Tag Archives: insulin pump

The Pump Myth

courtesy of Graur Codrin

When we say that an insulin pump provides better control, I think we should think about that statement.  Are we telling others who don’t have a pump that they would have tighter control with one?  Pretty much, right?  That’s not necessarily true though, is it?  If it were, I’d be on a pump according to my A1c and standard deviation results.  And in the past while I was on a pump, it would not have made sense to say I was on a pump.

It’s one thing to say that “For me, an insulin pump provides better control”  because then you’re talking about your own experience.  It is my hope that people on pumps everywhere will realize that many people are achieving very tight control without a pump and therefore it’s more helpful to stay away from comments like, “An insulin pump provides better control”.  Do you know what I mean?  It’s a general statement that might give someone without a pump the wrong impression about what is possible in their own lives.  I’m all for everyone having access to a pump, I wish everyone could at least have the chance to try it out, but what if someone doesn’t have access to one?  We should avoid giving them the idea that their multiple daily injections (MDI) are not enough.  If that is all they can get right now, don’t we want them to feel empowered to make MDI work?  For their own well being?

In some cases if someone can only get access to the older, slower insulin, then it still serves them better in the meantime if they believe that with a disciplined schedule, they can achieve good glucose management.  Yes, they deserve the opportunity for the flexibility a pump can give but if they don’t have access to that opportunity, isn’t it best they feel empowered to do what they need to do for their health?  And flexibility or no flexibility, I still think better glucose is more valuable-but maybe that’s because I’ve felt what unmanaged blood sugars can do.  I also endured the rigorous eating, snacking, sleeping, and waking schedule of R and N insulin of the past and in the end it wasn’t as bad as the unmanaged blood sugars.  I say this because of the complications that arise from high blood sugars.

A pump doesn’t provide better control or worse control anyway, it’s really up to the user.  Same goes for syringes and vials of insulin.

Does the pump add convenience in particular scenarios?  Totally!  Do syringes or pens?  I’d say so.

An unfortunate side effect of all this is people giving me pity or assuming I’m poor because they learn I don’t use a pump.  Or they assume I don’t use one because I’ve never tried it and fallen in love with it.  I get emails from very sweet people trying to convince me to use a pump.  But I did use one for seven years and so I know the pros and cons. While on the pump I literally felt I would die if it was taken away from me.  Then I tried to be without it and realized that what made diabetes difficult was not the shots, it was the variable nature of blood sugars and that with or without a pump, I was still being challenged to control them.  And after five years of the best blood sugars I’ve ever experienced, a wedding, a honeymoon at the beach, and a twin pregnancy, I really don’t miss the pump at all.

So let’s be accurate and supportive of better control, however one achieves it, because a pump being synonymous with great diabetes management is another one of those myths circulating out there.  And it’s a harmful one.

Diabetes Bloopers

Diabetes-Blog-Week-300x80

Today for Diabetes Blog Week, the prompt is as follows:

Diabetes bloopers – Wednesday 5/11: Whether you or your loved one are newly diagnosed or have been dealing with diabetes for a while, you probably realize that things can (and will) go wrong. But sometimes the things that go wrong aren’t stressful – instead sometimes they are downright funny! Go ahead and share your Diabetes Blooper – your “I can’t believe I did that” moment – your big “D-oh” – and let’s all have a good laugh together!!

Want to learn more about Diabetes Blog Week?  Go to Karen’s blog (by the way, Karen, great job in putting this together!)

“The Mutant Lady” Story

One day when I was at the mall by myself (I was about 20 years old and at my peak of “coolness”).  I was approached by a little girl and her mom.  The girl looked around age 4 and was dragging her mom over to me.  The little girl’s mom kept saying, “Ariel, honey, what do you want, where are you going?”  Finally they made it over to me and the little girl looked up at me with a big smile and sparkly eyes and said, “Are you a mutant?”  I kind of stammered, “uh..whaa….um…no…”  Then the girl’s mother said, “I’m so sorry ma’am, honey let’s go, leave this young lady alone”.  The little girl pointed to my pump tubing and said, “My brother said mutants have tubes and I’m so happy because I found a mutant!” 

I turned a little red and felt quite embarrassed because people around us were staring at me and my mutant tubing.  The little girl squealed with glee to have found her brother to be a “truth teller” for once.  I couldn’t tell her she was wrong, she was sooo happy.  The girl’s mom tried again to get her to walk away but the little girl then started tugging on my tubing and trying to trace it to it’s place of origin. 

She was a harmless, adorable little kid so I didn’t slap her hand away or anything.  I just stood, frozen.  She found my insertion site on my abdomen and said, “Oh my gosh!  Mommy look!  It must be a mutant feeding tube or wire! WOW!”  The mother grabbed the little girl, apologized profusely to me and dragged the girl away who left screaming, “I want to see the mutant lady, mommy pleeaasseee!!!”  I’ll never forget the looks from the other people in the mall, everyone wondering what the mutant tubing thing was about. 

I went home that day thinking, “One day this will be funny…”

I’m glad I had an excuse to share it with you all today, lol.

How to be an expert on your diabetes (plus, awesome resources for diabetics!)

 

[picappgallerysingle id=”7282463″]         Master Your Diabetes

 

Here is a follow up to Why diabetics hate going to the doctor and to The professional diabetic.

We’ve established that we all need to be well educated about our diabetes.  So where can you find the right information? 

First off, it isn’t easy.  There are thousands of diabetes resources out there.  Here are the guidelines I’ve used to try to separate the good info from the bad info.

Educating yourself about your diabetes

First, begin with the basics.

You must have a pretty thorough understanding about the following:

Know how the particular insulin you use works.  Find out how long it lasts in your system, how heat affects it, and when it expires.  This information is in the literature that comes with your prescription.  Read it and if you don’t understand something, ask your doctor.

If you use a pump, make sure you understand everything about it.  If you have ANY doubts don’t hesitate to go to the maker of your pump (perhaps their website) and get the information you need.  You might even want to find a local insulin pump educator in your area who can meet with you and answer all of your questions.  You can ask questions on online forums, too.  Just be careful about automatically trusting any/every response you get.

Know your insulin/carb ratio. 

Mine for example, is 1 unit of insulin (humalog) per every 15 grams of carbohydrates.  If you don’t know your ratio call your doctor and work out a strategy to find out what it is.  Typically, the more you weigh and the less active you are, the more insulin you need but, we’re all different so when it comes to figuring out the right ratio for yourself, be careful and get guidance from your doctor.  No guessing.

Learn to count carbohydrates.

This is where a nutritionist or dietitian comes in to help you.  They can teach you all about portions and how to read nutrition labels and how to eyeball carbohydrate content in foods.  You can probably learn a lot about this online, too.  Check out this site and this one.

Know all about diabetes complications and the signs of those complications. 

This is scary but necessary.  Learn about these here.  Or here.  And don’t be afraid but do take the information seriously.  Diabetes is serious.  We can’t get around that.  We have to meet it head on if we want a fighting chance.  When I read this stuff I take deep breathes and take some notes.  Then I do something completely unrelated like listen to music or call a friend.   

Understand how physical activity, stress, and even your monthly period affects your blood sugars. 

Go to your doctor and ask about how each of these might affect your blood sugars.  For me personally (and you may be different), physical activity lowers my blood sugar and lowers my need for insulin.  Stress makes my blood sugars go up and makes me require more insulin.  PMS makes me turn psycho and makes me require more insulin and as soon as I start my period, I have to decrease insulin again.  But, that’s just me and all I can claim to know.  Yet, it helps me out so much to know this stuff about myself so if you don’t know yet, find out.  You’ll see better blood sugars!

Journal to understand your diabetes.

Write down in a journal what you eat, how much insulin you give, and your activities throughout the day.  Make note of major moments of stress or unusual symptoms.  Track what times of the day you have problems with blood sugars and track when you feel good versus bad.  Then after a month or two look back and note any trends you see.  You could show this to your doctor and see what you two come up with.  A wonderful place to to use as a resource is Livestrong.com.  You can register for free and keep an online diary that is truly handy.  It is called My Daily Plate and it lets you track what you eat throughout the day as well as how many calories you’ve consumed and burned.  You can use MyDPlate which will also allow you to track your blood sugars and units of insulin used each day.  You can keep this online journal private or make it public.  Mine is public in case you are curious about how it may look (although I just started so there are just a few days tracked).  To see what I’m eating and how much I’m working out just go to http://www.livestrong.com/profile/SysyMorales/.  Now if I eat a candy bar you can catch me in the guilty act. 

For some info about how I problem solve, read Diabetic troubleshooting method.

Once you know all of the above you can be much better at managing your diabetes and anticipating highs and lows in your blood sugar.  You will also feel more confident with your day to day decisions.  Don’t be afraid of learning all you can about your diabetes and remember that knowledge truly is power

As you learn you can ask your doctor specific questions instead of just telling him/her you don’t know why your blood sugars are high.  Doctors can’t help us much without enough information.  When you understand the basics about your diabetes, you have a much better chance at handling any issue diabetes throws your way.

Why you don’t need an insulin pump

 

Perhaps my most controversial post ever, let me begin by saying this is not about bashing insulin pumps.  I think they are a nice tool and a great piece of technology.  They’re just not great enough for me to use.

Nothing can compare to a fully functioning pancreas (duh) but, I find it interesting that most people I have talked to who have insulin pumps say they couldn’t live without it.  They mean it, too!  I understand.  I used to feel this way.  Yet, now that I’ve been off of the pump for a few years I realize I felt that way because of fear.  I can assure you there is nothing to be afraid of.  Please read on to find out what exactly I’m making a fuss about.

I recently heard someone say, “if you aren’t on the pump you must be crazy!”

Oh really?  Let’s be more open minded here.  First of all, why does it matter to me that people out there feel this strongly about having a pump?  Well, because of the negative power these words might have on an individual who cannot afford a pump or who for some reason or other cannot get access to one.  People should know it is very possible to manage their diabetes without one if that is the hand they are dealt at the moment.  I would hate to think some people out there feel they don’t have good control over their diabetes because they can’t get a pump.  This isn’t true but, they might be lead to believe it is.  They need empowerment and those of us who feel strongly about using all that modern technology has to offer should think twice before speaking.

Even my own doctor (I refer to him as my ex-doctor) laughed at me when I told him I wanted to get off of the pump.  He said, “nobody goes backwards, people always want to seek to improve their blood sugars, not disturb them”.  He disturbed me!  What ignorance!  (Its ok, he wrote about me later as a case example of a diabetic who did better coming off of the pump-although he still doesn’t understand how or why)

How come I  have A1c percentages in the 4-5% range (non-diabetic range) without a pump?  Is it assumed I’m doing something wrong?  I assure you my blood sugar is typically around 100 instead of swinging up and down.  So, there is one person’s proof they can do very well without a pump.  What about others?  Mary Tyler Moore doesn’t have one.  Many professional athletes don’t either.  Does this mean they are crazy or that their diabetes management is out of control?  I doubt athletes can perform well without controlled blood sugars.

There are valid reasons to choose not to have an insulin pump and those reasons should be recognized.

After several years scar tissue buildup becomes a serious issue for many people on the pump, causing changes in insulin absorption.  The famous Dr. Bernstein has said that after about 7 years on the pump, scar tissue is likely unavoidable and a real barrier against insulin absorption.  Interesting…I found my glucose numbers swinging mysteriously during my 6th consecutive year on the pump and decided to switch back to prehistoric syringes after 7 years.  Those glucose numbers stabilized with syringes.  Dr. Bernstein in fact, doesn’t even recommend insulin pumps to any of his patients.

I observe that there are more ways for a pump to potentially mess up your glucose than a syringe and vial of insulin.

Let’s take a look:

The syringe needle could break off (although it has only happened to me once).

I can’t think of more possible ways a syringe can go wrong.

The vial of insulin could be dropped and broken (I’ve dropped vials everywhere and luckily never broken one).

The pump itself is an imperfect machine which can go wrong (it may not go wrong, but the point is the potential is there-and I know it happened to me for no apparent reason more than once-a total mood killer when you hear the mad beeping).

The pump’s tubing can have air bubbles which cause high blood sugar if not caught in time.  You bolus for a meal and you think you are getting insulin when in fact all you got was air. (This also happened to me a couple of times, enough to infuriate me all the way to China).  The tubing can also knot and prevent insulin from reaching you. (I hear this often happens to active children and teens).

The pump’s battery might run out (obviously it warns you well ahead of time but, it is another thing to deal with).

You know, some people have told me, “well, at least with a pump you don’t have to carry anything around”.

I’m sorry, did I hear that correctly?  Does this mean you don’t carry around some form of sugar, emergency glucose gel, or glucose testing device?

For me, adding a small batch of syringes and a vial of insulin to the above required items is too easy.

Something I found negative in a pump was only an issue when tied to a specific person’s tendencies.  I call it being, “trigger happy”.

I gained a lot of weight when I first got on the pump the summer before 11th grade.  I was so excited to have insulin on me at all times and had heard the pump pitched to me as a way to eat whatever, whenever I wanted.  (Obviously not good advice.)  Problem was, I snacked just because I could do it so easily.  I also would give insulin when I suspected a high blood sugar and instead of testing first, I gave insulin with the pressing of a few buttons.  It was just too easy.

Now obviously this may not be you or most people.  Yet, I know I’m not the only one this happened to and honestly, I felt very free when I switched back to shots.  I thought twice before throwing something in my mouth because I had to give an injection for it.  I felt relieved that I was no longer addicted to the all too convenient buttons on the pump.  Again, I recognize this isn’t an issue for everyone.

Some people may feel that they enjoy the convenience of hitting buttons and enjoy snacking often.  Remember though, the more often you give insulin, the higher your margin of error due to a higher rate of incidence and the more unstable blood sugars you will have throughout the day.  This is scientific fact-not my own idea, and it has been talked about before.

I also wonder that if because insulin pumps make certain people so much money, insurance companies, doctors, and hospitals all end up promoting them over shots.  Just a thought.

Let me reiterate again that I am not against the pump.  If you have one and control your blood sugars well with it then that is awesome and I couldn’t be happier for you!  I am simply making a case for the cheaper, not-so-nifty, yet always reliable syringe which is so often made to look as the inferior alternative left for poor or unfortunate diabetics.

Thanks to syringes I give the exact amount of insulin I am intending on giving-every time.  This is priceless for me.  The fact that I can keep things simple and achieve great glucose numbers without something attached to my body is freeing for me.  I just want others to know that if they cannot try out a pump, don’t despair!  You can still manage your diabetes just as well with shots-if not better.  The goal for all of us diabetics is the same.  We deserve to freely choose how we reach that goal.

I know this struck some nerves so lets talk about it.  Just leave a comment :)

 

What will you do with your diabetic supplies once it gets hot out?

This is a good time for all of us to remember that this time of year is when we must find a way to keep our stuff cool.

Insulin doesn’t work as well when exposed to heat.  Insulin pumps must be protected from too much heat and even our meters shouldn’t bake in the sun. 

So what can we do?

Make sure to invest in something that you feel comfortable using to keep your things cool.  Aside from what you own for daily use you need something for when you are outside at the park, or the pool, or the beach. 

I’ve discovered a product called FRIO cool pouches.  They are amazing, are loved by beach and extreme sports enthusiasts alike, and come in great colors.  They work without ice!  They get activated with water so nothing has to stop you while you are out on the go. 

And most importantly your insulin will work how they are supposed to. 

Have an insulin pump?

Use a cover or case on it when in the sun and if you need to be out for long periods of time in the heat-just change your infusion set more frequently so you have fresh and optimally functioning insulin.

Let us know in comments what pouches/products you use to keep your supplies cool and if you would recommend them! 

I, myself am on the lookout for a good pouch for the meter…

Dating and the pump; Is it in the way?

       When I switched from my insulin pump to syringes 2 years ago the main reason was to achieve better control.  It worked, too.  My A1c dropped to normal non-diabetic person levels.

This article isn’t about that, however.  Let me share a little secret with you. 

A tiny motivating factor involved my boyfriend (now husband).  He always supported me and the pump and everything I had to do regarding that little machine.  He never complained when it beeped or backed up or gave me a headache.  He understood its importance.

Having said that, I on the other hand, felt it was in the way… who wants to make out with someone and the entire time worry that they might get their hand somehow tangled in your tubing? 

A total mood killer that’s for sure.  My husband once went to grab my hand as we walked through the mall and accidentally looped his thumb through my tubing which was sticking out and jerked my site, causing me to yell out in pain.  A common incidence for pumping diabetics.

Let me make something clear.  This is not about convincing someone to get off of the pump.  It is about relating.  I understand completely about what thoughts and worries you are having because I’ve been there.  I know you are paranoid about what your partner is thinking (I promise they are worrying much less about your pump than you are).  It is inevitable for us, though.  As if it wasn’t enough that we are worried about our appearance, what we say, and how we act.  Then there is this tiny machine which is actually attached to our bodies by plastic tubing.  And it is always there. It isn’t easy.  That is why I’m begging you to believe me when I say that a loving partner is not going to be bothered by your pump. 

I had the pump throughout all of high school and no guy thought it was in the way.  This is because I acted confident all of the time.  I fooled people a bit because often I didn’t feel confident but, faking it works-trust me.  Over time you’ll grow the real thing which is great.  People respond beautifully to confident people.  I’d have to say confidence is important ammo for any diabetic.

Do I enjoy the freedom of not having a pump?  Yes.  I also kind of miss those convenient little buttons so if pumping works for you and you are out and about on the dating scene, don’t fret.  Use laughter to ease awkward situations and honestly, if someone really likes you, they won’t be focusing on your pump.

The insulin pump versus the syringe; weighing the pros and cons.

       About half of my diabetic life has been spent on the pump and the other half using insulin shots. I started out on shots, then spent 7 years on the pump and have now spent over a year back on shot therapy. There are a few things I miss about the pump but, my A1c is better using shots and therefore I’ll continue using them instead. No matter what your case is, let me share why I believe I will never use the pump again.

With the pump, I gained a lot of freedom and convenience. So much I was tempted to become “trigger happy” and give insulin anytime I wanted to eat something just because I could. Well, often, we over or underdose our insulin needs and when this happens, blood sugars become out of control. This happened to me and I gained about 40 pounds on the pump. My A1c was around a 7 or 8 which isn’t extremely awful, but we know it isn’t good enough.

The pump also complicated matters for me due to its components. With shot therapy, you have a syringe and a bottle of insulin and you know exactly how much insulin you are injecting. Unless you rotate religiously, insulin pump sites create a lot of scar tissue which over time can cause difficulties, pain, and bleeding when inserting or removing a site. The tubing can have air bubbles in it, meaning some insulin may not reach you like you think, causing an unexpected high glucose reading. The pump itself has many safety checks, but it is STILL a machine which can err. After a few years on the pump I became paranoid that something wrong would happen to the pump or the tubing or with my site (because things DID go wrong) and I would distrust the machine and often give too much insulin “just incase”.

So about a year ago I got off of the rollercoaster. I was scared to do this thinking about the freedom I would sacrifice. I first bought a gorgeous orange leather clutch with 2 zipper pockets to fashionably store syringes and bottle of humulog in. When I pull this out in public people have no clue what I’m doing.

I also began taking 20 units of lantus insulin every morning. I don’t like giving shots (who does?) so I only gave a shot when I needed it or before meals. I gave a shot to cover only those snacks I deemed worthy of giving an extra shot for. I ended up losing weight and getting better glucose readings.

Often for lunch, I’ll have a salad and some nuts or chicken. Before I begin eating I give a tiny shot of about 1 or 2 units (depending on what is in the salad) and then I eat and relish the fact that I’m not connected to a tiny machine which is unpleasant and time consuming to connect every other day, isn’t waterproof, and often gets in my way when I’m doing an activity. And because I didn’t give much insulin and kept my carbs low, I almost always maintain perfect glucose after a meal-meaning I stay feeling good and my mood doesn’t plummet.

Sometimes, as with jewelry, its true ladies, less IS more. So if you are on the pump and your control could be improved, I urge you to try using shots, especially if my experience sounds familiar to you and you eat too much and too easily because of those convenient little buttons.

If you have great control on the pump and love using it-awesome! I commend you and urge you to continue exactly what you are doing.

Why should a girl care about what Bruce Lee had to say?


 

“One does not accumulate but eliminate.  It is not daily increase but daily decrease.  The height of cultivation always runs to simplicity.” 

~Bruce Lee

When I stumbled upon these words by Bruce Lee-master of martial arts and fascination to every man on earth, a light bulb went off. 

I realized I had been practicing this very idea with my diabetes management for some time.  Bruce Lee was right on with this.  Here’s why:

First off, I decided a while back to simplify the task of giving insulin by following a lower carbohydrate diet.  What I eliminated were some carbohydrates. 

This allows for less insulin administering and smaller scale errors afterwards.  It also translates into less time waiting for the insulin to work before eating.  Sometimes I eat something which I don’t have to give insulin for, depending on my blood sugar at the time and in that case there is less pain, too. 

All in all I eliminated a lot with one move. 

Another example is when I switched from using an insulin pump back to the humble syringe.  I wanted to eliminate the possible impediments of air in the tubing, a faulty insertion site, and a mishap with the computer of the pump itself.  Any of these issues would hurt my diabetes management (and frustrate me).  So I eliminated them. 

Left to use was a bottle of insulin and a syringe.  I draw up the exact dosage I need everytime and inject in a different spot (practicing good rotation).  Then I relish in the fact that I don’t have to worry about the insulin not reaching me for some reason.  And if I am not home I don’t have to worry about a problem with the pump-which would makes me return home to fix or take the time to inconveniently redo the site wherever I’m at. 

Simple, yet reliable.

These two changes alone have made my life so much easier AND have allowed me to take my A1c level to the 5% range.

Oh yes, and did I mention I lost weight?  It is more tempting to hit a button on the pump than pull out a needle and inject. 

So just think about this concept, you don’t have to try anything I have.  Just consider what you might simplify in your life.  Then joke with your guy about having something in common with Bruce Lee.  He’ll give you a strange look, but he’ll be listening.

 

 

 

How to rock the outfit AND the insulin pump

          Whatever your style is, you CAN wear the pump proudly and NOT feel that it is inhibiting or crushing your sense of style. I took a very creative approach during my pumping years. I would wear the pump inside my jean’s pockets backwards so that the clip was the only thing showing. When I wore a dress I would clip the pump to my bra (in between my breasts). Granted this only works with size B cup or larger.

Sometimes people would see the pump through my clothes and ask me “what the heck is that?” I would explain in a nonchalant sort of way like it was no big deal, making sure to smile once or twice and yet sounding like it was absolutely no bother to me to answer their innocent question. The result? People would be like, “oh ok, cool”. People LIKE it when others have guts and they are impressed when you explain something awkward in a casual and cool manor.

If your style is very “posh” or “chic” get a black or grey pump or pump cover. If you have a more colorful or eclectic style, get a fun color to wear. Wear the pump with the attitude that you are in charge of it and it helps you with something important and people will be impressed.

The point of course, is not to impress people, but the fact of the matter is, most of us care to some extent how others view us, and we don’t want this to get in the way of our diabetes control. This is why I encourage you to “rock the pump”. This is done by your CONFIDENCE. You stand up straight, you walk with assurance, and you live freely, all the while doing those extra things diabetics must do to stay healthy.

Your attitude is the most important ingredient here. Your attitude will allow you to free up your frustration and be creative about how you wear your pump, how you explain it to others, and how you appear with it on-FABULOUS!

Copyright © 2019. Powered by WordPress & Romangie Theme.