Thursday, February 18, 2016

My Life With T1, Part 14

My Life With Type 1
.........Part 14........
In 2002 I was in very good shape physically and mentally. I had my A1c under 6.0, and my blood sugar control was the best I had ever seen. I was enjoying part time teaching, and we were flying twice each year to Atlanta to see our sons, daughter-in-law and grandchildren. I had a temporary setback with prostate cancer in 2003, but recovered nicely after the radiation treatment, and two years of minor side effects. I kept up my exercises as well as possible after radiation treatment. I dieted, counted my carbs, and kept very careful charts of my diet and control. In late 2004 I felt great. I had lost 26 pounds, and had very good control. Cutting down on my daily carb intake, and exercising rigorously on my treadmill enabled me to lose that weight. My A1c's remained below 6.0. I taught my last class at the college that year. I felt strong and healthy.
I did a lot of work on my house to keep myself occupied. I painted the whole house, inside and out, replaced some interior doors, remodeled the master bedroom, and built a home entertainment center in my oldest son's former bedroom. That is where I sat to type these chapters, and post and talk to my friends. By 2006 I had finished my construction work, and I was bored again. That is when I started posting on the dLife website. Janis Roszler, the moderator there, is a CDE and a RD. She taught people all about pumping. She told me, online, that I should consider pumping even though I had good control with injections. Several friends on dLife started encouraging me as well. I liked the idea of only one needle every three days instead of 6-8 daily injections like I was doing then. I liked the freedom and convenience that a pump provides. I wanted to pump, so I asked Dr. B. and he said it was not a good idea. He thought it was unnecessary since I already had good control. He told me that several of his diabetic patients had worse control after starting to pump, and they had more hypos as well. He would not support me with pumping.
I called an endocrinologist in Poughkeepsie, and made an appointment for Jan. 30, 2007. That was about the time that I had left dLife, and joined Diabetes Daily (DD). I made friends there, and they also encouraged me to pump, to get still better control. The endo approved of my pumping, and sent me to get some blood tests required by Medicare. Something about the lab results did not meet the approval of Medicare, and they would not finance my pump. I was so disappointed, and thought that I would never get a chance to use a pump. The pump itself would cost me $6,000+, and the monthly supplies were also too expensive for my budget. The endo's office phoned me the following week, and told me that my secondary insurance would cover the cost of the pump, and all of the supplies. I was thrilled! The NY State Empire Plan was my secondary health insurance plan. All employees of the state were eligible to have that insurance. While I was employed the college paid all my premiums, and the coverage was for my whole family. After retirement our sons were no longer living at home. The college paid all of my premium, and we paid my wife's premium.
The lady from the endo's office asked me to pick a color for my pump and the order was sent out. I went to the diabetes education center at a hospital in Poughkeepsie and met my trainer, and a dietitian. They gave me a kit containing a manual and a CD. They told me to become thoroughly familiar with the Minimed 522 pump before the pump they had ordered arrived at my home. I had also ordered the book "Pumping Insulin" by John Walsh. It was highly recommended by my friends on the DD website. My friends on DD and on Janis Roszler's site were all cheering me on. The pump arrived in late April and I had one week to have a hands-on experience with it. I started pump training in early May. It went very smoothly, but my trainer was old-fashioned, and wanted to take it very slowly. She was very sweet, and we liked her very much, but four different trips for training was not necessary. We made a separate trip to talk with the dietitian about carb counting. The charts I took with me convinced the dietitian that I knew all that I needed to know to start pumping. Another wasted trip. It was all worth it though. I had to cooperate with my endo who insisted on all this training. Her office was in the same building as the diabetes education center. They all work together.
In the last week of May I was pumping saline solution just for practice. That solution put too much salt into my body, and I had a lot of water retention. I already took water pills for water retention. I called my trainer, and she said to stop pumping saline. I went in on June 19 to be hooked up with my pump. The endo looked at my charts, and read off numbers for my trainer to put into my pump. My basal rates, carb ratios, targets, insulin sensitivity factor, and all the rest. I went home full of enthusiasm and was really looking forward to the next few days. Later that day my blood sugar was over 300 and climbing. My endo did not want me to change anything without her approval. I called her that evening at her home. She had given me several phone numbers. She did not seem to know what to tell me. She had me change a couple of things, but it did not help. I decided to take over my own control. Before doing so I disconnected the pump and resumed injections for a few days until good control was reestablished. With my math and statistical background, my 61 years of injections, and the good control I already had, I should be able to do this by myself. I completely changed all the numbers in my program. After a few days I had much better control. Everything was going much better, but I started having trouble with the needles in my Quick sets pulling out of my body. Putting my clothes on and off, rolling over in bed, and other such things seemed to cause that problem. I started having very high blood sugar whenever this happened. I tested for Ketones every time my test was 250 or higher. I used injections to get myself back under control before reattaching the pump.
I told my friends on DD my problem and I learned about the Sure-T infusion set. It is made very differently and the needle is very unlikely to pull out of my body. I ordered a supply of the Sure -T's, and have been using them ever since. They are great! My control was much improved, and my analysis of my testing from mid July to late August showed control equal to the control I had before pumping. The lab visit I had in the third week of August was only 10 weeks after I had started pumping. I expected the A1c to be very high because of all the high blood sugar I had had during the beginning stages of pumping. I had an A1c of 5.6 before pumping. When I went to Dr. B's office in late August my Aic was 5.7. I was so surprised. The A1c covers the three month period preceding the lab date. I had poor control with very high numbers during the last 11 days of June and the first 10 days of July, but my control was quite good for the rest of July, and all of August. The numbers for the first month of the three month period covered by the A1c are not so influential in the A1c result, the numbers during the second month have a greater influence, but it is the numbers during the third month that have by far the greatest influence on the A1c result. My numbers were very good for the last 6 weeks of the period covered by my A1c test and that overshadowed the bad numbers preceding that 6 week period. That is why my A1c was so good.
I was very happy with pumping at that point. I was able to sleep late in the mornings. I could delay meals. I could vary my eating schedules, and eat very different types of meals without affecting my blood sugar. Counting the carbs very carefully, and pumping the insulin that my pump indicated to be the correct amount was working very well. The very rigid schedule that was necessary while still on injections was no longer necessary. I was unchained, and free to live like a more normal person. I had a machine that worked very much like a pancreas, and I was very pleased with my pumping experience.

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