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This Blog used to be about the question: What is Science?
Now, it asks: What is Happiness?

Wednesday, July 23, 2008

But what are the Units?!

Wednesday 23rd July 2008

I am well back in Durban, en route to Nairobi, but will probably only be heading out of town towards the month end.
I am sitting looking at the images from the week in Cape Town and smiling every time the 'Green Lady' pops up. She is a stately 1966 Mercedes Benz loaned to my by my dear friend, Holger Wellmann....Thanks for the loan of 'her majesty'. She behaved exactly as you described, from the occasional cutting out when cold to the very dubious sounding thuds from under the car when taking off...normally before she was up to cruising temperature. But once on the open road, she came into her own and only the mountains and work load prevented me thundering off Northwards with her gleaming chrome outshining anything else on the road. On several occasions, otherwise mean-looking Cape Flats taximen would open their window and beam at me, saying, 'Madala! Madala!'

Also thanks for the update on the mechanics of diabetes. I came back to a typical first/third world interface with a frantic sms at 5h30 in the morning, last Monday. 'Mr buggie, is Mzala. Gogo she is very sick'.

So off I shot into the night to Inanda to find Gogo somewhat unconscious but breathing. Sadly the local clinic had not been able to provide test strips for the glucometer so we were unable to assess the relevant levels and instead took the trusted McCords option. This meant wrapping her up in a blanket and loading her in the back of Ida's SUV.
After a spoon of sugar or two Gogo woke up in the resus room at McCords. Her Blood glucose level at 2.1.
A slightly confuzzled doctor went thru the maze of notes and histories and was particularly confused by the last script from the local Inanda clinic prescribing 60mg of Insulin. Strange, because up till then the dose had been 6 units.
At this point I decided to find out more about the units and standards around insulin. It was clear that somehow Gogo was getting too high a nocturnal dose.
Gogo back at home with suitably raised sugar levels, I checked up on the injection procedures and watched as the caregiver (grandson, Mzala Julayi) carefully measured out 60 units. Quite understandable as the U100 syringe he was given by the state was marked in 2 different units. On one side, 00 to 100 and on the other .1 to 1.0. He had simply been given the equipment with no training and presumed that the .6 (ml) was 6 units.
He had changed from a pen to the syringe when they moved from McCords to the state system, but no solid info was provided to get him going.
I am now measuring Gogo's fasting level in mml/l in the morning and giving her 6 units of insulin at night. She also has a 1g dose of Metformin. Sofar we have seen the following results.
21st July - 21h00 (after supper) : 11.2mml/l
22nd July - 07h00 (fasting): 4.2ml/l
22nd July - 21h00 (2 to 3 hrs after supper): 14.4mml/l
23rd July - 08h00 (fasting): 5.4mml/l

I will continue to monitor the process till the weekend and then it is over to the family again. Even this is fascinating. The 37 yr old grandson who is the most reliable family member comes around every night at 21h00 to give Gogo her medicine. However, he is training up the 10 yr old great grandson, Siya, who, despite his lack of years is clearly a bright young fellow. I have attached some images I took last night.
The sadness of course is that during the day when everyone is out working or jolling, often Gogo is left under young Siya's care, who then has to abandon school to be there for her.

Tonight, I will film the process...seems like some good Ubuntu in action!

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