…A change happened….
At just after 5am I woke up on the sofa to a gentle nudge from Matt, it was time to get up and ready if we were to leave by 6am. We had decided to drive to Westfield and catch the Tube from there (rather than Wombling Free), travel planning now being an important aspect of hospital appointments since moving my care to London. I can’t say it enough, had Matt not been there I suspect I may have lost my mind; whilst I got washed and dressed, he took over making tea and toasting crumpets (only 1 oven glove and 2 crumpets were burned in the making of this breakfast). En route, I checked my BG, it had shot upto 21 which I suspect was due to the emotions and the reduced basal dose that I’d given over the last few days. It was here in the passenger seat of Matt’s car, crawling in traffic on the M40 that I took my last regular injection.
Despite the traffic as we approached Westfield, we arrived only 5 or 10 minutes later than planned, so the next mission was to find the Wood Lane Tube station. As we left the warmth of the shopping centre car park and marched off into the cold day towards the Tube, a combination of wanting to make up time, anxiety and the near freezing air saw me struggle to catch my breath. We stopped and I realised I was having a panic attack. As he would do at so many points this day with the squeeze of my hand or a giant bear hug, my incredible guy held me close and reassured me that I needn’t worry. In the safety of those arms I found the calm I had momentarily lost, I was excited again, still nervous but not panicking. Next stop Hammersmith!
As we got to Charing Cross Hospital, I told Matt about it being where Anna was treated and how we’d talked about me visiting her back in August when she was in for her last operation, she was excited at the prospect of us both being at the same hospital for the care that we needed, and we were both excited at the prospect of being reunited. When I came for my first appointment, I admit I was concerned that there would be many emotions about the plans Anna and I had tentatively put in place, I feared I would feel utter sadness. Instead it felt like she was there with me – it was comforting and reassuring; I felt like I was in the right place. I felt that again today, especially as Matt held my hand as we found our way up to the training room.
We walked into the room and it is here that we met Kate who would also be starting pump therapy today. Naturally you could feel there were some nerves in the air as we waited for our DSN, but once we got chatting they soon dissipated….for a moment at least. Our DSN joined us and, very importantly….offered us tea or coffee. Anyone who knows me will know that tea is my go to hydration method, having not had a cup since about 5.30am it’s fair to say I was gasping for a brew.
Teas in hand and introductions made, our DSN explained that we would be with her till about 1pm and the rep from Medtronic would be joining us shortly. We began with writing down our usual daily insulin intake. I doubt I’m alone in always struggling with this question, in part because it depends what I eat, but also if I eat and above all; how many units I need for my morning correction dose. In this instance, I was able to use the data on my Libre from the last few days to work out my most likely mealtime insulin doses.
If you’re about to start Insulin Pump Therapy, make sure to record all your data in the run up. I log carbs and insulin doses on my Libre monitor, but there are some excellent apps available that will enable you to record everything: My Sugr, is a popular app that many of my pals from the GBDOC use.
Your DSN (or whoever is teaching you on the day you start IPT) will need this information to calculate how much insulin to start you off on…
Once the numbers were handed over Kate and I had some paperwork to fill out. I’ve gotta hand it to my fella, he started going through the instruction manuals and paid close attention to what was going on. I didn’t expect anything less, but to have him there actively participating was the best feeling ever; even more so as I was exhausted from 4 nights of restless (read: barely any) sleep and needed a backup brain. Next up we started by opening the box containing the device that would be keeping us alive from now on. I felt like a kid at Christmas, or a visitor to a trade fair – merch central, although this is so much more than a handy spare pen! Once out of the box, we went through the process of starting our new Insulin Delivery System up. As I was pressing the keys and selecting the relevant menus, Matt was at the relevant page in the manual and we worked through it together. He also did a pretty awesome job of helping Kate if she needed it by sharing the info he’d read, or what he’d seen me do.
We took a little break whilst more tea was made and upon our return it was time to really make a start on pumping. We first made sure all the settings we would individually need were in the pump, both the DSN and Medtronic rep were so helpful and knowledgeable at answering any questions and explaining the reasons for the settings we were entering, the tips they shared were also an incredible help.Then it was onto the active learning part of the day, drawing up insulin into a reservoir, connecting this to an infusion set, locking the insulin cartridge in place in the pump and then……inserting the infusion set into ourselves!!
All this seemed quite straightforward and the instructions provided in the kit are easy enough to follow. The chap from Medtronic mentioned many videos online that could help with this process too; it all meant the thought of doing this at home unsupervised wasn’t as daunting as I’d expected it to be, in addition Kate and I had decided to stay in touch and become #PumpBuddies. Once the sets were in, the final step was to test our blood glucose with the new Contour Next Link meter that from now on, would send our BG results to our pumps. We watched as the meter told us our BG levels, and then marvelled as the screen on our pumps sprang to life and told us what our Blood Glucose was. I needed a correction dose, no surprise there given the reduced basal and emotions. So I used the bolus wizard on my lovely new Medtronic Minimed 640G which Matt had so lovingly applied the pump skin to, I entered that I wasn’t having any carbs and went through the steps to confirm how much insulin this bionic addition to my body should give me. As soon as my pump beeped with the bolus complete sound, I felt a rush of emotion…..I cried. I was connected. I’ve so much hope tied up in my as yet unnamed pump; I was truly overwhelmed and grateful to finally be receiving a treatment that has the capacity to help me live better with my Diabetes than I ever have.
We were nearly done with our pump training and inception, the last task before being sent out into the wild as fembots was to go and have a snack and bolus for it. Matt & I were going for a little lunch date before we headed home, so we went to Costa and I decided a Black Forest Hot Chocolate would be a good test. Fortunately Costa has nutritional info online, which includes carb content; to be honest it’s not particularly mobile friendly but it’s better than guesstimating from thin air. Once I’d found the carb amount, I took a fingerprick test, waited for it to connect with my pump which I had stowed away in my pocket at this point. Gingerly taking the pump out of my pocket, I was excited to use the bolus wizard for actual carbs. Again I went through the steps: entered the carbs in my drink, observed how the wizard accounted for my current BG, active insulin and the carbs I was about to consume. I then enjoyed this festive treat with the knowledge that as long as my ratios are correct, this was going to be a hassle free Black Forest Hot Chocolate (and for those of you who’re aware of my love for Black Forest Gateaux, yes I would have the drink with the cake).
So with the first tentative fembot steps seemingly successful, Matt and I headed back up to the training room. I had decided to move my pump to my bra, clipping it in the middle (I’m trying to be delicate about this) and I showed Kate as we’d discussed it as an option before we went for our snack and bolus, I’d not been keen at that point. Matt’s face as I pulled my top down enough to show Kate was a picture. Always a moment for something to giggle at in Niki’s world.
Before we could leave Kate and I had a little bit more paperwork to fill out to set up our medtronic accounts, this would be how we order our pump supplies, then we got a list of the things we’d need to add to our prescription with our GP. Our DSN asked us to send over our results each day, there would be some fine tuning to do in order to get the basal patterns right but she would be with us every step of the way. With those reassuring words, my #PumpBuddy and I; accompanied by the increasingly amazing man that is my boyfriend, waited for an hour for a lift to leave the hospital (It wasn’t really an hour, but it could’ve been quicker to get anywhere on the Piccadilly Line that day). We all walked back to Hammersmith station where Matt and I said bye to Kate. I’m so grateful to have her as my #PumpBuddy, as much as I have an abundance of support the like of which I’ve not really had with my Diabetes journey before to literally, step for step be on a parallel journey like this with someone; is the finest form of peer support.
Back at Westfield, we went for our lunch date to Wagamama, thankfully the nutrition info online is not only mobile friendly but it’s so clear and easy to find!! I wish it was this easy in all restaurants! There are some excellent resources online for working out carb content whether eating out or cooking yourself, so even if a restaurant doesn’t have a menu with detailed nutritional info, a more accurate guesstimate is only a Google (other search engines are available) away.
Lunch date over, we headed home. Sated by the delicious food, exhausted by the excitement of the day and for me at least, a little nervous for my first night as a pumper.
Home at last, a snooze and a hug later and Matt had to go to work. I was alone….as a fembot….Eeek!!
Later on in the evening, I was exhausted and struggling with a persistent hypo. Having some quality time with my Haribo collection wasn’t what I wanted to be doing, I had insulin on board and a basal dripping into me and I panicked, forgetting the advice I’d been given earlier in the day. So I messaged my Diabuddy Brian who began pumping a few weeks before me. I knew he’d be able to advise and I wanted to touch base with him anyway, in addition to being a valued friend Brian has also been on my cheerleading team in the run up to pumping. Bri reminded me of temp basals, but as I was planning to go for a bath, for which I’d just disconnect the pump, he reassured me that that’d help my hypo treatments take effect. It worked, Thanks Again Bri!! I reflected on why my BG had dipped so persistently, and concluded that I probably still had Degludec on board. But at least now I’d know what to do if it happens again.
Bedtime….I fell asleep, pump next to me in bed…..hopeful it’d still be attached in the morning! Today will be cherished for so many reasons, the day feels like a gift from somewhere I can’t even imagine.