How do you all manage the fear, if any, with all this.
If you're using short term acting insulin, you can stop the pump. I've never heard how to retract insulin when it's delivered with a syringe.
I've had a lot of lows with MDI, and my pump gives me fewer lows and a good A1C. Not perfect, but it's more stable than injections, which gave me an A1C of 4.6. The pump has brought me into the low 6s.
For me a tslim pump has given more stability and more flexibility than MDI. With the micro delivery system I do not fear a pump malfunction dumping large amounts of novolog on board. The program flexibility has allowed me to match my basal and my I:C ratios and my C.F.s to the time of day/personal needs. With knowledge of how to evaluate the data I get from frequent FS's along with my CGM data I can quickly adjust when I see a changing trend that needs addressed.
It means that I am involved with data review and adjustments on a regular basis. I can't set it and forget it, but it does mean I can I can pre bolus easily on the way to a meal, add in more bolus if my meal is lager than predicted. I can use a temp basal to help bring down a high or decrease basal to help with an over correction.
I check my pump settings vs cgm data on a regular basis, and periodically check basal rates and I:C ratios through out the day. I have learned how my D works and make my own adjustments on a regular basis.
I use manual insertion sets and have never had a kinked cannula, have learned through trial and error that straight sets means I need 30% more insulin compared to a slant set.
The only times I have had problems with lows are when I dose and then get distracted and don't eat, highs are when I goof on my carb guestimation. These are operator error not the pumps fault.
As long as I do not get complacent and lax on my vigilance/data review then I have no fear, if I stop doing what works, adapting as things change then it's on me if bad stuff happens.
I'm making another "the pump screwed me up BAD" post but seriously. I have told you before, but MDI turns out to be the best for me. Not only for my physical health, but my mental health. I'm still just getting out of a bout of depression caused by my pump experience. I have had anxiety attacks ever since using it whenever I get a high reading and I have had to go on Xanax to control my anxiety for now (which I now take 1 pill of the lowest dose EVERY SINGLE MORNING or else because my mind is a mess right now) . I mean I'm still not free of a DKA OR severe low hospitalization risk on mdi, but I run less of it than on the pump as on the pump I woke up with a 59 once (and didn't feel it at all) and also spiked up to 244 with ketones (and had to give myself a couple manual injections to fix this). I don't run into that on MDI and didn't even when I started using it in the first place when it was a new thing for me. MDI is just easier in the long run for me. The pump wrecked my mental health, made my life feel more complicated , made my blood sugar go out of control, and made me unable to feel hypos and that was after only a week.
I understand you have your dawn phenomenon issue, but if you're this scared to go on the pump you should really just stick to MDI and try to figure something else out? That's just my thoughts.
For me, the pump, and then CGM, made me feel a lot more at ease. The lows were less often and less severe. And the same for the high bgs. But then I test 10-15x a day. I do a lot less correcting with my pump because I was able to get the bolus amounts tailored to me - by time of day, not just the number of carbs. I can also use a temporary basal to cover times when I am very physically active or those times when I decide a good book is about as active as I want to get - I can up the basal by 10% increments. The CGM has also made a major impact. It is important to find what works for you. I prefer taking lots of itty bitty doses if need be, than playing catch up to a larger than I needed does on MDI. The thing that made me decide to pump was the fact that I could get 0.10 of unit if that's all I needed.
Sarah, are you listening to the experience of the people who have successfully used pumps for months and years? A pump is a tool and a good one. We are people who use pumps and like our doctors, they work for us. But we need to be willing to educate ourselves to their capabilities and take charge of our use. If we have a bent canula we can recognize and account for it. If we (like I have) find that metal sites work well for us we can eliminate one variable. We are not powerless, and things don't "happen" without our ability to recognize, intervene and make alternative choices as appropriate.
Zoe, here here! I wish I could bring you with me to my next Endo appt. I'm sure you've read about my frustrations with the doctors' attitudes that I've had to put up with lately in posts here)
One "good thing" about type 1 diabetes is that we can be in charge of our treatment, and have an impact on how things go and turn out.
I have no doubt you can speak up for yourself, artwoman! You know I wonder if guys have as many problems as we do with doctors not listening to them!
I''m really happy with my pump. I've had it for 8 years with no major problems but it is just recently thanks to TuDiabetes and Think like a Pancreas that I have been able to really lower my AIC and get my basal appropriately programmed. I am 100% confident in my pump. Last month I had two bent canula problems. For some reason my doctor had given me 9mm canulas and the 6mm seems much better. Anyway, I think that Zoe had a good solution for this in another thread - if you seem high on the day you have changed your set, redo it quickly and there will be no problem.
Good pump education and follow-up should be able to keep you out of anxiety. Each person to his own. I can't help recommending the pump though and my endo has asked me to talk to some people about changing over. Just telling them what I like about it not trying to force them of course.
Zoe wrote:I do what I do for me to stay positive and move forward without a lot of time spent in fear or regret I agree wholeheartedly. I am very content with my pump. Most of my hypos have been due to bolussing errors or not turning down the basal prior to exercise. I had a few scary trip to the ER lows when I was on MDI ( less than 5 total). Yet, I have never been paralyzed by worst-case scenario fears; not while on the pump nor on injections.Just not my mindset>:"Too blessed to be stressed."......
God bless,
Brunetta
Like you I think that we will experience enough highs and lows in our lifes to get used to these events. With experience the fear will get smaller and smaller and the management gets more rational. Just handle the BG you have been dealt, make a good documentation of your mistakes, learn from that and try to adjust to new developments proactively. The best answer to fear is to experience that you can take control of the things that you are afraid of. Many deaths after Tschernobyl have been connected to the fear of invisible radioactivity and its negative impact on diseases of the heart. This shows how negative the experience of being powerless can be. Better take control and gather all the knowledge to stay ahead. Look at the good statistics for complication rates and life expectancy. Look at the good examples in the medalists group of the Joslin hospital. This is all very encouraging.
Well put, Zoe!
I've been on the pump for 3+ years and I've never had a low so bad I passed out or a high so bad I went into DKA. As long as you're aware of yourself and how you feel, there won't be a problem. Test regularly, eat normally, and you'll be fine. With the pump, the lows can be lower and the highs higher, so make sure you're cognizant of how you feel in each situation. I know I'm low when I start sweating and feel like I'm drunk even if I don't feel hungry or weak etc. The pump is so liberating, I'd definitely recommend it!
I can add that it I've found it *extremely* difficult to do musical activities when my BG is low. I don't sweat as much as I used to but still get weird auditory distortions, like reverb, but not consistent. I can tune a guitar through amp reverb but hypoverb is all over the place. If I can't tune, I can't play and the notion of playing with other people whose gear would be contributing to the clamor would be a pretty difficult so I found that part of his story to be somewhat credible. Although the last time that happened to me (I'd played golf before band practice too...), I drank some chocolate syrup and beer (separately!) and was fine.
Fear can be a good thing as it helps us avoid bad outcomes. But we have to be careful about fear as it can mess with our heads and fear hypos may drive us to run high all the time (or vice versa). And you shouldn't feel fear all the time, it just isn't good.
Sorry to anyone following this thread on RSS or email, I ran some tests of word blocking controls and they failed.