Joining 'team pump'

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everydayupsanddowns

everydayupsanddowns

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Hello to all you happy pumpers....

Just had an email from my DSN to say that my application has been supported and I'll be switching to pump therapy over the next month.

Due to go on saline from 31st October and insulin from early November.

Still a few 'intro/set-up' chapters of Pumping Insulin to get read before then 🙂
 
Congratulations, I didn't know you were waiting for a pump............

How long?

Exciting times, I am sure you will settle in quickly........
 
Have been moving toward it for 2 years I think (I had significant pump-aversion). While I realise they are still not perfect, I've come to the point where I recognise that pumping is the most subtle/tweakable system available and that whatever I try on MDI I will still have problems, but that these might be severely reduced/eliminated by pumping.

We shall see.

If all goes to plan I'll be pumping insulin around 8th November 😱
 
everydayupsanddowns said:
Hello to all you happy pumpers....

Just had an email from my DSN to say that my application has been supported and I'll be switching to pump therapy over the next month.

Due to go on saline from 31st October and insulin from early November.

Still a few 'intro/set-up' chapters of Pumping Insulin to get read before then 🙂
Click to expand...

Good news! Must say you are already off to a good start with the "Pumping Insulin" book, wish we had found it earlier, it wasn't until 6 months in we came across this and things really made sense from then on.
Millie was on the saline too but I asked after 2 days if we could just get on with it, (the insulin) which we did - the practical aspects were straight forward enough. Its the fine tuning which takes the effort.
Best of luck with it all 🙂
 
Terrific news Mike! I hope/am sure it will be of great benefit to you, given the knowledge you have aquired and the work you put in 🙂 Do you know which pump you will be getting?
 
Northerner said:
Do you know which pump you will be getting?
Click to expand...

I've gone for a Medtronic Veo. Mostly because it allows me to access the inbuilt CGM from time to time (whenever I can afford it!)

M
 
Great news Mike...you will be really pleased with it, I'm sure! Saline....paa! I got my pump and played golf the same day! 😱:D
 
Glad to hear it Mike. It's been a long timecoming, I know. I'm amazed how quickly they've approved it. Way better than I expected.

Will be watching with great interest.🙂

Rob
 
Great news regarding the pump although I'll admit that I didn't know you were looking to switch from MDI. I always understood that the criteria for a pump was if someone was struggling on injections and had hba1c's of 8 and above, have they now relaxed the rules or have I got this totally wrong?
 
toby said:
Great news regarding the pump although I'll admit that I didn't know you were looking to switch from MDI. I always understood that the criteria for a pump was if someone was struggling on injections and had hba1c's of 8 and above, have they now relaxed the rules or have I got this totally wrong?
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That is one of the criteria under which you can be considered (and you're right, that does not apply to me).

Where I do qualify is 'excessive hypos/hypo unawareness, fear of which affects quality of life...'

I've done a lot of work on hypos over the last few years and I have far fewer and less serious ones than I used to, but still far too many. My awareness is improving, but it's still a constant nagging doubt. I've not needed help from Mrs EDU&D from crushing overnight hypos for over a year having changed timing of Lantus, but my basal needs fluctuate quite often and the fixed/flat profile of a basal analogue is always going to struggle. Just a tiny overshoot of Lantus can leave me chugging upwards of 60g CHO in Lucozade trying to firefight relentless lows (or whacking in 6-8u of seemingly water-like corrections of Humalog to pull BGs down). I rarely drive for fear of dropping into an unexpected hypo, and when I do I tend to try to run around 7-10 just to be on the safe side.

My hope is that the more flexible/accurate/responsive basal profiles that a pump offers will help keep me in that tiny target range with fewer 'wobbly weeks' while I test and adjust Lantus and wait for it to wake up to the new dose.

I'm not without a degree of lingering pump-aversion, but I'll never know without trying it. I'm pretty sure I'm doing about as well as I can on MDI, but it's still not good enough. I'm lucky enough to be in quite a pro-pump area (postcode lottery again), and have been able to make a successful case despite a pretty good A1c.
 
I look forward to seeing how your results compare and to your subsequent blogs on the topic....................😉
 
Preparing myself for a lot of work at the start. Seems to take a good few months of 'Argh!' and relearning how everything works before you begin to get more reliable results.
 
That's brilliant news.🙂

Toby - Carol's HbA1Cs have never been above 8, only for the first 3-6 months after diagnosis. Carol got hers because of swinging levels and too many hypos under 3, which she didn't feel. Carol was first offered her pump at the clinic visit where her HbA1C was 6.9. I thought that was a brilliant result, but the consultant wasn't happy.
 
everydayupsanddowns said:
That is one of the criteria under which you can be considered (and you're right, that does not apply to me).

Where I do qualify is 'excessive hypos/hypo unawareness, fear of which affects quality of life...'

I've done a lot of work on hypos over the last few years and I have far fewer and less serious ones than I used to, but still far too many. My awareness is improving, but it's still a constant nagging doubt. I've not needed help from Mrs EDU&D from crushing overnight hypos for over a year having changed timing of Lantus, but my basal needs fluctuate quite often and the fixed/flat profile of a basal analogue is always going to struggle. Just a tiny overshoot of Lantus can leave me chugging upwards of 60g CHO in Lucozade trying to firefight relentless lows (or whacking in 6-8u of seemingly water-like corrections of Humalog to pull BGs down). I rarely drive for fear of dropping into an unexpected hypo, and when I do I tend to try to run around 7-10 just to be on the safe side.

My hope is that the more flexible/accurate/responsive basal profiles that a pump offers will help keep me in that tiny target range with fewer 'wobbly weeks' while I test and adjust Lantus and wait for it to wake up to the new dose.

I'm not without a degree of lingering pump-aversion, but I'll never know without trying it. I'm pretty sure I'm doing about as well as I can on MDI, but it's still not good enough. I'm lucky enough to be in quite a pro-pump area (postcode lottery again), and have been able to make a successful case despite a pretty good A1c.
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That explains a lot and can well understand why you feel the need to switch. Never really heard of anyone changing to a pump and regretting it afterwards so hope this is the case with you too and all goes well. Good luck🙂
 
Monica said:
That's brilliant news.🙂

Toby - Carol's HbA1Cs have never been above 8, only for the first 3-6 months after diagnosis. Carol got hers because of swinging levels and too many hypos under 3, which she didn't feel. Carol was first offered her pump at the clinic visit where her HbA1C was 6.9. I thought that was a brilliant result, but the consultant wasn't happy.
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It would seem that hypos are a major influence in persuading clinics to change you from mdi to pump therapy, hope others who are experiencing these difficulties read this thread and learn from Carol's and Mike's experience. Thanks Monica🙂
 
Welcome to the club Mike

Some of your problems are very similar to ones I had before I started pumping and I think that you will be taken aback when you find out what the pump can do for your basal profile.. I had all sorts going on with mine, from DP and EP with a large range flucuation to top it off.. The pump copes and flattens it off to a good working platform.. And it's a case of pressing a few buttons to go from the basal needs of a work day or very active day to an lazy day off..

I used to have to do some real high end intensive management daily to keep my BG's in a reasonable range and keep hypo's down to 2-4 mild ones a day and avoid as many highs as possible, so adveraged out around 6-8 jabs a day in this effort..

Don't be surprised if you feel a bit emotional after a week or so, it's pretty natural... I sobbed my heart out with tears of joy after the first week purely because I hadn't had one hypo for 7 days...
 
That's great. The first couple of weeks have been tough, but I have had only two night time hypos in the last three weeks, which is wonderful.
 
everydayupsanddowns said:
Preparing myself for a lot of work at the start. Seems to take a good few months of 'Argh!' and relearning how everything works before you begin to get more reliable results.
Click to expand...

Hi Mike,

Like you I was on MDI for a fairly long time and I too was 'pretty well controlled' although not without hypos and feeling that I could do better but not on the insulin regime that was available. My main problem on MDI was my Basal (Lantus) I was never confident about the dose, time of dose, whether to split the dose and how long it was working in my body for (consistently). I did get complacement with my diabetes for several years i.e not testing often enough and carb counting was only introduced after 10 years of living with diabetes (it was never mentioned to me before! 😱)
I have been on my pump for 6 months now and although not a perfect cure it is much,much better than being on MDI, I never really minded taking injections it was the sometimes inconsistent readings I would get that frustrated me so much. You are right that starting pump therapy is like being diagnosed again, however your diabetes education is such that I expect you will adjust to it with few problems. The differences or problems I faced were:

1. Getting the basal rates right....and even when you think you have, you may need to change them again! (Lots of tiring fasting testing). My basal rates are massively different per hour eg 3 units per hour early morning (to combat DP) v 1 unit per hour in the afternoon, plus many other rates in between for the rest of the 24 hour period! So much better than MDI!

2. I had problems with the type and length of cannula and transfusion sets to use, I was getting high readings due to 'tunneling' with teflon so changed to metal cannulas. Also I have to pay close attention to the siting area, sometimes the absorbtion rate may not be perfect (high readings will confirm this) If I find an area that is a bit lumpy it is almost as if no insulin is working at all....at first you think that your pump is broken or you have air bubbles in your cannula or all manner of 'reasons' why you are high, instead of going back to basics.

3. Finding the right Temporary Basal rates for periods of activity/inactivity or illness...this takes time also and is really trial and error, for example when I play golf I give myself a TBR of 10% and if I'm on a long journey (plane etc) I up it to 200%. I haven't been really ill yet, just recovering from a heavy cold which didn't really affect my levels.

4. I change my cannula every 2 days, I don't leave it for 3 days as recommended because for me after 2 days the insulin doesn't deliver as well and my levels start to climb.

To think I've already missed 930 injections during my 6 month pump therapy makes me smile!

Good luck when you get it, I'm sure you will adjust with few problems.
 
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