Taking a Pump Vacation

For many people, the pump has been the most exciting invention since insulin!  I remember as a kid going to summer camp and watching a counselor fall into the lake and leap out almost as fast as he fell in!  He had been wearing an insulin pump feared that he had killed the pump.  But with a hair dryer, the pump sprang back to life and disaster had been averted in the Maine woods.

Watching that experience gave me hesitation about wearing a pump.  I love my active life and worried it was not appropriate for me. Plus, in those days, the pump was the size of a briefcase.

Then 5 years ago, my certified diabetes educator (CDE) felt my life would be much easier with a pump. My A1c hemoglobin was 6.8 and she thought it would ease the 6.8 A1c down to 6.5 or lower. The bolus wizard would make carb/insulin ratios easier to manage and the myriad of bells and whistles would streamline my management into tight control.

But, that hasn't been the case.

In 3 years I have had 4 pumps. Two of my pumps ate right through batteries, one simply stopped working and one kept sending a "no delivery" reading.  In each case, Medtronic was awesome at getting the replacement pump to my door in less than 12 hours.  Then, there were issues with canula and tubing leaks.

The canula itself was another issue.  I would bend the plastic needle and get a "no delivery" signal from the pump when I would use the quick set in my stomach.  I tried the silhouette, but found that the holes took a long time to heal.  Only recently have I tried a canula called the sure-T.  It is a metal needle instead of a plastic tip and I found that I could use it in more places on my body. Eureka, the right canula for me!  

Last Monday night, I started a new quick set and reservoir.  By Tuesday morning, my blood glucose was in the high 200s and by 11 am it was in mid 300s.  Not really knowing the cause, I increased the basal rate and waited. By 4 pm, I started having chest pain and I pulled out my bg meter to check - it was at 480.  I was stuck at the office for another hour, so I increased the temp basal to 100% and worked on my last client of the day.  When I got home, my blood sugar was down 260 and I assumed what I was watching had been hormonal or something within my body.  By the next morning, though, my blood sugar was back up to 380.

I finally disconnected the pump from my body and ran my hand along the tubing.  Sure enough, there was a leak.  Leaks are often hard to detect because the amount of insulin passing through the line is so small that a leak is not a drop you can see.  You have to feel it, and sometimes it's even harder to know if the little bit of moisture is from your hands or the tubing.

Because of the high blood sugar, I was not feeling great and I decided I needed a vacation from the pump.  I have not been able to get my A1c below 7, it has been stuck at 7.2-7.5.  I have felt frustrated more than I have benefited while wearing the pump.  Both my endocrinologist (endo) and my certified diabetes educator (CDE) had supported my move to have a pump vacation.