Do As I Say, Not As I Do

ready-to-go-1472989-640x480When it comes to “organizing my diabetes” and making sure I have plenty of extra supplies when I travel, I’m a convert to being over prepared.

I had an insulin pump failure almost a year ago while at a conference. It could have been disastrous if I hadn’t been standing next to someone who happened to have the same brand of pump and happened to have brought her “travel spare” pump. (It was a diabetes conference, so the odds were slightly higher that this might be possible.) However, if she hadn’t been there, I would have been up a creek without a paddle… or long-acting insulin… on a Friday night.

I talk about being prepared for the unexpected and traveling with diabetes. It’s easy to talk about it.

My “go diabetes!” travel bag (lovingly packed in a ziplock plastic bag for easy viewing by TSA) has pump supplies, insulin for the pump, back up insulin pens (both short and long-acting), pen needles, a syringe (for McGuyver purposes) blood meter strips, and all the other fun items that we lug around just in case. Depending upon how long my trip is, that bag may be accompanied by a second “go diabetes!” travel bag. I’ve learned my lesson.

Or not. 

I carry glucagon in my purse. (Not that a stranger is going to rummage around in my purse if I’m passed out, but family knows it’s there.) I throw insulin pens in my purse, even though they don’t get used often. An extra infusion set. What don’t I carry?

An extra pump body and insulin cartridge for the Asante Snap pump I refuse to give up just yet. (I still have supplies, so I’ll use it until I have nothing left. Boo.)

We weren’t going far yesterday. The Kid and I headed up to my parents’ house to visit; a two hour drive at most. While on the highway (of course, traveling exactly the speed limit), my pump alarmed.

“Low power…. change pump body soon.”

The Asante Snap pump was brilliant in incorporating the battery into the pump body, so when I replaced the body, I got a fresh power supply and fresh cartridge of insulin. The pump body is changed every week. This was a new alarm for me. And I had changed my pump body two days before.

“Well, that’s another thing to put on the list when I get home this evening.”

Less than ten minutes later, a high-pitched screech had me scrambling to pull the pump out of the clip case on my hip. The pump was dead. Pining for the fjords.

“Blech.” Please note: this was not the word that I used.

I spent the rest of the drive doing calculations of IOB and looking at my CGM. Arriving at my parents’ house, I explained the situation and that I needed a few minutes to figure out what I needed to do next, because… I had no clue.

You see, I haven’t taken a long-acting insulin in 16 years. In fact, the longest amount of time I have been off of an insulin pump was for 12 hours, during the prep and c-section of The Kid and I was attached to an IV. I’ve never done a pump vacation or an untethered regimen.

I didn’t have my “in case of emergency, take X units of Lantus” notecard and even if I did have the piece of paper, it wouldn’t have been correct; taking Invokana has changed my total daily dosage.

I called my CDE and left a message. I texted her as well, hoping that she’d see that before she got the message. Then I crowdsourced/hiveminded/asked my DOC friends for what they would do, because I just didn’t know how much Lantus I should take.

In a few minutes, I had varying responses (with the “your diabetes may vary” caveat that we all give) and then the text from my CDE came through…

“Do you have insulin on you?”

“Yes, pens of both.”

“Do you have pump supplies at home? Will you be home today?”

“Yes and yes.”

And then it hit me at the same time I read her next text:

“You can take the fast-acting as a basal in small amounts like your pump basal until you get home.”

I microbolused for the rest of the day, checking both my CGM and fingersticks. (My basal is less than a unit per hour, so adjustments were made.)

Got home, changed my pump body, and plugged back in. It was like nothing ever happened. Back to the status quo.

And I was humbled.

My goal for the rest of the week?

  • Get the correct estimated dosage for Lantus in case something does go wrong with my pump again.
  • Create a purse “go diabetes!” bag with a pump body.
  • Thank my friends for the great advice and the non-judgement.

Do as I say, not as I do.

I may talk about being prepared, but now I have to learn to walk the walk, instead of just talking the talk.