Insulin Gone Bad?

Just when I think Gee, C's numbers have been really great lately...boom!  Relentless highs.  I mean blood glucose readings in the 200s, 300s, and yes, even 400s. Gobs of insulin corrections weren't making them even budge at times.

These highs began happening as soon as the kids were out of school last month.  But I couldn't figure it out.  It didn't make sense.  We were even more busy, with lots of activities...swimming included.  And swimming always makes C go low.  It was so frustrating.

What was totally insane was that it wasn't just at one or two different times during the day.  It was round-the-clock.  I'd get her down to the mid 100s with jumbo corrections, only to have her test in the 200s or 300s before her next meal.  This continued throughout the nighttime.  I did a couple of our famous middle-of-the-night-site-changes to no avail.

I began changing the site daily...opening another insulin vial, and then another.  Maybe it's gone bad, I thought.  Maybe it's a bad lot.  I just kept pushing forward, checking and correcting overnight, feeling overly exhausted.  You know this kind of tired...when the first thing you think of upon wakening is the bottle of Advil.

And then one day, I B-lined it for the pharmacy.  The insulin must have gone bad, I kept thinking.  Maybe they'll replace these vials that are barely used...I know, wishful thinking.  But, I was tired.  So off I went with C to the pharmacy.  I asked to speak with the guy who's been there the longest, as long as we've been getting insulin for C.  There are really only 2 employees left at our particular pharmacy who  remember me from the beginning...the haggard, emotional mom who needed, yes, 300 test strips a month for her baby.  He's one of them, so I thought for sure he'd see things my way!

"My daughter," I said, "her numbers have been crazy high.  I've opened like 3 new vials of insulin in the last week.  Could the insulin have gone bad?"  I asked.

"Uh, no," Mr. Pharmacist said.  "Let me see the cartons...Hmmm...no, they should be good.  Our shipments go directly in refrigeration.  She's possibly having a growth spurt."

A growth spurt?  That really didn't cross my mind.  Why hadn't it?  I thought for sure the insulin had gone bad.  Her numbers were high across the board.  Usually when we make adjustments and tweek basals in the pump, it's because numbers are creeping up, sneekily...not all at once.

So, with blurry, sleep-deprived eyes, I nodded, "Hmmm," I said.  "thanks."  We headed back home...determined to make adjustments and figure this out.  Over the course of the next few days, with some nurse help over the phone and internet, we adjusted every single basal setting and even added 2 more.  We changed so many things!  It made me nervous.  I'm very much a fan of the scientific method of changing one variable at a time.  But I knew we had to wrangle these numbers in a bigger way.  So, that's what we did.

It seems to always take several days for any type of setting change to really work itself out and show results.  We dug in for the long haul.  I knew this meant lots more testing and lots less sleeping but...oh well.  That's life with diabetes.

And, did the basal changes help?  Boy, did they?! But that's to be continued in another post...
Insulin gone bad?  Well, I know it can.  But not this time.  Now we have 3 newly-opened vials...ug. 
 

Sometimes insulin can go bad.

Brown Paper Packages...

-Brown paper packages tied up with strings...
These are a few of my favorite things.
                            -Rodgers & Hamerstein

Well, our brown cardboard package came by way of UPS today.  (That doesn't sound nearly as romantic as a brown paper package, tied up with strings.) 

My heart seems to leap each I open our front door to find it there.  For some reason, I always feel a huge sense of relief.  Maybe it lightens up the stress of getting those meter errors and wasting a test strip.  Maybe it's the sense of preparedness it brings and helps me feel like we're properly stocked up.  Or maybe it's the memory of having to drive my preschooler out to Northridge, California (home of Medtronic) because we actually did run out of supplies during our first months of pumping.  I don't know.  But I certainly like the feeling of a full supply cupboard.

The Cost of Diabetes

"The national cost of diabetes in the U.S. in 2007 exceeds $174 billion."  This is taken from the American Diabetes Association website.  That was the most recent statistic to be found.  I am certain last year's calculations are higher just as 2009's amount will be higher still.  But $174 billion?  That's overwhelming right there.

I don't exactly know what that amount includes.  Doctor fees?  Surgeries from complications?  Medication?  Co-pays?  I don't know.  But I thought I would do a little research of what diabetes actually costs our family on a monthly basis and beyond.  Without insurance, it would be nearly impossible.

100 lancets:               $ 13.99

300 test strips            $356.97

2 vials of insulin          $227.98

10 resevoirs:              $ 33.00

10 infusion sets:          $116.00

total monthly expense: $747.94

The following items are not monthly, but still an expense.

alcohol wipes:              $   3.00
iv preps:                      $ 12.00
glucagon kit:                $117.99
emla creme:                 $ 63.99
glucose tabs                 $  5.00

                           total:  $201.98

The following items last a while but need to be replaced once in a while.


QuickSerter:                $ 24.95
meter                           $ 69.00

                          total:  $ 93.95

Finally, the pump itself...this expense is replaced every 4 years.

Minimed insulin pump:    approximately $6,000.00

Thank God for insurance!  Now, don't get me wrong.  We've had more than our fair share of insurance woes.  Like the time they wouldn't believe that we actually really use 300 test strips per month.  And sometimes they've "forgotten" that we paid a copay and bill us again.  Or, there is the occasional mystery bill that comes and puts us on the brink of collections for no apparent reason.  However, they do pick up most of these charges.  Yet, glancing over this list, if we simply paid an average $20 copay for each item, diabetes is not a cheap disease.

Diabetes?  Expensive.  Keeping our daughter alive and healthy in spite of diabetes?  Priceless.

Warning:

Is it just me?  Or does everybody get a bit unnerved opening pump supplies to find that one piece of paper telling you that the products you are about to handle, actually place subcutaneously into your daughter's skin, contains potentially cancer-causing substances?

I try not to anymore.  But everytime I open that box from Medtronic, there it is.  Every three months, that single sheet of paper is victorious in taking a few minutes of my mind's thoughts.  Potentially cancer-causing.  Potentially.

It aggravates me.  I mean, what option do I really have?  We're dealing with diabetes.  I want the best insulin therapy for my daughter.  It feels like a double kick-in-the-shins to know that the products that are keeping her healthy could, ultimately, be harmful.

On another front...I'm a cancer survivor.  So my antennae are working overtime, all the time, when I hear that word.  Or read it.  I'm more mindful now.  I watch what I feed my body.  I am cautious about many things that normally a person would not think about twice.  I over do it with the sunscreen.  I've made peace with vegetables.  I don't want to give cancer even the slightest advantage over me or my family.

But, then, there it is again.  Every three months...a reminder.  A reminder that it's really out of  my control.
___________________________

Do we, as consumers, pump users and parents of pump users demand products that do not contain these harmful chemicals?  Do we add this to our ever-growing lists of things to do.  I think, maybe, we do.