Elsie and I, day #49

Day 49 already.  There’s been a bit of a hiatus. For around 8 weeks I’ve been getting chest pain and shortness of breath. This has more or less since I got Elsie – a few weeks before going live.  After 3 hospital admissions – one rather disastrous and two extremely efficient, I now know for certain that I don’t have coronary artery disease. This is good news, given that I’ve been Type 1 for almost 30 years. I saw the evidence myself on a screen at the Royal Infirmary of Edinburgh after having an angiogram on Friday.

I’d been prepped for this by lots of people telling me it would be a relatively straightforward procedure – which it was and that as a Type 1 of 30 years, I could expect to see some narrowing and this would be sorted out there and then by a Stent being put in. Thankfully this wasn’t needed. The last few weeks have been pretty stressful to say the least, but I reckon Elsie and I have managed ok. I’m still having pain but at least its not my heart.

In the middle of all of this, I kinda lost the impetus to get on top of the diabetes, but Elsie has been there, quietly reminding me to test and sort out the highs – of which there have been a few.  On the particularly stressful days I found a temp basal of 140% seemed to do the trick.

Despite this, I’ve made a few changes in relation to my overnight basal in an attempt to sort out the Dawn Phenomenon.  I had a bit of a crisis of confidence when my beta-blocker was increased and I lost my hypo symptoms for a few days.  I was convinced the long feared night hypos were going to come back and slashed my overnight basal rates in a blind panic.  I’m slowly sorting this out but could do with another increase in my rate around 6.00am. Time to set that alarm again.

Things that are going well: Huge drop in the number of hypos. Basal rate getting there.

Things to work on: Low Carb, post meal highs and dual/square bolus.

Last 14 day averages: CHO – 276g, BG: 11.5 mmol/L (207 mg/dL), Tests per day: 6.64.

 

Elsie and I, days #10 – #16

The last week has been ok. Not fantastic, but not too bad either. There have been a couple of minor (potentially major) fails. Minor, because i was sort of prepared. Had I not been, they would have been fairly disastrous.

  1. First one was something I’ve been assured by others on Twitter that has happened to almost everyone when they begin using a pump. I showered before leaving for work and in my usual routine got dressed, grabbed my lunch and left the house, with Elsie sitting on my bedside table. I never realised until i got to work – some 40 minutes later. No need to panic though. I managed with a spare reservoir and an insulin syringe – with lots of testing and lots of very small injections.
  2. Saturday morning Elsie ran out of insulin at work. I thought 20 units will last me until lunchtime no problem, but it would seem that I either go through 20 units more quickly than I realise when I’m grazing at work or 20u doesn’t really mean 20u. (I’ve a feeling it may be the former). Elsie is now set to start nagging me (gently) at 30u left in reservoir.
  3. Following 2. above, I had a rather hasty set change followed by 24 hours of not so great blood glucose readings. These weren’t off the scale but higher than I’ve been used to recently. I put this down to it being the weekend, not having basal rates set for working early shifts and eating more carbs than usual – weekends usually involve pizza, crisps, a small amount of wine or beer and other things that would have the Dietician foaming at the mouth. I finally paid attention when the cannula site became painful.  On closer inspection, much of the insulin Elsie had delivered was just sitting under the skin. A not so hasty set change quickly sorted this out. I need to trust my carb counting abilities – I’ve been doing it for years and knew that I shouldn’t have had to correct as much as I was doing.
  4. I drove to my Other Half’s last night to discover I had left my emergency bag in The Shire. A brief panic at the prospect of an 80 minute round trip was making me more than a little bit grumpy, but I’ve been  forgetful for a very long time – as you can probably tell from this post – and have got into the habit of keeping spare meters in various places as well as insulin in various fridges. Panic over.

Still feeling great. Still got lots to learn. To top it off, my HbA1c has come down to 7.7% (60.7).  Looking forward to the next 7 days.

Elsie and I, Day #9

My going live date for my insulin pump was 17th February 2014. so today is day #9 by my reckoning – if I finish writing this post before midnight.

After a few days I decided to name my pump Elsie. I quickly got the feeling she, as I’ve decided, was a bit like a gently prodding, well meaning Granny. Reminding me to do stuff quietly and generally keeping an eye on me…

So far it’s been good. Good, but not great. This is to be expected. I’ve also dropped the ball a little.  I had a weekend away walking and indulging myself and my other half as our Christmas present to ourselves this (last) year.

The first five days were pretty hard going. With lots of overnight testing of my blood glucose. The diabetes isn’t a new thing, and I’ve had years of getting to know what happens with my slightly dysfunctional body. I know, for example, that first thing in the morning my liver is likely to go into overdrive, dumping glucose stores into my bloodstream, making me feel like I’ve been awake for days in the Sahara desert – parched and exhausted – usually as irritable as an old rabid sloth with a wasp in his ear.

This dawn phenomenon isn’t unique to me, or indeed other people with diabetes. It’s a natural response to help us get up and going for the day but for me it’s aways been a thing – take enough long acting insulin to cover it and I’m fine through the day but overnight I’m dangerously low and have been known to take hypo related seizures. Sort out the low blood sugars overnight and I feel awful first thing in the morning. Vicious circles here we come.

After 4-5 sleepless nights with me (almost) managing to test 3 hourly overnight and a couple of days of fasting the standard basal rate is almost there.  It’ll no doubt need some tweaking but it seems not too bad already.

I’m slowly starting to trust Elsie, I’ve had years of anxiety about night hypos and getting there with the basal has been one of the biggest thing for me so far. As a shift worker I’ll need to sort out patterns too, but I reckon this will be a fairly straightforward shift of the whole day by a few hours as it was with my MDI regime.  I’ve got that to look forward to over the next wee while.  I would often joke that my default state was tired and hungry. Always exhausted, particularly in the mornings and constantly hungry – all day, every day. The hunger has gone. I still don’t quite believe it and I have far more energy too.

I’ve been known to witter on a bit, so I’m going to finsh here with a few points:

  • Biggest leap of faith – switching off the automatic shut off overnight.
  • Biggest inconvenience – infusion set packing in through the night.
  • Biggest positive – feeling far better than I could have imagined after only a few days, not being hungry and no overnight hypos (yet).

Ramblings of a Stressed Diabetic

My name is John.  I have had Type 1 Diabetes since July 1984. For most of my life with Diabetes, I have been treated with multiple daily injections of long acting insulin in the evening and quick acting insulin with meals. (MDI).

I decided to start this blog after (finally) beginning treatment of my Diabetes with an insulin pump. This was partly to try and share my experience of this as I was reluctant to consider a pump for a number of years.

My life with Diabetes has been relatively uneventful.  I’ve never had a full blown Diabetic Keto-Acidosis – even at diagnosis.  My older sister is also Type 1, so my mum recognised the signs and symptoms relatively early when I was first diagnosed. My HbA1c (rough measure of control) was always relatively good – sitting somewhere between 6-7%. Kidney function is good and I have no diabetes related problems with my eyes. My single biggest problem has been recurring overnight low blood sugars, or hypos.

At times I have had problems with anxiety, stress and depression. I don’t honestly know if this is related to my diabetes or not.  There is certainly good evidence to support that this is the case. What I do know is that when my diabetic control isn’t great, I don’t feel great. Either physically, or emotionally.

Why consider the pump then? Recently I have more and more overnight hypos. These generally leave me feeling terrible for the next day and also make me prone to further hypos; my control has gradually worsened with my HbA1c shifting to between 9-10%; I have developed chronic pain in the joints in my feet and hands with trigger fingers. This pain may or may not be Diabetic Cheiroarthropathy – I’m still being investigated for this; all of these issues were affecting my overall quality of life and more importantly, my mental health. So, I decided now was as good a time as any.

I’m currently on day #9 of my pump regime, the link will take you to my thoughts of how it’s going so far.

I’ve tried to include some links where a more detailed explanation of something may be required. These aren’t personal endorsements of sites and I can’t guarantee the validity of the content of any articles I’ve linked to.

I’ll also try to add a little bit of Tech stuff every now and again.