Not Quite in Arm's Reach, or What Happened When I Broke My Humerus

I come from a long line of klutzes.  Sometimes I trip, lose my balance, or flounder around while walking because my ankle decides it doesn't want to stay upright.  I think it was one of the latter two reasons that caused me to fall from the top step of my front stoop onto the sidewalk on March 28th.  This resulted in my first-ever major broken bone, my first-ever ambulance ride, my first-ever arm sling, and my second-ever surgery.

There are many places in which your arm can be broken.  In my case, it was my humerus--and before you say anything, it wasn't funny at all.  For those not in the know, the humerus is your upper arm bone.  Think of it as the bone that connects your elbow and your shoulder.  Now, imagine the pain and annoyance that comes with not being able to use your dominant arm for anything without considerable pain.  They say bone pain is some of the worst pain imaginable, and they are right.  Healing from surgery was less painful than trying to walk up the steps in my home with a sling on my arm.

Many things became difficult to do with only my left hand, including brushing my teeth and texting.  Video games could not be played on the Xbox.  I couldn't open any bottled drink.  I had to have help washing my hair and half my body in the shower, and for a while I couldn't get my arm wet, so I'd have to don a trashbag raincoat for my right arm first.  Still, no task seemed more daunting in terms of asking for help than diabetes management.  Things you can't really do with just one hand include:

-Drawing up insulin into a syringe
-Unwrapping an Inset infusion set, as well as cocking the insertion device
-Checking blood sugar
-Changing out everything on my pump
-Pouring orange juice to treat a low

So that's...nearly everything diabetes related you could do within a day?  At least my pump was always within reach!  With the T-Clip, I had no problems hooking my t:slim onto the strap of my sling.

The last time I had anyone else use a needle on me for diabetes management was probably the first time I tried a Dexcom Seven in Gary Scheiner's office, when the tech was so new he inserted my sensor for me.

"Well boys," I announced to Matt (the hubs) and Harper (the housemate), "I'm going to need a lot of help from you guys, and this includes a crash course in setting up my insulin pump and jabbing me with infusion sets."  Let me just say that in the nearly 16 years that Matt and I have been together, he's never given me a single injection.  We've known Harper for over two years now, and he is the kind of guy who can pass out at the sight of his own blood, so naturally I was concerned about asking him for help with needle things.

But what happened?  Everything worked out just fine, and I think I was more nervous about someone else sticking me with a needle than the guys were about learning everything.  Great partners and trusted friends are true treasures to have in an emergency.

I just wanted to take some time today to send a huge thank you to my two biggest caregivers/house helpers in the month and a half I was out of commission.  Blood sugars were monitored, infusion sets were placed, laundry & dishes were done, and meals were cooked!

I am back at work, driving again, and starting physical therapy next week to return my arm to its strength and full mobility.  So while I am not cleared to lift anything that's over five pounds, it's good to be back.  If you really want to see it, I'll show you my badass surgery scar sometime.

Insulin Pump MacGyver

You may have seen that I got hooked up to my new t:slim this week.  Actual impressions on the pump will be forthcoming, after I've been able to use it for several days and give some opinions.  In the meantime, I still feel like I'm in pump transition from my Cozmo.  Additionally, I think my brain is still in transition from last weekend's vacation.  Why?  I ran into some odd pump-specific trouble this morning.

I drove to work knowing I needed to refill my pump and change my site this morning.  I had a box of supplies in my tote bag, left over from pump training two days ago, so I figured I'd be fine.

Whenever you say "I'll be fine", you should probably accept that there's a chance something is going to go awry.  In that sense, I was correct.

After doing some things at work, I pull out my t:slim to refill it.  I can't slide the cartridge off right away, so that was a bit frustrating until I popped it out with a coin.  I open my box of supplies, pull out a new cartridge, and realize I am missing a fill syringe.

With the t:slim, the cartridge isn't like your usual reservoir.  It's different than loading insulin into the cartridge of a Medtronic, Animas, or my old Cozmo.  You get a big ol' 3mL BG syringe, and you inject insulin into a port on the t:slim cartridge, which you've just installed into your pump.  So there I was, the Syringeless Wonder. 

Image found at:  intrepid.com.au

But!  My Cozmo was still in my purse from training two days ago.  If I couldn't refill my new robo-pancreas, I could just use the old one!  They both have a luer-lock connection so my infusion set would fit either pump. I pull out my trusty old purple pump pal, ready to remove the reservoir, screw on the spare reservoir needle and plunger I keep in my test kit, fill it up and kick it old-skool pump style.

Important Sidenote:  I AM NOT A MEDICAL PROFESSIONAL.  NONE OF THIS IS MEDICAL ADVICE, JUST THE SHARING OF MY OWN EXPERIENCE.  WE NOW RETURN TO THIS BLOG POST, ALREADY IN PROGRESS.

Yes, with my Cozmo, and even my Medtronic years ago, I'd keep a spare reservoir needle and plunger in my purse at all times.  You never knew when it might come in handy, and it was easier than carrying an extra reservoir for emergencies.  It also meant if I had to change out a whole set before schedule, I could save the insulin left in my reservoir.  Nobody encourages reuse of pump supplies, but I have a feeling a lot more of us have done it than we admit.

But I digress.

So I pull my handy-dandy Cozmo out from my purse only to find it is dead.  Dead for a ducat, dead!  (I don't mention it often but I'm a Shakespeare lover.  Digressing.  Again.  Unprofessional.)  I realize at my pump training Wednesday morning, I had a low battery.  I now had on my hands a dead battery, and not another AAA battery in sight.

So I've got a pump with no filler at a 75% charge, and a pump that I can fill but no power.

This is when the reservoir in my old pump, combined with the needle and plunger, came brilliantly into play.  I filled my old Cozmo reservoir, stuck the needle into the t:slim fill port (after a test that the needle itself would fit), and muscled some insulin into it.  There was a lot of resistance, I couldn't get all 3mL out of the Cozmo reservoir into the t:slim cartridge.  Cozmo reservoir needles are not meant for injecting, obviously.  I managed to get about 2mL into the t:slim and called it good enough.

I ran the priming sequence on my t:slim, and so far it's working just fine.  I'm anticipating a big SWAG-gy, carb-y dinner tonight, so most likely I'll have to refill again tomorrow.  With the proper new needle, of course.

I feel like MacGyver.  I took the parts available to me, and I made it work.  No explosions necessary, though some kickass 80's background music was most likely playing in my head while I worked this whole thing out.  While I am mullet-free, I am now, once again, full of insulin.

What have you wrangled up in a diabetes emergency for yourself?

All in a Twist

Seriously, how does this happen? What was my pump tubing doing all night? Must be quite the game of Twister you're playing there.

Thankfully it didn't stop insulin delivery.

If I ever wake up with it in a braid of some sort, I am going back to injections, because surely supernatural forces will be the ones governing my pump tubing. No human amount of wriggling could make that happen overnight.

We are serious about soft pretzels here around Philly, but this is not the kind of soft pretzel I had in mind.