Let’s Have A Party!

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 TenderLink Infusion Set

HbA1C

If you are Diabetic then you’ll probably know what an HbA1C test is, if not then I’ll tell you now.

Haemoglobin

HbA1C is a test which looks at the amount of Glycated Haemoglobin in your blood and returns a result which gives you an average blood sugar reading over a number of months.

As far as I have been able to figure out the way it works is that when your body creates red blood cells they contain the amount of carbohydrate that your body has in it at the moment they were formed. Because red blood cells have a lifespan of around three months it means that a sample of your red blood cells will always tell you what the average reading has been over the last three months or so!

For a Diabetic this is obviously important, the closer we can get to normal (between four and eight) the better our long term prospects will be, health wise!

Anyway I went to have a blood test a couple of weeks back in order that my results would be ready in time for my doctors appointment on Monday of this week. I went along quite excited but unsure of what to expect because it is the first blood test I’ve had since really understanding how the Insulin Pump works and how best to use it. It was my first visit to the consultant since getting the pump so that was also a bit nerve racking.

It was quite a good meeting, I asked a few questions and we discussed how it’s been going and then she let me know what my result was.

6.9mmol/l

I was amazed, this is the lowest I’ve ever had so obviously something is working 🙂

Advance Australia Fair

Diabetes Australia

We’ve recently booked our tickets to go to Australia next year, the main reason for this being that Deanne is from Australia and all her family (and by extension my in-laws) live there, in Perth to be precise. Therefore the only ones who have met the Little ‘Un face to face are his Nana and Aunty Donna who came over last year just after he was born. So we’re going to go visit and show our boy off to all his relations. “Sounds nice” I hear you think (didn’t I mention I’m telepathic?!?!?) but with a trip to Australia come a number of  Diabetes related challenges:

1. Time zone

2. Heat

3. Food

4. Routine

5. Supplies

I have been over there before but never with an insulin pump so I’m going to have to relearn some of my coping mechanisms. For point 1. I think it shouldn’t be too much of a problem, rather than a big bang I think I’ll do a phased time change altering the time on my pump by two or three hours starting the day we leave. The time difference is around eight hours so it’ll take a few days to normalise but the jet lag usually takes that long to get over so this might even help that process…

UPDATE… I had my checkup at the hospital and my consultant suggested that it would be simplest to set my basal rate back to the original setting of half a unit an hour and see how I get on, can change it to the right time zone after a few days when my body has caught up or leave it if it seems to be working then!…END OF UPDATE

For 2. it’ll be autumn over there when we go and so the temperatures should be between 30° and 24°, which is obviously a darned site hotter than it is over here, even in the middle of summer! ThereforeI’ll have to keep a close eye on my control and possibly drop my basal and meal rates depending on how I go.

3 is only really a problem if I do what I have done in the past and snack between meals, however I seem a lot less inclined to do that now I’m on an insulin pump as I know the slightest amount of carbohydrate can send me sky high, so I’m guessing I shouldn’t have too much of a problem as I just give myself more insulin if I’m eating more food.

The difficult one of course is number 4. While I may not do the same things every day I do generally have a fairly standard list of things that I do, both inside and outside work, being on holiday is more like a weekend, only for a whole month or so. I guess we’ll have a routine of sorts as with a 2 year old child you can’t really help it but even so it’s not the same as being at home.

Finally I have to do some forward planning which, frankly, I’m a bit rubbish at. For number 5 I have to make sure I have plenty of infusion sets + cannulas, insulin, blood test sticks and lancets, batteries for the pump, batteries for the monitor and to be honest probably loads of other things I’ve forgotten about at the moment. This means I need to contact and probably have an appointment with my GPs surgery in order that they will allow me to order, e.g. twice the number of things to normal, as well as ordering new stuff from Accu-Chek in enough time to actually have them arrive (when no one is in the house as per normal) then have enough chance to go to the post office collection depot to pick the stuff up which was delivered while there was no one at home because we both work…as I would imagine is the case for most people. “Not too much of a problem” you think (see I’m doing it again) but did I mention that I’m not a good organiser and only tend to remember these sort of things at the last minute.

On the bright side I’ve added an appointment to my calendar at work which will keep reminding me so hopefully that’ll be enough to actually get me to remember to make a call to Accu-Chek and an appointment with the doctors!

Anyway, aside for all that and any worries I might have about travelling with a two year old and adjusting my regime for foreign climes I’m actually pretty excited really, the other two times I’ve visited Perth have been brilliant, admittedly one was to get married and the other was to attend a wedding so you’d expect it to be relatively cheerful, but even so I feel a lot more confident about my Diabetes these days and hope that it isn’t a misplaced sense of confidence!

A Long Afternoon

When's Home Time???

This afternoon has been a very slow one to pass, as you can probably tell from the title I’ve given this post, however on the bright side it’s nearly over now!

Part of the reason it has seemed long is ’cause I’m doing some frankly not super-interesting stuff, however the other reason is that I have been quite low twice, a 3.3 mmol/l at 13:35 and a 2.7 mmol/l at 15:16. “Why so low” you ask? To be honest I have no idea, I had my lunch at about 11:30 in the morning (a habit I picked up many years ago when I worked with my Dad) so the one o’ clock test was two hours after lunch and then the three o’ clock one was after a particularly dull meeting.

Because one of the team bought in some gingerbread men I also had one of those after the last couple of Jelly Babies, at 7.8 grams of Carbohydrate it’ll hopefully be enough to keep me going without sending me sky high.

Anyway I thought I should give a quick update on how life is going as I have been a bit busy at work lately and not really had the time to craft my prose on all things Insulin Pump.

It’s been over four months now since I first got plugged in, it has been  a fairly steep learning curve since day one but it is now a part of my normal day to day life and doesn’t really cause me any problems as far as changing  the infusion set or filling up and putting in a new vial of insulin (which I just had to do at my desk at work!).

My control is obviously only as good as my guessing of carbohydrates and for the most part it doesn’t seem to be going too badly, for instance I had a HbA1C test a while back which tells you how your blood sugar average has been over the previous three or so months and it came out at 7.0 mmol/l. This is fantastic and I believe the best result I’ve ever had for one of these.

I’ve also pretty much come to terms with doing exercise while plugged in, at volleyball now I tend to eat about 12 jelly babies (around 60 grams of CHO) over the course of a two hour training session and that seems to keep my blood sugar fairly steady.

I still haven’t got round to doing all my fasting blood glucose tests, partly because I have been lazy but mostly because it is hard to guess when a good date will be for waking up every two hours in the night when you have a hectic lifestyle and a 15 month old baby, however I really must try and do at least one before my appointment to see the consultant in September in order that I can get as near as possible to perfect. I know almost certainly that my blood sugar goes up at some point in the night because when I  wake up in the mornings I tend to be hovering around between about 8 and 14 mmol/l, even if I haven’t eaten anything prior to going to bed with a 5 mmol/l.

Of course whatever happens I am still Diabetic and therefore my control will never be perfect but all that means is that there is always room for improvement and work on my control.

I feel like I’m rambling now so I’ll bid you adieu and write again some time soon when I’ve gathered my thoughts.

One last thing, I recently wrote a short article for the Nottingham’s NCT (the UKs largest charity for parents) Newsletter, I have scanned this in and posted it here if you are interested in reading something totally unrelated to Diabetes that I wrote!

 

My Eyes, My Eyes!!!

1% Tropicamide

This afternoon I went for my Diabetic Retinopathy screening at Boots in town, therefore if there are any spelling mistakes in this it is down to the fact that I can’t actually read what I’m writing because the 1% tropicamide has taken effect and everything is blurry and bright.

I don’t have a great deal to say following on from the essay I wrote yesterday, what I do need to do is start preparing my talk for the Notts Type 1 group in three weeks time otherwise I’ll just end up jabbering on about whatever comes in to my head and that could be very dangerous for everybody who attends.

Oh yes, there was one thing which was possibly useful that I was told at my EDWARD follow up yesterday, looking through my blood test results it looks like I am invariably high the morning after I have changed my infusion set, it was suggested that other people have had this same problem and the way to overcome it is to leave the previous infusion set in for a couple of hours after swapping over…

I can’t really see how this works because there is nothing (e.g. no pump) pushing the remaining insulin from the infusion set in to you but being an open minded sort of chap I’ll give it a go and see if I get better post change results.

My next change is on Thursday night which is volleyball night anyway so not sure if that’ll give me a sensible post change result but I’ll try and remember to keep my eye on my post change results the next few times I do it and update you on whether it’s helped.

Busy

Busy, Busy, Busy!

In case you were wondering I’m kind of busy at work at the moment which is why I’ve been a bit quiet, blog-wise! Thankfully I’ve managed to steal a few minutes this afternoon to post an update.

I think the last time I wrote anything I was still having high blood sugars first thing in the morning and was wondering if it was something to do with my extended time off work. Well it looks like it was because I am now back to where I should be with my morning BMs, which is good.

I had a strange night last Thursday at volleyball because didn’t drop my basal rate I just had about three lots of 20 grams of carbohydrates and was fine throughout the practice and the night afterwards. Think I might try this again this week, although the season and practices are nearly over so I will then need to remember this stuff until we start back again in a couple of months.

Went to my EDWARD 12 month follow up course today, I’m quite pleased because my HbA1C test came back at 7.0mmol/l which is frankly better than it’s ever been, Admittedly my previous results were 7.8, 7.6 and 7.8 again but the main reason for that was the number of hypos I used to have, pretty sure it’s gone down or at the very least they aren’t as severe as they used to be as I seem to get warning signs in the high 3s now rather than under 3.

I built and installed a raised bed in the garden yesterday, excitement central at the Ladle house, but the reason I mention it is because I didn’t have a hypo even though it was quite good body and brain exercise. There was however a fair bit of swearing, even though I have vowed to stop, the only times I seem to swear now is while doing DIY or volleyball, personally I think that’s excusable.

Last (but obviously not least!!!) for anyone interested I will be doing a talk at the next Nottingham Type 1 Diabetes Group meeting on Tuesday the 7th of June at 19:30 at the YMCA on Mansfield Road. I have entitled the talk “A rambling session from Dan about his life with Diabetes and obtaining and operating an insulin pump“. I think that may perhaps be overkill in terms of wordcount for the title of a talk but I asked Alex and she didn’t disagree so that’s what it is. I will be talking about my life up to now with Diabetes along with information on how I managed to persuade the NHS to give me an insulin pump and how my life has been since getting it. Feel free to come along if you are interested.

That’s it for now, back when I get some more spare time!

Forty Six – Volleyball-A-Go-Go

50 Percent Off

The change to my basal rate in the afternoon seemed to work okay because yesterday I was 3.7mmol/l at about 6pm and having just done a blood test I’m 4.8 which is a little low but not hypo at least! I suspect another couple of fasting afternoons may be necessary to get myelf completely sorted but I’ll worry about that when I get the chance to do them! I might also do some micro adjustments on my morning doses at some point to try and get the slight peaks I have later in the morning a bit flatter.

So, to the main issue, I went to volleyball last night and tried to manage my blood sugar using a mixture of the exercise setting on the pump, a temporary basal rate, jelly baby therapy and extreme violence (okay, no “extreme violence”, it’s a quote. Ten points to whoever can identify it first!). I dropped my basal rate to 50% and had an exercise dose for my dinner at 6pm. Got to volleyball at about 8 and started practice then realised I was feeling a little low by about quarter past.

I didn’t do a blood test just had four jelly babies, followed five minutes later by another four ’cause I was still feeling a bit light headed, after that I just played on! Did a blood test at about 9:40 and it was 5.5mmo/l which is a lot better than any previous attempts I’ve made to control myself through the rigours of volleyball. Did another test at about quarter past ten after finishing and it was 4.4, had some supper and again set the exercise dose on my monitor.

Woke up this morning and I was 4.9mmol/l which is AMAZING!!!

So next time I might try having four jelly babies before I start practice and then another four after the warm up and see how I go from there.

So once again I’d like to thank the staff at City Hospital’s Diabetes Unit for all their help and encouragement, they are stars.

Thirty Nine, Forty, Forty One – We’re All Going To The Zoo Tomorrow…

A Bit Like Our Shed

…actually that’s a lie, we went to the zoo on Saturday!

It was the Little ‘Un’s birthday on Sunday so we had a big birthday weekend, on Saturday Deanne and I and the young ‘un went to Twycross Zoo, I started off very well writing down all my blood test results in the little book and trying to accurately judge what I was eating (ice creams, etc.) but by 11am had given up completely and was just trying to play it by ear. The main reason for me giving up was because my blood sugar was dropping like a rock and so I had to keep doing blood tests and eating to try and keep up with the high level of carbohydrate that pushing a pushchair and carrying a one year old round a zoo entails.

A good day but a very tiring day.

Sunday was pretty good, didn’t do a great deal in the morning (opening baby presents, playing with new toys, going to the toilet on a potty (him, not me!!!)) but in the afternoon while the weather was hot I decided to start clearing the garden shed out. To understand this fully it is worth mentioning that our shed (prior to me starting this) looked very much like one of those old shops you go in that have bits and pieces of everything stacked higgledy-piggledy on top of, inside and around each other with a blatant disregard for health and safety.

So I started by clearing a lot of stuff out of it, then screwing some hooks up so I could hang some things up to save floor space, then I started chucking out old rubbish and filing stuff in to boxes.

Interesting as this probably isn’t to read what it meant is that I had to do a lot of blood tests and have quite  an amount of carbohydrate-y things over the course of the afternoon – which I did! Although the work wasn’t particularly back breaking it was constant and so my blood sugar just kept going down. More on this phenomenon in a minute though.

Today started with a high blood sugar, mainly because I had a piece of birthday cake with dinner last night and failed to calculate the carbohydrate correclty apparently. However everything settled down enough by lunch time in order that…wait for it…I’ve finally managed to do my afternoon fasting blood glucose tests. Hooray 🙂

So far all is going well with a small surprise of my BM taking a swift upwards turn from about six to about nine at 4pm. This has shocked me because I was expecting it to start dipping about then, however I’m still guessing that I’ll be low before the end of the results. But don’t quote me on that.

I also managed to speak to the Diabetes Nurse this morning about my exercise rates and she pointed out something quite obvious which is that just because I have gone on to pump therapy doesn’t mean I don’t need to have carbohydrate while I’m exercising! So tonight I have a volleyball match and so I am going to have drink/food while I am playing to keep my blood sugar at a sensible level, as well as using a temporary basal rate and the exercise setting on my pump.

Frankly I should have realised this myself and/or called them up much earlier, but there are such a lot of things to consider when initially using a pump that you just have to try and address them one at a time.

Day Fifteen

Random Banana

If I’m reading his updates on Alex’s status right then it looks like Jeremy might have got his pump today, that’s at least four of the committee that have them now, Jeremy, Alex, Haydn and yours truly. We’ll have to try and strong-arm the other committee members who are currently pump-less in to getting them.

I went through resetting the basal units on my pump last night as per the conversation I had with Clare at the Diabetes Unit yesterday. Now I have to wait a couple of days before I can do another lot of fasting blood glucose tests to see if I need to adjust it some more, my suspicion would be that yes, I do. But don’t hold me to that!

I now feel like I’m settling in to life with a pump, I think I’ve been through most of what it has to throw at me, some highs and some hypos, quite a few infusion set, tube and insulin changes and at least one occlusion alarm. I’m really impressed with the level of control it gives me over my basal rate and my boluses, and I also feel different, not necessarily better, just different!

However I would say that ’cause I’m just recovering from quite a bad hypo so I don’t feel altogether with it at the moment, probably not the best time to write this but hey, I’m hardly Shakespeare at the best of times so I may as well just get on and do it.

I’m quite looking forward to the next few weeks as I start to configure it specifically to deal with my daily routine and how my body processes carbohydrates from hour-to-hour, I’m also feeling pretty good about the fact that I don’t have to do injections any more, it’s such a strange feeling getting to 6pm and not having to give myself Lantus every day.

Actually now that I’m properly recovered I’ll rescind my earlier statement that I don’t feel better on it! I do actually feel like a different person and I think it’s already starting to affect my behaviour. I don’t think I realised quite how heavily my diabetes was weighing on my shoulders prior to changing on to the pump, but I’m pretty sure that I feel a lot more care-free and confident about controlling my diabetes and keeping healthy and happy now.

Of course I’m sure I’ll still have highs and lows, both blood sugar and emotional, but already Deanne has noticed that I don’t seem to get as grumpy when my blood sugar is high, and that has to be a good thing.

Sorry if this has been a bit of a random post but that’s Diabetes for you, sometimes you just can’t help your blood sugars, and what you do when they are low 😛

Two Weeks and Counting

Dundee House at City Hospital

I’ve now had the pump attached to me for two weeks, although it feels like no time at all! I’m guessing the main thing I should talk about today is my fasting blood glucose tests but first of all I’d like to make a small apology!

Anyone who has been reading this since I started will have seen the post entitled “Days 5, 6, 7 and 8”, which was about my weekend away in Dorset, at the start of which I suggested that the team at the Diabetes Unit at Dundee House had given me some advice which I failed to take any notice of! Firstly I didn’t actually fail to take any notice of the advice and secondly the advice they give tends to be more suggestions which more or less tell you that you know best and so I would like to say sorry to Clare and the other ladies if I have been writing untruths. You guys are the best.

Okay, back to me (my favourite subject!!!)…

…I got myself all prepared last night to miss supper and wake myself up every couple of hours in order to do blood tests. As the time drew near I started thinking “I’m quite hungry”, which I should have taken as a sign really! I did my first blood test at 10pm and I was 2.2mmol/l which obviously meant that I had to knock the whole thing on the head as I had to have some Dextrose which would of invalidated the whole thing.

So I got up this morning and decided that I’d do it then instead, this meant I missed breakfast (the most important meal of the day) and did a blood test every hour from 7am until 1pm. My blood glucose stayed around five until 10am then I got up to nearly seven, then had three nines!

I called Clare at the Diabetes Unit this afternoon and she has given me some advice about altering my doses (thanks very much, again) and so I need to have a fiddle with my basal dose before tomorrow morning and see what happens over the next couple of days.

The whole fasting process wasn’t as painful as I thought it might be and the results are interesting. I’ll be interested to see what effect changing my basal doses actually has on my control and of course I’ll update you as and when I have any news on this!

Web-Monkey’s Pump – Day 1

My Pump, On Me

Well, I’m now plugged in, it’s a bit like being in the Matrix only with less slow motion and more insulin.

The consultation with the nice lady from Roche Diagnostics and the Diabetes nurse took about three and a bit hours during which time they helped me set the pump up in order that it delivers “about the right amount” of insulin, of course these things aren’t an exact science because everybody is different so we’ll have to see how it changes as time passes.

I’ve started off on half a unit an hour, still using Humalog, that works out to about 0.025 units every three minutes (it gives a dose every three minutes in case you were wondering!). Compared to the rather clunky half unit that was the least I could inject at a time with my pen it feels like a whole different world of Diabetes control.

Have only had one slight…erm…hiccough so far, Deanne dropped me off at the hospital and went off with the little ‘un to playgroup, when I finished she couldn’t pick me up ’cause he was having a sleep so I decided to walk back from Dundee house at City hospital to home, near where Edwards lane meets Mansfield Road, got home, decided to have some lunch and my blood test was 2.4 mmol/l. Oops! However it’s a good lesson that I still need not to be a complete donkey when managing my diabetes!!!

Apart from that I finally made it in to work at about 2pm and everything seems to be going very nicely so far.

More to come as I work out what’s happening.

Oh yes, one last thing…I think I might have to shave my belly :-S