Why did I need to take a pump break?
In a word:
"Burnout"
Even on a High Sierra trek.
About a year ago, I started looking into the possibility of taking a break from the pump.
Not because of anything detrimental to my health, in fact the pump therapy was working pretty well for me, and I had figured out some pretty handy ways to get the pump to fit into my active, outdoorsy lifestyle.
So, then why would I want to part ways from the pump if it was working out for my therapy?
In a word: Burnout.
After 34 years living with type one, and 21 of those years on some sort of pump, I had felt the weight of that little plastic brick in my pocket become “heavy”. (metaphorically speaking)
Here are the main factors of this burnout?
Factor #1
Running with a 'brick'
Tubing fed through "access" hole in my shirt.
each time I'd head out for a run on the trails.
and a very individual one at that.
Long trail runs, and the freedom to just go and go until the sun sets.
Is that what I’m after?
Yes. Yes I am.
And that pump?
What to do with that pump?
…If it’s a short run, I could de-tether (and deal with the wonky blood sugars later)
(… Here’s a post I wrote about that …)
Or, I could set a temp basal and bring this little brick along for the long run in the hills.
And how nice would it be not to deal with this little inconvenience?
Setting a temp basal on the pump, training for running on roads, on trails, dealing with post running blood sugars, the topics seem endless, and if you’re curious, there more info here:
… Check out the discussions on this subject here on the Type One Run online community threads …
Or, if you’re on Facebook, jump in this group for even more on the subject:
… Type One Run Community FB Group …
Factor #2
The 'little' snags
Just hiking through some of Southern California’s wild and rugged terrain, the casual hiker will soon realize, the natural flora of this region really doesn’t like fabric (or human skin for that matter)
It’s rough. It’s prickly, It’s what makes the vegetation so resilient here in So Cal.
Now let’s add pump tubing to that equation! YIKES!!!
Let’s just say, there were some snags along the way.
And how nice would it be not to deal with this little inconvenience?
Factor #3
The Climbers Dilemma
I'm a climbing guide.
I climb often.
Usually outdoors, so it's not uncommon the pump is subject to scratches, cracks, cut tubing, and these issues can be solved by protecting the pump with a sturdy case, covering the tubing with a sturdy material like velcro strips, but there's one major issue which always reared it's ugly head while climbing"
And how nice would it be not to deal with these inconveniences?
The infusion site
- Often around the abdomen or legs where the harness waist belt or leg straps were.
- The adhesive can be doubled up, tripled up by means of skin-tac, and KT-Tape
Harness arresting the fall
- Falling is a big part of climb ing, it’s why we use a harness.
- To arrest a fall, climber goes down. Harness goes up. Climber is caught by the harness.
- As harness goes up, it cinches tight on the climbers waist and pulls everything along with it: clothing, adhesives, infusion sites, etc.
Moral to this story, a pulled infusion site can really ruin your climb day.
Here's a couple pictures of infusion site issues brought on by the climber's harness:
Literally
I'd always carry extra KT Tape in my provisions pack
for these occasions
Factor #4
104 site changes per year !
(minimum)
That's anyone's guess.
Lipohypertrophy
n.
is a lump under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin. It may be unsightly, mildly painful, and may change the timing or completeness of insulin action. It is a common, minor, chronic complication of diabetes mellitus.
Besides Lipohypertrophy, which is something that all pump users will encounter eventually, there's also the frustration of failed infusion sites, low reservoir alerts, and inconvenient low battery situations
Yes, it leaves a scar.
Pump users are quite familiar with this:
That little infusion site will leave a scar, a small one, and over time, a lot of little scars.
Here's a close-up of my infusion site, just after removing the canula set.
You can clearly see all the other, nearby site scars that have accumulated over the years.
Factor #5
Pumps in the Backcountry
For multi-days backcountry excursions, it's not just a pump I'm carrying.
There's also all the infusion site change supplies that will be necessary after 3 days out there.
Yep... All this gets packed in
and packed out.
All these "medical" supplies bring with them their own, unique circumstances, and unique chemical odors especially when camping in "Bear Country"
So, in order to be "Bear Safe" all these pump supplies (including insulin) need to be stored in a bear box or bear canister and stored just as you would food.
This, of course, takes up a bit more space.
Again, just one more burden.
Factor #6
An expensive backup
Loved it.... Until it was bought by Medtronic
The "Backup" lifeline
For extended travel, were often told to ask the distributor for a "backup" pump to bring along while we're abroad just in case something were to happen while we're away from home.
It's a very expensive piece of tech should we need to replace it for some reason.
There are quite a few "less expensive" backup options.
(Discussed more in the follow-up blog post)
Factor #7
Tech fails...
in the worst places
Tech will fail in the backcountry.
It's a matter of when.
It's not just tubed pumps that have their fair share of epic fails.
Of all the pumps I've used, none were more prone to failure than the OmniPod.
Sure, it's a convenient solution to that pesky tubing dangling around and getting caught on things, but the times I took the OmniPod out on backcountry excursions, it's fail rate was off the charts.
(you know that sound)
These were some of the frustrations to my mental state of burnout.
Have you experienced diabetes burnout?
and what things have you tried to remedy that?
Check out Part 2 of this "Pump Break" series
Pump Break – Part 2
Going off pump therapy after 21 years on a pump takes some planning, and a little inspiration.
Here’s how my pump break plan came together.