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

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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!).

Saturday, April 14, 2007

Pumping?

Well….I think I’m pumping. But how would one know, really?

The ParaPump seems happy. No little circle icons, white or black, to indicate trouble. No squeaks, squawks, beeps or boops. All is quiet on the Western Front.

I’ll take you through the hook-up process step-by-step some other morning, but here are some quick observations today, my first Medtronic hookup. It seems to me that Medtronic makes us go though quite a few more steps to do just about everything than the other guys do. But, I’ll really need to sit down and count the various steps to be sure, it may just be that things are different so it seems harder.

I put in the sensor first, as the new books from MedT say to wait five minutes before hooking up the transmitter. I decide to push it in myself, rather than use the inserter. Seems to me that sensors failed more often after being snapped in, than when I did it manually.

Next I fill a reservoir with NovoLog. MedT has a really clever little device on the end of the reservoir that holds the insulin vial in place. I really like that a lot. In fact, they have a lot of idiot proofing technology, which I appreciate, as I’m as big an idiot as anyone else. Which brings me back to why do we have idiot-proof machinery with rocket-scientist menus? More on that later…

I choose the Paradigm Quick-set in 43” hose and 9mm canaula. Unlike my old Comfort sets that went in at a 45 degree angle, these go straight in. I’m pretty excited about that, because I’ve been having some bizarrely different BGL responses to same-food, same-bolus situations. There are a couple of studies that suggest the straight-in canauls infuse the insulin more repeatabley. We’ll see!

Also, I feel, with no evidence what-so-ever to back it up, that the straight-in will cause less tissue damage. Less scaring issues. However, one nice thing about the Comfort set that I’ll miss is that the package is thin, thin, thin. Easy to carry a spare “just for incase.” The MedT package is quite thick. Gonna have to re-configure my “go bag.”

I did use the serter to put in the infusion set. Worked great. Once I had the courage to do it. Funny, I know several MedT pumpers that had to replace infusion sets away from home, away from their insertion devices. Caused them much mental trauma to put one in by hand. I’ve put in God only knows how many sets by hand no problem but stood in my kitchen with my fingers on the buttons for about three minutes before I could get up the courage to squeeze them closed to fire the set into my stomach. In the end it was fast, totally painless. Wonderful, of course.

The set’s hub on my stomach is thicker—the hub is higher. No big deal really….just different. I haven’t tried a disconnect yet, it’s a rotate to unlock and pull affair. I’ll let you know how it goes.

Another new-for-me and very cool feature is the needle guard on the set’s guide needle. Once you pull out the needle you can snap shut a plastic guard that keeps you from sticking yourself, your spouse, your child, your cat, or your garbage man. The International Brotherhood of Trash Collectors will thank you.

So anyway, as far as I know the insulin is dripping, dripping, dripping into my subQ space on my right side; about four and one half inches from my belly button. Funny, I’ve been pumping for what seems like forever, but always with the same pump. I took it for granted. Never gave it a moment’s thought as to whether or not it was working. I live, therefore I pump.

Now with a new style of infusion set and a new pump, I feel a creeping sense of paranoia. Is it working?

The sensor is on her two hour warm up, so I’ve got no BG data flowing yet either. I do a finger stick to make sure I’m not on the DKA express. I plan a couple of more, just for in case.

Two hours later…. (French Accent a’la Sponge Bob)

Huh… I should have received the “BG now” message to calibrate the sensor by now. I wander through the Menus seeking more information. A five-year-old lost in the mall. There aren’t that many menus…. Have I been at this one before? I’m dropping mental bread crumbs as a go along blindly with a male’s typical stubbornness not to just get out the damn manual and look it up…

Eureka! I find it under the Sensor Status screen (ESC button four times, for what it is worth), and I didn’t have to resort to checking the manual. And the next Calibration is due….huh? Oh. Still 45 minutes off. Maybe the new system takes longer? Darn. Oh well, not really that big of a deal. Guess I’ll balance the check book. Or maybe I’ll have another cup of coffee…the check book has waited three years to be balanced, another couple of days won’t hurt.

45 minutes later….

The appointed time for our calibration date has come and gone. I check the sensor status screen to find that ParaPump had changed the time of our date. (I guess ParaPump is female after all). Huh. I did get a couple of sensor error messages in the last hour. I’ve also had some telemetry trouble with the seashell transmitter, which I think I fixed. The ParaPump is on my belt, above my right hip. The sensor is implanted in my right leg, about mid-way between my hip and my knee. Roughly between them is the metal folding box cutter that I wear as a pocket knife. I wondered if all that metal might have some how screwed up the transmissions. I moved the knife from it’s usual home, clipped into the top of my right jeans pocket to a new home on the left side. No more signal trouble. Did the knife cause it? Don’t know, but looks suspiciously like probable cause to me. Hence forth knife will have to dance on the opposite side of where the ParaPump crew is on a given week. New estimated calibration time, ten minutes.

10 minutes later….

This is not looking good for the home team. I wonder if I’ve got a bad sensor insertion? If they bleed when you put them in, you might as well rip ‘em out and start over. They almost never run smooth if it is a bleeder. I didn’t see any blood, but…. ParaPump says she’s almost ready, will I come back in five minutes? Yeah, OK, I waited this long for our date, another five minutes won’t kill me.

Five minutes later…

This is a little like trying to take my wife out for dinner. I put the CGM sensor in at about nine this morning or so. I expected a steady stream of BG data to start rolling in by 11am. It is now almost 1pm. Parapump asks for one more minute.

Official countdown on the Girl was 2 hours, 20 minutes, but she always got to the party early. ParaPump, on the other hand, seems to be on Navajo Time. I’ve resorted to actually looking at the manual again. The manual for the new sensor says the initialization period should be two hours, so my sporty new mistress should be even faster than my old one. Well, isn’t that the point of getting a younger mistress, after all? So what’s up?

OK, I’ll wait at the door.

One minute later…

Can you come back in one more minute? Again? OK.

One minute later…

Can you come back in one more minute? You’ve got to be kidding me! OK, I’ll be back.

One minute later…

Can you come back in one more minute? How long can this possibly go on? Is there some sort of malfunction? Should I try another sensor? Should I just wait until the end of the day and see what happens?

One minute later…

Can you come back in one more minute? Again? You’ve got to be F’en kidding me! No! I will not come back in one more minute, Sam-I-am, I will NOT eat green eggs and ham!

Beeeeeeeeeeep. BG Now.

Oh for Christ’s sake….OK out with the BD Link meter (which I’ll come up with some catchy nickname for later on). Lets get this show on the road! Let’s get this integrated system integrated!

Oh, by the way, my BG is pretty good. I’m not DKA or even on the way. I guess the pump is working! Pump I can, pump I can, pump I can. Whoo, whoo!! OK, I guess I’m spending way too much time with Rio’s books….

1 Comments:

Anonymous Tom said...

"I live, therefore I pump."

Such a profound, and somewhat saddening statement. I feel a post centered around this idea in my future. I'm glad that your mistress finally showed up. :-)

11:01 PM  

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