So here we are, three weeks after being cybernetically transmogrified into one of the Borg / Cybermen / Culture (delete as applicable depending on your personal science fiction preferences), how have I found my initial weeks of pumping?
In general, not bad at all. To begin with a pump is certainly a very steep learning curve. As I mentioned in an earlier article, we set all my usual basal rates, carb ratios and so on back to bog-standard default levels and have worked them out again from scratch to allow for the greater flexibility that a pump affords. I also think on MDI I had too much favouritism towards a high background level of Lantus and relatively low boluses, so I’ve used this as an opportunity to get the basal / bolus ratio closer to 50 / 50.
The primary consequence of this is that instead of automatically putting in, say, 8 units for a plate of whatever I now put in, say, 11 units. After years of guestimating my insulin amounts this takes quite a lot of re-training to get used to the new amounts. However, this transition has been helped a great deal through the wonderful bolus wizard.
I’ve been using the Bayer Contour blood glucose meter which beams its results to the pump by radio frequency (cool, I know!), I then dial up the amount of carbs I’m stuffing down my neck and said wizard works out how much insulin I should put in. I can, of course, disagree with it and change the amount, but usually I just do what the computer tells me to (that’ll be that Borg / Cyberman / Culture thing kicking in). When I accurately carb count this has resulted in bang-on accurate levels two or three hours after eating. Top stuff!
Of course, the pump itself is just an expensive paperweight unless it’s fancy bolus wizard and flexible basal levels are tailored exactly to me and this is what I’ve been doing for the last three weeks. I’ve been doing the usual logging, testing, logging, testing, logging, testing and looking at results.
At the beginning I was testing about 15 times throughout the day and night (this, dear readers, is an astonishing amount of fun – try it!) but I’m now doing a good 6 or 7 tests a day. I’ve been using the results to gradually adjust my basal levels, bolus ratios and so on pretty much every day and then looking at the resulting results.
After about three weeks this is starting to get some nicely consistent levels throughout the day; but it’s still not perfect – I’m going high first thing (waking up at about 9.0) and low in the late afternoon (dropping down to about 4.0). This doesn’t sound too bad but the pump allows me to further fine tune its settings to ultimately (I hope) get it pretty much perfect.
In terms of other, more general stuff, the pump has been great. It’s not a problem being connected to something all the time. After a week I hardly noticed it during the day and after a couple of weeks I don’t notice it during the night. Set changes are easy after a bit of practice and I can almost do them blindfold (now, there’s a party piece!)
I love the fact bolusing is so convenient. I now bother to stuff in half a unit for that small biscuit I shovel down my gaping maw, whereas before I wouldn’t have bothered. In restaurants I’ve also found it easier to discreetly fiddle around with the pump rather than get out the pens and inject. Equally, I can shove half my estimated bolus in before food arrives so it starts working and the remaining half when food arrives. Previously on MDI I wouldn’t have bothered with two injections.
So there we have it. Pumps certainly are hard work and can be frustrating to set up, but even though I still haven’t got it configured perfectly I think I will and life will be that wee bit easier as a result. So double thumbs up for pumps!