2 for the price of one...

Last night we caught up with my brother and sister-in-law to be and I was busy creating the best salmon-en-croute of my cooking career so far, so didn't have chance to update you on yesterday's fun.

As you've probably read I'm getting married next year and as well as seeing the sights of London this week we have been planning to catch up on our wedding plans. Yesterday we met up with the photographer Paul White at the Photographer's Gallery to see his work and vet him out as a potential wedding photographer. He has a really style and some great shots.

We also ventured to St Paul's Cathedral for a whistle stop tour, an amazing building, we climbed up the many steps to the dome, however I couldn't quite manage the tight, spiral, wrought iron staircase to the very top, not my cup of tea.

Speaking of tea, the highlight of my day this week is definitely the cafes! Yesterday was a pot of tea and the last scone in St Pauls. Today's caf probably scores top marks for the 'most impressive cafe on a day out' EVER. The V&A cafe, like an extravagant ballroom, amazing, especially with a nice cup of tea in hand.

Pictures via Flickr here, here and here plus Paul White.

A little bit of history...

Tuesday, London, 20 degrees. 
First stop British Museum. Lots and lots of stone... and history and plenty of school kids, seems we can't escape them this week. Realised how little I remember about history from school, found myself eavesdropping on teachers conversations to brush up on my knowledge...

I like the roof by the looks of it.
A funny looking statue that made us smile. We stopped for a coffee in the cafe, just as I hit 3.9mmol so coffee was accompanied by a few jelly babies and a cereal bar, felt I needed both, we still had the whole of the mummy section to tackle yet! (couldn't not get any diabetes talk in) Hard to work out what caused the low, perhaps the 'holiday' drinks the night before or perhaps the soda farls we had for breakfast that were so stodgy I could only eat half as one bite took about five minutes to chew.

After a massive lunch we headed off to the Criterion Theatre to see The 39 Steps. Wish I was allowed to take some pictures of this inside, was just like sitting in you Nan's pink furnished living room, bit like a marshmallow. We were probably the youngest people in there, that was until the school trip walked in, must be following us. With a cast of only four actors playing over 150 parts this play was very clever and funny too, plus a bargain considering you would pay the same price to go the cinema in some parts of London.

So that was Tuesday, pretty much, won't go into the football results...

Pictures via Flickr and Flickr and me.

Autumn Days...

So once again I have been slack in posting, apologies. Hope you haven't lost interest, slap on the hand and all that...I promise I will try harder!

First, a quick diabetes round up then onto other things. A couple of weeks back I had my first appointment at the hospital since converting to my pump, disappointing my hba1c had only dropped by 0.1% (to 8.0%) although my diabetes team ensured me this was good as most peoples goes up, but I wasn't so sure as I thought I had been doing much better. Then I have been doing some experimenting with basal rates, which has meant me scouring for no-carb alternatives, brazil nuts currently top of the list and testing on the hour. Serious science experiment.

But, I wanted a bit of a change to my blog this week and it means I probably won't be writing about diabetes that much. We have decided to take a week off work from the trials and tribulations of making magazines and toys and go on holiday. Well, we're not actually going anywhere, we're having a holiday in...London. Not so much big red buses and Harrods, more along the lines of the arts and culture of this fair city.

Let's back track to Saturday as our holiday started with some excitement as we had two gigs in one night, first was the talented and up and coming singer songwriter Chris Macaree in Camden then a quick cab across to Kentish Town where we were on the guest list for Gang of Four. Rock and Roll.

Skip to today and one of the more blog-friendly activities (you don't want to hear about a trip to the dentist and the the town hall surely?) was a stroll around Holland Park (hence the opening shot) where we saw lots of dogs, autumn leaves and little people playing. I wish I had taken this picture myself, but it's just from Flickr, tomorrow camera will be in hand and maybe (no pressure) I will bring you some visual delights of my own.

My old friend

I've been a bit slack with posting recently, work has been my number one excuse, much to the disgust of everyone who keeps asking me when am I going to post again so they don't have to look at that picture of that boy...

Actually I think it was the busyness on Friday (nothing to do with rushing to the pub for a drink) that made me accidently leave my blood meter at work, in the toilet cubicle, on the floor, all alone, all weekend. 

When I got home at 8.30pm on Friday night I rummaged in my bag and my heart stopped, I remembered it falling on the floor vividly. At first I panicked then I realised I could just use a spare one. Only thing is my spare one is dodgy (see here) and the test strips for my other spare expire 09/09. Argh! So I spent most of the weekend using the dodgy one and then comparing the results with the other meter with the close to expiry/expired strips. We were away at the weekend and I stuck to using dodgy meter, Sunday morning I woke up high and I corrected but I think the meter was reading high as I went low 90 mins later. 

My meter was waiting for me on my desk on Monday morning, a nice samaritan must of left it there for me, or perhaps one of my colleagues who always sees me clutching that little black pouch...

What I had missed most though was my finger pricker. My beloved finger pricker that I have owned for years and is the most comfortable one yet and also the one that has been redesigned and is no longer available exactly the same (it's an Accu-Chek Soft Clix) A few years back I had the same type which broke, I then had to suffice with a different finger pricker only to uncover a spare one day at home, much to my excitement.

The thing is I dread the day this one breaks or I lose my meter bag. I can feel that happening soon, the other night I left it in a restaurant. As we walked out we suddenly had this man running after us in the street, we thought we hadn't paid enough money, but no in his hand was my little black meter bag. So a restaurant and a toilet cubicle within a couple of weeks, they say things come in threes, lets hope not! 

Winter Woes

I was on the Tube this morning reading the Metro when I noticed the headline 'Risk of diabetes rises in winter'. Being diagnosed in January I thought this was quite interesting, I read on waiting for the mystery of my diagnosis to be revealed....I then got to this paragraph:

'It may be caused by seasonal changes in blood glucose and insulin levels, seasonal viral infections or the fact that young people tend to eat more and do less exercise in winter'

It was the last statement that annoyed me, not only do I have to explain to people that I didn't get diabetes because I ate lots of sweets or because it runs in my family but now I potentially also have to explain that I wasn't an overweight lazy child who at the first sign of a chill in the air suddenly had the urge to overeat.

Maybe I should of adopted the head wear at the top of this page and that might of prevented me 'catching' diabetes. Whatever next. Read the full article here.

Picture via Flickr.

Here comes the bride..

I went to try on my wedding dress earlier in the week.

When I first went dress shopping I wasn't on my pump and originally I thought that I would probably go back onto injections on my wedding day, but as confirmed in a conversation with HTB (code for husband to be - let's hope he doesn't read this post as he doesn't like that nickname) I am now pump converted and would much rather have my pump by my side when I say 'I do' than worry about bleeding after an injection onto my dress, to name just one downside of injections, I know I've changed my tune...

As I started to explain to my wedding dress designer I had something to tell her - I could see the horror on her face as she contemplated what I was about to reveal - before I could finish properly she said 'Oh you've got a box' it turned out someone who bought a bridesmaid dress from one of her stockists also had 'a box' and she had sewed a pouch into the dress. Phew, a thirty minute explanation into diabetes wasn't needed and turns out maybe I won't have to get my needle and thread out after all, I might get my own designer pouch!

Picture via Flickr 

Excess Baggage

I got home from work this evening looking like I had just had a shower fully clothed.

I had been contemplating going to the gym this evening but my heart wasn't in it. I had reduced my basal rate before I left work and ate a cereal bar on the tube and in my head I was battling with going and then not going, then going...I resolved the decided factor would be what my blood sugar was when I got off the tube. 8.1 - not going. Then I saw the rain, definitely not going now.

 I changed into my trainers (flip flops pretty useless) whilst everyone else was cowering under doorways, I put my umbrella up and braved it. Yeah, I thought this is fine it's only a bit of rain, I had been so hot today in the sauna that is my office that the first few minutes in the rain was positively cooling. Then my jeans started to stick to my legs, the rain off my bag was running down my back, my trainers were getting heavy as they were so bogged down with the rain, it wasn't good.

When I got home and opened my bag, everything inside was a little soggy. I emptied the contents of my bag onto the coffee table and it nearly filled it. It was then I decided to take a picture of how much STUFF I carry around with me. And this was only one bag, I had two bags with me today.

One of my boyfriend's books he had lent me to read earlier in the week was probably the worst hit, I've now got a crinkly DAFNE diary, some soggy business cards, a wet baby sock (for my pump)...I'll let you study the contents, but I'd like to point out as much as I like writing and drawing, why on earth does a girl need 4 pencils and 2 pens?

Sugary Fingers

Yesterday I had a few issues with my blood meter. My blood sugar was clearly low, but my meter wasn't sure: 5.3 followed by a 4.4 then a 7.3! Followed by a 4.7 then a 3.7 - can you tell I don't trust it?! I'm obsessed at the moment, it's ridiculous, I have to test enough without having to test again to check the first test was accurate!

Looking back at how many times I tested to confirm what I already knew seems a bit crazy, but I just wanted to see what bizarre results it would throw at me. These were all consecutive tests some using exactly the same drop of blood and fair enough I'll admit it I hadn't washed my hands immediately before. Half an hour earlier it had read 14.4 so I had corrected. The morning before my blood sugar was 15.4 on waking, I corrected, ate my breakfast and took insulin for that; later that morning I had a hypo and wasn't quite sure why, now I am thinking was it really that high in the first place?

So, I have been doing some tests comparing my Optium Xceed meter with a One Touch Ultra Easy meter I recently got. I have been washing my hands for those who think that's the reason for these results and I have been changing the needle in my finger pricker as well.

This morning on waking Xceed said 9.8 and One Touch said 5.3 (then 6.3) - a distinct difference that could result in me taking a unit of insulin more/less than I needed.

I've just done the same now, who knows what my blood glucose really is, see for yourself.

These tests were all done consecutively and you can see that even my One Touch meter is a little inconsistent, with the 9.3 throwing a spanner in the works.

I just had dinner and tested myself before, this time I had 3 meters! A new Optium Xceed I had as a spare read 15.4 and the One Touch read 15.8. At last some consistency but not good as my blood glucose is high.

I can't believe the inconsistency in something so vital. I would love to know if anyone else has had these problems too?

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

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...

Pre-pump

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!)

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.

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!

Picture via Flickr

Testing - Part 2!

11.3 mmol/L

Not bad for 45 mins after eating my feast.

14,000 people around the world testing together!

Testing...

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

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

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...

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...

Picture Credit: www.flickr.com/photos/dalbera/3600301569

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)

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)

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!