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I'm terrified...

sjm1308

Well-Known Member
Messages
152
Type of diabetes
Type 1
Treatment type
Insulin
Again after 5 years on waiting list I'm extremely thankful to be approved for a pump. I hate to come to you all with my concerns as I know many of you've fought hard for yours. But I'm terrified. I feel like I'm stuck between a rock and a hard place.

I cant continue as I am, either getting up twice during the night to correct, waking up with good bg but exhausted or I sleep through the night but wake up with a bg in the teens equally exhausted. **** dawn phenomenon


I'm due to get my pump in Sept and as I've said before that's a busy month for me...moving house, wedding abroad and starting home assessment for adoption. The thought of this alone puts my bg up!

I've brought my concerns to my Dsn several times but she keeps reassuring me it wont be as bad as I'm imagining. I've asked about deferring but that's not an option due to their training schedule. And the pump is to help me get good control for the adoption medical.

I guess my main concerns are,
1) I notice a massive difference in my bg on stressful days. I.e a bad day at work I'll tend to struggle to come down below 12 whereas on a relaxed day off my bg is very steady around 6-8. How do I manage that on the pump? Especially that first month which I will find many stressful days.
2) I sometimes take on an odd night duty at work to help them out or if I'm saving for something..will I have to stop this?
3) is the math a lot different? It took me a while to get my head around carb counts/ratios so am worried I won't catch on.

Thank you everyone who commented on my previous post. I just csnt stop worrying over it. I think if the timing was different I'd be very excited.
 
Hi @sjm1308 first thing....calm down (you know your bloods will rise lol)

1) Stress days you could raise your basal rates by a percentage.....a couple of button presses
2) You can do exactly as you are doing now, no difference at all
3) The math for ratios etc will be programmed in to the pump by your DSN when you get the pump. All you have to do is test your blood and tap in the carbs and the insulin will be delivered. Sometimes you may have to alter the ratios BUT that is super easy to do

And lastly......you can do this, it is easy(ish)
 
@sjm1308 I understand you are concerned. A pump is a different way of thinking about your insulin dosing and there is a bit of a learning curve but once you get there it is great ... no more waking up for night time doses, for a start.

Here are my answers to your questions (I am sure others will have slightly different approaches or additional things to add)
  1. I notice a massive difference in my bg on stressful days. I.e a bad day at work I'll tend to struggle to come down below 12 whereas on a relaxed day off my bg is very steady around 6-8. How do I manage that on the pump? Especially that first month which I will find many stressful days.
    • A pump is brilliant for this. You can have a stress day basal profile and a relaxed day profile. If you think the pump will cause stress at first, you can focus on getting the stress day profile sorted and then add your relaxed day when you are comfortable with it.
    • I strongly recommend making sure you ask how to add additional profiles when you get your pump: mine was fixed to one profile and I had to do some sleuthing how to add three more
    • If you find your BG needs are different for other reasons (exercise, holiday, monthly cycle) you can add another profile for these
    • If you find your basal needs are just a percentage different, an alternative approach could be to set a temporary basal. Make sure you ask about this too
  2. I sometimes take on an odd night duty at work to help them out or if I'm saving for something..will I have to stop this?
    • Nope. Guess what? You create a "night duty" basal profile if you find you need something different.
  3. is the math a lot different? It took me a while to get my head around carb counts/ratios so am worried I won't catch on.
    • You still need to carb count and you should try to be a little more accurate
    • But, most pumps have the ratios programmed in (they can be different at different times of the day) so you just tell it your current Bg and how many carbs you are going to eat, Then it does all the hard work for you
    • I think most pumps also have the option to do all the calculation and then add a "manual bolus" if you want to. This may sound silly but it is useful to remain familiar if your pump fails and you have to go back to injecting temporarily. This is very very rare so don't panic about it.
From your questions, it sounds as if a pump will be brilliant for you - it can control your different insulin doses depending on your stress levels and it can do the maths.
 
Can’t really add much to what the others have said, other than it’ll be ideal for night work, as you can work out a basal profile for the nights you’re working - I’ll be doing nights in my new role and it’s havimg a pump that enables me to do it with little bother, I think. Good luck
 

Really? Mine wasn't, and still isn't, come to think of it. The DSN said the ratios were likely to change from mdi to pump, and also throughout the day. I'm happy doing the math in my head. Also, the pump calculation doesn't take into account exercise, temperature or stress, so my calculation is likely to be closer than the pump's.

Did everybody else get their ratios put into the pump by their DSN?
 
Seacrow said:
Did everybody else get their ratios put into the pump by their DSN?
Click to expand...
I had an initial ratio put in my pump based on a known average reduction from MDI ratio and have tweaked it adding different ratios at different times of the day as required.
I can't remember if I was shown how to do this or worked it out myself.
Likewise, I have tweaked basal settings, insulin sensitivity (at different times of the day), etc.
 
@Seacrow I preset mine before training and liked mine better so I kept them!

@sjm1308 I would just like to add, if it's easier in the beginning to not set up a second profile, most pumps just allow you to give extra whenever you need it! You can also suspend your basal or decrease it as needed in case you end up busier than you expected. It really is very easy. Dive in! They will program it for you at the beginning and then make adjustments as needed.
 
Hi @sjm1308,
I recall some years back when i had a lot of things on my plate , events, decisions and what not.

The best advice i received about this situation was: what will matter in 20 years time?
Most things do not matter when looked from that perspective, or if they were deferred, changed, but moving to an insulin pump is the one thing that does and did matter for me.
Nothing compares or comes even close to that in technical terms.

So please grasp this opportunity. Yes, it is like you have been piloting your diabetes and now are moving to an upgraded pilot system. but one which will give you the best chance of continuing to fly without crashing !

The posts above show you that the new system is a game changer.

Weddings, house moves etc will come and go but your diabetes, my diabetes, all of us with TID essentially have it for life.
What could be more important.?

Sometimes we also take on so much and find that we are often failing to keep up and this is a form of stress that in hindsight we coukd have avoided or at least minimised.
No, an insulin pump is not a 'set and forget' item. It still takes work and concentration but it can make overall control a lot easier. Your health team woukd nit have recommended it fir you if they did not believe you woukd benefit from it.

Best Wishes and please let some of your overfull coffee cup overflow whilst retaining the best and most important and best tasting portion remain !!!
 

I have altered mine from what my DSN has put in. BUT for starting off it was close and the OP was asking and a little worried about moving over to pumping and was trying to reassure her on how easy it can be
 

Yes, my DEd programmed all my details into my pump ie, ratios etc. I just need to add my carb count when eating and the pump calculates everything for me. I message her between visits if any concerns, download my records and she messages back any changes needed, and how to change them. If she feels the need to for me to see her she will advise me to make an apt. Did exactly tis, this morning.
 
Thank you, I appreciate your reply and looking out for me
porl69 said:
I have altered mine from what my DSN has put in. BUT for starting off it was close and the OP was asking and a little worried about moving over to pumping and was trying to reassure her on how easy it can be
Click to expand...
 
Thank you all once again. I'm feeling a little less nervous! So thankful for this community
 
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