But before I tell you my story about how I went onto an insulin pump, I must stress that mine was not a 'usual' transition and for the majority of people it is a seamless process that happens over a number of days and they get on with life soon after. I was not so fortunate for a number of reasons, however having been on one for a few years now I would not go back onto injections now for all the tea in China (and I do love tea).
Pre-Pump Life
When I was aged 20 and about a third of the way through my final year of my under graduate degree in university, I started to become insulin resistant. Meaning that when I took my injections- I was on 3 fast acting with means and 1 slow acting for night time, they did not have much of an affect on my blood sugars. Hypo's were a distant memory because I was running constantly high for such long periods of time. I was drinking a lot because I was so dehydrated and I felt constantly lethargic. Slowly through the need to feel better I started to increase the number of injections I did between meals, firstly to deal with rise in blood sugars that came after eating and secondly because I was training 5 times a week and knew I should not be exercising with blood sugars of 13mmol or above.
Luckily a couple of months into this happening I had a clinic appointment, unfortunately the appointment was with a stand-in consultant as my usual consultant from adolescent clinic was away. I told the consultant about the issues I was having regarding injections, especially the really badly controlled days when I would have to do up to 10 injections a day and he just nodded and moved on. Eventually my clinic appointment came to an end and I went home. A couple of days later my blood sugars began their usual rise that came after food, but this time they kept on rising. And they carried on going up and up and up every time I tested my blood sugars. I kept seeing double figures on my metre (and not just because my eyes had gone funny from the high blood sugars). Obviously I was checking for ketones too and when I started showing signs of ketones being present, my Mum decided it was time to go to the hospital. By the time we got there my muscles felt like I'd just finished running a marathon and I had so much saliva in my mouth I couldn't swallow. So I was kept in for a few days until the hospital could bring my blood sugars back down, and was sent home.
Regime Change
But this horrible experience had stirred something in me, despite having poor blood sugar control I did look after myself and my diabetes well. I exercised regularly, I ate healthily and despite being a student I barely drank. So I took control of the situation by requesting I be moved out of the adolescent clinic immediately, and into the adult clinic as soon as possible. And not only that, I requested a consultant that would understand what I had to say and help me. Straightaway I was moved to a consultant that attempted to address the high blood sugar problem quickly. Firstly he put me on a course of Metformin tablets that increased my sensitivity to insulin, whilst he put me on the waiting list for one of these new insulin therapy treatments called an insulin pump.
There's no two ways about it the symtoms of tablets were horrific, as I mentioned in my previous blog. Whilst reasonably effective in obtaining blood sugar control, they had horrendous side effects on my digestive system. But thankfully after 6 months the wait was over and I could begin on the training program to become a pumper. It began with carbohydrate counting lessons with the dietitian, learning to understand the carbohydrate values in food and how much insulin to take accordingly. I remember going onto the course with two other ladies. One suffered with extreme hypoglycemia and the other worked nights and couldn't get her insulin to work properly with her topsy turvy eating habits. Because in those days only extreme cases got pumps to my understanding, but hopefully this is something that is starting to change.
Trials and Error
So after about 3 months of carb counting lessons we were finally ready for our saline trial on our insulin pumps. This is where you maintain injection therapy as normal, but practice also giving your dosage through the pump as well, but when it has saline in it instead of insulin. This was a really good idea in gaining confidence on how the pump worked without the added pressure of under or over-dosing on insulin. And not long after I got my pump and the real trials began...
Read Tuesdays blog on what it first feels like to have an insulin pump, to suddenly be connected to a machine 24 hours a day.
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