Posts filed under ‘I-Port’
Gah! Another day of slightly elevated blood sugars. In order to simplify my troubleshooting, I think I’m going to have to stop using the I-Port for a week or so. I’m not happy about it but I’m more even less happy about waking up above 100 and having problems getting under 130 all day long. Other possibilities:
- hidden infection or impending illness (I feel fine though, gums and mouth fine, etc)
- insulin gone bad (I just changed my Humapen cardridge on Saturday)
- lingering repercussions from The Pizza (could one bad day really throw me for this long?)
- my meter is off (seems unlikely but I could make my newer backup meter my primary just in case)
- my strips are bad (am almost done with this vial so will be able to check that off in about two strips)
- hormones (possibly, but that usually happens on the 4th week of my birth control pill, not the 3rd)
- I’m developing insulin resistance and need to adjust my carb/insulin ratio
That last possibility scares me the most – is it possible that after only a month and a half of injecting less than 15 units of Humalog a day, I’m becoming resistant to it? Is a carb/insulin ratio of 1 unit per 8 carbs in the A.M. and 1 unit per 10 carbs in the P.M. excessive for someone under 115 pounds? Is it normal to have to increase your carb/insulin ratio after only a month and a half of usage? I always understood that MODYs were very sensitive to insulin, so of course this makes me wonder – what if I’m not MODY after all?
The other thing that has been worrying my lately is this constant anxiety surrounding losing my basal insulin production. Every morning when I wake up and test, I pray the number is under 100, and every time it isn’t, I think “well, this is the beginning of the end”. I know that sounds terribly melodramatic, but I realize just how lucky I’ve been to still make some insulin and make it in a consistent manner, and I am determined to preserve that functionality! Then today I was doing some googling on insulin resistance and MODY and came across this terrifying statement:
Progressive beta cell failure?! My PA also seems to believe that my MODY will inevitably progress, but I still don’t want to believe it. What if the MODY patients they based that observation on destroyed their own beta cells with high blood sugars or oral medications?
All this makes me want to shell out for the genetic profile needed to determine once and for all what type of MODY I have… but what if I spend thousands of dollars just to find out I’m not even MODY? If I did turn out to be the “progressive” type, would I regret finding it out? Or would I benefit from having some time to come to grips with the fact that eventually I will have complete dependence on insulin? What if I have MODY2/glucokinase? Would I celebrate? What is it I really seek to gain from such a diagnosis? Judging by the tone of this post, the money would probably be better spent on a beach vacation or something else aimed at restoring my mental health. 😛
Maybe there is more I can figure out on my own. The diagnosis flowchart on the Athena Diagnostic MODY page shows a path for Ketotic and Non-Ketotic. MODY falls under Non-Ketotic. I picked up some Ketone testing strips at Walgreens last week, so next time I’m above 200-250 I will test and see what happens.
I messed up big, big time last night. I thought I was ready to attempt to cover pizza with insulin, but my body thought otherwise and I payed the price – mentally, physically and in cash at the rate of the eight dollars worth of Freestyle test strips I used testing and re-testing on my backup meter. I struggled the rest of the night to get back down from the high 200s. I was injecting directly (no I-Port in the equation – I’d attempted an upper-backside install but it left me in tears so I threw it away) yet it was as if the insulin couldn’t keep up with the digesting pizza (or my lack of patience). It was getting late so I set my alarm to wake me up an hour and a half after I went to sleep so I could check and make sure I wasn’t still high or going too low too fast, and it was back down to 140, so I gave up and went back to sleep because I was too tired to change my suspect Humalog cartridge and I knew my own basal insulin would eventually take care of the rest anyway.
I woke up this morning with an elevated fasting of 108, but I was ready to start clean – clean diet, exercise, new insulin cartridge, new I-Port… but I can’t get my head in the right place. I’m mad at myself and don’t feel like doing anything productive, and I am dreading the blood sugar see-saw that I’ll likely experience today. Writing about my mistakes always helps me move on, so now that I’ve confessed, I’ll make myself go lift some weights and try to make up for whatever horrible things I did to my poor body with that (to borrow a word from Monday) insidious pizza last night – which, by the way, left even my non-diabetic husband at 130 mg/dl an hour and a half after! How did I stand a chance? 😛
Originally uploaded by Irish Pica.
I am amazed by Flickr user Irish Pica‘s recent contribution to the Diabetes Made Visible pool. She posted photos of her thought-provoking and beautiful thesis project: a chair made of 2,190 insulin syringes – the equivalent of what the average type 1 diabetic injects in a year. Click on the photo above to read her full thesis statement and view more photos of the project.
In other news, my freshly-applied abdominal I-Port got bent and went drooly on me sometime between yesterday afternoon and this morning and I forgot to bring an extra to work. I have no idea what I may have done to bend it. This wouldn’t be such a big deal if I hadn’t eat 40+ slow-digesting carbs at breakfast. Watching my blood sugar rise into the 200s even after a correction is scary, yet I still can’t wait to get home and get another one installed. It may just be a matter of moving to a lower-carb breakfast – that way if the port goes wonky overnight, I’m not putting myself in danger of high blood sugars after breakfast.
A properly installed I-Port does not drool.
If there is more than a single drop of insulin left over on my pen after injecting, I know my I-Port is no longer good and I can expect high post-meal blood sugars. A tiny little drop doesn’t seem to make a difference, but if there are two drops left on the needle, or drops bubbling out of the septum of the I-Port, then I’m going to have to trash it and start all over again. I’m still trying to figure out how and why a seemingly good I-Port insertion will suddenly start dribbling, but I suspect it has something to do with me being clumsy and getting it caught on things. Constrictive clothing over the I-Port is also not a good combo, so sorry ladies, but you’ll have to save your corset for times where your I-Port is installed further south or on an appendage.
A properly installed I-Port doesn’t hurt.
Any pain or discomfort lasting more than a few minutes after an install is usually an indication you didn’t do it right. I installed my third I-Port on the side of my abdomen about two inches north of my left hip-bone. The insertion hurt so bad I briefly considered what would happen if I hit the floor, but I survived. I gave myself an especially painful bolus before dinner, the found myself over 130 after an hour, so I knew something was wrong, but though maybe I was just going through one of those low pain threshold times of the month, so I decided to give it overnight to acclimate. The few times I moved in bed that night were painful, so I decided to take it off when I got up. When I ripped that sucker off I found a blood-filled cannula. Ouch! That was my first experience with pain and bloodshed and an I-Port. The second came Saturday, where I learned:
A properly installed I-Port doesn’t bleed.
Saturday I went to change a 3-day old I-Port, and after removing the insertion needle on the fresh I-Port, blood started dripping out the top. It was pretty gory, so I grabbed the phone and called the 1-800 number on the I-Port package. I wasn’t sure if anyone would be around on a Saturday, but soon I had friendly help on the line. After they advised me to remove the “gusher”, I chatted for a while with a guy who’s name I didn’t catch about my general lack of I-Port-ready real estate. Which brings me to:
I-Port Loves Flesh
I may have inherited my mom’s diabetes genes, but I was also blessed with my dad’s build and metabolism. So add to that the fact that I am petite, and I’m not left with a whole lot of prime abdominal real estate. The person I spoke with at Patton on Saturday suggested I try wearing the port where KK (the inventor of the I-Port) wears hers, which is on the backside “right below her beltline”. I even learned that some pump users put infusion sets on their breasts, but I was too embarrassed to admit that I don’t have enough fat there either. 😛 He also suggested arms, but even if I did have extra flesh there, I think it would interfere too much with my current workout routine.
I tried the upper-butt area over the weekend. The first try I installed while standing, but when I went to sit down the I-Port felt stretched and hurt, so I took it out and, rather than waste an I-Port, decided to try re-installing the same one while sitting. The seated bum installation was a win, but it only lasted as long as it took me to have to go to the ladies room. I completely forgot about the new location (a nice testament to how comfortable a properly installed I-Port is!), and it ripped right off my bum when I pulled my shorts down. Much blood was shed, but its my own fault for attempting a 2nd install – not only did I forget to clean the area first with alcohol, but I think removing it once compromised the adhesive. Will try the “lower back” area again soon, and will try not to forget about it (or maybe wear a skirt).
I imagine pump users go through the same trial-and-error with their infusion sets, so if there are any petite pumpers out there with some placement advice for me, please do leave a comment!
So despite my few installation issues, I am determined to find a way to make the I-Port work for me, because when it does work, it is such a beautiful thing! Split boluses are no longer an issue, and the little red dots that the I-Port leaves in its wake are so much nicer to look at than the sea of yellow and blue that the injections leave me with. I’ll have to upload a photo showing an I-Port dot vs. an injection site, and maybe even photograph an area for a week or two to see how long it takes to disappear completely.
It’s also worth noting how helpful and responsive, both via email and phone, the people at Patton MD have been. It is nice to know you can pick up the phone on the weekend and have more than just a call center drone on the other end. All of Patton’s employees, diabetic or non-diabetic, have worn I-Ports and done saline injections through them, so no matter who you talk to, they have at least some personal experience with the product they sell. I also forgot to mention how easy it was getting my insurance to cover the I-Port. All I had to do was provide the prescription and my insurance info, and Patton MD took care of the rest through their vendors.
If anyone out there reading this is an I-Port user, I’d love to hear from you! I’m curious to know where you wear your I-Port, where you avoid wearing them and why, and if there are any other tips you’d like to share.
Things are continuing to improve on the insulin front. I had a follow-up with both the dietitian and PA last Wednesday, and left with two prizes: an A1C of 5.8 (I was expecting higher) and an I-Port.
For those of you not familiar, the I-Port is a neat-o insulin delivery device that gives you one place to inject into for 72 hours, after which it is disposed of and a new one is installed. You inject into it rather than your skin, so there is no pain involved other than the normal sting associated with the insulin hitting your tissue.
I’m on my fourth day and second I-Port, and the novelty of feeling a bit bionic has not yet begun to wear off. I adore not having to hunt for injection sites, endure bruises, and remember to rotate. It’s too soon to say whether its having any affect on my BG control, but expect a full review and more photos after I’ve spent a bit more time with my new, button-esque friend.