December 22, 2014

An old fairy tale in a modern jacket

Dear Bloggers,

During the my wanderings through my funny mind.
I wanted to put an old fairy tale into a modern form. 
Everyone knows the sad story of the girl with the matches. 
As a young bloke this story made me cry and I realized that not everyone is 
that lucky in this life, some have to live under harsh conditions
This is my version of it. I wish everyone a warm and loving Christmas time.


It was a frigid cold night outside on the streets of downtown Groningen City, the coldest night of the year in fact. It was Christmas Eve and all along the littered and paved road were buildings with warm glows coming from the windows of the apartment buildings. Everyone was happily celebrating the Christmas spirit with glasses of brandy or a beer and a typical Christmas movie on their televisions. The snow fell down fast and thick, blanketing the sidewalks in a soft but chill powder. The snow ploughs would have quite a job clearing all the walkways and roads in the morning.


A public service bus emblazoned with Groningens famous grey and red dotted pattern managed to find a vacant spot along the side of the busy street and parallel parked, coming to a stop. The back passenger door opened and a man in a dark trench coat and dark hat shoved a young girl onto the unploughed sidewalk. The bloke threw a box at her, revealing quite a large stock of packaged cigarettes. “Now, I don’t wanna see you back on my doorstep until every last pack of smokes has been sold, you got that kid?” the owner of the hat yelled harshly. The girl sighed and shivered as the wind tore through her thin jacket and ragged jeans.


“Yeah, alright! I’ll sell ‘em!” she snapped back, thoroughly irritated with her big brother doing this to her again. He had sent her out in the frigid cold every night this week to sell those disgusting cigarettes his buddies smuggled in from other countries. She had gotten quite ill from her late-night job and even now, her eyes were streaming and her nose was dripping terribly. Her lungs felt about three sizes too small for her body and every now and then, she would be plagued with a wracking cough that left her gasping for air.


Of course, her brother would not take her to the hospital. He didn’t want to waste his precious money that she earned for him on something as trivial and unimportant as medical care. The bus slowly took off again and got out of sight again, leaving the sick young girl of about twelve years by herself on the streets of Groningen City.


She wore no gloves and her sneakers had holes in them that allowed the snow to soak through and freeze her toes. Her jacket was too ragged and thin to wear in March, let alone late December. Pulling the thin fabric tighter around her scarf-less neck, she put her head down and trudged her way through the bitter cold snow, being jostled back and forth by busy Groningers who were in too much of a hurry to notice her.


Finding a rather busy intersection, with bustling traffic all around her, the girl decided to advertise the cigarettes there. Placing the box in front of her on the ground and pulling out a brightly coloured, freshly wrapped package, she cleared her aching throat and shouted out. “Get your cigarettes here! Fresh, smooth cigarettes with a new mint flavour! Only three fifty a pack! A great low price!” she yelled out, displaying the carton as high up as she could to grab people’s attention. A few passing folks bought a package or two, but most just turned their heads and kept walking without a word. She had only sold four packages of cigarettes and needed to sell the entire box full before returning to her brother.


A bout of severe coughing caught the young girl by surprise. Doubled over, she hacked and spluttered until she thought she may vomit right there on the pavement. Luckily, the feeling passed although she was left gasping for breath, hands on her knees at the intersection. Of course, the bustling Groningers walking past paid no attention to her. The suffering of a little girl was no concern of theirs.

Wiping her runny eyes that were now mixed with hot, salty tears, the girl shook her head to shake the snow out of her hair. “Forget this! This is dumb!” she muttered to herself angrily, giving the box of cigarettes a good kick, leaving a sizable dent in the soggy cardboard. Picking up the box and continuing to walk down the street, she had to bite her lip to stop from crying out in pain. She was so cold she couldn’t feel her toes or her fingers and she was aching all over from the beating her brother had given her the day before for coming home with no profit.


“Psst! Hey, kid! You got some smokes there?” the voice of a homeless man wafted out from an alley. The young girl was not afraid of street people. Most of them were usually kind enough to spare an encouraging word or a few extra scraps of food when she made her rounds. She nodded and stepped forward. “Yeah, but I can’t give ‘em to you for free or else my brother will beat me,” she told him apologetically. The homeless man waved a hand as if to brush off her words.

“Ah, that’s okay kid. I got some matches though. Care to trade a pack of smokes for some matches?” he asked, pulling out a small handful. The girl was about to apologize once more and say that her brother would hit her for trading any of the cigarettes when a thought struck her. The matches would provide some kind of warmth for her numb fingers. Unable to resist, the girl eagerly nodded and traded the homeless man for the matches. “Thanks, kid. You’re alright,” the man complimented her, walking away with his new treasure.


Taking the man’s place in the dark alley, the girl struck one of the matches against the rough brick of the building beside her. Thankfully, the match wasn’t wet and a small fire glowed brightly in front of her eyes. Looking up, the young girl witnessed the most amazing sight. Before her lay her old living room from when her mother had been alive, decorated lavishly for the holidays. A gleaming pine tree covered in twinkling lights and tinsel shone magnificently and presents were laid underneath, covered in festive wrapping paper as a roaring fire spread its warmth throughout the room. As the girl reached out to touch her surroundings, the flame of the match flickered and died out; leaving her once again in one of Groningen City’s many dark and frighteningly cold alleys.


With a cry of fear she desperately struck another match. This time, she was in her old dining room, also decorated for Christmas and the table groaning under the weight of all the delicious food upon it. Roasted turkey with cranberry sauce and gravy, mashed potatoes, wine and eggnog all freshly made by her mother. The scent made the girl’s mouth water, but again the vision did not last and with the death of the match’s flame, came reality once more.

Just one more… the girl thought to herself hopefully, again striking a third match. Rather than seeing visions of her old home with food and decorations made by her deceased mother, she saw her mother before her. She was alive and well, looking healthy and jubilant. She smiled warmly at her daughter, holding her arms out to embrace her. Sobbing with joy, the girl frantically lit the rest of the matches she had, not wanting the image of her mother to fade away like the others had. “Mom! Mom, take me with you! Don’t leave me again, mom!” she wept.


“Come. I’m taking you with me, where you will never be sad or cold or hungry again. We will be together forever,” her mother’s sweet, gentle voice called out calmly to her. Smiling through her tears, the girl ran into her mother’s arms and they were floating higher and higher. As they ascended, the young girl could feel all her sadness, loneliness, hunger, and cold fade away, leaving her in a state of bliss as she embraced her mother. She would never feel these things again.

The morning rush hour traffic on the first day after Christmas was brought to a standstill as police tape surrounded a snowy alley. A female officer leaned over the body of a little girl, surrounded by lit matches and a box of cigarettes nearby. She cleared her throat and spoke into the walkie-talkie attached to her breast pocket. “We seem to have a Jane Doe here, approximately ten to thirteen years old; seems like she froze to death last night. We’ll have her at the coroner’s by midday. Over,” she told another officer. The officer sighed and shook her head. “Poor kid. Probably she was just trying to keep herself warm.”


Light a candle in these dark days for those who are no longer with us,
but somewhere up there waiting for us. And when our time has come 
to exchange the earthly to the afterlife. 
Whatever you believe and no matter who you are. 
Just remember Love conquers all. 

The Old Sailor,

December 4, 2014

Racing Cars and Freight Trucks in my body

Dear Bloggers,

My ups and downs have been a little more up and down of late (read for most of this year, it's still nearly Christmas, right?). Not exactly disastrous, but I've not really managed to ever get things into any kind of groove for more than a week at a time. A bit wearying to say the least. Yes my brain exists best by complete chaos.


Part of me knows the best way to improve things is to go back to basics and do some fasting basal tests and tweak my basal profiles based on actual information rather than the (un)educated guesswork I've been relying on for a while. Another part of me is having enormous difficulty summoning up any enthusiasm, since I know that the holidays are coming and I'm likely to stop going to the gym for a couple of months which will have a knock-on effect in itself.


So I'm spending my time grumbling and hurrumphing instead (my family are so lucky!). The old nagger is coming to town and no it is not Santa, it's Santabetes

 

On the plus side it does give me a chance to jot down this analogy that I've been meaning to for some time. It's something that usually strikes me when my blood glucose levels are a bit errant, and Victoza and food are just not playing nicely.

When it comes to trying to balance the effects of food and Victoza on blood glucose levels (well and everything else.. but specifically food and Victoza), one thing that makes it very tricky is the difference in the speed of action of carbohydrate and Victoza. It's not enough to accurately match the dose of Victoza to the amount of carbohydrate you are eating - you have to try to ensure that the two act more or less together to reduce blood glucose wobbliness (technical term).
Almost all carbohydrate is very much in the Formule1 car class. Fans of glycaemic index tables (GI) might agonise over whether something is high GI, medium GI or low GI, but in my experience the differences equate to something being 'almost instantaneous', 'really very fast indeed' or only 'very fast'. Not a great deal of protection against the ravages of a post-meal spike, either physiologically, or that emotional kick in the guts of seeing your levels rise from a decent pre-meal number well into double figures an hour or so later. From the very first mouthful those big outboards start roaring and the carbs go zipping and zooming about, gleefully spraying glucose in their wake.


Victoza, on the other hand - even the fancy schmancy 'rapid acting' analogues can seem painfully slow to get going. More like one of those behemothic freight trucks or road trains. With a great groaning and clanking, the thrum of the plunger on an insulin pen or pump delivers the dose and then... Nothing. Watch and wait. Is it an illusion? Is it actually moving yet? Nope. Still can't see anything happening.

Vooooom! Swish! The carbs go tearing past again. Running rings around the slumbering giant.


This is particularly the case for me when I am waiting for a correction dose to kick in. I've had to stop myself from checking post-correction blood glucose levels before an hour has elapsed. Any less than that and the chances are my blood glucose levels will be almost unchanged. An hour!
 

Of course... one of the things about a freight truck is that once it is moving, there's not a lot you can do about it. All those stories about them needing however many miles to slow down or turn a corner. And so it can feel with rapid insulins. 


Nothing... nothing... nothing... Ah good, movement! Good... All good, back into range. Right that's enough now thanks... STOP!

But on and on, the dose lumbers forward - an unstoppable force. All-ahead full. The truck has now run straight over those race cars crushing them to matchwood and we could very well be steering directly toward Hypocity.


Corrections can be a tricky course to navigate. My doctor tries to help by offering a suggestion of 'Active insulin' - how much dose is still working away, but there are many variables to factor into that equation. Sadly I find my doctor's attempts to be the vaguest of indications at best, and often wildly inappropriate to the particular circumstances of the moment.

 
Patience is the skill I have to master. I am always trying to remind myself that while the spike in my blood glucose levels may have happened in only 45 minutes or so, the insulin correction will only have stopped after something like 4 or 5 hours. If I get impatient and overcorrect in the meantime I am likely to cause myself another problem (and more wobbles) by overdoing it.

The Old Sailor,

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