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Holly * 15 years sent in 1 March 2008
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!MY POCKET PANCREAS!
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My name is Holly, I am a 15-year-old type 1 diabetic, controlled by an insulin pump.

So what's it like to have a pump? Well, for a start, it does exactly what it says on the tin. It continuously pumps small amounts of insulin into me, just like my pancreas USED to, meaning that I have the luxury of being able to tweak and tune my insulin at any time of the day, and flexibly boost for any food that I eat. It has removed some day-to-day annoyances that many diabetics face, such as the militarily precise mealtimes, early-morning wakeup calls on weekends, injections and nocturnal hypos.

I have traded 12 injections in a typical 3 day period for just one simple site-change, which is by no means traumatic or painful. I would say that is a pretty good swap!

Luckily for me, when I suggested I try a pump, my diabetes team were open to my request, and willing for me to be their first ever guinea pig. They went on a weekend training course where they actually wore a pump with saline fluid: meaning that my consultant and nurse know exactly what it feels like.

A few months passed, whilst the funding was approved by my PCT and hospital, until one day, my purple (yes, PURPLE!) 'pocket pancreas' arrived on the doorstep!

We dragged my Dad to the hospital (his last visit being two years previously on the day of my diagnosis, when HE was the one who ended up lying on the bed, feeling faint!) and training began. It was a fairly intensive process but it truly is one of those things that you never forget. The room was packed with 'spectators' - dietician, medical students, Medtronic pump-trainers, Consultant, Diabetes nurse, Mum, Dad, oh and me.

We began by just getting to know our way around the pump. It was cool learning all the amazing functions that this small but intelligent plastic box can perform.

Now, I am completely at ease with the pump - it is surprising how quickly you get used to having it attached 24/7 and it is far more robust than you would expect. So far it has survived skiing, trips to the beach, roller-coasters, a Duke of Edinburgh expedition and school lacrosse lessons, the latter being the root of all evil, in my opinion.

However, as with everything in life, there are downsides. Having it connected to you the whole time can be irritating, and you have to find inventive ways of concealing it about your person and discreetly disentangling yourself to give a bolus of insulin (think skirts and dresses!). I still have some hypos, albeit much less frequently, and because it only uses short-acting insulin, when something fails, it can all go pear-shaped in a much shorter length of time - so you still need to finger-prick.

For me, it has meant an improved HbA1c and more freedom. I think that, having my pump at this age has set me in good stead for a healthy and independent adult life, which can only be a good thing!

If our NHS can learn from the experiences of patients like me, and other countries which have a much higher percentage of pump-usage, for example, Scandinavian countries and the USA, then maybe, many more diabetics can have access to this beneficial and precious technology. We need to focus on the exciting advancements which are constantly being dreamed up, developed, trialled and produced. We are just a few steps away from an 'artificial pancreas'.

The best advice I think I can give is to be brave and take the plunge. Don't be afraid to ask for new types of treatment and don't just accept the status quo.

Keeping people updated and well-informed can empower them to make their own proactive decisions, to live the life they want, with their diabetes just a companion in the background.

© This publication is protected by copyright. All rights reserved.

Thanks for reading this essay.
This is one of the contributions to the 2008 DIABETES ESSAY COMPETITION organised by DrWillem.
This is a page on www.drwillem.com.