Thursday, May 2, 2013

D-Talk: Officially Pumping - A Rough Start

We went to our follow-up diabetic ed class Monday morning, and left with insulin in the pump, ready to go!  Jamers did super with it all evening. 

He was perfectly in the range the doctor wanted him at bedtime.  Matt checked him at midnight and he was 194.  I checked him at 2 am and he was 235 - both numbers within goal range.  (Goal range between 7pm and 5:30am is 150-250.)

The next day, I got a call around 11 am that he was over 600!  Holy!  They said he was drinking and peeing a ton.  Not good.  I gave him a skin shot, thinking that the infusion site was bad.  After nap, he was still at 520.  I had Matt go over to day care and dose him again, this time with the new insulin, and again through a skin shot.  After that, he ended up going low, to 56. 

We got him home, got dinner into him, and checked him every two hours through the rest of the night.  He did fairly well after that.

I just got back from dosing him for lunch and he was 552 today.  Holy roller coaster, batman.  I have left a voicemail with the endocrinologist, so hopefully someone calls me back soon so we can get this all figured out.

I know that his body is just adjusting to the pump, now that he doesn't take Lantus (long-acting) insulin any more.  My hope is that with our constant vigilance this weekend, that he'll have great numbers.

I took some pictures of the infusion set change the other night, and a short video

Here is what the infusion set looks like, right out of the box.
(Note:  You can prepare an infusion set it more than one way, and not necessary in the exact order in which we did the steps.  This is just the way we did it.)

You un-cap it, and free up the tubing.

Then you pull the tubing out.

Then you pull off the spiral paper, which exposes the sticky part that will hold the infustion set against Jameson's skin.
Then, you put the end of the tubing through the cap, attatch it to the cartridge that will go inside the pump (no picture of cartridge), and screw the pump lid back on.
Then you have to go through a series of steps that pushes the piston in the pump up into the end of the cartridge so that it can push the insulin out of the cartridge when it's time to dose. 
When all of that is done, you're ready to put the infusion set into the skin.
You turn the set over, and peel the paper off the back of the set, which exposes the white plastic you see below.

Do you see the two rectangular pieces, right in the middle?

You pull up on those two pieces to set the infusion set so that it's ready to "shoot" the needle into the skin, as shown in the picture below.

I had Matt take a short video of me actually inserting the infusion set.  I felt cruel doing it, but I know that some of my readers are probably curious about how it works, as I was before we started this process.
I will warn you, we did not use the numbing cream in this instance, as it takes 45 minutes to take effect, and we didn't have that kind of time.  We were facing dinnertime, bath time, bed time, etc.
That being said, Jameson does flinch when it's inserted, then starts to cry.  It's not easy to watch, but honestly - this is our life.  Constantly poking and prodding our little man, who isn't even two years old yet.  I'm not looking for sympathy, just putting it out there. :)
So, in a nutshell, that's an infusion set change.
I spoke to the nurse just now, and she said that often times the doctors are conservative in the insulin dosages when transitioning from injections to pumps, so it's possible that Jameson could need more insulin.  I am going to fax in the numbers and we will go from there.
I'll update once I have any new information.  Thanks for tuning in!
Have a great Thursday.

1 comment:

  1. Kaylan's Endo "tweaks" her pump settings at every visit. There are so many things to consider, basal rates, insulin to carb ratios, insulin sensitivity factor, changes in activity, changes in weight, all these things make a difference. Its amazing they can figure any of it out. Keep up the good work.