Diabetes education programme

I attended a group education programme conducted by the Australian Diabetes council.  The program ran for four successive Tuesday mornings starting from 3rd July 2012. There were eight sessions in all and the sessions were conducted by a diabetes educator, an exercise physiologist and a dietician.  The sessions were on: education regarding type 2 diabetes, importance and types of physical activity with both theory and hands-on session, and diet and nutrition guidelines for persons with type 2 diabetes.

Type 2 cases are those where the insulin making capacity of pancreas is not totally impaired. So these cases are normally treated with tablets where the pancreas is stimulated to produce enough insulin through tablets like diamicron (Gliclazide) or the body made to act more sensitive to insulin through tablets like Diabex (Metformin) or by a combination of both types of tablets.  In certain extreme cases insulin may have to be administered daily either by injection or by insulin pump.  At present type 2 diabetes is not curable, after onset, but its progression and onset of complications can be arrested by adopting a healthy life style and a good management programme.  So physical activity and healthy eating along with periodic monitoring of blood glucose levels, become as much important as taking medicines regularly.

Physical activity helps the absorption of insulin that can lower the blood glucose levels.  Secondly it can lower the blood pressure and cholesterol levels, keeping the heart and blood vessels healthy, reducing the risk of diabetes complications.  One of the important exercise programme demonstrated and taught in this session was the resistance exercises using thera-band. Thera-band is a natural resistance band made from rubber latex.  The bands come at various resistance levels, from very light to heaviest, indicated by the colour of the band (see picture).  Resistance exercise is a form of exercise that requires the muscles to move against a force such as weight or gravity. This helps by increasing basal metabolic rate i.e. the rate at which our body burns calories/kilojoules (1 calorie=4.184 kilojoules), improves joint function, increases bone density and reduces the risk of falls. This type of exercises can be supplemented by aerobic activities like walking, swimming, cycling or dancing etc.

Healthy eating along with regular physical activity can help to manage the blood glucose levels, reduce fats in blood like cholesterol and manage body weight. A healthy food is one with less fat, especially saturated fat, and has high fibre, carbohydrate and is not of a large size.  A regular routine of medium sized meals and small snacks spread evenly over the day is better than a routine of heavy meals at fixed times or any time of the day.

Goal setting and monitoring form part of a good management programme.  The goal should be a smart goal i.e., specific, measurable, achievable, realistic, with a timeline. Monitoring includes not only self-watch of blood glucose levels  regularly but also annual examination of feet, eyes and gums, as these are served by capillaries which can be affected by long term diabetes.  

As part of the programme, various food choices and the importance of label reading in selecting shelf-foods was also discussed. One other important factor stressed is the care to be taken on sick days. More water is to be taken to prevent dehydration and also close monitoring of blood glucose levels is to be done to see one does not slip into hypo or hyper state.  General guidelines as to dos and don’ts if this occurs was also discussed.  Handouts on various topics discussed and also a list of accredited exercise physiologists and accredited practicing dieticians in Sydney was given. It was quite a useful programme that came to a close with a Q & A session. (picture from – Therabands, Australia)

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Pacific Pearl Cruise

This is the story of our cruise by P&O ship Pacific Pearl.  The cruise was called Pacific Escapade and carried a cruise no. P222.  The cruise was for eight nights, leaving Sydney at 4 p.m. on Saturday, 23^rd of June 2012 and covered visits to the islands of New Caledonia; Noumea, Mare island and Isle of Pines. The ship has 14 decks, of which 11 are passenger decks.  Deck 12 is a leisure deck with bars, grills, Restaurant, swimming pools and open area with a giant screen overlooking the open area with lot of recliners. In Deck 14 there is a walking cum jogging track and a closed area called Dome where classes on Yoga, Pilates and stretch exercises were held in the morning and quiz sessions and workshops were held later in the day and late night parties after 10 p.m.  In the passenger decks along with rooms are a gym, a casino, shops, bars, a library, closed theatre, an open entertainment area, tour desk, reception desk, internet cafe, and a medical centre. Ours was cabin no.182 in deck 10. This was on the port side with a window giving sea-view, besides the usual shower, toilet, wardrobe, T V, telephone, fridge facilities. In deck 10, there was a laundrette midship and an open deck with recliners, on the rear side. The ship has a passenger capacity of 1817 and it was full, with more than 300 children.  The ship has crew strength of 727, of whom there were quite a number of people from India, mainly Mumbai with a few from Tamilnadu, Kerala and Pondicherry.

On day 1 we first explored our room and our deck, participated in the passenger safety drill and then went to the open deck to watch Sydney shore drift by as the ship leaves the port.  The skyline of Sydney from the 14^th deck of the ship was a memorable sight.  As the ship sailed under Harbour Bridge with its flag mast almost touching the underbelly of the bridge, the ship sounded a siren and we stood mesmerized by the magic of the moment. Opera House, the other icon of Sydney presented a grand sight, with the backdrop of Centrepoint towering over other CBD towers, as the ship sailed slowly past it.  The Cockatoo islands and Fort Denison and the promontory all were scenic superlatives as we drifted out to touch the open sea.  Equally thrilling and wonderful was the sight of Sydney shoreline in the early dawn of 1^st July as we drifted in for landing.  On both occasions we were fortunate to be blessed with good weather which made all the sights watchable and enjoyable from the open deck. 

That night we had our dinner at the waterfront restaurant in the 7^th deck, where we had met earlier the supervisor Edison, who is from Mumbai and he had arranged for serving of rice along with a vegetable dish for dinner, along with the usual menu, for all the nights of our stay. Further as it was a restaurant where there was only table service, he was good enough to reserve a table for the night.  As reservation is necessary for dinner, we made reservations for next night, as we left after dinner.  In the restaurant we met a waiter, Charles from Mumbai, who took special care to recommend other vegetarian dishes and also relay to cook our suggestions for improvement in the special dishes served to us. He was a quite a character with a fund of brain twisters, with which he kept his tables quite regaled.  He also took care to see we were seated in one of his tables. Other interesting, helpful people from the crew we met on the cruise were Veeraraghavan, called Veera from Pondicherry, Ramasubbu, called Rama, from Cuddalore, Samuel, supervisor from Indonesia who is a Bollywood fan, Jacintha, receptionist from Mumbai who is married to Anup Nair from Kerala, a steward in our deck. The photos of the ship and the Sydney shoreline sights and some of the activities we witnessed, 75 in no., can be seen as a slideshow from the Flickr set, Pacific Pearl - Ship and activities:                                                          http://www.flickr.com/photos/sam-sekar/sets/72157630411107298/

On day 2 & 3, the ship was at sea sailing to New Caledonia. Day 2, i.e.,24^th June was a beautiful day with a nice warm weather.  We went for a walk on the open deck in the morning and had our breakfast in the plantation restaurant in Deck12, where continental breakfast is available from 6 am and full breakfast from 7 am and coffee and tea all the time from machines.  In full breakfast we had a wide range of choices in cereals, fruits, croissants, juices, toasts besides pancakes and hash browns on some days. We had our lunch also there on the last few days there as we could get rice, yoghurt and salad sandwich besides the usual fruits, cakes, soup, pasta and bread, thanks to the assistant food manager there. Also we could get from the grill in that deck cheeseburger without the steak. After a leisurely heavy breakfast, we curled up on the recliners under the open sky, watching a film on the giant screen, basking in the mild sunshine.  Lunch and dinner were at the Waterfront restaurant where they gave us channa with rice for lunch, and mixed vegetables with rice for dinner, besides the usual soup, Yoghurt, papad and pakoda. This evening we witnessed the Laser show in the atrium in deck5.

On day 3 i.e., 25^th June, the weather turned very windy and the open deck was closed and was not available for walking and jogging.  As there were also intermittent showers, the open deck was almost empty, with the recliners in the open area folded. This day I opened an internet account in the internet café and browsed my mail and sent home a mail. Though there were activities like Facebook get together, team trivia and fitness seminar we did not participate in any, but enjoyed reading the Junior Vikatans, Kumudams, we had accumulated for the trip. One other book we read  was “Tamil in Tamil cinema” by Sivakumar and also some short stories from “Selected stories of Sujatha”.  Evening we watched the circus show in the atrium by Pacific Cirque.
Day 4 i.e. 26^th June was our first shore-stop.  This was at Noumea, the administrative centre of New Caledonia, a French foreign territory of France with an independent governing body, where France has representatives. The language spoken was French and Kanak dialect, and English is scarcely understood locally. We went on a tour of the islands in a shore tour called “Noumea in a nutshell”.  The tour was in the afternoon and was for three hours.  We went ashore after lunch and made a small tour of a supermarket and transit hall souvenir shops before joining the tour. The tour crisscrossed the city and took us around the island showcasing the bay and the beaches. We returned to the ship before 5 pm.  As we disembark, our identity cards are scanned through computer and an identity check performed. On embarking back, an identity check as well as a security check of persons and any bags they carry is done. The card scanning also helps them to keep count of the people leaving and coming back and verifying that all have returned.  The ship left for next island after ensuring all have returned. This evening we watched in the Marquee in deck7, a musical show by Pacific Entertainers and Pacific Cirque titled     “Pirates II- The Mutiny”.  The photos taken in and of the island of Noumea,      42 in no., can be seen as slideshow from the Flickr set, Noumea:                                                                        http://www.flickr.com/photos/sam-sekar/sets/72157630399613496/

On day 5 i.e. 26^th June, the ship anchored off the waters of Mare island.  We were transferred to the shore through tenders. The island is small, but it has beautiful beaches with crystal clear wave free waters, ideal for swimming and snorkeling.  We did neither but chose to go to a remote beach, Yejele beach, by a shuttle bus, thereby getting to go round the island.  In the beach we just strolled on the seaside, wetting our feet and taking in the pure white sand and sparkling crystal clear waters and watching others swimming, snorkeling and sun-bathing. After two hours of strolling we returned back to the ship in time for lunch. That night we witnessed an open air acrobatic show “Glow” in the deck12. The photos taken in and of the Mare Island, 37 in no., can be seen as slideshow from the Flickr set, Mare island:                                                                                           http://www.flickr.com/photos/sam-sekar/sets/72157630399035262/

On day 6, i.e. 27^th June, the ship anchored off the waters of the Isle of Pines. The weather which had been fine the previous two days was not that good this day.  The sea was a bit choppy and we could get in the tenders only with the crew lending a helping hand. There had been showers overnight in the island and even in the morning there was slight drizzle. Luckily we had booked the 11.10 am tour.  So we took the tender a bit late and by that time rain has stopped, though the sky was overcast.  The tender also moved slowly, with caution.  But there were no rains while we were ashore. Here also we took a tour, “Island discovery”, which took us around the island.  The local scenery reminded me of Kerala with its lush greenery, but the island was thinly populated, unlike Kerala.  Because of the overnight rains, the Grotto of Queen Hortense was flooded and so was closed to tourists.  Mostly Melanesian islanders are seen here as in Mare island.  For the adventurous here also there were other tours like snorkeling, boating adventure etc.  That night we went to the musical show “Centre Stage” in Marquee in deck 7, but didn’t sit through it fully.  The photos taken in and of the Isle of Pines, 23 in no., can be seen as slideshow from the Flickr set, Isle of Pines:                                                             http://www.flickr.com/photos/sam-sekar/sets/72157630384471030/

Day 7&8, were days of return journey from the islands. These days we spent leisurely, lazily, playing Bingo, walking around the open decks, sipping coffee and juice watching sea go by, exchanging pleasantries with the staff and acquaintances, touring the kitchen, watching culinary demo, besides watching shows in atrium and Marquee.
On day 9, i.e. 1^st July, we got up early and as the dawn broke out, we were in the open deck drinking in the sights of Sydney shore line. By 9 am we disembarked with the happy memories of the most enjoyable days spent on the cruise.  All the photos of the cruise together as a single slideshow can be seen from the Flickr set, Pacific Pearl Cruise:                                                                         http://www.flickr.com/photos/sam-sekar/sets/72157630380283938/