After 33+ years I thought I’d made all the dumb mistakes you could make with insulin, but tonight I discovered a whole new one. Yay me!
So it goes like this: every once in a while, when I’m getting down toward the end of a pump reservoir but I need it to last a while longer, I’ll bolus from a Novolog pen instead of my pump. Tonight was one of those times. Wife and I staying at an Air BNB for our wedding anniversary, out to dinner and I’ve decided to take off the carb choker and have some stuff I stay away from normally–beer and fries!–you know. So I did a fingerstick: 81; run the calculation, add some extra because restaurant food is always higher than you think. So I inject, go about my meal. The little xDrip widget on my phone catches my eye: suddenly it’s reading 265. Wha? Then five minutes later, 40 with double down arrows. WWWHHHHAA?? Then it’s absolutely zeroing out. So I had noticed after injecting that the needle had bent a bit, and I thought, better check if the spot is all wet, which would indicate the insulin hadn’t gotten injected (not that that would make sense of those readings). So reached down to the spot, all dry, no problem… except for the fact that I’d stupidly not realized the spot was EXACTLY where I have my CGM sensor. Like I went right through the sticky patch. Um, oops.
Unfortunately for whatever reason I didn’t bring a spare sensor. It’s about 3 hours later and it’s still registering 0, as in zero. Kinda hoping it might recover but I don’t know. Never did this before because normally of course I’m bolusing from my pump and I’m smart enough not to locate same virtually on TOP of my sensor.
Anyone ever inject insulin right into your sensor location? Do you know if the sensor recovers? Guess I’ll find out. But hey, at least it’s a NEW mistake! For me anyway.
Thanks for sharing and good luck, we all know you’ll work it out. For some reason this reminds me of perhaps a similar story from @acidrock23. Anniversaries are not supposed to be difficult!
Agree w @Timbeak48: People who make mistakes are called people. True.
Thanks all. After I posted this I did a careful, hands-washed, 2nd-drop calibration and it seems to be tracking reasonably well as of this morning. End of next week I’m switching to Guardian3/670G set up, so hopefully it’s good enough until then. I’m considering keeping the Dexcom running in tandem for a week or so to see how it compares, if I can tolerate all that territory being taken up by this stuff.
Like I said in the OP, on fairly rare occasions I do it when my reservoir is getting low but it’s not convenient to change it. For instance, I get the alert in the a.m. before work that it’s going to run out at, say, 7pm (I set mine to 12 hours ahead). Great, I’ll change it when I get home. But that’s only if I don’t do anything but basal all day. So I can change it now, waste a bunch of insulin, or change it in the middle of my work day (really a PITA), or use an injector to bolus for lunch and change it when I get home.
I set my low cartridge alarm at 10U. If I think it is going to run out at work, I take a filled a filled cartridge plus the tubing in my bag and change it when it gets down to below 5U.
I haven’t taken an injection for 9 years. I think I took one once just after I started pumping and a correction didn’t seem to be working. Since then, if a correction doesn’t work I just swap out the set and take another correction using the manual bolus on the pump. That almost invariably sorts out the problem.
YDMV. Sounds like you don’t change the site, just the reservoir/tubing? I find absorption deteriorates noticeably after 3 days, and I don’t like having to deal with the rigamarole of changing sites at work. I keep a set of injector pens (Lantus and Novolog) in my fridge for emergency backup in case of a pump failure (which has happened), and at one point when I had one of those days where I knew I was going to run dry after my lunchtime bolus, it occurred to me I could use the pen and not have to worry about it. There are some drawbacks (the pump doesn’t “know” about the bolus) and I don’t do it very often. Not saying this applies to you in particular, but I also don’t have any aversion to pens/injections. I know for some people changing from injectors to pump was life changing, but for me the MORE life changing event was changing to Lantus-Novolog MDI after 20 years on R/NPH, my loathing for which still burns with the heat of a thousand suns. After 10 years on MDI I changed to a pump, and it is more convenient, but for me it’s R/NPH that is evil incarnate and anything short of that is quite tolerable.
Re low-alert timing: one thing I also hate is my pump squawling like an unfed cat in the middle of the night and having to drag myself out of bed at 3 in the goddamned a.m. to change infusion sets. Setting it at 12 hours out lets me avoid that. At worst it goes off at stupid-o’clock and I have to wake up enough to acknowledge the alert, but I can go right back to nod land knowing I have plenty of time to change it the next morning.
Nice thing, of course, is that we can set these things to meet our own needs.
On the contrary - I have ongoing site irritation problems and have ti change my sets on a 2 -day rotation. I change my reservoir approximately every 4 days when, it gets below 10 U. I always have a bunch of packs of spare tubing hanging around.
I don’t have any pens for injections. I have a couple of micro-syringes that I keep in my kit in case of pump failure. I had to fight the system in order to get my pump, so I have an aversion to using a syringe unless I have absolutely no alternative (i.e. catastrophic pump failure). I used to have some backup Lantus cartridges, but they went out of date around 2011.
I am surprised that you can set a 12 hour alarm for your reservoir. My Animas Vibe (and IIRC my previous MM522) simply allowed you to set the alarm when 10 or 20 units were left. With the Vibe its no big problem as Insulin remaining in cartridge is shown on the pump home screen, so I check it regularly.
Mine is a Medtronic–the’ve always been pretty flexible about most settings, including that one. You can set it by amount remaining instead of time, but I find time is easier to work with mentally.
I hear ya about aversion. My experience kind of parallels yours, only for me I had to fight the system to go off R/NPH to get on Lantus/Novolog MDI. My non-specialist Dr’s kept saying “You’re doing fine let’s not change anything,” which translates as “I don’t really know that much so I’m afraid of having you do something I don’t understand.” Not having to live my life around that relentless, unforgiving R/NPH peak schedule was like being let out of prison, and my aversion to the stuff as I said is very intense, much the same as yours for injections. Funny how that is; after all, I’d have been dead without it, but that doesn’t change how I react to it on a gut level.
I don’t actually have an aversion to injections - not at all. Injections never bothered me. It is long acting insulin that I HATE. That goes for Lantus just as much as for N/Insulatard. It’s so inflexible in terms of basal dosage and I was typically either hypo, recovering from as hypo ,or waiting for the next hypo.
Ten years ago, there was a very anti-pump culture amongst the medical and health care professionals in the UK in general and Scotland in particular. When I got my pump, the local NHS health area (with >6K T1’s) had <1% on pumps and was running at around .7 new pump starts per year. Most of the medical profession regarded pumps as unnecessary, and the Health Board administrators regarded them as a waste of money so tried to block funding. I had to fight hard for mine, so it feels like a betrayal to take an injection.
After a long campaign, we managed to persuade the Scottish Government to put extra funding into a pump initiative and now nearly 50% of children (great) and 10% of adults (still not good enough) are funded for pumps, a great improvement although there are still unacceptable waiting lists in some areas and we have to keep on hammering at the Government…
Of course now we are into the same situation with CGM/Libre. Only a few hundred funded in Scotland out of >27K with T1D. The campaign goes on.
I hear ya. Since going on a pump five years back I’ve only had to use it once, almost exactly a year ago, when my pump went frozen-button and died. On a Friday, of course, and I couldn’t get the replacement until the following Tuesday. Could hardly remember how to use the stuff.
There is one obvious use of shots when you’re using a pump…and it’s happened to me. A few years back at Thanksgiving, I planned how much I was going to eat and pre-bolused with my pump. A few hours later, I’m starting to think about that pumpkin pie, but I do not feel good at all.
I take my BG and it says 440! So I look at my infusion set and it has come off of my stomach. I’ve just been watering my stomach with insulin. So, BEFORE I replace my set, I give myself a correction shot, THEN I take care of my pump.
This is literally what we are taught to do in pump training.
Pretty sure I can confirm it. I was told that rolling over the same sensor to a new session is verboten and not possible with this set up, and that the calibration requirements are also more stringent. But hey, if it drives me nuts I can always switch it back to standard operation and go back to using Dexcom.
