The Path To Pumping - Pt.5 Permission

 I think that it's pretty safe to say that you do not get to live a life without seeking permission to do something at some stage. Perhaps permissions are sought more when we were younger, as we learn rights and wrongs, then we might seek permissions more as we start employment - reducing as we mature, move up the employment ladder. becoming parents, financially independent and ultimately adopting the "with age comes wisdom" stance as we reach seniority. Perhaps. Of course, life moves in different directions for us all and a host of different things will affect what permissions you seek and from whom. So, that's a generalisation.

Diabetes doesn't escape permissions. IF we do certain things then other things are possible or, at least, safer. If you're running a high blood glucose and you're hungry then you'd probably give yourself permission to only eat that slab of cake if you inject or pump some insulin into your body. Probably. 

Of course, we can and do by-pass permissions in life and Diabetes because we're wild and just won't be told (kidding) or we know enough at that stage in life and in OUR Diabetes to no longer need the go ahead from another person or a group of people. We know the right answer and sometimes we just grab the bull by the horns and ride that bovine wave. 

By now, you've realised where this blog is heading. Since writing my Path To Pumping blogs, there has been lots of discussion on Twitter, WhatsApp and even in my Inbox around the subject of pumping and mostly how to get started with pumping. As an NHS patient, it boils down to permission. 

Many who have expressed an interest in pumping to me have queried where to start. It's never been an option, they didn't like the idea until recently, they didn't realise they could reduce their burden, they couldn't afford it! The list is surprisingly long. I've tried to encourage each to start a conversation with their Consultant. It could be that you're eligible under the current NICE guidelines and the NHS are obliged to start you on pump therapy. In that case, great. You're good to go and good luck! For the rest of us? We're going to need some permission.

Your Consultant may tell you that you're doing "too well" and that you don't need a pump. They might be right! But if you're going to dramatically change your insulin therapy, learn something new and quite scary & be brave enough to speak up about it in an often intimidating situation then they're probably wrong. They're probably using this positive refusal technique because your HbA1c is under 8.5%. Clever, isn't it? the old positive refusal. Did you ever end a relationship with "It's not your fault, you're great, it's me, you can do better..." to soften the blow. Maybe you've had a positive refusal for pump funding and it was so good that you took to social media because your HCP told you how brilliantly you were doing? Maybe that's just me.

So, what happens after you're refused? I mean, the nice Consultant was really kind and complimentary. Perhaps you should suck it up. Until you can't suck it up any more. Hurray! You've reached Burnout level. This is where things get worse for you until you eventually reach that 8.5% A1c and the Consultant is less complimentary. By that stage, you may not be in the right frame of mind to move to pump therapy. You might not be in the right frame of mind to do very much in regards to Diabetes. Then you might need psychological support, maybe counselling, and a pump, which you might or might not use correctly because your mind is a frazzled, deep fried, lump of lard at that stage. Things could get expensive for the NHS from then on in and become a worry for you and your long term outcome. 

I'm sorry if that last paragraph reads a little gloomy. Imagine being my Consultant!? 

Let's just touch on that 8.5% thing a little more then I'll let you go and demand new things from your own D team:

That is a criteria you must meet for a no questions asked agreement to start pumping (alongside having no hypo awareness and hopefully not dying from a hypo hospital admission). If you don't meet it and you're sure that pump therapy is for you then look up the ABCD recommendations for pump therapy. Do you meet any of those? Dawn phenomenon? A splash of hypo fear, perhaps? How about some other QoL issues? If they apply to you or anything else which is a solid reason for you to switch to pump therapy then "No" is not an answer to accept when you start the conversation. You have options, there is help in exploring those options.

Sometimes you'll wait a while for permission. A patient patient is a good thing. If you do find that your wait seems to be a little long then do drop me a message. Everything can be hurried along and even a Joe Bloggs Diabetic, like me can reach far beyond the initial gatekeeper. 

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.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

The Path To Pumping - Pt.2 The Gift

'Are you pumping already? That was fast!' Well, yes and no. No, as I write this but hopefully Yes within 24 hours of publishing and once this blog goes viral. What? I go viral! Some of my tweets get like... 8 Likes!

Welcome to Part 2 of The Path To Pumping. I've titled this one "The Gift" because that's exactly what you see in the photo above. I'm a firm believer in "Pay it forward", especially in relation to Diabetes. That's not because I'm trying to buy my way into the good books or affections of others. It just feels good to help others who need it. It's a great form of peer support and paying it forward can come from gifting or loaning equipment, such as a pump or just sharing your knowledge and experiences. This blog is also dedicated to my friend for making a monumental effort in gifting me this pump, one of the kindest and hardest working people you could ever meet. I am truly blessed.

So, how does this impact upon me getting a pump through the official NHS channels? I'm still following that route and the ball is firmly in the court of DAFNE. If you've followed some of my tweets then you might know that getting an appointment there hasn't been a smooth process. Following my Diabetes review and agreement to attend DAFNE as a gateway to pumping, a letter arrived in the post which invited me to make a registration appointment to find out about the course. K, can do. I sent an email to no response. After 2 days, I sent a follow up email, stressing that the clock was ticking on arranging this appointment and being appreciative of a soonest reply. The NHS letter stressed that I must arrange an appointment within 2 weeks. Sadly, no response. Perhaps emails aren't routinely checked. I still have a week until my deadline at this stage. I let the weekend pass and then I tried a phone call on the Monday morning and voicemail picked it up. I left my details and politely asked for a call back, again expressing concern that this is a time sensitive appointment as noted in the letter. No return call happened and I tried again at 4.30pm, around 7 hours later. No ringing tone, this time just straight to voicemail. I hung up, not wanting to leave multiple voicemails about the same issue. Tuesday arrived. Tick-tock. Just before midday, I called again and finally spoke to a real person! Apparently, she was going to call me back. We arranged the registration appointment (telephone) for late September. 

So, that's that. But, not really. After making noises on Twitter, it became apparent that education/training isn't necessary for access to technology. I shouldn't need my GCSE in DAFNE to be offered pump funding. The temptation now is to refuse the course, dig my heels in and start quoting NICE guidelines. But! I'm a Joe Bloggs Diabetic, the everyday chap with T1D who has walked in, off the street because he's heard that pump therapy might make his Diabetes management better, provide a better long term outcome and reduce his day to day burden. I'll take the course because that's what the Joe Bloggs Diabetic would've been advised to do, what I've been advised to do. What you may be asked to do. Not everybody knows about guidelines or the right people to follow on Twitter.

Enough DAFNE, for now. 

The pump!

Right, I've loaded my small and over-worked brain with information, I have support from friends and anonymous HCPs. I'm ready to go! When my Lantus isn't on board., which'll be tomorrow morning. Today, I'll be checking and double checking and probably Zooming with pumping friends to be sure that I'm not going to make an enormous balls up. Assuming all goes well and things are settled, in a few weeks or maybe months I will investigate Looping through this pump but that's something for the future. The now is for getting used to pumping and not injecting anything. The very thought of not injecting insulin is completely alien to me. I do that approximately 60 times a week. I've never smoked but I wonder if this going "cold turkey" from injections might be similar. Old habits die hard and all that.

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

Meeting Diabetes Peers

 

Another peer support blog? Kind of! But without the warnings, the concerns or possible problems. I'm going to focus entirely on the positive. Yes, I'm feeling alright.

I think we've reached a stage of twitchiness. 18 months of pandemic and avoiding the general public has been hard work and I say that as a pretty "happy to be alone" sort of chap. The horribly named Freedom Day signalled that it was time to interact a little more without the aid of Zoom or other video call apps. I've tried it a few times, now. Wow! have I missed it. The old saying of "you don't miss it until it's gone" really has applied when it comes to meeting my peers from the world of Diabetes.

Last weekend, a bunch of Diabetes and GBDoc folk & families met up to celebrate the 50th birthday of GBDoc Queen Jules. It was an outdoor event and, despite a brief rain shower, it felt entirely comfortable and Covid safe. It was fantastic to see familiar faces alongside a few new ones and I regret having to leave early, missing other great individuals from the Twitterverse. It was nice to see such interest in the event, despite it being a semi-invite only thing - as much as you can have an invite only event in a park. The majority of people responded to the messaged invites sent by Beth (Diadarl1) and myself and I know that Jules was very appreciative of those who RSVP'd without her chasing up.

Never been to a meet up? Neither had I until 2018. My Twitter persona might indicate otherwise but please don't assume confidence from a written word. I'm a quiet man and still suffer from social anxiety but to a much lesser extent than 3 or 4 years ago. Those early days of meeting my peers greatly reduced that social anxiety. Subsequently, I've hosted a video podcast, video quizzes, gave interviews to the media including BBC radio, took part in JDRF Fusion and stood in front of a room full of business people to talk about my CGM. All of those things and possibly others in the future (wink, wink!) are reaped from the seed sown at that first Diabetes meet up. Are you still undecided about meeting your peers? 

It's not all Diabetes, you know? Seriously, it's not. Everybody might be wearing Eau De Banting and there might be a hypo or two knocking around but the conversation isn't all Diabetes based. Don't worry about being bored, I never have been, just talk to your favourites from social media. You might have a question or two so just ask! I will be...

...and that'll be at the next "meet up" which is going to be much smaller in size but equally as glamourous as a park. I'm heading North to meet Dawnie (Moodwife) who is heading South to talk about pumping and looping and possibly coffee. The subject, for me at least, is exciting enough because I'm attempting to move from MDI to pumping which will likely lead to looping and to learn from your peers is the greatest education. It's also massively exciting because it's Dawnie! C'mon! 

And on we go. Talk is of other get togethers in other areas of the UK for GBDoc. I hope such talk bears fruit and I can meet others from this amazing community. Did you see the TAD announcement for March 2022? Maybe see you there! and at many other things for years to come.

I told you this would be a positive blog.

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

Quack, Quack!

I'm afraid that you have Type 1 Diabetes. Have you tried a leech on your pancreas?

Before I get into it, today. I'd like to address the lovely comments and discussion that surrounded my last blog; The Path To Pumping Pt.1 Over 1,500 of you have read that and I'm astounded by that figure. I really will be following that up in the coming months.

Alrighty then! It's 2021 and Quackery is alive and well. It might even be thriving! Last week, my blog was spammed a total of 18 times from an individual in Ghana who promised cures for pretty much everything, ranging from Herpes to HIV. Diabetes got a mention, of course. Fast-forward to today and something involving salmon placentas and stem cells arrived in my inbox. Those aren't the only incidents, either. Throughout my time using the Internet, some 26 years, that kind of quackery has been an almost constant event. 

I think I'm well enough informed to never have fallen for such nonsense even in the early days. It's persistence and longevity does worry me, however. If there was never a buyer for such ridiculous advice then there wouldn't be a market. Since the dawn of the Internet, I wonder how many desperate people have become seriously ill or died from the advice of Quacks? It's terrifying to consider.

Not all advice is quackery, of course. Mansplaining, for example isn't usually a money making exercise. A keyboard and an urge to feel important and knowledgeable is enough motivation. Incidentally, men rarely mansplain to me. Make of that what you will. Advice, even in well meaning forms can be a dangerous thing. As Diabetics, we administer dangerous drugs to ourselves and just a small miscalculation can have dramatic, perhaps fatal, results. 

When it comes to the Internet, especially social media it's still the Wild West for medical advice. There are warnings on some platforms when keywords are picked up. Covid is a great example and Facebook appears to be taking some notice to SOME problems surrounding dangerous advice. Twitter is not and that's really disappointing. It's easy to report tweets and accounts for lots of terrible things but when it comes to dangerous, misinformation around health? Nothing. It's left to us as Twitter users to decide on what is correct and good information and what might put us in our graves. That needs to be addressed as a matter of urgency. Stronger content policing would serve social media platforms and the users well but if that will happen is debatable. Why? Well, content means views and views mean ad' impressions. Impressions mean income. Are the social media platforms really interested in taking care of us or taking care of their shareholders? 

I feel the eyes of the Freedom Of Speech brigade, muttering something about the "Thought Police" because they can't grasp how their bright ideas expressed through the Internet might damage others. They likely never will. Did anybody change their opinions and admit to being wrong on the Internet?

I think the Internet and social media are great places to get wonderful information and support. They're imperfect, of course and so is general society. I encourage treading carefully when it comes to your health and online advice. Would you listen to a stranger in the park in regards to your insulin dosage? I didn't think so. What's different to the stranger on Twitter?

I feel like this little blog has become a public safety information message which the majority probably don't need. If nobody was buying those pancreas leeches, though... 

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.1

It must've been during one of the last Diabetes appointments for me at my old clinic, before I threw my toys from the pram and transferred all my care to my GP, because the memory of the event is very hazy. The numbers weren't looking great, I wasn't feeling great, volunteers were wandering around and making small talk - which added to my tension and it was waiting room temperatures in there. 

"We could try you on a pump"

Have something attached to my stomach? 24 hours a day!? The idea was dismissed by me immediately and probably not in the kindest of tones to that HCP. What an idiot. 

Here we are, probably 20 years later, and I would crawl through fire to trial an insulin pump. In fact, what I've agreed to do might feel like crawling through fire but I'm going into this with an open mind, a clean slate, no judgements... at least none that I'll verbalise until it's over.

I got pump-curious after meeting so many #GBDoc folk, hearing their stories and wondering if that might work for me. I've carefully listened to their joys and woes and after many tweets and many messages I decided to make some noise about it to my consultant. We'd spoken about it in 2019 but my A1c was great, I wasn't really struggling with anything which might make pumping a priority and I felt the appointment time would be better served by bringing up Libre access. So it proved, although Libre funding wasn't straightforward and took some intervention by Prof. Partha Kar to make it happen.

This time! There will be no name dropping, string pulling or threats (just kidding). I'm going through the process as an ordinary Diabetic. I am, after all, an ordinary Diabetic as I've mentioned many times. I'll create a blog for each step of the process in moving from MDI to pumping, you'll hear about everything and this is Part 1.

The conversation with my consultant went exactly how I want every appointment to go. I know that I'm doing alright, I'm getting by, and once that had been confirmed I brought up the subject. I know it's not a case of ask and you shall receive with the NHS. The money pot is not an endless one and criteria has to be met and I think that's fair enough. I'm not here to abuse the system. I genuinely think pumping could take my T1D management to the best place it could be and here is why:

- Dawn phenomenon

- Impaired hypo awareness

- Injection burnout

- MDI & CGM (or Flash) use has reached it's limits in improving my Diabetes management

and a quick look at the details for those four points? Sure, okay. 

There is only one Phenomenal Dawn and that's @MoodWife. Dawn Phenomenonononon is really annoying and has begun happening to me more frequently despite Basal changes and tweaks. It's affecting my Time In Range and increasing my average blood glucose level and, of course, my HbA1c.

My hypo awareness is cancelled. In the last 5 years, I've gone from feeling hypo at 6mmol (when my BGs were too high) to feeling hypo at 4mmol (Yay!) to feeling hypo-ish at 3mmol and only having the strong feels when the number is low 2mmol. Worrying stuff, right? I'm glad I'm CGM'd up to the eyeballs and that I have alerts for falling BG otherwise you may have seen dramatic images of me in hospital. My hypos tend to happen when I'm asleep and my alarms usually wake me. However! sometimes they don't until things are very urgent. Worrying stuff again, right? My overnight BGs are a mess and it would be wonderful to have a pump provide more stability.

I inject at least 7 (SEVEN!) times per day. That can rise to 10 if things are really bouncy! and I'm becoming increasingly tired of the burden of it all. The idea of changing a canula twice in six days, compared to possibly 60 injections in that time, sits very pretty in my mind. That would represent a huge decrease in my Diabetes burden and a better QoL.

My overall management of my condition is very good. "You have very good control", said my consultant. I know, I'm kind of a big thing. I have many leather-bound books and my apartment smells of rich mahogany. 60% of the time, it works every time... I'll stop with the Anchorman stuff now (watch the movie and think of me). I know that I'm doing alright but I know it could be better. It can't be better with my current therapy. That can only happen via technology or I will likely suffer from burnout by trying any harder.

So, those points were put across and! it seems I'm good to go... good to go to DAFNE. Remember earlier when I mentioned crawling through fire? That's right! It's DAFNE time. Deep breaths. I know that it's been a great thing for many of you and in the interests of peace and ticking a box and being an ordinary Diabetic, I'm going to go through with it. And that's where I am, right now. I'm waiting for the call from the DAFNE lady, who I really hope is called Daphne, to begin the training process. When that happens I will publish Part 2. I bet you couldn't be more on the edge of your seat.

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

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