A Slim Chance

I may have mentioned that my warranty ends on my Minimed in February, prompting me to get excited about getting the new 530G and Enlite sensor/transmitter system.

But I thought… hmm, I have the opportunity to shop around for a new brand of pump because my insurance isn’t limited to a Medtronic contract, why am I not taking it?

I know Kim over at textingmypancreas is also shopping around for a pump, so I’m following her trials and reviews a bit more closely.

Lifestyle-wise, I’ve added the T:Slim to my list of possible upgrades.

This is the T:Slim:

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It’s a touch screen insulin pump, similar to a smart phone. This would alleviate the issues I seem to have with button errors when sticking the pump in places other than a pants pocket. (See my NYE story last year…) It also has a rechargeable battery rather than being powered by an Energizer disposable, so the tree-hugger in me is semi-soothed. (Insulin pumps still produce a lot of waste, but whatever.) The infusion sets seem fairly similar, if not better, than my standard sets from Medtronic. You can enter carb counts on a keypad rather than scrolling through a sequential list. It’s flat – so more comfortable to sleep on. Color screen is easier to see in the dark or bright light – much like a smart phone. And there is an app to upload data for evaluation by a health care provider.

Sounds awesome, right? Well – you take the good with the bad. The T:Slim was introduced in 2012 by Tandem – a brand new start up trying to revolutionize pumping. Fine and dandy unless you are someone who doesn’t like to try the first version of anything. With the startup comes complaints about customer service, etc. and so forth. However, I’ve had some interesting customer service from Medtronic over the years so, that’s not a HUGE concern. (But still a valid one.) The other thing to consider is that I would need a separate device to act as my CGM. The obvious choice would be a Dexcom, which many in the DOC love to pieces and tell me it’s heaven compared to my mosquito sensors… but again, the inconvenience (and expense) of ANOTHER sensor device to tote around feels like a hassle when compared to my All-in-One, no matter how inaccurate it may be.

(Though – rumor has is that t:slim and Dexcom will be integrating eventually into one device as well… but it’s not yet.)

Anyway, I told my husband about my cursory research and that this could be the future of my pumping. Here is how the conversation went.

M: It’s fancy.
J: Yup.
M: It looks like an iPhone.
J: Yeah a little bit, huh?
M: Can it play your Snoopy game?
J: No, probably not.
M: What about Insulin vs. Carbies?
J: …Yes… actually, yes, that’s exactly it.

Think about it…

GRAAAAAAIIIINNNNNNSSSSSS!!!

GRAAAAAAIIIINNNNNNSSSSSS!!!

I think my husband is on to something.

Thankful for: Temp Basals

It’s Thanksgiving Week and I figured I’d throw out a few “thankful for” posts, as that seems to be a trendy thing to do this month.

Anyway – I’ve been MIA for the last few days because the hubs and I decided to go see Disneyland all decked out for Christmas. YAY! We had a very expensive enjoyable weekend to ourselves while admiring how The Mouse does itself up for the holidays.

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It does quite nicely actually.

My blood sugars were tricky, in that you are generally surrounded by not-all-that-healthy food choices but you are active for up to 8 hours per day.

1459814_10152059354311257_21927445_nThis is generally what I saw an hour to two hours after a meal. (That high trend was me skipping breakfast and getting on an airplane at 8 am.) So – a bit scary to see that slight downward trend with 5-6 active units left in your system and no typical post meal spike present. (I think I might have had one high alarm the entire trip.)

So I used the temp basal setting on my pump a lot this weekend. It didn’t always work and I still hung out in the 60s and 70s. But – it saved me from a lot of grief during some of my middle of the night alarms. (Because, exercise can effect BGs long after the day is done, y’know.)

On the flipside, I got to enjoy a Dole Whip, half a churro, and gingerbread bengiets without any spikes in the sugar. (Or insulin for that matter!)

Oh and this:

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Certainly not a Disney breakfast without one of these. YUM!

Episode I: The Phantom Bolus

Don’t worry – Jar Jar won’t be making an appearance. But this pump quirk is probably just as scary… or annoying.

This was my early Sunday morning…

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I treated an awful 46 mg/dl at around 5:30 am with a crap ton of juice and a graham cracker. I didn’t offer a bolus for the extra snack because I was exhausted and just didn’t care at that point. I’d just deal with it in morning. I didn’t have my transmitter on, so I wanted to take advantage of this uninterrupted sleep for the next couple hours.

I woke up about an hour and a half later because the cats were going crazy. I figured then would be a good time to check again and assess the damage. 192 mg/dl. Not great, but not horrible. Especially for a BG in the 40s. I go to administer a correction for the 192, which should have popped up a 2 unit correction bolus, at least.

It told me to administer .7 units. What?

It also told me that I had 1.3 units already in my system. WHAT?

I scroll to my bolus history and find the following:

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So about an hour after my low, I administered a 1.3 unit bolus for a blood sugar of 164. Which I don’t have record of on my meter. And 164 is a pretty specific blood sugar, so it’s not like I was like oh – I accidentally rolled over onto my bolus button and hit the up arrows. I would have physically had to enter that number in.

Did I just sleep bolus? Did this randomly just show up on my history? Why would I still be 192 a half hour later?

So I did something even more stupid and gave another unit of insulin because I was convinced that I didn’t actually get the full correction that I needed.

And apparently, I didn’t because I woke up about 2.5 hours later with a BG of 99. Excellent.

But – um. WTF?

Upgrade?!

This could be my future, very soon. (In purple, of course.)

During a routine supply order call to Medtronic, I found out my warranty date is coming up quick on my lowly Paradigm. (I say lowly just because Medtronic has released 2-3 new models since I upgraded last time and my doctors all keep referencing features on the new shiny models, but then are sad when they realize I can’t help them with my care without these features. Bah!)

So I figured… I’m on the phone with them right now, might as well figure out what I can do with that pending warranty date.

I have two options:

1) Upgrade now and pay Medtronic’s early upgrade fee of $800. (!!!) Get said shiny new pump with bells, whistles (literally), and re-order brand new stinking sensors, which apparently don’t look like evil hummingbirds nor hurt like hell going in. (But – apparently, I can keep my transmitter.) No insurance prompting necessary. This is Medtronic’s gift to you. (Merry Xmas and crap.) My warranty date, however, stays the same. (Which I don’t understand…)

2) Wait three months and have the insurance pick up part of the tab… which would be 80% of a $5000 device. Hi – you do the math. Option 1 is much cheaper. Well, sort of. However, I guess Medtronic also has other payment credit options, blah blah blah.

Secret option 3: I do nothing and carry on with my old school device because I’m going to end up paying through the nose on either option. (Or blowing my entire allotted FSA for 2014 in one order.)

Decisions, decisions.

Dropped

A particularly appropriate title to encompass a number of things.

– I have not dropped off the planet, but keeping up with the blog has definitely dropped off my priority list. Lately, my topic ideas have been circulating around the new health care laws and how it’ll effect me personally. However, I’ve got enough politics floating around on my Facebook wall as it is –  involving close friends. I don’t need to invite strangers to the party as well. But I have to note that I started this blog about a year ago and I’m still thrilled when I get comments from y’all. Maybe now that conference season is ending here soon, I’ll have more time to write.

– I headed out to a super fun convention for a day and a half, which was much more than I expected because I thought I would be working all weekend. So I attended as a relaxed social dancer and cheerleader to my friends. It was quite nice. One of my friends insisted on carrying me on to the dance floor to a safe spot and goofing off. He lead me through a rather stomach-churning drop safely (because he’s twice my size), however, my pump managed to fall out of my pocket mid-trick and I had to fish for it with the tubing. Ouch. Mental note – clip the pump to the pants next time.

– My blood sugars have risen to sky high levels (for me)… and have just stayed there. I get so frustrated with the resistance and the micro-boluses I have to administer every 30 minutes that I usually just give up hope and over-correct…. THEN I drop. A lot. My CDE is considering having my try out a different infusion set, as my extended highs seem to occur right before a set change. (Nevermind that I usually change my site if I can’t get the sugars to come down over an extended period of time anyway…) She brought up using the Silhouette. I already hate inserting the sensors of death in at a 45 degree angle. Why the hell would I want to do that for infusion sets too? However, I only seem to be shrinking in my ab area (yay?) thus exposing the years of built up scar tissue in that area. I dunno…

Happy-ish Monday.

I can’t draw straight lines with rulers

My CGM can, however,

Just under my high-alarm threshold. For the last three days.

For reasons all too familiar for the female PWDs, I haven’t been running my best and it’s starting to wear on me. It got to a point that I changed my infusion set at 3 am after an additional over-correction that didn’t work 2 hours earlier, a 135%  overnight basal rate for three hours, plus an injection of the same correction I administered with the pump.

I woke up 37 mg/dl. But – at least I woke up!

I probably shouldn’t make wild judgements at 3 am… but I was getting up every 2 hours to clear a high alarm that wasn’t budging and I wanted to sleep. And when there wasn’t a high alarm, I was checking my CGM to see if my correction(s) were working every 5 minutes so I really wasn’t sleeping anyway.

The site change may have been helpful because I managed to get a 90 at around lunch time. But my mornings are still incredibly resistant to all drugs. Maybe this is my body’s not so subtle way of telling me to find something different for breakfast.

A Missing Link

31vxY3W6QTL._SL500_SL160_Well, I’ve waited long enough I guess. I finally broke down and bought a data cable for my OneTouch UltraLink meter so I can sync my readings to Carelink. This comes after the half hour conversation with my CDE who couldn’t, again, pinpoint any patterns to fix based on my (slightly inaccurate) CGM readings alone. Since I test myself around 15-20 times a day, I can’t manually enter all of those readings into my pump… especially during a low. (And I can’t wirelessly sync my meter to my Paradigm, because it’ll want to calibrate.) So she felt that my CGM wasn’t telling her the whole picture. (Obviously!)

So I bit the bullet and dropped $40++ on a glorified USB cable. (I guess there is software to go with it… which is dumb, but the Carelink site still runs on an old version of Java, so I guess it comes with the territory.)

It’s not a perfect solution, because the pump and glucose meters won’t combine results for my CDE to download… but it beats having to drop into my doctor’s office every week.

I also get to pick a week to write down everything I consume and my reasons for giving the insulin dosage that I did.

I also purchased lancets, on my own, for the first time ever. They’ve always been donated to me or I’ve never gone through them enough to purchase, or they came with a freebie meter. But I was only given 10 Delica lancets and I didn’t install my remaining new one properly (i.e. I bent it in half).

#WW: It’s TOO Quiet

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I have enough friends with kids to know that when it seems too quiet, there is usually trouble.

Same goes for my CGM. My alarms go off for sugars below 75 and above 180, respectively. But I don’t have trend alarms, so I could be trending in either direction and not know it until it’s too late. (Given delays, I’m usually in the 200’s by the time my alarm goes off.)

My instructor asked one night if it’s weird to NOT have alarms going off all the time. The answer? Yes!

Today I treated myself to a larger cup of coffee than normal because I went to sleep around midnight. (And I work both jobs today.) No alarms. So I got nervous. Safely under my high alarm range but higher than I want to stay for a long period of time. Bolus administered.

CGM Wants to Hear the Kangaroo Song

My CGM is going back on tonight because appointment with the big magnetic tube was this evening. On one side, I’ll miss sleeping soundly without being awaken by alarms in the middle of the night or at other inopportune times. However, I won’t miss second guessing my symptoms and waking up randomly at 6:30 am with a 58 mg/dl.

I was trying to think of a pop culture reference to showcase my internal reaction to every time my CGM buzzes at me incessantly. So here is a really crappy-quality video of the exchange between Adam Sandler and Dylan (or Cole) Sprouse in 1999’s “Big Daddy.”

This should be safe for work. Other versions weren’t. I’d only really recommend that movie if you are a fan of Sandler, have had a lot of alcohol, or both.

Happy Monday, y’all.