(1) Tell me about your background.

Okay.  I was born in 1971, and I grew up in a place called Eastham on the Wirral.  I suppose it would be classed as suburban.  My father worked originally in the bank, when he met my Mum, who also worked in a bank.  He then, I think in probably his mid-thirties or thereabouts, obviously made the decision that he didn‘t like all the changes that were starting to happen in the banking world, so he moved to - I think it was - BOC, the chemical people.  And that involved sort of some shift work, and he also worked in a pub at night.  My Mum brought myself, my two brothers up, because obviously my Dad was working.  When we all went to school, my Mum started work.  ‘Cause of having been in the bank, she then wanted to do something herself, so she then became a market researcher, and she‘s still doing that now.  My Dad‘s just currently retired.  I went to the local primary school, which was a Roman Catholic primary school.  I suppose most of my friends would be people who went to the parish church.  In my final year at primary school, I‘d taken the eleven plus and the entrance exam to Upton Hall Convent School, which was the secondary school that I joined in 1983.  I suppose the key date, as a start to all this, was at the end of my year at primary school.  Every year that they finished, you know, your school - sort of before you started secondary school - they then took you off on a trip to Scotland or somewhere like that, so we had a week away in Scotland.  And normally... I mean, I was quite a sensible girl growing up, but I also would say I probably was quite open to having some fun.  And there was a teacher who‘d been at my primary school, who‘d left a couple of years before, but he joined us when we had this school trip in my final year.  And he noticed that I‘d lost a lot of weight.  He also went to pick me up to throw me in the water, ‘cause we went to the beach for the day, and I got quite upset, which isn‘t normally like me, because I don‘t cry very often.  And when we got back off the holiday…  I mean, I was just drinking gallons of water and, you know, Coke and anything, really, because I was just always very thirsty.  And I‘m a very sens... I was sensible, because I can remember we went on a day trip, and knowing that we weren‘t actually that far away from wherever we were staying, I had to ask them to stop the coach so that I could go to toilet.  And obviously everybody was almost wanting to look out the back window, and I was behind the bus somewhere, and that was humiliating at the time.  And for me to do that, wasn‘t quite normal behaviour.  So, when I got off the coach, having come back from the holiday, my Mum looked at me, and I had these huge eyeballs and my clothes were sort of hanging off me, and then I went straight to the doctor‘s the day after.  And that‘s when I was diagnosed with diabetes, which was August - the eighth of the eighth, 1983.

How long had you been away on this school trip?

For a week.  So,

(2) I suppose, leading up to the school trip, people had started to think - like my grandma would say "oh, you‘re getting taller, you‘re getting slimmer" - so I suppose my Mum subconsciously put it down to me growing up.  But at the same time, I can remember, when I was first diagnosed with diabetes, she‘d obviously heard about a friend‘s daughter who‘d also become diabetic some time before, so she could almost realise now why I was losing the weight, but just hadn‘t connected it.

So, what happened, then, when you got back from the school trip?

Well, as I say, my Mum knew there was something wrong.  I think this whole chat she‘d had with a friend about her daughter who was diabetic must have made some vague connections, so we went to the doctor‘s.  And I think he did a urine test, and told me he thought I was diabetic and that I needed to go straight to the hospital.  So, I went to the hospital, and I was in hospital for two weeks, where initially... I mean, I can‘t remember the details, but I do know that I practised injecting on an orange.  Again, my Mum... I mean, I had things like, you know, teachers coming to see me, friends coming to see me.  And I think, at the time - my Mum‘s version of events and from the vague bits I can remember - I was quite sensible about the whole thing; I didn‘t really get too upset.  I mean, we were meant to be going on holiday as a family, and my brothers ended up going on their own with my Dad, and I, obviously, was in hospital.  And then my Mum and I came back to the house together, whilst my brothers and my Dad were on holiday.  But I didn‘t really... that sort of thing didn‘t really affect me, at the time.  I just seemed to go through the motions of getting through it.

What are your memories of the hospital?

Well, I gather that my memories must be pretty pos... I mean, I couldn‘t honestly give you an answer to that, other than I don‘t have any bad thoughts about the hospital, so, on that basis, I assume that it must have been okay.  I mean, you know, I had plenty of visitors, and it wasn‘t like I was isolated or anything, so.

Did you begin to feel better very quickly?

Again, I can‘t really remember that.  A key thing that I can remember having happened, because, you know, people have reminded me that it happened: when I was actually in hospital for the two weeks - I mean, the other thing to be aware of is that I had... I was short-sighted growing up - and when I was in hospital, for about a day or two days, my eyesight just went normal, which was quite bizarre.  And so that, I was explained by the doctors, that that was partly to do with the fact that all this was going on.  I mean, that‘s about it, really - I can‘t really explain that any other way.

Can you remember how often you had to inject and what insulin it was?

Yeah, back then I was injecting twice a day - once in the morning, before my breakfast, and that was a mixture, I think, of short acting and long acting insulin, so that covered my breakfast and then my lunchtime.  So, obviously, I was always having to guess at what I was going to be eating.  And then I‘d have another injection again in the evening, before my evening meal, which again, I think, was a short acting and a long acting to cover my evening meal and then through the night.  And I must be very honest with you, but, I mean, up until 19…

(3) up until 19... sorry, July 2003, I was basically doing the two injections a day, and that was Humulin I and Humulin S.  Now, what I can‘t remember is whether very early on I might have had something other than Humulin, but my recollection is that I‘ve always been on the Humulin I and the Humulin S. So, the Humulin S was the short acting insulin and the Humulin I was the long acting insulin.  And obviously, in the whole time I‘ve been diabetic, new things have been developed, and I was told probably ten years or more ago about the new regime, where you did more injections, but it supposedly gave you more flexibility.  And I always avoided that, because I just didn‘t want to do more injections.  But then I had an accident in the car, which... well, this isn‘t actually... well, basically, I got to a point where I just realised I needed to be more flexible, so I decided to change to the new regime, and that was in 2003.

We‘ll go back, then, to the time in hospital, and tell me what they taught you about testing sugar levels.

Okay, I mean, again, when I was in hospital originally, it was very different to how it is now, because most of what I was doing was testing my urine.  I honestly can‘t remember, when I was in hospital, whether... well, they obviously tested my blood sugar for me, because I certainly didn‘t do it to myself.  I didn‘t have any little gadgets or anything; that‘s only come about since... well, I couldn‘t even give you a date, but more latterly.  And obviously, when I went back, once I then left the hospital, I used to, you know, I took lots of the urine sample test things with me, and that‘s what I used to do everyday.

What did you do?

I suppose I used to test my urine samples, I suppose, about four times a day.

Was this with strips?

Yeah, I had strips, which you used to run under your urine.  And I used to keep a record of what the average was in a little notebook thing, or, I don’t know, a little book that they gave you; sort of am, pm.  I never did as many... I mean, I suppose originally I was very, very efficient at that, but as I got older I didn‘t test it as often.  And I certainly went through a period where I was a student when I didn‘t test very often at all.

Can you remember how you felt, aged eleven, nearly twelve, having to do this?

It‘s an interesting question, because I don‘t.  I can‘t remember feeling "why has this happened to me?"; I don‘t remember any of that kind of thought.  That‘s the sort of thing I‘ve had more now - those kind of thoughts have gone through my head as I‘ve got older, really.  But to be honest, I mean, the diabetic thing, I just seemed to deal with it reasonably well.  My Mum just was amazed at how sensibly I coped with it all.

What did they tell you in the hospital about diet?

(4) I‘ve still got the book now, which is green, amber, red; you know, the whole traffic lights, in other words.  Green things are safe or good to eat, yellow or amber things are not too bad, and then red things are the things you should avoid and are danger.  So, the green things being things like fruit, vegetables, pasta, rice, brown bread in those days.  Amber being things like... what would amber be? - biscuits, crisps.  Certainly the red things would be things like cakes, sweet drinks, anything really sugary.

How did you find adapting to that diet?

Again, I don‘t know how I found it - I obviously just did it.  I don‘t know why or how, but I can remember one of my Mum‘s best friends, who lived across the street from us - she worked in a chemist.  And I can remember she brought in something, which I think was called One Cal, which was one of the first diabetic... well, low sugar drinks that they must have started.  And, I mean, I don‘t know - I imagine at the time that I probably thought it tasted slightly different to sort of normal Coke, or whatever it is I drank in those days, but I quite quickly adapted to the diet drinks routine.  And now I can really tell if somebody gives me something that isn‘t Diet Coke, and I don‘t like drinks that aren‘t diet drinks.  And that‘s the one thing, as a diabetic, that I‘ve been very strict about, unless I‘ve been... you know, nine times out of ten, I would never drink… or probably more than that - I‘d say ninety nine point nine percent of the time, I don‘t drink drinks with sugar in - unless it‘s alcoholic, perhaps, I suppose, but there is a different element there… but, you know.  So, that was always interesting, and she was quite pleased, I think, to be able to have an input and be able to give me something that was actually beneficial to me.

Can you remember being told anything about exercise when you were in hospital?

Exercise doesn‘t... I mean, it doesn‘t particularly stand out in my mind - I think, probably because I was young; I was probably quite active anyway.  I mean, I‘m sure it must have been mentioned as being something that would be useful to me, but I couldn‘t say it particularly stands out.  But, I mean, certainly as I‘ve got older, exercise has always been something that I‘ve thought as being important, so…  I can‘t honestly remember.

Do you think you or your family were trying to work out why you‘d got diabetes?

Yes, I‘m sure that discussion did come up, and still does from time to time.  You know, certainly people... you know, we certainly looked at "has anybody in the family got diabetes?" at the time, and I don‘t think anybody particularly did.  Certainly, it‘s been interesting as I‘ve got older, because I had a lot of elderly aunts and grandmother... my grandma sort of died last year at ninety seven, you know, and her sisters were sort of in the nineties

(5) when they died.  And they got late... you know, the old-age diabetes.  My Dad‘s got diabetes now, and my brother‘s just been diagnosed with it, but that‘s purely, I think, because they‘re both overweight.  I mean, that‘s what it comes down to, because it‘s the late onset or obesity sort of element. So, I was quite, you know, the unique one, because there seemed to be no particular reason.  But one thing, I suppose, that did come up once - I can remember talking about people who… I don‘t know - breastfeeding came up for some reason. And I‘m sure my Mum said that she‘d breastfed my two brothers, but with me, either she only breastfed me very briefly, for a couple of weeks or something, and then I went onto bottled milk.  So, she‘s always had this angst that that might have been a reason, because there must have been an article, perhaps, in the press at some point about there maybe being a link between breastfeeding and diabetes.

Can you remember how people reacted when you told them you‘d got diabetes - family, friends, school?

I think my Mum wrote a letter, or even rang.  My Mum probably would have rung the Head - well, the secondary school that I was starting was an all girls‘ convent school, so the nun was the head teacher - and I‘m sure my Mum would have rung her, rather than just writing to her.  Again, I don‘t know how all the teachers had it communicated to them, or even whether I just told them all at each class, kind of thing. But I think my - what are they called? - form teacher would have known.  So, I think the head nun must have just said she would communicate it to people, but just to make, I suppose, to get me to make sure that I made people aware, really.  I mean, at the time, I can‘t really remember.  People just seemed to be a bit inquisitive about it, more than... I don‘t think people said "oh, aren‘t you amazing?" as such.  I think that‘s probably happened more as I‘ve got older, and odd people who aren‘t used to me, or, you know, see me doing it.  People who knew about it - who‘d been told probably through the press, because everyone talks about these things - I don‘t think they really said "oh, aren‘t you great for doing it?", or if anyone did, I‘ve always just said "well, I just have to do it - get on with it".

Would you have needed to inject yourself at school?

Probably not, no.  But what, I suppose, in those days, what I would have maybe done - if, like when we had games at school - I‘d have, you know, had a biscuit, or I might have eaten... I suppose in those days, because I used to have, you know, my snacks in the afternoon, I‘d have a biscuit, so I‘d have to open a little packet of biscuits and open those, you know, and that sort of thing, so...  But I don‘t think it really bothered me; things like that don‘t really bother me.

(6) Did anyone else at your school have diabetes?

No, I think I was the... I think, I mean, I‘m sure most people were quite surprised at the whole, you know, me sitting there in class having to eat a biscuit, maybe, but at the time, I just didn‘t really feel that conscious about it, really.  I mean, maybe I did a little bit initially, but once my friends got used to seeing me eating the odd thing at odd times, and then obviously if I went to dinner at a friend‘s house or whatever, I‘d have to do an injection.  They were more inquisitive than anything.

How did you cope with diet at school?

I recall, I think that I probably took sandwiches with me most days anyway.  I don‘t think I ever really had school dinners - well, certainly not - you know, when I was at primary school maybe - but no, secondary school, I‘m sure I had sandwiches.  So, I just monitored it myself.  I didn‘t... I mean, I was...  Although my Mum would have tried to keep me reasonably strictly, I certainly ate sweets.  I was never one of these people who didn‘t eat sweets, because I‘ve got a very sweet tooth, as has my Mum.  So, whilst my Mum probably thought she was giving me treats once a week or something, I perhaps would have been less rigid - you know, I might have bought sweets and had them before I did my games or something.  So, I was never that strict.  I would have always been consciously aware of it, that I shouldn‘t be eating these things, probably, but I like sweet things, so I ate them; rightly or wrongly!

Did you find they made any difference to how you felt?

At the time, I don‘t remember, but in hindsight... well, there are things, I suppose, as we move on to talking about me as I got older, then there are definite things that make me realise that at the time it was...  Well, basically I wasn‘t checking my blood sugars enough, so I know about things that happened that make me realise that my blood sugars were probably higher than they should have been.  But bear in mind, when I was at school, I had - I desperately wanted to remember the name of the doctor that I had, ‘cause I was mentioning this - he always sort of seemed to be okay where my urine tests were up to about ten.  Anything above ten was high, whereas anything ten or below was acceptable.  But, you see, as I got older, that changed.  So, as I‘ve got older, I‘ve become much more aware of the numbers implication and what that means.

When you mention your doctor, was that the GP or a doctor at the hospital?

A doctor at the hospital.  I mean, the GP was very much a family friend, so he was interested more on a personal level than anything.  But the doctor at the hospital, at Arrowe Park Hospital, which was where I was first at, he was very well known in the diabetic circle at the time, and I just can‘t for the life of me remember his name.

How often did you go to a diabetic clinic at the hospital?

(7) I‘m sure, initially, it was probably about once every three months, and then, I think, as things started to stabilise, it would have been once every six months.  And then, perhaps, into my teens or whatever, it became more - well, sort of my late teens - it probably would have become more once a year.

Now, teens are notoriously a time of not being all that controlled.  What were your teens like?

Well, linking back to what I said earlier, certainly the times that stand out as being where I would have observations would have been when I was a student.  So, I went to university when I was, I suppose, seventeen or eighteen… maybe I was probably just nearly eighteen, I imagine, ‘cause I did O Levels and A Levels.  I mean, I can‘t remember any particular things standing out through any of O Levels, A Levels that was particularly related to me being diabetic.  Whether my Mum would tell you something different, I don‘t know, ‘cause I haven‘t actually asked her that question, but I don‘t remember anything specific.  But when I became a student, I did an HND for two years, and then I transferred onto a degree. And I can distinctly remember that when I lived in - ‘cause we did halls of residence in the first year - and, I mean, I‘ve always been a late person in the morning - I hate getting up in the morning, that‘s just me, and I take after my Mum from that, whereas my Dad‘s very much an early bird - but I can remember as a student, you know, my friends would always laugh at me, ‘cause I could quite easily lie in.  But I think the reason why... I mean, I did work late, because I used to work on security, so I‘d get back late.  And, obviously, I was always a night person, so I‘d like being up late.  But I‘m sure there must have been a link to the fact that, because I didn‘t check my blood sugar... not my blood sugars... because I didn‘t check my urines very much at all when I was a student, I think my blood sugars were probably high a lot of the time, or it wouldn‘t surprise me.  And I think that‘s possibly why I could sleep so much.  Because now, if I wake up and my blood sugars are high, I really find it hard to get out of bed, whereas, you know, generally now, although I still like to lie in, I am up my nine o‘clock, even at a weekend.  So, I‘m sure there‘s a connection with the blood sugar.  But, you see, again, bearing in mind that when I was a student, I don‘t think even as a student I had blood test kit.  I think, again, it was urine, and I just got out of the habit of testing it.

Well, I‘m trying to do the maths. If you were diagnosed in 1983, then perhaps you were a student in two thousand and...?

1990 to 1995.

Yes, so were blood testing kits available then?

I don‘t know whether they were available.  I mean, I do remember my Mum buying me a kit, because, again, because my Mum‘s friend worked in a chemist -

(8) they‘d obviously been in the press quite a lot, these gadgets - and my Mum bought me one.  Although I probably could have got it free on the NHS, my Mum, obviously, she got it at a discount through the friend.  So, I got this piece of kit.  But I‘m sure I didn‘t have it when I was a student, and I‘m pretty sure that I didn‘t test me urines very often, so.

How was your health while you were a student?

I remember, it was interesting, when I...  The week I started at university - or polytechnic as it was then - I must... I can‘t remember what I had wrong with me, but it was like ‘fluey kinda, or some sort of, you know, run-downness, whatever it was.  And, I mean, I‘m not really an ill person.  I mean, okay, I might get a cold once a year, like people do, but I was never really a sickly child, or my Mum would tell me that.  But, as I say, the week I started, I went... I don‘t know whether I was ill leading up to going away, but certainly I had to come back from college in the first week or fortnight, which was, again, just not something I would do, because I‘m a fighter; I don‘t give in to things.  And I ended up having some sort of viraly infection of some sort, and my eyes swelled up because I reacted to what must have been penicillin, so from then on it‘s kind of "Lisa‘s allergic to penicillin".  But I was in a right mess, because my eyes were all swelled up, and it was horrible.  So, I can remember going back to college after that, and, you know, people who I got very friendly with were talking about me in the pub, saying "oh, there‘s the girl with..." - I mean, this is an awful thing to say, but, you know, the whole student thing and drugs and everything - people were like "there‘s the girl with the hash", meaning "there‘s the girl with the rash", because they were trying to be humorous about it and make me feel sort of light-hearted.

Did you experiment with drugs at all?

I would say virtually not, because, you know, lots of people would have tried... I mean, when I was a student, there were lots of people, I suppose, reliving the sixties, so they were trying all sorts of dramatic things.  Whereas a) because of being diabetic, I was quite sensible about it, but secondly, I just wasn‘t really into smoking and drinking at all.  I mean, I certainly tried dope a couple of times, but that was about it, really.

And what was your alcohol consumption during your teens?

During my teens…  When I was a teen - I mean, this is going back, I suppose - but when I was a teenager, I certainly started going to the pub when I was about fifteen, because obviously I was fifteen when my friends... you know, because I was old for my year, kind of thing.  And my brothers both went to the local pub anyway, so they were there to sort of vaguely protect me, and we used to go to pub every weekend. And yes, I liked drink.  I don‘t think I was ever... well, I‘m not an alcoholic, even now.  I‘ve never been that kind of stupid, because I‘ve always subconsciously kept at the back of my mind that I‘m diabetic.  Obviously, as I‘ve got older, you know, I would have nights out where I‘d drink more than I probably should, but I think I‘ve always had that element of sensibleness about me.  But yes, I like drinking - you know, that‘s the one thing I would do.

And were you sensible about drink while you were a student?

I think, like most students, I had nights when I probably had more than I should‘ve done, but, I mean, again, because I worked a lot as a student - you know, like I worked on security at the local bar, the students‘ union - that somehow kind of helped me not drink as regularly as lots of other people might have done.  I mean, I was at university from 1990 to 1995.  You know, yes, I probably had some wild nights, but I think compar... you know, when I can see what other people got up to, I think I was reasonably sensible, to be honest!

(9) Did you always do paid work during your education?

Yeah.  I think I started work when I was about thirteen - I did a paper round.  In fact, I can‘t remember whether I did a paper round before I was thirteen, but I certainly started off with a paper round.  Then I worked at various retail outlets when I was at school, where I‘d work Saturdays.  And then, when it got to the point... oh, I remember - there was a craft centre not far from home, and I used to go there, because I was really into ancient Egypt when I was growing up.  And I used to pop in to this place with my Mum on a Saturday or a Sunday, because they were open Sundays as well. I just remember, one day - I must have wandered around for about… you know, having been there several times - and the guy who ran the shop just came up to me and said "are you interested in a job?".  And I sort of... he said "you know, I‘ve seen you here a few times, and we‘re looking for somebody to help us out".  So, I can‘t remember whether I‘d just finished at... I think I used to work at Tandy - you know, the computery people, whatever they were, radio and music people - and I think the job had just come to an end, so it was quite good timing.  And I just said "yes". So, this place sold arts and crafts in terms of ancient Egypt, and so there was a great connection for me.  So, again then, I started working Saturdays and Sundays quite regularly, although I didn‘t always do Saturdays and Sundays, but it got to a point where I was doing quite a lot of Saturdays and Sundays.  And that went on, I think, till I was at uni.  And even when I was at uni, I used to come back, and in the summer holidays I‘d work almost all week for them.  Then, when I was a student, I actually worked - as I said earlier, I think - at the polytechnic.  I worked on security, and I was one of the first girls to do female security, so that was quite novel.  Oh yeah, I‘ve just realised, that draws me - another connection is when I worked at the craft centre.  This is kind of just relevant, because the fact that when I was, you know, at school, you know, my Mum probably thinks I did check my blood sugars quite - not my blood sugars - my water - urine - sample quite a lot.  But there must have been periods when I probably didn‘t.  I don‘t know at which point I stopped doing it rigidly, but certainly when I was at university I stopped.  But certainly when I worked at the craft centre, there used to be a little coffee shop across the road who sold cakes and things, and really nice biscuits.  It was when nice biscuits started happening, and I used to love that kind of thing.  So, they used to say "go and get yourself something to eat, Lisa", so at lunchtime I‘d go over and, you know, ad hoc buy a nice cake or buy, you know, the nice biscuits.  So, there were always things there that were just amazing to eat.  So, again, the whole tiredness thing and diabetes - I‘m sure at the time, had I been checking myself properly, there would be a connection as to why my urine samples were probably often erring between... my average, probably then, would have been between ten and fourteen, which was reasonably high. 

And were you tired?

Don‘t know - it‘s hard to say, really.  At that, I think, sort of school period and teenage, I don‘t recall being a tired person.  Like I say, I was often a tired person in the morning, but I still... I mean, to go to school, I had to get a bus to school for an hour, so I was... you know, my Dad always had to wake me up.  But I don‘t know whether that was just because that was my way, rather than because of the diabetes.  But it was more later that I saw the connection with sugars and diabetes.

(10) Yeah, I suppose another connection there is that when I was at university, again… well, certainly at university, I went through a period where I probably didn‘t check my urine anywhere near as often as I would have been doing when I was at home, say in the holidays with my Mum and Dad.  But I imagine that my friends, you know, have said - I can‘t remember whether I mentioned this earlier - but my friends have talked about the fact that I was always able to sleep in quite a lot.  And I really believe that my blood sugars probably erred between ten and fourteen or something, in those kind of days.  Certainly, when I went for the long-term range tests, that‘s what it seemed to come out at.  And I imagine that... you know, we‘d get a packet of biscuits and just eat them, not, you know, eat several of them, and not really think about what I was eating.  Or I‘d get, you know, curried prawns, and not consider what amount of carbohydrate might be in it - I‘d just eat them.  Or we‘d go to the pub, have lagers and then have a burger.  So, I imagine that my blood sugars could, for quite a period, have been highish, and I just, although I was aware of the connection, I don‘t think I let it rule me.  I sort of did what I did.  But in hindsight, now, I‘m so aware of the implications of what I was doing then.

And when you went to the hospital, what kind of reactions did you get there?

I can distinctly remember having different doctors, because obviously the guy that I‘d had initially when I was diagnosed was the key consultant.  He was a nice man; very sensible. You know, he said it as it was, but he wasn‘t... well, I was comfortable with him.  And then I can remember going through... having an Egyptian guy, who I had for a while, who was, you know, very methodical and everything, but I didn‘t think he was particularly good at advising me on anything, really, other than the factual points about diabetes.  I didn‘t think he was particular advisory.  Then I had a guy who was very stern with me about the good and bad points of eating the wrong things, and like almost telling me off, like a school ma‘am.  And then there was a couple that I had, who were, I suppose, better in the point that they‘d say "you shouldn‘t be doing that - you know you shouldn‘t be doing that, but let‘s talk about it": much more advisory.  And they were the kind that I would get on better with, because then, at least, I could be honest about what I was or wasn‘t doing, and not feel like I was going to get a rollicking.  But I remember the ones that would almost give you a rollicking, and you used to feel like a naughty school girl. I used to think "well, you don‘t deal with this day in day out, so who are you to give me a rollicking?"!

Did you have much contact with nurses?

Yeah, because - again, I can‘t remember the girl‘s name - but there was a nurse that I had at the diabetic, the original sort of clinic, for years.  And she was just constantly there, and just a nice... I felt like I got to know her.  She was a nice lady.  Again, I can‘t remember her name now, because it‘s quite a long time ago.  Once I then joined... because again, when I joined poly, I went to the GP, but again, I had somebody who was more of a specialist in diabetes.  Didn‘t have much connection at all with nurses in the days I was at university, I don‘t think. But then, once I got older, you know, again, I have more links now with the nurses.  So, I‘ve kind of had both: phases when I have and phases when I haven‘t. But, I must admit, I think my local GP here now in Gatley has a diabetic nurse. You know, it‘s nice to go and chat to her if I needed to, but I feel like I generally know more than they do, so I almost feel "what‘s the point in having an appointment for the sake of it?", which is a bit cynical of me, but I spend a lot of time in hospitals, so...  It‘s good, probably, when you‘re first diabetic, because you need the support.  But I think, unless something new comes along that they can tell me about that I‘ve not read about, then generally I find they act more like administrators than useful people who can give me any...  I mean, you know, they‘re good, I suppose, from the point of view, again, if you‘ve got a doctor who‘s one of these bossy types, then maybe you might get a nurse who‘s the other way.  So, that can be quite supportive, but I just generally...  The best experience of a nurse that I‘ve had was when I was in hospital recently, and when I was first diabetic, because I had a consistent lady who just got to know me.

Did you have any serious hypos while you were at school or university?

There‘s very little that stands out specifically.  I mean, I do remember that my friends were always very supportive, and they would check "are you..." - you know, if we went out late drinking or clubbing or whatever - my friends would say "Lisa, are you all right?".  And I don‘t…

(11) Yeah, so when I was at - sorry, just to explain what I‘m talking about - when I was at school, and we‘d perhaps go out drinking or clubbing or whatever, they were always - you know, once it got later in the evening - they would say "are you okay?", sometimes just because they were good friends, or sometimes perhaps because I wasn‘t being as communicative as normal.  And I can‘t remember, in those days, whether I would then check my urine or whatever, or whether I would just sit... I think, probably, I would just sit there and think "do I feel okay?", and either I would or I wouldn‘t.  So, I‘d probably then just eat some Dextrose, just to make sure.  I suppose the other thing that my Mum would mention, if she was talking about my diabetic era at home, sort of thing, would be, you know, occasionally I‘d... I don‘t know - I used to go to bed, I suppose, probably around eleven o‘clock-ish, or sometimes sit up even later than that.  But if I had a hypo at all, that would stand out, it might have been that I would wake up at say midnight, half one or whatever, and for some reason I would wake up with it, and I‘d become a bit damp and sweaty.  And I would know, so I‘d wander downstairs, get a glass of milk and a biscuit.  She might hear me, and she‘d be "are you all right?", and then I‘d go back to bed, and it was as simple as that.  So, I didn‘t really have dramatic hypos where there was any big saga.

And you mentioned a virus that you had at the beginning of your time at university.  Was your health okay for the rest of the time at university?

Yeah, I mean, my health wasn‘t too bad at university, apart from the fact that in, I think it was 19...  Basically, when I was at university, I did a two year HND, then transferred onto the degree.  So, I had the first year on the degree, then I had a placement year, and then I did my final year.  And whilst I was on the placement year, I basically came down with glandular fever.  It might have been just before I started the placement year I became ill, and again, I was losing weight and I was always tired, and didn‘t know what was wrong with me.  And it turned out to be glandular fever.  But again, you know, because I am one of these people who doesn‘t give in very easily, I didn‘t take years off work, or months off work, or even weeks off work.  I think I was off for a few days, maybe a week at the most, and then I used to get a lift into work with the guy that worked with me, who was a very nice chap.  And he used to just, you know, pick me, I‘d come home, have my tea and go to bed, and that‘s how I dealt with the tiredness.

(12) Did your diabetes, in any way, affect what you chose to do after university?

I don‘t think it did, per se.  Basically, once I graduated, you know, lots of friends took a year out, other people found very good jobs.  What I did, I applied for various jobs, and kept my eyes on... we used to get like a monthly magazine from the university, I think, telling up what jobs were coming up in the area.  I mean, I decided to stay in Manchester.  Some people went back home, but there was a couple of us who basically both moved into a flat with another friend, and we rented for a while.  She got a job - I can‘t remember whether it was with whoever she‘d had her placement year with - whereas the company where I‘d had my placement year, I didn‘t really want to go back to them.  Not because I didn‘t like it, but just because I didn‘t see it as being any great career developing opportunity.  It was good at the time and I wanted to move on.  So, I worked part-time at Marks and Spencer‘s, I think it was, and then an interview came up at a local IT consultancy, and I went for the interview.  And lots of people... I can‘t even remember how, but... I think I must have also done a bit of part… a bit of almost… some sort of part-time role at the airport.  And the people at the airport knew the people I was going to have the interview with, because I think they‘d done some IT consultancy for them.  And they said "oh, they‘re very intelligent people that work there".  So, that kind of inspired me, and thought that might be quite interesting then, because although I‘d done an IT degree, because I did Business Information Technology, I was not an IT person.  I mean, I used it to do the job.  So, yeah, so I start... so, as I say, I worked part-time at M&S, or virtually full-time at M&S, and then I had the interview at this IT consultancy, got the job, and started there September 1995.  I worked there till April 2001, and the role that I played was a mixture of sort of sales and marketing.  Some of the time I was out on the road doing meetings, travelling around the country, you know, meeting customers, selling things to customers.  Hard work, and I felt like it was a really good learning curve.  But it wasn‘t a big company, so, from a career perspective, they eventually went into administration, but I was kept on. And at that point, I should have left, but because I‘m a very loyal kind of person, I didn‘t leave.  I did meet my husband while I was there - or my future husband whilst I was there - so that was a good point.  We got married in 1997.  He then decided it was time for him to leave.  And, I mean, I spent quite a lot of time encouraging him, I think, ‘cause neither of us particularly believe in ourselves, but we‘re both actually very capable.  So, I‘m good at encouraging him and he‘s good at encouraging me.  So, he eventually left, and then I left in 2001 and joined a company called TMI.  And I was there until the twelfth of January this year, 2005, where I was a business development manager.  And again, I was out... I mean, there I didn‘t manage anybody, because in my previous role I did manage a team at one point, whereas in my last job I didn‘t manage anybody.  I was just out on the road or working from home, selling training and consultancy to companies.

Have you always told the people with whom you work that you‘ve got diabetes?

Yes, I always tell them that, sooner rather than later, to be honest.  I‘m always very upfront about it, because I‘d rather not go through all sorts of interviews, and then be... I mean, I know, in theory, they can‘t stop you getting a job because of it, but I always think, well, I‘d rather say it sooner, because if it‘s going to be a way that they will use to not allow me to have the job, then I‘d rather get it over with quicker.  But so far, it‘s not been a problem with either, or with any of the employers I‘ve had.

How have people reacted?

Most people have just said they don‘t really know very much about it, and then it‘s only because they‘ve worked with me, once they‘ve offered me the job, that they‘ve got to understand what it‘s about.  And I have been very lucky with both my friends, my family, and my employers, that they‘ve always been very supportive if I‘ve had a hypo. I mean, ironically, my brother saw me have a hypo, probably for the first time in years, recently, and he was almost in a panic, because he didn‘t really know what to do, you know, and I‘ve been diabetic over twenty years.  So, I‘ve been very lucky.

Have you had many hypos at work?

I think most of that... I‘ve had ad hoc ones in...  Well, yes, I have had hypos at work.  It‘s been more recently

(13) that I‘ve had more, and part of that, I think, is linked to what I mentioned earlier.  As I said earlier, when I was growing up, I didn‘t... well, a) blood test kits that you could check your blood sugar levels have only started in my later life.  I couldn‘t give you a date, but probably within the last, perhaps, five years, perhaps a bit longer... dunno.  But they obviously allowed me to control my blood sugars, and at least check them regularly.  Certainly, since I started working in 1995, I used to check them regularly, a) because I was on the road quite a lot, so I was driving, so I was always very conscious of it.  But at the same time, when I was a student, I was bigger in size -I was probably a size sixteen jeans.  And I‘ve always been very conscious of my weight.  You know, growing up, I was an average kind of person, you know, reasonably slim - okay - but then, as I became a student, I was drinking lager and eating and just generally enjoying myself, I did put on quite a bit of weight.  And because I was always doing exercise, I remained quite fit, but bigger.  And I was always concerned about it, because I didn‘t want, you know… I was influenced by the people around me, and I didn‘t want to be that big. But, you know, I didn‘t stop eating because of it, I used to just do exercise. But that didn‘t seem to lose me the weight, because I‘ve always enjoyed my food.  And so, as I‘ve got older, I‘ve become much more aware of my size, I suppose.  I mean, I suppose the thing to say is that in my final year, I was very, very stressed, in hindsight, because I was doing my final - sorry, I‘ve jumped back a bit here, but this is relevant - I did my final degree, you know, my exams and my dissertation, and I was still working the whole time.  I didn‘t stop working, like a lot of people do, and I didn‘t stop working after that, before I started my job.  So, I suppose, by the time I took my exams, I was probably an emotional wreck, in hindsight, and just physically and emotionally worn out.  But I just carried on, I suppose.  And as a result of that, I did lose quite a bit of weight in that final year, because I am a stress-head - I mean, I get stressed about everything.  I mean, that‘s got worse as I‘ve got older as well, and my Mum always thinks it‘s to do with work - well, yeah, she‘s probably right.  But by the time I then started losing the weight, I seemed to have managed to retain most of it, ie I‘ve kept it off pretty much.  And that‘s partly because I check my blood sugars much more regularly now, because, obviously, the gadgets are available.  I‘m driving, so I‘m much more aware of what my levels are.  And realistically, if it goes high, now, because of where I‘m at with my insulin, I can straight away do more insulin to bring it down again.  But that in itself has its own implications, because there is so much more flexibility.  Food is guesswork, so whilst, if you buy a box of lasagne and it tells you how much carbohydrate it is, you can be much more accurate - if you make something, you can‘t.  So, the interesting thing that my diabetic consultant would tell you now is, that - because I go to the diabetic clinic in Manchester - and he would say that of all the diabetics in the clinic, I am the most amazing, in the sense that my average - what is it - Hb1c is five point five, or the last time I went, the average is about five point five, five point six, and it has been for a number of years.  You know, and okay, it can be nineteen one day, it can be six another day, but the average is always around five point five, and he thinks that‘s amazing.  But it‘s because I am quite obsessive about checking my blood sugars.  But that in itself doesn‘t mean that I don‘t have hypos. I do have hypos, and probably because it‘s so good, on average, therefore it‘s prone to dropping.  So, it‘s as I‘ve got older that I would say I‘ve had more hypos.

(14) And what have your hypos been like more recently?

I think I mentioned earlier, when we talked, that when I was at home and at school, you know, I would be aware of the symptoms.  And I‘m sure now, in my records, there will be a note somewhere that my symptoms... sometimes I‘m not aware that I‘m going to have a hypo.  And like Mags, my husband, will say "you need to eat something", and I‘ll have an argument with him because I‘m getting argumentative.  And that‘s not to say I didn‘t get argumentative with my Mum when I was growing up, because I certainly did, but now I just vary between being argumentative when I‘m having a hypo, and not being argumentative, depending on the mood I‘m in, obviously.  But there are probably more times now when I‘m less aware. And there was a... I don‘t know, I think it was about twenty first of July 2003, I was basically... With the job, because I was driving in the car, if I was going to where the job was based, which was south of Birmingham, if I had to be in for nine o‘clock, I‘d be up at sort of five to get there.  And obviously that makes the day longer, and it means the whole injection routine is thrown somewhat.  So, I drove down to south of Birmingham, and I vaguely feel as if I remember the fact that I knew I was having a hypo, was trying to eat something, but obviously just wasn‘t soon enough to realise it.  And the next thing I remember is coming round.  And, I mean, I know what happened, because I was... it‘s almost like I was seeing what was happening - it sounds a bit odd.  But basically, I came onto the slip road of where I was due to come off, got to the end of the slip road, and rather than stopping at the top, I went straight over the little roundabout at the top, and I ended up, you know, in the middle of the little roundabout.  So, I‘d gone over a bit of the road, was very fortunate, in that no cars were coming on this little roundabout, so I didn‘t hit anybody and nobody was, you know, hurt.  But I did wipe out a lamppost and I wiped out a signpost, so my car was a write-off.  I was okay, probably because I was so far gone that I didn‘t really notice.  But the point is that I came round. So, then the ambulance driver turned up and checked my blood sugar, or got me to check my blood sugar.  I‘d checked it myself anyway, I think, so I don‘t quite know how that had happened, how I‘d... maybe the adrenalin affected me or something; I don‘t know.  But then the police obviously interviewed me, just to check that I was okay.  I didn‘t get any charges pressed against me, but, you know, that was quite shocking.  So, obviously I went to work, ‘cause a girl that worked with me saw what had happened, recognised my car and me, so she then rang work, told them I was going to be late.  And when I got to work, they were all very concerned and very nice about it - nobody sort of held it against me.  But it sort of shocked me quite a lot, but I then realised I had to get in the car sooner rather than later, so I didn‘t scare myself half to death.  But, I suppose, that also links to the fact that any hypos I‘ve had, or anything that‘s happened, I don‘t really let things hold me back.  I will... rather

(15) than thinking about it , I‘ll just bounce back.  That‘s just my style, because otherwise I‘d become a hermit, I suppose.  And I‘m not saying the diabetes particularly stopped me doing anything, but I don‘t want it to suddenly take over my life, so I kind of just act a bit too normally, perhaps.

Did you change anything as a result of this car accident?

Well, it‘s quite ironic, as a result of the accident, because I‘d been to the diabetic doctor quite recently, and I was due to then... I‘d made the decision some time ago that I wanted to change my routine.  So, having spent twenty years doing the Humulin I and the Humulin S, I just became aware that I wanted more flex... I can‘t remember whether there was a particular trigger, but I just decided I wanted more flexibility. So, I was due to start the new regime, which is the whole DAFNE technique, which is like four injections a day.  So, it was almost a week later that I started that.  So, it wasn‘t because of the accident - it was just unfortunate timing that I hadn‘t already moved on to it.  Whether that would have made any difference, I don‘t actually know, because I have had a number of hypos since I‘ve started this regime.  But almost the flexibility almost makes it that you... I suppose, you know, now, I‘ll do an injection and think "oh, I might eat something in a little while", so, in some ways, the flexibility almost makes it that I‘m too flexible.  I don‘t know how to explain that, but, you know, I have had a number of, I suppose, reasonably bad hypos since I started the new regime.

Did you go on a DAFNE training course?

No, no sort of training course at all.  I‘ve not even read anything on it - I have to put my hands up and say that.  All I‘ve read is the books they gave me with the... because basically I‘ve got two pens now, because previously I had a plastic syringe, which was just a syringe and my needle bottles.  Now I‘ve got what looks like a pen with cartridges that get fitted in to it, separate needles, and obviously I‘ve got one for my morning, lunch and evening meal, and one for my evening...  Sorry - Before I do my breakfast, I do an injection; before I do my lunch, I do an injection; and before I do my evening meal, I do an injection; and that‘s on something called NovoRapid.  Then, before I go to bed, I do a long acting insulin called Lantus, which lasts me sort of twenty four hours, to just make sure there‘s always a bit of insulin in there.

Was this new regime suggested by the diabetic clinic at the hospital?

Well, I‘d known about it for quite a long time, the fact that there was this thing where you could do four injections and it was more flexible.  I think the DAFNE thing, I almost... it was mentioned to me, but not, I don‘t feel... that was almost like a side comment, a bit.  I know that sounds... I‘m not trying to be critical of the doctors or

(16) anything, but I didn‘t have any in depth discussion about what is the DAFNE and what can it do for you.  The way I saw this routine was the fact that it would give me more flexibility - I wouldn‘t have to think as much about what I was going to be eating.  Whereas previously I‘d had to think, "well, okay, if I do my injection in the morning, what will I be having for my lunch?" - in other words, "how much insulin do I need to do?" - whereas now I was going to be able to think either "I‘m doing my injection, I‘m going to eat this", or I‘d eat something and then do my injection, because it was that bit more flexible.

So, what happened - you went along to a clinic and said "I want to change my regime"?

Yeah, I just went to one of my six monthly check-ups.  Over the last sort of three to five years, I‘ve been going either every six or every twelve months - I can‘t quite remember which; it sort of varies slightly.  So, I just decided I wanted to change, so I said to them "look", you know, "you‘ve talked to me before about this regime, I‘m ready to try it", ‘cause previously, I suppose, I was just scared of the change, because nothing had happened to make me need to change, whereas I just decided I wanted more flexibility.  So, they just said "fine, let‘s have a chat about it".  The doctor explained a little bit about it to me, and then I think I had to book an appointment with the nurse, for her to sort of show me exactly how it worked.  And then I was given... and again, that was a good situation, ‘cause she was very supportive.   She gave me her mobile number, and, you know, she said to me "let me know if things are particularly high or low in terms of your blood sugars, so that we can monitor it and check that we are doing the right levels with you".

And can you remember the existence of training courses being mentioned?

Certainly it wasn‘t mentioned, and ironically, considering I work in a world where training and development is what I do or is what I sell, I didn‘t even ask the question.  I just, I suppose, subconsciously must have assumed if there was a training course, it would be mentioned to me, but I never thought to clarify it, which is quite interesting for me!

Can you clarify in what way you sometimes find this new regime too flexible?

Well... yeah, I mean, flexible might not be the right word, but, I suppose, now, knowing that I can... I mean, historically I would eat what I wanted, and I would do slightly more insulin if I was going to eat more, which other people were less... I know from talking to the doctor that I was more flexible in my previous regime than most people.  But my view of the world has always just been that, well, I‘m not going to let diabetes rule me, so if I want to eat something, I‘m going to eat it; rightly or wrongly.  You know, if you want to be really cynical, yes, I could get an amputated leg in ten years time.  Well, I suppose I‘ve just subconsciously knocked that out my head and not worried about it too much.  But I‘ve always done more insulin, because my view was that people who are normal - like you probably are - if you have something to eat, you produce insulin to cover it.  Now, for me, I sort of thought, "well, therefore, if I‘m going to eat a cake, I‘ll do more insulin to hopefully cover it".  And I might not always get it right all the time, but I was trying to adapt accordingly.  So, the new regime wasn‘t any different in my head for that point, because I‘d always been reasonably flexible.  It just meant I could be flexible at the appropriate time.  But, I suppose... I don‘t know. I think I have just seemed to have recently got into a bit of a habit where I do more insulin than perhaps I should be doing, because I always sort of think "oh, well, I might want to eat a bit more", whereas I should just be strict with...  Maybe I‘m not as strict with myself as I should be.

(17) Can you talk about the role of your family - those close to you - in helping you cope with diabetes?

Yeah, I mean, I suppose, doing it from an observational point of view - in terms of looking back at how things have been - obviously, growing up, my Mum was very good.  She was there when I was first diagnosed, and she was there helping me through the initial injections.  She never actually injected me - just it didn‘t seem necessary, because I managed to do it from the word go.  She‘s probably always been a bit curious. I don‘t know whether she was quite happy to not have to - I‘ve no idea.  But she always, you know, if I was at home and I was having a hypo, she would always check up on me, and make sure I‘d eaten enough and worry about me, and all that kind of thing.  So, she‘s played a very good role.  I mean, more latterly, I suppose, if I go to meet my Mum on a Saturday, for example, she would say I seem to always have a hypo when I see her.  And I don‘t know whether there‘s a particular link there, or whether it‘s because we meet round lunchtime and the blood sugars drop for whatever reason, so we eat later than we should. That‘s just something we should try and sort out, but we never seem to.  But, you know, in general terms, she has been very good and has been very supportive. You know, she‘ll tell me off and be cross with me if I‘ve done stupid things, but generally, you know, she‘s been good about it all.  My friends have been very good as well.  You know, if they see that my blood sugars have dropped, they jump in straight away and sort me out, or if they think I‘m not making sense, like my Mum, they would just say "Lisa, you need to eat". And either I‘d have an argument with them, because I was that way inclined, or not.  But most people that I know have been really good and sorted me out. Obviously Mags, my husband, he has been very, very good.  You know, there‘s been some quite difficult hypos where he‘s been at his wits end knowing how to deal with me, because I can get quite argumentative.  And I‘m sure my Mum would say the same, but I suppose the ones with Mags are more recent, so they‘re more vivid in my mind.  You know, I can remember odd days where I‘ve woken up, and he‘s said "are you all right?", and I‘m like "why, did I have a hypo?", so I‘ve maybe not remembered.  Or there‘ll be times when it‘s almost like I‘ve had a hypo and I‘ve been aware of it, but it was almost like I was watching what was going on, which might sound a bit dramatic, but that‘s sometimes what it can be like.  There was an instance - going back, when I was at home - where I was in the car, and my Mum was in the car with me.  And there was like a little lane that we used to drive down to get to my Grandma‘s.  And I think we were driving home from my Grandma‘s, and my Mum obviously realised that she was talking to me and I wasn‘t making much sense, and she was obviously a nervous wreck, because she realised I needed to eat.  So, she was trying to get me to eat something, and I was driving, and this was a little narrow lane in the dark.  And fortunately she managed to sort me out, but she was a nervous wreck.  I can remember vividly feeling this intensity in the car, and she was probably very upset and angry with me.  But, at the end of the day, that‘s the way it was.  But, you know, Mags has had a few of those kind of situations - not necessarily in the car - but he‘s observed me in that quite ‘far gone‘ state.

(18) Has diabetes affected any decision on whether or not to have children?

No.  I mean, I suppose, me being one of these people who analyses everything, I‘ve always wondered whether it would be an implication, because I know for some people it can be, or you certainly have to be a bit more cautious once you become pregnant, in terms of checking your blood sugars a lot more and all that kind of thing.  But no, it‘s not something that‘s stood in our way; you know, we‘d like children.

In what ways do you think your life might have been different if you hadn‘t had diabetes?

I suppose hindsight is a wonderful thing.  I always think that diabetes hasn‘t particularly influenced what I‘ve done, although saying that, I suppose at the back of my mind, you know, when you see things like the current Thailand disaster, you know, I sort of think "oh, wouldn‘t it be nice to go out there and help out?".  And, I mean, my natural style probably is that I don‘t think I naturally would, just because I don‘t think... I don‘t know; it‘s just not really me.  I‘m more the sort of person that would try and do some help over here, if it was appropriate, or whatever.  You know, I‘m not into the "let‘s nip out and get our hands dirty", ‘cause it‘s just not my style.  But I don‘t know whether that, subconsciously, has also... because, at the same time I would be thinking "well, I‘d just be a hindrance, because I‘m diabetic, and someone‘s then going to have to worry about me rather than worrying about the job in hand". And I don‘t know whether that‘s an excuse, or whether that‘s actually because I am concerned about it - probably a bit of both and really.  Yeah, and the other thing, I suppose, that‘s relevant is that over the years, when I‘ve had odd treatments - so, for example, when I had my wisdom teeth out - whereas most people would just go in for a local anaesthetic, I‘d gone in the night before and had to have a drip and all of that, just because they monitor you more because I‘m diabetic.  Similarly, I recently had to go in hospital, and again I went in the night before, whereas most people would have had the treatment done as a local anaesthetic.  So, that‘s happened about three different time... oh, I think I had a cyst behind my ear when I was at school, and again, I had to go in the night before, rather than just have a local anaesthetic. So, that‘s just something that seems to happen, because I‘m diabetic.

(19) And how do you see the future?

Well, I think I mentioned earlier that I don‘t particularly think about what does the future hold from a diabetic point of view, but that‘s, I suppose, subconsciously, because I try not to let diabetes rule my life.  You know, I‘m aware, and occasionally I contemplate the fact that at some point - or people might ask me questions which might make me mention the fact that, you know, at some point there may be transplants available.  But I know, just because of my style, that I‘m not the sort of person who would offer to be a guinea pig, ‘cause I‘m not really a risk taker in that way.  That‘s not to say, you know, five years later I might not consider the operation if it was available to me, but, I mean, that just depends on where it leads, I suppose.

In the twenty plus years that you‘ve had diabetes, have you observed any changes in the medical care you‘ve received or in the National Health Service?

I think overall, I probably would say I‘ve been very lucky.  I seem to have consultants who have been good, ie with their interpersonal skills.  I mean, I‘m very much an interpersonal person, ie I communicate quite well - I like talking to people.  So, from a doctor, I need that kind of a person, because - I think I mentioned earlier again - that when you get one of these strict doctors who will almost tell you off, that doesn‘t actually do it for me.  And that almost makes me want to rebel, because I just think "well, how the hell do you know?". But, I generally have had mostly quite good doctors, who will at least have a conversation with me - maybe give me the pros and cons, but not tell me how to do things.  And I don‘t mind people challenging me, so long as they‘ll at least communicate and have a conversation with me.  ‘Cause more recently, in the last five years that I‘ve been working, I‘ve had two very different doctors as my consultants.  One was an older man, who was a professor: very open to discussion and very chatty.  The one now is very different: very dry sense of humour.  But, you know, they both will at least have a conversation with me, and they‘ll offer an opinion and they‘ll challenge me, but they will engage with me.  So, I think... you know, there was definitely a phase where I was at school, when I was going to the school‘s diabetes clinic, where it almost became a bit of a routine - "oh, here we go again.  Let‘s go, have the blood test, have the urine samples, bit of a chat", and that was it.  I didn‘t really feel like I was ever getting any new advice, per se.  It was almost "let‘s check Lisa‘s doing okay".

It sounds as though consultants have been the key people for you, rather than nurses?

Yeah, that‘s probably quite true. I mean, again, saying that, there was a lady called Kate - I think her name was Kate, I can‘t remember her surname - but she was my nurse when I was at Arrowe Park Hospital, and I felt like she knew me, because I was with her for quite a long time.  And she was very good at being a supportive role, or, you know, if the gadgets I was using needed updating or whatever, she was always very good at teaching you how to use the new things, or, you know, recommending that I see her...  Oh, that actually draws my attention to something. I obviously originally saw a dietitian, and when we decided we were interested in having children - I think it was to do with that - anyway, somebody must have said to me, you know, "you‘ve not seen a dietitian for twenty years, perhaps now‘s the time".  It might have actually been when I started the pen - I can‘t remember.  So, I went to see a dietitian, which was interesting, because, you know,

(20) things I‘ve assumed, ie "I eat brown bread - I‘m a good girl, because I eat brown bread rather than white bread".  He quite clearly said to me "Lisa, you might as well be eating white bread.  It‘s the granary bread that‘s the good one, if you‘re going to be fussy about what bread you eat".  You know, and obviously I‘ve tried to eat more fruit and veg as I‘ve got older, because I have really changed my eating habits.  I still love my sweet things, but I try to eat more fruit and veg.  But he really reinforced that a great deal, and talked about things like lentils, pulses, and those kind of things.  But he also pointed out odd things that I‘ve not really wanted to admit, or not really thought about, you know, for example, cereals really are a waste of time.  I eat breakfast cereal - Kellogg‘s Cornflakes.  "Well, all of those", he said, "really are a waste of time".  He said "none of those actually are any good for you.  They‘ve all got sugar in them", because I think I must have smugly said "yes, I have Weetabix for breakfast everyday" - or Weetabix or bran flakes - ‘cause I used to think I was quite good because I was having those, thinking they were quite healthy.  And he said "well, actually, they‘ve all got sugar in, so they‘re not actually that good at all".  And I now proudly tell all my friends that these things aren‘t particularly good for you.  And I know mine‘s more from the blood sugar point of view, but it‘s interesting, because quite recently my friends have suddenly got into the GI thing.  Now, I didn‘t actually know what GI was until this dietitian guy, and he gave me a book, which I still haven‘t read, and I‘ve got it upstairs.  But a lot of it is linked to the way I‘ve always should have been doing things, ie green, yellow and red kind of scenario.  Because my friend had a book talking about the GI routine, and just the comments they were making, it led me to believe that what it‘s basically saying is that there are green foods - which are good, amber foods - which are not so good, and red food - which are bad for you, which is what diabetes is all about.  And I sort of laughed, because they‘re talking as if they‘ve got this new world going on.  And I‘m like "well, it‘s just modern language of...", which might be more up-to-date, and I - you know, "great, I admire you for having a go" - but I just think "well, I‘ve known about this for years".  And yes, I should sit down and read the book. But yeah, I suppose you are right - consultants probably have had more influence. But what I‘m trying to say is that it‘s not that nurses haven‘t been good, because they have, but I‘ve had less interaction with nurses.  It‘s only been on certain - you know, the doctor might have said "right, you need to do x, so speak to the nurse".  And I‘ve probably had good - like the nurse that taught me about the new pen, the, you know, the Lantus and the NovoPen - I mean, she was great.  The nurse I had when I was at school, she was great.  But it‘s been the interaction with the consultant that I‘ve valued much more.

What advice would you give to someone newly diagnosed with diabetes?

It‘s an interesting question, because, funnily enough, I don‘t know anybody, really, with diabetes.  I know one person indirectly, who‘s a daughter of my Mum‘s friend.  But there‘s a guy at work who‘s got a son who‘s diabetic, and he‘s at university.  And I said to this guy, you know, "if your son ever wanted to speak to somebody, and, you know, people don‘t always want to talk to their parents", I said "I‘d be more than happy for you to give him my contact number, and I‘d willingly have a chat with him".  And he said "oh, thank you very much for that", and he said, you know, "my son probably wouldn‘t do that, because he‘s very different to you and he‘s quite shy and reserved, and probably would just not know what to say to you", but, you know, the offer was there.

(21) I think the key thing is, I would sort of say, you know, that I have been through a phase, or through phases, where I‘ve been good, bad or otherwise, in terms of thinking about the diabetes.  But I think I would mention the fact that it is important to keep your blood sugar levels at a reasonable level, and that I think people should take it more seriously than I certainly did when I was a student.  So, I think I would really emphasise the fact that it is good to get into the routine of testing all the time, and to make it a habit, rather than a hindrance.  So, for me, I just do check it regularly, and it might be annoying sometimes, but I think it‘s good, the fact that I‘ve got into that routine now, and I do do it.  And I would say, you know, don‘t let it rule your life.  If you really want to do something then there is generally a way round it.  Try and find a doctor who is good, and if not, then, you know, I think I would probably hazard a guess that within most surgeries, or wherever it is you go to have your consultations, even if the doctor‘s not as easy to get on with, I‘m sure there‘s a nurse that is, you know.  Because I‘ve probably had situations where I‘ve said to the nurse "oh, the doctor‘s having a go at me", you know, and they will have a bit of banter with you, so.  I think it‘s about finding people that you can talk to, really, and be open and honest with them.

And do you think a lot about being diabetic?

Yeah.  I mean, not all of the time, but ad hoc - when situations arise - I do contemplate the fact that, you know, basically I am very lucky to be alive, because either... you know, if I don‘t take insulin, I am basically dead.  I mean, that might sound a very blunt statement, but that‘s the fact of the matter.  You know, I don‘t know, whenever it was, in the, you know, early 19-whatever up until 1920-odd, I would be dead.  Thereafter, people have been able to be cured, because of - well, not cured - but, you know, I‘m kept alive because I take insulin. You know, and sometimes, if I‘m having a narky moment, it can really annoy me - "why me?" - you know, that kind of element can come out.  But, on the other hand, you have to think of the positive, and say "well, actually, I‘m lucky that I am kept alive because of this".  So, you know, that can be quite... because I do think about things a lot, so it does… you know, I do contemplate "why do certain people have it happen to them?". But then, you know, you can link that to any disease or any disorder, or anything that goes wrong, if you like.  And is it something...?  I don‘t know.  Why does it happen to certain people?

What keeps you going?

I think like I‘ve sort of just said, really.  At the end of the day, you know, I‘m lucky to be alive, so I have to try and remember that.  I suppose I am a bit of a pessimist most of the time, but, you know, I realise that I‘ve got a really good support network around me - you know, my family, my Mum and Dad, my brothers.  You know, all my friends have been really helpful and supportive over the years, and Mags, my husband, and, you know, any other family members in the wider family - sort of Mags‘ parents and all that.  You know, all these people will look out for me, and I‘m really grateful to that.  You know, employers, just people I come across who get to know that I‘m diabetic.  I‘ve been very lucky, and I think you just have to think about that.