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
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!).

Wednesday, April 04, 2012

New pump Redux

I’m sure that you’re happy to see I survived the night.

Let me see, how can I describe what it feels like to spend a night with a pump whose manufacturer suspects might be on the fritz?

Oh I know: sleepless.

The helpline folks sent me the UPS tracking number for the new-new pump. When I went to bed last night, it was in Louisville, Kentucky. This morning it’s in Santa Fe. Later in the day they called Debbie, waking her up, to let us know it would arrive today.

Right now, it looks like it might acutally make it to me today. But this is New Mexico. Sometimes delivery drivers decide to spend the day with their mistresses or at the Indian casinos, rather than making their appointed rounds.

It’s a different pace of life out here.

But the Brown Truck came mid-morning, ironically, as I was helping another Revel user adjust his basal rate based on his CGM traces over the last week. Old-new Revel was still chugging along, with no alarms (knock on wood) and the morning was crazy. I also had a parent-teacher conference with Rio’s teacher in the afternoon, so I left the old one on my belt and the new one in the box.

When I met with Rio’s teacher, she was delighted to tell me a Rio story I gotta share with you. The students were asked to choose a hero to write about, and while most of the students—predictability—choose music, sports, or movie stars; my little rebel choose (of all people) Captain Nemo.

Yes. Of 20,0000 Leagues Under the Sea fame. The prototype anti-hero from Jules Vern.

I wish I had his full report in front of me, but some of his supporting reasons were:

He’s smart.

He treats his crew well, and they look up to him.

He built his own ship.

He doesn’t like the way the world is, and is out to change it.

And he’s a little bit crazy.

What more could you want in a hero? “Of course,” his teacher told me, “I had to explain to the other children who Captain Nemo was.”

I could not be any fucking prouder. Rio choose the ultimate anti-hero as his hero.

She also described third-grader Rio “as a man of few words” but was continually amazed by his extensive vocabulary, analytical thinking processes, and good behavior. None of which has anything to do with CGM, pump problems, or mySentry. But I just had to brag. Oh, and Rio’s waaaaaaaaaaaaaaaaaay behind on the standardized tests because he’s a slow reader and a slower writer. Despite of that, his teacher would give her right arm for a room full of Rios.

But back to our story of Captain Wil and 20,000 mg/dL Above Target.

So it was evening, after a botched DQ Blizzard bolus (hey, it was a hot day), before I sat down with the box and got out the replacement pump. I had earlier used the CareLink USB device to upload the old-new pump’s data. If you’ve not used the USB receiver yet, you should. It’s way cool, and easy-peasy after the first use.

Getting it ready the first time is a small hassle, but you’ll live through it. Here’re my tips. First, for God’s sake don’t do the first thing that comes to mind: which would be to plug it into your computer. No, instead, first go online to CareLink at Med-T’s website, tell the program you want to upload, and then select the USB device option. At that point, using the rather scary magic of modern snoopy computers, the Med-T system will peak into your underwear drawer to see what your operating system is, and will then feed your computer the right drivers for the receiver. After this, the USB receiver is plug-n’-play.

I happen to be working on a 64-bit Windows 7 Gateway right now. I say “happen to” with all sincerity. When my previous computer bit the dust—taking with it both an external hard drive and three months of writing—I went to the I.T. guy at work and said If you were buying a computer today, what would you get? He gave me a list of three: a high end machine, a mid-end machine, and low-end machine (price wise). The little Gateway was the cheapest one on his list, so being poor that’s the one I choose; and the two of us have been very happy together ever since. The computer and I; not the I.T. guy and I.

Oh, and once bitten, twice paranoid: I now have two cloud back up services—SOS and Carbonite. FYI, I think the Carbonite is the better and easier of the two to use, especially when you need something back again, but the SOS has a real-time feature that backs up files as you create them; something that’s hard to beat.

Anyway, the 64 bit systems seem to be somewhat harder to find happy software for, but CareLink got me squared away and I was able to print out a pump settings report from the dying pump.

I then sat at the kitchen table and started manually entering all the settings into new Pump Redux. Talk about a step backwards. The previous Med-T Paradigms had a software program called Paradigm Pal that let you program your settings on a computer and download them to the pump.

You can’t do that with a Revel.

You gotta enter every fucking thing by hand.

It took me about half an hour to plug in my basal pattern, insulin to carb ratios, correction factors, the various CGM alarm thresholds, the ID numbers to the two meters, the CGM transmitter ID, and all the rest.

In fact, check this out:

With the meter’s transmitter ID entered into both the old and new pumps, they can both receive the same data from the meter.


Oh. The 336 mg/dL? Remember the DQ Blizzard I was telling you about? Nuff said.

Also, both pumps were receiving the same CGM data from the sensor in my leg until I pulled the battery out of the ailing one and sealed it up in its cardboard coffin for its return ride to Northridge.

Now the new pump was fully up and running, programed, pumping insulin into my carcass (with some over-riding on my part as the new machine had no knowledge of the correction bolus from the old pump, and thus thought I had no active insulin in play), and was receiving data from both meters and my CGM.

It was not, however, talking to the Sentry.

I had to fall back on the manual. Manual in hand, I went to the Utilities Menu on the Sentry monitor, selected link to pump, followed all the instructions on the screen, punched all the buttons on the pump I was supposed to, and was informed that the pump and the Sentry were now linked and the Sentry was standing by, searching for the pump.

And it searched.

And it searched.

And it searched.

And it searched.

I’m on the roof and the water is rising. At what point do I call for help?

Well…. Shit.

The old pump is still alive, so maybe it’s causing some kind of interference. I pulled the plug—it’s OK, it signed a DNR—by removing the battery. An odd sadness came over me as I watched it’s screen fade to nothing. I guess I’d gotten kinda fond of the little critter in the two weeks we had together. (I’m guilty of frequently anthropomorphizing technology.)

I restarted the Sentry/Pump link process, and this time the Sentry woke up and the color screen flooded with fresh data. Full battery, bright green. Full insulin cartridge, bright green. Strong telemetry, bright green. If we were a submarine we could dive the boat. All the hatches are closed.

Of course there was no CGM trace. The pump hadn’t been on the job long enough to collect any data. Oddly, however, as soon as I linked the new pump to the existing sensor it was ready to rock and roll. I had expected a two-point-five hour warm up. I had actually planned to wear the old pump for a couple of hours, letting it drip insulin out on to the floor, and use it as an unofficial Guardian (Med-T’s standalone CGM unit) until the new pump was on the case; but it turned out to be unnecessary.

But what about the Outpost? From the Network Status menu on Sentry, I could see the Outpost was broadcasting loud and clear to the Sentry. So the two of them were still linked. I also knew the new pump and the Sentry were having a grand conversation, but I didn’t know for sure if I needed to re-link the Outpost. Would it “hear” the new pump?

We ran a one-rat study to find out.

Yes, I am the rat.

I moved the Sentry to our Library (the Outpost is across the house in my bedroom, technically the master bedroom, but as noted previously, I’m the lone occupant of it 95% of the time). Then I hung out in the Library until the Pump Redux linked up with myAssistant.

Then I assigned Debbie to the Library Watch while I hung out in the kitchen. To kill the time, I decided some wine tasting was in order. I don’t really know how quickly myAssistant lost the telemetry from the new pump. It might have been right away. It might have been after five-to-seven minutes of no data packets being received. The reason I don’t know how long it took was because I was tasting wine and my mate was lost in thought reading People Magazine online.

At some point she reported to me red bars—no data was being received from the pump. I put the wine away and moved my bedroom, flopping on the bed with my Kindle and passing the time by reading about the Navy Sea Lab experiments and the development of saturation diving to record depths (diabetes is SO not what I want to read about by the end of the day).

“Three bars!” shouted Deb. Followed by, “And what the fuck is your blood sugar doing so high?!”

As I side note, I should probably mention that when Rio was, oh, I dunno, about three years old, his maternal grandmother pulled me aside one day, voice hushed, “Rio used the f-word today,” she whispered, her eyes wide with shock.

I thought about it a moment. Did he use it correctly? I asked.

His Nana hesitated. Thought about it for a second. “Well… yes….”

OK then.

Anyway, so should your pump develop a juvenile delinquent personality and be sent back to Northridge for re-education, know that you need to link the new pump to the old Sentry monitor, but that you don’t need to worry about the Outpost. So long as the Outpost is linked to the Sentry it apparently doesn’t matter what radio station the Sentry is tuned into.

Oh, and speaking of the Outpost, ours has a new home in our home. Let’s talk about that tomorrow.

Next time: Alpine Outpost


Blogger Scott E said...

I recently went through the painstaking process of copying all of my settings from my old, cracked pump to my replacement (thanks, Medtronic) pump. I'm still not convinced I got everything right. They certainly don't make it easy!

11:03 AM  

Post a Comment

<< Home