Trouble in paradise?

So me and my pump are not currently on speaking terms. I'm 'in a mood', and giving it the silent treatment, despite it being our ‘one week anniversary’. It has given me so much grief and stress this weekend I think my hair is going grey.

I'll take you back to Friday when it all went horribly wrong. My blood sugars had been great all day, and I was getting ready for my 2nd night out since the pump with some friends (I must have been feeling particularly sociable this week).

I tested my blood sugar just before I was about to leave to find that it was 19. This is very, very bad. I gave myself a correction and helplessly waited at home, testing every 10 minutes to see if it was going down.

This high blood sugar was annoying for several reasons.

I was all dressed up in my glad rags and moments away from possibly having the best night in my life (doubtful, but who knows)

They had been fine all day, why had it decided to spike now?

Was my pump working? Had I eaten something and forgotten to adjust my insulin?

So I sat and waited... and waited.... and finally it started coming down. It should normally take between 15 and 30 minutes for quick acting insulin to take effect. Which just proves that my pump was in fact working, and I know that I added my food up correctly the last time I ate.

Despite all this I left the house and went out with my friends. But at the back of my mind I was constantly thinking about my blood sugars, and sneaked off to the toilets every so often to test them.

The next day I got up at 7am to catch an early train to London, I'm moving there in 3 weeks and was planning to stay with my cousin Saturday night and explore the area a bit more.

My blood sugar was 15 when I got up, again annoying, but I was due for a site change and decided to disconnect, have a shower and then put in a new cannula/cartridge.

When I got out the shower I was experiencing classic hyper symptoms. I was thirsty, had a dry mouth and my vision was going a bit blurry. I tested (by this point my fingers were ready to drop off) and it was 25!

I went into panic mode. I did my infusion sight quickly and gave myself a correction. Thinking it would sort itself out in half an hour, or at least drop, I carried on getting ready so I could make my train.

But oh no, my blood sugar was rising, so obviously there was some sort of problem with my pump.

I went through all the possible reasons why the pump might not be working, and noticed that the tubing was all scratched and kinked. It was clearly faulty.

By this point I was in tears, I had missed my train. I felt so alone and scared, all I wanted was to take the stupid thing off and crawl back to bed as if none of it had happened.

But I couldn’t. I changed the tubing and sure enough, my blood sugars started to come back down. My worried parents offered to pay for a new train ticket so I could still go down to London as planned. Within an hour my blood sugar had come down considerably, I dried my eyes and made my way to the station.

I could try and pretend that this has been a one off weekend where things have gone wrong, but I don’t think that is realistic. I think I’m probably going to encounter a few more ‘teething’ problems in the next few months before I’m settled. I just hope that each time I get stronger and can cope with it better.

I’m putting a lot of faith into this little machine and feel a bit betrayed by it right now. Hopefully this will just be ‘a lover’s tiff’ and we will kiss and make up by next weekend

I'm not as think as you drunk I am

So last night was my first experience drinking alcohol whilst on the insulin pump, for educational purposes of course. But in all seriousness I wanted to see how the pump affected my blood sugar levels after drinking, and how I emotionally and physically dealt with my new companion when slightly intoxicated.

Alcohol consumption affects every diabetic differently, depending on how sensitive your blood glucose levels are. The general rule is that alcohol with raise your blood sugars temporarily, and quickly lower them several hours later as the liver tries to get rid of all the toxins you’ve been drinking. This is why most diabetics are advised to eat something stodgy after excessive alcohol intake.

I’m going to be honest and say that I rarely eat after I’ve been out drinking. Whilst some people suddenly acquire the urge for a greasy kebab or cheesy chips after a heavy night out, I’m the opposite. The thought of eating anything filling makes me want to hurl.

For this reason I only drink spirits and orange juice on nights out, and never any sweet WKDs or ciders which I know would send my blood sugar levels plummeting once I crawl back into bed in the wee hours.

So last night I tested my blood sugars before I left the house (they were fine), and carried on with my normal drinking routine. It was the first time I’d seen my friends since I had the pump fitted, and they were all intrigued to see my new toy. The pump loved all this attention, and wasn’t embarrassed at all to be seen in public.

By the end of my night I think I’d shown the pump to anyone that was remotely interested in listening. But I was proud of how far I’d come and wanted to show everyone that it isn’t as scary as it sounds. Being connected to something 24/7 isn’t going to be easy, but I’ve accepted that the pump in just another lump and bump on my body that I’ve got to carry around.

I was a bit naughty and forgot to test my blood sugar before I went to sleep, but remembered first thing this morning when I woke up and was pleasantly surprised by perfectly normal readings.

So there you have it, I went out drinking with my pump and we both enjoyed ourselves. Next time I will remember to test before bed, but old habits die hard my friends.

To pump, or not to pump?

Throughout my life I have always been told “There is no such thing as a stupid question”.

Whilst the question itself might not be silly, you might feel like a bit of a plonker saying it. Chances are though; you’re probably just saying out loud what everyone else is thinking. So here are a few questions that I have asked for you. Thank me later.

Q. Will I gain weight on the pump?

A. Maybe. Eating and carb-counting is so much easier with the pump and you might be tempted to gorge on things you wouldn’t have before. But, you are in control of your own body, so if you decide to eat a lot of high-fat food – it’s your own doing.

Q. What happens if I lose the pump?

A. Losing the pump is a bit more serious than losing your keys. Firstly, if it came off and disconnected you’d probably hear it fall on the floor. It may be small, but it isn’t exactly light. If you took it off, say to go swimming and left it behind, you would have to claim it back on your house insurance. The hospital recommended insuring mine for £3,000. The same applies if the pump was stolen. You would have to resort back to your insulin pens until your pump company provided you with a new one. If your pump broke however, it is the pump company’s responsibility to replace it.

Q. What happens when I go through airport security and set all the alarms off?

A. When you’re going through airport security, or any security for that matter, you should always be prepared to show officials a letter from your Dr, explaining what the pump is and why you have it. I’m going away at the end of the month, and worried that I will get frisked at the airport. The animas trainers assured me that the pump shouldn’t set any bleepers off, but warned that I can’t be X-Rayed as it will interfere with the pump technology. So it is important to take a valid letter with you.

Q. Can I keep my pump on during a roller-coaster ride?

A. No! The magnetic forces in rollercoaster’s will damage the pump. So leave it with your scaredy-cat friend or relative and reconnect afterwards.

Q. Can I swim with the pump?

A. Depends if your pump is waterproof. Mine is, and when I asked my diabetic nurse about holidaying etc. she said to swim for an hour, reconnect for an hour, disconnect and swim for another hour and so on. Your blood sugars won’t be perfect that day, but you can still enjoy the pool.

Q. What happens if the pump breaks on holiday?

A. With Animas, you can take a spare! If you tell the company when you are going away they can supply you with a spare free of charge, should anything go wrong. I imagine this would be particularly useful and reassuring to parents of diabetic children.

And the final question is probably the most awkward...Mum, Dad, it’s time to look away now.

Q. Can I still have sex when I’m on the pump?

A. Um, yes. You can still ‘get intimate’ (my instruction guides' words not mine) whilst on the insulin pump. As I’ve said before, you can disconnect it for one hour. It might not exactly be romantic, but it is still possible. And if you’re lucky enough to go more than an hour, stop. You are making the rest of us jealous.

These are just a handful of typical FAQ’s concerning the insulin pump, but if you have any others that haven’t been mentioned, ask your diabetic specialist. You might think it is a ‘stupid question’, but I bet they have heard it before. If not, check out this YouTube link below for some answers. Warning: He is a very happy American, and makes me look like a miserable teenager in my clip, but he does offer some very helpful and informative advice. 

Fingertips of Steel

It had been 3 days since my new friend the pump was fitted, and time to change my infusion site and cartridge. I laid out everything I needed on my kitchen table, armed with 3 pages of instructions from Animas. I was visibly nervous and needed everyone to vacate the surrounding area so I could concentrate (anyone would have thought I was performing surgery on myself or something).

But this was a big step, and I wanted to prove to myself that I could do it alone. I filled up a new cartridge with saline, and struggled a bit using the old injecting method of a syringe. Anyone who has been diabetic long enough to have once used syringes will be fine I’m sure, but I was diagnosed in 2005 and had never seen one before. It’s quite hard trying to draw out the saline without getting any air bubbles, but the trainers told me that insulin won’t be as ‘bubbly’. Five minutes and a puddle of saline later, I had successfully loaded up my new cartridge.

Injecting the saline, the'old' way

Next comes the cannula! I managed to fire it into my stomach without any hesitation, but it is quite fiddly detaching the apparatus from the skin once it has fired. I guess it will get easier the more I practise. So at this point I had my new infusion site ready to be connected to my new cartridge, but I couldn’t figure out how to remove the existing cartridge from my pump. It was stuck on really tight, and nowhere in my instructions did it tell me what to do.

The apparatus to fire the cannula

This made me even more angry and stressed. How on Earth was I supposed to do this myself if the instructions weren’t even clear? I could feel a ‘diva’ moment coming on, so I decided to just save myself an aneurism and call the support line number on the back of my pump. It was about 8.30pm, so my call was transferred to the American line.

A happy American lady answered the phone, and I explained my problem to her. She helpfully told me that I needed to leave the tube attached to the existing cannula, and that way I could just pull it out. It made sense. She stayed on the line with me until everything was sorted, and I felt much happier. It was nice knowing that advice was only a phone call away.  And when she ended the phone call with ‘Have a nice day Ma’am!’ I found myself replying ‘You too.’

So there you have it. My cannula and cartridge change wasn’t exactly stress-free, but at least I know that I can call for help should I need it. I’ll just have to make sure for now that I change my site when my phone is fully charged, with reception. Shouldn’t be too difficult... right?

Moving on and today I had to return to hospital to switch my saline for real insulin. I was a bit nervous, because now I have no safety net to fall back on. My confidence took a blow when I showed the Animas trainer the cannula I had originally fired in on Thursday. When I removed it yesterday I noticed it was bent, and wondered if that was normal. It wasn’t.

All weekend I’d had my infusion set in wrong, and had it been real insulin and not saline, I would have been in trouble. The ‘diva’ in me wanted to just throw a wobbly; I hate not getting things right first time round. But I’m human, and I have to accept that this is going to take time and lots of practise.

My blood sugars were a bit too high when I went to the hospital, 11.7*, and so I decided to test my pump out and make sure everything was connected properly this time round and do a correction. A correction is where you inject (or in my case pump) quick-acting insulin into the body to bring down low-blood sugars. Within an hour it had worked, but a bit too well. My sugars had dropped to 4.4 in a really short space of time, and anything below 4.0 is considered ‘hypo’, and needs to be treated with some fast-absorbing sugar ASAP.

The diabetic specialists tell me that I’m going to have to test my blood sugar a lot over the next few weeks to try and fine-tune my pump to my body. I really wish I had fingertips of steel, because at the rate I’m testing I don’t think I’ll have any by the end of the month.

Come back soon for more blogs on questions you wanted to ask about the pump but were too afraid to ask!

*A good blood sugar level for a diabetic is between 5 and 8

High Maintenance

Two days in and already I can tell that I am going to be more high maintenance than my pump. I tested its versatility this morning and took it out for a run. I say run, actually it was more along the lines of a slow-paced jog. Nonetheless it was exercise, and I wanted to see how my pump coped when I was running in motion.

 

I clipped it onto my hoody pocket and double checked it was securely fastened, but still couldn’t fully let go. I held it like a mother holds a newborn baby, terrified it was going to fall on the floor and take a big chunk of my skin with it. To my relief, the pump didn’t jiggle about too much and after about 10 mintues I gingerly let go and jogged like a semi-normal person. I kept a watchful eye on it the whole time, but it behaved itself and stayed inside my hoody pocket.

It’s promising to know that the pump isn’t going to restrict the amount of exercise I do, which is limited I assure you. Now that I’ve got this new companion attached to my stomach, people are going to be intrigued and start asking if they can see it. So if I’m going to get my belly out on a regular basis I should really jog a bit more in the hope that a six-pack will suddenly appear over the next couple of weeks. Keep your fingers crossed for me.

After my sweaty jog, my parents practically shoved me in the shower (my first since the pump). Whilst my pump is waterproof, I wouldn’t take it in the shower as I obviously wouldn’t have anywhere to clip it on to. The Animas trainers assured me it was OK to disconnect the pump for an hour, but no longer, and the cannula can stay attached to my stomach. After a speedy 55 minute shower (I joke, my family would kill me) I simply connected the pump back to the cannula again.

A disconnected cannula

A connected cannula

What connects me to my pump

So there you have it. I’ve exercised and showered and no harm has come to me or my pump.

Join me tomorrow as I change my cannula site and cartridge for the first time, hopefully without any hiccups.

iPump

OK, so it’s in, I didn’t have a diva strop and the tubes didn’t strangle me in my sleep. But I am not ‘technically’ pumping yet. The hospital has given me the weekend to practise pressing buttons and pluck up the courage to fire the cannula into my belly without their help. So for now, the only thing that the pump is giving me is sterilised water (or saline if you want to be posh.)

WARNING: This is NOT a toy

The pump reminds me of an iPod, or an iPad. It's so clever and technical, but at the same time really ease to use. Of course, I'm from a generation that was lucky enough to grow up with technology, and have the advantage of just knowing how things work without having to sit down for 5 hours and shout at instructions. But don't be fooled into thinking that the pump is just 'young people', it can benefit any diabetic. I think that everybody, no matter how old you are or how good you are with technology would be able to wrap their head around it eventually, with the right kind of help and support. 

I’ve decided to record a video diary of the last 24 hours, rather than write it down. Hopefully this way you will be able to see the pump in its full glory, and you get to see me moving and talking. I really do hope you watch this clip, as I spent ages doing my hair and make-up to look pretty for the camera (what?! I’m a diva!).

I've realised today that the pump is not an easy way out. It's an amazing piece of technology and will do wondrous things, but only if I work with it. It doesn't have a brain, and won't know what to do unless I tell it too. In the long run, I expect good results from the pump, but for the next few months I'm going to have to put a lot of effort and time into testing my blood sugars and getting it in sync with my body.

Hopefully by Monday I will have successfully changed my cannula and loaded my cartridge up with some more saline! Then comes the real test as I go back to hospital for some insulin, and then me and my pump will be officially united in holy matrimony. 

Stay tuned for more blogs on practising with the pump, the mystery that is carb-counting and more tales of a ‘divabetic’.

D-Day

So today is the day I’ve feel like I’ve been waiting an eternity for. I go into hospital at 2pm to have my brand spanking new insulin pump fitted. I’m not exactly sure what this afternoon has in store to tell you the truth, and I think it's probably best that I don’t know. I have this awful habit of over-thinking and playing out possible ‘what if’ scenarios in my head. These are just a few of today’s pre-pump panics:

1)      What if... it hurts?

Ironically, I’m terrified of needles. Always have been, probably always will be. Before I was diagnosed with diabetes you literally had to wrestle me to the ground for any sort of medical jab. I don’t see my insulin injections as ‘proper needles’ though. I think because I’m doing it myself, and I am in control, it’s different. Blood tests on the other hand are a different story. Just the thought of one makes me go all miserable and moody (for future reference, it’s probably best to keep out of my way when I am due a blood test). Between the ages of 15 and 20, I point blank refused to have my blood taken. Mind you, my consultant didn’t really spend a lot of time trying to convince me to get out of my strop and just have one taken. Maybe he cottoned on to my ‘divabetic’ ways early on, and decided it would be better to just keep the peace. My main reasoning for thinking it is going to hurt is because of how everybody reacts when I explain the pump to them. When I talk about the cannula connected to a little tube under my skin, people subconsciously screw up their faces and make ‘ooooh’ and ‘ahhh’ noises, as if I am poking them with a metal prod. So pain is a major concern right now.

2)      What if... It doesn’t work?

In my head, the second I am attached to my new pump I think that all my problems will be over and my blood sugars will be right as rain. This is an illusion. In reality, yes, my blood sugars should in theory improve, but that doesn’t mean I should go back to my naive teenager days and sweep my diabetes under the rug. Once I’m ‘pumping’ (not sure if I like this phrase yet) I will be at a higher risk of ‘diabetic ketoacidosis’ (DKA). If my blood sugars are extremely high for a constant time period, my body will use fat as an alternative source of energy and produce toxins called ‘ketones’. This is extremely dangerous, and fatal if untreated. As I explained before in my last post ‘Pump It Up’, the insulin pump only uses fast acting insulin so there is no need for me to take my long-acting insulin before bed. Whilst this is a good thing, if my pump somehow comes off, or isn’t connected properly, my blood sugars will quickly shoot up. Because there is no long-acting insulin in my system, they will rise twice as fast, increasing my chances of DKA. Sounds a bit scary. So now I am probably going to check my pump as often as my Mum checks that our passports haven’t gone walkabout at the airport.  

3)      What if... I don’t like it?

Whilst I am partial to the occasional lazy day every so often, the rest of the time I am quite a busy person. I am always on the go, whether it be off to work or coming back from a night out with my friends. Because I’m so active, I’m slightly worried that the pump will be a bit of a nuisance. I’m pretty certain that for the first few weeks I will be walking around clutching my pump like precious cargo, and keeping a safe distance from the rest of the world. What if someone knocks it when I’m out dancing, or on the underground commuting to work? I can’t remember a time when I haven’t been bashed and bumped in a club or on the tube. Making your way to a crowded bar, or forcing yourself into strangers just so you can squeeze into the last tube carriage is a battle and a half. I can’t be walking around at a snail’s pace for the rest of my life?! Also, what happens when I’m asleep? What if my parents or friends walk into my room one morning only to find that I’ve been strangled by my pump tubes in my sleep? OK, so maybe I’m being a little dramatic, but I am worried about accidently pulling it out during the night.

So now you know what is currently going through my head. I don’t have the answers to any of my above questions, and no-one can answer them for me. All I know is that my life is going to drastically change at 2pm today, and fingers crossed for the better.

Come back tomorrow for more on the different pumps out there, and a video diary of my first 24 hours ‘pumping’ (I think I like it!).

If you don’t hear from me, I’m probably still at the hospital having some sort of nervous breakdown. Kicking and screaming no doubt, like a true diva.