Always Double-Check Your Replacement Insulin Pump Settings!

I’ve had many replacement pumps in my years of pumping. To my recollection, I had:

  • 1 Disetronic replacement
  • 1 Accu-chek Spirit replacement
  • 1 Animas Ping replacement
  • 2 Medtronic Revel replacements
  • 5 or 6 Tandem t:slim replacements
  • and now, I’m on my second Medtronic 630G replacement.

So, as it should seem, I’m pretty well-versed at what to do. You know, upload the old pump if possible to save all of the history and settings. Once you have the replacement in-hand, go through the process of setting up the pump using that data you uploaded. However, I’m not usually one to look at the upload because my settings are simple and straightforward.

And, until this week, I have never missed a setting.

Rewind to Tuesday. I had missed the initial delivery of the 630G pump replacement because I had to take my daughter to her check up (which had gone well). I rushed to try to make it home so to avoid another hour-long trip to go pick it up, but alas, I missed them. And, at the time, I didn’t think I would be home Wednesday at the time they were going to deliver it, so we made the trip to go get it. Which, we almost didn’t, because UPS had some sort of problem releasing my package and I came thiiiiiiis close to almost having had it sent back, even though it was sitting right there in front of me. But, in a miracle event, somehow the UPS clerk was able to get it to release and we went home.

It was late, so I went through the settings to get it started up. I was more worried about whether I could save my 2-day old sensor than anything, which where the problem came in at. I rushed through my settings, forgetting ONE very important one.

For the last few mornings, I’ve been waking up with very high blood sugars. Wednesday, I thought it was my panic attack over the low I had to which I ate way more than I should have, but forgot to correct for after I started coming up. So, I was almost 600 mg/dL when I awoke and sick as ever.

But I came down within a few hours with some rather large boluses. I thought that would be normal since once I’m over 250 mg/dL, I typically need to add more to the dose.

I had been staying a bit high through the day, but I had been stressed a lot lately, and drinking way more coffee than water, so I thought that must have been the trouble.

Wednesday night before bed, I was high, but again, not terribly, so I took a bolus and increased my basal rate.

Thursday morning, I was almost 400 when I woke up, despite an increased basal rate and a bolus around 4am.

My day went relatively the same as Wednesday. My son had his summer reading camp awards ceremony that morning, and when I got home, it was full-steam into work-mode, with lots of coffee and Diet Coke. I still thought it was strange I was struggling to bring down some highs, but I mean, it could be anything, right?

I could be getting sick… It could be about the time for a mid-cycle bump due to ovulation… It could be that I really need some water in my veins….soooo many things!

So, last night, before bed, I took a bolus yet again for an almost 300 high (we had also eaten canteloupe and watermelon a couple hours before) that I thought should have been down by then, and I set a 125% basal rate, and went to bed.

This morning, I woke up sick yet again, and clocked in at 398 mg/gL. So, I uploaded my pump to see if I could spot anything at all that could be the cause. Then, that’s when I saw it.

I had a 0u basal rate.

I NEVER SET THE DARN BASAL RATE!

Again, I have had wayyyy to many replacement pumps in my life, and settings are crucial to set right away. Basal is almost always my very first one to set. I have NO idea how that happened. I’m still kicking myself. I mean, it’s set for sure now, but HOW ON EARTH!??? DID I MISS THAT!? Also, hoooowwww could I not realize that before? I mean, does that mean I, indeed, have too high of an insulin-to-carb ratio? So. many. questions!

So the moral of this story, kids: always have a check list. Always go back in and review those settings. Don’t think because you’ve done it lots of times before, that you’re impervious to a mistake like this.

Which leads me to a pump manufacturer request: Please make a plug-and-program option into your pump software? That would make switching over so much easier, and reduce human error such as this! Please, thank you ūüôā

 

Our Decision to Switch to Medtronic Minimed 630G Insulin Pump – Part 1

A few months ago, I was at home with the kids, and didn’t feel quite right. After a quick fingerstick, I saw that I was in the 20’s. In a panic, I couldn’t get anyone on the phone to talk with me until my sugars came up. I began to “eat the kitchen”, as it were. I finally reached my sister-in-law, who came to sit with the kids until I could get back to myself again.

After that day, I was scared out of my mind to go below 100 if I was at home with the kids by myself. So, I started running my numbers higher — much higher than I’m comfortable with, and I knew I would be risking damage doing so.

That’s when I realized, Dexcom Share wasn’t enough. It’s great to be able to Share and have people call to check on you… but what if they can’t actually reach you? My son and daughter can’t use my iPhone just yet (he can’t remember my unlock code), and neither¬†know how to use a glucagon kit.

I looked into the Loop system, but honestly, while I love that everyone is so willing to jump on board, I’m not.¬†I’m not confident in my own abilities to make this thing happen since it’s something done from home. I don’t mind tinkering and playing with Nightscout because it’s not directly affecting my insulin dosing, whereas the Loop system does. That’s a-okay if you’re on it – I’m not trying to down the system or anything. I’m just not comfortable with the idea of using it myself.

So, we looked into Medtronic. I know. It’s known as the big evil empire of the insulin pump world. And, while I am interested in the 670G, I was more interested it the 630G since it suspends insulin if the user is low. I know this is the exact same technology as 530G, but somewhere along the way, they’ve improved the CGM technology. I kept reading about how sucky the 530G was but that the 630G was much better on different sites, like Instagram and TuDiabetes, and a few others. People who had absolutely zero success on the 530G were being impressed and excited about the 630G.

After a lot of debate and hemming and hawing about it, I decided to take the plunge. I was going to trade in my Tandem using the Switch-to-System program, but I couldn’t afford the $1249 out of pocket to do the switch. So, on a whim and a prayer, we submitted for insurance coverage. Backed with letters from myself and my doctor, along with pages of blood sugars showing the amount and severity of the lows I had been having, we held our breath and waited.

On the evening of 4/28/2017 just after 5pm, we got the approval from my insurance. And, on 5/1/2017, I began as a Medtronic pumper again.

Pump to MDI: Pleasantly Surprised

I know I haven’t written in quite a while, and mostly because¬†I haven’t had time. I’ve had plenty to say, though, trust me. So I’ll try to spare you and give you the Cliff’s Notes version of what’s been going on the last two months since starting on MDI (multiple daily injections).

IMG_4204When I came home from the beach that day, I had no idea how long I would actually take a pump break for. Usually, it would only be for the weekend… if that long. I always felt much safer using an insulin pump for reasons like temp basals and such.

But in addition to feeling safer, I felt unashamed. It’s crazy — me, the advocate for those who prefer MDI and wish to inject anywhere they want to — was suddenly the one who felt too self-conscious to dose in public. With an insulin pump, I didn’t care. No matter where it was stashed, I would pull, shake, or shimmy that bad boy out and bolus without batting an eye to see who may be staring. Now? I find myself injecting in the car before going into a restaurant… or ducking into the bathroom. ¬†In my mind, others are staring at me and judging me for taking my shot in public. I’m slowly getting out of this mindset though, and trying to move past it.

But, I’ve loved being tube-free. I went back on my pump last weekend because we were going to have pizza, which is something I have no idea how to dose for on MDI, and I wanted to be able to extend my bolus like I’ve always done. And, not wanting to waste the insulin, I stayed on the pump for 2 days before taking it off again. During which time, I constantly fumbled with where to put it and I almost ripped my site out practically every time I went to the restroom. It’s crazy how quickly I adjusted to being without an insulin pump. The freedom feels amazing.

My numbers aren’t worse on MDI as I expected either, but quite the contrary. My averages are roughly 10-15mg/dL lower than what they are on my insulin pump, to which I have been pleasantly surprised. I have no idea why there is a difference, but part of me wonders if actually injecting the insulin is better for my skin and metabolism verses an infusion.

IMG_4148Of course, it could be because of the awesomeness of the basal insulin that I’ve been using, Tresiba. I honestly love it. Out of all of the ones I’ve tried (Levemir, Toujeo, and Tresiba), it’s been the most steady, and as long as I bolus correctly for meals, my BG is not nearly as “swingy” as it is with other basal insulins. I don’t notice any peaks, and I can take it every 24 hours without worrying about it running out in my system.

Now, my pump warranty is up in 5 months. I’ve been on the fence about what to do — to get a new pump or simply keep going with MDI and use my current pump as a backup or if I wanted to switch over for a break or anything. Then comes the question of¬†which pump to go with… to stay with Tandem, or go back to Animas or Minimed, or go with Accu-chek since I love their Expert and Connect system. I mean, it’s a big decision. It’s one that I have to be confident that I’ll be happy I’ve made as I’ll have that pump for another 4 years.

Either way… I’m happy and comfortable currently with my MDI treatment. It’s going well, and for the first time, I don’t feel the urgency to run and put my pump back on. It’s almost like… freedom.

I Heart t:slim!

So, yesterday, I was able to see hands-on a demo t:slim insulin pump.  We went over the functions of the pump and how it works, and some of the cool features it has over other available pumps.

When the rep pulled it out, my jaw literally dropped. I could not believe how tiny the pump is! It’s slim and sleek and all sorts of awesome. ¬†I compared it to the size of my Animas Ping and it was like – whoa. Super thin. Then, I compared it to my Verio meter – it’s a bit thicker, but not by much.

 

I didn’t get any frontal pictures, just because there are so many out there available now. What I was really looking forward to seeing was if it lived up to it’s name and their slogan. Well, color me happy because it is SUPER slim and certainly lives up to it’s name.

So what about this “touch simplicity”?

I have to tell you, while it doesn’t have the super responsive feather-touch sensitivity as an iPhone would, it’s is very easy to touch the screen to get it to do what you need it to do. While I know that’s not the slogan’s meaning, it was a concern for me. But, once I got to touch it and play around with the menus, it’s not that much different at all. I liken it to the touch-responsiveness of the Kindle Fire. I did keep laughing at myself though because I wanted to scroll with my finger instead of touching the up or down arrows to scroll through the history screen!

The pump does live up to the slogan though. It is so easy to use this pump, and having the touch screen does make things so much faster and easier. I loved that all I had to do was touch a few places and a bolus was delivered. No scrolling up, missing the mark, scrolling back down, etc. It just a simple tap-tap-tap and your’e done.

The thing I’m most excited about is the different¬†profiles¬† and not just different basal¬†rate¬†profiles. This is the most ingenious thing ever in my opinion because someone FINALLY realized, “Hey, if they need to change their basal rates, wouldn’t they be sensitive/less sensitive to the¬†other insulin factors as well??” Super smart, Tandem!

Oh, and the T button (the ONLY button!) on the top/side not only wakes the pump, but can be used for an audio/vibrate bolus. {Yeah, so! What’s so special about that? All pumps do that now.} Except (from what she told me) it can be set to go in increments of units OR carbohydrate! So, no more doing the math to figure out how many units you should need for “x” amount of carbs while trying to keep the pump hidden away. Just press it how many times you need to to increase the number of carbs you’re eating and it does the math for you! HOW TOTALLY AWESOME!!?? The only time I can figure that would be an issue would be if you’re needing to do a correction… then you would have to do some serious math to convert the BG overage to what¬†would be equal to carbohydrates and then deliver the bolus.

I am super stoked about this pump. I am eligible to get one after December 14th, and I cannot wait. (Read: I’m such a nerd that I have a countdown clock going… T minus 31 days!) This is the first time in a long time I’ve been so excited about pump technology. I would gladly trade in every one of my pumps to get this one if I had to. I know, a pump is a pump is a pump – in the end, they all do the same function. And while each pump has their own niche and ways to trump the other, the end decision is going to need to be based off of what you like/want the most out of the pump you choose. If you want something that’s all connected with CGM and meter and all that jazz – then the Revel would probably be best. If you want a color screen, but prefer to have tactile buttons as well as a remote to bolus with so your pump can stay tucked away, then the Animas Ping would be better. If you want small, sleek, color screen and touch-ability, then the t:slim would be a good choice. They all perform the same basic principle and that’s to deliver insulin. As for me, I want the t:slim. It’s like a Kindle, Omnipod, and Ping had a baby.

Besides, did you really think this technology geek¬†wouldn’t¬†want it??

The Right Stuff

I don’t know why this seems to be a “revelation” to me this week, but it has been. Blame it on the fact that I realize now that the reason why I’ve never been able to let my hair just “air dry” is because it’s wavy – I just have to put a little effort into it. But that effort is null without the right product. So, I’m on the hunt to find out the right product to emphasize and bring out that natural wavy goodness.

Cheezin

 

What does that have to do with diabetes? Everything.

We all know that diabetes is different for everyone (YDMV {Your Diabetes May Vary}), but everyone’s treatment is also different. It’s not a one-size-fits-all disease. Not everyone needs or wants to use an insulin pump, and not everyone wants to use shots all their life either. And those who do use pumps, there are many many many different brands. Where you might like an Animas Ping Pump, others might prefer their Minimed Revel {raises hand!}, or you might want to go “wireless” all together.

Some prefer not to have a CGM (why, I’ll never know), while others practically fight tooth, nail, arm, leg, and foot to have one. Some go with the “egg“, others either integrated into their pump or separate if on injections.

Some pull out measuring cups, spoons, weight scales and all manner of measuring devices for each meal to get spot on carb counts. {During pregnancy, I was one of these people. Anal, yes, but hey, it worked for me!} While others are fly-by-the-seat-of-your-pants SWAG {scientific wild a~~ guess} champions who eyeball foods based on carbs known in portion sizes… mostly relative to sizes of fists, palms, and thumbs.

All in all, you have to make your diabetes work for you. You also have to use the tools that work best for you. What works for someone else may not be what works the best for you. Research the options to their fullest extent. Ask yourself, “Will this really benefit me? Is this something I can keep up with long-term or is it just a “oooo, pretty!” decision?” And most importantly, keep in mind that the technology we have is pretty darn awesome, but it’s not perfect.

Now, off to research hair products.