Recently this blog has received some anonymous commentary that gives me pause because it reinforces—not merely empathizes with—anxieties I’ve expressed here about body image. I hate to be unaffirming, as such remarks are quite possibly the genuine writings of people in need of support, and I want this blog to be all about support. But I will not be engaging in dialogue with anonymous posters whose contributions aren’t constructive in some way.
The anonymous comment quoted below falls into a different category. It bears discussion because this writer and anyone who follows her practice IS PUTTING HER LIFE AT RISK:
“Everytime I get in a new realtionship I am so terriofied of exposing my pump. I end up ripping out my infusion set and sacraficing my health. Total self image thing. It is a love/hate relationship with the pump.”
No, no, no. Please do not do this. This is a recipe for DKA, which any person with diabetes should know CAN AND DOES KILL. If you remove your infusion set, have sex with someone who doesn’t even know you depend on a medical device for your very life, and then doze off, you could find yourself 6 hours later in need of emergency medical treatment. And unable to get it because you’re exhausted and ill (or already in a coma) and the person lying next to you has no idea you're even diabetic.
This practice is not only dangerous, it’s entirely unnecessary. You can safely disconnect for a romantic day/weekend/whatever if you return to a regimen of injections that includes basal insulin. (I infer that this poster does not do so because she refers to jeopardizing her health.) This regimen could be in the form of Lantus + short-acting insulin, or multiple shots of short-acting insulin. The key is to work with your diabetes team to determine such a regimen.
All my very heartfelt concerns about intimacy and body image notwithstanding, I would never, ever, ever place myself at risk by compromising my diabetes care in the way this poster describes. Indeed, if you’re engaging in intimacy with a person you don’t know well enough to trust with the sight and experience of your pump, you’re placing your life at risk in another way—by becoming physically vulnerable to an essentially unknown partner. And we all deserve better self care than that.
May 4, 2005
In which I am my own guinea pig
Small adventure yesterday: I am eating lunch at work. Cheese sammich, V8 juice, apple. I have dutifully counted, tested, administered bolus. I am a good diabetic, yes I am.
Charlotte, without warning, makes her crankiest beeping sound.
Hello, NO DELIVERY. I remember you . This time the bolus has stopped after 3.8 out of 4.9 units.
I disconnect and study the tubing. Hmm. Looks fine. I see no bubbles or kinks or breaks. Is something wrong with Charlotte? To find out, I dangle the tubing over the wastebasket and do a manual prime. Straight away, my favorite liquid (ahem) drips out.
So. Charlotte is working fine. Must be the infusion set. Boo.
Up goes the “please do not disturb” sign. I thank the gods of work, yet again, for granting me an office with a solid door.
Remove reservoir, rewind, fill new reservoir. Knock the damn bubbles to the top, squirt bubbles back into vial, fill again. Insert reservoir. Prime. Ponder abdomen. Load new infusion set into serter thingie. Ponder abdomen again. Swab. Push buttons. Ow. Manual prime to fill cannula.
I’m getting to be a professional bionic.
Okay, up and running again. Now to remove the old set. Ow. I don’t have baby oil with me to loosen the adhesive. Ow. Stupid sticky stuff. I settle for an alcohol swab.
To my surprise, the old cannula looks just fine. I thought it would be bent or kinked or something that would cause the alarm. Apparently not. And there’s no pool of insulin above the site to suggest that the bolus didn’t make it down the cannula, either.
Hmm. A new dilemma faces me, and it’s far less appealing than the uneaten remains of my lunch. Do I redo the interrupted bolus or not?
A no delivery alarm means, in theory, that insulin delivery has (brilliant, I know) been interrupted at some point. The question is when. Charlotte decided that I wasn’t getting insulin at the 3.8 unit mark. But I might have gotten some up to that point, or all of it, or none of it.
I certainly need at least 1.1 units to finish up the bolus—unless I want to subtract food from my plate. Not an option. As for the rest, I have three options:
1. Assume I didn’t get the insulin and redo the bolus. Problem: if I got the bolus, or part of it, I will go low later. Possibly very low.
2. Assume I got the insulin and take only the 1.1 remaining units. Problem: if I didn’t get the bolus, I will go high later. Possibly very high.
3. Assume I got some portion of the bolus, roll dice to determine how much that portion might be, and take the rest. Problem: see #1 and #2 above. Plus I don’t have any dice at the office.
What would you have done? I picked the least life-threatening of these options, #2. One can always correct for a high later on, but a serious low could leave a diabetic beyond the point of caring, ever again, whether her latest A1C is up or down.
My experiment under way, I finished eating and went for a ferocious walk—which can itself cause lows, of course, but in this case I knew that if anything I was short on insulin. (NB: see, I did repeat the miracle, woo hoo!)
Three hours after the alarm, I tested at 120. Phew.
So why did I get the alarm if nothing was actually wrong? Fellow pumpers have suggested that maybe the tubing was squashed in a funny way under my clothes, or maybe it was a battery problem, or maybe Charlotte was trying to tell me that she wants one of those fancy pump pockets that all the girl pumps are raving about. Could be something else altogether.
Hmm, now where did I put my dice?
Charlotte, without warning, makes her crankiest beeping sound.
Hello, NO DELIVERY. I remember you . This time the bolus has stopped after 3.8 out of 4.9 units.
I disconnect and study the tubing. Hmm. Looks fine. I see no bubbles or kinks or breaks. Is something wrong with Charlotte? To find out, I dangle the tubing over the wastebasket and do a manual prime. Straight away, my favorite liquid (ahem) drips out.
So. Charlotte is working fine. Must be the infusion set. Boo.
Up goes the “please do not disturb” sign. I thank the gods of work, yet again, for granting me an office with a solid door.
Remove reservoir, rewind, fill new reservoir. Knock the damn bubbles to the top, squirt bubbles back into vial, fill again. Insert reservoir. Prime. Ponder abdomen. Load new infusion set into serter thingie. Ponder abdomen again. Swab. Push buttons. Ow. Manual prime to fill cannula.
I’m getting to be a professional bionic.
Okay, up and running again. Now to remove the old set. Ow. I don’t have baby oil with me to loosen the adhesive. Ow. Stupid sticky stuff. I settle for an alcohol swab.
To my surprise, the old cannula looks just fine. I thought it would be bent or kinked or something that would cause the alarm. Apparently not. And there’s no pool of insulin above the site to suggest that the bolus didn’t make it down the cannula, either.
Hmm. A new dilemma faces me, and it’s far less appealing than the uneaten remains of my lunch. Do I redo the interrupted bolus or not?
A no delivery alarm means, in theory, that insulin delivery has (brilliant, I know) been interrupted at some point. The question is when. Charlotte decided that I wasn’t getting insulin at the 3.8 unit mark. But I might have gotten some up to that point, or all of it, or none of it.
I certainly need at least 1.1 units to finish up the bolus—unless I want to subtract food from my plate. Not an option. As for the rest, I have three options:
1. Assume I didn’t get the insulin and redo the bolus. Problem: if I got the bolus, or part of it, I will go low later. Possibly very low.
2. Assume I got the insulin and take only the 1.1 remaining units. Problem: if I didn’t get the bolus, I will go high later. Possibly very high.
3. Assume I got some portion of the bolus, roll dice to determine how much that portion might be, and take the rest. Problem: see #1 and #2 above. Plus I don’t have any dice at the office.
What would you have done? I picked the least life-threatening of these options, #2. One can always correct for a high later on, but a serious low could leave a diabetic beyond the point of caring, ever again, whether her latest A1C is up or down.
My experiment under way, I finished eating and went for a ferocious walk—which can itself cause lows, of course, but in this case I knew that if anything I was short on insulin. (NB: see, I did repeat the miracle, woo hoo!)
Three hours after the alarm, I tested at 120. Phew.
So why did I get the alarm if nothing was actually wrong? Fellow pumpers have suggested that maybe the tubing was squashed in a funny way under my clothes, or maybe it was a battery problem, or maybe Charlotte was trying to tell me that she wants one of those fancy pump pockets that all the girl pumps are raving about. Could be something else altogether.
Hmm, now where did I put my dice?
May 3, 2005
One foot in front of the other
I did it. I went for the walk. This seemingly minor act is all about something much bigger, as anyone who struggles with this stuff knows. It's about overcoming all those forces--exhaustion, entropy, athletic socks left behind at home, depression, stress, the sheer brutal longing to give oneself a break because nothing else in life is, goddamnit--and acknowledging: OK, today is no better day to exercise than yesterday was, but today the costs of not taking care of myself are too high.
Today I will try to repeat the miracle.
Today I will try to repeat the miracle.
May 2, 2005
Crawling out from under a sugar-coated rock
Hello, I'm back. Or trying to be. This hasn't been my easiest month of the 6 (ooh, count 'em) since my dx. I've had a lot of stress from various sources, I quit exercising (bad Violet!), and I more or less withdrew from my online existence. Why is it that when bad stuff happens, I lose the energy I need to do the very things that would help me most? Exercise would help; talking & writing would help. Isolation, after the relief of the first couple of days of quietude, does NOT help me. I get lost out there in the big mean world. I succumb to the illusion that I'm on my own with my disease and the rest of my silly life. I see myself as outside the gatherings of like-minded souls, looking in but unable to connect.
That's a lot of self-destructive crap. I am no more alone than I choose to be. So...I'm going to try to write here, or elsewhere in the diabetes community, every day this week. And I'm going to try to walk today. Yes, yes. I can. Small slow walk. I can handle that. I will report back on the results of same. Please hold me accountable, guys.
That's a lot of self-destructive crap. I am no more alone than I choose to be. So...I'm going to try to write here, or elsewhere in the diabetes community, every day this week. And I'm going to try to walk today. Yes, yes. I can. Small slow walk. I can handle that. I will report back on the results of same. Please hold me accountable, guys.
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