Reconnected: Shots, Timesulin, and Public Druggery.
The first few days back on shots were awesome. I haven't done anything "new" in my diabetes management in a while, not since switching to the Verio meter, so the novelty of injections was shiny. There were some definitive pros and cons, though, and it only took me a few days to miss that little pump thing.
- It was really, really nice to wear a dress and not end the day with the buttons on my pump etched into my sternum. Or to grapple with ye olde disco boobs. Or to feel like I had another thing to be a bit self-conscious about.
- Birdy was a little disconcerted - "Where your pump, mama? In the dryer?" because that's where her favorite blanket always is when she wants it most - but eventually we were both used to having mommy take an injection instead of a pump bolus. And it was comfortable injecting in the privacy of my own home.
- I loved sleeping with out the pump attached, because sometimes I wake up in the morning and feel very "princess and the pea," having spent the better part of seven hours with my hip smashed against the pump housing.
- Packing on MDI was pretty easy - I threw a Humalog pen into my meter case and the bottle of Levemir into my medical travel bag, along with a handful of syringes and some needle tips, and I was good to go. Bit of a lighter fare than bringing along pump change supplies, etc.
- Timesulin. This thing is awesome. I know it's a product that's been around for a while, but this replacement pen cap for my Humalog pen saved my brain from guessing when I last bolused, as it keeps track of that "last bolus" moment. More on this pen in another post later this week, but having a bridge between the information stored in my pump vs. the lack of information stored in my syringe use was very helpful.
- And this excursion into MDI confirmed for me that I do best splitting my Levemir dose every 12 hours. So at 10 pm, and again at 10 am, I would take 8 units of Levemir. According to my Dexcom, this was the right dose to keep me steady without significant peaks and valleys.
- And I was happy to finally be able to travel with my insulin bottle "koozy," which is a simple tool I learned about from Jim Turner during my days at dLife. This little bottle traveled safely and soundly on a quick business trip from Rhode Island to Philadelphia, and I didn't have that fear of the bottle cracking and exploding against the bathroom tile.
- I missed my pump a lot in the morning, when my dawn phenomenon would kick in and cause my blood sugar to jump a few dozen points. This meant I needed to consciously bolus before the upswing would begin, and taking a half unit bolus with an insulin pump felt like a frustratingly unnecessary, yet very necessary, needle poke.
- And I missed it a lot at night, when I would remember to take my Levemir injection in a swooping moment of "Oh shit, did I take my Levemir yet?" Having the pump on me 24/7 makes forgetting my insulin pretty difficult.
- See also: sleeping in. My MDI experience was the first time in a while that I had to set an alarm solely to wake up and take an injection.
- But I missed it most when I was at the ePatient Connections conference, listening to presentations and attending meetings for two days. I did not enjoy injecting in public. I know that my past includes a lot of public injections, and I didn't care about it at the time, but I've spent the last eight years discreetly bolusing with my pump, and I like that discretion. I like not having to push a needle tip through my clothes. Busting out the syringes and pens for a few days made me long for the convenience of my pump.
- Basal rates with the pump are just plain easier for me. Negotiating the morning "spikes" attributed to the dawn phenomenon is easier with the basal rate profile on my pump. I went on the pump for two main reasons: ability to micro-dose down small high blood sugars and the option to increase basal rates during different times of the day to avoid lows/highs. Levemir works well for me, especially with the dose split, but I did see some pre-breakfast highs that I would prefer to manage with a bumped up basal to fix the problem before it starts, versus taking a correction injection.
- And yeah, those little highs. Like the 140s and the 160s that I take half a unit to correct down to 100 or so. The pump is brilliant for fixing those little suckers.
- But most of all, I like the pump because it's one less needle. I didn't remember the discomfort of injections until I was a few days into my MDI cycle and saw the small bruises popping up on my injection sites. For me, I prefer putting a pump site in every few days rather than taking a needle every few hours.
Insulin pumping isn't magic. It's not like going on a pump automatically creates better diabetes control - it's just a different way of delivering insulin. But for me, it's a tool that does make diabetes management easier, and more convenient. I'm glad I took a pump break, because I now feel more confident bouncing back and forth between injections and pumping, as needed. Or chosen. But I do prefer the pump over injections - it works better for how things roll out these days.
Options are nice. I really appreciate them. Almost as much as I appreciate coffee. Almost.