Friday, June 12, 2009

Breaking the Rules

Disclaimer: I'm not a medical professional, just another diabetic, so don't take what I do as's just what I do.

We had a series of thunderstorms this week, and my 90 year old father-in-law lost his power. So he came to spend the night with us. We got up early the next morning, and he was stressed out about getting home...insisting he needed to take one of his medications right at 6:45 am. We took him home right away. This may have been right for that medication, and perhaps a few minutes on either side would really matter.

Since then I've been feeling resentment about the many "rules" that I was told early on applied to my diabetes care. I know the folks who taught me these rules were erring on the side of caution, and telling me what they were legally bound to say. But diabetes puts enough demands on life that I don't need any "extra" ones. Early in my diagnosis, I didn't know how to sort out what was really critical, so tried to follow everything to the letter. Here are the ones I can think of that I have kicked to the curb over the years:
  1. Change your lancet after every use -- umm once in a blue moon
  2. Swab your finger with alcohol before you do a finger stick -- never
  3. Swab your injection site, pump site, CGM site with alcohol prior to injecting (or inserting) -- never, just make sure area is clean
  4. Always refrigerate your insulin -- I used to stress over whether there would be a fridge at hotels, now current bottle stays at room temp and additional supply is in fridge at home
  5. Change your pump site every 2 days -- umm 4 or 5 days usually
  6. Change your CGM site every 3 days -- I lie to my pump -- telling it I have a new sensor when I really don't -- so I can use for each sensor for 6 days. The poor thing has yet to wise up!
  7. Take Lantus at same time every day -- early on I was dogmatic about this, but soon found out that for me the darned stuff didn't last 24 hours anyway
  8. Swab top of insulin bottle with alcohol -- never

How about you? Are you a diabetes renegade?


Araby62 (a.k.a. Kathy) said...

Wait, you can actually change the lancet...?! {;-)

I clean the bottle tops every once in a while, but I'm guilty as charged for the rest. I re-use needles too. We generate enough medical waste as it is!

Val said...

lancets - I asked my CDE for a free sample multi-clix about two years ago, and I'm still working with the first of the two "Drums" that came with it. Maybe in another year I'll actually need a script for lancet refill - original has long since expired.

CGM - I once got 22 days out of a 3-day dexcom sensor. I have been unable to get more than ten or eleven from a dexcom 7-day tho.

and you forgot "Don't bolus off your CGM" - heck, if it says I'm 300 I will put in a correction then and there - maybe a slightly more conservative one than a fingerstick-based correction...

Carol said...

Kathy, thanks for the laugh re: changing the lancet. I forgot about reusing needles...used to do that before I started pumping.

Val, wow 22 days, I'm impressed! Just started on CGM a few weeks ago, so I haven't bolused off the CGM #.....yet...

Lee Ann Thill said...

Those are all rules I break too. Until I started using a pump 5 years ago, I can't remember the last time I used alcohol. I'm diligent about the alcohol for pump and sensor sites though. Of course, even though I have the swab there ready and waiting, it doesn't even occur to me to swab the top of the insulin bottle.

Like you, I get tired of constantly following all the rules, so I have corners that I cut. They're corners that don't seem to have any impact on my BG management though, so I'm OK with disregarding those rules.

Scott K. Johnson said...

Haha! Great stuff! You know I'm a rebel!

Lili said...

I use IV-Prep but I don't use plain alcohol for anything diabetes-related. said...

I ave Type 2 diabetes.

Am I a renegade? Well, you decide:

1. I refuse to take medications, any medications.

2. I once told a new primary care physician that I refuse to take "those bizarre chemicals" (my term for medications). She jumped up from her chair, threw her clipboard across the room, and started screaming at me. I have a new primary care physician.

3. I am on a high-fat diet consisting almost entirely of avocados and guacamole.

Am I a renegade? You decide: