I am very, very (extremely would be a good word choice here) pro insulin pump. I love my insulin pump to bits and can’t imagine life without it. First, I have a confession to make… I have never used Multiple Daily Injections. I was diagnosed with diabetes at the age of 5 years old. When I was diagnosed treatment was quite “old school”, I remember being allowed three jelly babies or five chocolate buttons as a treat. Carbohydrate counting was actually quite big back then my mum informs me. I also remember practising injecting oranges and then my (impressively brave) parents at the age of five with needles. Not using short pen needles. I used Syringes, with to my five year old brain, very long needles. Jump forwards a few years and I had excitedly moved onto the Humalog pre-filled pens.
I hated injecting. I hated it with a passion. I still struggle to use my stomach as a site due to poor site rotation. I didn’t use my arms because they hurt. I did not want to inject and no more than two injections a day would be done. Then I saw on TV something which change my life and my diabetes. The insulin pump.
Yes it was bulky, yes it was big, yet this boy did not need to do injections. I wanted it. Multiple Daily Injections were often discussed, however I knew that there was something else waiting for me. The insulin pump. NICE finally endorsed insulin pump funding in 2003 and just before then at age 13 I got my first insulin pump. I remember sitting in a room with the wonderful Deborah from Diestronic (which then became Roche and now Accu-chek Roche) and many, many consultants. I was the first person in the hospital to receive an insulin pump and I loved it. No it wasn’t aesthetically pleasing, but it meant no injections.
I was shown the basics such as how to insert a TenderLink infusion set. Deborah inserted one into her to show that it wasn’t so bad then I had to do mine in front of a crowd of diabetes consultants. There were no insertion devices (I still don’t use one) and the needles have become shorter over the years. Inserting a needle at a 45 degree angle for the first time was worrying and difficult especially given the length of it, however over the years it did become easier. Especially as when I first had a pump you could only use your stomach, being allowed to use my thighs and bum was a great revolution although my stomach is covered in tiny scars from the TenderLink!
Next I had to learn how to carbohydrate count and bolus for meals. Obviously to do this the only appropriate thing to do was to go out for lunch with consultants in tow. I will never forget the advice given to me on carbohydrate counting for potatoes. There were no carbohydrate counting books as such, so it was use the back of packets, memorise your carbs for certain foods, weigh out every food you eat on kitchen scales including your breakfast cereal (which must be 30g exactly) and judge potatoes by the size of your first. I still use these methods and think of myself as a carbohydrate counting pro – my eyes are a mathematical carbohydrate x-ray machine!
After that I had to find somewhere to keep my pump. The only case that came with my pump was a clip case. That was it. Wearing a clipcase with your school skirt was not a good look, yet this did not bother me. I didn’t have to inject. Furthermore bra pouches were an item which came along a few years later. Trousers had to have pockets; unfortunately my favourite pair of jeans could no longer be worn due to not having pockets.
Getting an insulin pump was not easy either. First of all it required my mum to collect a lot of letters from school, from the GP and writing to my local Primary Care Trust. Once it had been approved we had to reapply for funding every six months initially. I can’t remember the last time I had to reapply for funding for my pump, yet I will always remember waiting to see if funding had been approved by the Primary Care Trust (my diabetes hospital is out of my PCT area which made matters more complicated) during my time at secondary school. This was also in an age where there wasn’t access to things like input diabetes or other such areas of knowledge to help you access a pump.
Moreover pump problems were trickier to solve. No 24/7 helplines – I doubt there were enough customers. Instead I had Deborah from Diestronic to ring with any problem (she will always be my most favourite insulin pump rep!). The cartridges of insulin were prefilled glass cartridges which meant that dropping your pump would result in smashed glass and the time consuming process of using a cotton bud to dry up the insulin from inside your pump. I am very lucky in that I have a spare pump. When I got my pump my injections were binned, never to be seen again, and you were provided an additional pump free of charge. If you had a problem you used your spare pump and got a new pump replacement sent out in a week or so – no 24hour shipping. Your new pump then became your spare and when that expired you moved onto your spare and so on. This has resulted in me now having a range of insulin pumps – I don’t know how. Who have all been on a range of adventures – that is in Part 2 as this has become a very long introduction into my love affair with insulin pumps!