SHANE WITH DIABETES
Shane is a 20 year old young man, sleeping rough since a relationship breakdown 18 months ago. Diagnosed with Type I Diabetes 3 months ago. After a 3 day admission to hospital, Shane is discharged with some education that is not really clear to him, 2 different types of Insulin to administer, a glucometre with limited test strips and a follow up appointment for 1 week.
Being homeless he has no fridge to keep his Insulin in; a diet that is limited to Soup Vans and drop in centres; often high in sugar and carbohydrates; and a diagnosis that is extremely difficult to come to terms with for any young person. When we met Shane he was fortunate enough to be staying at Tom Fisher House for 2 nights. He had run out of one of his insulin’s, had no test strips and very little knowledge of his disease – and no intention of doing anything about his situation, it all appeared too daunting. His blood sugar level (BSL) was 30 (normal range 4-6). We were able to provide immediate education, in small doses, set up an appointment for the next morning at the RUAH centre where Shane was given scripts for Insulin, strips and introduced to the Street to Home (S2H) programme co-ordinator.
We see Shane on a weekly basis now and as of last week he has been put into Foundation Housing in Fremantle.
YOUNG MAN WITH DIABETES
Another young man with newly diagnosed Diabetes, new to Perth from Geraldton, was seen at the soup van at Supreme Court Garden’s, he had had all his belongings stolen – including his Insulin, glucometre and wallet. He was not aware of any services and did not know where to start. His BSL was 27. We set up an appointment with Homeless Healthcare for an hour, were able to provide him with a glucometre and scripts and made an appointment for him to see someone from the Street to Home program that afternoon.
30 YEAR OLD WOMAN
Aruha is a 30 year old Maori woman who has been in Australia for 6 years, mostly in Darwin. She has been in Perth for 6 months, sleeping rough. She was first seen at the soup van and was reluctant to engage for a couple of visits. She asked one morning to have her BP checked and stated that it was high, she appears healthy and energetic. Her BP was 210/110 (normal 120/80). After checking it several times over a period of about 2 weeks and much encouragement, she agreed to visit the Tranby drop-in centre and see our service.
We now see Aruha weekly, she is on medication, has had further investigations to check kidney involvement and hopefully has prevented or reduced permanent damage to her kidneys. She has appointments made with Royal Perth Hospital renal clinic.
An elderly Aboriginal man walked away from the soup van, he had no shoes and a very dirty bandage on his left foot. We asked if he would like his bandage changed, he agreed. This delightful man, Ian, was in Perth from Cotton Creek for a funeral. He had stepped on glass and had it removed and sutured 2 weeks prior. It was difficult to get a lot of information from Ian as his English was limited (he speaks 6 aboriginal languages) and he was very shy. On examination his foot was in a terrible state, the odour was putrid, skin had broken down and ulcerated, the sutures were still in situ but had torn open.
Ian is a Diabetic, he has neuropathy to his feet (no sensation) and very poor blood supply. He also just wants to go back to Cotton Creek so his foot was very low on his priority. After cutting dressings off Ian’s foot, removing sutures and dressing the foot as best we could we supplied him with clean socks (donated by Rotary) and he was given a pair of thongs by the soup van staff. An appointment was set up with Homeless Healthcare for further treatment at the Ruah centre immediately. The Crossroads Outreach workers were also in attendance at the soup van and they transported Ian to Ruah.
He was seen by a doctor, linked up with a case worker to help with accommodation or transport back to Cotton Creek. This man was definitely at risk of losing his foot and may still be, but he would not have presented at Royal Perth Hospital for fear of being admitted.