Shoot Up or Put Up

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by Tim

Great expectations met

14 March, 2011 in Kit & equipment, Living with diabetes

Readers with a memory slightly longer than your average goldfish may dimly recall that I before I started on my pump I made some predictions about how I thought a pump might benefit me.  So four months after starting said pump, have these predictions come true?

Basal rates

I mentioned that like most of the pancreatically challenged horde, my insulin needs vary throughout the day. I used to put in about twice as much Humalog in the morning as I did in the evening. I hoped that a pump will ultimately allow me to up the basal rate early in the morning, allowing me to smooth off that irritating post-breakfast high.

And this is exactly what has happened. My pump automatically ups the background level of insulin that dribbles into me while I sleep and then tails off during the day. This means I wake up at a good level and carry on throughout the morning without having my traditional before-lunch-hypo. Score one to the pump!

Basal rates (again)

I mentioned that during the week I lead a relatively sedentary life, sitting in my office and only venturing out into the daylight to grab a sandwich at lunch time. However at weekends I am, sometimes, a ball of energy – long walks in the Pentlands, cycling, working through the long list of chores Katie has given me and so on. Hypos at the weekend were therefore much more of a problem.

Lantus just didn’t have the flexibility to allow for on-the-fly adjustments. However, the pump allows me to temporarily reduce the amount of insulin that goes in when I’m out of the bike, walking round John Lewis (a notorious hypo spot) and so on. After a bit of practice, I’ve got the amount I need to adjust my basals down to a tee. Exercise hypos are now a thing of the past. Score two to the pump!

Difficult meals

We all have our diabetic food nemeses – fish and chips, Chinese take outs, pizzas. I hoped that I could use dual wave boluses and other fancy pump things to help take account of dietary misery.

I tend to use dual waves occasionally but they don’t seem to have made a wild difference to tackling difficult foods. Maybe that’s because I don’t tend to eat them often and so haven’t had much practice. So we’ll call this one a draw.

More flexibility

I muttered about the crudeness of injections – the Autopen 24 for Lantus could only do double units and the finest control you can get with a Humalog-filled pen is a half unit. My pump goes down to 0.1 of a unit. When combined with the wonderful bolus-wizard, tiny units really come into their own. You can really, really fine tune things. A definite score for the pump.

The cyborg thing

I wondered whether being attached to something all the time would be a problem. It’s not. I got used to having the pump within a few days. Even in bed. Yay!

Other stuff

A few other benefits of the pump spring to mind after using it for four months. Firstly I have far, far, far fewer hypos. Instead of being an everyday occurrence they are now a rarity.

I used to expect to have a hypo before lunch and before dinner – it was just part and parcel of having diabetes. Now I realise with a pump I didn’t need to have all these hypos – I could adjust basal rates and carb ratios to keep my levels just right all through the day.

As well as avoiding the misery of hypos, this also has had the added benefit that I now consume far fewer fruit pastilles, Lucozade and so on to combat said hypos. This has meant I’ve lost nearly a stone in weight. Bonus!

I’ve also found that using a pump in public is far more discrete and convenient. I’ve never been shy with injecting in front of other people, but just dialling up a few units on the pump is three million times easier than getting a pen out, pulling up my shirt and injecting. In fact, because it’s so convenient I bolus for tiny things – like apples, oranges and other snacks – for which I wouldn’t have bothered before. This inevitably leads to better overall control.

So the pump has given me everything I expected it would do and more. It’s a brilliant bit of kit that has given me much more flexibility in day to day life and has genuinely improved my quality of life (it wasn’t bad before, it’s just better now). So all-in-all double thumbs up for Englebert Pumperdinck!

Video Blog – Being attached to a pump

12 February, 2011 in Video Blog

Lots of people ask us what it’s like being attached to an insulin pump all the time. In this video blog we talk about what it’s like to live, breath and sleep with a pump:

Avatar of Alison

by Alison

Identifying the perfect piece of flesh

2 February, 2011 in Kit & equipment, Living with diabetes

The thing about injections and infusion sets is there are so many options and such a vast selection of flesh to put them in it’s hard to know where to start. 

I started young with the whole injection business and with that came a picture of a man/woman/android complete with grids on each injectable area. Each thigh and buttock was divided into 8 squares, the same for the stomach and a grid of 6 on each arm. Then as you injected in each place you coloured in the corresponding square on your man/woman/android. When the picture was complete, thrillingly you got…another picture to start again on. That was my first lesson in quite how monotonous this diabetes thing can be. 

But, aside from the repeated disappointment it did set me off on a lifetime of site rotation which is no bad thing. When I stopped using the pictures I did rebel and have been doing so ever since…without the motivation of having some squares to colour in I stopped injecting in my arms. I’ve never liked it; I only did it so I could complete the picture and move on to the next man. 

Infusion sets are a bit harder than injections because wherever you choose to stick it, you need to be happy you can live with it there for 3 days. My favourite spot is my lower back. It’s the quiet little cul-de-sac of the body. It’s out the way so I don’t see it if I look in the mirror and there really isn’t much activity or passing traffic to tangle with the set and tubing. It’s perfect. It’s also my favourite spot for CGM sensors so they usually get priority there and infusion sets are relegated to the thigh or buttock. Either is fine but it did take a while to stop me pulling the thing out every time I pulled my pants down. In the early days of thigh/buttock exploration so many toilet trips ended in much cursing and irritation. 

The stomach seems to be the spot where most people start with infusion sets. I venture there every now and again for a bit of variety but it’s my second favourite sensor spot so I do like to save it for them. 

I use Quicksets on my back, thighs and buttocks and they work really well for me. For my stomach I prefer Silhouettes. While I may be an insulin tart, when it comes to infusion sets I’m quite the young innocent. I found two that work really well for me and I’ve stuck with them. 

The final piece of the butchered human injection/infusion set site puzzle is arms. I don’t do arms. At all. Ever. I’ve reached a level of maturity where not even the satisfaction of being able to move on to another picture would make me do arms. Maybe if I was offered diamonds or holidays, or a significant amount of cold hard cash for a fully coloured in virtual person I would consider it, but for now, arms are safe. 

What about you? Where do you put yours?

Avatar of Alison

by Alison

Where to put a pump

31 January, 2011 in Kit & equipment, Living with diabetes

Now you see it

The human body is a marvellous thing, but it is sadly lacking in storage space. All the organs have their own spot, but there’s no room for expansion. When you decide to wear your pancreas on the outside rather than the inside, it does make for an interesting storage challenge. Where the hell do you put it?

I mostly wear my pump clipped to my waistband.  It’s convenient and I can get at it easily. People rarely notice it and when they do they think I’m a relic from an age before mobile phones and have a pager clipped to me. I’m not quite sure what they think the tube is for; perhaps it’s a petrol powered pager?

The waistband clip thing works well for me but the ongoing costs are rather high. There isn’t a doorway in our house that doesn’t have a paint chip in it at waist height. The pump is less than an inch deep and it’s not like I only have an inch clearance either side to pass through a door. Nevertheless, the pump and the doorframe are great friends and I’m sure we have to redecorate more than the average person because of it.

Trouser pockets are also a good place for hiding a pump. That’s fine with jeans but I find with tailored trousers it just looks plain weird. I’d rather have a visible pump on my waistband than a bizarre rectangular bulge in my trousers.

Now you don't

Some people manage to run their tubing down their leg and then clip the pump to their sock. I’ve tried this once. I hated not being able to get at the pump easily and the tubing really tickled.

All these ideas are of course marvellous, until you decide you’d like to wear a dress. Then it gets a bit more complex. You can get a garter type thing that goes round your thigh and you attach the pump to it a la Lara Croft. This is marvellous for pretending you’re a superhero, but beyond that I seemed to spend a lot of time fretting that it was going to fall down or exposing myself to the world as I pulled my skirt up to try and get to the pump.

I find bras to be marvellous pump storage devices. I clip mine in the middle at the front. I can’t feel it there and although I can see it clearly from my viewpoint, careful posing in front of the mirror shows it to be invisible to all except the most dedicated perv. I have my pump and CGM alarms set to vibrate which does mean that I occasionally find my boobs start vibrating mid conversation. This is initially quite unnerving but curiously I’m now used to it. I look on it as one of the more entertaining diabetes complications.

The other danger with bra based storage is that you inevitably have to delve into your cleavage at the dinner table to retrieve the pump. Remarkably, most people don’t notice and if they do it normally starts off a good conversation. It’s certainly less embarrassing than when I tried the thigh holster thingy and seemed to spend the whole day flashing my knickers.

Who’d have thought you could get 3 paragraphs out of insulin pumps and bras? Anyway, last point on bras is that some people manage to put their pump in the side of their bra. I’m impressed they manage it but to me it always feels like I’m wearing an insulin pump in my armpit which I’m never going to enjoy no matter how hard I try.

So that’s where I’ve had my pump over the last 4 years. If I’m getting changed I sometimes clip it in my hair briefly rather than take it off or keep moving it around, but that’s never going to work for me longterm. Where do you keep yours?