Animas Vibe? Hello new friend!

I'm connected! Excuse the poor photos. 

I still can't believe I have this device. I feel lucky and grateful. And happy and excited to see the difference it makes on my blood sugar levels. 

This is the pump connected to my belt right underneath my.....boob. 

My current Basal Rate - these are going to need some tweaking.

I'll write a longer post at a later date. I'm feeling a bit sleep deprived at the moment and am home from work ready to nap. 

Any one have any specific questions relating to a pump start? I want to record my feelings/thoughts/reactions as I know looking back it'll be the start of something new and I want it recorded :)

The long and winding road to becoming an insulin pumper

On the 9th of August I received funding approval for insulin pump consumables from Pharmac - due to a bit of a mix up I received funding for the actual insulin pump two weeks later. I am on my way to becoming an insulin pumper. Well on my way.

This isn't a post on pumping. This is a post on my feelings of having diabetes and how it has influenced my pumping decision.

My feelings on Insulin Pumps - Through the ages. 

I was diagnosed at the age of 15 and was initially put on a twice a day insulin regime, taking Protaphane at 7am and 7pm. For the life of me, I can't remember how long that lasted for. A little while, a couple of months. I don't think it was longer than 6 months. I remember my blood sugar not getting lower than 15 mmol/l and it'd been warned if that happened I needed to go to the Emergency Department, I did that and luckily didn't have Ketoacidosis. I did still have to have those painful blood tests where they take blood out of your wrist. I think that's my diabetes nemesis. The day after that visit to the Emergency Department I was put on the more usual regime, taking novorapid before meals. I remember at that time, or not long after I switched regimes that my Diabetes Educator gave me a brochure about insulin pumps. I'd had a read and they looked pretty cool but were expensive. Had it been a more viable option financially I'm sure it would have been something my parents looked into for me. But alas, it wasn't.

Insulin pumps have always been something I was aware of but wasn't something I gave much thought too. I was on Protaphane from 2003 - 2010. I was offered the switch to Lantus on 2005 but it wasn't funded back then. I'm sure my parents would have paid for it if I had asked but the big reason I was happy to stay on Protaphane was that Lantus was not available for pens in 2005 (not in NZ anyway), so I would have had to have used syringes. I was and in some ways still am, a needle phobic person. Syringes? No thank you. In hindsight, the protaphane's peaks and lulls and my own less than stellar timing of taking injections, resulted in some pretty scary lows in 2006/7/8. However. I was young and wasn't in good contact with the Diabetes Department at the Hospital. I visited the GP occasionally for insulin prescription repeats and also went to diabetes check ups with the nurse there. Somewhere between diagnosis, high school and going to Uni,  my feeling of needing to hide my diabetes began. I was growing up! I liked the feeling of independence I had! Over the years, this turned into a dislike of my diabetes. Having Diabetes made me feel like I was reliant on someone or something. I hated the idea of people needing to watch out for me, of being less than other people because I had this chronic medical condition. During this time, I barely kept up with advances in technology. In fact, one day I went to the Pharmacy and they'd told me my prescription for test strips was for the wrong type of meter. It turns out the meters had changed and I didn't even know. The girl I know today would have not let the technology pass her by! Back then though, I didn't follow the technology updates, or the DOC or anything diabetes related really. I let my prescriptions to Diabetes New Zealand and to Accu Chek expire which meant I didn't get their newsletters.

This isn't to say that my experience with Diabetes over those years was all bad. I met someone in 2006 who was in some ways a bit of a role model for me. She wasn't afraid of testing or injecting in public. Or of asking a bar tender for a free coke as her blood sugar was low.

My outlook on life with Diabetes slowly began changing, it did include a couple of very scary moments including being woken up my paramedics in my bedroom and in ICU for ketoacidosis. I've always thought about writing about them on my blog but haven't yet. Maybe soon. But where was I? Insulin pumps!

When I discovered the DOC, my reality changed entirely. I was suddenly not alone. And one thing I noticed was that everyone had a pump! There were very few blogs where the writers were on MDI - It was one of the reasons I started my blog, hardly anyone was writing about MDI so I wanted to.

I've written before about my diabetes control and how much a jigsaw and roller coaster it is. Over those appointments my DNE kept mentioning maybe a pump was an option. I was hesitant. I don't know why./con At the appointment where my DNE told me she was putting in a pump application she asked me, why I wasn't keen on the idea. I said it wasn't that I wasn't keen but that I didn't like change. I knew if I was given the opportunity of having a funded pump, I wouldn't turn it down. There was a couple of weeks before I heard back about the pump funding application and in that time I did a lot of research. I read, read and read even more about pumps. And that's when I knew that this was something I really wanted to do. A few special mentions - the videos from Diabetic Danica and Sweetful Stuff are fantastic! And I was lucky enough to find a fellow diabetic based in the North island who is a couple of steps ahead of me with the pump - but its been great to have someone to share questions, concerns and fears with. She's started pump training and has written about her experiences on her blog here.

But the roller coaster of feelings in my head didn't stop then. Over the past 6 weeks I've felt like I'm stuck in this giant whirl of feelings going on around me. I was so hesistant to tell any one about the pump especially while waiting for confirmation of funding. But even when I got confirmation I was scared to tell people, scared that something might go wrong. It didn't, but my special authority number was delayed meaning I didn't get my pump prescription for a while. That was frustrating but not the end of the world. I guess in my mind, telling people meant that it became real. I've been going through periods of excitement and then also utter terror. Having a physical manifestation of diabetes isn't and idea I am particular fond of.

And here I am, 25 years old, about to hit my 10 year anniversary of diagnosis and three weeks out from pump training. Nervous? Yes. Excited? Yes. No idea what to expect? Yes and No.

The whirlwind of feelings is on going and is the main reason this blog post has taken me so long to write but I am trying to roll with it! I know there's more to come. My pump start date is the 14th of October and I am told I can expect to be pumping by 11am. The countdown is on!

S

A Nail Polish Post In Which My Meter Features .

The majority of my posts relate to my day to day life and living with Diabetes. So I thought I'd post something that was a bit of fun. Nail Polish Baby! I'm wearing OPI Nail Polish "Do You Lilac It?" and "Grape...Set...Match" for the feature nail colour. 

I'm a big fan of the feature nail trend that's been going.Something a bit different and a bit fun.

Much like this post. 

I think a lot of the reason for this post is that I have a huge change coming up diabetes wise and I am still taking time to reflect on it in all it's glory. I have been approved funding by Pharmac for an insulin pump for 9 months. After 10 years of injections this upcoming change is unbelievably exciting but also terrifying. We shall see. I'm almost ready to write a blog post about it so there'll be one in the not so distant future :)

Hit with the Sickness

It's come to my attention that I need a new sick day plan.

To be more precise, I need is an actual sick day plan. I haven't really had one before. My plan is the past has been "Don't get sick" and that has worked. I think I've had antibiotics once in ten years. For the most past, infections, the flu and colds usually pass me by.

However, not so much with this recent flu/cold/sinus infection. I've felt terrible and my levels have been going sky high and haywire. When my ketones threw out 0.8 I was panicking a little bit.

Cue: Panic

Physically I was feeling fine (except the head cold and blocked nose). After some food, fluids and insulin the ketones had come down to 0.1 so I took extra Lantus and went to sleep. I made the decision to not go to the Emergency Department for the 0.8 worth of ketones. To me, it made sense to keep hydrated and wait it out a bit. The next morning I woke up at 0.4 indicating that something was still going on in my body. After breakfast they'd come down to 0.1. Since it was working hours I thought I'd call my GP for advice. I've never really had the best of faith in my GPs - see my blog post here. But since that post I'd decided I would try and use my GPs to my advantage. Incorporate them in my medical support team if you will.

The GPs advice was to go to the Emergency Department. I thought this was pretty stupid given they had no idea of my level of ketones or the fact that I was sitting at 0.1 which was in fact within the normal range of ketones. Green even.

It clearly says that reading under 0.6 mmol/L are in normal range....

So, I trusted my gut instinct and didn't seek further medical attention. Reasons why I didn't?

• I was still in normal range - In the green if you will
• I wasn't vomiting
• My levels were high but not super high (10-13mmol/L - am currently running my levels higher to claim back some hypo unawareness)
• The insulin was working (As evidenced that morning with breakfast and the night before when I was at 0.8)
• I wasn't feeling like I was in the onset of DKA, I've been there once and the symptoms aren't something I'm likely to forget

Reasons why I would have gone?

• I had high ketones the night before (0.8) and they showed up the morning after (0.4). That was what was worrying to me. 

So I didn't go and was lucky enough to see this number of ketones later in the day:

Relief

It was a scary 24 hours. I've heard a lot of people going into DKA with pump failures and infections/viruses etc. I was terrified that I was coming down with some hideous bug and this was the start of it. 

A couple of days later I emailed my CDE if we could talk sick days at our next appointment and told her about my recent time of it. Her response:

"I think you have managed recent illness superbly well and plan to go to ED if remained ketotic entirely appropriate"

In my own heart I knew that I had acted appropriately, I just felt better when I was reassured that by someone who is a specialist in that area. 

I've never really felt much sympathy to people that have colds and coughs. One of the reasons is that I hardly ever get sick so don't really have empathy to their situation. I think the other is that I manage with this chronic medical condition every day and is that when I get sick, where others might be able to wait it out with chicken soup and ice cream, I'll have to go to the Emergency Department to get better. I'd prefer the chicken soup thanks. Hold the ice cream though, not too much of a fan. 

How does everyone else manage their sick days? Would love to hear about other experiences :)

S xx

GPs versus Diabetes Specialists

I've never really treated my GPs as my primary care physician. I've always felt that since a lot of them don't have a clue about diabetes I shouldn't waste my time with them. After all, every aspect of my life is connected to my Diabetes. Things that are easily treated by a GP become complicated with Diabetes. An eye infection for one patient can  mean much more to a diabetic.

When I began having trouble with numbness in my left hand, I naturally thought of Diabetic Neuropathy and mentioned to to my Diabetes Nurse Educator. Her recommendation was that I should to talk to my GP about it and if necessary get a referral to see an endocrinologist. I'm not sure why but her comment really made me stop and think. I work in a job where I refer people to their GP if they are having issues with other health providers, so I should have confidence in my own GP.

I need to find a GP I like and stick with them. My current Medical Centre makes appointments with the next doctor that's available so I've ended up seeing about 5 or 6 different ones. My latest appointment went fine and I was happy when the Doctor mentioned his friend uses an insulin pump. I thought well, hey here is someone who I know has some form of experience of Diabetes in a real life sense. I made up my mind to ask for this doctor next time.

The numb fingers are most probably not Diabetic Neuropathy which I was happy to hear. The GP I saw reckoned it was a mild form of carpal tunnel syndrome. He sent me off with a few blood tests that included words like a full blood count, thyroid and liver functions. I was happy to do it, mostly because as someone with an autoimmune condition I know I'm likely to get another one. I don't think I've ever had my thyroid checked before? Not sure. In any event, I haven't heard back from the GP which means that nothing has showed up on the bloods. My GP has said that if I am still feeling symptoms to go back and get it checked out again but that he thinks it'll go away. It hasn't but it isn't painful so is something I can wait to mention until my next GP appointment.

I like to think that over time I'll build up trust and confidence in a GP. At least now I am trying to go into appointments with an open mind not some mantra I've carried around with me for years.

Sometimes... you just need a cookie

Or in my case, three.

Three.... four, no five Mallow Puffs all in a row.

My oh my it was delicious.




I've been trying to tighten up on my eating and drinking habits lately. I do have a focus on healthy eating, trying to make sure I get enough of the good stuff in my diet. I've been making conscious choices to say no to that beer with dinner or picking a healthier take away option. My nurse educator said when she looked at one of my diet records that there was a little bit too much unhealthy stuff. Fried chicken is okay every now and again as a treat but I think at one point I had it three times in one week.

So I stopped that carry on! I think I've only had fried chicken once in the past month. Tonight would probably be the only time I've eaten that many mallow puffs in one go. It was right before dinner and I included them in my carb count. Two hours late and I'm testing at 6.7 mmol/l. Is this how I should be eating all the time? No.

Is it okay on occasion? Yes, If I ensure I carb count and inject appropriately for them.


Am I going to eat 5 Mallow puffs tomorrow? No and not just because I ran out.

But, in all seriousness, I'm a big believer in taking things as they come, one step at a time. For me, those mallow puffs were like a step sideways. Which is okay every now and again.

Reflections on the last few months

In some ways I feel like I've got a bit of the old "Diabetes Burn Out" going on. In other ways I know I don't. I'm still taking ten times better care of myself than I was 4 years ago. I'm testing 4-8 times a day, correcting, carb counting, injecting. I'm doing everything I need to.

For me, this feeling of Burnout, of hitting a wall, of smacking my head against said wall stems from trying as hard as possible with my Diabetes management and not getting better results. Cate says I need to stop beating myself up about it. But it's so damn hard. I've really struggled with my feelings. I've struggling to let myself be okay with numbers between 6 and 12 mmol/l (108 and 216 mg/dl). But that's what my body needs right now in order to get back my awareness of low blood sugars,

After the week long trial of the CGM, I was supposed to take diet records for the following week and send them to Cate. But I couldn't bring myself to do it. I'd literally recorded every thing I ate for the previous 20 days and to write everything down again was not something I could face. So I didn't. It felt really great. I was still testing and taking the right amount of insulin. Just the fact of not having to sit down and type it all up into a record sheet made me feel so free and liberated! I think it was my mini "Take that" to Diabetes. The holiday from diet records was one thing I could do that would allow me some of my sanity back without compromising my health.

Looking back on the last 1.5 months since I did the CGM trial I could see in myself a change of mindset with my Diabetes management. I no longer feel hope when I leave appointments with my Diabetes Educator. I've talked about this before, that I used to feel hopeful and inspired that we were together on this Diabetic Jigsaw Puzzle. I used to feel that we were chipping away at it and that things were getting better. I'm sensing she's feeling a bit confused at what to do with me. She took one look at my most recent records from last week and said "Well, we're not winning here are we?" I think she also said exactly what I needed to hear. That I needed to stop beating myself up about it, stop blaming myself for my levels because I am doing everything I should be doing. There's a small part of me, hidden in a back corner of my mind that says I still need to work harder but I think it's okay to have that there. You always need to push yourself.

Our latest development in terms of my management is to take my novorapid at least 15 minutes before eating, not correcting until 3 hours after breakfast novorapid and exercising 40-60 minutes a day. The first two are to target some after breakfast/before lunch blood sugars I've been having. The last is a given and something I've been told for years but I was basically told what I'm currently doing isn't enough. It has inspired me to start a sticker chart and put a sticker on the days where I do more than 40 minutes of exercise. So far for August I have 3 stickers in 4 days so I reckon that's a good go of it.

I think I've wallowed in my own self pity for long enough, I need to change my mindset. Exercising more is bound to help but I need to get that hope and drive back. I think wanting it is a start.

Fingers crossed anyhow.


S