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 21, 2007

Reply to comments

First off thanks for the blizzard of email condolences on the passing of Deb’s Grandmother. I had posted late at night and my blurry eyes missed the fact that I had mistyped her age: she was 86, not 69. I’ve amended the post, but a lot of you had already read it by the time my brain was working again the next day.

I haven’t had the chance to respond to questions and observations left in the comments sections, so I thought tonight I’d do that post-by-post. I’m just attacking questions or things I felt compelled to comment on, so I won’t list all of you name-by-name. Don’t take offense, I love the positive feedback, it’s great for my ego!

Calvary. Anonymous: yeah, even with the things that drive me crazy, the ParaPump system is an answered prayer. I’m often harsh ‘cause I get bugged when something is only 75% wonderful when there was no reason for it to not be 100% wonderful. I’m really pretty happy with the system, and I get more so everyday. Val: I’m probably one of those people who washed the lottery ticket that was never claimed… Scott: soooooo much to talk about, I’m really gonna try hard to post every day.

Box. Janna: I haven’t messed with the CareLink logbook yet. What I really like is being able to see the traces of the BG from the sensor. No real value to you if you don’t use the CGM (yet!). Tom: thanks for de-lurking, welcome! Bernard: software does seem to be a low priority for diabetes companies. Julia: OK to be jealous. Megan: I actually went through three CozMonitors in two years. They just mysteriously crap out. Each time Smith’s sent me a new one for free, but never commented on what went wrong.

Boxes. Janna: my home town pharmacy in Podunk New Mexico had the BD strips in stock, bummer you have such trouble in the Big Apple. For me, the bigger problem has turned out to be my new insurance from the clinic. The BD test strips are upper tier. They charged me $55 bucks for 150 (which really isn’t enough for a month anyway). I called the customer service folks and was told Accu-Chek was preferred and that I could have any number of strips my Doc could justify for $10 bucks a month. Good deal if true. Stay tuned. Meantime, I’ve been using the BD Link some, and also playing with a Accu-Chek Aviva to get use to it. It is, like all these damn things, both good and bad. Overall, not too bad. I’ll devote a post to the Aviva later. Oh, and the remote—fun, fun, fun. A post all about my first experience with it is coming up in a few days. So, sorry my well-endowed friend, I’m keeping it for my selfish self! Allison: I always love to hear your four-cents worth. A lot of folks have been emailing me about the BD meter. About 70% hate it. Many reports of inaccurate readings at low BGs. I haven’t had a real spectacular hypo yet to try it out on. Only a matter of time, I’m sure…. Julia: new transmitter more wonderful than words can describe. That said, I’ll throw some more words at it soon.

Homework. Anonymous, well as I work in photography about half the week, you’d think I could manage some images…but fitting that in has proven problematic. Don’t look for any real soon, but maybe down the road… Aaron: the Pal software is a great way to program the pump, but for what ever reason MedT does not include the cable necessary to make it work with the basic pump package. You’ve got to go on-line to CareLink site and request it. They did ship it out promptly, but by then I had already programmed the pump. It’ll be great for updates and fine tuning though! Jana: I agree that the B-wiz and the idea of a target range is an odd couple. I didn’t bother with a range and just set both high and low at 115 from 7pm to 7am and at 100 for the daylight hours. Wanted slightly thicker ice under my feet for nighttime corrections. Penny: trust me, the new transmitter will not be too large for your little D one. Scott: as soon as I read your note I ran and got Hirsch’s book from my nightstand. It has been sitting there along with Amy’s book waiting for a chance to read. I haven’t cracked either open yet. Also on the pile unopened are Thom Hartmann’s Screwed, Dr. Bernstein’s updated tome, a the latest Tony Hillerman novel and a half-read copy of Friedman’s The world is flat version 2.0. I went to page 150 of Hirsch’s book, and sure enough you are right, he quotes my most popular post…minus my name. Oh well.

Magic. Megan: keep in touch on your BD, let us know if you have better luck than in the past. I’ve received a lot of scary emails about the meter since I posted my happy thoughts about it. Lili: that is true, you still need the BD for your computer to talk to your pump and visa-versa. MileMasterSarah: we all live and die by our insurance companies. Literally. Randee: lack of a back light is a huge problem with the BD, and also with the Accu-Chek my insurance will pay for. I hate having to fumble for both a flashlight and a meter and strips and a lancer in the dark. Mini/Flash also has a cool strip-port light that sends a beam of light down the strip so you can test in the dark. Also works while driving at night. Not entirely safe, but very useful….George: I’m hearing a lot of insurance companies love the One Touch. Good meter (all three of the current models) and great strips in my experience. Allison: in my book, if a meter doesn’t work low, it doesn’t work.

Pumping? Tom, if you blog the concept of “I live, therefore I pump” please let me know, I’ll want to read it. Sad truth is, although I love all of you I’m sooooo short of time I only read three fellow bloggers (and even then, not every day). I read Amy at DiabetesMine, she’s the New York Times of Diabetes. I read Kerri at SixUntilMe because like everyone else I can’t help but love her. That said, if she has one more hypo without some sugar on her body I’m sending her a carton of glucose tabs… And I read Scott at Scott’sDiabetesJournal because we’re cyber buddies and I love the way he writes and thinks.

Mistress. Jana: thanks for the tip on peering through the murky crystal ball of the ParaPump menus to figure out insulin on board. And you’re right, I had figured it out. You can actually enter any BG and any carb amount to make this work. If you leave the BG blank the active insulin will also appear blank. I use 115 and 1 carb for the minimum number of button clicks. Every time I have to do it I get pissed off on two levels. First that I don’t have an active insulin screen to look at; and second off that the stupid ParaPump always goes back to a blank screen rather that showing me something useful. Anonymous: alarms that are too quiet are the real Achilles heel of this system. Of course, right now, no one else has a pump with a CGM built in, so ParaPump with it’s assorted quirks and weaknesses is still the best game in town. It’ll get real interesting when other pump companies start making CGM pumps. A feature like an alarm that really doesn’t work will cost MedT boat loads of customers if one of the other guys has a system with a loud alarm. I can’t fathom the decision that lead to an alarm without a volume control. The original Guardian had a wonderfully loud alarm, and personality too. Are you using the new MiniLink transmitter or the larger older one? The MiniLink will lose signal sometimes, but seems to keep a more robust connection to the ParaPump. Aaron: glad your wife is there, but what about all the diabetics who are single? Or whose wives sleep with their children instead? The alarm should be loud enough to wake the dead so that we don’t join them.

Pie eating. Glad to keep all you CoZmo pumpers happy…. But I do have to admit, once you get used to the system it isn’t as bad as it seemed at first. And when the pie eating contest is over I’ll be first to know I’m having an excursion when my high BG alarm goes off. Of course, I won’t hear it….

Dark Clouds. Arron: too big a hassle to carry different types of meters for different jobs. I went all-manual and switched to Accu-Chek due to insurance coverage of strips. As I have a limitless supply of BG meters of all types I’m test driving Gary Scheiner’s approach as revealed in his wonderful book Think Like a Pancreas. He keeps meters all over the place. I now use six (yeah, I know, sounds like overkill, but my life is complicated). I’ve got one in my car. One in my wife’s car. One on my night stand. One at the lab. One in my digital camera bag (weddings and events). One in my film camera bag (art and personal projects). Oh. Yeah. One in my “Go Bag” that I carry all the time and has my assorted backup and emergency supplies (and both a small digital camera and a small film camera), and there is One on my desk at the clinic which I also use for screenings. OK, so I guess I have eight, not six. Damn. I feel like a diabetic version of Imelda Marcos with all her shoes… By the way, thanks for the tip on how to turn off the send feature on the meter. I had shut it down at the pump end, but when I do still use the BD from time-to-time the poor thing blinks for hours searching for the pump. Very sad. Like a lost kitten. Now it acts like any other meter. Like anything else that pisses me off at first, it turns out not to be that big a deal. We humans adapt quickly. Entering BG manually is a minor pain, but in the greater scheme of things…No wait. Screw that. MedT should not have done this to us. I’m not cutting them any slack on this. A minor change in the programming could have made all of the parts of the system work in harmony like a well oiled machine. That didn’t happen. I’m going to keep harping of this until it is fixed!

Pal. Randee and Aaron: always lots of good reasons for a backup program. Anyone out there ever NOT have a computer failure? Lili: I have not pushed, pulled, prodded, bent, folded, spindled, or mutilated the connector that plugs into the test strip port. That said, it did look to me like the kind of thing that could get broken pretty easily if it were thrown in a draw or fell into the hands of a five-year-old boy. As soon as I down loaded the pump, I put it back into its plastic hood. Good safety tip for everyone.

Tomorrow: back to our regularly scheduled program


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