Jan and the Amazing Disappearing Syringe

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Welcome to my Twilight Zone. Can you hear the music playing? I did this morning as I was attempting to change the infusion set for my insulin pump. And I do mean “attempting.”

Would you please tell me how I can sit in the same place and lose things? I do it all of the time. This time it was a giant syringe used to fill a pump reservoir with 300 units of insulin.

In case you’re unfamiliar with insulin pumps, here’s the skinny: They’re really mini-computers. They come with a reservoir, which you fill with insulin. Today’s pumps generally hold 200, 300, or 315 units of insulin. A vial of insulin is 1,000 units of insulin, so you can do three fills per vial, with some left over to be added to the insulin from a new vial.

While some pumps stick directly to your skin, most need tubing to get the insulin from the pump into your body. The tubing is connected to the reservoir at the pump end and into an infusion set you’ve put in your body at the other end. An infusion set has a tiny catheter covering an introducer needle. You stick the needle in anywhere you would give yourself an insulin injection — arm, leg, or abdomen — then pull the needle out, leaving the flexible catheter in. (The catheter is attached to a sticky small bandage-type piece that adheres to your skin.)

The pump is programmed to automatically deliver basal insulin (the “background” insulin your body needs in order to function) and you program in a bolus amount of insulin depending on how much you need when you eat, or need to lower your blood glucose.

I keep my pump change-out supplies and other necessities (such as the bottle of insulin I’m using at the time, and a coin to pop the reservoir on my pump) in an index-card-sized plastic box. This morning it contained the syringe I’d used on my last set change. I’m quite sure it did. But where was it? I remember seeing it, but don’t remember taking it out and placing it someplace else.

The syringe I was going to use to fill my new reservoir was on my keyboard, still in its packaging. I just wanted the old one to suck the few units of insulin still in the old reservoir in case I needed some for emergencies. I could have sworn I had more insulin in the fridge, but it turned out that I had just one bottle.

Thinking back, I recalled that the pharmacy had given me a partial fill the last time. Then, before it could fill the rest of my prescription, the insurance company changed its formulary and no longer covered the insulin I was using. It was the beginning of the year and the company hadn’t added money to my flexible spending account card, so the purchase was put off until money was added.

Then nobody got around to ordering the rest of the insulin. It will be done today, for sure!

So I used the syringe I’d taken out to suck up the emergency insulin and took another out to use for today’s set change. And that was that.

Oh, yeah? Whoever said the care and feeding of diabetes was easy?

Next up was a cartridge malfunction. I popped out the old cartridge and snapped in the new one. Well, the snap! wasn’t quite as vigorous as usual, but I shrugged that off and filled ’er up.

According to my pump, I had forgotten to remember to put in a new cartridge. That was as far as I could go unless I took out *another* new cartridge and snapped it into my pump. SNAP! it “said” when I put it in.

From there, it went without mishap. Well, until I temporarily misplaced the cap that goes over the needle on the syringe. I realized the cap wasn’t on there the usual way: I stuck myself. But the bottom line was that the pump was happy because it was full and I was happy because I now had insulin in my pump and could now fill me up…with breakfast.

But I still haven’t found that syringe!

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