As I keep banging on about it, beloved readers of your soaraway Shoot Up will, by now, be well aware that I was hooked up to an insulin pump earlier this week. Anyway, I’m pleased to report that I’m still alive and all seems to be going well so far.
Training started up at the Royal Infirmary on Tuesday with a small group of slightly apprehensive pumpers, accompanied by DSNs to a ratio of 1 nurse to 2 patients – so top quality training provision. We were led through how to do the button pressing on the pumps (pretty straightforward); how to insert an infusion set (pretty straightforward but slightly fiddly) and the basics of pump use (easy to get not bad control, complicated to get it perfect). Training consisted of a base of top notch textbook knowledge, backed up with a tonne of useful, practical experience from our DSNs. We were all finally hooked up by midday and allowed to escape for lunch.
To make things as simple as possible, we were advised to use a flat, constant basal rate and to use one carbohydrate ratio all through the day. The theory being that once we’d established what a basic, flat level did to us we could then start fiddling about customising one thing at a time. We also reset our usual BG targets to between 8 and 10 – somewhat higher than usual, but a much easier level to recover from if something went horribly wrong! So to achieve this, my DSN plumped for a basal rate of 0.875 units per hour and a carbohydrate ratio of 1 unit of insulin to 10 grams of carbs.
More training followed in the afternoon and once our BG levels looked like they were behaving themselves we were released back into the community. We were advised to keep checking our blood glucose every two hours during the day and every three hours during the night. If you are looking for a miserable way to spend a couple of days, then I can highly recommend BG testing every three hours through the night. Hideous though it was, it did – of course – allow us to see what was happening while we were asleep. In my case, not a lot blood-glucose wise. We all had our DSN’s ready on call all through the night and I’m pleased – mainly for Joan’s sake – that I didn’t really have any problems; but it was highly reassuring to know a DSN was only a phone call away!
Two days later saw us all back at the Royal Infirmary – considerable more cheery and already swapping war stories of our limited pumping experiences. In general, pumps got the thumbs up, once allowances had been made for early teething problems.
So after four days, I’ve begun to establish a pattern of my blood glucose through the day and I’m starting (with the help of my DSN) to tweak things and customise them to my needs. Which is nice.
It’s obviously early days yet, but I’ve been impressed with the pump. There are a whole load more variables you can adjust when compared to MDI – which is both a good thing and a bad thing. It gives you more flexibility but also more things to potentially screw up! I like the fact I don’t have to inject and I love the bolus wizard (the built in calculator which tells you how much insulin to put in).
So there we have it – Englebert is certainly in my good books, but it’s early days yet. I’ll report back with an update in due course!