Donald writes: Tuesday 19th March 2013 will forever be known as P-day. The day I was plumbed in to my insulin pump. Just three days into the new regime and I can already see the major benefits. So far, not a single hypo. They have started me off running slightly higher BGs than usual, and are gradually dialling in more and more settings to tailor the pump to my metabolism. The first day saw a potential problem which fortunately happened at the clinic. Sky-high BG readings shortly after putting in my first infusion set. Change of set and cartridge, plus a bolus with my pen and when I took the old cannula out, the reason was discovered. Bent double. Since then, all infusion sets have gone in cleanly and are working perfectly. But lesson learned, to always test my BG an hour after changing my set.
I can’t praise the team highly enough who are seeing me through this transition, and most thanks go to Joan Grant at the Royal Infirmary of Edinburgh.
The first meal out with the pump is tonight. Planning to go Italian so I may experiment with the dual bolus feature if I opt for pizza. I’m finding that I’m eating less already as I don’t have to cram carbs like a ravenous chimp when my BG dips too low. The rule to only take 15g of carbs to treat a hypo is going to take some getting used to. Normally I empty the contents of the fridge, biscuit tin and sweetie drawer down my throat.
So far so good. Here’s hoping that the funding keeps coming for this life-changing treatment. I waited three years but it’s totally worth it.
Had my first on-pump hypo yesterday but I can pin that on additional activity and a delayed lunch. Been experimenting with combo boluses and put in a reduced basal rate for a couple of hours to allow me to walk around Edinburgh without the worry of another hypo. Still getting peaks during the night and will be glad when I’ve got this aspect sorted as I don’t want to have to get up at 2 or 3 am for the rest of my life. So far, so good. No sky-high readings and just the one hypo. Tomorrow is the one-week mark, so I’m hoping that the honeymoon won’t be over then. Funny thing is, it feels totally normal now having this wee blue box attached to my side and I’ve already got used to not reaching for my pen after meals. All the paperwork is a bit of a pain in the arse, though, so it will be a relief when I don’t have to fill in forms in triplicate every time I look at a biscuit.
I think it took me about three months to get the settings right; but I still fiddle around with them from time to time – it’s a way of passing the long winter evenings.
It’s surprising how quickly you get used to being attached to a pump isn’t it? I hardly ever noticed it after the first few days. Weird, eh?
I think getting the basals sorted overnight is fairly easy – you don’t really do much, aside from sleep, so it’s all nice and stable. Working out basals during the day I found a bit more complicated. Some times I ended up throwing the damned pump across the room with frustration (just as well it was attached to me). But it’s worth the effort!
Overnight basals now sorted (I think) – at least it’s staying level overnight so no more 3am correction boluses. Managed to hit 14.0 late morning, so did a correction via the pump. 1 hour later, it was up at 14.9 with 0.6 ketones. So back to the pen for a 4 unit correction dose, trick the pump into delivering 4 units (whilst disconnected from my tummy) to keep its records up to date and changed the infusion set a day early. Here’s hoping that it was the infusion set to blame…. be glad when Joan’s back on Tuesday and I can pick her brains about getting my levels down into single figures.
Still keeping the levels level overnight, but spiking after meals. Does this mean that my carb ratio needs adjusting? So far, I’ve just been working on the basal rates. Finding that I spend my whole day testing and correcting high BG levels…
Could be the cab ratio. When I started on the pump, I just worked on basals and ignored post-meal spikes until I thought I’d got the basals worked out – a few weeks of high BGs isn’t oging to kill you. I found it too difficult to work on basals and ratios at the same time – but then I’m a bit thick!
Been to see Aunty Joan this morning and she’s sorted out my carb ratios for me, as well as reducing my target area to 7.0. I was on 1:8 but now I’m on 1:5 which is pretty much what I was on with the pen. Here’s hoping. I did a test in the clinic an hour after breakfast to prove my point: 21.0. Been working on the basals myself and not doing any damage.
Yet another set change this morning – I’ve been doing so many correction doses it’s not lasting the recommended 3 days. Rather than be woken by the pump alarm (a wonderful electronic rendition of Beethoven’s ‘Für Elise’ which offends my musical ear) at 4am on a Saturday, I decided to change the cartridge this morning (last change was on Weds morning). The previous set was a bit nippy when the insulin went in, so a change has made things a bit more comfy. Levels went up overnight last night for some weird reason. 11.5 up to 14.0 despite having 2.85 units on board when I turned in for the night. Not sure why, unless I’ve been sleepwalking and eating crisps.
Things are improving day by day. No results in double figures all weekend, and no hypos either. It’s now Wednesday and I’ve had a couple of hypos, but I will learn to gauge the CHO in risotto a bit more accurately in future. Only snag is that the cartridge really won’t last 3 days at this rate, so I’m having to change the infusion set every second day. Either I live with this, or eat lower carb meals. I’m now finding places where the set works really well, and others where it’s a bit uncomfortable. Totally accustomed now to not injecting after meals. And I’ve only had one collision with a door handle. All positive stuff. Long may it continue!
Spoke too soon. Just tested and it’s up at 24.7. With 0.9 ketones. Ouch. I’d changed my set after breakfast, so the breakfast dose had gone in OK. The new set, however, was as bent as a very bendy thing, and then some. So I hadn’t had any more insulin going in since about 9am. Manual injection by pen, same amount bolused through a disconnected tube, new set plumbed in (don’t forget to take off the covering from the sticky plaster – I did and just punched a large bloody hole in my side). Mopped up the results, got yet another fresh set and this one is now attached. Fingers crossed this one’s gone in OK.
All sounds good, wholesome early-pump-days Donald! Before long you’ll be able to do set changes in your sleep and you’ll probably find the incidences of set failures will decrease. However, I guestimate that one in every, mmm, 15-20 sets goes wrong. I wonder what everyone else’s failure rate is?
Anyway, I had loads of “oh shit” moments when I started on the pump – with high BGs galore! But it’ll get better!
Argh! Annette – you’ll have just invoked the powerful “Curse of the Pancreas”! The minute you say something like “I never get a kinky canula” or “I never have night-time hypos” is the minute that precisely that thing happens.
Just tried to set up Diasend, having discovered that my ancient Mac is actually just one decimal point new enough to run the software. There’s a log-in button but nowhere a new user can register. Is this something your DSN or the Animas rep has to do for you?
Latest update – a few hypos so I’ve been tweaking basal rates and it looks like they’re working (for today at least). Set changes becoming second nature now. Having a few carb-free meals now and again to enable the cartridge to last the full three days. Weight has dropped by 6lb in 4 weeks but my kilt belt is still a bit tight 🙂
Hi Donald, I use Diasend and I definitely didn’t need a rep or DSN to set it up – can’t quite remember what I did though! If you click on the log in does it give you the option to register? Are you doing it via the website?
Registered, downloaded and the software won’t run. It says it will run on Mac OS 10.5.7 or later. I’m 10.5.8, which should work. But it doesn’t. I’ll have to try it on my similarly ancient laptop (vintage c.2006). Fingers crossed . . .