“I’m LITERALLY afraid that I’m going to hurt you!!!”
These are all phrases uttered by my dear friend who was ultra-curious about the site change I had to do in the middle of our hangout. She wanted to watch me do it, but I stepped it up a notch by asking her to play a key role in it: I invited her to remove my old pod from my leg.
“Just do it, it’s just like ripping off a band-aid. I can guarantee you won’t hurt me.” I said, in an attempt to reassure her. I also swore I wasn’t lying just to make her feel better, because I’ve rarely ever experienced a pod-rip-off that truly hurt.
“But there’s something in you, right? Like a needle?” Her face creased with worry. I smiled and told her that yes, there was a cannula that was in my skin, but I couldn’t feel it.
“Let me start it for you,” I said, when I realized she still wasn’t quite ready to rip it away. I peeled up an edge of the adhesive and she started squirming.
“You don’t have to do it if you don’t want to -” I said, but just as the words left my mouth, she finally tore off the pod. Much to my chagrin, a drop of blood appeared and she squealed as I began to apologize profusely and explain emphatically that it didn’t hurt, it’s just that sometimes blood will appear and nothing can be done about it.
“I can’t believe you have to do this every 3 days…” she said, her eyes widening in wonder. I told her I’ve done it so many times now – literally just over a thousand, according to my calculations – that it’s no big deal. I’m used to it. It’s just life with diabetes…lots of repetition and more math than I’d like.
I accepted my reality a long time ago, and I’m truly at a place where it’s no big deal.
WARNING: If you are at all squeamish when it comes to blood…then this blog post is NOT for you! I will not be posting any graphic photos or anything, but I’ll be telling a bloody tale that might make the faint of stomach a bit queasy. Read on if you have no fear…
There’s nothing quite like waking up and doing a routine pod change…only to have blood literally pour out of your body the moment you tear your old pod from its site.
Okay, so using the word “bloodbath” in the title might be a gross exaggeration (LOL at my pun because yep it was GROSS), but I digress…blood really did stream in a rivulet down my arm. It sounds wild, but it’s true!
This happened to me a couple of weeks ago. I don’t often change my pod first thing in the morning, but every now and then, I’ll time it so that my pod is set to expire (like, really expire – pods expire for good 8 hours after receiving the initial “pod expired” message on the PDM) as soon as my wake-up alarm goes off. My only goal in prolonging the pod like that is to use up as much insulin as possible that’s left in the reservoir…naturally, I don’t like the idea of tossing a pod when it’s still got 50+ units of insulin left in it.
So I literally woke up on this particular morning at 6 A.M. to my pod screaming because I’d hit the 8-hour mark. I rolled out of bed and stumbled over to my mirror so I could have a better view of the pod, which was sitting on the back of my arm, and proceeded to rip the pod off. That’s when I saw blood – not just a tiny drop, but a full-on stream running down my arm!
I was surprised, but still had my wits about me to the extent that I was able to run into my bathroom and grab some tissues so I could start wiping up the blood and apply pressure at the site. I barely made it in time – the blood was coming out so fast that drops were falling on the floor and my sink was getting dotted with red. I wasn’t really freaked out, per se, because I knew that if I just pressed hard enough with a tissue, then I’d be able to staunch the wound. And sure enough, within 5 minutes or so, I’d successfully done just that. I peeked under the last tissue I’d used and noticed a purplish mark at the old pod’s site, which indicated to me that I must’ve hit some sort of vein when I had put that pod on. Definitely not intentional, but something I hope to avoid going forward.
And undoubtedly…definitely not my favorite way to start the day!
One Friday per month, I’ll write about my favorite things that make life with diabetes a little easier for me.
Not too long ago, it occurred to me that I am very, very, very, very, very strict about following a specific protocol every three days when I change my pod. In fact, it rarely deviates, but when it does (due to circumstances beyond my control), it throws me off track, like, a lot…which is why the way I do it is my favorite way.
What’s so precise about my pod change procedure? Let me walk you through it…
Step 1) The numero uno thing I do, a half hour before I start my procedure for real, is remove a vial of insulin from the refrigerator. I’ve always been told that it’s important to let the insulin reach room temperature for at least 30 minutes before I start the pod change process. My mother was the one who told me that this step is crucial, because years ago, she’d heard from a representative at Insulet that room temperature insulin works best with pods for whatever reason.
Step 2) Once my insulin has reached room temperature, I set myself up at the island in the kitchen to go through the rest of the process. I make sure I have a totally clear area and ample lighting before I start on step #2.
Step 3) Next, I take an alcohol swab and wipe the top of the insulin vial that I’m drawing insulin from, and then I wipe my new site.
Step 4) Before even touching my PDM, I grab my syringe, stick it into the vial, and suck up the amount of insulin I’ll need for the next three days. This is usually somewhere between 100 and 150 units.
Step 5) This is where I deactivate my old pod, and jab at the buttons on my PDM to start the new pod activation process. The only reason why I get insulin into the syringe first is to minimize the amount of time I spend without a pod on my body. You might be surprised to learn that a short period of time without insulin can make a difference on blood sugar levels, but that’s just the way it is.
Step 6) I fill the new pod with insulin and hit a button to get it to start priming. During the priming period, I use an adhesive wipe around the new pod’s site to help it stick better to my skin.
Step 7) I finish up the process of removing the pod’s needle cap, then the adhesive stickers. I apply it with care to the new site and put pressure on it as I wait for the cannula to inject itself under my skin’s surface. And then I’m good to go!
Of course, I can’t always follow these steps as I’ve outlined them above. And while it messes me up a bit, and I usually have to take a little longer to change it, I roll with the punches and get it done. For instance, when I last visited Disney World, I had to change my pod in one of the park’s dimly-lit family restrooms with my mom using her outstretched hands as my mini work surface…far from ideal, but it was what it was.
Like all things associated with diabetes, I guess that I take comfort in keeping a routine, even with something as minor as a pod change.
I had just zipped up my coat when I heard a faint, high-pitched beeeeeeeeeeep emerging from somewhere in the vicinity.
My mom and I exchanged looks. “Uh, oh,” we said simultaneously.
“It isn’t me,” Mom said, patting her pod.
“It can’t be me, it sounds too far. Are you sure it’s not the refrigerator door that was left open?” I asked, as I unzipped and peeled off my coat.
She didn’t have to answer the question, though, because as I took my coat off, the beeping sound grew louder. I looked down at my abdomen and cursed. Yup, my pod had just failed.
I wasn’t totally surprised that it happened. The dry winter air was triggering excessive static electricity that weekend, and the sweater I chose to wear that day seemed to be charged with it. I couldn’t move my arms without hearing little sparks going off. If I was smart, I would’ve changed my top to one that was less filled with static. But I had somehow managed to convince myself that there was no way my pod could possibly fail due to my clothing choices.
I know better than that.
The real kicker in this situation is that we were obviously headed out somewhere – we were hoping to go to our favorite bar for a quick drink. But with the pod’s failure occurring at basically the most inopportune time, we were left with a three choices:
Stay home. Take out the insulin, wait a half hour, and resign ourselves to the fact that it just wasn’t a good night to go out.
Go out, but take a syringe and a vial of insulin with us. That way, I could give myself a shot, if need be, while we were at the bar. We could head home after the one drink and I could change the pod once we were back.
Go out and take a total risk by leaving all extra diabetes supplies at home, and just wait until after we had our drink to change the pod.
I like living on the edge sometimes, but option #3 is just way too dangerous. So we went with option #2. If you’re wondering why we didn’t just opt to wait a half hour (insulin needs 30 minutes to come to room temperature before it can be put into a new pod), it’s merely because we didn’t want to stay out late. And yes, a half hour can make that much of a difference to me and my mom!
So we left the house with an emergency insulin vial and syringe in tow. And it’s amazing how much better it made me feel to know that I had both, just in case.
Fortunately, I didn’t need them. I monitored my blood sugar carefully during our hour-long excursion, drank plenty of water, and deliberately chose a lower-carb, whiskey-based cocktail that wouldn’t spike me. And I was able to enjoy every last sip of it before returning home and changing my pod soon after walking through the front door.
I do have to say, though, that under different circumstances, I’d absolutely make different choices. If we weren’t less than three miles away from the house, and if we’d planned on staying out for more than a single drink, then you bet your bottom dollar that I would’ve changed my pod before going out. But in this situation, I made the decision that felt right for me, and felt comforted by the fact that I had backup supplies in case I needed them.
“It’s better to have it and not need it, than to need it and not have it.”
Growing up, this mantra was frequently repeated by my mother regarding my diabetes supplies. More often than not, I’d roll my eyes at the saying – not because I was annoyed with her, but because the prospect of carrying extra supplies “just in case” felt very inconvenient. My purse/backpack/overnight bag would already be crammed to maximum capacity, so squeezing in backup needles or insulin was practically impossible. But typically, I’d cave and make it all work somehow, because the fear of not having something essential when I was away from home was strong enough.
I’ve kept up this practice in my adulthood, as overnight travel and increased distance from home have become more common. And I was reminded why it’s a good idea very recently.
I was staying at a friends’ place for the night. They live about 45 minutes away from my house, which isn’t far, but it was far enough for me to want to make sure I had extra supplies. I definitely did not want to have to make that drive twice in one night, and I knew it wouldn’t even be a realistic option, because chances were good that I’d be drinking alcohol – it was game night, after all.
Pizza, beers, and laughs were had, and before we knew it, it was one in the morning. We all headed off to bed, and just as I do every night, I checked my blood sugar before I got totally settled.
I was wicked high – the mid-300s, actually.
I was worried, because I thought I’d been on top of my blood sugar for most of the night. I gave myself an extended bolus for the three slices of pizza I ate, limited my beer intake (too many carbs), and kept a watchful eye on my CGM. While I did know that my blood sugar was climbing, I thought that I was staying on top of it with correction doses. Apparently not.
No matter, I figured. The best I could do was take more insulin, drink some water, and try to relax a bit before bed. I didn’t want to sleep until I knew my numbers were coming down, but I also knew that my willpower to stay awake was fading. So I set an alarm on my phone to wake up in an hour and check my blood sugar again.
When I did, I was 377! I couldn’t believe it. I followed the same process again – bolused, drank water, set an alarm to wake up in another hour – and hoped for the best. But when my alarm blared again at 3 A.M. and I discovered that I was STILL stuck at 377, something told me that there was more to the story here. I lifted up my shirt to check my pod, which should’ve been securely stuck to my belly…except it wasn’t. The end with the cannula was sticking up, revealing that the cannula was not underneath the surface of my skin.
I felt simultaneously pissed off and relieved. I was mad because I’d just changed my pod earlier that day, so it should not have come off so easily. But I was relieved because finally, I had an explanation behind the super-high, super-stagnant blood sugars.
And I was seriously relieved that I’d thought to pack my insulin, a spare pod, and an alcohol swab in my overnight bag.
So there I was, changing my pod at 3 A.M. Far from fun, but it was necessary. I even wound up giving myself an injection with a syringe – yet another diabetes supply that I don’t really need to carry but had stowed away in my kit (just in case) – to ensure that my system had insulin in it to bring my blood sugar back down.
From there, it was a long night (morning!) as I set numerous alarms for the next few hours to wake up, check my blood sugar, and bolus more as needed. I couldn’t rely on my CGM for readings, because guess what? It got torn right off my arm as I tossed and turned in bed. Go figure, right? (I didn’t have a backup sensor because the CGM is one thing that isn’t exactly necessary. It makes life a helluva lot easier, but for a single overnight trip, an extra sensor wasn’t needed.)
I probably only got three hours of sleep that night, and I was pretty damn defeated looking at a shitty CGM graph the next day. But you know what? The whole incident serves as a stark reminder that it’s important to ALWAYS have backup supplies: You never know when you might depend on them.