Crooked Cannula

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Sunday started for me like most days. Wait, let me revise that sentence and begin again. Sunday, as far as diabetes goes, as far as my health goes, started for me like most days. I woke up, checked my blood glucose — which I was happy with — took my thyroid hormone (since in addition to Type 1 diabetes, I also lack my thyroid thanks to thyroid cancer), and then about twenty minutes later Kathryn and I headed out with Ellie to Dog Church. Dog Church is the 18-acre members-only dog park that Ellie loves, and which is our Sunday morning ritual.

So far, so good.

Our afternoon plans were to head up to Kathryn’s family for a nephew’s birthday party, at which there’d be much good food, but which I was prepared for. My brother-in-law can do things with meat and a barbecue that can make most carnivores weep with joy, and Sunday was no different. I bolused appropriately for the barbecue ribs, the grilled chicken, the bacon-wrapped venison. It’s a rare treat, because I only indulge in these delicacies three, maybe four times a year. I decided, going into the afternoon of meat and birthday cake and ice cream buffet to bolus in small doses. A unit here, three units there, six or seven units for the small piece of cake and one scoop of ice cream. All afternoon my blood glucose ranged between 140 mg/dl and 160 mg/dl. I was very proud of myself. (OK, not proud, but when I checked my glucose, I expected it to shoot up over 200 mg/dl, and when it hadn’t, I took some satisfaction in knowing I’d predicted the appropriate amount of carbs in all of the food I didn’t prepare and for which I didn’t have food labels telling me how many carbs were in each serving.)

That evening we drive home. Kathryn’s driving. I check my glucose two or three times in the hour-long trip home. Just fine.

A little later, before bed, I need to replace the insulin pump’s reservoir, because I’m almost empty. Although I’d recently swapped out my infusion site — Saturday morning at the gym, I think — I went ahead and put a new site on.

Before bed, my glucose had gone up to about 240 mg/dl. OK, that’s high. Except I was tired, except the day’s festivities were loaded with lots of sugar and fats and I was pretty certain it was the blowback from my indulgence. I didn’t give a thought to the site change, because it’d been only an hour earlier that I replaced the site, and in my experience it takes hours for the consequences of a bad site change to show up.

So the high blood glucose was from the evening before.

Yet I woke up around 3 to pee. Checked my blood glucose. 280 mg/dl. No no no. That’s not right. Check again. 287 mg/dl. Dang. I issue a correction bolus, go back to bed.

Monday morning I woke up, walked the dog, got ready for work, got to work, ate breakfast at work and bolused for the granola/yogurt combination I often eat. I didn’t check when I woke or before breakfast. I was tired, and because of the high blood glucose, I’m sure I wasn’t particularly in a good frame of mind.

Mid-morning I feel incredibly warm. Sweaty. It’s not pleasant. My allergies are bothering me, as well (the ragweed and pollen out in the country the day before wasn’t helping). I attributed my discomfort to that. I check my blood glucose. 350 mg/dl. Holy crap!

To problem solve, the first thing I did was swap out the reservoir and change my site. That’s often my first line of defense after I confirm with a quick mental checklist that I bolused for my food and that I’ve not done anything else too far out of the ordinary.

When I peel off my old infusion set — well, the infusion set I’d just applied the night before — I hold it up and look at it. The cannula looks like a candy cane; it’s crimped in two places, effectively turning it into a J, and effectively closing off any insulin that I’d been trying to infuse in my body for the past 14 hours.

Problem solved.

New set, insulin on board, and two to three hours later I checked my glucose and I was below 200. I felt so much better.

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