Kinky cannulas are no laughing matter, despite the comical-sounding name. Far from the...ahem...'good' kind of kinky, a kinked cannula can wreak havoc with blood glucose (BGs) and emotions alike when unbeknowst they strike. A kinked cannula is literally no more than a cannula that has become bent or distorted under the skin and is no longer delivering insulin in the drip-drip-drip way it should. But the effect of that delay or complete drought of insulin can take away whole mornings of your life spent chasing the Mr Hide out of your usual Dr Jekyl control.
I went through a phase when I first when onto the pump of pulling out any cannula that appeared to be acting out. If my BGs became elevated after a set change, out it would come. Mysterious rises; out it would come. The beep...beep...beep of a pump warning alarm; out it would come. I was a mean old mutha' when it came to sharp increases I suspected of messing with my day.
But after pulling out what felt like dozens of cannulas that didn't seem to have the tell-tale quirk in the teflon needle, I developed a strange sense of guilt about it. The cost of these little suckers is pretty steep: apparently as much as up to $120 for a box of 10 when buying privately! I am 'lucky' in that in England I don't pay for these as they are available to me on the National Health Service, but nevertheless, I don't like throwing good equipment away. It feels...wasteful; ungrateful, even.
So the thrifty stubborn cannula-hoarder in me decided somewhere along the line to start leaving them, waiting, watching. 'Give it a minute', I would tell myself. And sure enough some of the cannulas just seemed to be bedding in: getting comfy perhaps (if my abdomen is a 'comfy' place to be!). Many times the rise in the first few hours could be tackled with a 150% temporarby basal rate (TBR) and the delay of a meal just to make sure I wasn't adding petrol to the fire.
But there were still the occasional stinkers. Some you see, are sneaky little blighters that masquerade as a happy, healthy cannula, serving your insulin needs. Until that is, you go to sleep. THEN, out come the cannula demons and somehow you find yourself awake three hours into your night jabbing insulin into your previously nicely tucked-into-bed thigh, hoping the hypodermic needle will achieve what the cannula didn't. I'm not sure why it happens to me at night the most, but it's usually always after I had my 'suspicions' about a cannula.
The suspicion might be anything from it feeling strange beneath the skin, to immediate 'hikes' in my BG. I can't really explain it, but something just feels different. And usually if I can really feel my cannula, it's a good sign that something beneath the surface is not quite at peace.
And so, after one nasty 22 mmol (400 mg/dl) too many I bid farewell to my aforementioned thriftiness and decided to go all Samuel L Jackson from Pulp Fiction on any sneaky or suspicious-seeming cannulas. You see, as I approach the time in my life when my husband and I creep towards the goal of becoming parents, I can't risk any of those stealthy hypers in the middle of the night. Or in the day for that matter. Now more than ever I have to tell myself "If in doubt...switch it out."
Do you risk cannulas you have a sneaking suspicion might be plotting evil on you? Or do you switch it out in a bid to stay safe?