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Untethered, After a Fashion.

Around 8.30 am, I took an injection of Levemir.

At about 9 am, I switched my basal profile to “OTHER” and disconnected my insulin pump.  The OTHER profile has me at 0.025U basal rate per hour (as close to zero as I can get on my pump) but still holds all my other settings.  I kept the pump in my purse and the infusion set attached to my body, with one of those pump caps (there are two that come with every box of Insets) to keep the site closed.

At 9.03 am, I put on a skirt with a loose waistband that had previously been tugged down by the weight of my insulin pump BUT NOT ON THIS DAY.

Throughout the day, my basal needs are served by the Levemir injection, but I reconnect the insulin pump to deliver my boluses (allowing me to take my meal boluses and correction doses with precision and also without piercing my skin another time because the infusion set is still in place).

Around 9 or 10 at night, my Levemir injection is pretty much toast (over the years, I’ve seen that Levemir leaves my system after 12 hours, so I usually split my dose completely on pump vacations), so I reconnect my insulin pump and spend the overnight connected, receiving the basal bump at 5 am that is delivered to combat the dawn phenomenon my body experiences.

And then, depending on what I’m doing the next day, I’ll decide to keep my pump on or off during the day.  The Levemir pen in my toothbrush holder serves as a reminder to take a morning dose, if that’s my jam.

I like having a choice.  Can’t un-choose diabetes, so having a choice as to how I deliver my insulin is a plus.

It sounds complicated, but it works for where I’m at right now, because I am aiming to make good on the whole “fit diabetes into life, not work life around diabetes.”  And as petty and superficial as it may sound, it made me bananas (read: super angry, not yellow and slippery) when I went to get dressed for the sticky, summer heat and didn’t have a good place to shove my pump.  On the waistband pulled my skirt down.  Between the cups of my bra made for weird lumps and also unnecessary warmth.

This kind of frustration is the shit that can send me into a week-long DBM (Diabetes Bad Mood) and I am trying to mitigate as much of that as possible.  So off came the pump.  On came the highly structured plan to untether in the most graceful way possible.

Keeping an eye on my CGM showed when things were working and when things need tweaking, and I felt at peace with my diabetes instead of Rage Against the Islets.  Which, while a solid band name, doesn’t do much for my emotional health.

11 Comments Post a comment
  1. Tricia #

    Kerri-
    Whenever I wear skirts or stuff with not super tight waistbands for clipping a pump to I clip it to both the waistband of the skirt/shorts/whatever but that together with my undies waistband- an extra reinforcement and I have never had a pump pull down my pants!

    07/27/15; 10:49 am
    • I’ve done that, too. It was just the added lumpage that I wasn’t on board for, either. I wanted a little freedom. 🙂

      07/27/15; 10:54 am
  2. Brandy Schmidt #

    I love the untethered methods. We used it for years for Brandon. Especially in summer when we spent many hours in the pool or at the beach.

    07/27/15; 12:14 pm
  3. About that Levemir that you have on-hand… do you have any trouble getting it, along with your pump supplies, approved by insurance? And will you end up using the vial before it expires? It’s none of my business how much insulin you use, but I know if I injected a half-day worth of basal just two or three times a week, I’d probably be throwing a lot in the trash at the end of the month. It would take some creative math by my endo to get one passed my insurance company. (Then again, the pens probably hold less than the vials, so maybe it works).

    Also, you are incredibly fortunate that it’s done after just 12 hours. If I could take something that would work during my awake-time and not my asleep-time, I might be willing to try the untethered regimen occasionally myself.

    07/27/15; 12:46 pm
    • My doc writes me a script for Levemir for pump emergencies and pump vacations. The pens and vials don’t expire for quite some time, so I probably fill my prescription every year. Maybe twice a year, if I’m feeling ambitious and my insurance company is feeling generous. 🙂

      07/27/15; 4:12 pm
    • Catherine #

      I keep Lantus in my fridge for backup use (pump failure) at all times and have a script with a couple of refills that my insurance fills without any problem. My endo also will give a sample vial or pen if I ask for one for this sort of reason. Maybe she has one, or both, of these situations. I do a sort of partial MDI sorta thing on days I’m on/in the water and do an injection of novolog every four hours to cover basal rate and bolus, also, for meals/corrections. My endo is considering NPH for me for those days only, but I’ve never actually used it, so there would be a learning curve! Have never tried levimir, either. I was dx t1d at 31, so I’m not, ten years later, as adept as so at switching things up.

      07/27/15; 4:22 pm
  4. Carolann #

    Have you ever tried Omnipod? No cords to get caught on doors or pants.

    07/27/15; 3:16 pm
    • I haven’t, but I like the tubing aspect of pumping. Omnipod, at this stage, is not for me.

      07/27/15; 4:10 pm
  5. Apryl lowe #

    Kerri-
    I so love your writing and you have often wrote excatly what I have felt and I send your articles to my family often.. So thanks for taking time to write down your thoughts.. Anyway, being on the Medtronic pump for ten years and having it malfunction on me every single summer I too took a pump break but mine was 24 hours a day for 6 months. I researched Omnipod and this was the time it came out with the smaller model.. I totally love it and I don’t have something hanging off me all the time.. Such a blessing.. Something you may want to try..
    Good luck and diabetes can suck it.. We got this!! Especially when we can find comfort in keeping each other to laugh..
    Apryl

    07/27/15; 4:16 pm
  6. Erika is doing also doing this right now. She often uses Levimir with the pump just for bolusing. Maybe it’s all the cute summery clothes she likes to wear. It is nice to have options

    07/27/15; 7:21 pm
  7. Melissa #

    This is brilliant!

    I’ve been on an extended pump break since July 2nd. I was camping for the 4th of July weekend and as I have every year, I disconnected and went on the pens. Well when I got home on the 5th, I didn’t feel like reconnecting. And haven’t since. I’ve been pumping for 6 years straight with only 3-4 days of a break/year the past 3 years. So I guess I was due? Lol.

    The only troubles I have had is the not as accurate dosing for food and corrections. Hasn’t been bad, but not as precise as I’d want. Might have to try the hybrid when I decide to reconnect!

    07/27/15; 11:57 pm

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