Friday, August 8, 2014

Challenging the Experts

This weekend, I'm at the inaugural AMSL Diabetes Sports and Exercise Weekend at the Australian Institute of Sports, Canberra.
I'm here because I was offered a sponsored spot, and I'm extremely grateful to Australian Medical and Scientific Ltd., for the opportunity.
As I look around the crowd, I note that the majority of attendees are in their 20's - 30's, but there is a good handful of people in their 50's. I note this, because I have an agenda. I'm not just here to learn more about the physiology of Diabetes and exercise, I'm going to ask some hard questions about ageing and exercise. I'm going to ask where the support for the psychological effort that you need to make as you get older, to keep yourself motivated, is. I'm going to ask, "Who is doing research into Chronic conditions and motivation?" I know there is research into the physiology of exercise and it's effects upon glucose levels, that's part of what we are doing here this weekend. But what happens when you can't workout as hard as you used to, when old injuries, arthritis, hypothyroidism, and general ageing combine to thwart your motivation and reduce your ability? Is anyone researching the effects of ageing with Diabetes?
What's Next?
I've decided I need three things to keep me exercising:
1. Good company, and preferably the company of other T1's who 'understand'.
2. Psychological support. Tools to help motivate me.
2. Better medical support - physio, pain management, energy supplementation. The drugs for the hypothyroidism have helped, but I want more!
I've spent most of the past 27 years, working quite hard at managing my health. Unfortunately it doesn't get easier. Over the past two years I have stepped back from a high stress work life and started to work for myself, so that I would have more time to look after my health, however this has meant heavy financial penalties as I'm single and don't have a supporting partner. I'm trying to balance the physical and mental health demands of T1 with my ability to earn income and maintain a roof over my head. I need better support from our health providers to make the most of what I put in. The efforts that I have put in consistently over the past 27 years have reduced and delayed the likelihood of onset of long-term complications and thus reduce my cost to the public health system. I'd like to continue to maximise my options for long term health as much as possible.

Sunday, August 3, 2014

Ageing Gracefully NOT

I've been meaning to start writing about how it feels to be getting older while living with a chronic illness. How it feels to be finding that I don't bounce quite as well as I used to, that I'm tireder, more stiff, more sore, less able, more unsure than I used to be and that I don't like it.

We've just added yet another of the insidious auto-immune diseases to my collection, this time it is an under-active Thyroid, caused by a disease called 'Hashimoto's Disease', fairly common and more common in women with Type 1.
I like to tell myself that I'm immune to the long term effects of Type 1. That because I didn't 'get it' until I was 25, (oh my goodness, I've had T1 now for longer than I didn't have it!), I thought that the creeping long term effects wouldn't impact on me. No heart disease, no eye problems, no neuropathy, yeah all good... or is it?
A long time ago, soon after I was diagnosed, someone told me, or I read it somewhere, that having T1 means that you will age about 15 years faster.
I went into early menopause at 42. 10 years earlier than my older sisters and my mother. Luckily I had an alert GP at the time and she put me straight onto HRT, carrying me along for another 10 years. Menopause does lots of weird things to your metabolism, all of which have lots of long term effects such as loss of calcium from bones leading to low bone density and increased risk of breaks, loss of concentration, loss of muscle density and elasticity. The HRT helps slow the impact of the hormonal changes. I didn't really notice any changes until a couple of years after coming off the HRT.

Now, as I approach 60, I'm feeling less energetic, less able to cope. Going up ladders on my own is scary, I worry about my capacity to work and keep earning money to pay my mortgage.
I am full of aches and pains, during the night, when I wake to go to the toilet or to check my bgl, my hands hurt so much from the arthritis. When I get up in the morning my hips hurt and I'm stiff all up my thighs and my spine. No real cause, just ageing.

But really, I'm not that bad, just getting slower. I do worry more about what is around the corner, but I know that bad things can happen to anyone as they age, not just T1's. But I worry about what life will be like when I'm 70, 75, 80? Will I be able to manage my own insulin routines? Will it all become confusing? What if the endocrinologist wants me to change insulins to something newer, different?
Will I feel much like I do now? Will I be able to make myself keep going out for walks, keep gardening and bending from the waist down to see if I can still touch my toes? I used to be able to put the palms of my hands flat on the floor, fingers nicely spread and walk them back between my legs. Legs that were straight as a rod, no buckling at the knees, no complaining hips.
Today I am feeling every bone, every tendon, every muscle after two days gardening.
What about my cycling? I love long day rides with stops for coffee and the changes of road and wind. Lately I've been suffering from something no-one talks about. For us post-menopausal women, vaginal dryness can equal discomfort on the bike. When I was in NZ last year, I met some delightful  Septuagenarians, travelling around in motorhomes, with bikes attached to the back of the vans. We talked about trails and 'must do' rides, then out of the blue one of them said to me, "You're a woman, we can ask you this. What do you do about, you know, feeling uncomfortable on the bike seat? Sometimes it feels like there's a dry stick up there!" Indeed I knew exactly what they were talking about, "K-Y gel!" I said brightly and quickly, but you know, that is not the total answer.
Sometimes I think, there must be better solutions to ageing than this.

Does ageing mean spending more time attending to the diet and exercise routine. Stretching feels so good, maybe I need to add a yoga routine to my daily schedule? The day begins to look like this:
7am Rise, Blood test, breakfast, dress
8am Take the dog for a walk
9am Stretches/Yoga Get changed into bike gear, & check tyres etc
10am ride the bike for an hour,
11am home & shower
12 Noon - heck it's lunchtime already.

Hang on a minute, aren't I supposed to be at my desk by 9am?
I am still trying to earn a living after all.