LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

My Photo
Name:
Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Thursday, April 12, 2007

Homework

I’m eager to get started, but first things first. I gotta learn the rules of the road before I jump into this mustang convertible and head out. I got to the clinic early and my first patient was late, so I got in 17 minutes of reading time. Then, I studied Quickserter instructions in the bathroom between consultations. The instructions are a cartoon that takes up 15% of a over-sized tabloid sized sheet. The rest is taken up with legal warnings in, I swear to God, thirteen languages. “Never point loaded insertion device toward any body part where insertion is not desired.” Kid you not. Do you think the Medtronic lawyer who wrote that one surfs for porn on the company computers at lunchtime?

It also tells you to be sure to remove the needle guard before sticking the needle into your skin and mentions in passing that if you shove the needle into your eye you might go blind. What it doesn’t really tell me is how to put the damn set in. Well, this part isn’t rocket science. Between the cartoon and my previous experience, not to mention a tiny bit of mechanical intelligence, I think I can figure this much out.

The sensetter instructions are of similar cartoon ilk. On the other hand, the minimalist approach was not taken with the ParaPump manual. All 160 pages of it. Plus a 58 page Sensor Features User Guide, a 12 page Pump at a Glance booklet. Twelve pages of anything is more than a glance. Someone who still reads Playboy should count how many pages of photos the centerfold gets and report back in comments. There is also an Introduction to Insulin Pump Therapy, 30 pages. And of course the Practical Guide to CGM, which I haven’t read yet ‘cause I’m still sulking.

I read the intro first. It is geared towards newbies. It’s got that horrid photo of the couple on the scooter motorcycle on the cover. Remember that one from the Now I can! campaign? Only this time, like the pizza on the ParaPump box, someone just got their first copy of Photoshop and can’t resist mixing photos and clip art. The red and white scooter has been turned into clip art. Anyway, the booklet is harmless and probably helpful to those who are new. I don’t recall Smith’s sending me anything like that with my first pump, and it would probably have been nice to have a Pumping 101 text. It has little text sections with mini-quizzes. Nuff said.

At lunch I drank an Atkins shake… (5 net carbs – 4 fiber = 1 net impact carb, right? Ha! Trick question. You don’t take fiber off of meals under five carbs. If you don’t believe me just see page 20 of the Intro to Pumping.) …and plowed deeper into the books. In the early afternoon one of my home visits to a terminal patient got cut short. No, not like that, so I holed up in my office and got some more book time in. I considered reading on the drive home, but as I was driving it didn’t seem prudent.

I finished over dinner.

The pump at a glace was baffling until I had read most of the manual and skimmed the parts that made more sense with pump in hand. My advice: use it for pump-in-review instead of as a getting acquainted tool.

The main manuals are about what you’d expect. Not great. But not terrible either. No humor. Not always clear, other times insulting. They are full of flow charts and black-and-white drawings. Surprisingly, the best medical device manual I’ve even seen was the beauty that came with the retched GlucoWatch. Horrid device, wonderful manual. All of that said, the Medtronic Manuals are OK. They get the job done.

After dinner I sat down with my little ParaPump, put a battery in and got to programming it. Once I got the hang of the Medtronic menu system it was pretty straight forward. My only initial complaint is it looks like I’ll have to take quite a few more steps to accomplish things like….oh eating… than I did with the CoZmo. But, we’ll see.

I just plugged in all the same numbers I’ve been using from my current pump. I got my 18-step basal pattern in with no trouble, ran out of space for insulin sensitivity (max 8 steps in day). Damn. Well a little averaging….Programmed the pump to recognize the BG meter and the sensor transmitter when they knock on the door and set up the “Bolus Wizard.” The Bwiz is a software that looks at BG, insulin already in play, your targets, sensitivies, carb ratios and whether the moon is in Leo or Scorpio and then recommends a volume of insulin for delivery. More on that on another day.

BTW, kudos to Medtronic’s wizards for shipping the pump in screw-around mode. Well, I’m sure that’s not what they call it, but your new ParaPump arrives set up so you can explore at will. Once you initiate a “rewind,” which is part of the loading of a new reservoir you cancel screw-around mode and you are into honest-to-God pumping.

Of course in addition to the manuals there is a blizzard of various warranty sheets, wallet cards, and other lose bits of paper.

So….it is well after midnight now, but little ParaPump is fully programmed and waiting. I’m gonna hook up in the morning. Then I’m going to put in a sensor. It’s been a while, all the hair on my legs grew back! But I started shaving it off a few days ago and I’m ready. So ready. Ready to watch the flow of the water again, rather than the stones in the stream. To use the crystal ball. To be in a red state. To celebrate defeat and to be the lion tamer.

And I’m ready to do all of that with one box on my belt and to be able to watch the bizarre alien twists and turns of my BG trace on this little blue screen. This time, in real time.

7 Comments:

Blogger Lili said...

One thing about "screw-around mode" (heh) is that if you run out of "insulin," it is over. On the old Paradigms, you could reset it, but it looks like you can't on the new ones.

11:26 PM  
Blogger Chrissie in Belgium said...

Will - SO glad you are back in the blogosphere. Good luck with the new gizmo! I am all ears!

12:52 AM  
Anonymous Anonymous said...

Welcome Back. It would be cool if you could fit in some pictures to go along with your wonderfully elaborate descriptions, but I understand if you can't. I know you are busy enough with the blogging, job, family, set-up of new toy, etc., etc.

Thanks for all of your efforts in educating the blogosphere...

7:27 AM  
Anonymous Aaron said...

If you want to make programming the pump easier, there is software form MiniMid called Paradigm Pal. You load this on your computer, program your settings in that, then sent it (through the Link meter) to your pump. This is considerably easier than going through the menus.

8:01 AM  
Anonymous Jana said...

Yes, the funny thing about the Bolus Wiz is that it always gives you enough insulin to aim for the nearest "border" of your target range. So if you're 70 before dinner, it will give you enough insulin to (theoretically) end up at 80 if your range is 80 to 120. Because of this, my pump educator recommended setting the range to the middle of whereever you want to be--i.e., 100-100 (so not actually a range at all). I started with 100-100 and now I've got 90-90, and I might experiment with 80-90 because I don't have too much trouble with lows and I usually end up a bit out of range after bolusing for a meal when I clock in in the 70s, so I think it's subtracting too much insulin to "correct" for the slight low.

8:23 AM  
Blogger Penny said...

Welcome back Will.

I can't wait to hear about your first experiences with this new device.

And, as a mom of a little one with D, I haven't really paid much attention because other ones look too bulky for his little frame. But, the fact that you mentioned how small it is, has me intrigued.

1:27 PM  
Blogger Scott K. Johnson said...

With your mention of "watch the flow of the water again, rather than the stones in the stream" - that line of yours made it into James Hirsch's "Cheating Destiny" book (p. 150) - he credits "a blogger", but not you by name (I was disappointed).

I recognized it was from you right away though.

Other than that I thought it was a fantastic book. :-)

9:31 PM  

Post a Comment

<< Home