# howdy pumpers



## SilentAssassin1642

Hello =)

ok, so for a whole week last week I thought I had my overnights spot on. I was waking up with levels of 6 and 7. Awesome. But then...out of nowhere for the past few days I've been back ib the 9's and 10's 

I am a pumping enigma.

Now then, I daren't say I'm scheduling a basal test for x night because it will jinx me 

However, for some odd reasons since playing with my onight basals (the ones I thought were done awesomely...) I've noticed that during the mornings at work I float at somewhere between 8 and 10...very annoying and yet again after lunch I tend to shoot up higher than normal (today it was 2...I accepted that cuz I started on 9 or something...and lunch is always an issue especially if i buy lunch out :/) but then, right before I leave for work and despite setting pump to 0% an hour before leaving due to epic walk home...I find myself dropping. Like a freakin' stone. I eat, I still drop and this is with 0% basal for an hour or so. 

I don't get it.

Now, I know a daytime test is due. However at work this is kinda difficult becuase I have to set pump to 0% ready for my walk to work and then switch it back to normal when I get to work.

My question is thus...how do I work a daytime basal test around that factor. Surely if I set to 0% for my walk, that's gunna mess up any daytime results? And also, surely I need to get night times spot on...

And yes, I am sheduling a night time one at some stage this week...I'm just not gonna tell you guys when because whenever i do something goes wrong 

many thank yous


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## Ellie Jones

Sam

Use another profile for work..

How does your present profile work for a day off?

It might be that with your work profile, not only do you need to a zero basal to cover the walk, but when you start delivering your basal, you may need a increase of basal (a wack) to stop your BG going upwards..  

Its easier to work with this as a basal for work days,

And rest days work with another basa profile to get a stable day off...

As you do a 2 shift, need a separate basal profile for each shift, once sort you just flick you basal to which every profile you need..


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## SilentAssassin1642

no one told me about different profiles...

great, yet again i show myself as useless...i've been muddling through with the same basals for every different shifts 

this sucks


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## bex123

hiya sam i have 3 profiles one for hormones one for normal days and one for super hectic days... they are brilliant means you just set it up once for however many you need and then next time you need to change your profile its really easy..u just activate it  if that makes sence lol

ps good luck with the daytime basal test..... ive never managed to do a full one yet !

pps ..if you flick through the pump menu you will get to basal rate selection , you just go into that and set up as many profiles as u need


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## SilentAssassin1642

oooh! EPIC!

So to start them up do I just like...set it up exactly the same but like, change the basals for the times I leave work and then basal test accordingly?



wow, i wish pump nurse had told me all of this


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## Adrienne

Hiya

Yep set the basals exactly the same as a starting point.

Remember that generally what you do to a basal will have an effect 2 hours later.   Therefore if you are high at say 10 am you will need to tweak an 8 am basal and similarly if you are low at say 6 pm you need to tweak the basal at 4 pm.   

This is a general rule of thumb and even that may need tweaking by an hour or so.

You are going great Sam, you are getting there, it just takes ages.


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## bex123

yup , i should say what ever time slot u get the problem in you need to adjust the time slot before it... if u see what i mean .... gah i should wake up before i type


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## SilentAssassin1642

I hink I will start playing tomorrow on my day-off - set up a 12-8 profile etc...

its all very confusing  i feel like i ask too many stupid questions


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## purpleshadez

Hi Sam,

I just wanted to stick my oar in so to speak. I don't think your questions are stupid. Nor do I think you are stupid for not knowing about the profiles options in the pump. If no one tells you about them then you are not going to know that they are there. 

Not everyone is brave enough, if that is the right word to use, to go in and explore all the options if they are unsure as to what they are or how it will affect them. Especially with a device on which your life depends!

Getting to grips with the pump does take an age! I started in March and I am still tweaking various points and there are others on here who have been pumping for longer and still need to tweek levels. I know the basal testing can be frustrating but you are doing well with it.

Basically what I am trying to say is, chin up, stick with it, and you are doing great 

Martin.


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## shiv

Yep I have 3 different profiles - one for my days off, one for morning shifts ( working 7am - 3pm) and one for late shifts (working 1.30pm - 9.30pm). I need totally different things for all three profiles so it's great having the ability to set them!


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## Rainbow

I also use 3 profiles. One for work, one for non working days that aren't at the weekend and a weekend profile. I could do with a fourth for the time before ovulation as that really tests me! But alas my pump only has three so I am currently trying temporary basal rates to solve that but not there yet. 
When I began tweaking my work basal I used my non working profile as a starting point and tweaked it slowly in three hour blocks. It did take a few weeks to sort but it feels really good now that I have. On the other hand I'm not so confident yet using temporary basals so I know how you feel about adding another element to pumping. No question is stupid, this place is great for pooling knowledge and if we can share something that makes a difference then how blessed we are.

I have been pumping for five months and still haven't eaten rice- now that's stupid!! 

My DSN went on a course last week run by a pump company. She was told that all meals above 50g should be dual waved. 30/70% over 30 mins or starting at 60mins depending on fat content. I was told at training to use DW for meals above 60g. We're learning all the time. 

Weetabix still puzzles me! Pump or no pump can I crack it, I'm not giving it up tho!!  

Take Care, you're doing great even though at times it definitely doesn't feel like it x


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## Adrienne

purpleshadez said:


> Hi Sam,
> 
> I just wanted to stick my oar in so to speak. I don't think your questions are stupid. Nor do I think you are stupid for not knowing about the profiles options in the pump. If no one tells you about them then you are not going to know that they are there.
> 
> Not everyone is brave enough, if that is the right word to use, to go in and explore all the options if they are unsure as to what they are or how it will affect them. Especially with a device on which your life depends!
> 
> Getting to grips with the pump does take an age! I started in March and I am still tweaking various points and there are others on here who have been pumping for longer and still need to tweek levels. I know the basal testing can be frustrating but you are doing well with it.
> 
> Basically what I am trying to say is, chin up, stick with it, and you are doing great
> 
> Martin.



Hi

Just want to say I agree with Martin here Sam.

I would also like to say that once you think you have all the basals right then you may think that is that.    Unfortunately it isn't and things will always change and there may be the odd tweak or two every so often but it won't be as much as what you are doing at the moment.   Just get through this bit, get it sorted now and then you will second nature to you to do the odd tweaking here and there.


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## Adrienne

Rainbow said:


> My DSN went on a course last week run by a pump company. She was told that all meals above 50g should be dual waved. 30/70% over 30 mins or starting at 60mins depending on fat content. I was told at training to use DW for meals above 60g. We're learning all the time.



Mmmmm no idea what pump company told your DSN that but that is not always the right way to do things.    I can easily bolus Jessica when she has 100 g carbs all at once if the meals needs it.

A starting point for everyone who doesn't know the best dual wave is always 50/50 over 2 hours and you work from there.    We have found that 30/70 over 4 hours is fabulous for Jessica for all pasta and rice.  However if we are looking at a chinese takeaway we bolus about 100 g carbs (she is a child by the way so would eat less) and do 50/50 over 6 hours !   It works.

You are right, it is a huge learning curve and after 4 years it is still, for us as well, a learning game.


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## Ellie Jones

My dual wave aren't never as long at that, norm is aorund 90 minutes, if I'm eating chinese etc, I check about the 3 hour mark and set a TBR if necessary..  I split my dual wave, large dose first other wise I spike too much, the actually split used will be dependant on starting BG and carb type..

But once you've got up and runing, then you still have to monitor, do the occasional fasting test to ensure every is still in line, and tweak as necessary, we aren't machine that trudden on in the same manner...

When tweaking I find that I need to do it very much nearer to the time I need it to change than most pumpers, but it works for me..


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## Adrienne

Ellie Jones said:


> My dual wave aren't never as long at that, norm is aorund 90 minutes, if I'm eating chinese etc, I check about the 3 hour mark and set a TBR if necessary..  I split my dual wave, large dose first other wise I spike too much, the actually split used will be dependant on starting BG and carb type..
> 
> But once you've got up and runing, then you still have to monitor, do the occasional fasting test to ensure every is still in line, and tweak as necessary, we aren't machine that trudden on in the same manner...
> 
> When tweaking I find that I need to do it very much nearer to the time I need it to change than most pumpers, but it works for me..



See, this is where everyone is different.   We tried 1 hour, 2 hour, 3 hour etc etc, we tried more up front or equal etc etc and it was our DSN who pumps herself who suggested 80 carbs (as a guess) and 50/50 5 hours so we took it from there and ended up with what we do now as carb intake has increased due to getting older and eating more.

We generally still need tweaking two hours before anything happens except regarding the breakfast spike at 10 am where we need to tweak the basal at 5 am so a whole 5 hours before.  Amazing really.

This is why it is so very individualised for each person.


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## SilentAssassin1642

aww thank you guys

I'm gonna try and do a test overnight tonight, but to be brutally honest with you I'm suffering epic burnout right now. It's obvious something is happening early morning before I wake up and part of me just wants to play with the 3am-wake up times and just fingers crossed hope it works. Last night I hypoed before bed, so couldn't test. If that happens again tonight, I just...I just don't even know.

It just seems that no matter what I do, I can't wake up on decent levels. When I tested at 3am last night I was at 11 or whatever it was. I corrected and woke up at 7.1. Epic. But something needs doing.

I'm not sure I can handle another all night tester right now. But I *know* it needs doing. 

I just feel like all I'm doing is basal testing. I feel like I'm so behind with everything too. I was hoping that after nearly 3 months I would have cracked at least some of it but it seems I just cannot get it right. There have been many tears shed over it.

I just NEED to get this sorted so I can start playing with my daytime rates and playing with these profile things. It's just so blummin difficult   and I'm gonna admit there are times at the moment where I just don't want to care and I find myself thinking so negatively and wanting to go back to my pens. I feel like all I'm doing right now is fighting it, and fighting the prejudices of various people. Just...urgh.


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## Adrienne

SilentAssassin1642 said:


> aww thank you guys
> 
> I'm gonna try and do a test overnight tonight, but to be brutally honest with you I'm suffering epic burnout right now. It's obvious something is happening early morning before I wake up and part of me just wants to play with the 3am-wake up times and just fingers crossed hope it works. Last night I hypoed before bed, so couldn't test. If that happens again tonight, I just...I just don't even know.
> 
> It just seems that no matter what I do, I can't wake up on decent levels. When I tested at 3am last night I was at 11 or whatever it was. I corrected and woke up at 7.1. Epic. But something needs doing.
> 
> I'm not sure I can handle another all night tester right now. But I *know* it needs doing.
> 
> I just feel like all I'm doing is basal testing. I feel like I'm so behind with everything too. I was hoping that after nearly 3 months I would have cracked at least some of it but it seems I just cannot get it right. There have been many tears shed over it.
> 
> I just NEED to get this sorted so I can start playing with my daytime rates and playing with these profile things. It's just so blummin difficult   and I'm gonna admit there are times at the moment where I just don't want to care and I find myself thinking so negatively and wanting to go back to my pens. I feel like all I'm doing right now is fighting it, and fighting the prejudices of various people. Just...urgh.



Test at 2 am not 3 am.   If the 2 am is ok, and you are always finding the 3 am is too high then add in a basal at about 1.30 slightly higher than it is at.

If you find normally that the basal carries you through from 3 am to wake up time pretty level then you know the basal is ok at that time and you just need a kick start to get you to an ok level at 3 am, the basal, which you know is ok, will then carry you through to wake up time.

Trial and error and that may not help.   

So if above makes sense, you will have to add in two basals, one at 1.30 am slightly higher and then one at say 3 am back down to what it was so all you are doing is adding in 1 1/2 hours of a slightly high basal to take you down so that the ok basal will take you through and wake up at ok level.

Try it and see.


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## SilentAssassin1642

hello, i'm super exhausted, didn't sleep partly reasons i don't want to discuss but also through testing

2am 5.6
4am 8.6

so

looks like a 3am basal rise is on the cards. i actually corrected that 8.6 - I say corrected, my tired self gave 1u and a bit. Waking bg 5.6


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## Adrienne

Ok, what basals do you have at the moment Sam from midnight.  Type them in a list for us.


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## tracey w

SilentAssassin1642 said:


> hello, i'm super exhausted, didn't sleep partly reasons i don't want to discuss but also through testing
> 
> 2am 5.6
> 4am 8.6
> 
> so
> 
> looks like a 3am basal rise is on the cards. i actually corrected that 8.6 - I say corrected, my tired self gave 1u and a bit. Waking bg 5.6



Going off this, I would want the change from 2 am, so i would change midnight to affect 2-3 am, change 1am to affect 3-4 am.

I would be tempted to test at 3am to see if there is a rise maybe first? A 3 am change would usally kick in at 5 am too late, or for some 4am again too late as you have already risen.


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## Adrienne

tracey w said:


> Going off this, I would want the change from 2 am, so i would change midnight to affect 2-3 am, change 1am to affect 3-4 am.
> 
> I would be tempted to test at 3am to see if there is a rise maybe first? A 3 am change would usally kick in at 5 am too late, or for some 4am again too late as you have already risen.



I agree.   I think Sam has said that when she has tested at 3 am before she is high already so I would guess the rise is starting at 2.30 odd to make her high at 3 am so I would suggest, like you said, putting in a higher temp at 12.30 or 1 am (probably 1 am to see what happens first of all) as not everyone needs the 2 hours before and I am always wary about night times.

Do you agree Tracey?  I know you've done all this as well.


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## tracey w

Adrienne said:


> I agree.   I think Sam has said that when she has tested at 3 am before she is high already so I would guess the rise is starting at 2.30 odd to make her high at 3 am so I would suggest, like you said, putting in a higher temp at 12.30 or 1 am (probably 1 am to see what happens first of all) as not everyone needs the 2 hours before and I am always wary about night times.
> 
> Do you agree Tracey?  I know you've done all this as well.



Absolutely what i would do, but for me i would start two hours before to get my affect, depends how long Sam needs for the change to affect her, she will know.  The spirit combo lets you change on the hour only not half past.


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## SilentAssassin1642

here's my current basal rates from midnight

00.00-01.00 - 0.43
0100 - 0200 - 0.43
0200 - 0300- 0.47
0300- 0400 - 0.52

I dunno what to change   and I want to do a change tonight.

Help?


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## SilentAssassin1642

tracey w said:


> Absolutely what i would do, but for me i would start two hours before to get my affect, depends how long Sam needs for the change to affect her, she will know.  The spirit combo lets you change on the hour only not half past.



I've noticed that even changing an hour before things tend to go upside down...

like for instance if I put a 0% on an hour before I leave work, and then I get home and I'm still hypo.

I'm so confused with all of this at the moment

(and sleep deprived...)


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## Adrienne

SilentAssassin1642 said:


> here's my current basal rates from midnight
> 
> 00.00-01.00 - 0.43
> 0100 - 0200 - 0.43
> 0200 - 0300- 0.47
> 0300- 0400 - 0.52
> 
> I dunno what to change   and I want to do a change tonight.
> 
> Help?



Gosh a different one each hour.   Is it like this throughout the 24 hour period?   If so maybe that is why you are getting confused.  Did you put these all in yourself?

Do you have the Medtronic (I thought you did but maybe you don't).  If you say things take effect only after an hour then maybe you should change the 1am basal be 0.47 so you get an extra hour at the higher rate, ie same as the 2 am basal.

I can't obviously guarantee this will be right but it is a start.  Tracey, do you agree?    Sam can pull it back to 12.30 if needed or even go forward to 1.30 if it doesn't work (if she has the Medtronic of course which does do the half hour).


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## SilentAssassin1642

Adrienne said:


> Gosh a different one each hour.   Is it like this throughout the 24 hour period?   If so maybe that is why you are getting confused.  Did you put these all in yourself?
> 
> Do you have the Medtronic (I thought you did but maybe you don't).  If you say things take effect only after an hour then maybe you should change the 1am basal be 0.47 so you get an extra hour at the higher rate, ie same as the 2 am basal.
> 
> I can't obviously guarantee this will be right but it is a start.  Tracey, do you agree?    Sam can pull it back to 12.30 if needed or even go forward to 1.30 if it doesn't work (if she has the Medtronic of course which does do the half hour).



not all the time, am on pretty much the same for a few hours at a go in the day...

0500-0700 - 0.60
0700-1200 - 0.55
1200- 1600 0.60
1600-2000- 0.55
2000-000 0.45

then during the night it gets all scewiff...I'm ok til 2am then boom, high at 3-4am. I'm just all like 

So, dyu think I should up it to something the same between maybe 12-3?

Also, I'm on the roche spirit combo,not the medtronic...


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## Adrienne

SilentAssassin1642 said:


> not all the time, am on pretty much the same for a few hours at a go in the day...
> 
> 0500-0700 - 0.60
> 0700-1200 - 0.55
> 1200- 1600 0.60
> 1600-2000- 0.55
> 2000-000 0.45
> 
> then during the night it gets all scewiff...I'm ok til 2am then boom, high at 3-4am. I'm just all like
> 
> So, dyu think I should up it to something the same between maybe 12-3?
> 
> Also, I'm on the roche spirit combo,not the medtronic...



Oh ok.   Where have you come up with the odd numbers ie 0.43 or 0.47,  do you not think it would be easier to work with numbers like the rest of the day ie 0.45 and 0.40 and 0.50 etc.

If so then you could change it all a bit.


00.00-01.00 - 0.43
0100 - 0200 - 0.43
0200 - 0300- 0.47
0300- 0400 - 0.52

I would maybe do this :


00.00-01.00 - 0.45
0100 - 0200 - 0.50
0200 - 0300- 0.50
0300- 0400 - 0.50

So you will be looking at :

0000 - 0100  -  0.45
0100 - 0500  -  0.50
0500 - 0700 - 0.60
etc etc

I take it you can't use the half hour like Tracey, is that right?

All I have done is round things up and down and make the 1 am the higher amount so you are getting a bit more for an extra hour.  You may find you need to make it 0200 starting at 0.50 if you go hypo at 3 am.   It is just trial and error.

I was thinking about your post breakfast spike and once you are waking up ok, you could tweak that 5 am basal a bit higher and see if that counter balances the post breakfast spike.   This is where we have to tweak if for Jessica for a 10 am post spike, a full 5 hours before it happens.


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## SilentAssassin1642

Adrienne said:


> Oh ok.   Where have you come up with the odd numbers ie 0.43 or 0.47,  do you not think it would be easier to work with numbers like the rest of the day ie 0.45 and 0.40 and 0.50 etc.
> 
> If so then you could change it all a bit.
> 
> 
> 00.00-01.00 - 0.43
> 0100 - 0200 - 0.43
> 0200 - 0300- 0.47
> 0300- 0400 - 0.52
> 
> I would maybe do this :
> 
> 
> 00.00-01.00 - 0.45
> 0100 - 0200 - 0.50
> 0200 - 0300- 0.50
> 0300- 0400 - 0.50
> 
> So you will be looking at :
> 
> 0000 - 0100  -  0.45
> 0100 - 0500  -  0.50
> 0500 - 0700 - 0.60
> etc etc
> 
> I take it you can't use the half hour like Tracey, is that right?
> 
> All I have done is round things up and down and make the 1 am the higher amount so you are getting a bit more for an extra hour.  You may find you need to make it 0200 starting at 0.50 if you go hypo at 3 am.   It is just trial and error.
> 
> I was thinking about your post breakfast spike and once you are waking up ok, you could tweak that 5 am basal a bit higher and see if that counter balances the post breakfast spike.   This is where we have to tweak if for Jessica for a 10 am post spike, a full 5 hours before it happens.



you are an angel!

Those random ones were me thinking that tidgy adjustments would work best...they didn't. I failed yet again D:

*is going to favourite this thread*

re breakfast, the only thing i've found to not hugely spike me is sainsburys own instant hot oats. Very odd. But when I get to work I'm either hypo or floating at 8/9 where I stay for the rest of the day and it irritates me no end. But its the post lunch that gets me...anywhere between 13 and 19 most days after lunch, despite eating the same, and doing exactly the same with insulin each day. Very annoying. Just as soon as I'm waking up on decent levels I can start tweaking day time, cuz that needs tackling asap!


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## tracey w

Adrienne said:


> Gosh a different one each hour.   Is it like this throughout the 24 hour period?   If so maybe that is why you are getting confused.  Did you put these all in yourself?
> 
> Do you have the Medtronic (I thought you did but maybe you don't).  If you say things take effect only after an hour then maybe you should change the 1am basal be 0.47 so you get an extra hour at the higher rate, ie same as the 2 am basal.
> 
> I can't obviously guarantee this will be right but it is a start.  Tracey, do you agree?    Sam can pull it back to 12.30 if needed or even go forward to 1.30 if it doesn't work (if she has the Medtronic of course which does do the half hour).



I do agree, i would start at 1am if you see an effect after 1 hour Sam, you can always go back to upping the midnight one if it is not enough.  Just checking are you sure its 1 hour not 2, because i would think thats why you hypo after work you are not changing to the zero percent early enough and the basal the hour before the zero is having the effect?


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## SilentAssassin1642

tracey w said:


> I do agree, i would start at 1am if you see an effect after 1 hour Sam, you can always go back to upping the midnight one if it is not enough.  Just checking are you sure its 1 hour not 2, because i would think thats why you hypo after work you are not changing to the zero percent early enough and the basal the hour before the zero is having the effect?



mmmhmmm. Could well be...but having 0% on for before the hour before i leave for work...it frightens me a bit. Nurse may have been all like ONLY DO IT AN HOUR BEFORE OR YOU WILL GET SICK or something to that extent.......

maybe an hour and a half before I leave.

So say for instance, I get up at bout 6.30/7 every morning, and leave the house at 8.15. So If i set the TBR for say 6.45am at 0% and leave it going for 2.5 hours? Same for when I leave from work, maybe start it half an hour earlier than usual? Urgh, I dunno. Head about to implode from all the complicated numbers


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## tracey w

Sam i only change rates up or down by 0.05 each time, as you have found the tiny amounts will make no difference, think about 0.05 its very small, if its not enough up it again the next day.........you go a long way before this is even 1 unit.

Now think about mdi, huge difference the pump can make eh, dont give up you will get there.


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## SilentAssassin1642

tracey w said:


> Sam i only change rates up or down by 0.05 each time, as you have found the tiny amounts will make no difference, think about 0.05 its very small, if its not enough up it again the next day.........you go a long way before this is even 1 unit.
> 
> Now think about mdi, huge difference the pump can make eh, dont give up you will get there.



Thank you tracey - gonna bear that in mind for future  

Hoping Adrienne's suggestions bear some kind of fruit most definitely. Need a night off tonight however, and may have had a glass of rather strong (18 year old...) JD and coke! Oops. 

If I wake up with brilliant numbers however tomorrow  But I guess like anything it will take a few days to show properly? Or am I still in MDI mindset?


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## tracey w

SilentAssassin1642 said:


> mmmhmmm. Could well be...but having 0% on for before the hour before i leave for work...it frightens me a bit. Nurse may have been all like ONLY DO IT AN HOUR BEFORE OR YOU WILL GET SICK or something to that extent.......
> 
> maybe an hour and a half before I leave.
> 
> So say for instance, I get up at bout 6.30/7 every morning, and leave the house at 8.15. So If i set the TBR for say 6.45am at 0% and leave it going for 2.5 hours? Same for when I leave from work, maybe start it half an hour earlier than usual? Urgh, I dunno. Head about to implode from all the complicated numbers



I didnt want to get too in depth i know you are tackling a lot! But i used to do zero and disconnections for exercise, but my consultant is not happy with disconnections or no insulin for long periods. My lowest now is 0.05, i exercise on full amount and TBR for a few hours after, better to have small snack than no insulin, it just messes you up later on. 

If you are exercising (walking to work), i would not do zero basal, i would give less breakfast insulin as you are exercising.

I would not do zero at all now especially not 2.5 hours, this could be why you rise much higher later Sam, just a thought.


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## SilentAssassin1642

tracey w said:


> I didnt want to get too in depth i know you are tackling a lot! But i used to do zero and disconnections for exercise, but my consultant is not happy with disconnections or no insulin for long periods. My lowest now is 0.05, i exercise on full amount and TBR for a few hours after, better to have small snack than no insulin, it just messes you up later on.
> 
> If you are exercising (walking to work), i would not do zero basal, i would give less breakfast insulin as you are exercising.
> 
> I would not do zero at all now especially not 2.5 hours, this could be why you rise much higher later Sam, just a thought.



now that's an idea...maybe if I stick myself on a 10/20%? And slash my breakfast insulin by a bit?

Whoa very confusing...

p.s. you can do a 0.05 TBR????


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## tracey w

SilentAssassin1642 said:


> Thank you tracey - gonna bear that in mind for future
> 
> Hoping Adrienne's suggestions bear some kind of fruit most definitely. Need a night off tonight however, and may have had a glass of rather strong (18 year old...) JD and coke! Oops.
> 
> If I wake up with brilliant numbers however tomorrow  But I guess like anything it will take a few days to show properly? Or am I still in MDI mindset?



yep thats mdi forget it!


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## SilentAssassin1642

so plan, I'm gonna try and stick myself on a 20% TBR for 2.5 hours pre leaving tomorrow, so from 6.45 instead of 7.15 (or whatever time I leave). Also, have put myself to a 1:8 ratio at bfast instead of a 1:7 - just to play around with it. 

And will do the same pre leaving work.

Now, I am off for a bath and bed


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## Adrienne

SilentAssassin1642 said:


> now that's an idea...maybe if I stick myself on a 10/20%? And slash my breakfast insulin by a bit?
> 
> Whoa very confusing...
> 
> p.s. you can do a 0.05 TBR????



Tracey is right.   For exercise for a half hour swimming lesson, an hour before we put on a 50% temp basal for four hours !!! Within that four hours though there is an hour where the pump is off and she is getting changed so there is three hours of 50%.

You could try a 20% tbr for a few hours putting it on an hour beforehand.   Or an hour and a half before hand.   Then start tweaking that up as needed.

The rule of thumb for exercise is to eat your body weight in free carbs.   So for example Jessica is 42 kilos and so should eat 40 free carbs.    This is just a starting point and may be too much or in come cases not enough.   You could start by 20 free carbs and see what that does and take it from there.  ie only bolus for part of breakfast making 20 carbs of it free !

Good luck, I think you are finally getting there and understanding it, which is fab.  xx


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## tracey w

SilentAssassin1642 said:


> so plan, I'm gonna try and stick myself on a 20% TBR for 2.5 hours pre leaving tomorrow, so from 6.45 instead of 7.15 (or whatever time I leave). Also, have put myself to a 1:8 ratio at bfast instead of a 1:7 - just to play around with it.
> 
> And will do the same pre leaving work.
> 
> Now, I am off for a bath and bed



good luck worth a try, least you will have no zero insulin as thats not a great idea really.


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## tracey w

SilentAssassin1642 said:


> now that's an idea...maybe if I stick myself on a 10/20%? And slash my breakfast insulin by a bit?
> 
> Whoa very confusing...
> 
> p.s. you can do a 0.05 TBR????



hmmm, yes but you would need to see what ratio you are on for that hour if it makes sense, eg. if its 0.10 and you do 50% decrease that would be 0.05............dont ask me work out anything harder this late but you get the picture.


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## SilentAssassin1642

Adrienne said:


> Tracey is right.   For exercise for a half hour swimming lesson, an hour before we put on a 50% temp basal for four hours !!! Within that four hours though there is an hour where the pump is off and she is getting changed so there is three hours of 50%.
> 
> You could try a 20% tbr for a few hours putting it on an hour beforehand.   Or an hour and a half before hand.   Then start tweaking that up as needed.
> 
> The rule of thumb for exercise is to eat your body weight in free carbs.   So for example Jessica is 42 kilos and so should eat 40 free carbs.    This is just a starting point and may be too much or in come cases not enough.   You could start by 20 free carbs and see what that does and take it from there.  ie only bolus for part of breakfast making 20 carbs of it free !
> 
> Good luck, I think you are finally getting there and understanding it, which is fab.  xx



 this is so complicated. My 40g bowl of borridge is 33g carbs...so erm...that would mean bolusing for just 10g of that  whoa, this is making my head hurt  unless...unless I have a large bowl of breakfast, bolus as normal?

Blimey, this is all too complicated for nearly 11pm. I'm off to beddy byes - thankfully tomorrow is just a 5 hour shift so fingers crossed I can get something working hehe.

Have changed those settings and praying praying praying that something a bit more friendly happens tonight. I might shedule a 3am test or a 4am, just because I'm curious


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## tracey w

SilentAssassin1642 said:


> this is so complicated. My 40g bowl of borridge is 33g carbs...so erm...that would mean bolusing for just 10g of that  whoa, this is making my head hurt  unless...unless I have a large bowl of breakfast, bolus as normal?
> 
> Blimey, this is all too complicated for nearly 11pm. I'm off to beddy byes - thankfully tomorrow is just a 5 hour shift so fingers crossed I can get something working hehe.
> 
> Have changed those settings and praying praying praying that something a bit more friendly happens tonight. I might shedule a 3am test or a 4am, just because I'm curious



I know your tired, but if you make a change you do need to test to see if it works or needs tweaking. If it helps im doing 3am as im going to bed on 6ish and getting up at 8 or 9ish, things change all the time! good luck.


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## Adrienne

SilentAssassin1642 said:


> this is so complicated. My 40g bowl of borridge is 33g carbs...so erm...that would mean bolusing for just 10g of that  whoa, this is making my head hurt  unless...unless I have a large bowl of breakfast, bolus as normal?
> 
> Blimey, this is all too complicated for nearly 11pm. I'm off to beddy byes - thankfully tomorrow is just a 5 hour shift so fingers crossed I can get something working hehe.
> 
> Have changed those settings and praying praying praying that something a bit more friendly happens tonight. I might shedule a 3am test or a 4am, just because I'm curious



This is just a rule of thumb and you can start differently but have that in the back of your mind.  

You could try one thing or another ie either the temp basal an hour before for the free carbs.    I would start with the TBR and forget the free carbs.   That way you can see what effect the TBR has.

This may seem a lot of faffing around but it is all practice and practice makes perfect.  You are on the right tracks.  This doesn't happen over night.  We are nearly 4 years down the line with pumping and I still learn stuff.

Night


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## SilentAssassin1642

tracey w said:


> I know your tired, but if you make a change you do need to test to see if it works or needs tweaking. If it helps im doing 3am as im going to bed on 6ish and getting up at 8 or 9ish, things change all the time! good luck.



bu...bu...i's just want a full night sleeeppppppppp *cries*

I'm going...to...be...zzzzzzzzz 

I'll see you at 3am


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## Adrienne

tracey w said:


> I know your tired, but if you make a change you do need to test to see if it works or needs tweaking. If it helps im doing 3am as im going to bed on 6ish and getting up at 8 or 9ish, things change all the time! good luck.



Yep I'm with you on the 3 am but might make it 3.30.   I don't set the alarm anymore, I just wake up, not good eh !


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## SilentAssassin1642

tracey and adrienne, thank you for being awesome. I am being summoned to bed now, so I best be off before I get the death glare 

Will let you lovelies know how things go overnight 

eta: how about 3.15?


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## Adrienne

SilentAssassin1642 said:


> tracey and adrienne, thank you for being awesome. I am being summoned to bed now, so I best be off before I get the death glare
> 
> Will let you lovelies know how things go overnight
> 
> eta: how about 3.15?



3.15 sounds good.  Night Sam, you best get off before you get me and Tracey into trouble.


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## rossoneri

Hey very interesting thread.

I have only just picked up what you have been discussing here but lots of very helpful insight on how each of you are dealing with these issues.  This intricate degree of control is very challenging.  I won't butt in with my questions now while Sam is still making progress, as I don't want to distract from the assistance to improving her control.

In the meantime I just want to say that I hope all three of you get useful and/or good results from your 3am tests (if Adrienne is also waking up to test her daughter).  I might also still be around at that time as I am currently doing some work at home and there is also a radio programme I like to listen to in the early hours of Saturday morning!    If so then I can add a further sense check, if you like, to what gets posted and certainly authenticate any maths that might need doing.  Like Sam and Tracey I am on the Accu Combo too.


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## SilentAssassin1642

well i woke up just now and found my phone across the other side of the room, on silent (I left it on loud last night...) and no evidence of a 3am test at all.

And a fasting bg of 14.7 

told you i was tired...and i know thats no excuse. I must have thrown my phone across the room when it started beeping at me.

So I'm sat here feeling rough as anything and very sorry for myself. Looks like I'll have to keep a closer eye on things tonight again with a couple of tests. I'll make sure matt knows dinner for me is gonna be boring, or just a teeny bit of whatevers planned at an earlier time.

 i feel like a failure 

No breakfast for me, I feel so sick I can't face any kind of food. Might have a yogurt before work. I don't know. least there's no sign on any ketones.

seriously thinking a cgm would help me out...nursey???


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## tracey w

Sam, did you not set alarm to test on meter, i find thats enough and the light certainly wakes me before the alarm beeps?

Try again tonight if you are up to it.

my results 12.30 am 6.9 (still had bolus working from supper at 9pm)
                03.30 am 4.9
                7.30 am  6.1 (not the usual 8 or 9, but i know im rising here and the bolus made me lower during the night)


so i will increase my basal 0.05 at 2am and same at 3am to effect my rise which i think is happening after 4am, i will test again to check

but maybe not tonight as i will be having chinese late and will be on a 6 hour dual wave most of the night!


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## Adrienne

SilentAssassin1642 said:


> well i woke up just now and found my phone across the other side of the room, on silent (I left it on loud last night...) and no evidence of a 3am test at all.
> 
> And a fasting bg of 14.7
> 
> told you i was tired...and i know thats no excuse. I must have thrown my phone across the room when it started beeping at me.
> 
> So I'm sat here feeling rough as anything and very sorry for myself. Looks like I'll have to keep a closer eye on things tonight again with a couple of tests. I'll make sure matt knows dinner for me is gonna be boring, or just a teeny bit of whatevers planned at an earlier time.
> 
> i feel like a failure
> 
> No breakfast for me, I feel so sick I can't face any kind of food. Might have a yogurt before work. I don't know. least there's no sign on any ketones.
> 
> seriously thinking a cgm would help me out...nursey???



CGMS  - great idea, its a great idea for everyone.

You are not a failure.   You are human and you need sleep and sometimes you just get too tired.   So no worries.   You need to find that rise.   It may not be until 4 am ish not 3 am ish, so try and test at 3 am.   Could you OH test you at 3 am for a change without waking you, any chance of that perhaps !


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## rossoneri

SilentAssassin1642 said:


> well i woke up just now ... and no evidence of a 3am test at all.
> And a fasting bg of 14.7
> told you i was tired...and i know thats no excuse ...
> i feel like a failure ...
> seriously thinking a cgm would help me out...nursey???


Sam, being too tired is a very good excuse for missing a middle of night BG test and is certainly no reason to feel like a failure.  As Adrienne says we are all only human.  
If it is any consolation after settling down last night to listen to my radio show whilst completing my last email I awoke at 7am still in my chair, my laptop warming my lap, a couple of biscuits lying on the floor and a BG of 2.8 - I guess I should have eaten all of those biscuits that I had Bolused for!    After I had had a few jelly babies and re-booted my PC I was faced with an email from my colleague asking what had happened to my email, a complete fail on my part!    Oh well, it is now sent but they probably won't read it until Monday morning their time.  I guess I was more tired than I thought, at least the radio prog is available on the iplayer.  

CGM soulds like a very sensible idea for you.


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## Rainbow

CGM has *got* to be an option fo you.  My team hooked me up for 6 days when I was struggling with my work profiles and it provided me with some of the answers I needed regarding my basal rates.  It does tend to beep alot during the night though so catch up on some sleep before you even consider it!


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## SilentAssassin1642

so last night a painful cannula lead to a change at about 11pm. It hurt and was itching and burning. Not nice. So changed and found the old one to be covered in blood and it looked like a teeny tiny kink in. May have been my eyes though. This lead to obviously having to prime the cannula, 1u active insulin with a pre bed level of 6.9 and it kept dropping. So basal testing was out. However, I topped myself up with a mouthful of lucozade. 3am I found myself ar 3.8, mouthful of lucozade. 5am 11.9, correction. 10am wakeup 5.6 

New cannula feels much better and hopefully today/tonight will be better.


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## tracey w

Sam, shouldnt really drop too much after priming the canula, after all the 1u is just filling the canula. If you find you are droping after, maybe you should have a small snack at same time?

to drop to 3.8 from 6.9 after priming is not right? I would suggest basal or bolus for food more likely the problem.


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## SilentAssassin1642

tracey w said:


> Sam, shouldnt really drop too much after priming the canula, after all the 1u is just filling the canula. If you find you are droping after, maybe you should have a small snack at same time?
> 
> to drop to 3.8 from 6.9 after priming is not right? I would suggest basal or bolus for food more likely the problem.



tracey, there was no active insulin on board (i doubl checked...scuse spelling mistakes, recovering from a 2.8...) ut i find after every cannula change and prime I drop like a stone  maybe I should start backing it up with a snack  or prime with less?? 

I'm all cuffuffled


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## tracey w

SilentAssassin1642 said:


> tracey, there was no active insulin on board (i doubl checked...scuse spelling mistakes, recovering from a 2.8...) ut i find after every cannula change and prime I drop like a stone  maybe I should start backing it up with a snack  or prime with less??
> 
> I'm all cuffuffled



dont prime with less as the tube wont be filled, maybe think about small snack in that case. I do occasionally drop a little following set/canula change but not to the extent i need cho.

concentrating lowers me too, i find i drop 2-3 mmol when driving! they say 5 to drive i make sure im at least 7!


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## Ellie Jones

I've got a feeling the drop is partly due to the cannular prime, comparing it to my prime it's a lot..

I  use the tenderlink 13mm and the prime for this is 0.5 units...

I'd double check your booklet that comes in the the box to check what prime to give


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## SilentAssassin1642

Ellie Jones said:


> I've got a feeling the drop is partly due to the cannular prime, comparing it to my prime it's a lot..
> 
> I  use the tenderlink 13mm and the prime for this is 0.5 units...
> 
> I'd double check your booklet that comes in the the box to check what prime to give



yeah, i didn't go for the tenderlinks, they frightened me. I use the flexlinks - 

I've just checked the leaflet and it says to do 0.7 prime. Is that where I'm going wrong then? At least with what happened last night and with every other cannula change I've done?


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## Ellie Jones

It may not be the total answer, but probably played a part, it does depend on how sensitive you are to insulin, 0.2 units for me can cause a lot of havoc, but I'm very insulin snesitive though


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## tracey w

Ellie Jones said:


> I've got a feeling the drop is partly due to the cannular prime, comparing it to my prime it's a lot..
> 
> I  use the tenderlink 13mm and the prime for this is 0.5 units...
> 
> I'd double check your booklet that comes in the the box to check what prime to give



wow Ellie, i use these and was told by dsn 1u, therefore never read the booklet  maybe i should have!

I suspect Sam been told the same thing!


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## SilentAssassin1642

Ellie Jones said:


> It may not be the total answer, but probably played a part, it does depend on how sensitive you are to insulin, 0.2 units for me can cause a lot of havoc, but I'm very insulin snesitive though



that might be a part definitely. I have to do a full on change tonight anyway so I'll give that a go. I am really sensitive too, it's why a change in just a unit or 2 can change my levels so dramatically. Very odd.

I just wish everything with this could fall into place. I'm starting to get really bored of it, the overnight testing etc. It would be so nice to wake up on a good level thanks to basals being great rather than waking up and correcting *sigh*


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## Ellie Jones

I've just doubled check my book, and it says 0.7u I've never questioned it when training to go onto my pump, the rouche rep reccommended 0.5u

Now that explains why if I take my old cannular out before setting up my new, that I get a rise in BG after a change..

Learn something new every day


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## SilentAssassin1642

yep, was told my roche rep to use 1.0u  just goes to show that maybe they don't know everything  am gonna try and do a 0.7 when I do my next change


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## Adrienne

tracey w said:


> wow Ellie, i use these and was told by dsn 1u, therefore never read the booklet  maybe i should have!
> 
> I suspect Sam been told the same thing!



Ellie is right.  1unit way too much.

However some people find they need more when having a set change.  Some people even need a higher temp basal but some need lower temp basal.  It is very individual.

Sam, go with the 0.7 next time and see what happens.


----------



## tracey w

SilentAssassin1642 said:


> yep, was told my roche rep to use 1.0u  just goes to show that maybe they don't know everything  am gonna try and do a 0.7 when I do my next change



well the roche rep was present when i was told 1u, you just dont question it do you, thanks ellie, will do 0.7 in future


----------



## tracey w

Adrienne said:


> Ellie is right.  1unit way too much.
> 
> However some people find they need more when having a set change.  Some people even need a higher temp basal but some need lower temp basal.  It is very individual.
> 
> Sam, go with the 0.7 next time and see what happens.



I always drop after set/canula change, will now try 0.7 and see.

This site is brilliant, you can always learn something thay you think you already know but dont!


----------



## SilentAssassin1642

tracey w said:


> well the roche rep was present when i was told 1u, you just dont question it do you, thanks ellie, will do 0.7 in future



my roche rep said exactly the same. Who did you have? We had a lovely lady called Helen, tall skinny thing, utterly mad.

Have tried 0.7 this evening. Let's see how it goes.

I woke on 4.4 this morning after battling a couple of lows last night - but that's entirely my fault as we made dinner, and it tasted manky so didn't eat it all...well barely any of it. Tried topping up with desert, but it totally failed. Ended up floating between 3.8 and 4.9 all night...


----------



## tracey w

SilentAssassin1642 said:


> my roche rep said exactly the same. Who did you have? We had a lovely lady called Helen, tall skinny thing, utterly mad.
> 
> Have tried 0.7 this evening. Let's see how it goes.
> 
> I woke on 4.4 this morning after battling a couple of lows last night - but that's entirely my fault as we made dinner, and it tasted manky so didn't eat it all...well barely any of it. Tried topping up with desert, but it totally failed. Ended up floating between 3.8 and 4.9 all night...



Cant remember her name Sam, but sound similar. Ive been doing 0.7 and seems ok.


----------



## SilentAssassin1642

yeah 0.7 has been working fab, less of a drop


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## tracey w

SilentAssassin1642 said:


> yeah 0.7 has been working fab, less of a drop



me too, only took a year to find out


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## Jennywren

Glad 0.7 is working for you , luckily my rep told me 0.7 from day 1 so never had any trouble .


----------

