10/2/2008

I Am The Pump Man

Uncle AndrewUncle Andrew
Filed under: @ 6:44 pm

Goo goo ga joob. ­čśŤ

My new insulin pump has been sitting around the house for a couple of weeks now, waiting for my factory-certified trainer to get hold of me and set up a time for a consultation. That finally happened on Tuesday, and I am now the proud bearer of yet another expensive electronic device clipped to my belt.

This thing is actually pretty cool: a pager-sized chunk of plastic that holds around 300 units of fast-acting insulin. A wire-thin catheter runs from the pump to a neat little two-part, detachable interface that is secured by some medical-grade adhesive flaps to a spot on my midsection. A 5 millimeter length of tubing feeds out of the back of the interface and pierces my skin, providing a pathway for the insulin to travel from pump to person. The tubing and injection site have to be replaced every three to four days. This feels kind of wasteful, but certainly not noticeably more wasteful than disposable syringes, which I no longer use.

The company that puts this thing together has done pretty much everything to make the operation as simple as possible. It even comes with a glucometer that transmits my glood glucose levels wirelessly to the pump. I just take a reading, enter in the amount of carbohydrates I plan on eating, and the pump dumps the appropriate amount of insulin into my system. If you have the scratch—or if your insurance is particularly generous—you can even get a separate blood glucose sensor that attaches to your body. It continuously samples your levels and sends it to the pump, which adjusts your insulin accordingly. It’s the closest thing going to an actual electronic pancreas.

My trainer did some calculations to determine both the ideal rate for the basal (long-term) drip and for the bolus (short-acting) infusion, making some educated guesses as to my insulin sensitivity and my reaction to carbohydrates, and I was more or less good to go. In addition to handling sugar control for meals, the pump also pushes a steady trickle of insulin into my system for regular blood-sugar maintenance. This ought to significantly reduce the peaks and troughs in my blood glucose levels that are likely responsible for the minor kidney damage that I have already incurred, and prevent it from getting any worse.

One of the aspects of using the pump that I thought would be a pain in the ass has turned out to be no biggie: sleeping with it. Since the thing is designed to constantly juice me with insulin, I have to be hooked up to it 24/7, except when bathing, swimming or soaking in the hot tub. Most pump users I spoke to just stuff the thing under their pillows, but I spend all night switching from side to side (I don’t sleep on my stomach because it’s not comfortable for some reason, and I can’t sleep on my back because Margaret will smother me with a pillow; she claims I snore, but I’ve never heard it), and I’m afraid I might garrote myself with the tubing. So instead I clip the pump to my jammies and it takes my nightly roller coaster ride with me.

There’s going to be an adjustment period, in which I and my new belt-buddy get used to each other. I have (hopefully only) one more meeting with the trainer as a follow-up and final tuning. Then I’m released into the wild.

In case anyone who is considering the pump as an option stumbles across this entry, I would urge you to pursue it. At first the prospect of hooking yourself to a little chunk of machinery via a creepy tubey thing, swapping out the whole mess every few days, for the rest of your life seems daunting. But really, compared to injecting oneself three to six times a day, it’s a piece of no-sugar-added dietary low-carb cake. I and my doctor are quite optimistic that this will stave off further damage to my insides, but even if that weren’t a factor, I would take this option were it offered me. It’s easier, it’s safer….and it gives me another computerized doohinkle to futz around with. So what’s not to like?


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