The Real Reason

IMG_5108Earlier last month month, I learned that my Animas Ping was actually not under warranty until July of 2014, but rather the warranty had already run out. And as much as I love the system, I don’t feel comfortable wearing it all of the time because I don’t want something to happen to it and I’m out a good back-up/as-needed insulin pump with no way to replace it other than pay for a new one. Animas did just replace it in November, so it should be okay, but I just don’t want to take the risk right now. And without going through a whole appeal with doctors note thing and possibly having a denial anyway, there’s no way I’ll get one for another 3 1/2 years thanks to my decision to get the t:slim back in December.

I have a confession to make.

I really only had two reasons why I went back to the Ping anyway. One, after going to the Diabetes Sisters event, I felt that since I didn’t have tubing or a pump clipped to my belt, that my “calling-card” was not there. That I was a non-diabetic in a place full of diabetics showing off their bionic parts. After so long of trying to hide tubing from the outside world and not show off that I wear a pump or that I have something attached to me, the one time I wanted it was then because it’s almost an instantaneous kindred-ship when you and another d-person are brought together to talk because they see your tubing, you see theirs, and there’s just that mutual “fellow pumper” feeling. STUPID, I know. {You’re probably sitting back thinking, Yep, this girl is uber-crazy. RUN!}

The final straw as to why I switched back to the Ping to begin with was because I had gone to a party and left my PDM at home with no way to bolus. Silly, I know, but I was so embarrased by it. I felt as if I had let myself down. I felt more like a diabetic then than I had ever felt because I honestly, at that time, couldn’t participate in enjoying the food because I wouldn’t be able to bolus for it. I felt so angry at myself for leaving the PDM at home and putting myself in that situation that I said I wouldn’t be stuck like that again, and that I would use the Ping since, if I left the remote at home, I could at least bolus from the pump itself.

But, in light of finding out I have no warranty on it and with summer being here (POOL TIME!!!), I put on my Omnipod system again. I wrote about it a couple of weeks ago and how much I loved wearing summer dresses again freely. And I have enjoyed it so much. I’ve also enjoyed painting the pods to look “pretty”. It’s also much easier to deal with than having a pump clipped to me and worrying if my kidlet is going to play with the buttons. As much as I’ve always said I feel safer with the tubes, this time, I actually don’t mind it. After listening to someone’s suggestion about pinching up in an area I usually have trouble with when it’s inserted, I’ve not really had any issues. I honestly – from the bottom of my heart – can’t find a reason as of right now to not use it. Not to mention, my bg’s have been SO much better since using it.

I’ll probably still switch off later {knowing me, anyway}, but as for the summer, it would probably be best to use the Omnipod with as much water as I’ll be around. I don’t want to miss a crack or something in the Ping and ruin it.

 

My Pros and Cons of the t:Slim

I’ve been reading and studying my reports and it seems that I only needed to adjust insulin-to-carb ratios for my day-to-day issues. And, while I’m thankful that Tandem has the ability to show me things I need in their reports like Insulin-On-Board action and all, the system is really messed up for me right now. I’ve asked that my pump be replaced to see if that’s the issue (which I strongly feel that it is), but they won’t yet, so I hooked back up to my Ping. I know having a pump is a big deal, but for me I’ve grown to know how to read and interpret my reports to make my therapy decisions, and so I rely heavily on their accuracy of data recording.

As much as I want to really like and even love the t:slim, I just can’t right now. They have a lot of things to work on and improve first. That doesn’t mean I want to abandon it – because I don’t – but I’m tired of running up against something else every week or so that I don’t like. So, for pros and cons sake ( I guess this was a long time coming), here’s my list view for the t:slim (remember, I’m not comparing it to any other pump – I’m looking at it for what it’s features are):

Pros:

  • Touch screen – super easy for fast operation of the pump
  • Small – It’s so much easier to hide when it’s “naked” and not in a case than any other tubed pump I’ve used.
  • Customizabe – You can have it be as simple or as complicated as you need to be, with personal profiles that can just be duplicated to start a new one and make small changes without having to start from scratch.
  • Chargeable – No battery needed. Just plug it in.
  • Future – It was the pump used for the Artificial Pancreas trial, so that makes me hopeful. I’ve also seen a screenshot of what it would look like with Dexcom integration, and that is SUPER cool.
  • Software – When t:connect worked right for me, it was awesome. It was sleek, cool, and very VERY informative.
  • Reservoir Size – while I wouldn’t use 300u in a 3-day span, I know others who do, so it’s good to have that option out there. Besides, I’ve been able to get a good 6 days out of one cartridge fill that way. 😉
  • The screen has an instant view of most everything I need. IOB, Insulin remaining, Date/time, and battery charge.

 

Cons:

  • Logging – If you enter a carb entry into the BG section by accident in the pump, even when you press “back”, it’s saved as a BG. There have been many times I’ve done this, so my report thinks my lowsest BG is 16, when it should have been 16g of carb. And there’s no way to delete it.
  • Software – It’s on the fritz for a lot of us. For some, it works fine, for others, it doesn’t. I was one who it worked great for.. and then it went screwy after I put the pump into sleep mode. Now, all of my bg readings are entered as-is, but all bolus and carb information is recorded in quadruplicate. (Is that a word? It just looks so weird!)
  • The clips – Oh the clips. I still cannot figure out why it seems the clip is in the middle of the case. One of the things Tandem spoke about as to why the connector is not on the side of the pump but rather in the “pig tail” is because people complained that they hated the “stump” connectors on their pumps…. well, now, with the t:clip, the whole end of the pump stands just as far above the belt as the other pump “stumps”, so it seems a bit redundant…. and irritating. And good luck getting them to clip firmly to anything but a belt too. My pump has fallen off or on the verge of it so many times because of the way the clip is designed.
  • No prefillable cartridge – Let me explain this one. Yes, the pump has a cartridge, but it’s a bag that’s inside of a plastic piece that’s snapped onto the pump that you inject the insulin into. I have no way to check for air bubbles other than making sure there aren’t any in the fill syringe…. and this just throws my OCD all out of whack. I like to see that before I place a cartridge into a pump that there are no air bubbles. Granted, the system is supposed to have some mechanism that pushes air out, but still… like I said… OCD-brain. I mean, who all of you have gone and filled a cartridge, and emptied it back into the insulin bottle just to get rid of a bubble hanging around the plunger and not seen all of the micro-bubbles that come back into the mix???
  • (Currently) No reverse-correction for lows – this is not news if you’ve been reading my blog, so I won’t go over it again.

 

And these are just me, but I’m freaked out by the screen. I feel like I have to baby it. I’m scared the pump will drop and it will shatter (as I’ve seen other’s do). Also, did you know that you are not supposed to have the screen pointed towards you when you clip it in or place it in your pocket (or wherever)? Yeah. So, I’ve almost always put my pump inside of my pocket and clipped it there, screen facing my leg… and it bugs the ever-living crap out of me that I can’t with the t:slim. (Well, I’m sure you can, but the book says youre  not supposed to so… I guess if you accidentally bolus yourself it’s your fault for having the pump clipped towards you and not away.)

All of these won’t fit everyone. Some people may see my cons and not think they really are cons for them. And that’s cool. While I think the t:Slim is awesome and the iPhone of insulin pumps, I also feel like I have to baby it somewhat. I’m sure I don’t and it’s just my paranoia, but I’m constantly in preparation for the OHSHIP moment when this pump could go on the fritz or I get clumsy and I do something that renders it useless. Yep, total paranoia that I know probably isn’t warranted, but even still… I’m just freaked out by it and not comfortable. As cool as it is, it’s not an iPhone that if I drop mine and destroy it, I can order another one on eBay to replace it for a couple hundred bucks.

Where am I going with this? I don’t know… by now it’s a complete ramble. So I’m ending this post…as I’m sure it’s not helping anyone at all.

Mush and a Promise

There are times when I just shouldn’t be left alone to think. And it’s not that I have too much time to think, it’s just that once I start thinking about certain things, like insulin pumps, my mind is completely consumed by each one’s pros and cons and which one I like better or which one I think would work for me better.

Over the past, well, almost year, I have been doing too much “pros and cons” thinking instead of just stepping back and looking at the picture overall. Instead of comparing how they fit me, I’ve been comparing them against each other. So, after long thinking and irritating the life out of my friends, I’m lightening up the load.

I’ve called Accu-chek about the Spirit pump I had (out of warranty), and they are sending for it so they can dispose of it properly, and a few friends have claimed the other systems (the MM Revel and older, bigger pod system) I had after offering them on Facebook. I feel so guilty having what I do when others out there need pumps but maybe can’t get them or only have one and have no backup system.

So, that will leave me with the t:slim in the arsenal of pumps that would just be sitting around. I’m working with Tandem now to see if I can get approval to return it. It’s a long shot, but we’ll see how it goes. With no promise of when the update will be released to fix the issue of safety I have it it, I just don’t want it sitting on a shelf for possible use. I’ve also given out the accessories that I bought to go with it, so I’m down to what it came with.

That will leave me with the Animas Ping and the Omnipod (gen 2) system. Both of these work well with me and my needs, and I don’t mind trading off every now and then. The Ping will be good for if I want to rotate leg sites because I just can’t get good absorption with the pods there. It will give a break to my stomach and sides from using the pods. I think the benefits of the upgraded pod system are wonderful, and being tubeless is a definite plus, though it still gives me the hebegeebies. And, if I know we have something big coming up, like, say, beach vacation, I can take either system and not worry at all about the water.

So, with all of that being said, I leave you all with this promise… which I have signed:

pump promise

And I have Erik and Cherise to hold me to this. If I don’t, they have permission to go bat-snap crazy on me and take any and all pumps away from me and make me deal strictly with insulin pens. That, in itself, is enough to make me want to not say another word.

I’m confident in the fact that I do not want to give up my Dexcom for another brand nor do I want to switch insulin brands again.. now I need to be confident in my choice of insulin delivery and get over it and move on.

The First Week With The Revel

I’ve now had a week to play around with my new Revel pump and I thought I’d write a post about my likes and dislikes of the system so far.

First of all, the main thing I love is the CGM being integrated. No more need to have two devices hooked to me. Granted, I know that they will not be the only pump company on the market for long (thank you, Animas!) to have this feature, but having had it for the past week, I have to say, it is heaven to have just one device. And yes, I know that even with having a CGM is a blessing, so I am not trying to cut down or say that having a separate CGM device is not worth it – it totally is, but having it integrated is awesome.

Now, one thing that the system does not have that the OmniPod and Animas Ping has is remote bolus from the meter. This is a good feature for parents or ladies who wear dresses or men who hide their pumps in places out of sight and don’t want to take it out to bolus. But for me, I was so used to having the “traditional” pump when I had the Disetronic H-Tron Plus, that I guess old habits die hard. Even with the OmniPod and Ping, I would hold the remote in my hand while it delivered a bolus just to make sure it was delivering. And even with the Ping, at times I would just bolus from the pump because it was what I was used to. So having to bolus from the Revel isn’t that big of a deal to me. But I do see where it could be an issue for some.

But in speaking of bolusing, it does have on of the best bolus calculation + delivery systems I have used. I like that when I check my bg with my meter, it is “beamed” over to the pump, and from there you just press “act”, enter your carbs, press “act” again, it does it’s calculations for you to review, and you press “act” to deliver the suggested bolus. What’s different here between the Ping in particular is that with the Ping, it gives you the suggested bolus amount, but you still have to dial in the bolus to match the suggested amount. With the Revel, it’s already there, you just have to confirm it. Then, when it’s being delivered, it shows you as it counts up to the bolus amount. Granted, it delivers slowly, but I found out while I was on the Ping that I did better with a slower delivery. I’m assuming it helps the insulin not pool beneath the skin as much.

revel alarmOne feature that the pump has over the Guardian CGM is that when you are low, instead of just flashing on the screen “Low BG”, it shows you the glucose level. I would have liked to have that feature on the Guardian while I was using it. But, that’s neither here nor there. Either way, you still have to escape out of the screen, otherwise it alarms constantly to let you know until you acknowledge it.

Which brings me to my main gripe about the system – both the Guardian and the Revel. Unlike the Dexcom, when it alarms, it gives you a few minutes to be able to dismiss it. With this system, it seems to alarm every 30 seconds until you dismiss it. Which I’m sure this is a good feature for some, but for me, it seems to always be right as I’m sitting down with BabyK to feed him or rock him to sleep. And it just so happens to be in the pocket that’s inaccessible at the time, so it vibrates and vibrates and vibrates until eventually it does it’s own “baby cry” (you know, the one where when the baby thinks you’re ignoring it’s initial cries so it amps it up a bit and screams bloody murder at you to get your attention? yeah, that one…) and you have to dismiss it. That is the one reason why when I go to church, I will be putting the alarms on silent for those two hours. Can you imagine? Like Kerri’s “disco boob” encounter, I’d be having a “disco boob” or “disco hip” move of my own during prayer or something.

The system setup is pretty well the same. You have the cartridge, tubing and site. And, for the most part, these are no different than any other system, accept they have their own connections verses the standard Luer Lock connection of the Accu-chek Spirit and Animas systems. But one advantage they do have is their cartridge. The trainer told me that with the way theirs is made, if you were to be stranded without supplies and need to give a shot, the cartridge acts sort of like a vial of insulin and it self-sealed at the top. So, if you have a syringe with you, you can actually draw the insulin you need out into the syringe and just give yourself a shot for what you need until you can fix whatever you need to with your pump (whether it’s gone bezerk or if your battery has died, that kind of thing). That’s pretty cool if you ask me!

All in all, I do like the system a lot. I’m not going to say that I’m in love with it completely, but I do admire lots of the functions it has. I will have to say though that even though Medtronic is supposedly coming out with a better, more accurate sensor that lasts longer and all of that jazz, they still may be one step behind the ball game when the Animas Vibe is allowed here in the US. Why? Waterproof capabilities! That will be the biggest clincher that Animas will have over Minimed from what I can tell. So I hope they come up with a pump that’s waterproof along with a better, longer lasting sensor with the next “edition” of the Minimed Paradigm.

Thinking Animas Vibe

Granted, I know we’re a while away from this being available to us in the US, last night I went over and over the product information given to me on the Animas Vibe.

One biggie that most people are looking at is the remote-bolus feature that the current Animas Ping has. While this is a great feature, especially for us women who keep the pump nestled in places that shouldn’t be reached into in public, it’s not perfect. I have had many times where my meter and pump will be well within range and a bolus will cancel. So, for the most part, I hold the meter-remote and watch until the bolus finishes anyway, which kind of defeats the purpose. Also, using the meter-remote locks you into using that meter if you use it for everything.

With the new Animas Vibe system, though it will be lacking the remote bolus feature, I don’t see it as that big of a deal. Yes, it would put me back to having to make sure my pump is either accessible in public or inconvenience me to have to excuse myself to the restroom or nearest closet to bolus, but that’s not any different than if I were on the MiniMed Revel or Accu-Chek Spirit. Omnipod will always trump at this feature since EVERYTHING is controlled by the PDM. BUT one thing that will be an advantage over the Omnipod, yet simiar to the MM Revel and AC Spirit would be fact that you can use any meter. You’re not locked in. (Which, technically, you’re not locked in now if you have the Animas Ping, you can still check bgs with any other meter and use the reading to plug into your pump’s bolus calculator for BG or Carb boluses, but why would you if you have a remote meter??) You can choose whatever meter, brand, etc, you want to. Before switching to my Ping, I was a Freestyle meter girl. And I’d like to have the option, if I wanted to, to go back to their product.  Smaller meter, smaller blood sample, and just as much accuracy… why not?

I do love that the Vibe will have a color screen, like the Ping does now, and from one of the videos I saw, the screen functions will work in a very similar manner (menus, etc). Of course, I can’t speak too much of that since we don’t have a live demo video to watch yet, but I don’t think it will be that much different other than the additional screens for CGM use. I’m just hoping that we will still have the option like we have on the Dexcom now to see 1/3/6/12/24 hr views in the window and not just a 3 hr view. I would be disheartened to lose that function. How else will I be able to see if I have a possible “no-hitter” on my hands??

And WATERPROOF! Yes, the Ping is currently waterproof now, but that is a big thing when it comes to the CGM part. Right now, I’m scared to death every time I go to the restroom that my beloved Dexcom receiver will drop out of my pocket and into the toilet and, since my warranty is out, I’ll have to pay lots of money for a new one. And right now, money is tight with BabyK on the way. Not to mention I cannot bear the thought of not having my CGM while pregnant even for an overnight replacement. This thing has been a HUGE help!

From what I can see, the same colors that are available for the Ping will be available for the Vibe:

49461-hi-Family

As for me, though I love my green Ping, I reeeeaaally want a pink one… so if and when the upgrade is available, I’m going PINK! (Even though I had reeallly hoped there would be a purple one in the new line up. Oh well.)

The size of the Vibe also looks to be the same as the Ping model as well, so maybe (hopefully) the Ping skins will fit, as well as the cartridges, but I have no confirmation of that, so don’t quote me or hold me to it just yet.

Either way, looks and remote-bolusness aside, I’m still holding out for the Vibe and praying that it will be approved sooner rather than later here in the US. Just the thought of having a CGM+Pump combo is amazing, and I can’t imagine loving it any more than I already love my Ping, but I’m sure I will.

So, thank you, Animas, for working so very hard to have the best available to us. You guys rock.