My Pump Story

by Jason Glass jasonglass@sbcglobal.net

After 22 years of being controlled by Diabetes, I made a change in my diabetes treatment and now I have taken control over it.

I have always waited for a Magical breakthrough curing diabetes. The technology is so close to developing a cure but still so far away. I was starting to worry that the next 22 years may not be as forgiving and complication free. After all my grandfather lost a leg and later his life to this disease. So after being challenged by my Dr. to obtain a 6% Hemoglobin A1c to avoid future complications, I took her up on the challenge.

My regular two injections and strict diet would yield an 8 to an8.3% A1c. No matter what I did to try and lower it. I would start going high in the late afternoon and also in the middle of the night. My Dr. mentioned some new insulin types and more injections to lower my A1c levels. (I was unwilling to take more than the two most of the time painful injections each day after 22 years I was about to get tired of them) With my resistance to more injections she mentioned the insulin pump. My first experience with a pump was in the mid 1980's at a diabetic ski camp. Technology was not what it is now and the pump was big, used a needle in the skin and used regular insulin. Not too much of a benefit in my mind after all, my goal was to be free of needles. With injections the needle was in and out, but with the pump the needle was always in. That was my view of the pump for 20 years.

While trying to lower my A1c a buddy called me and told me about going on the pump. He was very excited, hopeful and encouraging. So now I have looked and thought about it twice now in the same year! I am a technical person so I looked into the pump and what all the excitement is about these little pager sized apparatuses and what they could offer. Needless to say I was very impressed with every bit of information I gathered. I even ordered and read the book Pumping Insulin 3rd edition and gathered a wealth of wonderful diabetes treatment information. Re-learning about the good and bad issues of this lifelong disease made me realize the seriousness of this disease and what can be done to overcome it and live a long and healthy life.

After much internal debate I decided to give the insulin pump a try. I signed up and got 'hooked' up on January 24, 2002.

Wow! After one month on the pump I got my Hemoglobin A1c results back... 6.5% average blood glucose level was 130. Awesome!

That is the short of the story. Keep on reading for the unfolding events that allowed me to come to this conclusion.

Jan 24th, 2002 I went in to my pump trainer, having taken the first dose of Humalog, fast acting insulin ready to test the water! (No backing out now—and I am 'Pumped' up about this whole thing.) The hardest part about getting to this point was the emotional struggles of making a change with something I was comfortable about. (Even if the results were less than perfect) I mean after all something is going to be attached to me 24 hours 7 days a week. Wow!

After some explaining my trainer says to hook it up. First problem. The received the wrong cannula tube (now a small tube is place in the skin rather than a needle). I had ordered the short 6mm tube and was sent the 9mm tube. (I am too thin for the long ones). The trainer happened to have one short set available to get me rolling. So the first issue was resolved quickly. I go through the set up procedure and using the automatic inserter insert the cannula tube into my stomach. Actually there was not much more than a small sting. But I decide to try and pass out anyway. I did get light headed and started to sweat (most of this was to impress my trainer and prove to her that I was tough!)

We talked and set insulin ratios to start off with and then I was on my way, ready to go to the Burger place and try a nice big Bacon Burger and fries for lunch. I found out that a kinked cannula tube does not allow insulin to flow. I had done something wrong when I inserted the tube (hey it was the first time I was allowed to make a mistake) but now the problem was the fact that I had no more short tubes or insulin in my body. By 7:30 pm I had realized the tube was kinked and had to take it out and injected some insulin. I was about 300 and needed some insulin quick. I called my pumping buddy and he offered some short cannula tubes to keep me going. What a friend! After a quick trip to his home I was back in business. This time I got the cannula inserted properly and it was completely pain free. The first try seemed to be irritated because of the tube being kinked, the next try was wonderful, no pain!

The following several days were spent figuring out how much insulin was required for each food item I was eating. Right off the bat I figured out that foods that were packaged and labeled as to the amount of carbohydrates it contained made it easer to determine the amount of insulin needed as compared to home cooked meals. So far pretty good.

My emotions were very mixed at the beginning, everyone would ask how it was, how I liked it etc…The first week I was still really excited about it even with several no delivery alarms and miscalculations, it was OK. The second week I was in a foul mood and wanted to throw it as far as I could. Mainly due to my coming to grips with the fact that I actually had diabetes and it is a 24hr thing to work with. With shots I could take a shot and appear normal the rest of the day and almost forget or pretend to not be diabetic. With this thing attached to me I felt a bit different I was reminded of it all the time. I even started wearing pajamas to bed at night to have something to clip the pump on to. I am very glad to report that by the third week I began to enjoy the pump and normal blood sugars regularly. I wasted no time in testing this out with a Mr. Goodbar or a plain glazed donut. It is such a new and great feeling to be able to eat these things and never see my blood sugar go over 120. Nearly all the frustrations I had were mainly due to my emotions and attitude. It just took some time to get used to having this new 'friend' with me always.

I did figure out in the first week or two that you must take up the slack on the pump and syringe by priming and also prime it once you insert the cannula tube. I found this out by jumping up to the low 200's several time. Now I even bolus a tiny bit after unhooking for showers etc.

The funniest thing (Now) is how I felt the first two and three weeks with the pump. I can remember laying in bed and being very still and sleeping very light so I would not roll over on the cannula tube in my stomach. It was if I were sleeping with a full length cast on my leg or a body cast! I am glad to say that is a thing of the past and everything is just as normal as it was before and I even like pajamas now!

After two months I must say that you could not pay me money to take shots again! It was one thing to take two shots each day, that alone was bearable. But to have poor results-high blood sugar levels while taking the shots was another thing. In all honesty I was VERY reluctant to even think about the pump, the second week of wearing the pump I even took it off one night and went to injections because I thought I had enough. That did not work any better so I sucked it up and put the pump back on and have never looked back since.

Now that I have been on both sides of the fence (injections / pump) I clearly see huge differences. I cannot say enough about how wonderful the pump is and un-complicated my life has become because of the pump. It is completely amazing to see continual blood sugar readings under 140 and usually lower than 100. Even after a candy bar! I had the lovely opportunity to be sick with the flu and again with a head cold. During this time I adjusted the pump and my blood levels stayed normal. Never did that happen before.

My mind set was the only thing that had to change and become satisfied that this was the best way to treat diabetes. I have spoken to several diabetic friends about considering insulin pump therapy. Each one of them has had the same initial reaction that I used to have and wrinkled their nose at the thought of this. I thought I could never do the same things I did with something attached to me. It seems crazy to me now to even think back and say that this would slow me down. I feel great, and I do everything I used to do with the most minimal reminder that I have a pump on my body.

I now get up in the morning and test my blood sugar and get dressed and go eat breakfast (if I want to I can skip or eat later) and go to work. NO shots. When I want to eat lunch I take off when I want to and eat what I want. Dinner can now be at anytime of the evening or can be skipped. I can control when and what I want to eat now that I am on the pump.

Well to keep the long story short- The pump is great! There are a few little bumps in the road to work out but with patience and determination and encouragement for someone already pumping they are very small bumps in the overall picture. If you or someone you know were even considering the insulin pump, I would strongly encourage you or them to get on the pump. From my experience, the quality of life will be better.

Update 11-6-04

Some notes:
The glucose range setting was tighter on the pump than on shots. The blood glucose range for shots was 70-150 and for the pump I changed it to 70-140.

the glucose range setting was tighter on the pump than on shots. The blood > glucose range for shots was 70-150 and for the pump I changed it to > 70-140.
BG's on shots, click to enlarge
BG's on shots: PLOT
BG's on shots, click to enlarge
BG's on shots: HISTOGRAM
BG's on pump, click to enlarge
BG's on pump: PLOT
BG's on pump, click to enlarge
BG's on pump: HISTOGRAM

Sincerely,

Jason Glass

My Endocrinologist is Dr. Diana Kennedy
My Pump Trainer is Kim Boaz


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