What was your care in the "old days"?

General
1

For those of us who have been T1 for a while, I thought it would be fun to remember our old regimens -- it always makes me feel amazed that I made it this far and am still (knock on wood) healthy! It also makes me grateful to my parents who were basically guessing what my BS's were!

I was diagnosed in 1981. We did have disposable needles as far as I remember. But, no home blood sugar meters. I had to pee on a ketone strip and it would tell me what my BS had a been a few *hours* ago. I sill remember a couple of years later getting my first meter w/ this huge lancet device that was scarier than my shots!

I was on NPH and regular, I think. (Don't really remember). But, it was definitely pork insulin -- I remember at a JDF get together for T1 kids, making a pig puppet as an art project. (: I only took 2 shots a day, I must have mixed the R and NPH. I also remember having a meal plan and weighing my food with a little scale. Wow, do I love carb counting, now!

Anyone else have similar (or older!) memories? As much as I wish for a cure, we sure have come a long way!

2

Well, I can't say anything about the "old days" since my daugher was dx last August, but I do have to say that your post came at an odd time.

I have been having problems sleeping lately, and at about 3 am this morning, I am laying in bed, thinking, "Wow, we have it kinda easy, I wish I knew more on how it used to be handled". I was thinking about how it used to be, where you had to weigh foods, eat at specific times, take only a couple shots a day, and all that. I was seriously considering posting a question about this. I was wondering how it all worked, and when did the carb counting start, and how did you get to that point? Was it where you walked into your endo appt and they say "we are changing the way you do things" and wham, all new education and insulins? This really has got me curious. I am going to have to watch this post to see what all kind of changes you have experienced.

Thanks so much Sarah for asking this... even though seeing you post this after my late night thinking has me kind of weirded out!

3

I am similar to you - '78 for me.  I was on two shots a day - R and Lente.  I remember having the books with all the food exchanges - 2 bread, 2 meat 1 veg  etc -   basically going off the old food pyramid.  I think my parents spent big money on the new home meter.  I can rember the days standing in line for a fasting blood sugar at the blood lab b4 getting the home meter.  That was every 3 months and would have to get it a week in advance so the lab could get the results back to the doc in time.  

I also remember trying out the Medi-Ject - I think that was it.  You drew the insulin into this big stick looking thing and it would use a fine spray through the skin - that was a bad idea - would split my skin and bleed - I went back to shots in a hurry!

4

I was diagnosed in 1980. Before the ketone stix I used to have to pee into a dixie cup. Then use an eye dropper and drop a couple of drops of pee into a test tube with a tablet of some sort.  It would all foam up and then turn a color depending on how much glucose there was in the pee.  Then I'd have to hold it up to a chart with colors on it and it would show me the range that my BG was in.  Talk about coming a long way...

And the only thing that wasn't allowed back then was sugar.  No one knew anything about carbs back then or how they'd affect BGs.  Bread, no problem. Rice, no problem.  Pasta, no problem.  Oh god...when I think back about it I can just imagine what my BG was after a big heaping plate of pasta and a huge glass of milk (or two).  Yikes.  

The worst part was never actually knowing, for sure, if my BG was low.  If I felt funny I'd eat something sweet.  Makes me wonder how many times I ate something sweet when I didn't really need to.

5

It's a wonder we made it thru the 70's and 80's. Just stick with the same old dosage no matter what, and using those tablets in the tube. Of which mine always seemed to turn orange. I think that was the bad color.

6

I was dxd in 1989. I remember beef insulin, and huge blood sugar machines that took 3 minutes to get a reading. Before having an insulin pump, I took over a hundred units of insulin a day. I took two shots of nph, and countless shots of R throughout the day. My a1c use to be between 9-11. I am so thankful for my pump :)

7

Doug, I had forgotten about those medi-ject things. I was always scared to try one. Somehow a big needle seemed less scary. (:

Melanie- You may be interested in the book "Bittersweet: Diabetes, Insulin, and the Transformation of Illness" (Feudtner). The style was a little repetitive, but it was really interesting and a quick read. A historic look at diabetes tx and how the treatment didn't really solve the problem of the disease. (I got it used for cheap on amazon.)

8

Sarah, thank you for the info on the book. I had no idea where to even start to look for something like that. I will have to see if I can get it at my library, if not, I will order it on Amazon or half.com.

If anyone else has any good reading suggestions, please let me know. I just finished Mary Tyler Moore's new book, and I found that to be informative, as well as an interesting read.

9

For me, the “old days” was BEFORE there was any finger stick BG testing., and BEFORE there were any pills or Testape to simplify urine testing. The urine test I started with used Benedict’s solution. Benedict’s solution was a dark blue mixture of several chemicals, mostly copper sulfate solution. We got it in large glass bottles at the local drug store, and although I’m not sure, I think they mixed it themselves, rather than getting it from a supplier.

I don’t remember how many drops of urine were added to maybe two inches of Benedict’s solution in a test tube. Then the test tube was supposed to be heated with a Bunsen burner for I think it was five minutes. I think you all know what a Bunsen burner is – aren’t they still used in high school chemistry labs?

But we didn’t have a Bunsen burner at home. Our only gas appliance was the kitchen stove. Either I, or my parents, figured out that I could put the test tube in a metal measuring cup (1 cup size), mostly filled with water, and supported between the grates of the burner grate on the stove. As I recall, I had to boil the water for five minutes. I don’t know if my parents might have had a discussion about whether the kitchen stove should be used for this purpose, but if they did, they never told me about it.

Of course, the urine specimen had to be collected in the bathroom. Both of the bathrooms in our house were on the second floor, with the bedrooms. And of course, the kitchen stove was in the kitchen, on the first floor. So, after collecting the specimen, and preparing the test tube with Benedict’s solution and urine, I had to carry the test tube down the stairs, through the dining room to the kitchen. I don’t recall ever having an accident and spilling the test tube, either on the way to the kitchen, or going back upstairs to discard the almost always orange (4+) result of the test in the toilet.

It was probably three years before there was any improvement in the method of testing urine. Those were war years. No new products were being developed until after the end of the war in 1945.

10

I was diagnosed in 1977 and remember having to pee in a cup, then use a test tube, dropper and tablet.  I only took one shot a day for the first year or so I think.  I hated going to two shots a day! 

I also remember the first glucose meter I got where you had to use a little bottle of water to wash the blood off the strip and pat it dry before you put it in the meter.  Ugh...that thing was a pain.

I am amazed at how hard my mother worked to take care of me and how well she did.

 

11

it has been great reading these! i never realized how easy i had it.

i was diagnosed in '89 as well. we had to fight our insurance company to get a testing meter because they kept telling us it was an "unnecessary treatment" (the same thing happened when i first tried to get a pump 10 years ago, and a CGMS 2 years ago). we had a gigantic meter and finger poker and it took a couple minutes for the numbers to read. i still had to pee in a little cup and check for ketones but it was a little pill and i would use a dropper to drip pee onto the pill and whatever color the pill changed to was how much ketones i had (if any). initially, i was on 2 shots a day: nph & regular. eventually, right before i started pumping, i was on 4 shots a day-2 nph & 2 humalog. i never tried lantus or any other fast-acting insulins. i briefly tried apidra in my insulin pump but switched back to humalog after a couple months. i love pumping and am amazed at all the improvements in technology and diabetes care just within the last 10 years.

12

I was diagnosed in 1977.  The diagnosis routine then was to come back the next morning.  Then they took blood out of my arm to test BS.  Then I drank some sugar water junk they gave me.  Then wait 30 mins and get more blood drawn.  Then wait another 30 mins and more blood drawn.  It was supposed to go on for four hours, but after about two they said, "OK, enough, you got it."  I was then put in the hospital for about a week while they got everything straightened out.  The only way they could test BS was with the blood  out of the arm so they did several times each day while I was in there.  At first I had the urine test tables and test tube stuff.  Then when I got back ove the US I got stips.  I didn't use them very often because I was a rebelious college student!  I took one shot of NPH (40 units per day).  I had a diet to follow but really didn't follow it too close.  Layed off the sugar and tried to keep the carbs in check.  I'd go to the doctor once every 3 months and they'd check my BS and figure out how I was doing from that.  I followed this regimen until about 1990 when I got a tester and started doing R and NPH.  Pretty much what I'm still doing now.  The old regimen was not as good, but it was a heck of a lot easier!

13

I was diagnosed in 1987 so there were home meters available.  The one they told me to buy was the same one they used in the hospital.  I think it was an Ames Glucometer II.  The test strips looked like ketone strips, long with a felt pad at the end.  It required a huge, hanging drop of blood and I know that you had to apply it and wait awhile then blot the blood off.  You then had to press a button on the meter and get the strip into it at a certain point.  The whole process took several minutes - nothing like the 5 second tests now!  You could also just compare the color on the pad to the boxes on the vial of strips, just like urine strips.  The meter I guess gave a more precise estimation. 

I was on 2 injections of NPH + R; N/R in the morning and N only at night.  I was told to eat a specific mix of exchanges for each meal and at what time to eat them.  I was never told to do anything for a high BG.  I had no insurance for years so I took the same doses for 11 years or so!  I remember the endo in the hospital telling me how great the human insulins were, as if that meant anything to me.

14

I was diagnosed in 1970 at the age of seventeen.  Like the others of my T1 generation have already mentioned, I tested my urine for sugar with CliniTest, a tablet which was chemically similar to the Benedict's Solution test Tom described above.  With CliniTest you didn't have to heat the test tube externally because it go hot all by itself once the chemical reaction began.  If you touched the bottom of the test tube you were not likely to forget it and touch it again... it got real hot.  The solution would change colors from "blue" (no sugar in your urine... yay) through "green" to "brown" and to "orange," which pretty much meant 300mg/dL or more (boo....).

Syringes at the time were not made of plastic... they were glass.  The needles were entirely metal and were removable from the syringe.  Everything had to be taken apart, cleaned and sterilized in boiling water (although I do remember eventually being able to use the dishwasher).  The glass syringes were kind of "pretty", they were quite expensive and they would never survive being dropped onto the floor without shattering glass all over the place.  (just what you wanted when you were walking barefoot through the kitchen and had just been told what will happen to your poor diabetic foot if you happen to cut it.  Yikes!)  Oh and I should add that the needles were much thicker and longer than the ones we use today.  Are you wondering if the injections hurt much more then?  Sure did.

I was on one injection of 52 units of NPH per day for the longest time.  The difference between those old days and today was that back then you ate the right amount of food at the right time to accommodate your insulin.  The best way to stay in control was to eat the same meal at the same time every day.  Did it work?  It's hard to tell for sure because we really couldn't test it often enough.  But I'm still here.  However, it was much easier to forget you were a diabetic in those days than it is now.  You took your insulin in the morning along with your other medications and went on with your day.  Simple!

15

diagnosed in '88 only 7 years after his dad died from T1 (he just gave in or gave up...was going down hill and just quit taking injections)  That was his memory of what T1 was.  plus, boiling glass syringes and going to the hospital to test.  I remember when we saw an endo outside the Va for a minute and they put him on Lanuts!!!  we thought it was a miracle...he said " you mean I don't HAVE to eat if i'm not hungry?"  with NPH and regular...you have to keep up with the drug.  Within the year his A1C went from 8+ to 7.8! he hadn't had an A1C below 8 since being diagnosed - 15 years...I dream of a pump for him but we can't afford it and the VA won't provide it...frankly, it may not be a good time for him anyway, but, I can dream...

16

Dx in fall of '77. One shot of NPH pork in the morning and urine test strips.

January 1988 went into a diabetic pregnancy research program in San Diego. Switched to R and N and given a home blood test meter.

January 1996 entered the research program for Humalog at Sansum Clinic and was switched to Humalog and Humalin.

2004 insurance refused to pay for Humalog and I was switched to Novalog, Novlin and Lantus. Quit taking the Lantus after 4 months of lows.

August 2005 moved and lost health insurance so I switched back to Humalog.

17

Well, here's one thing I used to have to do. It involved a test tube and this pill looking thing. You put a urine sample in the test tube and then added the pill. If the specimen turned blue, it was "within range" lol. If the color was something else, well...uh oh...blood sugar out of range!

There were two pills...the second one was, as I recall, a little smaller and changed to various shades of pink, based on whether ketones were present or not and how concentrated they were within the specimen provided.

Then there were these wipe off strips with a color chart on the side of this around-three-inch-tall vial. The lip on the vial was sometimes hard to get off of the top of the bottle, and it popped like a champagne cork. Anyway...you stuck your finger and applied a generous drop of blood to the strip and then waited...and wiped it off...then you compared the color of the strip (it's been a while...I think you waited for some more time before comparing the strip color to the chart).

In the hospital where I was diagnosed, they saved my life, but they were lacking somewhat in care levels...they would take a razor, tourniquet the arm, make an incision, let the blood drip onto a plate which they held underneath the arm, and use that for I suppose blood sugar tests. It was 1981 in France. The care was not the best, but I survived because of it. I was on pork insulin as well. For some reason, I still have some insulin from back then, along with the differently-gauged syringes. I tried to use one of those older syringes with newer insulin......bad, bad idea.

Did you ever use...what was it called...the Monolet? It was this hand-sized...hard to describe...maybe I can sort of "draw" it...

It looked like this:

 

                            0____________________0

                     0----                                            )--0

plunger end  0----                                            )--0 lancet end (there was a large opening, an indentation, where you put your finger

                            0____________________0

 

connect the 0 with vertical lines with the corresponding 0 directly underneath it...anyway...this is a poor illustration, but it was this thing that was about hand sized that you had to push the lancet up into...then you pushed this gigantic plunger on the other end while wincing and holding your finger at the target location.

The autolet, compared to that machine (it made scary sounds as well, sort of a winding, mechanical twisting sound, like a guillotine being cranked up before the blade is let loose) wasn't so bad. I was glad I could actually see the dang lancet.

I love carb counting, too. Sweet Humalog, lovely insulin pump...I still take them for granted, though, and the whole no sleep thing is for the birds. Ah, memories.