Shoot Up or Put Up

I’ve used a Medtronic Paradigm insulin pump for the past 2 years. Pumps are getting more and more popular in the UK and I get asked a lot of questions. Inspired by Shelley of circleD fame here are the top 11 questions I get asked about using a pump (sorry, I tried for a nice round 10 but couldn’t quite manage it).

How does it work?
The pump is about the size of a mobile phone and contains a cartridge of short acting insulin that drips into your body 24/7 via a tube attached to your body via an infusion set.  It works like a pancreas giving you a constant  background drip of insulin called a basal rate and when you need extra insulin for food, high blood sugar etc you press a button to deliver a bolus. Most pumps have a calculator on them to help you work out if your glucose is X and you’re eating Y you probably need about Z units of insulin.

Do you still need to take injections?
Not unless you really want to in which case I’m sure you could inject water for fun. You need to change the infusion set every 3 days which is like an injection. You can put your infusion sets pretty much wherever you have fat – I swap mine around between my stomach, back, thighs and bum.

Are they hard work, do you need to blood test more?
A pump isn’t going to solve all your problems. I think it’s a great tool but you’ve got to put the effort in. Personally I think you need to be testing at least 4 times a day to get a good idea of what’s happening and be able to use your pump to get maximum control.

Aren’t they hard to get?
They shouldn’t be but they can be – it’s a real postcode lottery. The National Institute for Health and Clinical Excellence (NICE) basically says that insulin pump therapy is recommended as a possible treatment if you can’t reach your target HbA1c without experiencing disabling hypos or your HbA1c is above 8.5% despite you carefully trying to manage your diabetes. The first step is to talk to your consultant. INPUT is an insulin pump support group and have some great advice on how to go about getting a pump.

Can you fly with them?
No, you still need to use an aeroplane; pumps can’t generate enough lift to transport a human. But you can take them on planes with no problem at all. You can go through the airport security scanners with it on and it doesn’t set them off. If security spot it they often think it’s a mobile, a quick explanation usually sorts it.

Can you swim with it on?
My pump isn’t guaranteed to be waterproof, some other makes are. Personally, I take it off to go swimming if I’m going to be in there less than an hour. If I’m going to be longer I take a bit of extra insulin before I take it off. I’ve also got a waterproof cover for it that I used when I went white water rafting.

What do you do with it when you ahem, blush, you know with your husband?
Personally I take it off. I know some people leave it on. It’s completely up to you.

What’s it like being permanently attached to something, doesn’t it get in the way?
You get used to it surprisingly quickly. If I’ve left the tubing hanging out it sometimes catches on door handles but it doesn’t hurt. If I’m trying on loads of clothes in a shop changing room I sometimes disconnect it for 5 mins and put in on the side so that I don’t have to worry about it. Most of the time it’s clipped onto my waistband or my bra and I don’t know its there.

What do you do with it in bed?
I sometimes leave it loose next to me in bed, I toss and turn a lot but it just follows me. Sometimes I put it under my pillow or clip it to my PJs. If you’ve ever had long hair, it’s a bit like sleeping with that, you catch it sometimes but you move it automatically in your sleep.

What’s the worst thing about the pump?
Two things. Firstly on a serious note, if you get a blockage in your infusion set you need to change it quickly as you’re not getting any insulin so your sugars rise really fast. It’s happened to me once in 2 years; I spotted it pretty quickly and changed the set. It’s easy to deal with but important to be aware of.

On a more frivolous note, it can lead to the occasional childish tantrum when I’ve found a beautiful dress and then have to figure out how to hide my pump when wearing it. It’s doable, there are loads of tricks, it’s just irritating at times.

What’s the best thing about having a pump?
I’m going to cheat and have three best things. Firstly the ability to adjust my basal rates so I can set it to increase at 3am to solve my early morning highs, increase them if I’m having a lazy day, decrease them if I’m planning a lot of exercise etc. Secondly because you get insulin at the push of a button I now take a few units 20mins before a meal to help flatten out the peak and more through the meal as and when I’ve decided what I’m eating. Third is the fact that I no longer spend half my life thinking “have I got my pen with me” because it’s attached – I wasn’t expecting that to be a benefit.

So, that’s my view on the things people usually want to know, if you’ve got other questions or views just leave me a comment.

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