Category Archives: Insulin pumps

Tale of the Middle of the Night Occlusion.

It was a little after 1am when I woke up kind of suddenly.  I heard a loud car motor outside and thought that was probably what woke me.  Then I heard this faint, steady beep sound.  What the hell is that? I wondered sleepily.  The car drove away but the beep remained.  I sat up to get a better sense of where it was coming from.  Then I realized.  I lifted the blanket and the sound got much louder.  It was the undeniable sound of a screeching pod coming from my abdomen.  Come on.  I grabbed the PDM from next to me on my nightstand and pressed the home button.  That then began beeping  too along with the message that there was an occlusion detected and then poof, the pod was deactivated.  I have to be honest.  In my half asleep state, I pondered for a few seconds about saying no to the “would you like to activate a pod now” question asked by the PDM and going back to sleep.  But actually using my head, I realized that 5 hours was way too long to go without insulin.  So I reluctantly got up, gathered my supplies and went inside to do a pod change.   The pod was on day 2 and had become a bit sore but my BG readings were fine so figured nothing was really wrong.  When I removed it, the canula wasn’t bent at all but there was a small welt on my skin where it was.

Bad time for an occlusion.

This is only my second occlusion since on the OmniPod so it’s not as if it’s a major issue.  I just would have appreciated it to not happen in the middle of the night.  It seems like the occlusion was detected before it was bad enough to stop the insulin from actually getting through.  Thankfully my BG cooperated during this ordeal.

Factor One of Too Many.

I have been having a rough time with my blood sugar lately.  Stubborn highs.  And by lately I mean in the past few weeks.  I have been more sedentary than usual; being sick twice in a span of about a month and fully recuperating from said illnesses.  But I am starting to get back into more exercise.  I am under a lot of stress.  And I know this can and will affect my readings.  Hello cortisol.

I am trying to account for these things with more insulin.  Not that I like taking more insulin but if that’s what it takes to get better BG right now, that’s what it takes.  However it’s not always helping.  I can have 20-25% more basal running for a few hours and my 200 mg/dL won’t budge.  I can add a few grams of carbs to what I’m actually eating and still see an upward trend.

Frustration anyone

There are so, so many factors that impact blood sugar that I’m trying to think of everything.  Well almost everything anyway.  This made me wonder if there is another underlying cause.  Scar tissue.  I have been pumping for a little over 6 years now.  And using the OmniPod for 1.  The abdomen and lower back areas are my primary real estate for infusion sets.  However I rotate all over those areas as best I can.  I occasionally use my arms but that area is iffy when it comes to absorption so it’s rare.  I get no absorption from my legs so those are my main territory for Dexcom sensors.  When I remove old pods, there is no sign of bent cannulas or blood and I am not getting no delivery alarms so there are no obvious occlusions.  This may sound like an uneducated question, ya know coming from someone who has been living with diabetes for over 30 years, but how do you know when scar tissue is a problem?  Obviously the insulin isn’t absorbing the way it should so high BG would be a clue.  But what else should I look for?  How do I know if scar tissue is the cause of my frustration?  Any experience or information is welcome!

 

I Like When Change is Good.

I have made two rather major changes to my diabetes management recently. And I can’t say for sure if it’s one or the other, or a combination of both, but I have seen improvements in my overall BG readings. Which of course is a good thing. For the first time in my insulin pumping life (5+ years) my CDE reduced ALL of my basal rates. Each and every eight of them. That has never happened since I’m on the pump. I wasn’t sure how I felt when I left her visit. I wasn’t exactly experiencing way too many lows. But there have been hours at a time in the past couple of weeks where I’m stuck around the 70-80 mg/dL range. And the lows I have had, she was able to trace to too much basal insulin. So I thought the worst that can happen is I run high and change them back. Right?

Well my first day on my new basal rates have resulted in readings of 60, 99, 112, 152, 142, 115, 106 and 122 mg/dL so far, with the Dexcom line to go with it. I am pretty surprised actually. I guess the reductions may not be too much like I thought! Props to M 😉

So what are these changes you are probably wondering? Switching from Novolog to Apidra insulin and from a tubed pump to the OmniPod. Now your guess is as good as mine why the OmniPod would better control my BG. My guess would be that there is no tube for the insulin to go through so a more direct delivery into my system? No kinks or bubbles from tubing? An angled infusion set as opposed to a straight one? Has any of this been proven? Not that I know of. But for some reason it seems to be working better for me. The Apidra has improved my postprandial (post meal) numbers. My current endo, as well as my previous one, felt there wasn’t much difference between Novolog, Humalog and Apidra. But according to their website “Apidra® works quickly to help control mealtime blood sugar ‘spikes’. You can take Apidra® rapid-acting insulin within 15 minutes before your meal, or within 20 minutes after starting a meal.”  I had tried Apidra once about a year ago or so and didn’t stick with it for some reason.  But this time I paid more attention and tracked the difference it has made.   

Whatever the scientific reasons behind these changes improving my BG results, I truly hope it continues. I’d really love to see an improvement in my A1c in April.

*please keep in mind that I am in no way stating that taking Apidra or using the OmniPod will improve everyone’s diabetes management – don’t forget – your diabetes may will vary*

New-to-me Product.

So I’m a bit late on this one … this has been out for quite a while but I got my very own Tummietote from Tallygear in the mail yesterday. And I used it during my workout last night.

But let me take a few steps back. Living with diabetes in this day and age, there are a few devices that you need to have with you all the time. Some of these may even have to be on you. With that in mind, short of creating a “tool belt” for diabetics, Donna and Matthew created the Tallygear line for their daughter Tally who was diagnosed with type 1 diabetes in 2007. From their site “Our wish for you or your child is to make wearing an insulin pump or any other personal item more comfortable and secure. We began with the idea to create a belt to make wearing the insulin pump more comfortable…we believe we have gone beyond that. The belt is not only comfortable but, it is also extremely stylish and can be very discreet.”

I’ve heard so many great things about this product but never got around to getting myself one. After recommending it to a twitter friend based on others’ reviews, I decided to order one. And I’m really glad I did. Recently switching to the OmniPod, I no longer have an external pump to wear somewhere on my body. But I do see how convenient this belt would be for a pump. I do however, still need to carry my Dexcom receiver with me all the time. That fits perfectly in one of the pockets that closes with velcro and is easily accessible to view my BG trends. It has three of those pockets altogether.  The belt is extremely comfortable; it is wrapped around your tummy with velcro.  I also like how soft the material is.

 
They come in so many different fun colors and patterns and various styles too. I would also recommend this belt for people who do not have diabetes. You can very well fit an iPod, phone, or other little important little gadgets in it to take with you on the go, especially when active.

*Tallygear did not provide me with their product for review. I purchased the Tummietote on my own accord and these opinions are strictly my own.*

JDRF Summit.

This past weekend I had the great opportunity to attend the JDRF Type 1 Research Summit in Maryland hosted by the JDRF Capitol chapter.  I have attended diabetes events before but never one that was focused on research for advancements in management and a cure for type 1 diabetes.  I’m really glad I went.

Joe and I made a weekend trip out of it and did a little sight-seeing in DC.  That was nice.

Of course the first thing I spotted when getting out of the metro station was Crumbs bakery!  We didn’t indulge but just seeing the sign put a smile of my face 🙂 

We also got a glimpse of the Occupy DC movement that still resides near the capitol.

The summit itself was a day full of education to say the least.  We heard from presenters like Dr. Juan Dominguez-Bendala from the Diabetes Research Institute, Adam Brown from Close Concerns and diaTribe, Dr. Mark Atkinson and Dr. Desmond Schatz from the Diabetes Center of Excellence at the University of Florida, Dr. Stuart Weinzimer from Yale School of Medicine Pediatric Endocrinology, Cynthia Rice from JDRF Government Relations, Marie Schiller from Health Advances and T1D First and Gary Scheiner from Integrated Diabetes Services.  The moderator was Riva Greenberg, columnist at the Huffington Post.  I thought each and every one of the presentations were very informative and well demonstrated.

A lot of the guests spoke about the current and future research that is being done for type 1 diabetes.  Some in terms of the steps to get to the artificial pancreas and some in terms of getting to a cure.  I won’t pretend that I understood all the scientific or medical terminology but it did reiterate how extremely difficult it is to find a cure that will work.  I’ve been living with diabetes for 30 years already and for so many of those first years, my family and I heard that there would be a cure in the next 10 years or so.  For this reason and not being a pessimist, I don’t think I will see a cure in my lifetime.  However, hearing all that is being done in terms of research, even to improve the quality of diabetes management, does give me a little more hope to hang on to.  Especially after hearing Gary’s presentation about how much things have changed in the last 25 years.  Who remembers the autolet lancing device (shown below)?? That thing was horrible!

One highlight of attending the summit was not only did I get to spend time with some of my D friends, I got to meet some more in person!  I got to meet Tony, Colleen, Bennet and Kim and that was a huge plus to the weekend.

Another highlight was getting to see the t-slim insulin pump by Tandem in person at the exhibit hall.  I got to hold it and test it out (without being hooked up of course).  My initial opinion is that it is very sleek and slim – hence the name!  It holds 300 units of insulin which is a plus to a lot of people.  The touch screen makes moving around the menu and entering functions very simple and easy.  Tandem says the pump is waterproof for up to 3 feet for 30 minutes.  To me that’s not really water”proof” but better than nothing if getting caught in a downpour or accidentally coming in contact with a lot of water.  The only thing that makes me hesitant about the device is that it has to be charged like other electronic devices.  Charging something that is attached to you poses some doubts for me personally.

Overall it was a great experience and I applaud the JDRF Capital chapter for organizing a great event at no charge to the attendees.  I would highly recommend going to any future conference to anyone that has a loved one with type 1 diabetes in their life.

What I Love About It.

It has been over a week since making the switch from a tubed, more traditional portable pancreas (insulin pump) to the OmniPod.  It has gone very smoothly thankfully, which is what I was hoping for.  Here are a few things that I love about the Omnipod:

Showering – being connected continuously and not having to feel rushed to get connected again to my pump.

Getting dressed/using the ladies room – not having to worry about keeping a pump connected while moving articles of clothing around.

Working out – not having a pump weighing down my pants!

Using back sites – yeah I’m not so bendy or flexible anymore (thank you getting older and putting on a few pounds) so having to just stick the pod on without having to pull a needle out or reconnect is so much easier.

Automatic priming and insertion – I love that the pod primes itself and mostly that it inserts itself with the push of a button on the PDM!

The PDM – this thing is awesome.  All the information right there on the meter/manager without having to download anything is great.  I think the lists of BG history is my favorite. 

I think most of what I love about it comes down to not having a pump to keep somewhere on my body.  It wasn’t really the actual tubing that I minded so much but I feel so “free” with just a pod on my skin.  Now I can wear my pancreas on my sleeve!  Or my back.  Or my tummy 😉     

Also, please go on over and check out my interview with Tony from Blogging DiabetesPodcast 

Thanks so much Tony for the great conversation 🙂

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!

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.

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.