Category Archives: Insulin Pump

My Insulin is Artisanal Water.

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Oh hi. I’m still alive, just buried under work and anatomy books. I came out of hibernation to vent! Isn’t that fun!?

It’s been one of those (14) days where I want to take a large hammer to my insulin pump. It feels like my average blood sugar has been 1,000 mg/dl. On the real, I’m holding steady in the 170’s at the lowest — usually in the 200’s. I have brief periods where I see 140 and below.. but brief is the operative word. I increase my basal rates and bolus extra to no avail. Last night, my CGM said I was 80 with double arrows down, and I didn’t even flinch. I knew it wouldn’t last.

I hear you asking: did you change your sites? How about new insulin? Change the location of your sites to avoid scar tissue? Increase your basal? Exercise? Are you eating right? Drinking enough water?

Yes, yes, yes, yes, yes, yes.

I’ve done it all! I threw away a half vial of precious insulin, I’ve gone through a pump set every two days (and I’ve put my set basically everywhere except my side boob and my forehead). I have very few options left to consider, it seems like (and thank you to my dear friend for troubleshooting with me this morning).

  • Husband’s theory: Insulin pump has gone AWOL. It’s delivering only half of what I tell it to give me. I feel like my pump is sophisticated enough to sense that, though. Plus — normally I can feel it when Animas boluses (because it injects at 75mph).
  • My most obvious theory: Basals need to be jacked up across the board. Seems odd to have happened all at once, but maybe it’s been happening more gradually than I’ve realized, and now I’m just frustrated. Today I’m rocking a 10% increase for 24 hours (and I’m still at 170 after bolusing extra for my peanut butter waffle this morning). I’ll try 20% tomorrow and then, *UGH*, some basal testing this weekend 🙂
  • My “I don’t even know if this is really a thing” theory: Have I developed antibodies to Novolog? Would my body be that cruel? I did some research and alas, this does seem to be an issue with some folks.
  • My far reaching theory: When I sleep on my pump set, I’m squishing the cannula, so I’m high at night and it’s setting my up for failure for the rest of the day. I can argue, though, that I haven’t changed my sleeping habits in the last 17 years, so..
  • Another logical theory: I’m stressed out. I don’t feel ridiculously stressed out, but I do have a lot on my plate right now.
  • My enemy theory: Someone at the pharmacy) hates me and my insulin is actually artisanal water flavored with bandaids.

Any theories from you guys? Any funny stories to distract me from beating a really expensive medical device against the pavement? Thanks for letting me vent. Hopefully I’ll be back soon with more stable sugars, more fun updates and better stories — my last pre-requisite course is done in May!

endo appoinment – (that’s) what she said.

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Last week I posted some ‘points of interest’ that I wanted to address at my most recent endo appointment. My dr. is really great about giving me time to bring up things of concern/things that are on my mind — so I actually got to cover all 5 topics. I’ll debrief a little bit of what she said — but please note that this is my interpretation of what she said, it’s not medical advice (IT’S NOT MEDICAL ADVICE), your diabetes may vary, yada yada yada.

Duke charges each appointment as hospital based services. I’m still paying off over $1,000 in medical bills. I can’t keep accumulating this much medical debt.
OK, first of all, she said she wanted to keep me as a patient (I was touched!!) and I agree – I want to do anything I can to keep this endo. She also said that she understands I need to do what’s necessary to take care of myself diabetes-wise and otherwise. She set me up to speak with a Financial Care Counselor within the department (immediately — I met with her right after my appointment) who felt very confident that with my recent insurance switch, I’d be much happier with my out of pocket costs. My husband I agreed that we would wait until we get the latest Explanation of Benefits from this visit and go from there. If it’s not ridiculously expensive, we’ll stay — we both agree that good care is worth it.

Basal Rates
I was sure that my basal rates would need to go down during the middle of the night, and I was right. She also advised me to lower my insulin:carbohydrate ratio at dinner time. In the past, I’ve tended to spike a bit after dinner (if consuming much more than 30g carbs) and then I’d get low while sleeping. Hopefully with a 1:9 ratio at dinner, I’ll cut out any postprandial spike (ha.ha.) and the lower nighttime basal with help with overnight lows. 

Alcohol. Two beers makes me plummet. Never happened in college.
“You have no reserve!” she said. I guess because my control is a lot tighter than when I was in college — when the alcohol makes me dip, I’m going from 120 to 60 instead of from 200 to 140 (college was not a great time for my diabetes). New plan (not medical advice) try to go for red wine instead of beer (beer makes me spike, so naturally I try to bolus for it, then I get low. I’m not willing to give up IPA’s altogether, though. By all means, I’ll work hard to learn how to bolus for a Bell’s Two Hearted, holla if ya hear me.) Also, am going to be certain to have a snack before bed unless I’m extremely high, and I’ll set an alarm to check in the middle of the night. I sound like I drink all the time — I don’t, but I was experiencing some pretty scary lows when I was simply trying to enjoy some drinks with friends. Diabetes will not make me afraid. Diabetes will not hold me back. (Sorry so many parentheses).

Excercise Tips
Going to start setting a temp basal thirty minutes before exercise. Not sure of the percentage — will need to play around with that. I’ll also work hard to make sure I can exercise without diabetes getting in the way. See aforementioned statements about not being afraid or held back.

Ketones (Had ketones on Monday with a steady 180 all morning. I had exercised. Maybe it was my insulin.)
Not uncommon, she said. That surprised me. I guess I normally don’t check ketones when I’m 180 — but I was feeling particularly crappy that morning. I think she called them diet ketones, and told me I probably hadn’t consumed enough carbs that day. She recommended drinking a glass of milk in the mornings if I’m having a low carb breakfast.

Have any of you ever experienced any of the issues that have been on my radar as of lately? Any and all advice is always appreciated!

 

thigh set.

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For the first time in 15 years, I’ve placed my pump set in my thigh. I know I’m not good at math – but that could very well equal over 1,800 pump sites placed elsewhere on my body – including: stomach (used to use a LOT, but it’s super scarred now), back of my arms, lower back, upper butt (#makessenseifyouhavediabetes). Now that I write that out – there really aren’t that many options. I guess it was inevitable that I try my thigh out at some point.

So, how is it working out, you ask? As I mentioned on Twitter, I feel like I’m alternating between the urge to limp and the urge to tighten my thigh muscle. In time, I’ll get used to it! I’ll try to keep you posted on Twitter or Facebook about it’s absorption.

So, what not-so-normal spot do you use for your pump or CGM when you feel like all of your real estate has been used up? Has anyone used their side boob? Seriously, I know someone has. And seriously, I can guarantee I never will.