Insulin Pump Set Change Process

Been a long while since I've blogged.  There's a lot behind that and I'm not sure how to get back "in to" it except for to just jump right in.  I may have written this before but I just don't like to focus on my diabetes all of the time.  I'm glad that there are diabetes blogs out there for others to read should they do so but I don't always have the head space to make it MORE a part of my day than it already is.  I'd rather focus on living my life as the normal person that I feel I am.  That isn't to say that I don't focus on taking care of myself because I certainly spend plenty of effort doing that, I just don't care to blog about it (or even talk about it) constantly.  You won't see much about diabetes on my Facebook page or on my family blog.  There is MORE to ME than just diabetes, diabetes news, diabetes articles, diabetes research... I am so much more interesting than all of that.. and again I don't mean that in a negative way.

ANYWAY, I have realized recently that there are some people who are interested, possibly curious, about my life with diabetes.  And that, I don't mind sharing.  I have lived in my new location for just about a year and many of the people I now associate with, my friends, don't know a whole lot about diabetes like some of my friends whom I've been associated with longer have already learned from me about my condition.  So, for their benefit I've been posting little snippets on my Instagram and Facebook.  When the reaction is positive, I tend to be more willing to share more... a little.

SO... Here's what I've recently shared.  It's nothing new.  It's stuff people who wear insulin pumps already know, but for some of my new friends, they were fascinated. They had no idea I could chose where I want to put my site, that I could move it every three days, and that I could wear my pump in any place I want to.  I wear my insulin pump on the belt clip and apparently in the same location on my waistband that one of my friends thought it was permanently in that spot at about four o'clock on my belt.

Without further ado, I give you the process of changing out the insulin pump set in a step by step post.

Going from right to left, top to bottom here are the steps of changing out my site- or my pump.

1. (not pictured) I rewind my pump, remove my old site and throw away the tubing, reservoir, and infusion set.
2. (top left) fill the reservoir with enough insulin for three days (300mL for me)
3. (top middle) attach the reservoir to the tubing (the little blue thing that's on top of the insulin vial in photo 1 is thrown away
4. (top right) I insert the full reservoir (now attached to the tubing) into the pump... I should have taken a different photo.
5. (bottom left) Fill  or prime the tubing by holding down the ACT button.  In this photo you can see 2.6 units being primed into the tubing.  I hold that down until it reaches about 14 units and then I see drops coming out of the needle and no air bubbles in my tubing.  Sometimes it takes more units and sometimes it takes less.  I like the longer tubing ( I think it is 42 centimeters long or something) so it takes a few more units of insulin than the shorter tubing but that length just works better for me.
6. at this point I attach the insulin pump- see next photo

7. This needle goes into
8. my arm, hip, or stomach (let's be honest, I NEVER use tummy sites- bad experience)
9. I pull the needle (blue piece and attached metal needle) out and the plastic cannula 6mm long stays inside of my body for the next three days.


Just as a bonus here's a BRIEF explanation on  how pumping insulin works.

I use fast acting insulin only mine is called Humalog but there are a few other brands and names.  I have programmed my pump with the help of my doctors and logging my blood sugars to meet the needs of my body without food or exercise throughout the day.  This type of insulin delivery is called BASAL insulin.  It is like my baseline.  So hypothetically if I am fasting all day long this is the amount of insulin I need throughout the day and night.
The second way I give insulin is through BOLUSING or a BOLUS.  I give a bolus of one unit of insulin for every gram of carbohydrate I eat.  So, if I eat a meal of 30g. of carbohydrates I need a bolus of 4.2 units.
To take it a step further, my pump and my glucometer (blood tester) communicate with each other wirelessly (blue tooth) so at a meal time I will test my blood sugar and the value gets beamed to my pump.  Then I count the carbs in my meal and enter my bolus.  If my blood sugar is high I need one unit of insulin for every 25 points over 100 mg/dl that my sugar is.  So... if I were eating a meal of 30 carbs and my blood sugar was 125 I would need 5.2 units instead of 4.2.
Conversley, if my blood sugar is low then I need a little less insulin.  So if I tested and my blood sugar were like, 65 then I would take about 2.2 units instead of 4.2.

Wow!  It's a good thing I know how to do a little math!  But don't worry because really my insulin pump has all of my own calculations entered and it really does all of the math for me!  ;) Maybe I'll do some screen captures and photographs of insulin deliver for my next series of Instagram photos.

PS: If you're still way down here reading this entire post you can look up on this blog for my tag "a day in the life" and see the series of posts I did back in 2007 for a more comprehensive look at my daily diabetes routine.  Not much has changed even though it's been 7 years, diabetically speaking.

Traveling with Diabetes

Below are my experiences in traveling with Diabetes. Recently, I moved to Singapore from the United States. I was in four air ports around the world. I have taken many flights previous to this journey whilst having diabetes. I've also been on road trips and have blogged about my pumping vacation last summer for a trip to the beach here: http://sugarfreesweety.blogspot.sg/2012/07/pump-vacation.html

Disclosure: I am not a doctor nor a TSA agent. These experiences are my own and as always, your diabetes may vary.

I've got SLC International Airport down to a science when it comes to wearing an insulin pump. But, I had never taken a year's worth of insulin across the world with me. So, I was a little bit worried about how that would all play out but it turned out fine.

I looked it up on the TSA website as well as asked them on twitter (and they responded!) about how to travel with diabetes supplies.  There I found out that I could indeed take a year's worth of insulin as well as the ice packs necessary to keep it cool on the 21 hour journey.  The website just said that I had to declare my insulin before putting it through.  Easy enough, I thought!

As I approached the security check, I told them that I had insulin and ice inside my bag.  The TSA agent asked that I separate them.  I pulled out both my insulin and my ice and put them in the totes provided and sent them through security.  I hid my pump under my shorts and easily walked through security. No issues and on to boarding.

The reason I choose to hide my pump is purely from experience.  The insulin pump has NEVER set off the alarm.  But, I've been leery of taking it through before, thinking it would set off the alarm.  A couple of times, while traveling through SLC int. I showed them my pump, told them what it was, and then proceeded through the metal detector.  Because I had shown them my pump, and NOT because it set off the alarm, I got the pat down.  As security measures increased, and full-body scanners, and full body pat downs came around, this process also involved an extensive full-body pat down.  Personally, I do not think a simple insulin pump warrants such treatment.  It is a medical device, OBVIOUSLY  a medical device.  It is also VERY COMMONLY worn and used by millions of diabetics in the United States. Therefore, I see no reason why a pat-down is necessary.  Especially when it doesn't set off the alarms.  The entire process would make me more and more frustrated and I just HATED the entire process. The ONLY positive side was that my husband had to deal with the kids, their shoes, coats, bags, the stroller, and whatever else our family of four was traveling with... for just a few minutes, while I was held up in security.  He usually had it under control by the time I finished and all I had to do was put on my shoes and follow them to the gate.

So.  One time when traveling to see the in-laws, I decided to hide my pump by wearing it clipped to my underwear (I ALWAYS wear my insulin pump with the belt clip) underneath my jeans.  No issues.  Whatsoever!  so... that's what I've done from now on!

But.. I digress. In San Francisco, we didn't have a lot of time.  So little, in fact, that unbeknownst to us, our bags didn't make it.  Security at the International gate at SFO was basically a nightmare.  It was HOT and extremely crowded.  The line was moving very slowly.  If we hadn't had business class priority, we probably would have missed our flight... maybe.  I followed the same procedure I had done in SLC but this time I made the mistake of ASKING the TSA agent whether or not I should separate my ice from my insulin inside of my carry on.  He agent told me that I did NOT need to do so.  And... of course, my bag was held up.  The boys' bags were also held up for some reason which they decided NOT to tell us about.  Damn those crayons!  ha ha ha.  Anyway, The woman on the x-ray side started chewing me out about not separating my ice from my insulin and I got right up in her face.  I was NOT losing my cool, but very firmly, and calmly, I said to her, "THAT is why I specifically asked about it.  I asked him, (pointing), right there, if I should separate my ice and insulin inside my bag before I sent it through the belt because they told me to do so in Salt Lake City and he told me that I did not."  "And that is why I ASKED SPECIFICALLY".
"Well," she responded "you should always do that."
"Well, that's why I asked" I told her again.
Eventually, our bags were all cleared through security and we were on to the gate at Singapore Airlines.

Our layover in Korea wasn't really long.  I think we had about an hour.  It was like 4:00 am our time and we all did very well with being awake at that time.  I have to give it up to the Koreans, their Incheon airport was fantastic.  Security could not have been easier.  It was 6:00 pm local time and there was no line whatsoever.  A nice man helped us all put our belongings into bins and carefully guided us though security.  No issues with the insulin, ice, or any other bags!  Quick, easy and so friendly.

By the time we made it to Singapore, we'd been en route for 21 hours.  My blood sugars did very well the whole time.  I did check them quite frequently, as recommended.  My insulin was still cold by the time we made it to our hotel and everything arrived safely... except for our bags.  ALWAYS carry on your diabetes supplies, even if you are taking a year's worth!

How to wear the pump

How to wear the pump: A Day in the Life

1. Hook the pump onto your pants, shorts, or skirt. I even hook it onto my pajamas. When I wear a belt, the pump doesn't get in the way as much because of the belt clip. I didn't take a picture of it on the belt, but you can "get the picture".
2. With a pump cover. I love this black leather cover. It has a hole for the belt clip to slip through and velcos over the front. It has clear plastic through which I can dial the setting buttons easily, and see though well. I have a few other covers, but I rarely use them.
3. To wear the pump inside your pocket, first you have to take off the belt clip, so it's not as bulky.
slip inside pocket
inside the pocket


4. The pump can also be worn when you are wearing a dress, but it is more of a pain. I used to wear it inside the front of my bra, but if the top is tighter, it looks like a strange bulge. So, I've started wearing it inside my pantyhose without the belt clip. They make fancy leg straps and stuff but I've never bought one. Usually, I'll just wear a skirt because it is much easier with the pump.

5. When you go in the water, you have to take the pump off. Like for bathing or swimming. Usually I just stay in the water a short amount of time so I'm not "disconnected" for very long.

It may seem cumbersome, but I've had the pump for almost 5 years now, so it's really no big deal and most of the time I don't even notice it, and it doesn't bother me. A lot of people worry that they'll have a "badge" telling the world they have diabetes when they choose to wear the pump. I don't mind. Most people don't notice it. Others are ignorant and don't know what it is. Those who do know what the pump is usually strike up a conversation with me, "so, how long have you had diabetes?" And I love talking with diabetics and their families. I'm not ashamed of my disease and I could talk about it (as you can see) forever. Maybe someday I'll become an educator- diabetes educator that is.