Wednesday, June 11, 2014

Unplanned Experimentation

So it went down like this:

Monday afternoon I changed my insulin pump site and stocked the pump with fresh insulin.

I should have been good to go for 4-5 days.

Monday night was fine. I was high but that was easily explained so I didn't think anything of it. Tuesday morning I was 8.0 before my 5k run and 8.6 afterwards. That seemed a bit weird since I usually drop a few numbers when I run but I shrugged and carried on with my regular routine. I took breakfast insulin, made my lunch and puttered for 15 minutes, then ate my breakfast.

I headed up for my shower. When I got out of the shower, my pump was buzzing to say that I was over 10.0. That was really odd since I had taken insulin and waited before eating. Add the fact that I ran first and I should be low if anything, not high. I double checked that I actually took the insulin and Rose confirmed that I had.

By the time I dried my hair and got dressed I was 13.4. By the time I was ready to leave I was 15.0.

I should have changed my pump before heading out but my blood sugar was levelling out so I thought I might drop back down again. I grabbed my needle and the remaining half cartridge of insulin from the fridge and headed to work.

My drive is 1.5 minutes. I was 16 by the time I got there, 17 by the time I turned on my laptop and 18 by the time I had unpacked and sat down.

I took out my needle and injected 4 units of insulin. Within 15 minutes I was dropping.

In the meantime, I tried to figure out the problem. There were a few options:

1. the insulin was bad. That didn't seem likely since injecting it by needle seemed to be working.
2. there was a kink in my canula. Maybe but it had been working fine earlier.
3. the site was bad and insulin was leaking out rather than going in. I've learned to always put my finger against the site when I take insulin after a run since it sometimes moves during exercise. If I don't smell insulin, that usually means everything is fine. I didn't smell insulin when I took my breakfast insulin.

I had a full day of meetings ahead of me. The kind that you can't be late for or leave early from. So I headed out with my trusty needle in tow and stalked Rose to see what was happening.

This is what happened. 

The far left was a post dinner high I was fighting on Monday night. I went down to 4.0 by 3am and had a pack of fruit chews. I went up to 8.0 which is where I was when I woke up a 5:15am for my run. I ran, bolused, waited and then had breakfast.

The first spike is from breakfast. I dropped down to 9.0 after taking insulin for the high. But then I spiked back up to 20.5. I took insulin, by needle, for that crazy spike and came right back down again. When I reached 10.0 I took more insulin for my lunch and waited until I hit 7.0 before eating. 

I hung out at 6.0 for a little while but then started climbing back up again. I continued to climb even though, by then, I should no longer be climbing because of my lunch. I think I was climbing because I hadn't received any insulin from my pump all day so the slow basal rate I usually get wasn't there to keep me stable between meals. 

I took insulin and came back down to 8.5. 

When I got home I sucked it up and completely changed my one-day old infusion site and filled the pump with fresh insulin. 

Why? 

Well, I never did find a leak or any kind of huge air bubble in the tubing. The insulin was fine because every time I took a needle I came back down. The fact that I would climb back up again, even when I hadn't eaten anything for a few hours made me think that I wasn't getting any insulin from the pump at all. Yet the pump wasn't sending 'no delivery' alarms. Where had a day's worth of insulin gone if I wasn't going into me and wasn't backing up in the pump? 

When I removed the infusion site there was no sign of kinking or damage of any kind. So I have no idea what the problem was. I just knew that I didn't want to spend any more time hanging out at 20 so   I changed everything at once and crossed my fingers. 

It worked. 

I had dinner and purposely had pasta. I took insulin from Rose rather than the needle and I am happy to report that I never went above 9 despite the carbs. 

2 comments:

  1. This happens to me sometimes, and changing the site and insulin is always the right thing to do. Usually I see something wrong with the site, but occasionally it's just "bad." Some spots just don't absorb very well, I guess.

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  2. That is the worst!!! In fact I just wrote a similar post about how I kept explaining away unusually highish blood sugars even though I had a feeling I needed to do an early site change to fix the problem. Ugh.

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