Getting Used to an Insulin Pump

Posts tagged ‘Volleyball’

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!

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

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!

Up and Down

Up and Down

Up and Down

Having an odd day today – Control wise!

These are my blood test results since midnight:

Time 24hr Blood Glucose in mmol/l
02:30 31.7
05:02 27.0
07:01 23.8
11:32 13.2
13:00 7.8
14:26 2.9
15.11 3.9
16:17 2.9

Let me give you a bit more information…

Deanne and I had a nice meal together last night after we’d put the Young ‘un to bed, it consisted of Pizza, Garlic bread and then a wonderful chocolate Torte all from Waitrose (other supermarket chains are available!) I made some frankly random guesses about the carbohydrates but did do a bit of checking up afterwards and thought I’d massively overestimated. But as it turned out I hadn’t!

I woke up at 2:30 ish needing to go for a wee (sorry too much info.) but I also felt pretty ropey so decided to do a blood test as well, the 31.7 was not what I was expecting, usually my highs only go up in to the 20s even if I’m ill (which I suppose I might actually be).

I didn’t consider that my infusion set may not be working properly because frankly it was half past two in the morning and I wasn’t really thinking straight. So I stayed up and watched some six-s-side and beach volleyball on TV as it was on when I turned on the telly. I did the next blood test at 5 and was a bit shocked to find out I’d only gone down by 4.7 mmol/l. so I did another bolus and went back to bed.

Got up this morning and realised there was probably something up with the infusion set so I changed it (it was due today anyway) and waited to see what happened. Had my lunch at half eleven and was still 13.2 the pump gave me a couple of extra units bolus to get my blood sugar down!

It worked. The rest of this afternoon my blood sugar has been rock bottom and I’ve been eating Jelly Babies like there is no tomorrow.

I don’t feel particularly unwell, although I’ve had such an up and down day that it’s hard to say for certain and what I’ve eaten hasn’t been massively different to normal so I really have no idea what’s caused it.

I’m not asking for sympathy, advice or even acknowledgement from anyone I just thought it might interest those of you who are more newly diagnosed that even after 35…nearly 36 years of doing this I can have a bad day. I’m not trying to depress you all just reminding you and all of those who support and live with you that you can never take Diabetes for granted.

…and on that cheerful note I’ll sign off for now 😛

Unidentified Flying Illness

Unidentified Flying Bacteria

Unidentified Flying Bacteria

I’m Ill!

Okay that may seem like stating the bleeding obvious, however I’m not talking about my Diabetes, this is something new and frankly not super-comfortable. Let me tell you about it.

A couple of weeks ago we visited my parents in Dorset for the weekend, everything was fine until Saturday Morning when I started feeling a bit odd. Then at about ten or eleven in the morning I ran to the toilet and was ill. I continued to feel unwell for the rest of the weekend.

After getting home I forgot about it until the next weekend when I got a kind of pain under my ribs which lasted a good chunk of Saturday. We went to our neighbours’ house in the evening and frankly got a bit drunk, which was quite good fun, then on Sunday I didn’t feel great, which I put down to the alcohol I’d consumed, however I had a volleyball game on so I thought “self-inflicted, just put up with it” and played anyway (even with my ill-health and at-the-time-unrealised underlying health condition we won three sets to none – I actually played pretty well!!!).

Anyway, it got to Tuesday and as the day went on the pain under my ribs came back and I was having pains every time I took a deep breath in, coughed, sneezed or laughed…funny! I got myself to the NHS walk-in centre in town and got seen by a Nurse. Deanne had suggested it was Pleurisy but he discounted that because when he listened to my lungs they didn’t rattle, probably a good thing really.

After a bit of consultation he decided that it was possibly pancreatitis, caused by my recent-ish change in regime on to an insulin pump, he said this may have upset my pancreas due to the difference in my blood sugars and general control from being a bit random and bad to being quite well controlled.

This actually seemed to make a lot of sense to me but he said it was sensible if I went and saw my GP anyway so he booked me an appointment in the afternoon. I went and saw the GP and after a bunch of questions she decided that she wasn’t sure exactly what it was but that it may have something to do with my diaphragm and lungs or else something completely different so she gave me some pills called “lansoprazole” which seem to calm the acid in your stomach down so it doesn’t upset your other organs but sent me to the blood-letters at city hospital in the morning for a blood test just to discount the pancreatitis.

So currently I have no idea what’s wrong with me but still have pain and no idea when I’m likely to hear about my results.

Great!

A Long Afternoon

A Big Clock

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!

 

Feeling Better

12 Jelly Babies

12 Jelly Babies

Got to dinner time on Wednesday and was 2.1mmol/l…which is obviously low so it was at that point that I stopped giving myself extra basal insulin and the illness setting!

Thursday went pretty well, admittedly I woke up a bit high in the morning and my next blood test after that but after that I was between 5.8 and 7.6 for the rest of the day, including after volleyball, once again I didn’t try adjusting what I had with dinner I just ate 12 jelly babies over the course of the session and that seemed to do me fine!

I did however use the exercise setting when  got home and had supper, I normally have about 8.2 units for supper, my adjustment dose was -0.1 and the exercise setting removed another 2.4 units of insulin, I did this because I have woken up a few times after volleyball with blood sugar verging on the low side.

So I woke up this morning and did my blood test and I was…

13.7!

Hmmm, back to the drawing board I think.

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