Started on pump!

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Mand

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Tuesday 7th July 2009

Hello everyone!

Today was the big day! My sons nurse arrived at 9.15am and was here until 12.15pm. We did not have to go to clinic or hospital as she came to our house which was excellent. But i slightly on information overload now!!

My husband, myself and my son had the opportunity to ask loads of questions as she was explaining everything to us. It was quite an emotional moment when he injected the cannula as he struggled a little due to nerves and i had to hold back the tears and also to stop myself from taking over but it was fine in the end and he was pleased once connected. Phew!!!!!

He ate his lunch at home and gave a bolus for it. No injection! Fantastic! He was so chuffed! I took him to school at 1pm and will pick him up at 3.30pm. He was very happy to go off to school and just took it all in his stride.

His pump trial had been with a medtronic 772 (or is that 722?) but the real one he got today is a veo! So he has the very lastest model! (same as you Lou!).

He has been put on a starting basal of 0.65 units per hour and we have to work 1:15 for carb/insulin ratio with each meal to begin with. We have been told to use a correction ratio of 1:3 to start with. We not to bring him down below 10 for a correction yet either. Also we have to test for ketones on any blood glucose of 14 or above. So this is our starting point and we will adjust as we go along.

We have to test his blood at midnight, 3am and 6am (oh blimey!!!!!!!) as well as throughout the day. But we were prepared for all this.

I could write reams more but do not want to send you all to sleep! also I have to go a fetch him in a few minutes.

Please feel free to ask anything if i have forgotten to mention anything.

I will update you all again this evening and also read all your posts and threads to catch up with your news.

So, here begins a new phase of his and our lives......................🙂
 
Hi Mand...


Here's to the new chapter in your families life.

Glad everything went ok for you all this morning

Take care

Heidi
🙂
 
Hi Mand,

Fantastic news! I wondered if you may find the time this afternoon or not (I can completely appreciate the information overload!) to post and its so great to see your thread pop up!

Your little fella sounds like a brave young man. You must be very pleased with his attitude to take it all in his stride and go of to school as normal. Such resilience, Im sure he has done you both proud.

The Veo- I am so chuffed to hear this news as I think this gizmo has much more advantages to the parent and child situation than mine without the sensor at present. Apparently, according to my DSN the manual is much better than the previous paradigm manual so that alone is one benefit. Just out of interest, what colour did he choose?! 😉

I am also on a target of 10mmols. I have a reguime of 2 hourly testing for 48 hours (except at night, but with a 3am test) and a background at the moment that is consistantly 0.55u/hr. I am very impressed that your DSN has done this as a home visit, I assume this is so to make it all less stressful and what a great idea.

I am not suprised you had a moment when you saw the "Quick-serter" technique....my insides did when I saw my DSN do it before us. To my complete shock I can honestly say I didnt really feel anything and I have also increased from a 5mm needle on a pen to 9mm on the quick set, so I was expecting much more OUCH factor (and lets be honest, a torrent of swearing) but it was fine. Sounds like he has done well. I found this link useful last week as I couldnt remember anything when I got home, it is a short video (2.42) made by Medtronic taking you through a set change http://www.youtube.com/watch?v=BfG4-YMu0Vo using quickserter.

Must dash- Im on an even hour eating deadline, if only I could recall the rational for this?! Im wondering now if there is any reason other than perhaps my DSN hates me?!:D

Hope your evening goes well and the young man has had a good afternoon at school. Fingers crossed for good numbers.

Well done to you too Mand, its a lot to take in.

Lots of love,

Louisatronic (naahhh?!)🙂
 
Hi Mand

Fab start. Great DSN, it warms the cockles of my heart when I hear about great DSN's they are few and far between.

The basals will soon all change and that's why you need to do lots of testing, Sugarplum is right and testing 2 hourly which we still do during the day anyway, its the only way to tell if the levels are ok or not.

The ratios will change as well and I imagine he will need a lot more insulin at breakfast than 1 : 15.

What a star your son is and to go to school afterwards. I bet he wants to show it off ! He has his own mini computer attached to him after all. What colour did he go for?
 
So pleased Mand, well done to you and son. So good too for him to knuckle down and do it - but, sniff!, I know what you mean. So proud of them...

Anyway, hope his day was a good one and that his numbers were not too dramatically weird the first day. No injection! Yay! It's so amazing.

Good on him. Keep us posted. Can't wait.

xxoo
 
hi mand so pleased everything went ok this morning

i wish you and your son every sucsess in this new chapter xx
 
Thank you all for your posts and kind words.

Well we are already in love with his pump! (which is black. We did not get a colour choice, it was just what we were given. But he pleased as black is a cool colour!).

He was fine at school and he staying steady so far on readings of 9 and 10. It is just so great to not have to inject! It feels like a workload has been lifted from us and his anxiety levels have dropped as he had developed a bit of a needle phobia.

Tonight will be interesting (and tiring!) with the several nighttime checks. Will let you know how it goes.

Yes, Adrienne, i can imagine that it will all be changing. Before the pump he was on 1:6 for breakfast, 1:8 for lunch and 1:11 for tea so doing 1:15 now seems very odd!

Anyway, nothing else to report at the moment but will update my thread each day.

Bye for now! x
 
The not injecting bit takes time to get used to doesn't it. It is so weird. I never really felt the meal was finished properly unless there was an injection. It took some time. It was like having pudding although not a nice one but it rounded off the meal.
 
Adrienne said:
The not injecting bit takes time to get used to doesn't it. It is so weird. I never really felt the meal was finished properly unless there was an injection. It took some time. It was like having pudding although not a nice one but it rounded off the meal.
Click to expand...

Adrienne! Today is the first day in I dont know how long that I have had no injection or set change etc and man it is weird!

Mand, pleased to hear things are so far so good! Hope your night goes ok- for you all, I assume you will be burning the candle at both ends too?! By the way I think the black pump in the Veo (it has a bit of red on one button right?) is really really nice. Nice and discreet for your boy, doesnt look too different from an ipod or mp3 player or something.

Good luck tonight!
Louisa x
 
hi mand how did it go on the first night ??
 
Yes, no injections feels that way exactly Mand -- a weight lifted! And somehow, an anxiety lifted too. The head space suddenly afforded is kind of weird...Not to speak of the needles etc...

How was your first night, to echo Steff?
 
Hi Mand and son!

Well done to your son for going to school so soon! I suspect Alex would do the same to show it off!
Your DSN sounds great - i am not sure whether we will spend our training day at hospital or at home yet.
Alex is also keen on the black one as he says it looks discreet and no-one would question what it was.
Keep the posts coming as i want to know everything.🙂

Will you be using sensors?

Bev x
 
Hi mand, how are you and family this morning?

Hoping you have had a smooth night. I thought of you this morning when I got up to do my 3am BG check! I wondered if you were doing boys at that time? We joke in our group it is the 3am club- reminds me of old DAFNE days!

Hope you day goes well Mand, thinking of you all.

Lou xx
 
Hi everyone!! Thank you for your words of support and well wishes.

Wow!!!!!!!!!!!!!! We had a great first night!!!!!!!!!

His readings:

Midnight = 7.9
3am = 6.0
6am = 7.1

Fantastic!!!!!!

During the past few months his readings have regularly been between 10 and 20. I have had no peace of mind and it has been horrible. so to get these readings is great! He had no problems sleeping with it and barely disturbed when we checked his blood.

He ate breakfast this morning and bolused. Wow!!! no injection again! Then he went off to school as normal without any anxiety or worries. He seems to be completely taking it in his stride!

I asked him to text me his readings but not heard anything yet but may do in the next half hour as it will be lunchbreak and i guess he cant use mobile till then as they have to be switched off, of course, at school.

I am totally shattered as after doing his 3am check i could not get back to sleep so have been awake since. I am a housewife but also work 10 hours per week in an office (2 days of 9am to 2pm) and had been needed to go in this morning to do some overtime as my workload had staked up while we were on holiday. I felt like a zombie! But, let me assure you here, I am a very happy zombie!!!!!! Yes Lou, i was thinking of you too at 3am and wondering how you doing and thinking that perhaps Patricia was up too! Yes Lou, it has got a border of red around one of the buttons.

I have to say that the pump looks like many of the modern gadgets that the kids carry round these days anyway. Like a mobile, mp3 or ipod thingy. My son is so proficient on it already because like all kids he is used to technology and gadgets.

So, all i can say is, so far so good!! I might be tired but i can't stop grinning! If the pump works for him then it will give him better quality of life and a better chance of not developing complications later in life. It will also give me some peace of mind that i desperately need!

I will update you later on how his day/eve has been. I will now take a look at your threads Patricia and Lou! I will be thinking of you both at 3am again!

Love Mand x

Ps yes his dsn is very nice. She only works 3 days a week but said that she would be happy to be contacted at weekends during his first few weeks on the pump to support us. On the two week days that she does not work then if i phone the local childrens unit they will put me in touch with a dsn from another county. So we fairly well supported. Then of course, i have all of you! Gosh I do feel very lucky. 🙂
 
Mand said:
Hi everyone!! Thank you for your words of support and well wishes.

Wow!!!!!!!!!!!!!! We had a great first night!!!!!!!!!

His readings:

Midnight = 7.9
3am = 6.0
6am = 7.1

Fantastic!!!!!!
Click to expand...

Terrific! Goodness, what a difference!🙂

...I have to say that the pump looks like many of the modern gadgets that the kids carry round these days anyway. Like a mobile, mp3 or ipod thingy. My son is so proficient on it already because like all kids he is used to technology and gadgets. ...
Click to expand...

I just had a not very pleasant thought that maybe some unpleasant types might mistake it for something like an ipod and think they could sell it, hopefully a close inspection would show that it's not?
 
You are exactly right, northener! This is a big concern of mine as he has to remove it for certain pe lessons and i not overly happy with the safety of it at school as he already has had his mobile stolen. His dsn has spoken to the school of the value and importance of it but i still not satisfied with its safety during pe lessons yet, so will pursue.

It is not overly obvious what it is on first glance so could be walked off with, fiddled with then discarded but this not good news for my son. 😱

Of course, most of the time it will be attached to him and impossible for anyone to take it. It is just for pe lessons that we need to ensure its safety. There is no swimming at his school. 🙂🙂
 
Hi all

Well after a great first night, we have not had good readings today but all of them can be explained, so in theory, tomorrow will be better!

At 11am he was 19.9 but we think this is because he has been started on a ratio of 1:15 for all meals and he had been on 1:6 for breakfast so clearly needs more for breakfast.

Then he took pump off for pe. We have been told to do a bolus of 0.3 u when re-attaching if off for a hour but he accidently did 3.0!

Just before lunch he had a hypo - presumably due to above event.

Two hours after lunch he was 19.1. Again we think it because 1:15 not enough to cover his lunch as he was on 1:8 before. He then did a correction bolus but did one unit too many and had a mild hypo before tea.

So as you can see, not a good first day for readings but all can be explained so hopefully will improve tomorrow. We have been advised by his dsn to try 1:12 and if that not enough then move on to 1:10.

The good news is that he was not bothered at all about wearing the pump and found it comfortable and without problems so this is a big thumbs up. Just need to get the carb ratio correct and pay extra attention to what he is bolusing when correcting.

I hope he was a second good night and that tomorrow i will be able to report better readings! But i still totally in love with the pump! So is he!

Feeling pretty tired now after last night as i did not return to sleep after 3am check this morning. Anyway bracing myself for another disturbed night but i not complaining. I love my son and would do anything for him and i know how lucky we are that he has got a pump. I appreciate it with all my heart. 🙂🙂
 
Mand, great to hear that you can find a cause for all the day's events, even if the numbers were a bit wonky! Doesn't the pump give a warning if the correction is set hugely high? There may/ought to be a way of this happening (put it on the wish list for medtronic if not!).

But those things will be ironed out with experience - the biggest plus point has to be that he is so comfortable with it! Hurrah! :D
 
Mand, hang in there like I know you are. We were told that initial numbers are usually fabulous because there is extra background insulin left over from MDI underpinning things. So not surprised that things have gone a little weird at first....

It *will* get better and quickly... If you can trace the highs through to two hours after eating, you are one step ahead of course identifying it as bolus rather than basal. But I'm guessing it's important to measure fasting (pre meal) regularly as well, to see about basal? Like MDI, my impression is to get basal sorted first...

Also, sorry to say I've never heard of a .3u bolus after disconnection! E just puts it on and off. Our team said that in the hour of PE, so little basal is lost that it's not worth it -- and of course PE itself tends to lower bgl, so in theory it sort of balances out... We *have* been given a 'sliding scale' of what to do if the pump is disconnected for longer periods, which we haven't used yet. But even for E swimming in France -- two hours -- he tested twice, and still hypo-ed -- all disconnected!

Anyway. Hang in...And keep us up to date! I want to hear it all...

xxoo
 
Hi Mand,
At the medtronic demo the other day - i asked this very question about correcting after the pump has been disconnected, and they told us that there is NEVER a reason to use a correction after having had the pump off for an hour etc..(well unless of course your high!).
The reason is that over 1 hour there is such tiny amounts that have been missed that it would be very complicated and time consuming to work it all out! They said its just too negligable to bother about. I am not saying your team has given you the wrong information - but perhaps if you check it with them because you dont want to start a pattern of correcting if there is no real need to!
Keep the posts coming - i am learning so much and from Patricia's too!:DBev
 
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