Blog Entries With Tag: infusion


Posted: Jul 29, 2014

Well, recently that hash tag statement went abit wild on Twitter and other social media areas.  Mainly I think due in fact to Ms. Idaho’s recent win – and showing off her insulin pump proudly (wonder if she has a name for hers like I have always done with my pumps?).

This past weekend I was sailing with some friends on Jenna’s Journey.  I decide to be brave, and show off my pump after I’d had a splish splosh in the water (I no longer wear my Animas 2020 aka George Michael in water due to trying to keep him functioning as long as I can, as he no longer is under warranty).

So, viola …. here I am poising with him clipped onto me after I came back on board (well – clipped back on about 1 hour later I REMEMBERED that I had to reengage him).  I know …. Bad, bad, bad.

One thing though, since having that picture taken.  George has taken a few dives of his own.  Off my body.  I’ve been using a longer infusion tube (36”) due to the fact I can stick him into my pockets of my button up front dresses, skirts, pants.  He’s easier to access to do calculations, etc.

Well, long tubing means, when he takes a dive, he goes plunk onto the ground.  For the picture above, I only clipped him on temporarily, but after that he was sitting "snug" under my rash guard, until I did something that made him plop out).  Twice on the weekend he went clunk, OUCH, onto the gel coat of our sailboat.  It sounded HORRIBLE.  I thought for sure I had killed him!!!

Of course, I examined him like I would a real life baby, checking for any cracks, etc.  Trying not to tickle him.

And to top it all off, last night, I remember having one dream of dropping him, and the casing cracking.  I think I woke up to that pretty startled, realised I was dreaming, went back to the land of nod.

A Child’s Garden of Verses” by Robert Louis Stevenson and illustrated by Dorothy E. Russell. Introduction and notes by Blanche E. Weekes  ©1928 by The John C. Winston Co.

So, just now, after having done an infusion change (with a 23” tubing for a change of pace).  I’ve now dressed him all up in one of the skins I’ve gotten over the years at Friends For Life events in Canada.  If he ever takes another plunge, at least he’s got that protection.  Much like we have for our mobile phones.

Oh – and notice – I’m back in reduced basal mode again?  This seems to be a common thing with me lately even with my weight gain, which should be reverse, you would think I need MORE insulin. Thank goodness for being able to do that with a pump as well as SUSPEND.

Now, if only I could get a royal blue colour for him …… Animas Canada ….. are you reading this?  Hint! Hint!

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Posted: Mar 7, 2014

It’s been a month now since coming back to Canada from what I think was the best holiday I’ve had in ages.  I’m still in the process of getting my thoughts together for a good travel blog on the experience along with going thru’ the 1,000’s of pictures both my DH and I took – but in the meantime – it’s back to business for blogging about what I do the best … diabetes … staying in control with it … using whatever method suits you best.

For myself, on this past holiday, I was determined to use the I-Port for all my rapid insulin shots that I take during my waking hours.  I average about 6 shots a day when using my rapid insulin for my meals and corrections.  The ability to not worry about where I last injected (yes – some people keep charts).  I’m lazy – too much work - using the I-Port – which is like an infusion set on an insulin pump (both devices to infuse are very similar) – makes it easier to give time to heal as you move the I-Port/infusion to the next spot.  It makes my life easier!

If I could have put my long lasting insulin into the same port – that would be great – but you can’t – according to the instructions.  It makes sense – since the long lasting insulin (Levemir / Lantus) – work at a different speed – so best to keep them separated.  So, for my regime of using Levemir during my holidays (x3 a day) that was fine (though the 6 AM wake up call for 1st of 3 shots – yawwwnnn – did I say I’m not an early morning riser???).

Anyway, the jist of my blog here is that … I had to ditch using the I-Ports into the 2nd day of our 14 days of sailing.  The reason why?

  • Heavy seas when sailing (we sometimes had waves of 12’ high) – a lot of movement – equals unable to get the needle into the rubber port  that you inject into on the infusion set – tres difficile.   Often I would just inject with pen needle the regular way – and forgo the I-Port altogether.  Sigh.
  • Lack of light.  You need GOOD light to be able to see the rubber port.  A few times when going offshore – the places we were going to – either candle light – flashlight – or next to no light at all.  The life of a boater – lighting is not always what we are used to in our homes that are connected to the grid.

So, I ditched using the I-Ports for the whole 3 weeks of my holidays.

And yes, I am back on the I-Port now back on terra-firma – still enjoying the pump break I’m taking for now.  Testing out Levemir once again – but only on 2X a day injections (sorry Doris - the 3X regime was too much like being a slave to insulin - all I did was worry about times, etc. - not my personal style of controlling my diabetes health - too stressful).

Sadly I only have 6 I-Ports left – and after talks with Diabetes Express / and Fay at Medtronic Canada – who knows when we’ll be able to obtain more.  Discussions are ongoing for distribution since Medtronic took over distribution from Patton Medical Devices in February.  It’s also very sad – when I hear from parents of kids who use the I-Port – and their not being able to get what they need (most kids use 6mm – as an adult – I use the 9mm – otherwise – I’d give the I-Ports to those that need them most).

Feel like discussing this in the forums? You can go check it out here - where I originally posted about the I-Port back in 2008.  It's not new - and many Americans don't know much about it. 

Meanwhile, back to dreaming I’m still living on water ….

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Posted: Aug 31, 2013

Thursday, August 8th, 2013 (excerpt from my diary)

I’ve been on holidays, so not keeping record of my daily diabetes regime (what works / what doesn’t – the roller coaster ride of diabetes … right?).  I’m back home now – heading off on last bit of holidays for 1 more week after 2 weeks of sailing in the 1,000 Islands.  My next part of holidays – road trip (e.g. The Antidote in Northampton, MA – bit of a coastal break in a B&B). 

I experienced on the 2nd last day of my sailing adventures – something I’ve not had happen since I was in 12 or 13 years old (my memory of when this exactly is kind of not the greatest – I guess it’s one memory I like to forget about – as I’m not proud of it).  I had my 2nd DKA experience in my almost 50 years of having Type 1 diabetes.  The last time – it was a slow forming DKA – I kept on getting sick with “flu” – or so we all thought – remember – this was the days before BG meters and various insulin formulas better suited to each individual.  You had what you had back than (this is in the 70’s) – depending on your economic situation.  I also had been given the “golden key” by my parents at what some parents today would consider very young – to handle my diabetes on my own.  My parents “trusted” me that I took my insulin, tested my urine, was honest …. Hmmm – yeah sure.

So, all I know is, with that first DKA episode, I slammed myself into a coma. I have broken memories of being taken by car, whizzing along the highway, the lights blinking on/off (this was at night).  We all went, EVERYONE, to the ER.  After that, I don’t really remember too much, I was in/out of consciousness over the next few days – remembered the nurse trying to find a vein to hook me up to saline probably, and then there was the cute doctor.  How could a young teen not forget a cute doctor who was trying to figure out WTF this silly girl had done.  I’d actually been over almost a year – not been taking good care of my diabetes.  I wasn’t in denial – I’ll never really know what I was going thru’ –  I was just like any teen – just with a little health problem – that buggered things up. 

Now fast forward to 2013 … after a rather hectic sail in the “Forty Acres”  (we jibed – things got abit crazy in high winds, chopping waters, I was ready to divorce my sweet DH, yadda, yadda, yadda – it’s a normal thing I’ve been told amongst other women wives who sail with their bespoken).  We decided at that point – to tuck our tails in between our legs – and motor back to safe anchorage.  Let’s just say, I needed a stiff drink once we got settled off of Endymion Island.

Time to change infusion set just after dinner – and I was all set.   I’ve been using either the Inset II (preloaded plastic cannula unit – very easy to use) or during the silicone allergy I had with the Inset’s – the plain ol’ Contact Detach.   I chose the Inset II for a change of pace – and all went in well – until I tested just before bed time.  I was REALLY high – 18 mmol/l (324 mg/dl).   I’d not had anything unusual to eat, so wondered if perhaps stress from that day was causing it.  So, I did a correction bolus, and retested an hour later – and I was climbing up – I was now at 21 (378) – I felt around the area – it didn’t feel wet – which would have explained something was up.   Test for ketones – and of course – yuppers – beautiful deep purple!  My next step was to take a correction shot – with the fear of the previous correction bolus and the shot making me go low – into hypo fairy land.  I could see I was in for a long night.  Meanwhile, DH is snoring away at this point, oblivious to what I’m feeling (at that point – I was feeling abit sick, thirsty (drinking lots of water), just plain yucky).  Set alarm for 1 hour later to retest – tho’ of course – what diabetic can sleep when facing this?  Next BG test – reveals I’m creeping up to 25 (450).  At that point, I realise it’s got to be the infusion set, but before I can do anything – I started to have horrible cramps – so I rushed off to our head (very tiny little place – to do your business in – you can’t be too big living on a boat I’m telling you).  Then it’s woosh out the backside, and now I’m feeling REALLY bad, and memoires are starting to flood back from the 70’s.  Like WTF????  Then next second – I’m rapidly turning around in the head – knickers down at my knees (Knees up Mother Brown playing in my head).  

Praying to the Porcelain Goddess I was – and it really hit me hard at that point – that things were not good.   I started to call for my DH (not hard to do – the boat is only 30’ long by about 10’ wide).  Though at this point he point was waking up – knowing something wasn’t right.   Later on, he was telling me he was ready to call out Mayday – to get a port nearby us – prepared with an ambulance or helicopter to airlift me.  Now, is that movie material or what?

I can jest about it now, but as you can see in the picture below, the cannula NEVER entered the skin, it basically got trapped sideways into the adhesive tape.  What still gets to me this day – is why there was no occlusion alert from my pump – I would have thought it would have noticed a problem – and the other thing that still mystifies me – but not worth the bother anymore – why the areas wasn’t wet with insulin.

Check my blog at Blogger - where I'll have more detailed pictures - due to inability to make them any larger!

Many scenarios go thru’ a diabetics head when this happens – with high blood sugars – insulin gone bad – you name it.  There are a few scenarios that goes thru’ our head while we try to be calm and figure out what to do.  For some, you might have headed to ER, in my case, it was abit difficult.


Long story short – in went the Contact Detach – and slowly over about 48 hours – my BG came down – tho’ it took almost a full week to get fully “normal” again – my system was that screwed up by this f-up with the infusion mishap.

Last week when I got back home finally, I did call up Animas – to tell them of the experience – since I noticed when I decided to try the Inset again that there was a similar sound I remembered hearing when I was pulling back the Inset II that evening.  Part Two will reveal what this "sound" is - along with some tips from the Animas Technician – who is also on a pump like ourselves– and how to avoid this type of this type of ordeal – which hopefully will help others like yourselves if you’re ever in this situation.

I don't want any of you feeling this way the next day after a fun ... NOT  ... night of DKA ... 

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Posted: Jul 18, 2013

When I first started to wear an insulin pump back in 2008, I didn’t realise that wearing one would restrict some of my clothing options.  Living in Montreal, the fashionista capital of Canada (okay – there’s Toronto – aka mini-me USA – but they just don’t have that French flair like we do ).

It was sort of nice since January, when I took a pump break, not to have to spend the extra time to pick out clothing that would not reveal a bulge of George Michael aka GM (pun intended there – remember – I grew up with Benny Hill) my insulin pump.  Now that I’ve been back on the pump for over a month now, I realise that I have to take extra time to figure out what to wear that will allow me easy access to George Michael.   Hmmm, should have I had added that time factor into my application for DTC?

I did the stint for almost a month of wearing the infusion set in my arms.  That was kind of neat – almost like I wasn’t wearing an infusion set except when I’d hit a muscle or nerve ending in my arm with the stainless steel infusion needle (found Contact Detach/Sure-T does this more than the Inset 2 sets). One thing I am going to try out if I can get some samples of shorter needle/cannula length for the infusion sets - just like I have done with the shorter 4mm pen needles I started to use back in April.  My absortion with the shorter pen needle created no change in my BG's - which I thought it would due to my not being a slim gal (as I had told the RN when she gave me some samples of the BD 4mm pen needles said skin depths for absortipon of insulin doesn't change in the human body).  Anyway, back to old GM, here  I was tucking him into a sports bra – where I couldn’t believe that despite how hot it gets inbetween the girls – the insulin would keep on performing 100%.  My fear, like other diabetics is that heat will deteriote our insulin – but after 3 days of using the same insulin in the cartridge – my blood sugars (BG) stayed stable.

Actually, stable isn’t the word I should be using here.  I’ve been experiencing hypos (low BG) more often - that almost reminded me of my days when I was MDI prior to going onto the pump (one of the reasons I went onto the pump in the first place was due to having frequent hypos.  I sort of didn't understand how to use my combinations of insulin properly pre-2008, I was trying to learn how to do the poor man's pump method - but not quite doing it correctly.  As I keep on telling pumpers who’ve never gone back to MDI since starting on the pump - being on the pump has taught me how to fine tune with ONE insulin and that with that knowledge - you can easily transferred over to using TWO insulins when doing MDI.  It really isn't that difficult - honest - you've just got to know how to use your insulin(s) - and their little quirks.

So, with the hypos I’ve been having – sometimes a few a day – the things I have planned to do – that usually involve some activity (even simple grocery shopping believe it or not) – have to be shelved.  I do NOT like to have my diabetes rule what I can or cannot do.  My poor DH has to put up with my having to tell him that I can’t do this / that – and he’s so far not really sad much – as I go “I’m so sorry, I’m so sorry” or “Get me some quick acting sugar NOW!!!”.  What a range of emotional outburst I put him through – that is so not me – that it makes me cringe if a fly is on a wall witnessing this (thank goodness they don’t have the ability to hold a video camera).

My basal rate has now been reduced by almost 20% - but I’m still needing to tweak it abit with some more basal testing since now I am going low in the afternoon (very rare for me).  If that doesn’t work and I’m still experiencing low blood sugars (hypos), then it’s looking at my carb ratio (I:C) – which I have slightly changed since I’m now understanding I’m insulin sensitive.  The other thing to look at is my Insulin Sensitivity Factor (ISF) - which to me is a trial and error type of test - since there are a few different formula's out there to deterimne what is best for "you".  

Ahh isn't diabetes control a fun puzzle or what?
 
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Posted: Jun 21, 2013

My tummy having a Contact Detach put into it
I noticed in a diabetic group the other day on Facebook - that some people have never heard of the stainless steel infusion sets that some of insulin pumpers use (Medtronic (MM) is a Sure-T, Animas is a Contact Detach, Accu-Chek is a Rapid D).  I know the ones made for Animas and Medtronic – are all made by the same company –
Unomedical.


For some people, giving an injection, with a syringe or pen needle, even with the smaller gauges available AND length of needles, TOTALLY freaks them out.  I can understand with what we had back in the early years of needles meant for elephants buttocks (wait – I was using them on my human buttock as a child – yikeroos).  Times have changed, thank goodness, it's easier to inject, but still some diabetics who have had this disease as long as I have, can’t inject themselves.  Putting a CGMS or infusion set into place on their body - they cannot do. I find with the Contact Detach I have no problems with placing into my skin (it is 29 gauge).  With other infusion sets available, I find the introducer needle that comes with the plastic cannula infusion sets very daunting.  I almost fainted the first time I put one in place, it was sooooo long, compared to the 6mm / 8mm length stain steel needle.


                             Image courtesy of http://www.traveling9to5.com/

To help some of you understand what one of these infusion sets are all about - since some people think the needle portion of the infusion set had to be removed from the skin - here's a great video of a young boy putting in this type of infusion set at this link.  He makes it look so easy (and it is - though watching him made me realise - how long it takes to do this procedure - as it's about 6 minutes from start to finish to perform the task).


Hopefully the video helps explain what a stainless steel infusion set is for some of you who don't know what it is.  Personally, I find it causes less skin irritation for me - as I have a slight Teflon allergy in the plastic cannula's that are used in infusion sets). The other good thing is, it's less expensive to purchase than other infusion sets.  Also, I find due to the connecting port that is on your skin (there is the infusion site AND the connecting port – both glued to your skin) – less chances of ripping off infusion set completely – it’s like a safety chain in a way.  I'd posted about the Contact Detach a few years ago as well - if you want a less model type figure to look at - then you can check out my blog that contains the link.


Contact Detach
The one thing I do have a beef about - and I'd mentioned about this a few weeks ago at Blogger - the cost of the infusion sets to Canadians (and those of us not living in the USA).  The price that we pay for the infusion sets shows quite a wide gap in prices.  For example, my Contact Detach here in Canada costs $155 - if I was an American - I'd be paying $94.  I thought it was perhaps due to our value of our dollar - but we're pretty close to being at par these days.  The price list as well - since I started pumping over 5 years ago - hasn't changed at all.  When I spoke to Animas Canada about the price difference today - Alexis - one of the staff there who took my order (and a pumper herself) - said that due to duty/tarriffs and our smaller pumping compared to the States that this is why we - and other countries pay more.  Huh???? I tried to figure out what the cost was to ship the product from Mexico - to United States - then Canada - but I'd have to have my brain go to school to figure all the ins/outs of trading between these countries through the Canada  Border Service Agency website.
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