtours.co.za


I spent the past 3 days on a slack pack through the Dargle forests with Julia Colvin and Jonathan (Italian surname) and a few other SNAFU’s that greatly help her with all the organisation it takes. Spekboom is a relatively new company but Julia is not new to traversing beautiful ground.

We had the absolute best “bathing in the forest” adventure possible. Nine ladies on the hike and what a wonderful time of awe and wonder (and a lot of blood sweat and sore feet) but how worth it – can not be quantified what this kind of thing does for the soul.

The sole on the other hand – she takes a beating. (Especially when you discover on the friday that your boots have literally gone walking and you now realise that the old pair of running shoes will have to suffice).

If you are in need of soul food, a little piece of heaven for the soul I would highly highly recommend this. The food was phenomenal, the company was glorious, the views breathtaking and the general injection of delight into ones being simply unquantifiable.

http://www.spekboomtours.co.za

 

 

 

New insulins


Is it not a joy and a delight to be able to know that these days we can prescribe an insulin that is far more predictable and sticks to the rules than ever before.

If you are not a type 1 diabetic or parent of one you will never understand how easy it is to either over or under dose on this medication. Add to the fact that sometimes 10 u behaves a certain way and other days it behaves in another way.

So to have both Toujeo and Tresiba – true long acting analogues with SMOOTH delivery available in SA at a price that is competitive fills my whole being with delight. I can prescribe knowing that what I am hoping the insulin to do will ACTUALLY happen 🙂

By the way this lovely awesome cellist is also a type1 – no-one can deny his talent and poise. Just saying ! Type 1’s ROCK!!!!

Royal Wedding what a splendiferous treat!


So rarely in one lifetime is one treated to 2 royal weddings as spectacular as that of Diana and that of Meghan the Marvellous Markle.

My heart shon with joy all day long.

What absolutely divine presence of God during the entire day!

The love -pure love between Harry and Meghan is something that God desires for all of us. The fact that it is so rare is sad and a travesty.

NEVER under-estimate the power of love. That reading from Song of Solomon personifies what God intended for love and the outflow and the overflow of love.

Yes I am lyrical. Indeed. This is what my heart has always told me quietly and boldly.

Also the fact that I discovered a beautiful example of love quite by chance. I had always just assumed that Harvey (Gabriel Macht) was a player. Wow what a lovely special gift to see he’s been married for 14 years and #Ilovemywife, was his comment – it made! my day.

Yes LOVE does exist. Indeed.

Meghan you are a diamond and Harry the way you love is how every gentleman on earth should!

We are all people, we share the “commons”” of man of human kind so to speak. And yet we make it all so complicated. God ordained for us to love each other as we love ourselves. Yet so little self love in this world and so little love for one another – despite creed, culture or colour. Be the love today. Thanks Meghan and Harry and Diana for your shining example with NO words of pure redeeming LOVE.

 

Ek wil he jy moet saam sing …. My hearts deepest desire for you my darling is for you to sing when the music plays


Hulle se ons moet glo net soos die kinders …

They say we should believe, just like the children

So is hierdie lewe dan net vir beginners?

So is this life, just for beginners?

Little boys become men and then

sit in a pub and be bored …(look tired)

my boy, listen please,

one day you will have to fight with your whole being,

sometimes it will feel like the goal is a whole heap of shit,

enough is enough

but! I want you to sing when music plays, and dance in the summer rain.

Search for the rainbows my darling,

run into the sea with your jeans on

and search for the mermaids

take part in discussions about all the beauty along the coastline

stay conscious

of yourself

Not too much, but also not too little, just really not too much

Please sing when music plays and dance in the summer rain

Look for the rainbows on the road

my darling

and when you feel that this life is just one big suffering suffer!

reach out and help someone with less

and make someone happy -true joy

because then you will always be able to sing when the music plays and dance in the summer rain, search and find the rainbow,

run into the sea fully clothed,

if you find that mermaid my heart will be filled with joy because two dreamers is so much better than one …

 

karen zoid – I just love your philosophy and trying my best to impart to my girls 🙂

Alles van jou …


Afrikaans poetry is just my best,

Via jou :

Vra my wysheid Ek verwys jou Ignoreer my Ek upstage jou My meningspyling onderskei jou Jy speel saam want ek verlei jou Ek wil vertaal in waterverf dimensies Ek wil verdwaal en nooit weer hoef te wens nie As ek naby is aan jou As ek naby is aan jou Deur die skare soek ek net na jou Jaar na jaar, jy’s al wat ek onthou Al die kitare speel weer net vir jou Serenade, sang en dans vir jou Ek gaan nooit verloor nie Ek gaan nooit wen nie Jou ten volle verstaan Of ken nie Maar ek is useless sonder jou Ek is useless sonder jou Ek lewe klein en uncomplicated Die een fout is so underrated As ek naby is aan jou As ek naby is aan jou In n kroeg of in n kerk As ons slaap of as ons werk Ons is swak maar ons is sterk Ons is vry maar in geveg Sonder liefde het ons niks Sonder liefde is daar niks Sonder liefde is ek niks Sonder liefde Deur die skare soek ek net na jou Jaar na jaar, jy’s al wat ek onthou Al die kitare speel weer net vir jou N serenade, sang en dans vir jou Ooh ooh ooh Net vir jou

 Hard to translate because the words themselves are enriched with a meaning that is really almost untranslatable – certainly with word for word. One needs a whole sentence to try and impart the deep deep meaning.
Just felt I had to share, anyone who has not heard any of our richly talented artists. There is honestly a treasure chest full of delights to delve into.

Abbott Francis Pfanner


What a lovely story of a man who gave his life for others. The founder monk of Marian- hill Monastery whose handiwork still stands today in testament.

Apparently a sickly young man who ministered in albania and europe and then come out to “africa”, landing in PE after having vomitted for most of the sea journey. He made his way up to durban and then established the monastery at marian hill. He had a different way of working to the vatican and ended up being dismissed.

He was passionate in his faith and demonstration of it, yet differed from his superiors on some of the doctrines which seemed to be deal breakers at the time.

Yet his work, handiwork, leadership etc still stands for all to see. He died feeling a great sense of injustice which I feel is so terribly sad and yet I am fairly sure that once he arrived on the other side his joy would be complete.

My own mind still boggles at the strangeness of man, I can only imagine how God’s must.

 

Diabetic feet …


So what a hugely ignored region of the body feet are. The very base of us. The very instrument of motion. Disregarded at large by most. Diabetic and non-diabetic.

Why do some diabetics have problems ? The long and the short is that largely this area can be protected, well taken care of as well as preserved.

Diabetes is a systemic disease that affects the whole body, including the feet. The blood vessels and nerves going to the feet are tiny calibre vessels, easily damaged. Think of coke rushing through your arteries and veins and what stickiness that would cause?

An ulcer on a foot is a serious thing. In fact any break in the skin is something that has to be dealt with asap. The thing with diabetic feet is that often the nerves are damaged first and there is no proper feeling and damage occurs much more easily and worse damage due to no feeling.

The human body is an amazing thing and can do spectacular processes of healing.

There are so many awesome wound treatments these days, no amputations should be taking place if the correct care at the correct time takes place.

If in doubt ask a caring practitioner to take a look.

Don’t leave a foot injury even for one day.

0832898351

2 Quarry road

Eva Mackenzie : Prins Alfred street and in hilton

Toujeo or not to jeo?


Yes folks we have a new insulin and the best best news is that it is priced affordable – R590 SEP for a long acting insulin that almost guarantees NO hypos!!!

What great great news !!!

I can barely contain my excitement as I scribble out scripts for gazillions of patients for whom this means a huge leap up in quality of life living with type 1 diabetes or diabetes that requires insulin injection.

What is it? Toujeo – or insulin glargine U300 – lots to figure out. In a nutshell it is the same as lantus/optisulin BUT squashed smaller. What does that mean?

Science is “fucking” wonderful – sorry I had to – I LOVE !!! science. When you make a molecule smaller you decrease the surface area and thus slow the absorption rate right down. So now you have a more concentrated molecule (U300 vs U100) that is “dissolving” or releasing much more slowly and predictably and yes you guessed it all you insulin boffins out there – no stacking of insulin, which means no HYPOS !!

Simple yet brilliant, don’t you think – or am I just a proper nerd.

Once daily dosing – truly once daily.

No hypos, predictable.

Need I say more

Toujeo or not to je o ??

😉

Gut microbiom and diabetes – of cats, kefir and insulin :)


I have a patient who is a type 1 diabetic and that patient has a cat who is also type 1. Needless to say they are both on insulin. Now if you thought that is it hard to dose a human try dosing a cat or a dog with insulin. It’s so hard and the margin for error is SO big.

These 2 patients have cut their insulin dose by half and halved their hypos by having kefir three times a day.

Then I came across an article in the Journal of Diabetes (South africa) about the gut bugs and diabetes. It mentions how important gut bugs are in terms of metabolic functioning – normal functioning as well as disease. It concludes by saying that “gut microbiota represents an exciting field with novel therapeutic potential”.

I say you have nothing to lose. Give it a try.kefir.jpg

A peace poem


some times frogs boil

some times minds foil

sticks and stones can not hurt nearly as much as words, ever

some times I wish I lived in the land of never never

hearts beat strong

lives live long

and actually sometimes there is even a king kong

world’s collide

sometimes divide

the crashing waves of hurt subside

and peace can become the normal tide

life is a pulse

a heart beat or two

so simple yet so complex

rather not be constantly vexed

peace is a path

chosen

on purpose

our lives a tapestry recorded and finite

choices all ours and have an impact into eternity

weird to think

sometimes a heart sink

and yet a choice

let peace be your choice

 

 

Children with type2 diabetes


In the last month I have diagnosed 2 children with type 2 diabetes. This is a first for me and greatly concerning. The prediction was there but I guess I hoped I would never see it.

What does this mean?

Type 2 diabetes is where you “run out” of b cells – the ones that make insulin and run high sugars due to a bad match between carbs (too many) and insulin (too little).

This was previously only seen in adults really towards the age of 40. To see this in children is a wake-up call.

We have an epidemic of logarithmic proportions and it needs to be tackled in a multifaceted way. By governments – providing funding and facilities as well as knowledge sharing. By health practitioners – early diagnosis and implementation of turning the tide for both individuals and population groups. By society – recognition of poor eating and not enough exercise – ditch the device across the board. Go outside more often/daily for physical activity. By you and by you, yes you.

The drakensberg …


What a privilege to spend easter with divine friends in the pristine drakensberg mountains at Cobham near Underberg.

“Die heuwels fantasties”.

Easter camping on the riverside breathing in the fresh air up there, diving into streams of clear fresh water. Children playing, friending new friendies. Braais and “braai-pie” – thanks Suzette – watched your you tube clip and was indeed a crowd pleaser and so easy.

What a privilege.

Newer insulins


Are they any better ?

Yes, yes and yes, if I needed insulin I would only be on the newest latest of them. Are they for everyone?

I certainly believe individualisation is the key here. We now have so many tools in the armament of diabetes and to this end they require to be prescribed for the greatest benefit for the individual.

So, when it comes to what we call basal insulin – background insulin. The insulin that controls your sugar before a meal and overnight and in the back ground so to speak (out side of meals). We now have a lot to choose from : protophane, other long acting basals, analogue basals like : glargine, detemir, newer ultra-long acting like degludec.

In terms of the choice it needs to match the needs of the patient.

If a patient wishes to only inject twice a day we have an option for that.

If a patient prefers an insulin pump we have an option for that.

If a patient is wanting ultimate control above all else there are choices for that.

What is critical is aiming for an A1c of 7 with very little variability. I am always happy to sacrifice A1c for less variability and my most important criteria is no hypos! or as few as possible. They are “Kak” for both brain and patient.

A little video


degludec video

https://www.tresibapro.com/resources-and-samples/video-library/tresiba-mop.html

Diabetes death rate a shocker


Following on from yesterday, there is so much we can do.

One of those things is : better insulins.

Arriving on the scene shortly in SA and already there all you first world folk, is degludec. Why is this an extraordinary insulin.

Well long have we hoped for these properties : less hypos, more even delivery, longer acting (thus forgiving if a dose is skipped), safe in the context of double dosing !!!

Yes yes and yes.

So why the tardiness in terms of medical aid re-imbursement?

Good question as I tell my 4 year old when she asks a good question.

Degludec in SA marketed as Tresiba – a wonderful new arrival on our market, folk I need the groundswell to convince the funders that this will SAVE them money and YOU your life and quality thereof. I can not do it by mine self 😉

 

Diabetes – the biggest killer of women under the age of 60


Shock horror indeed!

The medical people have long been warning of this tsunami and everyone has just yawned and gone – not me. and carried on munching on that way too big carb full meal.

Not me. Not today.

Only to find out 10 years down the drag that actually yes me too.

Diabetes is a tsunami and it IS happening and best we sit up and take notice. There is so!! much that can be done and also there is much to be said about early diagnosis and best management.

Which brings me to medical aids. In their best interest for good management to happen and yet so slow on the uptake. Folk, medical aids need the ground swell pressure of the people to force them to do what is actually best for them – ironically.

And yes CGMS, continuous monitoring and good insulins and newer treatments and earlier interventions actually SAVE money in the long term BIG time and death and morbidity (that’s when you suffer but don’t actually die).

So, folk, women and men folk. Really so much to do, so little time. Go out and have a blood test, if is it negative don’t just accept that as up to 30% of people will have a “normal” fasting sugar but an abnormal post meal sugar – and you guessed it – you could STILL have diabetes.

Stop reading and get a proper test.

Ek lewe – I LIVE! Annelie Van Rooyen


Dag na dag dreun ritme om my heen

Dag vir dag dreun ritme om my heen (day after day the rythym’s around me – droning)
voel die ure vol en tog alleen, (the hours feel full and Yet I am alone)
Maar jou blik verslaan my vrees (but your gaze destroys/chases away my fear)
sonsaffier lag in jou wese (sun saffire- joy of laughing in your living – no words to describe in english)
bring geluk wat lank verlore was.(brings joy that was long lost)

Ek lewe!


gemaak om na liefde te strewe
op vlerke van vriendskap te swewe (to fly on wings of friendship)
sonder vrae oor wat more mag bring (without a worry about what tomorrow might bring)
Mm … ah – ha
O ek lewe!
verstaan weer van droom en van vrede
die vreugde van leef in die hede
dat ek hier is vir ‘n rede.

Die vrae was soos skadu’s binne my
deur die ligte lag en andwoord jy.
En ek sien die sonverhale
in jou oe nuwe tale –
lees die storie van weerbegin. (reading the story of a new beginning)

Ek lewe!
gemaak om na liefde te strewe
op vlerke van vriendskap te swewe
sonder vrae oor wat more mag bring
mm … ah – ha
O ek lewe!
verstaan weer van droom en van vrede
die vreugde wat leef in die hede
dat ek hier is vir ‘n rede.
Ek lewe!

 

Don’t stay where you are tolerated go where you are celebrated!


Someone sent me this and more than a penny dropped for me. I can’t explain how much a moment of “I hear you” in turmoil can mean.

Life is full, life is a bull, life is hectic-smectic sometimes.

It is in the times of dire need that occasionally true character pops up it’s head and blesses you with a pearl, thank you thank you.

For anyone out there who may feel as if they are in a sinking boat : understand that you ARE celebrate able and should be !

celebrated

T-slim in south africa ??? A little bird told me it’s going to be here soon …


I came across a product called T slim – insulin pump that “talks” to dexcom …now wouldn’t it be nice to have this product here in RSA.

Insulin pumps deliver a set rate (hourly) subcutaneously as well as a “bolus” for meals without having to “inject”/jauva. It’s also so much more “physiological” and results in less low sugars less very high sugars, less variability, better A1c, better quality of life.

Just saying 😉

“SUID-afrikaners” is plesirig!


Not to be controversial or anything, I honestly believe that as south africans at large we are extremely talented and have the greatest potential on this green earth of ours.

I watched “die wonderwerker” on the weekend on showmax, a story about Eugene Marais. Oh my word, our actors! our people, our film makers – I could wax lyrical and then some.

I just love Karen Zoid and her republic of zoid afrika. She show cases the best of us!!!

Again and again and again.

Opens our eyes to the beauty around us. Allows us to dream harder, believe.

WE so can. We are amazing people. Resilient and talented and beautiful and amazing

“ama” zing.

My absolute best is at the end of the show what one thing would you wish for OUR country – watch and be inspired – I am!!!

@ 2 Quarry road :)


We are here, we are settled and we are happily ensconced at the Ellen bird.

Ellen bird : coffee shop, gift shop, play area, party area, homework area etc.

Practitioners : speech therapist, remedial teacher, integral coach.

Dr Lee the GP @myinnatehealth (www.myinnatehealth.co.za) : GP, 2 dieticians (diabetes and eating disorders), life coach as well as PRP/laser/quantum therapist.

0832898351 for whatsapp or phone calls.

drleesecretary@gmail.com for emails.

MOVE – Dr Lee THE GP …0832898351


Dr Lee is moving to The Ellenbird in hilton – 2 Quarry road, New phone number : 0832898351, we are relinquishing telkom. We have to pay them 30k to go away. And trust me this is the “cheap” option. IN a nutshell, don’t sign a contract with telkom.

NUFF said!

Fran Steart, Michele Albets, Fiona McRimmon and Elze Scheepers will join us at the Ellen Bird. Fran and Michele are dieticians specialising in diabetes and eating disorders. Fiona is a life coach and Elze is a laser and PRP practitioner.

Pop in – coffee at the coffee shop, gifts and the gift shop and medical help including speech therapy etc all available.

AN idea of the feeling you get at our new practice :

Tips for appearing at the CCMA


First things first,

1.) They generally run on time

2.) A matter generally takes ball park 1-2 hours to “settle”

3.) They ALWAYS “settle”

4.) Arbitration is a myth that hardly happens

5.) Be prepared to settle

6.) IN pmb park in Chapel Street as close to langilabelle as possible and walk it’s your best bet – no parking closer and you will just get frustrated

7.) There really is not much point in taking anyone with you as they will almost always attempt to get you to settle, I suggest you learn the labour law and ask as many questions to your legal buddies

8.) In the first place put things in place so that you never land there it is awful and a process that makes you grey

9.) Conciliation is a process whereby the commissioner urges you as the employer to “settle”, this is NEVER in your interest and always in the employees

10.) anyone with questions or needing advice (non-legal) is welcome to email me : drleethegp@gmail.com

Moving …


We are moving to 2 Quarry road, it is first right along Quarry road out of hilton avenue, literally on the corner.

WE will only have 0832898351 available for bookings and whatsapp (feel free to whatsapp). Telkom will not be moving with us ;(.

telephone

The Ellen Bird boasts a coffee shop, a gift shop, kiddies play area as well as lovely parking.

See you there …

http://www.myinnatehealth.co.za

Phones down again, telkom …


Please call 0832898351

Emotion


Listened to a fascinating talk shared on Facebook this am : Watch Susan David‘s TED Talk on how to control your emotions in a healthy way:http://t.ted.com/kZ3eEcm. She explores the paradigm that being positive has become to be morally “correct” and that we seem to all have bought into this delusion.

I love the way she expounds the fact that this is a dead man’s perrogative.

Emotion is part of being human and the full range of emotions is what makes us alive. They do not control us, however going through the full range actually enables success not the way we currently just wish to put on a smiley face and pretend it all happy.

Humans are complicated, thank the Lord for that. We do have emotions. We are NOT artificial intelligence robots.

Stop before you criticise a fellow human today for what you perceive to be negativity or grief or a “negative” emotion. Allow compassion, understanding and quiet supportive stillness to abide.

The joy of kinship is something I feel was worked at on a daily basis by the ancients. Community, living in “communion” and “supporting” one another friend to friend, lover to lover, something we don’t really really do anymore. Perhaps we are too busy. Perhaps we are too driven by things that actually don’t matter in the end.

We do actually need each other. And we do actually have a role in each others lives in terms of empathy, compassion and even just silent standing by –  a deep recognition of another just by “being” there in spirit and truth.

February the month of love


Love love the big love. Which organ serves you most in love?

Is it the heart ? Or could it be the brain?

Could it be the gut??

Are the gut and the brain connected? Is the heart just a pump or it the seat of the soul there?

Love is patient love is kind. Love is in essence a pure distilled un-muddied thing.

Yet the process of love is very muddy.

We all yearn for it, even the toughest amongst us. Even the hardest of the hard, well some would argue they yearn for it more. In more ways than one 😉

The body is a vessel that contains so much, working in synergy, a whole lot of stuff being co-ordinated on a minute to minute basis. A miracle indeed.

Physical, biological, chemistry and so much much more! Then throw emotion in there. It’s a wonder we can “contain” it all.

I will end with my favourite Kalil Gibran ” The deeper the sorrow carves into your being, the more joy it can contain.” Sad but happy.

 

Cataracts gone, vision returned and life in abundance


Once a year I pilgrim to Zithulele Hospital in the transkei. A special place. I call it pilgrim as I have been going for a while now and my girls are 4 and 6 and they make the long journey with me. Sometimes travelling with little folk is a little challenging euphemistically speaking.

Zithulele hospital is a place that is full of peace and joy and HOPE. Look them up and look up Jabulani NGO associated with it and if you believe in south africa, even if you believe in humanity and life and goodness – donate – I promise you it’s the best money you will spend in 2018.

Grace Vision is a place on par with Zithulele -look them up too. They also need some money. Put it here instead of bitcoin and ether whatever.

The gift of vision from blindness to the elderly and even some younger patients is precious and a profound privilege to be a part of in any way.

I am extremely lucky to be trained in MCSIS – scleral tunnel cataract surgery – suture – less.

Grace Vision is an impeccably run project. The entire team are dedicated, hard working people. The entire team, and each person is part of the miracle occurring in the blind.

So begin 2018 with purpose and a gift – I challenge YOU !

Mina – Claudine – the pictures here are of Glenn Strauss – the amazing guy who taught me this technique – look up helpmesee  …. and support him too!! so many challenges …

 

Diabetes and the holidays …


So I have blogged about this before, but they are upon us now.

What should you be doing/not doing or doing differently during the holidays.

We all know that glucose control is one way in the week and quite a different way on the weekend and holidays. This is partly because we are human and life is well just not always easy and letting your hair down usually goes with a bit of alcohol (if you are old enough) and a bit of cheating (dare I say it).

So all things considered, where does this leave you with your diabetes?

Consider it. Be mindful of it. Carb count it. Accurately.

With the holidays come a little bit of time – that we don’t usually have. Choose to exercise – must be something you love. Be creative. Horse ride or bike ride or dance!

Factor the exercise in. IF you are not sure how to do this, consult someone. Even if you are on holiday – trust me most of us (health care folk) are at work : dieticians, GP’s, nurse educators etc.

Don’t just go ape on yourself. It’s so much harder to get back the lost ground.

Enjoy yourself but be fair about it. Restraint is required.

Give yourself a Christmas present of being present more often. This will carry through to the new year and be a wonderful asset.

Top sites that I feel are invaluable : http://www.fatsecret.co.za – south african ,excellent for carb counting and so much more!, pinterest has awesome pictograms of diabetes.

Feel free to share your best app, resource with me.

Merry Christmas.

Abbott Flash special extended


2 days left ONLY

actually extended to January

R190 instead of R990 for the reader that is also a meter for glucose and ketones

R990 for a sensor that lasts 2 weeks and reads a sugar every minute

phone 033 343 1826 for a form and you are set to go 😉

don’t miss out

Diabetes non-month -we can still make folk aware ;)


Hello. Today is the first of December. November (diabetes month) officially over. “Ca dover”.

Diabetes is a growing problem. Most people do NOT choose it. More so type 1 – spontaneous destruction of all beta cells of the pancreas making you insulin dependent (like alcohol dependant only a little different (this is a little joke so don’t get too upset about this statement if you are prone to getting upset).

Type 2  can be lifestyle induced but that does not mean you should judge the person. Or that anyone has given you the power to do that. Or the right.

Insulin only comes in the injectable form. Yes that means you have to inject anywhere from one to 6 x a day. Then you also have to test your sugar – another “prick” required.

So don’t be a prick to diabetics as having dealt with so many already they can’t tolerate you too. And for that matter the moms and dads of diabetic children also fall into the category of not needing any more pricks in their lives – they are hard enough. Grow some empathy. Please? Even if just for the festive season.

So, in december, the festive season. Not everyone in this life is as blessed as you : health and wealth and mental health wise. If you only do this this festive season let it be that you are kind. To all around you. Truly kind not the falsely kind of kind.

Born in the wrong country


So sometimes I feel that really deep deep down in my soul I am actually a mixture of spanish, italian and a few kinds of south american.

I love to dance. Even in the light. Even in the night when no-one else is. Even in the sun shining day. Even in the hay. I just love it. I love the beat. I love music with a beat. I love music with a soul, and I love a community that embraces that as do the afore-mentioned.

As south africans and (I am told as men) dancing is something learnt whilst drunk and can only be performed in such a state and the window is quite narrow as once too many drinks are on board the physical act of standing is even hard.

So I am native to another country and my soul beats that drum.

It would be so great though if as south africans (at least) we could embrace the person who is dancing instead of rejecting, dissing and naming and shaming them.

Just a thought.

Different is not bad and it should not be intimidating. It certainly should not ever invoke nastiness.

As a nation (at least the privileged part thereof) we tend to be quite critical as well as sharp with our words. We tend to be a little arrogant and set in certain ways we call our own. There is nothing wrong with our own ways but by the same token there is also nothing wrong with another way ?

Anger is a map?


Anger is a voice, a map, it shows us boundaries and points the way. Anger in itself is not an enemy of something to be feared or rejected. It is a powerful human emotion that stirs, rocks and beckons to guide. Anger is not the action. It is action’s invitation. No this is not my wisdom it comes from 2 books : Drawing as a sacred activity and The Artist’s way.

Life is in many ways a puzzle and needs a bit of figuring out.

We move through it, short as it is, in a way that we essentially choose for ourselves. Sometimes it feels as if we have not chosen it, but in essence it is our choice.

Living with that choice is sometimes hard to come to terms with. But oh the joy of knowing that the path going forward can be chosen in a better way.

Plato said that the life unexamined is not worth living. And I like this.

Also Albert Einstein said Imagination is more important than knowledge and I like this even more.

Synchronicity (fortuitous intermeshing of events) according to Jung is a thing of wonder and beauty too.

All matter has energy and it is in constant motion. That’s not what I invented or even a creator invented, it just IS.

And so much is gifted to us for the using of navigation in this life, yet because a lot of it is mysterious we don’t attach the value to it that it shouts out for, like anger.

Many folk dis art and relegate it to the empaths and “feelers” of this world. I say art is life. Art is part of the path, art is part of the navigation and part of the tools to navigate.

We are complex beings men and women. And yet we are actually so simple. The tools are all right there in front of us, yet so hidden that many of us don’t see them. Our lives are our own responsibility and cry out for us to take ownership fully. Grasp that and then grasp life. Live : whatever you think you can do or believe you can do, begin it, Action has magic, grace and power in it – Goethe.

 

 

Myths around diabetes


November is diabetes month – awareness around what it is and treatment etc. There is actually quite a lot of strange information that circulates, “fake-news” so to speak regarding diabetes at large.

So let’s dispel some myths.

1.) Diabetes is caused by poor diet : firstly type 1 has nothing to do with diet and is bad luck essentially. It seems to be an auto-immune disease and essentially destroys the b cells of the pancreas creating an absolute lack of insulin.

Type 2 diabetes is a lifestyle related as well as genetic disease and even more complex in nature.

Insulin resistance is a condition more and more prevalent due to lifestyle as well as stress – a big factor. More about this another time.

2.) IF you eat properly you will get better : well firstly type 1 diabetes, without insulin – you die, children in the era before 1921 died. Only since 1921 and Banting and Best’s discovery do type 1 ‘s survive with normal life expectancies.

Concerning type 2 diet is critical and important (as it is with type 1) carbs are key and obviously healthy eating and exercising are key but eating 100% correctly will unfortunately not bring back b cells that have died.

3.) Type 1 diabetics should never eat carbs : whilst one should be mindful of the type and quantity of carb and dose the insulin accordingly it is by no means advised that type 1’s exclude all carbs. This is a tricky one and best discussed in consultation with a dietician.

 

Myinnatehealth diabetes ball …we had a jol


Your sugars and your holidays


holidaysHow does one approach glucose control during the holidays?

Holidays are generally a time where we relax and let our hair down a bit more than at other times. Included in this are dietary relaxations like consuming more refined sugar than normal as well as alcohol in slightly greater amounts and strengths, depending on your preference and age. Also for some it may include more than normal outdoor activity and exercise.

All of these have repercussions for glucose levels.

So, obviously each person has an entirely unique set of circumstances as well as metabolism but roughly speaking here are some basic holiday guidelines.

If you are a type 1 and injecting insulins and testing :

1.) Consider testing your sugar more often if you are exercising more and possibly feeling hypo.

2.) Consider adjusting your insulin dose at meals with more carbs and simple carbs than you are used to (perhaps go through your dietician and doctor re this).

3.) Understand that if you drink a lot and sleep in the next morning this is dangerous and alcohol will at first raise your sugars and then after about 10-12 hours drop your sugars, so watch out for a “missed” hypo and make sure you tag a mate to check on you at least.

4.) If you are snacking and the carb count is more than 10-15 g of carbs you may need to bolus for this kind of snack in order to keep your sugars stable but it really depends on a number of factors other than just this.

5.) the weather plays a bigger role than you think, some people will go either high or low depending on very hot or very cold conditions so try to understand your body and rather pre-empt the rise or fall or at least be vigilant and test more often.

6.) consider wearing a type of medic alert bracelet in case of unconsciousness – it may save your life.

For type 2 diabetics on oral agents only or have additional insulin injections

1.) Most importantly holidays can mean massive weight gain, and this is very bad and hard to get rid of in the long run. Pre-empt this by seeing a dietician who could give you guidelines on how to cheat without too much weight gain. Also see it as a challenge to maintain your weight rather than a punishment and reward yourself with things other than the wrong food on the holidays. Set incentives and be kind to yourself with spoilers that blow your hair back and don’t put weight on.

2.) Make sure that you have enough medication and testing strips for the time that you are away as well as some back-up diabetes supplies.

3.) Know what carbs are and how they affect your sugars and plan accordingly.

4.) Know the carb content of the alcohol you are drinking and factor it into the daily calculation of insulin (if injecting) as well as the total effect of the alcohol and your activities (physical) or not.

5.) Try to see the holiday as an opportunity for increased movement -exercise in many different forms and find one that works for you, start the routine on holiday.

6.) Experiment with different healthy food and take mental note of how you feel and what it does to your sugars.

We all need a break, a re-set and a proper unwind. So most of all give yourself the mental  “space” and time you need to do just this. Planning for your holiday around your diabetes will aid in enjoying this time more and taking stress out of certain situations.

There are always healthcare professionals on duty, know the nearest casualty location and telephone numbers as well as ambulance and other emergency numbers before leaving home.

Mental health, impossible tasks and other musings


Why is it that when we are ill either physically or mentally and it comes to support for the person it is hard to find. In fact a very common reaction is for people by and large is to withdraw. Leaving an already vulnerable person more vulnerable and more likely to become sicker. Why do we do this as a society?

It seems we are quite cruel.

Much like being a type 1 diabetic. Once diagnosed your life depends on testing sugars and injecting insulin. People are wary, they hide, they run they disappear from your life entirely. Schools refuse to admit children with it. Kids don’t want to have them at their party. And why ?

Yes it’s different. Yes it’s a disease that requires things that some humans are uncomfortable with. But, can you not dig a little deep and conquer that fear, reach out and be a friendly face, hand , eye?

We are actually all connected and our reactions have repercussions. We have choices to make daily.

I challenge you today to not run and hide. To be present, even when it is uncomfortable. To be present. Really there. In the flesh and the mind. Present. That’s all. To be there.

Pushing past impossible is something that is actually possible.

And you know that we all – collectively benefit from that.

And the world at large can be a better place.

 

Diabetes and governments


Why is this not a more pressing issue? The diabesity epidemic threatens to ruin the whole world and yet so much of silence?

The log curve that shows no even inkling of abating rises like a tsunami and we are all “thula-msindo” – zulu for not saying a word.

Urgent action is required, yes I said action. Urgent.

Alternatively we can go with the tsunami of medical costs that are unsustainable, ill populations, knock effect to the economy due to loss of income, knock on due to high costs (medical) etc etc. It is a disaster and yet we look on.

Wake-up oh sleeper!

Now is the time to do something, its fast becoming too late.

 

Medical aids and the future?


In my opinion which some may argue is not humble. I argue it is.

Medical aids restrict care for patients as well as shoot themselves in the foot when it comes to downstream costs.

Particularly in an environment like south africa where we have this tsunami wave of a diabetes epidemic. Approaching things holistically (as CDE which originated in Joburg and is now all over RSA) is the only way to manage the finances we have. Yet the push back from some medical aids is interesting to use a word so as not to offend.

I am merely a GP – general practitioner. I have made it my mission to stay up to date (as well as the most qualified I can be) regarding diabetes at large. I am passionate about it. I am even more passionate about the best care for my patients. This largely could translate to the best money spent for medical aids but alas it does not turn out that way 9 times out of 10.

There are medical aids who are open minded and practice preventative care like Discovery and medications and appliances are provided with insight and good application.

I wish this were across the board. Alas not in our beautiful country.

Patients vote with where they pay their money.  The next few years are critical as to both the direction of medical aids and whether the money will be spent effectively saving downstream costs or whether the whole thing just implodes. Every day another massive wave of patients are added to this problem. It is soon to hit that critical mass where devastation occurs.

We have to become more preventative, we have to manage what we have to the best of our abilities with what we have.  That is best done with more brains. Team is key. Technology is key and unfortunately not everyone is on this boat.

Think before you drink before you drive, think before you eat that cake and you don’t survive.

 

Derma pen is amazing!


What can it do : remove pigment and scarring, re-junenate, remove fine lines, remove tattoos, remove stretch marks and MORE …

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Death Oh who art thou?


To lose a loved one is one of the hardest things for me. I am so unsettled by it, especially if it is someone my age or younger. Because I am young. And Death is so definite.

At someone’s memorial or funeral one expects to gain closure and to get some kind of “feeling” that the world is upright again. But alas it is not always so.

My “friendus” Mark Reynolds was a larger than life person who was always going to defeat death until he didn’t. I met Mark on the “kleuterskool” play ground in a small town called Tzaneen where english speakers were in the minority. There were 3 of us : Mark, Vivienne and myself.

We played on the “baantjie” and said ” get away, get away” a lot. We forged a friendship right there and then that lasted an eternity (I hope). Death confuses me and many of the things I hope for (faith) elude my desire for confirmation thereof.

Throughout junior and high school we played, we learned, we experimented. Mark was the first to offer me a cigarette -menthol nogal. I tried it, hated it and it convinced me lifelong that I would not smoke. We hiked in the gorgeous agatha forest, slid down the rocks. We laughed so much mostly our sides split.

We rode horses in Sabie – galloping into eternity together.

More recently Mark attended my sister and my wedding. I will never forget Mark giving my bemused husband-to-be a flower as was his custom.

Mark’s laugh was one of those that triggered others to laugh and not stop. His smile captivated. His heart was one the most beautiful I have ever seen. He sacrificed so much for others – his important others.

In love I believe he was let down so badly it still hurts me. He painted out of that and gave up on romantic love – which is so so desperately sad but I believe he was trying to self preserve. For me this is so tragic as he was a gorgeous soul and the love between 2 people – true romantic love as it were is something that can take one to heights that nothing else can- and it did – only it dropped him too (as it does many).

He had so much to give – in life and love.

Taken way way too soon, I just don’t understand and I guess never will.

What I know is that we must live here now, and make each minute count. We must cherish each other in the moment. Be present in the moment and live each as if the last.

 

To Mark – my “friendus” ignite heaven as I know you will with your soul. Devastate them with the joy that radiates out of it. The deeper the sorrow carves into your being the more joy it can contain. I love you and I always will.

Celebrate and live each minute


Our time on earth is limited by a number none of us know. The quality that we experience depends almost entirely on us – each one, in our own capacity.

Life is very short for some and interminably long for others. The enigma is that there is no way of knowing.

Where does that leave us each, individually?

Life is a strange bag of tricks and boils down to little more that about 40-60 years on average of a daily slog : waking, working, paying for things, sleeping. And yet it can be so much more. It can be.

It depends entirely on your own self. The quality of each minute. The minutes add up and create memories. But essentially if you are not present in the present and enjoying that very minute wholeheartedly it may be a wasted minute, hour, life.

I wish we knew in a way. The hours we each had and the moments that we should make count.

But we don’t.

Perhaps only when you lose a loved one do you re-evalute life on a minute to minute basis.

Today actually counts for more than you think and if you understand that in the realm of time and space we are each such a small inconsequent speck that may or may not live another day, surely it’s worth making this very minute worth it.

Sorrow and sadness fill my being for the loss of a life so huge at some moments and so full of the very essence of life. He lived indeed and took the time to make it special. I so hope that one day I will understand the reason we have a this life and a “death” or after life. I certainly don’t today.

Tidal wave required


Ok so life is interesting in south africa. I would like the kind of money that Manyi  has, 450 million? was it. I would use it to “fund” my patients needs.

Diabetics, type 1’s in particular have many needs. Most of these are not taken care of by their medical aids and despite the fact that patients pay a LOT of money for the privilege of being on one.

Type 1’s require tight control of glucose above a certain range and below a certain range and everything including the weather impacts on blood sugar. Thus continuous monitoring is a tool that can make a very very big difference in a patient’s life – it can also make such a difference that the medical aid is spared costs of admissions for highs and lows, for amputation, renal dialysis, heart attacks as well as costs attached to being blind.

However medical aids at large do not seem the slightest bit interested in saving themselves money.

Far rather milk the patient for all they are worth and at the same time provide the minimum service and complain about any request made by the health care provider who has studied long and hard and has a passion to save the medical aid costs.

Yes I am angry, perhaps at this time of day I am even h”angry”.

I am tired of begging, pleading for minimum standards of care.

I am tired that overseas things get “accepted” years before they do in south africa. Are we really 3 rd world? Despite having the “Manyi’s” ???

We require a tidal wave of protest in the form of intelligent debate with the stakeholders that matter in the realm of diabetes. I am just so tired of fighting.

Please from far and wide across  this beautiful country we call home join me, join the debate, write to your medical aid. Email me : drleethegp@gmail.com.

Please.

Continous monitoring is available in 4 forms in south africa : dexcom G5 and G4, libre flash abbott, medtronic standalone CGM and most new to the scene : ever sense.

Coming in at the lower end is the abbott flash R990 once off and R990 every 2 weeks. Dexcom is a cost upfront more than about 25k and then monthly around 4 k, medtronic around 15 and 2k per month and ever sense brand new so not too sure but in the ball park for the last 2 mentioned.

What is boils down to is MARD and quite frankly this is the bottom line with CGM is accuracy. The lower the MARD the more accurate. There are really only 2 in the market that a great on MARD : dexcom G5 and ever sense, however for the cost the libre is actually a very good value for money.

The other thing that helps me as a practitioner is a trend and all of the devices are good for this.

What we need is for the medical aids to realise that CGM is a tool they their patients can NOT afford to be without! FOR THEIR own sakes – the medical aid’s sakes.

Please tsunami arrive and let’s flood the medical aids with the truth.

Alternatively could the guptas or the Manyi’s or maybe Grace Mugage give me 450 million to spend on my very deserving patients.

Thanks ;).

The injustice of medical aids


demonstrate

 

So I have applied for continuous monitoring for a type 1 patient who has multiple hypos affecting daily living. He is on a top plan of momentum (I have other patients on this plan who fund continuous monitoring). I then appealed and put in a second appeal to their DECLINE.

We have been told in writing that they have declined it a third time but with no reason and that they are withholding their criteria from us.

This is common garden crime!

I say this is bullshit! to put it mildly.

In south africa where we have human rights we have a very progressive legislation and law. We have so much and yet we have nothing.

Medical aids keep moving the goal posts and now we don’t even know what they are in this case.

NO transparency. NO patient care. NO clear communication.

I believe that there needs to be a tide by both patients and doctors against this kind of bullshit decision and policy.

Let me know if you are in and we can go to the ombudsman.

Diabetes does not have to be


To be or not to be – TYPE 2 I mean. Lifestyle induced diabetes. This is a disease that we hardly saw 100years ago. It’s a new thing really.

A question of quality of life I believe. Both to prevent it and to “cure” it. Type 2 diabetes is essentially “toxicity of life” disease. Too much sugar, too much bad stuff, mainly sugar that causes inflammation generally but is specifically bad for the pancreas and the reason being it is like flogging a horse. Every time YOU demand insulin of the pancreas (every time you eat sugar or carbs) it has to produce it. Only it only has so many b cells to do this and the harder you flog it the harder those cells work and you literally flog your pancreas. At some point – once you have lost 50 % of those cells you become diabetic.

Now here ‘s the interesting thing. At 49.9% you are not diabetic but at 50% you are – go figure. Like with a lot of things there is a spectrum. So, surely you understand that one can “pick up ” this continuum BEFORE you qualify for type 2. SO why not find out??

Once you have type2 for real it is a matter of time before you flog those last 50% and then need insulin to save eyes, heart, limbs etc. However IF you take it seriously and “recruit” dying cells that are about to become apoptotic you can actually turn it around a bit, not back to 100% but you can slow the progress and retard the disease. So why not do that?

To be or not to be ? The choice is yours and the decision in your hands for the grab or not?

 

How Bell Pottinger can get away with this??


I know that we have a lot of interesting things happening in the banana republic of south africa. You gotta love our pres and one of his wives looking so sauve at the G20 as if all is just peachy (not to mention dressed to kill).

But hells bells Bell Pottinger please could you go on a quick course on how not to screw over a “cowntry” in a few short months unethically purporting shit.

What I am battling to get my head around is how this happens? And they are just going to get away with it????

I guess in a world where Donald Trump is the US president and making “deals” with Russia (his new/old best friend) and Brexit goes forth with all those shenanigans I should not be surprised by a PR company that is able to purport shit that affects everyday normal multi-coloured (rainbow-nationed) people.

The average person is worse off Bell Pottinger because you sided with a bunch of criminals and chose to spit out trash.

You are the devil along with Donald Trump and all the other role players quickly killing this world. And I guess in this world where the one with the most money gets to be a bully and get away with it this kind of thing will continue to happen. How you sleep at night I do not know.

Wouldn’t it be nice if one could get paid large sums of money for a more mandela like society in Mandela month. How I think he would cry at the likes of you and what you have done.

bellpottinger

Why holistic management?


Why is it important to see a team when you have diabetes?

Well because complications are preventable. Dialysis, amputations, blindness, heart attacks and strokes are sequelae to sugars above 10.

Why? This is like pouring coke on the floor, the vessels stick to each other and everything else – creating a sticky stuck mess. Hence blindness, renal failure, amputations etc.

The answer is to be vigilant. See your team every year at least once a year and some of them twice a year, some even 4 x like your doctor if you are a type 1.

The team : dietician (1-2), the podiatrist (1), the educator (1-2) -essentially also the co-ordinator, GP (2-4), or endocrinologist, ophthalmologist (1). Additional benefits : psychologists, biokineticists, nutritionists, life coach.