Days 1 & 2

So how's the insulin pump going?

I came home today with two new holes in my body without anything attached to them, no insulin entering said holes, a surprising amount of medical litter in my bag from today's failed attempts, puffy eyes from my late afternoon frustration cry, and a needle guard caught in my pants where it had fallen earlier, unnoticed.

Dad says I'm right on track.

I got the training on Monday. I was super nervous and while it didn't take me 45 minutes to work up the nerve this time, it didn't go in right. I did the process under the trainer's practiced and watchful eye, and he said I did it great, but I didn't know until the next day that the cannula got bent. (I will look for helpful diagrams for you.) The trainer says that there may either scar tissue or something else in that spot (above and to the right of my belly button), but when I was relating this to my know-it-all coworker, she said "Oh, you bent it." Fuck you, lady. Granted, I may be a little sensitive at the moment, but I'm pretty sure it wasn't me just messing it up if the guy who is

1) training people how to do this
2) diabetic for 24 years
3) on the insulin pump for 12 years
4) a dietitian and
5) a certified diabetes educator

is telling me that it may not be a viable spot. But we already knew that that lady- though she means well- likes to act like an expert.

I left the training with this weird prickly feeling, but I figured it must be my paranoia, because I had that feeling before the infusion set ever touched my skin. He also told me that the adhesive feels weird at first, and most of the time, that's what people react to.

When I left, my blood sugar was at 83. I had a snack and went to meet Jody for dinner. I was super excited not to have to take a shot, but the pump stopped halfway through and flashed NO DELIVERY and started beeping like mad. I had to take a shot anyway, but because I had no basal...

Ok, quick primer:

The pancreas produces insulin, and it's all the same kind, but it's categorized by its purpose.

Basal- Think of this like baseline insulin. This is the insulin that is constantly secreted a little bit all the time to keep blood sugars steady.
Bolus- Think of this like bonus. This is the extra insulin that is secreted for the food you eat.

The pancreas also makes glucagon which, of course, raises blood sugar, but when insulin is externally introduced, it overrides the pancreas' ability to detect when the body needs sugar. Since Type I diabetics need to replicate both the basal and bolus insulin, there should be a steady flow of insulin, so there is pretty much never going to be a time when the pancreas should be producing glucagon. That's why starting on insulin means that the floor drops out below you and you now have to watch out for going too high AND too low, because your body can no longer produce sugar when you need it.

So wait, Jenny, why were you on two different kinds of insulin? One was the short-acting insulin for the bolus. The other was the closest thing they could get to a 24-hour insulin. They (mysterious scientists) developed an insulin that would work slowly, trying to mimic a basal rate. The problem is that long-acting insulins have an arc, so it's never going to be consistent, and apparently they can fall short, and then they're out of your system by 18-20 hours. The only way to truly mimic a pancreas, short of injecting yourself every 15 minutes, is to create a drip system with a port- hence, the insulin pump.


Back to dinner. My insulin irrigation system stopped, which meant that I had to take a shot with my insulin pen. (It was neat when I thought I'd have less to carry around.) That worked fine, but the pump wasn't giving me the basal rate yet- it was waiting for 10pm, when the long-acting insulin I'd taken the night before was supposed to wear off. The basal rate came on, but I didn't know the cannula was bent, so I was receiving no insulin. The night went on, and the pump dripped, but who knows where. I woke up too high, attributed it to my dinner, corrected, and dragged myself to work. I made it 30 seconds into the morning meeting before telling my boss that I needed to go. I felt sick and horrible and something was clearly wrong. I left a message for the trainer and called my diabetes nurse. I could hear my endocrinologist yelling in the background, "It's the pump!" All my supplies to redo the infusion set were at home. My blood sugar was at 468. I took a big shot and went home, where I called Medtronic, let one of their people talk me through the whole process, which has got to be a fun job talking to newbies who are already confused and emotional, but especially confused and emotional due to high blood sugar. A very patient and kind woman helped me through, step by step, and I did a successful attachment of the infusion set. Then I went to bed and slept ALL DAY, gently interrupted with a call or text every hour or so by various friends and Medtronic employees checking up on me.

That evening, I sailed along just under 100. That's too low, but it felt amazing. I've never had blood sugars run so good so consistently, I was able to run around with crazy errands that I will tell you about later, make dinner for 4, juggle situations, and every time I went to test (8-10 times a day for the first couple weeks), I was just cruising along with super awesome blood sugar.

Things went a little poorly with the infusion set change today (I'll normally have to change the set every three days, but I didn't change out the reservoir on Tuesday, so I had to change it before I ran out of insulin.), but as for right now, I am back to cruising along, so that is where I'll leave you. There's lots more coming.