Getting Used to an Insulin Pump

Posts tagged ‘Accu Chek Aviva Combo’

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

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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!

Holiday Time, Sort Of!

An Umbrella

Not that Kind of Holiday Sadly 😦

After today the updates may be a bit intermittent for the next couple of weeks as I am not at work for a bit. However I’ll do my best to keep updating every now and again until normal service is resumed.

My blood tests yesterday afternoon did not finish as I expected staying pretty much where they started for the rest of the tests, even going up a bit towards 6pm. I believe the reason for this is because once again I’m not entirely well, I have a sore throat, a cough and am apparently snoring like a herd of Aberdeen Angus (sorry Dee)! What with this and my annual leave I’m going to leave the fasting blood tests until after I’m back at work again.

I also badly misjudged the amount of mashed potato I had served myself at dinner time last night and ended up with a blood sugar around 18mmol/l which just goes to show that you’re much better to check if you’re not sure, which I wasn’t!

My time off work is going to be spent doing a variety of things including trips to Dorset and Cornwall, another (final) birthday party for the Little ‘Un and a host of DIY tasks at home so it should be a good test of my pump management skills.

The party should be good as all three of my brothers are making it, even the one who lives in Brazil, so it’s a nice way to celebrate my son’s first birthday, even if it is nearly a month after his actual birthday. There will be cake and chocolate and all manner of interesting foods.

Talking of tasty food I don’t think I’ve mentioned it before but Deanne is from Australia and with it being ANZAC day we should be having ANZAC biscuits on Monday (the 25th of April) so I need to figure out how much carbohydrate they have in them, not such an onerous task really 😉

Volleyball tonight should be okay, I’m feeling a little more confident about how to not have hypos and not get too high while playing now but I shouldn’t get too complacent because that is always when things go wrong.

I’ve also got the Nottingham Type 1 Diabetes Group website fixed and have updated that, including details of the talk I will be doing on the 7th of June on how I went about getting hold of my insulin pump and then how I’ve been dealing with adjusting to having it so be sure to check that out and keep the date clear in your diary.

So for the time being I’ll sign off and until I’m next on-line I’ll bid you farewell and have a nice bank holiday.

Pump – Day 3

My Pump

My Pump

Well, things are continuing in much the same vein, the pump is continuing to pump and I am continuing to be pumped in to.

Last nights BM was 6.7 and then this morning I was 5.6 so I’m feeling pretty happy about overnight but still may need to adjust when I do my fasting blood tests overnight.

Had another high and a “nearly” low but at completely different times to yesterday. was 13.9 before lunch but forgot to do a test mid morning, was 15.0 and needed a bolus at two hours after lunch, weird ’cause I had the same lunch as yesterday when I was fine, then two hours after that I was 4.4.

I think the pump may have adjusted by -0.7 at this point but it didn’t make it very obvious. Have a horrible suspicion I might be low at dinner time but I’ll let you know tomorrow…

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 😛

From the Start – Pump Me Up

The Accu Chek Spirit Combo
My New Pump

Our Web-Monkey, Dan, will be attending City hospital on Monday morning to have his insulin pump fitted. He’s a bit nervous but for anyone interested will do his best to try and post the odd update to let everybody know what it’s like and how it is working for him. He’s most interested in the fact that everyone says that on a pump you feel “normal again”, he’s had diabetes since he was 22 months old and therefore has no idea what “normal” feels like, could be interesting, keep your eyes peeled for updates through all the websites!

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