When pumps fail: 24 hours on MDI in Vegas

I killed my insulin pump last Thursday.

What happened?

Not on purpose, mind you- I was in Las Vegas for the 2017 USBC Open bowling tournament (that’s tenpins if you’re overseas). It was hot – 100℉ (38℃). I was hanging out by the hotel pool with some friends drinking piña coladas, and decided to sit in the pool for a bit to cool off, and I guess I stayed in just a hair too long.

But I’m not sure there’s anything as unnerving to a person with T1 diabetes as the blaring sound of a malfunction alarm coming from their insulin pump. It wasn’t an unmitigated disaster, though. I silenced the alarm, paid my bar tab, and returned to my room to begin dealing with the situation.

Handling the situation

Step one: The Phone Call- The first thing I needed to do was to customer service at Tandem Diabetes Care (the pump manufacturer). It’s NEVER good when something goes wrong with insulin delivery, but the young lady I spoke to was helpful, gathered information about the error code, confirmed that this was NOT something that I could fix myself, and immediately made arrangements to have a replacement pump sent to my hotel. Then, she made sure that I had another method of delivering insulin available (I did- a Lantus pen for basal, and a Humalog pen for boluses). Next was instructing me as to how to actually turn the pump off so that it would not blare its alarm. Those issues addressed, I moved on to taking care of my insulin needs.

Step two: Back to Basal- I’d been running a tad high thanks to a few piña coladas, so I knew I needed to get some extra insulin on board ASAP. Fortunately, I’d brought pens of Lantus and Humalog along with me on my trip. I’d uploaded the data from my pump the weekend before into Tandem’s t:connect system, so it was a piece of cake to log in, pull up the report, and determine my total daily basal insulin requirements. It’d literally been years since I’ve used a pen, but the process hadn’t changed: put on a needle, prime, dial up the dose, and inject. Easy Peasy.

Step three: Correct, but do it gently- I have by baseline correction factor and carb ratio memorized (although they fluctuate slightly by time of day), so figuring out how much of a bolus I needed to come down from the blood sugar of roughly 210 that I was sitting at wasn’t an issue. I intentionally under-bolused by a unit because without a pump, I can’t tweak basal rates on the fly to compensate for an over-correction, but other than that small adjustment, the same dosing continued.

The end result

It all worked out wonderfully. I spiked a little higher with meals than I normally would, but other than that, my blood sugars stayed in range almost the entire time.

I have to give props to Tandem- I got a delivery notification at 9:30AM the next morning that my replacement pump had been delivered to the hotel. I swung by the hotel’s Business Center on the way to my second day of bowling and picked it up, and the timing worked out such that my Lantus dose was just wearing off when I finished the singles and doubles events and had time to program the pump and resume my normal routine.

While it’s not something I would have done by choice, I’m giving myself a pat on the back for having successfully negotiated my first temporary interruption in pump therapy.