Priming the (Insulin) Pump (Part 7)

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Eric continues to meander through "morning with insulin pump and site change." This entry follows last week’s blog entry, "Priming the (Insulin) Pump (Part 6)," and you’ll probably see several more entries that follow this narrative before he moves on to something else diabetes-related. Enjoy!

One of my early fears about getting an insulin pump was the surgical tubing, how it was so there, so obvious. When I first saw this surgical tubing, long enough to chain a bike with, I wondered why I couldn’t just get shorter tubing; that way, I wouldn’t have to worry about the excess. Shows you how much I’d thought about it. In theory, a 6- to 10-inch length of surgical tubing would be nice, unintrusive. But to monitor my blood glucose (my blood glucose monitor is attached to my pump), I’d have to contort my body to read the pump if I had the short tubing I initially wanted.

The extra length of the tubing is necessary. It helps when I’m getting dressed; I don’t detach my site when I get dressed or undressed, so I need to do something with the pump itself. Thanks to a fellow insulin pumper’s advice, I now put the pump end of the insulin reservoir—or, more precisely, the hard plastic nub where tubing attaches to the reservoir, a.k.a. the Luer connection, between my teeth. It works wonderfully. The connection tip pokes out at the top of the insulin pump, and the twist cap is notched to aid fingers in tightening or loosening. Yet that little notch also fits between my teeth comfortably for the 30 or so seconds I need to pull on jeans, put on a belt, and get my pump cozy Velcroed onto my belt so that I can move the pump into a more secure location for the day.

Pump tubing straightened, it’s now time to check my blood glucose. Most mornings it’ll be between 110 and 130 mg/dl, and today’s no exception. Except that’s not it for the day. My site reminder reminds me that it’s time to change the site. I have only 20 units or so of insulin left, so I decide I’ll do this after I shower and eat breakfast (may as well use another 2 or 3 units of insulin from the current stash before breaking into another).

In my diabetes closet, I have my three-month supply of diabetes medical necessities. Showering finished, I get into the closet and pull down an infusion set, a reservoir, the packet with surgical tubing, and an antiseptic wipe. Before showering, I remembered to take the vial of insulin from the fridge and set it on the counter. They tell you to always have the insulin at room temperature before drawing it up into the syringe, and they aren’t lying. Cold insulin will lead to air bubbles in the syringe, in the reservoir, in the surgical tubing, and in you—and bubbles of air don’t really do much for your diabetes control.

Before I shower, I also remove the old infusion site, which is always a slightly painful process. It’s much like removing a super-sticky Band-Aid. I wince. Then I look down so I can see where it was attached and make sure there is nothing unusual about the site. After all, this is a place on my body where a nonnatural hole has been made, and it’s been there for three days, so I want to ensure there isn’t any infection or discoloration.

Where the set was attached, I see a pale circle of flesh. Where the adhesive rubbed against my shirt is a small, dark ring of fabric and glue that will come off with some added scrubbing. This is also, of course, a wound. I mean, that’s what it is. I’ve stuck a needle into my body, and the remnant of that is the tiny red welt in the center of the circle where the cannula dipped into my flesh. Sometimes I’ll see clear fluid (some insulin, some interstitial fluid) and sometimes just the tiniest bit of blood creeps out of the wound.

Dare we be so cliché as to say it? Will Eric get around to changing his site? Will the insulin make it into the syringe, or will he be thwarted by air bubbles? Tune in next week as Eric continues with his “Morning of the Site Change” series on Priming the (Insulin) Pump.

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