Pump upgrade: Medtronic 640G

Since I last posted on my blog, a few things have happened...I turned 18, booked my first driving lesson, and yesterday I got my new insulin pump!

June 14th marked exactly four years with my purple Medtronic Veo, or as I liked to call it, Maurice. Maurice and I had a good four years together, there was a slight love-hate relationship going on but on the whole I loved my Veo. It had been through a lot...I dropped it in the bath accidentally a couple of times, dropped it on the floor countless times, let it swing from my body many times, accidentally bashed it on cabinets and door frames and experienced the dreaded 'Button Error' which thankfully did not amount to anything more. Through all the rough and tumble, it survived all four years with no replacement pumps! I did return a very scratched up pump to the hospital, but it was my original pump and it proved to be a very robust pump indeed.

I've moved on from my purple Veo, Maurice, and have a new insulin pump- the Medtronic 640G! I went to the hospital yesterday to get the pump along with a couple of other people who were also upgrading their pumps and we spent from 2-4pm learning all about the 640G and it's different features. In general, I love the look and feel of this insulin pump, it's sleek and it looks modern and the buttons have a nice 'click' to them, if that even makes sense! The colour screen is a huge improvement from the older Medtronic pumps, it no longer looks like an old Nokia phone with the game 'Snake' installed. The fact that it is waterproof really excites me, I mean, my old pump did come into contact with water more times than it should have done...but it was ok, and so I like to think that the old pumps are water resistant to some extent. I'm looking forward to plunging my 640G into the sink one day to really test out it's "waterproof-ness" (That's not a real word I'm sure), but I won't be doing that any time soon, it's too new!

In terms of the actual functions of the pump, they're also pretty cool. I love that you can stop a bolus. If you change your mind about how much you're going to eat or if you want to eat more then you can stop the bolus, the pump will tell you how many units it had already given you, and then you can go ahead and set up a new bolus. On the old pumps if you wanted to cancel a bolus you had to suspend it which in turn suspended everything, including your basal rates, whereas with the 'Stop bolus' feature, it just stops the bolus, nothing else...your basal will continue and won't stop either. Whatever it has just given you, will go straight into your 'Active insulin' which now shows up on the home screen, unlike on the old pumps were you had to press 'ESC' to bring up the screen and then scroll down to see your active insulin. You can also change the volume of the alarms, and set it to vibrate or sound...it's a bit like a mobile phone in the fact that you can see what sound setting you have on in the status bar. To save battery you can make it "sleep", so you can make the screen go off and it won't suspend insulin delivery or anything. If you're wearing a sensor then the home screen will display the sensor graph, if you're not wearing a sensor then it will show your most recent BG for 12 minutes, the Medtronic rep told us that they chose 12 minutes as the time frame to display your BG because after 12 minutes you might have checked again if you were low and after 12 minutes your BG will have most likely changed.

The buttons light up which makes it so much easier to use in the dark, the carbohydrate and bg screens are all on one screen now, whereas with the older pumps you had to enter your BG, then press ACT and then move onto the carbohydrate screen and if you wanted to go back a step it would make you re-enter the carbs. If you're on the menu you can just hold down the back button and it will take you all the way back to the home screen, but if you don't want to go back to the home screen then just press back and it will take you back a step...but if you're changing insulin settings or anything like that you just have to make sure that you press 'Save' before going back to the home screen! I also enjoy the fact that it has little icons up in the status bar such as an insulin vial icon that is green and turns red when you're low on insulin, it also has a green battery icon that will turn red when you're low on battery.

Last but not least, this insulin pump has 'Smart Guard' on it. This feature is activated when you're wearing a sensor with the pump, it will suspend insulin delivery when the sensor detects a downward trend in your blood sugar. You set a 'Low limit' on the pump, which is something like 3.4mmol, and the insulin delivery will be suspended when your blood sugar is 3.9mmol above your low limit and it detects that your blood sugar is falling...it will then resume insulin delivery once your blood sugar is back to normal, or your can resume it manually once you know your blood sugar is back to a safe range. What I learnt yesterday during the upgrade that this is a very sensitive sensor and it can fail or end early. For example, the Medtronic rep at the pump upgrade told us yesterday that if your blood sugar is not stable at the time of calibration it can reject a calibration and will tell you to do it again, two rejected calibrations in a row will make the sensor end because it will suspect that something is wrong with it and tell you to put in a new sensor. Another tip the Medtronic rep told us yesterday was not to calibrate it too much or it will get confused, the best times for calibration are before meals or at a time when you know your blood sugar is stable. My sensor ended yesterday after two failed calibrations and so I am yet to experience the Smart Guard feature as that was my last sensor until I order more, but I will be sure to blog once I have a sensor on and once I experience the Smart Guard.

That is all I have to say about the pump and it's features so far, but overall I really like the pump and I think the fact that it still has tubing is made up for with it's really cool features.

-Ellie

Low blood sugar

Since getting my blood sugars back under control I've noticed that I tend to experience low blood sugar more often than not, it's not a major issue but I would preferably not have to worry about low blood sugar more than I do under normal circumstances. My consultant reduced all my basal rates by 10% when I last had clinic and that is a really positive step for me because it shows that my body is using insulin as it should be and isn't putting up any resistance anymore.

In light of the subject of low blood sugar I'm going to talk about what I now know to be my first ever low blood sugar experience. This particular experience took place before I was diagnosed, I can't remember exactly how long before my diagnosis it was but I don't think it was long before. I know you're probably wondering how it was possible to experience a low blood sugar if my beta-cells were being killed off by my immune system at that very moment...and I wonder that too, but it happened and I am certain that what I experienced was low blood sugar- although I actually really had no idea what was happening to me at the time.

We had just arrived at my auntie and uncle's house in Clacton after a drive that was about an hour and a bit. I felt funny but ignored it. As soon as I got out of the car I immediately felt weak and my legs were shaky- I had never ever felt like that before this moment so I was a little bit disturbed but to be honest I didn't think anything of it...I put it down to sitting in the car for a long time. I had the sense that I needed to eat and thank goodness it was lunchtime! I couldn't make any sense of the situation, all I knew was that I felt terrible and I needed food- and so I ate (loads!) and I felt better right after lunch. That confirms it even more that I experienced low blood sugar at that moment, but I didn't know.

What I didn't know was that this feeling would soon become something that I know and can make sense of, what I didn't know was that the horrible weakness and jelly legs would be a sensation that I would and will experience many more times in my life. I still remember being quizzed by the nurse at the hospital after I was diagnosed, I was going home that day and she asked me questions about the symptoms of low and high blood sugar...I found this so daunting because I wasn't exactly sure and couldn't really differentiate between the two just yet as I was still taking in my diagnosis of T1! Needless to say I didn't quite manage to answer the questions perfectly, but I soon became to know the signs and symptoms that my body gives me if my blood sugar is high or low.

I feel like I might aswell tell you about my lowest ever blood sugar- my lowest ever blood sugar was 1.9mmol, I know there are people who have had blood sugars lower than this but this was a particularly unsettling experience that I wish not to repeat. I didn't feel too horrible at first, I felt shaky and knew I had to check my blood sugar but I didn't think I was as low as I was. So I picked up my testing kit and went to sit on the sofa and I opened my testing kit and set up my finger pricker and put the test strip in my meter but I couldn't get any further than that...I tried to align the blood on my finger up with the test strip but I was shaking so much that this was an impossible task and I was beginning to experience tunnel vision and getting dots in my vision so I gave up and I called my parents in to test my blood sugar for me and I just laid on the sofa waiting for the reading to flash up on the screen. It was not a nice experience at all, and I remember literally eating so much for dinner in order to bring my levels up and make sure they stayed up.

Recently my body has been exhibiting a couple of new symptoms of low blood sugar such as experiencing a wave of nausea (really annoying symptom because I don't immediately realise that I'm low when a low presents itself in this way!) or it just doesn't give me a sign at all until they reach the 2's and then I start to feel light headed- also very annoying. I also tend to get a numb/tingly mouth, it's hard to describe it and it's very strange.

The experience of low blood sugar seems to be ever changing. New symptoms, new hypo treatment ideas...It's the blood sugar extreme that scares me the most, it makes me anxious and it's the most irritating because it always makes you stop whatever you're doing. But it comes along with the insulin that keeps me alive, and it's paired with the high blood sugar that tries to damage my organs, and it is all in all part of the "gift" that no beta-cells a.k.a T1 diabetes provided me with the day I was diagnosed.

I deal with it...and it introduced me to the "original" version of Lucozade...which by the way is not my cup of tea.

-Ellie