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!).

Sunday, August 29, 2010

Infusion confusion in a box

I got a box last week at the clinic. I love getting boxes.

Inside were a whole bunch of materials to promote Infusion Site Awareness Week, which I had never heard of before, and you probably haven’t either, as its brand new. Oh, yes, and it’s this week, all week long. But I gotta tell you, I hesitated to post about it at all.


Well, first off, the Week was created by Accu-Chek/Roche. So it struck me a little like Hallmark creating a Send Your Fiends a Card Week. Roche, after all, makes the Accu-Chek branded Tender, FlexLink, and Rapid-D infusion sets for insulin pumps. So it seems like there is an inherent conflict of interest here.

And I was also turned off by the ultra-slick media packet that came in the box. It has a disc with Word files that allows you to just drop in a few names from your organization to customize a pre-written press release. Most egregious, from an ex-journalist’s point of view, was the section where they have created a quote that you can attribute to someone in your clinic. Now, I understand that the media relations folks at Roche were trying to make it easy for non-media-savvy clinical folks to try and get some attention in the local press, which benefits everyone I suppose, but attributing a quote to someone who didn’t say it crosses the Rubicon for me. It’s too much. Too far from the truth. A lie with good intent is still a lie. I know the world is not black and white, but we have to have some standards, for God’s sake.

I also dislike jumping on band wagons, writing about what everyone else is writing about. Yeah, my hang up, I know. I just like marching to the beat of a different drummer. But sometimes, we do need to function as an organized movement. To flex the muscles of our collective power. So long as we all write about the same subject with our own styles, flare, and viewpoints—so long as we are not regurgitating press releases—then our voices can unite into a chorus.

But beyond all of that, I wasn’t convinced that we need a Infusion Site Awareness Week. I mean, is this really an issue at all? There are some other weeks I’d like to see first.

Like Insurance Won’t Pay for Enough Test Strips Week.

Like Insurance Won’t Pay for Insulin Pens Week.

Like We Need Better Access to Insulin Pumps Week.

Like We Need CGMs Week.

Anyway, here’s what brought me around: as to Roche being Hallmark; I would prefer that industry not create awareness weeks for their own products. But, as we’ve all been talking about recently, the organizations who are supposed to stand up for us, to create awareness weeks, are failing us miserably. Take the ADA and JDRF’s failures to recognize the hard work of the IDF in creating an international awareness DAY for diabetes. Here in the USA our heavy-hitter organizations seem to have abandoned any sense of mission towards the patient population, beyond milking our wallets.

So if our organizations won’t help us, should we turn our back on industry when they reach out to us? When they step in to try and fill the void? Obviously, I wrestled with this a great deal. It’s a delicate symbiotic balance. We are parasite and host to each other. We cannot survive without industry and the industry cannot survive without us. Literally, on both accounts.

So it sounds like we have a lot in common. And so what if industry gains from an awareness week, if it also helps patients? The world, I remind you, is not black and white.

So that’s what brought me around. Well, that, and the tattoos.

See, in addition to the press materials disc, an educational DVD that I have not bothered to watch, and bunch of happy orange buttons in the box, were the tattoos. These are very cool, numbered temporary tattoos in both bold tribal, and colored girly flowered styles. The concept is that after you pull a site, you slap on a temporary tat so you don’t reuse the site. They are big enough to not only protect the actual cannula injection spot, but also the surrounding skin landscape that has been suffering under adhesive for three days.

The tattoos come on a lightly branded card with the Roche and Accu-Chek logos, with instructions for putting on and removing the tattoos on one side, and infusion site rotation basics on the flip side. The info on the card is well-written, neither too medical nor too dumbed down.

I gotta say, this is bar none, the coolest out-of-the-box, fun, funky, different and inspired teaching aid I’ve seen in a long time. All last week I was handing out tattoo sheets to my T-1 pumper patients of all ages; and they loved them.

So I raise my wine glass (hey, it’s almost ten in the morning) in a toast to Roche. I toast them for taking the reins when our non-profits will not. I toast them for their creativity. I toast them for their generosity.

And I forgive them for crossing the line in their press release, and pray they never do so again.

Oh yeah, and happy Infusion Site Awareness Week.


Blogger Auntly H said...

They had me at the tattoos, too! Now I need to find a way to get my hands on a bunch. With pumping and CGM going now, I need more help in rotating around the real estate of my core. Arms are likely to be called into duty soon....

1:38 PM  
Blogger Penny said...

hey Wil! I thought it was funny that they devised a whole WEEK for this. I just received a sheet of them from my friend Bennet at YDMV and my gal, who is 8 and a T1 loves them so far.

As far ad ADA and JDRF are concerned, I am starting to sour on them and my gal has only been T1 for 2 years. They have not done much for us as a new family, honestly. Yes, research, research, I know - that's one of the things they have done. But other than that - taking advantage of the DOC? listening to what families need? rocking a good support group in our urban area of Philly? Yeah, well, that they sorely lack.

2:06 PM  
Anonymous Rachel said...

I do think this was an awareness week worth having - especially for guys like my husband who are still shying away from the pump. It makes him more aware of how he can avoid infections should he ever choose to go on it.

I would love to send you my box worth of the tattoos and pins, not going to use them ourselves and I know you could use more. Let me know!

2:30 PM  
Blogger Bob Fenton said...

Wil - happy to see that you are accepting the assistance. You have some valid points about ADA and JDRF and this will be their downfall in many respects if the industries learn how to step up to the plate and do many of the functions that they should.

Everyone that I have talked to in my area already has two or more boxes from Roche and I am not sure they (CDE's) are even going to use them. Could you use another box? Let me know and like Rachel, I will send you mine.

4:25 PM  
Blogger Jonah said...

I saw this on another blog and I love the idea of the tattoos, especially since for now they seem to be free. But I keep thinking, I bet they'll stay free for a little while and then they'll start saying that the tattoos improve patient health and charge or something.
I'm thinking now about getting a whole lot of temp tattoos for other injection sites to remind me where I injected; my right thigh is currently looking like I have chicken pox or something an I didn't notice until I had 9 separate areas there.

8:58 PM  
Anonymous Anonymous said...

Honestly, I didn't look at the press materials much and was already swayed by the tattoos myself! But I had already written about the week ahead of time, and was a little more tuned into the need because of my own past practice of not-changing-infusion-sites-adequately-like-the-FDA-or-pump company-tells me. I like how Roche is promoting this awareness. Though, I'd concur about the press release no-no... Grrr.

11:55 PM  
Anonymous Bernard Farrell said...

The tattoos look like something useful (I need to hand those out in some way), but I'm completely with you on questioning whether this 'week' is needed.

I understand the importance of rotation to try, as best we can, to reduce site damage and thereby improve insulin delivery. But is that worth a whole week's worth of press, hmmm.

7:22 AM  
Blogger Araby62 (a.k.a. Kathy) said...

This has absolutely nothing to do with your post, except the donating part...I'm moving and have a nearly full box of BD pen needles that I never used. They're about a year old when I got a Humalog pen trial. After reading your blog these last few years I thought it was worth asking if you could use them at the clinic. I know it's a drop in the bucket :-( Let me know via email if you would like me to send them to you.

3:44 PM  
Anonymous Sysy Morales said...

I see what you mean about a conflict of interest. I think awareness about the subject is super important but, I also see them charming everyone's pants off with these fun tattoos. They are reading everyone's reaction to them right now going, "yes! they love the tattoos!"

I dunno...I just use shots. Hey, question for you...has anyone ever brought up a lack of adrenaline to you? regarding you not feeling lows... I mention this because I know someone whose son never felt his lows (many years of frequent ER trips) and one day discovered he didn't produce sufficient adrenaline. He now takes adrenaline every day and doesn't have a problem feeling low blood sugars anymore. I couldn't help but mention it. Forgive me if this info is useless.

3:34 PM  
Blogger Wil said...

Thanks all, for your offers. I'm pretty well set on temp tattoos. Give your spares to your kids, neices, and nephews to play with. Also good on pen needles, but thanks for asking. If anyone has some old medtronic 508 reservoirs laying around, that I DO NEED for one of my patients.

12:34 PM  
Blogger Wil said...

Thanks all, for your offers. I'm pretty well set on temp tattoos. Give your spares to your kids, neices, and nephews to play with. Also good on pen needles, but thanks for asking. If anyone has some old medtronic 508 reservoirs laying around, that I DO NEED for one of my patients.

12:34 PM  

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