Wednesday, July 25, 2012

Pump Vacation

This summer my family and I took a vacation to Southern California.  We planned to camp on the beach for 8 days and 7 nights.  Every day was spent at the beach, and every night sleeping in a tent.  This is actually a family tradition I've been doing my whole life.  I knew what this kind of trip entailed and I decided that I'd like to go ahead and take a vacation from my pump while camping at the beach.

I spoke with my nurse practitioner at my last appointment a few weeks before my trip about going on a pump vacation.  She wrote down my dosages, my conversion tables, and instructions for switching off of pump and back again.  She gave me samples of insulin pens so I didn't even have to fill a prescription.  I felt perfectly prepared for leaving my pump at home and taking my insulin pens and needles.  

I was really looking forward to going off the pump because everyone needs a break from it now and then.  I also knew that this vacation would be a LOT easier without worrying about my pump, my site, where to clip it while at the beach, changing sites, sand, sun, heat, water, etc. It was also a whole lot less to pack, I realized.  I only took my meter, extra strips, 4 insulin pens, 1 extra vial of insulin, insulin pens, and a few syringes.  Usually I haul insulin vials, infusion sets, reservoirs, setters, test strips, and my meter- lots more bulky.  

We left for California on a Friday night.  On Thursday night, my pump ran out of insulin.  So, I decided then was as good a time as any to turn off the pump and switch to MDI.  I waited for bed-time, took off the pump, turned the batter around, and took a 35 unit injection of Lantus.  Friday morning, my sugar was quite a bit higher than it should have been so the next night I increased to 37 and eventually up to 40.

I quickly realized that the computer at the doctor office had a 1:20 lowering dosage when I usually use 1:33. So, I was coming down too low after corrections.  I adjusted that to 1:33 and it wasn't quite enough so changed to 1:25 and that worked out okay.

My meal dosages were working out okay.  I noticed that I was significantly more aware of my carbohydrate counting and intake, especially at snack-time.  I had purposefully packed some low-carb and no-carb snacks for our trip.  Many of you know about my battles with weight and my attempts at calorie counting and dieting.  On the first of my summer vacations, where I spotted another pumper in the wild, I gained 5 pounds in 3 days.  With this vacation being 8 days, I did NOT want a repeat of our last vacation.  I worried quite a lot about gaining weight and I think that injecting helped me manage my portions and snacking pretty well.  Don't get me wrong, I ate like I was on vacation but I tried to keep it in check.  I also made sure to stay active walking, hiking up the beach stairs, swimming, riding bikes, boogie boarding with the kids, and just chasing the kids around during the day.

Despite all of my efforts, I struggled with SEVERAL high blood sugars.  I saw numbers in the 3 & 4 hundreds every day.  It was frustrating.  I was doing everything I could to get them under control, and keep them there.  But, no matter what I did, they still seemed to be out of control.  Even though it was so nice not WEARING my pump, worrying about a broken belt clip, or where to hook the thing while wearing a swimsuit, I looked forward to coming home and putting my pump back on.

I have to admit though, I wish I had played with the numbers, ratios, and dosages a little more to get it REALLY right before going off.  However, I knew that I had to get my numbers back under control and FAST.  So, the first night I was home, I threw my pump back on and skipped my Lantus dose.  I knew I'd go low during the night.  And I did.  But ever after, my sugars have been much better and I feel oh, so much better too!

I'm not sure what I would do next time.  Maybe I'd try wearing my pump at the beach, maybe I'd try being more aggressive with my insulin pens.  I'm just not really sure.  I suppose I'll cross that bridge when I get there.  I'll weigh my options, perhaps revisit this blog entry, and make a decision.

PS: my first weigh-in post vacation was minus 1.2 pounds.  I couldn't have been more thrilled.

Pump free me teaching my son how to boogie board!

Wednesday, July 18, 2012

Pump Spotted in the Wild

I went out of town with some friends for a long weekend.  One night we went to a pizza restaurant where an interesting chain of events occurred.  As we were getting ready to pay our bill, we noticed the man in front of us was having difficulty paying his bill.  We decided to go ahead and pay it for him. We anonymously spoke with the manager and offered to pay the amount for his meal.  As we were standing there, I noticed that he had a clear tube coming out of his pants pocket.  Sure enough, he was a pump wearer, spotted in the wild.  The longer I watched him, the more I realized that he may be experiencing a low blood sugar.  His movements were slow and lethargic, his speech was slurred, his thought process seemed labored.

The more I thought about it, the more compeled I felt to do something about the situation.  So, as we exited the restaurant and made our way to the parking lot, I told my friends that I wanted to confront him about it.  I walked up to him and began in with the small chat about diabetes.

"Hey, I noticed you have an insulin pump."  "I'm diabetic too, how long have you had diabetes?"

He was still acting strangely.  Told me that he was from a small town about 70 miles away.  He mentioned he'd had some meet-ups with other diabetics but hadn't done anything in a while.  He also mentioned that he had a daughter in the NICU up at a hospital in Salt Lake (about 350 miles away).  Side note: a friend of mine who was with me on the trip works at that same hospital treating infants. I began to feel sorry for him.  He seemed quite down on his luck.  I hesitated, but he had a young child with him, and I wanted to make sure he was safe, so I asked him if his blood sugar was low.

"Do you think maybe you're low? You seemed a bit shaky back there."

He told me that he didn't have a meter with him and that sometimes his meals were metabolized quickly but that he didn't think he was low.  I offered my meter and suggested that he test.  I asked him probably three or four different times and ways if he would like to test to see if he were low.  I figured that maybe he was just a little tired and that he probably knew that he was okay, although I really wished he would have tested with my meter.  He had a box of leftovers with him so I suppose if he thought I was right he could have finished eating that on his trip home.

We parted, and the more I thought about his actions, the more convinced I became that he was experiencing a hypoglycemic episode.  I did all that I felt I could have though, to encourage him to test and treat the low.  It was quite the experience and I don't think I'll soon forget it.  I'm not sure there was much more that I could have done for him, but I wish that I had insisted that he check his sugar, or offer him a juice (which I did not have) or SOMETHING more.

I'm not sure what the moral of this story is... but it was definitely an interesting spotting of a pump in the wild, so I thought I'd share...