CHAPTER 17
My previous chapter ended on a very positive note. I was very happy with my pumping but there were problems encountered later on that were very annoying. These problems were not due to pumping though. They were problems that would have occurred even if I was not pumping. Every time the seasons change the temperatures fluctuate and so do my blood sugar levels. Having to deal with this in October and November was difficult. I encountered highs and lows and I had much less control than I had in August. Much of my programming had to be altered until the colder weather of late November when the temperatures were more stable. I tend to need more insulin in colder weather and less in warmer weather. I have read that many diabetics have this problem but apparently there are some who do not have the problem. I imagine that diabetics who live in parts of the country where the temperatures are more stable the whole year do not have a problem with this. Diabetics in the deep south may not notice much difference in insulin dosages throughout the year. A friend in California told me that his dosages remain more constant but then the temperatures there are very stable. The temperatures here in NY can vary as much as 20 degrees Farenheit in a week’s time.
In December I started having “no delivery” alarms on my pump. I changed infusion set and the alarms were still there. I called the Minimed hotline and a very young sounding lady talked to me for about 20 minutes. She had me give her a lot of information from my pump’s memory and she decided the pump was not at fault. Then she asked what part of my body I was using for my infusion set placement. I had used my upper abdomen from the start. I had also used the same area for injections prior to pumping. I occasionally used my legs when injecting but it was my upper abdomen for many, many years. The young lady told me to start using other suitable body parts and let my upper abdomen rest. She thought I had scar tissue due to overuse of that part of my body. She was right! I started using my lower abdomen below the belt line and I had very fast and thorough absorption. No more alarms. I was amazed that a young lady who sounded like she might be in her teens could solve my problem so quickly.
There were still problems. The absorption was so fast that I had to change my programming on my pump again to combat the low blood sugar I was having. I had many lows in the 30-60 range for several weeks until I got the feel for the new absorption rates. I was using less insulin. It was not until February of 2008 that I had everything under control. That month was the best I had experienced since I started pumping. My average blood sugar for that month was 88 and my standard deviation was 27. That is a bigger standard deviation than I wanted but I have plenty of time for tweaking. I rarely have a high above 140 now. The discovery of my scar tissue has helped me very much.
I have decided that many of the big jumps from high to low blood sugar for perhaps fourty or more years prior to pumping were due to uneven absorption and scar tissue. No doctor ever told me that I should rotate my sites and use different body parts to prevent scar tissue from forming. I remember very clearly all those times it was difficult to insert the needles into my abdomen. The skin was tough from scar tissue, I am convinced of that. There were times when I hit soft tissue and other times when it was hard. I had never heard of scar tissue being a problem for diabetics. Why didn’t a doctor ever tell me to rotate my sites? Even Dr. B. had never mentioned this. Did he assume I knew? He acted so surprised when I told him that I had this problem. It seemed as though he had never heard of this happening. I know that many diabetics have lots of ups and downs in their blood sugar levels, and many of them for unexplainable reasons. This may very well be due to scar tissue developed because of using the same region on thetr bodies for an extended period of time. Rotation of sites on a regular basis will prevent this from happening. Absorption will be complete and more even. This can prevent many highs from occurring when the insulin is trapped in an area affected by scar tissue and then, much too slowly, reaching the blood stream.
There have been many things that my doctors should have known but did not tell me during my 62 years as a diabetic. In chapter 2 I mentioned that a low carb diet was used to help diabetics even before insulin was discovered and sold. It was therefore known in the early 1920’s that a low carb diet was helpful to diabetics. So why didn’t my doctor in 1945, when I was diagnosed, tell my parents that I should eat a low carb diet? Why were they told that I should not eat sugar and then never mention carbs? None of my four doctors during my first 35 or so years as a diabetic ever mentioned carbs to me. Did they not know anything about this? I eventually learned about the importance of carb counting in an article in a magazine. I mentioned this to Dr. B. and he looked at me with such a puzzled expression when he realized that I did not know about the effect of carbs on my blood sugar levels. He assumed I already knew. Perhaps some of my previous doctors made the same assumption. I think every doctor who has diabetic patients should hand out a pamphlet containing important facts about the proper care and treatment of diabetes. All diabetic patients should receive this pamphlet even if they have been diabetic for many years. I found out about carb counting in the 1980’s but the foundation for this knowledge existed in the early 1920’s. Why did I have to wait 35 or more years to gain this knowledge? If I had known during my early years I could have avoided much of my high blood sugar. I am so fortunate that I have not developed serious complications but what about all the diabetics who did develop terrible problems with their eyes and kidneys? How about the ones who had heart attacks, strokes and amputations because they did not know they were supposed to eat a low carb diet? I am sorry if I am using my blog to rant about this but it is something that has bothered me very much since the early 1980’s when I discovered that counting carbs is so important. All this has occupied my mind and caused me much frustration for over twenty years. This is the first time I have written or talked about this to anyone. Thanks for listening!!!
I want to take time out to brag on my wonderful daughter-in-law. She was born in Tientsin, China. She lived there with her parents and brother and went to a Chinese university. She majored in engineering. When she finished four years at the university she was allowed to go to the USA to continue her education. She was an excellent student at the Chinese university. She had to be very good to be allowed to go to the USA for graduate work. It is my understanding that only the upper 10% of those graduating from college in China were permitted to continue in our country. She attended Oklahoma State and majored in business administration. She had studied English in China. She arrived in the USA late and had already missed classes the year she arived. She was an engineering student in China and business administration was a completely new field of study, so she was in a different country, speaking a different language and majoring in a different disclipine. She was a super student! Nothing was going to stop this young lady. She earned her masters degree and interviewed for a job with a company that had an opening in Atlanta. A former aquaintance of David, my son, knew her in Oklahoma and asked him to meet her and help her when she arrived in Atlanta. He did so and they started dating. He brought her to our home for Christmas in 1999. She did not speak English very well but understood most of what she heard. We played a lot of monopoly while she was here. That seemed to help her relax. We were all together and got to know her that way. She was so thrilled by the ornaments on our Christmas tree. We gave her several of them. She and David were married on her birthday in April of 2001. The wedding was wonderful. We met her parents at the wedding. They were wonderful people. They did not speak English. Her mother came to Atlanta before the birth of their first child, Vanessa, in June, 2003. She stayed at their home for two years and was so much help to them. My son loves his mother-in-law. She might not speak English but they get along so well. She returned to China when Vanessa was two. Now they are back in Atlanta since Jason, my grandson. was born in March, 2007. They will probably be there for a year or more to help like they did with Vanessa. My son and his wife are so grateful to them for their help. My daughter-in-law is so precious! She is a wonderful wife to my son and mother to our grandchildren. We are so proud of her!!