A Bit Bumpy

I spent way too long trying to come up with a good title for this blog post.

Let’s be real, here. It’s hard to think of compelling, descriptive titles that will make people want to read a piece of content. This post was particularly challenging for me because of the subject matter: bumps.

Before you jump to any conclusions, I’m not talking about baby bumps or any sort of metaphorical or literal bumps in the road. The bumps that I’m referring to are physical manifestations on my skin of my diabetes that I find unsightly, which is why I had a difficult time figuring out how to talk about them in a blog post.

I don’t understand why the bumps only appear on my thighs, but…c’est la vie.

Let me elaborate on the exact nature of these bumps. They only show up when I remove a pod that had been on my thigh. No other site experiences this blemish, and no other diabetes device (e.g., my CGM) causes a raised bump to appear on my skin’s surface. The bumps themselves are relatively small – they look a little bit like mosquito bites. You can always tell the exact location that the pod’s cannula was in because the skin looks slightly more irritated and raised there, whereas the skin around that site has a pink tinge to it. These bumps don’t hurt me, aren’t typically itchy, and usually fade in a week or so.

In the grand scheme of things, the bumps probably don’t sound like that big of a deal. But I can’t help but feel self-conscious about them because to me, they’re stark reminders of the physical marks that diabetes leaves on my body. I made peace with having to wear two different gadgets (my pod and my CGM) years ago and having those stuck on my being, but these ugly little bumps? I didn’t exactly consent to having those on my body, too.

I suppose I could solve the problem by avoiding using my thighs as sites for my pods, but to me, that’s just giving in to my diabetes and giving up an extra bit of real estate on my body that I need so I can properly rotate my pod and CGM sites. I’m a little too stubborn to just accept that I shouldn’t wear pods on my legs if I want the bumps to stop appearing. That doesn’t mean that I have to be okay with them, though.

Sharing about the bumps in a blog post is me being vulnerable about a component of my diabetes that embarrasses me. I’m hoping that it results in that shame evolving into a sense of acceptance, or maybe even pride, over my bumps. Because even though they’re far from cute, they do add visibility to my diabetes and represent the strength that my body and mind have developed in order to coexist with it on a daily basis.

Maybe writing this post is the launching point for me to think of these bumps not as blemishes, but as diabadass beauty marks, instead.

Navigating New Insulin Pump Sites and Nerves

This was originally published on Hugging the Cactus on September 7, 2020. I’m sharing it again today because my mom and I were recently talking about pod placements and the places where we would (and would not), hypothetically, feel comfortable wearing a pod. It got me thinking about how I’ve had to work up the courage to try new sites over the years, which inspired me to write this post to hopefully help others who feel the same way about navigating new pump sites and nerves. Read on for more…

Am I the only T1D out there who feels incredibly nervous about trying new insulin infusion sites?

I’ve been this way as long as I can remember, now that I’m thinking about it. Throughout my childhood, I stubbornly stuck to injecting in my arms, legs, and upper buttocks (tee-hee) because those were the areas I felt comfortable with. I don’t think I even considered jabbing myself in my stomach until I was in my teens, and it was only after I realized the importance of site rotation and reducing scar tissue.

So it’s kind of funny that when I went on the OmniPod just over five years ago, I only used my stomach and my lower back (just above the upper buttocks region, tee-hee) for pod placements. It was partly because my guinea pig – I mean, my mom – used those areas for her pods with success, and also because I was hesitant in the beginning to wear my pods on my arms or legs because of their increased visibility.

It went that way for a couple of year – four basic sites ’round my abdomen – when it occurred to me yet again that site rotation was also important for insulin pumpers, not just MDI-ers (multiple daily injection…ers). So I added my upper arms into the mix, and soon after, my upper thighs followed.

The little diagram (courtesy of Insulet/OmniPod) above only shows a few of the sites that people with diabetes use…over the years, we’ve gotten a lot more creative!

But lately, I’ve shied away from wearing pods on my thighs because the area isn’t overly comfortable. When I roll over in my sleep at night, my pod presses up against my leg and the resulting pressure is just enough to disrupt my sleep and make it difficult for me to find a more restful position to sleep in.

As a result, I’ve started contemplating potential new pod sites, and one of the first places I went to for advice was…Instagram! Because…duh.

The DOC (diabetes online community) on Insta is a natural resource for this sort of thing because many people tend to share photos of their sites. It’s kind of a thing. One simple scroll through my feed taught me that people can get very inventive when it comes to finding new locations to place their CGMs and insulin pump infusion sites.

I saw people wearing Dexcoms on their forearms and calves. I saw pods on backs, calves, and even the upper chest area, the latter of which I found most intriguing. For men, it seems like a very accessible spot that causes little irritation, but for women? How the heck did the T1D ladies I saw with pods on their chest deal with it?

The general consensus, it seemed, was that women wearing pods on the upper chest agreed it was a site with great absorption and minimal discomfort.

I was still skeptical, though. I was worried about how it would look if I was wearing a v-neck tank with my pod poking out of, well, my bra! Then it hit me that my pod garners questions from strangers regardless of where it’s located. Furthermore, people will (probably?) be less likely to ask about it if it’s located on my chest because, um, that’s really awkward. My eyes are up here, people!!!

Then I remembered: I could give the site a try without wasting a pod because I have a demo pack that I got from a diabetes conference awhile back! The demo pack comes with a dummy pod that looks and feels just like a regular pod, but there’s no reservoir built into it, so insulin can’t be injected into it.

So right now, as I’m writing this, I’m wearing two pods: one on my upper arm that’s actually giving me insulin, and a fake one on my chest just to see how I like it. I must admit, so far, so good! I slept comfortably with it on last night and I haven’t had any issues wearing clothing or undergarments with it. I even went for a jog with it on and got pretty sweaty, but it stayed secure/I didn’t feel it bouncing around at all (thought the adhesive got a bit too damp for my liking…it stayed on but if I wasn’t careful I totally could’ve knocked it off).

While I’m still having a hard time wrapping my head around an actual cannula piercing my skin at this location (eeeek), now that I know I can handle the pod itself living there, I’m one step closer to trying (and liking) a site that’s more intimidating to me – a win in my book.

Can Certain Sites Trigger More Insulin Pump Failures?

Insulin pump sites have been a hot topic for me lately.

Not only did I share that I’m in the process of experimenting with some new (intimidating) sites, but I’m also contemplating the efficacy of all of my current sites.

My site lineup (as of this writing) includes the abdomen, upper arms, lower back, and thighs. And I’ve noticed an unusual pattern emerging with one of these sites that I know for a fact isn’t happening just to me – it’s happened to my mom, too…

…and that pattern is a series of failures with sites on the upper arms.

I can’t offer any explanation for it other than it’s definitely been a “thing” for my mom and I these last few weeks. It started happening to her first. I think she had 3 or 4 pod failures throughout August, and it only happened to pods that she was wearing on her upper arms. At first, I was skeptical of this and assumed it was maybe a bad batch or a total coincidence.

But then it happened to me, twice in a row.

On both occasions, I’d been sitting there, minding my own business (well, the first time, I was a passenger in a car and the second time, I was leading a virtual meeting with a couple dozen people on the call…the latter was far more disruptive).

Can Certain Sites Trigger More Insulin Pump Failures_
Here I am, holding up the second offending pod, right after I wrapped up the call during which it alarmed. Clearly, I was not amused.

My pods hadn’t been delivering a bolus.

I didn’t bump up or come into contact with the pods in any manner whatsoever.

My pods weren’t due to expire for another 12ish and 48ish hours, respectively.

There was no blood at the pod sites.

The cannulas on both pods weren’t kinked.

Static electricity wasn’t a factor.

But what these pods did have in common was that they were on my upper arms – one on the right, one on the left.

It’s straight-up bizarre, and when I called Insulet/OmniPod to report the second instance, I made sure they noted in their records that this phenomenon has occurred not just for me, but also for my mom. The representative didn’t say whether other people have been calling in with this issue, but it’s definitely weird that it’s happened more than once to both my mom and to me.

So while I can’t say for certain – at this time, anyways – whether particular sites result in more pod failures than others, I can say that I won’t be wearing a pod on my upper arm any time soon…and I’m going to be on the lookout for similar stories from other OmniPod users in the DOC. After all, our ingenious community can be even better than the pump manufacturers themselves when it comes to troubleshooting, so I’m hopeful that I can get to the bottom of this before long. I like my upper arm as a site because my insulin absorption is great there, but I’m not willing to use it again until I know I won’t experience another pod failure in the foreseeable future.