What I Learnt By Taking A Pump Break.

In bullet point fashion, of course:

• Injections are hard work! Can't just press some buttons on my meter and away I go. No, I actually have to stop and take the time out to make sure I get insulin into my system.
• I'm much more mindful of what I eat when injecting - is that snack really worth the extra shot I'm going to have to take to cover it?
• That being said, on Friday I had pizza for dinner. Pizza on my pump? No problem! Multiwave bolus, and I manage to dodge the inevitable peak. Or at least stop it from peaking to high. Pizza on injections? Hello blood sugar of 15.4mmol when I woke up Saturday morning. (And I did two shots trying to stop the peak that way.)
• My cannula is a source of comfort. Over the last few days, I've found myself reaching for cannula sites, to find there is no cannula. And I've panicked, and then remembered that I've decided to be device-free. Feeling my cannula in place seems to provide a sense of comfort for me. Weird, I know, but we all have strange tendencies, right?!
• The dawn phenomenon struggle was real and frustrating. 

• I forgot how much I enjoyed using the phrase "shoot up". You just don't say it when using a pump.
• Although I was itching to get my pump back on, I was not looking forward to sharing my bed with it. That was the one thing I loved about my pump break - not rolling over and having my pump dig in or having to fish it out of the duvet cover in the mornings. 
• I'm a micro-corrector. A micro-doser too, for that matter. On my pump, I could, and would, micro-correct a blood sugar of 10. And I could micro-dose insulin to cover my morning coffee. But to do that on injections is near enough impossible. I can dose and correct in increments of 0.5. That, and is 10 a high enough blood sugar level to want to correct it with another injection?!
• Temp basal is one of the best things ever. I can't remember the last time I actually used a temp basal, but suddenly, when I don't have the option to use it, all I want to do is use it. 
• In short, I have a new-found appreciation for my pump, and welcomed its' attachment back on my body with open arms this morning! I've also proved to myself that I can revert back to injections with no real difficulties. My pump isn't permanent, and now I have the confidence to go back to injections, on a whim. Constantly wearing a medical device had taken its' toll on my mind, and taking a break from it has given me the time to get myself in the right place to start wearing it again. This morning, I felt ready to suit up once more. So I did.

A Break Up, Of Sorts.

Friday, June 5th, marked one year with my insulin pump. (Where has that year gone?! Seriously?!) Now, I love my insulin pump: it's smart enough that it almost mimics what my pancreas should do, it offers me more flexibility; there are a lot of pros to wearing it and using it to manage my diabetes. There's no way, at this point, that I'd ever give it back. 

That being said...I do want to temporarily break up. Only for a few days, a week at most. Because as much as I love using my pump to manage my diabetes, wearing it, owning it, feeling comfortable with it, using it to it's fullest potential, is something I'm just not doing so well with at the moment. 

I'm sick of sharing my bed with it, for one. I roll over and lay on it, it gets caught in the duvet cover and sometimes goes sky diving off my bed, tugging at where-ever my cannula is that morning. 

And trying to figure out how to work it in with an outfit is beginning to annoy me. 

And I'm not making use of the different types of bolus I can use. 

I think I'm just done with being constantly connected to it. 

So, a temporary break up it is. As of yesterday morning, I welcomed back my trusty Novopen, and took a shot of Levemir to be my background insulin for the day, and packed some syringes to draw insulin up from my Novorapid vial. It did feel strange not having my insulin pump attached, but for the first time since I got it, I felt free. No device attached. I also felt like everyone would notice (a silly thought, given I hide my insulin pump!)

I felt like I'd got lazy with my insulin pump, a little too complacent. I was hoping that coming off it would remind me (again) just how smart my insulin pump is, and how much flexibility it offers me.

In the ever so eloquent words of Dave, "giving myself a kick up the arse".

And I'm happy to say it's working. 

Not Prepared.

Usually, I am so on the ball when it comes to making sure I'm prepared for whatever diabetes-related situation may arise. Spare battery, check. Ketone meter (which also doubles as my back up glucose meter), check. Back up insulin, check. Needles, in case I have to manually inject, check. Glucose tabs, check. Spare cannula, check.

More often than not, I'm pretty on it! I'd much rather carry everything on me, knowing that if my best friend calls and wants to go for an impromptu dinner, I can. Or go to the pub after work with my colleagues. Being prepared means I can be spontaneous when it comes to those decisions.

Last Friday, however, I was only partly-prepared!

I noticed that my insulin cartridge was running low. Not a problem. I grabbed the vial of insulin from my bedside table before I left for work and put it in my bag. I knew I had enough insulin left in the pump to last until lunch. Lunch came round, I checked my blood sugar, and saw I had 3 units left, so I bolused that to cover some of my lunch (I do my very best not to waste insulin - it's precious stuff!). I took my insulin vial from my bag, and then looked into my diabetes bag for my spare insulin cartridge.

Except I didn't have a spare insulin cartridge. And I'd just bolused the last 3 units I had in my pump, something I wouldn't have done if I had checked for the pump cartridge first. Because that 3 units could have been my basal insulin until I got home, and just done an injection to cover lunch.

But, feeling like a bad-ass and using up the last of the insulin in my pump, I didn't check, and this afternoon saw me doing a few injections, something I hadn't done since I started on my insulin pump back in June of last year.

Going back to injections, albeit for only a few hours, felt strange. It's weird how something that was my normal for four years suddenly feels alien to me. It's also made me very aware of the fact that I'm not actually confident anymore when it comes to injections. I wasn't entirely certain how to calculate my basal rates for the time I was disconnected from my pump, and I also didn't know if my insulin to carb ratios would be affected, as the way the insulin is absorbed is different. 

Perhaps I'll go on a pump break in the near future. For me, it's important to feel confident with your method of insulin therapy. And when using an insulin pump, like I currently am, it's important for me to feel comfortable with both my pump and injections, in case my pump ever breaks. 

A lot of this disease is out of my control. But knowing, understanding and feeling confident with my insulin therapy is. 

Pumping Insulin: Thoughts At Three Months.

On Tuesday, I had my first pump clinic appointment since starting back in June. I was going to blog about it, but as I started pumping, I realised I had very little to say. It was a fairly standard appointment, my consultant and DSN are happy with how things are going, and I'm more than happy with where I'm currently at with regard to my diabetes. 

One question I was asked at my appointment, however, was has the transition from MDI (multiple daily injections) to pump been what I expected?

I wasn't really sure how to answer. I feel it's too soon for me to answer that question. I'm still making adjustments to make pump therapy work for me, and "experimenting" with different types of bolus and temporary basal rates (TBR). 

However, there are things I'd wish I'd known, which weren't mentioned before the switch:

Where I stashed my pump for Graduation.

I wish I had known that people would just assume that, because I have the pump, I'm practically cured. So many times, I've heard something along the lines of "so...that's it. You wear that, and it does everything for you..." Not the case. I still have to check my blood sugar and count carbs. I just don't have to do the injection anymore - the pump delivers the insulin instead. 

It takes time to adjust. Don't get me wrong, I was prepared to hate the pump initially, and I did. I missed the comfort of injections, as I knew what I was doing there. But I thought I'd feel a lot more comfortable with it at this point than what I do. However, as I said at the start of this post, I'm still making adjustments and "experimenting" to make insulin pump therapy effective for me.

Not necessarily for everyone, but for me, there's a lot of stuff that comes with pumping insulin that's not prescribed. Cannulas don't always stick, and I hate waste, so I make sure I always have surgical tape in my handbag/diabetes supply shelf. That, and I also find I have marks from where cannulas used to be, so use BioOil (although have been told tea-tree oil is better?) to help them heal quicker...to just insert a new cannula there. And then, of course, there are the glucose tablets (or other hypo-treatment of choice).   

It's okay to hate it. Now, I am incredibly grateful for my insulin pump, especially knowing how difficult it can be to get approval and funding for them on the NHS, and I am seeing the benefits of it. It's the fact that I need it in the first place that I hate. During my appointment, my consultant asked me if I'd hand the pump back, and I answered very quickly with a definite "NO!" and then I hesitated. "You wouldn't give it back, but you don't want to have to use it either." It wasn't a question that she asked me, it was a statement. A fact. I nodded, not really sure what I was meant to say. "That's okay...feeling like that is 'allowed'. Of course you don't want this. But it's working for you, you're seeing the benefits of it with regard to your health, well being and lifestyle." It's a constant, visible reminder of the fact that my body doesn't produce insulin, but one that, at present, appears to be suiting me better than MDI did. It's something I love and hate, often at the same time.

And, finally, on a lighter note, no one ever mentioned how awkward going to the toilet would be with the pump! Don't drop it/let it fall out of my pocket. Lower jeans/skirt/shorts/pyjama bottoms without pulling at the tubing or just getting tangled up in it in general. I feel it's something they should teach you the moment you're "hooked up", as my first toilet escapade was hilarious! (Housemate: "What took you so long? Actually, no, don't answer that!" Me: "I don't know how to pee with a pump!") Now, my pump tends to hang out in my bra instead of below the waistband, so I avoid getting tangled in tubing and tugging at the cannula site!

Waste.

I hate wasting diabetes supplies. Always have, but even more so since I interviewed Lucy, founder of The Pendsey Trust.

When I was on injections, I would use every last drop of insulin in the cartridge before disposing of it, even if it meant taking two injections (one to finish the cartridge, another to take the rest of my dose from the new cartridge). 

One time (quite a while back now) I smashed an insulin cartridge, and I was so angry with myself for doing it. I mean, it was an accident, but I was angry because it was a new cartridge, so that was a good two weeks' worth of insulin for me, if not more.

Since going on the pump, with some trial and error, I've been learning how to limit what I waste.

Cannulas that are starting to un-stick around the edges? Tape 'em down, and re-tape as often as necessary.

Leftover insulin in the cartridge after the six day limit? Don't fill the cartridge up with as much insulin. When I was first put on insulin, the cartridge in my pump was filled with the maximum amount of insulin (about 315 units!) and at the end of the six days, I had about 100 units left! I was so annoyed about having to chuck it. So, when I did my first cannula change, I filled it with just over 200 units, and have been doing this ever since. 

However, I sometimes find that I still have anything between 20 and 30 units left. I'm trying to perfect my cartridge refills so I'm in single digits when I switch it out. That would definitely be considered a win in my book!

The one thing I'm finding really hard though, with regard to waste, is having insulin left in the vial. Often, I'm finding that I don't have enough insulin left in the vial to fill up my cartridge with the approximate 200 units that I like. I hate the thought of just chucking it, so, at the moment, it just sits in the fridge.

So, dear diabetes online community, my question for you is this: what do you do with any remaining insulin in the vial? 

Any and all responses will be greatly appreciated!

Happy Friday!

Infusion Set Change Day.

Here's a run down of what my infusion-set-change-mornings (such as today) look like:

Step 1:

Disconnect pump and remove old set, hoping there will be no blood. 

Step 2:

Shower, enjoying the fact that there is no cannula attached to my body. 

Step 3:

Get dressed, and ponder wardrobe choices for the next two days as well, as this influences where I will place the new infusion set.

Step 4: 

Prepare new cannula and load the LinkAssist insertion device thing. Make a final decision about where the set is going to go. 

Step 5: 

Prepare. Jump up and down. Pace. Stare the LinkAssist and the mother of a needle that's used to insert the cannula out. Whatever works to then get me to press the button on the device. Keep on repeating this step until I can finally press that little button.

Step 6:

Hold LinkAssist where I want the new site and press button. Reconnect insulin pump.

Step 7:

Get on with my day.

Happy Friday!  

Show Me Your Pump!

It's been all over the diabetes online community, and other media outlets for the last few days. #ShowMeYourPump is the initiative of Sierra Sandison, the very recently crowned Miss Idaho, who realised her goal with an insulin pump clipped to her hip. 

Since then, she's encouraged people with diabetes to wear their devices (if they use them) proudly, and to post photos on Facebook/Twitter/Instagram with the hashtag #ShowMeYourPump. The hashtag has not only gone (still going) viral, but it's also putting type one diabetes in the spotlight, raising awareness and inspiring others.

I'm not going to lie...since getting my insulin pump, I've always hidden it somewhere on my person, whether it be in a pocket, in my bra or clipped around my leg with the help of an insulin pump garter.

Diabetes is a huge insecurity of mine - it's the one thing about me that I can't change, no matter how hard I try. So the thought of wearing my insulin pump for the world to see...it's daunting for me, and I'm sure there are others that feel the same.

That's why the #ShowMeYourPump hashtag is so awesome: it shows people from all over the world wearing their pumps with pride. It's been a better pick-me-up than my coffee this Monday morning!

So, adding to the Monday-morning-happy, my contribution to the #ShowMeYourPump feed. 

And a huge well done to Sierra for having the courage to strut her stuff with her insulin pump on show, and for winning Miss Idaho. I wish you all the luck in the world in the Miss America pageant. 

   

The Things We Fear.

Fears are funny things. I have a lot of them. I'm scared of spiders, clowns, roller coasters and flying. I'm the worst person to watch a horror movie with - I will almost definitely scream, and I will have nightmares. I'm scared of the fact I have no life plan at present and, not that I'll openly admit it all that often, I'm scared that I won't get my (happily-)ever-after. And not in a I-need-to-settle-down-right-now way, but more a will-I-even-let-myself-settle-down-with-someone. 

But fears often change. Not all of them, but as we grow up and change as a person, our fears change too. When I was a kid, I was terrified of dogs. Looking back, I'm not sure why, but now I'm such a dog person! Sleeping in the dark used to scare me too. Heights were a no-no. And, somewhat ironically, I used to also be terrified of needles. 

When I was diagnosed with diabetes, I was sent to A&E and on arrival I was given a bed and told that a nurse would be round to insert a cannula into my arm. And I was terrified. My Mum did her best to distract me, but I could not focus my mind on anything other than the horrible nurse putting a cannula in my arm. (I should say, he wasn't actually horrible at all -- he was just the one inserting the cannula, so by default I didn't like him). Throughout my hospital stay, I had many blood tests done, my fingers were pricked every two hours, and I had to have another cannula inserted too.

After three days of being on a sliding scale of insulin, a DSN came to see me and told me that I couldn't be discharged from the hospital until I could administer my own insulin injections. If there was ever going to be something that made me get over my fear of needles, that was it. I took the insulin pen from her, I screwed the needle onto it, I pinched the skin of my right thigh, and I did my first injection. I was desperate to go home. 

After that, I can honestly say I haven't flinched at needles. The needles my insulin pen took got progressively smaller (8mm, 6mm, 5mm, 4mm), I went for my flu jab every year, I had my BCG jab earlier this year, and I moved onto an insulin pump where the cannulas I started out with were 6mm steel ones. No problem. 

So, yesterday morning, why did I completely freeze up when I had to use this?

My brain would not let me press that little button on the side to insert this cannula, a FlexLink, one where the needle comes out after. It took me about half an hour to work up the courage to do it (as well as a text to Lizzie and Shep, and some encouragement from some wonderful people on Twitter).

It's funny how our fears manifest themselves. I'd seen other people use the LinkAssist. I knew how to use it. I'd even used it on one of the soft-toy-pumps at clinic (yes, my diabetes clinic has soft-toy-pumps...very weird at first, but now I kind of like it). But holding it against my hip to "fire" into my skin...fear took over. Very weird. 

On a lighter, and much funnier, note, the tubing that came with the cannula above is 80cm long. And I am a very short, clocking in a height of 5ft1" (and a half...the half is very important!)

It's safe to say I'm very much looking forward to my delivery of 30cm tubing!

Pumping Insulin: The First Month.

I've now been using my insulin pump for a month. Although there have been some difficult moments, I really do mean it when I say I wouldn't hand it back for anything! 

Testing, testing.

The focus during this first month has been on basal testing and making sure my insulin to carbohydrate ratios are correct. I really hate basal testing, but I fasted during all the relevant time periods (well, I had carb-free (fun-free?!) foods) to make sure my basal insulin was correct, made changes with my DSN, which I'm now beginning to understand (yay!), and I'm pretty certain I now have my insulin to carb ratios sorted as well! It's been intense, but I'm now hoping that, with those foundations in place, I can start fitting the pump around my life, and not my life around the pump!

Wearing an insulin pump.

I do a lot of volunteer work with kids. And I have a three-year-old, Spiderman-obsessed Godson. And I swear I have the longest tubing ever at 50cm (which is effing long when you also factor in that I'm 5ft1"). So I quickly learnt "tricks" when it came to wearing, and hiding, the pump, thanks to the DOC (doctor may have told me how to use the pump, but the DOC have been integral in showing me how to wear, and "own", it.)

I've cut holes in pretty much all of my trouser pockets that I can feed the tubing through. I can no longer put change in my pockets, but it sure makes life easier when it comes to keeping excess tubing tucked away! I was also given a bra-clip-type-thing, which is useful. As well, I bought an insulin pump garter (not being asked to advertise, but I like the product, so I've included the link to the site I bought it from). It's not something I use often, but has come in useful on the rare occasion I wear a skirt or dress and want the pump concealed. 

Getting the bloomin' cannulas to stick!

Surgical (micro-porous) tape is my best friend right now! Without it, I would probably be changing cannulas every day! Am currently awaiting the arrival on the Accu-Chek Link Assist to try the Flex-Link Cannulas. I've been told the stick much better than the steel cannulas I'm currently using. I guess I'll find out soon enough!

Cartridge changes.

I'm getting better. And quicker. And I don't have to declare war on quite so many air bubbles. Progress! 

Reading.

Allison Nimlos (blogs at The Blood Sugar Whisperer) kindly recommended a couple of books to me now that I'm using an insulin pump. One of them was Think Like A Pancreas by Gary Schiener, which I actually downloaded when I was on my year abroad, and the other was Pumping Insulin by John Walsh. I'm currently looking back over Think Like A Pancreas as I definitely remember skipping the pump-related sections, as they weren't applicable at the time, and I'm definitely going to look into reading Pumping Insulin.

Think that just about sums everything up!

Happy Tuesday!

Learning Curve.

I love my insulin pump, I do. I know it's still early days, but I'm still in awe of just how smart this piece of technology is. 

However, I'm also frustrated, and I put this down to not understanding how the pump works. I know how to use it: I can bolus and set a temporary basal rate (TBR - insulin pump therapy means more jargon), and I know how to change my basal rates, in that I can put the new numbers onto the pump. But I don't understand how or why I'm changing them. 

I phoned my DSN yesterday, as I'm waking up low a lot, and having real problems with afternoon and evening highs. I was pretty certain it was the basal that needed changing (although I could have been very wrong there), and I told her that. She agreed, and said a load of numbers and I input them into the pump. Fine. Fingers crossed it works. But I don't know why I changed them or how she came to the numbers she came to. 

Like I said at the beginning of this post, it's early days, and I by no means expect to be a pump expert at this point, but I want to understand why changes are being made so that I can apply this to blood sugars and changes I may want to make in the future. That, and I've been asked to do over night testing and a basal test between 12pm and 6pm, which was expected, but when my nurse turned round and said "and I'll call you Thursday for the results", well, I could have cried. Sounds stupid, I know, but I feel like, right now, I'm revolving my life around this new device, but what I want is for this insulin pump to fit in with me and my life. 

It's a learning curve, one that I knew wouldn't be easy. I guess I just miss that feeling of being "comfortable" with my diabetes management - right now I don't, and that's not something I'm okay with.

I love my pump, but I miss the "comfort" of injections, and I'll be grateful when this feeling passes.

Pumping Insulin: The First Week.

I've officially been using my insulin pump, with actual insulin, and not saline, for a week now.

To be honest, it was all going well until the weekend! The weekend is, of course, when no DSNs are in clinic to pick up my calls! Typical! But let's start at the beginning of the week.

Monday, I started on insulin. Sunday night, I had to take half my usual dose of levemir, have breakfast as normal and inject. So far, so good. I arrived at the hospital, and saw a DSN. She asked how I'd got on with wearing the pump over the weekend, and I explained to her how I'd had an issue with getting the cannulas to stick (still do!) but other than that, everything had gone well. Of course, the pump was only giving me saline, so I wasn't expecting things to go wrong. 

I learnt how to fill a cartridge, which is SO much harder than it looks, how to get rid of air bubbles, priming the cannula and tubing, and felt very thankful for having a DSN there to fall back on! The thought of having to change my own cartridge at the weekend filled me with dread (which I have now done...it was interesting...but we'll get to that!) I had to do my first bolus at the hospital, so I went to the nearest café and bought a tea and cereal bar. I checked my blood sugar, input the carbs, pressed the right buttons, and the pump delivered my insulin for me. Very weird not having to do an injection! After I'd eaten, I went back the DSN's office, and she went over what I needed to do when it came to going to the gym, and double-checked that my meter was programmed correctly with my new insulin to carb ratios, and I was good to go.

"Please, please call tomorrow so I know you got on okay! Please!" The DSN said to me as I left. 

"I will!" I promised, sounding a hell of a lot more confident than I felt about this first night!

Things were surprisingly okay. When I had my evening meal, I didn't believe my meter when it told me I only needed 4 [point] something units for my pasta! It just didn't seem like anywhere near enough, but I went and did what it told me to anyway. (I used to be on a 1u:7g, but on the pump, I'm on 1u:15g. HUGE difference!)

Sleeping with the pump (I don't know how to word that so it doesn't sound weird) wasn't an issue, as I'd already done that over the weekend. (Definitely sounds weird - I'm sorry!)

I also did my first basal test, at the request of my DSN. Due to some low blood sugars at night, I checked my evening basal rates first, the results of which I will report back to her via phone call later today.

It's been this past weekend where that "yay-I-love-having-a-pump" feeling somewhat disappeared. 

Saturday, no cannula would stick. I ended up replacing the cannula three times in the end! Three times! Not fun. 

Sunday, I had to change the insulin cartridge. SO STRESSFUL! There was myself, my housemate, Shep, and another friend, sat round the kitchen table with the training handbook, an insulin vial, one of them cartridge things you put into the pump when it's filled (technical definition right there!) and new tubing. Between the three of us, we managed it, but, holy eff, did we get frustrated with air bubbles and trying to decide how many units to tell the pump were in the new cartridge!

However, between this insulin-refill-stress, I completely forgot to start a temporary basal rate (TBR) before going to the gym. My blood sugar was high on arrival at the gym anyway. Had dropped a bit by the time I'd finished at the gym, but then I had lunch and my blood sugar shot up again. I corrected, but felt sluggish all day. Things were a lot better by the evening though, and my blood sugar was a lot more stable. So, maybe something to do with the cartridge change?! I'm not sure, but it's something I will bring up with my DSN when I talk to her later today. 

Closing thoughts? I knew this first week was going to be up and down, and it has been. More up than down, admittedly, but there have been struggles. Mainly this past weekend. But it's still very early days, and I need to give myself time to learn how the pump works and how to use it to it's fullest capacity, so that it makes my life with diabetes that little bit easier. And that's not going to happen over night. So, with patience and perseverance, into week two we go!    

Pumping Saline.

Thursday of last week, I attended a pump training day and was set up with saline for the weekend to get used to wearing the device. 

I arrived at the community centre to discover that I was missing part of my delivery (good start!) - I'd received the pump, and the cannulas, tubing, cartridges, batteries etc that came with it, but I hadn't received the training box. I didn't even realise I was missing anything, but the rep from Accu-Chek who was also at the pump training day made a phone call, and it was arranged that what was missing would be delivered before 10am the next day (and they mean before 10am - I believe there was a delivery man knocking on my front door at 8.45am! How's that for service?!)

I learnt all about priming the insulin pump, how to bolus, how to find out what various error messages mean, how to draw up a cartridge (albeit of saline) and my meter was programmed with my basal rates and insulin to carb ratio (thanks to what looked like various calculations done by my DSN). 

After a long day, I left, pump in my pocket, rather relieved that it was only pumping saline, as I could hardly remember anything!

I woke up Friday morning to find that my cannula had come out during the night. Very relieved to only be on saline! So I got to do a couple of cannula changes over the weekend. 

Wearing the pump on my person has been...interesting. I was given a bra pouch, and clipping the pump to my bra strap has been a great place to wear it. I also spent Sunday night cutting little holes in the pockets of my jeans so that I could feed the tubing down the inside of my trousers. The tubing length I currently have is 50cm, and I am a short person (5ft1"!) so it's much easier for me to hide the excess down the inside of my trousers than it is to have it hanging out from underneath my top!

Another problem I've had is getting the cannulas to stick! As I've already said, one cannula had completely come off Thursday night/Friday morning, and the one I put in yesterday morning at clinic is already coming loose round the edges! Any advice on that front will be greatly appreciated!

Other than that, things were pretty smooth-sailing. I have a feeling things will be different now I'm on insulin though. 

But that will be a whole other blog post! 

Ketchup.

Image taken from Google Images.

You'd think finishing my degree would leave me with more time to write! Clearly, not the case for me! Between celebrating with the girls on my course, starting on my insulin (saline) pump and everyone finishing (so more celebrating), I honestly haven't had the time to sit down and write what I want.

This week, however, things will change. Just, unfortunately not today! (Sorry!)

So, instead, a "ketchup" of what's been going on and what to expect over the next week or so:

I finished my degree!

Such a great feeling. I really hope I've done enough to graduate with my class. 

I started on my insulin pump.

On Thursday, I made my way to a community centre, pump in hand, ready to begin my "pump training". It was a long day, with lots of information thrown my way, so I'm relieved that for this first weekend the pump has only been giving me saline. Tomorrow morning, I have an appointment at my diabetes clinic and I will start on insulin. Expect a blog post this week covering both pump training and starting on insulin (which happened today!)

Friends that aren't on my course finally finished their degrees!

And we celebrated with a night out at a local cocktail bar, along with the girls on my course. It was a good night :-) 

It's Diabetes Week 2014!

Diabetes Week 2014 is upon us and the theme this year is "I Can". Again, expect a blog post later this week. In the meantime, you can check out JDRF's Blood Sugar Selfie, Type 1 Uncut on Youtube and the Diabetes UK website for more information. 

It's Official...

...insulin pump's a-coming! Start date: June 5th!

Pump Information Evening.

Walk to the hospital.

Last Thursday, I attended a pump information evening at my diabetes clinic. Having been accepted for an insulin pump, I was keen to go and listen to what they had to say about insulin pumps and what comes next. 

I feel like I've lived at my diabetes clinic for the last few months: pump assessment clinic, dietitian, a follow up with my DSN, my annual review and then finally the pump information evening. Well, appointments aren't going to get any less frequent with the insulin pump, especially during the first year or so. It's a good thing the hospital has a nice, new coffee shop that I can frequent, and the walk there is really nice too! 

There was a girl there that already had an insulin pump who was able to answer any questions we had about the practicalities of having one, which was very useful, and a DSN talked through the advantages and disadvantages of it. 

We were shown various types of insulin pump. I was surprised by the Omnipod. It was a lot smaller than I expected, but, for me personally, not something I would want. If you don't have the personal diabetes manager (or PDM), or the PDM fails, you have no way of bolusing with it, where as with the Accu Chek, Medtronic and Animas pumps you can. I like to be as prepared as I can be for various diabetes-related situations, and not being able to bolus without the PDM isn't something I'd feel comfortable with.

My diabetes clinic tends to start patients on the Accu Chek insulin pump, which I'm happy with. I already use the Accu Chek Aviva Expert blood glucose meter, so that's one piece of equipment I already feel comfortable with, and I like the fact that I can bolus remotely with the meter (as well as press buttons on the pump should the meter fail).

So, now we wait. I know I can't start on the pump until after my final exams (at the request of both myself and my consultant), but fingers crossed for early June!     

Pump Assessment Clinic.

Way back when, I received a letter "inviting" me to attend a "pump assessment clinic" where I would be able to put forward my case for an insulin pump. 

That appointment was on Tuesday, and I'm happy to report it was a very positive clinic. 

Image taken from Google Images.

I was so nervous. I mean, I'm always nervous before my appointments at the diabetes clinic, but where I didn't know what to expect from this one, I was even more nervous. Now, I understand that "pump assessment clinic" is carried out in various different ways depending on your hospital, but I'm going to document here what mine was like, in the hope that it provides some insight into what to expect, as I had no idea.

First things first, I had my weight and blood pressure checked, as well as having some blood taken for my hba1c. Routine diabetes clinic checks, yes?!

The actual appointment, however, was very different to what I'm used to.

For a start, there were three health care professionals in the room with me: the head of pump clinic (who happens to be my consultant too), a DSN and a dietitian. I felt a little intimidated walking in, but they were quick to put me at ease, and we got started. The appointment seemed to be split into two main "subjects": my current diabetes management and then insulin pumps themselves.

My current diabetes management: blood sugars - where do I have problems? Is there a reason for those problems (exercise, time-of-the-month, stress, etc)? This then led into talk about insulin injections, insulin to carbohydrate ratios, correction factors, carbohydrate counting. It felt like they were testing me. In fact, I'm pretty certain they were. I think they needed to see that I knew what I was talking about. And in spite of having a meter that does everything for me (the Accu-Chek Aviva Expert), I could answer all their questions.

Insulin pumps: what do I know about insulin pumps and why do I want one? Now, this isn't something I've entered into lightly. An insulin pump is a big deal. It's going to be like going back to day one of diabetes. It's a completely new way of managing it, and I'm well aware of the fact that it's going to be a learning curve. As a result of this, I'd done my research: what pumps are available, how they work, the pros and cons of using them. I told them what I wanted from the pump and I was also very honest about my concerns.

The appointment was an hour, and I was very happy with how it went. Got a few more hoops to jump through, but hopefully it'll all be worth it. 

Watch this space!  

You've Got Mail.

Not quite as awesome as the Tom Hanks and Meg Ryan classic, but look at what was waiting for me when I got back from Florida:

Pump Assessment Clinic?!

Yayyyyyy!

Like I said, not quite as awesome as the movie, but this is good news. For me it is, anyway! I know it's forever away, and I'm very aware of the fact that there are no guarantees, but it's definitely a step in the right direction! Guess we'll just have to wait and see what happens!