Category Archives: dancing with obstacles

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

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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

 

 

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.

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 ūüėČ

 

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 Рno 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!

 

“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!!!