Sunday, 29 September 2013

Day Eight

Today started with good levels and the remained good all day, including when going for a 25 mile bike ride whilst running a 50% Temporary Basal Rate, so it's looks like I'm close to getting my levels dialled in.  Time to look at the stats...

Yes, that's a fairly complex looking graph, but it's really quite interesting once you work out what's going on.

The vertical red line, I've added as that's when insulin went into the pump.  The green band is what my target range is currently set to (6-8), the little x's are BG readings and the dark horizontalish line amongst them is the trended average.  As you can see, it's on the way down :o)

So, how has it been being attached to the pump all the time?  Well, it's been fine.  I haven't found it annoying yet and in some ways it's been slightly comforting having it.  It's been to work, the daily commute (2 bike rides and one train each way) a lively gig, a charity quiz night, a mountain bike ride and a road ride and even the dentist.  In all these situations I've had no issues at all.  Next week it gets treated to a physio session, badminton and another gig :o)

I think the pump is brilliant and wouldn't want to be without it now

Saturday, 28 September 2013

Day Seven

It's all still going well, and from the various logs and charts, there does seem to be a slight downward trend in average BG levels.  I shall examine the stats in more detail over the weekend.

After a call with my diabetes nurse, we've decided that as things are going well, we'll lower my target range and up my insulin to carbs ratio.  This should, hopefully, bring BG levels down to a good level on a more constant basis as I've been a bit 'peaky' after food.

Friday, 27 September 2013

Day Six - night out

Another good day with the pump.  Levels pretty stable, no issues and using the pump is becoming second nature.  TBRs, Multiwave & Extended Bolus's, all things that were out of reach when doing 'normal' injections, are very useful and despite being a bit daunting to start with, easy to use.

Today saw a big test - a gig at the Underworld in Camden to see The Howling.

Going to see The Howling is usually a pretty lively affair and they didn't disappoint, loud, lots of bouncing around, lots of heat and sweat.  So, how did the pump cope?  It didn't miss a beat.  

Wednesday, 25 September 2013

Day Five

The first night on a 'live' pump last night and it's a revelation.  Had to do a 2am test - 4.6 was the number.  Normally I'd think 'hmmm, that's a bit on the low side', but threw caution to the wind and just went back to bed.  06:30 hours and a test reveals 4.5.  Now that has never happened before, I was usually going slightly high in the mornings.  I'm impressed.

More training and a run through of the differences between Standard, Extended and Multiwave Bolus as well as Temporary Basal Rates (TBRs) Interesting stuff.  I think I've understood it all and will be put putting it into practice later in the day.

My copy of Accu-Chek 360 arrived today, so that was duly installed and the infrared USB reader doodah connected.  I have my blue light now :o)

I gave the software a quick run through and it all seems pretty straight forward and gives loads of data & graphs, etc.  I can see me using this quite a lot.
The nice people at Accu-Chek are also sending a copy of the configuration app as well, which will make changing pump settings nice and easy.

I also headed out on the bike for a couple of hours this evening, and following the advice I was given earlier started a TBR of 50% 1 hour before I went out until 1 hour after my return. Before I started the ride I was 7.5.  Previously I'd have had something to eat to 'top myself up' and invariably I'd get back after a couple of hours at around 5 or lower.  Not today.  Today I just started the ride, tested myself about half way (6.7) and as I finished, tested again and was 6.9.  Awesome - TBR's work!

Just got to see what happens tonight now, another 2am test awaits.....

Tuesday, 24 September 2013

Day Four, or should that be day one? Insulin!

That's it, no more dry runs and fiddling without consequence, the pump is now running for real with insulin.

More training today, a fair bit to take in, but I think I got it all.  I was warned by various people that my levels would likely be a bit wayward.  Well, they were right, it's been a day of literal highs and lows, but nothing too bad.

Filling the cartridge from a vial was a bit like the old days when the drill was a vial of insulin and syringes.  It was strangely comforting doing something I hadn't done for years, but at the same time excitingly new.  Some more training and tweaking tomorrow.  If all goes well, I may venture out on the bike tomorrow evening.

Monday, 23 September 2013

Day three - The office

First day at the office with the pump and the dilemma of what to do with it.  Tried a few different options:

  1. Hanging from a lanyard round my neck.  This was somewhat annoying and, frankly, looked daft underneath a formal shirt
  2. In a pouch clipped to the inside of my trousers.  Pretty much invisible, but a bit annoying at times, especially as I get to work via Bicycle and train.  Persevered with this for a few hours before reverting back to:
  3. Belt Clip.  It's on show and the tubing could snag, but was by far the easiest / most comfortable solution.

I guess the next step is to start looking at deploying scissors to pockets!

Tomorrow is the next big step - using the pump for real.  I think that, despite being physically connected to the pump 24x7, it will be quite liberating!

Sunday, 22 September 2013

Day two

The pump was taken out in public yesterday, to a wedding reception, which involved the usual dancing and general tomfoolery that wedding receptions require.  I was aware that I had the pump with me, but it didn't get in the way and I forgot about it for much of the time.  I had the pump in the belt clip, it stayed where it was put and I don't think anyone else noticed it was there, despite the infusion tube hanging out from under my shirt a few times.

I reckon that's a pass.

I've been impressed with the Bolus calculator on the meter and used the recommendations it  makes for units of fast acting insulin and injecting it with a pen (no insulin in the pump yet, that happens on Tuesday).  All was going well, but then I found myself having a hypo.  I was a bit perplexed, but a bit later sussed out what had gone wrong.  The pump hadn't had any basal data entered into it, so it rightly assumed that I had no insulin in me.  Trouble was I did as I'd had my long acting injection as usual, so a hypo was inevitable.  Technology is great and the Combo system is impressive, it's downfall is that it was given to me and my stupidity!  A hypo shortly before going to a wedding reception, hardly ideal, but that's all part of the deal for a T1.

Today has been spent playing with the Combo and getting to grips with what it can do and how to do it whilst it's not loaded with insulin.
 If's there's one thing Accu-Chek like, it's documentation,  I reckon there's at least about 1,080 pages of the stuff!

I've been learning how the different Bolus modes (Standard, Extended and Multiwave) work as well as how the Basal works.  I think I now know the reason that DG tests 'every two hours for 24 hours' was mentioned.  Can't say I'm looking forward to that!

Saturday, 21 September 2013

One day in...

It's been nearly 24 hours since I received my pump, thoughts so far...

Where to put the pump?  Well, don't know really, just a case of trying different places.  It's been most frequently on the belt clip at the moment, this was me at work earlier

My biggest fear, well the only one really, was what would I do with it at night and I'm still not sure.  Last night, I used the waist strap that came with the pump and it seemed OK.  Was I aware of it being there?  Yes, but it wasn't uncomfortable and didn't really 'get in the way'.  I'm pretty sure I slept on it at some point.  The cannula stayed put, nothing was pulled out.  Here's a picture of the pump on the waist strap - it's not going to be winning any fashion awards.
No, that's not me in the photo

First impressions on the meter - it's bloody good.  The bolus calculator is great - no more sums - test blood, enter carbs and the meter does the rest.  It'll be even better from Tuesday when the pump is delivering insulin.  The meter also has some nice graphs and lots of info on what it, you and the pump have been up to.

The screen itself isn't anything like as good as , say, Apple's Retina screen, but it's clearly legible and does the job well.
The only thing the meter is missing, is a nice blue light.  Blue lights make anything awesome ;o)

Getting the pump

Yesterday I got my pump, an Accu-Chek Combo.  It came in a big box with a bewildering array of manuals and ancillary bits.  There was me thinking there'd be a lot less kit, I'm going have to rethink where to store it all now!

20th September 2013 by -Cheesyfeet-
20th September 2013, a photo by -Cheesyfeet- on Flickr.
I spent 2 hours at the hospital getting shown round the basics to get the pump and meter up and running.  I'll be 'using' the pump, but with no insulin in it until Tuesday morning when I go back for more training, so for now I'm attached to the pump, but still administering insulin via pens.  This gives me time to get used to the way it all works without the risk of cocking up on insulin delivery.

You can read all about the Combo via the link above, but it really does seem to be a very good set up.  The meter talks to the pump wirelessly, so you can do everything without getting the pump out.  It was slightly daunting at first, but everything is straight forward , and me reading some of the manuals before I got the pump certainly helped.

Walking out of the hospital with the pump attached and am arm full of everything else, it certainly felt like things were going to change.

So, what's it all about then?

Multiple daily injections are a pain, sometimes literally, but mostly just from the point of view of carrying stuff around, remembering to do them, doing the carbs to units sums and, occasionally, people giving you funny looks.

I'd heard about pumps and after some research decided that a pump would be good for me.  Specifically it was going to help with the following (in no particular order):

  • Forgetting to inject.  It's rare, but sometimes I'd forget if I'd injected or not.  Then I'd remember that I'd forgotten, or that I might have forgotten.  A bit of a conundrum, do I inject and risk having double what I need or don't and go high?
  • No injections.  Biggie this one, the pump replaces the need for all those injections every day :o)
  • Sports.  Despite not being one, I like acting like a teenager on a bike and doing silly things that can and do make me fall off (and occasionally break things), or just ride somewhere for a few hours.  Problem here is that with Basal (slow acting insulin) and Bolus (fast acting insulin) injections, ideally it requires some preparation in advance.  Reducing the Basal amount  can require that planning to be 24 hours in advance, so you'd reduce it, then it might rain biblically and the ride get called off.  That'll be high BG (Blood Glucose) all day then.
  • Less to carry around.  Don't need to carry the pen and needles as the pump will be attached to me.  Still need to take the meter with me though.
  • Gigs.  I like going to gigs.  Gigs and insulin pens are not happy bedfellows.  This may seem trivial, but hey, it's a solid reason to me!
  • Better control.  Highs are bad for you.  Lows make me feel like crap.  I'd rather not have either thanks, the way the pump delivers should smooth BGs out to much nearer normal levels
  • 'Dawn Phenomenon.  More often than not, I'm a bit high in the mornings when I get up.  The Better control will hopefully deal with this.
  • No more sums.  Believe it or not, when you're 'low' doing the sums (in my case 1.5u of fast acting insulin to 10g of carbs consumed) can be bloody difficult to work out if your a bit low.  Add in corrections (less or more on top of the 1.5 x 10) and sometimes I may as well just get a random number generator

There are some other reasons as well, but they ^ are the main ones

I won't go into details about how pumps work, etc as many people have already done this.  Have a look at the Diabetes UK Website to get started

Anyway, I'd made up my mind, and luckily my Diabetes clinic and Primary Care Trust agreed and a pump was funded.