# yesterdays pump appointment



## curlygirl (Apr 21, 2015)

Thanks to everyone for their well wishes for yesterday.
Appointment was ok - a lot of information to take in, but got connected up and they programmed a 'best estimate' of the basal rates required etc
However, i have had 3 hypos over 13 hours and i am, at this time, feeling pretty overwhelmed. I guess this is fairly normal for starting out on a pump, but as i have a fairly serious fear of hypos, i am not feeling very relaxed at the moment!
I was told not to alter any of the rates initially, although they did programme a -10% &-20% +10% & +20% in, so i might try switching to one of those for a bit and see how things go. 
Curlygirl


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## everydayupsanddowns (Apr 21, 2015)

Always a bit of a 'best guess' when starting out isn't it!

Did they reduce your Total Daily Dose by much Curlygirl when they worked out your basal pattern? And did they take into account your basal:bolus split on MDI when looking at your total basal dose? 

It's not uncommon for people to be much more sensitive to insulin delivered on a pump because of the way it 'trickles in' (various proportions of MDI doses are often 'lost'). Plus if they based things on a 50:50 basal:bolus split from your old TDD and you are actually more like 40:60 it might explain the hypos you've had.

It also might take a week or two for your body to settle in to pumping (my initial doses were *much* lower but then they gradually rose and settled)

I can understand that they don't want you to do too much fiddling in the early days, but like you I'd be tempted to knock a bit off if you get the same number of lows today.


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## m1dnc (Apr 21, 2015)

It might be residual Lantus hanging around, or other long acting insulin. When I started my pump it took four or five days before all the Lantus worked it's way out of my system.


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## curlygirl (Apr 22, 2015)

Thanks for the replies. They did look at my tdd and do some calculations before programming the basal rates. They have put a higher hourly rate at certain times of day - one time being from 3/4am through to 7/8am and this seems to be an area that as yet is causing an issue as i have woken up hypo both mornings so far! I put the rates down by 10% overnight last night, but the only effect from that was that the hypo was an hour later this morning.

My dsn said it could be residual long acting insulin, but it feels like, even if that is contributing (and hopefully that should have left my system by today), there is still too much coming from the pump.

At the moment i am eating to the insulin rather than being able to feel like there is a steady background and insulin to manage the food in between. I know it's very early days, so  this is probably the way it goes for everyone when they swap to a pump...

Anyway, thanks again for taking the time to reply.
Curlygirl


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## Sally71 (Apr 22, 2015)

Hi Curlygirl

Don't panic - pumps are hard work at first because it does take a little while to get used to them and to get it all set up ideally for you.  But once you get there you will never look back, you just have to be patient at first!  Hope it will settle down soon


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## trophywench (Apr 22, 2015)

Curlygirl - it's the basal insulin you took about 2 hours ago, up to when you went hypo, that contributes to your hypo and you need to change.  So eg hypo at 7am - reduce basal from 5am.  Ish !

Some don't realise quite how far in advance you need to make the change, so I thought I'd better say.

Presumably you have your DSN's number - so ring her if it keeps happening!!!!  I expect you are back to see her next week?


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## HOBIE (Apr 22, 2015)

Good luck & keep at it !  Pumps are so so adaptable. They take a while to get it tuned to the individual.


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## curlygirl (Apr 22, 2015)

Thanks Sally71 for your encouraging words - hearing that it is normal to feel overwhelmed and have blood sugars all over the place at this stage reassures me that things will hopefully get better.

Thanks Trophywench for the info about which hours relate to when - the pump rep did go through this with me, but there is a huge amount of information to take in so i appreciate you mentioning it as someone who has been there and done it. I have an appt for 2 1/2 weeks from now with the dsn, but i am able to speak to her on the phone too.

Hobie - thanks for your comments, you clearly love your pump from threads i've read, so it is good to hear that too.

Curlgirl


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## trophywench (Apr 22, 2015)

Curlygirl - first week was OK for me, second not too bad, 3rd week it started to go wrong, at the end of the 4th week I was absolutely ready to bin the stupid thing.

Hang on - am I really going to let a stupid heap of stupid plastic and stupider electronics beat ME ?  No way Helmut or whatever you're called, not sure which bit of Switzerland Roche live in!

So I didn't, and about 3 weeks later I was in love!   LOL


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## HOBIE (Apr 23, 2015)

Can you imagine in a few months time when you have it sorted & are comfortable with it.  Its bait time & you want that extra bit of whatever. A couple of pushes of buttons & sorted. . I do this all the time now, if I have no time for lunch I miss it & I double adore that feeling of being in charge.


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## kincaidston (Apr 23, 2015)

just over 2 weeks in on a pump and i'm still in the trying to figure out what is happening but getting there, best advice is patience and much like science change one thing at a time so that you can see if it had an effect rather than changing everything at once and then having to guess what might have worked.

my total basal insulin has halved since being on the pump and my carb ratios have changed quite a wee bit too but everyone is different, i found the book think like a pancreas quite useful for trying to describe what someone with a fully functioning pancreas basal insulin changes over time and approaches to try and work out what your pattern might be though i'm definitely still working on that


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## Maryanne29 (Apr 23, 2015)

I totally agree with Hobie. Soon you will be wondering how you lived without it. But it can take a bit of time. And Hobie is right - you're now in control and that's a good feeling. Just hang in there and it will come together.


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