A Rough Patch

I’ve been going through a bit of a rough patch with my diabetes lately.

I’ve been using an insulin pump for six weeks now. I am loving it, and I do genuinely feel a greater sense of control compared to what I did on Multiple Daily Injections. I feel that I am putting far more effort into my diabetes than I did towards the end of my reign on injections, which is a good thing. I feel motivated to put that effort in, because that effort does produce both results and less stress.

Yet at the same time, the insulin pump has been one of the greatest challenges I have faced in the course of managing my diabetes. There are an endless number of variables I can program for with the pump. Fine tuning the pump settings has taken a great deal of time and incredible patience. With a job that entails physical activity, this workload is essentially doubled. As I’ve somewhat come round full circle in fine tuning my pump settings, I am finding that my basal insulin requirements need to be lowered further. I’m needing to go round the clock again with basal testing (urgh).

The occlusion I wrote about yesterday was the last straw. It set off a rollercoaster of emotions. Sadness, failure, anger and frustration. I’ve been snappy. I’ve been quiet. I felt very tempted to rip out the pump and take a break last weekend. The words fucking diabetes have often been on my breath. I’ve even wished my diabetes away, something I can honestly say rarely happens. Opting out of renovation work last weekend was a tough, but necessary call so that I could have some time alone.

My diabetes educator recently reminded me that sometimes we need to take a step back from diabetes. Not literally, of course. I guess more like trying to put it to the back of my mind, and bringing some of the non diabetes stuff to the forefront.

For me, a big part of dealing with this burnout has been taking a step away from social media. I’ve really just needed a break from reading and engaging myself in the the constant conversations about diabetes online. I’ve pulled out a book, and started reading again. I even finished it. (If you know me, you will know how much of an achievement this is). I made dinner on Thursday night. I’ve focussed my attention finding some different stuff to snack on. I’ve also been ducking out into the Winter sun when it makes an appearance, too.

At the moment I’m just trying to look at my diabetes day by day, and trying not to set unrealistic expectations in fine tuning my insulin pump. I’ve put a plan in place to move past that occlusion. I’m giving the centre of my stomach an indefinite break from insulin pump sites. I visited my doctor last week, and am subsequently applying bruise cream to the centre of my stomach to hopefully heal some of that scar tissue. I’m placing my pump sites on the outer edges of my stomach, and drawing dots in permanent marker to track my rotations. I’m also checking my pump sites when I get dressed each day for signs of bruising and bleeding.

This week, the bruises are finally starting to fade. And with it, I feel like some of that burnout cloud is beginning to clear, too.

The Occlusion That Triggered a Burnout

Two weeks ago, I made my first venture over to the right side of my stomach. I had worked my way across the left side of my stomach during my first month on the insulin pump. Infusion sites only need to be changed every three days compared to injections, and I was pretty damn pleased at the thought that the right side of my stomach had gotten a break for a whole month. So I was pretty surprised to discover bruising underneath that very infusion site two days later in the shower.

I knew that I had to rip it out straight away. As I ripped it out, it began to bleed. As I watched the bleeding and nasty purple bruising on my stomach, I really couldn’t believe it. I hadn’t touched that side of my stomach for a whole month, and I really had no explanation for it. I was pissed off, and wondered to myself where I had gone wrong.

As I went about replacing the infusion site, I wasted two insertion devices in the process. The first site came a little unstuck from my stomach as I pulled the insertion device away from my body. Not wanting to risk a failed site, I pulled it away from my body completely and started over. The second one was also a failure. The details are a little hazy, but I remember seeing a bent needle as I pulled the insertion device away from the site. By the time the third one was in, I had wasted close to an hour of my afternoon dealing with it. In addition to being angry, I was now very much emotional as well.

Yet, it was only about to get worse.

I decided it was as good a night as ever to turn down one of my favourite dinners (stuffed eggplants) in favour of testing my evening basal rates. Ironically, I was also moderating an OzDOC chat that night on diabetes and emotional health.

My levels were in range prior to kicking off the chat. I was confident my basal rate was close enough, although I did suspect that my levels might drop a little that night. So it was to my great surprise to find that towards the end of the hour, my BGLs had hit 10mmol with an upward trend arrow. I don’t know what possessed me to check my stomach, but I did. And I discovered my very first occlusion in my insulin pump line.

This one didn’t bleed a little. It bled and bled and bled. Words cannot describe how devastated I felt that night as I lay there on the couch, applying tissues on my stomach and waiting for the bleeding to subside. The two nasty purple bruises that were left on my stomach in the days that followed were a lasting reminder of my diabetes and of how long I’d had it. I had never felt so failed by my body in my life.

I stood for at least five minutes in front of my wardrobe, deliberating whether or not to replace the site. After the day which I’d had, I really didn’t feel like dealing with another site change. After the events that had transpired, I wouldn’t even be able to go to sleep with confidence that the site would stay put. I was seriously considering injecting Lantus and taking a break from the pump for a day or so.

I eventually gathered the courage to replace the site, opting for the outer edges of my stomach. I’ve since decided that the centre circle of my stomach needs an indefinite break before it’s ready to handle three day long infusion sites. I’ve visited my doctor, and I’m applying bruise cream to my stomach in the hopes that it will heal some of that stomach tissue.

I now make sure to look at my infusion sites every day. In the shower, when I’m getting dressed and before bed. I always make sure that the skin underneath the site looks clean and free from dark marks and bruising, because I want to minimise the chances of this ever happening again.

It was the occlusion that triggered a really rough period of diabetes burnout over this past week and a bit.

Six Hours

Six hours on an empty stomach, on a quiet Sunday afternoon at home sure does give you a lot of time to think.

I’ve been so intensely focussed on testing my basal rates over the weekend. Making sure that the rate of background insulin my pump delivers is keeping my blood glucose levels steady through a six hour window. To do this, I can’t have any bolus insulin active in my system, meaning no food for six hours.

I was laying in front of the television at lunch time yesterday, trying not to think about my growling stomach. I had my FreeStyle Libre within arms reach, scanning every half hour or so, watching the movement of my blood glucose levels.

Every time I saw a trend arrow, I started to obsess. Am I too stressed? Have I been on my feet too much this morning? Does lying on the couch represent a typical day for me? Have I been less active than I normally would have? Was there too much fat in my breakfast this morning? Am I feeling the cold today?


I tried to lay there and focus on the television, and not obsess over my actions that day. Resisting the urge to pull out my pump and tweak the basal rate, instead opting to let the pump do it’s thing.

Sure enough, the trends were only small ones. By the time I scanned again, the trend arrow had shifted in another direction. However, as I was laying there yesterday, one thing became very apparent to me.

Everything affects diabetes. Absolutely everything. Even something as simple as laying on the couch can mean the difference between a lower or a higher rate of basal insulin.

We strive for perfection, and yet it’s not always realistic while we are trying to live our lives at the same time. Some days we can only do our best, and remember that diabetes does not rule our lives.