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!).

Monday, April 16, 2007

Why I won’t win the pie eating contest, but the guy with the CoZmo will

Let’s eat! First, like all good diabetic citizens, test…don’t guess! (Free plug for D-Life). Strip out of vial…oh damn, they all fell out. The disadvantage to having that tiny little canister. Pick up strips from floor and counter top. Put them all back and remember that you still need one to test. Try carefully for one, get three. Put two back. What was I doing?

Oh yes. Test…don’t guess. Insert strip, BD Link meter wakes up. Confirm code 19. Stab finger, get tiny drop of blood. Touch to strip….zipppppppp! Meter counts down 5… 4… 3… 2… .1 and the winner is: BGL of 160! Meter flashes and the number floats through the air. The ParaPump chirps. Now, press the B-for-Bolus-Button on the pump. 160 flashes at me, the BGL the Meter just revealed and sent to the pump. Ya gotta press ACT. Now ParaPump asks for the carbs. You arrow up, one gram at a time. That’ll encourage you to eat low carb meals. It goes faster and faster as you hold the button down. Next an “Estimate Details” screen comes up, detailing:

Est total--this is how much insulin the B-wiz thinks you should take.
Food intake—this is the carb number you just entered a few seconds ago.
Meter BG—this is the number that was just beamed over that you had to confirm.
Food—in units, this is the part of the estimated total bolus that is covering your carbs.
Corr—in units, this is the part of the estimated total bolus that is for correction.
Active Ins—this is how much insulin is still “in play” from previous boli or corrections based you the duration of action you set.
ACT to proceed
ESC to back up

Of course all of this doesn’t fit on one screen. Ya need to do some scrolling.

Let’s assume you agree with the B-wiz, or are too tired of watching your food get cold to care. You press ACT. Ha! No insulin yet! Now you must choose Normal, Dual, or Square wave bolus. If you choose Normal you still don’t get insulin. If like me, you like to have the pump remind you to check your BG in a couple of hours after a bolus you must go through a BG reminder screen each and every time you use the B-wiz. It does remember what you did last time, but it is still another step. Then at last, you can deliver the bolus, right? Well, no. You need to confirm the delivery volume, again. Then it delivers. One speed fits all, slow but that’s OK with me, I don’t like fast infusion anyway. But wait, what if you wanted a Dual Wave? Oh yeah, then there are more steps to go through.

So you MedT pumpers are saying, yeah, OK…so what’s your point? And anyone on a CoZmo pump is laughing their ass off right now.

Here is the CoZmo routine. You take out a test strip. Still possible to drop them all on the floor, but even the fattest finger fits inside the ridiculously over-sized FreeStyle canisters. You have to wake the pump up by pressing any button and then slip the strip into the CoZmonitor, which sits piggy-back on the rear of the pump. When you put the strip in, the meter software wakes up and takes over. Confirm code 17. Stab finger, get much larger drop of blood than they claim you need. Touch to strip….zipppppppp?? No preview window on a Freestyle test strip. Meter is also fast, but there is no countdown. How long it takes depends on how high or low your BG is. If the pump vibrates in your hand as soon as the blood hits the strip you know you are in deep, low trouble. If it takes a looooooooooooong time you know there is a correction bolus in your future. Our 160 shows up on the screen. You have a couple of choices, meal bolus, correction bolus, or just back to home screen. BTW, a CoZmo can be left on any number of its useful info screens, rather than returning to the blank home screen that the ParaPump does after 30 seconds. I always left my CoZmo on the IOB screen. That stands for Insulin On Board, and it tells you how much bolus insulin is in play. Handy thing to know when you look at a BG reading. If you have 5.8 units on board and your BG is 112, you have a problem.

But I digress. So in this case you’d select meal bolus. If you have various types of boluses programmed in the next screen asks you to choose. Next you dial in your carbs, by five unit jumps. It asks if you want a correction bolus. If you say yes is shows you the BG result you just got. Then it shows you the corrected (up or down) bolus and you press deliver.

All of these actions are done with the right-hand button. You can rest your right thumb on the button and fly through the procedure in no time at all. And it never asks you about reminders. If you’ve programmed it for reminders from the get-go it just does it automatically.

Let’s see…writing about it takes more time than doing it. How many menu screens did that take? 1…2…3… OK… Six total. The ParaPump sends us through eight… well, I guess that really isn’t that many more. Maybe it’s just the strangeness of a new way of doing business. In a month’s time I may be so use to this that I won’t give it a thought.

Maybe I’ll have a chance at winning that pie eating contest after all…


Blogger Christine said...

Ok, I confess, I was laughing.

9:11 PM  
Anonymous Anonymous said...

Guilty also...(laugh, laugh)- good stuff

10:58 PM  
Blogger asskeeper said...

I was laughing. Sorry.

8:50 PM  
Anonymous Anonymous said...

Unless you use the Square Wave or Dual Wave bolus options often, you can turn them off in the bolus menu. Then when you bolus, you have one less step in the process; it will always be a normal bolus. The few times I want to use the other bolus options, I just turn the feature back on.

10:07 PM  

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