Tuesday, June 17, 2014

Now the fun begins

Today is Monday 16th June. It is also the first night that I will hand over control of my insulin pump to a smartphone and an algorithm. The low suspend safety function on the pump will be switched off and the pump will respond to information from my sensor by itself.

As I sit at the station waiting for the train into town, with my backpack and computer bag I start to think about all the what if's. Suddenly I want to phone my daughter, to say to her, "If it all goes wrong, remember I love you, everything you need to know is on my computer and there's a back up disk on my desk at home."
I can't phone her, she's at work, but the urge to tell her is so strong, I start to sms. Her response is swift and short. "Geezuz! Don't panic! I'll call you after work tonight."
I get on the train feeling quite surreal. A good friend calls on the phone and I tell her my fears, she listens patiently and kindly, and quietly brings me back to earth. I tell her, "I feel like an astronaut getting into the space rocket."
Once at St. Vinnies, my medical team settles me in, they are a diverse mob, intelligent, articulate and full of amusement at my fears. "The pump CAN'T go spacko and give you a massive overdose, it's got maximum bolus settings, remember? In fact you're more likely to overdose with an injection." says my DNE.

I remember the time I took a long flight and arrived in a town early in the morning, with insulin pens and no needle caps for them. I made the Taxi driver take me to a pharmacy to buy a syringe so I could draw up the insulin and inject. Sitting in the back of the cab I realised as I finished injecting into my thigh, that the syringe I'd purchased was in units ten times the micro units I normally used and I had just injected ten times my normal dose. The taxi became airborne as it crossed intersections where the road surface humped. The driver dropped me at the hospital emergency entrance and took off without his payment. I spent the whole day attached to a glucose drip on a trolley in the emergency ward. They wouldn't draw a curtain around me for fear that I would slip unobserved, into a hypo. I felt like I was in a glass bubble, like one of those people who are born without any immune system.

The set-up checks begin, did I put a new sensor in on Saturday? Have I put a new pump line in? Am I ready for dinner? 68gms of carbohydrate. This time it's packet Lasagne, followed by biscuits and cheese. Thankfully my lovely DNE has brought in some fresh spinach leaf to add some greens. I'm prepped with a cannula in my left arm for the hourly blood taking.

So here I am and everything is working brilliantly, the smartphone screen shows my bbl levels tracking and the pump insulin delivery tracking right alongside of them. My BGL goes up, the insulin delivery goes up, my BGL goes down, the insulin delivery goes down or stops. It is extraordinary.

 People come and go, mostly wanting to talk and while away the time on the long overnight shift. I want to focus on what I'm feeling and prepare to try and describe it for you. The vein with the cannula in it collapses and decides not to allow any more blood to be drawn. A new cannula is inserted into my right forearm. This one is more comfortable than the one in the inside of my elbow.  By midnight I'm feeling more secure about what is happening, but my levels are drifting lower going as low as 4.8 before turning back up. I can't sleep if I'm lower than about 5.5 and I spend an extra hour or so restless and hungry. I decide not to eat, and to allow the system to right itself and by 1 pm I'm back up to 6 and thankfully drift off to sleep. I'm aware of the nurse coming and taking blood every hour, but basically I don't care and I stay asleep until 8am!
Top line BGL, Bottom line Insulin dosing, currently delivering 0 units p/hr as bgl drops.

The system is an 'intelligent' one. All the fine tuning we've been doing over the past couple of months has been uploaded to the system so it can 'learn' my responses to insulin and glucose.
One of the side benefits of taking part in this type of research or clinical trial is that you are given an opportunity to intensely focus on your health. I have never had such good results from using the pump as we are currently achieving after two months of cgms and fine tuning. To all those doubters out there, all I can say is pumps and cgms are awesome!

The next step will be for me to have the system switched on at home for 4 nights in early July.
I can't wait!

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