Wearing an insulin pump (and not hating it!)
After 39 years of taking shots of insulin, usually 3-5 times/day, and having better and better blood sugars, two years ago I heard something that finally made me consider going on a pump. My then CDE said “you’re using a hammer for a job that requires a feather.” What she meant was that because I take very small amounts of insulin, and I’m very sensitive to it, that even with an insulin pen that doses half units, I’m still not achieving the fine tuning that could give me better results in both the short term and long term.
So that shifted my thinking, but it has taken another two years of thinking, researching, talking – still resistant to having something (else) attached to my body 24/7. I did start using the Dexcom CGM, which I mostly love, and which has helped me see the direct benefits of being connected, wearing a device. I still don’t enjoy wearing the plastic transmitter and sensor taped to my thigh (my favorite spot). I don’t like how it looks, don’t like how my partner is afraid of getting close sometimes for fear of tearing it off when the tape is peeling (which does happen), don’t like the cost…
However, the benefits of being able to watch my blood sugar rise and fall, tracking it like I imagine a surfer watches the waves, is huge. I can SEE, and correct, within an hour or two. If I’ve miscalculated my insulin dose with a meal, I don’t wait til the next meal to discover I’ve been over 200 for hours, and need to wait to eat, or deal with going higher if I don’t… Or if I’m starting to head low, I can catch it at 80 and have a small snack, rather than testing and discovering I’m in the 50s and can’t function well as I wait for my blood sugar to climb up and my brain to come alive again.
Now that I’m 51, living with type one since age 12, I’m even more focused on living well for the rest of my years. I want to continue to feel well, be able to do pretty much whatever I like without diabetes stopping me. So far I have no complications, other than some minimal background retinopathy, which is so small there’s nothing to do about it. However, I’d like that to go away completely. I’d like to be right that my risk for heart disease, etc, is no greater just because I have type one, since my A1C is excellent. I also eat as much organic, whole food as possible, take supplements that I research that feel right (i.e. fish oils, vitamin D, spirulina and chlorella in my smoothies…), pay close attention to what my body is telling me. I also am a Reiki Master and do energy work as my vocation, so I receive lots of healing energy each day, and know that is another aspect of my good health. I attribute my healthy eating and lifestyle at least in part to diabetes (and in part to my mother and my partner for being such great teachers and examples), and for that I’m grateful.
So now I have health insurance again, and a wonderful CDE (diabetes educator), and was able to receive an older model Medtronic pump donated through an amazing organization, American Board for Child Diabetics, that is set up to financially support children with diabetes. They have expanded their generosity to adults like me, who have benefitted as well! (I would have had to pay thousands of dollars even with health insurance to receive a pump otherwise, and am still paying hundreds more per month just for supplies…)
(Some of you may remember my brief foray into a pump, with a gifted, used Omnipod, which I now think may have been just too old to be working correctly. The basal and bolus rates I used were similar, but with terrible results. Mostly, the pods were uncomfortable/painful, and it just didn’t work for me.)
I didn’t expect to see improved BG numbers for a few weeks or longer with the pump (see above). There’s usually a lot of tweaking of basal rates and insulin:carb ratios initially, but somehow, with the help of a great trainer and my CDE, I’ve started out very smoothly and my numbers are somewhat better already it seems.
From my experience wearing the Medtronic 722 in the first couple of weeks…
- Wearing/carrying a pump, about the size of a deck of cards, in my pocket is not that comfortable. It just doesn’t fit that well anywhere (including my bra, where a lot of women like to wear theirs). I’m hoping that when I get the smaller, correct, size pump soon, that will help a bit (that’s a whole other story about the customer service at Medtronic). I am waiting for a clip so I can wear it on my waistband, rather than in a pocket. I have ordered a “tummietote” belt, a soft tubular belt that has folded pockets to wear and carry devices like a pump, cgm, phone… The issue I was most concerned about – what to do with it while sleeping has actually been minor. It just stays on the bed, even when I turn over, and I don’t notice it until I wake up in the morning.
- I still have to make decisions for boluses, based on what I see on my CGM, and on all the variables I am aware of – exercise, stress, glycemic index of foods, etc. (but see the Bolus Wizard below…)
- there is about 24 inches of tubing connecting the pump to my body, and that’s not a huge hassle, but it means tucking it in my pocket or my waistband every time I use the bathroom, so it’s not going to catch on things.
- on that note, there’s the issue of getting dressed and/or not wearing clothes, and having to hold the pump or find a place to set it down where it won’t fall and yank on the tubing. a bit awkward.
- replacing the infusion set and tubing every 3 days. It takes time, a lot of trash, and so far I’m throwing away some insulin each time because I haven’t got it my 3 day totals quite set.
- I’m starting to see some better blood sugar numbers, especially at night. It’s SO nice to start the day with a good fasting sugar! Makes the whole rest of the day go so much more smoothly and easily.
- I can eat one square of dark chocolate, or half a nectarine, and take tiny amounts for a bolus, like .3 units. I used to only eat a bite if I was already running on the low side, or only eat foods with no carbs, like cheese if I needed a snack.
- the “Bolus Wizard” is actually quite helpful. When I’m going to eat, my new meter sends my current blood sugar to the pump, (yes, I still need to test with a meter, even with the CGM) then I enter the carbs I’m going to eat. The pump factors in how much insulin is still active based on the timing of the last bolus, and suggests how much to bolus. It is based on the insulin:carb ratio we put in, and so far it’s working surprisingly well.
- I like being able to just pull the pump out of my pocket and give myself insulin wherever I am. I’ve always been comfortable taking shots in public, but was discreet. I’d often test and draw up my shot under the table at a restaurant, or walk a bit away from people to actually inject. This feels a bit more free, and that makes me more likely to stay on top of taking insulin when I really need it, rather than waiting for a convenient place.
It’s now been another week and I’m getting more and more comfortable with wearing and using the pump. One big improvement was getting the Tummietote Belt. It works so much better for me than keeping the pump in my pocket, and even makes getting dressed easier… very happy about this!