As mentioned last time, I saw my Endo and he was supportive of whatever decision I wanted to take. Thanks to the thoughts and input of the DOC my lingering doubts have been lessened. I wouldn't say removed; more that I'm coming to ask if it's really that important.
So what are the driving factors for change for me:
- Convenience. The ability to be able to bolus in tiny amounts and easily must be my number one driver. Taking today as an example; I'd been floating around 7.8mmol/l (142mg/dl) all morning. At this point I always find a single unit too much of a correction and a half-unit by itself injcted has no effect at all. Tomorrow I'll be going to a sporting event where fish 'n' chips are the traditional pre-match cuisine. Normally I'd skip as, for me, injecting on the street has never been something I'm comfortable with - blood testing, yes, injecting, no. I know that's my hang-up but this is my decision after-all. A pump would give me the chance to bolus-and-go which would appear to be much simpler.
- Number of injections. Recent improvements in my control have brought along an increase in injections. Previously I'll admit to being very lax and injecting at main mealtimes and the basal at night but since I actually started testing effectively I'm finding most food comes with a stab in the stomach. And a few weeks ago my basal stabs doubled from once day to twice. Now after 32 years you'd think I was used to injecting but I'm afraid I'm still not that keen. A shock, I know, but there it is. The idea of one 'shot' every three days has a much greater appeal even if I know that that one hit might sting a little more than before.
- Funding and approval is available. The way I'm seeing it is that I've thought about it long enough and the only way to see if it works for me is to give it a go. As it stands currently I'm getting support from my Endo and DSN so why turn it down now? I might have another 12 months of umming and ahhing to decide that maybe I should give it a go, only to find out that cut-backs mean it's no longer available to me.
- Tech is gooooooooood. I'm a tech boy and like my gadgets. New meters excite me so having new tech to play with is always good. My current Accu-Chek Aviva Expert is a fantastic meter and whilst losing the bolus calculations, having a pump to do that for me is good. And it also means I can shrink BG meter again back to the Aviva Nano which is also good. Yes, I know I will need much more kit now but being able to slim down one piece compensates a little.
- Choice of pump and CGM. Well, technically no, not a choice. My clinic only supply the Minimed Paradigm Veo. This is good for me as out of all current generation pumps available this is the one that floats my boat. Permanent CGM is not being offered initially as the clinic like to loan out a wireless Minilink transmitter for 6 day sessions rather than fund it individually. However the loans can be pretty frequent as not many people do it. Going forward I may start a campaign for the CGM so having a pump that is compatible from the start makes that easier. And.... tech changes, in the four or so years I'm gonna be connected to the Veo, CGM functionality may develop so having the capability now gives a little bit of future-proofing. Ever hopeful anyway. I'll end this little bit with apologies to those unable to get one if they do want one. Funding (either NHS, private or health insurance) is always a primary driver and I know I'm fortunate to be able to have the choice.
- I can go back. This is a big one. If it works great, if it doesn't I won't have lost much in the meantime. Carpe diem and all that bollox!
What happens next?
- Whilst I was there today an email was sent confirming my desire and for the NHS Trust to proceed with the purchase.
- I need to read. Pumping Insulin - thanks for the many, many recommendations, is on it's way to me thanks to the wonders of Internet shopping - so I need to get into that and do some serious cramming. The way I see it is that if I can hit the ground running, me and P (yet to give it a name, although Adam appeals to me for some reason) will get on much better from the start.
- On the 18th and 21st October I have some 1-2-1 training sessions with the DSN to go through the workings of the pump and ask any practical questions. I expect then we'll go through the detail on infusion sets etc. As a side-note I'll be sticking with Novorapid (Novolog) as my insulin of choice as it works and we've not fallen out yet. 30 years of Novo can't be wrong.
- In early November P (or Adam) gets presented to me and I leave 6 times daily injections behind for a lifetime of wires and tiny adjustments - well, for ten years anyway when the 'cure' arrives. It has to be ten years as it's been that far away since I was diagnosed.
As always, thoughts, comments, arguments and mild abuse welcomed.
Next update expected either after training or once pump arrives.