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Unplugged – taking a pump holiday in lieu of a real holiday

July 25, 2013

Diabetically speaking, July has been a tough month for me.

It began with about two weeks of relentlessly high BGs. It was the kind of time where, as I put it on facebook, just breathing air seemed to raise my blood sugar. It’s times like that where emotions escalate pretty fast; I became afraid of food, angry with myself, hateful towards the various gadgets that normally keep me thriving (both my meter and my pump got thoroughly anthropomorphized, receiving the kind of verbal abuse typical of a marriage on the fritz).

I am still not quite sure what triggered it all. For a little while I thought it was pre-menstrual hormones at work; one fellow diabetic on facebook informed me that it was simply my honeymoon ending (his misinformed opinion did not rub me the right way – I dealt with that shift almost two years ago and I received his comment as condescension from an “older” diabetic). It was my naturopath who suggested overall life-stress was causing a roller coaster in my sugars. I think she had the winning vote.

High blood sugar can be a vicious shadow-companion to stress. This has been a challenging month for me life-wise: I’m working and living in two cities, adjusting to a new job, finishing up a master’s, managing a relationship with someone in a third location who is even busier than me, and trying to make grown-up life-plans about longer term life after my graduate degree is officially done. Work plans, debt-repayment plans, settling-down plans.  All the while putting a lot of pressure on myself, ironically, for the kind of self-care I’m used to: vigorous exercise every morning (a huge factor in stabilizing my BGs for the day), time with friends, time by myself, wholesome food, meditating, practicing, creative writing, journalling, reading, sleeping – a gamut of activities that my current schedule simply cannot accommodate.

It’s not clear whether high BGs have been a symptom of a stressful time, or a major contributor to already-stressful circumstances.

After meeting with my naturopath two weeks ago, where she delicately suggested that my system was raising alarm-bells with high BGs as a result of how much I had on my plate, and after I recovered from the good bawl-session triggered by hearing those truthful words, my BGs magically began to calm down. I began to set more realistic, and nurturing, expectations of what I could do self-care-wise with my current commitments. I began to react more compassionately to a high number in my meter, which had the miraculous effect of reducing their frequency. I began to trust that I could eat food again, without getting fucked over by it. I began saying more frequent ‘no’s’ to things that wouldn’t nourish my spirits, and ‘yes’ to things that would.

Then this week, a cannula kinked inside my back-fat.

It happened on Monday. I went through a full day with BGs not budging from 14.5mmol, despite giant boluses every hour, one long, desperate run (with insulin on-board, supposedly), and a banquet of self-blame, before it occurred to me that maybe the site was to blame, and not myself. So I ripped out the site, beheld the bent tip of the cannula, put in a fresh one, gave a correction bolus, went to bed, and then woke up twice in the night with hypos of 2.5.

Last night, during yoga class, I actually uttered an audible “fuck you” to my pump when I kept knocking against it during some low lunges. The fact that I could be so triggered by my pump in a yoga class – an environment that is normally such a wonderful part of my self care routine – was a big honking indicator to me. I decided then and there: sister, it’s time for a pump holiday.

I’ve been thinking of taking a pump holiday for awhile, but with all these high BGs this month, it has never felt like a good time. Going back on shots means there is usually a couple of days of fiddling with the Lantus, relearning routines, and actually doing the math of carb-to-insulin ratios, that result in some unpredictable numbers at first. Now is not a good time, I’ve been telling myself this month, especially on the days when I blessedly manage to keep “normal” numbers. Do you want to mess this up again, now??? is the voice in my head. I’ve been listening pretty hard to that judgemental, fearful voice.

But then I realized: maybe this is as good a time as any to take a break. If there isn’t much of a “normal” in either my life- or diabetes-routine, it might be wise to try something new now, to get a change from a draining regimen, and maybe even expect a little less of myself in my management. If I’m getting unpredictable numbers anyways, I might as well be getting them from switching over to shots. A change is as good as a rest, they say. And I frankly can use a break from having a sweaty, clunky pump clipped to my pelvis 24/7, and a sweaty, itchy site giving me a heat-rash.

So I gave myself my first shot of Lantus about an hour ago. Set the pump on my dresser and switched it to “Suspend.” Then I got dressed, and felt the mental breeziness of not-having-to-think-about where to clip the pump. Once dressed, I went downstairs to put on a load of laundry, and felt the same breezy feeling when I walked through the basement door without worrying about tubing getting caught. On the way back upstairs I stood for a moment by the full-length mirror in my hallway, beholding me without a pump. Me, without that honking piece of technology that keeps me alive, but also keeps me tethered to this bittersweet diabetic identity. And I felt, momentarily, free from diabetes.

So the very next thing I decided to do was come upstairs and write this post. Because this mental breeziness is so precious, so distinct in the spectrum of emotions unique to diabetics. It is something worth capturing, and has been a long time coming for me in this emotionally-draining month of diabetes management.

I have no idea how long this pump holiday will last, but I recognize that it is part of my self-care. When I take pump holidays, and when I end them, I do it because it’s right for me. I’ll give myself a couple of days to adjust to the shots, and when I go back on the pump, it’ll be because I want to.

In times of stress and burnout, when I’m aching for a holiday I simply can’t take right now, this might be as good a time as ever to loosen the reigns on my disease management.  Here’s hoping a pump holiday helps breathe some more compassionate self-care into these busy days of mine – and heck, maybe even give me the emotional energy to confront diabetes’ unpredictables with graceful, Zen-like non-attachment (get it?).

As this fellow ‘unplugged’ person put it, I’m coming as I am. Diabetic. As a friend. As an old enemy.

 

 

In the spirit of self-care, I am committing to becoming a more regular contributor to my own blogs. Two years of graduate school have kept me a bit distant from blog writing – a medium I adore, and which has taken a back-seat to the academic and clinical writings I have been immersed in. Also, I have wanted to distance myself from my diabetes a little bit in the past couple of years, after having made it the centre of my life for the first 18 months post-diagnosis. As I try to find a place for diabetes in my life that can hold the tragedy, humour and the hope implicit in life with a chronic illness, blogging more regularly will hopefully be a helpful resource. I welcome the support of my readership to encourage me to keep posting here! 

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2 Comments leave one →
  1. michelle s. permalink
    July 25, 2013 1:26 pm

    Great post Sarah! I hope this holiday creates some mental space for the relentless self management involved in T1. I liked your observation that looking at the high numbers with more forgiveness and acceptance meant those numbers were more likely to come down! I have tried to teach myself to have a shorter memory for the numbers I don’t like. I try to just leave them behind and move on.

  2. July 26, 2013 11:53 am

    Hi Sarah,
    I found your blog through your mom’s link to it on FB. I’ve known her for a long time through JASNA, and we’re looking forward to hearing her speak in Halifax in the fall. Great post! I hope your pump holiday is helpful. My brother has Type 1 diabetes, and I’ve often thought of running to raise money for diabetes research. Your story is inspiring — thanks for writing.

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