Monday, July 18, 2011

A Decade of Site Changes

This is my 10th year of insulin pumping.

So apparently, this marks a milestone Pump-A-Versary in my D-Life.

We met for the first time in June 2001, the summer just before my final semester of college and one of the busiest times of my life. After 17 years of two to four injections a day, I gave up those daily syringe meetups for a piece of technology. A device that promises to provide a constant stream of insulin throughout the day, and some extra boosts when needed for food or other variables.

An exact day isn't marked on the calendar, but it was mid-year and warm and I remember getting my intro to pumping while wearing shorts. My Minimed pump rep was a fellow PWD, a cool guy who later went on to work at Deltec Cozmo and helped convince me to try that product out for a bit.

Much has changed in the past decade, from the pump itself (early Minimed versions, upgrades, a switch to the Cozmo briefly, then back to MM Paradigm) to the style of supply needed to make it work. We've moved from Michigan to Indiana, gone from single to married, college kid to professional working guy.

Yet the process for connecting to the pump has remained mostly the same.

(Here's the remedial part, for those non-pumpers who are curious or anyone else who might have an interest in the Pumping 101...)

Disconnect the now-empty tubing and reservoir from the pump. Punch a few buttons and listen to the pump whir as it primes to start again. Wait for the beeps to alert me it's finished, and ready to go. Twist on the new tubing and hold down the ACT Button, then waste as much as 16 units of insulin to fill the 43'' tubing until little drops appear at the end.

Then, the self-stabbing ensues.

Mostly, I've relied on manual insertion rather than the intimidating insertion devices that are supplied. I can easily stab myself with the set needle by hand, but just dread the anticipation and unreliability of waiting on a device to do the dirty work for me. That's changed during the past year a bit, and I've also started allowing my wife to assist on some hard-to-reach spots on the arms or backside. But mostly, it's all me. The 90-degree sets hve never worked well for me, so I have mostly used the Silouette or other angle-insertion sets.

Find a new spot of real estate somewhere on my body that isn't sore or scarred from past use, keeping in mind where I've most recently gone. Sometimes I wonder whether there's any upcoming activities, like dancing at a wedding or wanting to sleep on a particular side again, that might deter me from using a particular spot. An accompanying CGM site might also influence the decision-making here. But once it's settled, the stabbing begins.

Squeeze some of the fatty tissue on my body, assuming there is some. And tease my skin with the sharp needle, holding it above as if to warn myself of the nearing self-stabbing. Even though I've done this a thousand times before, I hold my breath before piercing the skin. Sometimes, I clench my teeth. Enough times growing up of hitting a muscle or nerve has jaded me. Slowly, the set sides in. I release briefly, then pinch again just to make sure all is well.

Pull out the needle. Connect the tubing. Send in the .3 units to fill the cannula. Inspect the site, just to make sure all looks OK and no signs of blood are found in the cannula.

Once in a while, the timing works out to allow for a rare shower where I'm not connected to anything and have no sets attached to myself. Sometimes, I'm already dressed and ready to start the day. Other times it's afternoon or evening. Occasionally, I am at work or visiting somewhere else and being a bit more discreet about the new set connection.

By my count, I've done more than 1,000 of these. (The math: Estimating two a week, multiple that by 52 weeks -> 104 per year x 10 years = 1,040. Subtract my five-month Pump Hiatus where I went back to Multiple Daily Injections, and you get about 1,000. Assuming I've done more than the two a week at times, the number is likely a little bit higher than that.)

Sometimes, the frustration has mounted and become overwhelming. A break helped. But, we move on. Just another day in the life of an insulin-pumping diabetic. Another site change, another day, another year. Now, we start the next decade of site changes.

With that, we find an old pal from earlier this year: Larry The Loaner CGM. Hello again, my friend.

To Be Continued...

10 comments:

Reyna said...

Thank you for this ... To know that it hurts you sometimes helps me understand Joe's reactions. Sometimes he yelps out if I hit a sensitive area. He also winces with the first bolus sometimes. Do you ever experience that? I asked my CDE about it (she has type 1 as well) and she hasn't ever experienced that. Just curious. Happy Decade! You show us grace and courage Mike.

Un-Apologetic Diabetic said...

Aw, happy pump-a-versary. :D

I was fascinated by the instructions for pumping, since I'm still on injections. I did try on one of those snappy little insertors at a seminar so that I would know how it felt and not be scared, but I hear you...I hate waiting for the SNAP. Thanks for sharing this Mike, makes me a little more confident about going forward with the pump one of these days.

Judi said...

For Reyna - I sometimes feel the first bolus and it kind of hurts. In fact, in some places, a larger bolus will be a little painful each time, but not enough to remove the site. And the site is never bad, just for some reason more tender.

Jess said...

happy pumpaversary, mike! :)

i love how we make up so many new words! my 14th pumpaversary is coming up in august. based on your math, i've done about 1400 site changes, though it's likely more.

congrats on the milestone, bittersweet as it is.

Jeff said...

This year marks 10 years for me, too. I can't remember exactly when, but it was sometime between the first of the year -- a few months after I pestered a fellow PWD/classmate about her MM 508 -- and late summer. I wish I could remember the date, since it made my life so much better.

Crystal said...

Awesome!! Happy Pump-A-Versary, Mike! :-)

shannon said...

happy pumpaversary! thanks for the detailed description of what you go through.

Hallie said...

Happy Pumpaversary! THanks for sharing this. I love the pump. It's been a life saver for us, for sure. But it still makes me a little sad. 1,000 site changes... 1,000 needles. Ugh...

ninnifur said...

Congrats on 10 years pumping! You started pumping just a month after I was diagnosed :) June was 3 years pumping for me!!! such a newb compared to you! Then again your diabetes is older then me and we are not even that far apart in age!!! :) Congrats!!

sbo said...

thank you verry much
sbo
sbobet