Category Archives: dancing with obstacles

Libre flash monitoring – “freeing” you up to live life


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

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.

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

 

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.

dexcom

“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.

solitude

 

“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.

simpsons

Even the Simpsons seem confused 🙂

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.