A little bit late, but here's today's photo. I found this when changing my infusion site. I guess this explains why it hurt to bolus...
I've had a few thoughts and things that keep coming back. In no particular order:
- We moved about a month ago. In the midst of unpacking and tidying, I've had a few lows that have fuelled house-cleaning rampages. These flurries of vacuuming, bleaching, etc are incredibly productive, if not particularly healthy.
- Hoosband was away camping with friends about 3 weeks ago. I fired up the Minimed Connect and added my mom to the list of people to be alerted by text if I went low, since Hoobs wouldn't have any cell service. Night 2 of this camping trip, I had a bad overnight low and I woke up to my dad offering me a glass of juice. I really, truly thought I was in good shape and had a handle on my overnight blood sugars. Guess it just goes to show that things are never certain when it comes to diabetes.
- My mom came grocery shopping with me on my first shopping trip after the move. When I mentioned that I needed dish soap, she pulled me aside and solemnly explained how I should go for the soap with a flip-top instead of a pull-top, as the pull-top bottles tend to get all gummed up with soap. I ended up stifling a laugh as I told her that it is a new house, yes, but this is far from my first time buying dish soap. I know what I'm doing. Sort of.
- I still haven't finished unpacking my pump supplies. I'll get to it... when the current box of infusion sets runs out.
Diabetes has been taking a backseat to the rest of Life lately. That should really change, soon.
I know I have no right to complain.
My site was on day 4, and as an upper-butt-cheek-infusion-set, it has seen quite a bit of wear over the last 4 days.
My 6-day-lifespan sensor was restarted and was on day 8.
I postponed changing my site and sensor last night. "It's wasteful to change a site when I still have a half-day of insulin left." "The infusion set doesn't even hurt that much. I'll just sleep on my other side again tonight." "That sensor worked so well for its first round! It will be fine for a few more days."
The lies we tell ourselves to justify not having to change a site. Not having to feel that jab, twice, as two devices are inserted for 3- and 6- day spans (or 5 and 10, if you tend to stretch out your supplies like I do). All of this led to me sitting at work this morning with a splitting headache and a thirst like you wouldn't believe (I'm at almost 2L of water so far. Been at work for just over 2 hours). Cal reminder alarm prompted me to check my BG and to be quite honest, I probably wouldn't have bothered if not for that alarm. My cgm had me at 8.4 and dropping, so I wasn't worried.
Still, though. I should calibrate.
Fingerstick, 18.6 (335 mg/dL).
Working on a set change with this kind of headache is challenging. I rip open an alcohol swab, then stop. Squint. Rub my aching temples. What was I doing? Oh, right. Syringe, wipe top of insulin bottle. Use now-disconnected pump to calculate the correction dose. Deliver correction.
Another alcohol swab. What was this one for? Wipe top of insulin bottle, feeling vaguely like I've already done this. Think back, pushing through the throbbing haze of red that clouds my head and makes coherent thought a distant memory. Aha! Yes, I did do this.
Do it again. Change infusion set. Charge transmitter. Replace sensor. Look at the mess of medical waste and wonder why I didn't do this yesterday.
I thought I have been doing quite well.
Sure, I've had a few more lows than usual. Sure, stress can do that. And sure, I keep having to remind myself after treating these lows that maybe it's time to slash away at my basal rates so these lows happen less often, but then I forget right up until the next 2.7 is staring me in the face.
Then this happened, and I found myself sitting in my office 2 days ago with an empty pump and a 6-day-old infusion set. That may be the norm for some, but I usually try to keep to a 3- or 4-day site rotation, so 6 is a bit much. Limiting sets to 3 or 4 days usually easy for me, since I've never made it past day 4 with any insulin left in my reservoir.
I think at this point it's safe to say that despite my best (okay, my medium-est) efforts, wedding planning has bested me. Diabetes care has fallen by the wayside. I'm still here, still bolusing for food and chowing back on glucose tablets when I'm low, but being proactive about my self-care is taking a backseat to all of the wedding stuff.
So, step 1 has been Recognizing The Need For Change. I guess step 2 is actually doing it. On that note, I will upload my cgm data to Carelink when I get home tonight. I will. Tonight.
I mean, not right away tonight. We have a meeting with the wedding DJ after work. But after that. Definitely.
Pump says low.
Melody says shhhh pump, I sleep.
Boyfriend is not home.
Pooch says NO HUMAN WAKE UP YOU ARE BEEPING WAKE UP EMERGENCY OMG OMG OMG.
I saw something cool on my Facebook feed tonight: Minimed Connect will be available in the US sometime in the Fall of 2015.
What is Minimed Connect? It's an uploader that sends pump and sensor info to a smartphone, which then reads it via the smartphone app and lets you view your pump info via phone. It doesn't allow you to control your pump, but it does let you set a "text message threshold" which will send out a text to friends/family/loved ones if your sensor glucose levels are too high or too low.
The uploader also sends your sensor data to your Carelink Personal account every 24 hours, so those reports will always be up-to-date in case you or your doctor want to log in and check out that info.
I feel like this will help out with the "pump alarms aren't loud enough" problem. It will definitely also be nice to have Carelink data updated automatically, rather than the current system that requires that the user manually upload their data (in my case, frantically the night before every endo appointment :P).
The article (and the ensuing comments) mention that the release is in the US only, and will cost around $200. They do not expect the device to be covered by any insurance carriers.
The comments also mention that they have no info about a Canadian release for now. I hope they provide an update about the Canadian release sometime soon!
I sometimes find myself negotiating with myself to downplay the gravity of my diabetes care. "Oh, I've been waking up high all week? ...Yeah, but yesterday I tidied the main floor AND vacuumed. PLUS, I emptied the garbage for the whole house this week so that Boyfriend didn't have to, because on garbage night he was out at his mom's place fixing that crack in the drywall beside the kitchen counter, so he would have been too tired to do the garbage, soo......yeah. I should get a pass on the diabetes thing. I'm obviously too busy to retest overnight basals."
"I wore an infusion set for 5.5 days last week? Yeah, BUT the DCM at work (A manager who is, I think, 5 or 6 managerial levels up above my boss) came to our office with a rush request on a Friday afternoon, so I stayed suuuuuper late on a Friday. I was crazy-efficient though! I produced everything that they needed for their meeting on Sunday!"
Or, my favourite, "I wore an infusion set for 5 days again? Well, that's 5-days-ago-Melody's fault. She shouldn't have filled the reservoir with enough insulin to last 5 days. She should've only filled it with 3 days' worth."
Sometimes I wish I knew some other actual, real-life diabetics, so I could figure out whether this is a thing we all do. I feel as though if others do it too, that makes it less bad. I'm sure there's a word for that.
I want to ask Medtronic what they recommend when pump-users find laaaaarge air bubbles in their tubing.
Bolusing it out (while disconnected, of course!) might work, but it will count all of that insulin as IOB/Active Insulin, which can severely mess with bolus or correction calculations for the next 4 hours.
Re-priming it isn't as simple as it seems. In order to re-prime you have to let the cartridge rewind, which requires removing the reservoir from the pump.
Problems with this:
1) The little plastic nubbins that lock the reservoir into place tend to break off when the reservoir is removed from the pump. I have not found a way to be gentle enough to keep them attached while removing the reservoir.
2) It counts this re-prime as a set change, which will skew data on how frequently set changes occur.
This issue was particularly frustrating on Friday, as my workday started with a LOW RESERVOIR alarm on my pump.
I checked my settings, and - grrrrr - I was a day overdue for a set change. I guess the set had just been comfortable enough that I didn't notice I was on day 3 on Thursday. The LOW RES alarm wasn't a problem though, as it triggers the alarm when I've still got 20 units left in my reservoir, and 20 units is more than enough for basal insulin over my workday plus a lunchtime bolus for food.
The story doesn't end there, though!
Not long after the low res alarm, I visited the bathroom and had a chance to actually look at my infusion set (it was sitting in the top of my thigh). I was quite surprised (and more than a little upset) to notice that my tubing was decorated with tiny spots and differently-coloured flecks. Closer inspection revealed that I actually had some pretty huge air bubbles all along the length of my tubing.
I removed my reservoir (breaking one of the two tiny clips in the process) and restarted the set, which allowed me to re-prime my tubing... but by then I was down a few more units of insulin in my pump. By the end of my workday, sitting there with only 4.4 units left in my pump had me a bit on edge. Grrr!
Sometimes these moments of diabetes fatigue hit me out of nowhere.
Last night my pump site was itchy and sore. I'm not due to change it until tonight, so I figured I'd ride it out and just put up with the sore site for a day.
This morning I woke up late, rushed in to work without testing in the morning, and only checked when I got in to the office. I'd been going on my cgm values, which were a little high but nothing too critical.
My BG once I got to work? 18.7.
The most likely culprit is a site that's not absorbing properly any more. I know that to fix it the next thing I should do would be an injection (not a correction delivered through my pump!) and a set change.
I open the "diabetes drawer" at work, pull out my spare reservoir and Mio set... and I pause.
I just don't want to.
I'm actually finding myself contemplating getting the vial of long-acting Levemir that I keep in the fridge at work and switching back to shots for a day or two.
I know that a sore site makes me much more likely to want to take a break from pumping. A sore site is a reminder that I've got a plastic cannula below the skin, making a tiny part of my body itchy and uncomfortable.
For now I've delivered my correction and am waiting on the whole set-change-or-not issue. There is no need to decide right now.
It is uncomfortable, painful, and unfortunate, but it is not currently life-threatening. I can afford to take a minute to try to remind myself why I started pumping in the first place.
I've been having some issues with overnight lows lately.
I've been setting a 70% basal overnight for the last few weeks. Most of me knows that a 70% basal will make me wake up ok; fortunately for me I have a pretty solid network of friends who help me to fee not-so-terrible when I've had some delicious delicious wine.
My overnight basal rates have been too high for a while, and the weird thing is that it seems to take having friends over for dinner and drinks to figure out that I need to do something more permanent than a 70% overnight basal.
Bah! I don't want to have to re-jig my overnight insulin rates! Sometimes changes, whether stress levels or natural life stuff, BLOW.