Monday, 20 June 2011

A fraught few days

A few days ago I started to use Humalog instead of my usual poison, Novorapid. It's been a bizarre few days. On the Humalog start day (H day) I woke up to a fifteen point something or other. Not a pleasant way to start the day. I was obliged to correct my BG and leave it a little while until things were back in order. The second day was one with near perfect BGs. Yesterday was the first day at work on Humalog. A very nice day. I suppose the success were more attributable to me getting the temporary basals right. Then again, Humalog does feel like it is a more forgiving insulin than Novorapid was. My insulin to carbohydrate ratio is the same. It doesn't seem like I need to tinker with that as yet. Thankfully.
Today hasn't been too bad. Well, It could be worse. I was fine when I woke up at three this morning (BG of 7.5) but when I awoke a few hours later (ok I got up at ten) I had a 12.7 which was something of an irritation as I've been going to bed on decent levels and waking up very close to the level I went to sleep on. Secondly I thought my pump was going to pack in. Fortunately it hasn't packed up. After a bolus not going too well because the pump was giving off very unpleasant sounds I phoned Medtronic. After a rather panicky conversation with the lovely woman at the end of the phone it has been found that all is well. I've just changed cannula and gorged on ice cream. I can't be arsed with testing my BG for a while now. I just want to get today over with! That and I just want to forget diabetes again. Some bloody chance.

Friday, 17 June 2011

What's your poison?

All ready for the morning...

A little while, when I last saw my DSN (see post The King is dead, long live the King) ago the decision was made for me to switch from Novorapid to Humalog. I picked up the first vial of that today. Tomorrow is the big day as I've got enough in my current tank to last me until tomorrow morning.
It'd be fair to say that I'm a little nervous of this change to Humalog. I suppose the change is a good thing. At the time the decision was made I was having a rough time of it on the Novorapid. True to form, things are now behaving prior to the big switch. I'm more scared of having to make changes that I suppose will be needed with a new insulin. Just as things were getting good.
I'll make the change tomorrow morning. New reservoir, new set and, most important of all, new insulin. I suppose I'd best start with a completely fresh everything really. I'll be using a Sure T set as well, those just don't fail unless you're really, really special. I've yet to meet someone whose skin has caused a steel cannula to kink.
What the more shrewd amongst you may notice is that I've filled up a reservoir. The change is more than twelve hours away. I always pre fill my reservoirs as I find that I get fewer bubbles left in them if I leave them to stand and the bubbles dissapate. It's like leaving a pint stood at the bar for too long, all the fizz goes. Not desired in beer but most certainly desire in my pump reservoirs.
I'll put something else up after a few days on my new poison. This'll be interesting as I wonder how long it'll take for the dregs of the Novorapid to get out of my system and for the patterns of the Humalog to make themselves known.

Wednesday, 15 June 2011

I had a good day yesterday!

Yesterday I had a day when my BGs were pretty much perfect. I'm still trying to work out how I did it but more on that later as here are the scores:

09:44 - 6.7
10:25 - 6.5
14:16 - 8.5
20:23 - 6.2
23:15 - 5.0
23:45 - 4.8

I'll be buggered if I know how I managed to do that so here's what I did in the day.

Woke up at quarter to ten then went back to sleep until half ten. Massive breakfast of beans on toast smothered in cheese. Arse around and watch TV.
Quarter past two I ate lunch. Two rather large sandwiches and a monstrously sweet cup of tea. I used a take on the super bolus way of doing things. I gave my usual bolus for the carbs that I had plus a small correction to take things down then I put on a temporary basal for an hour and let it roll. I wandered into town to go shopping after that. It's not usually a BG friendly activity as I tend to get rather stressed and fed up with shopping after all of five minutes. I managed to waste a few hours and eventually (after much swearing and moaning) but eventually got what I wanted. Then I went to the pub and chilled with a few friends who I used to live with last year. a few pints of the great Sussex relaxation aid Harvey's Sussex Bitter. God I could live on that stuff.
In my last post I moaned about how things just weren't going overly well. I suppose I just needed to kick back and live life without diabetes being at the helm. I suppose the point that I'm trying to make is that whatever we do to stop diabetes from getting to be the forefront of everything it still manages to get there from time to time. That's when we need to step back and take a miniature holiday from the D. Well, I say a holiday I mean taking it easy for a little and doing anything to take the D from the front of my mind. I reccomend a few pints of the aforementioned Sussex relaxant. Does the job everytime especially if you choose to take it in the sun and beautiful surroundings of a pub garden. Always needed.

Sunday, 12 June 2011

Until tomorrow...

Today I just can't be bothered with diabetes. That's why I want to leave everything to do with it until tomorrow. Except I can't just put it off. For the past few hours I've been fighting to bring down a 15 mmol/l but it just hasn't happened despite a cannula change and that sort of thing. I'm hoping that the Silhouette set that I put in about four or five hours ago hasn't failed as I'll be rather pissed off to say the least! Normally I don't eat if I've got a high like that going on. I've left that for tomorrow.
Leaving things for tomorrow, so to speak, has it's pros and cons. Firstly, my 15 mmol/l won't drop as quickly as I'd like it. Then again, the stress that it brings about would make it harder for things to drop so to avoid some stress I've just given in to eating as not eating drives me up the wall and therefore makes me stressed.
I've corrected the BG of fifteen with five units. In theory that'll make my BG drop to five but now that I've eaten, it won't happen for a while. What else have I done then you might ask? I've whacked on a temporary basal of two hundred percent in an effort to bring things down. This'll help things drop quicker. If it works it'll be nice but I've a sneaking suspicion that it won't be working. Hope for the best and prepare for the worst. I'll be loading up a reservoir with fresh insulin and finding a set to use instead of the current Silhouette that I've got in. Probably a Sure T as those just don't fail. A Quickset is also an option as I don't really have trouble with them so maybe that's on the cards.
Tomorrow I will pick up the diabetes ball again even though I haven't really dropped the ball today. I just want to put in less effort. Every finger prick is much harder than it was yesterday. Bolusing is just above and beyond the call of duty. Even so I'm still doing it. What I'd give for a day free of diabetes... I'd almost settle for a day of decent bloods with little or no effort. I don't allow myself to dream of that much at all because it tends to get me down. This is the disease I never asked for nor wanted. It is Moriarty to my Holmes, my perpetual nemesis who I can never vanquish, merely stay equal with.

Thursday, 9 June 2011

I read something today!

Ok, for those who know me, I am something of a voracious reader. I'm currently working my way through Victor Hugo's Les Miserables. Quite an epic and something I consider should be read by everyone. We all have alot to learn from the Bishop of Digne, Jean Valjean and Insepctor Javert. I digress. Today I read this post on Six Until Me written by the lovely Kerri and it got me thinking.
The question is that of need versus that of want.
Now in the fluffy bunny, hippy loving world that the small, repressed and generally hated part of my mind that is rarely let out of the box we would all have what we needed to manage our D to the best of our abilities. However, the part of me that is usually expressed knows full well that this is never the case in the NHS upon which we so readily depend and love.
I would love a CGM. This is something that most of the folks across the pond have seem to be able to access this wonderful technology with comparative ease. The same goes for pumps. On the other side of the pond in The Sceptered Isle we go through hell high water to keep outselves in decent nick. Now, I am well aware that I have had a damn easy ride as opposed to some (see Siobhan at Click Of The Light for further detail
Back to the point in hand. I would love a CGM given the amount that I believe it would benefit me. As it stands there is nothing like the NICE quidelines which exist to make insulin pumps available to all who need them (well that's the theory at least) there is nothing like it for CGMs.
Now a CGM is a very gucci piece of kit which serves a very good purpose. I would love to have a twenty four hour picture of what my BGs are doing. That and I would love to see what they are doing on a screen without stabbing myself. Now I do know that a CGM is not a replacement for BG sticks. It would be a hell of a help given the line of work that I am going to go into. Nursing is a hell of a job it's demanding. Then throw in diabetes. When you combine the two you need every little bit of help that you can get. A CGM would help me so much. It would give me so much more information as to what happens to my BGs during the thirteen hour shifts that I do at work. Remember, a BG stick is but a snapshot. Basal testing is the most impractical thing when I am at work for many reasons. I need to see trends so I can have a good chance of getting a basal sorted for work so I am less at risk of hypos and that type of things. At the end of the day, I am a liability if I am not in decent control of my diabetes. I can get days with decent control and some when it's night on impossible to maintain control. A CGM would do very nicely at keeping me in check or helping me to keep in check. If I find a CGM friendly consultant I will happily play the patient safety card to get what I want. At times, I wish I had some form of health insurance that would fund this for me. If I had the money, I would self fund it. However, on a band two NHS salary you can just about live let alone fund that sort of technology. At the end of the day I want one of these things because I have that thing that most men have. Gadget fever. That and I'd like to maintain good control over my diabetes. I need one because I want to be as safe as I can be in terms of diabetes in my chosen line of work, nursing. I suppose the need is greater than the want which I have for this technology. Only just. As with everything pertaining to diabetes it is always a balancing act, albeit one from hell.

Thursday, 2 June 2011

The King is dead, long live the King!

I saw my fabulous DSN yesterday. The result of that encounter is that I am going to change from my current preferred tipple of Novorapid to the alternative which goes by the name of Humalog.
There are many reasons for this. One of the key reasons is that my basals have changed so vastly since the last time that I saw my DSN, as has my insulin to carb ratio. We're begining to think that my body has started to take a set against the Novorapid, which I hasten to add I have been on since 2002 or 2003 when I started using it in pens. I believe that it came out onto the market around that time too. My DSN also uses Humalog in his pump. It's supposedly a little more pump friendly than Novorapid. I don't know if it's possible to start to become resistant to a certain insulin but it does feel like this is happening with me at the moment.
I've also got to refine my insulin to carbs ratio. the rough cut has been done, so to speak, by putting me onto the one unit for every seven and a half grammes of carbs. I've a feeling that I might be able to get better post meal results with something like one unit to eight to nine grammes of carbs. Well, I say better results, I mean the two hour post meal readings are pretty damn good, almost too good at times. I also appear to be able to drop into a few hypos about three hours or so after meals. I do love low readings post meal but when they are so good they make me think I'll hypo, well, things need to be done. I'm almost due a check two hours after my lunch. That and I'm planning a little bit of a basal test this evening. Nothing like getting it all done at once eh?