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Posts from the ‘Robot Life’ Category

Looking Back: Ironmom.

This morning, Birdy and I were talking about Halloween and our upcoming costume opportunities.  “You can be Batman, mom.  Just wear a black shirt and the mask and be helpful.”  “Sure, and I can stick my pump on my BatBelt?”  She laughed.  “Or you could put it in  your shirt and be Ironman.” 

Which reminded me of this post.  So I’m re-posting it, because being Ironmom isn’t too shabby.

*   *   *

“I really like Ironman.  And Superman.  And Spiderman.”  She paused.  “But not the Hulk, because he smashes things.  Why he smashes things?”

“He gets angry and that anger makes him turn into the giant green guy, and he smashes.”

My daughter, thanks to her father’s affinity for all-things superhero, has developed a taste for the slate of superheros and supervillains.  She rocks her Superman t-shirt at school, and her Batman pajamas at home with both encouraging regularity and vigor.  But that’s the nature of her being three years old – she is learning so much every day, taking in her surroundings and chewing on them until they make sense for her.

Part of what she’s hyper-fixated on, in addition to superheroes, is the location of  my Dexcom and insulin pump.  At least once a day, she asks me to show her my devices.

“Where is your Dexcom, mawm?” she asks me, patting my leg knowingly.

“Right here, on my right leg.”

“And your pump is right here, right?”  she asks, pressing her finger against the screen.

“Exactly.”

The other day, Birdy was troubled because she couldn’t find my insulin pump in the dress I was wearing.  “Mom, where is your pump?”

“It’s in the front of my dress, here,” I said, pointing to where the pump was clipped to my bra (disco boob style).

She contemplated this for a minute, and I could see the laundry list of information she’s been collecting in the last few weeks rolling around in the dryer in her head.

“You’re like Ironman, mawm.”

“Ironmom?”

She laughed that wild, unfettered laugh of a toddler who just learned what “a joke” is.

“Yeah!  Ironmom!  You made a joke.”

When Good Insulin Goes BAD.

Ninety percent of the time, my high blood sugar has an identifiable reason, and there’s a cluster of common causes.  Did I under-estimate the carbs in a snack and therefore under-bolus?  Did I over-treat a low blood sugar?  Did I eat without bolusing at all (it happens)?  Is there a lot of stress floating around that I’m responding to?

Most of the time, those questions cover the why.  Once in a while, my highs are for rogue reasons, like an air bubble in my pump tubing.  Or when I eat something carb-heavy right after an insulin pump site change (it’s like that first bolus doesn’t “catch” somehow).  Or I forgot to reconnect my pump.  Or if the cat bites through my pump tubing.

But rarely, if ever, is one of my high blood sugars the result of bad insulin.

Except it totally happened last week, when two days of bullshit high numbers had me mitigating every possible variable … other than swapping out the insulin itself.  (And clearly I’m stubborn and/or in denial about the quality of my insulin’s influence on my blood sugars?)  I rage-bolused.  I exercised.  I low-carbed the eff out of an entire day.  I did a site change at midnight to take a bite out of the highs.  Nothing.  The downward-sloping arrow on my Dexcom graph had gone on hiatus.

(Always a punched-in-the-gut feeling to see the word HIGH on a Dexcom graph, accompanied by an up arrow.)

But ditching the bottle of insulin entirely and swapping in a new Humalog vial?  That did the trick in a big way.  For once, it was the insulin.  Next time, it will surely be the cat.

Diasend: Now With More CGM!?

Is it a glitch?  A misfiring Internet tube?  A mistake that they haven’t realized yet and now I’m that jerk for pointing it out?  WHEN DID THIS HAPPEN?!!

Dexcom data, now available for upload on Diasend.  I don’t know when this changed (last time I looked was over 18 months ago), but it’s working now.  Even here, deep in Rhode Island (can’t go too deep, actually, as it’s a very small state).

After digging through the box of diabetes-related cables that lives in my bathroom cupboard, I can easily upload my glucose meter (Verio Sync), insulin pump (Animas Ping – actually not the easiest upload because it requires dongle dexterity and I can barely say “dongle” without losing it, so being dextrous is extra difficult), and continuous glucose monitor (Dexcom G4).  All my data garbage, dumped into one source.

It’s not streamlined, but it’s closer, and I’ll frigging take it.

(For a list of supported devices, check out this link.  And if you knew Diasend worked with Dexcom for US accounts a long time ago, sorry for being late to the game.  Also, why didn’t you tell me?  I am now VERY EXCITED and the CAPS BUTTON is sort of STUCK.)

Best Intentions Need to Stick.

Yesterday, my bag was packed with all kinds of good intentions.  My CGM sensor was only three day old, on a bright and shiny Toughpad to prevent adhesive rash!  The Dexcom receiver was fully charged!  My CGM in the Cloud rig was all charged up and ready to send my data into the cloud so that I would have a safety net while traveling to Washington, DC for the night.  Extra test strips and a fully charged Verio Sync meter?  I’M ON IT.  My wallet even had a few slips of Opsite Flexifix tape cut into band-aid sized strips and wedged into the change purse, ready to help hold down a wilting sensor.

Much best!  So intentioned!

… which did me zero good when I arrived in DC and my receiver threw a SENSOR FAILED error message after I went to the gym, forcing me to reboot before dinner.  Which meant I went to dinner without a CGM graph, which made me feel like I was sort of flying blind, but then I realized I left my glucose meter in my hotel room so I was actually flying blind without any way to check my blood sugar or calibrate my CGM during the meal.

… and then, sometime during the night, the sensor came loose and fell off my thigh.

All these good intentions? They need to STICK.

CGM in the Cloud and All Over the Web.

diaTribe has posted a new column about CGM in the Cloud and the why (and why not) of clouding your Dexcom data, and thanks to a lot of input from people in the diabetes community, there are a dozen different perspectives.  Click over to diaTribe for a read.

And diaTribe isn’t the only site talking about CGM in the Cloud this week.

Why wait?  #WeAreNotWaiting.

Changing the Set.

Changing out an insulin pump infusion set is a methodical moment for me. I do things in the same order almost every time, with the same mildly frenetic mindset.

  • Remove old set from my body so I can enjoy the “connected to nothing” feeling for as long as possible.
  • Take out a new infusion set and new reservoir.
  • Ferret out the open bottle of insulin from wherever I’ve stashed it last in the bathroom.  (Usually it’s in the medicine cabinet, but during the hotter months of summer, I tend to keep it in our bedroom, where it’s cooler.)
  • Line the insulin set, reservoir, and bottle up on the counter.
  • Unscrew the reservoir cap and remove the old infusion set and reservoir from the pump.  Throw the tangle of tubing into the garbage, making sure said tangle doesn’t dangle over the edge of the garbage can because otherwise Loopy and Siah will find it and drag it all over the house.
  • Open the packaging for the reservoir and take out all the little parts (except that one frigging thing that I don’t know what it’s for and I usually throw it right into the garbage – see below):

  • Rewind the pump.
  • This is the point where I mentally set some kind of timer, challenging myself to race against the time it takes for the pump to rewind.  While the pump is whirring, I rush to fill up the reservoir and connect it to the tubing.  I do this every, single time.  It’s as satisfyingly ritualistic as shaking the bottle of test strips before I check my blood sugar.
  • Thread the tubing through the battery cap and connect the luer lock, then insert the cartridge into the pump.
  • Load the new cartridge.
  • Prime the cartridge, trying to stop the prime before more than a single drop of insulin escapes from the needle in the infusion set.
  • Hold the tubing up to the light and inspect it for bubbles.
  • After the pump is primed, again the mental timer is set.  This time, the challenge is to unpeel the sticky backing from the infusion set and find a place on my body that’s suitable for insertion before the screen on my pump goes blank from inactivity.
  • Insert the new infusion set, prime the cannula (sort of holding my breath while it primes because I’m never certain that the first introduction of insulin won’t burn under my skin).
  • Tuck the tubing out of sight and clip the pump to my clothes.
  • Fin.  (As in “the end.”  There’s no marine life actively involved in this process.)

This process takes less than two minutes to complete, but if it’s interrupted in any way, I’m thrown so far off course that it takes me five minutes to recover.  The method of this madness is that it’s one, fluid mental movement and any upset to the process makes my brain disengage to seek the comfort of something shiny.

It’s an intricate process involving several steps, precision handling, and the safe housing a powerful drug.  And if I have to change the battery at the same time …

 

Not A Single Decent Number.

“Huh.  223 mg/dL.  Still.”

This was the mumbled mantra of our vacation to Maine.

Aside from the long drive to Bar Harbor (six hours, plus coffee stops and bathroom stops and “Hey, look at that lobster!” stops), the time we spend in Maine is usually very active.  As a family, we did the hike around Jordan Pond (about 3.5 miles), the hike up South Bubble Mountain (with a stop at Bubble Rock), and spent hours walking through downtown Bar Harbor.  The lure of blueberry ice cream was enticing, but I tried to avoid the sweets and instead downed buckets of iced coffee instead.

And yet my blood sugars were complete shit while we were traveling.

I wanted to blame my infusion set, but I changed it once while we were in Maine and my blood sugar numbers remained crap.  I wanted to blame the bottle of insulin but it was the same bottle that worked just fine at home (and it wasn’t like we microwaved it or let it bake in the car).  I wanted to blame my own actions but I was exercising, checking my blood sugar, pre-bolusing for meals, correcting highs, and sticking with reasonable carb intake.

So I blamed diabetes.

The graphs over the four days we were in Maine were gross.  When I wasn’t high (which was the majority of the time), I was erring on the side of high, teasing the edges of 160 and 180 mg/dL all day long.  Why?  No clue.  Hesitant to up my basal rate in the face of constant walking, I just watched the graph ride the mustard for a few days.  Not convenient, because blood sugars running higher means more water, more “Hey, it feels like someone put cement in my sneakers,” more teeth sweaters, more bathroom breaks.

“Mom, do you have to go potty?”

(Fun when the four year old is asking me, instead of the other way around.)

Sometimes the numbers don’t make sense, and this time, I choose to roll with it for a few days.  There are probably six dozen different things I “could have done” to take a bite out of the high blood sugar trend, but I didn’t want to the micromanagement of diabetes to eat up my brain on vacation.  Instead, I did what I was willing to do and thankfully, now that we’re back at home, my Dexcom graphed has settled back into a more forgiving pattern of Pac-Man dots.

I prefer mountains in the landscape, not in my Dexcom graph.

 

 

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