Women's Artwork in Waiting Room for Mammogram

Navigating Mammograms with an Insulin Pump: A Guide for Women

As I celebrated my 40th birthday, the milestone came with an important healthcare reminder: it was time for my first mammogram. As someone who manages life with an insulin pump, every new medical procedure requires thoughtful planning. This experience was no different, and I found myself pondering how to handle my insulin pump, transmitter, and sensor during the mammogram. My journey, filled with research and personal decisions, led to insights I believe are valuable for others in similar situations. Here’s what I learned and did, hoping it can help demystify the process for fellow insulin pump users.

Making the Mammogram Appointment

I thought I needed a referral, so I asked my primary care doctor about it during my annual physical. She said that she’d refer me to radiology for it. I waited but didn’t get a call. I looked at the hospital’s website and found that they don’t require a referral! I called and got it scheduled, about a month out.

Appointment Scheduling Tip

  • Optimal Scheduling for Comfort: To ensure the least discomfort during your mammogram, aim to book your appointment within the first two weeks after your menstrual period starts. This timing is beneficial as breasts are usually less tender, making the screening process more comfortable.

Preparing for the Mammogram

Scheduling my mammogram was straightforward, yet I noticed a significant lack of guidance regarding the management of insulin pumps and other medical devices. This gap in information led me to conduct my own research.

Given that mammograms are a routine procedure recommended for all women, I was confident that others with Type 1 Diabetes who use an insulin pump had faced this situation before. I turned to social media and diabetes groups to gather insights. The advice varied: the consensus was to remove the insulin pump and place it in a separate room during the procedure. Opinions on managing the transmitter were mixed. While some individuals chose to remove theirs, others felt it was safe to leave it on, provided it was positioned away from the chest area. Notably, there were no reports of mammogram X-rays causing damage to either the pump or transmitter.

Based on this information, I opted to err on the side of caution for my initial mammogram. I removed my insulin pump, leaving it securely in the dressing room to avoid any risk of damage—a concern given the high replacement cost. Regarding the transmitter and sensor, I initially removed both since they were attached to my arm. However, for my follow-up appointment, I planned ahead and placed the transmitter and sensor on my upper outer thigh, a location comfortably distant from the imaging area, and chose to leave them connected. This approach balanced my diabetes management needs with the procedural requirements of the mammogram.

The Mammogram Experience

Armed with insights from both medical professionals and online communities, I decided to err on the side of caution by removing my insulin pump and transmitter. The mammogram process itself was less daunting than anticipated:

Arrival and Preparation: Upon arrival, I was directed to a dressing room and instructed to remove everything from the waist up. I was given a front-opening cloth gown. I was allowed to leave my jeans, belt, and shoes on. I left my glasses on too, although in the mammogram room, the tech asked me to remove them and place them on the table.

The Mammogram Procedure: The lady technician was incredibly understanding, guiding me through each step. The mammogram machine was the newer curved type which is designed to be more comfortable. She carefully placed my breast in the machine and compressed it and instructed me to tell her if I was in pain. Fortunately, it wasn’t painful. Just mild discomfort. She asked me to to breath in and hold my breath while the mammogram picture was taken. For each breast, there were several pictures taken, and she re-arranged me so that multiple angles could be captured. Despite initial apprehensions, the procedure was quick and manageable, with minimal discomfort.

Post-Mammogram: After the images were taken, I promptly reconnected my insulin pump. However, since I had removed my sensor, I faced a brief period without continuous glucose monitoring until I could replace the sensor at home. I use the Medtronic Minimed 780G Insulin Pump which still delivers insulin automatically without the sensor. For up to 4 hours, it will even stay in Smartguard mode and deliver a safe basal. After 4 hours, it’ll switch into manual mode. It’s important to note that while it’s more challenging to manage without a connected sensor, it’s still possible. In such a case, I usually do frequent finger pricks for blood glucose testing to make treatment decisions.

Follow-Up Mammogram and Ultrasound

The call for additional imaging led to a follow-up appointment that included both a mammogram and an ultrasound. This time, I experimented with placing the sensor on my thigh, away from the area of interest, which allowed me to keep the transmitter connected. The second mammogram mirrored the first in its straightforwardness, further easing my initial worries.

The Ultrasound: A Different Experience

Unlike the mammogram, the ultrasound used sound waves, not X-rays, eliminating concerns about my insulin pump. After the mammogram, I re-connected my insulin pump and resumed insulin. The sensor was still working flawlessly and the pump managed my glucose levels automatically during the rest of the appointment. I had to wait about an hour for the ultrasound. I was so happy that I had decided to place the sensor on my thigh and that the transmitter had been unaffected by the mammogram! (I had reasoned with myself that worst case scenario would be that the transmitter would fail and I’d have to buy another one, but given that there were no reports of this happening, it seemed unlikely. A transmitter costs about $350 so a replacement is not cheap, but nowhere as expensive as the pump. And while inconvenient, I can keep pumping without a transmitter.)

As for the ultrasound procedure itself, the technician applied a warm gel to my breast and used a wand to capture images, explaining the process and reassuring me that the black circles in the pictures were cysts and not necessarily cancer. After the procedure, the radiologist talked to me and informed me that they were benign cysts. He said that I should have a follow up ultrasound in 6 months, but it was all good news today. What a relief!

Managing Diabetes During the Procedure

The emotional stress of medical procedures can impact blood sugar levels. Throughout my mammogram and ultrasound, my insulin pump, temporarily disconnected only during the X-ray procedure, was crucial in managing these fluctuations. I also kept a blood glucose meter handy for added peace of mind.

Medtronic 780G Insulin Pump with CGM graph showing slightly elevated blood glucose

My blood glucose was a bit elevated during the procedure. I was definitely stressed as I was worried about what would happen if I had cancer, and we all know stress can increase glucose levels!

However, a slightly elevated blood glucose is a minor thing. Once the procedure was over and I got the good news, I relaxed, and my glucose level returned to normal range.

Preparation Is Key

  • Inform the staff: Make sure to inform the medical staff about your insulin pump and any concerns you might have about the procedure.
  • Plan for device management: Decide in advance how to manage your insulin pump and CGM during the procedure. Bringing spare supplies, like a new sensor, might be helpful if you anticipate needing to remove it. Bring the transmitter charger too, so that if you do need to remove it, it can charge during the appointment.
  • Monitor your blood sugar: The stress of the procedure can affect your glucose levels, so monitor closely and adjust as needed.
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Smart Curve Mammogram for Better Comfort

This is what they had at the facility I went to! The below video shows you a bit about this procedure. They studied this new curve design for both comfort and results, and now it’s commonplace. Improved healthcare for women! Yay!

Please Share Your Experiences!

The journey through my first mammogram and follow-up ultrasound taught me the importance of preparation, advocacy, and flexibility in managing diabetes care during medical screenings. By sharing this experience, I hope to ease the concerns of other women facing similar situations.

I encourage you to share your own experiences with mammograms, insulin pumps, and diabetes management during medical procedures. Your stories can help build a community of support and knowledge, making each step in our health care journeys feel more navigable and less daunting.

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