Monday, April 28, 2014

Closed Loop Here I come!

Day One of the big research project and I have to be at the hospital by 8am. Up at 5:30, I'm worried about not taking the dog for a walk and I leave the house with the back door wide open so she can go outside. She looks at me lazily and only gets up 5 minutes before I leave at 6:40.

I'm anxious about parking in at the hospital, I'm broke and don't want to spend money on parking fees, so I catch the train to North Melbourne and ride my bike up along Victoria Pde., to the Daly wing at St. Vincents. The Diabetes Education Department is on the fourth floor in an old ward which looks as though it hasn't been repainted since it housed patients. I wonder about the psychological impact of such an old building on the people who work here.

My appointment starts at 8am and the morning is spent meeting the team who will be working with me over the next two and a half months. 

I meet my 2 DNE's, the 2 research Doctors, the 2 Psychologists and the woman who brings the Actigraph 'watch'. I sign the consent form. The pump and sensors that I will use during the next 14 weeks are set up. I put on the Actigraph and agree to fill in the 6 day record keeping sheet that accompanies it. The actigraph is basically a movement sensor that records information about my activity during the day and at night when I sleep. (Little do they know that I'm a very restless sleeper, I worry that they won't be able to tell the difference between when I'm awake and when I'm asleep.)

There’s more filling in of questionnaires and participation in an extensive interview with the psychologists about how I feel about using a pump and cgms, what I think I will feel about the 'closed loop' period of the study and what my expectations are. This gives me pause for reflection and when I say I think I will find handing BGL control over to the technology, 'confronting', I realise what a control freak I am about managing my own BGL's. I am measured and weighed and am delighted to find I'm a kilo lighter on their scales than on mine. I'm blood tested and blood pressure checked.

I spend half an hour practicing Cognition tests on a laptop that I am to take home for when I am doing the monitored sessions at home. The tests consist of recognising cards and the patterns in which they are shown. I will need to do these tests in the evening before sleep and first thing in the morning as soon as I wake up. I don't like to think what the results will look like if I've had a couple of glasses of wine with dinner. I think this is going to be the funniest part of the program. The tests are unutterabley boring and to have to repeat them morning and night is probably going to make me fall back to sleep when I’m supposed to be getting up.

I also have to do urine collections while in the monitored phase of the project. The last time I had to do a urine collection was when I was living in Townsville and the Walter & Eliza Research Institute called for participants in a research program they were running. I dutifully collected around 2 litres of urine and carefully placed the large plastic bag inside a foam '6 pack' esky they had supplied, taped it all up and had it sent back via airline transport, from Townsville, Qld., to Melbourne..... unfortunately the plastic bag broke in transit.....

I’m relieved to find that my first round of the program will be  a ‘dry run’, everything will happen except for the activation of the closed loop. I will be wearing the Actigraph, the sensors and of course the pump, and they will all be connected (wirelessly, thank heavens!) to the web-based monitor which is actioned through some sort of smart-phone ap. (This bit I haven’t seen yet). My DNE tells me that while I am sleeping 'hooked up', there will be up to 4 people monitoring me as I sleep, one of them in California!

At 1:30, I’m given a late lunch at the cafeteria, where the barrister makes me a beautiful coffee and finally I'm sent home with 2 boxes of sensors, a new pump, a new meter and strips, and the Actigraph!
I’m feeling a little over-awed.

The monitored sleep sessions are set up like this:

1.  In 2 weeks time, I have my first overnight stay in St. Vincents
2.  2 weeks later, I do 4 nights connected to the monitoring system while at home.
3.  6 weeks later, I do another overnight stay at St. Vincents. This time with the closed loop activated.
4.  2 weeks later, I do 4 nights connected to the monitoring system with the closed loop activated, while at home.

So that's it for the first big day. Now I have two weeks of using the sensor,  filling in the diary for the actigraph component to set up a baseline about my sleep patterns and living normally. 

If you've got any questions - leave a comment and I'll try and answer you.