The first time I was offered an insulin pump must have been around 4 years ago, in early 2006. I had been off work for 6 weeks, because I was going through a period of what the pros referred to a 're-diagnosis'. You see, the problem was, I was diagnosed at four years old. At such a tiny age, I had very few (indeed, if any!) memories of what life was like before I was 'taken over'. I lived out my child years being closely monitored by my parents, who, despite the challenges they faced, managed to keep my BS well in check.
During my teens, as I got too old to be 'monitored' and became more independent, the control started to twindle. I rarely did blood tests and if I could help it, avoided all appointments where I was constantly reminded about the gravity of the disease. So when I hit my twenties and wanted to think career, children and travel, I decided I needed to pay far more attention to what was going on. I emerged from my cave of ignorance and tried to change everything at once. I excercised every day, tested more often than anyone could ask, changed my diet and made enough appointments keep me busy for months. Only there was one problem; for the first time in my life, I really learned how much diabetes takes to control. Before I knew it, I was obsessively testing, achieving awful results and becoming so stressed, I had to go off work on long-term sick. In total, the six weeks I was off held more desperation and devastation than I had ever known. I would test first thing in the morning and staring back at me from the BS reader, the angry screen would shout "21.7mmol!". How could this be? I haven't even eaten yet and had only just woken up, and still I felt like I could drink non-stop from the kitchen tap for six hours, and would still need more water thereafter.
For the first time in my life I was terrified about my future, and couldn's see a point or reason to try. This was the first time I was offered a pump.
"Are you serious?"
I was at my lowest point in life. I felt trapped by a disease I didn't deserve, and had convinced myself that I wouldn't last long. Yes, as a diabetic, I COULDN'T last long. The thought of living out whatever short life I had, attached to a pump with wires trailing from places I didn't want to think about was to me, too much.
The next time I was offered a pump was about a year ago. I attended a course which was designed to provide diabetics with the tools they needed to be able to achieve better control. At the end of the course, although it was informative, it didn't seem to make a difference. My A1c was still 9.5% and I didn't feel any more in control.
All I had to do was say that I was interested. I was given a start date, an idea of how many other people would be on the course with me, and got to see what the pump looked like.
That was it. A year later I've been on it two months, can't believe some of the results I am getting, am happy, in control and shocked at how much more I am getting for the effort I put in.
The pump was offered to me with enthusiasm and an 'of course you can' attitude.
So why is it that while I read the comments on the diabetes UK website, so many people are being told flat out that they can't have a pump. "There is a two year waiting list", "Your control isn't bad enough". How can this be the way the world works in 2010! There are desperate mothers and fathers trying to find a way to extend their lives and make themselves healthier for the sake of their kids.
The insulin pump has been available in the UK since the turn of the century. How is it possible that people still have to 'prove' they are poorly enough controlled to warrant a pump. It seems to me that it comes down to a postcode lottery. Some people, like me, are able get a pump even after turning their nose up at it, while others, who are asking to go on it at every opportunity, are still refused on the basis of funding - surely the cost of dialysis, sight problems and amputations outweighs the cost of pump therapy?
It makes perfect sense to me now, why injections didn't work for me. By body needs changes in insulin between one hour and the next, as little as 0.1u/h. So during the night I need 1.4u between 9pm and midnight, then between midnight and 7 I need 1.3u/h. How I ever survived on one injection every 24 hours, where I injected 24 units and waited for it to slowly 'wear off', I will never understand.
By no means is my control perfect now, but the fact that 87% of my sugars are in single figures, where I only used to have sugars in target 13% of the time (yes I admit it, the control was awful!), shows that injections could never have worked. It baffles me that despite the overwhelming evidence that pump therapy benefits most diabetics (pump therapy is a lifestyle choice - that much is true), the NHS still struggle to find the funding for people who are willing to make that choice. I know it isn't the fault of the professionals, or at least that's what I hope, but as a diabetic and a pump user (and a happy one at that!), I feel a sense of guilt when people ask me how I got a pump. I feel embarrassed that I turned it down. But I guess I know that for me, it wasn't right four years ago. The effort I have put in to testing, monitoring and experimenting, means that in the midst of my 'breakdown', I simply couldn't have taken any more. My time was now.
I truly hope that things begin to change and that others will be able to go on the pump. After all, why should wanting to look after yourself be stopped by funding. To me, that is just politically incorrect!
Showing posts with label MDI. Show all posts
Showing posts with label MDI. Show all posts
Friday, 9 April 2010
Holiday highs and lows
Well, Thailand is perhaps one of the most breathtaking places I have experienced. Until now, the hottest places I have been were Florida and Spain. Being hot and dusty places, I wasn't quite expecting the unbelievable and unparalleled beauty of the landscape, the limestone cliffs, the stunning coral reefs surrounding each of the hundreds if islands or the tireless hospitality of the locals. Crystal clear water, cloudless skies and beaches only movie sets could mirror.
But enough about the perfection, this blog is about one thing. Diabetes and how to cope with it. In the past, holidays have been something which have brought a mixture of both good and bad. Great to get away from the grind and enjoy some peace and quiet, an opportunity to let my body reset and get back to a healthy state. On the other hand, the minute I am eating food which isn't perfectly weighed and carbohydrate calculated, those sugars start having a party. Mix that with a time difference, hot temperatures, alcohol and even sleeping in, and you have yourself the perfect concoction of trouble. A mix of trouble which would make even the most well behaved diabetes would fall off the wagon. So many variables that the diabetes runs off like a spooked horse which has no intention of stopping!
There were certainly some challenges which arose with the pump. Of which I will concentrate on only one. Mainly because this was the biggest problem, and because it would be quite a long blog if I listed all the challenges.
For those who read my previous blog about the planning which goes into packing for holiday from a diabetic's point of view, you will know that I planned for every possible eventuality, including tropical bears (!) when I calculated how many cannulas I would need for holiday. Well, it turns out I forgot one. The fact that I would be in the pool or ocean everyday and would be sweating more than normal. For those reasons, my first cannula fell out, or rather tugged out with ease after just one day of wear. Now, I took 10 cannulas, which was enough for one month. I figured that this was enough before I left, but in my new knowledge about the wear that water could cause to the sticking plaster, if I continued to lose them at one a day, I would run out after 10 days! I decided to try my hand back at injections, because I knew I had enough insulin and needles to last.
BIG MISTAKE.
After just two days, I had had more sugars over 20 than I could remember, lost a whole day to sleeping because my BG (blood glucose) and was so out of control that my body gave up. So I got myself back on the pump quick smart, having never been so grateful of being attached to it. And guess what happened? At 11pm when I re-attached the pump I was 23.2mmol, by 9 am, once back on it, I was 5.6mmol.
So I decided to stick with the pump but to try and keep the site as dry as possible, which meant checking it a lot and having a little tug now and then, just to make sure it wouldn’t pull out in the middle of a trip or god forbid, the middle of my friend’s wedding! Now it was still a challenge, especially on days when we went snorkeling, because of the constant water contact to the cannula. But somehow it all came together ok. I just had to ensure that I was mindful of the time so that I didn’t stay in the water much over an hour. Those who are on a pump should only ever be off it for around 30 minutes – 1 hour. This may sound like a lot, but when you have some of the best snorkeling Thailand has to offer, 1 hour is not enough. But I’m still here and despite some ups and downs, I obviously made it through the holiday, so no harm done. And even though I hit some high highs, and some low lows, my sugars were still nothing like they were when I was on MDIs. I would still wake up with sugars of around 5mmol everyday, and I didn’t worry nearly as much as I used to. Perhaps that one dodgy cannula at the beginning was a fluke, or a faulty, or perhaps I had knocked it on something and caused it to become a bit loose. Whatever it was, I eacked them out to the very end and they lasted. Phew.
The moral of this story (blog)……it may still be rough, but the pump makes it a damned sight easier.
But enough about the perfection, this blog is about one thing. Diabetes and how to cope with it. In the past, holidays have been something which have brought a mixture of both good and bad. Great to get away from the grind and enjoy some peace and quiet, an opportunity to let my body reset and get back to a healthy state. On the other hand, the minute I am eating food which isn't perfectly weighed and carbohydrate calculated, those sugars start having a party. Mix that with a time difference, hot temperatures, alcohol and even sleeping in, and you have yourself the perfect concoction of trouble. A mix of trouble which would make even the most well behaved diabetes would fall off the wagon. So many variables that the diabetes runs off like a spooked horse which has no intention of stopping!
There were certainly some challenges which arose with the pump. Of which I will concentrate on only one. Mainly because this was the biggest problem, and because it would be quite a long blog if I listed all the challenges.
For those who read my previous blog about the planning which goes into packing for holiday from a diabetic's point of view, you will know that I planned for every possible eventuality, including tropical bears (!) when I calculated how many cannulas I would need for holiday. Well, it turns out I forgot one. The fact that I would be in the pool or ocean everyday and would be sweating more than normal. For those reasons, my first cannula fell out, or rather tugged out with ease after just one day of wear. Now, I took 10 cannulas, which was enough for one month. I figured that this was enough before I left, but in my new knowledge about the wear that water could cause to the sticking plaster, if I continued to lose them at one a day, I would run out after 10 days! I decided to try my hand back at injections, because I knew I had enough insulin and needles to last.
BIG MISTAKE.
After just two days, I had had more sugars over 20 than I could remember, lost a whole day to sleeping because my BG (blood glucose) and was so out of control that my body gave up. So I got myself back on the pump quick smart, having never been so grateful of being attached to it. And guess what happened? At 11pm when I re-attached the pump I was 23.2mmol, by 9 am, once back on it, I was 5.6mmol.
So I decided to stick with the pump but to try and keep the site as dry as possible, which meant checking it a lot and having a little tug now and then, just to make sure it wouldn’t pull out in the middle of a trip or god forbid, the middle of my friend’s wedding! Now it was still a challenge, especially on days when we went snorkeling, because of the constant water contact to the cannula. But somehow it all came together ok. I just had to ensure that I was mindful of the time so that I didn’t stay in the water much over an hour. Those who are on a pump should only ever be off it for around 30 minutes – 1 hour. This may sound like a lot, but when you have some of the best snorkeling Thailand has to offer, 1 hour is not enough. But I’m still here and despite some ups and downs, I obviously made it through the holiday, so no harm done. And even though I hit some high highs, and some low lows, my sugars were still nothing like they were when I was on MDIs. I would still wake up with sugars of around 5mmol everyday, and I didn’t worry nearly as much as I used to. Perhaps that one dodgy cannula at the beginning was a fluke, or a faulty, or perhaps I had knocked it on something and caused it to become a bit loose. Whatever it was, I eacked them out to the very end and they lasted. Phew.
The moral of this story (blog)……it may still be rough, but the pump makes it a damned sight easier.
Taming the [carbohydrate] beast!
Well, after a few posts all about general life as a diabetic, it's back to some features of the pump I am starting to discover. And I think this is perhaps the best function yet! So much so that I had to write about it one day one!
One of the biggest challenges to a diabetic, is conquering the the art of working out how quickly or slowly the carbohydrate you have eaten will work off. Now, how quickly the insulin works will depend on each person, but for me it is generally around 3-4 hours. The pain about carbohydrates is that some work quicker whilst others work slower. For example, complex carbohydrates found in pasta, will take longer to burn off than simple carbs, such as sugar or glucose (or in fact, any of the 'oses' you find in foods). So in theory, if you have one type of carbs, you can inject according to how quickly or slowly your body will use them.
BUT, and it is a big [pain the the] but[t], when these carbs are mixed, you need to adjust your insulin in order to cater for carbs which will release quickly and those which will take longer. The best example I know of is a Korma Indian curry, for which the knowledge of calculation of insulin has completely baffled and evaded me for years. A Korma is very sweet (simple carbs which release very quikcly) but also has rice with it (which has complex carbs which take longer to work). The problem is, in order to manage this meal on multiple daily injections (MDIs), you would undoubtedly have to inject several times just for one meal in order to counteract the effect of the slow and fast acting carbs. Yeah, pain in the butt! And when you alreayd inject 4 or 5 times a day, injecting another 3 for one meal is just not worth it. So much so that for the past 3 years my partner and I have had to eat a Korma on a Friday or Saturday night. Why? Because the effect it would have on my sugars would be so huge, the whole of that night I would be almost drowning in beakers of water and visiting the loo every five minutes, thanks to the 20+ BG readings I would have throughout the night. In turn, this would leave me feeling hideous the day after. In fact, I even had to call in sick at work on one occasion (the first occasion) that I ate a Korma, because of the effect the night before had made. That was when 'the rule' was put in place.
Two of the fantastic benefits the pump offers are something called dual-wave bolusing or square-wave bolusing. Now, a bolus is the name for the dose of insulin you give yourself before a meal. This would be used if you are eating a meal which contains carbs that you think will take around the time to burn off that your insulin will be effective for. The meal is probably one which has a source of steady releasing carbohydrates, but which remain active for longer than your insulin normally takes to burn off.
The square wave bolus is designed to release insulin steadily over a time you specify. Therefore, if you are eating a meal like a jacket potato with beans, the potato (due to the way it's cooked) will get into your system quickly and therefore will require insulin to go in straight away. The beans however release slowly and are likely to continue releasing energy longer than the insulin I take. Before this would have mean I would have needed to inject in the middle of the meal (yeah, I didn't exactly go for that either!). Instead, square wave-bolus means that I can set the total amount of units I will need for the meal, only I can tell the pump to continue releasing this insulin over say, 5 hours. This will mean I won't need to worry about my insulin running out and my blood sugars going up, after the 3-4 hours it normally takes me to run out. Awesome!!!!
The square-wave bolus function is similar, but instead of releasing it steadily, you can use it for a meal such as the dreaded (loved) Korma. The instant effect of a Korma is that your sugars will fly up, due to the sweetness, meaning you need an immediate dose of insulin to counteract that. But later, the rice will continue to release energy. Thanks to this function, I can work out how many units I need for the rice, and set the pump to carry on working for several hours afterwards! I haven't tried a Korma yet (mainly because I don't have total confidence in how long to set the dose for and how many units I need in total), BUT, for the past week I have been trying to figure out how much to inject for my lunch, which was a sandwich and a chocolate bar. For the past week, I've been battling with it and coming out with any range of numbers, but all over 15. Today, my sugars were a little on the high side anyway (10mmol), but I decided to give it a go, as I had a good night and a stable morning, meaning an 'experiment' had less variables than the usual 12 I can find at any one time!
So, today I gave the dual-wave bolusing a go! My thinking was that chocolate isn't too bad in itself, but it was honeycomb which was sweet would kick in quickly. The sandwich on the other hand was wholegrain bread, meaning it would work much slower and would last longer. So, in total I needed 10 units overall. So I decided to inject 5 units straight away, as that was for the honeycomb which would kick in quick and work off quick, while the bread would start to work almost immediately and continue releasing. The rest of the dose I asked it to release over the space of two hours.
What happened? It worked perfectly. Well, almost. My sugars are now at 4.3mmol, which is a little on the low side, but for the first time in two weeks, I didn't have my horrible high which I was expecting. Meaning something must have gone right! It may be that I needed to ask it to release over one hour, seeing as that would then mean that I still had active insulin for around 5 hours, and it is fairly unlikely the few seeds in the bread were still releasing energy 6 hours after the meal. BUT, it was the first time I have eaten that meal with success.
Over the next few weeks I will continue to play with the pump and ask them team at the hospital about how to use these functions properly, but it has finally opened the doors for me to eat the meals I enjoy without the nasty after effect that I know so well!
Anna - about to eat a curry!
One of the biggest challenges to a diabetic, is conquering the the art of working out how quickly or slowly the carbohydrate you have eaten will work off. Now, how quickly the insulin works will depend on each person, but for me it is generally around 3-4 hours. The pain about carbohydrates is that some work quicker whilst others work slower. For example, complex carbohydrates found in pasta, will take longer to burn off than simple carbs, such as sugar or glucose (or in fact, any of the 'oses' you find in foods). So in theory, if you have one type of carbs, you can inject according to how quickly or slowly your body will use them.
BUT, and it is a big [pain the the] but[t], when these carbs are mixed, you need to adjust your insulin in order to cater for carbs which will release quickly and those which will take longer. The best example I know of is a Korma Indian curry, for which the knowledge of calculation of insulin has completely baffled and evaded me for years. A Korma is very sweet (simple carbs which release very quikcly) but also has rice with it (which has complex carbs which take longer to work). The problem is, in order to manage this meal on multiple daily injections (MDIs), you would undoubtedly have to inject several times just for one meal in order to counteract the effect of the slow and fast acting carbs. Yeah, pain in the butt! And when you alreayd inject 4 or 5 times a day, injecting another 3 for one meal is just not worth it. So much so that for the past 3 years my partner and I have had to eat a Korma on a Friday or Saturday night. Why? Because the effect it would have on my sugars would be so huge, the whole of that night I would be almost drowning in beakers of water and visiting the loo every five minutes, thanks to the 20+ BG readings I would have throughout the night. In turn, this would leave me feeling hideous the day after. In fact, I even had to call in sick at work on one occasion (the first occasion) that I ate a Korma, because of the effect the night before had made. That was when 'the rule' was put in place.
Two of the fantastic benefits the pump offers are something called dual-wave bolusing or square-wave bolusing. Now, a bolus is the name for the dose of insulin you give yourself before a meal. This would be used if you are eating a meal which contains carbs that you think will take around the time to burn off that your insulin will be effective for. The meal is probably one which has a source of steady releasing carbohydrates, but which remain active for longer than your insulin normally takes to burn off.
The square wave bolus is designed to release insulin steadily over a time you specify. Therefore, if you are eating a meal like a jacket potato with beans, the potato (due to the way it's cooked) will get into your system quickly and therefore will require insulin to go in straight away. The beans however release slowly and are likely to continue releasing energy longer than the insulin I take. Before this would have mean I would have needed to inject in the middle of the meal (yeah, I didn't exactly go for that either!). Instead, square wave-bolus means that I can set the total amount of units I will need for the meal, only I can tell the pump to continue releasing this insulin over say, 5 hours. This will mean I won't need to worry about my insulin running out and my blood sugars going up, after the 3-4 hours it normally takes me to run out. Awesome!!!!
The square-wave bolus function is similar, but instead of releasing it steadily, you can use it for a meal such as the dreaded (loved) Korma. The instant effect of a Korma is that your sugars will fly up, due to the sweetness, meaning you need an immediate dose of insulin to counteract that. But later, the rice will continue to release energy. Thanks to this function, I can work out how many units I need for the rice, and set the pump to carry on working for several hours afterwards! I haven't tried a Korma yet (mainly because I don't have total confidence in how long to set the dose for and how many units I need in total), BUT, for the past week I have been trying to figure out how much to inject for my lunch, which was a sandwich and a chocolate bar. For the past week, I've been battling with it and coming out with any range of numbers, but all over 15. Today, my sugars were a little on the high side anyway (10mmol), but I decided to give it a go, as I had a good night and a stable morning, meaning an 'experiment' had less variables than the usual 12 I can find at any one time!
So, today I gave the dual-wave bolusing a go! My thinking was that chocolate isn't too bad in itself, but it was honeycomb which was sweet would kick in quickly. The sandwich on the other hand was wholegrain bread, meaning it would work much slower and would last longer. So, in total I needed 10 units overall. So I decided to inject 5 units straight away, as that was for the honeycomb which would kick in quick and work off quick, while the bread would start to work almost immediately and continue releasing. The rest of the dose I asked it to release over the space of two hours.
What happened? It worked perfectly. Well, almost. My sugars are now at 4.3mmol, which is a little on the low side, but for the first time in two weeks, I didn't have my horrible high which I was expecting. Meaning something must have gone right! It may be that I needed to ask it to release over one hour, seeing as that would then mean that I still had active insulin for around 5 hours, and it is fairly unlikely the few seeds in the bread were still releasing energy 6 hours after the meal. BUT, it was the first time I have eaten that meal with success.
Over the next few weeks I will continue to play with the pump and ask them team at the hospital about how to use these functions properly, but it has finally opened the doors for me to eat the meals I enjoy without the nasty after effect that I know so well!
Anna - about to eat a curry!
Why the insulin pump?
Well, I officially now a 'pumper', or so I am told. After 8 months of planning, pondering, setting goals and countless hours of Internet research, the day arrived when I would officially become an insulin pump user.
For those who don't know this, type 1 diabetes is a chronic condition in which the human body can no longer produce insulin. It is usually diagnosed in childhood or early adulthood (although recently, many more people are being diagnosed later in life) and is not related to weight or unhealthy lifestyle. The body requires a certain amount of glucose in order to function properly (as a rule, between 4 and 7 mmol). For type 1 diabetics, in order to maintain these sorts of levels, multiple daily blood tests must be done, insulin must be injected using either an insulin pump or multiple daily injections (MDI). Type 1 and 2 diabetes are often confused, but as I am a type 1, I choose not to comment on type 2, as I don't have the right or experience. But as a type 1 after 23 years, I am an expert. Or as much of an expert as anyone can be with a condition which regularly throws in surprises and confusing results.
I started out on 2 injections per day, which meant weighing food and tiresome calculations as to how much I could eat and when. At the age of about 14, the specialists as the hospital gave me the option of going on 4 injections a day, which soon became 5. This gave me a lot more flexibility (you can eat bigger meals and take larger doses, or eat less and only inject according to your needs). However, after years of trying to gain better control, it was clear that something still wasn't quite right. So, after much thought and consideration, we (yes, because to choose to go onto a pump will involve those around you) decided to go on the insulin pump.
The insulin pump is a mobile phone sized device which is attached to someone for around 23-24 hours per day. Rather than having to do MDI, the pump stays connected to you via a flexible needle, cannula and tubing. It remains at the same site using a strong plaster like material which sticks to the skin and keeps the needle in place, usually for 2-3 days at a time before the site needs to be changed to avoid infections and soreness. After all, your body is never going to like having a piece of plastic inserted into the skin, even if it is keeping you alive! Throughout the day, the pump will deliver minute doses on insulin, which can be adjusted to release different amounts at different times of day, according to the needs of the person using it. For example, my sugars often run higher in the afternoon, so my dose will be higher during the afternoon hours. Then, if you want to eat, you calculate how much your intended meal will require and you give yourself an extra dose (using the pump again - still no more needlesticks!).
Although it may seem strange to want to be connected to a machine for you whole day, the constant reminders of what poor control and erratic sugars can do to a person is pretty powerful (kidney failure, blindness, heart disease and gangrene to name a few). In the US, from what I hear, you can only get a pump if you are adequately insured and are prepared to put your case forward that you should be allowed to have access to new medications. If you do not have insurance, you pay. A lot! In the UK, although the pump only became more recognised in recent years, the pump is free. As long as you complete a successful trial and can prove that it is in the interest of the primary care trust to fund your treatment, you should't pay for a single thing. One heartbreaking moment that woke me up a bit was when I was reading extracts from an insulin pump chatroom. A mother was on there asking if she could buy someones old pump, with the limited resources she had. How could I turn around and say I didn't want to try the pump in case it affected my sleep, while there were people out there asking for second hand pumps (a no-o) in a desperate attempt to better their children's lives.
I have reached the age where having children and good health are important to me and having tried for many years to gain control, this seems like the only (and by far the best) option for me.
So for me this was an exciting year, learning all about the benefits and pitfalls of life on a pump. My next post will be about the pump I am on, my experience of putting it in for the first time and the bag fulls of freebies I came home from the hospital with (an no one can deny, freebies always make you smile)!
See you soon!
For those who don't know this, type 1 diabetes is a chronic condition in which the human body can no longer produce insulin. It is usually diagnosed in childhood or early adulthood (although recently, many more people are being diagnosed later in life) and is not related to weight or unhealthy lifestyle. The body requires a certain amount of glucose in order to function properly (as a rule, between 4 and 7 mmol). For type 1 diabetics, in order to maintain these sorts of levels, multiple daily blood tests must be done, insulin must be injected using either an insulin pump or multiple daily injections (MDI). Type 1 and 2 diabetes are often confused, but as I am a type 1, I choose not to comment on type 2, as I don't have the right or experience. But as a type 1 after 23 years, I am an expert. Or as much of an expert as anyone can be with a condition which regularly throws in surprises and confusing results.
I started out on 2 injections per day, which meant weighing food and tiresome calculations as to how much I could eat and when. At the age of about 14, the specialists as the hospital gave me the option of going on 4 injections a day, which soon became 5. This gave me a lot more flexibility (you can eat bigger meals and take larger doses, or eat less and only inject according to your needs). However, after years of trying to gain better control, it was clear that something still wasn't quite right. So, after much thought and consideration, we (yes, because to choose to go onto a pump will involve those around you) decided to go on the insulin pump.
The insulin pump is a mobile phone sized device which is attached to someone for around 23-24 hours per day. Rather than having to do MDI, the pump stays connected to you via a flexible needle, cannula and tubing. It remains at the same site using a strong plaster like material which sticks to the skin and keeps the needle in place, usually for 2-3 days at a time before the site needs to be changed to avoid infections and soreness. After all, your body is never going to like having a piece of plastic inserted into the skin, even if it is keeping you alive! Throughout the day, the pump will deliver minute doses on insulin, which can be adjusted to release different amounts at different times of day, according to the needs of the person using it. For example, my sugars often run higher in the afternoon, so my dose will be higher during the afternoon hours. Then, if you want to eat, you calculate how much your intended meal will require and you give yourself an extra dose (using the pump again - still no more needlesticks!).
Although it may seem strange to want to be connected to a machine for you whole day, the constant reminders of what poor control and erratic sugars can do to a person is pretty powerful (kidney failure, blindness, heart disease and gangrene to name a few). In the US, from what I hear, you can only get a pump if you are adequately insured and are prepared to put your case forward that you should be allowed to have access to new medications. If you do not have insurance, you pay. A lot! In the UK, although the pump only became more recognised in recent years, the pump is free. As long as you complete a successful trial and can prove that it is in the interest of the primary care trust to fund your treatment, you should't pay for a single thing. One heartbreaking moment that woke me up a bit was when I was reading extracts from an insulin pump chatroom. A mother was on there asking if she could buy someones old pump, with the limited resources she had. How could I turn around and say I didn't want to try the pump in case it affected my sleep, while there were people out there asking for second hand pumps (a no-o) in a desperate attempt to better their children's lives.
I have reached the age where having children and good health are important to me and having tried for many years to gain control, this seems like the only (and by far the best) option for me.
So for me this was an exciting year, learning all about the benefits and pitfalls of life on a pump. My next post will be about the pump I am on, my experience of putting it in for the first time and the bag fulls of freebies I came home from the hospital with (an no one can deny, freebies always make you smile)!
See you soon!
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