Pumping Fun

OK, I didn't really get to see much of the news today, so forget about talking about the Republican National Convention. I don't think I'd really have much nice to say anyway. I'm just not a fan of George Bush. I know, George is probably really down that I'm not a fan, so sue me. So, instead of using my sharp, rapier wit to spear the President, I'm going to do the next best thing - complain about carb counting.

Actually, today I did pretty well with carb counting, so what the hell am I going to complain about. I'm not on Atkins or any of that crap. I don't have time for that. But I do have to be sure that I count carbs so that I know how much insulin to take. This is good, actually, because since more people are now counting carbs, more food tell you how many carbs they have. But then again, a lot of the foods lie. Like the .2 gram chocolates or the 2 gram pieces of bread. Diabetics know that these things are just big lies. The doctors tell us to ignore the net grams and stick with the total grams, because the net grams are good for Atkins dieters but are bull shit for diabetics. Like the first time I tried no sugar chocolate and got the shits from them. Useless things. So the things that drive me crazy are like tonight - Chinese food. I had garlic beef. Mmmm great stuff. Really, I could live on it ... well, really, no, I couldn't ... but I'd like to think I could. The problem is not the garlic beef. The problem is the rice and the egg rolls. They are the evil in Chinese food, because you know you can't eat just a few nibbles of it. They give you scoops and scoops of rice and each grain is like one gram of carb. So you eat one forkfull of rice and you have to shoot one unit of insulin.

OK, maybe not quite that bad - but the point is that if you eat more than you thought you would, and you know you always do, then you have to go back to take more insulin. That's one thing I'll like about the pump. Ate more than you thought you would? No problem! Just tell the pump you ate more and it will fix it for you. Of course, you have to eat what you said you would... or else you end up sweating like a pig and your brain fried because you can't take the insulin back once you've shot it in. If you say you're going to eat 36 grams of carb you better damn well eat 36 grams of carb or else.

So that's that, my bitch and moan for the night - I wanted this to be more coherent, but I think my blood glucose is hovering around 70 right now. Either that or it is just damn hot right now. Gotta go.

Morning edit: after I wrote this I had to wipe myself down because I was sweating like a pig, and it wasn't because of the heat or humidity. Definite low. I ate two half Pop Tarts that were in the freezer (yum!). When I woke up this morning, I had a 178, so I know I was low when I went to bed (one Pop Tart is like 40 carbs, and if I ate that at a normal reading with no insulin to counteract, I'd probably have woken up with a 200 or 225). I would have tested to find out just how low I was but I was tired and just plain didn't feel like it.

I just ordered the pump from Animas - it will take two weeks to get here, though, the guy said. What the hell am I going to write about with two weeks left to go!? Sitting here now, I'm not sure if he said it would arrive on the 12th or 14th, but it was one of those... he must have said the 12th, since the 14th is a Saturday.

Well, OK, that's that. I guess I can write about the Republican National Convention and about school starting for the kids this week, and just wing it next week...

I'm lamenting the cost of being diabetic - and praising my insurance plan. I can't imagine paying for all this stuff out of pocket. Today I'll have to go to the pharmacy to buy a few boxes of pen needles (they may be my last boxes, since I'll be buying infusion sets once I have the pump). I'll be transferring three other prescriptions to my local pharmacy at the same time - one for Lantus, one for Humulog, and one for regular needles. As with the pen needles, I may neve need to get these filled again. Well, I will need Humulog for the pump, but no more regular syringes, and no more Lantus. I buy Humulog in pen cartridges, and I guess I'll need to buy that in bottles now. I'll get all the details later.

So today I'll be calling Animas to set up the purchase of the pump. I'll probably put it on a MasterCard just so that they can get the payment right away - we don't like using credit cards, but this is the type of thing we do use them for, to buy big things over the phone or Internet, and then we just pay off the balance. Rarely do we buy something big without already having the money to pay for it. We bought our daughter's new computer on our Amex card and transferred the funds to the card a few days later. That way we got the Blue Cash credits. Plus we got about $300 in rebates from the purchase, and we are sending in that money as it comes in (so far we've gotten about $200 of the $300 - I hate rebates, what a pain in the ass).

Any way, I lost the number for the guy I'm supposed to call, but I got their number off their web site and I'll call that - I'm sure I can be directed. As long as their sales hasn't been off-shored! I got a reply from Dell about a support question via email the other day that was obviously from off-shore. As a programmer, I hate off-shoring, and wish I could find a way, other than hating it, to avoid it. But it is unavoidable. Maybe if Kerry is elected, we can work on that.

We're all over the map today, aren't we?

So I wanted to wait until 9:00 am to call Animas, and it is 9:30 now, so I'll make the call soon. A few things I wanted to say about the pump first, though, because I want to be able to come back later and see what my fears were.

I resisted the idea of the pump when I first heard about it. As I mentioned, I was a bad diabetic, not really in denial, but more just lackadaisical. High blood glucose, who cares? Tight control was not something I really cared about. And the thought of being connected to something all the time was unappealing. But as I read about some of the benefits, the desire to be freed from the inconveniences outweighed the desire to be "free." Yesterday we went to our local county fair, and I had to tote a needle along with me, since I knew I'd be eating fried dough or onion rings or cotton candy at some point. I did end up having that fried dough (note to self: one of these per year is plenty). Though the pump won't help with carb counting (they don't publish nutritional information at the local fair - I guessed 90 carbs), it would have helped with the self-consciousness of whipping out the pen needle in the middle of that crowd and shooting up with insulin. I really don't care what anyone thinks (many people gawk, or look away in disgust - for the gawkers, I'm happy to put on a show, and for the look-awayers, to hell with you). I'm more concerned for what my wife thinks. It was worse when I used regular needles all the time instead of the pen - drawing from a bottle and all that was painfully obvious and she got embarrassed. Maybe I'm a bit masochistic - I've always thought it would be fun for a cop or something to come up to me and demand to know what I'm shooting into myself.

I read some things in the Diabetes Advisor magazine, some letters from women who were complaining about the pump and women's fashions. Nothing I need to worry about - I always wear something to which I can clip the pump: jeans or shorts. But reading the letters, I realized that there will be things that will be a pain with the tubing and stuff always there. I knew that going in, but reading the letters made it more real, made me realize that soon I will have to deal with that stuff. How careful will I have to be with the infusion set as I shower? If I'm water skiing, could a fall tear out the set? How will I sleep (I sleep nude, so I won't have any where to clip the pump [no funny stuff with that one, please])? Will I stick it under my pillow? On the nightstand? We'll figure that out as it comes, I guess.

OK, gotta go, I have a call to place.

Well, my wife and I discussed buying an insulin pump for me today. I have put off this discussion for a while simply because we ran out of time. But I've gone through all the motions of getting the pump, from the classes to the literature to the Java-based demos on line, and the last steps, buying it and getting it, were all that are left.

This blog will be my first, and here I will chronicle my use (abuse?) of the pump. I don't know if anyone will ever care, so my main point in doing this is for me, so that I'll have a way to look back and see how I was feeling about it over time, and so that I can jot down any notes that I want to get to my endocrinology team but don't want to trust to my (increasingly flakey) Palm.

In case anyone else out there does care, here are some facts about me. I know all these facts, so these are here only for the benefit of others. As of this writing, I am 35, and I've been diabetic since about 1992. The exact date is not really important to me, so I don't know it for sure. I do know that I was out of college and I was married, so that puts it after 1989 and 1990 respectively. I had a couple years left on my six year tour of duty with the National Guard when I got booted out (no insulin-dependent soldiers allowed, a note to any future draft dodgers out there). So that makes it around '92.

I was a baaaad diabetic for many years. A few bad cases of hypoglycemia that scared the crap out of my wife basically got me to get my act together. A belly that hung too far over my belt got me to start taking care of my body. The two of those things have me in the best health I've been since college. I did have a trip to the hospital in January 2003, when my wife couldn't shake me awake and it turns out I'd bottomed out at a blood glucose reading of 2.1 (well, OK, not that low, but it was damn low). I worked hard with my team after that to get things under control. I had been using Regular and 70/30 insulin for a decade, and went onto Lantus and Humulog after that. The pump came up a few times, but I wasn't interested.

But more recently, as my weight dropped and my A1C's dropped, and my control got tighter, and my routine got a lot more complex, the pump started to look more attractive. Let the freaking pump do all the calculations - why should I have to count carbs AND ratio AND compensate AND blah blah blah. I work with computers all day, why can't a computer do all this for me. Well, it can. That's where the pump comes in.

So I decided on an Animus pump (they're water-proof - no way I'm paying $5000 for a beeper-sized computer that gets ruined if it touches water). They contacted my insurance company and I have to pay $520 for the pump and a three-month supply of ... supplies. Of course, test strips and insulin are not included in that. Let's be real. $520 is still a big chunk of change, and even though they let you pay over time, I couldn't decide to do it on my own. So we discussed it, my wife and I, and she said to go for it.

So, on Monday I'll call the company and tell them to do it. I'll have them charge it so I won't have to wait for any thing, and we'll just pay the credit card off when the bill comes. So, from now until then, I won't have anything in particular to write about. I'll come back and update when I've made the call.