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March 14th, 2010
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Bernard Farrell on Flickr

Right now, I'm a complete bundle of nerves. Last night, I suddenly decided that today I would go off the pump. I know that I've been talking about it, but I assumed that I'd get it all straightened out and be back into "normalcy" before April 1st came around.

 

But you'd be surprised to find that poor control is actually NOT the reason why I'm going off the pump. In the past two weeks, I've had some highs and far fewer lows (which is just amazing). My averages are still in the 150 range though, which is what I'd settle for to get down to the 130 range (slowly, without lows).

 

The reason why I'm taking the plunge today is because my infusion sites are giving me a lot of trouble lately. There has been a certain patch of skin for about two weeks that has been extremely sensitive to the adhesive on the infusion site. But now, it's spreading to the rest of my body. And I'm itching like crazy.

 

So I've just decided to let my body and my skin have a little break from the pump and it's infusions. I know that I could use IV 3000 (as I have before for these issues), but it doesn't usually solve the entire problem. The IV 3000 still causes my skin some irritation. And the tubing and needle often present a problem too.

 

I don't plan to be off the pump forever. I just plan to give myself a break from the pump. I'm going to assess how my Lantus/Humalog routine works for the next week to two weeks, then go from there. I'm also going to keep an eye on the infusion sites to make sure they heal and stop itching.

 

I'm just extremely, EXTREMELY nervous right now because I don't know how this day is going to go. I looked in "Pumping Insulin" last night to see protocol for going off the pump for more than a day. It says to use half of my normal "total daily dosage" in Lantus. For the past 31 days, my average daily dosage has been around 41. So I plan to split 20 units of Lantus into two injections, one in the morning and one in the evening.

 

This morning, I woke up at 139. I've now eaten breakfast and bolused appropriately for both those things. I also set a temp basal to 0.0 units of insulin for the next three hours. I plan to take a Lantus injection at 11AM CST of 10 units. Then I will take another Lantus injection at 11PM (right before bed) of 10 units.

 

I can't exactly recall my previous carb factor or my insulin sensitivity factor, but I believe it was 1 unit for every 15 carbs and 1 unit for every 25 mg/dl. On the pump, I'm at 1 unit for every 10 carbs and 1 unit for every 50-55 mg/dl. So I'm guessing that I will keep those numbers to see how it goes. I'm actually going to keep the pump on me, but set to a 0.0 unit basal, because I'm scared that I'll forget to bolus with the syringe.

 

I'm planning to be high today since 20 units of Lantus seems like such a small number. I was previously taking 17 units in the morning and 17 units in the evening, so I don't think that 20 will cover me throughout the day. I plan to test my blood sugar every three hours today, which would mean checks at 11AM, 2PM, 5PM, 8PM, 11PM, and 1AM. That roughly works with my schedule and I will probably check a few more times in between.

 

I'm just hoping this is easier than my nerves are letting me think it will be. Right now, I'm so nervous that I'm considering staying on the pump. But I know that I need to give my skin some time to de-sensitize and give myself a little stressor break. So here's to a day of the unknown!




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