20 December 2014

High there: All I want for Christmas…

Thankfully I have my own Rudolph
to keep me upbeat through D storms
...is Blue. Quite a snappy summation of my current thoughts on Pump vs injections! I have been meaning to do an update, and after a few enquiries on my blog/twitter as to how I am faring, here it is...

When I made the switch back to injections in October, I knew it was not going to be the easiest ride. There are many reasons I went onto the insulin pump at the age of 11, but not one of them was due to lack of trying. On the contrary, it was that - four years and three injection regimes later - nothing else had really worked. 

The insulin pump is by no means a magic fix, or a cure, but it works best for me… until this year, when a decade of continuous penetration, by what must be close to a thousand small tubes, finally caught up with me. So the decision was made to switch back to "the old ways", lantus and novorapid. Multiple Daily Injections. Goodbye Blue - for the time being.

I did an update post after about two weeks on MDI, and it has now been around two months. So how are things faring now? Suffice to say, I have had Diabet-ter days. I have worn the pump since then - for around a week approximately a fortnight ago. I reached a point where I was quite simply worn out from the shots, the feeling of sporadic control, along with persistently elevated sugars. However, I had also had two nights where my blood sugar had plummeted to 2.1, and that honestly scared me. Realising that, in being this low, I also had no control over what insulin was still in my system.

Back To Blue 

That morning I reconnected Blue, and instantly my reading stabilised. They were by no means perfect, but I felt such a sense of calm and relief! Then halfway into the second day, something wasn't quite right. Whenever I put a bolus through, I could feel a sharp pain round the site. I glanced down, and could see discolouring round the tube and a trace of blood. 

My first Christmas with the
 pump was a happy one indeed
I continued on for another half a day or so with a degree of denial. My sugars were still good, and I was determined to make this work! 

During the night, however, the pain had become constant, and hard to ignore. My blood sugar had also gone up to high teens, which sent small alarm bells ringing. I glanced down again - the tube is almost completely red. Out comes set numero uno, along with enough blood to send Twilight vampires into a feeding frenzy - long story short, it took ten minutes of constant pressure before the blood flow would start to ease! Two weeks on, the bruise is still here. 

I tried again with another set, and a similar tale unfolded. Within a week (and three sets later) Blue was back in the box and the pens were out. The site area that had finally started to look a bit better, now resembled a three year old's art work. Lovely grey and purple splotches, with the occasional mini red dot. 

I moved back to injections with reluctance - I wanted to to be back on the pump for Christmas - but argued that I could "make it work". Well, that hasn't exactly been the case… 

High There

At the risk of making this a TMI post, the past couple of months has seen a positive development in terms of my health - after 2 1/2 years of amenorrhea (a dangerous side effect of undernourishment) my period finally came back. This is something have worried about for a long time; most of all I feared I that I might no longer be able to have children. So I should have been overjoyed... except for the small diabetes issue. The fact that my body was suddenly filled with all these hormones, which aren't exactly great for blood sugar predictability. 

The past week has seen my blood sugars the most out of control, in as long as I can remember, For about a week now, I have not had a single figure reading. Since around Monday, I think my lowest reading has been 15. In recent years, my underlying blood sugar has been very good. As a lot of my eating disorder was centred on trying to maintain 'perfect' control, my blood sugars were almost abnormally stable. My hba1c was often around 5-6 (55 in 'new money'). 

21.7… what a pleasure to see you
How do I feel? Exhausted. Thirsty. Apathetic. Cross with myself, although I know I am doing all I can. This is the thing with diabetes, it is so easy to fall into self-blame, but the nature of the condition is that it throws curveballs second to none.

I have had to really face up to my increasing insulin fears (which I talk about here) and am currently giving nearly double the daily insulin I was only a few months back. I have had moments where I panic, but I am pumping in (ironically sans pump) this extra insulin, giving bigger doses than i have in years, in the hopes it will make the reading budge. It barely seems to be touching the sides. When I saw my diabetes team on Wednesday, they said it could very well be hormones, and that it should settle down after this initial stage - they said that my body will be confused with this sudden reintroduction of hormones, so it will be unpredictable.

For me - Little Miss Perfectionist - this is very difficult to accept. It is posed a huge challenge on the recovery front, and I am not perfect. I still have that raging battle where my head sees carb avoidance as the 'only way' to solve this, and I have become more anxious around food  - I am thankful to be home, where my family can offer support, because I have come too far to allow myself to be thrown back into that awful place I was in 2 years ago. 

It's not Christmas without the Santa Plate!
In the past week, I suppose I can discern one (very small) silver lining - eating despite the reading. Before, if I tested and my blood sugar was just slightly in double figures, I would have been inclined to wait. Now? Reality is, an extra halfway is likely to do nothing! A reading of 11 would once have made me so anxious, but now I would honestly be overjoyed to see that! I hope, when things have settled, I will consequently have a better perspective on it all. Nuts have continued to be a trusty ally, and eggs. I actually saw a tweet the other day on eggs being a diabetic's  best friend, and it made me smile. 

I want my family to have an amazing christmas too, as we have had a difficult year and I also feel in myself a responsibility to make up for the frustrations my eating disorder caused in previous holidays. However, I want to have a lovely Christmas for myself, too. Somehow I always forget to factor myself into these things! But as I have been reminded by quite a few people, how I feel means something too. 

Maybe this feeds into my perfectionism too - I am building up this day, as I have done in the past, and the trouble with expectations is that you inevitably fall short of them. I think it is much better to go into it, just thinking of what actually matters - being with my family, having found quirky, original and thoughtful gifts, enjoying the meal and accepting that diabetes might not like it, but it is not the end of the world. 

I am sorely tempted to put the pump on Christmas Eve, to try and ensure a day where I feel up to more than lying on my bed, completely wiped out, and can also engage with life! I am battling to stay upbeat, and do little things - having friends round for dinner last night, I did feel more animated than I had all week. Sometimes you need to push yourself to go and do things, rather than stay isolated - that only causes you to dwell and overthink, which is never good. 

...but sometimes the unpredictable things work out
in your favour - like last year's (£5…) scratch card win! 
Hyperglycemia is horrible, no two ways about it. I feel better than I did a few days ago, but that in itself is a slight cause for concern - it is as if my body has become accustomed to it? I am worried than when I actually get it back in range, I will feel like I am having a constant hypo! Mum and I both feel the lantus is simply not a good fit for me, and that is true - as I opened, there's a reason I went onto the pump. I do split dosing, with a 1:3 ratio (6:12) evening:morning. Novorapid… I've lost count. It must be around 20, if not more, and this is considering I am not eating a lot of carbs, in the grand scheme of things. I hope an appointment with the diabetes dietician on monday might enlighten me more. I might also possibly give the sure-T sets a go.

As far as vacations go, this 'pump-holiday' hasn't been the most enjoyable, reading, or fulfilling. I want Blue back, but I also don't want to completely ruin my sites again. Recent blood tests showed my platelet count is low, which means I bruise very easily… how convenient! I was told by my doctor this could be linked to my menstrual cycle coming back though. It is a real mixed bag! I feel there are so many things that are working against each other, and I am a bit caught in the middle. However, I refuse to be trapped.

If anyone has any advice they could offer me, whether on injections, hyperglycemia in general, or even pump site solutions, I am all ears! In the mean time, I will try to go nuts (literally) for Christmas, and enjoy it regardless of circumstance. Nothing is ever perfect, but that doesn't mean it isn't worth experiencing. What is more, if all good things are a certainty, how can we ever truly appreciate them when they come? 


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