Sunday, November 30, 2008

Grr Mumbly Shit Fuck!
I hate diabetes and I hate high sugars and I hate the fucking pump and not having complete control over my management.
This message brought to you better the letter FUCK! and the number 15.7mmol feels like SHIT!

Friday, November 28, 2008

New Computer

I've been thinking of doing it for a long time now and I finally did it online tonight.
I bought my macbook.
It was a mixture of the numerous payroll deposits and the enjoyment-ish I'm getting from my other piece of new technology.
It's been on my long-term to-do list for over a year, and tonight was the night.

With that said, I feel a little nauseous thinking about how much money I just spent, but I'll pretend that the money I got yesterday wasn't already spoken for and I'll be just fine!
Meet the newest part of my life. I haven't named it yet, or even decided on a gender, but I should introduce it nonetheless.

It appears I have some diabetic readers now that I have started writing about my pump, so welcome one and all!
I hope that my experiences are helpful to you, and feel free to ask questions about anything - I'm always looking for useful topics to write about.


Here are two pictures of my new pump. I hate taking pictures - with the flash(above) it whites out part of the picture, and without (right) you can't hold it still enough so you get a blurry picture. Anyway, combining the two will give you all the detail and perspective you could desire!

I've been absent minded today - forgetting to take my two-hour glucose tests right on time, forgetting to check my sugars before starting to eat. These little things will make the process a little more complicated, but I think I can deal.
There are just a lot of things to get done at this time of year!
The pump is the same as it has been. No news to report.

Yesterday was a phenomenal day for finances.
My student loan money was transferred in, my dance school pay cheque came in, AND my double pay cheque from the school came in (November is the month where we get the year's lump sum of vacation pay and pay increase settlement). Long story short, my bank account looks very happy.
Don't worry, it's just temporary! I will be buying my macbook soon.. I almost just bought it on a whim, but I'll put it off for another little while.

Wednesday, November 26, 2008

I talked to my nurse today after having emailed her my blood sugars from the first two days. She says that I'm doing quite well! We've adjusted the amount of background insulin that I'm getting overnight because my sugars keep dropping overnight. Other than that, we agreed that it's best to not make other changes for a little while because it's only been a few days. We will talk again on Friday and see if we need to make any changes then.

I've started using a really cool feature of the pump - a square wave bolus. Basically, it delivers the insulin evenly over a time span. These are perfect for high carb foods with a low GI value. On injections, these kinds of meals were nearly impossible - they would need a lot of insulin so if I took it too early, my sugars would drop before the food was absorbed, the liver would shoot out some glucose of it's own, and then the food would be absored, so my sugars would end up high a few hours later. If I dosed too late, the food would spike up my sugars, and then it would take forever for them to come down. I was able to eat fast food today and not feel like shit because of it! Well, fast food still makes you feel icky, but non-diabetes related ick!

Tuesday, November 25, 2008

night #1

So, I woke up at 4 am this morning to check my sugars. It's a good thing I did because they were 2.5(they are supposed to be between 4-6, slightly higher overnight).
Overnight lows are the worst - you're tired and cold and all you want to do is go back to sleep, but you know that you can't until your sugars have stabled.
I tried to follow the procedure for treating a low which is:
1)Drink 20 carbs of juice, wait fifteen minutes
2)Test sugars, if still below 2.8, repeat
if still under 4, eat 15 carbs and wait fifteen minutes
if over 4, test again in an hour, eat a small snack to keep sugars afloat

I did step one and had a cookie while waiting (preparing for that small snack). When I tested, I was still 3.5, so I had more juice, and ate another cookie or two. Since my sugars were still low, I was savagely eating these cookies (it is nearly impossible to control ones self in this state). The third time I tested, I was slightly over 4, so I ate another cookie just to be safe, then went back to bed. I woke up with higher sugars because of the cookies, but at least I wasn't low again.

I was told to expect lows because there will still be some residual insulin in my system - let's hope that there is none left for tonight.

My sugars have been running higher than I would like all day, but not as high as I was expecting, and I'm sticking to the orders I was given. There's a chance that my insulin requirements might actually be lower than I expected, but I'll cross that bridge when I get to it.

This morning I cleared the insulin pen and pen needles out of the front pocket of my bag and moved them to the emergency / infusion set change supply section(formerly an empty zippered section). This is just one of many changes I will need to/get to make as part of this transition period.
YAY!

Monday, November 24, 2008

First Day Done

Today went quite well, better than I had feared.
Now, I'm sleepy.

The morning class went over a lot of stuff in detail, most of it I knew from reading and practise, but important safety stuff.
I talked to the nurse and she agreed with my plan to fix the basal rate for today, and as of an hour ago, I'm on the prescribed rate, so we'll see if that is enough to keep my sugars stable overnight. I get to wake up at 5 am today to check my overnight sugars. That means I should go to bed soon.
I had to change which pocket my wallet resides in because the pump renders its home pocket inaccessibleish. Tonight is my first sleep with the pump and the tubing - I'm wondering what the likelihood of pulling it out while I sleep are, but I imagine they are pretty slim.

The insertion of the infusion set was rather painless - that's the thing that serves as the membrane between the pump and my insides. As the day goes on, I can't decide if I'm actually experiencing any discomfort from it. It doesn't hurt, but I can feel it on and in me - I suppose that's just a sensation I will need to get used to.

Saturday, November 22, 2008

After the fact, it occurred to me that I just took my last normal daily injection of long-acting insulin. The dose I will take tomorrow will have been lowered, and then I will be on the pump.

As of 10:30am ish on Monday, I will be on the pump. It's finally setting in that this is actually happening. Being on the pump has always been in my mind as such a far off thing - it's odd to think of how close it actually is. Even as I'm typing this, I keep thinking that I won't actually be benefiting until the first few weeks of set-up are done, but that's not true.

Bottom line is that I'm anxious, apprehensive, nervous, scared. Of course, I won't actually let these feelings negatively effect me, but that is just how I feel right now. Tomorrow, my last day as a non-pumper will go by far too quickly - diabetes aside, I have so much to do: ballet exam rehearsal, and of course learning that music beforehand, writing massive chunks of my thesis, paperwork, printing out scores for the people who are writing reference letters for me, and organizing myself for the pump start...

Friday, November 21, 2008

PrePump Training

Today was my 3-hour pre-pump training. We didn't actually touch our pumps, though. The nurse went over our rates and plan for switching from the long acting insulin to the pump. There was a little talk on how to take care of high/low blood sugars. Finally, there was a presentation by a dietitian.
I'm not convinced about the transition...they told me to cut my dose down, but only from 36 to 30. The starting basal rate on the pump is the equivalent of 26... so in effect, I will have 56 units in my system rather than 36... I will have lots of juice on hand that day. The cross over will be about 12 hours and will end just in time to go to bed. My plan is to take my last long-acting insulin early the night before, which will at least save me a few hours of discomfort.

The thing that I'm most worried about is the fact that I'm not supposed to correct high sugars unless they are above 13. I currently feel uncomfortable when my sugars are anywhere above 10, and I always aim for my sugars to rest at 5. The reasoning is that they need to see how my sugars are reacting to single doses of insulin and it complicates it if you have multiples..
[Imagine one person trying to do a task. It doesn't matter if they suck at it, you have to just let them struggle with it on their own so you can see just how bad or good they are.]

Mostly, this is a control thing - I have been in complete control of my condition for so long... I don't think I'm comfortable with letting someone else make these decisions for me. Especially this last year, I've been constantly making adjustments and I'm learning a lot and improving because of it - now I have to throw that all away for a few weeks!?!

Nevertheless, I have to go through these hoops to get the pump up and running, so I'll suck it up and be submissive to the Assistive Devices Program master for a while.
Then I'll say, "I told you so" when things end up being what I expected them to be.

As a point of reference, these are my predictions:
Basal Rate - 1.4
Insulin Sensitivity - 1 unit = 1 mmol

what they are starting me at:
Basal Rate - 1.1
Insulin Sensitivity - 1 unit = 2 mmol

The Sensitivity number is the one that bothers me most - yes it is good to be safe, but they are cutting mine in half! That means that even when my sugar jumps to over 13, the correction will be only partially successful. For example, if my sugar were 14, I would want to take 9 units, but I would only be allowed to take 4.5. If I am correct, then it would take me 3 or more hours to lower my sugar down to 9.5 - still double the healthy amount of blood sugar. If I were wrong, then I would notice that my sugar was dropping too rapidly, and I would know better the next time. I understand that they need to be safe, but I'm not going to like the safeness!

Thursday, November 20, 2008

Despite the fact that it starts at the unfortunate hour of nine, I am slightly excited for my pump training tomorrow.
The first 2 days of detailed food/insulin/sugar recording went well, but today I seemed to forget things.. Nevertheless, it should be enough information to get me started!

Wednesday, November 19, 2008

I filled some of that empty space on the wall in my room with post-it notes. It's like a tangible calendar of my deadlines and other notes to keep me on track.
Unfortunately, the notes don't stick very well to my wall, so I will have to find a more reliable adhesive which won't damage the wall.

I am into my last week as a syringe-using diabetic. I realized today, as I took some insulin in my German class, that it would be my last time taking an insulin injection in a lecture. My next class is Monday, so if I need insulin then, I will simply press the button. When I press the button, it will make a little noise, which is a good feature, but that will be a whole new issue to deal with - how many alarms and beeps I will put up with. Eventually I will set them all to vibrate, but to start I'll keep them all on so I get used to how and why it will make noises at me.

I am going to be getting new glasses sometime soon. One of the eyewear retailers here has a 25% off sale on frames for this month, so I will likely get them within the month. It's not that I need new ones, or that my prescription has changed, rather I have 200$ of insurance coverage for glasses while I'm at UWO so I need to make use of that before I'm done.
I currently have 2 pairs that I wear. My daily pair is conservative, but has transition tinting (not recommended), the other ones are much more stylish with blue arms. I am trying to decide if I want something zany just because I can, or another conservative frame so that I don't need to put up with the transitions anymore. Suggestions are welcomed, though I might pick them out tomorrow.

Sunday, November 16, 2008

Last night we had a little cracker party - we provided crackers and people brought things to put on or dip crackers into. It was also a salon party, so people were encouraged to bring music to play.

My roommate rightly pointed out that the cleaning we were doing before the party was just like the cleaning our parents used to do before they had company over. Only this time our mother's weren't telling us to stay out of the way because we were just making a mess...
As a result of the cleaning, the apartment was suitable for photos, so I finally took and posted pictures of my apartment online so people could see them.
To the left is the view of my apartment from my work desk. The piano, the kitchen, and the dining table are featured. The ceilings are about 12 or 14 feet (my numbers might be wrong, but they're really high).

You can see how high the ceilings are and how tall out windows are in this one(right). If you stand in the window frame, you can't even touch the top with your arms stretching up. Because we live downtown, the windows are great for people watching. The homeless people downtown seem to sit in front of the cafe across the street from us in shifts - morning, afternoon, and night - and each cast of characters provides a different type of amusement.
On the left is a picture of my room - it's pretty empty, I know. Since the walls are so high, I feel like I'd have to put huge things on the walls to even come close to filling the empty space, so I just don't. I like bare walls, maybe I'm crazy, but all I do in this room is sleep and take my insulin.


Ok, back to the party. It was quite successful - we had about a dozen people here. Lots of crackers and dips and spreads and wine kept people happy and full. No one else brought instruments, and only one person brought other music. My roommate and I performed some PDQ Bach specialties and later in the evening, we sang show tunes. Three people shared the role of pianist, by divying it up into duets. It's a lot of fun to play only the right of left hand of a piano part!

All in all, it was a delightful evening. There is little cleanup, other than washing wine glasses. I like having parties with respectful grad students.

Friday, November 14, 2008

World Diabetes Day

Today is World Diabetes Day. This year's focus is on Children and Diabetes - a topic that is close to my heart as... well... I spent a good chunk of my childhood as a diabetic.
Here are some hard-hitting facts about diabetes and how it relates to children.

I often get caught up in the way diabetes effects my life: hassles with insurance, paying for this and that, paperwork, having to overthink what I eat, feeling guilty about the foods that I should maybe avoid, the drudgery of routine. The first few of my concerns are actually good things - I have coverage for my drugs; I'm not like the millions of American diabetics who don't have coverage and, as a result, let their control slide. Still, I'm only thinking within North America - we are developed countries and still having concerns about where the money for medications is going to come from.
In developing nations, they simply don't have the money or even the access to the basic medications.
Even worse, they often don't know to properley care for their diabetes.
The worst case is that in many places, they still don't know enough to get diabetes even diagnosed.

I will stick with addressing the concerns I can actually help - I will inform those around me.
Getting my insulin pump will be the perfect opportunity! Using a pump in public is a great spring board for people to ask questions. I can tell them all about diabetes in general, the pump, some of the advocacy and programs that got the pump covered in Ontario.
Excitement.

Since my pump training starts next Friday, today was the last Friday that I will spend without an insulin pump at my side. Tonight is the last Friday night that I will sleep without a pump attached to my pyjamas.
This is actually quite exciting - I will be quite reflective this week. I've been on needles for as long as I can remember, and I've been carrying an insulin pen around with me since high school. It's been so integrated into my life, and now something else will take it's place. It's kind of sad in an odd sort of way.

Wednesday, November 12, 2008

I have a very poor concept of time, and I can't add. I was under that conception that it was much earlier in the month of November than it actually is.
I will have my pump training start in a week tomorrow, and then the following Monday, I will get hooked up. Though I am still quite impatient, I will survive.
I have compositions and applications to keep me occupied. Some of my applications for grad schools are due in barely over a month!

Impatience

I finally got ahold of the diabetes centre to book my pump training session.
DAMNATION!
Apparently the next training session is not until November 21/24, so it will be nearly 2 weeks until I actually start on my pump.
Why must I wait?!? I can't handle the anticipation.
I've been playing with the pump in training mode and done all the settings and read the manual, but I'm not allowed to start using it until I've gotten the official training.
It's just so anticlimactic; I've been waiting so impatiently for my pump and now it's finally here, only I don't get to use it yet.

Oh, cruel torture!

Tuesday, November 11, 2008

I had left a note, so they delivered it to the bookstore downstairs.
I am now the proud owner of my little insulin pump.

yet another update

so, I got the package that was en route yesterday...
It was two boxes of insulin pump paraphernalia, but nothing useful and certainly not an insulin pump.
I have been given the tracking numbers for the remaining 2 boxes that are en route, they are indeed on the truck for delivery today, of course on a day when I actually have to leave the apartment to go to school.
Would it really have been that difficult to shove everything into one box and send it to me on the day you said you would?!?

There's a slight chance that I'll have a pump later today, but who knows!

Monday, November 10, 2008

Apparently it IS en route - I got the tracking number and it was on the truck this morning...

Why would she lie to me?!?

Having spent my entire Friday locked inside waiting for my delivery, I was filled with excitement knowing that today is the day.
On the other hand, every delivery I've ever gotten has come in the first hour or two of the day, so if I wait the rest of the day, it's a lost cause. At 11:30 today, I decided to call the company and get a Purolator tracking number, just out of curiosity. To no surprise of my own, there is no tracking number on file - meaning that the pump has not left their warehouse yet today.
More than likely, I will not be getting my pump today...
BOO!!
As long as I get a tracking number out of them, then I can track it myself and not have to rely on their vague guesstimates!

Sunday, November 09, 2008

Having done a load of laundry today and not having the requisite 13 quarters needed to do another, I washed dishcloths by hand in the sink this afternoon. I actually found this to be a very relaxing and rewarding process, though my hands looked like shit afterward. Hot water, laundry detergent, and being submerged for so long are not things that hands like.
I guess there's something nice in the process of wringing and rinsing.

I'm taking a brief moment to think about how I feel about the insulin pump now, before getting it - this feeling is probably very different from what it will be like to be a pump user, and it's quite different from how I've felt about pumps for the last decade or so.
Having spent so much time convincing myself that pumps don't make much difference, I'm now trying to reassure myself that I'm doing the right thing and not just wasting resources.
In conclusion, it will be worth it and I have a feeling that I will soon feel some guilt over having effectively lied to myself about it for so long.

Saturday, November 08, 2008

Bland day

When the insulin pump called me and told me that it would be delivered either Friday or Monday, I should have known better than to get so optimistic.
I stayed in all day working on one of my commissions - I got some good work done, though not nearly enough. I am budgeting the rest of my time to my thesis between now and Tuesday.
It will be difficult to stay focused on Monday once I get my insulin pump - I'd better get it!

Thursday, November 06, 2008

Financial Stuff

I've been talking to one of my few loyal readers about the new Tax-Free Savings Accounts which will be available in Canada as of 2009.
I won't talk too much here, but it makes me realize that I really enjoy thinking and talking about financial stuff. I only wish It wasn't just applicable knowledge.... Once day I'll have money - one day!

Wednesday, November 05, 2008

Post 751

As I enter the third quarter of what might eventually be a thousand posts, I have happy news to report.
I got a call this evening from the Insulin Pump company and they said my pump will be delivered either Friday or Monday. If I get it early enough on Friday, I could do my pump info class this Friday and then I'd be up and running on a pump by next week! I will cross everything that can possibly be crossed. As I'm sure you can tell, I am very excited.

I'm wondering if I should make some kind of change to my blog to commemorate having posted 750 times... Not a superficial one, but maybe one of style. Having looked back over the years, my writing has gone through introspective phases, bland phases (which would be the current one), bitchy phases, ranty phases, and a few others that I can't find the words for right now.
Please feel free to comment and let me know what you would like to hear more of. I've been feeling lately that I need to be more creative, rather than put people through the daily chore of reading....as if anyone does that!

Monday, November 03, 2008

Merry Christmas

So, I got a call from my Diabetes Educator who has been helping me through the long and arduous pump getting process. I had that appointment with my doctor last week, and that was the last of the paperwork that needed to be done.
She called to tell me that within about a week and a bit, I will hear from Medtronic - the insulin pump company - to set up a delivery date/time. That means that I might have an insulin pump within 2 weeks!
I'll have to double check with the pump training center, cause they close down in December over Christmas, so hopefully there is enough time before that to get me trained and settled.
If there's not enough time, I'll start in the new year, but I want to start Now NOw NOW!