Note to self: Don’t wonder. Just fix it.
There are very few things I miss about taking injections since going on a pump in 2008. Pretty much everything is easier and works better for me with my insulin pump, and I don’t miss those orange-capped spears floating around the bottom of my bag threatening to poke me while rummaging around for a lip gloss, and I don’t miss the constraints of using injected basal insulin which can’t be changed, raised or lowered once delivered. But there is one thing that I miss about injections and that is the simple fact that if you inject insulin, you know you got it. With a pump, there’s a million and one reasons to wonder if the damn thing is working or not. Case in point, Saturday night.
Saturday had me throwing a party for one of my best girlfriends in celebration of her recently born twins (that kind of party, wherein the babies are present for the shower is actually called a “Sip and See,” in case you didn’t know, and I find them to be the ideal way to celebrate a new mama because she can consume the alcohol along with the other guests at the party and quite frankly, she deserves the most). There was running around to set things up, all sorts of combinations of foods I don’t normally have (cheese plate, sushi appetizer, sandwiches and salads and of course, cake and champagne to really up the festivities), and bolusing intermittently to keep up with it all. By the time the party ended, I was over 200mg/dL with plenty of food still digesting.
I bolused another two units and got things down to a more respectable 123mg/dL, but that was as low as things went. I bolused for dinner (this was also a large meal of restaurant foods I don’t usually eat, and a combination carb-and-high-fat-meal to boot) and hoped that things would even out but they didn’t. Midnight showed a steady increase in BGs and then by 3am I was over 200. I sleepily bolused another two units. Then at 5am, I was up at 280mg/dL…with an arrow straight across. I was due for a pump change later that day but, finally exhausted by all the wondering and not wanting to postulate if it was the pump or the food or the gravitational pull of the moon causing the high I got out of bed and switched out the pump anyways. Within an hour I was settling back into a normal range with no problems. It probably had been a pump problem all along.
So why not change the site when I first realized I was staying high, despite the bolusing? Well the train of thought goes like this: Hhhmm, still high even though I bolused…well I guess there was a lot of cheese on that salad and sushi always does a real number on me and maybe I should wait it out a little but and just see if it comes down soon and oh I need to call that dinner place for a reservation tonight and wait that’s still high but not so high that I’m convinced my pump is broken because wouldn’t I totally be over 400 right now if that was the case and I’m not so I shouldn’t change it yet, right….?”
And so on. Recently, a person I work with said they change their son’s infusion site if he’s too high and has been holding steady for a few hours after the last bolus. Because if the active insulin is technically done and you’ve corrected and you’re still too high, then clearly, you’re not getting all your insulin, right? Why I don’t think like this in the moment, I don’t know but sometimes, I just push things too far with pump sites.
With injections, you never really have to wonder if you delivered the insulin or not. With pumps, they can play all sorts of mind games with you - making you wonder if they’re just “sort of” working, delivering just enough insulin to let you run high but not crazy town high…which is the same amount that will drive you just a little but nuts while you hem and haw over whether you should change your infusion site.
Note to future self in this same scenario:
Change the damn infusion site. If for nothing else than to salvage a good night’s sleep. That’s totally worth it in and of itself.
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Comments
One thing I’ve noticed about being on the pump is that I notice the effect of things like losing a few hours sleep (especially because my sensor is wailing at me or itching). Getting back to equilibrium after an “episode” is not as easy and I don’t know why.
Tim - getting back to equalibrium is exhausting because I think it actually is really hard on your body - when you think about all the activites that go on with rapid (relatively speaking) rises and drops in BGs, it’s no wonder it wears us out! Everything from your heart to your blood vessesl has to work harder when that’s happening and it’s no wonder that the “glucoaster” can tire you out more than anything else.
Floh - you just highlighted the essence of diabetes…we’re always living in the space of “keep things even…am I too high or too low? What am I fixing right now?” It’s mentally exhausting. Between the mental and the physical exhaustion we just discussed in these comments, I think I need another coffee…. 
“Recently, a person I work with said they change their son’s infusion site [...] Why I don’t think like this in the moment [...]”
Because your brain is getting mushed up by weird blood glucose levels. And it’s especially bad with long highs that make me angry and willing to bolus amounts that are truly ludicrous or with lows that make me want to finish “just one more thing oh and that over there and I need to cook dinner for 12…”.
Wait … that’s all cases except for when my levels are normal. Ah yes. Don’t we love it