I'm beginning to notice a pattern.
Every Tuesday. Or Thursday. Never both but always one. My infusion site leaks insulin.
Only when it's hot out.
And only when I've gone for a run before work.
This was not a problem last fall. Nor was it an issue over the winter. And, trust me, I do sweat when I run in February. A lot.
It is a problem in the summer. Ever since I've switched from long pants and jackets to shorts and a t-shirt, my site leaks.
Here's how things go.
I go for a run. I come back dripping wet. I check my blood sugar and I bolus for breakfast. I keep one finger lightly on the infusion site and, once the insulin is bolused, I do the finger sniff test. If it's wet and smells of insulin - we have a problem. If it isn't, we might still have a problem but I don't know for sure.
No insulin smell means the breakfast bolus most likely worked but it increases the odds that the lunch bolus won't.
Yesterday, Tuesday, breakfast went well. My site passed the sniff test and my blood sugars did what they normally do after a run and breakfast. Lunch time came around and I bolused. The insulin was still going in when I felt wetness on my site. Damn!!
How much got in? Will I have to go home to change it? Does my entire office have that dreaded insulin smell now? I hope not.
I waited a while to eat to see if my sugar would drop. It did. I ate and ended up around 11 two hours later. Not bad but it never came back down again. I hovered at 11 until 4pm. Not high enough to warrant going home but high enough to be mildly annoyed. I did a test bolus around 3pm and could smell insulin. So after work, before heading to my parents' for dinner, I rushed home, changed the site and then hopped on the highway. Problem solved.
This only happens on Tuesday or Thursday. Not Tuesday and Thursday. I think it's because one of those days is usually a pretty new site and one of them is usually a site that is almost due for a change. I also think that wearing a loose t-shirt instead of a tight base layer top is a problem. The loose shirt, combined with sweat and humidity, rubs back and forth against the site while I run, causing problems. And a wee bit of chaffing.
The problem is that the site looks fine even when it's not. It's not like the tiny tube is sticking out or the adhesive came off. It's still securely attached and everything seems good. It's only when I bolus a large amount (5-6 units) that it seems to pool on my skin rather than go in. I have thought about doing 5 one unit boluses over a few minutes. It might solve the immediate problem but it does sort of take away from the 'convenience factor' of a pump. I've also thought about tossing my needle in my purse after runs and bolusing with that instead. Because I think the basal insulin is getting in just fine. It's the bolus that's a problem.
I'm going to try wearing my tight tank top on Thursday to see if that reduces the movement and helps the site survive the run.
Oh, and I'm putting this out there so that I actually do it. On Thursday I will also be doing 800m interval repeats in my neighbourhood. For the first time in about three years. I'm excited and more than a little nauseated at the thought.
I'll keep you posted on how both experiments go.
Wish me luck!