Untethered

Me and my pump
Originally uploaded by amblass.

Ms. Amy caused a minor debate in the O.C. a few weeks ago when she joined the community forever subjected to the incessant "Is that an iPod?" question.

The debate was circled around the pros and cons of being "tethered" to an insulin pump. Those using the traditional pumps liked the tubing because it allowed them to disconnect occasionally, there was no PDA to remember, there's no lump under clothing and you don't have to throw out each one every time you change the site (which, I believe, has brought PWDs a kind of kinship with medical devices not seen in many other health circles).

On the flip side, you don't have to worry about clogged tubing, strange people gawking at your waistline, waking up with your insulin pump trying to choke you to death or having a 3-year-old try to yank out the tubing with her foot when you put her down (or perhaps that's just me...). You also don't have to worry about finding a place to hide it/stash it/clip it every time you get dressed.

My entire wardrobe is pump friendly. All my skirts and pants (except one) have pockets, and the one that doesn't have pockets has belt loops. I don't wear dresses.

It's been at least seven years since I wore my last dress, possibly longer, because I don't really think I look that great in dresses (that abdomen needs toning).

While I love the pump and everything they stand for, I am sick of being tethered to insulin pump.

I have decided to take a pump vacation and am now on the "Untethered Regime."

Those of you who frequent the CWD website may have seen the page written by Dr. Steven Edelman about the Untethered Regime. Essentially what it means is using a shot of Lantus to cover your basal and reconnecting at meals for the bolus. This allows people to use extended boluses and temp basals (but only if you're going up, not down) and you can disconnect for long periods of time without worrying about going high.

You also don't need to worry about clipping the insulin pump to your clothing.

This July, it will be seven years on the insulin pump. It's not that I don't like the insulin pump or think that what it does isn't useful, but after seven years, I just don't want it on me anymore. I don't want anything on me. I don't want tubing on me and I definitely don't want a piece of plastic mounted to my body 24/7. I am wearing a set like usual, that will have to stay unless I wanted to switch to injections - which I don't. Who would?

I have only been on the Untethered Regime for two days, so I'm still getting the hang of things. Gary initially put me on 26 units of Lantus, which worked overnight and in the evening, but I spiked at 372 mg/dl yesterday afternoon. Which I was completely expecting. On the pump, my basal rate overnight goes down to .75/hr, but reaches 1.3/hr in the afternoon. Quite the difference. I went up to 28 units for today and my highest I was 214 mg/dl. Not too bad. I think I might be able to fix that high with an increase in my bolus ratios.

I've been carrying the pump around in my meter case, so I'm not too worried about forgetting it or leaving it anywhere. It certainly is an odd sensation to suddenly not have an insulin pump essentially fixed to your hip. I reflexively reach down to catch my pump when I get out of bed in the morning and I keep trying to look at my pocket to see what time it is. Now I need to get used to using my cell phone to find the time.

I find it a bit ironic that I'm leaving for California tomorrow to attend a CWD regional conference on pumping. Though I will add that Dr. Edelman is going to be speaking at a session on the untethered regime and other pumping strategies, so I'm looking forward to seeing if he has any tips to help me get the most out of this experience.

I haven't decided how long this little experiment will last. Probably until I get sick of being untethered! Either way, I will keep all of you posted.

(P.S. Apparently I failed to mention that I got a pump skin awhile back. They are jellybeans.

Don't worry, that irony has not been lost on me either.)