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Finally got plugged in

Donald O'Donnell works in the kitchens of the National Theatre, London. He tells us about his first few days on the pump.

Mon 8 Oct 2001

Hi there every future pump person, my name's Donald.

Today I have been connected to my pump - the first week of the training.

Photo of Donald O'Donnell. London, 23 June 2002

Photo of Donald O'Donnell

[ See photo bigger ]

I met up with the nurse at the Homerton London hospital in Tower Hamlets, the nurse had a problem finding a room and a National Health nurse to meet up with and in, as the London Whitechapel Hospital did not have a nurse available as they have not been able to engage a replacement since the last one had left.

Ann was the nurse who met me and she came from Wales as the London based nurse was on holiday, so she drove down to London to meet up with me, my appointment was for 10:00 and she made it for 10:30.

On arriving in to the room she introduced me to a nurse from the Homerton just to look at the pump and to see what happens to us in training and more so to find out about the pump.

All three of us got on with my training Ann went through the first part of my training asked me about my insulin intake at the moment and the blood sugar readings, this was to give her an idea of what insulin I will have to set on the pump,

She showed me how to connect the pump to me with the needle what needles are available, how to place the insulin into the pump reservoir, how to connect the reservoir to the pump, the drive arms, how to connect the pump to the tubing with the needle on, and starting up the pump so that the insulin would arrive to the end of the tubing - priming I believe.

She showed me how to set a boluses for the meal insulin and the basal rates that the insulin you will get all through the 24:00 hours, I have to say I am not using the pump for the first week with insulin, but sodium chloride (that's pure water). I am still injecting the insulin the same old way till I get used to working the pump. So insulin next week.

Hope this helps more next week.

(Can I say hi to all the Isle Of Dogs Pumpers!)

Sun 14 Oct 2001

Well it's been five days since I started the saline week with my pump.

Monday I was connected to the pump with the lovely nurse Ann, then it was up to me from now on.

The first time I had to get changed in front of someone, I was waiting for them to say Ho! what's that Donald, but do you know, nobody said anything and I am not even sure that they noticed, then again maybe they find that I am not worth looking at, that must be it.

Anyway I started to do my boluses and I got mixed up, I remembered when Ann was talking to me she said that I have to divide the unit of insulin by 15 grams of carbohydrate to work out how much unit of insulin for each meal.

You can see my mistake, what she was telling me was how many gram of carbohydrate goes with each unit of insulin.

The first night at home when I was frightened to give myself a bolus even if it was only water. I wanted to get it right the first time, and cause I got mixed up. (sorry Ann!)

The next day at 8 am it was time for my breakfast bolus and now I don't get out the calculator to work it out I just put in 8 units of insulin as per the pump tells you.

Now it's Thursday and I could not wait to get home and have my nights bath and change the infusion set over and fill a new reservoir up with the water/saline.

So before I jumped it to the bath I disconnected the pump and pulled out the calliper, the first bath this week with out any hindrance from the pump, it felt good.

After the bath it was time to replace the infusion set so I picked the set to try. It was the Silhouette set. I got the booklet out and went through the instruction with "number one - wash your hands" and so on. But I thought I could remember all what Ann had told me on my first day so I did not work my way through all of the info on the page.

What did I do wrong? I was priming the infusion tubing and I forgot the priming setting and I primed it with the bolus control - 5 units, 10 units and no bubble at the end of the set, another 10 units and still no bubble. What was going wrong? I got on the phone to Ann she was not there. So I left a message for her stating the problem, and then I sat back down feeling a little down because I could not get it going.

Ann phoned me back, I told her what was going on.

I had forgotten to prime manually before the prime control. So I went in to it and primed it the way I was suppose to, first by hand, then with the pump. I set it to 5 priming units as the booklet stated, or should I say what Ann had pencilled in, and then the bubble appeared.

Today is Saturday and I had a hard day at work, the time is 19:30, time to bolus or should I say eat, so I got the pump out to press the SEL button and what did I see? "LO Volume". What was this? I got the book out and found that if you prime the setting wrong then something happens... I was at a loss. I phoned the 24 hour help line as I thought that I would not get through to Ann straight away.

Spoke to the fellow and he explain what to do.

Look at the number that mark the ml on the reservoir I told him it was just blow the 2 ml mark , he said is it more than 180 or less than 200 I told him 180 and I did what he told me and it was set to go again.

I have tried to remember how he did it but I cant, so I will have to go through this once more so it will sink in to my little brain. I have such a lovely brain.

Anyway I am set to have a restful Sunday maybe lunch out in Greenwich we will have to see.

More after Monday "THE INSULIN DAY"

Mon 15 Oct 2001

Got to the hospital for 10:00 with a cup of coffee in hand. Remember - Ann, my nurse, arrived late last week as she had to drive down from Wales, and yes she was late. The time was 10:20 and I didn't mind.

One of the office staff came up to me and said Ann has now arrived into the car park she will be with you in a few minutes. I said thanks.

Suddenly I could hear in the distance a bell. Just then I saw a security officer walk through the diabetic clinic. Then one of the girls from the clinic came out and asked us all to leave the clinic and assemble outside in the gardens.

I have to say here the garden outside the clinic is a really a nice place to sit, drink coffee, listen to the birds and spy on them eating the bread that other people throw on the grass for them.

15 minuets later we were asked to go back in, and as I did Ann came looking for me and we went in the our room with the same nurse as last week.

Ann asked me about my week on saline/water and I went through all my stories that I had to tell her and she made notes.

Now, she said you can change the infusion set and lets fill up with insulin.

So I washed my hands. Then she said what one have you chosen. I asked her the difference in price of the two, Sof-set and the Silhouette set, she said there's not a great deal of difference. So I had a think - 1/2 a second really, as the one that I was most comfortable with is the Silhouette. She said OK. I asked her how do I get them? She said that she will order them for me and have them delivered to my place of work. This was to my request as I am at work more that I am at home. I said great.

So I continued to replace the infusion and reservoir and installed it in to a new place on the right side of my waist remembering to keep it 2 inches away from my kidney scare. I lost the kidney 17 years ago and a year later I became a diabetic.

Now she asked me to prime the pump and I did it the right way. Remember, I did it all upside down the last time on Thursday. This time I got it right.

We then set the basal rate to 0.6. It was Ann that worked this out and as she said I will have to keep an eye on my blood sugars to make sure that this will be OK for me.

Now she told me about the bolus that she recommends I use at meal times. I will have to keep an eye on these too because I can change them according to my meals.

Now I am at home and just had a bolus of 8 and sat down to steak and chips and some French bread.

As I was finishing it, the phone rang. It was Ann. She asked me how I was doing and I told her I reminded her that she started me at a blood sugar of 20 mmol/L (360 mg/dL) at 11:00 with a bolus of 3.5. Then it went to 17 mmol/L (306 mg/dL) on its way down at 12:00. Later at 13:00 it was 13.5 mmol/L (243 mg/dL). The next reading was at 14:00 and that was 4.2 mmol/L (76 mg/dL) and it was at this time I had my lunch and a bolus of 8 units.

She said she told me that she thinks that 8 units is to much now for me. I told her I forgot and I made another note of this, she then said that she will speak to me tomorrow in the morning, I told her that I will be at work.

Author: Donald O'Donnell <Donald7@btinternet.com>. Donald O'Donnell is not a medical professional. He has Type 1 diabetes and uses an insulin pump. The information given here is based on his own personal experience. More about Donald O'Donnell...

Created: Jun 2002; Last updated: Sunday 23 June 2002

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