Bernard Farrell on Flickr

I started using a pump back in October of 2007. It was a rough and terribly rocky start. The pump company wasn't helpful and left me stranded in the dark with this new technology. There were moments that it left me sobbing over the phone to my mother, claiming that I was seconds from throwing the expensive device against the wall. My A1c climbed from 6.9 to 7.6.

After about six months of that and some help from the online community, I finally got the pump closer to being stabilized to my life. It still wasn't pretty. My A1c plateaued around 7.3 and 7.4. I couldn't seem to make the pump fit with my life, despite what everyone was saying. Apparently, I wasn't as stable as I needed to be with my schedule.

Here I am with about 18 months under my belt with this thing, and I'm still not so happy. My A1c is at 7.3. I have all sorts of lows. I have highs without any reasonable explanation, and often highs that don't seem to come down. It seems like no matter the tricks that I use and the advice that I follow (the book Pumping Insulin was a God send back in the day), I can't get the pump to work for ME.

So I'm left wondering again...should I leave it all behind? Maybe pumping just isn't for me. Or maybe it's just not for me at the moment...with the crazy schedule and the other unstable health conditions. I hate to give up the benefits of the pump, but I'm at the end of my rope with the lows and the highs and the site changes and all that.

What exactly are the PROs and CONs of the insulin pump? I guess I need to weigh them out.

PROs of keeping the pump: better control for sick days; a semi-instant way of throwing in a work out or skipping a meal; less insulin needs; more help with "difficult" foods (i.e. pizza, Mexican, and Asian) than regular injections; closer hour by hour management; software management of my diabetes.

CONs of keeping the pump: increase of lows (especially severe lows); unexpected highs from bad sites, clogged tubing, etc; having something constantly attached to me (especially tricky during the summer months); frustration of instability compared to previous MDI lifestyle.

It's hard to say which is better or worse, which is obvious since I've continued to put off going back to Lantus and Humalog. There are two main points that are slowly convincing me of that route: the amount of lows I'm having and my previous A1c.

As far as I can remember, I didn't have an issue with lows like this when I was on Lantus and Humalog. I had stabilized at 17 units of Lantus in the morning and 17 units of Lantus in the evening with Humalog as needed for food (1 unit for every 15 carbs) and corrections (1 unit for every 25 mg/dl). And my A1c was the best that it has ever been...coming in at a beautiful 6.9% from a previous number of 8.9%.

But part of me is held back because I do love the ease of the pump. I can plan a workout, then if something comes up, I just dial a little extra insulin and switch my basal rates and I'm good to go. I can easily maintain perfect blood sugars on sick days. I have instant access to my insulin needs.

But what is better for me? Less lows and a better A1c? Or the variability of the pump? Despite my flexible schedule with this device, I'm not as flexible as I'd like to be. I don't want to stop my life or take in an extra 500 calories a day to treat so many lows. I'm sick of basal tests and stressing over the out-of-range blood sugars.

I'm scared that if I go back to Lantus and Humalog, it won't be the same. I'm scared that my A1c will soar much higher than 7.3. I'm just scared that it will be a major mistake. Sure, it isn't like I have to give the pump back...it will just be sitting in my house somewhere, but it still seems like such a risk.

I'm very much considering taking a break from the pump just to see if I could maintain better control without it. I have no idea how it works to go on and off the pump; I just know that it takes some practice and patience. But maybe I just need a break. Even if the Lantus would let me run stable for a few weeks, I could come back to the pump with a renewed outlook.

Maybe I will try another week or two on the pump, just to see if post-vacation numbers are any better. If not, April 1st might be a good day to get back on the Lantus and Humalog routine (even though I'd have no idea how to judge what I'd need from either) for at least a month to see what I could do. At this point, I'm willing to at least try to get rid of the lows, maybe lose a few pounds, and stop stressing over diabetes.