This is for everyone who has expressed interest in a running diary of the early days of pumping...
Yesterday my son began his awaited foray into pumping, after a week's saline. He's 13, type 1, diagnosed Nov 08. We've been lucky, with a cooperative PCT and keen GP and consultant, to get him through quickly. He's also very motivated, which seems to have helped us all along.
So far, so interesting! We had kept very good records of bgls and meals, carb counting, bolus units, etc, so were able to hit the ground running, receiving training on everything from all the parameters that need setting to dual and square waving. He's on a medtronic, and finding it simple to use. And I'll admit that he's come to grips with it hugely faster than I could have. It's like a mobile phone to him, whizzing through all the menus, etc...
Yesterday he started the day at the hospital on 17 because we were asked to skip his morning levermir dose. He instantly bolused a correction upon being hooked up (1 unit = 3 mmols sensitivity), and 45 mins later he was down to 9! He was then starving. They offered him a Hobnob. 8 g -- bolused for that: 0.9 units!
Half an hour later we'd gone to lunch. Panini, packaged, so tested (7.7 mmols by this point), 63 g carb. Bolus wizard worked it all out and bingo, in it goes.
Two hours later, he has a mild hypo, 3.8. Treat with glucose only, in half an hour up to 5 ish. Has hot choc, boluses with bgl inputted. Fights lows (no hypos) all afternoon, but is ECSTATIC with numbers, bless him. I feel the control is a little *too* tight for my comfort.
After speaking with our nurse last night, she agreed and changed one of his basal rates, asked us to track him through the night, and get back to her at 7am this morning, before his breakfast bolus. We did so: 5.7 before dinner, 5.7 2 hours after dinner, then at 12 am 4.5 (woke him up, gave snack, not bolused), 3 am he was at 6.6 (from snack no doubt) but this morning he was back on 3.9. Still too tight!
Our nurse's suggestion was to lower all basal rates (set at different times and rates over the day according to his patterns of rise and fall) by an increment, and to under-shoot his morning bolus while we waited for this to have an effect.
Morning text from E says: 17 at 9am (under two hours after breakfast, but still high. He corrected with wizard, which took into account active insulin from breakfast); 13 at 11am (he had snack with bolus wizard and correction).
He's going to be cross because he loved the low numbers. But to be honest, I'd rather approach it from this end, working down -- rather than always worrying about propping him up! Had some difficulty sleeping last night...
Question to ask DSN tonight: what level to you aim to 'go to bed on' with a pump? We completely forgot to ask that yesterday....
No doubt he will be 'tweaked' this evening. If yesterday is anything to go by though, by the time he gets home he will be right down where he's supposed to be, the magical bolus wizard having done its thing. The high numbers this morning are partly a deliberate under-bolus and partly quite a reining in of basal rates, no doubt.
But that's OKAY BY ME as I say. The young man had exams today on top of everything else, though he didn't seem even remotely fazed by the prospect....
Yesterday my son began his awaited foray into pumping, after a week's saline. He's 13, type 1, diagnosed Nov 08. We've been lucky, with a cooperative PCT and keen GP and consultant, to get him through quickly. He's also very motivated, which seems to have helped us all along.
So far, so interesting! We had kept very good records of bgls and meals, carb counting, bolus units, etc, so were able to hit the ground running, receiving training on everything from all the parameters that need setting to dual and square waving. He's on a medtronic, and finding it simple to use. And I'll admit that he's come to grips with it hugely faster than I could have. It's like a mobile phone to him, whizzing through all the menus, etc...
Yesterday he started the day at the hospital on 17 because we were asked to skip his morning levermir dose. He instantly bolused a correction upon being hooked up (1 unit = 3 mmols sensitivity), and 45 mins later he was down to 9! He was then starving. They offered him a Hobnob. 8 g -- bolused for that: 0.9 units!
Half an hour later we'd gone to lunch. Panini, packaged, so tested (7.7 mmols by this point), 63 g carb. Bolus wizard worked it all out and bingo, in it goes.
Two hours later, he has a mild hypo, 3.8. Treat with glucose only, in half an hour up to 5 ish. Has hot choc, boluses with bgl inputted. Fights lows (no hypos) all afternoon, but is ECSTATIC with numbers, bless him. I feel the control is a little *too* tight for my comfort.
After speaking with our nurse last night, she agreed and changed one of his basal rates, asked us to track him through the night, and get back to her at 7am this morning, before his breakfast bolus. We did so: 5.7 before dinner, 5.7 2 hours after dinner, then at 12 am 4.5 (woke him up, gave snack, not bolused), 3 am he was at 6.6 (from snack no doubt) but this morning he was back on 3.9. Still too tight!
Our nurse's suggestion was to lower all basal rates (set at different times and rates over the day according to his patterns of rise and fall) by an increment, and to under-shoot his morning bolus while we waited for this to have an effect.
Morning text from E says: 17 at 9am (under two hours after breakfast, but still high. He corrected with wizard, which took into account active insulin from breakfast); 13 at 11am (he had snack with bolus wizard and correction).
He's going to be cross because he loved the low numbers. But to be honest, I'd rather approach it from this end, working down -- rather than always worrying about propping him up! Had some difficulty sleeping last night...
Question to ask DSN tonight: what level to you aim to 'go to bed on' with a pump? We completely forgot to ask that yesterday....
No doubt he will be 'tweaked' this evening. If yesterday is anything to go by though, by the time he gets home he will be right down where he's supposed to be, the magical bolus wizard having done its thing. The high numbers this morning are partly a deliberate under-bolus and partly quite a reining in of basal rates, no doubt.
But that's OKAY BY ME as I say. The young man had exams today on top of everything else, though he didn't seem even remotely fazed by the prospect....
