Tuesday, March 8, 2016

Insulin Pump Change Day

Today is pump change day.  That means we have to insert a new inset/cannula and fill the girls' insulin pumps with new insulin.

Since starting on insulin pumps in October of 2015, the girls are thrilled to not have 4 - 6 shots via a pen needle or syringe each day.  However, the 'big poke' every 3 days is still painful and challenging.

We use a numbing cream to help offset the pain, but sometimes it still hurts.  We've learned that putting the cream on before breakfast and letting it sit while the girls eat results in much less pain for them both.

Today, as we prepare for Selah's inset she quietly speaks, "I really don't like the big pokes."  Following a short pause, she continues, "But I'm sure glad it gives me insulin to live."

I fight back tears but quickly agree with her.  "I'm glad it gives you insulin too, baby.  I'm sorry the pokes hurt, though."

We proceed to change her pump site.  She rewinds her cartridge.  I fill the new cartridge with insulin.  She takes out the old and inserts the new bottle into her pump.  She hits load cartridge.  Once it is done setting up, we prime her pump.  This fills the tubing that connects the pump to her body with insulin.  She likes to watch the insulin as it travels the curls and swirls of the tubing - chanting, "It's going, going, going, NOW!"  When she yells now, I know the insulin should be coming out the needle at the end of the tubing. I stop pushing the button to make the insulin flow.  Now she's ready for 'THE BIG POKE'.

We remove the tape that is over the numbing cream. Wipe off any excess.  Swab the area with alcohol to make sure it's sterile.  Then, get her inset ready to be inserted.

I line up the inset where the numbing cream was applied.  She takes a few deep breaths.  "Ok," she mutters quietly.  With a quick squeeze of the inset case, the needle strikes; imbedding the cannula under her skin to enable it to deliver the life saving insulin for the next 3 days.

Her inset after I squeeze to inset the needle.
The cough drop is for size comparison.
It's not exactly a tiny needle.
Her inset before I squeeze to inset the needle

Now she's ready to reconnect her pump and fill the cannula.  She's set.  Her insulin pump should deliver whenever programmed or prompted until it's time for another change -- as long as no complications arise.  (Thankfully, we've not experienced too many difficulties with the girls' pumps thus far.)

It's become our routine.  Every three days we go through this little ritual.  Gather the supplies, apply the cream, disconnect the pumps, fill the canisters, prime the pumps, insert the needles, re-connect the pumps, fill the cannulas, and away they go.

I can't say it's mundane because the anxiety it provokes in our little girls is anything but.  The internal fight of knowing this is for their good, yet knowing I am causing them physical pain is daunting.  But... it is becoming our norm.  I personally no longer get heart palpitations at the very thought of filling a canister by drawing out insulin from a vial with a syringe; fearing I may leave bubbles that could cause high blood glucose levels if not fettered out.  I also no longer cry each time I have to give the girls a shot or another inset.  They no longer cry either.

Guess we're learning that we are tough.  They much more so than me.

I'm so very thankful for the many advancements we have today to help us manage the girls' type 1 diabetes.  We have a lot of tools at our finger tips that help us monitor and cope with this disease.  Yet, none of them are full proof.  None of them are simple.

It will continue to be my prayer that a cure will be found soon.  That our little girls will no longer have to have 'THE BIG POKE". That their pancreases will be rejuvenated and produce it's own insulin again.

Until that day, however, I will be the best pancreas I can be.  I will do pump changes every 3 days.  I will advocate and educate.  I will monitor highs and lows.  I will give fast acting carbs to bring up a low and give more insulin to bring down a high.  I will strive to help our girls live a fulfilling life.

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