Updates.

So summer 2015 is almost over already.  And only 4 months left of this year.  How on earth did that happen??!?  This year is completely flying by.  It’s been months since I’ve posted, so I thought I’d give a general update.  In case anyone wants to know 🙂

Since mid-March, I’ve been back on my beloved OmniPod.  I switched to a different pump at the end of last year because of insurance changes.  My durable medical equipment is no longer covered at 100% and the cost of pods are significantly more expensive compared to traditional pump infusion sets and reservoirs.  However, I received a promotion at work in March that came with a decent raise.  So I jumped back on the OmniPod since I could afford it better.  And I’m one happy pumper!

I was using Apidra in my insulin pumps for over 3 years.  Come January 1st, my insurance stopped covering it.  Since they were already not covering Humalog, that left me with switching to Novolog.  I used Novolog for some time before switching to Apidra and it worked ok.  So I went back to it.  Until recent weeks, I was noticing high postprandial readings and realized it could’ve been the insulin.  One of the benefits I found from Apidra was better postprandials.  I consulted my CDE about it and she offered to file a pre authorization for me.  I figured why not?  Well it was approved!  So I am now able to get Apidra for the next year.  Phew.

I had my quarterly appointment last week with my retina specialist.  Since it’s going on 4 years since I was diagnosed with retinopathy/DME, these appointments are always a little nerve racking.  But I received a good report!  After just one treatment of Lucentis, my eyes have been stable since.  For this I am EXTREMELY thankful.

Other things have been a bit hectic over the past two months.  I’ve had numerous doctor appointments with no end in sight yet.  It started with a trip to a cardiologist, which was a first for me.  I mainly went for peace of mind and not because I was having symptoms.  Of course with type 1 diabetes, especially having it for a long time, the higher chance is there for heart issues.  I had an echo-cardiogram and a stress test which thankfully came back normal.  Although not without major anxiety.  I was having some periods of dizziness so that lead to a bunch of tests including a cat scan of my frontal bone and carotid artery test.  Luckily those were normal and the dizziness subsided.  I had a full blood panel completed which did not reveal any major health issues.  It did show that my A1c went up a bit but I’m hoping Apidra will help get that back down.  I found my very first primary doctor.  I do not actually see the need for one since I have a multitude of specialists and see my endocrinologist regularly.  However it seems for certain things, she may actually be helpful.  And I liked her so that’s a plus.

I’ve been dealing with leg pain when walking for years and years.  I had an NCV test done a few years ago which showed no signs of nerve damage.  I also had an arterial doppler done two years ago which showed no sign of any vascular abnormalities.  Along with the echo-cardiogram and stress test, my cardiologist ordered an ABI test, which tests for peripheral artery disease.  This test was inconclusive which in one way is a good thing since there was no definite sign of PAD.  My primary doctor ran blood work to check muscle enzyme levels.  Normal.  She referred me to a neurologist who I saw today for a consult.  She ordered an MRI and an EMG which I will have done in the coming weeks.  She thinks it is a mechanical issue which I’m not even really sure of what that means.  This chapter is to be continued.

I was diagnosed with gastroparesis a few years ago and IBS before that.  And they have not been playing nice lately 😦  I’m paying a visit to my gastroenterologist next week (she’s probably feeling left out!) to see if we need to explore other treatment options.  And praying she doesn’t want to send me for any tests!

While all of these issues may not be diabetes related, they have most certainly been explored more thoroughly and seriously because of it.  My head is spinning because of all the appointments and tests, and it’s hard not to get down from it all, I’m trying to remain positive.  Staying on top of my health is something within my control.  I am more than happy to endure endless tests and meetings with doctors if that means I can identify issues early and treat them accordingly.  Diabetes be damned.

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Finding Real Estate.

I’ve been using a portable pancreas (aka insulin pump) for seven and a half years now.  And the OmniPod for a little more than two years.  My favorite spot for putting pods or infusion sets is my abdomen.  However to prevent scar tissue from building up, I don’t want to use just my abdomen.  Even though I can rotate about 4 different areas of my abdomen comfortably with the pods, I don’t think that is enough rotation.  I’ve used my lower back and upper tush area as well but lately I’m finding the absorption isn’t consistently the same resulting in higher BG.  I’ve never been able to use my thighs for sites – the absorption there just plain sucks.  I’d love to think it’s because one part of my body is actually muscular, but if Kris Freeman can use his pecs for pods, I should just shut up 😉

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(photo credit goes to https://twitter.com/TeamFreebirdXC)

 

I think this is a common problem for insulin pump users.  My question is, how did you find a resolution?  I’m getting a little frustrated and don’t want this to turn into a huge issue if I can help it!

Diabetes Art Day 2014.

Happy Diabetes Art Day!  If I’ve learned anything from Diabetes Art Day over the past few years, it’s that I’m really not too creative.  And I’m okay with that!  Most of the time anyway 😉  Thank you so much to Lee Ann for creating this event – I really do love all the passion you put into it and seeing what everyone else creates.  I’d have to say my favorite form or art is photography.  Especially since I used this last year too!  Without further ado, here is my piece for 2014:

A world with diabetes is a world with numbers.

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Does Size Really Matter?

Or more specifically, does angle really matter?  I’m going on 2 years with OmniPod.  And I LOVE this insulin pump.  For its tubelessness, its PDM, its convenience and functionality.  Prior to OmniPod, I used straight infusion sets with Medtronic and Animas insulin pumps for about 5 years.  And never had issues with them.  I could count on one hand how many occlusions or failed infusion sets I had over that time period.  Even though my lowest A1c’s have been in the last 2 years, more recently, I am beginning to wonder if the angled set is as effective as I need it to be.   And the one unfortunate thing about the OmniPod, is that it doesn’t give a choice of cannula angle or length.

While I consider myself an educated PWD, I am not certain if the angle of infusion sets can really make a difference in insulin delivery.  But I imagine it could.  I’ve read that the angled sets are usually better for areas of less “meat”.  (Unfortunately I do not have to worry about that)  But does that mean the straight sets are better for areas of more “meat”?  Does anyone know?  I’d love to hear your thoughts/advice/opinions.

Device Revolution.

The definition of revolution, according to Google, is a forcible overthrow of a government or social order for a new system.  I am starting to think that my diabetes devices are starting a revolution.  I am not sure what new system they would like.  Maybe a working natural endocrine system?  That would sure be nice!

I have been using the OmniPod system for 19 months; the new generation system for over 2 of that 19 months.  Within that time frame I’ve only had a few instances of bad pods or issues of that nature.  Until recently.  I obviously cannot prove that these new issues are due to the mechanics of the new pods.  However since I haven’t had issues before, that is what I am lead to believe.  A couple of weeks ago I had three pod issues in a row – two bleeders and one that was leaking insulin.  On various site locations.  I took a break from the pods for almost 2 weeks.  Today was day 3 of my first pod since that break.  And I got an occlusion during my breakfast bolus.  Unfortunately I did not have an extra pod with me nor any syringes  (that situation was remedied as soon as I got my hands on my supply) and I had to go home from work to get insulin.  Not the best situation to be in.  When I removed the pod, there were no visible signs of cause for an occlusion.  Taking another break.

Also, I have been using a Dexcom CGMS for almost 5 years; the G4 system for 9 months of those 5 years.  For most of that time I have used my outer thighs primarily for sensor sites since I cannot use them for infusion sites (due to lack of absorption).  No major problems other than the occasional failed or wacky sensor, one bad transmitter and one broken receiver.  In all that time.  Then all of a sudden in the past few weeks I have had numerous bleeding sites.  Some that have not affected the performance, some that have.  I am sensor-less at the moment, giving my skin time to breathe.  But I am going to attempt another one this evening.  I am honestly lost without my CGM.

Using diabetes devices should not be stressful.  I normally do not feel burnt out easily when it comes to my diabetes.  But these recent problems have me totally burnt out.  I can’t help but feel that all of a sudden, I am doing things wrong.  I’m hoping this revolution will be put to an end soon when they realize a working pancreas is not going to happen 😉

Talking with a True Inspiration.

Two weeks ago, I had the pleasure of speaking with Kris Freeman. If you are not familiar with who he is, I hope I can help with introducing a great person in the diabetes community. Kris is a professional American cross-country skier. He was diagnosed with type 1 diabetes (T1D) at 19 years old.

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(image credit: Lilly Diabetes)  

Kris has been partnering with Eli Lilly since 2002 for advocacy. He wants to teach others “don’t let go of dreams because of diagnosis”.  This year he will be the guest of honor at 10 diabetes camps across the country in conjunction with the Lilly Camp Care Package program.  Kris feels that in a setting such as diabetes camps, people with diabetes can draw together for support and be more mentally equipped to handle the day to day challenges. I could not agree more with him. I have never attended diabetes camp but I have attended other events or just meet ups and have made so many friends along the way.  My attitude or my outlook would not be where it is today without that support, that’s for sure.

I’ve been working out more than usual recently. By that I mean 4-5 times a week for 30-45 minutes. And I felt so accomplished for this. Until I spoke with Kris that is! A basic day for Kris would include about 4 hours of some sort of training. A 2 hour roller ski, an 8 mile run, 2 mile swim. Then when he is training for the Olympics (which are coming up in a few months!) that is taken to a whole other level. He does 100 mile bike rides, 5km road races. Six days a week with only one off day a week. Whoa. Now I’m not a professional athlete but that kind of workout schedule still impresses the hell out of me.

Kris is a fellow OmniPodder and Dexcom user. I could imagine that being an athlete like himself, wearing the pod vs. a conventional insulin pump would be much more practical and easy. I asked him what his favorite site was for the pods and believe it or not, it’s his pecs! Beside his triceps, that is where he most wears his pods.  He never takes a Dexcom break and likes that he can be more discreet, able to check his BG with a glance at the Dexcom instead of having to do a fingerstick among his non diabetic peers.  I think we can all appreciate that!

In addition to using modern technology and heavy duty sports training to manage his BG, he also is a big believer in a high glycemic diet.  He is always thinking about his blood sugar.  I sit on my butt all day for work and think about my BG constantly so I can only imagine that being as active as he is would make me think about it even more.  A rhythmic diet full of fruits and vegetables, high in protein for breakfast and high in carbs for dinner is what he finds works best for him.

One thing Kris said resonated with me very much. He said that diabetes doesn’t go away but learning about it makes it easier. After living with T1D for 31 and a half years, I myself am still learning. And I have to agree that the more you know and understand, the easier it can be to deal with.  After being told to forget about his Olympic goals after diagnosis and dealing with road bumps along the way, it never even occurred to Kris to give up.  That is what makes him stand out.  What makes him a true inspiration.

Thank you so much Kris for taking time to speak with me. It was a pleasure hearing from someone as inspiring as you.  And best wishes for your upcoming endeavor in the winter Olympics!

New and Improved.

So it has been almost 3 weeks and a full box of pods since I have been using the new OmniPod system and thought I’d get a review out there for those who may be interested.  The first users that I know of were Melissa and Sarah that provided reviews as well.  I did start with a failed pod on my first try.  And I admit I was a bit concerned after that happened.  However it must have been a fluke since the rest have worked just fine.

The biggest difference, in my opinion, are the pods.  They are significantly smaller, thinner and lighter as advertised to be.  Are they still somewhat bulky?  Sure.  You cannot compare it to an infusion set.  However, compared to the original pods, there is a noticeable difference.

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Keep in mind that the original pods never bothered me in terms of getting in the way or showing through clothes.  But who doesn’t want a smaller, lighter pod to wear?  There is a new pink insert on the top of the pod that should be noticeable if the cannula is inserted properly.  They also changed the cannula color to light blue to be more visible after being inserted.  I however, find the blue cannula to be no more visible than the clear on the original pods since they also changed the housing edge of the pod to black.  Maybe it’s my vision but also not a big deal.

The PDM also went through a makeover.  It looks different on first glance since it’s black and not blue.  Other than that, it’s the same size with the same buttons on the front to operate it.  Nothing new to learn there.  There were many additional confirmation screens added to various functions of the PDM.  The main one you will notice immediately is the PDM ID screen.

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You must set a name and color for that screen and this will come up every time you turn the PDM on or enter a test strip for a BG test.  It can be a small pain in the rear to do this constantly but I have gotten mostly used to it.  I did not see the need for a safety feature like this however after viewing the training video, I can understand the need for it in say families that have multiple pod users.

There is a reminder an hour and a half after a new pod is activated to test your BG.

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The IOB (insulin on board) calculation has not only changed but is also now visible on the status screen, something I am extremely happy with.  There are times when this information is invaluable and one should not have to scroll through various menus or screens to find it.  Readily available – the way it should be.

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In the original system, IOB was calculated only with correction boluses.  With the new system, when the suggested bolus calculator is turned on, it will account for both correction and meal boluses for insulin on board.

There are also two new screens during the pod change process.  One showing more explicitly how to remove the pod’s needle cap and one showing how to properly apply the new pod.

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There is a new vibration mode for alerts.  I have most of the alerts/reminders turned off so the beeping of the PDM was never a bother to me.  But I still appreciate having this new option.  The functionality of the new PDM is not totally different.  And I think that can be a good thing for many.  Mainly a few new steps to get accustomed to, which I have already.

Overall I think the changes made by Insulet to the OmniPod system were good ones.  And I look forward to more positive changes to their system in the future.  Although hopefully the next ones will not take so long for us to see.

*Please note that since I am a current user of the OmniPod, I have not yet been upgraded by Insulet but instead purchased the new PDM out of pocket from a diabetes supply distributor.  I expect to still be officially transitioned at some point.