Kit + even more stuff.

In front is my current kit. I will not normally carry around two meters and two bottles of test strips, but for right now I am using up the old while also using the new one that sends results directly to the pump. In the kit I've also got my lancet device (finger stabber), extra lancets (You're supposed to use a new one every time. I try to switch it every other time.), my insulin pen, needles for the pen, an extra battery for the meter, notes, plus I usually have an actual pen and a log book.

What I'm going to need to add is at the back. Starting from the very back: my insulin vial. I did make some foam holders for my vials years ago, so in those, they'd take up about half the space. To the right are the glucose tabs, which are usually in my kit when I don't have two meters to carry around. To the right of that are two plastic snack bags. I use those to store waste, and I separate sharps from trash so I can easily dump them into the appropriate container. Some of this new waste is recyclable, which is awesome, but I'm not thrilled about needing to 1) upgrade to sandwich bag size or 2) put it all in one bag to sort at home.

Next is the inserter box with the inserter sitting to the left of it- the blue and white toilet bowl looking thing. That's the spring loaded thing I put against my skin that attaches the infusion set to me. I need to keep this clean, so it needs to go in a sealable container- some kind of small box. The black piece to its left is a lock for the top of the pump. I switch that out with the belt clip, depending on whether the pump is clipped to my clothing or in my pocket. I will probably settle mostly on using one over the other, but for now I am changing them out all the time. The belt clip is obviously much bigger.

To the left are two reservoirs. The needle to draw the insulin out of the vial is already attached to these- that's the blue part. To the left is an unopened quick-set. The top blue piece is the needle guard (and what got trapped in my pants yesterday). The needle doesn't stay in me- it goes in, pops out, and leaves the cannula behind. The open quick-set at the bottom right shows off the tubing and the part that attaches to the reservoir. The other end is where it attaches to the cannula- that's the part where I put it on and off. Don't worry- I'll give you more graphic pictures of that later.

To the left you'll see a nickel, which is what I use to open the belt clip/pocket locks. They warn specifically not to use a butter knife, etc., and I need my quarters for laundry, so I'm starting to stash nickels all over the place. The two clear plastic circles are essentially shower caps. It looks exactly like the attachment part, just without the tubing. When I go to take a shower, I remove the attachment part of the tubing and the pump, and put this cap on to protect the port. Again, I'll show you later.

The blue Y thing is a capped used needle. This contraption is originally part of the quick-set. Once the needle part gets removed, you push one arm up and the other arm surrounds the needle, bends it over, and it locks closed. That will go in my sharps baggie. Finally, a battery, but I'm supposed to carry two- a backup for my backup, as the trainer said. After yesterday's mishaps, I see why.

I'll have more freedom through being tethered to a machine and carrying around twice the amount of stuff. I may have found a new example of situational irony.

I have the Nissan of Reno song stuck in my head, so I need to go cleanse my soul with pop music and coupons at Kohl's. Keep your fingers crossed that I don't find any pants I want to try on.

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.