To Pump, Or Not To Pump?

I’d like to put it out there immediately that this post has nothing to do with my digestive movements…

The insulin pump. An absolutely wondrous example of technological advancement being used for good. They gave me a batch of syringes when I was diagnosed as a back up to my injection pen. We’ve come a long way.

So what’s an insulin pump? As many of you will be aware, it’s an alternative method of delivering insulin for type 1s, replacing the need for multiple daily injections (MDI).

It’s something that’s been on my radar for a good few years, but every time it’s been dutifully mentioned at my clinic appointment, I have wrinkled my nose and shaken my head without much further thought. Sure, I’ve been aware that pump therapy often improves blood sugar control. And sure, I’ve spoken to many happy pumpers who have cautiously switched and subsequently never looked back, resigning their poor Novopens to a dusty shelf alongside Woody the cowboy, a vast collection of Enid Blyton books, and those size 8 jeans I appear to be keeping for no reason whatsoever. But to me, for every year that my diabetes team have asked, the pump just didn’t ever seem to appeal in a real way. This is not to dismiss the thousands upon thousands of people who are happily pumping away out there, and to the many newly-diagnosed type 1s who have never had it any other way. But for me… I run around like a moron a lot of the time, and I’ve always liked being able to whip out my pen, dose up and carry on. I’m ridiculously clumsy and get myself in spots with alarming frequency – and so I had hilarious/tragic visions of me getting it wrapped around my legs/tube rails/dog leads, just because that’s how my life works. And if we’re being perfectly and shallowly honest, the thought of attaching myself via tubing to a piece of medical equipment struck me as something of a passion killer, and while I was young, free and single, I wanted to also remain free of wires.

Apparently some things have changed.

It was almost a year ago. I was on the second day of the big cycle to Paris, where I was surrounded by more diabetics than I’d ever been in my whole life for any extended period of time. All of various ages, with various relationships to type 1. I was chatting to a lovely lady called Lorraine, whose husband and teenage daughter both have this beautiful disease, and we started talking about her daughter’s pump therapy – the fight Lorraine had had on her hands to get pump funding approved and then how much it had benefitted her daughter, both in terms of control and also socially – it was overwhelmingly clear that it had made life a whole lot easier. But my ears really pricked up when Lorraine casually mentioned how much lower each dose of insulin was – something like half as much.

And here comes the Great Carbohydrate Debate. I eat carbs most days but I’m fairly selective about the carbs I eat most of the time. Oats, sweet potatoes and quinoa (oh hey middle class Londoner) see me right, but I won’t eat them at every meal, and I don’t eat as many if I’m not able to get to the gym. That is, of course, with the exception of Christmas, birthdays and the like when I tend to face plant the roast potatoes/triple cooked chips/whatever comes my way. Years of practice (plus hours of exercise) have taught me which foods I generally can and cannot cope with, and which I’m prepared to compensate for later, most likely via an intense carb coma and elevated doses. But for the most part I’m generally of the view that the less insulin I need, the better. Exercise is a MAJOR factor in that – a tough bike ride followed by decent food choices has previously left me injection free for 48 hours. I’m not by any means scared of taking insulin; quite the opposite – if I’m gonna eat like a pig and upset my waistline, I’m going to do my utmost not to upset my sugars too. But if I’m sat there endlessly poking myself with yet another double figure dosage of insulin three hours after even the finest, most gourmet veggie supreme, only to still have high blood sugars the next morning, complete with accompanying thick head and unusually moody demeanour, I generally am left unsure as to whether it was entirely worth it. I digress – basically lower doses = less room for error & less sluggishness, insulin hangovers and general nastiness going on in my bod in the long run.

So… the pump. Some seeds had been planted, and it took me a year of occasional and fleeting pondering to enquire at my latest clinic appointment to find out a little bit more. The raft of exercise I undertook for the challenge is now a steady routine, and the pump started to appeal for the flexibility it could offer me in the gym and on my bike. The other main factor in my new found curiosity is the appearance of an actual human man who since day one has been overwhelmingly supportive and taken more of an interest in this wholly uninteresting and unsexy disease than even I do at times. From the mundane day-to-day of peeling yet another used test strip from under his feet *sigh*, to stepping in and saving me from needing an ambulance in the depths of the night, I’ve never felt more capable of controlling this thing, and even more important than that, I’ve never felt more comfortable with letting someone help me control it, instead of carrying on my one-woman-without-pancreas crusade of auto-immune independence.

Still – this was merely intended as an enquiry. The huge reservations about being permanently attached to anything remained, and despite the wholly positive stories I’d heard, I knew I was doing more than ok, on the whole, with my trusty Novopen. Blunt needles and bruised legs aside. But my continual, seemingly incessant background retinopathy and the associated utmost fear of going entirely BLIND is constantly lurking at the back of my mind, and if there’s a way I can possibly maintain the gift of sight in order to actually see my future kids grow up, well… pass me the tubing and rig me the hell up.

The clinic appointment came, and my DSN was happy enough to chat through the options, but she seemed hesitant that it would offer me huge benefits, being already a generally healthy and happy type 1. My particular hospital offers two pumps. First, I was shown the ‘traditional’ Medtronic Veo, which I’d seen before and was expecting to see; a pager vibe with tubing attached. But then, behold… I met the Omnipod. It’s a wireless pump. A WIRELESS PUMP. I mean, I know we’ve sent people to the moon and stuff, but to me this was just incredible. I had no idea these things even existed.

Ohhh so teeny. (And someone get me a manicure…)

I held it in my hand, turned it over, held it up, felt the weight and was just in disbelief as she told me I’d load a three day supply in, and that the dosage was controlled by me via my blood glucose meter, and I could wear it in the shower, and I could wear it in the gym, and I could move each pod around depending on what I planned on wearing. Fella’s eyes had widened too – this was a brave new world to me after nearly 20 years without a functioning pancreas, let alone him, less than a year into my idiotic life.

We came away with a lot to think about. Exciting as it was, it was still a big leap to be hooked up to a plastic bug pretty much round the clock. So, if in doubt… take to Twitter. You bloody wonderful lot.

I’m aware that I’m very lucky my clinic are happy to put me straight on a pump without a fight. I’m also aware that the wireless pump isn’t available at every clinic; which isn’t entirely ok. Tubing works wonderfully for many, and who’s to say I’m right about any wire-based reservations I’ve previously had? I’ve no experience in this whatsoever, and I went into that clinic ready to ask about the pump with no idea there was any option but tubing. I’m by no means right in my thought processes (27 years in my head have taught me that), I’m just relaying them to you, dear and unfortunate reader.

Nonetheless, buoyed by your encouragement to at least give it a whirl, I asked for a dummy pod to test. I proudly stuck in on and continued bopping about my life for three days; in the gym, on my bike, at work, out with friends, in my flat, in bed… (hey, pump or no pump, diabetics have sex hold hands atop the covers too). Apart from one fleeting moment of self-consciousness in the gym changing room, all I felt was overwhelming excitement. And an urge to show my dear non-diabetic compadres to give them a glimpse of how exciting something as ridiculous and seemingly unattractive as a plastic pod could be. The response was a liiiiiiittle overwhelming. But then, after all the amazing support I had on my cycle, I should have known…

Told you my friends were great, right?

Now, I’m under no illusion that this transition is going to be rocky. And that I’m going to get this very wrong before I start to get it right. But after coming to the conclusion that 1. I have nothing to lose and 2. I can always give it back if I reaaaaaaally don’t like it, the funding is being applied for. It will be at least a month or so before it gets ordered and I get hooked up. But hold tight cannula, you’re going in.