This is our update on day 1 of Pumpmania. When we got up this morning the excitement was palpable. The last scheduled injection was with breakfast and was in itself a change to a rapid only injection, no more long acting insulin. The green pen is now resigned to the cupboard, which is a bit of a relief,as it’s the same colour as mine so very easy to get mixed up.
Our appointment with the Diabetic Nurse, and the pump rep was 9.30am this morning. We arrived all prepared with our Star Wars lunchbox, filled with everything except lunch – blood test meter, animas pump set, pump cartridge, insulin vile, spare battery, emergency sweets, record book, pencil, novorapid insulin pen (incase of pump failure), blood ketone meter and ketone strips. This will now be the standard equipment we take with us everywhere.
Straight away we set to work. I nearly broke into a cold sweat as Aileen the rep asked me to draw up the insulin and fill the cartridge for the pump. “What comes next?” she said; I looked blankly. “I’m sorry” I said, “but I don’t have my step by step guide (currently stuck up on the side of the fridge) to refer to.” “Oh of course” she said, and produced one out of her bag. What a relief! The pressure of trying to do this for the first time unaided, with all eyes on me, was too much.
We worked through filling the cartridge, putting a new cannula on Archie and answering the barrage of questions being fired at us to make sure we knew and understood everything. “What do you do if you get an occlusion in the pump?” she asked. I looked blankly at Cormac who pulled some genius answer out the bag. In the car on the way home after he said, “Do you not remember them talking about that all the time in ER”.
So after another hour of training and a first bolus of insulin delivered we were sent home with instructions for blood tests every two hours and the details of the records we had to keep. We have worked all day as instructed and so far Archie has had 9 blood tests. We have managed to successfully stay in single figures, so no adjustments required just yet. Archie has also so far reaped the benefit in his food consumption; a full tin of tomato soup and a cheese toastie for lunch – unheard of prepump because of the rigidity of his injection doses. Amazingly afterwards, no spikes in his blood glucose levels.
We did have one minor mishap today when he inadvertently pulled the cannula out of his hip when he was hiking up his trousers. A shout from Cormac to my mum and I was tracked down in the toilet; couldn’t even manage a wee in peace. Anyway we speedily rewound, reprimed and reshot him with a new cannula – so major incident averted.
As I was writing this earlier and feeling pretty satisfied with our efforts today, we did the 8pm blood test to find blood sugars had rocketed to 20.5. That feeling of anxiety and panic just grabbed me by the throat, and was exacerbated when the diabetic nurse on call wasn’t answering the phone. Immediately we did a bolus correction and then the pump prompted me to check the cannula site and check for the dreaded ketones. Site was fine, so grabbed the ketone meter only to realise after much poking and shoving that the test strips we have been given aren’t the correct ones. So then had to ply Archie with loads to drink so we could get him to pee on a stick. All clear though so thank goodness for that. Much to our relief the phone rang and it was a different nurse (ours was sick), so she talked us through a temporary basal rate with instructions to text back at 10pm. We currently have the pump set for 120% basal rate for 2 hours to work alongside the extra correction bolus we gave, so fingers crossed for the next test.
It’s been a long day so far, monitoring bloods and looking for any physical changes in Archie, but on the whole it has gone better than I expected; that said the nightshift is ahead of us, so we’ll see how that all goes. I asked Archie what he thought had been really positive about today and he declared without hesitation “no injections”. Small steps today on the road to Pump success and some freedom from the constraints of Type 1.