Saturday 4 April 2009

3 months in - how am I doing?

Three months into 2009, time for a re-cap on how I'm doing.

Keeping to a daily routine

I could do with more work in this area. I'm tending to want to stay up long past the 1am mark and this is leaving me tired in the week

What have i learned?
  • Going to bed after 2am each night leaves me tired and sees me needing to go to bed as soon as I get home from work some days.
  • This then messes up my sugar levels and my ability to get things done.
  • It also may have led to a couple of days of unusually high stress I experienced the last two days of this week.
What next?
Try to go to bed before 1am during week days and see how much it helps.


Blood sugar levels
They've been good but there's definitely room for improvement.

What have i learned?
Despite quite drastically changing my diet, i've still managed to neglect key aspects of controlling my sugar levels.
  • I've let testing slip a little bit - not testing quite so much
  • I've not been recording the results every week
  • I've occasionally not injected at the right times
I've also noticed how eating certain things have had more of an effect on my sugar levels than I thought they would.
  • Eating a fair amount of protein seems to push the sugar levels up a bit
  • Small amounts of carbs need to catered for - such as eating a handful of nuts
What next?
The biggest thing I'll do is to make more detailed notes on how much insulin I'm taking and when, and writing down what I'm eating each day.

I tried to do this last month but clearly I hadn't fully committed to it. This month I'll make it my duty to keep this up.


Debt levels
My debt's grown smaller over the last 3 months. It was over the £4000 mark and now it is under £2000.

What have I learned?
The overriding thing is that it has been possible for me to significantly cut my debt in a relatively short space of time.

What next?
To help myself further I'll write down the things I'm spending money on so that I can see what how my money is being spent.

I'll make a new spreadsheet for this.


How's this blog doing then?
It's doing ok. I set it up to make myself take care of certain areas I felt I was weak in and I have seen improvement in all of the main areas, above.

What have I learned?
Just writing this post today, I see how it's helping me to review how I'm doing and it's made me come up with some ideas for getting better at different things.

What next?
I'll make a point of updating my blog at least once a week and make sure I review the main areas I'm focusing on.

So next week
  • I'll check whether I've been going to bed before 1am on week days
  • I'll check whether I've been writing down more detailed information on what and when I'm injecting and what I'm eating at those times
  • I'll check whether I'm noting down my income and outgoings
Let's see how it all goes. :)

Saturday 14 March 2009

Job interview strategy

After a recent discussion which touched on job interviews, and knowing that i wish to be taking a job interview of my own soon, i wrote a guide to interview technique.

Interview technique

Negative experience
Think back to an interview which you felt went badly.

First remember things through your own eyes so you can connect with the feelings and your mind set that day. Make a note of the way your voice sounded, what you were focusing on - in your mind and with your eyes, and the feelings you felt. Then imagine yourself from the interviewers’ perspective or as a fly on the wall so you see yourself in the interview room and can see how you may have appeared in the eyes of the interviewer. Make a note of how the interviewer or a third person would have seen you.

List the things would you have liked to have changed.

My bad example
I had a disastrous interview at a hedge fund soon after I started working in London.

I was naïve when it came to interviews. I didn’t know how to prepare for them; they were a whole new world to me, as was the financial services world.

In the interview I felt like I was on the back foot. I ended up being very defensive, trying to explain why I wasn’t able to do things rather than saying what I could do. The tone of my voice and attitude was of someone who felt hard done by – even early on in the interview. I let myself feel I was being interrogated. I didn’t feel my strong points were particularly strong either, so any confidence I had was very much hemmed in and wasn’t given a chance to show itself.

I was quite nervous as you might expect. I was concentrating too much on myself, concerning myself about how I was sitting, clutching my own fingers and being very preoccupied about the long black hair I had at the time.

I made possibly every mistake in the book that day.

Learning from bad interviews
Take a while to identify all the things you would want to change from your bad experience and think about how you could change those bad things. Think also about it in terms of the visual, aural and emotional experience as to how you’d change.

Positive experience
Now think of a more positive experience in an interview. This might be a part of an interview you were pleased with or could be the whole interview.

Imagine you are in the interview and are seeing it again through your own eyes this time. What things did you do particularly well? How did you sound? How is your body language in your memory? How did it feel?

Write down anything which you feel could be useful.

My good example
In a job interview I had a couple of years ago, whenever I was asked to recall a time I’d done something, I just made sure I said yes, I could show the particular quality, and gave a simple example from my past. I made sure I didn’t complicate matters by letting myself recount anything that was negative – something I’d had a tendency to do in earlier interviews.

For example, if asked how I’d shown bravery in performing a task; in the past I’d have said something like “usually I’d be a nervous wreck but on this occasion but I approached a client who I’d never spoken to before and sold 2 units of product there and then”.

Whilst the last bit is good, I’d be shooting myself in the foot by admitting that, usually, I would be useless!

I was still quite self-conscious of the position of my hands and fidgeting but my answers were simple, clear and positive, and I’d prepared well. In fact some recounts I gave were completely made up experiences. Luckily I had enough real life experiences mixed in to make my lies fit in fairly seamlessly. Made up things are best avoided if possible but sometimes, I think, it’s perfectly fair to use them.

I was really surprised how easy it was to just say yes to all the traits they wanted and keep things simple. Nowadays, keeping things simple is something I try to apply as often as I can.

In this good example, the tone of my voice was much more assured, my posture was better and I felt a bit like a ship slowly coming into port. I just had to hold my line and keep steady.

A good state of mind
With the good experience you come up with, you can start to invoke it in future by thinking back through the good past experience as clearly as you can – including visual, audio and emotional memories. It gets your mind into that positive state again and your body will also naturally respond to your mind in conveying a more positive you.

If positive experiences are few and far between you can instead start to think of how you would like to behave. Think about how your voice would ideally sound, what your posture would be like, what things you would be seeing and looking for in the interview and how you would be feeling in this ideal interview.

As it is not a complete memory you may need to work extra hard on imagining all the pieces – like your smile as you walk in, the things you notice in the room before you get down to the interview itself etc. It will be well worth the effort though.

Imagining your future interview
Imagine going through a future interview. You won't know exactly what the interviewer is going to necessarily ask but you can pick some common questions which you are more than likely be asked, to get your mind into practice.
  1. First of all watch yourself from a 3rd person perspective. Greeting the interviewers, sitting yourself down and answering the typical questions - pay attention to how you sound and the image you project.
  2. Think about what things you'd change and then re-run through it. Keep doing this until you're happy with the result.
  3. Then imagine it over again but this time from your own perspective - this time pay extra attention to how you feel and how the interviewer and anyone else in the imagined room may respond to you. It's useful to find out, in advance, how many people will be interviewing you for this reason.
  4. Again, think about what things you'd change and re-run through it. Keep doing this until you're happy with the result again.
Tailoring how you present yourself
Recently I’ve been looking at what things I would ask of myself if I was to be my future employer.

Some of the things are very obvious but are still things which didn’t use to cross my mind as things to pick out:
  • Being reliable and punctual
  • Being well turned out
  • Demonstrating the communication skills you have
  • Demonstrating examples of problem solving or successfully overcoming difficulties
  • Having an overview of the company and the industry
  • Having an idea of what will be expected in the role – what will be the challenging aspects and what will be the things you will be particularly well suited to
  • Someone who will fit in with the company culture

After identifying all the things you would expect to see in yourself, you can then look at how you measure up to the criteria and identify which areas you could work on and improve.

Examples of tailoring
For the roles I’d like to take on in future, they stress ethics as one of the important qualities. I think this is something I could conceivably work on in my spare time and have something quite impressive to show for it. It wouldn’t be too difficult for me to run a marathon for charity or to do some voluntary work, so it makes sense to invest some time in this area.

Another area I may want to improve is making sure I fit in with the company culture. I won’t want to completely change who I am but I could read the trade journals to at least get an idea of the kind of people who make up the industry. I might even be tempted to read up on certain subjects like polo, golf or horse racing to give myself a greater feeling of familiarity with the type of people in the industry.

If someone said they liked polo to me right this minute, I’d expect to have a knee jerk reaction of shock and maybe even slight disgust. However, if I were to read up on the subject I might not be so taken aback if it came up in conversation and I may be equipped to make some basic small talk around the subject.

A long term relationship
I’ve also started to look at the interview as less of a job interview and more like a first meeting of potential friends. This is something I can handle more easily and have better associations with than seeing it, purely, as a job interview.

A job interview, to me, invokes a very detached and artificial sense in my mind; something that’s quite superficial and just a small moment in time, like an exam. Viewing it as a meeting with potential friends, gives it a more familiar feel; I can quite warm to the idea of sitting in the chairs and having a glass of water as the interviewer and I assess one another.

It also feels more comfortably weighted this way. Rather than being under pressure to perform – with them occupying the high ground, instead I’m viewing it as a level playing field with both them and I wanting to impress each other.

So by looking at as a long term commitment to someone, or some people, I start to think about it in a different way.
  • I want to know who they are – the company and the interviewers themselves
  • I want to concentrate on establishing a rapport with them as soon as I can
  • When I speak to them before the interview – say to confirm the interview arrangements and who will be interviewing me – I will approach as if they are people I’m relatively familiar with
  • I want to impress them in how I look and the things I say – and make sure I steer clear of putting them off at all
  • I want to meet up with them in future
  • I want to work with them rather than for them – just this can have quite a profound difference on how you’ll view them

The list could go on in even more detail.

Preparation
I used to hate the idea of having to prepare but it really has proven to be one of the best things I can do.

Having a set of pre-prepared answers is really useful. You needn’t remember answers exactly. Try to distil responses to their simplest form and this will not only make answers easier to remember but also a lot more effective.

The preparation really makes a difference as it takes the pressure off having to think of an answer to each question. The less actual thinking you have to do, the much easier things become. You can start to pay attention to details in the questions which will make answering all the more easy.

Your preparation is like setting the course of a voyage. With good preparation, you can concentrate your mind on simply keeping the ship steady and making sure you pass the right buoys and avoid straying off line.

Getting things the right way round
When I’ve been to interviews, appointments and meetings I’ve often got things the wrong way round in my head.

My mind would naturally imagine what the building might be like. I generally had one fixed idea of what the interview environment would be like and then, when I got there, I’d find the building was very much different to what I imagined and I’d find it quite difficult to adjust myself. It only increased the sense of alienation and detachment.

What I should have done was to imagine the interview many times and change the appearance of the interviewer and room each time, or perhaps every other time, I replayed my imagination. I should have imagined a pristine room and then an untidy room, a female interviewer and then a male interviewer. The more changes the better - you'll feel like quite a seasoned interviewee even before the interviews!

Even more importantly, I should have been concentrating on imagining myself. How I would act, how my voice would sound, how I would look and how I would be feeling - as mentioned in detail in 'Imagining your future interview' above.

Furthermore, in the olden days, in the interview itself, almost my entire focus would be on myself.

This is the opposite of what I should have been doing. When in the interview, your focus, ideally, should be on the interviewer and their questions, rather than on yourself and your answers. With good preparation, your answers will come out almost automatically in response to the questions you’re focusing on.

To summarise this

Avoid
  • Before the interview – imagining how the building or your interviewer looks like or how they might sound as a fixed entity.
  • During the interview – focusing on what you’re doing, saying and feeling
Encourage
  • Before the interview – imagine what you will look like, say and feel
  • During the interview – focus on what the interviewer is saying, how they are reacting and, if possible, how they may be feeling

How about you?
What are your experiences? What things have you learned from interviews and what advice would you give? - I'd be really interested to hear.

Sunday 1 March 2009

Numbers falling down

Halfway through February I went onto a low-carb diet to improve my numbers to a level whereby they could almost be considered to be normalised.

So far it's working well. I look at my blood glucose meter and it gives the following averages:

Last 30 days: 6.1
Last 14 days: 5.8
Last 7 days: 5.6

Averages aren't the best way to show control as I have a tendency to test more when too high or too low so it can distort the results a bit, however it still gives a general idea.

To find my averages under 6.0 since going on the low-carb diet is really encouraging. I'm giving myself a congratulatory pat on the back because to get to this from the woeful results only two months ago is really great.

I feel a lot better than I did in those 'dark ages' when I didn't really know quite where my levels were at throughout each day. My head certainly feels a good deal less stressed.

Here are the full figures

0 2 4 6 8 10 12 14 16 18 20 22
01
15.6





6.7


02 4.2










03

4.4





7 3.4
04 7.4





7.2


8.6
05



7
7.9
8.6


06 9.6


6.8 9


4.6

07 6.8



2.8





08
7.6



5.4


3
09 6.6








2.8
10 5.8







7.4 4.1 6.2
11



4.8 7.9 4.7 5.2
7
8.5
12



4.7
8.4 4.3
5.5 3.2
13 9.8
4.1 5.3

8.3 5.3 10.8

6.6
14





11.6 6.9 6.6
9.1 8.9
15
6.9

3.4
5.8 3.5 3.7
4.6
16 4.1




7.3

8.9 7 9.1
17 9.4 8.1

3.8
3.7

6.6
4
18 2.7


7.4
8.4 5.7



19 4.7


6.2
4.6

5.8

20 4.6


2.8
6.2


6.1
21 4.6



2.9


8.3
9.1
22
10.2



5.1 5.6
6.1
12.2
23



3.2
7.7 3 6.4


24



3.1
5.1

5.1

25 4.3


3
4.6 2.6
6.1

26 7.5


8.9
5.4

6.4

27 5.9


2.7
6.8

6.6

28






3.7


13.9

Monday 16 February 2009

new year's day

this weekend brought with it a revelation, one that had me walking into a completely different world. a world better than the one i'd been in (whether i was fully aware of it or not) since the early 90s. no love found, and no, no love lost.

the revelation was that my type 1 diabetes could be brought under a tight level of control.
the revelation that i may actually be able to reverse some of the damage my illness has inflicted upon me.

the solution is one which, by some irony, is blindingly obvious to anyone without diabetes.

tell someone you have diabetes and likely they'll think: "you poor thing, you won't be able to have any sugars now"

and that's what i thought when i was told, at the age of 11 that i had type 1 diabetes.

lead down the wrong path
however, what i was then taught was that i could, and should, eat like a normal person, just so long as i did my injections.

my type 1 as a child was relatively simple but as i grew into adulthood things got steadily more difficult, to the point where i was firing off shots of insulin that could hit any target in a very random fashion. in short, my levels were all over the shop.

where's the right path?
and then this weekend, i read in full Dr Bernstein's Diabetes Solution which said the complete opposite of what i'd been taught. he put it to the reader that all one needs to do to get their control to manageable levels is to stop so eating such a ridiculous amount of carbohydrates.

with insulin you're trying to hit a target level. the more carbs you eat the more insulin you need. it's like trying to hit a target with a rifle. for small ranges you're going to have a much better chance of hitting the target than if you're a long way back from it.

similarly with hitting your target sugar levels, you've got a far better chance of hitting the target levels if your carbs and insulin are small amounts.

busting out of vegas
so with this in mind i can get out of the losing lottery i was playing for all these years. damage has been done and i owe a large debt to my body, but i've now got a chance to halt and possibly even recoup some of those losses.

all i've got to is make sure i don't overdo the carbs. avoid eating the sugars, just like i thought i should be doing all those years ago as an 11 year old.

it feels like i've climbed a mountain for nothing but now i've at least got the chance to run back down it, to a place of safety.

Thursday 12 February 2009

Analyse this

This is venturing into geeky territory but it's good stuff for knowing what's happening in me when I eat.

The idea is that when I eat and take my insulin shot the insulin tries to get the energy into the cells (or liver or somewhere) and out of the blood stream at the same rate as the sugar is entering your blood during digestion.

It works something like this
  1. I inject insulin
  2. I eat more or less straight after
  3. The sugar starts to be broken down and begins to be absorbed into the blood
  4. The insulin starts to be absorbed into the bloodstream
  5. The insulin works to get the sugar from my blood into my cells
In an ideal world the insulin would be acting on the sugar in my blood at the same rate as the sugar is entering my blood, but this is rare.

Typically with meals involving a fair amount of carbohydrate, the sugar will get to your blood at a faster rate than the insulin can get the sugar into your cells.

If the digestion rate is faster than the insulin absorption rate, like this, my blood sugar will start to rise. The further my sugar levels rise, the less ideal the balance.

Of course, different foods have different sugar absorption rates. High GI foods get absorbed quickly, low GI foods are absorbed more slowly. GI means glycaemic index which essenially means how quickly the sugar in different foods are absorbed into the blood.

So how can you measure the balance?
To measure whether your insulin is reacting fast enough to cope with the sugar absorption, you can test yourself after meals. Two hours after meals is thought to be the point at which your blood sugar levels are likely to be at their highest after eating.

So it makes sense to take a sugar reading just before eating and a reading or two 1 to 3 hours after eating.

So how did I do?
Here's my sugar level readings from the last few days


0 2 4 6 8 10 12 14 16 18 20 22
10 5.8







7.4 4.1 6.2
11



4.8 7.9 4.7 5.2
7
8.5
12



4.7
8.4 4.3
5.5 3.2

Evening meal analysis
On the 10th I had pasta for evening meal with half a glass of orange juice.

7.4 at 18:11 just before eating
4.1 at 20:10
2.4 at 21:16 (I ate sweets to get levels back up to a normal level)
6.2 at 23:37

This shows two things.

I probably took too much insulin for my evening meal (as my levels went significantly below 4.0)
The pasta at this time of day isn't causing my sugar levels to jump up - a very healthy situation

Breakfast analysis
On the 11th I had mini-shredded wheats for breakfast with skimmed milk

4.8 at 09:13 just before eating
7.9 at 10:33
4.7 at 12:45

This shows I'm taking the right insulin for breakfast.
It also shows that my breakfast is being absorbed a bit quicker than my insulin can keep up with.

Why are the levels going up between meals?
My shredded wheats are probably not too dissimilar in GI to the pasta I have at tea time. I would expect the sugar in the shredded wheats to be absorbed about as quickly as the pasta.

However, I think there is another reason that is causing the raised sugar levels. It's a phenomen which I've seen referred to as 'the dawn phenomenon' in Dr Bernstein's 'Diabetes Solution' book. The idea is that in the morning hours, just after one wakes up and for about 2 to 3 hours after, the insulin is less effective at lowering blood sugar levels. The insulin is slightly impaired.

This would offer a good explanation for why my sugar levels are raising a few points up to a couple of hours after eating breakfast.

What can you do?
As far as I can think tonight, there are two main options available
  • try to eat less carbohydrate (sugar) by choosing a lower-carb breakfast
  • try to eat a lower GI breakfast
I don't really want to change my breakfast as it is already fairly low GI, quick and easy to make, and a cheap option too.

However, I may be able to lower the GI of the breakfast if I switch to using full fat milk instead of skimmed milk.

I am told that having fat with a meal can slow down the absorption of the sugar, so it's worth a go. I'll give it a go next week and see if it helps at all.

Where from here?
I'll spare the lunch analysis but it is along similar lines.

So now I've got an idea of how good these particular meals get absorbed and how well the insulin works against them.

If I were to analyse each relatively regular meal I have I would be in a very good position to control my levels really well. That's the ultimate goal.

As a bonus, the results I've been getting this week have been really good.

Monday 9 February 2009

that's what you get

So what would've happened if I stayed getting the numbers I was getting in December?

If I'd carried on how I was, I would be really risking some seriously horrible stuff happening to my health and well being. One thing that happens when you have consistently high readings over a number of years is that you start to get haemorrhaging of the blood vessels in your retina - a condition called retinopathy. As more vessels burst, you start developing black spots on your vision that you can't shift. You'd need some serious-ass surgery to sort it out which is beyond the means of most - if it exists at all?! If several of them bood vessels start to burst, you're on a one way ticket to blindness.

Ouch.

...and it gets worse
High blood sugars don't just hurt your eyes, they will really fuck around with your kidneys, your heart and, scarily, your nerves.

Keep the blood sugars too high and I'll be asking for big trouble. Your nerves are really important. They're a big factor in controlling digestion for instance. When the nerves have been degraded by consistently high sugar levels, they cause a constant alternation between constipation and diarrhoea. This condition is called neuropathy.

When you read about some of the sufferers in their 20s and 30s it's hard to accept. The stories are beyond heartbreaking, they're heart stamping. I don't mean to venture into hyperbole but if you read what some people are going through, you'll understand what I'm trying to describe.

The sad thing is that there are loads of people, often teenagers who are struggling so bad to keep themselves controlled that they're heading straight down the railroad to this real-life hell.

I was riding this very track until this January and it's only will power that'll keep me away.

What a difference a month makes

The difference is clear

I replied to an email from my grandparents this evening and I gave them an update on the work I've been doing to get my sugar levels back on track. To illustrate the point I gave some statistics about how things have stepped up a gear.

Here we go:
In December 2008
41 tests taken
17 were above 10.0 (this is a high result)
9 were above 15.0 (this is a too high result)
2 were above 20.0 (this is a potentially dangerous level!)

In the month since I started this blog
79 tests were taken
9 were above 10.0
2 were above 15.0
0 were above 20.0

A huge improvement
To keep myself healthy, I should is to keep as many tests as possible below 10.0

In December, 59% were under 10.0
In the month after starting the blog, 89% were under 10.0

That's a massive difference.