Pumping Ain’t Easy

I know, I’m burning this post title awfully early in the grand timeline of my wearing an insulin pump, but enough has happened already – in just 48 hours – that I’m going for it.

I’ve had an eventful start.

  • My first night on a pump, we had pizza for dinner – like you do – celebrating my ability to program a legitimate extended bolus.
  • Somewhere in the process of living my life, my infusion set went wonky.
  • Despite the wonk, corrections had some effect. Which (incorrectly) led me to think my pump settings were off. Because I would know things were wrong after my first-ever 20-hours wearing this thing.
  • After continued blood glucose tests, failed corrections, and general frustration, I did a full site change. Infusion set, insulin cartridge, everything.
  • The next 12 hours involved staring at my iPad (monitoring my Nightscout site) as the number slowly fell back into range.

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Charting my Diabetes

I’ve worked with the system well as aggressively, and respectfully, as I could to move my insulin pump start date up as much as possible. Given what I’ve had to deal with in simply getting this far, at some point I knew it was best to accept what I could accomplish and go from there. My final timeline looks like this:

  • Basic t:slim training and saline start on 10/1.
  • “Pump Start” class at my diabetes education center on 10/3.
  • Pump saline, and still take my proper insulin injections for 3 (?) days – I’m going to get that clarified at the class.
  • Review pump data (?) at the education center on 10/14.
  • Start insulin that same day…?

There are still a lot of question marks on that list, but dates are locked-in appointments. From there it’ll just be a matter of filling in the gaps and getting as many questions answered as possible. Considering how much of a challenge it was to get to this point, you better believe I’m going to maximize every minute I have with these folks.

One particular aspect of this process that has had a surprising impact on my diabetes, already, is the process of charting. Everything.

The t:slim, and I assume most insulin pumps, have a lot of programmable settings such as basal rates, insulin correction factors, insulin:carb ratios, and so on. In order to get the most accurate settings, I (we) need to have a reliable baseline of data to work with to start things off. I know the settings I put into my pump on Day 1 will not be the same as Day 100, tweaks will likely be made as the process of controlling diabetes is fluid, albeit fickle. But if I’m going to have the best possible experience from the start, there needs to be a lot of data to build a solid foundation for my pumping experience.

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Camping Is Its Own Basal

I’m not a doctor.

During our camping adventure in Sequoia this weekend, I knew there would be an abnormally high amount of physical activity. Between walking everywhere, and walking everywhere, I knew insulin adjustments would be necessary to avoid as many lows as possible.

Precautions were certainly taken: I bought gatorade mix to stock my water bottle every morning, we bought some tasty granola bars, and picked up some trail mix to top things off. And Dayle and I ensured all of our diabetes devices were sufficiently charged before going off the grid. But even with all of that preparation, lows can still happen.

I suppose there are worse places to stop and take a snack break though. I mean…  Continue reading

A Fishy Metaphor

Our fish tank has been having some issues with nitrites. We’ve been testing our tank daily for the past week as we try to fix the problem.

At first things were pretty rough.

After a little patience, we saw some progress.

Now we’re hoping for some consistency and stability.

There’s a diabetes metaphor in that sequence, right?

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Lacking Context

Out of context, this number looks great. But it doesn’t tell the story of the 8 hours above 200 yesterday. Or the 51 at 4am. Yes, numbers never lie. But these numbers will never tell the whole truth either.

I shared that nugget of wisdom this morning. It’s important for the outsiders, the onlookers, the casual observers, for anyone paying attention to all of the chatter about our lives with diabetes to understand that these blood glucose checks lack the context to properly illustrate what living with this disease entails.

Of the thousands of decisions I make each day, both conscious and unconscious, and the constantly evolving set of external factors that influence a given blood glucose check, a single number doesn’t come close to telling the story of what happened, what is happening, or what will happen.

And yet, I still find joy in seeing numbers in range.

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