Saturday, 4 April 2015

Back on the pump

Tonight I was reunited with my insulin pump. A couple of months ago I made the decision to take it off, I decided that I wanted a break from it but also I felt like I needed to be back on injections to allow myself to find 'routine' again. I feel like I will always have to be the kind of person who has to consciously tell myself to test and give insulin, I often lose the routine of caring for my diabetes and when that happens wearing my pump isn't the best idea.

The pump has two main functions, one is to deliver insulin as a 'basal', the basal rates on a pump have the same effect that your background insulin injection (e.g lantus) would do. The difference is that the basal rate is a fast-acting insulin and so it continuously drips through the cannula all throughout the day and night helping to keep your blood sugars stable just as an injection of lantus or levemir does. 

The other main function on the insulin pump is the 'bolus', a bolus is an extra push of insulin through the tubing when you eat or need to correct, it's the equivalent of an injection of fast acting insulin. 

And the joy of the insulin pump is that all of this can be done with the push of a few buttons. 

However for me, the functions of an insulin pump that are so brilliant are both a blessing and a curse. 

What I'm saying is that a lot of the time that I've been on my insulin pump (more so in the past year or two) there have been times where I have become 'lazy' with it, so to speak. I relied on the basal rate to keep my blood sugars from going super high and I hardly ever bolused because I thought it wouldn't be a huge issue, I knew I would run high but I also knew the basal rate would cover me in terms of having insulin in my body to avoid ketones. So all in all I let my basal rates deal with the blood sugar and I fell out of routine over and over again. It's bad, I know! But it's the way things often got for me and that's why when I get like that I switch back to injections for a little while. 

Switching back to injections is a bit like a "fresh start". When you're on injections you have no choice but to inject or you'll develop ketones because there is no basal rate to keep you covered. So knowing that I absolutely have to inject or go into DKA is what helps me get into routine again because I bolus like I should and give the background insulin. 

And then come along wonderful blood  sugars and they help with my motivation because I work harder to keep them in range. After spending so long with constantly high blood sugars I found that I developed an "I've got nothing to lose' attitude and so often wouldn't test because I knew I would be high anyway  and/or would test, see that I was high and just not do anything about it because I didn't want to deal with it and/or think "I'm high anyway so I have nothing to lose if I don't give insulin for this". So my point is that seeing good blood sugars is a real motivation for me in itself because I try harder to keep them that way once I achieve them. 

And with better blood sugars and having to inject or risk DKA comes the routine. I manage to find it again and I find myself again and I remember that being high all the time is not okay. 

So after having a two month break from my insulin pump I feel ready to put it back on again. However I'm taking it slow and will only be using it for boluses and corrections, my background insulin will still be done as an injection of lantus to help me avoid becoming reliant on it and not bolusing as I should. 

I hope this is the last time that I've had to switch back to injections from my pump. I don't want to spend the rest of my life not being able to keep up the routine, I don't want to continue having these spells of laziness and complacency with my insulin pump. I want to be able to stay on the ball properly and be able to do this properly. I don't want to be the kind of person who will never quite fully grasp the act of controlling diabetes, I want testing and giving insulin to come easy to me, I want it to be permanently etched into my mind because that way I can be me. 

And me is someone who wants to be healthy and happy and live life to the full,  I don't want caring for diabetes to always have to be such a challenge for me. 

When I was diagnosed I was told looking after diabetes would become as routine to me as brushing my teeth, six years later I'm not quite at that point but I'm getting there and switching back to injections has helped me reduce my HbA1c from 12.9% in January to 8.9%. 

I still have a way to go, but let's hope I can keep up the good work. Seeing a HbA1c under 8% is a massive goal for me and I'm going to fight damn hard to get there. 

-Ellie