Monday, July 29, 2013

I need more insulin, please.

Tried to do an overnight basal test last night.

This is something we've been trying to do since I got the pump, but since I pretty much have been awoken with highs every night, and bolusing them down, it hasn't quite been successful.  Many times the boluses aren't that successful either, but that happened with shots too.  I swear I'm resistant at night, or it's possible that just lying there not moving doesn't really get the insulin flowing.

(One night, I bolused, and then set the CGM high alarm to 300 in case the bolus didn't work and I was too asleep to notice. I didn't want to wake up in the 400s. I am telling you, seeing the "acceptable range" be from 70 to 300 really makes it look like you have awesome control.  Everything is between those 2 lines.)

So last night, after dinner I was fine for a couple of hours, and then I went close to 300, and all these multiple highs are really setting my mood to "constant PMS" prompting my husband to ask things like "when are you just going to throw away that pump?"

Anyway, I set the basal to 150%, which didn't help.  So then I came home from a meeting and dug out a needle and gave myself a shot.  It felt strangely familiar.

20-30 minutes later, I get an alarm that I was "dropping rapidly."  I started crying with happiness. I never thought a 175 with double arrows down would get me so worked up, but apparently it does. As the CGM continued to report the uber drop, when it hit 101 with the arrows still double down, I pulled the pump off, seeing as how it was time for a site change anyway.

I still went low.  I didn't care.  I was thrilled.  My body can still go low!  I'm not doomed to 170's and above my whole life.  And while 59 is a sucky blood sugar, it was SO nice to see a 2 digit number.

Anyway, I did the site change.  And may I take this moment to say how much I still hate site changes?  They're so....constant.  I ate candy.  My sugars came up.  I fell asleep at 102.  I haven't gone to bed that low since Mr. Pumpy took up residence.

Woke up at 232.  Yippee.

So, that was a bust.  I know, I thought it was just a reaction to the low as well, but CGM showed the rise didn't really start until 4 a.m.  The low was at about 11:00.

You see, I did go in last Thurday, and we did tweak the insulin on the pump.  But by "tweak"  I mean, she let me add .05 units to the 2 a.m. hour.  I was like "I need way more than this."  And she was like "you're being your own worst critic.  I've seen far worse numbers for Type 1's, and an average of 170 with a standard deviation of 50 is pretty good."  And I was like "There's no way that's going to get my a1c down, and frankly, my moods can't handle the constant 200s".  And she was like "This will start your day lower, and everything will be lower with this.  We're still figuring this out, and we want to take tiny baby steps, because we want you to have a good experience." She kept saying that - Baby steps.

I get that.  Nobody wants to go on the pump and be bombarded with lows, not to mention the liability that creates.  She says to give this change a full week.

And if it did start my day lower, and keep everything lower, that would be great too.  So far, that doesn't seem to be happening.  How long does it take to adjust to the pump?  Seriously, I don't want to be the only Type 1 that hates pumping.  I'm already the only one that prefers syringes to pens. (I still carry a pen though for pumping emergencies, they're far more transportable, even if they do stink of insulin every time you prime them.)

I want to like this.  I want to like this A LOT.  I want to sing the praises of pumping to everyone who will listen, instead of wondering when I'm just going to give it up and go back to what "worked".

I guess nothing "works" as well as a pancreas.

Still.  I need more insulin delivered here.  Because nobody wants to be bombarded with highs either, and there's only so much of "constantly angry and weepy mother" my family can take.  There's only so much I can take of me acting like this, too.  It's like a line from "Buffy" - "This tone in my voice?  I dislike it more than you do, and I'm closer to it!" (Anya says it.  I love her.)

And if you aren't obsessed with an old Joss Whedon TV series, then I feel sorry for you.  Not really.  There's a possibility you might be normal.


  1. Hang in there, H! Enough baby steps will get you there, and each step is a bit closer.

    I know it's terribly frustrating, but hang in there. It will all hopefully be worth it in the end.

  2. Oh, and here's some good discussion on stacking insulin/IOB.

  3. In my experience, I'm often too impatient to let my first dose finish working before I hit the high blood sugar with a second dose. Then I end up crashing. And I think when you're dealing with just carbs, you're right, you still need the insulin. It's when I start mixing in correction doses that I lean on the IOB tracking.