Wednesday, 20 July 2011

Semi-officially a pumper


I has a pump. (kinda)

As of 14h30 on monday afternoon, I’m a pumper.

It’s only semi-official. My medical aid will technically only start paying for stuff like a pump from next month, so in the meantime I’m lucky enough to be able to have a “trial run” with the Accu-Check Spirit. It’s a pretty basic pump, without all the bells and whistles of newer models. But for now I can use it to work out my basal rates and get used to pumping, and next month I should be able to officially get my own fancy-shmancy one. 
[on that note; the roche-rep who set up the Spirit did a pretty good sales pitch to me on the Accu Check Spirit Combo system. It looks really good; I like the idea of the glucometer-remote and some other details sound good, but it doesn’t have the integrated CGMS option. So now I’m feeling a bit torn between the Accu-Check Combo and the Medtronic VEO systems- any chance anyone is willing to offer some pointers/ opinions on these two? I’ve got a few weeks at least to decide, but I’m a slow one for decisions, so deliberating starts…now.]

Pumping so far? Well, I’m impressed that inserting the cannula wasn’t as painful or uncomfortable as I thought it might be- actually, it barely hurt at all.

 But this did:

I practiced putting in two cannulas; one manually, and one with the LinkAssist inserter device. I'm definitely not a fan of the inserter- the suspense before you press the button is horrible! But seeing as I’d inserted two, I connected the pump to the one I’d done myself, and pulled the other one out. And it was a gusher. Thankfully not a sprayer at least, but apparently it had caught a capillary, and as you can see, the bleeding was a little prolific. And yes, that monster of a bruise is pretty darn sore.

Otherwise, honestly, I’m finding pumping a bit weird (a need-to-get-my-head-around-this-and-get-used-to-it weird, not a bad weird). Even though I’ve read up on it obsessively, it’s weird to suddenly be connected to one, and have to pay attention to this little machine to dose my insulin. An everytime 10:30 rolls around I have this thought- oh! Need to take my lantus now… oh, no, wait, I don’t anymore... 
But this I can get used to.

The biggest change seems to be in the actual insulin doses I need. I know that you usually have a slightly smaller total daily dose on a pump than on MDI, but the change seems HUGE. The nurse/educator worked out a starting basal rate for me, which on paper looks really small, but i’m bouncing around between 2 and 8 mmol most of the time- except twice when I overcorrected for lows (semi-deliberately, when I’ve just wanted to get my BG above 5mmol, darn it). But this, I’ve been told is also a part of the normal adjustment process, it’ll take time to work out the basal rates I need. The weirdest thing for me is the change in my insulin: carb ratio and insulin sensitivity factor- the nurse worked out values for each that are literally half and double what I was working with on MDI, respectively. That’s such a huge difference, I was certain she was wrong… but so far they seem to be working. It’s really weird for me, I can’t help but wonder if such a big change is normal? How can I be using so little insulin?

Despite all the lows, I braved my dance class last night, and survived, although I had to stop after an hour- when I took a break to check my BG I was hovering around 4.1 mmol, and couldn’t raise it, even with a box of juice. But I’m glad I could go, and didn’t actually go low during it. I did work out that a stomach pump site isn’t all that comfortable with all the bends and twists of dancing, so at my next site change (technically my 1st site change I guess) I’ll give someplace else, like my leg, a shot try.

I still feel a bit like I’m in a type of pumping limbo- knowing that I’m not going to be on this specific pump for all that long (hopefully), and knowing that whichever system I choose to go with eventually will have a bunch of extra stuff for me to use, more buttons for me to play with, and more functions for me to get used to. But so far so good, and even if I have to endure a bunch of lows during this adjustment process, it’s nice change from sticking a needle into myself 6 or 7 (or 8 or 9 or...)  times a day.

Semi-officially pumping is still pumping.
And I know it’s a change for the better J

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