Wednesday, October 31, 2012

Our Halloween Scare: Unplugging the (Insulin) Pump

I'm probably going to regret writing this post, but if it helps someone else out there not feel alone or wrong by making a similar decision, it's worth all the comments I will get about how I'm doing it backwards.

WARNING: This post may not make any sense to you unless you are familiar with insulin pumps. Sorry about that!

The situation is this: our immediate family has four type 1 diabetics, all controlling our blood sugar with insulin pumps (Minimed, so that I get no questions from people who want to suggest a different brand). Over the last few months, our twelve-year-old son has been having difficulty with infusion sets working. When he was first diagnosed, he still had a bit of the baby chub, but as he's grown over the last few years, he's thinned out quite a bit and gotten serious about working out. He lifts weights, plays soccer, wrestles, does sit-ups and push-ups--your typical, all-around active kid. And now he's got literally no subcutaneous fat to insert the cannula into. We switched to a shorter cannula, even tried the sideways ones (which leave worse scarring and seem to be less versatile in where you can place them). He just has no place to put them.

In the past week alone, our son has had two different days when his blood sugar has risen quickly to over 500 because a brand-new infusion set got bent when inserted. In both instances, we went through at least three infusion sets trying to get one into his skin without the cannula turning into an accordion.

So today, on probably the worst day of the year to do so (remember, this is a kid on Halloween), we are switching him from the pump to Lantus and insulin pens. Can I tell you what a difficult decision this has been to make? As a mother, of course I hate to see him in pain. But which is worse? The pain of repeated failed insertions and then vomiting and missing school and feeling terrible because his blood sugar is too high, or taking multiple shots every day? Luckily, he has decided it is something he wants to try, so at least we're not forcing him to do something he doesn't want to.

Not only that, but we've bought into the idea that insulin pumps are better for his A1-c.Maybe this will help his A1-c (which was a little high thanks to the infusion issues). Maybe it won't.  Maybe this is a temporary change. Maybe it isn't. One thing I do know--it will be easier for wrestling. At least I won't have to worry that his infusion set will be pulled out during a match (not that it factored into our decision).

Anyway, is there anyone else out there who has had to switch from an insulin pump back to shots because of low body fat (boy, I wish I personally had this issue!!)? What are your thoughts?