# Pumping in pregnancy??



## Twitchy (Aug 4, 2009)

Hi all...

Well after my comments to Phoebe the other day, looks like I am going to have to take my own advice! 

I was just wondering, has anyone managed to get the hospital to put them onto a pump whilst pregnant?...I was supposed to start on a pump today, but after getting a (well, 2, I didn't believe the first!!) postive preg test yesterday they are now refusing to put me on a pump... I can kind of understand why, ketones & all, but if my control is bad (HbA1c of 7.5% in June, but things have got even worse since then...) on MDI surely that's a definite risk as opposed to the possible risk of ketones on the pump?!   Anyway, I digress... 

Has anyone managed to persuade the hospital to put them onto a pump despite being already pregnant, and if so, how did it go?!

Really hope someone has some good experience out there!! 

Thanks,

Twitchy


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## Emmal31 (Aug 4, 2009)

Congratulations twitchy! hope you get the pump issue sorted after all during pregnancy getting stable is even more important. Can't help with regards to pumping whilst being pregnant unfortunately but hopefully someone can for you. 

Emma xxx


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## Twitchy (Aug 5, 2009)

Ho hum... no pump at least until the end of the first trimester... really frustrating appointment today, the consultant wasn't there, which was really disappointing.

The only advice I got was not to correct so much, to wait longer before reacting to let the insulin complete.  I've got to go back in a week.  I'm a bit frustrated as I had trace ketones today, which is v scary being pregnant, esp as I haven't tested positive for ketones in years.  Not a happy bunny.   

Got very upset as they also started querying whether I even meet the criteria for a pump, they kept telling me how expensive they are, and how they are confident they can manage the pregnancy on injections.  THEY?  Are THEY going to come around to my house & do my night time 3am booster shots while I sleep so I can get some rest?!  Don't think so. Anyway, I take their point about the first trimester, but the way they are now talking about pump criteria is quite frightening...I can see a lifetime of 3am jabs ahead of me & frankly it's a very depressing thought.

Oh well...


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## sofaraway (Aug 6, 2009)

twitchy, sorry to hear you had such a disapointing appointment, will the consultant be there next week when you go? 
If you have already been approved for the pump, it was like a few days before you were about to start wasn't it? then why they are questioning if you are still eligiable confuses me. 

Are you injecting fast acting insulin at 3am to counteract dawn phenomenon? Have you ever tried insultard at night? possibly since you've been diagnosed a long time, but have you tried it recently in combination with lantus? 

I hope things are better next week, this shouldn't be such a stressful time for you, so I hope things can be worked out and you can enjoy your pregnancy, keep posting here I'm sure you'll find support.


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## Twitchy (Aug 6, 2009)

Hiya,

yep, 3am boosters every day...mind you, I've been doing this for months now which is why I was to go on the pump in the first place, alas! 

At the mo I'm just getting braver with the background insulin (the manufacturers of Determir will make a nice profit this year at least!) & doing 2 hourly checks & corrections as required around the clock... 

What was really scary was waking up to do my booster at 3am today, with a BG of over 17 & +++ketones.  I don't have any contact details for out of hours, so dug out my old DAFNE notes, as I didn't know what to do.  Looking at the DAFNE rules (assuming ill because of the ketones) would have meant a dose of 16u 2hrly which seemed excessive even now (didn't want to go hypo with the following upswing), so I had 7u, and another few units at 5am.  Things were more reasonable by 7am but I still had ketones by 9am, when I went to see the GP just to be sure I don't have a water/kidney infection or something (achy lower back too!)...at least that was all clear, so it does just look like the ketones are just down to being pregnant.

I did eventually manage to speak to the consultant on the phone, he was very kind & reassuring & said that it looked like what I was doing was sensible & they'd start getting really worried if I was vomiting & couldn't eat... luckily although I'm feeling really sick with the ketones I'm still able to eat.  So I guess it comes down to gritting my teeth and getting on with it & trying not to get too stressed.  Certainly not holding my hopes up though... I don't think I'll let myself get even a bit excited until / unless we get a good, clear 20 week scan with a healthy baby... but to be honest at the mo, I'm kind of just waiting for what feels like the inevitable m... sorry that's so negative, but with such sugar & ketone levels I just don't feel very hopeful. I've lost confidence in my ability to control things tightly enough & I'm not sure the hospital are going to be able to help much.

Guess we'll just have to take it a day at a time.


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## Northerner (Aug 6, 2009)

Twitchy, this is all so much outside of my experience, but just wanted to say that I hope the levels settle soon and those ketones depart! I know you will do your absolute best to get things stabilised, it's a real shame that you're not getting the support you need.


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## Steff (Aug 6, 2009)

Twitchy;
  I don't have any contact details for out of hours said:
			
		

> god seems crazy you got to do that when it should not be that way xx good luck and hope you manage to get the care you deserve xxx


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## sueneil (Aug 11, 2009)

Not sure if this will help you , I am not pregnant but have had 5 children since being diabetic diagnosed in 1970 when 2 now 41 lol.
I never had a pump until last month and managed good healthy pregnancies.
However I do know that in my PCT area (Milton Keynes) they do put the pregnant ladies on pumps this I know as fact as I have a good friend who is a midwife and another who is a DSN. I am also an A&E sister


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## Twitchy (Aug 11, 2009)

Thanks everyone.  
I managed to get a grudging verbal consession that they might consider a pump if "absolutely necessary", but not until the second trimester.  Meanwhile, thank God the dawn phenom seems to have gone?!!  (sod's law though, I'll never get my mitts on a pump now...after all, they're "very expensive you know"!). 

I've managed to get it so that I'm running between 4.5 - 8 most of the time now during the day.  Night times... (checking 2hrly-ish, as advised, yawn..) it was quite stable for a couple of days (!) at around 5-6 over night (wow!), but now it's dropped slightly and is more persistantly 4-5 mmol, which feels a bit low... and I had a hypo of 2.8 the other night which was really scary because hubby was away...

But if I even have a 1/2 carb portion (cp, 10g) to nudge my blood glucose (bg) up before bed it goes up to the high 8's (8.6, 8.9) and I've been getting ketones at anything 9+ now, which means that if it goes to 8ish I have to have an extra cp + 2u insulin (2u because if I have 1u it just "disappears", hence the extra cp to absorb the extra unit)... And if I drop the background insulin (bi) at all (even 1u) it will go too high & I will end up with ketones again...so I will only end up having to lift the bi again after a few days of awful levels again... so at the mo I am having to eat biscuits periodically throughout the night!! Grrr.  Not good. 

So once again, as before, I am eating to the insulin & will put on loads  more weight (gained 2 st last time, never been able to shake it), will get told off for putting too much weight on, will get awful pre eclampsia again & all inall feeling a bit stressed at the mo.  I'm not eating fruit, as i can't carb count it accurately enough, I'm not exercising, as it totaly screws up my sugar levels...stress!!!

I've got a hospital appt tomorrow, but I'm not holding my breath.  I really feel like from a diabetes care point of view, I'm in this on my own at the mo.


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## Steff (Aug 11, 2009)

fingers crossed for you twitchy xx


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## Emmal31 (Aug 11, 2009)

wow well done on those levels you should be so proud of yourself! The whole night time thing sounds an absolute nightmare. Why are they saying that in your second trimester you might be able to get one, why not just give you it now? seems so daft. I had the second worst hypo i've had since diagnosis in the middle of the night last night was so horrible! hope the hospital appointment goes well tomorrow x


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