Me and my pump.

The pump has been with me for a little over 2 years now. Officially, it’s a Medtonic Minimed Paradigm® Revel 723 pump. Unofficially, I have a love-hate relationship with it. Actually, you can make that a like-hate relationship. But that’s not as bad as it sounds.

When you add up the score, it’s not all that bad:

Pros
First and foremost is the convenience factor. I can go just about anywhere (not the water) with it and get insulin when I need it. A good example for me is my too infrequent day trips to New York. Instead of injecting a great deal of Lantus and hoping that my BG stays in range all day, or taking along a flexpen with something fast-acting and then looking for a quiet place alone from time to time (try finding that in Manhattan), I have what I need resting on my belt. Love that convenience.

It does help me keep my numbers in line a little better, but my numbers were pretty good for about a year before going on the pump. What the pump does is make it easier to manage my numbers. When I was first diagnosed with type 1, I was put on a twice per day Humulin 70/30 product. Same dosage every day, no matter what. That lasted for about 14-15 years. Then after having a difficult time handling lows, I was introduced to Lantus. It changed my life. For about two years. After that, I started to have additional issues with lows in the morning and highs late in the day. So the answer to that was to cut down on the Lantus and use a fast-acting insulin (Apidra) for boluses prior to eating.

By the way, this was the first time I’d heard about the word “bolus”, or even the idea of adjusting insulin dosage based on my BG and my carb intake. About 18 years into my diabetes. Until then, it was the same dosage, same time, every day, no matter what.

The next part is my fault. I found the bolus idea to be too much of a nuisance during the day (crazy, I know). Particularly because I work in a conservative environment where appearing to be out of the norm has, in the past, sometimes been seen as weakness. So I only bolused with the fast-acting insulin at night, at home, where only my family would see it. At work I still check my BG before lunch in a separate room with no windows. People at work know about my diabetes. Some of them have freaked out about it at times. Or maybe I’m still a little unsure about giving them a reminder about it every workday.

I eventually started looking into insulin pumps about 3 years ago. I decided I wanted to check it out. I loved the idea of having continuous delivery, and the fact that I could program everything in, even variances to my routine (I’m talking temp basal adjustments). I finally got hooked up with the Minimed after I started with my super Endocrinologist, who has been great.

Cons
The hardest part about wearing a pump is that you are wearing a pump. It is attached to you, 24/7/365. You can’t understate that. But let me be clear in saying that you can get used to it. And if you’re not fond of giving yourself multiple injections per day (never a problem for me), I guess one stick every few days is not so bad.

I am not a CGM (continuous glucose monitor) wearer. I tried it for a while after going on the pump, but there were two big reasons why I gave it up. First was the annoyance of having another thing attached to me all the time. The other was that I’m very concerned about real estate (??). I’m starting to read about some of my fellow pump-wearing PWDs who are finding that some sites have scar tissue after being injected many times. I’m interested in preserving potential sites as long as I can, so while a CGM might help me get real-time BG info, it’s not yet worth me destroying extra real estate. Maybe later, but not now.

In the final analysis, I am happy to have the pump. I am very happy that I have an employer that cares enough (I’m being honest here) to cover my pump, and pump supplies, and strips, and lancets, etc. It makes me sick to see people lose their benefits and think, “what if they or their family has to deal with this disease on their own?”. And I’m looking forward to the improvements that technological advances will bring to the market. Maybe the real estate issue won’t be such a big deal in the future.

And one final thought: This is just my blog… it’s very much a personal journal of my life with diabetes. Every pump and CGM decision is a personal one. You must decide for yourself. If you’re thinking about whether to take the plunge, get advice, not opinion. Get the facts, not a viewpoint. I wish you the best of luck, and the most of happiness.

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