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I try to change my infusion site every 3 days. Generally, I hit the mark almost perfectly at 72 hours. Lately, I've been running the pump all the way to the last drop of insulin so my infusion sites go a little longer (only about 5 hours). I've just gotten lazy in changing them out.
Even before I started doing that, my pump supplies started piling up. I would get shipments for 3 months before I was anywhere near being out. I have a 3-month supply just sitting in my closet while I still use the current supply I have (about 1 month). My next shipment will probably be here within the month.
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Elizabeth commented on yesterday's Pump Nostalgia post, saying she has been type 1 for 38 years and has in the past resisted the idea of going on a pump. She wants to know what I find so thrilling about it.
For starters, and probably the biggest things for me, it's the precision and the convenience. As for precision there are a couple of aspects: I don't have to conform to a certain number of carbs to match my insulin:carb ratio. For example, like many people, I am more insulin resistant in the morning, so my insulin:carb ratio is lower. So if I'm having 45 carbs and my insulin:carb ratio is 1:12 and my sugar is within target, I can't take 3.75 units with an insulin pen. So I either have to decrease or increase the number of carbs or the amount of insulin and deal with the consequences later.
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I woke up this morning about 30 minutes before my alarm to answer a call from nature. I stumble to the restroom and as usual I set my
insulin pump on the sink counter. I should explain that I have a relatively small bathroom so the sink is pretty much half of the room. Well, no sooner do I set my pump down that it slides off and slams on the floor.
Ouch!
I have had my pump fall before but this one sounded extra hard. I leaned over and picked up my poor pump to see if it was okay. It was not. The screen was blank and even though I closed my eyes and wished for it to be fixed, it did not work.
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As I sat in the lower level of the on-campus trolley stop I thought about the injection I just took and the maze of shots I take every day. How many more shots will I take in my life? How many more times will I have to stutter-step, looking for a good place to shoot-up some insulin? How drastically might an
insulin pump change my routine?
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I've never been a trendy person. In junior high when Bass loafers were all the rage, I didn't get a pair until they were almost out of style. There's a lot of that in my life.
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I arrived home from work on Monday night to a very brightly colored, giant-sized envelope from Smiths Medical. 'Important Information' it declared. 'Open Immediately!'
So I did. And read: Your current Cozmore System warranty expires in December of 2008. Please begin the process of replacing your pump immediately, as we will be unable to replace your pump should something go wrong after December 9, 2008. Alright then.
The very next day, I went online and printed out both an Insurance Information form and a Medical Necessity Form. I filled out the first form, signed and sent to Smiths. Then I faxed the second form to my Doc (who is amazing) and by that afternoon, it was filled out and faxed to Smiths. Great. I'm on my way to a new pump. Right?
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It took me nearly
two months to finally get a solid range of good blood sugar numbers. Many checks would have me hovering in the 200's, only to be followed by a bottomed out low caused by a flagrant over-correction. The devil is in the details when it comes to pumping and I started out with the wrong details!
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I called an emergency meeting with my endo last week. For the first time in my pregnancy, my blood sugar was out of my control. My fasting numbers, which I prided myself in keeping at the low end of the healthy range, suddenly shot above range and my post-meal readings were so erratic I actually threw out an insulin pen, convinced it was defective.
On MDI for the duration of my pregnancy, I did what I was told to do-upped my insulin-carb ratio, cut back on carbs, reviewed my food journal. I even checked to see if I'd consumed a bag of chocolate truffles in my sleep.
Clearly, I encountered the dreaded insulin resistance that plagues most type 2s and hits hard during the second half of pregnancy. I'd never had this problem before. Frantic, I posted on all my diabetes sites, begging for advice. The answer: Exercise more.
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I'm so frustrated right now. Like cry myself to sleep frustrated. I started walking again five days ago. I had to skip this morning because at 5:50 a.m. my blood sugar was 231. I hate myself for that. But here's what happened. Yesterday, we were invited to a barbeque. In addition to the dessert I left on our kitchen counter, I also forgot to bring my medicine with me. I took the meds when I got home and ate something small just in case, but I still woke up to this hideous number. And of course, no matter how diligent I was all day I remained high because I can't take fast-acting insulin with Byetta.
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I should have known that there would be frustration. I guess I thought that since I wasn't new to basal/bolus therapy that my transition from MDI to the pump would be smooth. And it mostly has, but the last two days I have been running higher than usual with no explanation. Enter frustration.
So when Mom called last night to see how Toohey and I were getting along, I was telling her about all the things that could be making me high:
*basal rate set too low
*active insulin time set too long
*were my jeans too tight today?
*I think I'm ovulating
*or maybe my period is going to start soon
*does my infusion set need to be changed?
*when I was on Lantus, I took it at night; do I need a higher overnight basal rate?
*is all this stress about my high numbers making things worse?
I think I exhausted her with all these possibilities! I took it all in stride yesterday, but today--not so much.
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