Next, a young, nervous-looking nurse was given the job of
escorting me down to radiology where I was to be given a chest X-ray. The lifts
at the hospital seem to be the slowest lifts anywhere in the world for some
reason; maybe just the sheer wait of demand on them! Getting from the 14th
floor to B1 seemed to take forever. We were joined by a doctor, wheeling
another large machine and playing on his iPhone, and scowled at by a nurse on a
lower floor in charge of an empty bed who couldn’t fit into our ride. In spite
of the usual lift battle, the hospital was like a ghost town: the lights were
off and the usually busy corridors were almost empty. The nurse seemed a little
lost, but we found ourselves in the x-ray department before long, where a
radiologist was sat, bored, behind the desk. They exchanged a few words in
Korean, then aimed a single word at me: “Brassiere?” All ready for bed, I was
just in my pyjamas, but I couldn’t help smiling. The radiologist took me into
the X-ray room. First I had a couple of X-rays standing up, I was then asked to
lie down on a bed, face-up, to have a couple more. In the UK, I’m sure they
cover up other parts of the body that are not being photographed… Here, I felt
very exposed! Standing in a room with X-rays floating around in the air…
The nurse and I made our way back up to the wards where I
got into bed. It was still fairly early, but perhaps unsurprisingly I was ready
for bed: the anticipation and illnesses of the past few days/ weeks/ months had
caught up with me, I was finally at the point I had been waiting for and
worrying about: in a Korean hospital about to get a pump. Needless to say the
bed is reminiscent of concrete, the pillow is small and inflexible and the lime
green blanket is heavy duty. All this aside, it’s not really so bad! Hard beds
are good for your back, right? And I think I sleep with too many pillows
anyway, so it’s probably doing my neck good!
Evenings in hospitals are always fraught with noise and
disturbances and last night was no exception. I am sharing my room with 3
Korean ajumas… The lady to my left is fairly quiet, especially at night. The
lady to my right I have (secretly, of course!) nicknamed Farty McFart as her
wind is quite something to behold. However, she very kindly game me some
satsumas yesterday and seems very nice other than the wind… The woman in the
bed opposite is Snorey McSnore. She fell asleep at around 8pm and snored and
snored and snored. This morning, I am re-evaluating these names… Farty McFart
unfortunately also seems to suffer from insomnia… At various points in the
night, I awoke to find her light on, or her shuffling around the bed, bashing
and banging, or splashing about in the bathroom. And Snorey McSnore has turned out to be
Grumpy’s older sister…. All in all, my sleep was broken to say the least!
At around 2 am, I was woken to test my blood sugar, and at 6
am I woke to find a nurse, carrying a little tray with empty vials, poised with
a needle to fill them with my blood; not the nicest wake-up call I’ve ever had!
But at least it was over quickly, and I barely felt a thing because I was still
half asleep.
This morning, the nurses have been mainly communicating with
me via messages written on paper. Often old patient records with ID numbers,
names, ages and medical details (such as “scrotal elevation”) on. My temperature and blood pressure has been
monitored twice so far, and all normal, my pulse has also been taken, something
I forgot about!
At around 9:00 I had a couple of lovely visitors who were
joined at my bedside by Dr. Tae Nyun Kim, who managed to somehow sense my
excitement… And then, at around 10:15 it was time to make my way downstairs to
the Endocrinology outpatients: P-Day had arrived!
My trusty sidekick, Pork Chop, and I were shunted into the
‘Diabetes Education’ room and sat down opposite a man in a suit. The table was
littered with diabetic paraphernalia and on the table was a pump. The English
liaison nurse joined us, as did one of the nurses from the department: 5
people, one table…
First, my CGM cannula was put in, on the right side of my
belly. I have had a CGM before and I find them fairly uncomfortable. For some
reason, the cannula remains sore and I am very aware of every movement around
it. The sensor takes a while to activate, so we continued on with the pump
lesson.
The next hour and a half are pretty much a blur! The
training consisted of lots of talk in Korean, translated into English, a bit of
back and forth in English before turning back to Korean for a little more back
and forth. I have to say though that it was amazing. Every question was
clarified and answered, the Medtronic rep explained and re-explained as
necessary, flicking between pages of the manual in English and Korean. At the
end of the session, it transpired that the poor guy had been really nervous
about it all… Teaching in Korean is one thing, but teaching to a Wayguk in
English, I can understand the nerves!
Using a practice pump, we went through how to set my basal
rates, how to set a bolus, how to change the infusion set, how to draw up the
insulin into the pump reservoir and how to insert the cannula, using a foam
apple as our victim. A lot of it reminded me of the first time round, 18 years
ago, when I was learning to draw up insulin into my syringe from tiny vials and
practicing injecting a grapefruit. Maybe
that’s where my affinity to grapefruits comes from…
It was a LOT to take in.
For my starting basal rates we decided on:
·
1 unit per hour from 00:00 to 06:00
·
0.8 units per hour from 06:00 to 18:00
·
1 u/hr from 18:00 to 00:00
I was a little nervous about this. It was calculated from
80% of my total daily dose of basal insulin (24 units) which should have been a
total amount of around 19 units altogether, actually, it turns out to be around
22.4 units. When speaking to Lisa, she
suggested I should start on around 0.6/ 0.7 units per hour. However, she also
suggested listening to the doctors and going along with what they said! So, in
spite of not being completely confident, we went ahead with the suggested
doses.
The Medtronic rep programmed the date and time and then
allowed me to set the basal rates for my very own, brand spanking new pump!
It’s dark grey. A little disappointing as I had my fingers crossed for blue,
but hey, beggars can’t be choosers! Setting the basal rate was easy, it
involved pressing the up and down buttons and the ACT button a lot. I would
consider myself fairly confident with technology/ gadgets which means 2 things:
one, I like the pump simply because it’s a gadget; two, I find it pretty easy
to navigate (so far!).
The next steps were harder… Mainly because they involved
more than just a screen and pressing buttons.
Filling the pump’s “reservoir” was more complex than I was
expecting. The Novorapid (short-acting
insulin) I am not taking is the same as the insulin in my pens. However, now it
comes in a bottle. To fill the reservoir you need to draw up around 3 days’
worth of insulin plus a little spare: my approximate 3-day dose + extra is 200
units. The reservoir is just like a syringe. To draw up the insulin I had to
draw back the plunger to 200 then push the 200 units’ worth of air into the
insulin bottle. When I turned it upside down, the pressure then automatically
filled the syringe with the same amount of insulin: genius! But, the tricky bit
is the bubbles! I remember from before, how important it is to get rid of
bubbles, but now it’s imperative. With a lot of flicking from the nurse and I,
eventually all the bubbles had floated back into the bottle and the syringe was
bubble-free. For now. The next step was
loading the reservoir into the pump. Easy. Or so you would think! TO do this, I
had to remove the plunger from the syringe. Anyone with half a brain, would
realize that simply pulling out the plunger would result in more air getting
in! Not me… Seconds later there was a bubble-party in the syringe. Oops. A
little problem-solving and the bubbles were back out where they belonged! I
UNTWISTED the plunger from the reservoir and it slotted easily into the pump.
At some point, I had to push insulin through the tube which
had been attached. But I can’t remember now if this was before or after it was
put into the pump! Then, I have to insert the cannula. This was fiddly. And it
didn’t help that both the nurse and I were trying to do it simultaneously. Our
fingers kept clashing and I got a bit flustered: I kind of needed to make any
mistakes I was going to make, even if it meant pulling it out and trying again.
The device used to put the cannula in looks like a mini modern version of a
medieval torture device; I’m not sure what its proper name is, but I’m going to
call it the ‘shooter’. I loaded the infusion set into the shooter, forgetting
to pull it back to set it ready to shoot. Then I set the two guiding arms onto
the flesh of the left-side of my belly. It was an awkward position, but one I
am sure I will get used to! It took me a few seconds to pluck up the courage to
shoot, but when I did, I was surprised: there was a sting that lasted for a
second or so, then nothing really. The next bit was the frustrating bit! I was
sitting there, with the shooter sticking out from my belly; the nurse, the rep
and I trying to fumble around with it. I needed to peel back the sticky bit to
stick to my belly, unhook the shooter from the cannula, then remove the needle
just leaving the miniscule plastic tubing under the skin to administer the
insulin. Eventually, everything was where it should be, but I was not really
any the wiser as to the order of these things!
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Immediately, my pump was up and running. And it suddenly dawned on me that that was it: No more needles of any kind for 3 WHOLE DAYS. I got goosebumps and I nearly started to cry… It was totally overwhelming, but absolutely amazing.
After all this excitement I was pretty much exhausted! After
I got back to the ward, a nurse came to fix up my CGM. Then, as I was dozing,
another nurse came to get me for a ‘study’ appointment at 15:00. I had no idea
where I was going or why! We ended up taking the elevator back down to the Endo
outpatients where I had to undergo the diabetes complications tests: the part
of the day I had been dreading (and thought I’d got away with!). I was weight
(62.5 kg) measured (165.4cm) then asked to lay down on a bed for my ‘artery
test’. I have never had this before… I had an inflatable band – like a blood
pressure band – attached to each ankle and wrist and electrodes on my chest.
The nurse punched a few buttons and the bands began to inflate. They inflated
more and for longer than a blood pressure machine… It felt like my blood vessels
were going to burst! Then, it was my retina test. I was taken to a dark room
and had photographs of the back of my eyes taken. On my way back up to the
ward, I asked if I would get the results of the tests and was told I could, if
I wanted to. Why would anyone not want to?! I said I wanted to… But was not
told when or how I would get the results!
When I got back Pork Chop and my lovely housemate,
Vegetable, were waiting. V produced an amazing little ‘care package’ full of
all the things you could possibly need when in hospital (and have just been
told you can’t shower for 3 days because you are attached to a CGM!):
mouthwash, hand and face wipes, chapstick, hand cream, lady wipes, Dentyne Fire
gum, Coke Zero and Jalapeno flavor kettle chips. Yes! We settled back to watch
this week’s Made in Chelsea and caught up on events.
The rest of the day was relaxed. As expected, my bolus rates
resulted in a number of hypos over the course of the evening and night.
Week beginning:
|
Breakfast
|
am
|
Lunch
|
pm
|
Dinner
|
eve.
|
Night
|
||||||
before
|
after
|
before
|
after
|
before
|
after
|
bed
|
3am
|
||||||
T
|
TIME
|
1:50
|
5:30
|
6:20
|
9:00
|
10:00
|
5:00
|
||||||
Blood
Sugar
|
212
|
128
|
62
|
168
|
95
|
84
|
49
|
||||||
CHO/ g
|
60
|
60
|
30
|
||||||||||
Total
bolus
|
12.4
|
5
|
|||||||||||
Physical
activity
|
Time:
|
Intensity:
Low / Moderate / High
|
Duration:
Short / Moderate / Long
|
||||||||||
I had a hypo before dinner, which resulted in my bolus being
cut down from 8 units to 5 (if I had calculated it based on my previous ratios,
I would have given myself 7 units – I’m glad I didn’t!) Then, in the evening
hours, my levels fell by 10 mg/dL in an hour… A dangerous state to go to bed
in! PC and I snacked on some fruit given to me by Farty McFart and one of the
packs of jalapeno crisps. In spite of this, I still woke at 5:00am with a
reading of 49.
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