Six Until Me.

The Associated Press has issued an article about the safety of insulin pumps, claiming that deaths have been linked to insulin pump use.  What's that phrase again?  If it bleeds, it leads?  Our own Scott Strumello, research blogger extraordinaire, has provided a very fine synopsis of the article - you should definitely take a read.  I was contacted by Steve Sabicer, a representative at MiniMed, and had the opportunity to get a little feedback from their camp. 

How does Medtronic respond to the claim that "insulin pumps can be risky and have been linked to injuries and even deaths"?

Medtronic stands behind the many years of clinical evidence that support the benefits of insulin pump therapy in patients of all ages

• Insulin pump therapy is proven to improve patient outcomes versus multiple daily injections (MDI) with long-acting insulin (glargine).
• Insulin pump therapy has shown strong results in pediatric patients as young as one year old.
• Insulin pump use in children and adolescents may be associated with improved glycemic control and improved quality of life, and poses no greater, and possibly less, risk than MDI.

We don't think this will significantly impact physician or insurance company practices moving forward.  The clinical data in support of insulin pumps is very strong.  In fact, Medtronic has noticed that many physicians have proactively come out in support of the therapy in response to this article. That said, we anticipate patients may be concerned because of the lack of context provided by the AP story. Medtronic encourages every patient to speak with their physician before making any decision about insulin pump therapy.

It's important to note that the article conceded that insulin pump therapy is beneficial for adolescents. They only suggested vigilant training and attention by parents and physicians. Medtronic encourages significant parental/physician involvement and we have designed a robust product training protocol to ensure our patients receive optimal instruction on the use and functionality of their insulin pump therapy.

• We have more than 3,000 certified product trainers
• Comprehensive online tools (Pump School Online, web-based training modules) for general diabetes information and product specific training
• Paradigm REAL-Time CD-Rom product training
• Code and PIE classes

How is Medtronic planning to address this issue with the media?

Medtronic is available for comment and interview to any journalist, and we also encourage them to contact pediatric endocrinologists and patients who have experience with insulin pump therapy.

What can pump users do to show insurance companies and doctors alike that insulin pump therapy should be available to any insulin-dependant diabetic?

As I said before, we don't believe this story will significantly impact physicians or insurers regarding insulin pump therapy. The clinical data in support of insulin pumps is strong.  That said, if patients are having difficulty getting coverage for their insulin pump, they can visit our website for claims information and helpful tools to demonstrate the case of their therapy.

(End of interview)

I've made no secret that I'm a fan of Medtronic's insulin pump line and that I believe pumping insulin has been one of the best decisions I've made for my diabetes management. What makes me craziest about this article is this line:  "There were two possible suicide attempts by teens who gave themselves too much insulin, according to the analysis."  This statement makes it seem like an insulin pump holds a substance far more dangerous than what I injected for over 17 years.  Point is, pumps are not for everyone, but that decision should be made by the diabetic and their caregiver.  I'd hate to see an article like the one from the Associated Press be something that keeps an insurance company from approving use of an insulin pump.

Scott summed it up nicely by saying, "But blaming the pump itself for problems that are not clearly tied to these Adverse Events seems to be irresponsible reporting at its worst."  Hear, hear!

Posted by Kerri. at 11:06 AM | Permalink | Comments (6) | TrackBacks (0)

I am not the one who just lives in the moment - I'm the one preparing for the moments to come, as well.  I live it up and have a great time doing whatever it is I'm doing, but as I'm hanging with my friends or having dinner with my fiance, my brain skips ahead a few hours.

"Do I have juice in my purse for the drive home?"
"Is there enough insulin in my pump to get me through dessert and coffee?"
"How many test strips are left in that bottle?"
"I called in the prescription, didn't I?"
"If this train ends up being delayed, do I have enough snacks on me to get through?"
"Don't forget to bring home the charger for the Dexcom."
"Shoot, did I send out that article?"  (Whoops, not diabetes-related.)
"I need to buff out that scratch on my car."  (Okay, not diabetes-related either, but it looks terrible.)

It's hard for me to tell if I am this way because I'm diabetic, or if I would be this way regardless.  Would I be so prepared and fastidious if I didn't have to worry about the minutiae of diabetes?  Whatever the case, I'm always noticing how much juice is left in the fridge.  I know exactly how many bottles of insulin are in that styrofoam container.  I keep track of the co-payments, the medical insurance, and when it's time to make a doctor's appointment.  (Yet I can't keep track of my email inbox to save my life, but I've digressed yet again.)

I notice how many AAA batteries are stashed in the bathroom cabinet.  I think about when my next site change is.  And when both the insulin and battery life indicators on my insulin pump start pinging, those facts burrow themselves in my brain and stay there, gnawing until I fix the problem.

Diabetes causes me to keep a constant tally of moments, a ticker tape of tasks that run through my mind and has me always thinking ahead to the next possible scenario.  Diabetes requires so much preparation in efforts to enjoy even the smallest moments.  This is not a depressing fact - just an honest one.  But after more than two decades of doing this, it becomes autopilot.  And not just for me.

Friends:  "Ready to go ... and do you have your meter?"
My Mother:  "Do you need the carb count on that?"
Chris:  "Is there juice on the nightstand?"
Me:  (smiling because I know they love me and I know they care)  Yes. 

It's good to be prepared.  Thinking ahead keeps me safe.  (But after I refill my pump, I'm going to buff that damn scratch out of my car and send out that article.  And move closer to my wedding - 17 days!)

Posted by Kerri. at 03:33 PM | Permalink | Comments (11) | TrackBacks (0)

Well hello - I'm rather grumpy today.

I had a moment of cyborgy-ness yesterday, when I was dressed for bed at the end of the evening, yoga pants and a sports bra, and I realized that my pants were sort of falling down, thanks to all of the gadgets hooked to my waistband.  The pump and the Dexcom, separately, are not heavy items, but together they are a bit weighty.  Even though I welcome the protection from lows and highs that Dex is offering, I felt a bit unattractive and robotic.  And my blood sugars have been troubling for the past few days, causing the Dex to sing at me with that loud, loud, loud BEEEEEEEEP!

(Note to readers:  If this post is making you feel like you want to chime in about how being sexy/attractive is far less important than good diabetes control, now is not the time.  I understand how important diabetes control is, and I work hard to achieve a relatively respectable rein on things.  But for that moment last night, I wanted to feel like a girl, not a robot.  I am entitled to these desires.  I am a real human being, not a spokesperson of any kind.  :: steps off soapbox, though laughing at the literal illustration of the bar of soap on the box over there on the right.  Hee hee. ::)

Dex and I are linked back up again this week, only this time the sensor is on my right thigh.  (My pump infusion set is on my left.  I'm sporting diabetes saddlebags this week.)  I'm hoping that having the sensor in a place that doesn't bend, flex, and deal with waistbands will help keep in place more than four days.  The numbers have been pretty precise all day long, except I've seen my first "???" indicators popping up.  According to the user manual, this means that the sensor may be disrupted by my clothes rubbing against the sensor face.  With the site on my thigh and sporting jeans today, that may be the case.  It seems to help if I keep the Dexcom clipped to my pocket, closer to the sensor itself.  However, numbers are still relatively accurate.  My faith is still strong in this product.

But the annoying bit I'm noticing the most, and which is sending me into a bit of grumpiness, is the beeeeeeping.  The "Above 180 mg/dl BEEEEEEEEP" that permeates my office.  It's not the fault of the product but more of an alarm that announces my body's failures.  It bounces off the wall, ricochets into my ears, and shaves off a bit of my ego.   "BEEEEEEP - Kerri, you're high.  Your diabetes is uncontrolled at the moment - HEY EVERYBODY!  She's high!"

Over the past two weeks, stress levels have once again crept up, and I'm finding myself a bit looped out at times.  The wedding is closer, finances are spoken for before they arrive, work is extremely busy, and personal projects are ramping up, thus grabbing and needing more of my attention. 

Most often, I'm very upbeat, quick-witted, and pretty damn smiley.  But today - meh.  I'm grumpy and frustrated with stress, the snowglobe of ideas in my mind, and that damn BEEEEEEEEEP.  I become disheartened when my efforts at good diabetes control - hell, good LIFE control - are thwarted by these unseen little factors, like stress, or maybe weak insulin, or the pile of wedding things that still need to be wrangled ... it's a bit much today. 

I would love a personal assistant.  Or, better still, a vacation.  Instead, I have a headache.  And BEEEEEEEEEP! 

Posted by Kerri. at 05:47 PM | Permalink | Comments (19) | TrackBacks (0)

The Dexcom has added a whole new dimension to my existence:  Muttering.

Kerri:   (muttering, of course)  Okay, so you say 176 mg/dl.  My meter says 150 mg/dl.  But you say I'm rising. 

Dex:  (silence)

Kerri:  (checking her pump for any insulin on board)  Hmm.  I don't want to end up high.  I can see that the numbers are climbing on the Dex and ...

Dex:  (like a lion roaring through a megaphone, or maybe a jet plane taking off inside an empty pool)  BEEEEEEEEP.  High - above 180 mg/dl.

Kerri:  Ahhhh!  

Kerri's Office Mates:  Kerri, are you beeping?

dLife CEO:  (from office)  Is that you or me?

Kerri:  Yeah, it's me.

Dex:  Beeeeeeeeeeeep!

Kerri:  (muttering again) I don't want to be high.  Dex says I'm high.  I should take a little bolus to correct this.

Pump:  Boop beep boop.

Dex:  Beeeeeeeep!

dLife CEO:  (from office)  Did you bolus?

Kerri:  Ahhhhhhhh!

Working with the Dexcom has really enlightened me as to how quickly my blood sugars skyrocket during times of stress.  It has also shown me that my overnights are so finely-tuned that my numbers are flat-lined throughout the night.  (That makes me very, very happy.)  But Dex is also making me a little more OCD than usual, and I'm feeling oft-compelled to correct blood sugars when I should instead let them ride and settle neatly on their own.  I'm quickly developing a nasty habit of pinch bolusing for EVERYTHING, which is causing some tricky little lows. 

I need to learn to be patient with this new technology.  I also need to remember that the Dexcom updates much faster than my insulin works, so I can't be chasing every Dex result with the boop of a bolus.  Sometimes I just need to let my insulin work and learn to better manage the emotional blow of an upward cresting graph.   

(Unrelated:  I saw llamas today on my lunch break.  They did not have diabetes, but they did have wonderful personalities.)   

Posted by Kerri. at 02:32 PM | Permalink | Comments (8) | TrackBacks (0)

I made the mistake of saying the following to Chris the other morning:

"You know, I haven't had a low in like two weeks!"

The next morning, the alarm went off and my eyes slowly opened, as though there were weights attached to each lash.  Brushing my hand against my forehead to wipe off the sweat, I reached for my meter and loaded in a strip.  For some reason, the lancet wasn't pricking my finger.  Shunk.  Shunk.  Shunk.  Chris stirred beside me. 

"It won't bleed."  Said as though the blood wasn't mine, the finger someone else's.

Finally, a ruby red spot leapt up from my fingertip.  Five seconds later, 48 mg/dl winked at me from the meter.  I drained the small bottle of juice on my bedside table and snuggled back underneath the comforter, waiting for my body to catch up.

I had two more lows that day, one that left me shaking at my desk at work and another that had me stumbling on the treadmill at the gym.  The next day, I hit a sticky high of 409 mg/dl after a site change, the sweaters knitting up in my mouth and lethargy wrapped around every movement.

So when the Dexcom Seven arrived at my office, courtesy of the reps out in California, I didn't think twice about suiting up for another round as the Dexcom Warrior.  I installed my first Seven sensor on Sunday night.

I know what you're thinking:  "You had a rough experience with the MiniLink - why are you doing this again?"  

Why?  Because I found the Dexcom to be a superior CGM product.  Minimed makes my pump and therefore has my appreciation, but their CGM unit is sub-par.  Aside from the flopping sensors and the painful insertions, the darn thing just wasn't right.  I know CGMs aren't supposed to be a substitution for manual blood glucose testing, but I had little confidence in even the trends offered by the MiniLink - and I was very frustrated by the errors that were cropping up.

The Dexcom, however, had a more reliable trending ratio and the actual results correlated tighter with my meter.  I'm not thrilled about using a second device (the receiver being its own entire hub device), but if I'm going to make use of a CGM on occasion, I want things to be as "right" as possible.  Like right now:  Dex says I'm 146 mg/dl.  Meter says I'm 137 mg/dl.  It also says I'm on the rise, which is true - I was 92 mg/dl an hour ago.  

So I'm spending this week with the Dexcom Seven, making it part of my work day, my workouts, and my wedding stress.  With wedding planning coming to a wild and all-consuming crescendo, I'm hoping Dex can help me stay more tightly controlled.  Because, between you and I (and the entire internet), I'm having trouble keeping my numbers steady these days.  Diabetes is rearing its head and I, for one, am not feeling very armed for battle.  Hopefully I can sharpen my Dexcom skills and have it as my secret weapon. 

Posted by Kerri. at 10:26 AM | Permalink | Comments (10) | TrackBacks (0)

Diagnosed in 1986 with type 1 diabetes (Kerri, you're diabetic?  I had no idea...), my first diabetes meal plan involved that dreaded exchange system.  Two starches, a protein, a fat, a fruit ... a headache with each meal.  Since my insulin at the time was Regular and NPH, I was matching food to insulin and constantly chasing that bell curve.  Meal times were a constant hassle, with my poor mother whipping out measuring cups and teeny food scales at restaurants, referring to the Big Red Joslin Handbook for exchange values, and swearing under her breath with savvy and discretion.

As a result of this willy-nilly (ooh, fun phrase) mash-up of insulin and food, it was tough to hold my numbers steady.  We could only predict somewhat how my numbers would react to my mealplan.  It wasn't until fast-acting insulin, the precision of insulin pumping, and the frustrating miracle of carbohydrate counting that I was able to eat with more pleasure and better predict the blood sugar outcome.

However.

I am not good at "eye-balling" food portions.  Without second-guessing, I can convince myself that a cup and a half of pasta is only a cup.  What looks like fifteen green grapes captured in a plastic bag ends up actually being 26.  And please don't even ask me what a tablespoon of ketchup is, because I have no clue. 

Which is why, when the guy at Eat Smart contacted me about his nutrition scale, I was all about giving it a go.  He offered to send me a sample scale to review, at no cost and no payment to me.  So FYI - this is not a paid review. 

The scale arrived in the mail yesterday and it has a jazzy, streamlined look to it, which I like. Figuring out  how to turn the thing on and make sense of all the buttons was not intimidating to me (as I've mentioned before, I have serious techno-joy) but I could see it being a little overwhelming for someone not as tech-savvy.  However, the instruction manual was very straight-forward and within a few seconds, I was weighing in my mid-morning apple. 

According to the Calorie King website, my apple should have contained roughly 19.1 grams of carbohydrate.  This is an estimation based on the size of the apple and my perception of that size.  According to the nutrition scale, my apple contained 15.3 grams of carbohydrate.  At first glance, it looks like a "tomato, to-mah-toe" issue, but when I'm aiming to keep my numbers as steady and eliminate as many variables as possible, even 5 grams makes a difference. 

In addition to weighing random items with precision, the scale also offered up plenty o' nutritional info like calories, carbohydrates, fiber, fat content, sodium ... and on and on and on.  At this stage in my life, I'm mostly focused on carbohydrate content and occasionally sodium or fat values, but I can see how this data would be really helpful for other health conditions.  There's a list of 999 foods that are pre-programmed into the device, with an option to manually calculate using the food label on an item - like a dollop of cottage cheese or similar.  This feature was very helpful for me because I tend to eat a lot of fruits, fresh vegetables, and protein, so I don't have the benefit of an FDA nutrition label on everything I'm chowing.

So the data is helpful.  The scale is a little on the bulky side (see the picture for comparison against your average, garden variety office pen - grown fresh here in the dLife garden) and it's also on the pricey side ($75 bucks for this sucker!) but the return on this investment could be worth it.  I haven't tooled around with it enough to make a long-term assessment, but my initial feel is "Hey Scale, You're damn useful!"

Do you guys use scales to measure the "unpackaged" food?  Or are you more apt to wing it?  I'll admit - I wing it more often than I'd like, even though I'm eating a very healthy diet for the most part.  Hopefully a scale like this, a more focused determination to carefully account for my carb intake, and more coffee (yay!) will help me fine-tune this chaos.

Now let's see if this booklet has a value for "cheesecake" ... yum...

(Also, Hannah wrote a great post on the old exchange system from ADA - check it out!) 

UPDATE:  If you want to order your own scale, enter "KerriSentMe" into the coupon field during checkout on the EatSmart website and receive 10% off your order.  How's that for cool?

Posted by Kerri. at 01:17 PM | Permalink | Comments (19) | TrackBacks (0)

Dear Medtronic,

How are you?  It's been a few weeks since we've touched base, but I wanted to let you know that my new insulin pump is chugging along just fine at the moment.  It's finally a bit scuffed and I have all my new carb ratios and basal patterns plugged in there - just like the old one.  So thanks for making such a great pump and for having a commendable level of customer service.

Why am I sucking up a bit?  Well, this is a little awkward.  I'm really disappointed in something I've read today.  I've always liked you as a company and I've always been proud to be a part of your user base.  But I received an email from Marcus last night that upset me. 

He sent me a link to the Medtronic Global Heroes campaign, aimed at highlighting the achievements of runners with diabetes.  According to your website:  "A Global Hero is a runner. An inspiration. A person whose life has been improved by medical technology."  Aside from earning some recognition and plenty of product benefits, the Global Heroes will also have this option:  "Medtronic Foundation will donate $1,000 on behalf of each Global Hero to a non-profit patient organization that educates and supports individuals who live with the runner’s condition."

What an awesome opportunity!  I know plenty of strong, talented runners from the blogosphere.  Like Marcus Grimm.  And Anne.  And Ed.  People who are conquering their condition and pushing themselves to higher levels of physical fitness and health.  But only if they fit the specific criteria.

Because you have added a stipulation this year that states: "Runners 40 years or older with insulin pumps and who have had diabetes for more than 15 years are ineligible."

Medtronic, would you care to explain to us how you justify leaving them behind?  Your Global Heroes program is inspiring and can really show people with diabetes how limitless their lives can be.  I understand the need for a CYA caveat, but to forbid them to even participate?  Taking away their option to earn funding for their chosen charity?  That's shameful.

Medtronic, you make a great pump.  But you've made better impressions. 

-- Kerri. 

Posted by Kerri. at 02:56 PM | Permalink | Comments (15) | TrackBacks (0)

I've made it pretty clear that I'm an advocate for using my thigh to host my insulin pump infusion sets.  I like having it placed lower on my body, keeping it a bit incognito, even from me.  It doesn't rub against the waistband of my pants, it doesn't press against Chris when I hug him, and it doesn't get in the way when I'm at the gym.  Overall, the thigh placement keeps my blood sugars stable and my pump tucked away most easily. 

I'm a fan. 

But there are times when it's a little tricky, too.  Take this weekend:  I spent the majority of the day lolling around the house and traipsing around town in jeans, vs. the dress pants or skirts I wear at work.  The jeans aren't baggy or loose, so the denim fabric is pressed pretty snugly against my legs.  Over the course of the last few months, I've noticed that wearing jeans while wearing a thigh site leaves my infusion sets a little battered.  The white edging gets frayed and stained with blue fibers.  Eventually, if I wear jeans for a few days in a row, the site gauze starts to peel back a little, threatening to dislocate the site entirely.  

Aside from the times I've almost ripped the site out while getting dressed, this jeans thing is the biggest problem.  To help keep the site from bailing before its time, I will stick a few pieces of medical tape around the edge of the gauze.  The tape ends up frayed and blue, but the site remains intact.

I've been thinking about doing some site rotations again - maybe trying out the arm site again or perhaps making an attempt at the (gasp) rear end location.  I'm such a creature of habit, though, a little shy to try something away from my regular routine.  Are you guys using some creative locations for your infusion sets?  (Aside from the breasts - I cannot bring myself to try that one.) 

(Also, THANK YOU for all of the great music selections yesterday.  I have been at Amazon all morning long, picking out CDs and previewing stuff on Seeqpod.  I feel like I've been completely revitalized.)

Posted by Kerri. at 02:55 PM | Permalink | Comments (19) | TrackBacks (0)

I have had plenty of infusion sets that don't hurt.  I wipe the site with an IV prep wipe, load up my trusty Quick-Serter, and shunk in a new infusion set into my skin.  Pull back the needle, leave the cannula inserted, and hook up the tubing.  Prime, stash the pump somewhere on my body, and move on with the day.

But lately, I've had a few infusion sets that stung like snakebites.  I'll be sitting on the side of the bed, pull back the white plunger on the Quick-Serter, and then send that infusion needle hurtling into what must be a happy little nest of the most sensitive nerve endings in my body.  At this point, I usually hop up on one leg, tears stinging in my eyes, and I bring forth my best Yosemite Sam impression (reserved for moments like this and for when my car makes me fume). 

Sunday night, I put in a new set and the string was unbelievable.  Determined to soldier through until the pain passed, I gritted my teeth and laced in my dinner bolus.  I could feel the cold of the insulin spreading underneath my skin like snowflakes.  I ate my dinner (spinach salad with chicken, as previously discussed) and tested two hours later at 228 mg/dl. 

Sometimes it feels like it takes a few extra hours for a new infusion set to "stick," so I decided to correct the blood sugar, go to sleep, and see what the morning brought.  

7:30 am - 156 mg/dl.  Though higher than I normally run in the morning, I didn't worry about the site.

All day yesterday, my numbers were crunched - 189 mg/dl, 221 mg/dl, 192 mg/dl, 201 mg/dl, and then finally 102 mg/dl.  It's like it took all freaking day to come down.   And oh how that site smarted like holy hell all day long.  Just the brush of my pants against the edge of the thigh sent spirals of pain down to my knees.  This was so not normal.

When I came home from work, I ripped the site out as fast as I could.  While the cannula was perfectly unkinked and appeared to be normal, the site gushed pus (ew, sorry) and blood immediately.  Over the course of the night, I'd managed to riot up an infection in that site - no wonder it was on a 2 hour delay accepting all my boluses and no wonder it was swollen up like someone had shoved a Mento under my skin.  

(Note to self:  If it hurts and you're high, just suck it up and change out the set.  Stop being so darn stubborn!)  

Today's numbers:  78 mg/dl, 138 mg/dl, 158 mg/dl, 108 mg/dl ... and holding steady.   

Posted by Kerri. at 03:41 PM | Permalink | Comments (14) | TrackBacks (0)

Two minature grizzled old prospectors sit on the corner of my desk at work, chewing tobacco and watching me work. 

"Blizzard's a-ragin' outside." 

"Yep, reckon 'tis."  

Leans towards spittoon - clang.

"Pilin' on up yonder.  I think she's fixin' to go home early and work from the confines of that there apartment."

"Seems that way.  With all them vermins."

"Cats.  They're cats, not rodents."

Clang.

"Makes no matter to me.  So should we give her a good scare before she leaves?  Rustle'er up a bit?"

"Yessir.  Let's wrangle up that pump site and shift it off course like a tumbleweed makin' its way through the desert."

Blank stare.

"She's wearin' jeans, Old Timer.  Let's rub the seam of the jeans against her infusion set until it spins a bit and comes loose from the site."

The piano stops playing abruptly. 

"You mean you want to stop that there insulin from gettin' in her?"

"A'yup."

"Okay, but just for a few minutes.  Just so she gets all riled up and has a little ol' fit.  A-hee hee hee!"

Kerri:  So I uncross my legs while sitting at my desk and notice that I could feel the cap of my site scraping against my jeans.  How the heck did that happen?  After a quick consultation with my thigh in the ladies' room, I noticed that the tubing had come loose from the hub of the set, leaving me without insulin.  I checked my blood sugar and saw a harmless 87 mg/dl, so there was no need to freak out. 

Then I noticed the two minature grizzled old prospectors with their spittoon, sitting on the corner of my desk.  I'd been done hornswoggled.

It was as this point that I decided I was burnt out and needed the weekend. 

Posted by Kerri. at 02:59 PM | Permalink | Comments (7) | TrackBacks (0)

Dear Edges,

You've been a part of my life for as long as I can remember.  When I was a baby, I used to lean on you in my crib.  Then there was that day when I was two years old and broke my nose against you on the fireplace.  My mother used to keep my baby bottles on you in the kitchen.

Oh Edges, you've been around forever!  From resting my elbows against you on the table in anatomy class senior year to the you above my bed where I had a library of books, you have always been there.  And we've lived in relative harmony, until the last few years.

Edges, I know you know what I'm talking about.  Listen, I understand that I've added these shifting bits of technology to my body - a pump infusion set on the outside of my thigh or on my abdomen, or the CGM transmitter on the back of my arm or on my hip.  I realize this adds an additional inch, maybe three inches at best, to my overall surface area.  But must you grab at these bits so much?

Was it really necessary for you to snag my pump site over the weekend?  I was undressing for my wedding gown fitting and the edges of my pants caught a small bit on the infusion set.  Granted, I moved slowly enough to thwart a complete site removal, but still. 

And did you really have to reach out for me when I was picking through my jewelry box this morning in search of the stupid matching earring?  I leaned against the edge of my dresser and didn't realize I was pressing up against the infusion set until I stood up straight and felt that ping of pain when the feeling came back to my thigh. 

But the last straw was this afternoon at work.  You know exactly what I mean, when I was talking with H about something and then I turned around quickly.  It was like you came darting out at me, snagging my shoulder on you and pulling the CGM transmitter almost cleanly from my arm, but not cleanly enough that I was sure it came out.  Just enough so that it stung in that oddly warm and slightly painful way, enough to make me wince but not enough to make me grimace.  I had to go into the bathroom at work, push up my sleeve almost to my shoulder, and see the sensor needle dangling from the back of my arm like a tooth that just needed a quick tug to come free.

Edges, I had just put that sensor in this morning and it was calibrated perfectly.  The results were working and I was watching my afternoon trend happily away.  But you had to reach out and say hello, didn't you?  Couldn't just sit back and let me sport this sensor for at least 24 hours before you grabbed it and yanked it out?

I am putting another one in today.  I am going to use my leg, I will tape it down to eliminate any variables, and I expect you to keep your grabby little edgy hands off of it for at least three days.  Three days, damnit. 

If I have to walk around with a giant nail file and round you all out, I will.

Best,

Kerri.

SUM Tags: open letters, insulin pump, Edges, CGM, diabetes

Posted by Kerri. at 07:13 AM | Permalink | Comments (10) | TrackBacks (0)

The dress gathered in beaded ivory folds at my feet.  I stood on the fitting pedestal while the seamstress sat, pinning up the edge of the dress and adjusting the seam of the beading so she would be able to hem my wedding gown. 

"Hemming this gown is tricky because of all these pretty edges," she said through clenched teeth, her hands busy folding and pinning with precision.

"It's going to be beautiful."  I looked in the mirror and felt every bit a bride, despite my smudged make-up and my rumpled hair.

"It already is beautiful.  That dress fits you perfectly, Kerri."  My mother grinned as she watched from her chair. 

"It's going to fit perfectly after I take it up a few inches, my friend."  The seamstress laughed a bit and stood up, admiring her pinning job.  "This will work fine.  Just a lot of work to move those beads!  Okay, now tell me about the pocket."

"It's for that insulin pump.  It will need to be off the seam and big enough to fit this,"  I reached down and lifted the edge of the dress so she could see the insulin pump, hiding out in my trouser sock.

"That?  Okay.  Do you need to keep that on or can you take it off?"

"It's for diabetes.  For her insulin?  It stays on all the time."  My mom asserted from her seat, shifting around a bit.

"Yes.  It can't come off.  And the pocket needs to have a hole in it for this tubing, so it can be fitted through all the layers and reach my thigh.

"Show me this tubing."  The seamstress put her hands on her waist and furrowed her brow.

I lifted the dress and removed the pump from my sock, following the tubing up to the infusion set on my outer right thigh.  "Here.  This is the pump itself, and this plastic tubing needs to be fed through the layers of the dress so that it can reach this, "  I tapped the plastic cap of the infusion site with my finger.  "It delivers my medicine this way and needs to be connected, but hidden at the same time."

"Okay."  She reached into her sewing kit and removed a seam opener.  "So we'll just open this here and," She opened up the seam of my wedding dress and placed pins on either side, pushing the pump through the hole.  "We'll sew in the little pocket.  Maybe add some edging to it so you don't notice it.  A bit of velcro to keep it closed.  Very small.  Very pretty."

I watched her in the mirror as she took her seam opener through the different layers of my dress - from the gown itself to the petticoat layers underneath and then to the slip.  I knew once she was done with the alterations that the dress would fit me perfectly, and would have the perfect hidden pocket for my insulin pump.  A little makeup would cover up the small red marks on my arm from the CGM transmitter.  I raised my chin proudly.  I have had type 1 diabetes for over 21 years, and I have found good health and strong love and support in those decades. 

I caught a glimpse of my mother in the mirror's reflection.  Her eyes were a little red and her smile was a little softer as she watched her oldest daughter fitted for her wedding gown, the seamstress holding my insulin pump in her hand.

SUM Tags: wedding, insulin pump, gown fitting, mother-daughter moment

Posted by Kerri. at 03:21 PM | Permalink | Comments (18) | TrackBacks (1)

An Exercise in Jotted Thoughts, by Kerri Morrone:

Ahem.

I am on day five of the sensor (placed it last Friday into my arm) and it seems that the longer I wear this, the more accurate the results become.  Last night, I tested with my OneTouch and saw 132 mg/dl.  My CGM said 130 mg/dl.  I'll take that.  I just want accurate results.

The thing is, this sensor stung a bit going in.  The site itself is slightly reddish and a little sore to the touch.  I know I should change the site today, but I'm reluctant to because I don't want to wait the 24 hours for decent results again.  I spoke with another Minimed Rep last night and she told me that the first 24 hours tend to be a little dodgy for everyone.  It's a difficult decision, making the leap from "trialing" to "purchasing."  Every time it buzzes when I'm high or low, it's hard to think about taking it off.  But every time it buzzes because it's bored or lonely (or whatever the hell it's buzzing about), it's hard to think about not feeding it to the cats. 

I'm still on the fence as to its place in my diabetes life.  But for now, I'm trying to learn from this experience.

I was working out last night at the gym and during my run, watched my numbers hold steady for about 15 minutes, then make a sharp turn towards hypoglycemia.  Testing to confirm and then taking a quick swig of juice, I finished my cardio workout at 108 mg/dl.  Watching workout trends helps me better determine when I should hit the ol' juice bottle and when I need to watch out for falling sugars. 

Also during my workout, while wearing a sports bra and a tank top on the treadmill, I noticed a woman staring at the exposed sensor on my arm.  It made me feel self-conscious for a minute, then oddly empowered.  Go ahead and stare, lady.  See if you can find it next week, when I put the transmitter somewhere else. 

One thing I'm definitely picking up on, like I did with the Dexcom, is that my numbers cruise around when I'm not counting carbs with precision.  I know this sounds like diabetic common sense, but when I bit into that sharon fruit this morning, I didn't bolus for the actual carbs, but I dosed instead for the estimated carbohydrate content.  Apparently, this sharon fruit had more than 18g of carbohydrate in it - more like 22g - and my numbers after consuming were in the 190 mg/dl range.  Lather, rinse, repeat.  If I want a tight A1c, I need to buckle down and pay attention to all the details, both delicious and detrimental.

It's been a week of serious diabetes stuff, with tangled emotions and blood sugars alike. 

Good thing I had a little Siah Sausage to wake up to this morning, her small nose pressed against my cheek and her paws on my face, the sound of her purring like a jet engine in my bedroom.  It felt strange to wake up laughing.  Damn cat.

SUM Tags: diabetes, insulin pump, MiniLink, CGM, learning curve, frustration, Siah, laughter

Posted by Kerri. at 11:56 AM | Permalink | Comments (10) | TrackBacks (0)

Last night, Chris and I wrapped up on the couch and watched Signs.  As we watched the movie, I felt Chris absently start rubbing my shoulder.  His hand started at the top of my shoulder and went down towards my elbow.  I felt his fingers skip up against the CGM transmitter.  It made my eyes fill up, and I’m not exactly sure why.

I have been receiving some good data from the MiniLink so far.  It has confirmed that my overnight basals are pretty much spot-on, with a small bit of tweaking to be done for the weekends, when I sleep past 7:15 am.  It has shown me that my run at the gym makes my blood sugar plummet after about 15 minutes.  I like being alerted when my blood sugar is over 180 mg/dl because I want to spend as much time away from that high end as possible.  I feel somehow safer wearing this device; a watchdog while I am otherwise indisposed.

All of this information can help me better manage my diabetes.  Tight control can help me reach my goals of good overall health.  I’m being proactive.  I am testing and bolusing and making use of the latest diabetes technology in efforts to live a long and healthy life

That is what’s best.

It’s just hard to be so focused at all times.  I've been emotional lately.  I lost my edge.

Today, the alarm sounded on the CGM all morning long.  “Bad sensor.”  “Cal error.”  “Bad sensor.”  “BG Now.”  This rotation went on for three hours.  I had resolved to leave the sensor in and go home at lunch to change it out, but after a series of seven errors in a row, I stormed into the bathroom at work and ripped out the sensor early.

I went home at lunch and inserted another sensor into my arm, with Chris’s help.  It was the first sensor we had done on our own, so I had some trouble figuring out how to pull the needle out.  I tried.  Chris tried.  Unfortunately, we were tugging at the wrong angle and my arm became a bit mangled in the process.  The long needle remained stuck in my arm as I tried to wiggle it back, with Chris holding onto the side of the sensors.  Feeling under the weather both physically and emotionally, with the bruise already visible on my arm and a sharp pain edging down towards my elbow, I burst into tears. 

“I can’t get this out.  It hurts a lot right now.”  Tears, without asking my permission, fell into my mouth.  “I can’t do this.”

“We’ll figure this out.  It’s okay.”  Chris grabbed the CGM manual and started flipping through the pages, looking as quickly as he could for the page about removing the needle.  Frustration mounted, along with the soreness from the lodged needle, and I pulled the set from my skin.  Blood poured from the site.  Tears streamed from my eyes.  I felt defeated and frustrated and foolish.

It took several minutes to calm down.  It wasn’t about the sensor mishap.  It wasn’t about the infusion set two nights ago that stung all the way down to my toes.  It wasn’t about the low that had me sweating as I slumbered last week.  It wasn’t about the counted carbohydrates or the glucose tabs in my car or the press releases that I read every day, outlining diabetic complications.  It was simply an overwhelming sense of everything.

What’s best for me?  Is it all this concentration on diabetes?  Is it taking advantage of the technology that this decade, this job, and this blog have given me access to?  My physical health is of the utmost importance, but I value my emotional health just as much - maybe more - than I value my A1c.  Lately, my emotions have been capped up to keep me focused on my numbers.  Today, the bottle uncorked and they flooded me, leaving me bleeding and vulnerable and crying.

I dried my tears.  Chris gave me a hug.  I asked him what I should do.

“Do what you think is best.  I support whatever you decide, baby.”

Sometimes it just takes a good cry and knowing that you’re loved to make it easier to realign your heart and your head with "what’s best."

He helped me insert another sensor into my arm.  We were calm and focused.  It didn’t hurt at all.  It only bled a little, and he grabbed a tissue and blotted the blood with careful hands. 

“See?  Much better that time.”

“I was afraid if I didn’t do it again, right away, I would have given up for a while.”

He nodded.  I rubbed the sensor on my arm, telling myself that it was worth trying, that my moodiness would pass.  The pump was hard to adjust to at first, too.  Everything has an adjustment period, even what’s best.

I opened my mouth to tell him I loved him, but the sounds of the cats fighting over a cardboard box in the living room distracted us both.  Siah was leaping in and out of the box like a little gray gazelle.  It made us laugh.  And the laughter felt right.  I felt lighter.

Laughter, for me, is what's best.  It helps make sense of the rest of it.

SUM Tags: diabetes, insulin pump, MiniLink, CGM, Siah, frustration

Posted by Kerri. at 03:31 PM | Permalink | Comments (25) | TrackBacks (0)

11:30 pm. 

Meep meep meep.

"What?"  This thing sounds like a little RoadRunner attached to my hip.

More mournful this time.

Meep meep MEEP.

"What is it?"  Exhausted from the night before, nursing the beginning of a nasty head cold, and already tucked into bed, I snake my hand under the covers to retrieve my pump from the waistband of my pajamas.  The screen beams green light my way - "BG HIGH.  Above 180 mg/dl target." 

"Okay, okay."  After clearing the alarm, I grab my meter from the bedside table to confirm this result and, sure enough, I'm 202 mg/dl according to One Touch.

"Here."  I push against the buttons and bolus up a unit, realizing I'm talking to my pump the same way I talk to my cats when they wake me up early in the morning to fill their empty food dishes.

The beeping stops.  I rest my head against the pillow and fall into a deep, blissful sleep, with the pump on my hip, the infusion set on my thigh, the CGM on my arm, a cat at my feet, and my fiance by my side.  Full house.

What happened next is not something I remember clearly, but the memory of my machines filled in the gaps for me.

3:19 am - Pump Alarm.  BEEP.  BEEP.  BEEP.  LOW BLOOD SUGAR.  64 mg/dl  WAKE UP, KERRI.  WAKE UP.

4:08 am- Meter Result.  49 mg/dl.

7:15 am - Morning Carnage.  One empty juice bottle, meter unzipped and used test strips all over the floor, covers tossed off in my low-induced sweat, body freezing due to being exposed and damp all night long.

Oh CGM, you tried to warn me.  I changed my low glucose threshold value to alarm at 65 mg/dl and you did.  You just weren't loud enough.  Or maybe I just turned you off, like I have mistakenly done with the alarm clock on occasion.  Either way, the best laid plans of my CGM were thwarted (or at least muffled). 

Today, my numbers have been all over the place.  I know this because instead of the plateaus of graceful blood sugars, I'm seeing stock market indexes all over the screen of my pump.  Thanks to the sneezing, stuffed up head, and feverish feeling I'm currently enjoying, I at least know why my numbers are erratic.  Even though we've just started our relationship, now CGM and I can enjoy a head cold together and I can see how my numbers dance when I'm feeling ill. 

I have so much I want to write about - the CareLink software that I'm going to try out tonight, my challenges and successes with CGM-ing at the gym last night, and the insurance angle of things, but I'm almost fully immersed in this freaking sneezy cold and can't form another complete tho ...

SUM Tags: diabetes, insulin pump, MiniLink, CGM, RoadRunner, low blood sugar

Posted by Kerri. at 05:34 PM | Permalink | Comments (5) | TrackBacks (0)

My Minimed rep was meeting me at the dLife offices after work to hook me up with the Medtronic Minilink and I joked in an email that he should hoot like an owl upon arriving so that I would know he was there.

Around 6 pm, my cell phone buzzed.  The message left was not someone saying, "Hi, Kerri.  [RepName] from Medtronic calling," but instead, "Whoooooooo!  I'm here."

That's the mark of someone who's on my level, that's for damn sure.

After exchanging grins, we settled ourselves at a table at a local coffee shop and laid out our drug paraphernalia on the table.  The box of CGM sensors, the MiniLink transmitter, the insertion device, and our respective glucose meters (my rep is also type 1) littered the table.  Conversation flowed easily as he set me up with the MiniLink.

"Okay, so now we're ready to place the sensor."  He loaded up the inserter with my first MiniLink sensor.

"Great.  Let's pop that in on my arm."

He paused. 

"Inserting a sensor at a coffee shop is a first, that's for sure.  But in the arm?  This is a series of firsts for me." 

With a little help and almost no pain at all, the sensor was inserted and the transmitter connected.  (I didn't have the opportunity to take pictures of the actual insertion, but I will do a photojournal for the next sensor I use.) 

After the first three hours, the pros and cons were beginning to show themselves. 

PROS:  The sensor is small - about the diameter of a quarter (maybe a small bit bigger) and about three stacked quarters high.  It's on the back of my arm and is pretty low-profile.  It's also water-proof, so no crazy-sticky shower patches that leave red rings on my skin for days.  The MiniLink transmitter, like the Dexcom, takes two hours to fully calibrate when you first put the sensor on.  (This term is called "wetting," which I think is revolting.  My rep and I called it "percolating."  Much less icky.  And hearkens to coffee, which I need desperately.  I'll explain why in the "cons" section.)

This sensor also works in tandem with my Medtronic 522 insulin pump, so I'm toting around one device instead of a receiver and an insulin pump.  It also is able to calibrate using any glucose meter, so I could continue on testing as usual, using my One Touch Ultra2.   One hub device is a huge selling point for me. 

CONS:  The transmitter is floppy and needs to be secured against my skin with a bandaid to keep it from coming loose or dislodging the wire.  This is the biggest con for this transmitter so far.

HOWEVER:  This frigging thing kept me up all night long.  After being instructed that the CGM results are about 15 - 20 minutes behind my actual blood glucose (i.e. the CGM says 100 mg/dl, my sugar is actually 80 mg/dl or thereabouts), I set my low glucose alarm for 80 mg/dl, assuming my number would actually be close to 60 mg/dl once the alarm sounded. 

Thanks to my vigilance with my overnight basals and the fact that they're set with precision, my numbers run close to 90 mg/dl all night long.  Due to this tight control on my overnights, the low glucose alarm went off eight million times last night.  That was issue one.

Issue two involved another alarm - this one reading "Bad Sensor."  Unfortunately, this alarm went off at 2:53 in the morning and I was not going to wake up again just to reinstall a new sensor.  So, against the advisement of my Minimed rep, I manually told the pump that I had installed a new sensor and recalibrated it.  It reset its timer for the two hour calibration, thus waking me up again at almost 5 am. 

Then the low glucose alarm went off again at 6:15, because I was 79 mg/dl.

(Note to self:  Kerri, set the low glucose threshold at 65 mg/dl, for crying out loud.  Or you may never sleep again.  Seriously.  Every time the thing went off, you groaned, the cats howled, and Shoes most likely plotted revenge.  Raise the threshold.  Do it now, you silly girl.)

I have not slept well, but it's obvious that my numbers hold tight and steady throughout the night.  I'm hoping last night's escapades were a fluke thing and that a little tweaking will have me living in relative harmony.  

I'll have more on the technical aspects of this device throughout the week, but for now I'm going to check my number - ah, 113 mg/dl on the Link, 99 mg/dl on my OneTouch - and get another cup of coffee.

I am MiniLink.  :)

SUM Tags: diabetes, insulin pump, MiniLink, CGM, Legend of Zelda, low blood sugar

Posted by Kerri. at 10:58 AM | Permalink | Comments (29) | TrackBacks (0)

It ached a small bit. 

I noticed the ache when I leaned up against the kitchen counter to grab a mug from the top shelf for my tea.  Not a holy-crap-that-hurts sort of feeling, but more of a latent bee sting.  It didn't feel right and I knew it would be painful once I focused on it, so I pushed the pain out of my mind and instead reverted my attention to the tea.

I tested:  180 mg/dl.  Bolused half a unit to bring me down.

An hour later, I tested again:  186 mg/dl.  That bolus did nothing?  Didn't seem right.

Waiting for the shower to heat up and planning to change my infusion set afterwards, I pulled out my site.  Immediately after I pulled the plastic away, a drop of blood seeped up and scurried down my thigh.  The cannula revealed its vampiristic tendencies:

This explained the dull ache at my site location.  It also explained the fact that a 1/2 u of Humalog fell into some kind of useless void. 

No problem.  Changed the infusion set, laced in another half unit to correct the high, and slid a garter of garlic around my thigh. 

When it comes to these vampire cannulas, you can't be too careful.

SUM Tags: diabetes, insulin pump, vampire cannula

Posted by Kerri. at 11:40 AM | Permalink | Comments (14) | TrackBacks (0)

A few weeks ago, I was out to dinner with Chris and rang in at an excessively high blood sugar after taking part of my meal bolus.  Wondering if my site was conking out, I rummaged through my bag to find my always-on-hand insulin pen.

Well, almost always-on-hand.  This time, I had left it at home. 

Never fear - Old School Syringe is here! 

That experience pretty much encapsulates why I carry a syringe in my meter bag at all times.  Here's how I bolused in a bind:

In the side zipper part of my OneTouch Ultra2 meter, I keep an unused syringe, orange cap and all.

Wearing my pump is like carrying a teeny little bottle of insulin at all times. 

I unscrew the reservoir from the main housing of my pump.

Then I disconnect the reservoir from the pump tubing.

Using the syringe, I poke the needle into the spongy access point in the top of the reservoir.

And as though it were a bottle of insulin, I pull back a few units.  After I inject with the syringe, I reprime the insulin pump to make sure there are no air bubbles stuck in the reservoir or the tubing, and I reconnect to my infusion set.

This little trick has bailed me out a few times and can also be used in a pinch if my insulin pump ever fails on me (or if my brain fails on me and I forget my trusty old insulin pen).

Over the last twenty-one years, I have seen plenty tricks of the trade.  What have you come across?

SUM Tags: diabetes, insulin pump, insulin, diabetes tips

Posted by Kerri. at 11:54 AM | Permalink | Comments (16) | TrackBacks (0)

UPS arrived this morning, dropping off an early Christmas present from Medtronic. (Okay, it was from my insurance company, too.) 

Inside?

My new Paradigm 522 and accompanying Paradigm Link meter.

In a festive "smoke" color.

Working on getting those sensors sent out just after the New Year.  Oh how I love new diabetes gadgets.

Posted by Kerri. at 05:07 PM | Permalink | Comments (19) | TrackBacks (0)

When I got home from the gym last night, I ripped out that belly site with relish.  (And a small bit of ketchup, as it bled a teeny bit and that makes me wonder if I had nicked something and if that had contributed to excess pain.  But I've digressed.  Again.) 

After showering, I slid a little IV prep on the back of my left arm, where I took daily injections for so long, and held the circular, blue Quick-Serter against my arm.  Leaving no time for anticipation, I hit the buttons on the side and plunged the needle into my skin.  No real pain, not much impact, and when I pulled the Quick-Serter back, I exposed a neatly nested circle of white on the back of my arm, with the blue needle sticking out of it. 

"Gotcha now," I muttered. 

Pulled out the blue needle and fixed primed the set with 0.3u of Humalog.  No burn.  I clipped the pump to my yoga pants.  It felt weird to have the tubing all "up north" instead of the southern hemisphere of my body.  I laced the tubing underneath the side of my sports bra and kept it along the side of my body.  This worked for the most part, aside from the fact that it tickled a bit on the underside of my arm.

I pulled on a black t-shirt and surveyed the scene.  I could see the set bulging out a little bit underneath my arm, but since it was on the back, it seemed barely noticeable.  I fell asleep more aware of the fact that the pump wasn't on my leg, instead of hyper-aware of the set on my arm.

This morning, not much different.  Showering proved to be no issue, as the shower poof didn't come into direct contact with the site (it does when I'm using my leg -- I'm obsessive about shaving).  I got dressed in a pink sweater and black skirt and snaked the pump tubing underneath the side panel of my bra and along the side of my body again, coming to a rest tucked into the top of my skirt.

Pros to wearing it on my arm are that the area has been virtually untouched for the last four years, save for the rare injection.  It's up and out of the way, so using the bathroom isn't a tricky "hey, did I just skim the site with my pants?" excursion.  It's not creating a bulge that I can see without lifting my arm a little bit, and once the tubing is secured under my bra, it doesn't budge.

Cons to this site are that dressing/undressing is a bit tricky, as there's plenty of braided tubing to contend with.  It aches a teeny bit, but nothing too dissimilar from a thigh site and nothing even close to the ache of an abdomen site.  It's a bit tricky to connect/disconnect because I can't really see it, but since I don't usually look when I reconnect, I can do it by feel.  The main con is that I can't extend the tubing to my sock and hide my pump there, so I'm experimenting with different "above-the-belt" hiding spots.  Today it's tucked inside my tights, against my hipbone.

So, thanks to your encouragement, I think I have a new spot to rotate my infusion sets to.  And it wasn't too scary!  Now it's your turn to try something new.  :)

Posted by Kerri. at 01:37 PM | Permalink | Comments (15) | TrackBacks (0)

About 90% of the time, I do not mind wearing an insulin pump.

Yes, of course, I would much prefer to be cured of this disease and I don't enjoy the day-to-day maintenance of a chronic condition, but for me, pumping these past four years has been far superior to multiple injections.   I can hide it in the folds of my clothes.  I can disconnect for exercise, intimacy, and beachin' it.  And it delivers my insulin with a precision and stealth unrivaled by my orange-capped syringes.

However, the past few days have been holy hell.

Instead of sticking the infusion set on my thigh, like I usually do, I opted to give my legs a rest and revert back to my abdomen.  I originally started using my thighs because I thought stomach sites burned and felt like fire in my sensitive, nerve-riddled skin.  I liked having the tubing snaking down my leg instead of jutting out from underneath my shirts, and I preferred to have my infusion set nested on my out-of-the-way leg instead of my front-and-center abdomen.

But, in the interests of site rotation and absorption tests, I stuck the site in my stomach and went about my merry way.  Unfortunately, it was far less merry than usual.

The site is currently about three inches to the right of my naval, about two inches down.  While wearing sweat pants, this site location is not an issue because the waistband of the pants rests about two inches below the site.  HOWEVER.  The waistband of my jeans rest, with precision, where the infusion set sits, rubbing and pressing and making the site incredibly sore.  Every time my arm brushes against it, here on its third day, it's as though the cannula has made its home in a pile of ultra-sensitive nerves.

We're out at dinner the other night, and one big laugh had me squirming because the site had caught against the edge of my pants.  Driving home to RI was entirely uncomfortable because my seatbelt was snug against the bulge of the site.  Every bolus has a bit of a burn to it.  The sweater I wore to work today shows the faint outline of the infusion hub orbiting near my naval.  Even sleeping has me rolling over, folding my arm underneath myself, and mashing up against the site. 

For the last three days, that infusion set has gone from "something I barely notice" to "alien in my belly."  An alien in my belly has been a bit of a startling enterprise, to say the least.

I admire people who can do a full site rotation, hitting places like their rear ends, their arms, and even their breasts.  (Note:  I will never, ever use my breast as an infusion set site.  I cannot imagine that kind of ouch.)   But I officially hate the belly sites.  I can't stand them.  I feel like a stubborn kid, crossing my arms over my chest and pouting, "No more belly sites.  I'm going home."

So, in efforts to be more of a grown-up, I'm going to give an arm site a pass.  Once I'm home from the gym and neat and clean from the shower, I'll be trying out the back of my left arm as a home for my infusion set.  You guys have given me the confidence I needed to at least give it a whirl.

If an alien takes up residence in my arm, I'll be back to legs by Friday.   

Posted by Kerri. at 04:10 PM | Permalink | Comments (19) | TrackBacks (0)

"Just lift your arms up and ... okay, dive in!"

She held the seemingly endless yards of flowing fabric above my head, with her arms through the middle to guide me to the top.  The rustle and shuffle of silk and taffeta undulated by my ears until I had shimmied into the dress.

And I walked out to where my mother was waiting, the train of the dress following patiently. 

"Oh, that's the one.  That's it."  My mother started clapping softly, then realized it was an odd thing to do, so she just folded her hands in her lap and grinned.

I turned to face the mirror and, despite the exhaustion from the whirlwind weekend and the day of working remotely and the strong scent of Starbucks coffee, I felt pretty.  All in an instant, I didn't want to wait another seven months to be his bride. 

"Oh, that's the one."  My bridal consultant had patiently helped me try on over two dozen dresses and she showed no signs of slowing down.  But this one was it.  Hands on her hips, she followed the lines of my body with her eyes and nodded her approval.  "It fits you perfectly."

I nodded in agreement.  She leaned in to my mother.

"Let's get the pump and I'll get the seamstress, so we can see how we'll work with this."

My mother unearthed the pump from the depths of my purse, where it had been stashed during this dress-session, and handed it to me. 

The seamstress came out and gave me a coo of approval.  "Oh honey, you look beautiful.  Now what are we looking at here?"

"This is my insulin pump.  I need to have a pocket or something created in the dress so I can access the buttons here," I gestured to the front face of my pump, "and then the tubing needs to funnel through the dress layers to a port on my outer thigh."

"No problem, honey.  No problem at all.  Let's see this."  She reached out her hand and I placed the pump on her palm.  "Not too heavy at all.  We make a little pocket along the seam here," she pointed to the side of the dress, "and then we'll just tunnel through the layers to meet up with your leg.  A small bit of velcro to keep the pocket shut and viola!  You're a bride with a beeper."

"A pump."

"Pump."

The seamstress patted me on the arm.  My bridal consultant helped me slip out of the dress and I put my own skirt and shirt back on.  I looked at some options for my bridesmaids and ooohed over dresses for my flower girl (little MP).  We talked about when the dress would be ordered and how long it would take to come in.

And if I closed my eyes, I could still feel the weight of the train and the way the beading felt underneath my fingertips.

I can't wait until May.

Posted by Kerri. at 03:39 PM