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So, as I mentioned before, not long after leaving hospital, Tocky was put on an insulin pump. We were so glad he was able to as being so young, it was difficult to ensure he ate enough food to cover the insulin dosage administered by pen. By pen, the smallest amount is 0.5 whereas with a pump, it can be as little as 0.025.
We went to hospital to meet with the trainer, John from Medtronic, who is also T1. He took us through everything step by step but we knew we would need to refer back to training material as there was so much to take in. We felt confident that we could function the pump but also terrified of doing something wrong. We programmed the pump to the settings the Endo had suggested for Tocky and we were told to practice with saline solution for a week. This was so we could get used to inserting the infusion sets, filling reservoirs, setting and changing basal rates, bolus carbs, etc...(will explain in further posts)
Tocky's pump is a Medtronic Paradigm Minimed which you use with a Mio infusion set, a reservoir and insulin. You fill the reservoir with insulin and attach it to the infusion set. The soft cannula is inserted into the skin via the integrated insertion device all within the infusion set. It is quite difficult to explain but there are lots of examples online if anyone would like to see! The reservoir is then inserted into the pump and insulin is administered through tubing. This has to be changed every 2-3 days but with Tocky being such an active toddler, it can vary! Sometimes it can get blocked with blood which blocks the insulin going through which can result in high blood sugars. There's just so much to do and remember!!
Tocky also wears a CGM (continuous glucose management) Enlite sensor. The CGM helps avoid highs and lows as the sensor takes a blood glucose (BM) reading every 5 mins. It also displays graphs and arrows which indicate if blood sugars are rising or dropping too fast. Although the sensors are a godsend (especially at night) they are not 100% accurate. This can occur if insertion is incorrect, if the sensor has been knocked under the skin or if you are lying on it. I'm sure there are other reasons but we have had experience of these.
Again, the sensor has an electrode which is put under the skin via an inserter. My poor Tocky has both these insertions currently in his bottom although they are preferred in the stomach but because he is so young, he doesn't have enough fat on his tummy. A transmitter is attached to the sensor then all taped down. The sensor works wireless with the pump to produce results - it's all very clever!
When we first learned how to do the insertions, hubby and I tried them on ourselves to experience what Tocky would experience. They didn't hurt but Tocky's skin could be more sensitive than ours but generally the insertions are painless.
The sensor should last around 6 days so doesn't need changing as often as the infusion sets. It may need changing more often some weeks as it can be way out with what BM readings it picks up to what the BM actually is. For example, the pump may alert us to say the blood reading is a 3.0 which is classed as hypoglycemic (low blood sugars) where in actual fact after a finger prick test the BM is 7.0. Aaaaaarrrgghhhh!! That's when I get sleepless nights!
As a whole, we are proud of how Tocky has coped with wearing the devices and never messes around with them. He used to wriggle about in the early days when inserting but now he just lies still for us. He wears his pump around his waist in a pump pouch (homemade ones might I add!) and it just doesn't bother him. We are lucky to have such a happy, carefree child now that he has overcome his anxieties too. Hope he feels as lucky as we do!
Next post will be about hypos, hypers and the dreaded ketones!!
