By Caroline Binfield
We’ve said goodbye to my son’s injections. And we’ve said hello to a pump.
The transition from multiple daily injections (MDI) to the Medtronic 640 pump for my six year old son Jasper has been both easier and a lot harder in different aspects than I had predicted it would be.
When Jasper was diagnosed with type 1 at four years old, it came as a huge shock. But he was a little trooper and decided to do his own injections, after only three months since diagnosis. When the consultant suggested moving to a pump after six months, I had resisted for a couple of reasons.
Firstly I couldn’t bear the thought of learning a whole new regime and mastering new equipment. Secondly, Jasper is quite a typical little boy who likes play fighting with his mates. I was terrified of the cannula being ripped out and no-one noticing.
18 months on and two hypoglycemic seizures later, we agreed with the consultant that the pump could be a better way of managing Jasper’s condition. We had found his levels very hard to control on MDI and his blood glucose levels would swing like a pendulum. The seizures occurred at night in his sleep from a rapid drop in levels and had scared us a lot.
The consultant’s reasoning that the pump delivered insulin in a much more efficient way and so would reduce the pendulum swings and more importantly the likelihood of another seizure convinced us this was the right decision.
Despite Jasper being pretty calm when the medical team arrived, when it came to the cannula being inserted, he started kicking and screaming to get away. The plastic firing mechanism was very oppressive-looking to him when he had got used to a slim injection pen.
I had arranged to get a cannula and pump (demo) fitted at the same time to try to show him that I was experiencing the same thing alongside him. Although I had fired the cannula into myself in front of him, it didn’t make him feel any better and it took us half an hour to calm him down.
He did a saline trial for a week which he found very difficult because he wasn’t reaping any benefits as he had to still do the injections. The second cannula change was just as bad so I sought some advice from the CWD Facebook group. They gave me the idea of freezing the area first with an ice lolly before inserting the cannula and then allowing him to eat it afterwards as a treat! This worked brilliantly and we have adopted this strategy every time since.
He has had his pump for two weeks now and his blood glucose levels are certainly easier to control though we are still changing some settings. He has only had one hypo when his levels dropped suddenly without explanation. I find the pump relatively easy to programme and the automatic correction calculation makes it very user friendly.
I have been in school three times a day to support the teachers as they learn to programme the pump and perform glucose tests. They are picking it up quickly and their enthusiasm to do it correctly has impressed me.
The hardest implication of the change to deal with has been Jasper’s extreme mood swings. He can fly into a wild rage at the smallest thing and will kick and scream at the top of his voice. As his Mum who manages his condition on a daily basis, most of these moods are directed at me. I have requested to see the paediatric child psychologist to see if she has seen this effect previously following a move to the pump and for advice on how to deal with it. Should I reprimand him for this aggression? Or if this is a fairly normal manifestation of the process he’s going through physically and mentally, should I just ignore it and (try to!) remain calm?
It is horrible seeing him so angry but I do not want him to return to MDI as I really do believe the pump is better for managing his diabetes in the long term. I just hope that he starts to cope better psychologically in the next few weeks.