Monday, April 28, 2008

The comfort of a needle...


An interesting revelation was had earlier this week.  Cadence has had a cold/ear infection/ eye teeth coming in...you name it, this week has been one for the books.  Lying in the weeds, there is always the "D" and the sugar irregularity that comes with illness and irritability in a toddler. Is she high, super high, or low?  Those are the questions we ask.

It brings me back to my original point about revelations.  Parents of diabetics...scratch that...diabetics in general should not be too quick to switch to pump therapy, meaning that spending the first few months, let's say 3-4 months if we need to pick a number, is very important.  An about face?  No, just a realization that the time that we spent jabbing our baby with 6-8 needles per day, soothing the crying afterward taught us how to be strong, resiliant, and competent diabetic caregivers.  We have a keen understanding of how insulin works on our daughter, we are not afraid to stick her with a needle if needed, no matter how hard she fights.  That's a unique skill and not one to be underestimated.  Not convinced?  Ask someone on the street if they would be willing to give you an injection, would you trust them to do it for one?  Number two, would they be willing to give you a lifesaving injection?  Social experiment time.  

I know from our situation, the answer to the latter is probably not.  We have people close to us that refuse to learn how to save my daughter's life.  It makes you scratch your head asking why, but then again perhaps it is just how anyone else would behave.  Who wants to give a needle to someone?  Is it unreasonable then for us as parents to ask for help?  Is our wish for a couple hours off of diabetes forcing someone else to enter into an extremely uncomfortable situation? Are we being unfair?

So, the pump is absolutely awesome in the sense that it takes away the injection side of diabetes, which solves the social experiment.  It can provide very finite control, and offers immense lifestyle flexibility.  We celebrate those parts of it every day.  I hope that most Type one diabetics, when they are ready take this step toward normalizing and enhancing your life.  What the pump adds however is the uncertainty of the equipment, did the infusion site work, is the pump working properly, is there air in the line (we had to prime out bubbles twice today)?  Combine the unpredictability of diabetes and you can quickly begin chasing your tail if you don't remain centered.  With a needle, you always know the insulin went in.  

That is the comfort of the needle.

b.




Thursday, April 17, 2008

Pumping - a 2 week check in


What a whirlwind that last 2 weeks has been for our family!

Cadence began pumping on her Animas 2020 on March 31.  We started on one basal pattern and then went from there.  There's been alot of tweaking with her Insulin to Carb ratio (how many carbs 1 unit of insulin will cover), her Insulin Sensitivity Factor (of which I have no idea how they calculate), and of course the basal rates (how much background insulin she gets during periods of the day).  

Four days into the pump start we started getting some highs, it turns out that Cadence picked that week to get a cold and pinkeye.  Fun...not.  So we rode the high sugar express for the next 5 days, threw out any hope of dialing in our pump settings for that period in time and just wiped the nose and soothed the cries.  It was like real parenting!

After the illness was over we are back to the adjustment of no needles.  That being said we still have to put in Cadence's infusion sets every three days.  An infusion set (in our case) is a spring loaded needle device that puts a flexible plastic tube under cadence's skin with a port/interface above the skin which we attach her pump tubing.  It's pretty slick and easy but there is more involved with it than a regular injection.  Numbing the site, priming the pump, mixing new insulin, etc. etc.  

We've worked out a few kinks in the system as well.  We had an infusion set go bad on us one night and Cadence's blood sugar shot up into the 20's (VERY high), so I had to give her a needle at 3am one night to bring her sugar down.  So, the no-needle streak lasted 6 days, but was also the last one I've given since.  

One of the hardest adjustments to the pump thing is where we put it.  We bought a bunch of tank tops from Pumpwear, which are simply a little pocket on the shirt to hold the pump.  That covers the daytime hours, the night time is the weird one.  We can't figure out exactly how we want to have the pump on Cadence at night, leave it loose?  Drop it down one of the legs of her pajamas?  Pump pack?  We're trying everything out,  One night Nic went to pick her up out of her crib and the pump was wrapped around one of the bars and "rip", out came the infusion site (ouch).  Cadence was unimpressed and irritated by that.  Luckily, on a tip from another diabetic, we left the old site in for a few hours "just in case", no we reconnected and changed the site again in the morning.  GREAT tip there.

Overall we are loving the pump and Cadence's control seems to be better.  Lots of tweaking to be done still but as I've said before, I can't believe we waited this long to go this way.

b.