Tuesday, 28 July 2015

Pregnancy weeks 9-12: kidney-bean babies and leveling out

So at 9 weeks it's finally sunk in; we're having a baby-kid. It's a strange feeling, knowing you are pregnant but not really having tangible proof of that, other than the crazy sore breasts, insane lethargy and incessant crying at TV adverts with mistreated dancing animals.  I've donated a shit lot of money to charity during this stage of pregnancy.  Be warned.

I must have looked at that pregnancy test a millions times, but it wasn't until I saw the kidney-bean-with-ears shape on that first early scan, that I really 'felt' pregnant. There doesn't seem to be a 'standard' approach to scanning mums with D early, but ours was scheduled at 9 weeks, and offered estimated dates of conception and due date, and basic checks that everything looked OK.  Not that I would have had a clue because to me the image on the screen could have been anything, but seeing the flutters of the primitive heart flicking away on the screen was a pretty special moment, and made the many hypos and achey worn-out feet worth every single moment.

After donating more of my best blood cells to the hospital's store of my personal supply, now quite possibly needing its own wing of the hospital, we've been told all looks good with the growing kidney-bean, and that my HbA1c was holding steady just above 6%.  This, along with the fact that I'm learning how to manage the 45-minute hypos, means things have started to feel a little more normal again in life.  I'm packing away the carbs with the gusto of a famished post-hibernation grizzly bear, and if I ever start to waver or feel a little overwhelmed with the task ahead, I look at the photos of the bean, and remember why I'm doing this.

As a result of the first scan and midwife appointment, I'm now also in a regular routine of seeing my diabetes team every 2 weeks for them to look over my results, make suggestions and work with me towards achieving blood sugar levels as close to 5-7mmol as possible.  Some days this feels like a mammoth task, but keeping their email addresses to hand and dropping them a line if I am ever struggling has helped me enormously in feeling like any issues are addressed straight away.

Things I've noticed in the final parts of the first trimester:

~ I've become more sensitive to insulin, and more accepting of carbs.  Rarely rising above 9 mmol even after the most carbilicious meals mean the final parts of this trimester have left me feeling like life is leveling out, just a little.

~ Hypos still take a long time to recover from and some hit in 'stealth-mode', with little warning.  If you don't use CGM, I would highly recommend increasing blood tests if you haven't already, because the tiredness and general overwhelming need to be completely horizontal, if awake at all, in early pregnancy means those hypos-in-cloaking-devices can knock you for six.

~Blood tests still suck.

Friday, 10 July 2015

Pregnancy: weeks 5-8 (boob-ache and bolus-mayhem)

By now if the constant boob-ache and total lethargy hadn't given me reason to suspect I was packin' a baby down there, the five pregnancy tests sealed the deal.  I was one of those horrendous secretly-thrilled people filed under 'lucky bastard' who didn't suffer any sickness (yet), but, before you virtually strike me in the blog-face or permanently unsubscribe from my posts, I have taken to spontaneous day-sleeping.

Spontaneous day-sleeping is a marvellous condition which makes it all but impossible to keep the pregnancy a secret, and works wonders for your relationship when every film we watch together ends in me snoring or falling asleep immediately after the opening credits. Sex, has all but gone into hynernation, because I'm asleep all the time, and there are laws against one-way loving. Jamie, is thrilled.

Diabetes-wise, these weeks weren't too crazy of a time after the first 4 weeks other than some pretty striking hypos which seemed to take 45 minutes or more to recover from. Having been away travelling there was still a whole heap of late-night campsite-tramping and wicked post-meal hypos needing lots of fruit-juice glugging.

During these weeks you may well be going along to your maternity clinic for your first blood tests (these don't get any easier, even with a kiddo on board) and some information on how your care will take shape over the next few months.

Below are some of the things I noticed over these last few weeks.

~I've been religiously using gentle walks to budge down blood sugars when I know I have enough insulin on board but that my post-meal spike is going up just a little faster than I would like.  A quick 15 minute walk around the block once or twice is enough to bring me back into range, and the beauty of walking is that even when lethargy-face hits, it's not such a big ask to go walking for 15 minutes.

~On the plus side, carbs, which I was convinced had reached the end of their sweet life during pregnancy, are back in full force. With some cleverly timed bolusing, I've been enjoying meals with 70, 80 or even 90g carbs.

~ pregnancy gives you 'hunger-rage'. You'll know it when you see it, and you'll probably consider strangling any stray cows eating unattended in a field if hunger-rage strikes. Because you will be THAT hungry. 

~Blood tests still suck arse.

~For some reason my blood sugars have become increasingly more difficult to bring up after a hypo.  Initially I made the horrible mistake of treating hypos twice, because after 30 minutes I was still in the 3s at a stable pace. Be warned, treating twice is a false economy, because you'll most likely spike twice as hard and twice as fast when you recover.

Thursday, 18 June 2015

Insulin pump end of days: The Animas 2020, IR 1200 and IR 1250

With all the hype around the Vibe insulin pump in recent years it would be easy to forget about the the Animas 2020 insulin pump, which was a complete favourite across the diabetes community and at one time the most exciting pump on the technology landscape.  Many still wear one because they love it so much.  But for those people still using an Animas 2020 insulin pump (and the IR 1250 and IR1200) this New Year's Eve will signal the close of a chapter on their current insulin pump choice, because the software these pumps uses will no longer be functioning after 31st December 2015.

This has come about because of memory limitations of the technology at the time the platform was created, but as these products are no longer manufactured by Animas they are focusing their efforts on creating the next generation of products in order to provide patients with better solutions and sheckshy new technology.

After 31st December 2015 the pump will no longer function, and will generate a 'Call Service' alarm.

In order to avoid any disruption to insulin pump usage, it is really important that you contact Animas UK as soon as possible, who will offer a replacement Vibe pump, if eligible.  No additional warranty will come with the new pump.

If you use a 2020, IR 1250 or IR 1200 please contact Animas on:

Customer Service
0800 055 6606 (for UK)
1800 812 715 (for IE)

Saturday, 13 June 2015

A belated look back at the Animas weekend 2015

Somehow life has run away with me in recent weeks, but finding time to review the Animas weekend which took place back at Loughbourough University in May 2015 and give a little look at the photos from the weekend has been a 'must-do' for quite some time.  

Two years ago Sir Steve Redgrave said this about the journey he had been on since meeting Dr Ian Gallen after his diabetes diagnosis, and then going on to win his fifth Olympic Gold medal after his guidance and advice:

When I was diagnosed with diabetes and thought that my sporting career would have to come to an end I was absolutely devastated.  But with the support of Ian Gallen and his team, I was given the confidence to carry on with rowing and I was able to stay at the same level that I was at before having the condition; going on to win gold at the Sydney Olympics 2000.  I came up with the quote "diabetes has to live with me not me live with diabetes."  And that has stayed with me ever since in whatever I do in life. 

Want to find out more information for next year, so you can come along and be immersed in a weekend of fun, surrounded by people with type 1 all wanting to learn more about sport and the effect it has on diabetes, then email sportsday@its.jnj.com.

And check out the video montage of this year's exploits.


Friday, 29 May 2015

InPuT's virtual flash mob: The best kind of Sunday lunch get together

My passion for the work InPuT do is no secret.  Having witnessed first-hand the power of patients being given the knowledge, support and talking points needed to poke their consultants with a big technology-accessing stick, means I will always understand just how much they are needed in the diabetes landscape of the UK.  Just recently I had the pleasure of attending the Animas weekend and having spoken to several people trying - with limited success - to access technology which could improve their lives, I know just how much that need continues.

I've also seen first-hand how carefully InPuT spend the money they get. In a world where charities come under fire all too often for big business-like spending and abhorrent expense account-rinsing, InPuTs fresh and frugal attitude to spending is the antidote.  Encouraging the use public transport and relying heavily on the support of volunteers and part-time multi-skilled staff, their main aim is always to help people access appropriate diabetes medical technology.  And here's to not forgetting that they are the only charity in the UK doing this.

If everyone in the UK who uses an insulin pump donated just £1 a year, InPuT would have the money to continue their work in the UK.  If everyone who used some form of medical technology did so, they would be able to do even more.  So how can we give back to one of the lesser-known but truly needed charities? Well this Sunday we have the chance!

Rather than asking you to interrupt your usual basal dosing of money to the charities you support on a regular basis, InPuT's donation is just a quick bolus of support.  This Sunday, on the 151st day of the year (because NICE guidance TA 151 refers to the provision of access to pump technology, of course!), everybody is going to get 'together' for Sunday lunch, and in a virtual flash mob of support, will bolus just £5 to InPuT by texting 'INPU31 £5' to 70070.  

I've been 'pumping' now for 5 years, so this year I will bolus my £1 per year to InPuT as a tiny - but enormously appreciated - 'thank you' for the work they do.  Because I know how important it is that they have the funding they need.  So, I ask this:

Have you benefited from the work InPuT do?
Do you know someone desperate to access technology who InPuT could help?
Did you find out about InPuT after your own battle with accessing technology?
Do you want to help other people access a pump or CGM?
Do you want to be involved in a frankly fantastic event?
Could you spare just £5?

If you answered 'yes' to any of those questions, I will see you at lunch!

Sunday, 17 May 2015

Pregnancy: weeks 1 - 4

OK, so we didn't even find out we were having a baby until week 4 of pregnancy, when the hormone HCG was finally at high enough levels in my body to be detected on a pregnancy test but, we'd been planning starting a family for quite a while. And while it may not be time to add safety locks and baby-proof unit edging to all our furniture just yet, there were a number of things I learned can help along the early weeks of pregnancy nicely.

Considering 2 of the 40 weeks we are pregnant aren't even really pregnancy, there wasn't much of a change in anything in the first 4 weeks of pregnancy.  But I had been honing my basal patterns significantly and trying to convince my blood sugars - through diet, exercise and lots of deliberating over insulin dosages - to run a much smoother pattern over that 4 weeks.  You know, just in case.  I basal tested  to within and inch of my life, and re-read my already dog-eared copy of Gary Scheiner's Think Like a Pancreas, now defaced with scribbled notes in the margin and corners of the most important pages folded down.  His chapter on basal testing particularly helped me get much better patterns before we eventually did 'the baby dance'.  This also helped me nudge my recently rising HbA1c from a happy 7.4% to a 6.2% in the first weeks of pregnancy.  The general guidance is people with diabetes should aim to get it below 6.5%.  That may seem impossible, but it's funny how the motivation of a baby can help...

I also started to get back out there and use gentle low-intensity exercise like a stroll to nudge blood sugars down if they started creeping out of my comfort zone. Not only did this bring me down faster, but any gentle exercise is arguably good during pregnancy - although the advice I was given was not to start trying anything too intense if you didn't already do it.  Well...if it's doctor's orders... But by walking to the shop here and there after a meal, I managed in those early days to keep BGs generally under 10mmol after meals (180 mg/dl).

I also took a pre-natal vitamin and an increased (5 milligram - prescription strength) folic acid tablet daily for several months before we tried.  Whether or not the sales pitch of helping with conception is true, I will never know.  Perhaps we were just irritatingly lucky to fall first time.  Perhaps the daily vitamin had something to do with it.  But the folic acid is vital. Folic acid helps reduce the risk of birth defects and the good thing is any extra you don't need the body kicks out - so you don't need to worry about taking 'too much'.

Finally, I also learned that I had to stop freaking out about high blood sugar levels. I spent the first week after finding out we were expecting crying like a total lunatic every time my blood sugars rose too high. This wasn't fun, or necessary. You're partner doesn't want to be looking at you like you're a crazy person having just taken on the beautiful, but HUGE, news about his growing family. The only time high blood sugar levels are dangerous is for PROLONGED, UNTREATED highs. Just do your best to bring them down as soon as possible. And stop freaking out your partner.  Says the crazy lady who writes this blog, now much wrinklier and grey-haired than she was a few short weeks ago.

Weeks 1 - 4 of pregnancy really didn't bring anything more than I was already managing, and even the fabled tell-tale low blood sugars in early pregnancy didn't creep in until after this time.  But there are still 36 to go...who knows what else is around the corner.

Monday, 11 May 2015

D-Blog week: I can...

D-Blog week is the brainchild of Bittersweet Diabetes, and as it turns six years old. it provides another opportunity to hear from blogger voices across the world simultaneously.  I love that two people will see a completely different challenge from the same topic, and today's is sure to be a good 'un.  Today's topic is....I can...

When I was 12 years old I told someone who was asking me about diabetes, "Don't worry about me, there will be a cure in five years." I'd heard it spouted by Diabetes UK and blindly, fell for the line.  At the time very little was known about stem cells or even the causes of type 1, insulin pumps weren't yet routinely used in the UK, and CGM had yet to be invented.  Why I believed this wild claim with so very limited technological support for it ever happening, I will lay firmly at the feet of hope.  I hoped.  My God, I hoped.
By 22 that hope was all but lost, as I plunged into months of the worst burnout I have to this day experienced. My DSN, a fantastic woman called Sue Craddock, to whom I owe a great deal as she steered me back on track with careful words and constant support, referred to it as 're-diagnosis', due to the severity with which the reality of diabetes was smacking me in the gut.  "Please take me into hospital, I can't do this." I begged, after testing my blood and discovering I was 22 mmol before even having made it out of my pyjamas.  There was no cure.  It would never happen. It was lies.
By 32 another decade on and wiser, older, happily pregnant and still taming the diabetes beast as best I can, things have changed direction yet again.  Now, the technological advances and better understanding of the sheer complexity of diabetes has brought into the diabetes world a new term: Artificial Pancreas (AP).  While the AP isn't a 'cure' at all, if we're honest - it is a new ray of hope. The idea of a closed-loop system which could manage blood sugars on our behalf, and in most situations, is to me a dream come true.  I often ask when is 'good', good enough, because as a community we still hold on hope to stem cell research and islet transplantation, these were the hopes I'd clung to at 12, and those which had let me down by 22.  I still hope they will happen, but I don't let myself dream of days away from this life, quite the way I used to. 
But with the AP, tangible evidence is released almost daily in the form of human clinical trials, showing the literal steps which are taking place, bringing us ever closer to one of the most important technological breakthroughs since the discovery of insulin.  And at last, I can see a different future.  I can see that while a 'cure' might not be around the corner, if ever, there will be a time when I can sit with my friends from the diabetes community and enjoy a meal, day out or even just conversation, without our diabetes loudly interrupting our lives.
I can.