Return of the Motor Errors

There’re days that it just doesn’t pay to get out of bed. Yesterday was just such a day. I had to be in Albuquerque, yet again. This time it was for a university faculty meeting to revise the curriculum we’re using to teach community health workers about diabetes.

Unlike earlier in the week, when I had to get up at 5am for an 8am Albuquerque meeting, this meeting was at 1:30 in the afternoon, giving me the morning free to sleep in an extra hour and get some writing done.

But it didn’t work out as planned. I woke up depressed for no particular reason; or maybe for every reason in the world combined. It’s not like any of us lack things to be depressed about in our world. So I sat at my computer and moped all morning. I pecked half-heartedly at the keys. I double-checked the shipping status of some pump supplies from Edge Park. Triple-checked my email. And quadruple-checked the weather. I flirted with, and suppressed, the urge to check eBay for antique anatomical models or miniature typewriters.

It wasn’t writer’s block so much as writer’s blah.

Four hours later, having accomplished absolutely fucking nothing for the day, it was time to hit the road. I pulled on a sport coat (red-brown corduroy over a pink dress shirt—some guys say real men don’t wear pink, but I say chicks dig it), gathered up my Go-Bag, the mySentry Monitor, a couple of pipes, a cup of iced coffee, and headed out.

It was a fiercely windy day, and following ten years of drought, half the state is blowing away. Our normally deep-blue high-altitude skies were muddy brown with dust. The traffic got heavier and heavier the closer and closer I got to the city. My bad mood deepened, exacerbated by my inability to find any music on my Sirius/XM radio that sounded right. Fifty frickin’ channels, and today they all suck.

At the curriculum meeting someone brought a big sack of corn chips and a dip of mixed beans, salsa, cheese, and guacamole. I carefully nibbled away, taking micro boluses and keeping one eye on the CGM screen on my pump. I was cruising at an amazingly flat 140-something and feeling quite the master of my diabetes. Until I noticed I was becoming… rather… um… prickly.

Never a good sign.

But was it the sucky day, or…???

I got out a meter.

And I tested.

And I swore.

And everyone looked at me.

Oops.

Oh. Did I say that out loud? I’m sorry.

273 md/dL. This is so why the artificial pancreas is not ready for primetime.

You know, even when you really understand the nature of CGM, and even when you do everything absolutely right, the little fuckers just sometimes have nervous breakdowns. I checked the Isig on the sensor status screen—the “raw” signal strength coming off the CGM sensor. It was low. A low Isig with a high blood sugar is always bad news indeed, as it tells me the sensor is dying. This is day six for this sensor, yes, well beyond the FDA approved window for use, but well within the common lifespan. I’ve been robbed.

I sent the fingerstick to the CGM to calibrate it, knowing full well that it was a suicide mission. The fingerstick’s and the CGM’s world views were too divergent. I sat back and waited for the “Cal Error” alarm, Med-Speak for calibration error. Sure enough, within 15 minutes, I had it and the CGM shut down.

I could have pulled the transmitter off and reset it, but I knew from experience it was pointless. For whatever reason, the sensor had died an early death. There was nothing in God’s green earth I could do to bring it back.

I was 132 miles from home and had no CGM. Crap.

And my blood sugar was high. Double crap.

It was back to fingersticks every 15 minutes. Triple crap.

Oh, and look at that, I only have three strips left. Quadruple crap. Can this day get any worse? Oh yes. Oh yes it can.

Of course the test strip issue was a non-issue. I was only a Boy Scout for one day (a story for another time) but I do believe in being prepared; I had a spare vial of strips in my Go-Bag. I also carry two spare infusion sets, two reservoirs, a flex pen of Novolog, Dex fluid, blood ketone meter and strips, band aids, batteries, breath mints, and pretty much everything else you need to survive the end of the world. I don’t, however, carry a spare CGM sensor. They’re always so damn reliable, it never seemed worth it.

Harrumph.

I kept my temper in check and survived the meeting. Outside, afterwards, it was hot and dusty, the wind still strong. It was now the height of rush hour. I stuffed and lit a pipe, gave up on the radio and slapped a rowdy CD into the player, cranked the volume, and sat in traffic, trying to be grateful that I don’t actually live in a city where I have to deal with this on a daily basis.

Finally, clearing the city, I was able to get home-bound at highway speeds. I did a steering wheel fingerstick and was still high. I took a correction.

And that’s when it happened.

Again.

I had to pull off the highway. That’s when I took the picture that I shared with you yesterday. Shit. Fuck. Damn. And Hell. I thought I’d seen the last of these bastards. After eight days “clean” on a Pump the Fifth and with new/different reservoirs and infusion sets, I had convinced myself there was some sort of weird production issue with that one batch of supplies, and that they had somehow caused trouble over four otherwise healthy pumps. I had convinced myself I had seen the last of Motor Errors.

Now… Well, QED, I’ve just had the displeasure of disproving that notion. The mystery deepens.

I sat for a time, the wind rocking and buffeting my jeep on the dusty median, and contemplated how good it would feel to disconnect the pump and throw it out the fucking window onto the interstate, and let the passing cars and trucks smash it to bits.

I fantasized about just going back to shots. Getting a hypo alert dog. And living happily ever after on a tropical island.

But then I remembered. I don’t like shots. I don’t like dogs. I don’t like the tropics. And maybe, truth be told, I’m really not that good at happy in the first place.

I disconnected the set. I didn’t throw the pump out the window. Instead, I practiced an all too familiar ritual:

I removed the reservoir from the pump—calling it a fucking piece of shit—and rewound the pump. Then I re-inserted the reservoir. Locked it into place. Pressed ACT. Confirmed I was disconnected by arrowing down to “Yes” and pressing ACT again. Then I held the ACT button down to move the plunger forward, the pump chirping the whole time. Once I saw a drop of crystal clear Novolog at the tip of the tube’s quick disconnect, I told the pump, that yes, I see drops by arrowing down to “Yes” and pressing ACT. I then had to press ESC to bypass filling the cannula, and then twice more to get the home screen, and then a third time to get to my CGM screen, which of course was useless as the sensor was dead.

Then I pulled back onto the highway for the long drive home.

I don’t believe in hexes. I am, however, re-evaluating jinxes.

And I’m beginning to think, that for me, this whole Revel/mySentry thing is jinxed.