By: Ali Murphy MD
Hi all,
I've got lots to say about pumps. I like mine very much (MiniMed 507), and while I would have preferred the 508 which comes in a very pretty green, my bright blue 507 is just fine. I started pumping 9/12/99, the day after my 27th birthday. Cool present!!
I decided to go on the pump because I was getting tired. I was on Humalog and Protaphane, but the Protaphane and I didn't get along too well. I was routinely low between 1 and 4am. I would get up, eat and go back to bed. No big drama, except I was missing up to an hour of sleep a night. And getting very tired. At the time I was in my first year of clinical teaching as a Medical student, so I spent the day seeing patients, assisting in surgery and so on. I really needed to be on the ball.
I whinged to my endo, and he suggested various things, which I tried, then I told him I wanted the pump. He wasn't especially keen, but I gave him website addresses and information, and he seemed to think it was an ok idea. I would have done it anyway. The MiniMed lady, Vicki, gave me lots of helpful information, and strategies on dealing with insurance funds. We agreed on a date - it had to be between a friends wedding, my birthday, and my final practical exam for the year. I had to be admitted to hospital overnight, because my endo is a worrywart, and because of the way the insurance works (it's actually the hospital insurance, not extras, that pays for the pump). I felt like a complete fraud, but there you go.
The pump education was quite straightforward - considerably less involved than my VCR. I'd been sort of counting carbohydrates with my regular shots for years, so that wasn't a problem. The sterile technique is quite easy too, after a few practices.
The first time I stuck the cannula in my belly, I was extremely nervous, but I had approximately half the hospital watching, so I couldn't show it. It didn't actually hurt. It does sometimes, just like ordinary injections, and sometimes I need to pull it straight out and try again. I hit a vein once, and had a fairly spectacular bruise. There was no way I could have left the cannula there - way too painful. Mostly it's fine though. I stick it in, no pain, and it's fine for 5 or 6 days. That's not recommended practice by the way.
Wearing a pager sized thing 24 hours a day can be tedious, but as a junior doctor I have to anyway. I have adapted my clothing style a bit to make wearing it a bit easier - less elastic waisted clothes, more fitted. I've lost a fair bit of weight too, so that helps. Some nights when I'm on call, I have my pump, the arrest pager, and my hospital phone - I can hardly move without my pants falling down. The only time it is really inconvenient is mornings when I can't be bothered getting dressed, and wander around in my sleepwear (tshirt and underwear). There is nowhere to put the pump, so it ends up on the neck of my tshirt - very sexy - not!
Regular things like sleeping, showering and the other "s", are very straightforward. One can disconnect the pump at the tubing, and reconnect it later. I do gymnastics and trampoline sports, and I disconnect for these activities, but for running or cycling I stay connceted (not that I run unless I have to). I have to be fairly careful about where I put the cannula for gym - uneven bars with a cannula in ones lower belly is not a good look - it hurts!
Life as a junior doctor is hard, though apparently not as hard as it used to be (according to my superiors who used to work 27 days in a row after walking uphill through snow barefoot to get to work). Having the pump allows me to suffer in the same way as everyone else, ie no food, long hours etc. I don't have to make allowances for my self, and take little food breaks and so on. I can work all night without having to worry about what my Protaphane will do next.
Most people I work with don't know I have diabetes until I choose to let them know, some people will never know. My immediate supervisor didn't know until I blasted him one night for a dopey comment about diabetes management (I do have a problem with mouthing off to my bosses, not just about diabetes, but I am working on it, promise). Anyway, he didn't mind being yelled at by a midget at 3am before taking someone's appendix out, and managed to ask some fairly intelligent questions at the time.
Some of the doctors I have worked with very closely don't know at all. More girly doctors know than the boys, because of the change room thing. The pump is particularly difficult to juggle when changing for theatre in a hurry, and it's kind of obvious when one is jumping around the change room in underwear swearing 'cause ones feet are tangled in the tubing (I'm especially short - most people wouldn't have that problem).
Basically, I couldn't do my job properly without the pump, and I really love not being "special". I have far fewer hypos, and my control is excellent.
I am planning on a nice healthy tall baby at some stage in the next 7 years, and I think the pump will really help with making that happen. I have always eaten exactly what I feel like, so the pump hasn't changed that at all, but now I know I'm getting the insulin-food balance right, rather that just guessing. I can eat 8 times a day or once a day, the pump does it all.
I love it, and I will never go back to 4 shots a day. I am looking forward to continuous glucose monitoring and implantable, integrated pumps. I think this will be the future, rather than islet transplants and the associated rejection problems.
Love
Ali.
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