Friday, August 30, 2013

The Diabetes Learning Curve

The last time I posted anything here was a long two and a half months ago! So, so much has happened in those two months d-wise. I don't even know where to begin!

Most notably, I had my first insulin pump failure in the year and a half that I've been on the pump. I played in the sprinkler with my daughter and niece that afternoon, but mostly avoided the water with my pump clipped to my bikini top. I'm not sure if it got exposed to more water than I realized, or if the preexisting cracks in it allowed more moisture to get in than I expected, but it didn't react well.

That evening I went to a salad supper for a women's group at church, and when I went to bolus for my meal (which luckily wasn't very carb-heavy), my pump wouldn't respond. It got stuck on the Bolus Wizard screen and the buttons weren't functioning. Slight panic ensued on the inside, but I managed to keep my calm. After aimlessly trying all of the buttons, I got a button error message and the pump suspended itself. Fair enough, but it kept beeping and eventually vibrating, then screaming with a more alarming-sounding alarm--which I was assured didn't bother anyone, but made an already stressful situation more tense on my end!

I decided to leave after I finished my salad since I knew I'd be spending some time on the phone with Medtronic's customer service and it was already almost 8PM. I called my sister (who also has T1D) to ask her if I could borrow some of her Lantus until I could get a prescription for it the next day...since I've been on the pump for so long, I didn't even have a current one on file. After picking up some syringes and my Novolog vial at our house, I met her over at my parents'. I spent about an hour on hold with Medtronic since it was a Monday night and they had a higher than normal call volume, but once I got a senior technician on the line, it only took her about five minutes to determine my pump needed to be replaced and place the order for a new (well, factory-refurbished) one, guaranteed to arrive the next day.

After some discussion with my CDE about injection amounts, I was set on the insulin front. I had only been on MDI for about a week and a half when I got my pump, so even though it wasn't something I was used to, it wasn't bad. I actually enjoyed being wire-free (as weird as it felt for a while!) since I hadn't been without my pump for more than an hour in the past year and a half. I joked that I might even go to the water park or the lake since they're not easy to deal with when you have a pump that isn't waterproof, but alas my pump-free time was much more mundane! My new pump did come the next afternoon (impressive since it was after 9PM the night before when the order was placed!), and it waited patiently in its box over the next five days until I decided to reconnect.

My new (to me) pump...clearly a winner.

A couple of things made that experience easier...the fact that my sister also has T1D and had some Lantus for me to "borrow" (since it was in the evening and the pharmacy was closed), and having such an awesome CDE. I wouldn't want to deal with it on a regular (or even semi-regular) basis, but having to have a pump replaced wasn't near the nightmare I'd imagined.

Almost as frustrating, though, was finding out that my A1c was about the same in July as it had been three months before (6.6%). I know that isn't horrible, but I'm a perfectionist and that isn't close enough to perfect (i.e., normal) for me. I suppose that at least I can say that my numbers have been fairly steady and I haven't had many lows, so those are both good things.

In my final bit of big happenings, I forgot my insulin completely on a trip to my in-laws' anniversary celebration last weekend. In the rush of trying to get out the door since we were already getting a late start, I ended up leaving it on the kitchen table. I didn't even realize it until we got everything into the hotel room and it was notably missing. Then I freaked out.

Normally, I have relatively sane reactions to things such as this (case in point: the pump failure incident); however, this was on a completely different level in my mind. First of all, this happened around 11:30 on a Saturday night, meaning my local pharmacy had been closed for five+ hours and wouldn't reopen until Monday, and that my endocrinologist would also be out. Since we'd just driven four hours to get there, the last thing I wanted to do was turn around and go back home, missing the entire reason we ventured over there. I knew I had enough insulin in my pump to last me until about 11:00 the next morning, and that was without eating. The gathering was supposed to happen at noon, so you can see why this would be a problem.

I couldn't even process thoughts I was so angry at myself (and let's face it, at my husband for rushing us out the door earlier in the evening). I couldn't even believe that I could forget something so essential, especially since I'm always so careful to pack it. Plus, my blood sugar was in the high 300s because my tubing had somehow disconnected itself getting in the car after we ate supper, and I didn't realize it until a couple of hours and several wasted units of insulin later. To put it nicely, it was a crap storm.

I went downstairs to the car to look for my insulated bag again, but unfortunately it didn't magically appear. I then called my mom and explained to her what was going on, and she told me that she and my dad would bring it to me in the morning. I loved them for being willing to do it, but I also felt incredibly bad about the thought of them driving four hours because of my stupid mistake.

Finally, a stroke of brilliance (/common sense?): I could call my endo's office and see if their answering service was there. After all, what did I have to lose? The worst they could tell me was "Sorry, you're out of luck." To my surprise, they answered after just one ring. When I explained my situation, the receptionist put me straight through to the doctor on call. The endocrinologist that answered asked me for the usual identification information, then for the name and number of the pharmacy I needed it filled at.

In my non-thinking frustration-induced stupor, I didn't even think about having that ready. I scrambled to find the ever-present phone book in the hotel room, but no dice. I finally asked her if I could call her back, and even though I could tell she was frustrated, she said to go ahead. It took me a while to find the number of the local Walmart pharmacy, but I finally succeeded. I called the after-hours number back, and talked to the DOC again. She told me she'd call it in then. I looked up the pharmacy hours and found out they opened at 11:00am...perfect timing, right? I did have to wait 30 minutes for the Walmart pharmacy to fill my prescription the next morning since I'd never filled one there before, but I'm definitely not complaining!

All in all, the past couple of months have definitely taught me a lot about diabetes emergencies. I learned that no amount of water is good for a non-waterproof pump, and that you should always-always!-make sure you've packed your insulin. However, I'm also going to have my regular prescription sent to Walmart just in case it ever happens again...which, considering my luck, is entirely possible!


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