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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.

MDI PROS:

  • 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.
Snug as a bottle of synthetic hormones in a rug.

PUMPING PROS:

  • 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.

Comments

My 12 year old son has been on the pump for almost 1 year. He LOVES it! But, I often think we should take a break just so we don't become rusty with injections and having to do all the calculations ourselves. I don't think he would like that though! =o)

I've been thinking about taking a short pump break; for all the reasons you listed above. I think I'd really like to sleep, just a few nights, without "entanglements." Thanks for posting this. . it helps me make a better decision to know what you faced.

Kerri, you Levemir is all bubbly.

Shake, shake, shake...:)

Another excellent post! I took a "pump vacation" for one month this year (May 2012.) For me the worst thing was needing to jump into a rest room to inject. As a result, I would just NOT EAT (especially an afternoon snack). My A1C went down a bit on injections, but I lost 4 lbs. Within 2 weeks of pumping, I had put on 2 lbs., and within 3 I had put on the total amount lost: 4 lbs! I was happy about that, since I am slender and need fatty tissue for pumping. My best news is this: After I went back on my pump on June 1st, I had great control, and my A1C (taken at the beginning of September) was 6.5! I wish you the same kind of luck!

thanks for pro viding your point of view....
very helpful

I have spoken to 2 people recently who have been on a pump for yrs and yrs like me and are looking to take a pump break. Great review and good food for thought.

Can you tell me where you can buy timesulin in the u.s. their website seems only for u.k. or europe. Help!

I loove that koozy! I kinda made one by pulling the label off the glucose tabs bottle. Then stuffed cotton balls in the bottom with insulin on top. Not nearly as strong though! Where'd he get it?

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