1 more day of school for the little people and we are so happy about it! With the start of summer brings less structure, more freedom, carefree ways - sort of. For Betsey life is never care free, nor is it less structured. But the freedom part -well, that's something she likes to hear.Freedom..... from her pump.
Two summers ago, she wore the pump all summer. We spend many days and nights at the beach in the summer and it was kind of a nuisance - worrying about sand, water, the elements getting to it, the possibility of it malfunctioning from being left in a bag on the beach in the heat.... But we dealt with it. She took it off for a large part of the day because her blood sugars stayed relatively low during the day at the beach. All that swimming helped keep her numbers in check and she would test as often as I asked her to, sometimes every half hour while she was swimming if her numbers teetered on the low side. She'd eat if she needed to for extra carbs, or sit down for a break with the pump on for extra insulin if she ran high. Then, back into the water she'd go.
We thought it was working out well. Her numbers were great during the day for the most part, and I attributed that to the exercise all day long.
Then we slowly started running into problems during the night. She'd run high. Really high. All that time without a basal rate of insulin during the day - having the pump off - caught up with her.
Betsey's pump has basal rates that change every couple hours based on how much insulin she needs running through her during those times of day. The basals are crucial because they help sustain a normal blood glucose level in her body throughout the day; something our bodies do for us without us even aware. The pump works as a pancreas of sorts. When she eats, she receives a large dose, a bolus by figuring out how many carbohydrates are in the meal or snack and then the pump suggests a bolus amount based on Betsey's pump settings.
I was under the false assumption that while we spent days at the beach, she didn't need the basal rate if her sugars were in range... that she only needed to put the pump on to correct a high. I didn't realize all those hours of not wearing the pump, not having a basal flow of insulin, and just bolusing as needed for food, was not good. Those hours without a the pump would eventually catch up with her later in the night and in the wee hours of the morning and she'd end up running high... high enough to make her sick and develop ketones.
Ahhh.... So much for freedom from the pump.
So last summer we tried shots. We packed the pump away with all the supplies that go with it. We took out the needles, refilled Rx's for long and short lasting vials of insulin, broke out the sharps container and figured out how much insulin was needed throughout the day to sustain a normal level of glucose in her sweet self. It was a troubleshooting game; not nearly as easy as the pump or as accurate in terms of what to expect with her numbers and how to correct highs. There were more drawn out low's because once the insulin is in her, that's it. Where as with the pump, we can put a temporary rate on for less delivery or stop delivery all together in the event of a crash in blood sugar.
But Betsey was happy. She didn't mind being poked many times a day for shots. She welcomed it. There was no pump hooked onto her pants, no bouncing when she ran, nothing in the way when she used the bathroom, no tubing hanging out of her pocket, no needle in her bum.
Her site marks cleared up somewhat and mild bruising and some scarring was left behind on her tush.
So this summer she has decided to take the pump off and do shots again. Myself, I am not crazy about shots. I usually give them to her and she takes them with ease now. It's not like when she was first diagnosed and she cried, I cried... Now, she holds out her arm, I ask her to relax, she does, and then I inject her insulin. It's very quick. And no matter how "easy" it is for her, it's never easy for me. It's always the same thought I have every time I give her a shot. I'm sorry.
But it's freedom in Betsey's eyes. And if that makes diabetes a little bit more "enjoyable" for her a couple months, we'll do it.
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