Tuesday, December 22, 2009

sleeping with an insulin pump

there's only one downside to having an insulin pump and that is sleeping. it can be quite awkward. i suppose it depends on how you sleep normally; i was always a shuffler, so it's no great deal to me. currently my set is on my abdomen, and as such its really easy to sleep, as i only sleep on my side or my back, so it's easy to just roll around and move patrick with me whilst i sleep.

but when my set is in other places, ahem (it's so not ladylike to say it!), it is truly weird to sleep. although i can sleep on both sides technically, it really isn't wise too, becuase that generally results in a set failure due to some tube moving or my lying on the tubing. it can all get in a tangle.

i hope i don't scare you all. let me just say i wouldn't be without patrick, and i'm quite happy to shuffle. be very thankful if you sleep like a log always.

and there's another thing, my nightmares are always consisting of large pools of water and me forced to go in them with patrick still on. occasionally i get super natural dream powers to walk on the water, but not always. it can be kind of scary. thank goodness that these are the only type of bad dreams i have, but it's not a helpful sort of dream.

anyway, sleep is super important for diabetics as it definitely helps to establish a routine within your body, and gives it time to repair. i always have at least 8 hours a night, and feel the effects if i don't quite reach that many hours. because i'm so sensitive to what my body is saying, i can feel the eye strain and the worse circulation might have something to do with not getting enough 'repair time'.

having said that, i also realise that if i sleep for 8 hours but not at my usual time, my blood sugar levels are also slightly off balance throughout the day. even if it shifts by two hours, say instead of 10:30-7:30 (my usual times) i go to sleep at 1am and wake at 9am. as fantastic as it is to lie in, i'm never quite prepared for the reprecussions of eating later, and doing everything later (as well as being more tired!). you can always go to bed earlier, for sure, that never seems to make much difference, and in fact means i wake up more refreshed and energetic. but to wake up later is not usually brilliant...

as always, i hope this is helpful, and if you have any questions, don't hesitate to ask!

Friday, December 11, 2009

Counseling Diabetic Children

Thanks to Lauren for another amazing question! She asked:

I'm a Nursing Student and I'm going to a Children's Diabetes camp as a counselor. Having no experience with juvenile diabetes I was wondering if you could give me some tips on what to watch out for emotionally and physically with the kids.

This is such a relevant question to anyone who knows any kids with Type 1 Diabetes, as sometimes it's difficult to know what to be on the look out for.

I've never been to a camp, so I don't really know how they function and how strict they are with checking sugar levels and things like that, but a sure fire way of looking after your kids is to make sure that they know what their levels are all the time, especially when they're doing a lot of exercise, and more importantly to make sure they've always got a couple of snacks with them! Even I forget and need reminding sometimes, so always remind them!! And make sure you've got sugar tablets with you just in case too.

In terms of signs of high and low sugar levels, which will be a big thing to obviously be aware of symptoms of, everyone has their own specific symptoms, so check with your kids on what they feel and look like when their levels go up and down. I'll give you some for instances, and how I look and feel just as a hint and hopefully a little help:

- When I go low, I get really dark circles under my eyes, and my pupils dilate, also I do act totally drunk, I talk faster and my movements are much less coordinated. I also get very hot and dizzy. These are the symptoms that are the most important to watch out for, as they are the most immediately harmful.
- When I have a high sugar level, I get very thirsty and act hung-over, I get very tired and lethargic. Everything goes very slowly and it's difficult to get me to do anything. It's really difficult to keep my eyes open as my body is on shut-down mode. I also become really pale and start to look pretty unwell. There's also the tell tale pear breath smell, that's quite prominent in a lot of diabetics when they have a high level.

These really are the different physical symptoms that you will experience with the kids, but it is different with everybody.

I suppose it also might be worth mentioning that if they get homesick or ill at all that you'll need to monitor them very carefully, and stay with them whilst they're checking their level, and help them decide what to do when they see it.

If a child has had a couple of high sugar levels, it would be worth sitting with them to figure out how you can both bring the level down together. Sometimes when I've had a couple of bad sugar levels in succession I make bad decisions, and don't think properly about what I should do, like injecting rather than bolusing. I can get quite stubborn too, and think I know better, when I know I'm not thinking clearly! I can also get very forgetful when my levels are bad, and forget to bolus which makes things a lot worse...

in terms of emotional things to look for, if I haven't already covered them, then I'm not really sure! there'll be the usual camp problems like homesickness, which could mean disturbed sleeping patterns, illness or just some dodgy sugar levels. and homesickness won't just happen to the quiet ones, it'll affect the loud ones too!

i suppose also, there'll be a varying range of ages and stages of diabetes, and some children will be better able to cope with things themselves than others. Some might have just started on an insulin pump, whereas others might have started a few years ago, and some might not have made the switch yet and still be on injections. Make sure you ask them this, and watch carefully to see what they do know how to do. The great thing about a diabetic camp is that the kids can learn from each other and be supported by their friends, so make sure that they are all getting along well together!

I hope that kind of answers your question! Do ask other questions as a comment if you like, and I will answer as best I can! The other thing to do, is to read back through some of my older posts, which will help you get a better feeling for what living with juvenile diabetes is like, so you can relate more to the children.

Here in the UK, as far as I'm aware there aren't any diabetes camps at all, so I don't have any experience of them. Although I did go to a regular camp when I was younger, it's not quite the same...I would love to do some counseling at one though, it'd be so much fun! I hope you enjoy your experience! (I stand corrected on this matter, and am totally going to email Diabetes UK to ask about helping out at one...!)

Wednesday, December 09, 2009

what to wear with an insulin pump

Thanks Amanda for your fantastic question!:

I find that there is a restriction on the type of clothes that my girl can wear after having the pump. She can't tuck in the shirt into the jean like most of us did. It is also difficult to find her a dress ( one pcs type ) as there is no place to keep her pumpy unless she wear another shorts with pocket. Did you face similar problem ? Can you share where and how you put Phil?

Now, this is a question I know I have some expertise in answering! In some of my early years on the pump I got really frustrated with how to wear it, and I was really conscious of other people seeing it or the tubing.

Fortunately I got over it...it helps when you rehearse what you'll say to people when they do see it, and to realise it's nothing to be embarrassed about, in fact you ought to be super proud to have one, and also to figure that actually no-one will notice it being there and think it's a phone or a pager if they do.

If someone does notice it, sometimes they ask directly, but other times when they're staring or I catch them glancing curiously, I just straight outright tell them what it is and ask if they have any questions. Pump therapy (and juvenile diabetes for that matter) is something most people don't have a clue about, and so I like to educate people!!

Moving on to clothing. I used to cover up so much, but now I don't care. I'd sometimes rather protect P from too much damage or the weather, especially when I'm going to be quite active. In fact, here are some pictures of me, with my pump on, I've pointed out where Patrick is in these photos, but can you actually see him?

So here are my tips and tricks:

- A Pump Clip - so that you can clip your pump onto your trousers or skirts or underwear. These are useful and sturdy (but make sure you always have a spare, because they do snap if you accidentally sit down too fast in the cinema or on a plane where the seats are small with armrests to bash against)

- Tubigrip/leg support - these are particularly useful if you are wearing a hip skimming dress, as you can comfortably wear your pump on your inner thigh, without worrying he'll jump out.

- Empire line dresses - or dresses that are fitted around the waist, or just under the bust, will flare out as your pump is rested on your hip and therefore skim straight over the top. I buy lots of tshirt dresses and unfitted dresses, which i pull in the a belt under my bust, which creates a shape, but does not make Patrick too noticeable. I wear leggings with dresses all year round, as they are a sturdy support for P. In my experience, there's only one type of dress you cannot wear, and that is a very short, very tight one, as there's nowhere to put the pump.

- Long tops and cardigans - can protect my pump from the weather and any damage, i layer these up to create a stylish look and then patrick gets lost under all the fabric

- Hipsters - I don't wear trousers that are waist high, because there wouldn't be space enough for the tubes, and when I have tried them before they are too tight and block the insulin. Hipsters generally have more freedom of movement, plus they just look better on me!

- I even have a couple of jumpsuits that I wore most of the summer, which I loved. They are impractical in a few ways, but it does protect P, and when I bolus I just go to the bathroom or my bedroom

- there are some times that i forget that i'm wearing a dress, and i'll need to bolus for food, but i just absent myself to the washroom, and bolus there. people don't mind, at all, you'll just need to be polite if you've forgotten whilst you're already eating!

- in summer, if you've got your pump in your abdomen, make sure you've got lots of all-in-one swimsuits with you, or tankinis, as you might not want to wear a bikini, and i'd recommend not being in the water all the time, as the solution that sticks your plaster down may wear off with too much swimming

- try not to wear tight trousers or jeans whilst your infusion set is on your upper buttocks, as this might reduce the effectiveness of the site, and can be quite painful.

Tuesday, December 08, 2009

switching over to the pump

i was recently asked: is switching to the pump really difficult?

and my answer to that is, yes. but it is very worth it!

learning about insulin pump therapy is complicated, but if you put the time and effort in, it won't take you long. mind you, i was a teen, rather than a child so i was able to understand everything a little better and quicker.

there may be things you already know how to do, like counting carbs, but there will be things that are new. part of the learning is also working out real life problems that the doctors and nurses don't tell you about...which is why it's good to know somebody that is on an insulin pump already (like me, for example!) that's been through every problem.

the real difference about being on an insulin pump, which is why it is such a successful way of managing juvenile diabetes, is how much more aware of everything you need to be. you'll need to be more specific, check sugar levels more, be aware of the times you eat, what you eat, how much you exercise and when. there's basal rates to keep an eye on, and infusion set problems. but most of these you learn along the way. the key is to ask your nurse all the questions, and maybe take a pen and paper to write down things they tell you that aren't in the brochures.

all of this controlling is an effort to regulate your sugar levels, and can be trememdously successful and worthwhile in the end. and after all it does become routine after a time i promise! and as with everything, the more energy you put into it, the more you'll get out of it, and the healthier you will be.

i hope that answers things...

any questions anyone has, please don't hesitate to ask!

scars from infusion sets

thanks to Amanda for asking about infusion set scarring. i know this is a pretty frustrating issue for a lot of people who are on an insulin pump.

i do have a lot of little scars on my infusion set areas, and there are a few things that i do to avoid them getting really bad. the first thing is to make sure that i do regularly change my infusion set, as this will prevent any really bad scarring. my time change is every 2.5 days, that seems to work out pretty well for me, but it's different for everyone, depending on how your body copes with the absorption of the insulin in a particular area.

the other thing i do, is to rotate my sites, which will enable a particular area to heal itself a little better than it would otherwise.

as for the colour of the scars, my little white pinhole scars are practically the same colour as my skin, so i don't worry so much about them, but for anyone with skin darker than mine (which i would imagine is most people!) I can understand how this would be frustrating.

i would recommend using a body oil, as these are the most effective 'skin structure re-builders', and use something that's made for the intricate facial tissue, as it's more likely to have better and more effective nutrients in it. i would also recommend more expensive brands, as more refined oils are much less greasy, and more helpful. Two brands I would recommend are: Bio-Oil and Rosa Mosqueta Oil, which are both really magical re-structuring oils with great reviews.

make sure to apply it morning and night to the area, and give it a really good massage, as the heat from your hands will aid the oil to work properly, and the pummeling action will help to re-align the cells. massage for at least 2-3 minutes, working in different directions and motions.

if you still have questions to ask, please let me know what they are, i'd be happy to answer them for you!