Wednesday, April 26, 2006

Pump issues

As mentioned in one of my previous posts, I have agreed to try an insulin pump for 3 month. My diabetes nurse has tried for years to convince me about this, but it was a combination of several things that finally made me say, "okay, let get it over with then":
  1. my boyfriend suddenly turned around, thinking it would be a good idea - so now the pressure was on me from several directions!
  2. the fact that maybe, if pump therapy should really improve my daily regulation, now would be a good time to test that in order to finally be able to convince my boyfriend that going to Denver to do a Ph.D should not make him worry, if I deside to do that, even if he does not feel like going with me
  3. I am going to a conference in Prague in the beginning of May, and this would enable me to test and compare the challenges of travelling with a pump vs. pens
The reasons why I have been reluctant to try the pump were not that I could not see some advantages and posibilities of this sort of therapy, but mainly the fact that I could also see some disadvantages and difficulties of it, which didn't really excite me. A few of the latter mentioned have turned out to just be prejustices, now that have been pumping for almost 3 weeks. However, yesterday reinforced another of my pump prejustices: The one about the need to test frequently and ALWAYS have a back-up plan at hand. Yesterday started out okay. I was 7.8 (140) before breakfast, and I used the bolus wizard to estimate the breakfast bolus of 5.6 U. Because I have not come to trust this wizard function completely yet, and because I had a suspicion about being too high later that morning, I tested again about 2.5 h after breakfast: 17.1 (308)! WTF!!??? Although I suspected that I was high, I did not imagine I would be that high. While evaluating posible reasons for this, I took a correction. I inspected the site, wondering that it looked a bit moist, but maybe that was because I had been sweating a bit on my bike ride to the university earlier that morning. When the pump had given the correction I inspected the site again, though, and I wasn't pleased with what I saw! Now it was clearly wet and the smell of it let no doubt that the site was somehow leaking! Great, just one of my precausions about pump therapy had been confirmed. I did not have another infusion site at my desk, but fortunately the pen that I used to use beforehand was still in its place, so I turned to that instead. However, I had no idea how much, or how little insulin had actually been delivered by the pump, so I would have to guess on the correction and the bolus for lunch later. That went fairly well, though, despite going low before lunch (3.0 [54]). The rest of the day I debated with myself about whether to insert a new site when I got home, just prior to leaving again for soccer practise, or just leave the pump off until this morning. I was seriously tempted to do the latter, but I ended up inserting a new site when I got home anyway, and fortunately it seems to work as it is supposed to (*7-9-13*). I can't help wondering about how sane it actually is to miss injections!! You woundn't think that would be a posibility, having cursed the inconvenience of them on and off during the last 16 years ;-) Still, the experience confirms that the pharmacy that you have to bring along when on the run will be even more voluminous when using a pump, and I must admit that I think that I will rather carry the pens along with me than having to carry extra infusion sites, syringes, insulin bottles and so on. After all the pens easily fit in a pocket or a bag, while the pump supplies will require cargo pants with multiple large pocket or a bag with a compartment dedicated to the supplies to cover prospective issues of insulin delivery :-)

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