Sunday, January 27, 2008

Getting everything settled

Friday next week I will leave for Glasgow, spending 5 weeks over there. 5 weeks – with only a week to get everything settled for my departure!

Before Christmas my supervisor and I agreed that it would be good if I could come to Glasgow in the beginning of this year, but even so I don’t feel like I have had enough time to actually plan my trip. The reasons for this are that work has been crazy during January. My Danish supervisor expected me to assist and train a foreign post-doc coming here for a short visit end of January in order to learn how to analyse some samples that our lab had run for her. This was planned even before Christmas, and as I knew she would be here the last 2 weeks of January, I figured that I probably wouldn’t be able to leave for Glasgow until beginning of February. In the first days of January, I did start to make a draft plan for my trip, as well as the experiments that I would want to conclude before leaving. I had a plan for my experiments all set to start January 7th, and figuring that I could use the breaks in between the experiments to make the final arrangements for my Glasgow trip. However, as I wrote in my last post, my plans got messed up by an e-mail I received on January 7th, and because I have a short-term visitor that I need to help with data analysis this past week has been more than stress-full.

I managed to have a very decent draft of my review done last Sunday, and have used whatever few minutes I would have during the week to proof-read and refine it, while having to use the majority of my time to trouble-shoot data processing and software installation issues. At the same time I also had to get my trip to Glasgow arranged, ordering the tickets, so that I would be able to participate in a lab meeting over there at the 5th of February – a lab meeting I have to prepare a 20-25 min presentation for as well!

Being busy for me usually means an increased frequency of hypos and as my regulation haven’t been the best the past couple of months I have had even more issues with this. Just before this crazy schedule started I had an appointment with my D-nurse and we agreed that some basal testing was needed. Thus, on top of all the work/study related stuff, I have also tried to fit in some attention to basal testing. It has been very difficult, and it is probably not the most optimal to combine busy schedules with basal testing, but I felt I had no choice as I have had far to many hypos in general lately. I have been making some changes to my basals during this period of basal testing, but the changes don’t seem consistent – as in one day they appear to work, the next they don’t – and I still have too many hypos to actually not worry about my coming trip to Glasgow.

I went for a blood draw Friday morning to get some thyroid results, and at the same time I had an A1c done. The result was in my file on the Funen Diabetes Database later that day: 4.9%! That is a 0.4 drop from beginning of November, and the lowest A1c result I have ever had. Aside from the fact that Alice will probably “kill” me when I call her on Tuesday ;-) I don’t think I have even been that frustrated with a low A1c result before. Had this results been achieved without all the hypos then of course I would be thrilled, but fact is it has been achieved due to daily hypos, at least for the past month or so. That is utterly frustrating, especially when the changes you try to employ do not seem to help!

I have been thinking a lot about what to do about my stay in Glasgow. Even though I know from experience that changing my setting, even if it is just for a couple days at my parents, will generally elevate my sugar levels - the extent of the elevation depending on the actual “new” setting – I am worried about the risk of being alone with a hypo in Glasgow. Not to mention the fact that Jimmi has also been close to the past months’ low sugars and is of course worried too, because he cannot be there to help me. He will come for a short visit, but the majority of the time I will be on my own. I much hope that I worry without reason, but it is difficult, especially with the events from Hamburg this summer in mind. I plan on asking Alice if there is any chance in the world that I would be able to borrow a sensor to bring to Glasgow, but given the short notice and the length of my stay I don’t expect it. Anyway, I hope that the accommodation will enable me to notify someone about my condition and how they should react if I act strange or don’t show in the morning, and I will probably also make a deal with my colleagues in the lab about calling me if I’m not in at a set time and have them contact someone who can get into my room should I not answer. Otherwise I just hope and pray for my sugars to behave while I’m over there, so that none of the emergency contacts needs to get involved!

Wish me luck, and I will try to post about my adventures in Glasgow, if not during my stay then at least afterwards :-)

Wednesday, January 16, 2008

18 years, hypos, and busy schedules

In Denmark 18 is the legal age, allowing you to get a drivers license, vote, and officially take care of your self etc. Today, D and me turn 18 together, but somehow it doesn’t seem quite as big and important as when I turned 18 twelve years ago :-) Still, I cannot help to think about the progress within D research and treatment the past 18 years have shown. Although the cure that was also promised me within a few years when I was diagnosed still remains to be found, a lot of other important milestones have been reached. I remember a nurse on the hospital where I was admitted as newly diagnosed showing and telling me and my parents about how she could now eat and enjoy sweets again (as in not eating them to correct hypoglycemia) because she had gotten an insulin pump. Obtaining more information on the insulin pumps of the time blurred that picture quite a bit, and for several years I thought that I would never want to be treated that way because of the risk of DKA. 16 years and 3 months – and, indeed, a lot of progress – later I was hooked up to one for the first time, and while being somewhat reluctant about it, I have come to appreciate what this treatment strategy offers me in terms of freedom. It does of course have its issues and drawbacks, but I guess most treatments and/or equipment have that ;-)

Hypoglycemia and a busy schedule do not work well together. Today, once again my afternoon has been disturbed by a low BG, causing me to have to take a break from what I was doing. I couldn’t concentrate on what I was reading, and thought that I might as well take advantage of the time I needed to spend away from it, repairing the low BG, and write on my blog :-)

I am in the process of working this out, but it a process that is significantly slowed down by an immense amount of work-/study stress. Just after New Year I actually started the process of thoroughly testing my basal rates, as my numbers the last couple of months – and in general if you ask my loving pump- and D-nurse ;-) – clearly indicate that insulin levels need to be reduced. Even though I had a lot of plans to effectuate at work along with planning my trip to Glasgow at late January or beginning of February, I felt that I could work some basal test into the scheme. In the first week of 2008 I felt I was moving at a very decent pace, working out plans for experiments to carry out during week 2, researching the areas that I should check out when coming to Glasgow, as well as putting down the experiments and other practical issues that I should take care of over there. I knew that I was expected to stay in Odense until end of January to help an Italian post-doc with some data analysis, and I wanted to test the data and the software necessary for its analysis prior to her arrival mid month. This was a clever thought as I have, of course, run into trouble with this – bioinformatics is always a challenge :-)

My feeling of energy for the different tasks and assignments suffered an abrupt disappearance when I opened my University of Strathclyde mailbox in the beginning of week 2. I had received an e-mail telling me that my 3 month literature review was due now, and should be uploaded electronically as soon as possible. Reading the mail my jaw dropped down, and my mind started racing: What 3 month literature review? What should it contain? When is the exact deadline? Have I heard about this before?........ I search the university web-site to find information as I cursed the inability to obtain sufficient information about the obligations as a Scottish PhD-student. I couldn’t find the information I needed so I replied to the e-mail to inquire about it. That gave me an attachment of the institute’s post graduate study handbook with a note that I could find the information in that. Reading the 52-page Word-document sure provided me with some needed answers, both regarding assignments that should be handed in during the study (the intended contents of some of these reports were very well described) and the courses that I should attend. Unfortunately, the 3 month literature review that I was most keen on obtaining information about, was only just mentioned, its contents not described (I have later received another handbook, where it is described in more detail). Therefore, I started sending out inquiries to my supervisor in Glasgow as well as one of his colleagues. I didn’t want to start writing anything before I had some guidelines on it, and I could see that I was actually supposed to attend a course during my first year of study, where writing of literature reviews would be dealt with, but of course, since I have yet to come to Glasgow for several reasons, I haven’t attended said course :-/

Thursday last week and Monday this week, I finally received some information about what this review should contain, how long it should be, and when it should be handed in. I have 2-4 weeks to prepare an exposition about the literature available within the area of research in my PhD project, concluding with the aim and reasons for doing the actual project! It should, of course, be fully referenced. Now, if I didn’t have the data analysis of a post-doc coming up with all its issues, and the planning of my trip to Glasgow already at my plate, I probably wouldn’t fuss about this deadline, as I am not starting from scratch after all. I might even have enough energy to focus more on the basal testing I am supposed to do. But this isn’t the case, and even though I’m annoyed at low BG’s interfering with my ability to perform and concentrate, I find it very difficult to sit down and focus on analyzing the data that I have on my BG excursions in order to make reasonable changes. It is actually crazy, as taking the time to get an overview of it would probably safe me a lot more time and energy than it would cost me in the first place. Does that make any sense? As it is now, I just make minor changes from day to day, but this also means that it will take somewhat longer to get it all adjusted. I don’t know, I guess at the bottom-line I’m merely frustrated about the work load that have suddenly been placed upon my shoulders, and adding diabetes management to that doesn’t make it any easier. Anyway, it was nice to vent here :-)