Getting Used to an Insulin Pump

Posts tagged ‘About Me’

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.

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

Ban(ne)d

Tomorrow night I’m trying out with a band, they want a guitarist and I kinda play guitar…badly, or at least I used to about four years ago. Here’s a picture to prove it:

Me, Playing Guitar!

Me, Playing Guitar!

As I say I’m a little out of practice and probably need a few go’s before I can actually play along with their music so I’m hoping they’ll be patient.

Anyway last time I lived the rock ‘n’ roll lifestyle I was using a pen to inject four or five times a day, I didn’t do carb’ counting and I frankly managed my diabetes by crossing my fingers and having a lot of hypos and highs so I’m hoping it’s going to be a bit easier what with all this modern technology I’ve managed to persuade the medical establishment to supply me with.

However What I do have now is of course plugged in to my belly 24/7 and also has a three thousand quid piece of kit hanging off me, this is why I’m going to have to think carefully about my set-up before I head out of the house tomorrow night. I think I’m due an infusion set change tomorrow night so I’ll probably do that before I go, this means I need to pick a spot…and a side of myself that will cause the smallest inconvenience in terms of catching cannula on sticky out bits of guitar or continually rubbing said guitar over infusion set and causing discomfort.

Further to this is of course the fact that I have experienced most things which come up in every day situations since getting the pump, however I haven’t stood up for a couple of hours with a frankly rather heavy guitar (I own one of these now) which weighs about nine pounds, that’s about four kilo’s if you’re a youngster! Also there’s the unpleasantness of hefting guitars, pedals and even worse amplifiers up and down stairs to practice rooms and back to your car afterwards.

So with all these things considered am I having second thoughts about going tomorrow night?

Don’t be silly,  I’ll just do a lot of blood test before, during and after and hope Im lucky enough not to stab a finger so it hurts when I press the strings down, if I do I’ll just have to live with the pain. I’ll just make sure they are all aware that if I play particularly badly it may be a mixture of nerves, not having practised properly for about three years and low blood sugar all combined in to an ear splitting wall of feedback and noise. Or maybe that’s what they want???

Wish me luck 😉

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!

Better Man

Better Man by Pearl Jam

Better Man by Pearl Jam

In case you’re wondering I’m feeling much better today blood sugar wise.

Time 24hr Blood Glucose in mmol/l
06:47 6.6
10:46 9.2
15:29 5.3

 

Okay so I haven’t done half as many blood tests but I’ve had a pretty crazy day at work and because I haven’t been massively high or low I haven’t needed to thankfully!

Anyway after yesterdays misery I thought I’d better remind you all that most days are quite good once you’ve got the hang of this Diabetes thing and that it’s not such a bad affliction when you come to think about it.

For many people it’s a wake up call that they need to look after themselves (Hi Gareth if you’re reading this!) and for others it just makes for a much more stable life.

Not writing much today as I am still having a busy day and have better things to be getting on with :-S

By the way, should I find it cute or worrying that my 22 month old son can say “blood test”???

…and just in case you are wondering Better Man is a Pearl Jam song which is very nice!

Christmas is Coming

Oh Dear :-(

I Ate Too Much!

Well it’s less than two weeks until the big day…and when I say “the big day” I mean “the day where you stuff your face until you need a bit of a lie down”! Previously at Xmas I have had problems because as well as having a large meal…at least twice throughout the day…and alcohol…I have also never managed to resist the urge to snack between meals forgetting of course that I am Diabetic and therefore need extra insulin to cope with all the extra pummelling I am giving my poor stomach and digestive system.

However that was before I was on an insulin pump and knew quite so much about carbohydrate counting and how insulin is related to blood sugar and carbohydrate intake. Now I am fully conversed in ratios of insulin to blood sugar and carb’s, also “Mr Pumpy” (I’ve never actually found a decent name for him, still open to suggestions!) does a darned fine job of doing all the complicated calculations for me so all i really need to know now is that I have enough blood test sticks and how much carbohydrate is contained in whatever the next thing I am going to put in my face.

So…does that mean I am going to have a really well controlled seasonal feast this year?

Well, probably not. Getting the guestimates right takes years of practice and it gets a bit hard to remember what you’ve already eaten after the 4th mince pie so “I’m sure just one more won’t hurt” becomes a kind of self fulfilling pronouncement of blood sugar doom!

Unusually I am not heading down to Dorset this year to stay with my Parents, instead they are coming up to visit us so at least I will be in my own house surrounded by food I can easily calculate the carbohydrates of and without too many things that someone has made that I do not have easy access to the recipe for.

I do though feel a lot more confident this year and know that if I do have any wildly turbulent blood sugar episodes that at least after an hour or two I can be back on track and ready for another round of charades.

In Bruges

Choco Story - A Chocolate Museum

Choco Story - A Chocolate Museum

We spent last weekend in Bruges in Belgium, a really nice place with lots of history and architecture and chocolate, all of which were nice!

The holiday got off to a positive start although the young ‘un was a bit unsettled on the trip over. We went by train from Nottingham to St. Pancr(e)as to Brussels and then caught another train to Bruges itself. It was quite a long trip what with all the waiting around for connections, he was really well behaved though.

Things were fine until we got there and got settled in then I did a blood test and it turned out I was 19.6 mmol/l…Oh dear, the next couple were higher at 19.9 then 21.3, in the morning I tested three times between half six and half eight and didn’t get under 10 on any of them. This was when I decided I’d change my insulin, infusion set and cannula, the next test I did two hours later at 10:40 was 3.3 so I’m guessing my suspicion was right and something was up with some aspect of my pump or my insulin.

The next day went pretty well and with most of my results being around 6 then on Monday another good day, I put it down to eating ice cream and chocolates!

Funnily enough the 23rd (Tuesday) was also pretty good but I did have one test out of the ordinary at 17.4 while travelling on the train again, I was worried that the Eurostar was having some kind of negative effect on my pump but my worries were unfounded as the next couple of tests were around 4.

Yesterday was our first full day at home and I came to work, dropping the little ‘un off at nursery, I decided that I would be good and start redoing fasting blood glucose tests so I started at 12 o’ clock and got the following results:

6.9 mmol/l

6.9 mmol/l

6.0 mmol/l

5.3 mmol/l

6.7 mmol/l

7.1 mmol/l

I figure this is close enough to no change for me to leave it alone so I will do my morning tests again next and then something which I have been putting off and off which is night time.

I’m pretty certain I need to do these as I am having more insulin at night than I need for my supper in order to get my BMs about right in the morning, I think this means that at some point at night my blood sugar is going up and therefore I need more insulin, working this out shouldn’t be too hard it just requires that I get up through the night and do blood tests every couple of hours.

Anyway I’m signing off again now, sorry about my lack of communication recently but I’ve been doing some coursework for a thing I’ve been doing at work, however I’ve finished this now and therefore will hopefully get a bit of spare time back in order that I can start putting a few more updates on here again.

In the words of the Cat: “what is it?”

Insulin and Carbohydrate

What Happens to Carbohydrate with Insulin

Okay, I’ve had enough of what I’m meant to be doing at the moment and anywhere to get a drink or something to eat has shut so I thought I’d start on my A-Z of Diabetes, or at least trying to give a bit of background on what it is and what all the things I talk about mean so…

Type 1 Diabetes, also called Diabetes Mellitus is an autoimmune disease, that is it is a problem with your immune system, in my case I believe I got a virus of some sort when I was about 22 months old, my white blood cells killed off the virus but then didn’t know where to stop and decided that my beta cells in my pancreas were also BAD so they started destroying these as well!

Beta cells have a few roles but the most important of these (to a Type 1 Diabetic at least) is that they pump out insulin and (sort of) glucagon. Both of these hormones have an effect on carbohydrates, insulin turns carbohydrates in your blood stream in to energy which your body can then use to power itself, glucagon turns stored energy, e.g. fats, etc. in to energy if you don’t have enough carbohydrate in your blood stream when you need it.

Obviously you need energy to power pretty much anything you do, if you do not have enough then parts of your body can start malfuctioning! This is called “low blood sugar” or a “Hypo”. I have experienced a whole gamut of different types of hypo and personally find they tend to be different dependent on what I’m doing at the time, for instance if I am exercising, not necessarily full on cardio-vascular body pummeling, can be as low impact as walking (or more likely these days pushing a pushchair!) then I will tend to have a muscular hypo, that is some muscle group in my body, possibly all of them, won’t have enough energy and therefore I’ll get wobbly legs or arms or possibly collapse on the floor or else not be able to get out of a chair.

Worse for a number of reasons are hypos that occur when I am thinking hard, e.g. writing a document at work or doing a brain intensive DIY task, in these cases the organ in my body using the most energy is my brain and so when I run out of energy my brain ceases to function properly. The reason this is particularly bad is because my brain, being short of energy, is often unable to realise that it is short of energy and so I miss the signs I would normally pick up and just get lower and lower until (on occasion but not so much these days) I become unconscious, it can also cause bad moods, arguing (more than normal) and a general change in personality. If it is one of these ones the best thing to do is just to tell me it’s a good idea if I do a blood test, I might well argue but if I do too much you can just leave me until I collapse and then call an ambulance 🙂

So, because I am unable to produce my own insulin I need to somehow get insulin inside my body, over the years this has been by syringe and needle, plastic syringe, pen injector and most recently an insulin pump (hooray), all of these devices do pretty much the same thing but to different degrees of control, syringes were okay but you simply sucked up as much insulin as was required by eye and injected it, insulin pens were a bit better as you wound up the dose and it would give you the same dose, standardised, each time you wound it up on the pen so you knew you were getting exactly 10 units if that is what you selected. I’ll come to the pump in a minute!

Of course to control the level of insulin you are giving yourself you also need to find out how much carbohydrate is in your body, originally when I (in fact my Mum and Dad) had to do this you had to catch some urine in a test tube and add some water and a pill which would then change colour to give an indication of how “sugary” I was, e.g. whether I needed to exercise to try and bring my blood sugar down or if I needed to eat something, they were pretty much the only options available back in 1976. Then they bought out dextrostix, which were plastic sticks with a reactive piece of chemistry on the end which, again, changed colour when you wee’d on it, somewhat simpler and less prone to accidents or mistakes in the process. Nowadays I have a blood test monitor, this involves pricking my finger with a lancet to draw some blood, this blood then goes on to a strip, not a world away from the Diastix I used to use but plugged in to a machine which then gives a reading as to your blood sugar, this has a number of advantages!

The old Diastix used to have a number of colours for the different readings, I believe that “blue” meant your blood sugar was between 0 and 9 millimoles per litre (mmol/l the standard unit of measurement until fairly recently) green was between 9 and 12 (or something like that, it was a long time ago!) and then a range up to brown which was frankly much too sugary! Bearing in mind that a normal blood sugar is meant to be between 4 and 8 it obviously didn’t give a lot of fine control over your blood sugar. Also it meant whenever you wanted to test your blood sugar you needed to be able to pee…and find somewhere to pee! Finally because it takes a while for your body to process carbohydrate and eject it the tests were always about an hour or two behind where your body was currently at.

Blood tests are more or less instant, you still have to carry kit about with you but no longer need to find somewhere private to test and the results are to 0.1 mmol/l, in this way my average blood sugar results have come down from somewhere between 9 or 12 to about 7 these days which is obviously desirable and in fact makes me feel much better about myself.

So these days I need to do blood tests to check my blood sugar, guess the amount of carbohydrate in food I am eating and adjust my insulin accordingly (a bit more about insulin types another day).

The pump is a fantastic device, it is programmed with the amount of insulin I need to deal with 10 grams of carbohydrate (CHO) and the amount I need to bring my blood sugar down by 1mmol/l (0.3 units I think) and when my blood test monitor tells the pump what I am eating (which I program in to it) and what my blood sugar is it decides how much insulin to give me for the food and to adjust my blood sugar to the right level and then pumps it in to me! Technology is fantastic.

That’s it for now, gotta go. I’ll continue this another day, feel free to ask questions if you want more info about anything I’m talking about and remember these are my views and opinions and probably wrong on a number of counts!

Thirty One

One Month and Counting

One Month and Counting

Well I guess however you count it I’ve been on the pump for a full month now. So how am I feeling?

Pretty good actually! I’m still having a number of hypos and highs but they are getting less, and less extreme as the days go by and as I get better at the more specific carbohydrate counting that being on a pump means you have to carry out. I’m pretty sure that I have my morning (8am to 1pm) basal rate sorted out now, think I probably need to do one more fasting test for these to make sure and then I’ll start on the next ones (probably the afternoon in case you haven’t been reading these posts for long!).

I can now cope with most food-related situations and am slowly getting my head round how to manage exercise, although because I generally only go to volleyball practice once a week it means that working this out is slower than I would hope for, “maybe you should do more exercise” I hear you say, but with a (very nearly) one year old boy to look after I get plenty, just not the going to a sports club kind, and that doesn’t have quite the same effect on my metabolism.

So what am I hoping for next?

Obviously the basal rate thing is a pretty big one to work out but other than that I am just wanting to work out how to deal with unusual situations, e.g going out for a few drinks (which I honestly don’t do very often) or when my work regime is different to normal. I probably need to think about how my activity and food differs at the weekend too.

Do you feel normal again?

I really couldn’t answer that, having no recollection of what it was like to be normal because I got Diabetes before I was two years old. On the other hand I definitely feel different to how I did before, my hypo warning signs have changed and I have started to feel hungry and thirsty, rather than feeling low or sugary.

One final thing I wanted to say before I sign off for the weekend was that last night I got home after picking the little ‘un up from nursery, Deanne arrived back about ten minutes after me, got in the house gave him a cuddle, looked at me and said “you’re low, do a blood test” which I obediently did. I was 1.7 and had completely failed to realise! Which just goes to show that no matter how technologically marvellous your kit is and how many times a day you do blood tests it is still worth having people around who you trust and can rely on!

Pump-Monkey – Day 2

Waterstones in Nottingham

Where I Went at Lunchtime

Well I’ve been plugged in more than 24 hours now and it seems to be going okay, although I have a sudden, seemingly terrible, case of man-flu which I think is sending my blood sugar up a bit, as well as having had one particularly nasty high (15.9) at 9am, pretty sure I get the dawn phenomena but still need to wait a couple of days before I can start doing fasting blood tests as there will still be some basal insulin hanging around in me from B.T.P. (Before The Pump).

Total Hypo’s so far = 3

Total High’s so far = 2

The hypo’s are winning at the moment! Feel relatively confident that I’ll be able to sort it out but as I say I’m going to wait at least a couple of days before I attempt any kind of extra pump acrobatics.

As far as how I’m actually feeling betwen the highs and lows I am actually more relaxed about the whole thing than I thought I would be. I was expecting a feeling of constant nerves initially but it actually seems a lot more natural than I thought it would having a cannula stuck in my tummy and a tube coming out of me.

Bed was fine last night, wore a pair of shorts with pockets in and chucked the pump in the pocket, it survived fine and so did I! Not sure how long it’ll be before I feel brave enough to just let it dangle free when I sleep…I’ll let you all know.

The hypo today may possibly have been caused by my lunchtime jaunt to Waterstones, I have a suspicion that exercise shows itself a bit more obviously on a pump, might start playing with my exercise settings when popping out at lunch times?

I’ll jump on-line at some point this evening and get the pictures uploaded that Deanne took last night so you can see what the pump and the cannula actually look like on me. It is not, as my lovely wife suggested, just an excuse for me to show off my six pack 😛

A Bit of History

Dan, Playing Guitar

When I used to be cool!

Hi, I’m Dan. I’ve created this blog on behalf of the Nottingham Type 1 Diabetes Group, who are a community of type 1 diabetics within (and around) Nottingham who decided that it would be a good idea to get together every so often and have a chat about things.

Personally I have had diabetes since I was 22 months old, at the time of writing that means 34 years and 8 months. Wow, that looks like quite a long time when you come to write it down.

I may publish a bit of history about my personal “journey” with diabetes at some point but for now I just wanted to get this blog started and let you know that in the first instance it is going to be a blog about my insulin pump (which I’ve had for four weeks now) and how I’m getting on with it. Therefore my first task is going to be to copy all the stuff I’ve written on the other sites, http://nottingham-type-1.diabetesukgroup.org and http://www.facebook.com/nottstype1 to this page and do a bit of decommisioning to get that stuff gone!

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