After yesterday’s outpouring of angst (among other things), it seems important to record that the last 18 hours have been better. I am getting good numbers, have heard no unusual noises from Charlotte, and haven’t seen my own blood since yesterday. Woo hoo.
I also think: hmm, that was bad, but I handled it, albeit in my fuddly INFP way. It appears that I can cope. Any day when that sentence holds true is a pretty good one in the twisted universe of diabetes.
February 23, 2005
February 22, 2005
Change Is Bad, or, I Destroy Many Infusion Sets, with Blood
Have I mentioned lately that I’m not so good with the physical world? Yes? Good. Allow me to illustrate.
Set change this morning before work. I put out the supplies, try to fill the reservoir, rewatch training video, fill the reservoir, try to prepare the infusion set, rewatch training video, prepare the infusion set, ponder my abdomen (pumping gives a new twist to the term “navel-gazing”), swab. I am good to go. It’s a little complex because I want to use a 6-mm set, but the only one I have left has 43-inch tubing, and I need the 23-inch tubing, which is attached only to my 9-mm set. So I must attach the 23-inch tubing to the reservoir, attach the 6-mm set to myself, then swap the one for the other.
If you followed that, you have my empathy, as you must have diabetes.
Infusion set count: Two.
Quick-Sets can be used with a handy spring-loaded insertion device (called a serter in aren’t-we-cool-NOT diabetic lingo) that spares the user the terror of driving that thick creepy needle directly into the body. You plop the set into ther serter, remove the sticky tabs, pull down on the spring-loadie part, and off you go. Only something goes wrong. When I pull down the spring-loadie part, the sticky part of the set gets stuck to the serter. In my attempt to free it without impaling myself on the needle I make the problem worse. Soon the set is stuck to itself as well as the serter. I rip the whole thing apart and start over.
Set count: Three.
The serter has a button on each side. You have to press the buttons simultaneously to get the set to go in properly. If you don’t, the cannula might bend, which would be Very Bad. No insulin for you, clumsy diabetic! As a longtime video game addict, I ought to be very good at this button pushing. Not so. I seem to lock up and do it wrong every time. This time, for example, I feel myself pushing the buttons a millisecond apart. But the set goes in fine, and upon removal of the leftover parts I see that the needle is not bent, a good sign according to my trainer. I pat myself on the head and trot off to therapy (ahem, no wonder).
Two hours after changing the set, you are supposed to check your BG. I do so while sitting opposite my therapist, who has learned quite a lot about diabetes since October. 150, seems reasonable. I trot off to work.
Lunchtime. I am chatting with my friend Vicki, to whom I have proudly showed off my pump. I check the BG—163, hmm, that’s a smidge high, but isn’t it cool how Charlotte will calculate the correction I need—punch in the numbers, and sit back while she delivers my bolus. Ah, pumping. So much easier than injections.
BEEP BEEP BEEP BEEP BEEP BEEP.
Charlotte has never spoken to me this way before. I take a look. (Good thing the pump isn’t in the thigh thing today. Ahem.)
NO DELIVERY
Uh-oh. I remember the unmatched button pushing. But I am prepared. I can change the set right here at work. Vicki makes a graceful exit. I place do-not-disturb sign on office door. Suspend. Disconnect. Pull out cannula. It’s a bit liquidy, eww. And the needle is bent at a 90-degree angle. Ah, clumsy diabetic. Not Charlotte’s fault at all.
Set count: Four.
I put my backup set in the serter, ponder abdomen, swab. I am thinking, push the buttons at the same time. Push the buttons at the same time. I push the buttons, not at the same time. The needle goes in. I start to pull the serter off, but something is wrong. It’s not pulling off the set like it’s supposed to.
Oh. I forgot to remove the sticky tabs, so the set is not attached to me. Moron.
It is impossible to remove the sticky tabs when the set is on top of a needle which is already in my belly. I am a little fuzzy on the next details, but I manage to remove the set—along the way it separates from the needle—and then the needle, upon which a veritable river of blood gushes forth. I do mean a river. And I do mean gushes. Much more blood than ought to ever gush from such a tiny hole.
I and my skirt sop up the blood. (At least I wore dark denim.) This was the only set I had at work. I guess I could switch back to injections for the rest of the day. Bah.
Then again, the cannula isn’t bent. Nor is the needle, though it is now stained a charming scarlet. This is probably Very Bad Behavior, but I reassemble the set, grit my teeth, remember to remove the sticky tabs, ponder abdomen, swab. I am thinking: Push the buttons at the same time. Push the buttons at the same time. I push the buttons, not at the same time…
Set change this morning before work. I put out the supplies, try to fill the reservoir, rewatch training video, fill the reservoir, try to prepare the infusion set, rewatch training video, prepare the infusion set, ponder my abdomen (pumping gives a new twist to the term “navel-gazing”), swab. I am good to go. It’s a little complex because I want to use a 6-mm set, but the only one I have left has 43-inch tubing, and I need the 23-inch tubing, which is attached only to my 9-mm set. So I must attach the 23-inch tubing to the reservoir, attach the 6-mm set to myself, then swap the one for the other.
If you followed that, you have my empathy, as you must have diabetes.
Infusion set count: Two.
Quick-Sets can be used with a handy spring-loaded insertion device (called a serter in aren’t-we-cool-NOT diabetic lingo) that spares the user the terror of driving that thick creepy needle directly into the body. You plop the set into ther serter, remove the sticky tabs, pull down on the spring-loadie part, and off you go. Only something goes wrong. When I pull down the spring-loadie part, the sticky part of the set gets stuck to the serter. In my attempt to free it without impaling myself on the needle I make the problem worse. Soon the set is stuck to itself as well as the serter. I rip the whole thing apart and start over.
Set count: Three.
The serter has a button on each side. You have to press the buttons simultaneously to get the set to go in properly. If you don’t, the cannula might bend, which would be Very Bad. No insulin for you, clumsy diabetic! As a longtime video game addict, I ought to be very good at this button pushing. Not so. I seem to lock up and do it wrong every time. This time, for example, I feel myself pushing the buttons a millisecond apart. But the set goes in fine, and upon removal of the leftover parts I see that the needle is not bent, a good sign according to my trainer. I pat myself on the head and trot off to therapy (ahem, no wonder).
Two hours after changing the set, you are supposed to check your BG. I do so while sitting opposite my therapist, who has learned quite a lot about diabetes since October. 150, seems reasonable. I trot off to work.
Lunchtime. I am chatting with my friend Vicki, to whom I have proudly showed off my pump. I check the BG—163, hmm, that’s a smidge high, but isn’t it cool how Charlotte will calculate the correction I need—punch in the numbers, and sit back while she delivers my bolus. Ah, pumping. So much easier than injections.
BEEP BEEP BEEP BEEP BEEP BEEP.
Charlotte has never spoken to me this way before. I take a look. (Good thing the pump isn’t in the thigh thing today. Ahem.)
NO DELIVERY
Uh-oh. I remember the unmatched button pushing. But I am prepared. I can change the set right here at work. Vicki makes a graceful exit. I place do-not-disturb sign on office door. Suspend. Disconnect. Pull out cannula. It’s a bit liquidy, eww. And the needle is bent at a 90-degree angle. Ah, clumsy diabetic. Not Charlotte’s fault at all.
Set count: Four.
I put my backup set in the serter, ponder abdomen, swab. I am thinking, push the buttons at the same time. Push the buttons at the same time. I push the buttons, not at the same time. The needle goes in. I start to pull the serter off, but something is wrong. It’s not pulling off the set like it’s supposed to.
Oh. I forgot to remove the sticky tabs, so the set is not attached to me. Moron.
It is impossible to remove the sticky tabs when the set is on top of a needle which is already in my belly. I am a little fuzzy on the next details, but I manage to remove the set—along the way it separates from the needle—and then the needle, upon which a veritable river of blood gushes forth. I do mean a river. And I do mean gushes. Much more blood than ought to ever gush from such a tiny hole.
I and my skirt sop up the blood. (At least I wore dark denim.) This was the only set I had at work. I guess I could switch back to injections for the rest of the day. Bah.
Then again, the cannula isn’t bent. Nor is the needle, though it is now stained a charming scarlet. This is probably Very Bad Behavior, but I reassemble the set, grit my teeth, remember to remove the sticky tabs, ponder abdomen, swab. I am thinking: Push the buttons at the same time. Push the buttons at the same time. I push the buttons, not at the same time…
February 21, 2005
Midterm Report Card
Today’s big news is that I have gone 36 hours without a low. Woo hoo! I had, hmm, something like 6 lows in the 3 days before that, though none under 60. The only thing that I’ve changed, per my clinic, is the basal rate (from 0.30 to 0.25) and the addition of a bedtime snack when I’m below 120. Actually, I had some of those lows even after lowering the basal, so I’m not confident that I’m entirely out of the hypoglycemic woods yet. But it seems like progress.
I haven’t been exercising, though. This was a conscious, if seductively lazy, choice related to the pump start. I didn’t want to throw in yet another variable before the basals were worked out. So one goal for this week is to start wandering the habitrails (Minneapolis skyways) again.
Numbers: fellow diabetes blogger Scott (my attempt to create a link isn't working, bah, but try http://scotts-dblife.blogspot.com) asked how my grades—err, my BG levels—have been since the pump start. Thanks for saying hi, Scott :-) Given the prevalence of lows, my numbers have been, well, low. I’ve been anywhere from 76 to 120 fasting. One of the things about my CDE’s instructions that surprised me is that she isn’t having me check my 2-hour post-meal numbers. Not necessary, she said, because we already know that my carb ratios work. Hmm. As I’m typing this, I’ve realized that I think that’s hooey and I should have been checking those numbers all the time rather than just when I feel low as I’ve been doing. I have a serious neurosis when it comes to finding my own mind when interacting with medical people. Both the CDE and the dietician at my clinic have made subtle references to my being over-intense w/r/t checking too much and obsessing over my numbers, and I think I’ve internalized that a bit. Of course, neither of them are diabetic. Humph.
Anyhow, I’m not sure how good the post-prandials are, but the pre-prandials have been around 90-135. I got a 168 (oh horrors) one night after I overtreated a low. So…if not for the lows, I’d say these are pretty dreamy numbers. I feel very fortunate. (Thanks, Charlotte.) Put that report card on the fridge!
I haven’t been exercising, though. This was a conscious, if seductively lazy, choice related to the pump start. I didn’t want to throw in yet another variable before the basals were worked out. So one goal for this week is to start wandering the habitrails (Minneapolis skyways) again.
Numbers: fellow diabetes blogger Scott (my attempt to create a link isn't working, bah, but try http://scotts-dblife.blogspot.com) asked how my grades—err, my BG levels—have been since the pump start. Thanks for saying hi, Scott :-) Given the prevalence of lows, my numbers have been, well, low. I’ve been anywhere from 76 to 120 fasting. One of the things about my CDE’s instructions that surprised me is that she isn’t having me check my 2-hour post-meal numbers. Not necessary, she said, because we already know that my carb ratios work. Hmm. As I’m typing this, I’ve realized that I think that’s hooey and I should have been checking those numbers all the time rather than just when I feel low as I’ve been doing. I have a serious neurosis when it comes to finding my own mind when interacting with medical people. Both the CDE and the dietician at my clinic have made subtle references to my being over-intense w/r/t checking too much and obsessing over my numbers, and I think I’ve internalized that a bit. Of course, neither of them are diabetic. Humph.
Anyhow, I’m not sure how good the post-prandials are, but the pre-prandials have been around 90-135. I got a 168 (oh horrors) one night after I overtreated a low. So…if not for the lows, I’d say these are pretty dreamy numbers. I feel very fortunate. (Thanks, Charlotte.) Put that report card on the fridge!
February 19, 2005
Change Is Good
I did it! I changed my set. Details of the physical world not being my strongest area, I am proud. Happily, the videos on the CD that came with my pump were quite helpful. (I found it interesting that Minimed’s online Pump School doesn’t include infusion set videos, while the CD does. Safety precaution maybe?) I’m trying out the 9mm option to see if it’s comfortable; so far, so good. Best of all, that creepy smell seems to be gone, yay yay yay!
Note to self: next time remember to check which way the tubing is pointing before inserting the set…toward the belly button is a somewhat awkward direction! The CDE showed me a sample of a new set—if memory serves, it’s the forthcoming Clio for the Cozmo—that can be rotated so that the tubing can face whatever direction you like even after insertion. That’s an awesome feature, and I hope Minimed will pay attention.
I have also named my pump. She is called Charlotte, mainly for one of my favorite characters in all of children’s literature—the clever, compassionate, bold, creative spider of Charlotte’s Web. Charlotte is a name I wished I’d been given when I was a kid, along with various other girlie names. (I also used to want a nickname, and I liked Lottie for reasons I can no longer fully recall…) I like how it’s feminine yet strong and practical-sounding, very much how I want to imagine my pump. Seems to suit her.
Note to self: next time remember to check which way the tubing is pointing before inserting the set…toward the belly button is a somewhat awkward direction! The CDE showed me a sample of a new set—if memory serves, it’s the forthcoming Clio for the Cozmo—that can be rotated so that the tubing can face whatever direction you like even after insertion. That’s an awesome feature, and I hope Minimed will pay attention.
I have also named my pump. She is called Charlotte, mainly for one of my favorite characters in all of children’s literature—the clever, compassionate, bold, creative spider of Charlotte’s Web. Charlotte is a name I wished I’d been given when I was a kid, along with various other girlie names. (I also used to want a nickname, and I liked Lottie for reasons I can no longer fully recall…) I like how it’s feminine yet strong and practical-sounding, very much how I want to imagine my pump. Seems to suit her.
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