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Re: [IPk] Sasha's pump now postponed or cancelled!

Hi Jackie,
Your story sounds so familiar it was much the same when Paul was on the 
CGMS. One night we woke him to do BS and it was 3.6 so you have got to 
respond to it or else you would not forgive yourself if something happened. 
He was high a lot of the time but they couldn't believe how much he dropped 
and had about 5 hypos whilst the monitor was insitu, but by the graph it 
appeared Paul was about 4mmol but we had recording in the 2's.
Paul started pumping yesterday and i am writing this bleary eyed, we got up 
at 12mn 2am 5am 8am to do BS the pump rep and Paul DN came and stopped with 
us all day they are coming back today. Paul started off with BS 18.7 so we 
did correction of blood sugar then he had lunch so insulin with lunch then 1 
hour later had hypo so we had lower basal rate (I somehow think battery is 
not going to last as long as anticipated) He went footie training last night 
so we had to do pre, middle and post training blood sugars we took the pump 
off for nearly 2 hours and the last half of the training his BS shot up to 
18 again.
Better go
----- Original Message ----- 
From: "Jackie Jacombs" <email @ redacted>
To: "Insulin Pump List" <email @ redacted>
Sent: Wednesday, February 16, 2005 9:48 PM
Subject: [IPk] Sasha's pump now postponed or cancelled!

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> Last week Sasha wore a CGMS for 3 days.
> I feel so upset today.  The diabetes nurse from Gloucester Hospital has
> phoned us having said that the results of Sasha's CGMS were "interesting".
> We did worry that they wouldn't be of help in being able to adjust 
> anything
> because we had three days where we had some extreme BG levels.  But of
> course that's one of the reasons we wanted a pump.
> They are suggesting that our carb counting and insulin ratios are all 
> wrong
> and they need to think about a pump again because we need some months of
> accurate carb counting under our belts before we can even think about
> pumping.  It sounded rather like they were having doubts about giving 
> Sasha
> a pump full stop!
> On the first evening after the monitor was fitted Sasha was OK for the 
> first
> few hours, good BG levels, then I gave Novorapid with her evening meal. 
> But
> as I pulled the needle the injection site bled immediately.  I thought to
> myself, I hope all the Novorapid hadn't come out with the bleeding.  As 
> you
> can't tell whether it has or not I had to assume it was ok and just check
> later.  However the BG level rose and by 11.30 pm her BG level 18 mmol!! 
> So
> we gave 2.5 units to correct the high.  Apparently that was a BAD thing to
> do as at the Gloucester Hospital they would never correct a high level at
> night time.  But we have always been told to give 2 units for BG levels 
> over
> 15 mmols.  The nurse said that they leave high levels to come down 
> overnight
> on their own.  However because we have Sasha's insulatard set at the very
> minimum possible amount due to nigh time hypos, her BG levels never come
> down without extra insulin.
> Also we use a different carb to insulin rate for breakfast, lunch and
> evening meal.  However when I talked to the dietician at Glos earlier last
> month she didn't think that was correct and seemed to imply that the 
> insulin
> to carb rate is constant throughout the day. I don't know if that's what 
> the
> consultant thinks as well and maybe the diabetes nurses.
> There were also three hypos  below 3.8 that showed up on our meter but no
> hypos shown on their download of the CGMS.  We have these recorded on the
> meter though.
> One night Sasha had dropped to 4.8 at 2.30 am and we were worried it might
> drop futher so gave her just half a small cup of milk which only amounted 
> to
> 5 carbs.  In the morning at 7.30 she was 13 mmols.  I did think maybe it 
> was
> a rebound high, but apparently there was no hypo and they are questioning
> why we gave food in the night and think we gave too much, but we didn't 
> and
> in the past no way would 5 grams of carbs shoot her up to 13 mmols. So 
> this
> was very unusual.  I had thought that the CGMS reading would be a help to
> get us a pump but now it seems to have had the opposite effect.  The last
> afternoon on the pump wasn't very good either because the monitor kept
> alarming saying there was a calibration error.  So I assume that must have
> meant that the monitor was giving different readings than the meters were.
> We have to attend carb counting classes on Friday and then wait and see 
> the
> consultant in the afternoon because she is now doubtful about Sasha having 
> a
> pump because of the crazy GB levels.
> When we removed the sensor it wasn't straight but curled over in quite a
> bend.  Does anyone know if this would have caused the reading from the 
> monitor to be wrong??  We still have it as Sasha wanted it as a souvenir.
> Jackie, England UK
> Mum of Sasha aged 10 dx 1999, twin sister Rebecca, both coeliac 2001
> Mum also to Danni and Nicola, wife to Terry
> .
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