Started on pump!

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Mand said:
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. 🙂🙂
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Hi Mand

Actually I think they are great readings for a first day purely because you know the reasons for the highs and I presume the DSN is contacting you daily at the moment and you are tweaking away. It is the unexplained ones that will be a nuisance. Its a brilliant start. I think your son will be feeling all sort of stuff with the up and down but give it a week or so and he will be feeling 'normal'.

Great stuff.
 
Hi all

Firstly, re the correcting bolus. We were told to correct by 0.3u if pump off for an hour. So he did this after pe but not when he had a shower last night. I will double check with his dsn tomorrow that that was what she said. So do you ever correct when pump off Adriene and Patricia? If so how much and when? 🙂

His dsn does not work Thurs so have not had phone call today. I will speak to her tomorrow. Problem is that i am a little confused at to what to do now. Where do i start with the tweaking? :confused:

These are this readings:

Last night 10pm = 8.2
Midnight = 13.2
3am = 12.4
6am = 10.5

unable to check mid morning due to playing guitar in a music show at school.

12.30pm - before lunch = 19.1 (so bolused for lunch and added correction)
3pm = 9.2

Any advice? Do i take it that because his pre lunch check was too high that it is the basal rather than bolus to start adjusting? Any advice very welcome! 🙂

Can i take this opportunity to say that Monday he received his school report which was excellent.
Today he played bass guitar (he in a band with three friends) at a school music show where any kids from the school that had formed bands could perform a few songs to the rest of the school. He came home on a high as he said he loves perfoming on stage.
Anyway just wanted to do my proud mom bit there because it so warms my heart to know that he does not let his diabetes stop him achieving or doing the things he loves!
Gosh! Here on this forum, we are all blessed with very special kids! Lucky us! 🙂
 
Mand, I really hesitate to give any advice this early into your pumping, and I don't know your circumstances, etc...but I'm a bit cross your DSN has left you with these numbers when different ones are so in reach! Grrr...

But yes, I'd say your basal, esp in the morning, needs looking at (as I'm sure you know, this is very common, a rise in the morning). Start slow, and targeting the highest numbers first. How many basal rates are you on?

With correcting, you know you'll still be in pretty good shape until you speak to your DSN tomorrow. I know it's not perfect, but may be a better idea than trying to do it yourself now? I personally can really only see what I'm doing when I have all the figures -- rates and ratios -- lined up with the numbers, in columns, so that the readings correspond to the times of day and changes in rates and ratios....

More than that though: well done son! I mean, it's SO great, isn't it?! They are just fantastic, and I send lots of congratulations and heartfelt pride to you all. Between yours and Alex -- wow!
 
Mand said:
Hi all

Firstly, re the correcting bolus. We were told to correct by 0.3u if pump off for an hour. So he did this after pe but not when he had a shower last night. I will double check with his dsn tomorrow that that was what she said. So do you ever correct when pump off Adriene and Patricia? If so how much and when? 🙂

His dsn does not work Thurs so have not had phone call today. I will speak to her tomorrow. Problem is that i am a little confused at to what to do now. Where do i start with the tweaking? :confused:

These are this readings:

Last night 10pm = 8.2
Midnight = 13.2 Add in a 10 pm basal a bit higher than it is as obviously he is going up after the 10 pm reading.
3am = 12.4
6am = 10.5

unable to check mid morning due to playing guitar in a music show at school.

12.30pm - before lunch = 19.1 (so bolused for lunch and added correction) Would add in a 10 am basal maybe or but maybe wait until tomorrow to see what the 10.30 reading is.
3pm = 9.2

Any advice? Do i take it that because his pre lunch check was too high that it is the basal rather than bolus to start adjusting? Any advice very welcome! 🙂

Can i take this opportunity to say that Monday he received his school report which was excellent.
Today he played bass guitar (he in a band with three friends) at a school music show where any kids from the school that had formed bands could perform a few songs to the rest of the school. He came home on a high as he said he loves perfoming on stage.
Anyway just wanted to do my proud mom bit there because it so warms my heart to know that he does not let his diabetes stop him achieving or doing the things he loves!
Gosh! Here on this forum, we are all blessed with very special kids! Lucky us!
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Hi Mand

Yes I'm a bit annoyed your DSN is not contacting you. She should be ringing you at about 6pm every day for a week tweaking.

All I can do is tell you what I would do. You cannot take this advice as from a medical professional because I'm not.

I've answered above in your message that I've quoted as to where I would tweak. I would only make two changes to begin with.

If you can get the morning waking level ok then it will be easier to get the day ok, in theory.

He is too high at midnight and if you want to change something you tweak the basal about 2 hours before you want the change. That is a general starting point. So if the basal is say 0.5 at 10 pm I would change it to 0.6 or 0.55 depending on how sensitive he is to insulin.

If you change this one then the lunchtime might be better as the morning might be better if you see what I mean.

I would imagine looking at the wakeup level he will need basal starting about 6 am or 5 am much higher than it is. You then have the potential for a hypo at lunch time so would need a drop in basal about 10am. First I would look at the night time.

These are J's basal bearing in mind she is a 9 year old girl.

0000 0.30
0200 0.25
0400 0.35
0500 0.85
0930 0.05
1300 0.40
2000 0.45
2200 0.25

You will see that at 0500 she shoots up to 0.85 and I still need to increase this but this is for the mid morning spike. But she then would go hypo by noon so she has to have a huge drop of 0.05 at 0930 which sorts out the noon hypo.

I hope I have explained myself ok. I do get carried away.

As for the bolusing 0.3 if detached that is ok but it is very individual. I never have to do that. But I have friends who have to replace the missed basal so if the basal rate is 0.5 and they have been off for an hour then they have to have 0.5 . With the medtronic pumps the basal rate doesn't trickle in over the period of an hour. If the basal is 0.5 then it will deliver that 0.5 at the same time wait an hour and deliver the next amount for the next hour.

Hope I have helped a bit.:confused:
 
Adrienne, I thought the basal slowly released over the hour - rather than a surge?
Also, Laila King seemed to think that doing a correction after being off the pump for an hour was unnecessary as you lose so little increments of insulin - and she said it would make such a miniscule difference that it just wasnt worth it.
Interestingly she said to leave the pump running whilst it was off - the reason being that most people would forget to turn it back on and then maybe miss a couple of hours of insulin.
I'm still thinking about the dapper young chap at the demo........mmm........ooops sorry!😱Bev
 
Thank you all for your advice. Very much appreciated. I am going to digest it and then decide what bit of tweaking to do then speak to his dsn tomorrow.

Bev, we too told to leave pump running when he takes it off.

Adrienne, you have explained yourself brilliantly! Thank you. Will have a good read and digest all you have said and i am sure it will help me to decide what tweaking to do.

Patricia, he only on one background basal of 0.65 u per hr.

Do not worry everyone, i will only make minor tweaks until i have spoken to his dsn so that we do not run into any problems.

Thank you all again. I will post tomorrow with an update.

After tomorrow, I won't get a phone call sat, sun or mon as my dsn won't be in work again until Tue but if i contact the local childrens unit before 5pm on her days off (Mons and Thurs) then a dsn from a neighbouring county will advise me. If i need advice at the weekend i can phone the local childrens unit who will contact my own dsn and she will phone me. She is happy to do this weekend contact during the first few weeks we on pump. So i am not alone but, at the same time, i have to seek the help on some days rather than it coming to me on. My dsn lovely, just does not work full time.

🙂🙂🙂🙂
 
Hi Mand

I have to say how brilliant I think you are doing with the pump for your son.
I don't have any advice to give as Nathan is on MDI....but must admit the threads about the pump using have me questioning whether Nathan is on the right method for him...
I'm sure as other pumpers have said once the initial tweaking of the dose's have settled the results will be amazing for you both.
As others have also said it amazes me the DSN is'nt in more contact with you at this time...
Again you are a brill mum..and also mant thanks for your words in my thread...they were much appreciated and meant a lot to me
Look forward to following you on this journey and reading all your posts

Heidi
🙂
 
Mand said:
Thank you all for your advice. Very much appreciated. I am going to digest it and then decide what bit of tweaking to do then speak to his dsn tomorrow.

Bev, we too told to leave pump running when he takes it off.

Adrienne, you have explained yourself brilliantly! Thank you. Will have a good read and digest all you have said and i am sure it will help me to decide what tweaking to do.

Patricia, he only on one background basal of 0.65 u per hr.

Do not worry everyone, i will only make minor tweaks until i have spoken to his dsn so that we do not run into any problems.

Thank you all again. I will post tomorrow with an update.

After tomorrow, I won't get a phone call sat, sun or mon as my dsn won't be in work again until Tue but if i contact the local childrens unit before 5pm on her days off (Mons and Thurs) then a dsn from a neighbouring county will advise me. If i need advice at the weekend i can phone the local childrens unit who will contact my own dsn and she will phone me. She is happy to do this weekend contact during the first few weeks we on pump. So i am not alone but, at the same time, i have to seek the help on some days rather than it coming to me on. My dsn lovely, just does not work full time.

🙂
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Our DSN starts people on about 4 basals, they have a rough idea of what is needed from past experience. They got the midnight one right from day one for J. You will soon have a few more.

I'm away at the weekend but I am more than happy for you to have my mobile and ring me. You could use me as a sounding board so if you know you want to tweak something you could ask tell me and I could let you know if I think a good idea or not ! Just a thought. I am very aware that I can't advise you as I am not a professional but I'm more than happy to help in any way I can. Let me know and I'll pm you my mobile. You don't even have to use the number but it might be reassurance that you have someone there if you need it. Up to you entirely and I won't be offended if you don't want it. I don't get offended easily.


bev said:
Adrienne, I thought the basal slowly released over the hour - rather than a surge?
Also, Laila King seemed to think that doing a correction after being off the pump for an hour was unnecessary as you lose so little increments of insulin - and she said it would make such a miniscule difference that it just wasnt worth it.
Interestingly she said to leave the pump running whilst it was off - the reason being that most people would forget to turn it back on and then maybe miss a couple of hours of insulin.
I'm still thinking about the dapper young chap at the demo........mmm........ooops sorry!😱Bev
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Different pumps do it different ways. The paradigm is all in one go, we only found this out a few months ago, Jacqui on the other group found out.

I agree no need to turn the pump off. It doesn't waste any insulin, for some reason it knows it is unplugged from you and doesn't release anymore until you plug it back in, that is totally correct advice from the lovely Laila, (can't wait to meet her).
 
sasha1 said:
Hi Mand

I have to say how brilliant I think you are doing with the pump for your son.
I don't have any advice to give as Nathan is on MDI....but must admit the threads about the pump using have me questioning whether Nathan is on the right method for him...
I'm sure as other pumpers have said once the initial tweaking of the dose's have settled the results will be amazing for you both.
As others have also said it amazes me the DSN is'nt in more contact with you at this time...
Again you are a brill mum..and also mant thanks for your words in my thread...they were much appreciated and meant a lot to me
Look forward to following you on this journey and reading all your posts

Heidi
🙂
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Hi Heidi

If Nathan is having the amount of hypos you say he is then he qualifies under the NICE guidelines for a pump. You need to find a hospital that will give him one, persuade him first of all of course 🙂 which could be hard and then get referred.
 
Adrienne said:
Hi Heidi

If Nathan is having the amount of hypos you say he is then he qualifies under the NICE guidelines for a pump. You need to find a hospital that will give him one, persuade him first of all of course 🙂 which could be hard and then get referred.
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Hi Adrienne...

Ive just been having a chat on the phone to bev...and she said that to...Its certainly giving me something to think about and consider...as you say the hardest thing is going to persude Nathan....😱....He had recently 18 hypos in 10 days roughly...Not good by any means also the consequences of the damage he is doing

Heidi
🙂
 
Good morning everyone!

Well, another night over. Once again thinking of many of you at 3am!

Readings since my last post:

Last night 9pm = 12.3 We decided to bolus a small correction.

midnight = 7

3am = 11.1

6am = 10

My conclusion was that presumably the 7 at midnight was due to the correction at 9pm but that basically the basal is keeping him steady but is set too low?

Thank you all so much for your advice of yesterday but in the end, after much discussion, we decided that it was just a bit too early to start tweaking as we had only had two nights of readings and they were very different so we decided to play it safe, leave things as they were. The result being as above.

We did 1:10 for breakfast today as he running at around 19 in day. I have told him that if his bloods are good or too high then to do 1:10 for lunch. I then told him that if he hypos after breakfast then he must work 1:12 for lunch. I have put two stickers on his lunch box. One with units needed for 1:10 and one with units needed for 1:12 to make it easy for him.

I will be spekaing with his dsn at 6pm this evening and giving her all his readings.

Adrienne, it is most generous of you to offer to pm me your mobile. I would be very happy for you to do this if you are sure. As you say, it would be re-assuring to have someone to bounce an idea off and you would certainly have a better idea than me! Gosh, I have so much to learn! But, please be assured, that i would not dream of disturbing you unecessarily and please do not feel obliged to give me your mobile if, after giving it more thought, you decided not to. I would not be offended at all. I will be able to contact his dsn if i stuck this weekend so i not alone at the moment but this offer of contacting her at a weekend is, understandably, over for the first few weeks of pumping. 🙂 x

Thank you Heidi. I am delighted you decided to stay. Your supportive and encouraging words mean a lot to me. Perhaps you will be joining us pumping moms soon?! Of course, i will be an absolute expert by then so will be able to help you! Hahaha! In my dreams!!!! Oh well, at least we can muddle through together! x

We changed his set yesterday evening for the first time. The good news is that the proceedure went smoothly but the bad news is that it hurt him so he was a little upset (blimey, were my heart strings tugged or what!) but he ok a short time later.

You know, i have never thought of myself as a strong person and by nature i am a worrier. But having to deal with all the workload and emotions of my sons diabetes has made me realise that i am a stronger person than i thought. or maybe it has made me stronger. I guess us moms have to be strong for our kids and it spurs us on.

As always, thanks to you all for listening, advising and for being there for us.

Mand x
 
hi hope you dont mind me butting in on the thread peeps x

Just wanted to say mand sounds like things are going really well for you and your son , it is amazing how strong we become when we least expect it , just shows through adversity we come out the other end

i wish you every further success
 
Hi

Great night and lovely readings and you are totally correct need a bit of tweaking to get the level right at 9 pm and then again at midnight and then watch what happens.

Will be interesting to see what the DSN has to say and what she will do.

I'll pm you my mobile. I am happy to talk to anyone, ask Bev, she knows me quite well by now from the other list and from Hoburne and the phone of course. It is my mission to help all children with diabetes. So ring when you want. If it makes you feel better then text me first, makes no odds to me either way.

Set changes - some hints and tricks. Its hurts people more than others. Some just numb the area with an ice pop (in the packet obviously), do the set change and then your son can eat the ice pop (making sure it is a no added sugar one of course). You will get so quick at doing it, he won't bat an eyelid. I can put the needle in (using the inserter) and take it out in 2 seconds. We timed it last night as J was moaning so I said ok count and see how long it takes. She counted 'one elephant, two elephant' and it was out.

If he gets a be itchy with the sticky thing then we use Cavilon and spray it on the area first. It creates an invisible barrier and it has the added bonus of making it stick better as well. You can get this on prescription.

To remove the cannula and sensor we use Lift Plus spray (no wipes). Again on prescription but you can get a free sample from http://opus-healthcare.co.uk/liftplus.php

Hope that helps a bit.
 
Hi Mand

Great to hear from you! Numbers are looking good! The stability is amazing, isn't it...

We'll wait with interest to see what your DSN does.

We came back from clinic with Cavilon -- E is getting slightly red patches etc -- so will let you know if it helps him too. I've never heard of the other one Adrienne, that's useful to know! It does hurt to unpeel it...

Keep it up Mand.

And I echo Steff too: we don't know what we can do until we have to do it. Wish we didn't have to do it, but there you are... Right back at you, Steff.

xxoo
 
Adrienne said:
Set changes - some hints and tricks. Its hurts people more than others. Some just numb the area with an ice pop (in the packet obviously), do the set change and then your son can eat the ice pop (making sure it is a no added sugar one of course). You will get so quick at doing it, he won't bat an eyelid. I can put the needle in (using the inserter) and take it out in 2 seconds. We timed it last night as J was moaning so I said ok count and see how long it takes. She counted 'one elephant, two elephant' and it was out.

If he gets a be itchy with the sticky thing then we use Cavilon and spray it on the area first. It creates an invisible barrier and it has the added bonus of making it stick better as well. You can get this on prescription.

To remove the cannula and sensor we use Lift Plus spray (no wipes). Again on prescription but you can get a free sample from http://opus-healthcare.co.uk/liftplus.php

Hope that helps a bit.
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OMG Adrienne, this is great stuff. You really should write a book on your experiences or something properly that people can access. You can read all the manuals (as I am discovering) but this kind of advice is priceless.

Mand I am so pleased to hear how you are doing. You have bypassed the first hurdle too, the set change. I can imagine it was not going to be easy but well done.

I must confess I was AWOL from the 3am club this morning, too knackered!

Well done, we have all made to the end of a very difficult week and now its Friday and the weekend! Small pat on the back all round me thinks 😉
 
Louisa the thread thief!

Patricia said:
Hey, Louisa -- how the heck are you?!

Sorry Mand, just chasing. Want to know how things are with *everyone* (if poss!🙂).
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Hiya Patricia!

I am doing well thanks, hope you and yours are ok too!

Ive flown the nest for a couple of day so I havent been online so much as when Im at my place. I was advised to take the week off starting on insulin on Sunday, and guess what? Im bored! So I am round my mums!

Have had some high numbers, some swings and in the last 24 hours pretty good numbers for me. Looking forward to seeing my DSN on Monday and changing my basal, that will be great and I think will really help my numbers.

I had a good experience with Medtronic, got my delivery in less than 24 hours and all present and correct. My pharmacist is mucking me about, wants me to draw out of a penfill catridge to inject into the pup reservoir!!!😱 I dont think so love....! Gimmie the goddam VIAL! That should all come together on Monday afternoon. Pump clinic Monday and back to work Tuesday. Also much relief I with the new job at the prison, I went on a visit and didnt set off the metal detectors! Fantastic!

Im thread-hogging! Sorry Mand!😱 I keep thinking of more things to write so I will go and find mine wherever it has gone!!!

A great pumping week all round possibily for all of us? Patricia I hope things are good with you, I am going to go and track your line down too!

Lots of love xx
 
Sugarbum said:
OMG Adrienne, this is great stuff. You really should write a book on your experiences or something properly that people can access. You can read all the manuals (as I am discovering) but this kind of advice is priceless.

Mand I am so pleased to hear how you are doing. You have bypassed the first hurdle too, the set change. I can imagine it was not going to be easy but well done.

I must confess I was AWOL from the 3am club this morning, too knackered!

Well done, we have all made to the end of a very difficult week and now its Friday and the weekend! Small pat on the back all round me thinks 😉
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I'm sitting in a YH in Oxford and they have wi fi so I decided to log on.

Sugarbum, I have never read one of those books at all. I have the pumping book from medtronic, I have the Ragner Hanas and have never opened either. Nothing counts for hands on experience.

Have a good weekend not sure when I will be able to log on.
 
Hi everyone

Spoken to my sons dsn this eve. She advised we increase basal and she happy that i have increased food/insulin ratio to 1:10. so going to see how things go over weekend. Readings a bit up and down today but i know we have to be patient for a few weeks while we tweak things. iWill keep you updated on progress.

Hi Steff. Thank you for your support and you are very welcome on this thread. Join in any time! Just hope i do not bore you too much! :D
Mind you, that's the beauty of this forum - you are able to start your own thread and then people can choose to follow it or not. Ideal!

Adrienne, thanks for the tips re set change. Have made a note and will investigate getting hold of the stuff on prescription. Enjoy Oxford! x

Patricia, thank you as always for your advice and support on my thread and for your informative own thread. Have a good weekend and keep us posted! 🙂

Sugarbum! Great to hear from you! Will take a look at your thread. Please keep us posted on your progress! 🙂 x

Glad to report that we are still delighted re pump, having no regrets, just need to keep tweaking those numbers till we get it right! 🙂
 
Mand,
I just wanted to say i think your doing great! I hope our pump start is the same as yours has been! I must admit i am starting to feel a little apprehensive about 'starting again'!

Also, well done to your son about his band etc.. Its great to feel proud (as you will know by my threads on the subject!) - our boys have so much to contend with and it makes such a difference when they show they still have confidence etc...SO BE PROUD I SAY! (A goes to drumming lessons - perhaps they could all join up!).

On the subject of ringing Adrienne - i have had reason to on a few ocassions now - and i have to say she is the most knowledgeable person i know on diabetes and she gives extremely sensible advice - and if she doesnt know the answer she will go out of her way to find out for you! She is a mind of information - and she would NEVER tell you do something that she feels is out of her depth (not being a medical professional). I cant praise her enough! So if your ever worrying over the pump - give her a ring - she will sort you out!:DBev
 
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