Monday, August 18, 2014

Adventures in misplaced pods

One thing I sometimes have trouble with, with my OmniPod is that sometimes I don't place it correctly and then it either comes off or it doesn't work in the first place. One time I put the pod on my arm upside-down, and the cannula didn't get inserted. I should have known there was a reason all the illustrations show the pod being placed in a specific way! Another time I dislodged my pod by towelling off too vigorously after a shower and I wound up with super-high blood sugar until I changed it. Yesterday I had a combination of both. It was mid-afternoon when the pod change alarm came, and I am trying to remember to rotate my pod locations so as to minimize the effects of the adhesive on my skin. I decided to put my pod on my butt, but I remembered that when the pod goes on the butt or the belly it goes sideways instead of up and down. Unfortunately, I was sitting in an awkward position and I didn't put it either straight up and down or straight sideways. It looked wrong, but the cannula inserted itself and my blood sugar was fine at 5.3, so I figured everything was okay. Later I sat down at the kitchen table to eat supper, and I felt and heard my pod go "whack" against the back of the chair as I sat down. I did a quick visual inspection and nothing seemed to be wrong, so I ate my pizza and delivered an extend bolus, all the while scolding myself for forgetting to order the lower-carb thin crust pizza. I then set about unpacking the moving boxes sitting in my living room in the hopes of finding all my cooking utensils so that I could cook myself a proper dinner next time and not order pizza. I did this for about two hours, until I noticed that I was awfully thirsty and that I had downed several glasses of Coke Zero in a relatively short time. I checked the PDM (pod controller/blood glucose monitor) to see if my extend bolus was finished. It was, and I did a blood test. Result: 19.1 mmol/l. Uh-oh. My question was: was this because of my pizza or because I hadn't placed my latest pod correctly? I decided to take a correction bolus and wait an hour or so to see whether my blood sugar came down. Only when I sat down at the table to look up something on my laptop, the pod whacked against the chair again, and this time I could tell that the cannula had come out. Oh, well. A waste of insulin, but at least I'd learned my lesson about proper pod placement. I got out a new pod and realized that I didn't have enough insulin to put my usual 150 units into my new pod, but I figured I had enough to last me overnight and then I'd go get a new vial of insulin in the morning. However, it turned out that I didn't have enough insulin to feed the pod. Good thing the drugstore is open till midnight (it was now around 10:30 p.m.) I called a cab and hurried off to the drugstore. Happily, I had already ordered my insulin refill and it was waiting for me at the counter. I paid for the insulin, sat down and changed the pod. I also checked my blood sugar again. Result: 22.1. Ouch. I took a bolus of 15 units. The pod controller recommended a lower dose, but it believed I still had insulin in my system from the previous bolus that I'd taken before I knew the pod hadn't been placed correctly. I got the bus home and arrived around 11:30. My blood sugar had gone down to 18. Certainly better than 22, I guess, though still a lot higher than I was comfortable with. I felt a bit sick to my stomach, and I was worried that DKA was going to land me in the hospital (I've read that if you have nausea and vomiting when you have ketones, you should go to the hospital) but then I let out a huge belch and realized I'd just had gas from all the Coke Zero I'd been drinking! I curled up in bed with my cat and a good book. Two hours after my bolus of 15 units, my blood sugar was 16. By now it was 1:00 in the morning so I decided to just go to sleep. I didn't sleep well, unfortunately; maybe too much adrenaline was left over from my rush to the drugstore? However, when I got up at 8:00 my blood sugar was a perfect 4.8. I think I will not use that site for a pod placement again. I'll stick to my arms, legs and stomach. I don't want to risk another pod getting dislodged when I sit down in a chair.