31
Jan

I did this to myself

I know I have no right to complain.
My site was on day 4, and as an upper-butt-cheek-infusion-set, it has seen quite a bit of wear over the last 4 days.

My 6-day-lifespan sensor was restarted and was on day 8.
I postponed changing my site and sensor last night. "It's wasteful to change a site when I still have a half-day of insulin left."   "The infusion set doesn't even hurt that much. I'll just sleep on my other side again tonight."     "That sensor worked so well for its first round! It will be fine for a few more days."
The lies we tell ourselves to justify not having to change a site. Not having to feel that jab, twice, as two devices are inserted for 3- and 6- day spans (or 5 and 10, if you tend to stretch out your supplies like I do). All of this led to me sitting at work this morning with a splitting headache and a thirst like you wouldn't believe (I'm at almost 2L of water so far. Been at work for just over 2 hours). Cal reminder alarm prompted me to check my BG and to be quite honest, I probably wouldn't have bothered if not for that alarm. My cgm had me at 8.4 and dropping, so I wasn't worried.
Still, though. I should calibrate.

Fingerstick, 18.6 (335 mg/dL).
Well, then.
Working on a set change with this kind of headache is challenging. I rip open an alcohol swab, then stop. Squint. Rub my aching temples. What was I doing? Oh, right. Syringe, wipe top of insulin bottle. Use now-disconnected pump to calculate the correction dose. Deliver correction.
Another alcohol swab. What was this one for? Wipe top of insulin bottle, feeling vaguely like I've already done this. Think back, pushing through the throbbing haze of red that clouds my head and makes coherent thought a distant memory. Aha! Yes, I did do this.
Do it again. Change infusion set. Charge transmitter. Replace sensor. Look at the mess of medical waste and wonder why I didn't do this yesterday.

Looks like I have some tidying to do...

6
Jul

Keeping it together: Wedding Planning Edition

I thought I have been doing quite well.
Sure, I've had a few more lows than usual. Sure, stress can do that. And sure, I keep having to remind myself after treating these lows that maybe it's time to slash away at my basal rates so these lows happen less often, but then I forget right up until the next 2.7 is staring me in the face.
Then this happened,  and I found myself sitting in my office 2 days ago with an empty pump and a 6-day-old infusion set. That may be the norm for some, but I usually try to keep to a 3- or 4-day site rotation, so 6 is a bit much. Limiting sets to 3 or 4 days usually easy for me, since I've never made it past day 4 with any insulin left in my reservoir.
I think at this point it's safe to say that despite my best (okay, my medium-est) efforts, wedding planning has bested me. Diabetes care has fallen by the wayside. I'm still here, still bolusing for food and chowing back on glucose tablets when I'm low, but being proactive about my self-care is taking a backseat to all of the wedding stuff.
So, step 1 has been Recognizing The Need For Change. I guess step 2 is actually doing it.  On that note, I will upload my cgm data to Carelink when I get home tonight. I will. Tonight.
I mean, not right away tonight. We have a meeting with the wedding DJ after work. But after that. Definitely.

10
Sep

Ben says WAKE UP (or, Blood Sugar Dog to the rescue)

Pump says low.

Melody says shhhh pump, I  sleep.

Boyfriend is not home.

Pooch says NO HUMAN WAKE UP YOU ARE BEEPING WAKE UP EMERGENCY OMG OMG OMG.

image

Low alert

Thx pooch.

5
Jun

News from Medtronic: the Minimed Connect

I saw something cool on my Facebook feed tonight: Minimed Connect will be available in the US sometime in the Fall of 2015.

 

What is Minimed Connect? It's an uploader that sends pump and sensor info to a smartphone, which then reads it via the smartphone app and lets you view your pump info via phone. It doesn't allow you to control  your pump, but it does let you set a "text message threshold" which will send out a text to friends/family/loved ones if your sensor glucose levels are too high or too low.

The uploader also sends your sensor data to your Carelink Personal account every 24 hours, so those reports will always be up-to-date in case you or your doctor want to log in and check out that info.

I feel like this will help out with the "pump alarms aren't loud enough" problem. It will definitely also be nice to have Carelink data updated automatically, rather than the current system that requires that the user manually upload their data (in my case, frantically the night before every endo appointment :P).

 

The article (and the ensuing comments) mention that the release is in the US only, and will cost around $200. They do not expect the device to be covered by any insurance carriers.

 

The comments also mention that they have no info about a Canadian release for now. I hope they provide an update about the Canadian release sometime soon!

13
Apr

Bargaining?

I sometimes find myself negotiating with myself to downplay the gravity of my diabetes care. "Oh, I've been waking up high all week? ...Yeah, but yesterday I tidied the main floor AND vacuumed. PLUS, I emptied the garbage for the whole house this week so that Boyfriend didn't have to, because on garbage night he was out at his mom's place fixing that crack in the drywall beside the kitchen counter, so he would have been too tired to do the garbage, soo......yeah. I should get a pass on the diabetes thing. I'm obviously too busy to retest overnight basals."

 

"I wore an infusion set for 5.5 days last week? Yeah, BUT the DCM at work (A manager who is, I think, 5 or 6 managerial levels up above my boss) came to our office with a rush request on a Friday afternoon, so I stayed suuuuuper late on a Friday. I was crazy-efficient though! I produced everything that they needed for their meeting on Sunday!"

 

Or, my favourite, "I wore an infusion set for 5 days again? Well, that's 5-days-ago-Melody's fault. She shouldn't have filled the reservoir with enough insulin to last 5 days. She should've only filled it with 3 days' worth."

 

 

 

Sometimes I wish I knew some other actual, real-life diabetics, so I could figure out whether this is a thing we all do. I feel as though if others do it too, that makes it less bad. I'm sure there's a word for that.

3
Mar

Bubbles!

I want to ask Medtronic what they recommend when pump-users find laaaaarge air bubbles in their tubing.

Bolusing it out (while disconnected, of course!) might work, but it will count all of that insulin as IOB/Active Insulin, which can severely mess with bolus or correction calculations for the next 4 hours.

Re-priming it isn't as simple as it seems. In order to re-prime you have to let the cartridge rewind, which requires removing the reservoir from the pump.
Problems with this:
1) The little plastic nubbins that lock the reservoir into place tend to break off when the reservoir is removed from the pump. I have not found a way to be gentle enough to keep them attached while removing the reservoir.

2) It counts this re-prime as a set change, which will skew data on how frequently set changes occur.

 

 

This issue was particularly frustrating on Friday, as my workday started with a LOW RESERVOIR alarm on my pump.

I checked my settings, and - grrrrr - I was a day overdue for a set change. I guess the set had just been comfortable enough that I didn't notice I was on day 3 on Thursday. The LOW RES alarm wasn't a problem though, as it triggers the alarm when I've still got 20 units left in my reservoir, and 20 units is more than enough for basal insulin over my workday plus a lunchtime bolus for food.

The story doesn't end there, though!

Not long after the low res alarm, I visited the bathroom and had a chance to actually look at my infusion set (it was sitting in the top of my thigh). I was quite surprised (and more than a little upset) to notice that my tubing was decorated with tiny spots and differently-coloured flecks. Closer inspection revealed that I actually had some pretty huge air bubbles all along the length of my tubing.

I removed my reservoir (breaking one of the two tiny clips in the process) and restarted the set, which allowed me to re-prime my tubing... but by then I was down a few more units of insulin in my pump. By the end of my workday, sitting there with only 4.4 units left in my pump had me a bit on edge. Grrr!

23
Feb

A moment of hesitation

Sometimes these moments of diabetes fatigue hit me out of nowhere.

Last night my pump site was itchy and sore. I'm not due to change it until tonight, so I figured I'd ride it out and just put up with the sore site for a day.

This morning I woke up late, rushed in to work without testing in the morning, and only checked when I got in to the office. I'd been going on my cgm values, which were a little high but nothing too critical.

My BG once I got to work? 18.7.

The most likely culprit is a site that's not absorbing properly any more. I know that to fix it the next thing I should do would be an injection (not a correction delivered through my pump!) and a set change.

I open the "diabetes drawer" at work, pull out my spare reservoir and Mio set... and I pause.

I just don't want to.

I'm actually finding myself contemplating getting the vial of long-acting Levemir that I keep in the fridge at work and switching back to shots for a day or two.

I know that a sore site makes me much more likely to want to take a break from pumping. A sore site is a reminder that I've got a plastic cannula below the skin, making a tiny part of my body itchy and uncomfortable.

For now I've delivered my correction and am waiting on the whole set-change-or-not issue. There is no need to decide right now.

It is uncomfortable, painful, and unfortunate, but it is not currently life-threatening. I can afford to take a minute to try to remind myself why I started pumping in the first place.

21
Feb

Overnight lows

I've been having some issues with overnight lows lately.

 

I've been setting a 70% basal overnight for the last few weeks. Most of me knows that a 70% basal will make me wake up ok; fortunately for me I have a pretty solid network of friends who help me to fee not-so-terrible when I've had some delicious delicious wine.

 

My overnight basal rates have been too high for a while, and the weird thing is that it seems to take having friends over for dinner and drinks to figure out that I need to do something more permanent than a 70% overnight basal.

Bah! I don't want to have to re-jig my overnight insulin rates! Sometimes changes, whether stress levels or natural life stuff, BLOW.

6
Oct

Silhouette infusion set

Owwww!

I decided to try out the Silhouette instead of my usual Mio set this morning. Trying a brand-new infusion set in the morning as I'm rushing to head off to work? Baaad idea.

I watched Medtronic's youtube video about how to insert the set twice, then tried it myself. On my first attempt, I think I broke the little button on the insertion device that you push to expose the "teeth" that grab the infusion set. I pushed the button, and the whole pivoting piece sort of twisted. The pins on either side that hold it in had popped out, so it couldn't fit nicely over the infusion set.

I played with it for a few minutes and eventually managed to jam it back in to what I thought was the correct place.

Attempt #2!

I fit the set into the inserter, re-watched this part of the video again just to be sure, and chanted "insert, remove inserter, front tape, remove needle, back tape" (not a very catchy phrase, I admit) in my head as I went through the steps.

It went...okay. I squished some of the tape, so it doesn't look perfect, but overall I thought it went okay. It was not as painful as I thought it would be.

Until I sat down.

The site is in my stomach, fairly high up. I went there for visibility, and also because I was really hoping that an angled infusion set would make stomach sites more comfortable. It seemed a little sore, but mostly okay, until I sat - then OW OW OW OW OW. I'm hoping this irritation calms down a bit, because if not then I'm not sure I can make this set last three days :(.

25
Aug

Rafting and pump supplies

I went whitewater rafting this weekend.  I spoke to my d-team in advance so I could have a solid plan for switching to injections for a day, since my last pump vacation was a bit of a disaster. This time around wasn't perfect,  but it was pretty damn good!

I disconnected from my pump and left it in a cooler in the car (along with my transmitter) after giving a bolus for half of my morning basal insulin.  We decided  to go with half because
     a) rafting is a ton of exercise (possible lows),
     b) I would be in the sun all day (again,  another trigger for lows), and
     c) On my last "pump vacation, " I went super low for a loooong time (so my full dose of basal insulin would probably cause -- you guessed it -- lows!)

I went low somewhere during the safety training. 2 bottles of juice and a banana for me, & then we were off to the boats! The rafting team had my emergency bag in their dry bag; Boyfriend and another close friend both had glucose gel packs in the pockets of their shorts, and I felt as prepared for the day as I could possibly be.

By lunch I was 15.7. Hardly surprising,  since I gobbled down around 90g of carbs to treat the low before we left... At lunch I added together the insulin I'd need for the correction,  the meal bolus, and the "missed basal" bolus, then gave 2/3 of the whole thing, and by the time we finished for the day I was back at 5.6. I think I'd call this a successful(ish) pump-free day. I've obviously got a bit of work to do to fix what happened in the morning, but I stayed safe all day and ended up with a good #, so I'm happy with it!

Of course,  whitewater rafting beat the crap out of both my sensor and infusion set site. The infusion set (big bloody mess) still worked but was extremely sore afterwards,  so it has been changed to a new location. The sensor was also pretty badly squished and abused throughout the day (and gave me a sensor error when I first reconnected it) but seems to be working fairly well again. The excess tape that I had to use to hold it down is making the whole thing feel like a big sticky glob of constantly damp and itchy grossn.ess on my side, but at least it's only 36 hours until I'm due for a new sensor.

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