Month: December 2015

Revisiting Gwen

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I know that the decision to switch to an insulin pump is not something that I should take lightly. I’ve been deliberating the matter for a while. I wrote about it earlier this week here. I also recently went to see my diabetes educator, Gwen, for some advice.

Gwen is a truly amazing person. You can read about just how amazing she is right here. Gwen’s stated goal was to arm me with the knowledge and skills to manage my diabetes, so that her position as my educator would eventually become redundant. And it sure did. The last time I had a session with Gwen was back in 2010, towards the end of my first year living with diabetes.

I knew that Gwen was always available to me outside of appointments if need be. I had her phone number, e-mail address, and I can even remember her squeezing me in once during her lunch break when I was anxious about too many hypos. I can remember giving Gwen a box of chocolates on the first Christmas after my diagnosis, because she had just been so wonderful during that first year of diabetes. I’ve seen her a few times in passing at the clinic when I go to see my endocrinologist. However, since transitioning from the ‘young adult’ to ‘adult’ diabetes clinic, I’ve seen her less frequently.

I was extremely nervous to go back and see Gwen a few weeks ago, after such a long time. In the car on the way there, I was reciting over and over in my head what I would say to her. Would she take what I needed to say seriously? Would she be supportive of insulin pump therapy? Would I talk to her about my blog, and my involvement in the Diabetes Online Community this year? Would she even remember me?

But walking into her office that day, my nerves were instantly settled. As she began reviewing our last session five years ago, she was so thorough. As she talked through the results of my last endo appointment and hba1c result, she was so familiar and so well prepared for me. As her patient, it felt as though that last session five years ago could have taken place just yesterday.

So, Gwen’s verdict on pumping, in a nutshell?

A pump is a big commitment.

Pumping is not any “easier” than Multiple Daily Injections.

However, a pump can give me more “flexibility.” A pump delivers insulin constantly in order to regulate glucose levels, as opposed to injections which are given at set times of the day. The rate at which a pump delivers insulin can be adjusted throughout the day to factor in activities such as work, physical activity and sleep. The units of insulin delivery on pumps are so precise that you can bolus for something as small as the milk in your coffee!

There are also a few requirements for pumping in Australia.

First up, I must have an appropriate level of Private Health Insurance for a period of at least 12 months, in order for the cost of a pump to be covered. Big tick there.

Second up, I need to show that I qualify for a pump. Translation: I have type 1 diabetes and I’m a good student who will show up to my education sessions. Big tick there.

Third up, a pre education session with Gwen (big tick there), where paperwork is completed and passed onto my endo for sign off (not quite there, yet).

Finally, pump fitting day followed by 3-4 daily sessions with Gwen in order to fine tune the pump. Sadly, there’s a 3 month waiting list at my diabetes clinic for this.

I’m really glad that I did go and get another perspective from Gwen that day. Gwen was plain thorough. She discussed the matter with the seriousness that it deserved, without trying to sway my decision either way.

So, as the session came to an end, I sensibly decided that I would go home and think about it, and come back in the New Year for another check in. Class dismissed!

Type One: Breaking Misconceptions With Humour

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I don’t do Wordless Wednesdays, because I feel like I’m ripping you off of a blog post.

However, I feel that today’s entrant is a very worthy contender.

Landis got in touch with me last week and shared her web series, Type One with me. I enjoyed it so much that I felt compelled to share it here today.

Type One is about a young man, Matt, who has type 1 diabetes and is looking for love. Landis and her co-creator, Mike, both have personal connections to type 1 diabetes in their lives. Their web series uses comedy to break the common diabetes misconceptions and stereotypes, and if the first episode is anything to go by, they’ve done a smashing job.

It’s only an eight minute episode, and it’s well worth a watch. Look out for the part where Matt so casually pulls out his meter and insulin pen on a first date – I was hysterical.

Landis and Mike are hoping to raise enough money to film seven more episodes. You can check out their fundraising page here, which also features a Q and A with Landis and Mike.

To Pump, Or Not To Pump?

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A few weeks ago, I went to an insulin pump information evening. And I must say that I was quite keen on the idea after that night despite the politics of it all, which you can read about here. The promise of better control, long term health, insulin dose calculator, ease of insulin delivery and the statement that “very few people give these back to me and say that they don’t like it.”

But I’m not naive. I know that a pump is a big decision. I know that a pump is a big commitment. I don’t want to get a pump just for the sake of getting one, and then end up in no better of a situation with my diabetes management. I don’t want to get a pump with the mindset of being able to slack off and get lazy with diabetes. And it might not necessarily solve all of my problems. I’ve been talking about it at home, talking with friends in the Diabetes Online Community, and deliberating over the matter in my head for weeks.

My biggest struggle is achieving stable numbers consistently. There will be weeks where I seem to do it at ease. And then there are weeks where the numbers suffer, due to changes in my level of activity and the level of food that I eat. I seem to be adjusting my insulin doses every second day to get the balance right in the background. Lantus Adjustment Struggles are real. And they drive me crazy. There are times where my Lantus dose is more than enough, and other times where it’s just not enough. My hba1c level has been hovering around the borderline of “acceptable” for quite some time, but I’d really like to get it down further for the sake of my long term health.

In some ways, I feel that a pump could potentially offer that to me. I’ve heard nothing but good things about pumps from friends in the #DOC. But I also expect that the pump will be a big learning curve. It will be a lot of work. And I’m expecting a lot of frustrations in the beginning, at least. I’m concerned that a pump might make things more complicated. Potentially having control over more variables, such as basal insulin could do my head in. And, will a pump actually make my job as the operator of a broken pancreas easier? Or is it essentially a different way of doing the same thing?

At the moment, I do feel quite “free” with my Multiple Daily Injections. I take my insulin injections whenever I eat, and in the meantime my Lantus dose keeps me (relatively) stable for a whole 24 hours. I like the fact that if something were to happen and I couldn’t access my insulin, my blood glucose levels would be fine for a whole day.

I am a bit scared of being reliant on technology to keep me going. Relying on one, continuous source of insulin to keep me stable is scary. If that one source of insulin was suddenly cut off, or if my pump suddenly stopped working during the night, I could go into a state of diabetic ketoacidosis within hours. And I absolutely hate carrying junk in my pockets. An insulin pump would only add to that problem, as lame an excuse as it sounds!

A pump would certainly be more convenient, though. These 13 Truths About Insulin Injections would be no more. I would be able to administer my insulin at the touch of a button, rather than often waiting until the dinner table conversation has ended. The carb calculating function on the pumps look awesome. And, I wouldn’t necessarily be stuck with the pump. I could get it, learn how to use it, and then I would always have it as an option.

So, to bring this jumble of thoughts from my head to a close, I haven’t made up my mind about an insulin pump yet. I’m still thinking, I’m still researching, and I’m still talking about it.

Affected by diabetes? Join the Oz Diabetes Online Community for our weekly chat Tonight from 8.30pm AEDT (GMT+11) by following the #OzDOC hashtag on Twitter.