Guinea pig a.k.a. Exhubera Party
Sour Cream. Check.
Glucagon Kit. Check.
Powdered insulin packets. Check. A 3mg packet and a 1mg packet; based on my weight.
So…Time to rock. Shuuuuunk! Snap! Poof! Ahhhhhhhhh….Tastes like chicken. Not really. Just kidding. I just tried Exhubera. On my self. What the hell. Why not?
We’re having a party of sorts in my office. A small party, but aren’t those the best kind? I’ve got my pharmacy tech (perky blonde about 12 years old….or so she seems from my side of the hill), the out-reach coordinator (and my right-hand-woman in the diabetes program), and my Pfizer Rep (who brought cookies from the Chocolate Maven).
Pfizer is really trying to push their Exhubera, with varying results. I’m keen to have any arrow in my quiver, but this is far enough out there on the ledge that I’m not going to recommend putting a patient on it until I’ve tried it for myself. Eager to please, Pfizer has provided me with some samples.
So the clock is ticking. We’ve got ten minutes to wait before we start chowing down. I check the Girl. My blood sugar is stable at 116.
By the way, the inhaler was a heck of a lot easier to use than I had imagined. I thought the multiple dosing would be a pain, but it was fast and easy. The inhaler telescopes inside itself to make it more compact. It has a finger ring you can use to pull it out to its full length, but a quick snap of the wrist will “unfold” the device. Makes you look cool and sophisticated in a James Diabetic Bond kind of way. That’s the Shuuuuuuuunk!
You slip a blister pack into the mouth of the device, cock the handle to pressurize the system, and pull the trigger. All of the training devices have empty packets, leaving me very curious to see how the insulin cloud would really look. Snap! I pull the trigger and Poof! The clear chamber is instantly filled with fog.
Three sets of eyes are riveted on me, unblinking. I exhale, turn the mouth piece around and breath in deeply. I briefly consider grasping my throat and collapsing to the floor, just to freak everyone out, but we only have a one-bay ER, and only one defibrillator, so we really aren’t well equipped to handle three simultaneous heart attacks.
I expect a slight burning sensation, like when I used to smoke. But it is no different than any other deep breath. I feel…..nothing. No taste. No tickle. No cough. I exhale, expecting to blow a smoke ring. Again, nothing. So simple and uneventful as to be almost disappointing.
WhatdiditfeellikeWhatdiditfeellikeAreyouOK? Don’t you hate it when three people talk at once? I de-brief the crew and take the second hit.
Ahh. Ten minutes have passed. Time to chow down. We eat, chat, check the girl, and chat some more. Continuous monitoring offers not only the ultimate in safety and control, but it allows you to safely play with new meds like this.
My BGL drifts downward, then levels out. It stays that way for nearly an hour. I begin thinking a hypo may be in my future. Then, in the space of half and hour it shoots up from 110 to 192, which is the peak for the day. For the next three hours my BG stays bizarrely flat between 190 and 184. It is like looking at the cardiac monitor of a dead person. Flattest, longest, BG graph I’ve ever seen on a bolus. After three hours after spiking (four hours into the experiment) it begins a gentle drift downwards and bottoms out at 136 five-and-one-half hours after taking the hit. By the way, I want you all to know that for the sake of science, I sacrificed the opportunity to have a Starbucks Iced Latte. I didn’t want to add in any carbs until the Exhubera ran it’s course. See how much I love you guys?
Now a gentle drift upwards begins. The insulin has run its course. Looks like we could have used a bit more powder or a few less carbs. It is promising enough that we all agree to have to have another party soon and try again with a little more insulin. Hey, that’s not an excuse for a taco party, this is serious science here! Really. I swear. Have I ever lied to you guys?