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!).

Friday, April 27, 2007

Good news, bad news

I was drifting down when I lost the signal. The last SG reading was 102. About fifteen minutes later I got the lost sensor alarm. Damn. I try to reacquire. No go. I pull the transmitter off, plug it back in. No Roswell-Alien green light. Double damn. I’m at the clinic, no spare sensors here. Hmmmm… need to think about that. Should I keep a spare in my fridge here in my office, snuggled up with the Novolog, Levemir, Lantus, Mix, and Humalog samples?

Back to frequent fingersticks for the rest of the day.

My musing is interrupted by unexpected walk-in patient. Rough looking young fellow sent by his probation officer to have his sugar checked. Huh? Turns out he failed a urine test for alcohol. The officer thinks if his sugar is high it might effect the test. That’s a new one on me, but could be true. Turns out the punk is the son of one of my patients. Actually, he only looks like a punk. He’s actually a nice kid and we have a pleasant chat. Well, I guess he can’t be too nice if he’s on probation. Oh well, he’s friendly and has a good sense of humor. His visit presents my first opportunity to log an electronic encounter.

All week long this week we’ve been moving over to electronic medical records. Huge expense. Huge headache. Long term it will be wonderful. So it’s kind of like getting a root canal. Painful now, but in the long run you’re glad you did. Everyone but me got sexy new tablet computers (still pouting).

I’m still working on my desktop. Actually, that’s not true. I got my bosses’ desktop because mine was sooooooo old it couldn’t handle the new software. Our IT guy actually apologized to me. “I didn’t know we had any antique computers still at the clinic,” he told me. There are advantages and disadvantages to having an office in the Annex. Lots of privacy, but sometimes the powers that be forget we exist. Overall, a worthwhile trade in my book.

What do you want me to do with the old computer, IT Guy? He suggests I donate it to the Smithsonian to be displayed next to the Wright Flyer. In all fairness, it wasn’t that bad. My first six months at the clinic I had a big honking CRT monitor that literally took up half my desk. I was so happy to get rid of that nasty thing and get a thin, lovely, bright flat panel that the speed of the old computer never bothered me much. I mainly used it for inter-office email and checking EBay and blogs, on my lunch break, of course.

I got the hang of the new software pretty quickly. It is wonderful to be able to check my own schedule. Due to the number of licenses on our old schedule program, I never had access. I always roll my chair back so I can see out my door and holler down the hall, “Jane, do I have a 3 o’clock on Wednesday? What? I do? Uhhhh….what about 4 o’clock?” Now, not only can I check my schedule, but will ultimately I’ll be able to have all patient facts at my fingertips. Once everyone is in the system, that is. Depends who you ask how long that will take, six weeks, two years, sometime in 2030, or never.

Still, what power, in the best sense of the word. A patient calls with a question on their meds, I don’t need to run for a chart, I can call it up on my computer. All patient visits will be entered directly into the system too. No more paper charting at peril of your job, according to our director. That I worry about. Not that I can’t do it, but what it might do to the Zen of a patient visit. Can you image trying to share your hopes and fears with a guy typing on a computer? Well, we’ll see how that works out, but I can’t help but think I would have been better with a tablet computer in my lap. Well that’s what I thought until I actually got to use one of the tablet computers.

The kid whose probation officer sent him in is over in the main clinic waiting for me, so I scoot over to the nurse’s station to snag a tablet computer for the first time. I have no trouble talking a colleague out of her computer. All of the nurses are pretty frustrated and saying things like “I didn’t get into nursing to stare at computers” and “If I never have to look at another computer screen again in my life, it will be too soon.”

I delightedly start to demonstrate my prowness with the software on the snazzy new tablet and I get into trouble almost immediately. I get frustrated pretty quickly. The damn thing doesn’t recognize any of my letters. D-Screen becomes D-Scream. Well, in hindsight that’s pretty funny, but at the time it was stressing me out.

I finally push the thing away and grab a meter and a sheet of paper. I don’t want this poor kid to have to wait forever to get his sugar checked. He was 126 one hour after eating a burrito and drinking two gatoraides. Not a member of the tribe yet, but we had a talk.

After he heads out I go back to the tablet, determined to get this brief encounter into the system. Not a live entry, but postlive. Better than nothing.

Almost at once things go south on me again. When I try to backspace weird things happen. The computer then shuts down and my hands start to shake. I feel my blood pressure going up and my brain begins to fog. My mental processes are mired in molasses. I’m getting pissed off when a distant memory floats into my head.

……could it be?

……might it be?

……but I haven’t for years…..

I don’t have a meter on me. I’ve gotten lazy, why lug a meter around when you’ve got a ParaPump giving you BG data every five minutes? Luckily, working at a health center, there is never a meter too far away.

Grab glucometer. Snap. Zipppp! Wait for it, wait for it, wait for it….66.

Crap. Wouldn’t you know it. The first time ParaPump takes a coffee break I crash. But I felt it. Wow. I felt a hypo again.

What a great feeling to have such an awful feeling.

Of course, with my head resting on the tablet computer and drool coming out of the corner of my mouth, I look just like the rest of the mentally overtaxed medical team. It never occurs to anyone that I’m hypo…. Lucky thing I keep some very stale Cherry Slices in a drawer at the nurse’s station. Zip lock bag, labeled “Paws Off; Wil’s Hypo Candy.”

But I felt the hypo.

Next time: more on When Sensors Fail (take off on When Animals Attack).


Blogger Bernard said...


Now this is cool. Yet another reason why these CGM systems are useful.

And it's amazing to me how much I've come to depend on it. Right now I'm not wearing one because it started going flaky at 11 PM last night and I removed it.

Can't wait for your next installment.
I didn't want to put one in at that hour and have to wake up in the early AM to calibrate. Now I've read a tip that suggests putting on in a waiting longer than a few hours to calibrate it may actually produce less initial flaky results. I'll try next time.

4:05 AM  
Blogger Scott K. Johnson said...

Wow - any thoughts on why you felt this one? A good thing in my book!

10:48 AM  

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