It’s been almost a month since I posted. It’s crazy to think it’s been that long but at the same time, in my head, that was just last week. So much has been going on and I’ve basically just been concentrating on life than my blog, and I’m learning that that’s okay. I’ve been contemplating what to do about the situation… should I try to blog more? On a scheduled basis? But I’ve realized that I’m not a person who blogs based on schedules or requirements – I blog when I feel I have something to say or news to share. And, it may be that after 5 1/2 years that it may be time to slow down a bit. After all, I’m no person of authority or status to be sharing as if what I have to say or think is important – I just blog to blog. To get things out of my head. And I’m coming to grips with a lot of things lately in relation to diabetes and life, and diabetes blogging lately hasn’t made the top of the list…. it’s barely on the list, really.

Anyway, the updates I have are simply going to be bullet point style, because, honestly, there are a few topics that I’m just going to spit out randomly.

  • At the beginning of the month, I had a viral infection in my throat called “herpangina”. It’s the cousin to Hand, Foot, Mouth disease because both are caused by the same virus just different variations. It was painful, and I’m still – two weeks later – dealing with one big sore left in the back of my throat that’s taking a while to heal. The pain was awful in the beginning – and I could not eat anything that wasn’t a milkshake. 10665183_699683870117237_2650253020165325563_nNot even soup because it was too spicy (yes, soup!) and set me on fire. I sneezed at one point and thought my entire throat was going to come out. VERY very painful. I finally went to the doctor because I thought it may have been strep – but nope. He knew I was in a lot of pain, so he gave me a low-dose of prednisone to help the healing process. And, thankfully, the pain started to dull by that afternoon.
  • Speaking of prednisone, I now understand why doctors are cautious of giving diabetics steroids. Within 1 hour, my glucose readings went through the roof. But, the pain was easing, so I didn’t care. I raised my high threshold on my Dexcom, called my endo and asked how to handle the difference in BG’s (because, honestly, I didn’t feel like trying to troubleshoot on my own. I’m thankful to have a very good endo who has my back whenever I need him).
  • The prednisone gave me a new perspective on insulin resistance that was similar to how things were in my third trimester of my pregnancy, but without the worry of harming my unborn child. Seeing how I could go from a 1:8 carb ratio to one of 1:4 within 1 day and then have to remember that, yes, being off by just 2g of carb really COULD make a difference in my glucose later… yeah… it was nerve wracking, but so very cool at the same time. It was a learning experience, and one that made me feel even more compassion to those who deal with insulin resistance every day.
  • School is back in session, so my past weekend’s break was nice. And my BG’s were easier to control, so it made me realize just how stressed I’m staying while in school, and it makes graduating in May look that much better.
  • I finally have a treadmill. My husband promised we could get one for our anniversary, so we scouted and looked and finally came across one that was half-off and more within our budget range. It’s not a top-of-the-line gym model, but it will do for what we need, and for what we paid for it – I would have paid a 1-year gym membership, so we broke even there but the biggest advantage is that I can use it at home whenever I want/need to.
  • 1899983_705997876152503_6975308679029554123_nOn the topic of my t:slim and the Accu-chek Ultraflex infusion sets – I have been doing so much better with those verses the Insets that I loved so dearly. I have no idea for the reason, all I know is that it works. So, even though I don’t’ have the cool colors to choose from, I’m happy because I have been able to use my t:slim without issue.
  • And, lastly, my eyes. I went for my checkup about the swelling/edema from the macroaneurysm earlier this year and all of the swelling and fluid has resolved and my vision has gone back to normal in that eye. I do have some “hard exudates” (collections of cholesterol/fat stuff from the fluid) left, but he said those would resolve on their own, but much slower. I do have a few places that need to be watched just from simply having diabetes for almost 26 years, so I’ll continue to see him every 6 months from now on.

That’s about it.. Wraps everything up. I’m not sure how often I’ll be posting until the end of this month but I’ll be sure to try to post more next month since, you know, it’s National Diabetes Awareness Month and all :)

 

Also, starting on the 20th (that’s this coming Monday), the Big Blue Test restarts the counter for this year’s Big Blue Test challenge. Click HERE to find out more about it!!!

My last post talked about how I dream that the t:clip would be.. and I still do. However, I took a big leap and simply ditched it…. and attached the Hip Clip directly to my t:slim.

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It wasn’t an easy choice to make since I absolutely LOVE having the colors of the t:clips that I do and having the ability to mix and match them. The problem with affixing the clip directly to the pump is that you lose the ability to use the t:clips.. thus no fun colors. BUT, what I didn’t expect is how much it seems to lighten the pump… and makes it feel as if I’m not even wearing it.

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It honestly makes the pump seem so much thinner. 6XTGyHoc5wk3D9mp.jpg

I mean, yeah, it’s the same size it’s always been, but having mine stuck in the “otterbox” of cases it seems almost invigorating and new to see how thin it is… dare I say… sexy even. (Cause, yeah, pumps can TOTALLY be sexy… )

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I haven’t had any issues with the clip seeming to come off or anything. The clip comes with 3M bonding tape pre-attached, and you can get more from the hardware store or walmart if needed. We happened to have some, so after I took the clip off of the plastic t:slider, I needed to re-tape… which involved Unisolve wipes to remove the old bits of tape from the Hip Clip before I could attach more to it. The problem with having it attached to the t:slider case was that the case had a matte-feeling finish on it, so the clip didn’t’ seem to want to stay permanently. You might could sand it before attaching it, but I didn’t take anymore time with it after I attached the Hip Clip directly to the pump. I love it. It feels more like the clip on the Animas Ping did… and I LOOOOVEEEDD how it clipped.

The only thing is that the clip doesn’t seem as tightly tensioned as the Ping on did, so if you’re very active with it, it *may* come unclipped… but the you wouldn’t have even needed to be slightly active with the t:clip or even bend over wrong and it would fall over or something. That’s what irritated me – it was SO floppy. The Hip Clip doesn’t really let it “flop”.

Right now, I’m in love. I haven’t really missed my t:clips, just the bit of color they provided.

 

I have been thankful to Tandem for coming out with the t:clip so soon after launching their t:slim pump and hearing the complaints of the t:case and t:slider being so bulky. While I’m sure some didn’t mind it, a lot did and they listened.. and I’m glad. I am the proud owner of 9 t:clips (I think?) and still want yet one more… the orange.

But one thing I wish they would fix is how far the clip sticks off of the case. I’ve written about this before, but the design of the clip adds bulk to the pump that I wish weren’t there. After all, one of the attractive features of the pump itself is just how slim it actually is.. and the t:clip takes away from that. Not just that, but it’s not particularly a sturdy clip.

I had an idea from something someone posted on a forum. They linked the Hip Clip and told what they did with it. I’m going to buy another one just for my Dexcom either way, but I bought one this week to try a little experiment. I took the t:case that came initially with the pump (basically the t:clip without the clip part), cleaned it, and stuck the Hip Clip to the back of it. The instructions are to leave it for 72 hours to strengthen the bond between it and the clip’s industrial tape.

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I like the clip a lot, and I hope it sticks well. (If not, I’m going to try to glue it to the case) It was thin. It felt very similar to how my Animas pump felt… secure. Very secure.

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It didn’t feel like the clip top was going to poke me (because, technically, it’s not there to do it…) It felt like the pump was thinner too.

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The way the tape was placed on the clip from the factory allowed it to stick just a bit above the connection between the two pieces, allowing it to sit lower on the waistline was well.

My wish would be to see a revised t:clip with this type of clip. A thin, slide-on piece without that irritating belt wrap thing at the bottom.  Even if they still offered the current one and maybe came up with a new name with this one. Maybe t:clip slim or t:clip2 or make this one the t:slider since technically it would slide onto a garment.

 

Please, Tandem.. Consider this as your design for the clips. It keeps the sleek, thinness of the pump, which is, after all, why you named it the t:slim, right?

;)

Scott commented on my last blog post about the size difference that the Accu-chek Ultraflex seemed to have over the Unomedical Mio/Inset. So, I thought it would be a good opportunity to take a few photos and show you a couple of differences:

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This one, obviously, is a side-by-side view of the Inset verses the Ultraflex. It’s actually about the same in height. One thing about the Ultraflex is that it clips in more securely than the Inset does, and I’m thinking it may be due to the way the Ultraflex also clips, or slides, into a middle “stub”, rather than just two thin clips in the middle. The only difference is that place where the cannula is has a bit more tape in front of it….

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as you can see here. I’m not quite sure why this is, but it’s there. Not something I’m fond of, but it’s minor in my opinion, and something that could be cut if desired before inserting (something that can’t be done with the Inset).

 

One thing I was interested in seeing myself is just how different the cannula lengths are. Surely 6mm couldn’t’ be that much different from 9mm and having 8mm be only 1mm shorter than 9mm couldn’t make that much difference… or could it?

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Apparently it does. It seems to fall smack-dab in the middle of the two lengths, which is just what I needed. Lord knows I’d hate to see how long the 10mm of the Accu-chek one would look!

This was rather interesting to me, so a big thank you to Scott for your comment! :D

It’s been almost 2 weeks since I started trying the Accu-Chek UltraFlex infusion set based on a recomendation from my distributor after some unexplained issues with pumping. I still can’t pinpoint what’s going on really, but the problems seem to be somewhat solved, somewhat not. But, I’m not going to bore you with that, and I’ll just get on with the infusion set itself.

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The Accu-Chek UltraFlex is made for and distributed from Roche – the makers of the Accu-Chek Spirit and Combo insulin pumps as well as the Nano, Aviva, and Active meters (I’m sure there are others, but those are the one’s I remember). Also, they are the maker of my BELOVED FastClix lancet device. If there is ONE thing they know how to do, it’s make an awesome finger poker. And now, I’m beginning to feel the same of their infusion set… mainly because of the inserter.

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There’s nothing really special about their infusion set when compared to others like the Inset or QuickSet. It is also a 90 degree Teflon cannula, so no bells and whistles there. Their connector is a bit different, but again, no real difference can be seen with that one either. So what’s the big deal?

Two things: There are 3 different cannula lengths available, something the other’s don’t offer, and the way the inserter works.

With most all of the other types of straight cannulas, you have an option of only 6mm depth and 9mm depth. While this may be okay for most, these give a slightly wider variance in that you can get a 6mm, 8mm, or 10 mm. For me, this has been perfect simply because with the Inset, I’ve always felt the 6 was too short while the 9 seemed to feel as if it were “brushing” nerves or muscle tissue (I know, gross). So far, I haven’t had that issue with the UltraFlex sets.

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Next, is the inserter. This is where I honestly feel this device is truly set apart from the others. Rather than cocking the device and then having it press the infusion set in as it’s deployed, it simply spring-forced rapid-fires the infusion set into you. There’s no pressing or jarring of the spring action against the set. It does the work of the quick-jab like you’re taught to do when giving an injection without the pressing action of the other spring-loaded mechanisms. After it’s inserted, all you have to do is be sure to press the tape down and connect. I’ve used it a few times now and it has lessened the pain that I usually feel when using a new set.

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Now, a third thing I would like to throw out there is the packaging. I do like that the way it is set up, in that the tubing is separate from the site itself, and there’s a cap that can be reused to cap over the needle to throw into the sharps bin. Everything else can be thrown away or put into recycling (I think).

I’ll miss my pretty pink Insets, but the tradeoff has been somewhat better control. Maybe I can color it with nail polish or something… :D

If you’d like to watch the video version of how to use the Accu-chek UltraLink and LinkAssist, I put one up on YouTube yesterday… or just watch here:

And just for kicks and giggles, here’s the insertion in slo-mo!

Last week, I vented blogged about some issues I had with the pump since the weather has gotten very warm and humid here. (READ: very humid… like, drenched-in-sweat-as-soon-as-you-walk-out-0f-the-door humid.)  I called Tandem and they went through some trouble-shooting things with me to be sure the pump was working correctly (passed!) and we tried to troubleshoot some other things like sites and tubing problems. Since the pump had seemed to work fine, it had to be one of those things. After going through checking a few things there and even changing out my tubing and site, we sort of put a pause button on the conversation for an hour or so when she said she would call me back to check on me.

I also got a call from a very nice guy (Hi Chris!!) in the support side of Tandem later because he had read my blog and wanted to help as well. I have to say, that was really nice of Tandem to do that and to try so hard to help. He went over a lot of things with me and put my mind at ease about my concern that it was the heat/humidity factor causing the pump to fail. We went over things like insulin storage, checking the Luer Lock, checking the site itself for leakage or insulin smell… I really liked that it felt like a team-effort to troubleshoot and not a “our pump is superior, how dare you think there’s something wrong with it” session that I’ve had from some other device makers.

I also called my local distributor and ran the possibility of a site issue by a lady there and she suggested using a different type as well as they’ve had some customers with problems with Insets before. So, she sent me a couple of sample packs of Accu-Chek’s UltraFlex sets.

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I got the box on Saturday and changed out my pump (again). I’ve been using this set since then without any problem at all. I’ll post more later about the actual set, but this may actually be a resolution to the problem. Then again, we’ve not had really hot weather over the weekend and it’s pouring rain today and not terribly hot either, so we’ll see over time. I have three of these left, so I can get a good sense of whether to switch to them or not when it comes time to order again.

Crossing my fingers that this fixes everything and I can continue to use the t:slim… because as crazy as it sounds, I love that little thing.

 

In efforts to try whatever I can to figure this whole t:slim/dog-days-of-summer battle that seems to be going on with me, I’m trying to think outside of the box… or outside of the t:slim, that is.

Last night, I watched as I tried different amounts of bolus deliveries pump through the tubing and onto a piece of tissue paper. Trying to be sure that every bit came through without any pauses or spurts – just what would seem to be normal delivery for the t:slim’s delivery method. It all seemed to be fine. Nothing that would seem to have put me on the roller-coaster I was on at the end of last week.

So, what could be a difference between summer and winter other than heat? Sweat. Maybe… even though I’m cleaning the sites before placing them, maybe there’s too much skin oils that come up during the course of wear that possibly loosen the tape a bit… running with this idea, I cleaned the site very well with alcohol and then applied a good layer of SkinTac before placing a new site – a QuickSet (luer-lock style) instead of an Inset.

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It hurt like a good sting for a while simply because I didn’t have my Quickset Serter device.

So, here’s to hoping maybe it’s a set issue and maybe the only “fix” that is needed is to wear a different type of set during the summer – which would be fine. Better than having my endo or CDE give me looks for switching pumps.

It was about this time last year that I started having issues with my t:slim pump. The constant highs, the constant cartridge changes, you name it. I couldn’t get off of the roller-coaster that seemed to be happening. I eventually had enough of it and went on shots until I could get supplies for one of my backup pumps. It was so weird how just changing off and going to another pump seemed to fix everything.

Then came the cartridge recall in January and in February, I gave the t:slim another try with the new cartridges. I thought – well, even though my cartridges were not listed as part of the recall, maybe that was the problem. So, I paid out-of-pocket for a box of cartridges directly from Tandem…. and the pump worked. I didn’t have any issues at all. In fact, I continued to use the pump with no problems at all…

Until last week.

The same thing was becoming an issue.. it would seem my insulin wouldn’t deliver at all then BOOM! I was low as if all of it finally made it through. I was on a roller coaster and my body was paying the price.

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All the while, I did have issues with the pump not reading the correct amount of insulin I had in the pump. Tandem was very good about sending out a new box which seemed to stop the madness of “missing” insulin (I would put in 200, it would read 60, etc.. not the normal 160 that it should read).  But the replaced cartridges didn’t fix the roller coaster of glucose readings I was having.

I decided not to even waste my time this time. I knew my basal rates were right, I knew I was watching my food intake and dosing correctly (as possible). Still. There was no reason to have happen what I did. I got the spare pump together and by the afternoon, I had leveled off. Later, when it came time to dose, my boluses were working like they should. All using the same type of set and general site area and basal/bolus/correction factors. The only difference was the pump.

So, I’m wondering. Could it be just something around the area that I live in? Could it be that the pump can’t handle the heat of the summer like my others can? Could it be that with the heat + humidity that the insulin isn’t as stable as long right now and degrades just a bit quicker thus causing problems that are too minor for the pump to detect?

I’m not angry about what’s going on. I am a bit upset because I do truly LOVE using the t:slim pump – I think it’s been one of the best I’ve used aside from this issue or phenomenon. I dunno. I’m at a loss. It’s really hard to not be heartbroken – which seems utterly stupid since it’s just a piece of medical machinery. But I just want it to work for me. I’m envious of those who have used it since it came on the market without issue. I’m discouraged. I try not to even get excited about the t:slim G4 that’s rumored to be out next year because if I can’t figure out what it is about August/September that throws me so off with the pump, I may not upgrade to it when the time comes.

Or maybe I can just use the time period of August – November as a break and just go to MDI for a while? To give my skin a break? Still, though, it doesn’t fix the issue…

All of these thoughts and feelings keep swirling in my head. I probably shouldn’t blog them out because I don’t’ want to discourage anyone from getting the t:slim simply because it is a remarkable pump and works very well for others, but I can’t keep this stuff in my head or I’ll go crazy. So I write. Which is why I blog anyway. So.. and I need to hush.

Thanks for reading.

Have a wonderful day.

Colors for advocacy have been around for a long time. There’s pink for Breast Cancer and yellow/gold for Childhood Cancer, and blue ribbons for thyroid disease and sooo so many others. Colors for ribbons and colors for shapes.

Diabetes, though, seems to have a lot of different variations of colors…

There’s the known Gray that was around for a while, but seemed too depressing, so a drop of red was added for the blood drop we have to use for testing.

DiabetesCirclesThen, there’s the gray AND blue ribbon with the red drop thought to symbolize type 1, which is a good idea, but there is no ribbon distinction for type 2 or LADA or gestational…

There’s the orange for women with diabetes.

There’s blue (dominating) with orange for the JDRF.

There’s orange (dominating) with blue for TCOYD.

Green bracelets at CWD/FFL are for those with Type1.

And, of course, the blue circle – as a symbol of hope and unity among all types.

While I understand having differentiating colors would help in a way to bring awareness to your specific type – Type 1, Type 2, LADA, gestational, etc – I believe that they all should have one common color – just as the blue circle has to unify us all. We all prick our fingers and fight the numbers that come back on the glucose meters and deal with the emotions and stigma that comes with any type of diabetes.

And what makes me upset the most? The ones who try to make sure that type 1 has it’s own distinction from type 2. Or vice-versa. To me, it has an underlying feeling of haughtiness and judgement toward the opposite type.

Blue is not the color for type 1 no more than blue is the color for type 2. It’s the color for all types. That’s why I support the BLUE as just that – not ever as for a single type. We still don’t know the origin of diabetes or if, in fact, Type 1 and Type 2 are from different causes. After all, this study sort of says that they may actually be caused by the same thing.. so wouldn’t that even defeat the purpose of having them named separately anyway… in which they’d all be just “diabetes”? With so many questions still surrounding what happens and origins and treatments, why should there be any separation at all?

Don’t get me wrong – understand the validation that may seem to come with having a specific symbol or color for your “type”, but if that is going to happen, it needs to be a way to separate yet include. It’s a difficult task. And maybe one that doesn’t even need to be taken – but there needs to be simplification. Even something as simple as the blue circle, but with T1 or T2 or LADA in the middle if you want, but not a whole different concept of the unity idea.

There’s too many colors and shapes for this one disease. I’m glad that the Blue Circle is beginning to become more widely recognized and that the color blue is becoming our cohesive color. I’ll proudly wear it for any type in support of the struggles we all face.