Tuesday, 28 July 2009

Miss Muscles

Today I decided it was time I went to the gym. No, I wasn't motivated by seeing Madonna's muscles it just felt about time that I tackled the gym with my pump, no more excuses.

I had been wondering what I would do when it came to exercising and I wasn't sure which approach to try first so this afternoon I emailed my nurse for some advice (chances are if she hadn't replied that would of been my excuse to put it off till tomorrow...) 

I was thinking of perhaps taking my pump off all together and then I wasn't sure if I should eat something beforehand as well. Her advice was to reduce my basal rate by 50% starting one hour before exercise and continuing for one hour afterwards and that would probably mean I didn't need any carbohydrates during. 

I ate a cereal bar just before I left work and didn't bolus, blood glucose was 9.6, I was hungry and didn't feel like I would be able to endure much exercise without eating something. One hour later when I got off the Tube it was 9.3. So by now my basal rate was running at 0.15u per hour, not much at all really. Still I wasn't convinced I would make it past putting my trainers on at this rate so I had three jelly babies....then I had one more just for luck.

I did my usual - warm up for 5 mins, 20 mins on cross trainer then some sit ups on the swiss ball. I felt good, like I could keep on going and I wasn't sweating and looking too tomato like, I knew my blood glucose was good maybe even a bit low. Testing in the changing room afterwards - 6.8. Jelly baby for the walk home, 5.3 when I got home.

I was pleased with that, but I would quite like not to have to eat too much before I exercise, that was after all one of the pumps selling points. So if my pump was only dosing 0.15 units during my exercise and I ate 35g of carbs without bolusing I think I could try not wearing it at all next time. Now to get working on those muscles...

Picture via Flickr

Sunday, 26 July 2009

Vital Statistics

I've just finished writing my next diary feature for Sweet Magazine and emailed it off to my editor.
This issue it's all about the switch to my insulin pump, I hope it doesn't put the non-pump users off reading it, hopefully my silly stories will keep them amused.

Anyway when I was writing it I remembered that I meant to write a post when I started this blog with all my diabetes statistics pre-pump, so then I/we could compare my progress months down the line. So here goes...


Age: 29
Height: 5ft 6 and 3/4 inches
Weight: 60.6kg
Hba1c: 8.1%
Insulin: Levemir & Novorapid

Doses: (on average)
am: Levemir - 9 units
pm: Levemir: 7 units
B/fast: 8 units
Mid-morning: 1 unit
Lunch: 6 units
Dinner: 6 units
Total Daily Dose: 37 units

So the first development is my total daily dose has already dropped and is averaging at 27-30 units per day! 
I'm going to be waiting in anticipation for my next hba1c result, I'd love it to be below 7.5%, watch this space...

(Thanks to Nellie Ryan for my wonderful illustrations!)

Wednesday, 22 July 2009

Cup of tea and a slice of cake?

I haven't posted for a few days, had a busy weekend which seems to of carried on into this week.

After the problems with my infusion set on Thursday the weekend was pretty uneventful on the diabetes front. My mum and dad were down from Liverpool for a long weekend so our days were filled with sightseeing and plenty of tea and cakes.

I actually only had a couple of bites of this cake in the end and when I got home and checked my blood sugar it was spot on!

We went to Petersham Nurseries, a bit fancy for my mum and dad's liking but I liked the little bits and bobs around, a great place for a photo shoot.

A famished duck. I know how he feels.

Thursday, 16 July 2009

Infusion Set Issues!

I've had such a nightmare with my infusion sets today, I feel like a pin cushion.

It all started this morning, I sat down to eat my cereal and took my bolus. I felt a sensation at my infusion site so pulled up my top to see blood around the set. Argh! Panic! 

I had problems when I had tried to insert it the morning before. I had wasted 3 sets! I am using the 30 degree angled sets at the moment, I started on the 90 degree inset II (6mm) but they weren't completely comfortable so I have changed tactics. The fourth set I put in yesterday seemed okay as my blood sugars were okay all day but I wasn't wholly convinced it was in as far as it could be.

I decided to revert back to a 90 degree set. Mid morning my blood sugar was 19.1mmol/L the problem was I didn't know how much of my bolus had entered my body, not much by the results on my meter. So I corrected with 3 units, an hour later still high - 18.3 mmol/L. 

So it was time for my first set change at work! I went into one of our meeting rooms, when I pulled the set out it was kinked. So I inserted another set. An hour later it was really sore so I reverted back to a 30 degree set, which fingers crossed I think is working now. I won't be confident until after my morning bolus tomorrow.

I don't have any 30 degree sets left now until my delivery turns up next week so will be back on the others.

I think I might see if I can meet up with my Animas trainer and get her to check my technique is right. Once I know it is in correctly and working I can relax for a few days, but at the moment I am using all my spare energy worrying!

Tuesday, 14 July 2009

Testing - Part 2!

11.3 mmol/L
Not bad for 45 mins after eating my feast.
14,000 people around the world testing together!


So I only learnt yesterday, through my developing knowledge of social media, that there is to be a massive blood glucose testing at 9pm tonight UK time. 14k people will test their blood glucose at the same time.

I am ready to test! Although I have just eaten a massive dinner and I am soooo full. If I carb counted correctly I ate a whopping 110g of carbs. Woah!

Got to go and get ready to test!

Picture via Flickr

Sunday, 12 July 2009

I could get used to this

We went out for dinner last night to Wahaca

For once I didn't see what the toilets were like in the restaurant as I didn't need to run off to them pre/post meal and take my insulin. I just got my pump out and that was it. Nor was there any worrying about being interrupted mid-injection by the waitress wanting to take our order, instead I just looked like I was playing on some weird looking mobile phone. 

I took 3 units of insulin when the food came out with the plan that if I ate more then I would just take another bolus with my pump. I didn't need to in the end. 

Afterwards we went for a drink in a nice little wine bar near our flat, we'd never been there before, guess what, I didn't see the toilet in there either! 

Prior to all this we had been to the cinema and I decided to try out the combo bolus as we had some popcorn, I didn't really use it to proper effect though, as instead of grazing on popcorn throughout the film, I ate loads before the film even started and was then full. I didn't need to try and take my insulin silently or in the dark and the pump was very useful for checking how much longer I had to sit through Transformers for...

The pump is in my good books, along with my boyfriend for taking me out for the evening.

Picture via Flickr

Saturday, 11 July 2009

Pump Twins

I'm getting married next year and today my boyfriend suggested we sit down and try and progress the plans a bit further. You know colours, themes all that sort of stuff I have been nagging him about so we can get underway with designing our invitations. Two hours later and a slightly heated debate we've had enough, I've reverted to posting this and he's over the other side of the room flicking through channels on the tv.

This week I have been dropping the hints that I have been very brave going onto my pump and surely I deserved to be showered with gifts. He didn't fall for it. The other night I attached an infusion set to him and he said 'now we are pump twins!'

But the downside to that was now he knows being on a pump doesn't really hurt so I won't get any sympathy, the only pain he suffered was when I ripped it off his belly the next morning. He best watch out...

Friday, 10 July 2009

Blah, Blah, Blah

I was back at work today. I haven't shut up about the pump. Not that I mind, I don't hide the fact I have diabetes at work, but nor would I say I make a song and dance about it.

It was clipped to my jeans today, I knew a few people would want to see what it was all about so I went for the easy access option, no pulling it out my bra or pants.

A few people asked me if I had a good break, first I tried the reply 'not bad thanks' then I was faced with 'do anything exciting?' and then it just came out 'well I went on to an insulin pump...' I guess it is exciting if you're into diabetes.

Some of my colleagues know about diabetes and pumps as my company works with some medical companies so they were a bit more familiar, a couple of friends asked me how long I would have to wear it for, when I replied to one friend/colleague 'forever' she looked devastated. I found myself consoling her and saying it was all going to be okay.

I'm worn out. I think I might stop talking about it for now, maybe just until tomorrow...

Thursday, 9 July 2009

Spaghetti Sums

Don't you hate it when you make a silly mistake? 

After me saying I had nailed my evening meal bolus doses yesterday I woke up at 1am this morning with a blood glucose of 19.3!!

After I corrected and got back into bed I realised it must of been the carbs in my spaghetti, I had hardly took any insulin compared to what I normally take for pasta, the only thing I had done differently was I referred to the packet for the carb value (rather than my Dafne book).

When I got up this morning I checked the packet nutrition info:

As cooked per guidelines 
125g serving
Carbohydrate: 31.3g

Whenever I have pasta it's usually about 70g of carbs, but for some reason I seemed to forget this, I think I was too pre-occupied with telling my boyfriend how clever this pump was and trying to give him a demo as he was washing up. So then I checked my Dafne book:

Pasta - fresh - uncooked
100g = 55g carbs

So my 125g portion was near enough 70g of carbs. 

If only I was as on the ball as this pump seems to be! 

(Picture credit: http://www.flickr.com/photos/mukluk/1034486730)

Wednesday, 8 July 2009

Little by little...

Third day in and I can't believe how much more sensitive I am to my insulin/how effective my insulin is now I am on the pump.

I have cracked the latter part of the day (I think!) Two evenings running I have had steady blood sugars from my evening meals to waking in the morning. I have been weighing my food and referring to my carbs book just to make sure I can get everything accurate. It's the rest of the day that's the problem! 

I am still going a little too low for comfort, like this morning when I got out of the shower I tested and I was 3.9, so it was jelly babies pre-breakfast, then some more pre-lunch...good job they are on buy one get one free in Tescos at the moment.

The first challenge for the next couple of days is going to be working out what I need to take at breakfast, today I did 0.5 units for 10g carbs, not enough I had to correct. But 1 unit for 10g carbs would have been too much as the amount I corrected by plus the bolus I took with my breakfast was less than the total amount I would of taken if I had done 1 unit to 10g carbs. Get it?!

It's going to be a case of tweaking each day and seeing what happens, a bit like a science experiment, just a very long one, but hopefully a very beneficial one!

(Picture credit: http://www.flickr.com/photos/jurvetson/2798315677)

Tuesday, 7 July 2009

Up and Pumping!

So as you can see I am all connected and into my first 24 hours of pumping! I had a bit of an information overload yesterday so decided to steer away from an update till this morning. Although now I fear I am about to give you an information overload...

The pump training took about 4.5 hours yesterday and by the end of that I was all set up and on the bus back home. One of my first jobs was to find a spare cupboard for all my pump paraphernalia, my flat was getting over taken by boxes of infusion sets...

My pump is an Animas 2020 (in silver), filled with Novorapid and I'm currently using the Inset II 60 mm infusion set. My trainer advised to stick to the basics for now, so one basal rate, one insulin sensitivity factor and one carb to insulin ratio. It's kind of like starting again and if you go in with all different rates and ratios and don't get it correct (I think it would be a miracle if you did!) it's harder to work out what factor you need to change. So here's my set-up:

Basal: 0.600U/HR (a 20-25% reduction on my basal rates with injections)
Insulin Sensitivity Factor (ISF): 1 unit lowers 3mmol/l
Insulin to Carbs Ratio (I:C): 1 unit = 10g carbs
Target: 7.5mmol/l

I doubted that these settings would be suitable for me for the entire day, but I was willing to try it and see what happened.

I rang my nurse, Amy, before she left the hospital for the day to update her on my blood glucose (7.6) she had previously told me that I would probably run a bit high for the first few days so I was surprised I was getting lower readings. She recommended that with my evening meal bolus I override what the pump suggested if I felt it was too much. Which I ended up doing, in fact I halved my insulin to carb ratio. Despite the lows my results are looking good, my blood glucose already feels more steady, although I don't know if this is completely the effects of the pump or just because I am concentrating so much on it at the moment!

(all results in mmol/l)

16:45 - 7.6
18.15 - 2.3
18.30 - 3.2 
19.55 - 5.4
20.35 - 7.3 
22.50 - 7.8
01:00 - 8.7
04:30 - 12.3 
08:15 - 7.1
09:25 - 10.2
11:20 - 10.8

Don't worry I won't be letting you know every single result every hour of the day...
I'm going to see what this afternoon brings now, see if we have a repeat episode of yesterday and if we do I have evidence to suggest introducing another setting. I stocked up on supplies last night just in case, cupboards full of juice and jelly babies! 

Monday, 6 July 2009

P Day!!!

Haven't been able to post since Thursday, been so busy with parties and more parties...(a little taster above)

I could do with a long lie in this morning, but not today, as P day is here!! (P doesn't stand for party, thank god) Today I'm off to the hospital for my pump training with my nurse and Animas trainer. 

I'm just eating my breakfast and have already took my Novorapid, I have been repeating in my head 'don't take my Levemir, don't take my Levemir' (I'll be going onto basal rates on my pump later today so must not take this insulin too!) I've remembered that part. I've also got my pump in my bag along with a couple of infusion sets and the manual, I'm wearing jeans for easy tummy access, so I think I'm ready to go.

All being well I will be up and running on the pump later today and back to post!

Thursday, 2 July 2009

Adventures in the night..

Last night I had a dream, I can't really remember the full details, but I thought I was having a hypo (low blood sugar for those who are new to this) but a person in my dream was telling me I wasn't - 'it's just the same feeling as a hypo' they were saying - I believed them whoever this person was. But then suddenly I woke up, sweating and my heart was thumping, ah that wasn't just a dream I thought, I am having a hypo. 

I still tested myself just to make sure, waking up sweating isn't unusual this week...My meter read 2.9mmol but I felt lower. This was an unusual hypo, I glanced at the clock it was only 12.30am, I had only been asleep for 90 minutes. I knew straight away I had took too much insulin with my evening meal, I had over corrected as my blood sugar had been high. If I wake with low blood sugar in the night it's normally an hour or two before I am due to get up and I only need a juice and it's back to sleep within 5 minutes. This one felt different, I even contemplated telling my boyfriend (then thought he would just groan, roll over and fall asleep...so I didn't bother) I sat on the sofa in the dark and managed to pack away quite a hefty midnight feast (I felt starving!) - a big juice and a cereal bar and then after scrounging around in the cupboard, fridge and the empty biscuit tins I found the last packet of raisins in the kitchen cupboard and scoffed them down too. 

This morning I woke with a blood sugar of 13mmol - not too bad considering my 'adventure' in the night (that's my boyfriends new name for a night time hypo by the way...)

What I find most fascinating about this story is the beginning...it isn't the first time I have dreamt about desperately trying to get some food, trying to buy a drink but not having any money, trying to test my blood sugar but not quite managing to do it, to then wake and find my blood sugar low. 

It's clever don't you think? Even if in my dreams I'm still a diabetic I think it's pretty cool I have a built in hypo detector installed in me, no wires or batteries required!

(Picture credit: http://www.flickr.com/photos/slighning/513835291)