What I Learnt By Taking A Pump Break.

In bullet point fashion, of course:

• Injections are hard work! Can't just press some buttons on my meter and away I go. No, I actually have to stop and take the time out to make sure I get insulin into my system.
• I'm much more mindful of what I eat when injecting - is that snack really worth the extra shot I'm going to have to take to cover it?
• That being said, on Friday I had pizza for dinner. Pizza on my pump? No problem! Multiwave bolus, and I manage to dodge the inevitable peak. Or at least stop it from peaking to high. Pizza on injections? Hello blood sugar of 15.4mmol when I woke up Saturday morning. (And I did two shots trying to stop the peak that way.)
• My cannula is a source of comfort. Over the last few days, I've found myself reaching for cannula sites, to find there is no cannula. And I've panicked, and then remembered that I've decided to be device-free. Feeling my cannula in place seems to provide a sense of comfort for me. Weird, I know, but we all have strange tendencies, right?!
• The dawn phenomenon struggle was real and frustrating. 

• I forgot how much I enjoyed using the phrase "shoot up". You just don't say it when using a pump.
• Although I was itching to get my pump back on, I was not looking forward to sharing my bed with it. That was the one thing I loved about my pump break - not rolling over and having my pump dig in or having to fish it out of the duvet cover in the mornings. 
• I'm a micro-corrector. A micro-doser too, for that matter. On my pump, I could, and would, micro-correct a blood sugar of 10. And I could micro-dose insulin to cover my morning coffee. But to do that on injections is near enough impossible. I can dose and correct in increments of 0.5. That, and is 10 a high enough blood sugar level to want to correct it with another injection?!
• Temp basal is one of the best things ever. I can't remember the last time I actually used a temp basal, but suddenly, when I don't have the option to use it, all I want to do is use it. 
• In short, I have a new-found appreciation for my pump, and welcomed its' attachment back on my body with open arms this morning! I've also proved to myself that I can revert back to injections with no real difficulties. My pump isn't permanent, and now I have the confidence to go back to injections, on a whim. Constantly wearing a medical device had taken its' toll on my mind, and taking a break from it has given me the time to get myself in the right place to start wearing it again. This morning, I felt ready to suit up once more. So I did.

A Break Up, Of Sorts.

Friday, June 5th, marked one year with my insulin pump. (Where has that year gone?! Seriously?!) Now, I love my insulin pump: it's smart enough that it almost mimics what my pancreas should do, it offers me more flexibility; there are a lot of pros to wearing it and using it to manage my diabetes. There's no way, at this point, that I'd ever give it back. 

That being said...I do want to temporarily break up. Only for a few days, a week at most. Because as much as I love using my pump to manage my diabetes, wearing it, owning it, feeling comfortable with it, using it to it's fullest potential, is something I'm just not doing so well with at the moment. 

I'm sick of sharing my bed with it, for one. I roll over and lay on it, it gets caught in the duvet cover and sometimes goes sky diving off my bed, tugging at where-ever my cannula is that morning. 

And trying to figure out how to work it in with an outfit is beginning to annoy me. 

And I'm not making use of the different types of bolus I can use. 

I think I'm just done with being constantly connected to it. 

So, a temporary break up it is. As of yesterday morning, I welcomed back my trusty Novopen, and took a shot of Levemir to be my background insulin for the day, and packed some syringes to draw insulin up from my Novorapid vial. It did feel strange not having my insulin pump attached, but for the first time since I got it, I felt free. No device attached. I also felt like everyone would notice (a silly thought, given I hide my insulin pump!)

I felt like I'd got lazy with my insulin pump, a little too complacent. I was hoping that coming off it would remind me (again) just how smart my insulin pump is, and how much flexibility it offers me.

In the ever so eloquent words of Dave, "giving myself a kick up the arse".

And I'm happy to say it's working. 

"Conceal, Don't Feel, Don't Let Them Know."

Maybe it's just me, but I feel the need to hide my bad diabetes days from those around me. Maybe it's pride? Not wanting to admit weakness? Not wanting to be seen as weak? Or just different from those around me? All of the aforementioned? More than likely.

Here on this blog, I will write about my bad days. And my good days, for that matter. I feel comfortable doing that here. You're more than likely reading this because you "get" diabetes. Whether you live with it, you're the carer for someone who lives with it, or someone you love has it, you have a level of understanding. 

Those I work with know I have type one diabetes. They know I wear an insulin pump. And they know where to find my medical notes and emergency contact details (a document I drew up myself, and keep in a sealed envelope in my desk drawer). They know about low blood sugars and high blood sugars. 

For the last few months, as you may have gathered from previous blog posts, "high" would be a very good description of where my blood sugar's been at. For me, highs aren't as noticeable as lows. It was easy to plod along and pretend I had my shit together. Telling my manager that I needed to go back to see my consultant four weeks after my last appointment was hard ("You're really good at pretending you've got your shit together!" he said. "Thank you," I replied with smile. "Wasn't meant to be a compliment." Of course, I knew that). I felt like I was admitting defeat, that I couldn't deal with my diabetes on my own. And I know that if it were someone else in my situation, I would tell them to stop being stupid, it's not weakness, etc, etc. But walking my talk has never been something I'm good at. 

Over the past three weeks, I've put a lot of effort into basal testing, checking my insulin to carb ratios, correction factors, the lot. My blood sugars are starting to come down, which has been an interesting adjustment - running high for as long as I have done means I feel hypo at 6mmol. This has also meant that when I have actually been hypo, I've been hit with every hypo symptom: shaking, sweating, no coordination, lack of speech, double vision (manager with two heads, anyone?!) and, my least favourite of all, crying. 

(Painted you a lovely picture there, haven't I?!)

It's these "low moments" when I do everything in my power to hide what's going on.

Source.

Get through the meeting, then treat the hypo. 

Finish responding to my emails, then treat the hypo.

Finish my conversation, then treat the hypo.

Finish [enter other random tasks here], then treat the hypo.

It was after a conference call that my manager (getting ever so more observant) approached me.

"Are you okay?"

"Yes," I nodded, not trusting myself to string a full sentence together.

"Do you want to try that again?"

"I'm fine," I replied, proud of my two word sentence and use of a contraction in my hypo state.

"You ought to trademark that response. It's you're go-to," and he handed me a bottle of lucozade.

With shakey hands, I picked the bottle up. The lid had already been unscrewed, and I counted six gulps and waited for my blood sugar to come back up, my manager now sat the opposite side of my desk. 

As my blood sugar came up and my mind began focussing on other things, and not my low, I looked at my manager. 

"Thank you," I whispered.

"You need to start trusting us, Vicki. We're not going to look at you any differently if you need to leave to sort your diabetes. I'm not going to sit here are pretend I know what you go through on a day-to-day basis, because I don't. What I do know, however, is that you're not putting yourself first some of the time. Start doing that, okay? And know my door's always open if you need or want to talk. Is your blood sugar back up now?"

"I think so. I'll just check. You no longer have two heads, so progress!"

"You're forming full sentences too. Progress again."

I laughed. "I'm sorry. Put me first. Got it."

As much as I enjoy my job (most of the time, anyway), and want to prove myself and further my career, not putting my health first isn't going to help me achieve anything. No negelecting of me, by me. It's one of many balancing acts I'm working on.