Happy Birthday, Pumpy McPumpFace! almost. It's been around a year since I started using an insulin pump and phew, what a journey! You might have noticed from my frequent social rants; I like data from big numbers. A year of pumping, around 120 set changes, approx 26,000 units of insulin and, very importantly, 0 insulin injections from pens or syringes - seems like a satisfying amount of numbers to form a good opinion on insulin pump therapy (we'll get to the TIR later, don't worry).
Urgh! It's a nightmare, don't waste your time!
Just kidding. It has transformed my T1D and I'm absolutely delighted and massively grateful for the chance to pump. You knew that already, of course because you follow my socials because you have great taste in tweets. In this blog I am going to run through some of the stand-out experiences of using a pump in the last year. These are my experiences and you'll likely have your own should you decide that pumping is for you.
I remember owning this pump for a week before getting set up. That stemmed from a feeling of anxiety and nervousness that I might make a mistake and give myself a massive overdose or, as is my want with most tech, break it. None of those things happened and it only took a sweaty hour or so to get started thanks to a Zoom call with a former Accu-chek Combo user. In hindsight, I could've done the set up myself from watching YouTube videos but there was something reassuring to have that peer support on hand over a live video call.
Great, so, you're not interested in a day by day run down of pump use from here on in and, to be honest, I couldn't tell you what I had for breakfast let alone what my bolus for it was (obviously it was coffee). Let's get to the important bits, the positives and negatives, and I'll try to keep them brief.
Negatives:
Yes, there are some!
- Always attached.
Unless you're taking a bath or a shower then you're always attached to that little lump of plastic and 60cm of tubing filled with insulin. Eventually, it becomes a very normal thing and you learn to adapt even in the bedroom! However, it does mean you're aware of things like door handles, getting hung up on similar things and where to put the pump on your person. If you use a CGM then you're likely well versed in site rotation for your little "always on me" buddy. The same is true of a pump site but, a pump site needs to be changed every 3 days or so. Your CGM may last for 14 days. If you're moving to a pump then start considering the idea of different areas on your body for placement. Legs are fine for me, some use arms, boobs, love handles and top of the bum. I think I'm good with legs and tummy for the time being.
You may also need to get used to the constant reminder of having T1D. MDI means a jab and carry on & you might not jab again for several hours! Your pump is on your person and always dripping basal into you quietly. I firmly believe that having an acceptance of this condition is a vital part of living well with it and using a pump to help manage it. If you're struggling with acceptance then the reminder from a pump might affect your mental health.
- The blood!
It's not a common event for me, it's happened twice, the blood following a cannula removal if you nick a blood vessel. Wow! If it happens to you once then you'll have plenty of "just in case" tissues on stand by for the next occasion. A little blood can look like a lot, I know. If you scroll through my old tweets then you might find images of my blood-soaked tissues. They're not from a knife wound, I promise.
- Zero IOB
Remember when you were diagnosed and how utterly crap you felt? That huge thirst and a bladder with enough liquids in to end the national drought? Yeah, that's how things go when you've got zero insulin on board. A kinky cannula, an occlusion, a bad site or just forgetting that you've suspended your insulin delivery for a couple of hours will result in a rocket ship on your CGM graph. It happens! All of those reasons have happened to me and it's scary how quickly things can run away from you once the Banting Juice tap is turned off. CGM alarms will stop the worst of it, use them.
- The Fight
Specifically if you live in the UK, access to an insulin pump is not straightforward. I have documented the fight that I was faced with in this blog, just look for The Path To Pumping posts and settle down for a read. Things will undoubtedly change as technology becomes the standard and Looping is rolled out to all with T1D who wish to use it. Until then, it's still unacceptably bad. Criteria is used, of course, with many citing it as punishing them for working hard to manage their T1D. I agree with those people but I also agree that something has to be in place to protect the public purse and evidence to show pumping being worth the cost is a necessary evil. There are no easy solutions but perhaps with enough evidence and the passing of time we will see a much more relaxed attitude towards access.
Positives:
- TIR
Time In Range, now seen as such an important barometer of T1D health. For a while, I've known the good standard for TIR to aim for as 70% - that might be different for you. Although there were periods on MDI when my TIR was near to 70%, in my latter MDI days it was closer to 60%. The period of May 2021 to August 2021 shows my time in the happy zone at 63%. Since switching to pumping, I have seen a consistent TIR of 77 - 82% (currently 78%). That's a big jump and I do know that it might not mean a huge decrease in my chance of T1D related complications but it does mean some decrease.
- Burden
A vast reduction in burden has made me a happier person, a better rested person and a person able to function at a reasonable level. No longer do I look at another injection with lethargy and hate hanging over me. This positive is the most important one for me, peace and happiness have no price tag and achieving them is not an easy thing.
- Confidence
Do not read confidence into my words because I have a social media presence. I have struggled with social anxiety for most of my life and I probably always will. The removal of some of that anxiety through no longer needing to inject in public (or finger prick for that matter) is huge for me. It brings a sense of normality to me, something which I've rarely felt.
- Sleep
I have never slept so much! Not since I was a teenager who pretended he didn't have T1D. The difference is utterly amazing - to wake up in range, to have less nocturnal hypos, to not feel like the walking dead. Sleep is vital to human health and sleep loss is a massively overlooked complication of having T1D. Finally, I feel able to get enough rest.
Those are the biggies! for me, at least. There are lots of other little positives and negatives but I promised to keep it brief. I would love to know of your positives and negatives, if you've recently started pumping. Maybe you've stopped pumping and gone back to MDI? Tell me about it, you know where to find me.
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!
