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Three Month Pump-aversary!

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The very first thing Gwen emphasised to me last year was that using an insulin pump would not be any easier than Multiple Daily Injections. Boy, oh boy, was she right.


These past three months have been by far the most challenging I have faced since being diagnosed with type 1 diabetes six years ago. I have gone through site failures, occlusions, ketones, frustrations and burnouts that have lasted for several days on end. It has required enormous patience, a commitment to learn, and it has seen me agonise over many a decision. I have been through it all. I have poured my heart onto these pages over the last three months.

There have been a lot of low points that I have talked about quite candidly over the past three months. There have been a few times where I’ve reached breaking point. Times where I have found myself pacing up and down my room, deliberating over whether to rip my pump out and take a break for a couple of days.

But every time I have contemplated removing my pump, I knew that I really didn’t want to say goodbye to that added level of precision. I have never truly felt ready to say that this wasn’t for me.

Stability during the night is miles better compared to injections. I felt that when I was using Lantus, I could never get the dose quite right. I felt that I needed to eat a similar number of carbohydrates each day in order to achieve that smooth coverage I needed during the night. I felt that if I ate more than normal, my basal wouldn’t be enough to keep me stable through the night. Then if I were to skip a meal the next night, my basal would likely send me plummeting at 4am.

For the first time in my life, I have confidence that my basal rate keeps me stable. When I give a correction at 1am, it actually works and sends me back into range by the time I wake in the morning. When I go low during the night, it’s only through my own fault.

I could never seem to get my breakfast insulin dose just quite right. In the months leading up to the pump, I noticed that I would end up frustratingly high after eating virtually the same thing for breakfast each morning. Now my pump delivers extra basal insulin to cover the extra glucose that my liver dumps when I wake up each morning, and my breakfast insulin dose actually does it’s job!

Highs are also so much easier to manage with the pump. I remember stubborn highs that were so resilient they needed multiple insulin corrections that didn’t make any sense. Now with the pump, I know that highs are a little less sensitive to insulin. When my levels soar into the 20s, I can set a temporary basal rate of +200% to get things moving a little more quickly. When i think about it, I don’t think my levels peak above 15mmol half as often as they used to. And when they do, they don’t stay there for too long at all.

On pump day, Gwen reminded me that I was the kind of person who wanted that extra level of precision. I knew that I wanted to be able to customise my insulin delivery to match the hour of the day or a specific activity. I feel that my insulin pump has given me that.

The pump has given me an added focus and drive with my diabetes. I am working my butt off with carbohydrate counting, pre-bolusing and watching my portion sizes (which I could easily do without the pump, too). I guess what I’m trying to say is that my diabetes goals seemed unattainable on injections. With the pump, they do. Hence, the drive to keep up the hard work rather than being lazy.

I’ll hopefully have an a1c result at the end of today. I have a good feeling that it will likely be around the same mark as it was in May, and I’m pretty content with that. Over the years my a1c results have been ridden with too many peaks and troughs, so I’m pretty pleased that those peaks are a little less peak-ey today.

As I reach the three month mark on an insulin pump today, I feel like I can finally focus on some of my other diabetes goals, which feel far more in reach than they ever did on injections.

Thanks for all of your support and encouragement over the last three months. I really couldn’t have done it without you all cheering me on.

More Reasons For The Insulin Pump

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It feels like forever ago that I made the big decision to switch to an insulin pump, and now the big day is only two weeks away.

Over these past couple of months, one of my reasons for making the big switch is becoming much clearer.

I cannot wait to be able to fine tune my insulin to better suit the time of day.

I usually head to bed at around 10pm most nights, which is usually before all of my rapid acting insulin from dinner has worn off. I often find myself needing a good correction dose later on, and I’m not awake to be able to do this. If I’ve eaten something really Low GI like Pasta, it often needs some delayed insulin to cover it. If I’ve eaten something higher in fat or protein, ditto. So most nights, I end up setting 1am or 2am alarms which allow me to test and correct. It’s a lot of work.

Lantus tends to work best when I eat a similar amount of carbohydrates each day. Some nights, 10 units isn’t enough to keep me stable through the night. Some nights, 10 units will send me plummeting to lows. Other nights, my blood sugar will hold nicely until 4am, and then begin to plummet. Ideally, I imagine that my pump would be able to deliver a heavier background insulin rate between say, 10pm and 1am, and then a lighter rate for the rest of the evening.

Part of me is ridden with guilt. I feel like I have failed injections, and that I should have been able to get them right. I question whether I am getting the pump to be more lazy with my diabetes. I feel guilty for demanding an expensive piece of diabetes technology, when other people in the world can’t afford insulin alone. I feel guilty for not having the willpower to follow a regimented diet. I feel like I have a bad diet, simply because I can’t get my blood sugar levels quite right around the food that I eat.

However, none of this could be further from the truth.

I am working hard – extremely hard – with a very demanding condition. A condition that never lets me rest, and is changing all the time. I am striving, constantly, to do better. I know exactly why I am getting an insulin pump, and what I want from it. I haven’t made this decision lightly. I don’t eat exactly the same thing day in and day out. I enjoy variety in my diet, and I don’t apologise for it.

I’m going to try and stop feeling so guilty.

It’s my diabetes, and my choice in the way that I manage it.

Let the final countdown to pump day begin…

An Insulin Logging Adventure

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My meter is a pain in the ass at the moment. Every time I’ve gone to use it over the past couple of weeks, I’m reminded of a promise I’ve failed to keep. A promise to my diabetes educator that I would log my insulin doses into the meter. I flicked past Monday, February 29 in my diary, where I’d reminded myself of that very promise.

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I feel so guilty that I’m not using this new, smarter device to it’s full capability. I feel like I don’t deserve the luxury of having a shinier, fancier looking meter that goes with this decade. I feel like I don’t deserve the smaller test strips that use less of my blood and make less of a mess on my desk.

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I’m slack. I just haven’t been bothered to do such a menial task, when diabetes is already so consuming in itself. It’s a task that seems so worthless when there are so many more important things to do in the grand scheme of diabetes. I’ve also been a bit worried that the numbers won’t live up to Gwen’s expectations.

But I’ve made the decision to switch to an insulin pump. For lack of a better phrase, I’m going to have to own the consequence of that decision. Carb counting. Logging my insulin doses. Sending the meter reports to Gwen, so that we can fine tune things and prepare my insulin ratios for the pump. If I want to maximise the benefits of insulin pump therapy, then this is something I’m going to need to make a habit of. And I need to stop obsessing over the numbers not being “perfect.”

Today marks day 4 of my insulin logging adventure. I’m no longer relying on 3 different meters stashed in lockers, desk drawers and satchels. I’m carrying my Insulinx meter around with me everywhere, which gives me no excuse not to log an insulin dose when I forget! I’m also hoping to be able to send off some data to Gwen before Easter next week (eek!). 

Four days in, and I’m already seeing benefits. I’m thinking more carefully about what I’m bolussing for. When I go to test 2 hours after a meal, I’m reminded of how much insulin is still on board in my system. I can see on the screen how much more of a drop I can expect, which has stopped me from my bad habit of over-correcting and ending up hypo later on.

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Despite being sick, battling stubbornly high BGLs, and being hypo more than two times in one week, I am powering through all of this. When I looked at my lunchtime reading yesterday afternoon, I kind of felt like I was kicking diabetes’ ass!

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Stamp Of Approval

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“You want a pump, don’t you?” Gwen asked me in the hallway outside of her office on Monday afternoon.

“The doctor’s written here in your file that you’ve made up your mind and that you want a pump. Have you picked which one you want?” 

I knew which pump I wanted. It’s not like there was a huge choice to pick from, anyhow. I guess I was just a little surprised at how quickly things were moving. I honestly thought that I would have had to justify to Gwen why I wanted the pump.

“Right, I don’t think I have any of the Animas forms left,” Gwen replied as she hurried off towards Reception to retrieve paperwork for the Animas Vibe insulin pump that I’d picked.

We sat down in her office, where I was met with a stack of paperwork. We completed the order form for the pump itself. We completed forms to be sent off to my health insurer, who would be covering the cost of my pump. We completed forms to be signed off by the endo. We completed forms to be sent off to the NDSS, in order for me to be eligible to purchase subsidised pump consumables. We talked through order forms for the consumables that I will need to purchase prior to pump day. And we completed content forms so that everybody has permission to liaise with everybody throughout this whole loooonnnnnng process.

Gwen grabbed her diary from reception, flicking through pages in search of a block of free days for pump fitting. We eventually settled on a Monday and Tuesday in mid May, where I would be hooked up and trained under the supervision of both Gwen and a representative from Animas.

Gwen has been a significant part of my diabetes journey since the day I first walked into her office nearly six years ago. She’s been the one of the few constants I’ve had among an array of rotating diabetes healthcare professionals. I felt as though I owed her an explanation as to where my decision had come from. I felt like I needed to explain to her why I was abandoning the method of injections that she had taught me to do. In some way, I felt as though I needed her stamp of approval in order to move forward with this scary new way of managing my diabetes. 

But the words were struggling to escape from my mouth. I was overwhelmed.

“You don’t need to explain it to me,” Gwen said.

“I do. I never made this decision lightly. That’s why I didn’t decide straight away back in November. But injections are a lot of work. I don’t do the same things every day. I don’t eat the same meals every day. I don’t live that regimented lifestyle that seems to produce those good results. I feel like I owe it to myself to give the pump a go. My hba1c has been fluctuating within the range of a point over these last few years, and I’m aiming for it to be more stable and at the lower end of that range.”

But no matter how many words I managed to string together that day, I realised that this wasn’t Gwen’s decision to make. It was mine. It was a decision that I made for my own diabetes, and my own life. It was a decision that I will have to own. Right now, it’s a decision I’m damn well proud of.

Gwen totally respected that this was my own choice to make, and she never once tried to sway me either way. But it was still nice to feel a stamp of approval in her final words.

“I think you’ll enjoy pumping. I think it will give you the edge that you’re looking for.”

Three Hypos in One Night

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It was a cool, breezy Summer evening. That perfect kind of early Summer weather that never seems to last long enough.

We’d had a barbecue lunch that day. Steak, sausages, eggs, onion, salad and cherries. The kind of lunch that left me feeling like it was Christmas Day – stuffed, sleepy and happy.

I wasn’t particularly hungry by dinner time. I wanted to make sure that my blood sugar levels had stabilised before bedtime after that barbecue, and I didn’t want to spoil my appetite for breakfast the next morning. I had some leftover salad and cherries, and gave myself a small correction dose.

14 units of Lantus is what had been keeping me stable those past few nights. 14 units. I figured with that big barbecue lunch, 14 units would do the trick once again.

I sat down outside with my laptop after dinner, catching up on some of my dBlog reading. I started browsing for Christmas gift ideas a little later on, but somehow ended up comparing prices of items on my own Christmas want list.

My blood sugar levels were looking good during the course of that night, clocking in at 7.1 and 6.2. I had the best of intentions to settle in for an early night before the start of another working week. Little did I know, however, that my diabetes had other intentions.

I was 3.8 at 9.18pm. I figured that the majority of my rapid acting insulin had worn off. I thought 3 marshmallows would do the trick, but I gave 4 just to be safe. 20g of carbs, because I was about to go to sleep. I laid in bed, surfing on my phone for a while longer, until it was nearing 10pm. I was a perfect 7.6, but I was convinced that I’d given myself too much for that hypo. I set the alarm for midnight, ready to catch a rebound high in it’s tracks.

That was hypo number one.

I woke up a while later, and my pyjama pants were sticking to the sweat on my thighs. I knew that I didn’t need to test, but I needed to know how low I was. 3.2. I reached for the bag of Marshmallows beside my bed, carefully counting them out in my hand so my hypo induced brain wouldn’t forget how many I’d eaten. One, two, three, four, five. I shoved the 25g of carbs into my mouth and rested my head back on the pillow, feeling instant relief.

I finally noticed that it was 11.53pm, and switched off the midnight alarm on my phone. By this point, I figured that I’d given myself more Lantus than I needed. By this point, I knew that there wouldn’t be any rebound highs to catch that night. By this point, I realised that these hypos were a consequence of skipping dinner. I switched out the light, and went to sleep.

That was hypo number two.

By 4.30am, I was startled awake by my favourite sound in the world. I felt shaky once again. I wasn’t sure if it was another hypo, or if I didn’t have enough blankets on the bed. My meter confirmed that it was the former, clocking in at a very hypo 3.4.

I shuffled into the kitchen, my mouth tasting of dry sugar, and prepared myself the most refreshing thing I could think of. A bowl of Weet Bix, a sliced banana and lots of cold milk.

As I sat there relishing the cold, refreshing milk on my dry throat, I thought about what a great start to a Monday morning it had been.

That was hypo number three.