Friday, 10 April 2015

Bionic Clare

Ok, so before my last visit to the diabetic nurse (January), Paul and I had some serious discussions about me going on to an insulin pump to help manage my diabetes.  Since having Seb 4 years ago, my control has not been great.  Given that I have only been diabetic for 6 years, that's a big chunk of time.

It was time to get serious, and manage this thing properly.  Given everything that has happened in the last year, I owe it to my family and myself to try and prolong my life as much as possible.  Minimizing the risks for diabetic complications has got to be a good way to go!

So when I saw my diabetic nurse in January, I told her I was up for the pump and a continuos glucose monitor (CGM).  To say she was happy was an understatement.  She began the referrals.  I was tested for my hbA1c that day, and it was 8.2%.  A little high, but not the highest it has ever been.

I saw a diabetic educator in February.  I had met this lady before when I did a trial week on a CGM about 18 months ago.  I took Paul with me for this first appointment, as he needed to know everything that entailed it.  I think it was an eye opener for him.  Unless you live with someone with diabetes, I don't think you can fully understand what they go through.  Even then, all you can do is support, and Paul is awesome at that.  In that appointment we got to look at various insulin pumps and CGM's on the market.  All have their good and bad points.  Some are much better that others.  What suits one person, may not suit another.  I had been happy with my Dexcom when I trialed  it, so stuck with that for a CGM.  I decided on an OmniPod for the pump itself.  My main reasons were no wires, a blood glucose monitor in the hand held device (PDM) which communicates with the pod on my body, and an insulin wizard in the PDM.  This basically takes your blood glucose reading, you enter in the carbs you are gonna consume, and it calculates your insulin needs using pre determined ratios.

Confused yet?

Typically, my insurance decided to keep me waiting until March before they approved anything.  In this time I was dealing with representative from Dexcom and OmniPod via phone and email.  They were pleasant enough, and very pleased I had chosen their particular products.  

My Dexcom arrived in the second week of March, so I went back to the diabetes educator.  I saw a different lady this time, but she was just as nice.  Because I had been on the CGM before, it was a fairly easy appointment.  I left with one of these attached to me.

This is not a necessity.  I am not supposed to use it to make decisions about my insulin dosage.  It is ther to show trends and alerts.  It's a godsend.  I love it.  It shows me when I am high or low, and it is pretty small. The device itself is about 5 centimeters by 3 centimeters.  The sticky is bigger though.  It is pretty easy to put in, no more painful than an insulin shot, and each sensor lasts a week.  

This is the electronic device that goes with it.  What a pretty graph!  My aim is to get the line as flat as possible around the 100 mark, with slight peaks when I eat. It is not always accurate, and I have to calibrate it twice a day, which basically means checking my sugars.  That is fine by me!

Two weeks later, my pump turned up.  

The following week, on the last day of March, I was back at the diabetes educator.  This was the week after Oliver's operation, so he had the joy of coming with me.  We set up the PDM, with all my ratios and corrective doses.  A little note about this:  I have known these since I went on a Dose Adjustment For Normal Eating (DAFNE) course in the UK about 2 months after I was diagnosed.  This course, along with the good care I received in England enabled me to keep my sugars good all through Sebastian's pregnancy and after.  Pretty much till we moved here.  Nothing like a massive life changing event to throw you off course somewhat....

Anyway, we set up the PDM, and she showed me how to apply the first pod.  I have to fill it with insulin froma vial using a syringe, just like diabetics had to inject themselves till not too long ago (and some still choose to today!).  The insulin then goes into the pod. It beeps when full.  The pod is placed next to the PDM so they can communicate.  Once they have said hi to each other, the pod can be attached to me.  So far I have chosen to have it on my belly and my arm, but it can also be worn on the back and the leg.  I am thinking leg a lot in the summer when I am living in skirts and shorts.
The pods only last 3 days, and need at least 85 units to fill them.  I don't even hit 100 units in 3 days yet, so I am working on the right amount to fill the pod.  OmniPod have a pod recycling system which is awesome.  You collect them up, send them back in a pre addressed bag, and the postage is free.  Brucey!

CGM on left, pod on right, stomach sucked in

I had to go back 2 days later to the diabetes educator so we could change the pod, and discuss the ratios.  We made some changes.  I managed to bust my next pod by putting the syringe in at the wrong angle.  It didn't like that, so we did not use it.  The pod beeped at us for the next 3 days.....  The next one I tried was fine.

I also had to not exercise and not snack for a week, just so we could know the base line of insulin is right.  The not exercising was much harder than not snacking!  I think we have the baseline right now.

All in, I absolutely love my new devices.  It may take a bit of extra time to set them up, but once they are running it is a case of testing blood (did that anyway) and pressing a few buttons.  I have had a few instances with the stickies holding them on coming lose, but I have some tape, and a friend has recommended some sticky tack to go on them.  May have to invest in some......

Pod on back of arm

I saw my diabetes nurse on Wednesday.  She is over the moon about the devices.  We discussed many hints and tips regarding exercise, drinking and day to day life.  I won't bore you with it, but if you have got this far, you have done well.  

She also tested my hbA1c.  It was 7.8.  The lowest it has been since coming to America.......


I have been most fortunate regarding health insurance here.  Although our insurance company took a while to approve both devices, when they did, they covered them both 100%.  I get my supplies direct from OmniPod and Dexcom, and they bill the insurance company direct.  It is thanks to Paul's contract that we have such good insurance, they basically have to cover me for everything the NHS would cover me for.

Would the NHS cover these particular devices? Unsure.  I know they are both on offer on the NHS, but I don't know how often they are taken up/ advised for.  If you have any knowledge on this, please comment below, I would love to know!

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