The lows that have been creeping in lately need to stop. They are inconvenient at best, completely debilitating at their worst and the in-between is a muddled mess of glucose tab dust and frustration. Yesterday I had a diabetes technology fail coupled with a highly symptomatic hypoglycemic event that occurred simultaneously with a phone call to the Joslin Clinic … which sent me over to Twitter with an agenda of rage.
First, it was my Dexcom receiver that went berserk on me, telling me on both my Animas Vibe and my G4 receiver that my blood sugar was 202 mg/dL with double arrows down but after my feet weren’t responding to the “MOVE!” commands from my brain, I grabbed my meter to double-check. And saw a blood sugar of 43 mg/dL.
202 with double arrows down (on both the pump and the external receiver) is not the same as a meter reading of 43 mg/dL. #diabetestechfail
I immediately went for the glucose tabs and housed several of them. The low symptoms were intense – confusion, anger, tears, and a hand too shaky to hold the jar of tabs properly, so I held it with two hands, like those stock photos of baby panda bears drinking from a baby bottle.
Then the phone rang, and I answered it because: 1. When I’m low, I make bad decisions, and 2. It was the Joslin Clinic calling and I always answer their calls because Joslin.
And why did I answer the phone while low? b/c it was my endo calling to schedule c-peptide labwork to confirm that, yes, I have T1D.
And then the anger/adrenaline surge subsided and I was in that “weak with post-hypo panic, stupid body, knew I’d be fine in a few minutes but what the fuck” sort of fallout.
@CureT1Diabetes Rant has subsided. Post-hypo crying session in full effect. Honestly, this disease is doable until it's a fucking shitshow.
Eventually, as it always does, my blood sugar came back up and my brain tuned back into things happening on the planet. My CGM/Vibe/meter were back in alignment, showing me in the 80′s and holding steady.
Blood sugar now 81 mg/dL & all of my CGM devices finally agree with my meter. Now I wait for Joslin to call back w/lab orders to prove T1D.
Yesterday I had a hovering sort of low before a conference call, a low that took its sweet time letting my brain check back into the conversation despite my blood sugar number coming up reasonably quickly.
This morning, my pre-conference call routine involved a quick site change at my desk because I ran my insulin reservoir down to the fumes.
Diabetes, I have another call this evening. I fully anticipate that you’ll dress up in a clown suit and come skipping through the Skype screen waving your arms and burping, subtle interrupter that you are.
When you wear something every, single day, you notice every, single bit of it. I’ve been wearing this pump for four years and I know the lines of it by heart. (I remember the day that I switched from Medtronic to Animas and even those similarly-structured insulin pumps felt entirely different to me in weight, curve, and especially clip. As I wrote in my Animas Vibe initial review, change can be awkward.)
Two weeks ago, I dropped my insulin pump on the bathroom floor. It survived the fall, but happened to fall just so and smashed the edge of the battery cap the teeniest bit. See? (Ignore the hard knocks look of my pump overall. I’m tough on this thing.)
Okay, so maybe it’s not obvious (I can barely see it myself, even when it’s pointed out to my eyeballs), but my hip knew instantly. The jagged catch on the battery cap bit into my skin all day long and drove me bananas. (The photo is not accurate as far as how the chip lined up with my skin. The battery cap pictured is not screwed tightly onto the pump. When it’s on right, the chip faces my body.)
“Do you feel this?” I asked Chris, running his finger over the edge of the battery cap. “That teeny chip? It’s making me crazy.”
The point of this post? To illustrate how fully integrated these devices become into our lives, where we notice even the most seemingly insignificant blip. And to also note how awesome it is when your local pump rep just happens to have a replacement battery cap in the trunk of her car.
Again, disclosure: I work with Animas and have a sponsorship contract. Here are more details on my disclosures. I link to my disclosures more than I link to cat .gifs, which is saying QUITE A BIT.
As I mentioned, I’m testing out the Animas Vibe. Here are my first, quick impressions after a few days using the Vibe. (What, you wanted some long, flowery introduction paragraph? I’m out of words.)
First things first. Change can be awkward and uncomfortable. When I switched from Medtronic to Animas back in 2010, I had trouble with the switch not because of the pumps themselves but because of the change, in general. Wearing an insulin pump means being connected to a small box and tubing 24 hours a day, so you really get to know that box/tubing combination. The curves and edges of the pump became something I knew by heart, and wearing a pump that was even half a millimeter different than whatever I was used to made me grouchy. It took me about three weeks to become used to wearing the Animas Ping pump, and about a month and a half to become entirely used to the differences in filling the reservoir, changing the infusion set, responding to alarms, etc. (I experienced this all over again when I took the t:slim pump for a spin over the end of the summer. The pump itself was fine but the different size/shape/process made me grumpy like this cookie and I was less accepting of the pump because it wasn’t what I was accustomed to. This isn’t a comment on which pump is superior, but a commentary on why the learning/acceptance curve, for me, is a true curve. It also illustrates my hate for change.)
I was set up on the Animas Vibe on 12/31, so I haven’t had this thing for more than a few days, but going from Ping to Vibe was simple in terms of learning curve because I’d already done that curve. I have worn an Animas Ping since 2010, so the routine is familiar. Keep that in mind as you read through my perceptions, as they are colored by familiarity. And coffee. (I had two cappuccinos with dinner. TWO!! Bees in fingers [h/t CSparl].)
CGM Integration. I was unsure how I’d feel about integration, to be honest. I like having my Dexcom separate sometimes, and things like CGM in the Cloud and Share are important to me because I most-often travel alone, so having my data streaming to the cloud is an important safety feature. But, on the whole, I don’t stream my data (with overnight exceptions as noted). Basically, I am the main person who needs access to my data.
However. (And this is a big however.) I like, and appreciate, options. I don’t have the option of ditching diabetes, but I do have options on the tools and technology I use to make sense of diabetes. I LOVE having the Dexcom data showing up on my pump screen. Love, love, love. Why? Because I always have my pump clipped to me. I didn’t realize, until a few days ago, how often I was keeping tabs on my external receiver, bringing it from room to room with me, and keeping it clipped to my purse while I was out of the house. I went for a run the day that I hooked up to the Vibe and it was exciting to bring only one device with me. With a tube of glucose tabs in my pocket and pump clipped to my hip, I was good to go. It felt liberating.
@grumpy_pumper I went for a run yesterday and it was excellent to only wrangle one device instead of two. That was a big plus.
The best part, for me, is that I can run my separate Dexcom receiver at the same time. Yes, they can run simultaneously. (No, I have no idea how that impacts the battery life of the transmitter. Nor am I certain this is a sound idea. But I’m doing it anyway.) Both the Vibe and the receiver need to be calibrated separately, but for the times when I’m away for work, I’m happy I can still make use of the Dexcom Share without getting all weird. Options where there once weren’t any at all; I’ll take it.
(And I haven’t had a chance to test the accuracy of the receiver vs. the Vibe, but since I haven’t yet upgraded my receiver to reflect the 505 algorithm [we don't have a PC], I don’t know if my comparisons would be best. Once I hijack someone’s PC and update my receiver, I’ll circle back on this.)
One concern I had about integration was whether or not I would hear the alarms on the pump. In setting up my pump, I customized my alarms to reflect a vibration for any low blood sugars and a beeping for any highs, thinking that a vibration would be good for middle-of-the-night low warnings. While I haven’t had much time to test the highs and lows (thankfully, numbers have been reasonable for the last few days), I did have one 2 am low blood sugar and the vibration woke me up. I’ll have to wait a few more weeks/months to truly test how responsive I will be to the alarms.
One other concern I have is about the color indications for the different numbers. I’m a creature of habit (see above bit about hating change) and I am used to the way that the Dexcom G4 receiver lays out blood sugars, in terms of color. Ketchup and mustard, you know? Highs are yellow, lows are red, and white means don’t touch anything because in range. However, since companies cannot sync up their shit in a way that makes things easiest for end users (aka the PWD), the CGM graph on the Vibe is entirely different than that of the G4. On the Vibe, highs are red, lows are blue, and in range is green. For me, this has been a weird change because I like at-a-glancing at my CGM throughout the day, and now I need to readjust my mindset for what “red” means.
Screen Resolution. This might seem ridiculous, but there’s a new feature on the Vibe that allows for the brightness to be turned up/down with a click. The button on the edge of the pump with the little lock (or lightbulb, or whatever that icon is) makes whatever screen you’re on brighter, or less bright, with a click. I like this more than I should, I think.
Food Database. I haven’t used the Ping meter in a few years (I switched to the Verio when it came out, and am now using the Sync), so I haven’t done much with the food database in the past. On the Vibe, the food database is built into the pump, so if I go in to give a bolus and use the EZCarb bolus, I can access a customizable database on the pump itself. I haven’t had much time to play around with this feature yet, but I plan to as I fiddle around with the pump. (One note: on the “snack” screen, the food options are all junk food. Chocolate cake, cannoli, donut holes, key lime pie, just to name a few. Who categorized these as “snacks” instead of “junk food”? Confused the small, rational part of my brain.)
To that same end about not using the Ping meter for a while now, it’s important to note that the loss of meter remote capability in the Vibe vs. the Ping did not matter to me at all. I haven’t used the meter remote option in ages, so not being able to use it with the Vibe made zero difference to me. Your preferences will vary, of course.
Wearability. For better or for worse, this pump does not feel different on my body because it is essentially the same physical pump shape/size on my body. Having worn the Ping now since switching to Animas, the Vibe feels the same. But, for the record, I did try a blue pump this time instead of my time worn silver one, which feels sassy. Also, not needing to carry the Dexcom receiver makes for a lighter purse. (And when my purse holds glucose tabs, my meter, an insulin pen, car keys, wallet, gum, Batman, and a deck of Crazy Mates on an average day, one less thing is awesome.)
Battery Concerns. Since it’s only been a few days, I don’t know how quickly running the CGM and the insulin pump will burn through the battery. As it stands now, my Ping went through about one battery per month (maybe every 5 weeks), and my concern is that the Vibe will require more battery change outs. Time, again, will tell.
Software Questions. I haven’t uploaded my data to Diasend yet, but I’m excited to see what the overlap looks like for my pump, CGM, and blood sugar data. My past experiences with Diasend have been good – I like the software – but I’m not the best at uploading data from my pump (read: I never, ever do it because the process is annoying). I’m hoping that future iterations of the upload process make it more plug-and-play instead of “hey, weird dongle.”
Overall, I’m excited about the Vibe. (And even if you aren’t, let me be excited, would you please? I’m appreciating the fact that this system has finally been approved in the US.) I like carrying one less device while still using the CGM and pump combination that I trust and prefer (bias, bias, remember).
I’m looking forward to sharing thoughts at the close of this trial period, and then moving forward with a Vibe of my own … even if the name of the product gives me a bit of a smirky smirk.
(Disclosures aplenty: I have a sponsorship contract with Animas through 2015 and have received an Animas Vibe as part of a two week trial. I’ll receive an actual Vibe as part of my contract. Keep this in mind as you read through any reviews, because my perspectives are colored by my business relationship with the company. My reviews have a layer of bias to them. Picture a foamy cappuccino of bias. Mmmm … coffee.)
On the morning of New Year’s Eve, I finally stuck an Animas Vibe onto my body to deliver my insulin doses. This was exciting, as I’ve been envious of the International diabetes community who has had access to the Vibe for a while now. But this thing is finally approved in the USA, and I’ll be taking this bright blue one for a spin for a few weeks before receiving my own upgrade. (See above cappuccino o’ bias.)
I wish I could find the source for the following image, but I love it too much not to share. (I think it was Type 1 Diabetes Memes but I can’t re-find it. If you know the source, please leave a comment so I can link out appropriately!) This is real life as a pancreatically-challenged cyborg:
“My cousin Jeff is getting married in just over a month, and his fiance has diabetes. He got this tattoo of an infusion set (from a insulin pump) to match his bride. I think it’s adorably romantic.”
