The one with the swollen arm

Last night, I had a milkshake.

It was on the tail end of an infusion set. Took a truly absurd amount of insulin, ate, and enjoyed. Once I got home, I changed the set. Put the new one in my right arm.

Two hours later, I was at 165. Three hours later, I was at 120. I had owned that milkshake.

But then, suddenly, I got a ↗. Moments later, a ↑. By the time I rage bolused, I was up to 180 something and still raising. The pump wanted me to take about .7U, because I still had some on board. But I know better. So I took 7.0U. Blood sugar continued to rise as it was being absorbed but I topped out around 250. A second smaller bolus followed. Fought for a couple hours and got it down to 170, and went to bed.

Couple hours later, Dexcom buzzed. I was back up to about 230. Took the appropriate amount (not going to rage bolus if I won't stay up to babysit it) and went back to sleep. Looking at the graph, it got down to about 180 and then started right back up. Next time I woke up was closer to 300. Again, a normal correction, and back to sleep.

Tangent: Not sure what the point of trying to sleep with bad sugar is. It's the least restful thing I can imagine. 3 Hours of restful sleep is better than a full night of sleep on the glucocoaster.

When I finally woke up for real, I was around 200. And my arm felt swollen. And I realized, it wasn't the milkshake doing it to me, it was the infusion site. So I replaced it. Of course the old one bled. But the new one didn't stick! Half of it adhered to my belly while the other half flapped in the wind. I pressed and pressed, and there was no taming it. So I took it out. And it bled. Quite a bit.

The third infusion set in 12 hours went in without incident. My sugar is finally nicely and predictably declining. It just took using extra extra supplies that I'm going to need in another couple months. And enough time to convince myself it wasn't at all feasible that the milkshake was responsible for it all.

When I had the Medtronic pump, there was only one type of infusion site. It was 23" long, and I could put it in my belly, butt, back or thigh (and I wasn't brave enough to put it in my thigh). Now with the Ping, I have 46" tubing as well, and I'm using body parts like my arms that I just didn't ever use before. If I were to use the Ping exactly the same as the Medtronic, it'd work just as well. But it allows me to try sites I wouldn't have used before and they're just not at all a sure thing. The occasional failed site on a Saturday afternoon is one thing, but a failed site that costs me a night's sleep and 3 infusion sets is much more frustrating.

Feeling discouraged

It was early 2007 when I got a pump, the Medtronic Paradigm 522. The first month or two could have gone smoother but that was learning and growing pains. Stuff like dealing with the tubing. Or unlearning to pinch my belly before putting the injection in. Since then, I've dealt with a water-damaged pump, two other mysterious incidents where the pump would consume batteries in a matter of hours (for days at a time) but in general, it's all gone smoothly.

But these last few months have been harder. I've started to notice small scars or marks from the infusion sites that last weeks instead of days. As I've been more active this summer than I typically am, it's been a struggle to find fatty parts of my belly to use. And so, four years after starting pumping, I've been exploring alternative sites.

First was hardly exotic at all. I just went all the way to the edges. The infusion site was at my 3 and 9 o'clocks. The first time was on my left and it worked fine. But then on my right side, it could have gone better. Then I followed around to my back. There's little fat there, just two small spots above my hips. And again, left side worked, but on the right side, I struggled with high blood sugars and the infusion site came out with a bent tip.

Next, I tried using glutes. Pattern continued, left worked OK, right didn't work.

I've never been brave enough to try thighs. It's hard to imagine them working any better plus I'd need to shave. And I've heard of people using their arms but that makes me even more squeamish than trying legs.

So last night, being out of viable sites on my stomach, I tried the left side of my butt again. It went it, it didn't hurt, and I was relieved. My last 2 stomach sites have felt like beatings, so for it to go in relatively peacefully was a relief. Couple hours later, I went to bed with a blood sugar of 90.

I've slept better, waking up around 3AM but getting back to sleep. But at 6AM I felt like death. Checked blood sugar and was up to 414. Can't remember the last time I was that high. 350, but 400? Not in a while. I didn't even try correcting, went right to replacing the infusion site. And found the cannula sitting atop my skin. No wonder it didn't hurt!

The Dexcom should be coming in the next week or so, and hopefully that'll keep me from getting into that bad a place again. But I'm so discouraged about pumping right now. It's convenient and has worked well, but it's been so hard these last couple months to find usable sites and the rash of skewed cannulas isn't helping either.

The Search for Fat

It was time to put in a new infusion site this morning. I searched, groggily, for fresh torso that I could sink it into but found I was somewhat lacking in usable fat. Every really juicy part of my stomach still has those red marks from sites past. I couldn't find a spot on my back that was assuredly cushioned enough. My butt has been too unpredictable and I've never explored thigh sites or other parts of my body.

So I did find a clean spot on my stomach, and it had a bit of fat, so I went ahead to use that. Did all I could to loosen up before releasing the needle, pushed the button, and POW: It hit me like a metallic fist of fury. It was one of those insertions that makes you want to puke in response. Luckily, it passed quickly and settled into something closer to the typical dull pain that the first few hours of a new site means. But, OW!

Luckily, it seems to be working. Been in for about two hours now and my blood sugar's 82.

People often look at me like I'm crazy when wishing to be fatter. I don't want a beer belly or anything like that, but it's incidents like today's that makes me wish I had a little bit.