Pump Break

I first started pumping in early 2003. I have taken two pump breaks since then, neither one of which was really by choice. The first pump break was pretty soon after I started, the summer of 2003 between my junior and senior year of high school. I was at a pretty bad point in my journey with Diabulimia, and went into DKA. I was living in Kuwait at the time, and between my DKA episode and how hard it was to get all our pump supplies while we were there, my parents and I negotiated my going back to MDI (Multiple Daily Injections) so we could make sure I was actually taking my Lantus shots. My memories around all this are a little fuzzy, partly because I think I’ve blocked it out and partly because it was a long time ago. I’m sure my mom would have more to say about this time.

My second pump break was a few years later. I went through clinical depression and had to take a break from school for the second semester of my sophomore year and the first semester of my junior year at university. I lost a lot of weight (I was down to under 80 lbs for my 5’3” height) and just didn’t have enough meat on me to handle the pump infusions I had. I didn’t care enough to try a bunch out, so I just went back to MDI (Multiple Daily Injections) for a bit. I returned to both school and pumping the second semester of my junior year and still graduated on time.

Since then, I have been on a tubed pump until this past summer, when I switched to Omnipod. T1Dx3 is a lot of work you guys. Sure, my husband is a fully grown man and I don’t really have to manage his T1D for him. But I do most of the carb counting (I’m the main chef in the house) and I’m still in charge of his site changes that aren’t on his legs or abdomen. I’m in charge of ordering and keeping track of alllll the supplies and making sure we have enough for all of us and a little extra just in case. I’m in charge of all the doctor’s appointments. I’m in charge of pod decorating. I’m also in charge of all the meal entries and carb counting and low treatments and managing of blood sugars for both myself and our daughter for most of the day.

Ever since our daughter’s abscesses last year, we’ve been a lot more careful about site rotations. Keeping track of what went where last, and how long that skin has had a chance to heal and breathe has been a lot of work. I also became really aware of where my pods were at night. For some reason, I was having a really hard time sleeping. I have always tossed and turned at night, and was waking up in pain because I was trying too hard not to get a compression low or prevent a kinked infusion. My right shoulder hurt for weeks after one particular permutation of site changes because of where my daughter wanted me to match with her.

I got really tired of keeping track of all the meal entries, and site change tracking, and data and settings and just, all of it. So when Companion Medical announced that Fiasp was available for the InPen, I contacted my Endo. If I was going to take a pump break, I wanted it to be with Tresiba and Fiasp in the InPen specifically. But Kaiser doesn’t cover either of those things, so it has been a battle and a lot of back and forth between my endo and the pharmacy, but I finally have all the things I need to be able to let my body and my mind take a break.

It’s been about 11 days since I took off my last pod. It hasn't been easy. I still don’t have my Tresiba dose completely dialed in (pretty sure I’m going to need to try and split the dose because I spend a few hours in the 200’s every night). I have way more bruises on my arms and legs than I’ve had in years. My time in range has gone down by 10% so I know my A1C is going to be higher this next time. I have a bad habit of using my midsection for quick shots because it’s easy. I took my Tresiba dose a few hours too late once in the first week. And my husband seems to have more of a problem with how many needles I am going through than I do (he said he doesn't like me having to poke myself more, but he has never taken a pump break ever and fully doesn’t understand why I wanted to do this). It took him a week to get over the extra shot I was taking for the latte he was making me.

But I’m free. I LOVE only having one device on my body (you couldn’t pay me to take my Dexcom off). I love not worrying about what Loop is going to do with the data I put in and just guesstimating how much insulin I need instead of being a stickler about carb counting. I haven’t gone over 250 once since I always have long acting on board even if I messed up with said guesstimating. I really don’t mind just taking another shot, even if it’s for 0.5 units. I feel like I have a lot more options for shots than worrying about whether a pod or infusion would really stick in a particular place.

That being said, this isn’t a long term decision. I know I won’t be able to fast during Ramadan without Loop, so I will be going back to that a week before Ramadan starts (so in maybe another week). The mental burden of this condition is real, and I feel like I’ve given myself permission to just survive instead of pushing myself to ‘be in range’ for a particular percentage of the time. So despite my numbers not being as good as they were on Loop, I am so so glad I simplified my management for a little bit. I also feel a little peace of mind, that I can always come back to this when I need a mini break.