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Posts from the ‘Pumping Insulin’ Category

Plug It In.

I’m not a good traveler, but I am a good packer. Part of my preparation ritual is to make sure I only bring what I need and that outfits are tried on and coordinated before I go. (Because there was that one time I brought a shirt and forgot pants and that made for a different sort of panic before a presentation.)

Thinking ahead helps me prevent over-packing. (I have made a rule about not checking baggage, ever, if I can help it.) So before I left for a business trip on Thursday afternoon, my house was a brief flurry of coat hangers, dresses, and shoes. I tried on four or five different things before chucking them into my suitcase (who am I kidding – I military roll everything so it fits) and then it was time to get ready to leave the house.

It took me almost an hour to realize that, in my frenetic fashion show, I had my pump clipped to my hip but not connected to my infusion set. It wasn’t until I heard the Dexcom alarm let loose with the HIGH ALARM! that I realized my tubing was wagging like a tail. Disconnected from my body. Leaving me on an unintentional insulin hiatus.

So many variables influence my blood sugars – exercise! Insulin levels! Food! Stress! Exclamation points!

But sometimes it’s as simple as remembering to plug shit in.

Sharps, or “Shaaaahps,” Containers.

In the last few weeks, I’ve taken some device breaks and reverted back to some of my multiple injection (MDI) ways (until skin rashes healed up, bruises started dotting up my skin landscape, and frustration with trying to draw up 1/4 of a unit of Humalog using a syringe tossed me back into DeviceLand).  It was a good break and one I needed, but I was reminded of how many sharps I can accumulate during the course of a week on MDI.

Back when I lived at home with my parents, my mom used an empty detergent bottle to throw my sharps into.  When it was full, she taped it up with duct tape and my dad disposed of it somewhere “official.” (But to be honest, I have no idea where he brought it.  The shed at my childhood home could be filled with used insulin syringes shoved into fleets of Tide bottles, for all I know.)  When I moved out and went to college, I continued the same system only I brought my full sharps containers to our local pharmacy.

These days, I don’t generate a lot of sharps and currently have a few containers that need to be disposed of (tips from Joslin on sharps disposal here), but that’s largely in part due to the fact that I rarely use syringes these days.  Even when I’m on pump vacations, I tend to use insulin pens over orange-capped syringes.  (Did anyone use one of these back in the day?  I loved this thing.  It was like a fingernail clipper for my drug paraphernalia.)  I busted out a “formal” sharps container that I had in storage for the last few years and have been using it for pen needle tips, lancets, etc.

Sharps. Or, if you're from New England: "shaaaaahps."

A photo posted by Kerri Sparling (@sixuntilme) on

It feels strange and foreign to not be shoving my sharps into a discarded laundry detergent bottle.  I feel like my sharps went all professional.  Like they wear tie clips and have board room lunches. But, at the very least, they are properly contained and will be properly disposed of and that makes me feel like I’m properly PWD’ing.
 

Practice Turkey.

Chris and I are both from big families with piles of aunts and uncles and cousins at every birthday party.  Part of being part of a flurry of people means big holiday gatherings, and Chris and I are prepping ourselves to start hosting some of the holidays.

Problem is, I’m a terrible cook.  Or, better stated:  an inexperienced cook.  Cooking hasn’t ever brought me joy or satisfaction, and I’m not interested in the time it takes to perfect a recipe.  I cook for form and functionality (read: make sure my family doesn’t survive on garlic salt and overripe bananas), not for fun.  I’m not good at making the effort to learn.

But if we want to start hosting holidays, we need to learn how to prepare some of the main courses.  Which brings me to the Practice Turkey:

Practice Turkey is currently taking up residence in our freezer, and my goal is to use him to teach myself how to properly prepare a whole turkey.  (Sidebar:  Animal is in our freezer because Birdy is afraid of him, but refuses to let us donate him or throw him out.  She wants him in the house, but entirely contained.  So he lives in our freezer and has been there about a year.  I always forget that he’s in there, until someone comes over to visit, opens the freezer, and subsequently goes, “OOH!!”) In the next week, my plan is to practice my culinary witchcraft on Practice Turkey so that when we host holidays this year, I’m not in a huge panic because I can be all, “Oh, the turkey?  I know how to do that.  I’m all over that!”

I need to actually do it in order to make sure I can do it.

Same goes for technology hiccups in my diabetes management plan.  I use an insulin pump and a CGM (hellooooo, disclosures), and with that convenience and data comes an influx of autonomy and the sacrifice of my autonomy, if that makes sense.  The devices give me a lot of flexibility and freedom, but if I rely on them too heavily, I forget how to manage my diabetes on my own.

I need to be my own Practice Turkey, relearning the details of diabetes.  I need to make sure I know how to calculate a bolus, check my blood sugar regularly by finger prick, and finagle basal insulin doses if my pump ever breaks, or if I ever want to take a CGM break, or if my will to wear devices breaks a little.  And over the last week, I’ve been on a bit of a device break (thank you, winter skin issues), realizing once again that a refresher course on how to drive the stick-shift version of my diabetes (so to speak) helps me take better care of myself overall.  Taking an injection before I eat makes me think twice about the food I’m putting into my body, and also help me remember to pre-bolus (because it’s a process, not just the push of a button).  Using the treadmill instead of a correction bolus to fix a 180 mg/dL keeps exercise fresh in my mind.  3 am checks aren’t always necessary, but doing a few of them helps me spot-check my overnight basal rates.  I appreciate my devices, but I needed a reminder on what they do for me, and how to continue to do for myself.

Practice (turkey) makes perfect.

[Also, today has been unofficially designated as a “day to check in” (hat tip to Chris Snider) with the DOC blogs that we’re reading.  I read a lot of diabetes blogs, but I don’t often comment because I usually want to say something meaningful, instead of “I like your post.”  (But I do like your post!)  But instead of finding that meaningful comment, I usually roll on and forget to return to comment.  NOT TODAY!  Today I’m commenting on every blog I read, because that’s the name of the game.  I love this community, and today I’ll show that through comments.  So please – if you’re here, share what your favorite word is, or just say hello.  And thanks for being here.]

Why I Pack Heavy.

“And then Marcus gave me a Valentine and it had SPIDERMAN STICKERS on it and I love Spiderman stickers so that was the best Valentine I got except the one from Maddie that had a pencil and that was ALSO THE BEST ONE,” yelled Birdzone from the backseat as I was buckling myself into the driver’s seat.

“Yeah?  So Valentine’s Day at school was awesome?” I asked her, reaching over my left shoulder to grab the belt.

And then I felt that familiar, gentle * pop * of the infusion set coming loose from the back of my arm.

Rarely do I have the chance to use my emergency supplies (which is a plus because that means I rarely have emergencies), but I always carry them.  Even though I wear an insulin pump, I keep a back-up pen of Humalog floating around in my purse.  Sure, it will eventually expire and I’ll have to swap it out for a new one, but in a pinch, it’s enough.

And even though it’s a bulky little spaceship to keep on hand, I always have a back-up Inset for just-in-case moments, like when I accidentally rip out my infusion set in the parking lot of Birdy’s school.

This is why I don’t ever pack light; when you’re a klutzy PWD, a small purse just isn’t an option.

 

Animas Vibe: A Few Weeks Later.

Again, disclosure:  I work with Animas and have a sponsorship contract.  Here are more details on my disclosures. And this is the Mr. Plow theme song.  Mr. Plow would be great, about now, since the snow keeps dumping down outside.

It’s been several weeks since I’ve switched to the Animas Vibe insulin pump (with integrated CGM technology – doesn’t that sound like a rehearsed phrase?  How about “insulin thing with CGM thing built in and have you seen my coffee, pleaseandthankyou.”), and I thought I’d take a crack at some second impressions, since the first impressions were only compiled after a few days.

Talking ‘Bout CGM:  I am still into the concept and application of having one device that does the work of two.  While the Vibe still requires that I wear an insulin pump infusion set and a CGM sensor as two separate insertions, it removes the need for an external CGM receiver.  I wrote about this last time, but to reiterate:  I am okay with not using the separate receiver.  I’ve traveled a lot in the last few weeks and the first few trips, I brought along my CGM receiver so I could plug it into the SHARE port.

For the record, I still haven’t upgraded to the 505 software.  Judge all you want.  :)   Which may explain my identical CGM graphs.  (And, also for the record, I’m really, really excited to see the new Dexcom receiver.  That may change how I feel about clouding, as it would be much simpler.)

But then Chris and I came to realize that we aren’t good at this whole “data sharing” thing.  As much as it sounds like a good plan in theory, we aren’t good at the application of it.  I think this becomes a patient-specific preference sort of thing, and for this PWD, I’m not a data-sharer.  But as I mentioned with that previous dead horse that I keep flogging, I like options.  Love them, actually.  And anything that gives data options – LIFE options – to people touched by diabetes, I am all for it.

(That sentence was a grammatical nightmare.  Ignore the sloppy parts and move on, yes?)

DiasendYesterday, for the first time in a long time, I downloaded (uploaded? loaded.) my data to Diasend.

The data collection portion is cumbersome.  I hate dongles and charging cords and all the extra beeps and wires required to make sense of diabetes data.  (Which is why I’m such a fan of the Verio Sync idea, which uses bluetooth technology to automagically suck the results off my meter and spit them into my iPhone, but there are issues with that system, too, because it’s only iOS compatible.  Pluses in one way, minuses in another.  But see aforementioned “I love options” sentiment, because it still applies.)  But I did download my pump data, which also downloaded my CGM data.  And, because I was feeling ambitious, I uploaded my glucose meter, too.

So this was my first time looking at Diasend with information about my insulin doses, glucose meter results, and CGM results on the same screen.  (No, I am not sharing my results.  My numbers have been absolute shit lately and I’m not going to pepper my blog with confirmation that I have diabetes.  I’ll let the c-peptide test that’s required by my insurance in order to cover my insulin pump serve as that confirmation.  Yes, that’s a thing.  Yes, more on that later.)

Diasend is good for granular information, but the information on the “compilation” tab was ace for me.  Seeing my blood sugar averages based on time of day was powerful.  (I have midnight to 11 am nailed and awesome.  Everything not in that time frame needs a solid snuggle these days.)   As a Mac user who hasn’t explored the new Dexcom/Mac Portrait (I’m woefully behind on everything that doesn’t involve Birdy these days), seeing my Dexcom data on my laptop is amazing.  I’ll be exploring Portrait in the next few days but in the meantime, I’m happy that information can be siphoned over to Diasend.  And it puts the constant flow of data into digestible context.

Pump Stuff.  Since I was a Ping user before, using the Vibe feels familiar and easy.  I’m still glad this sucker is waterproof and the button clicking process is familiar to me.  All of that feels the same.  One thing I have noticed is that the more my CGM needs attention, the faster the battery in my pump needs replacing.  This is annoying, but makes sense despite the annoyance.  For the first time ever, I’ve invested in lithium batteries for my pump and it seems to hold much better than the alkaline ones I have been using for the last … forever.  But overall, the pump feels familiar and comfortable, and since I hate change, that familiarity is a plus for me.

Alarms, for whatever reason, remain easier to hear and feel when they are coming from the pump.  This was a huge concern of mine because I thought the pump alarms would be muffled by clothes and bedding, making them hard to catch.  But I actually respond to low and high alarms more readily on the Vibe.  I am not sure why.  Maybe because it’s attached to my hip and I feel the vibration?

What remains to be seen is how the changing state of Dexcom progress will affect my feelings about this pump.  Right now, it’s the only one integrated with the CGM I already use, so that’s a huge plus.  But I am concerned about the fact that the software in the Vibe is already behind on the current Dexcom system.  I know the FDA process creates hurdles that are hard to clear, but since the Vibe has already cleared the Big One, can I expect that updates and upgrades will come fast and furious?  As a PWD using the Animas product, I hope this is the case.

And lastly, I’m hoping to have this pump covered by my insurance company.  I’m still trying to get a c-peptide test done (travel, snow, and issues with fasting) to fulfill the requirements issued by Blue Cross Blue Shield, so that journey remains ongoing.

Thankfully, I’m still pretty effing sure I have diabetes.   So yay?  Yay.

Twitter Rant.

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.

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.

Yes, my insurance company is requiring a c-peptide test to confirm my type 1 diabetes status in order to cover my new insurance pump.

The irony was not lost on me.

I felt like a crumb for ranting but sometimes I’m a crumb.

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.

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.

But I’m still waiting for Joslin to call me back. You know, to confirm the type 1 diabetes I’ve had for 28 years.

Diabetes Interruptus.

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.


Standard work day: computer, iced coffee, insulin pump site change. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

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.

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