Thursday, March 28, 2013

My path to injections

I've been getting a lot of questions about my choice to go back to injections. Most of these connections are people I know. What's more surprising is they are all from friends who are currently pumping and now wondering how to go back to MDI. Although I didn't know what kind of affect MDI would have on me, I also didn't realize it would influence others. Of the people I've connected with, they all seem to be in the same boat. At the point of ripping that damn machine off or go crazy.

So here is more of what I've learned and the way I have been making it work.

First of all, you probably shouldn't do what I did. I didn't consult a single doctor or nurse or CDE. It never even occurred to me because I've never had a doc that was any good. I literally slid down the slide without a single regard. I like to experiment, what can I say? I DID write down all my pump settings. When I was on MDI 5 years ago I remember taking 24 units of Lantus once a day. This time I was going to split my Lantus in half to help reduce the insane amounts of nypos (thank you Bethany!) so I immediately started taking 12u at 12 hours apart. My pump was giving me 25 units of basal insulin per day so that seemed fair. It wasn't enough though and I was high all day. I bumped it up to 14, still high. Once more I went up to 16 units twice a day. I sat at this dose for awhile. I was having at least two really bad lows during the night every night so I  decreased my pm Lantus and now I take 12. I think it should be reduced to 10 but I prefer the lows over highs. If I've worked out hard that evening I may reduce it to 10 but more often I'll just eat that night with little or no bolus. If I am going to do a hard long workout during the day I'll reduce my am dose by 4 units.

Boluses (blouses?) are a completely different story. Other than breakfast, I rely on SWAGging (Scientific Wild Ass Guesses). My pump did all the calculating for me. I had my insulin to carb ratios at 3 different rates throughout the day. My pump was programmed so all I had to do was input my BG and the amount of carbs and voila! Magical bolus calculated right down to the .05th of a unit. I thought that was the way it goes. I had to re-train myself to do that math in my head. I don't do it in such detail though. I "dial-it-up" on my insulin pen and inject what I think is about right. Years of seeing my pump do it has ingrained a lot of that. I'm just not of the mindset to whip out my calculator. I'd have to figure out way too much and its more work than I care to do. 1 or 2 units is the option with a pen, not 1.75 units. I'm learning that it really doesn't matter that much (to me).

As for the psychological aspects, I feel oddly LESS stressed. I absolutely ADORE not being hooked up. I feel AMAZING. I truly believe all that extra stuff was complicating my diabetes management. I was putting too much emphasis on all the little things and not seeing the bigger picture. Pumping made it all-consuming and in-MY-face. I spend so much more time naked now! I still do a little dance around the apartment after a shower. There's a certain beauty to my love life that never existed before. I even ENJOY getting dressed and not putting a single thought into "where is my external pancreas going to go". This is especially obvious when getting into my cycling gear. It's a kind of freedom I took for granted before.

I used to think insulin pumps were the answer to my problems but it turns out they weren't. Well they were transitorily important (makes sense right?). All it took was for me to go ape shit crazy that I wanted that gadget to die. I fought for many years for an insulin pump. I saw it as my diabetes nirvana, my control mirage. For many years it WAS. It taught me so much that I was able to carry that knowledge forth to apply it to injection therapy. I am smarter for it. I was never able to get my 'betes under control the previous years of injections and that was from the lack of knowledge.

I can't say for sure but this may be it for me. The key to my diabetic comfort and confidence. I see my endo next week so I'll get a good idea the affect of the past 2 months of injections has had on my A1C. I feel good about it though. I do have far less stories to tell and junk for my blog. No more stories about dunking my pump in a hot tub or posts about kinked cannulas, clogged tubes, infected sites and empty reservoirs. Perhaps I'll write more about LIFE with diabetes than the diabetes itself.

As always YDMV (your diabetes may vary). This is MY experience only.


  1. Ugh, just wrote a long response and then lost it. The long and short of it is that I love this post, AND I'm jealous! But I'm actually toying with a pump vacation myself...and seeing where that leads. My main complication with the plan is that I still want to be on CGMS. I don't feel safe at night without it. So, tricky.

  2. I must admit to being somewhat jealous of your newfound freedom. And I'm really hoping you can find a good doc at some point. Someone who speaks your language (there has to be at least one out there, right?), and understands the athlete in you. Thanks for the insight.

  3. Heather B in VancouverMarch 28, 2013 at 3:31 PM

    Crap ... I, too, just lost a long response! Computers and insulin pumps ... fuck 'em! The short version is that you've inspired me to unhook, and it's been great. I don't think I'm going back — thanks for these posts, Scully! Re. mewithd's comment about CGMS ... I've also ditched that for an adorable diabetes alert dog (self-trained). :)

  4. Wow Scully!! Good for you. I hope you find the diabetes nirvana you're looking for. I am more of a newbie to the whole pump wearing and I still really like it & all the info it provides me. I am always curious to know how a person feels when they switch back to MDI's because I recall it being quite a learning curve to start on the pump. All the very best to you and keep us posted on your pump-free life.

  5. I think if I had diabetes, I'd want to use MDI. What a joyful thing to be all naked + happy-dancing!

  6. Yay!! Another MDI-er in the DOC! In the beginning, I was always jealous of the technology that pumping seemed to offer people. I felt archaic with my little insulin pens but now I can't even imagine being "connected" all day. I'm glad you've been able to gain the knowledge you need from pumping, and learned that MDI is going to work better for you. And, I just saw your FB status of your new A1C and you're obviously doing something very right!!! Good work Scully!

  7. My pump vacation has lasted 2 years.....and I have no plans of going back any time soon. You're so right about how freeing it is. I love it. And my A1c hasn't suffered a bit! Good to read about someone in the same boat.


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