Pump it up…

If you’ve taken the title of this email to refer to lifting weights or the slew of songs by this title, including the crooning Elvis Costello, the spunky Missy Elliott, or perhaps the best known “hit” by “D” (Danzel) you’re going to be sorely disappointed…The pumping up I’m talking about is with an insulin pump.

When I was first diagnosed with CF related diabetes, a physician friend of mine said, “I’ll give you a year before you get on the pump.  Everyone loves it.” At the time (16 months ago) I was only beginning to get used to checking my blood sugar all the time and giving myself shots.  I thought no way. I’m not getting on the pump. I don’t want something connected to me all the time. What would it be like to be on IVs and have my port-o-cath accessed and have this pump thing connected to me as well.  Ugh! So I did the shot thing and went on about the business of managing my blood sugar.  It was a learning curve. I was learning how to carb count and I was having some low blood sugar issues (which is not uncommon in people on insulin who are able to keep a tight reign on their blood sugar). Then in July 2007, while on vacation in Hawaii, I nearly died because of a hypoglycemic seizure.  During the night my blood sugar dropped to 25 and I was unconscious.  Luckily, my husband woke up because I was moaning/gurgling and saw that something was wrong.  He called the parametics, and out they came to the off the beaten path surfer’s hostal where we were staying on the North Shore of Oahu. They gave me glucogen and I woke up and they took me to the emergency room for observation.  We decreased my dose of long acting insulin and sent me on my way.

Obviously, I was fine, or I wouldn’t be writing this.  It did take me a few days to get all of my whereabouts back, but it seemed more or less like a no harm, no foul situation. Mind you, I didn’t know how horrifying I looked, laying in the bed unconscious. Nor did I experience the sense of panic he did at finding me that way. Needless to say, my husband wasn’t so fine. For months after, he wouldn’t leave me at home alone over night. I had to have my parents or a friend come and stay at our house. If I travelled to conferences, he insisted that I have a roommate. I appreciated the caution, but it did get tedious after a while. I hadn’t had a low blood sugar episode since the doctor changed my insulin regimen, but still I knew I would have to come with a plan to convince him that I didn’t need a night sitter to be at the house with me.

Enter the insulin pump.

The next time I went to see my endocrinologist, I asked him about the pump.  By the time I left his office that day, I knew I had to get on it. So what, you might ask, is the big difference between the pump and shots?  I was on two types of shots – long acting insulin, which controlled my basal rate (the back ground insulin that your body needs to keep all systems go) and short acting insulin, which is geared toward dealing with the insulin you need to use the food you consume.  The short acting insulin shots were working fine.  The long acting insulin shots were a little too unpredictable; they lasted for 24 hours and once you’ve taken it, you have no control over how they effect your body or blood sugar.  In contrast, the insulin I use in my pump is only short acting insulin.  I still need both basal (background) and bolus (food related) insulin, but I get all of that using the pump.  For my basal needs, the pump pumps a small amount of insulin in all day long (24 hours). If for some reason my blood sugar gets low, or I know I ‘m not going to be able to eat on my regular every 2.5 hour schedule, I can “suspend” the pump and it will stop giving me the background insulin. Because the insulin is short acting, within 30 minutes of suspending the pump  the basal insulin that I was getting has been used up.  So, there is less of a chance of a surprise, middle of the night extreme low like the one I experienced in Hawaii.  Good news!

I’ve been on the pump for 6 months now. And, I have to say that I do love it.  Ok, love is bit too strong. But, it has made my life easier and my blood sugar a little more manageable. My A1C has improved. I’ve gained some weight (which, I needed to do). I even managed to put up with being connected to two “devices” during a recent home IV treatment. There were a lot of tubes coming out of me, but somehow I managed.  I traveled to Spain for three weeks with it and it worked out great. I was able to adjust to the time change, the food differences, the long plane ride with minimal food without a problem (i.e. no hypoglycemic seizures).  I still perodically have trouble with low blood sugar, though, particularly during the day when get busy and can’t always keep to my eating schedule.  Not a huge deal, except that because of the earlier chronic hypoglycemia and the big seizure episode my body doesn’t always send up the warning signal that my sugar is dropping. So, I recently added (read yesterday) the continuous glucose monitoring system (which I had to FIGHT! the insurance company for 4 months and many letters to get them to agree to cover. They deemed it a “luxury” medical item and said that it wasn’t a medical necessity.  That story is a posting for another time).  So far it seems to be working ok.  And, it adds an additional piece of mind – if my sugar drops below a certain point, an alarm sounds to warn me. Ah technology.

Just call me cyborg. I’m ok with it…