Coordinating Devices with PumpPeelz

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. ūüôā

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.

Conflicted

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*

Studying and Tuning

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:

6 days on tslim 2
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. ūüėČ

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.)

 

Changes At The Half-Way

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.

3 Weeks

Three weeks ago, I began what I thought would be just a break from my Minimed pump / CGM combo. I was constantly getting frustrated with CGM sensors not lasting the full 6 days (usually only about 4 days) and knowing that my records were going to be all messed up. I have to hand it to Medtronic though, they stuck it out with me the entire time and without hassle replaced boxes of sensors and even my serter. But with all of the trying and trying and trying, I just couldn’t get them to work. So, I wanted to take a break. Being overwhelmed with that and just everything else, I just didn’t feel like I could troubleshoot anymore. Now, I’m not saying their product isn’t good, because I know a LOT of people who use it and have had a lot of success too, but I’ve learned one thing – there is a lot of truth in the fact that not every device “fits” everyone, and no, they don’t all work the same. Thus, my theory that everyone should get to “date” pump systems before locking in needs to be a must. And I don’t mean just over the weekend. I mean like, for a whole month or two. ¬†I just think with all the scar tissue I have and the sensitivity to the tape the Enlite has, it’s just not worth trying to make it work right now. So yes, in essence, it’s me, not them.

When I got frustrated, I switched back to using my Dexcom. Granted, it’s a pain in the butt to keep up with, but for me? The accuracy over the duration of wear time is much better. It wasn’t until everything happened with my eye that I realized just how important it was. I’m not saying it is super accurate, but I’ve been able to depend on it more than the pump CGM, and right now that matters a heck of a lot more than whether it’s integrated or not. Plus, I have no tape rashes or burns from the Dexcom, so that’s a huge plus for me.

IMG_5503Also, at the time, I had a fling.¬†No, not that kind of fling… a pump fling. Knowing how I am about wanting to switch up pumps between the Medtronic and my t:slim, I had actually planned on going through maybe two cartridges in my t:slim pump at the end of March. I don’t know if the battery works the same as most computer batteries, but with those, if you don’t use them, the batteries mess up, so every now and then I wanted to be able to use it so that just the lack of use didn’t mess up the battery. So, when the eye thing happened, I was on the t:slim. I was not having any issue at all with the pump like I had before, so I am not attributing what happened to that, but I am telling you that because when I spoke with my endo, he told me to “keep everything to the same” until I went for my appointment… which will be next week. So, for 3 weeks now, I’ve been using my t:slim pump. Much longer than I expected, but I have to say, I haven’t had the issues with random, uncontrollable highs that I did before. In fact, it’s been quite the opposite. My control has improved. I still wonder if the cartridges I had were affected by the recall, but that the lot numbers were too “young” to be considered in it (my lot numbers were in the 300’s, the recalls started in the 800’s). I’m not going to lie, I’m sort of hopeful that maybe that was the case and now the pump will work just fine.

And, as an update to the whole eye thing, I have good days and bad ones. For the most part, if I can keep my blood sugar as steady as possible and without any major swings (like, no arrows on the dex, and no BG’s above 180-200 for a period of time), my vision is pretty well clear. But if I have a period of time were my BG has run high for a while or if I have major swings (like when I went from 220’s to 70’s within an hour and a half), my eye is pretty well good for nothing for a while. It’s amazing me how things work and affect us all. If anything, this has taught me, as I said before, it’s not about¬†what you use to control your diabetes, as long as you’re using it the best you can and¬†doing the best you can.

Anyway, that’s sort of a rundown of what’s been going on. I know it’s probably confusing when I just throw stuff out there at random without any true point or purpose other than to just get stuff out of my head, but that’s sorta what I started blogging for anyway.

Learning.

It’s been two months since I started on the #Medtronic 530G pump and #Enlite CGM. I have to say, it was something I fully expected to just be able to just jump into and use with no issue at all. Go ahead.. laugh… I understand. ¬†While the pump’s operations are relatively the same (as far as bolus, basal, etc), the CGM is actually a very different thing than I remember the CGM being like with the old SofSensors.

Coming from the Dexcom and reading how the literature in the manual for the 530G’s Enlite was supposed to work, I thought it would be a simple transition, but there are some things that still hold true I’ve learned with the Enlite system. You do still need to have a schedule that you can stick to throughout the day to calibrate 4 times. For me, I find the best results come when I calibrate first thing in the morning, about an hour after that (so, when I wake up and then before I drive for work), at lunch, and then supper or bedtime. That, and making sure I don’t see ANY arrows ( I know the book allows for one, but I still don’t calibrate then) when I calibrate have helped tremendously.

One thing that Medtronic won’t… well… can’t (due to FDA) tell you is to explore other site locations. For me, my Dexcom was always a happy camper in my thigh. I never had issue there and it was out of the way. While my thigh would still be a good place for the Enlite, I have a very active (almost) 3 year old (GAH!) that I play with and he will inevitably knock the sensor in a way that would jar it and I would lose that sensor. For me, I’ve learned that my arms are my sweet spot for those. The problem is that it’s not always easy to insert there, and my hubby has to help me with it sometimes. Which, that’s okay because I’m finally getting full use out of the sensor and not having it zonk out after only a few days. For the past week and a half, I’ve had almost spot-on readings. Most of the sensor glucose values on my pump will be within 10mg/dL of my meter. And honestly, the amount even within 2 or 3 mg/dL have been uncanny. I’m hoping the trend continues and it’s not just because I’ve found a “sweet” spot for now.

Another hurdle I had to overcome was the taping issue. I’m allergic to the tape that they send so I had to find an alternative way to tape it. I know how to use Opsite pretty well and I don’t react to it, so I wanted to find a way to make it work. After trying various ways by myself and with the clinical nurse for Medtronic in my area, I think I have a solution… which is honestly nothing more than just buying the smaller 2″ width of Opsite (I had 4″ for my Dexcom sensors.. which was too wide) and cutting a piece the size of the Medtronic overtape, and cutting a hole in it similar to how the MedT overtape looks. By using that the same way you would use the supplied overtape and a thin long strip of the 4″ over the shell to hold it in place (since your arm isn’t flat, you sort of need something to keep the sides from catching on door ways, etc), It’s a pretty good system that has worked so far.

Most of all, I’ve learned to have patience with this system. If you take the time to learn it and don’t rush it, it can be used to your advantage. I’ve also learned that you can’t always follow everything exactly by the book. The instructions are meant to be there for the greater good of all of the customers as most are universal, but some things – like sensor placement and tape options – may have to be individualized…

and that’s okay.

ūüôā

Progress With The Enlite

On the 6th of this month, I wrote a post about how I was doing on the new Medtronic 530G system, and how things were going with the Enlite. I’m not going to lie, at the time of the writing, I was pretty upset that I had already used as many sensors as I had just trying to get one to last.

In that post though, I had one inserted at the time that had lasted successfully for 5 days by then. Well, I actually got a full 10 or 11 days out of it (shh!! don’t tell!) and was ever more excited to do so. The accuracy I had compared to my meter checks was almost spot on, and if not, it was within 10% or so. It wasn’t until the last day that I knew it was conking out on me and I had t pull it because the readings were terribly off and the ISIG value was very very low. Either way, I was able to get that one to last and get back the time I lost in the one sensor that got terribly kinked, so I’m happy with that. I hope to be able to get at least 10 days out of all of them if I can so I can extend them as much as possible. Granted, I knew going in that I probably wouldn’t be able to extend them as long as a Dexcom sensor, so I’m not terribly upset if I can’t. It’s probably healthier for my skin that way anyway.

It seems, though, that a lot of people have trouble with even the Enlite sensors, so I thought I’d offer a few things I’ve learned in hopes that it helps someone else.

1. Try to get your basal and bolus ratios worked out as fine-tuned as possible. If you’re someone who swings a lot (and I mean, like, a LOT), the sensors can’t be calibrated properly enough to give you good information. Granted, they’ve loosened up the calibration requirements (you can now calibrate at any time unless you have two arrows showing. I don’t recommend it, but you can if you have to)

2. Try other insertion spots. Yes, the Enlite is only FDA approved for your abdomen, but if you’re like me, you simply can’t wear them there. I have found my best spot is in my upper thigh area. It doesn’t get pressed on or knocked around at all, and the sensor stays pretty stable there.

3. Try inserting manually. I know, crazy, right? But it’s weird that the last sensor and this current sensor have been working so well, and yet I’ve manually inserted both of them. And really, it doesn’t feel any different than inserting a shot needle because of how thin the sensors are now. There are some videos on YouTube that show you how, so if you want to know how to do one, go watch those. I might do one later with the next insertion, I’m not sure yet.

4cartoon-clock-17420458. This has got to be the most important thing. Develop a routine for calibrating within your schedule. The calibrations you give is what it goes on to calculate your sensor glucose overtime in relation to the electrical current the ISIG signal is reading. So, for me, I found the most stable parts of my day, which happen to be as soon as I wake up, before breakfast (there’s usually a 1-2hr gap there), afternoon around 4-5pm, and then at bedtime. If I stick to this routine, I have better results. If it gets off during that time, I can still calibrate again in 20 minute intervals (usually takes about 3 to get it back in line at the most). Yes, this goes over the recommended 4 times max per day, but hey, if it works, go with it.

5. Never calibrate right when you test your BG and the pump asks you if you want to use it to calibrate your CGM. Always say “no” and then go look at your graph. See how you’re trending. That way you can make sure you’re not showing double arrows that could throw things off.

BG: 202 ISIG:27.28 (202 / 27.28 = 7.4) Technically I could calibrate, but I don't want to right now. SG is close enough to BG anyway.
BG: 202 ISIG:27.28 (202 / 27.28 = 7.4) Technically I could calibrate, but I don’t want to right now. SG is close enough to BG anyway.

6. Take some time to research what the ISIG is, beyond what the manual tells you. For me, it was learning how it relates to your trend over time. If your CGM is reading far off from what your fingerstick is telling you, you can do a simple math (yeah, I know, more math!) equation to see if it’s okay to calibrate or if your sensor is just being wonky at the time. (Of course, always wash your hands though if you get a wonky reading, since sugars and stuff from food can throw it off too.) If after washing your hands and retesting, the sensor is still off, take your BG and divide it by your ISIG value. If the value is between 1.5 and 20, then you should be okay to calibrate, though having a result that is closer to the middle of that range – between 8 and 13 – is probably even better. That means that more than likely the value you calibrate it by won’t be seen as erroneous and won’t throw a Cal Error at you. If it’s out of this range, try a few things like drinking some water, moving around or massaging the area (not directly ON the sensor, just around it – the fluid may not be moving around the sensor enough) for a minute or two and see if the ISIG changes in about 10 minutes. Also, if your ISIG is getting low, like around 4-7, it may be time to change the sensor out as no amount of calibrating will probably work.

7. Tape that sucker down. I know they’ve vastly improved the sensor taping this time around, and yes, you could go without using an over-tape, but I still use one piece over it just for security sake. It helps the sensor not to move or get jostled by accident.

8. I insert my sensor at night after the transmitter has charged (which I let it charge about 2 hours – no matter if the little light has stopped flashing), connect the two, tape everything down, and leave it alone until morning. When I wake up the next day, I tell my pump I have a new sensor in, and it usually asks for a calibration within a few minutes instead of two hours. This way, the sensor has soaked over-night and has settled in and has allowed any site trauma or irritation from a newly-made hole to calm down before giving it information. Also, this lets your first calibration come when you’re usually most stable, so you know you’re giving it a pretty good starting reference point.

9. Lastly, if I do choose to restart my sensor (if the ISIG is still “strong”… like, in the 20’s or higher), I carefully take off the tape while holding the sensor “head” still and then disconnect and recharge the sensor. After recharging, reconnect it and retape it. I do this at night so that I can calibrate in the morning just as if it were a new sensor. Then, just start the “new” sensor, calibrate and go. If you choose to restart the sensor, keep a closer eye on the ISIG as usually after a restart is when the sensor will start losing life. Some have made it a whole other 6 days with it, some only get a few more days (like myself). But if readings start going really wonky, check the ISIG (just the one on the pump, not the math equation thing). As I said earlier, if it’s getting low, like, 7-ish or below, you’re probably losing the sensor, so toss it and insert a new one.

I hope these help and not have your mind blown. I will say though, I’ve been very satisfied with their new system. In fact, I’ve not missed my Dexcom at all, and that’s pretty huge for me to say (which I’ll go into that stuff in another post.. this one is already a novel.) If you have any questions, feel free to ask in a comment and let me know.

First Impressions of the 530G

While I’m not officially using the pump and CGM to it’s full ability, I wanted to shed some light on how things are going so far in the 530G pumping world.

As far as the pump functions go, I really don’t see much difference between the 530G system and the Revel. There are some minor changes throughout the system, but overall, if you’re used to the Revel system, then the pump side of the 530G will be no surprise to you. I’ve been using it since I got it as a pump system, and haven’t had any issues, save for a motor error, which after a long trouble-shooting call with Medtronic, deemed it unsafe to use and I had a replacement by the next morning (and a Saturday morning at that, too!). Transferring information over from the Revel to the 530G was super easy to do, and once I did, I packed up my Revel and sent it in for the credit on the upgrade cost.

IMG_6853The biggest upgrade with the pump is the CGM component along with the Threshold Suspend feature (which I will refer to as TS from here on out). The new sensors have a new device that hides the needle, and it inserts at 90 degrees instead of a 45 degree angle. The sensors are much thinner and honestly, feel no different than an infusion set going in. That was my biggest complaint with the SofSensors was that they hurt like the Dickens (what does that mean, anyway?) and out of the three day wear, I would only get one good day. The new sensors are touted to be much more accurate than the SofSensors anyway, but time will tell. I know there are studies out there that prove they aren’t as accurate as the Dexcom G4, and I have to agree – but only on the basis that getting one to actually last 6 days has been troublesome.

I have used 4 sensors so far, and three of them have failed. One was inserted into my abdomen because, you know, that’s the FDA approved place… but what wearing a 35 pound toddler on my hip/stomach sort of throws that out of the window because, honestly, you have to be sensitive with these sensors. When I pulled it out, it looked like an accordion. IMG_6854The next sensor looked great, but it died after 4 days. The third one died after one day. No amount of calibrating, not calibrating, protecting it, restarting it, nothing, kept that sensor alive. When I called in to see if I could have at least two of them replaced, they went through and troubleshooted (troubleshot?) a few things with me, and basically, the sensor is delicate, and needs to be worn where it won’t get knocked or pressed. And really? Who thought that would be a good idea? People are active and we don’t want to have to worry about babying a sensor device. I could be all sorts of rough and tumble with my Dexcom and didn’t have much issue at all. Finding such an area on my body that won’t be knocked by my son or pressed on when I sleep or sit is hard. But, with this last one, I may have found a good one because I don’t sleep on it and I can be more conscious about my son hitting/sitting on it. It’s on my upper thigh, right were my pocket is. I also learned (from YouTube) how to manually insert a sensor (hence the ability to take the picture of the contraption, less the pedestal in the above paragraph), so I’m not sure if that had anything to do with it or not, but so far, this one has lasted just over 5 days, and with incredible accuracy. My only wish is that they had kept the idea of a slanted angle insertion verses the straight in. I think it causes the sensor to be more vulnerable to kinking and accordion-ing, which makes me nervous.

As far a the new CGM insertion device goes, it was relatively simple to use, but you had to pay close attention to how you used it. My advice here is to just play with it a bit and watch it from the underside so you know what happens when and how you press the green button on the side. A VERY good video on how to use the inserter and insert an Enlite sensor is on YouTube as well. The nurse explains it very nicely and in an easy to understand manner.

I’m honestly not ready to use the TS feature yet. I did try it out and it did seem to work okay, but I quickly turned the feature off. As I haven’t been trained on it (nor the sensors, but inserting and using a sensor is a lot different in my mind than using a function on a device that could cut off my life liquid) and I have a lot of questions about it.

I am excited about this pump/CGM upgrade, even if I don’t use it for what they are calling it to be (Artificial pancreas? nope. But we won’t go there). It’s been nice not to have to carry around my Dexcom with me. Granted, the alarms on the Medtronic pump is irritating to say the least, but I’m glad they are because I won’t ignore them.

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I may come back later after I’ve used it and give a more in-depth view of it, and if things are going successfully, I’ll leave some tips that have helped me.

Giving Credit Where Credit Is Due

Earlier this month, I had sort of a breakdown.

bad tweets

 

bad tweets 2bad tweets 3

 

Maybe I need to backup a bit.

For two months, I had called numerous times to both Medtronic, my insurance company, as well as my endocrinologist’s office, about getting sensors and the transmitter kit from Medtronic to use with the 530G pump that I had put my name on the wait-list for. I knew that the Pathway2System had a 90-day wait on it, which would put me not receiving it until January. The only issue was that with a new year, I would have to meet a whole new higher deductible come January that I could not pay along with upgrade cost. I also knew that with December comes everyone else trying to meet their year-end cut off for met deductibles and Medtronic would be flooded with supply orders and the like. I wanted to avoid the hassle and start early.

Two whole months early.

I’ve never been one to wait until the last minute to order supplies, but I’ve never been two months early on trying to forgo a new insurance deductible either. But, either way, I was determined and thought I was being smart by starting so early. I knew that insurance should take about two weeks after waiting a week on getting my endo’s RX for the system itself. So, three weeks of wait, plus about a week of shipping would be one month… add in the year-end rush for the company, I thought I’d aimed it right and would be receiving the shipment by the end of the year.

On the morning of December 10th, I called for what seemed to be the 20th time to Medtronic to get an update. My representative was the only person who would talk to me, and it was hard to get hold of him, which was understandable with the new system coming out and the year-end stuff. Only I thought I had dialed a wrong extension when a lady answered. “No, I’m sorry. He’s no longer with us. I can try to help.”

Oh. My. Word.

My heart sank. Here it is, three weeks until the end of December, and I’ll have to deal with someone new and probably start all over. She was helped by her supervisor with the call (oh that poor girl! Being added into a new position right as all of this was going on!) but to make a long story short, what the prior rep had told me was wrong and because the Enlite sensors and CGM was sold as a system¬†with the pump, I could not make the order until the pump was ready to ship, which would likely be in January or early February.

Two months of work and anticipation and high hopes… gone. It was then that I felt sick to my stomach. Hurt. Angry. Confused. Why, if it were not possible at all to begin with, did the rep not tell me when we started the process? I made a bad decision on my part and vented my frustration on Twitter. I didn’t tag Medtronic, but I did mention their name, which flagged their customer advocate team.

And I got a call at 9pm… that’s right PM. Night time. I missed the call but it went to voice mail. I still have that voice mail because it made me cry to listen to the voice on the other end. While he did not make any promises, the gentleman who spoke was very nice and caring. The mannerism in which he spoke was the sound of an invisible hug. I called back and left him a voice mail, as it was after his work hours, expecting a call the next day. Nope. He called me back THAT.NIGHT. He had worked over just to talk to me on the phone to find out what had happened.

He worked on my case for two days. He pulled and listened to the calls that I had with the prior rep. He heard the empty promises that were made, and apologized, though he wasn’t the one in the wrong. Without me asking, he spoke with supervisors and other departments and made things happen. He stepped up and not only spoke on my behalf and got the CGM kit and sensors sent to me, but the whole system including the 530G pump as well. They arrived this past Thursday.¬†Within 2 days, he accomplished what I had been trying to do in two months.

During the whole process, through emails and phone calls, he kept a kind spirit about him that you could tell he was a person who loved his job and loved helping others. I even think he was more excited than I was when he called me with the news of the approval. But you know, even if it hadn’t been, just his attitude and the genuine care and concern that came through the phone and his actions in following up with my case was more than I could have ever asked for.

All too often people who work hard and do good things aren’t openly appreciated for it. Rueben is one who deeply deserves recognition. I didn’t get just a simple reply from Medtronic to say “We are sorry for your frustration. Please give us a call at…”. No. He took the time to call¬†me to see if he could resolve the issue. That, my friends, is good customer service and being an excellent support advocate.

Letter
I never write letters to companies about their employees, but I felt this one was well deserved.

Confused? Me too.

“So wait… which pump are you on?”

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I get this a lot. Mainly because I switch up a lot.

So, to bring you up to speed, this is what’s going on. Back in October when my endo took me off of the Tandem t:slim and told me to stay on my Medtronic Revel pump, I submitted to Medtronic my request for a new CGM system with Enlite sensors in hopes that we would get approval by the end of the year so they could ship by the end of the year and fall under this year’s already-paid deductible and co-insurance. Why? Because otherwise, when the 530G upgrade actually does get shipped in January, I won’t be able to afford a new CGMS under the new deductible and all as well as pay the upgrade cost. Just can’t happen. Sorry. I was assured many times over by my rep at MedT that there shouldn’t be a problem. So, after two months of phone calls to both MedT and my insurance company, we got approval at the first of the month and I was told they would ship out in probably a week. Fast forward to today. I called to find out why I haven’t gotten a shipping notice. Come to find out, they hadn’t been shipped and won’t be shipped until the new pump is authorized by the higher-ups to be sent out… so which means my whole entire goal of getting everything handled as far as the CGMS goes by the end of this year was a crap-shoot and won’t happen. Which means I probably won’t be getting the system as I won’t be able to afford paying that much up-front next year. Which the Revel pump works just fine and so does my Dexcom, so that’s not a big issue, I just like to have all of my reports in one place. The upgrade is just a want, not a need. So if it doesn’t happen, I can’t get mad because I¬†do have the Revel that works, and that’s all that matters.

Right now, I’m on my Tandem t:slim because they have put me in contact with a rep for my area to see if they can find out what’s going on and why I’m having so many issues with it. If they can fix whatever is going on, then fine. I’m cool with it. I’m doing this because 1) it’s still got 3 years of warranty left on it and 2) even though I’ve had major issues in the past with it, I still like it. I like the pump’s interface as well as the intuitive reports (Hello 21st century!) and 3) I have like, 3 months worth of supplies that need to be used so they don’t expire. The pump seems to be a picky one anyway, and I’m not going to chance what could happen using expired supplies with it. The only thing that absolutely bothers me about it and that I feel completely wrong about is how much insulin it hides. I can’t do anything to fix it, and I’m throwing out with each cartridge an amount of insulin that could keep some people alive up to 2 days. It just feels¬†wrong.¬†My main concern is that even though things are going okay right now, I’m constantly feeling on-edge about it. I keep waiting on the one day when all heck breaks loose and the pump decides to go whacko on me again and I go two weeks trying to fix something that can’t be fixed all the while I’m battling 300-500 BG readings. I don’t have this issue with MedT and I trust it because I’ve never had an issue with it like that.

And please, PLEASE don’t get me wrong – I’m very VERY grateful for all that I do have. And, yeah, I probably should just let this all go and let it ride and take it as a sign. I just know a lot of people are probably questioning what the heck I’m doing when I’m talk about either system at any given moment, and this is just the summary of it. In all honesty, I want my MedT pump. I like it and it’s dependable. I’m ready to use up the t:slim supplies and go back to it.