When handed out his diagnosis in May 2021 that he had contracted diabetes, Iain Robertson was more than mildly shocked at its far too casual delivery.
Amputated legs both below and above the knee, the slicing off of necrotic toes and the removal of fingers, allied to poor blood circulation, are some of the common physical excommunications that can result from a diabetical diagnosis. However, do not for one moment believe that there is any commonality between what afflicts me and what may be having an impact past, or present, on anyone else you know. It is one of the monstrous anomalies of diabetes that no two conditions are the same and trying to seek a common repair is like trying to find that metaphorical needle in the haystack.
Millions of Pounds are raised every year for Cancer Research, with not dissimilar financial ramifications for Cardiac Research. Yet, cures are being found, surgical and even non-invasive procedures are being provided. People’s lives are being saved on a daily basis. However, there are slim pickings for the diabetic. In over 50% of diabetic cases, some form of control can be introduced by dietary changes, the patient dealing with their blood-sugar balance by cutting back on excess, losing weight and indulging in regular exercise, all eminently honourable, worthy and readily attainable goals. Yet, regardless of self-administering insulin and taking Metformin tablets, diabetes continues to wreck lives and remains incurable.
I can recall asking the physician giving me my diagnosis, as though I had just contracted the common cold, why it was treated so casually, to which he was unable to provide an answer beyond a Gallic shrug of the shoulders. I was extremely disgruntled by it and I sought to uncover more about a disease that I knew little about, only to discover that the medical profession is equally ill-informed. Having been checked morning, noon and night for my blood-sugar balance, a methodology that leaves pricked fingers looking like watering can roses after a few weeks of sustained testing, and trying to recall which of the nursing staff was more brutal in their applications of sterile lancets (the pricking devices), because they do not need to grasp and push as much as they think they do, I was confused. It took several weeks of sustained barbary, because, in hospital, the patient has zero control over his drug pile, or how it might be managed. Yet, I was in control of my pancreatic output…even though the damage had already been done to my extremities, which left me with necrotic heels and ulcerated lower limbs.
I can only presume that diabetes had been my disease of unwitting personal choice, following years of ritual self-abuse (fancy meals, foreign travel, smoking like a chimney and drinking like an alcoholic fish), as it appears to have been well entrenched long before I was informed so casually of its existence. However, managing pancreatic output also means being aware of both hypos and hypers…a situation that occurs if blood-sugar levels either drop too low, or rise too high, respectively. Measuring the mix is essential, although I have an amusing tale to tell about the nurse checking my blood-sugar at 5.30am, discovering that it was a lowly 3.1…she went into a tailspin, rushed off and returned with three pink sachets that she urged me to rip open and consume immediately. I declined and requested a pack of three custard creams, which bamboozled her somewhat. It might have been better had the sachets been either white (for granulated sugar), or brown (for natural demerara sugar), because asking me to consume ‘Sweet ‘n’ Low’ (aspartame) was simply incorrect. When I informed her that I needed sugar, not sweetener, she failed to understand that diabetes does not mean a ban on sugar! Three cookies and 25 minutes later, my blood-sugar level had returned to a more acceptable 5.6.
Within five months of initial treatment, by late-October 2021, I was rushed into hospital for the most serious of my conditions. There was talk of limb removal…below the knee, or BTK, in order to preserve the blessed knee joint (one less to worry about in orthotic terms), so I could not say that I had not been prepared for the worst. After the angioplasty had been carried out, to attempt to improve blood circulation largely inconclusively, the next procedure was left limb removal (BTK). The first operation, carried out economically, conveniently and consecutively after my necrotic right heel had been ‘saved’ by way of abriding the bad tissue and leaving an open wound, was the amputation. I had opted for a spinal anaesthetic, which is less damaging to one’s system than conventional gases and drips, with a rapid post-op recovery time and zero side effects.
The first amputation was a failure. Three weeks later, the tissue was not healing. A second procedure was scheduled for when the surgeon had returned from a vacation, in mid-December. It, too, would not take. The skin was compromised by my diabetes and even slicing off another 2-3cm of both tibia and fibia and filling the bone ends with medicated cement failed to achieve the desired aim. A second surgeon was called upon to effect an above the knee (ATK) amputation in late-January of this year, for which, again, I remained awake and aware through a spinal anaesthetic injection…trust me, the patient does not feel a thing! I was already feeling the impact of ‘surgical practice’, rather than ‘actual surgery’! However, it also presents a practical side benefit, in that I have not once suffered from Phantom Leg Syndrome, said to be the bugbear of amputees.
This final action has healed wonderfully, the stainless steel staples that I had requested for skin closure being removed around three weeks post-surgery painlessly and cleanly, leaving a neat, straight-line scar that would be perfect for potential prosthetic application. Sadly, the NHS hospital in Boston has failed to refer my case to the Queens Medical Centre in Nottingham, as it should have done, leaving me ‘dumped’ in a nursing care home, a beguiling 12 miles away from my own home, which I have not seen for the past four and a half months. Bear in mind that hospitals have been applying the strictest of COVID regulations, which has meant that I have had no visitors at all for much of my hospitalisation, a situation that has lessened somewhat in just the past couple of weeks. Hospitals also no longer do laundry, which makes things even more interesting at times.
Retaining my right leg and, thus, throttle foot means that, without resorting to hand controls, my choice of motorcar is now restricted to automatic gearbox type. With a future seemingly based on electrified transport this is less of a burden than it might have been. However, it has meant that my own personal, manual gearbox lease car, which I loved intensely, was returned to Arnold Clark Leasing ahead of the three year term conclusion. Yet, the company has charged me no excess or penalties, to which they were entitled. Full marks there.
Now all I need is a plan…I need to be mobile…I need to regain muscular strength…if I am deemed an unsuitable candidate for a prosthetic limb, I need to be taught how to walk with crutches. The wheelchair made for me is totally unsuitable, far too heavy and needs to be replaced by one that can negotiate 99% of most doorways, not the 1% it can barely muster today.
I have reached a number of conclusions: 1. Do not believe that the NHS is in anything but serious trouble. 2. The NHS’s problems are caused entirely by its own lack of waste management strategy and not a money shortage. 3. If NHS returns to an army-like regime within its ranks and rids itself of middle-management civil servants, it could be self-funding very quickly. 4. Never leave hospital without a confirmed action plan. 5. If you are diagnosed with diabetes, be aware that it is yours for life.
As soon as I am mobile, I shall be dedicating at least two days per week to a brand new diabetes research centre opening in the north of Lincolnshire. I have already written a ‘novel’ of sorts, the proceeds of which I am dedicating to the centre. As to future motoring material, I shall be back soon.