Monthly Archives: January 2012

I Think It’s Mad at Me.

I think my insulin pump is mad at me. I am currently waiting (and waiting) for the paperwork to go through for a switch over to the OmniPod. And I think my Ping pump knows it’s getting the boot.

One night last week I did an infusion set change in the evening. About three hours later, after going to bed, I heard the Fur Elise alert coming from my Ping. I knew something was up since I keep it on vibrate so the only time it will alert with song is when it’s not delivering. I looked at the screen and it said “Pump not primed. No delivery. Blah blah blah”.  I disconnected the site and went through the priming process then reconnected. This seemed to appease the pump and I had no other alerts after that. Until last night. I did an infusion set change kind of late last night (I do not recommend doing this but I kind of forgot about having only a few units left in the reservoir). Sure enough about an hour after changing everything, I got the same not primed alert. This instance it happened three times. I was so annoyed that this was happening at 11pm when I should have been sleeping. And poor Joe. “That thing goes off every night”. “No honey, this time it’s my pump not the Dexcom”. I went into the living room to call Animas’ technical support. I was just waiting for the alert to happen again. I was on hold for 20 minutes. Someone finally answered only to tell me that a representative would call me back. Probably in a half hour. Really?! At 11:30pm I’m supposed to wait for a call back?! I actually did wait for about 15 minutes but couldn’t keep my eyes open so left the phone off the hook and went to bed. Luckily the alert hasn’t happened again. But I’ll be very apprehensive when I do my next site change. I’ve always been a fan of the customer service from Animas. Last night, not so much.

Now is it really possible for an inanimate object to know I’m going to stop using it in the near future? I doubt it. But it certainly feels like it.

 

Quick editor’s note: I just checked my caller ID (since I left the phone off the hook) and Animas did not in fact call me back in a half hour – they called back at 12:49am.  Well over an hour later.  Boy am I glad I didn’t wait up!

Stupid Test.

Earlier in the week I had my endocrinologist appointment. Before heading there, I uploaded my BG readings from my meters to Diasend. (Dr. K likes looking at actual readings as opposed to Dexcom trend data. That job is for my CDE.) (And I heart Diasend by the way!) Printing out results from the past 30 days confirmed my already existing suspicions that I’ve been encountering a few too many high BG than I’d like. And as usual with me, there were no obvious patterns but more random, various times of day or night when they have been occurring. With my print outs tucked inside my bag, on my way to the office, my nerves grew. Although my average BG from the meters reflected 143 mg/dL, which I know isn’t terrible, I knew the high BGs would elevate my A1c. And I got really nervous that my A1c was going to be the highest it’s been in a while.

Nope. The same as 3 months ago. I’m currently holding steady at 7.2. For once I was very happy with that number. Last time I was satisfied. This time, actually happy. That it wasn’t higher of course. For the life of me I cannot figure out how the A1c works. Most of the time I anticipate lower than the results I get. This time I expected higher. And I was still wrong. When I was growing up I had my share of high A1c results. 9’s, 10’s, even higher. Those were a result of control standards not as tight (in the first years of my diabetes life) and later, not controlling it like I should. However in the past few years that I have been putting a lot of effort into my diabetes “management”, my A1c has always seemed to fail me at giving a precise picture of what my BG is actually doing. I know not to rely completely on BG readings to give the whole picture. There are many hours in between that can have BG swings. But in the past 3 years since I’ve been using the Dexcom system, knowing what my BG is 24/7, it still doesn’t always tie into my A1c. It wouldn’t bother me so much except for the fact that so much weight is put on this test. Every person in the medical field wants to know what a diabetic’s A1c is. My endo and CDE assess my management success with this number. The ADA and AACE predict how this number will affect my chances of complications. I’m all for managing BG as best as can be – obviously I want to be healthy now and for years to come. But this stupid test not only gives me anxiety every 3 months, it doesn’t even make sense. At least for me.

image credit: sodahead.com

Taking the Plunge.

Since I know that many of you have been keeping an interest in my OmniPod trial (which I greatly appreciate by the way), I thought it fair to share with you my decision.

Today I forwarded my request to submit the paperwork for getting my own OmniPod system. Yes I am taking the plunge. I have thought long and hard about this. And with the help of podder friends, both old and new, as well as my hubby and sister, my decision is to go for it. I’m anxiously hoping my experience with a brand new system will go more smoothly than my trial had. However I know in the back of my mind, if it doesn’t work out, I can always go back to my trustworthy Ping pump.

So there it is. I am taking a new step in my insulin pumping life. And of course I will share with you the experience of my transition.

A Weekend You Don’t Want to Miss.

Last spring, I attended the Weekend for Women conference hosted by Diabetes Sisters. I didn’t know of many women who had gone before and didn’t know of a lot of women who were planning on attending. But it sounded like a great event and decided to go. Plus I had never been to North Carolina before and thought checking out Raleigh would be a pleasant experience. Boy was I right! Both the setting and the event itself were fabulous. I got to hang out with Allison and meet Sysy and Sarah and Brandy, of course. I also got to experience memorable moments with my diabetes sisters.

This year’s conference is being held in the same location in May. I am so excited that I registered today for the conference and booked the hotel. Now all I need is to find me some cheap airfare!  This year they are even adding a special program for partners of those living with diabetes, hosted by some awesome guys. I highly encourage any female with any type of diabetes or that even has a loved one with diabetes to attend this weekend for women.  You won’t be sorry. You will positively feel like part of a sisterhood.

Please check out this link for all the info: 2012 Raleigh Conference.  And I hope to see you there 🙂

Impressions.

It’s been 6 days using the OmniPod insulin pump system for a trial period.  After the first few hours, I had a very positive first impression.  I am going to share what the following days have entailed as I know a few people have shown interest in my experience.

The first pod that I had placed on my back was scheduled to expire Friday evening.  That morning as I was riding the railroad to work, I noticed the batteries in the PDM were running low so thought I’d change them while I thought of it.  (I never let the batteries on any of my devices, diabetes or not, run all the way out) After putting the new batteries in, the PDM asked me to reset the date and time.  I didn’t think this was odd at first but then it told me that a pod deactivation was required.  No bueno.  Especially on the train.  I didn’t exactly know what was going on so in a panic, I texted Cherise who told me that it wasn’t normal for the PDM to do that during a battery change.  That made me feel better.  A little.  Since the PDM wasn’t allowing me to do anything else but deactivate the pod, that’s what I did when I got to work.  Luckily I had another with me and began the process to activate and insert a new one a bit earlier than planned.  This one I put on my right hip.  I went through the insertion process with no issues and the rest of the day went fine.  I also confirmed with the OmniPod CDE that this indeed was a fluke and should not happen.

Saturday afternoon, my BG started to rise for no obvious reason.  I checked the pod and saw a tad bit of blood around the cannula location.  After a few hours of rising BG, unsuccessful corrections and increased basal I decided to change the pod thinking that the absorption wasn’t fully working.  I wanted to try my arm this time so that’s where I put this pod.  I kept my basal increased for 2 hours or so but my BG wasn’t budging.  Patience? Yeah I don’t have much of that, especially when it comes to high BG.  I figured the arm site wasn’t working either (it was always hit or miss for me with infusion sets) and changed the pod yet again.  Since it was around 10pm and I was planning on going to bed soon, I chose my abdomen since I know I have no absorption issues there.  My BG came down nicely overnight.  Even a bit too much since I woke up low.  I was happy that the pod was apparently working.  Until around noon when my BG shot up to around 300 mg/dL for no obvious reason.  Since this doesn’t happen to me too often my first thought was that it was a pod issue.  But I didn’t want to jump the gun and change it yet again.  We went to a friend’s to watch the NFL playoffs and I went toting all my usual extra diabetes supplies plus my Ping pump and accessories.  Just in case.  Well things worked well and they still are going well.  So I’m inclined to now think it wasn’t a pod issue causing yesterday’s BG spike.  Saturday’s maybe since there was a bit of blood involved.  But I’ll probably never know for sure.

I have one pod left, with my current one scheduled to expire tomorrow night.  I’m really hoping to see this one through to its timely ending.  Overall I really like the system.  Being tubeless is actually better than I even imagined.  I keep feeling for my pump in my pockets and it’s not there!  It honestly feels like I have lost a part of me.  But in a good way.  I have to say the only drawbacks that I see are the size of the pods and the speed of bolus delivery like I mentioned originally.  More on those …..

The Ping pump delivers boluses very quickly.  The normal setting is 1 unit every second or the slow setting, which I use, is 1 unit every 4 seconds.  The Medtronic pump delivers at a slower rate of  0.15 units per second from what I’ve found online.  I believe the OmniPod CDE told me the pod delivers 1 unit every 40 seconds.  That’s a big difference. Now is one rate better than the other?  I’m not sure.  How I notice the difference is when I’m thinking of eating, I would have to pre-bolus more so with the pod.  Not really a deal breaker but something to consider.

Since infusion sets are so small, there are more options in terms of placement.  With the pod, since it’s bigger and more bulky, placement needs a bit more consideration.  I haven’t hated having them on my body though which is a good thing.  I think it’s something to get used to.  I feel that not being tethered may truly outweigh this slight incommodity.

Also, I know the fact the OmniPod does not factor in bolus for food when calculating insulin on board (IOB) poses an issue for some.  I’m not quite sure how I feel on this one.  Many times when the Ping would calculate me to take no insulin for either additional food after eating something prior or a correction within my set active insulin time frame, I would override the calculation to give some insulin.  Without taking too much and causing a low BG.  For me, OmniPod’s feature seems to be okay.

I’m going to make my decision in the next few days.  I’m very glad to have had this opportunity to trial the OmniPod.  I would highly recommend the same to anyone who may be considering it.  A special thanks to Leighann, Cherise, Penny and Scott for helping me out when I had questions.  Or issues.  Or was panicking.  🙂

*Once again, OmniPod had no part in this trial of their product or of my impressions using it.*

Appealing.

Today I do not have any device attached to me. There is nothing in my pocket or clipped to the waistband of my pants. For the first time in five years.

When I first went on the pump five years ago, the only options I really considered were Minimed and Animas. I believe OmniPod was very new at that time and I hadn’t even really heard about them. I was new to the diabetes online community and had very little knowledge about pumps. I sought out information from both companies and when Minimed was the first to get back to me, I went with them. Since then, when Animas came out with the Ping pump, I spent a little time with their rep getting to know the Ping and decided to switch. I’ve been using the Ping (mainly) for two and a half years now. And I have been happy with it. I was even happy with my Minimed when I used it. I never really gave much thought to being tubeless. The tubing never seemed to bother me much. I got used to it pretty quickly.

More recently however, I started thinking about how nice it would be to be able to control all my insulin delivery from my Ping remote, instead of just the boluses. And how frustrating the clip on my pump has been, having to replace it three times in the past few months. How much more convenient it would be not to have to disconnect for showers. The idea of the pod became much more appealing. I’ve received demo pods from OmniPod in the past and I found them to be a bit too bulky. However I wanted to use the system to really get to know how it works. And so last night I was trained and set up with a trial of pods and PDM.

It’s only been about 17 hours with it but my first impressions are so far very positive. By far the biggest difference is not being tethered. I cannot even explain how different it feels to not have something in my pocket. Not having to finagle the pump under my chin while dressing. Not having to worry about keeping the pump clipped on while pulling down clothing when using the ladies room. Not having an attachment on my body while sleeping.  The little things that you just get accustomed to.  My pump has been like an extra limb. And with the OmniPod, it feels like that limb is now gone! It is so exhilarating. The pod insertion is incredibly easy compared to inserting an infusion set. All you have to do is stick the pod on your body and the PDM does the actual needle inserting and priming for you. And it really doesn’t hurt more than an infusion set. The PDM. This thing is great. Yeah it’s larger than most meters these days and beeps pretty loudly but I control every aspect of insulin delivery with it. And that’s pretty darn cool. It also has a wide variety of data available on it, unlike other pumps and meters. Such as trends, graphs of BG readings and averages with goals of BG readings. It also lists last BG, last bolus amount with times along with current basal, temp basal amount and duration if applicable on the status screen.

The only downside so far are the pod itself is a bit bulky to be honest. I’m still getting used to that but it’s not horrible. It doesn’t feel so uncomfortable that I want to rip it off. I’m wearing it on my lower back so I do feel that it’s there but again not like I can’t stand it. And it also delivers boluses pretty darn slow. I took a pretty large dose this morning for breakfast and thought there was something wrong with either the pod or the PDM because it took so long! But I was reassured by the OmniPod clinician that it does delivery slowly. Phew.

Generally I was not looking to switch pumps at this time. However I may decide to do just that in the next few days if my experience continues to be a pleasant one.

Sidenote: OmniPod did not ask me to do this trial or compensate me in any way for it.  Nor did they ask me for my review.  I facilitated the trail on my own accord and the opinions expressed here are those of my own experience.

Please Make It Stop.

Last night I did nothing out of the ordinary. We had dinner of leftovers around 5:30pm and I finished an elliptical workout around 7:45. My BG was 153 mg/dL pre workout and 131 afterwards. Pretty good in by book. I took a shower around 9 and noticed on my Dexcom that I had dropped a little below 100 mg/dL. Still pretty good. I had some tea before getting ready for bed and was in the living room while my Dexcom receiver sat in the bedroom. I got back to the bedroom and it started with its 3 vibrations, signaling a low BG. A finger stick confirmed – 49. I had a juice box and waited a bit before trying to fall asleep. This was around 10pm. This 49 turned into a low that would not go up until 3am. That is a 5 hour low blood sugar. 5 hours. I had numerous juice boxes, decreased my basal first by 20%, then by 50% and finally by 80%. In all my years of living with diabetes I will never understand what causes persistent lows like this. You would think after a couple of hours, my liver would have gotten the hint for some glucagon! Maybe the exercise had something to do with it, however I should have had enough carbs in my bloodstream to compensate for it. I have also been exercising a few times a week so it shouldn’t have been a shock to my body. At one point, I was on the verge of tears wishing for God to please make the low stop. All I wanted to do was sleep. I am very thankful to have had my Dexcom. Although its alarms every 30 minutes was what was keeping me awake, I otherwise may have just fallen asleep and not able to stay on top of that darn low.

And of course since diabetes is a bitch, I have been around 200+ mg/dL since I woke up this morning. Needless to say, I am feeling like a zombie today. I’m already thinking of later tonight when I get home and can hopefully go to sleep early. Nonstop lows are bad enough during the day. But they are so much worse during the night, when you’re supposed to be sleeping.