When only the shower is free

Wonder of wonders, today was Free Shower day.  Wearing multiple medical devices on one's body means that this almost never happens.  But, the stars aligned and I was able to shower with no pump connection site and no sensor.  One of the major reasons that this so rarely happens is because I typically change my pump site at night and I shower in the morning.  It's partially my own fault.

So why was today different?  I'm glad you asked.  I did something I'm not supposed to do: I wore my pump site longer than three days.  Insulin pump manufacturers recommend changing your site every two to three days to prevent infection.  Granted, I only wore my pump for about 12 hours longer than I should have, so my risk of infection was slight.  But I had my reasons.

Two days ago, I realized that I still had plenty of insulin left in my reservoir.  That if I were to pitch this pump site when I was supposed to, I'd be wasting more than 10 units of insulin.  On certain days, when I eat fewer carbs than normal, 10 units can cover me for an entire day!

Now, I'm sure there is a way to conserve this insulin, or to put that reservoir in the pump after changing the infusion set.  But then I'd have to refill the cartridge or change it the next day anyway.  I suppose that's a possibility, but I've never done it.

Anyhow, after I realized that I had this much insulin left, I started pondering leaving in my site an extra day.  I've never had any site become even slightly infected.  Don't people do this sometimes?  Will not following the rules this once really cause problems?  But, it's a slippery slope.  Would I keep doing it if it worked this time?

You might ask why I considered being so stingy with my insulin.  Really, it's also being stingy with my pump supplies.  I'll get to that in a second....

So I talked it over with Nick.  I like to do this when I'm considering doing something abnormal, to make sure my logic checks out.  Nick did not like this idea.  He didn't like the possibility of infection, and didn't see it as worth it to take a risk like that.  He pointed out how much trouble and money it would be if I did develop a serious infection.

And he's right, although the likelihood of that is slim.  But then I pointed out to him that our lovely insurance policy would cover any doctor's visits or hospital bills associated with a complication.  And this leads back to why I'm becoming so stingy: it's so ironic to me that our insurance company will cover an illness or complication of diabetes, but it covers NOTHING in the way of making sure I can properly care for myself. All of the insulin, all of the pump supplies, all of the CGM components must be paid for by me.

Before we left the States, I hoarded supplies like crazy.  I refilled my insulin well in advance of running out.  I refilled my prescriptions for insulin pens and needle tips to make sure I had plenty of backups.  I ordered as many test strips and pump and CGM supplies as my insurance company would cover.  Now, I left some of these behind in Philadelphia with a friend (Hi, Michelle!) because I knew I would be returning to get my visa in a fairly short amount of time.  Because of this, I'm now starting to see my piles of hoarded supplies grow smaller and smaller.  I only have two more vials of insulin in Italy.  I think I have about 6 weeks worth of CGM sensors (and yes, I'm using expired ones because I don't really have a choice) and maybe 6 weeks of infusion sets and reservoirs.  Once I restock from the States, I think that I'll last until about March or April.  And then what?

Since I will have to pay for everything out of pocket, I think that I'll have to go back to 4-5 injections a day. The Lantus pens I have with me expire in May of 2012 and my Novolog pens expire in March of 2013.  Being in a very tight financial situation, I also want to make sure I'm not wasting any of these things.  But I think about what my diabetic life was like before my insulin pump, and I dread going back to injections.  Sure, it would be nice to not have my pump, my 24/7 companion, attached to my body, and I would love to wear dresses with ease again.  But, I live in a country that runs almost exclusively on carbohydrates.  PASTA. PIZZA. GELATO.  I'm swimming in carbs at all times.  It's true that I could ignore these and eat low carb or eat very small portions of these, but I want to live my Roman life to the fullest.  That includes eating cucina romana.

In the end, I know that diabetes makes me not normal and forces me to adapt to whatever situation I'm in.  I'm just being a bit of a whiner about it right now.  I hate that in order to maintain the normal I've been enjoying for well over a year, I will have to spend over $1600 for a 3 month supply of pump supplies and CGM sensors.  Plus insulin.  Plus test strips.

I knew that moving to Rome would require sacrifices, and I know that all will be well, even when I run out of pump supplies.  I'm just dreading that day and what it will mean: choosing to maintain my normal life or my bank account.