Friday, 13 January 2012

CGM Is MINE - well for a week anyway

Just a quick one today.  Please meet Adam's and my new best friend Mickey the Minilink Transmitter.

Added onto my Veo this gives a complete CGM-Pump combo that allows what I think is some of the best control options currently "available" to type 1 diabetics.  You'll notice I've put available it little speech marks as they're not available to everyone due to funding, insurance etc.

I am fortunate that my local clinic has a couple of transmitters that it can loan out with a single sensor applied by the DSN.  It was inserted using the 180 degree Serter and was relatively painless.  It's stuck on with the supplied sticky stuff which I'm hoping will be enough for the six days I have it.

After an agonising two hours whilst it calibrated I ate some food, bolused, for the first time ever I'm getting a linear graph of what's roughly happening to my BG levels whilst the carbs and insulin take effect.

The next six days will see me doing lots of basal testing and also exercise and using patterns to try and find out what works for me and what doesn't.  Tomorrow starts with a huge test while I spend the day replacing my garden fence recently bent to destruction in the wind.

I know people have varying success experiences with a Medtronic CGM but as this is my first time and so far the Veo is proving reliable I'm hoping we get on perfectly fine. An update will follow next week providing my graphs are as flat as I hope them to be - yes, I am now laughing and shaking my head.

Tuesday, 3 January 2012

Nine Weeks In

Firstly many, many apologies for the delay in updating the blog.  Life appears to have decided that free time no longer has a place in my existence so finding the chance to update has passed by too quickly sadly.

So, how have the last two months gone.  In summary it's been pretty good.  As predicted by the Team Pumpers from before I joined the dark side there are ups and downs but so far I believe I've made the right decision.

I thought it would be interesting to revisit my pros and cons list from beforehand to see if I was thinking logically or just trying to tell myself that pumping can't be as good as everyone said.

Firstly the perceived pros:
  • Better control - well so far that's a yes and a no.  It's too early for A1cs but I think my average is improving in the right way.  I've had a couple of evenings where set problems meant delivery either stopped or was hindered causing BGs of 19mmol/l (350mg/dl). I'm still not convinced similar control couldn't have been achieved by even tighter MDIing but the ability to bolus for 5g of carbs is just extraordinarily wonderful.
  • Public dosage - a big win here.  The ability to test then click and go means buying some food before jumping on the train doesn't involve a squeeze down a packed train carriage into a moving toilet to try and administer a roughly correct dose.  And it's also provoked conversation with my friends and family.  Whereas before I was very quiet about my injecting now they love the tech involved and are interested in what I'm doing.
  • Closer to natural - yep. No arguments that the method matches more closely what the pancreas would do apart from the random failures now and again.
  • Less injections - wow! What a big win. Grabbing some food and clicking a button wins every time.  Initially I had a few painful sets but moving to a shorter needle has fixed that generally.  Although a bit randomly the left side of my stomach tends to be where I feel any pain instead of the steady-away right.  I still do a little smile when delivering any bolus because of the ease and the precision.
  • CGM - Still waiting to test this one. I'm hoping to get a first go with the clinic CGM in two weeks so we'll see how that goes.  I'm very keen to give this a go as whilst my control is improving I'd love a more smooth-lined track of my BGs through the day (and night).
  • Tech - Oh yes baby! This is where the pump wins every time. Gadgets are coooooooool (and does me saying "cool" mean that I am not?).  My old Aviva Accu-chek Expert was the star performer in the MDIworld but the magic of bolus delivery and bolus-on-board calculations is a big winner. However, I do sometimes pine for the compact beauty of the Novopen that is sadly no longer my constant companion.
  • Long-term complications - It's only been two months!

Now the perceived cons:

  • Always there - This was what I thought would be a big negative and there's no denying it is. But, and this is a huge but, it's worth it.  Yes it's always attached but the number of times a day I think about it is very few and leaving the house no-longer needs me to remember my pen! Night-time is not a huge one but it's not yet at the stage where it can be forgotten when I er, sleep, with my wife. Detachment happens but the sticky-outy bit is still present.
  • Kit failures - Yep, these happen too.  I don't think I'm yet confident enough with the pattern of my BGs not to be scared by quickly rising 'scores'.  Early on I had a few problems with the longer sets and did a few extra changes when there was a background niggling pain.  I'm still not sure if I was over-reacting but it felt good to do something to fix an apparent problem.  I'm yet to have a total pump failure or a daytime problem so unexpected set changes haven't happened at an inopportune moment to cause me any problems.
  • Compulsory testing - I was already up to about 6 tests a day anyway so not much real change and I'll admit that if I want a day-off testing I'll bolus based on a perfect score and I haven't had any major failures yet.
  • Outside opinion - This has been fantastic.  For the first time people have properly spoken to me about it and more often than not they show a genuine interest as they know someone, somewhere who's injecting or pumping too.  I haven't noticed any increase in people perceiving me as 'ill'.

Unpredicted highs and lows

  • Square wave and dual wave boluses - I'm having fun playing with these to give better control over killer foods.  Pasta and pizza is just about mastered although, for me, Chinese food is proving to be a black art. I'll get there but it will take time.
  • Profiles - How fan-dabby-dozy are these little beauties.  My life is fairly static but planned profiles for days when I'm commuting by bike and train are superb.  It's on days like this when I could get down on one knee and propose to the Paradigm - if I wasn't already married and could actually marry tech!

So in summary: I love it but it's taking time to get sorted.  We'll get there and so far I have no regrets.

I appear to have rambled a bit again.  Thank you for getting this far and all feedback is welcomed.

This is the first of two posts today. Be sure to read the second one here Thank You DOC :-) 

Thank You DOC

This will be a brief one as the message is simple:

Thank you, thank you, thank you, thank you, thank you.

For once this isn't to anyone in particular. But to you and anyone else who has ever read something I've blogged or tweeted.  And an even bigger thank you to those who've just written about their experiences and troubles with the big D.

For years I was in an effective diabetes wilderness looking after myself but never talking to other diabetics and the DOC was just something I didn't even look for. And it's not that I couldn't find you; I just didn't look.  I didn't understand how much I could get from talking to others in the same position as me.  And I know this is because for years every D I seemed to speak to had perfect control and everything mastered. I didn't have this and didn't want to be told how stupid I was.

However, venturing onto Twitter and certain forums where A1cs weren't boasted about as badges of honour soon made me realise I wasn't on my own and people were facing the same or similar questions to me every day.  And because it's a worldwide community, whatever time of day it is there's someone somewhere to hold one or both hands if needed.

So in summary thank you and keep up the good work everyone. Someone out there, even if they don't speak up, appreciates what you're doing. Every day.

This is the second of two posts today. Be sure to read the first one here Nine Weeks In :-)