Tethered

I love my pump.

 I have since I walked into the Consultant's office on day 1 of my pump-life and saw the Medtronic Veo on the table.  It was the very same pump I had wanted when I was soaking up all I could from the Internet about them.

I liked the integrated CGM and low glucose suspend.  I know this is ridiculous as I'm not funded for CGM and as I don't spin gold from my hair, am unlikely to have it for years yet.  But I liked it.

I liked the colours it came in and the fact I could add a little touch of myself to it.  I liked the automatic inserter, meaning I didn't have to stab myself with the inch long silhouette needle (the first time I ever discovered that I harbour just a touch of needle-phobia).  I liked the Medtronic team and their many nudges in the right direction when I was acting like a diabetes-moron and kinking cannulas left, right and centre.  Most of all, I love the freedom it afforded me and new, improved, complication-free (ish) life it afforded me.  I loved feeling well again. 

I still do.

What I don't like, is the tubing.

Over the last two and a half years I have begun walking through doorways at a distinct angle.  To the knowing diabetic, this is because if there happens to be some wayward tubing protruding from your clothing, you could bet your house on it getting caught on the door handle, wrenching you back stomach-first in a cartoon-like rebound.  To the unknowing eye, I simply look disabled.  The 'in the head' kind of disabled, that is.  I have learnt never to change the cannula when in sight of a cat, because all that rustling and flicking of tubing is enough to entice even the most lazy feline into a stalking frenzy.  I am a little frustrated to say the least by having to find gym clothes with zip-up pockets in, because when I try to exercise, 'pumpy' flies off the trouser band, effectively assaulting anyone within a 3 foot radius (that's the length tubing I use).  I have also learnt that if you are going to snuggle up to the husband during the night, make darn sure he isn't laying on the 3 inches of tubing closest to your stomach, because when you turn over seeking a more comfy position, you will think someone is pulling out your insides, liver first.

As much as I love my pump and the freedom it affords me, I am more than ready to go tubing free.  And although Omipod and I didn't get off the the best start, they are gathering momentum in the UK all the time, and the positive reports make their way back to me time and again. Perhaps a second glance is worth a think or two.

We also have Cellnovo now on the horizon, who despite have gained CE approval (meaning it has been deemed safe for human use) are still hanging on to their new, very sexy, patch-pump.  And although they are a completely new company, most of their team have been head-hunted from the heady heights of likes  of Medtronic, my personal favourite (well, only really) pump-provider.

There are also rumours about the Solo making its way to ours shores in the near future after Roche acquired 'Medingo' (who??), which for me, is probably the best news of all.  Being tubing free but also from a very well established company and with a bolus button on board meaning if you forget the handheld diabetes manager tool you use to deliver insulin (you scoff, but beggar's belief I managed to go out the other day having not even connected Lord Pumpingtopn.  Clever.) then you can still deliver a bolus for meals.

Yes, it is definitely time that I ditched a tethered pump (even the name annoys me these days) and discover a new way of pumping. 

18 months to go before I should be able to apply for a new, less tubey pump.  And very much counting!

An accurate representation of how I currently feel. With only the smallest element of massive over-exageration

The low-down: Animas' Sports and Exercise weekend

If you don't get time to read through blogs then here at last are the cliff notes of the Animas Sports and Exercise weekend 2012.  It should give you a flavour of what the weekend was about and show you that everyone from total beginners like myself to channel swimmers and Iron Man competitors alike can benefit from the weekend.

Look out for yours truly towards the end making some, like, totally profound statements....

As the video is currently unlisted,you can watch it, here :

Enjoy!

Vascular antics: when aterties turn bad

For the past two years I have been struggling with some pesky sporadic pains in my legs which appear whenever I try to walk anywhere for more than a few minutes.  Similar to cramping, it feels as though my calf muscles have all of a sudden become too short for my legs, leaving me limping and in a lot of pain.  It all subsides after a few minutes but needless to say, a 28 (and a bit) year old shouldn't be having this kind of difficulty walking. I visited my nurse at my old (and totally useless) doctor's surgery a while ago asking about it, who during a routine diabetes review told me in a matter-of-fact manner that I had, and I will never forget this, a 'weak pulse in your foot'.

As with most things, the professionals just love to blame it all on the weight.  Because if having to drag clothes from the back of the rail (not so easy when you're sporting a couple of E cup cahoonas) wasn't bad enough, apparently we (the chubbies) need to be reminded on a regular basis that we just aren't doing well enough when it comes to our diet and exercise.  

'Just lose weight and it will most likely improve' she said.

Most likely.  That seems, well, like a hopeful guess.

But you see, I'm not silly.  I know that there are millions, maybe billions, of people far heavier than myself who don't get these crippling pains.  So there must be another cause.  Another explanation.  With the pains in the legs, the weak pulse in my foot (thanks, lady) and the fact that I am now back with my previous great GP, I decided two weeks ago that I'd had about enough of walking like I have wooden feet, and made by appointment with the doctor.

As I trundled through my week-long wait for my appointment, the thoughts of how serious this could be started to dawn on me. Of course with the wonders of Google and having typed in 'weak pulse in feet and pain in legs' I had convinced myself I was harbouring of a whole host of frightening conditions, starting North of 'calf strain' and ending somewhere South of 'fasciectomy' (where they cut limbs open to release pressure, before carrying out a skin graft). I have seen more photos of black feet rotten with gangrene in the last week, than I care to recall.  

I'm a catastrophiser, you see (look it up, there's a picture of me next to the dictionary entry).

'Anna Presswell', the familiar voice called.

Into the sterile, lemon-coloured room I went and launched into my symptoms, hoping he would immediately recognise and be able to explain my condition, offering me some reassurance that this really was just down to the weight.  

After having a good poke around of the feet and a good check of the toes, out came what he refered to as, 'The Doppler'.  It turns out, 'The Doppler' is the same machine they use to hear a baby's heart beat for the first time.  Out came the jelly, and before I knew it I was listening to my own pulse through the medium of foot-whispering.  Little did I expect that the first time I used one of these, it would be to try and hear my own heart-beat, through my feet.  I expected something a little more, conventional.

After some fumbling about, searching and eventual comparison to an area where my heartbeat could be heard clearly, a very faint, distant pulse was found.  And I really mean faint.  Too faint, for my liking.  When comparing it to the other areas, it was like a whisper.  One we had to listen really closely for.

I let out the breath I've been holding onto.

As he took me through the reasons it may be happening, I mentally check every one of the boxes.  Weight, check.  Cholesterol, check.  Diabetes, check,  Smoking, check.  And before you judge me, save it. It was a silly decision the first time took a drag of a cigarette as an angry and rebellious teenager, but it was my decision and I alone am allowed to judge.  I have turned a corner in my life in the last few years and learning that smoking really can be overcome, was on of those lessons.  The cholesterol has been addressed, the weight is coming down, the smoking is a thing of the increasingly distant pass and unfortunately, despite trying to give that up too, the diabetes is a keeper.

Having explained that I am doing all the things the Doctor would be advising me to do had I come in with no intentions of changing, I have been tasked with continuing the weight-loss for another two months and make a mental note in the diary to come back for another check.  I don't think I will be needing to make any mental note, thanks all the same.  It will be the 8th of October when I make my appointment.

I have always prided myself on having been able to keep the complications of diabetes at bay, but it seems I wasn't able to escape forever.  At least this kind of problem is one I can do something about, something I can reduce, reverse or at least stop in its tracks.  I have changed my lifestyle and continue to all the time.  I find new healthy options to foods I once craved all the time.  Each week that goes by cigarettes become more repulsive and exercise becomes more enjoyable, and more frequent.

I am becoming the text book diabetic.

This is the best kind of wake up call.  Yes, it is a complication of diabetes, but its also just a reminder that mixing all of those factors together does have implications, for anyone.  Ones that I can address, but implications nonetheless.

This is also the next challenge along the way.  The next hurdle. And it will be my next success.  There was the smoking, then the eyes, now the legs.

And I will wipe the floor with these vascular antics.

And just for the sake of it, here is a picture of a pair of lovely healthy feet, similar to my own.  I even carry around the leaves, for full effect.

Each little victory: spinning

With all eyes on the London 2012 Olympics, exercise and personal achievement are hot topics of discussion.  Watching our celebrated British rower Sir Steve Redgrave with his own lazy pancreas issues carry in our Olympic torch was certainly a moment to celebrate.  A couple of years ago a moment to celebrate for me was getting out of bed in one motion, eating a bumper portion of fried chicken or getting out of a chair without making that noise.  You know, the one that kinda goes  'oooourgghhhhh', followed by a sharp outlet of breath.  But over the last two years things have changed for me; something shifted.  I got tired of always feeling tired.  I missed the figure I once had and I realised how much I missed being active.  Outdoors had become a place I no longer had the energy or desire for.  

I'm not sure where it was I took a wrong turn in the road, but I hazard a guess that it was a mixture of going to university, where gym memberships and healthy food were a thing of the past and drinking was all the rage, starting a full time job and being exceedingly happy in my relationship.  Damn that happiness. *shakes fist in air*

In the last year however I have been clawing back whatever residual fitness I had left and could force our of hiding, and started exploring a different way of eating and exercising. But while my diet and attitude started to improve, I made no secret of the fact that managing blood sugars during exercise was a challenge I had no idea how to handle.  Failure happened frequently in even my best-laid plans.  Gentle walks in the country led to serious and embarrassing hypos and gym classes led to kidney-bashing blood sugars I could have achieved by saving myself the effort and sweat and chowing down on a bag of sweets instead.  I reached the point where I would go to an exercise session armed with insulin in case I went high, lucozade in case I went low, bananas in case I needed a littler something before exercise, and protein shakes to try and keep sugars stable (again, deludedly) both during and after exercise.

It was on the sports weekend run by Animas that I was given the tools I needed to start understanding what was happening in my body during my exercise sessions.  I learnt to abandon the bananas, get more confident when reducing basals and exercise as regularly as possible to reap the full benefits of more balanced blood sugar levels.

Piece by piece things started to come together.  The kidney bashing reduced, hypos happened far less frequently and eventually I was even happy to try new exercises, having grown in both confidence and skill at managing that beast called Mr Hyde.  I went from being the girl who hid at the back of the class, dressed head-to-toe in hideous black baggy clothes, hovering somewhere between the water-cooler and the exit (or 'escape' as I called it), to picking new classes, actually saying 'thanks' to the instructor afterwards and even bought myself some shockingly skin-tight running trousers.  And I mean spray-on kind of tight!

On the Saturday just gone however, the spray-on tights, tireless pre-, during- and post-exercise blood-testing and the trying to be as patient and scientific as possible, finally paid off.  I had my first real break thorough.   I arrived at the gym, having been hovering around 5-6 all morning and having lowered my basals to 50% an hour before exercise.  I'd eaten a healthy omelette for breakfast and tuna salad for lunch, so I knew I had some protein in board and that I wasn't likely to have any crazy highs.  I tested my sugars and a 5.6 was staring back at me.  A year ago I would never have dreamed of exercising at 5.6.  If I'm honest, I wouldn't have even 3 months ago. 

'Oh hell', I thought.  'Let's just go for it, what's the worst that could happen?' 

Well, contrary to the Dr Pepper adverts, I didn't run into any problems after asking that, somewhat dangerous, rhetorical question.  Halfway through my spin class I tested.  5.1. 

'OK, OK, I'm happy with that, let's keep going and see what happens.' 

I reached the end of the class and nervously tested again.  There's no way I will have scored a hatrick.   But there it was, a perfect 5.2.  The elated and somewhat unhinged grin on my face must have scared the living daylights out of the other spin goers that day, but it would have made a difference even if I'd noticed, or cared.  That was my first great success. The next two hours were made up of 6s and 7s, settling at 7.4, three hours later.

JACKPOT.

The moral? Keep at it.  The grass on the other side really is as green as it gets...

Occular lapdancing

There are a few dates in the calendar diabetics round the world ear-mark in the diary with a big red circle surrounding them. These are the dates when the (rather ominous sounding) ‘nine tests’ are carried in order to make sure we can still earn our tax money and don't need carting off to the nackers yard, just yet.  These include blood pressure, smoking status, a marker for blood glucose called HbA1c, urinary albuminm serum creatinine, cholesterol, eyes, feet and my personal favourite, weight.  The latter usually being pre-empted by a twitchy Anna standing on the scales professing that, 'I just joined a gym and have already lost a couple of pounds.'  I am lying, most of the time.

You've no doubt seen these nine tests mentioned in the media recently because figures from the National Diabetes Audit discovered that just over half of all Type 2s and a third of all type 1s are not receiving the full range of tests, meaning people with complications, or at serious risk of them, are falling through the cracks. In the NHS? Surely not.

I am glad to say that I am one of the two thirds of type 1s who do make the effort to get all nine done. But I should probably mention that I also have my consultant on speed dial (he just loves this, I can tell), my nurse on email and have inadvertently added my dietician to my broader social circle, through what can only be described as proof of the existence of the 6 degrees of separation.

But still, it does take effort to get them all done and relies on GPs, consultants and now, ourselves to be paying attention. Until 3 months ago, I didn't even know these were a benchmark for basic care. I just did it year-in, year-out, regardless.

It's part of the deal if you want to stick around.

Well last week was my annual occular lap-dance, when someone shines a light into your eye at a distance which would be considered sexual harassment in any other situation, so they can see into your eyes and check that everything is still as it should be. These had at one point in my life increased to every 3 months, because although my diabetes team did it subtly, due to many years of increased blood glucose (BG) levels my eyes were already beginning to show signs of damage, and I had to be transferred to a specialist lap-dancer who would assess whether or not to laser them.

I always go into these with a level of nervousness now. Although kidney-explosion (they don’t actually explode, that was for when (if) they ever make the film of this post…) is my biggest diabetes fear (if my absurd reaction to 30-second HBa1c test is anything to go by, I will need to be fully sedated for dialysis), a close second is going blind. As much as I want a dog, currently forbidden by my husband and cats, it's an extreme way to get there. Sneaking one in during the night and looking after my eyes is a much better way to go.

Holding my breath (partly due to nerves, partly because I can't remember if I ate garlic last night and the doc is now 1.5 inches from my face), I wait for the results. I search for a clue on his face at every opportunity, convincing myself that each tiny move is a secret 'Well, we kept it at bay but I better tell her,' being spoken through the medium of body language.

Tick

Tock

Well I am pleased to say that thanks to my leap into the pumping world, finally joining the gym (for real, not just because my annual chubb check) my acceptance that Simvastatin (now Atorvastatin – more on that to follow) and low-carb lifestyle, I am still managing to keep problems at bay. I have got evidence of the death of some blood vessels, but the real risk is when smaller, weaker blood vessels try to grow back in their place. These break, bleed and eventually need to be corrected by laser (not the kind on the TV adverts). This procedure can often leave you without peripheral vision, and your driving license.

For me however, things are still looking good (sorry about the pun). I can rest assured that if I continue to keep going as I am, I won’t be another statistic.

Are you getting the full nine tests?

 

The Big Event - Pumps, Apps and other gadgets....

Next weekend a great sounding day known as 'The Big Event' is taking place at the Rootes Building in the University of Warwick. Along with a series of workshops, the latest news on diabetes research, tailored information and the opportunity to meet with other people with diabetes - type 1 or 2 -  INPUT's own Melissa Holloway will be giving a talk called 'Pumps, Apps and Other Gadgets.'


You KNOW it's gonna be good!


It's only £15 or £20 (depending on DUK membership) for an adult, or £25-£35 for a family ticket and only £5 for a child with any paying adult. 


Check out full details here, and get yourself there!

You know you want to

Well ladies and gents, next weekend marks the occasion when INPUT bring the next in their series of insulin pump roadshows to Nottingham. So if you want the most up to date information on insulin pumps and who could have access to one according to the NICE guidelines then come along and join us....