Diary: A Week With the Pump

After living with diabetes for five years, Tory Miller decided to try an insulin pump on for size.

By Tory Miller

After living with diabetes for eighteen years, Tori Miller decided to try an insulin pump on for size. The following account details her first encounters with the pump.

Every time I get a physical, my doctor sends me a copy of the lab work with a summary of his thoughts. After my physical a few weeks ago, he also added a little note at the bottom: consider the pump.

How many times had I heard that from him?

I realized that it was time to make a decision. I had been considering the pump on and off for almost five years. I liked my schedule, but why live with all the risks? Current technology allows people like me another option, one that promises better blood glucose control without the hassle of rigidity and shots.

I decided to go for the pump.

A Peek at the Pump (Real Video 1:26.2 min) To view these video segments you will need to download the Realplayer by clicking here.

As I waited for the Fed-Ex truck, the moment seemed supernatural to me. I had no idea what it would be like having a pump connected to me...all the time.

It was this "all-the-time" reality that had kept me away for years. I had grown accustomed to my multiple shots. I had also grown accustomed to the inexact science of my blood sugar maintenance.

But not for long.

A nurse from the diabetes center came over to teach me how to use the pump. I was disappointed to learn that I would be filling the reservoir with saline and not insulin for a little while.

I woke up to a beeping sound. At first the sound was soft, but over the course of a half-hour it seemed to get louder and louder. I thought it was trash day. But after three alarms, I realized the sound was coming from me! It was my pump. I hadn’t touched it in eight hours.

Later in the day, I got another alarm. The autistic boy I tutor is highly sensitive to sound, so I left the room and checked the display screen. "No bolus delivery" was flashing at me, and, for a moment, I panicked. Fortunately, I had the whole manual to read on the BART train.

A Look Back at Care (Real Video 1:26.2 min) To view these video segments you will need to download the Realplayer by clicking here.

I went to the doctor to establish my basal rates and start pumping the real thing — insulin. I'll be checking my blood sugars eight times a day to determine how the basals correspond with my actual needs.

This reminds me of the beauty and ease of a tailored suit. Five years ago I had a suit tailored exactly to my specifications. Never before had a piece of clothing fit so well or looked so good on me. The pump fits each diabetic in this same way. The more you check your sugars, the closer you can attune your basals to your individual needs.

I felt a little sad tonight as I disconnected from the infusion set and put the pump on the dining room table.

I had a great first day pumping insulin. That is, if I just focus on the diabetic concerns of the day. Other than that, it was a horrible day. I was crampy and on the verge of my period. Todd was acting like he had his period too. In the morning we had some tense words about the hot springs and I begged him not to ask me to go to a hot spring right away, as this was my first day pumping. But, tonight, in a fit of anger, he asked me if I would mind going all the way to Fairfax for a soak! He went sulking away to bed at 6:30.

He’s mad or fearful or both about the pump. I don’t want to deal with his fears because I have the same ones, plus cramps. Right now, I must face my own fears about the pump and hot water. Do I disconnect? What happens if I keep everything on?

After rushing around downtown, I got on the BART and noticed that my infusion set had come undone. My body just spit out the cannula [part of a catheter for medication]! It's the third one I've had to insert in three days.

I called Todd at home, and it was soothing just to hear him go through with me the list of all the things I could do: pull off the set, keep it on, check my sugars, take a shot, insert a new set, etc. I decided to go to the back of the BART where people usually sit to sleep or eat food, open my kit of stuff and put in a new infusion set.

This got me thinking about my dad.

I have an early memory of walking into my parents' bedroom and receiving a terrible scolding because my dad was preparing to take his shot. He hated his diabetes because he often felt bad, but he didn't want to talk about it.

As long as I can remember, my father had been secretive and ashamed of his diabetes. His secrecy and shame divorced him from awareness and, gradually, from self care.

When he died from diabetes complications at age 51, I had been coping with my own diabetes and observing his for five years. I was determined to stay aware and unashamed of my condition, taking care to keep up on the trends.

I think most diabetics like to keep private about their disease, yet each person must find a self-care style to enable good diabetic control, whether they are private about the details or more forthcoming.

Embracing a New Challenge (Real Video 1:26.2 min) To view these video segments you will need to download the Realplayer by clicking here.

I guess this pump struggling is to be expected. But I am finally seeing some happy results. I feel better. The high-blood sugars that flooded my mornings are gone, so I have more energy.

Another thing I have to remember is to watch out for my cat.

Some cats like plastic, some cats like insulin. What if yours likes both plastic and insulin? My cat Roy loves plastic tubing, so I need to take special care to keep him from rooting it out from under my clothes.

The cannula came out while I was bustling around and I got high blood sugar very quickly. I quickly took a manual shot, removed the bad cannula and poked in a new one.

As I hammer out the details of the pump, I am reminded of what the trainer said to me when she came over to the house. The pump is a tool meant to help me with my diabetes, not meant to be this ball and chain that invalids wear because the end is near!

With that in mind, I have another training for another infusion set, and I will discuss how to disconnect from the pump for our trips to the hot springs.

The thought of using both insulin delivery techniques did not dawn on me until I started training and realized that syringes were indeed not going away, but sticking by as a safeguard if the pump fails..

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