Monday, 2 August 2010

What a Week It's Been!!!

Well, it's been a busy old week in terms of my Diabetes....

Last Wednesday was another session of laser treatment for Diabetic Retinopathy (which I did a huuuuuuge blog post on last week).  As usual, even though I have had quite a few sessions on both eyes in the last few years, I was terrified and got myself in a right old state beforehand.

Ever since the first time I had it done and I fainted I have had to have the anaesthetic injection in my eye before the laser session so I was quite prepared to have it done again, in fact, although it's not very nice and it involves them making a small cut in your eye ball, I would much rather have that than have to feel the pain / weird sensation that you get when your being lasered and risk fainting again so that they can't carry on and finish the session.  Anyway, the doctor, who I had never seen before (I hate they way it is a different doctor that does it every single time!!!) decided that she didn't want to give me the injection.  She said: "a lot of people tell me I'm very gentle with the laser" which didn't really make me feel any better but even though I said I really would prefer to have the injection she insisted that we would just "see how it went without it".....I was not happy at all and I started to panic even more.  To do the laser burns they have to shine an incredibly bright white light into your eye which always makes my other eye instinctively close, which then makes the eyeball that they are trying to laser move around....the doctor told me to try and keep my left eye open so that my right eye wouldn't move so I tried to explain to her that this is one of the reasons I always have the injection first so that it numbs my eye and it won't move during the lasering but all she said was "oh well".....Great!!

It didn't hurt too much for the first few burns but after about 5 minutes it got really sore and I started to feel faint and queasy so we had to stop....this happened another 2 times, by which point I was in a lot of pain (which can happen when you have had a lot of previous sessions) and felt very hot and sweaty and the room was spinning.  At this point she decided to stop.  I really did feel as though she hadn't done enough but knew that for her to carry on she would have to do the injection as I was in a lot of pain and she just did not want to do it.  I got the impression from the minute I walked in the room that she just couldn't be bothered doing the anaesthetic procedure for me.  I'm sure plenty of people can easily take the pain and discomfort of having it done but everyone is different and has a different pain threshold so I'm really not happy that she just fobbed me off and made me feel as though I was being pathetic!!!! Before she sent me off home she said "I've made a note that for your next  appointment you do need the anaesthetic doing first"......I do hate to say I told you so but....... 

Next time (31st August for my left eye) I am going to refuse to have it done unless they agree to give me the anaesthetic injection first and I do not want to see that same doctor again for laser treatment.

The next day was not nearly as was my appointment at Stafford Hospital to start my insulin pump exciting!!! I was expecting to take 2 home for the weekend but when we got there we discussed the 2 types and decided that I would only take home the Medtronic pump.  We discussed how I had been getting on with the carb counting and how I had been feeling in general.  I have been having far less headaches than I used to, I am able to stay awake much later than I used to - I used to get in from work and could easily fall straight to sleep or go to bed at 8.00 pm because I was constantly exhausted and I have been having quite a few more hypos than I used to.  Before I went on holiday I had my HbA1c done and amazingly it had come down from 11.6 in March to.....wait for it......8.8!!!!!!! (For those not in the know already, the target they always tell you to aim for is 6.5 so I am getting there).  I am so pleased that it has come down by that much already.  I did expect it to have come down but not by that much (it might not sound like much but in terms of HbA1c results every 1% counts a hell of a lot).  This reduction would explain why I have been feeling less tired and been having less headaches.  See below for a description of what the HbA1c test actually is........

HbA1c Tests
The HbA1c test, indicates your blood glucose levels for the previous two to three months.  HbA1c (glycosylated haemoglobin) is a measure of the amount of glucose attached to the body’s red blood cells; it is present in everyone. The level of HbA1c in your body rises and falls in line with your blood glucose – the higher your HbA1c, the more glucose is attached to your red blood cells.   

Your HbA1c does not change rapidly because the red blood cells in your circulation last for around 3–4 months. Any increases and decreases in your HbA1c will happen over a period of at least 6 weeks. An HbA1c test is not the same as a blood glucose test. Your HbA1c test may be done using a blood sample taken from your arm or from a finger prick test.

HbA1c Targets
For most people with diabetes, the HbA1c target is below 6.5 per cent, since evidence shows that this can reduce the risk of developing diabetic complications, such as nerve damage, eye disease, kidney disease and heart disease.

Individuals at risk of severe hypoglycaemia should aim for an HbA1c of less than 7.5 per cent. However, any reduction in HbA1c levels (and therefore, any improvement in control), is still considered to have beneficial effects on the onset and progression of complications.

HbA1c Results
HbA1c results are currently given as a percentage. However, the way in which HbA1c results are reported in the UK is changing. From 31 May 2011, HbA1c will be given in millimoles per mol (mmol/mol) instead of as a percentage (%).  To help make this transition as easy as possible, all HbA1c results in the UK will be given in both percentage and mmol/mol from 1 June 2009 until 31 May 2011.

This new way of reporting results will just be a different way of expressing the same thing. For example, the equivalent of the HbA1c target of 6.5 per cent will be 48 mmol/mol. The fact that the number is higher does not mean there is more glucose in your blood.

So anyway, back to the pump trial....I had a quick practice with an infusion set for the Medtronic pump and then once we had had a look through the menus on the pump screen I was given all the bits of kit I needed to take home with me for the weekend.....infusion set, saline, alcohol wipe, infusion set inserter, the pump, reservoir for the insulin (saline for the trial) and off I went.

We decided to go to my Mom's to set up the pump and put in the infusion set so I could show her how it works (I was dying to show off my new "toy").  I had a bit of a 'faff' with drawing up the saline into the reservoir but after that it was all plain sailing and I did my very first insertion all on my own.  I was really surprised just how painless it was and then during the evening I was surprised that I managed to forget it was even there!!!!
Spending our first night sharing our bed with the pump was fine apart from me rolling on it a few times as the one I had on loan did not have a waistband clip on the back and I couldn't attach it to my PJ's.
On Friday I loved showing off the pump to people in my office and explaining all about it which has earned me the new nickname of "the bionic woman".
I had a bit of a play around with the menus over the weekend and gave myself "fake" doses of saline but that part of it (setting the basal rates etc. etc.) will be explained to me at the training on 9th August.
The only two minor "freak outs" I had were when I was in the shower and the pump was disconnected from the infusion set.....I knocked the infusion set a couple of times and for some reason that really made it hit home that I will have one of them in my stomach forever from now on.  For some weird reason I found it stranger to look at it when the pump was disconnected from the infusion set/my stomach and all that was left was the device lodged in my stomach...I'm not sure why this made me feel so strange but I guess it's just all part of getting used to this new "part of me" and my new way of life.
When I took the pump off on Sunday morning I immediately felt "lost" without it which I think must be a good sign as I must admit the part I had been mot worried about was getting used to being attached to something "alien" for the rest of my life so if I already feel lost without it that can only be a good indication that I will soon get used to that side of it all.
All in all the trial went really well, much smoother that I expected, and I am now really excited to get started on my own pump and start to learn all of the more 'technical' aspects of using the pump.  The trial was more about getting an idea of how it will feel to actually wear the pump. 
Today I contacted my DSN at the hospital to let her know that it went well and that I would like her to go ahead and order my (bubblegum pink) pump from Medtronic!!!!
I can't believe that this time next week I will be "connected" and I will be a member of the "insulin pumping community".  I am so grateful for all the help I have had from my DSN's at my GP's in getting me referred, from my dietician at the hospital, from my new consultant and from my new DSN at the hospital.  It has been a very short "journey" from injections to pump and I really do appreciate how lucky I am to have even got funding for a pump, let alone get one so quickly.
All that's left for me to do now is think of a name for my new pump :o)


  1. Hi there - I was wonndering, does this mean that we are getting the American system of counting blood glucose. I think that will confuse me slightly :(

  2. This comment has been removed by the author.

  3. As far as I know, there are no changes to the way we measure our bloods on a day to day basis, just the HbA1c....I may be wrong but I havent heard anything.

  4. mmol/l = millimoles/liter Which is the UK form of Blood Glucose Measurement

    mg/dl = milligrams/deciliter is the US measurement.

    mmol/mol other than the info Bec provided about being millimoles/mole I have never heard of it before.

  5. mmol/l means millimoles per litre


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