In the last couple of weeks a chap named Roy Camp has been commenting on the blog, and some of the comments really piqued my interest – this one in particular: Talking about careers and those with restrictions. I tried to join the army when I left high school in 1962. I can still see and hear the sergeant telling me that under the Geneva Convention, they would not be allowed to stop the battle to let me take my insulin. I wonder if that would still apply today? Based on this, I asked him to do a Guest Blog. Roy is from Dunedin, and has had T1 for more than 50 years. Here is his story.… [thanks Roy!]

Roy Camp

I am number six of eleven (ten surviving), brothers and sisters, one of whom has T2 and one pre-T2. I was diagnosed with T1 on the 9th of October 1959 at the age of twelve. It was not a sudden onset; it had been happening (unknown of course), for perhaps two or more years as a constant run of everyday childhood illnesses and was finally brought into full play, by a bout of the mumps.

It was the first time I had ever been away from home and because the hospital was some twenty km: away (12.5 miles in those days), it could have been on the moon and my stay would be a month. I would continue with a form of school work for my age level.

I was a bed wetter and this was far more of a problem than being a skinny sixty-three kg (10 stone), very thirsty and somewhat malnourished person food wise, not to mention world wise and being academically as thick as two short planks, with a condition called Diabetes Mellitus now added to the life script, the outlook seemed grim. The middle two complaints although not diabetes related showing themselves within the first fifteen minutes of being interred in the general children’s ward. It was 3pm and after introductions to my three room mates none of whom had diabetes, they were allowed to have their afternoon tea, which was left over breakfast toast, cut up in slices called rusks and naturally, I was not on list.  A nurse asked everyone if they would like a bottle and all three said no, but when I didn’t say or do anything, she asked again, “Would you like a bottle, Honey?” I paused, showing good attention and care and then asked, “What of????” there was silence for a few moments then the entire room burst out laughing, including my family members. Seeing them, as she was holding one up by now, would not have helped, actually, they haven’t changed shape all that much, bit smaller and are no longer metal.

It was a total learning experience; you measured, prepared and cooked basic meals, eggs on toast, rolled oats or porridge, assorted veggies, usually very heavily restricted to certain types and to the exact measured amount, as well as testing and monitoring your urine and acetone. (See Kathy’s blog on urine testing)

Food was measured in calories and as I didn’t understand it, I didn’t catch up on any of this stuff until portions took over a million years later. Food was typically kiwi, high fat, high salt, but sugar free for the most part. Veggies and fruit were heavily restricted and I could never understand how watermelon was a free food. Even the smallest slice would send the BG into orbit. I drank a pint of whole milk everyday for twenty-five years to go with the one inch (2.54 cm), square block of cheese and this didn’t include the meat fat and the Friday fish and chips, which actually went on for thirty-five years and I am amazed to have reached 1999 before the heart blockages showed up, requiring the number eight wire treatment on the left side, the other side is still blocked, but only sixty percent, you needed eighty plus points to get the job done. I did turn some of this around, well that’s not true, my wife actually turned it around and removed the fat from my life from 1971, but I can claim to have been fully responsible for the fish and chips going, which become a half combination chow mien from 1999.

Measuring carbs I think comes from measuring calories and I am not a fan of either, I prefer the portions system. I finished up back in there seven months later, there were some murmurings about the diet not being the correct one, but I don’t think it would have made any difference. I didn’t have a clue how to control this monster and another month long stay didn’t improve anything on that test sheet.

You learned to give yourself an injection by first practicing on an orange and if you didn’t get the angle of the syringe right, the needle just bent itself to total destruction. Syringes were all glass and had to boiled, as did the needles after every use, which was one or two shots per day as a rule, one morning and one late afternoon and you had to swab for every shot. (Surgical meths).  Injection sites were in the leg or arm muscles and I did not use the abdomen until the first fast acting insulin’s appeared in the early eighties.

At home after boiling, they were kept in a solution of menthylated spirits and you had had to rewash hot and cold (boiled water always), to use them again and then boil them again after use. I flagged all this after five years and just boiled them and stored them dry, but over the years, a number of student doctors stayed over a weekend and most said this was not hygienic without the solution. Syringes and needles you paid for and a syringe was two pounds, I am not sure what a needle was but I think the first US made BD I used were a guinea or one pound and one shilling. In dollars, maybe four-dollar and two-dollars and twenty-cents. They were all 12mm long and 26 gauge and I still use this size.

You had to sharpen the needles and I used a very fine oil stone and I got reasonably good at this after a while. The main hassle to begin with was removing the bur on each side of the needle point shaft and if you didn’t take it off, you could feel it tearing its way in however quick you did it and it never seemed to remove it either, bruising was the end result. I never used the sandpaper that Kathy mentioned, mind you, I had a zillion people around me involved in the shipbuilding and repair industry who could sharpen anything and I was in the clothing industry for most of my working life and there was a lot of sharpening around overlocker sewing machines, so I was never without sharp needles and the burs were well removed. I bought an injector gun but this tended to break the syringes off at the needle fixing point, especially if it was metal, the boiling seemed to weaken them at this point.

Because NZ dealt only in sterling and not in US dollars, most of this equipment was British; Welcome Laboratories were the name I remember most, Novo was in there as well. I think Welcome merged with Novo? I don’t remember when this all changed and US products arrived, but I don’t think one was any better than the other, then or now.

The advice I got was very good and the two main points I remember very well.

One was: I was skinny, this had pluses and minuses. But over all, I would not have the energy reserves of the person with baulk and it was considered that with all factors combined, for the treatment of the time I would see a shorter working life, twenty years was stated and it was recommended that my job should reflect this latter period to allow a less demanding passage through it. Sure, treatment would change and did, but the rest of me didn’t and by the time I got to forty, I was not able to maintain a full year at work in anything. I also had control of my diabetes by then but it didn’t help.

Another major plus, is diabetes is the only condition I have. Many of you will have other conditions that will upset each other as well.

Okay! To mess up a good story, I did not listen to this advice anyway, which is probably why I remember it and I took a job which was very active, clothing cutting, but it was very suitable for BG levels, lots of walking and heavy lifting. The other point I did not listen to, was the word CONTROL and it was not a part of my vocabulary for the first twenty-five years and it was only the active work and sport, along with divine providence and modern medicine that helped prevent more serious damage today. For what its worth, you can consume the correct foods and still be out of control and just being in a state of permanent high (15 mm/l), year after year eventually takes its toll. Bleeding in the right eye had begun as early as 1969 and by the late seventies I needed laser in both eyes. This was on going for some years and I can remember the doctor saying they were only putting welds on welds and because the control was not good, the bleeding would continue.

I had; however, finally got to grips with what I was doing to myself and using rapid acting insulin and multiple injections I lowered my BG to the lowest permissible level and now when the eye department students look through them they can only see some of the laser scars, the actual damage has long since healed.

From a HbA1c point of view I was 8 and I took it down to 6. For the past twenty-seven years I lived at this level and sure, there have been hypos. I only ever counted a low as a hypo if I couldn’t treat it and running a tight control ship, you get to the stage where you can function as low as 1.5 mm/1 without even knowing you are down there. I add quickly, if you suddenly decided to  do something active like walk from one room to another or go outside and cross the road, you would most likely never make it. It was an accepted fact that after ten years on insulin most users lose symptoms of low BG anyway, I don’t know if this is still the case. I was told that having the BG in the 6 – 8 range brings them back.

I only started having them in public some ten-years ago and they were all self inflicted and a real let down. Like taking an extra shot if the BG was back up at fifteen, which was rare and was caused by having something, (fruit sugar), on the finger and not washing them, or taking a shot and forgetting you did. Actrapid had twenty-minute wait time usually anyway.

I had two life time resolutions, one is never to go into a court room anywhere in this land for even a public day visit and the other, was never be taken into hospital with a hypo. Well that one is three times shot to buggery now, but the fact the eyes should now see out the term however long it will be, must be a winner in the end.

Perhaps I will mention that I have had to go back to an HbA1c of 7 (53.?mm/l), as this is the recommended level and anything below is not acceptable, especially for driving. I am currently 7.2 brought up over the past ten months and I will be looking for the results of this years eye pictures with interest. I am told there won’t be any change in my eyes, but I have to say with fifty years of aneurisms present and healed maybe, I am not convinced, but I am not ready to quit driving either.

So! I am in my sixty third year, divorced and single again for twenty one of them and I have been able to stay the same weight since I was fifteen, 68 to 70 kg. Ah! I should say that staying the same weight is keeping it on and my skinny, I now consider healthy. The complications I have developed are heart related, resulting in angina, but how much is family genetic and how much is diabetes is anyone’s guess. It would seem that you use your heart more being skinny and the as the heart specialist put it, “You’ve buggered it Darling!”  But from about the early nineties, I heard the word “inevitable” come into the length of service one delegates to this condition. Everything else is still functioning and there are no signs that anything major is about to occur.

What have I learned over fifty years of diabetes? That in spite of all the ups and downs and twists and turns, if you remove stress from your life, you will find all of the foibles, even in person form will blend into your day a whole lot less disruptively and your forever nagging companion will not seem to be as prevalent as the day before and they might! Even do what you want for a short time.

Roy Camp.