Getting Used to an Insulin Pump

Archive for the ‘Type 1 Diabetes’ Category

The … Diabetic

The ... Diabetic

The … Diabetic

I received an e-mail the other day relating to playing volleyball with an insulin pump and thought that the questions and my answers may be relevant, not only to volleyball but to a lot of other sports and activities.

I asked the nice young lady if she’d mind me using it for a blog post and she said that was okay as long as I used her pen name which is The … Diabetic, She writes her own blog (click on that link to get to it). I’ve also changed her e-mail address for the one she requested so feel free to contact her if anything on her pages floats your boat.

Date: Tue, 5 Feb 2013 14:43:08 -0800
From: the_3dots_diabetic@yahoo.com
Subject: Insulin Pumps and Volleyball
To: NottsType1@hotmail.co.uk

Hi Dan,

I came across your blog when doing some research on insulin pumps and playing volleyball. I’m quite interested in getting an insulin pump, but am only at the start of my investigations. I have an appointment with a Pump Doctor at my local clinic in a few weeks time, so I’m trying to do some homework beforehand and be prepared at the appointment!

I’m quite a keen volleyball player. I train 2 hours on 3 nights each week, I help coach juniors for 1 hour on one of these nights (before training), and play matches on a Saturday. Depending on the match schedule, I sometimes play on a fourth night in the week too.  I guess my main worry is how well infusion sets stay in place when jumping, blocking, hitting and diving, as well as how easy it is to avoid a pump getting damaged whilst throwing myself around court.  Would you be able to give me a bit of insight? Do you disconnect your pump? Have you had problems with air getting into sets or sets coming dislodged? From your blog, I gather you’re using a Roche Spirit Combo – has it been a positive experience? Where do you put it when on court? Finally, did you have to ask permission from the referees commision to play with a pump at matches?

Apologies about the million questions, there aren’t many testimonies out there of people playing volleyball with their pumps, and providing details on how they manage, so any extra insights would be much welcomed.

Kind regards,
The … Diabetic

My Response:

From: Type 1 Diabetic <nottstype1@hotmail.co.uk>
To: The … Diabetic <the_3dots_diabetic@yahoo.com>
Sent: Wednesday, 6 February 2013, 16:34
Subject: RE: Insulin Pumps and Volleyball

Alright The … Diabetic,

I’ve actually quit volleyball temporarily for a number of reason’s, none of which, I’m sure you’ll be pleased to hear, are to do with the pump!

So to answer your questions as best as I can:

1. My infusion set always stayed in fine while playing, I chose the Accu-Chek TenderLink when I started off pump therapy but have changed to the FlexLink, both of these have a flexible cannula but the TenderLink goes in at an angle which I thought would protect it better from bumps while playing, however I am on the thin side (about five foot eight (1.72m) and 10 and a half stone (65kilos)) and I found after a bit of use my stomach looked like a pincushion. The FlexLink ones are, in my opinion, if anything a little hardier and come with the added bonus of the Link Assist Insertion Device which works like a kind of staple gun to get it in to you (honestly, better than it sounds!!!). If you have a preference for which side you dive on it might be worth considering that when placing infusion sets but with the amount you play your probably better just to stick it in and see how it goes. Certainly reaching up for blocks and the force of hits seemed to have no effect on the set staying put!

2. I have a neoprene pouch with a loop to feed the velcro elastic strap that came with it through, not sexy but worked for me, however you sound like you play pretty intensely so it might be worth you looking at the hard case along with sports belts here. I wore my pump on my back turned so it ran vertically up my spine, more or less, so there was little chance of me falling on it, kept it on the whole time and didn’t have any problems with bits falling off or coming loose.

3. Keep it plugged in pretty much all the time, only time it comes off is when I shower or swim.

4. Never had problems with air getting in, they are pretty well sealed units, although when I got it I was warned that I should keep checking the tightness of where the pump connects to the cannula and I now do that pretty much as standard without even thinking about it.

5. The Accu-Chek Combo has been brilliant for me, although I suspect that there are probably better pumps out there already, I’ve had it nearly two years now after all. This site is pretty good for the latest info, but as above it’s probably worth checking what accessories you can get when trying to make a decision, it might also be influenced by your healthcare team but frankly I have a lot of friends on various pumps and no one has been disappointed!

6. Never even thought to ask the referees, although I did check with my coach as well as my Diabetes consultant, whether they thought I needed to consider taking any action other than what I had already decided (e.g. wearing it strapped on and on my back while playing) and they both said it should be fine.

If there is anything else I can help you with, Volleyball related or otherwise please drop me a line, I’m always happy to help.

By the way is it okay if I use your e-mail and my response in a blog post? I suspect this information would be useful to a lot of people!

Cheers

Dan

Web-Monkey
Nottingham Type 1 Diabetes Group
I’m Gonna Stick You!!!

Hope you all find that useful!

Let’s Have A Party!

Xmas Pump

Xmas Pump

You might have noticed it’s getting a little close to the Crimbleton holiday period, which is nice, a week or two off work and food, drink, presents and family time for most of us. With this in mind I thought I’d just give a quick update on a few things.

  1. Don’t forget it’s the NottsType1 Xmas do at Fat Cat’s in the city centre this coming Saturday (the 15th of December). If you happen to be the sort of person who uses Facebook then you can tell us you’re coming here. If not just roll up and start imbibing. There will be the customary blood tests at ten o’clock, highest BG wins, plus we’ll probably have some kind of long drawn out discussion about the merits of drinking and bolusing.
  2. If you went along you’ll know this already but last weekend was the inaugural-probably-to-be-Annual NottsType1 Quiz Night at the The Willow Tree Pub in West Bridgford. According to those who attended the night was a roaring success. Personally I think it may have been some kind of set up as Sam won and she doesn’t even live in Nottingham, however the night managed to raise us £158.00 which isn’t bad and may go some way to allowing us to continue to hold our meetings and events and frankly do the stuff we would like to do.
  3. Web-Monkey attended a pump clinic yesterday, not as much fun as it sounds! The topic was festive eating and it mainly consisted of lots of Type 1’s guessing how much carbohydrate was in Christmassy fare like mince pies, etc. A useful exercise and handy because it meant Web-Monkey could invite all those people to Saturday’s knees up too so we might just get some unfamiliar faces turning up.
  4. The first “Travels with my pancreas” story has been submitted to Alex, if you have no idea what I’m talking about it was suggested some while ago that the NottsType1 group produce some kind of publication on holidaying in far flung places with Diabetes, without giving too much away the tale is called “How I Met Your Mother” and is about five thousand words long. If any of you are interested in doing something like this and becoming a famous writer, published author, target of others’ derision then get in contact with us and get writing,
  5. In case I’m too lazy to write anything else before the 25th, have a Happy Christmas.

See you all on Saturday.

Toothbrush, Boots and a Memory Man

Boots The Chemist...and whatever else they do these days!

Boots The Chemist…and whatever else they do these days!

When I have a shower in the morning I tend to leave my insulin pump in my dressing gown pocket and then plug myself back in as soon as I’m dry and have something to clip it on to again. You may wonder why I’m telling you this, don’t worry hopefully it’ll become more obvious as the events of today unfold!

I was busy doing some important stuff at work this morning and I’d not bothered making any lunch as I thought I’d have a quick trip away from my computer to Boots in town to grab something. Because it had been busy I hadn’t done a  blood test since breakfast time.

So, one o’clock arrived and I headed out in to the frankly unpleasant weather, swiftly walking the five minutes or so in to try and avoid getting too damp. I got to Boots, picked a “”Delicious” Cheese & Pesto Pasta Salad”, a packet of healthy-ish crisps and a bottle of Diet Coke, then I headed over to the dental bit ’cause I need a new head on my electric toothbrush. I paid up and left heading in to the Victoria Centre to find somewhere to sit and have my lunch.

First thing I did was look at the food I had bought to see how many carb’s I needed to wind up on my pump, I was a little upset to find that Boots have re-branded their “”Delicious” Cheese & Pesto Pasta Salad” so it doesn’t actually tell you what the carbohydrate content is. After searching all over the packet many times I resolved to guess at the contents and adjust after getting back to a computer that I could look it up on (Web-Monkey without his own smartphone – funny I know!).

I did a blood test, as I always do before eating. I was a little surprised to find my BM was at 15.6mmol/l. “Hmm, that’s a little odd” I thought, that new bread must have a lot more carb’s in than it says on the packet. Anyway I wound up the CHO and hit the bolus button to which I was greeted by a “communication error” message. I cancelled out and tried it again and it did the same thing. Then I had one of those moments when you realise what the problem actually is. I patted myself down and realised that the reason I was getting a communication error was because my insulin pump was about two and a half miles away in my dressing gown pocket at home!

I ran back to work, carrying my carbohydrate-camouflaging salad, crisps, drink and toothbrush heads, grabbed my keys from my bag, excused myself and ran to get the bus home.

I got home in a little under fifteen minutes, which isn’t bad going, surprised Deanne who works from home on a Monday, plugged myself in and did a blood test, I’d dropped a little to 15mmol/l, which must have been a mix of the residual insulin and the running to get the bus. Gave Deanne a quick peck on the cheek and ran out the door again.

Getting back to work I looked up the “”Delicious” Cheese & Pesto Pasta Salad”, (56 grams in case you’re interested), wound up the total on my pump and bolused as quickly as I could.

Sadly after being unplugged for about six hours my blood sugar hasn’t yet normalised and I suspect if anything I’ll get a sudden drop at about six o’clock this evening.

When I had sorted myself out to my own satisfaction I posted a message on the Boots UK Facebook page, and to give them their due they actually told me they would look in to a way of including all the details on the back of the packet, you can see my overly sarcastic posting and their responses here if you’re interested.

Anyway, it was a stupid thing to do and closely aligned with last weeks stupidity of bringing my insulin to work ’cause I knew it would run out before the end of the day but forgetting to bring a cartridge in which to put said insulin!

All in all I seem to be having a couple of slow brain weeks, I’m hoping it won’t last much longer!

Ooh, Pointy!

When I was at the clinic the other week for my annual pump check up I asked if I could try a different infusion set, because my stomach looks a little like it has a bad case of acne from the places where the needles have been. My pump is an Accu-Chek Spirit Combo and I’ve used the TenderLink infusion set since I got it because I thought having the bit that sticks in to me at an angle rather than at 90 degrees would be better for e.g. when I was playing volleyball and such like.

Anyhoo, I was given the only one they happened to have a few of laying around which was the Ultraflex, this one has a needle which goes straight in to you but is much shorter and (I think!?!?!) thinner than the TenderLink. Anyway I got four of them and so I used them over the previous couple of weeks, then last night I went back to the old standard.

I have put a picture of both below, the old one on the left and the new one on the right and I just wanted to say that the old one now feels like trying to stick Cleopatra’s Needle in to myself. Sadly I have about three or four boxes of the TenderLinks left and I don’t believe in needlessly sucking money out of the good old NHS so I’ll use them up first but when I next give those nice people at Roche Diagnostics a call I’ll be changing my standard order to the FlexLink infusion sets!

Accu-Chek FlexLink Infusion Set

Accu-Chek FlexLink Infusion Set

Accu-Chek TenderLink Infusion Set

Accu-Chek TenderLink Infusion Set

Wait for Me!

Some Food

Some Food

Today I am going to talk about something which nearly all of us Type 1 Diabetics have to endure, namely the discomfort that can be caused by eating with other people!

Some Plates

Some Plates

You meet your friends at a nice restaurant, or even just a pub or café for a bite to eat, you exchange pleasantries, hug kiss and generally try to think of funny things to say, you settle down at your table then pore over the menu until everybody has decided who’s going to have the crab, lobster or chicken nuggets. The waiter sidles over and takes everybody’s orders.

After twenty minutes and a couple of drinks you all breathe a sigh of relief as the food emerges from the kitchen, smelling like something you’d be quite happy to eat, of course the plates aren’t all brought out at the same time and invariably the last plate will be that of the Diabetic at the table.

You make a random guess at the amount of carbohydrates contained in your aubergine surprise, obviously failing to take into account the spoonfulls of sugar in the sauce, you grab your blood test monitor out of your bag, unzip the little case, attempt to prime the jabber, realise you need to put a new cartridge in, scrabble about in your bag again until you find another one, replace it then stick a blood test stick in to the monitor, only for the monitor to error out with some unhelpful message like “E3” or “LoTemp” or some such. Finally you get it working, stick yourself and bleed on to the blood test stick.

 

“2.3 mmol/l”

 

“Rubbish!” You go back in to your bag to find out your open packet of Jelly Babies has spilled and so you rub a couple of them on your trouser leg to get the fluff off before eating them. Finally you dial up the carbohydrate guestimate for what you’ve actually been served by the restaurant and inject/pump it in. You look up from your little world of Diabetes management and realise that at least one of your party has just finished a particularly amusing story concerning their trip to Beirut, another is just finishing their flambéed mushroom stroganoff and you’re just starting your meal.

Such is the life of the pancreatically challenged!

Of course this is a (possibly) exaggerated account of events as they often seem to occur but I’m sure I’m not the only one of us to always start eating after everybody else at the table. So what would I like to happen?

Well I’m not (that) selfish so I’m not after making everybody else wait until I’m done before they start eating, for one thing their food would probably be cold. I guess the main thing I want is not to feel like I’m always playing catch up, to be fair I could probably overcome a few of these problems by being better prepared and checking the state of my kit before going out, etc. however I’m not that well organised and so that is unlikely to happen.

What I would really like is not to have to think about it. “That’s never going to happen,” I hear you say but I’ve noticed a lot of articles on line recently about Continuous Glucose Monitors attached to insulin pumps and adjusting doses without interaction therefore I think it’s only a matter of time before my wish comes true and I’m able to just stick stuff in my mouth without having to faff about with little electronic devices.

Come on scientists, you can do it. If not for me then at least for my poor wife and son who have to eat with me at least once a day and endure my complaining and then watch as I try to inhale my food to catch up. To them I offer my most sincere apologies and keep my fingers crossed that the boffins get this sorted sooner rather than later!

Australia – A Really Badly Written Travelogue

Some Native Wildlife

Some Native Wildlife

In case you hadn’t realised Deanne, the Young ‘Un and I went to Australia for a month in March. This was partly to show the toddler off to the in-laws (Deanne is from Australia originally), partly because we hadn’t visited for five years and partly so we could all have a month off work/nursery and relax bit. I took the advice offered at the last Nottingham Type 1 Diabetes Group meeting by Dawn, she was rather handily (for me) talking about travelling with Diabetes. The main thing I was interested in, which she did actually mention was the fact that when she’s changing time zones she leaves her pump set on UK time until a few days have passed and she is more or less over the jet-lag. That may not be exactly what she said but that’s what I made it out to mean so that’s what I did.

The day of departure came and our bags were packed. My hand luggage obviously contained the requisite number of bags of Jelly Babies, a recently purchased Frio Insulin Travel Wallet (another suggestion from Dawn, thanks Dawn!), many, many infusion sets, insulin cartridges, blood test sticks and lancets and all the other Diabetes rubbish that we need to take when we go overseas. We arrived at Birmingham in plenty of time, which was lucky ’cause we had off site parking and had a bit of a job finding it, but then we got on the bus and it dropped us, with all our bags outside the main departures door at the airport.

The plane ride over was fine, although the service on the Birmingham to Dubai leg of the flight was less than we had hoped for, they (Emirates) hardly offered anything in the way of drinks (not talking alcoholic here, just water/soft drinks/etc.) and when the food eventually came they didn’t clear the trays up until about an hour later, which when you have a two year old makes doing anything in the already limited space available to you quite challenging.

Twenty odd hours after taking off we arrived in Perth. It was a bit of a change from the UK, it was about tea time when we arrived, eight or so hours ahead of the UK and the temperature was around 26 degrees (centigrade) when we left the airport. It was nice!

We actually went on a mini holiday the first few days we were there, drove a couple of hours south to Busselton which is a kind of hot version of Weymouth, only it’s nice! Being a bit further south the weather was nice but not too hot and we spent a lot of time going to chocolate shops and playing on the playground at the place we were staying at, it seemed to tire Deanne and myself out more than it did the Young ‘Un.

When we got back to Perth we had the important and serious task of meeting up with family and friends which included going to lots of parties and spending a lot of time sitting in coffee shops by the river. It was hard work! My control was relatively stable even though I was eating some pretty strange food. Certainly a lot better than the previous trip I had five years before where I was neither carbohydrate counting or dose adjusting (also didn’t have a pump at the time). Admittedly I had a few high blood sugars, seemingly for no reason although I worked out afterwards that it was actually due to ice cream cones which apparently had an awful lot more carb’s in than I was expecting (like 80 instead of 40 grams that I was guessing).

Me at Diabetes WA

Me at Diabetes WA

Anyway, once I had sorted that out everything went much better, I had a relatively low number of hypos and most of my blood sugars were below 12 with the exception of a few after meals out, however that happens to me in the UK too so it was nothing to do with being away. I even managed to do some Diabetes Web-Monkeying while I was away, I found a few bits and pieces in local papers and magazines which I posted on-line when I got the chance and also decided I’d go visit the local branch of Diabetes WA to find out what it’s like being Diabetic in Australia.

The main difference seems to be the fact that they don’t have a National Health Service, like what we do! Instead you have to take out health insurance which then covers the cost of a large percentage of the things you need as a Diabetic, e.g. needles, insulin, etc., etc., etc. They were very forthcoming and I in turn offered them some advice on how we use Twitter, Facebook and other on-line resources to keep in touch with people. It was interesting to speak to some people on the other side of the planet who have the same everyday problems and annoyances that we have over here.

After being on an insulin pump for over a year now my Diabetes certainly seemed to be a lot easier to manage and although I had highs and lows the way the pump adjusts them down and up again seems to be a lot more natural and my body seems to respond well to that, I don’t feel ill for hours after a high result and I don’t keep dropping and rising all day long like I did previously. I also feel like I can eat whatever I want while away and have almost got the hang of guessing carbs well enough to keep me fairly straight and narrow without needing to refer to my Carbs & Cals book all the time.

Now however I’m home again, in fact we got back about a month ago now and it’s taken me all this time to get this written down what with one thing and another including a Little ‘Un with chicken-pox, work, getting the house back to a manageable state after being away for a month and all those things you have to do upon returning from a long holiday.

The main difference between this trip to Aus’ and holidays I’ve had in the past is that whenever I’ve been overseas in the past I worried almost constantly about my control and about getting high or having hypos from having strange and exotic foods and experiences, this time however I didn’t worry, partly due to the pump, partly due to the fact that I have become a lot more confidant in controlling my diabetes with a pump than I ever was with injections and I guess mainly because when you have a toddler to look after you spend more time worrying about them than you do yourself!

We’ve already booked our next holiday in fact, we’re headed for Barcelona in the not too distant future, is there anything I’ll be doing differently because of my experiences down-under? Well no, the time away just went to prove to me that I am coping as well as I can with a chronic (/annoying) illness and all I need to improve even more is further practice. Which you only get by living it and doing things which you want to do rather than worrying about what might happen!

I Opened The Door And…

…Influenza!

Deanne and I have both had the flu (must be proper flu not man flu as she has had it as bad as I have) since Tuesday this week which has meant all the clever stuff I was planning on posting this week (honest) has gone out of the window. Thankfully we’re on the mend…finally, however as my brain still hurts and I need to get myself back in order I thought I’d just post the first scene I wrote for a book I started in 2005 that only ever got up to about three and a bit thousand words before I realised I had more important things to think about at the time, like getting a better job and stuff!

It was going to be a thriller about a diabetic guitarist in a rock band who got framed for the murder of one of his bandmates but I didn’t really have a plan after that, which is probably one of the other reasons it fizzled out! There are a few sweary words in it so please excuse that. Anyway, it’s not much but here you go…


The first thing I notice is that the back of my hand feels warm, and sort of slimy.  I look down.  My vision seems to follow the movement of my eyeballs after a couple of seconds.

It’s my left hand and its red, the hair on my arm is stuck to my skin.  I think the phrase I’d be looking for is ‘caked with sweat’ but currently I don’t seem to be geared up for thinking.

My temples are throbbing, as my brain starts to restart I realise that I’ve had a hypo.  It must have been quite a bad one otherwise there wouldn’t be blood.

The sweat is fairly normal but I must of cut something or there wouldn’t be blood, either on my hand or…bloody hell, on the carpet.  That’s going to be a bugger to clean up when I’ve come round properly.

There is a slightly more immediate problem though.  I’m lying on the floor in my bedroom but none of my limbs seem to be coordinated enough to actually carry me towards the kitchen.

I’m thinking the only reason I’ve come round is because of the adrenalin pumping round my body from whatever injury it is I’ve given myself.

I can reach the drawers from where I’m laying, I manage to turn myself over enough that I can use both my arms and my legs to lever myself into an unsteady upright position.

I’m definitely not stable but thankfully the kitchen is just down the corridor and the corridor isn’t too wide!

I make my way along by propping myself up with my arms on either side of the passageway.  I’m sure I look pretty dumb, but for one thing there’s no one here to see me and for another I wouldn’t care if there was.  In fact I wouldn’t be like this if there was somebody else here!

I meander through to the kitchen.  The adrenalin seems to be doing its job because by the time I get there I can almost stand of my own accord again.

I reach into the fridge while supporting myself with my hand on the bench.  I take the orange juice out with one hand and tip the carton back so it pours in to my mouth.

I never like the feeling of the raw cardboard against my lips.  I should probably cut the container so the top layer of waterproofing doesn’t rip off like that.

I don’t know how much I drink, I finish it though.  ‘Ah crap!’  My first words after hypos tend to be colourful metaphors of the four letter variety.

I put some bread in to the toaster and push the knob down, guess I need to wait until it’s done…


Two possibilities are that you will:

A. Think that is okay!

B. Think it is utter tosh and that you won’t get those few minutes of your life back in which case my work is done as I have been bed bound four out of the five days of this week and will personally definitely not get them back 😛

Have a good weekend.

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