The Color of Progress

About two months, ago I received a call from an Animas Pump Support Rep. He was wondering if we could return our back-up insulin pump.

Typically, "loaners" are provided if the user will be traveling out of the country.

Or, if someone's mother is at the end of her rope because her son is on his third pump in seven months.

"Could we just hang on to it for one more month?" I asked him, "This may sound superstitious, but if we could get past that four-month mark... the time when we always seem to have trouble, I'd feel a whole lot better."

Well, this rep-- understanding the concept of good customer service-- granted my request. In fact, he said we could hang on to the loaner for two more months, if that would make us feel more confident.

Good thing, too.

Joseph's numbers were pretty funky all day yesterday. He had a persistent low at school-- the kind that adamantly resists treatment. It took almost 40 minutes and a whole lot of glucose tabs to bring him up from 60 to 82.

He was high the rest of the afternoon, despite corrections.

Last night, Joseph was due for an infusion set change-- I had hoped this might help alleviate some of these wild fluctuations...

But all it would yield was more trouble.

You see, when I came to the "prime tubing" step of this set change, each time I held down the "prime" button, the pump stalled.

On the third attempt the pump froze completely, displaying an error code and a message that read "Call For Service."

This might be a good time to mention the phone message I'd received earlier in the day from my friendly Pump Support Rep. It seems our two-month extension was up and it was time to send back that loaner pump.

Uh huh.

So last night, while holding the ceased-up pump in my hands, in a state of near shock at the realization that this was our THIRD pump malfunction-- I called for Service.

After I recited the error code on the pump's display, a very calm Service Rep explained that "because the pump is always doing self-checks, it occasionally needs to be re-booted. Just take out the battery, put it back in, and do a full rewind."

"But what about the stalled primes? And we've had some funky blood sugars today. Should I be concerned that the pump might not be working properly?"

I asked these questions, hoping for some serious reassurances.

And in a very serious tone, the Service Rep responded.

"Don't put the pump back on him. Sandra, we'd rather be safe here. We'll send out a new pump right away."

Pump Number Four is en route.

We completed the set change using the silver loaner pump (all three of Joseph's pumps have been black, so this was quite the novelty for him).

"Mom, this pump looks so new," he said as he turned it over in his hands, "And I like the silver... it looks just like a cell phone."

At about 10:30 pm, Joseph's blood sugar was 143, and he was finally off to bed.

By 12:30 he was 241.

Two hours and one correction later, he was 289.

Two-and-a-half hours and a second more aggressive correction later, Joseph's blood sugar was 324.

No. Way.

Ryan, who'd been doing these overnight checks, wisely gave Joseph a MUCH more aggressive correction via syringe.

Within two hours Joseph's sugar dropped to 187. Less than 30 minutes after that (at breakfast) he was 138.

The very first thing I did this morning was change his infusion set.

As he pulled out the old set, we all noticed that the cannula was bent completely to one side. In fact, the cannula looked as if it had never even entered his skin.

Another horrifying realization... from 10pm until 5am, my son had likely received no insulin.

Thus it was no surprise that just before leaving for the bus stop he said, "mom, I'm feelin' a little nauseous."

A left hook, right to the gut.

"Honey, do you think you could pee real quick before you go... just so we can check for ketones?"

He's had ketones only once before, and they were trace; he'd never even had them at diagnosis.

But he had them today.

Almost immediately after dipping that ketone stick, it turned a deep shade of pink.

Small ketones.

"Let's have you drink a large glass of water before you go, and I'm gonna kick up your basal rate for a couple of hours." (We'd been conservative with his breakfast bolus because he was coming down so fast... )

After he left, I called the school nurse to give her the heads up on what was going on. To make sure that at the slightest sign of trouble, they would check for ketones... and call me.

So far so good. His sugars were in the low 130s at snack and right before lunch.

And he sounds good.

But man...

In the meantime, I keep thinking back to something Joseph said this morning, right after breakfast:

"Mom, Dad, I want to upgrade soon to the 1250, and this time I want a silver pump. "

He paused a moment, looking thoughtfully at the loaner pump in his hands.

"Because, you know... " he said, looking up at us with an absolutely earnest expression.

"Silver is the color of progress."