This is the start of a series of blogs I am planning to do. The change from multiple daily injections onto a pump is quite a big change to make. As such I want to get all the happenings written onto my blog, hopefully in the process this will help people who are due to start pumping. It will also provide some answers to people who are still considering if insulin pump therapy is for them.
How Long Was The Wait?
My wait wasn’t that long from time of asking to starting. I had been wanting to go on a pump for over a year before I actually spoke to my consultant.
I first approached my consultant on 31st May 2016 and I went onto my pump on 9th November. I really count myself lucky that the team at Darent Valley Hospital are so pro- active on this front. They looked at my needs for insulin pump therapy and agreed that it would benefit me.
There are so many people who really would benefit from insulin pump therapy, but for various reasons are not having this offered as an option. If you feel the pump would be right for you, do some research into it. Once you are ready the first step needs to be a meeting with your consultant. At this meeting put your views across and see what your consultants opinion is. Hopefully they will agree with you and the wheels can be set in motion for your pump journey too.
If you are having trouble check out Input Diabetes for some great advice
Start Day Delayed
My pump start date was all set for the 20th October. Just 2 days before I was due to start pumping the Medtronic rep had broken her toe, and as such could not do my pump training. Although this was annoying, with hindsight it might have been for the best. I was mentally ready for the pump back in October but my diabetes really wasn’t playing ball. I was getting some really unpredictable highs, and this would have made the transition onto a pump much more difficult. In my opinion you need to be mentally prepared for the pump as well as being physically ready. As everybody knows diabetes is an unpredictable beast, but to the best of your ability it really does help if your control is in some sort of order before your pump start day.
On the 24th October a letter dropped on my doormat.
” Your insulin pump training and therapy commencement date is Wednesday 9th Novemeber at 2pm”
Now I had a deadline to aim for, by then I wanted to be mentally ready, again, but also have all my ratios, correction factors, basal rates and exercise rates all as near to perfect as possible.
Start Day Arrived
Wednesday 9th November finally rolled around and I was ready for this. I had spent the past 3 weeks checking all my basal rates were in order, carb counting like a nutritionist, checking my carb ratios, checking my correction factors were all in order and just generally preparing myself.
Even with all this in place I was still a bit nervous about the day ahead, guess it was nerves of the unknown looking back at it now. This pump was going to be like starting again for me, akin to turning the clock back 2 and a half years to diagnosis. All of a sudden I felt like this is quite a big deal after all, I needn’t have fretted though.
Pump Training Session
At 2pm Gladys, my pump DSN, came out and met myself and my wife, thought it would be wise to take my wife along to this session. The whole theory of 2 heads are better than one rings true at pump start, it really is a whole lot of information in a short period of time.
We went in and sat down, then Gladys returned with another lady who was also starting on the pump.
On the table was a nice big box, and in there was my shiny new bionic pancreas, it was like Christmas had come early.
The Medtronic rep was great, everything was explained clearly and at no point rushed.
Can I Open My Box Now???
We each had a nice looking parcel containing 2 boxes. In one box was the Contour Next Link 2.4 meter, and in the other box, the main event, was my replacement pancreas. At long last I finally got to hold my own pump, still a great feeling.
Start Setting Your Settings
The rep had a demo pump to go through all of the settings we would need to change on our 640G’s. We started off with the boring stuff-time, date etc etc.
We then went through each of the menus in turn, showing us each item and explaining how to use them.
Setting The Bolus Wizard
I had to give Gladys all the information I had been working hard to get right for the past 3 weeks. Into her spreadsheet we entered all of my carb ratios, correction factors, basal requirements and target ranges. This gave us the initial settings required to get the pump up and running. In truth these are only a starting point and the process of fine tuning will be an on-going project for the next couple of months. Since it is diabetes we are talking about here, I am under no illusion that these settings are going to work forever. As with everything diabetic, what works today might not work tomorrow. This is something I am prepared to deal with on a daily basis forever more.
Individual Basal Settings
At this point I discussed my issues with dawn phenomenon and problems with blood sugars rising as soon as my feet touched the floor in the mornings. We then changed my basal rates in the pump settings to try to mimic my needs. We set up 5 different time periods as a starting point, each one with a different insulin requirement. These settings are the ones I am currently working on, once these are set correctly then I can look at everything else.
Let’s Plug This In Then
The moment had finally arrived to put in my first set. More boxes were handed out, one containing 10 infusion sets and the other containing 10 reservoirs.
First up was learning how to draw up the insulin from the bottle to the reservoir. This seems quite an easy thing to do but avoiding the air bubbles has a certain knack to it, as soon as I have worked it out I will let you know!
Having been a Freestyle Libre user for over 18 months I wasn’t too nervous about putting the cannula in, I knew what it was going to feel like. However I was surprisingly hesitant before pressing the insert-er. I needn’t of worried as it really is painless – so far!! I have done over 7,000 injections since diagnosis so just doing this every 3 days is a huge improvement.
We then went through how to load the reservoir into our pumps, filling the tubing, and priming the cannula. Once we had done all those bits that was it, I was officially pumping insulin!!!
That’s It I’m A Pumper – At Last 🙂
We were then given the opportunity to ask any questions we may have. Everything I had in mind to ask had already been covered in the 2 hours previous. I’m sure as time goes on many questions will arise, in general that’s where I turn to the online community for answers though.
The Legal Bit
Gladys then gave us a contract we had to sign, all official stuff to do with funding and the CCG etc etc. It was then explained how the pump is our responsibility and that we should take out an insurance in case of theft or damage. I have used a company set up by an insulin pumper, it costs me £7.25 a month. If my pump is stolen or accidentally broken I will have a new pump within 24 hours, to me that is well worth every penny.
Lots of people do just insure the pump on their household insurance, which is probably OK. As with all insurances until you come to claim on it you won’t know how good it is. I have heard of people having to wait over 2 months for a claim to be settled via their household insurance, not ideal when your health is concerned. I have also seen on Twitter someone whose household policy didn’t cover things outside of the house. This is not to useful when the insured item is permanently plumbed into your body.
Advice For Start Day On The Pump
Every clinic will do things differently. My clinic chose to start me live on insulin. Some will give you the pump for a week first to get used to wearing it. Others might give you a saline solution for a week to practice set changes. I think it really depends on your knowledge, your attitude to pumping and the DSN assesment of your needs. I am very happy that I was live on insulin straight from the start.
Well that’s the tale of my start on insulin pumping, for my tips on preparing for start day
Take care, pump insulin everywhere