The Path To Pumping - Pt.4 The First Month and Q&A

 

Time flies when you're having fun, right? A month has passed with me pumping and it's been an interesting, sometimes fun, sometimes frustrating time. 'Frustrating!?' I hear you exclaim. Yes, in parts but maybe not the parts that you're imagining. Let's begin.

I'll start with the news of my pump funding through the NHS...

...Hello darkness my old friend. 

That's probably a bit harsh but through me you get honesty, you get the good, the bad and the sad cats.

The good - Through arranging my DAFNE course (to be done remotely because it's 2021) the extremely helpful nurse (name forgotten, sorry) who took my registration promised to chase up a couple of things for me. Firstly, my appointment with the pump team. It's probably not going to be a team, I know exactly who it'll be but fingers crossed for an audience of cross-examiners. 

The bad, kind of - Secondly, self funding consumables. I need permission to BUY pump consumables from Roche. That permission must come via a letter signed off by my consultant. Cool, OK. It was to be done 22 days before this blog was published. I've politely chased it. Roche have politely chased it. Now, it seems the DAFNE nurse is going to chase it. This letter is harder to catch than Usain Bolt. He's not a runner any more, is he? Insert something or somebody fast in his place.

Frustrating? You're getting the idea, I hope.

But! I'm staying cool and calm about it all. I realise that I've dropped the news of my management of my T1D on my team's desk out of the blue, that I'm not the only patient with T1D who needs some attention. So, I'm not trying to be too demanding. Of course, once my generously donated consumables begin to run low then noise will happen. I'm hopeful of never getting to that stage and, as a Joe Bloggs Diabetic, I'll do what I think many would and I'll stare hopefully at my letterbox for weeks. So, that's where things stand with the funding. 

How about some truly good news? The pump has been a revelation. You may have already gathered that from my Twitter gushings. It's difficult to really convey just how much my life has changed from this change to pump therapy. If it's happened to you then you might get what I'm struggling to put into words. I could write several thousand words on situations and experiences which relate to me and pumping. You'd fall asleep or close the window before the end and I'm not about writing War and Peace blogs. So, relax. Let's try something new! I asked Twitter for some questions in relation to my pumping and I'm going to publish each one and answer those below.

David asked "You know we all want to know what goes on with sex if you wear a pump, right?"

Straight in there with the grown up stuff. I think you've got options, that's options and not positions, when it comes to sex and pumping. The easiest thing would be to suspend the pump and take it out of the cannula (keep the cannula in) and when you're done just plug it in again and unsuspend. There might be added benefits to doing that by not going hypo during your hubba hubba time, alongside not getting caught up in tubing and having a lump of plastic machinery flying around (stop giggling, at the back). A negative could be that you're getting no insulin and how long before you're hyper? My own pump buzzes and beeps every 60 seconds when suspended. If you find that you're being timed and it's distracting then hide the pump in another room or turn up the volume on your Barry White's Greatest Hits.

Adam asked "Any issues with pump placement during exercise? That and the sweat damaging the pump are two concerns I have. Also, how long would you say your teething problems were before you felt you had it under control?"

My pump appears to be very sturdy but you can get cases for more protection from moisture and general knocks and bumps. I think pumping and exercise is a question of finding where to put the pump to keep it secure and deciding whether to take it off all together for that period of time. My first two days of pumping were far more "rocky" than they are now. I'm so lucky to have lots of pumping friends, including some who have used the pump that I have. They've been amazing in taking my panicked calls over air bubbles, occlusions, insertions, etc. After a few set changes and basal tweaks, things seemed very smooth and predictable. 

Gillian asked "How much of a difference are you finding with being able to use different bolus patterns as compared to an single or split bolus?" 

I'm still learning but wow! game changing stuff. I've grown more confident in the pump to begin using different features and now it's just a question of getting boluses right for the difficult meals... I doubt that'll ever really happen but perhaps I can stop those overnight spikes from pizza dinners, at least.

Natalie Ann asked "Question about hypo awareness: has this changed for you? Look forward to the blog"

Thanks Natalie Ann. Sadly, no. At least not during the very moderate hypos which I've had in the last month (they're so brief that I'm showing 0% lows on my CGM). If my hypo awareness does return to the old levels then I'd be delighted. Just to get a little sweaty at 4mmol would be ace!

BrittanyJo asked "Hoping to get my son approved for one at his upcoming appointment this week. do you use cgm as well?"

Good luck with the approval for your son! I do use a CGM called GlucoMen Day. It isn't part of the pump and they don't "talk" to each other so, no Looping with this set up. However, it's an invaluable piece of technology for watching BG and reacting to problems. To set up with my pump without the aid of a CGM would've been much harder work.

And two private messages:

How are you sleeping with the pump?

Brilliantly in that I'm able to have a long lie in and not worry about my IOB from pens running out at 7am. Less concerns make for a calmer mind and better sleep. Physically, I sleep in shorts with pockets and it lives in there until I wake up.

How did you find pumping while wearing a suit at that wedding?

Pretty straightforward stuff. The suit jacket hid a very small area of tubing which I ran from a lower shirt button hole to the pump in my pocket.

How do you like the Q&A stuff? I'm always available to answer questions or to shoot the breeze with on Twitter @DiabeticDadUK or you can leave comments below. 

Oh, the Employee of the Month picture? The same as every other month; Me! Although my pump has put in a helluva shift. 

Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!

BUY DIABETIC DAD A COFFEE HERE

The Path To Pumping - Pt.3 The First Week

Whoa! What a first week it's been with my pump. Time has flown by and so much has happened, even progressed, since the last blog. Let's get into it.

Firstly, huge love and thanks to all my friends and peers within #GBDoc. I have been inundated with support and advice from seasoned pumpers, loopers, HCPs and curious MDIers. Sometimes, I feel there is a hoard of big hearted people who have my back and who can relate. It really does swell my heart and I doubt that I could ever repay such kindness and support.

The first week! So, no (or very minimal) insulin on board, on Wednesday morning I interrupted @Julesbhrh from celebrating her birthday month to supervise my first cannula insertion and to get started with pumping. Doing that over a video call is not easy! especially without a COB (coffee on board) and with a rapidly increasing blood glucose level. It took a while, as most things do in your 40s, but we got there with my CGM reading 17.4 mmol/l. Icky, right? Previously, a Novorapid pen correction would take several thirsty hours to bring me back from the brink. Not so with Fiasp in the pump. After 30 mins I was nudging the happy zone and I could even plan my lunch and pre-bolus. What a great start!

 The first 3 days proved to be a continuous stream of surprise and delight. Fiasp was working beautifully and is extraordinarily fast, I had begun to adjust to sleeping with a pump attached, my TIR rocketed, I wasn't overwhelmed at all, no injection fatigue, fasting BG numbers leading me to question if I'd been cured by the Cinnamon Fairy, overnight. Apart from a kinked cannula, which taught me that when no insulin is going in I will become hyper very quickly, it's all been smooth sailing.

Can I brag? Just a quick brag. Between Saturday evening and Tuesday afternoon, my TIR was 100%. What in the name of Banting's Balls! I've had two 24hr TIRs in 4 years. That's almost 3 days in a row. Yeah, it's gone well. I've since managed a full set change without supervision and I've grown confident and comfortable with the pump.

Of course, it can't end there. I'm not in this for a quickie and then back to pens. No way, Amigo. That means I'm going to need consumables and Fiasp on prescription. August, it seems, is a popular time of the year for annual leave within the NHS and I'd chosen a Bank Holiday to reach out to my HCPs. To their credit, I was replied to on the Tuesday morning by email and had a telephone call in the afternoon. Outstanding stuff. See! HCPs from UHL, I can be kind and give credit where it's due. No need for patronising DMs or to block me or unfollow me. There is nothing to fear. Meow! 

I digress, what did the HCPs say about me going it alone? "We've never had this before" made me happy because who wants to go to work and deal with the same thing each day? A really good discussion with my Consultant and DSN lasted for around 30 minutes. The great news is that Fiasp is happening right away. Beyond that, I have been referred to the Pump Team and a certain Professor who some of you will know from Twitter. No, Partha relax, it's not you. At that referral, I hope to continue the good, honest, dialogue with that team and work towards full pump funding.

While I'm waiting for that referral to arrive, I'm hunting for consumables and I've opened an account with Roche and Accu-Chek. I've been given permission to buy my own consumables, lucky me. It appears that the items I need will cost around £120 per month, that is excluding VAT. If I want to use an insertion device for my cannulas then that's another £25. Yikes. Hi Americans! I can relate... a bit. Some kind folk have sent some supplies to me for which I am hugely grateful. I'm looking at you @NanaNeylin and of course the world's hardest working person @Moodwife

And that's where things stand, today. I'm delighted to be pumping, amazed by the numbers, hopeful that the pump team will agree that funding makes sense and most of all I'm determined. This will happen. 

Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!

BUY DIABETIC DAD A COFFEE HERE