Today marks one year since possibly the scariest day I’ve ever faced in my life of living with diabetes. It has been an emotional week leading up to it and I’m sure I may catch myself having moments today as well. As I look back, I remember and feel the fear and the feeling of failure that I faced that day just as raw as ever.

It was the day I woke up and couldn’t see anything but light and darkness out of my left eye.

Since then, I have gone through dealing with three different diagnosis’, with the final one being a macro aneurysm that dissipated before the vessel could burst. The fluid from the swelling was what caused the temporary vision loss, and without it, I would have never known it even happened. The final diagnosis was both a blessing and a wake-up call. I was blessed in that it didn’t burst, it was a wake-up call that I needed to (1) find a new doctor and (2) stop getting so stressed about everything and to be thankful for everything.

image (3)I’ve been one to try to be positive about things in life, especially my diabetes. The Serenity Prayer says it best – “God, grant me the serenity to accept the things I cannot change…”. I cannot change the fact that I have diabetes. I cannot change the fact that after 26 years, there is a much higher risk of developing complications. I cannot go back in time and change how horribly I took care of myself for so many years – especially those teen rebellion years. BUT, the next part? “…Courage to change the things I can…” – Yes, there are things I can change. I can continually do my best to take the best care I can of myself. And lastly, “…and Wisdom to know the difference”… We have to know that there are things we can and things we can’t change. There are sometimes things that no matter how much we try, will never make the situation better. We have to recognize them and learn to let it go.

Not too long ago, a post I had written was syndicated to DiabetesDaily about if I were to be cured, what would I miss? A few commenters on their Facebook page called me crazy for even thinking I’d miss anything about diabetes. I don’t blame them – if I hated diabetes as much as some do, I’d think the article was pure craziness. But you know, after all of this time, it’s one of those things I’ve had to come to accept – I cannot change that I do have diabetes, so while I do, I have to embrace it and try to find the positives from it. Is it hard? Yes. Do I have moments of utter anger and resentment for having this disease that I know will progressively cause damage to my body? Yes.  I still get angry. I still get upset. I still cry when no one is watching because I’ve taken all I can take for the time being and I need a break. But you know what? I also realize that I cannot stay in that mindset. I have to have it and move on because I cannot change the fact that I have diabetes.

What I can change, though, is my attitude toward it. And I can continually work on knowing when to just let go and move on.

It’s been a rough year, to say the least, but it’s been one filled with blessings. I can see, my eyes are healthy again, and most of all – the thing I thought would no longer be possible for me – I’m carrying the most precious gift God could have ever blessed me with, and we’ve continued to be healthy throughout the pregnancy.

Hope, Courage, Prayer, and Faith. It’s what it takes.

 

(I turn to music for a lot of things. This song helped me through some pretty dark times. )

One little thing I like to do is design graphics. I piddle with it, mostly, so it’s not a big thing, but it gets my creative juices flowing and takes my mind off of other things that may be stressing me out.

So, I wanted to make a design to get a custom PumpPeelz made so that my Dexcom and Medtronic pump matched and looked cute. Crazy, I know, but that little bit of color and art makes having the devices not so mundane. So, I set out to make a design using a blank canvas in Photoshop and some “brushes” (some of them are more like stamps, like the ones I used). I also used color inspiration from my niece’s favorite show, Strawberry Shortcake. My favorite character is Cherry Jam because, well, she sings and her colors are pink (like, fuchsia pink), a purpley-tinged pink, white and purple. This is where I LOVE Adobe Color because I can pull the exact colors from the photo and use them in my design work in Photoshop. (okay, okay, enough about my geekiness…)

Scott was able to take my image that I sent him:

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And with it, he was able to make my matching skins:

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I love them.  And the purple almost matches the color of the pump too. And, since I really don’t like the pink that the Medtronic pumps come in (someone likened it to a naked mole rat once, so now that’s all I see with it!! hahaha!), this gives me a perfect mix of purple AND pink… a pink that I like.

Is this post about diabetes? Not necessarily. But I do believe that things that make us happy and creative around diabetes helps us to do better and be more encouraged to take better control of ourselves. And if a silly pump skin or Dexcom skin helps do that and also gives me a means to display my artwork, then hey, it’s all good. :-)

So go and get creative. If we have to use these things to help us be healthy, why not get creative with them? No use in being drab all of the time, I say. (Unless that’s your thing… if so, go for it.)

 

If you like this design too and would like to have one like it, feel free to email me and I can let Scott know that you would like to purchase one. I don’t charge for the designs, so it would be the cost of a custom designed skin from PumpPeelz.

I am one of MANY people who choose to use the Medtronic pump system with the the Dexcom CGM system. Since my endo took me off of my t:slim, the biggest thing I have been irritated by is how I cannot get all of my information into one report. I was finally SO happy to have that ability with Diasend for the t:slim and the Dexcom, and now I don’t. I know Medtronic has their own CGM system and I do have the 530G that will work with the Enlite sensors, but I had a bad run of luck (about 3 months worth) with it when I used it last year and I am hesitant to go down that path again, especially right now.

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Plus, now that Dexcom has Share built into the receiver, it has been SUCH a valuable tool for me and my family. I even contemplated using my old, out of warranty Animas Ping system so I could have all of my data in one place, but after one day of all of the irritating quick-scrolling and constantly missing my intended mark, I got irritated and used my Medtronic pump again. Not to mention, logging everything into the Medtronic through the Capture option so I could keep complete records was just irritating in itself (not that anyone else should have to do that, but I was just for my own sanity’s sake).

It really baffles me how Medtronic, being the big business that it is, and knowing that not everyone can wear their sensor, wouldn’t work with Dexcom to have a Dexcom version of their pump. Of course, I don’t know if maybe the feeling is mutual between companies and they just don’t want to be friends or what, but it would seem that if a company wanted to reach a HUGE customer base for their combination product, it would offer options that would fit almost everyone’s needs.

Anyway, that’s where I am right now. I have had a good experience over the past month and a half with my Medtronic pump and it’s made handling diabetes with pregnancy since switching a lot easier. I just wish I could have my reports all in one place, instead of two. It helps me make better decisions about my care. Sort of like what having access to Medtronic Pro reports would probably do too, but that’s another beef I have with them ( I mean, seriously?? Why can’t we have access to the more comprehensive stuff if our endo’s trust our judgement? And why have TWO systems anyway – other companies don’t [I don’t think, anyway].)

Bottom line is I know Dexcom works very well for me. I know that I like the Medtronic pump. I just want my world to be perfect and have the option of having those two combined.

*clicking my ruby slippers*

In a way, it’s sort of funny how the medication used to bring up a low if you ever have to go there is labeled D50W… sort of makes me think of the metal lubricant WD40 in a way – though it has no connection whatsoever other than the letters are the same and in different spots and one number is off.

BUT, that’s not what this post is about. It’s about actually having to go to the ER to get it.

Most of the time, a stomach virus is simply an inconvenience to most people. It sucks, no doubt about it. But when you’re a diabetic, it can be dangerous. Some people react with high glucose levels due to the sickness and can easily go into DKA (diabetic ketoacidosis) because you’re dehydrated from the sickness. That’s usually how I am in that I stay high for the most part because of dehydration, but I’ve never gone into DKA. I’ve also not had a situation where it had the opposite affect on me and made me low for an extended period of time… until this past weekend.

Saturday morning, I woke up feeling very queasy and knew I had caught my son’s stomach bug that he had the day before. Knowing that I usually run high, I didn’t turn my pump down at all, but also being pregnant, I didn’t want to assume that I would run high and turn up the basal unless my BG showed the need for it. And it was a good thing that I didn’t.

I was able to eat breakfast as long as I ate slowly enough. But, two hours later, I started trending down. I started eating glucose tablets and drinking juice as I could tolerate. Before long though, my stomach was full and not digesting anything, and my sugar was plummeting even more. I kept trying to eat glucose tabs. Eventually, upon smelling yet another drink, I lost everything. I could see that I had thrown up every bit of anything with sugar – glucose tabs, juice, my breakfast… all of it. So, as much as I didn’t want to, we had to get to the ER. I knew I wasn’t going to be able to hold down anything and I needed help.

It took 30 minutes to even get treatment, even though they took me back immediately. I had heard the doctor give the orders for half of the syringe of D50, but the head nurse was busy trying to find the billing code for it and apparently got side tracked. I guess because I was awake and not passed out they didn’t see it as quite the emergency that I felt it was. I knew before getting there, my BG was 52. By the time another nurse came in to start an IV of fluids, my BG as down to 45. I asked her about it, and finally the head nurse came in with the D50.

It wasn’t long and I began to come up again. However, it didn’t hold very long and they had to come back an hour later and give the rest. All this time I had been trying to find a good temp basal to set my pump at but that wouldn’t have me skyrocket and get sick from having no insulin at all. The last thing I wanted was to go into DKA straight from a low because I was dehydrated and now I was going to be cutting off all insulin… and from what I could tell, the staff in the ER had no idea of what to do with an insulin pump.

The ER visit

I was finally stabilized and set home around 3-ish, and I did okay the rest of the day. I will say it was one of the scariest things I’ve had happen in a long time. I hate when I am no longer in control of what happens with my diabetes for whatever reason and it makes me anxious, plus I was scared because it wasn’t just me that I was worried about but also this little person growing inside of me.

While I’m angry over how long it took to receive treatment and how some things happened while I was there (they were more worried about paperwork than treating me at all to begin with), I’m thankful that it wasn’t worse than what it was. My ultimate fear is losing consciousness and no one knowing what to do and how to treat me because they’re unfamiliar with how I manage my diabetes. That, along with being labeled as an uncontrolled or careless diabetic for letting it happen in the first place. I work my tail off to achieve the control that I do, but all it takes is one person giving into the stigma that only uncontrolled diabetics end up in bad situations (the ER, with complications, etc), which projects through their attitude toward me, to make me not want to trust them or feel like I have failed.

I know that I didn’t fail and that it wasn’t in my control, but it’s the emotional aspect that gets me every single time. I don’t know that I’ll ever be able to ask for help without that overwhelming sense of having failed and crying my eyes out every time.

Yesterday, I had my monthly appointment with my endocrinologist. I always look forward to my meetings with him – he’s always on top of everything to do with my diabetes, knows what a data nerd I am, and he fully trusts my decisions about my diabetes as much as I trust him to help me make decisions when I can’t.

He also knows that before my pregnancy, I switched pumps within my arsenal pretty regularly. He never had a problem with it. We even laughed about the amount of “backups” I have, even though all but one are out of warranty. When I received the second t:slim replacement in April of 2013 and started using it in January/February of 2014 after the cartridge recall and continued with it for a year until it was replaced earlier this month, he was impressed that I stayed with one that long. Last week, when I finally had enough of the craziness from my third replacement, he was willing to try to help because up until then, he (and I) was under the impression that I had found “the pump”.

So, when I went in yesterday, I told them about going to my Minimed once again (for documentation purposes), but this time I showed him the Dexcom reports between the two. He was floored just as much as I had been. Just as I had thought all along, he would expect to see that if I had switched insulin brands, not simply insulin pumps – because essentially they all should work relatively the same at delivering the set amounts of insulin. But the difference I had shown worried him. He told me not to use t:slim for the remainder of my pregnancy, and to stick to Medtronic. I had told him my husband and I discussed it and we had already planned to do that anyway, but hearing that from him validated it. And, in all honesty, it shocked me. He’s always been one to trust what decisions I make and go along with what I want to try, with the exception of ONCE telling me “no” to a medication I wanted to try, and this time I had the same reaction. He had stepped in and told me not to use a pump. Part of me is in shock, but partly not. It once again reassures me that he’s allows me to do what I want with my diabetes management, as long as it is within reason, and staying on a pump that would potentially cause harm would not be within reason, and he stepped in.

I will have add to all of this, though, that I did receive a call from Tandem at 10pm about replacing my t:slim once again. Since it is in warranty, that’s what I expect them to do. I went through all of the common questions they ask for record purposes, and the representative documented my answers. The replacement t:slim will be here next week, however both following doctors orders and for my own sanity, I will not be using it until the end of my pregnancy – or a bit later once insulin needs become somewhat predictable again. I’ll already lose some of my brain cells and energy to taking care of a newborn, and I won’t want to add switching pumps into the mix. He documented also that I wouldn’t be using the replacement until after August/September, so I wouldn’t be able to give feedback until then – and to my surprise, he didn’t try to pressure me into trying it any earlier. That made me feel very comfortable. I am glad that they reached out and were willing to replace the t:slim without hassle this time. I’ve only had a couple of sub-par experiences with their tech support, and the rest of the time it’s been good, so it does help to know that they are listening.

So, out of everything that’s happened this month, I am thankful to have an awesome Endo that I fully trust and that I know truly cares, and to know that Tandem does care – even at 10pm at night.

Usually, about once a month, I study my Dexcom trends and make minor adjustments here and there in my insulin needs (with permission from my endocrinologist, of course). This ritual then becomes a weekly thing during pregnancy, and this time is no different. And, later in the pregnancy, I tend to do this every couple of days or so due to all of the increased resistance and stuff.

Since I switched back to my Medtronic pump after issues with the t:slim last week, I wanted to get a good few days of data before making any changes since typically you do have to make some adjustments between insulin pumps. Not all of them deliver in the same manner (though relatively the same, but juuuuuuust enough to possibly need minor changes in insulin dosing). Here’s what I mean:

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6 days on the t:slim I had been using during the first part of my pregnancy…

6 days on the *replacement* tslim... NO changes in rates as they're the same brand of pump so it shouldn't have made a difference...

6 days on the *replacement* tslim… NO changes in rates as they’re the same brand of pump so it shouldn’t have made a difference…

...and the last 6 days since being on MedT with practically the same rates.

…and the last 6 days since being on MedT with practically the same rates.

If you compare the first and the last picture, you can see that there’s not entirely too much difference, and the average BG between the two was only a few mg/dL off from each other. The replacement, however, was whacko.

Either way, I’m doing a lot better on the MedT and will probably stay on it. And since I have made that decision, it’s time to get down to fine tuning things. I’m dropping every night around midnight, and it’s taking longer to treat them, thus I over treat and go high. BUT, the thing is, I’ve not corrected those highs. I’ve been trending back down on my own. So that tells me I have some work to do between supper, bedtime, and overnight basals and other factors.

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I usually look at my trends on the computer and try to identify things. If I think I see something or have a hunch, I’ll print out the Daily Trends report so that I can see the days individually and not as an average, and I’ll write my basal rates below it. This time (for example), I noticed that I dropped an average of 57mg/dL from my highest average to my evened out number when I wake up, which, ironically, is close to my insulin sensitivity factor (55mg/dL currently). So, I took the 1u and divided it by the number of hours it had been dropping  before leveling out, which was 7hours, and it came to 0.14, which I interpret that to be a needed basal rate change of 0.15u per hour less than what I have it set at now.  It all may not be exactly right, as most of what I think I’ve figured out is simply a hunch that I try out and see if it works. If not, I have record of my information pre-changes and I go switch everything back to what I had before.

This the stuff that goes through my head while I’m examining my data. This is why having as much of my data in one place is as crucial as air to me, especially while pregnant. It’s such a pain in the butt to have to look at multiple reports and have to spend more time organizing it than actually analyzing it. So, I’ve also resolved to leave my beloved Verio IQ and use the Contour Next Link meter that works with the pump, so that all of my data from the pump and meter at least are in the same place. That, and since using the CNL meter, my Dexcom data more closely matches it whereas it hardly ever matched my Verio. I’ve done a lot of research over the past couple of days, and it seems that maybe the CNL meter is a bit more accurate than the Verio, and with the Dexcom using the more accurate 505 software, maybe the two are just meant to be… Or I could just be completely off my rocker. ;-)

So, I’m off to my endo tomorrow for my monthly checkup and to share my observations and changes with him.

(What I do and write here are in no way medical advice that you should ever take as such. I have worked very closely with my endocrinologist over the years and he has helped me learn how to do these things. If you want to learn how to manage and fine tune, please speak with your health care professional, as I am not one.)

 

Typically, when one such as myself who is a device hoarder and who likes change becomes in a medical state where circumstances would favor more stable device use and more concentration on what is actually going on, one would stick to those devices no matter what and create a harmonious data record flow throughout the medical state.

My said state is, of course, pregnancy. A highly regulated and controlled medical state in those who are diabetic because both high blood sugars and wide variations in blood sugar control can cause damage to the developing baby. So, when I found out about this one, I resolved to stay on my t:slim pump, Dexcom CGM and Verio IQ meter – both because I was happy with my t:slim finally after having used it for almost a year without issue and for the sake of keeping consistent records. I had no concrete reason to switch back to another pump other than for my own sanity as I still didn’t 100% have faith in it. In all honestly, even though I had used it for the entire year without issues, I still -in the back of my mind- wondered when the issues would arise again. I held my breath with each cartridge change and said a prayer that it would work just fine. And it did… until earlier this month.

Granted, I know that being in the second trimester that insulin resistance would start to kick in, but there was a HUGE difference in my control after I had received my last replacement from Tandem on the 6th of this month. I was right back to fighting wild, crazy numbers from all ends of the spectrum without any rhyme or reason to them – and the only thing that had changed was the pump. And while I could call Tandem about it and have them replace my pump again, I just don’t have the mental energy to go through it again when even this last time was a bit challenging to get it replaced because the error I was getting was not a known problem and the pump had passed all other safety tests. I’m sure for other people, Tandem is a great company. I think they have a good product on their hands, but for some reason I just seem to not have luck with it for long.

Last week, when I had finally hit my breaking point – literally, I was sobbing Wednesday while contacting my Endo and letting him know I would be faxing records to him for help – I decided to go ahead and use my Medtronic pump. Crazy thing is, just for my own security of mind, I had just had it switched out from the 5 series (the 180u pump) for the 7 series (300u pump) to have as a “just in case” for the end of the pregnancy when insulin needs were going to be much higher. One of the issues with the t:slim seemed to be when I filled it up to 280, it would screw with the load sequence – thus the reason I had it replaced. Within a day, my BG’s became predictable again. I could bolus without skyrocketing and plummeting later – as if the insulin wasn’t being delivered. I could pre-bolus on a predictable schedule before eating again. And while I don’t like that now I can’t upload my pump and meter together so all of my data is messed up, I’m more at ease about my glucose levels overall. All from switching a pump.

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Saturday, I put my t:slim into sleep mode and packed it up and away. I do not plan to use it for the rest of my pregnancy, and even after that, I’m not sure if I’ll use it again. I’m absolutely torn about it because it was the first pump since my Disetronic way back in the day that I truly loved to use. But it’s like I’ve heard many other veteran pumpers say – I don’t care how fancy you make your pump, I just want it to deliver my insulin and work like it should. Especially right now.

Of course, this all is not to say you shouldn’t get the t:slim if you want it – there have been plenty of people who have used this pump since it came out without issue. I seem to be one of the lucky few who has had problems with it. Not every pump works for everyone, and you can’t go off of one person’s experience to assume what yours will be. 

And I know this is already a long post, but I want to give a shout-out to my Medtronic rep if he’s reading. He’s been so supportive of me through the past 4 years – no matter how many times I would switch pumps and go back to my Medtronic one, he was always there to help with whatever I needed. I can honestly say that I have never had a rep from any company be as good to me as he has, and I really appreciate that. So, a huge “Thank you” to Travis, especially this time for taking out a few moments on your day off (and on your way hunting, no less!!) to bring me a few sets that I needed until my order comes – you’re an awesome guy.

On Monday, we launched a giveaway from PumpPeelz for the new t:slim Screen Protector/Peelz.

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Five lucky winners would be chosen from the comments that were left on the blog post and that time has come. So, without further ado, here they are:

#1 giveaway winner 1 giveaway winner 1 - Shannon

 

#2

giveaway winner 2 giveaway winner 2 - Susan

 

#3

giveaway winner 3 giveaway winner 3 - Alyra

 

#4

giveaway winner 4 giveaway winner 4 - Amy

 

#5

giveaway winner 5 giveaway winner 5 - Melissa

 

Congratulations to the winners of the giveaway!! You guys will be receiving an email from me later today.

And for everyone else, Scott and Emily have decided to allow me to give a discount code to the rest of you. During checkout, use Sugabetic10 to get a 10% discount off of your order! Yay!

Thank you all for helping to make this launch a hugh success!

I’ve been working with Emily and Scott over at Pump Peelz to try to create a way to make Pump Peelz for the Tandem t:slim. I already knew I loved their Dexcom Peelz as well as the ones for the Verio meter, so being able to add even more personalization to my insulin pump? Well, that would just be the icing on the cake to me.

A couple of weeks ago, they sent me a prototype to try out. I was ecstatic. I knew it was a potential product for them, but to actually get to try one out and see it in person was pretty awesome.

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What was even more cool about them is that they are actually screen protectors and designs in one. Yep. That’s right. Since the t:slim is a touch-screen pump, you do need to try to have something on the screen to protect it against scratches and things that can interfere with the touch sensitivity of the pump. With having the ink printed directly onto the screen protector, this allows you to actually change the screen protector and not have to layer a peel on top of your existing one thus probably losing it if you ever wanted to change the design again. (And, if your screen protector that you have on it now is in good condition, you can also carefully remove it and simply save it on a piece of wax paper or baking parchment paper for later if you’d like).

The ink and process that is used to make the designs is actually pretty neat. These are printed in layers with a 3D printer – one of very few in the country. They start out printing the white, then add the other colors on top. It’s done similar to how 3D printers print Braille.

The fit wasn’t exactly perfect in the beginning,

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but we took some additional measurements and we think we’ve got it right now.

Yesterday, they announced on their Pump Peelz Facebook page that they are ready to go, and I am excited to share this with you.

And, courtesy of Pump Peelz, I am also going to be hosting a give-away fro them! FIVE randomly chosen (with a number generator) commenters can win a Tandem t:slim screen protector Peelz! Just leave a comment below to enter. That’s it! We’ll let you know by Friday who the winners are.

Happy t:slimming! :D

In my last post, I talked about the possibility of maybe filling one of my pump’s insulin cartridges and simply changing my site mid-use. Doing this would save how much insulin I waste both in tubing and in that “cushion” of insulin that Tandem’s t:slim pump has since I’d only be throwing those out every 6 days verses every 3.

So, I started my experiment last week. I filled my cartridge up, hooked up, and hoped for the best.

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After 3 days, I got the alert to change my site. By this time, I was down to 155u, so I was right on track for the mid-6 day site change-out.

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Now, last night was the time when I get nervous because a) it was night time and b) I had 18u of insulin left. Looking at my pump though, I used only .9u per hour during the night, so I would have had enough to get through until morning. So, I got my little change-out bag together with my site, tubing, cartridge and filled the syringe and had it all ready to go.

I got to work and after bolusing for breakfast, my pump was down to 2u. By 10am, I looked and it said “1u”, but I knew it would alarm empty soon…

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And then it did…

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So. After 6.5 days, I was ready to change out again. Best part was, I didn’t have any decrease in glucose control throughout the whole process. Granted, once warmer days get here, I may need to go back to changing everything out every 3 days, but at least during the cooler months I know I can do this as an option.

(*read: do not take this as medical advice for yourself. this is simply stating what I have done and in no way implies you should do the same. always consult your health care professional before doing anything different from your current treatment plan.*)

Now, on to find an angled site I can use higher on my belly or on my love-handle area since this growing little baby is now starting to use my mid-section for a temporary home. :)