Pumping, After a Fashion

by kerri morrone

For so many years, I had avoided making the switch to an insulin pump because I didn’t feel ready for any external signage advertising my diabetes. For over 17 years, I had lived with quiet injections and subtle finger pricks, which made switching to a pump the oddest combination of pride and fear. And people only knew I had diabetes if I chose to tell them. The frustration of feeling like a human pincushion all came to a head one night, when I was taking my fifth injection of the day; something inside of me broke in two pieces and my fear mixed with strength like socks in the laundry. I called my doctor that night and left a long message on her machine, asking her to write me a prescription. Within a few weeks, I was sitting at the Joslin Diabetes Center in Boston, attending my first pump training class.

When I first started pumping, I felt so strange with this machine clipped to the waistband of my pants. Unsure of how ready I was and worried about the perceptions of other people, I chose to wear the pump completely exposed, with the tubing loose and the device completely visible. The novelty of the pump and my inexperience had me constantly pushing the buttons and touching my hip to make sure it was still there. To be perfectly honest, I was terribly proud of myself for taking the pumping plunge. I wanted people to see it… I wanted people to ask. Their questions gave me an opportunity to educate and helped me gain a definite level of comfort.

However, as I became more at ease with the insulin pump and its novelty wore off a bit, I started making it less of an accessory to my outfits and more of a concealed instrument. I wasn’t ashamed of being diabetic or wearing an insulin pump, but I wanted to be in control of who knew. I am very proud of my decision to pump and elated with the profoundly positive effects it has had on my diabetes management. Keeping the pump under literal wraps had nothing to do with shame but was more about being seen as “Kerri” before I was “Kerri the diabetic.” I wanted to be in control of who knew I had diabetes. But I also wanted to be in control of the diabetes itself.

At first, I wore my pump clipped into the pocket of my jeans. This was an acceptable place when I was dressed casually, but moving forward as a woman in my twenties brought me into a more professional environment, where I left my jeans at home and instead introduced skirts, suits, and dresses into my wardrobe. When I was interviewing for different jobs, I wore my best black suit, a crisp button-down, and my insulin pump clipped discreetly into the waistband of my pants, undetected by everyone. When I go out with my friends, my pump ends up tucked into the back pocket of my pants. And a few weeks ago, when I ordered my wedding gown, the seamstress and I talked about the pocket she was going to create so my pump would not be the focal point on my wedding day.

Hiding an insulin pump can be done, but sometimes it takes a bit of trickery. Since I am using a Medtronic MiniMed 512 these days, I have both the pump itself and the tubing. I’ve done just about everything to keep my pump out of sight. When I don a fancy dress, I tuck the pump discreetly into the front of my bra. Depending on the neckline of a dress, sometimes the pump ends up secured in the side of my bra, underneath my arm. I’ve used the “thigh thing” favored by so many people with diabetes. It is a garter-esque piece of fabric with a sleeve attached, allowing for the pump to stay wrapped around my leg. And in a moment of desperation, I once rigged up a little contraption using the clip on straps to a convertible bra, the case from the thigh holster, and a slip of duct tape. MacGyver's got nothing on me!

My favorite spot is to hide the pump in my sock, which is a move I wish I had figured out years ago. With the infusion set on my thigh and the tubing snaking down my leg, a tight trouser sock keeps the pump resting neatly against the side of my shin.

The biggest problems I’ve experienced concealing the pump have centered on bolusing. Hiding it in my bra is one thing, but reaching in and digging around for the pump before meals makes for an interesting ice-breaker. However, my options range from foraging to using a pump remote to excusing myself to the bathroom. I’d never sacrifice my health for fashion, so even these frustrating moments of pump-wrangling come second to controlling my diabetes.

Admittedly, insulin pumping and all of its maintenance can be a bit of a burden. But when I’m looking at my blood sugars and how much tighter they have become, wearing an insulin pump has given me a stronger sense of control. Within three months of starting on my insulin pump, my rattled A1C dropped from a frustrating 8.3 percent to 6.4 percent, my dawn phenomenon had met its match, and my lows became less frequent.