Pump Hiatus

Woo hoo! (Feeling excited but maybe guilty too)
In early February my dd “sweetstuff” decided she wanted a break from her insulin pump. Trying to convince me she used the idea that she would have better control with shots because she wouldn’t have the freedom to eat whatever/whenever. As a mom (who knows everything) I knew it was more about her feeling different at school and the fact that an insulin pump does not go well with skinny jeans and tight ts. I didn’t call her out on it though. I supported her choice to encourage diabetes ownership.
For the last 5 weeks she managed her diabetes with MDI (multiple daily injections). She has done fairly well overall. Although, she treated the shots like she did her pump – she had no qualms about dosing for snacks in between meals. (So much for better control due to decreased snacking) She purchased an application called “RapidCalc” from the app store. http://www.gilport.com/rapidcalc/index.html
Honestly it was a great application. We programmed it based on her carb ratios, insulin sensitivity factors, and target blood sugars. It basically did everything her pump did except deliver the insulin of course.
The problem was of course the Lantus (long acting basal insulin). She started off with 10 units and hovered in the upper 200s each night. We increased to 11 units and still she was in the mid 200s. We increased to 12 units and that put her in the 60s. We were using the Lantus pen which only dosed in whole units. No problem, we switched to syringes and dosed 11.5 units and she was in the upper 100s low 200s. (We used each dose for 4-5 days prior to making a change)
Using the Lantus worried me – flashbacks to the months post diagnosis for both my kids left me in a constant state of worry. Both of them would be in the 40s for 4-6 weeks after diagnosis at the wee morning checks despite constant reductions in Lantus. (Honeymoon??)
The pump was such a blessing for both of my dear children. Being able to reduce/increase basal as needed made a huge difference in control and allowed for much needed sleep for me. While using Lantus I checked blood glucose multiple times during the night – never allowing myself more than 3 hours of sleep in between checks.
So a few nights ago after reading a post by Kerri S. www.sixuntilme.comregarding a stranger in the airport in which Kerri discussed her pump, my dear Sweetstuff decided she wanted her pump back. It likely also had something to do with me suggesting she might actually have better control using her pump and thus decrease the chances she would develop complications much later in life. (Disclaimer – I know a number of pwd that successfully use MDI and have excellent A1Cs – without the extreme highs or extreme lows but those that I know are also very disciplined in that they eat low carb meals, don’t snack, and exercise daily.) That does not describe my daughter. Like most 12 year olds she loves carbs, hates exercise and loves to snack too.
So that evening she said she wanted her pump back. We had already dosed her Lantus that night so I suggested she sleep on it and think more about it in the morning. I didn’t want to feel as though I coerced her.
The next afternoon she asked if I had figured out her basal programs so she could start the pump again. I actually had not. I had written them down when she gave the pump up – knowing that after 24 hours of being off the pump would reset itself and I would lose the programs. In my lack of organization I had misplaced my note (is that irony? – I have the hardest time understanding what is actually ironic – Alanis Morissette got me all confused with her song)
Late yesterday I found my note. She had asked me a number of times in the interim if I had found it. I replaced the pump battery, programmed it (wishing I had loaded insulin first so the dang thing would quite alerting me to lack of priming and causing me to scroll through the menu options a half dozen times). I loaded insulin and waited until her normal Lantus dose time to invite her to put an infusion set on. She seemed excited – like she had cleaned her room and found an old toy that she had misplaced and forgotten about.
We put on the infusion set and connected the pump. Then we both realized that the last low profile clip we had was broke (those dang things last just over the 3 month warranty mark). We did have a rotating pump clip. (I actually have 4 – we were asked by Animas to try them and report back – I really should do a blog post regarding them.) She was not excited about the rotating clip (reasons to be explained in future blog post). Thus, she chose to wear her spibelt instead. (Love our spibelts. http://spibelt.com/?gclid=CMqIyLb08K4CFQK9tgodVgT3Kgfor those that are not familiar with spibelt – they do have diabetic specific belts that have a pass-through hole for insulin tubing.
Sweetstuff’s bedtime check was 168 but she had eaten a fudge bar an hour or so earlier and still had insulin working. Her 3am check was 104 (woot woot) and her morning check was 122. I could likely increase her 3am basal dose by a bit but I’ll wait a few days to be sure.
I feel so much calmer with Sweetstuff back on the pump. I hope she doesn’t regret her decision tomorrow when she returns to school after the last week off (spring break). I also hope she doesn’t resent me and feel coerced back on the pump.
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