# Oh God Help!



## SilentAssassin1642 (Jul 26, 2010)

Pizza for dinner, after a massive hypo that wouldn't let me bolus on the handset. Doing a multiwave over 3 hours of 8 units. Gave 5 upfront and its now doing its buisness with the other three.

I gave the original bolus at 7.30pm

An hour later and I'm 13.5

Do I leave it and let the pump do its buisness?

I'm a little frightened of my levels rising horrifically. It feels kind of odd not being able to just...stab :/


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## am64 (Jul 26, 2010)

havent a clue sam but im bumping this for you ....WHERES TOM ????


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## rachelha (Jul 26, 2010)

Hi Sam - sorry can't help.  How are your levels now?


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## bev (Jul 26, 2010)

Hi Sam,
Try not to panic. I am probably too late to answer now - but I will try anyway. What were you before you ate? If there was a drastic rise - then perhaps give a small correction - but make sure you keep testing as you may need to end the multi-wave. Remember that pizza is hard to get right - so you havent done anything wrong - your just trying to find the best way of doing things.

I dont do 'multiwave' - we do 'dual wave' which I am assuming is the same? If so, how much % did you give up front? It sounds like you havent given enough which is why you have gone high. Let us know what your levels are like now if you get a chance.Bev


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## SilentAssassin1642 (Jul 26, 2010)

currently at 12.2 - multiwave finished 20 mins ago so its coming down. Will reconnect after shower in a min and see whats going on pre bed. If still floating around that then will correct.

bev - mine has something called an extended bolus and then multi-wave. Dunno what that compares to


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## bev (Jul 26, 2010)

Ok. Do you only have 1 basal set up for tonight? If so, set your alarm for 3am and test to see if you have dropped too much after your correction. Also dont forget that whilst your in the shower your not getting basal - so depending on how long it takes you - you might need to add that back in. We dont do it for Alex as he doesnt *do* long showers! But as your a girl - I am thinking you will. You might find that you have gone up a little after the shower - so just keep that in mind. 

I dont know about the multiwave etc - will ask Adrienne as she has more experience of different pumps than what I have.Bev


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## SilentAssassin1642 (Jul 27, 2010)

bev said:


> Ok. Do you only have 1 basal set up for tonight? If so, set your alarm for 3am and test to see if you have dropped too much after your correction. Also dont forget that whilst your in the shower your not getting basal - so depending on how long it takes you - you might need to add that back in. We dont do it for Alex as he doesnt *do* long showers! But as your a girl - I am thinking you will. You might find that you have gone up a little after the shower - so just keep that in mind.
> 
> I dont know about the multiwave etc - will ask Adrienne as she has more experience of different pumps than what I have.Bev



yep, currently at 0.65u/h

did a 3am test and it was 1.9  felt really awful! probably shouldn't have corrected (did a 0.5)

woke at 3.1 this morning  looks like I need a different basal rate!!! Hypo after hypo - although it's probably too early to say as there will still be levemir kicking about. I may stick myself on a 70% temp basal this morning, just to see what happens


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## bev (Jul 27, 2010)

Lucky that you tested.

When you did the correction - did you do what the pump said to do or did you go by what you would have done on MDI? I only ask because all the settings on the pump are so accurate that they wouldnt let you over correct - unless you have the settings wrong. What levels are you set to? What is your lowest level and what is your highest level?

When we first changed to the pump I found it hard to forget all about MDI and kept making decisions based on it - but I quickly realised that I had to change my mind-set and start thinking 'pump' and how that all worked.

You are doing very well Sam, doing multi waves and temp basals so soon is great - I was too scared to do them for at least a couple of weeks! Sounds like you are comfortable with making changes which is great. After you had the hypo - did you put yourself on a temp basal? We find that if its in the night we always put on 1 hour temp basal of about 80% - just to make sure that he doesnt drop again and it wont send levels up in double figures either. But do remember that when you set a temp basal - it very much depends what your basal is at that time as to whether it will make a difference or not. I wouldnt go changing your basal yet Sam as I think it could have been the food and over correcting. Perhaps try it tonight and have a lowish carb low fat meal so you can get an idea of whether its the basal or the bolus thats out.Bev


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## Viki (Jul 27, 2010)

Hi Sam,

I would say the best piece of advice i was given when starting on the pump, is dont expect it to be a quick fix. I would be very careful trying to use all of the features at once, you'll never know what tweak caused the problem and what was working. I would work on your basals for a while as these will make all the other things (ratios, extended boluses etc) far more likely to succeed.

Remember all of your insulin requirements are likely to change so you have to go right back to basics and you are practically starting again, learnign what effect each thing has on your levels.

It hard because getting the pump is so exciting and you want to get started with everything! I pick one thing, tweak it, see how it goes for a few days, tweak again if necc, see how it goes etc. Once im confident ive cracked it then move onto the next thing etc.

Id suggest night time basal are a great place to start, if you wake up in range for a few days it gives you a good solid platform to start changing the next thing and youll defo feel the difference in how much more "well" you feel. Its an amazing difference! (and it gets all the 3 am blood tests out of the way asap!!)


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## tracey w (Jul 27, 2010)

bev said:


> Ok. Do you only have 1 basal set up for tonight? If so, set your alarm for 3am and test to see if you have dropped too much after your correction. Also dont forget that whilst your in the shower your not getting basal - so depending on how long it takes you - you might need to add that back in. We dont do it for Alex as he doesnt *do* long showers! But as your a girl - I am thinking you will. You might find that you have gone up a little after the shower - so just keep that in mind.
> 
> I dont know about the multiwave etc - will ask Adrienne as she has more experience of different pumps than what I have.Bev



Bev, multiwave is same as dual wave, give a % up front then the rest goes in how ever long you set it up for.


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## rachelha (Jul 27, 2010)

Sam - hope you are doing better now.  Could you contact your DSN at all.  I know when they do the pump training in Ed. one of the DSNs is on call 24 hours for a week.


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## tracey w (Jul 27, 2010)

Sam, hope you are ok today, sorry I didnt see this last night.

All the advice has been great. I would have said the same things. But like Bev said, did the pump let you do a correcction, this is important. Occasionally I will override the pump if it says not to correct, but I have been doing it much longer and I then only give a small correction.

What I would say about multiwave and extended bolus though is that you can see a significant drop 1 -2 hours after they have fininshed, 

dont forget you will have to find your right multiwaves with different foods, well done you for trying so soon! Doesnt make things perfect or always work out as the last time, just remember that. I would say 10 months down the line I get most muliwaves ok, not perfect but ok, sometimes they dont work at all and I may have to correct after 2 hours, or stop the multiwave if going to low etc.

You are doing really well. I would say get one thing right at a time though, dont be tempted to change basals at different times, ratios etc or you wont know what the hell is going right or wrong!

You are doing brill Sam!


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## SilentAssassin1642 (Jul 27, 2010)

Hi all. I did what the pump told me to do, well infact I made it give a little bit less than what it said because I was scared of dropping.

Regarding the multiwaves and whatnot - that actually worked really well. Levels after dinner were actually relatively ok. 

As for playing, I'm only playing cuz my nurse told me I could  Plus, I feel more comfortable having the advanced settings on - just incase yknow. But I'm definitely not thinking MDI anymore. Like this afternoon I had a nasty 19.9 - corrected with the pump and left it...only to find myself dropping horrifically at the end of work  ended up at 2.5 when I got home 

It's very confusing.

Spoke to DSN at lunch and we've tweaked my overnight basals from 0.65u/h to 0.55u/h between midnight and 7am. I was sat there at lunch playing with the handsat hehe.


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## SilentAssassin1642 (Jul 27, 2010)

tracey w said:


> You are doing really well. I would say get one thing right at a time though, dont be tempted to change basals at different times, ratios etc or you wont know what the hell is going right or wrong!
> 
> You are doing brill Sam!




Thank you lovey  I spoke to my nurse at lunch and she suggested dropping my overnight basals a little so we've done that. And that was on her say so so I'm not playing...honest


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## bev (Jul 27, 2010)

I am wondering whether your correction factor is set too high as you have gone low twice after a correction? What level is the pump set to bring you down to?Bev


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## Copepod (Jul 27, 2010)

Glad you're on the way to sorting your situation, but please don't blaspheme (or swear in any way) in thread titles nor text. Thank you.


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## SilentAssassin1642 (Jul 27, 2010)

bev said:


> I am wondering whether your correction factor is set too high as you have gone low twice after a correction? What level is the pump set to bring you down to?Bev



It's currently set at 1:4 - maybe worth chatting with nursey about it tomorrow.



> Glad you're on the way to sorting your situation, but please don't blaspheme (or swear in any way) in thread titles nor text. Thank you.



I have sent you a PM


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## Viki (Jul 27, 2010)

Hey Sam, 

I was amazed when I started pumping at how much more efficient it is as a delivery system and as a result how much less insulin i needed. I think my ratios, correction factors and basals all went down sustantially!

I meant to ask, are you keeping records of all the trial and error work youre doing and your BGs? *sigh* all the extra homework . . .


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## Chrissie (Jul 27, 2010)

Hi

I hope your having a better evening today. I've been pumping for nearly 4 years now & it was really hard work & frustrating in the early days  but your doing a great job so far so good. 
I remember when i first started pumping having lots of highs & lows until i was able to fine tune things it is a little bit of trial & error to begin with (i still have some unexpained readings that make no sense) so what i'm trying to say is don't be too hard on yourself & use your DSN i was in daily contact for the first few weeks tweeking things. I find it useful to keep a diary of basal settings, bolus's, correction doses & blood sugars so i can quickly see patterns & where i need to make changes.
Maybe your sensitivity could be tweeked a little bit if you've had hypo's after a correction doses? it could be something worth mentioning to your DSN
Good luck the early days of pumping can be a bit stressfull!!
Oh i also meant to reply to one of your other threads on where to wear your pump....... I've hiden mine all over between my boobs (but take the clip off as there is less bulk to hide) side of bra, back of bra, in big support knickers, i've sewn pockets/pouches into dresses (2 ribbons usually does it) I don't find it comfortable to wear it on my leg but i know some use a garter or bandage,  if your wearing knee high boots you can pop it in the boot, but you'll need a longer giving set, i hope that gives you a few ideas 
 If you want to ask any questions or if i can help i'm often around (even tho i don't post vert often )
Keep up the good work & take care
Chrissie xxx


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## SilentAssassin1642 (Jul 27, 2010)

Viki said:


> Hey Sam,
> 
> I was amazed when I started pumping at how much more efficient it is as a delivery system and as a result how much less insulin i needed. I think my ratios, correction factors and basals all went down sustantially!
> 
> I meant to ask, are you keeping records of all the trial and error work youre doing and your BGs? *sigh* all the extra homework . . .



Thanks Vikki  Just as I read that, I started writing down everything in my notebook  Great minds eh? Great minds 

Nursey and I have reduced basals overnight, as it seems like 0.65 is waaaay too much. Am just gonna let things play out tonight, set an alarm for around 3am and see what happens. 

Sposed to be doing a basal test tomorrow morning - i just hope I don't hypo again


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