What a happy day! I was finally switched from U-500 Humulin-R to Novolog early this afternoon! I'm so stinking excited about this it's ridiculous!
The NP at my endo's office said it is definitely time to make the switch (I was pumping so little of the Humulin-R by this morning that it was just silly to continue with it).
This is a dream! No more running in a bolus (or blousing) half an hour before eating. And with having had weight loss surgery I never knew if I'd be able to actually consume the number of carbs I told the pump I was going to eat. I was sometimes running in half as much as I planned to try to eat just so I wouldn't have a catastrophic low later on if I couldn't eat my entire meal. And if I did eat the whole thing I'd bolus for more AFTER I ate the food -- not the optimal way to use Regular.
I was having one or two lows a day, sometimes more frequently, and they were getting to be very difficult to treat -- I'd take a 15 carb glucose gel pouch and drop again an hour later; I just can't always manage to follow up with a little "real" food to keep me level since the surgery.
My endo NP and I decided together to be very conservative with my basal rates, carb ratio, and correction factor. I'm expected to run slightly high for the next few days until I can see my CDE next week and discuss what we want to do to change the settings.
I've never run rapid acting insulin in the pump! I've pumped for about 4 1/2 years now and it was always the U-500 Regular. I used rapid acting via MDI before that, so I'm not entirely new to this type of insulin. But never in my insulin pump.
I had such a wonderful time at that appointment. I got some goodies -- a couple of Mio infusion sets to try out (I think I can more successfully place that type of site at my back hip and back of my upper arms to give my abdomen a break), a prescription for one box of Mios and one box of Silhouettes with each shipment, brand new script for more glucagon (that isn't expired like my old kits are -- time for them to become practice kits that my family members can mix up and pretend to inject), a back up Bayer Contour meter (the kind that talks to my pump if I want it to), a full vial of Novolog, the partially used vial that I filled my reservoir with in the office -- I'm ridiculously excited about all of this!
When my NP came in, she had Humalog in her hand and started to talk about it. I asked her, "what about Novolog?" She seemed surprised that I wanted to talk, but excited, too, to know that I've been doing some research and talked with you all about my options here. I told her I've heard it's more stable in the pump and she told me that's what she's heard as well. She was more than willing to allow me to lead the way in what I wanted to be infusing. She checked that I have Lantus (my butter compartment is filled with Lantus and Novolog now) and told me that I might as well get rid of the Humulin-R I have remaining as I don't come anywhere near to what she considers the level of use of Novolog to ever go back on that insulin. She said it's pretty dangerous to keep that stuff around -- I'm not likely to confuse that huge vial with the slimmer Novolog vials, but you never know what I might think in the middle of the night if I'm high and needing to take an injection because the pump might be acting up.
I will not admit to you how much Humulin-R U-500 I was once capable of injecting to correct a high and the hours I'd stay awake waiting and waiting and waiting for it to come back down -- often injecting more of that concentrated insulin! If I did that today I'd be a goner for sure.
I got my lab slip for my A1C and other tests for my next visit with her in about six weeks. I read something interesting on it. It stated my condition and the ICD-9 code for it. Next to those it read, "type 1 (juvenile) diabetes; not specified as uncontrolled; with complications. NOT SPECIFIED AS UNCONTROLLED. It has been YEARS, literally, since anyone could say that about me and the diabetes. It was always NOT controlled on the lab slips. I'm bouncing around right now. I'm ready to dance around my apartment just thinking about how happy I feel because of it. I'm still having occasional blips of something high-like (I had a 170 for no apparent reason that other night) and I dip low quite often (usually around a 50), but for the most part I'm staying in pretty good range. I am still testing about hourly and anytime I feel "off." I never thought I"d see the day when I said 170 was high. Used to be 170 was a good day for me.
I bugged all of my family members, friends, neighbors even, and on Facebook, too, about how happy today has made me.
Plus Rite-Aid in my town was selling Level Life Glucose Gel packets for just over a dollar a piece. They only had nine of them left, but I snapped them all up!
I don't know if it is absolutely silly to be this happy about diabetes. In general it is something I just deal with and I do my best to take care of myself. I don't feel depressed about it or angry about it very often. I feel like I can handle it now. I know there will be rough spots, but it's like I now have a little control of the situation. And that's wonderful.
Thank you for all of your input about the insulin types out there. :)