Life in LADA land

Living Philippians 1:6 with type 1.5 diabetes

Week One

I am a week into this pump vacation. So far, so good.  I am finding that overall my blood glucose levels are less erratic. I’m not wild about injections, and I now remember why I found the transition to a pump so joyful!  But there are some benefits to this regimen and I am happy about what I am learning.  About diabetes and about myself.

So one thing I have noticed is that it is clearer to me what and how things affect my blood sugar.  For the past few months, it has not always been clear to me if highs were due to something I have done, something in my environment or something wrong with my pump or infusion site. Now when my blood sugar is out of range, I can usually figure out what happened.  I find that things I don’t think are stressful are perceived by my body as stressful and my blood sugar goes up.  Sometimes dramatically.  I can see much more clearly how physical activity affects me – and how fast my blood sugar goes down. Sometimes it will rebound on its own, sometimes not.  I know better how long it takes insulin to get to work after I inject, and so I can try to time my doses before meals so that the spikes after the meal are not as big (this is an art, not a science though, and my best laid plans often go awry…..).

At the same time, I have been working on not being so dependent on knowing exactly where my blood sugar is at all times. I have consciously been NOT looking at my CGM unless something feels wrong.  This is hard. It was a challenge given to me by two people that I trust and respect dearly, and I took the challenge seriously.  I have been obsessing on data. Yep, I said it out loud.  I have been much too occupied with trying to control my blood sugar so tightly.  Being off the pump is a good opportunity to do this, because I am less tied to technology.  And, because the pump can dose much smaller amounts of insulin than I can do by injection, I would literally micromanage my blood sugars.  I can’t do that now. I can only dose in full units of insulin, and since 1 unit drops my blood sugar 50 points or so, I can’t afford to do that unless I am far above my target BG.  I have less control. And that is a good thing for now. I am learning to relax a bit about this. Really.

My plan is to stay off of my pump for another 3-4 weeks at least.  It is inconvenient, and sometimes it hurts to inject.  But it is what I needed.  I love the technology we have to manage this disease and I am really looking forward to the changes that are coming in the years ahead.  But I need to learn to use it wisely and not let it rule my life.  I think I am beginning to put things back in the rightful places in my life. Kerri Sparling says ‘Diabetes doesn’t define me, but it helps explain me’.  I want that to be true of me as well. I think it was beginning to define me. That is NOT where I want to be. I’m getting back to letting diabetes just be one part of who I am, and not a controlling part of me.  I am very thankful for that.

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Pump vacation

A few days ago, I decided to take a vacation from my insulin pump. This is something my CDE has actually suggested before, but I had never been willing to do. This time it was my idea (well, mostly.  Ok, partly).  I have been having a lot of unexplained highs and lows (at least, unexplained by me) and have felt like the problems have often been with infusion sites (where the pump tubing meets my skin…), or perhaps with problems with the pump itself.  I have found myself spending a lot of my mental energy on figuring out why I am low or high and what I should do about it (Wait? Treat? Change the site? Hit my head against a wall?) and finally I have had enough.

A pump vacation, in case you have not figured it out, is simply removing my pump and going back on  insulin injections (Shots. Yeah, fun stuff).  I can never take an INSULIN vacation, not with a broken pancreas.  Having worn my little pink friend for 5 years 24/7, this has not been the quickest of transitions. I still reach down to look at the screen for information (I have actually been using my pump as a watch since my watch battery died about six months ago….) and there’s nothing there!  It took a few days to transition off of the basal insulin from my pump while the injected stuff reached equilibrium.  And I miss some of the features of my pump, like using it to calculate how much insulin to take for meals or corrections of my blood glucose, or for knowing how much insulin is still active after a dose.

But mostly it has been positive so far.  It is really nice that when I give a shot of insulin, I KNOW it has gone in. The new long acting insulin I am using seems to be doing a great job of keeping me fairly steady between meals, though we will see if it needs some tweaking overnight.  I am pretty surprised that I don’t miss my pump.  I thought this would be harder.

One reason for the ease of the transition (and one of the reasons I took the pump vacation in the first place) is that I was so frustrated with how I was dealing with the highs and lows. My emotions were on a roller coaster, completely controlled by where my blood sugar was.  High? Angry and obsessed with bringing it down. Low? Hopeless and tired of having to deal with it. I don’t like being controlled by my emotions, and needed to do something to break that cycle.

So here’s the question. When I put my pump back on (and I will, no doubt about that), will I be able to control of my emotions and not get so worked up about the numbers? I honestly don’t know.  I think it is going to take some serious thinking and praying to realign my thinking.  I was getting to be in a bad place, one that was distracting me from the things that are truly important.  I don’t think it is an accident that this pump vacation has come at a time in my life when my prayer life is more consistent than it ever has been.  More about that in the next installment.

So, we will see what the next few weeks will bring. I don’t know how long this vacation will last.  A month at least. Maybe longer. Long enough to root out the discontent that has developed inside me and see if it can be replaced with something much, much better.

 

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