Tag Archives: Revel

Memory Error

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My poor Abby Cadabby is being replaced.

While on my Revel “pump break” from the beginning of August until this week, I did as always had and removed the battery and stored it back in the box with all of the Revel component parts. This week, when I pulled it back out, I simply put the battery back in, set the time and date, entered my basal rates and such, and went on about my business. No big deal right?

Last night, I decided to upload my pump just to see how the past two days had been since being on it. I plugged in my CareLink USB and went through the process to upload, and it failed. Thinking it must have just lost signal, I clicked the button that was going to “retry” the process. Failed. So, I checked my pump, checked the USB connection, and tried once more. Failed again. I even restarted my computer thinking maybe something was going amiss inside of the computer parts and just needed to be reset. Nope, the upload failed twice more. I contemplated calling into the 24-Hr help line, but then again, being raised the way I was – that it’s impolite to call after 9pm unless it’s an emergency – I decided not to because it was 10:45pm and I didn’t want to be a bother over something that seemed minor in comparison to a pump just not working at all. But I sat there… freaking out that something was wrong with my pump or I was doing something wrong upon upload (which I couldn’t figure out because I had done this process MANY times before). So, I called.

The lady I spoke with was VERY nice. One thing that I do like about their help line is that I don’t get a “Peggy”. I get a person who can talk and understand me just as well as I do them. That means A LOT to me. So, I described my problem and the representative walked me through where to look for some error codes in my pump… specifically A21 and A17… both of which I had. What do those mean? WEEEEEELLLLLLL…. Because I had removed the battery for such a long time, it caused a problem with the pump’s internal memory, causing all of my data to be unretrieveable. So, she made a record of what happened and had a replacement shipped out last night… at 10:45pm…..

And guess what?

Yeah. That’s right. I’m going to have it TODAY! By LUNCH break!

Wow.

Support to door in less than 24 hours!

That, along with the super rep who I can’t for the life of me remember her name but I’ll always remember how very very nice she was, helps me feel better about my battery mess-up. Oh, and a tip she shared with me last night –  if you’re on the Revel and you’re thinking of taking a pump break, keep the battery in and set the basal rates to as low as they can possibly go and turn off your alarms. Just be sure to remember to reset everything as you had it when you go back on it.

Duly noted. :-)

Abby Cadabby Returns

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Abby Cadabby returns.

After a week or so on the Animas Ping and the month on the OmniPod, I have decided to go back on my Minimed pump.

Why?

The Omnipod didn’t work because I need a longer cannula length.

The Ping.. well, I used it without the remote after a few days. The remote is nice at times, but it was irritating at times too. By the end of it, I was just bleeeeh about the Ping. It’s okay, and a very stable, good pump. I honestly don’t see anything wrong with it.

So why the switch?

Connectivity.

Ease of use when it comes to technology is very important to me, and this system has the easiest (in my opinion).

It came time to upload my pump and meter and the software, for me, is a pain in the buttocks. I still like the fact that everything can be logged into the Revel so that all you have to do is upload it via the USB device and there’s your whole complete logbook.

I’m still not quite concrete about the decision yet. But I do feel better about having weeded out the OmniPod option. Now it just comes down to the Revel and Ping and whether remote bolusing means more than easier upload of data.

Change of Plans

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First, let me say that Medtronic has a good insulin pump. The features that it offers – bg-check reminders, missed bolus alerts, an optional CGM component, ability to see almost anything you’d want to see from any menu you have available in regards to basal, bolus, average bg, insulin on board, etc – are great. It’s also a very durable pump as I have knocked, dropped, and sat on the darn thing on not so soft of surfaces and it has held up. I have put it through the ringer, I promise, and it has proved to be a very durable, reliable insulin pump. My only complaints that I can find about it are 1) it’s only water resistant, not waterproof, and 2) there is no remote-bolus option – two things that are very important to me, but can be worked around.

The ease of ordering supplies either by phone or ON my phone via the myMedtronic app has been great. I’ve also had the pleasure of calling the reorder department about an order that I already had received but needed to change the set and they were able to do that. I don’t believe I have encountered any other company that works so extremely well with customers and getting the supplies they need.

Oh, and their customer service line? One word: Awesome. I never ever had an issue with them. I’ve worked with other companies that, when I encountered an issue, the problem would be placed back on what I had done or was made out that their product was perfect as is and it was obviously my problem (drip that with sarcasm). Granted, I have spoken with customer support before about my calibration issues with the CGM portion, and that is still something I cannot figure out why I can’t get right on a consistent enough basis, but they put up with me through it, making as many suggestions as possible, and even following up on my complaint later.

Which leads to my point of this post….

While I believe that Medtronic is a good company who has excellent customer service and a good insulin pump product, I personally do not choose to use the pump as a pump+CGM combo any longer. The issues of the CGM that I was beginning to have led to more frustration than I wanted to have.

Since the end of June, I started becoming more and more dissatisfied with the CGM and the requirements of calibrations for it. I tried everything and made a full honest effort to stick to the rules, but it just wasn’t working out for me. Granted, I absolutely LOVED that it is integrated into the pump. That part is absofreakinlutely the most awesome thing ever to have both a pump and CGM in one and not have to worry about an extra device to keep up with. Accuracy wasn’t too bad at all either as long as you calibrated as required. Most of the time, I’d say, probably about 80-90% of the time, it was almost spot-on or within the allowed 20% deviation range. The only time I had issues were when I either hit a bad bleeder, the sensor wasn’t all the way in, or if the area chosen was just not a good placement. I had a pretty good system of being able to insert it manually and cover it with tape in a way that prevented most of those problems, but sometimes it still happened.

After speaking with Erik over the past few weeks and with my endocrinologist, we have made the decision to switch back to the Dexcom. This was not an easy decision to make as I hemed and hawed, thought and thought, even made a spreadsheet to help me reasonably make a choice that would be the best for me and what I needed. The only reasons are that it seems to work better at following my low or high swings, the pain of insertion is not nearly as bad, and the sensor lasts 7 days. Granted, it’s a pain in the butt having an extra device to carry around as I’ve already left it at home a couple of times on lunch break, but I don’t mind it being separate over all. I also don’t like that I have to avoid Tylenol again, which was one of the biggest factors of the Minimed CGM that I loved other than integration– no Tylenol restriction!

This has not been an easy post to write. As a matter of fact, it has been in my draft que for days and gone through several revisions because even though I made the switch over to Dexcom, that does not mean that I believe any less in Medtronic’s products. I contemplated not saying anything at all, but I also know that as a blogger, I believe in honesty and disclosure to my readers. Things that I have blogged about in the past in reference to how I may or may not have liked the Revel system as a whole still are true, but reflect my feelings as of the date of the posting. Things change. People change. Our needs change. And the change from the Minimed CGM to the Dexcom is just one of those changes for me.

I haven’t totally given up on the Minimed CGM though. I still have supplies for it and if I want to hook it back up, I can. But I feel that right now, I have to do what’s best for me and my diabetes treatment and, most of all, my sanity. And who knows? Next year, hopefully when the Enlite sensor is out, I can try it out and I may switch back. Just depends on how it compares and how it works for me.

*************************************************************************************************

The past year, as mentioned in my Disclosure, I have been a blogger for Medtronic on their site, The Loop Blog. Working with Karrie, Amanda and the Medtronic team has been enjoyable as well as a learning experience. I am so grateful to have had that opportunity. The contract has ended, but I hope that the friendship can still remain. A few posts that have been submitted for review may appear later on their site (which is up to their discretion), and do reflect my view of the topic honestly at the time of the writing.

The Right Stuff

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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.

 

My CGM Tips

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So, most of you know who have been reading my blog know that I am using a Minimed Revel pump + CGM for to control (or try to at least) my diabetes. Lately, I simply could not figure out what I was doing “wrong” with the cgm and why it wasn’t catching my lows or highs and things like that. I even posted a request on my DiabetesDaily blog asking for help from other Minimed CGM users as to what they do for more accurate readings. Well, after a week or so of buckling down to really try and figure this thing out, I have a few tips to share that may help you if you’re using the same CGM (or even a Dexcom – I’m not biased!). Of course, these are only tips that work for me. I am not saying you have to do these things, and as a matter of fact, I would rather you speak with your health care provider before trying these just to get the OK from them.

1. Undercover and overcover. (This one applies to the Minimed sensor – Dexcom users can’t do this one, sorry!)

After inserting a sensor, but before attaching the transmitter, put a piece of tape to cover the “sensor head” (the part that is purple-ish and flat), but under the “feet” of it. Take a piece of Tegaderm or IV3000, and cut it in half. Then, cut a slit in it that would look like your eyelid opening (just imagine this: () ). VEEERY carefully, slide the feet and connector end through the hole, so that part of it is under the feet and connector, but the other part is over and completely covering the sensor head, and secure it down.

Why do I do this? As an added layer of protection against water. I have found that if it gets wet and just a smidge of the sensor is above my skin, the sensor readings aren’t as accurate as they could be. Since I have done this, my readings have improved a lot!… but not as much as also doing this: (proceed to tip #2).

 

2. Don’t just let it get wet…. SOAK IT!

That’s right. Soak it. Overnight. If you put a reminder on your phone (or use the Medtronic app on your iPhone to remind you!) for the night before the sensor-change day. Insert a new sensor, secure it with the under/over cover method, and also with a total over-cover. Take another Tegaderm or IV3000 patch, cut a small square out of the paper that would be big enough to over the sensor, place it in the middle of the tape, then place the tape over the sensor. That way, you won’t accidently rip it out overnight or scratch it out (as I have done before). Then, the next morning, carefully remove the top layer of tape, and connect your transmitter, and add a final top layer of tegaderm to secure it and add that top layer of waterproofing. (Which, I have to say – the system is approved to be waterproof, but as I said before, I do it just for sensor accuracy for me.)

Sensor Change

Photo 1: Sensor under/over covered and covered for bedtime.

Photo 2: Carefully removed the top “sleeping protective” cover.

Photo 3: Connected the transmitter. Yey, green light!

The reason why I decided to do the soak it trick is because I noticed that my sensors (seeing as you only get 3 days out of these suckers) would be best  only on days 2 and 3. And, with me, extending the sensors just is not an option because I don’t get very good readings by day 5, so, I thought “hey, maybe let it soak and see what it does”. Well, by golly, it worked. And has worked ever since. (note: I also used to do this with my Dexcom, and it worked very well too!)

 

3. Log to calibrate.

I know it may be a hassle to do, but take one week to log everything – food, insulin doses (for food or corrections), exercise, etc, and find out your “quiet” times. The times when your blood sugar is going to be the most stable. Granted, yes, I know you Dexcom users are probably thinking, “Yeah, well, I don’t have to do this because I can calibrate at any time.”, and this is true, but trust me, it helps you guys too. Use these “quiet times” to calibrate your sensor. My times are (1) first thing in the morning, (2) mid-afternoon and (3) before bed. Your times may differ, just as your diabetes may differ from mine (to an extent). The reps will tell you to calibrate 4 times per day because though you’re required to every 12 hours (2x per day), 4 is the optimal amount of times, and more than that just gives it too much info. But for me, 3 times is a good number because it’s one more than 2, and one less than 4 – sort of the safe zone, so that it has enough information, but I have an extra “okay to calibrate” card up my sleeve as well for when it’s needed. And, if you are really, really, really a perfectionist about it (which, you’ll have to lose some of that perfectionalizm anyway to be any brand CGM user as they are NOT perfect), you can even set reminder alerts in your pump to go off at the times that are best for you to calibrate based on your awesome logging data.

 

So there you have it. I’m still working on other little quirks that may make it even better, but at this point, I’m pretty darn satisfied with the improvements I’ve had so far. And, if you have any tips you would like to share other than these, please – by all means, share them with me by leaving a comment. I would love some feedback from others who have some tricks up their sleeves too!

The First Week With The Revel

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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.

Revelling – Getting Started

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First off, let me say that I am very sorry for not getting this post up Monday as promised. I wanted to get it done, but learning to balance a new baby and diabetes is much harder than I ever thought it would be, especially when the baby throws an all-nighter at you. The only thing we can figure is that his diaper rash is back and he was just not comfy, and that’s completely understandable. I certainly wouldn’t be happy with a messy diaper on my raw behind either. And the poor thing just makes you feel terrible when changing him, screaming his cries to the top of his little but powerful lungs and even quivering his bottom lip. I try to hold and cuddle him a little more after his diaper changes, just because you can’t help but do that. I mean, you feel bad enough changing him knowing that it’s painful, but knowing you’re the one causing him pain is just awful. It has to be done, I know, I just wish I could make it more comfortable for him.

BUT (no pun intended)! As to the purpose of this post, I am here to talk about my first few days with the Minimed Revel. The training went very well. As a matter of fact, after speaking with her for a little while, we found out that she worked at the same camp I had attended when I was a teenager! I remembered her being in the infirmary and when she called to do her follow-up check-up on me the next day, she told me she had remembered me because of my organizational skills (I’m sort of OCD about that kind of thing. I organized her pump skins by model so she could find them easier when she handed them to me to look through to find a few I wanted for my pump). I did drop low a couple of times during training, but what was so neat to me was that she could tell before I could just by the look on my face. I need to know how she did that so I can teach Erik!

The setup of the Revel was very easy. The online pre-training guides you through getting your pump ready for the training class by helping you set the time and date, and letting you become familiar with the buttons and menus. It also has a course on the basics of how shot therapy is different from pump therapy and how to adjust. As an experienced pumper (11 years now), I started to skip this training, but I went through it anyway just as a refresher, and I’m glad I did. There were a few things I didn’t know, so my suggestion is that no matter how much you think you know or how basic it may seem, give your training the benefit of the doubt and just do it. You never know what you’ll be surprised to learn.

When the trainer arrived, I had everything set out. She went through verifying the basal rates, correction factors, IC ratios and BG targets I had moved over from my Ping to the Revel. The setup was fairly quick and easy to go through. The part that got me was getting the cartridge filled and inserted. It is a lot different than the other pumps as it all screws together in a screw+lock system, unlike the luer lock systems of my other pumps. It is something you have to learn the “feel” for if you’re not used to it. The rest of the setup through the pump was very easy as the screens guide you through every step, very much so like the way the OmniPod PDM does, giving you directions with each step, whether you know what you’re doing or not. That, I liked… a lot.

Next, we got the CGM part going by plugging in my transmitter ID and starting my sensor. The coolest thing about this part was I was able to keep the Guardian connected to the transmitter as well, so for a while, I was getting readings on both my pump and the Guardian monitor. They stayed relatively close in number to each other, but just like finger sticks, they were off somewhat, with my pump reading in the lower 80’s and the Guardian reading in the upper 70’s. I kept both systems connected until the sensor time “ran out” on the Guardian, which was only a few hours later.

Over the next few days, the pump CGM stayed in line pretty well with my fingersticks, which is a good thing. And although the system my look to some as outdated and not as pretty or fancy as other systems out there, it is a very solid system. Bolusing was very easy with the bolus wizard, with only needing your input of BG (if it wasn’t automatically “beamed” over from the meter) and carb amount and it does the rest. All you have to do is review the amount and tell it to “act”. You don’t have to dial up the bolus to match what the pump suggests like you do with the Ping system. It is a simple, easy, straightforward pump, and I like that.

I’ll write another post sometime this week (hopefully) and explain a little more about my likes and dislikes of the pump.

REVEL-ling In Disclosure Time Again!

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20100101-DSCN0667Yep, it’s that time again! It’s time to update my disclosure for all of you happy readers of the IGTS Blog, and I am so excited to share this with you.

Last month, I was given the opportunity to be a part of Minimed’s blog, The LOOP Blog. After speaking with the PR department (They are some super nice people!), sharing several emails, and getting some other legal stuff squared away, we now have a formal contract in place that states I will post once a month for them. In exchange for these posts, I have been provided a Minimed Revel insulin pump as well as a box of sensors free of charge, and are mine to keep. (I went with the clear one if anyone is curious! LOL!)

They do not reserve any rights to what I post here on my blog about their product, but they do, however reserve that right to what I send in for their blog (which is only fair). The blog entries I write for them will post on the 15th of each month, and I’ll let you know when they are up by posting them to Twitter and Facebook. My training for the pump is scheduled for today, so I will post here Monday about how it all went.

I am super excited to be a part of their involvement with social media and outreach to the DOC, and hope to represent both Medtronic Minimed and the DOC in a way that will make you guys proud.