Somebody Ran Over My Dexcom

I have to go back to regular blood tests for a while. A few days before Christmas while running errands my Dexcom receiver fell off of me. I had it in it's belt clip and was wearing it on my left side. I guess I jarred it a bit loose getting out of the car and while I was jogging across a parking lot it fell off. I didn't notice it missing until I got back to the car and found it, still in it's leather belt clip in the middle of a traffic lane. Unfortunately it had been run over as it sat there.

Over the past few days I've had to get used to not knowing what my blood sugar is between finger sticks. I gotta tell you it's really weird.

I got so used to glancing down and seeing where I was as far as blood sugar went. Waking in the middle of the night and picking up my receiver to see how I was doing. Trusting that silly thing to wake me up if I dropped too low.

The good news is, wearing it for as long as I did taught me enough about my body and it's reaction to insulin and food that I've been able to keep blood sugars fairly stable without it. Even through the Christmas Holiday and several parties with lots of dangerous grazing food available I didn't get too out of hand. So even wearing a CGM for a while will help.

The other thing I pretty sure I've decided is that I might have been believing I could do far too much with this technology. I was trying to make my blood sugars look, "normal."  I'm fairly positive that is not possible. My body is not normal and no amount of technology and work that I do could even begin to match what a functioning pancreas does on it's own.

My goal now is to control it. To be close to normal. To not be swinging from highs to lows and spending hours and days far too high. My blood sugar may not be normal but I spend far less time above 200 than I used to and I'm going to try and be happy with the occasional spike.

I can't wait to get a new DexCom receiver though.  I hope to ordering a replacement fairly soon.

Sometimes you do everything right and it still doesn't work.

Rough night last night.

Admittedly, I didn't eat great.  Everyone else was out so I just grilled a ham and swiss sandwich added some Cheetos. I had some crackers and dip too because Kristy left some of this wonderful ranch/bacon dip that she took to the ladies Christmas banquet. I might of had some dessert too, a couple of Hershey's kisses. I was fairly sure I accounted for all of that, though, when I set up my bolus. I took almost 20 units of insulin 12 units up front and the rest spread over a two hour period.

Thant was all around 6:30. Around 8 I started seeing my blood sugar go up. By 9 it was above 200 and I took extra insulin. At 9;30 it was above 250 and I took more insulin. Remember I haven't eaten since 6:30 (Ok I  had a pickle and some cheese, maybe a carb) Around 10 it appeared my blood sugar was taking a break from the rise. It had leveled off at 290. I thought, maybe all that insulin was going to start kicking in. It didn't. I started feeling bad and also started asking Mallory, who was watching Oregon  beat up on Arizona with me, If she smelled insulin. I began to look for  leaks  in the tubing or evidence that  there  was  something wrong with the infusion site. While I thought I smelled insulin I couldn't find any  liquid on the tubing or near the site. I told Mallory  that  I would wait till morning and see if my blood sugar ever went back down.

At 11:00 though I looked at my blood sugar one more time; 323 and rising. I thought, "I didn't eat that much. It's gotta be the infusion set." 20 minutes later I had changed all the tubing and changed the site where it was connected to me. I over-rode the pumps safety features and took 15 units of insulin. I figured I hadn't gotten most of what I had taken through the evening. I set my continuous glucose monitor alarms to high set it next to my head and went to sleep. I woke several times overnight and each time checked my CGM. Each time it indicated that my blood sugar was going down but not dangerously. I woke at 6:00 with a blood sugar of 98

A couple of points to make through this story

• Sometimes diabetics do everything right and it still doesn't work. If you have a diabetic friend or family remember please  don't assume that a problem With blood sugars means they aren't doing a good job controlling themselves. And if they get frustrated by this disease, remember you'd rather have them frustrated and fighting it than having them give up and let blood sugars run Crazy because they are too hard to control.
• Another push for CGM's. This entire night could have been a lot messier and a lot more difficult without it.

All about that pump

Found another great diabetes blog site. This video reminded me that all of the stuff I go through: There are millions of kids and their parents fighting the same battle, remember insulin is not a cure!

http://blog.thediabetessite.com/type1girls/

Surprising results in a weekend where I ate out a lot.

I'm wondering what affected these outcomes most

• Good carb estimation? 
• limiting extra carb input? 
• plenty of exercise? 

Kristy and I went to Louisville Kentucky for the weekend for a late celebration of our 27th anniversary. We ate out a lot and since I'm a craft beer fan and Louisville seems to be a center for craft breweries I sampled some craft beer. I didn't go to get drunk but did enjoy a few strong ales and stouts. 

To my surprise my blood sugar stayed well under control all weekend long. Even after the Pretzels and cheese appitizer the first night we were there. The Nacho's at Churchill Downs and the amazing "loaded Kettle Chips" at Troll Pub Under the Bridge. 

Several things I think I did right to help with Blood Sugars on this trip. 

1. I really focused on a good estimation of carbs and didn't hold back on the insulin to deal with it. 
2. If I added carbs in an appitizer (pretzels or chips) I limited carbs with my meal. No sides with my BBQ on the first night and left my fries on the plate at Troll Pub. 
3. We did a lot of walking. Even though it was cold, we walked most everywhere in downtown Louisville. 

the takeaway from the weekend? You can go out and enjoy yourself while controlling you're blood sugar. You just have to be intentional about it. 

On diabetes awareness day

If I had one thing that I wish the public understood about type 1 diabetes it would be understanding how difficult this is to control.

It's like when you interview the opposing team before they play Peyton Manning or Russell Wilson. The reporter will eventually ask the question, "What are you going to do to control that guy?" The answer is always the same. "We have a plan to try and contain him but the truth is you can't control him you just have to try and limit his effects." That's what fighting type 1 diabetes is like.
You  come at it with a plan, sometimes that plan works, sometimes it doesn't. The most frustrating thing about being a type 1 diabetic, as I get older, isn't the diet, the shots or even the blood tests. It's those times when you are doing everything you're supposed to be doing and it's still not working.

That's the thing I wish people understood. That insulin isn't just a medication you take to fix the problem. Taking insulin means a delicate balance of food, insulin and exercise. Stress and infection can affect the way your body processes the insulin you take and the food that you eat. Just about the time you think you have it figured out something changes and nothing seems to work anymore.

I love those days where everything seems to work and my blood sugars stay somewhat normal. The truth is though I spend most of my time trying to figure out what I did wrong and wondering why my blood sugar is either much higher or much lower than I thought it should be.

World Diabetes Day

Tomorrow is World Diabetes Day. I didn't actually realize there was a World Diabetes day until JoyFM listeners, Kim and Kamryn Lampfert asked me if I would wear a blue circle with them. I also didn't know that the blue circle was the symbol for diabetes awareness. I told the Lampferts I would be happy to wear one of the pins. I will be traveling tomorrow so unable to share this on the air but thought I'd share it here. The Lampferts also sent me a list of  facts about type 1 diabetes these are good for people to know.

1. Type 1 diabetes has no known cure. It is an autoimmune disease in which the body attacks beta cells in the pancreas.
2. When a person's blood sugar is low it's difficult for them to think. During a low blood sugar, the brain literally doesn't have the fuel it needs to function properly. 
3. When a person's blood sugar is high or low, they may also have extreme emotions such as crying easily and being short tempered. 
4. People with type 1 diabetes do not make their own insulin and must it via injection or insulin pump. They would die without it. 
5. Insulin is not a cure for type 1 diabetes. It keeps people with diabetes alive, but it does not make it go away. 
6. In many parts of the world a diagnosis of type 1 diabetes in a child is a death sentence. Access to insulin and testing supplies is limited in some developing nations. 
7. When at a birthday party and guessing carb counts, an average homemade cupcake or 3" piece of cake has approximately 30-35 grams of carbs. 
8. Diabetes is just one aspect of a child with type 1. Of course take care of medical needs but try to make them feel like a kid first and foremost. 
9. The cupcake is the unofficial symbol of the diabetes community. Why? Because people with type 1 diabetes CAN eat them as long as they have insulin. 
10. Minimally, a person with type 1 diabetes checks his/her blood sugar 4 times a day. That's more than 1,460 painful finger sticks a year. 
11. In one year, a person with type 1 diabetes (not on a pump) will give him/herself a minimum of 1,460 injections
12. Type 1 diabetes was formerly called "juvenile diabetes," a misnomer because children don't outgrow it when they become adults.

Thanks to this family for making me aware about the Blue circle and effort to educate people about this Chronic disease that takes more lives each year than the more colorful diseases. 

Exercise: It has to be part of the plan!

The truth is, I hate running. My legs hurt, the arch of my right foot feels like someone put a rubber bouncy ball in my shoe. I've realized though that exercise is of ultimate importance for my life.

Last week, with the JOYfm fundraiser, it was hard to find time to exercise. I was at the station from 5:30am to 7:00pm each day. This week I continued to slack off and continued to see my blood sugar do weird things. It was doing this slow rise overnight and I was waking above 200 even when I didn't eat a snack before bed. I went to bed last night with a Glucose reading of 97 You can see from the picture above it was well above 200 this morning. You can also see what a little exercise does.

I took insulin, waited for awhile to eat. Ate breakfast and reduced my basil rate to 30% for a half hour before my run/walk and left it at 30% during the 1/2 I spent running and walking.

exercise with the proper basil rate just brings everything down and levels it out.  I get excited when I see that flat line of Glucose levels at right around 100

The DexCom CGM to the rescue.. Again!

It was our annual Chili-Cook off at West Springs Church. I love the Chili Cook off even though it is not usually kind to my blood sugar. I went this year determined not to let it get the best of me but to still enjoy tasting many different chili's.

At the beginning of the evening I took enough insulin for 90 grams of carbohydrate and extended the delivery over 2 and 1/2 hours. I was hoping the extended delivery would help with the fact that I'd be sampling chili for a while.

Then I started eating. The only chili I had a full bowl of was may wife's Buffalo Chicken Chili. She only makes it once a year, for the chili cook off and I wait all year long to have some. After a bowl of that I got out the sample cups and got at least a taste of each of the 21 other chili's that were in the building. I wanted to make sure there was nothing there better than Kristy's Buffalo Chicken Chili. My daughter Mallory's chili came close but I ended up voting for the one I only get once a year. In case the story didn't make my point. I ate a lot of Chili

There was dessert contest going on too. I had promised myself that I would stay away from those. Someone brought candied bacon though. Morgan (youngest daughter) ran up to me and said, "Dad, did you see what's on the dessert table?" I had to try a piece of that. I did limit myself to one piece, even though it was amazing.

I looked down at my DexCom as the evening went on and saw that my glucose level was at about 203 and the trend arrow was indicating a gradual climb. There was still insulin left from my earlier bolus to be delivered but I thought maybe I still needed more so I tried to add an extra little bolus of 5 units. I later saw a warning on my pump that this second bolus was never delivered. It's probably a good thing.

Line dancing started next.  I went out to the dance floor, mainly to embarrass my kids.  I muddled through the Electric Slide, tried to learn some kind of country line dance, attempted the Cuban Shuffle and had a lot of fun with Cha Cha Slide. What I hadn't counted on was that all this line dancing was a bit of a work-out. I was fairly happy to see my DexCom showing that my glucose level had peaked and was trending downward now. 176 when I looked at it after dancing.

At the end of the Chili-Cook off and after helping clean up Kristy and I realized there was still time in the evening to go see this really cool band we had seen a couple weekends before. Pennsylvania Slim Blues Band was playing at a restaurant from 8 to midnight. We decided to go watch for a while. It took a few minutes to find a table in the crowded bar and when we did I glanced down at my DexCom, 89 - The trending arrow was flat it looked like all that exercise did exactly what it was supposed to do. Flat doesn't mean it's going to stay right there though. Your blood sugar will still drift its just not fast enough to change the trending arrow.

I did decide to partake in an adult beverage while watching the band. A Bud Select, it only has 3 grams of carbohydrate in it. I know alcohol will lower blood sugar so I kept an eye on my Dexcom. About halfway through my beer the DexCom buzzed on my side. Three Buzzes means I just dropped below 70. I looked and my blood sugar was 66. I slowed down on my beer and started looking around to see about appetizers or snacks. Our waitress was very busy but the next time she dropped by I asked for an appetizer menu. It took her a little while to bring it back and by the time she arrived the blood sugar was reading 56. Glancing at the menu I wanted something that was almost all Carb. Fat or protein would cause the carbs to absorb slower. Parmesan Chips didn't work, Cheese dip - no, Wings were not an option, So I decided to go with Toasted Ravioli. The order was put in and I waited while watching my DexCom. When our waitress came by again to see how we were doing I admitted my issue. I told her that I was diabetic that my blood sugar was little low. (53 now according to my Dexcom) I asked if they had any bread available. She said yes and within a few minutes had a basket of bread on the table for us. As my blood sugar started to rebound I orderd another Select and we enjoyed some great Blues and Rock-a-billy for another hour or so.

It turned out to be a great evening but I have to say that I was reminded again about the dangers of low blood sugar and drinking. I never really felt the symptoms of low blood sugar during that whole thing. Without the DexCom I probably would have believed that I was a little bit buzzed from the beer. It would have taken me much longer to react to the low and it could have been a much uglier night.

DexCom to the rescue again.

Diabetes makes you different

Last night I was telling a story about a piece of cake. It looked like wonderful cake, Triple Chocolate Decadence, or something crazy like that. I thought that if  I cut a piece in half took some extra insulin scraped off most of the icing, removed the chocolate ganache filling, I could have a taste of the cake without hurting myself too bad. A few minutes after eating the sliver of wonderful moist chocolate I looked at my CGM and saw 165 with two trend arrows pointed straight up. I kind of laughed and thought, "well that didn't work" and figured as it topped off I'd take more insulin to fix it. It took a wile to come back down. I kept pumping insulin two or three units at a time but I hung just a little over 200 all afternoon.

I was laughing about the story and explaining why I was deciding to skip the after meeting snacks available at our family group Bible study. Someone there looked at me with deep compassion and said "I am so sorry you have to deal with that."

I believe he really does feel this way. I believe his heart hurts when he sees other people have to deal with difficult things but I hope he understands that I don't talk about my disease in order to garner attention or sympathy. I talk about diabetes and the fight that it is for two reasons. First, it's part of my life. It's what I deal with on a daily basis. I spend more time thinking about blood sugars, what carbohydrates I'm eating and the amount of insulin I'm taking than most people do about their jobs, or the hobby they have that they want to tell everyone about. The second is, I want people to understand what diabetes is. There is so much misinformation and assumption out there. I just want people to know that insulin is not a cure. I want people to understand the delicate balance that all diabetics are trying to achieve, how hard that is and how easy it is to mess it up.

When  I was diagnosed at 9 years old they told me, "You can live a normal life, you can be just like everybody else if you take care of yourself." I was taught not to draw attention to my diabetes and to try to blend in with everyone else. The problem is, as.a diabetic you are different. In 1978 there were no home blood glucose test units. I had to go into to the bathroom 2 or 3 times a day to test for sugar in my urine. Try explaining that one to your ten year old friends. I had to learn an exchange list and at birthday parties either skip the cake, cut the icing off the cake or just act like I didn't have diabetes. The third is what I ended up doing most of the time. I was a kid, I wanted cake and I wanted to be just like everyone else.
I remember hiding my insulin syringes while working at a radio station in Joplin Missouri, in the early 90's because I was told the owner had seen me with one and thought I was doing drugs. Working in the restaurant business episodes of low blood sugar were assumed many times to be evidence of drinking or evidence that I was doing something wrong and couldn't be trusted. You try working a lunch shift as your insulin is peaking and you can't stop for a snack.
After an auto accident where another diabetic who was having a low blood sugar episode ran into me while I was sitting at a stop light my own insurance agent said to me. "I don't think those people should be allowed to drive." I didn't mention to him that I was one of "those people"
Until very recently my solution to all of these things was do everything I could to appear normal. Eat the cake, skip afternoon shots so I didn't freak out the station owner, Eat a whole bunch before the lunch rush to avoid the low.

As a diabetic though, I'm not normal. Here are some things to understand about type 1 diabetes as far as I've learned by living it and now wearing this continuous glucose monitor.

• What works today may not work tomorrow: Stress affects how your body deals with sugar and insulin, exercise affects it, insulin absorption rates from the site your pump is in you can affect it. I'm convinced that the synthetic insulin we use these days can come in stronger and weaker batches. I don't have any research to back this up but it would help explain why some days I fight with lows all and others I can't seem to do anything to bring my blood sugar down.
• Many type 1 diabetics have reached a point where they cannot even feel the symptoms of low blood sugar until they are way too far gone. I have my CGM set to warn me when my glucose level drops below 70 (regular blood glucose levels are between 80 and 120) due to watching my CGM and noting when I actually feel bad I know that I don't even start to feel symptoms until I'm near 50
• Low blood sugars are caused by two much insulin in the blood stream and not enough food. This would seem to be fairly simple to avoid but it is not. Exercise will use blood sugar faster. Diabetics can't just jump in to help with a strenuous activity at the last minute without risking low blood sugar. I remember one time at church, the chair team didn't show up to set up the sanctuary. I started setting it up and after a time started to get very angry. I was tossing chairs around and mumbling to myself about these people. I realized that I had to stop because my anger wasn't really about the chairs it was low blood sugar. Please if you know a diabetic don't blame them for low blood sugars. These things come out of nowhere and sometimes we don't even feel them coming.
• People over-react, As a diabetic I'm making decisions on what to eat and how much I can exercise based on what my body is doing right now. The problem I see is that people assume if I say I can't do this right now it means it's bad for me and I can never do it.
• At work recently after a weekend of fighting with highs they had a taco/nacho party. I decided to just eat the lunch I brought because I had carefully measured the carbs in it and wanted to bring blood sugars back to more normal. Everyone wanted to know why I couldn't eat tacos/nachos. It wasn't about the food it was about estimating the carbs in the food.
• After the chair incident at church I mentioned to some people in the men's group about what happened and told them they I thought they should know that if I ever seemed irrationally angry they should ask me if I need to eat something. Some of the guys in the group have taken my story to mean that I shouldn't be putting up chairs, ever. Whenever they see me doing it they tell me to go sit down.

Insulin pumps and CGMs have changed the treatment of diabetes so much but it is still a delicate balance that is difficult to maintain. Like you might get frustrated with a car or a job. Diabetics get frustrated with their own bodies when things don't work like you expect them to. I'm not looking for sympathy when I rant that frustration. I'm just frustrated and sometimes just letting people know why I'm doing what I'm doing. Tomorrow I may look at my glucose level and decide, "yeah, I can have some cake."

Guest Post - "I married Diabetes"

I met someone a few years ago. She was the receptionist at my Doctors office. I found out her husband was also diabetic. She sent this, which she wrote a few months ago, to me. It's a good look at the frustration a diabetic's family member has to deal with and addresses some of the misunderstandings of the disease. I'm happy to post it here as a guest post... 

I Married Diabetes

  

Let me begin by saying that I do not have a medical degree.  This is based on my life experience being married to a diabetic.  I am writing this to encourage you to stand by their side and help them, especially when they are tired of trying.  Remember, they did not choose to become diabetic.

 

Growing up my understanding of Diabetes was very different than the reality of it.  I thought having Diabetes was just not eating sugar and sometimes taking a shot.  And worse case scenario, you could get Gangrene and have a leg amputated.

 

I did not realize that Diabetes is a lifestyle.  Diabetes is a daily thing, it doesn’t take a vacation.  

 

There are Type I Diabetics that require insulin.  There are Type 2 Diabetics that control it with diet and/or pills and sometimes insulin included in that regimen.

 

When I first met Jerry, who is now my husband, I shortly learned that he was a diabetic.  I still didn’t fully understand diabetes.  Jerry would sometimes start with trembling hands, which meant that his blood sugar was low and he needed a sugar fix.  He would pop some raisins in his mouth and the natural sugar from that would raise his blood sugars.

 

If someone’s blood sugar is too low (hypoglycemic) they require sugar.  If their blood sugar is too high (hyperglycemia) they require insulin.  It can be a difficult balance to maintain.

 

Before we were married, I walked in and noticed Jerry was lying face down on the bed, presumably taking a nap, and his hands were shaking.  I tried to get him to sit up, his eyes were open, but he wouldn’t speak to me.  I didn’t realize at that time that he was unconscious, I thought he was messing with me.  I went and got him some raisins and offered them to him but he didn’t respond.  I still didn’t know what was going on and God was very merciful because what I did wasn’t the best course of action, I learned later that it was actually dangerous.  I put raisins in his mouth and tried to move his jaws to get him to chew.  He was still staring at me and I still thought he was being obstinate, I didn’t realize he was in trouble.  He did stop shaking and closed his eyes and calmed down.  I tried to wake him a bit later but he just stared at me.  I thought, I know, he always answers the phone when it rings, so I called his parents who lived really close and asked his mom to call him.  He didn’t move when the phone rang.  It rang and rang and rang.  I picked up and tried to get him to take the call from his mom.  His mom said they were coming over we had to go to the ER.  He was indeed, hypoglycemic and required intravenous glucose to bring him around.  Apparently from what they tell me, a little bit longer, and without the sugar that I gave him prior with the raisins, he would have died.

 

Jerry lived in a small town and was seeing an Internist.  He was on a single shot of insulin regimen, but that wasn’t working too well for him.  So, I called my mom and asked her about the doctor that a lady we knew went to.  This doctor turned her life around.  He was an endocrinologist.  

 

Endocrinology is the study of glands.  The pancreas is the insulin-secreting gland in our body.

 

After we were married, I finally got him to agree to an appointment with the Endocrinologist.

 

Going to the Endocrinologist was the beginning of all kinds of things.  We learned diabetic education, various regimens and how to fine-tune the diabetes for my husband.  I learned that it’s a team effort.  I learned how to properly handle a low blood sugar when he was unconscious.  I married diabetes.  In sickness and in health, from this day forward, the two of us were on this journey together.

 

We started on a regimen of multiple injections, instead of just the one time daily dose that would peak and drop him.  Then came newer insulins that offered a lot of promise.  Then the insulin pump, which worked for a while, but then due to my husband being so thin and building up scar tissue, was unable to utilize it anymore, so back to the multiple injections.  

 

There is always so much going on in Endocrinology, new options, but some things remain the same, you have to monitor the blood sugars and respond appropriately.  For everyone, that isn’t the same, the doctor and their educators work with you for your individual situation.

 

Unlike a lot of people, my husband is a brittle insulin dependent diabetic.  So, even with the best of attention given to his situation, the results won’t always be the most desirable.

 

Over the years I have heard a lot of people tell me that it’s his responsibility.  But that is only partially true.  When a diabetic is unconscious, they can’t instruct you what to do, it’s imperative that you, the family member know how to handle things.

 

Also, as a spouse, you are the cheerleader.  When the diabetic is tired of being a diabetic, it’s time to step up your game to encourage them to keep up the good fight and not to give up.  You need to be there for them the same way that you’d want them to be there for you.

 

There are times they will say things that will hurt your feelings and break your heart but you have to realize it’s the diabetes talking and not the person.  Especially when you know the person would never treat you that way under normal circumstances.  When a diabetic is very low or very high, there is no telling what will come out of their mouth.  They will sometimes reflect that of a drunk.  You have to learn to let what they say go because they can’t always help it.

 

There are times your plans for the day/evening can immediately change due to a blood sugar.  Be kind to them.  And sometimes, after a big fluctuation in blood sugar, they may require a nap, understand, their body has just went through a lot of work, swinging from low to high or high to low, that’s a lot of work on the heart and the rest of the body.

 

We have gone back and forth a lot over the years.  Jerry would try and try, and do what was expected of him and while it worked, he was great.  But, then, his body would reject that plan and we’d have to switch to something else.  

 

In two days we will be married 31 years.  It has been one big roller coaster ride.  Fortunately, God blessed me with a lot of diabetic educated people to support me when others told me it wasn't my problem.  

 

Much like being a parent, there were times that I would set the alarm clock to get up and check his blood sugar during the night, due to the circumstance we would be dealing with.  There were times that God would wake me to check him and he would be in trouble and I’d have to wake him and say, “eat this, your blood sugar is low”.  

 

After 10 years of marriage, we actually went through what turned out to be a miraculous situation.  Jerry was losing weight like crazy and his blood sugars couldn’t be controlled regardless of what we did.  The doctor ordered a test, and the doctor performing the test noticed a little pimple on his throat that turned out to be a fast killing throat cancer.  God mercifully got us through the throat cancer without chemo or radiation.  Again, a learning situation for me, learning what to do when they have a trach and a feeding tube and have a low blood sugar.  So many things happened, but God is so faithful and Jerry is still with us.

 

I could write for a long time of the ups and downs of diabetes.  I know parents who deal with this disease with their children.  There are spouses that deal with the pancreas transplant and the roller coaster ride that is.

 

If you know someone who is diabetic, become educated.  Learn how to help them.  Most importantly, don’t give up on them and walk away.  Yes, there are days they are ready to give up, encourage them, empathize with them, love them and allow them to come to grips with it.

 

It’s not a fun disease, it can be relentless.  Seek the expertise of an Endocrinologist, and a diabetic educator and dietitian and if need be, a support group to help you along the way.  Talk about it, don’t hide it, education is the key.  Love the diabetic, even when they can’t love themselves.

How the Affordable Care Act continues to affect this Diabetic

The Affordable Care Act, as I understand it, was designed to make insurance more accessible for people who were on the lower end of the income scale and wanted/needed insurance. The only problem is that it did this by reducing benefits and making medical care more expensive for people who had good insurance.  The President promised that "If you liked your insurance you could keep your insurance." Unfortunately this has not proved to be true.

In March of 2013, after I had just ordered a new insulin pump and begun using the DexCom Continuous Glucose Monitor I was informed that the insurance plan my company had chosen for the employees was not ACA approved. We were going to be forced to change insurance plans. Our plan was a good one, I'm not sure why it didn't meet ACA standards.

25 dollar doctor visits
40 dollar specialists
500 dollar deductible
100% coverage after deductible was met
The Freestyle test strips I was using were on the highest tier but covered and with a freestyle card I was getting them for 15 dollars a month.
OmniPod insulin pump was available ordered straight from OmniPod with minimul problems
DexCom was not a real problem.

Among the insurance plans presented as approved plans by BC/BS not one offered what is so important to me that 500 deductible with 100% coverage after deductible is met. Looking through approved plans offered by BC/BS and UHC the closest we could find was a UHC plan that looked more like this.

35 dollar doctor visits
50 dollar specialists
1000 dollar deductible
100% coverage after deductible is met
Freestyle test strips not available with help from freestyle and would have cost over $100 a month.
OmniPod not really covered and each order for supplies needed clinical notes and 3 months of blood sugars submitted. Forced to switch insulin pumps.
DexCom only covered with extensive doctors notes.

All that being said, the cost of the plan is less but all that savings is going to go for making up the difference in coverage and since it's not being taken out of my paycheck pre-tax, Washington gets a cut of that income. Does this sound Affordable to anyone?

It turns out all of the issues with inferior coverage are just the beginning of problems caused by changing insurance. If there is one thing I'm tired of it's Doctors offices and Medical Supply companies using the insurance issue as an excuse for poor service. Since UHC does not work directly with DexCom I have to order supplies through an UHC approved medical supply company. Below is the letter I wrote to DexCom last night about how their distributor has handled my last couple of orders. Thank you ACA for making my life so much simpler and more affordable. (Yes that's sarcasm)

My last order of supplies was in July. I knew that I had 500 dollars of deductible left so I kept waiting for a bill from Byram Healthcare. At the beginning of September I received a letter from UHC stating that they had not been able to make a decision on the payment of the claim for supplies because they hadn’t received requested information from the service provider. The letter stated that no action was needed on my part that it was only informational. the envelope included a copy of the letter that was sent to Byram for more information and doctors notes.

At the beginning of October I received a letter from UHC saying that my claim had been denied because the requested information was never sent. I called Byram Healthcare to see what was going on and the billing rep told me that I owed them all the money because I didn’t follow up with the insurance and get them the information they requested. I told them I had a copy of the letter that asked them for the information and told me that there was no action needed on my part. The person I was talking to on the phone told me there was nothing they could do and I’d have to handle it with my insurance.

I then called UHC and explained the situation. They told me I was correct and that they had a copy of the letter I was referencing. They asked me if I could remain on hold while they contacted Byram Healthcare for me. When UHC came back to the phone they told me that they were faxing a copy of the letter to Byram Healthcare and it should all be taken care of in 10 days. Since that time I have been waiting again for the bill from Byram. I plan on paying it with the end of my Beneflex account for the year.

Today I called Byram Healthcare to order more supplies. (I know I extended the life of some of my sensors) I was told by the Byram Health representative that I had an outstanding bill that needed to be paid and she asked me how I would like to pay it before she would input the order. I explained that I hadn’t even received an invoice yet. She said that they had been working with the insurance and the insurance finally told them that this much wasn’t covered by the deductible. The invoice would go out today. I asked if I still had to pay before I could order something else without receiving an invoice yet. I was worried about actually having the invoice as a receipt for beneflex if they needed. She indicated that the order may be held up until the outstanding amount was paid and complained about how much information the insurance company had asked for. I asked if she was suggesting that was my fault. She said no but it was the explanation for the insurance process taking so long. I mentioned that this was not the reason that it took so long. I explained that it took so long because they had not submitted the requested info in July.  In the end, I said that I would wait for the invoice to pay the order. she told me she would submit the new order but I’m not sure when things will actually move forward.

I just thought you should know how a company that is dealing with your products and customers that your salespeople are so good to during the sales process are treating those customers. It has been a very unfortunate and unprofessional handling of the situation and I’m worried that my ability and desire  to order the dexcom supplies may be hurt by it.

Halloween for Diabetics. It's really scary

Holiday's are rough for diabetics, especially kids. Most type 1 diabetics are diagnosed fairly young and have to start dealing with some tough choices fairly early in life.

Doctors and parents are telling them they can be just like everyone else, but they fight with the fact that they aren't really.

When I was growing up there were no at home blood glucose tests or insulin pumps there were no plans for fast acting insulin with each meal.  You took one shot in the morning of an insulin that peaked several times throughout the day and designed a diet to eat when the insulin was peaking. At home Urine tests were supposed to tell you how you were doing. If you spilled too much sugar in your Urine you needed to eat less or take more insulin. It was a very inexact science.

This also meant that kids were not allowed any real sweets at all. Candy, Cake, Ice Cream, that was called cheating. I cheated a lot. I stopped doing Urine tests after about a year and without any way of really seeing what the food was doing to me ate a lot of the wrong things.

Mom and Dad tried to help. On Halloween they would buy my candy from me. Whatever I brought home we'd have a little auction and I would get paid to give up my haul. Of course money doesn't taste as good as that Three Musketeers or Reeses your sister is eating so I would find the stash and sneak it anyway. As I got a little older I learned that I didn't have to go find the stash, I just had to hold some of it back.

Halloween is still a hard time for me. So much chocolate sitting around the house and you think "oh one won't hurt that much." I end up using a lot more insulin this time of year. This will actually be my first Holiday Season with the Continuous Glucose Monitor. I'm anxious to see how that will change things

In today's world of carb counting, CGM's, insulin pumps and more exact dosing, I wonder what parents are doing to help their kids get through a Holiday where the main goal for everybody else is to see how much candy you can grab and eat.

Thoughts on the Tandem T:Slim pump, A follow up.

After a couple more weeks of using the T:Slim and some more research I wanted to do a follow up. I will say up front that I still regret my decision to give in to United Healthcare and switch from the OmniPod which was working for me so well but I wanted to pass along additional information on this new pump that I'm wearing.

Again none of what I'm writing here is supported by research and I don't have any real explanation for some of it. It is only one users experience with the pump.

Fist off I'd like to give what I understand is Tandem's explanation for the seemingly disappearing insulin. According to my research Tandem's explanation is that they are being truthful with their customer's while other pump manufacturers are hiding the fact that insulin disappears. They say that no pump can deliver all of the insulin that is loaded into it. Other manufacturers hide this by having the syringes used to draw up the insulin modified to match their pump. You don't notice the insulin that is missing as you draw it up because it appears you are drawing up 200 units of insulin when you may be drawing up 220. Tandem claims that the syringe they give for drawing up the insulin is marked correctly and in an emergency could be used to manually bolus. After loading the cartridge the pump lists the usable insulin and you notice the missing units. I'm trying to figure out a way to test this. I think I have a couple of Medtronic Syringes, when I end up with an empty insulin vial I may draw insulin into one syringe put it in the empty vial then draw it into the other to see if the units match.
I've also found that there is a metal tube at the bottom where the cartridge goes in that can get dirty and cause incorrect insulin level readings. One website I was reading said that Tandem recommended that they clean this metal piece with an alcohol swab at each cartridge change. I've started doing this and it seems to help some.

Another feature I've been reminded of with the T:Slim, that I forgot to mention in the first post was it's carb entering screen. It has a built in calculator. A nice feature if you're out to dinner and trying to count up your carbs. Instead of having to add the entre, potato, veggie, all in your head (yes we've all learned to do this over time) you can just put the carbs for you entre in on the screen hit the plus button then the carbs for your potato (or side) hit the plus button again and so on. The T:Slim adds up the carbs for you.  Not a huge deal but it does make things a little easier.

Those two things being said I'm still unimpressed by this new pump my doctors office seemed to like so much:

• Cartridge change and site change take a lot longer than any pump I've used in the past. This morning at least 15 minutes if not 20. This was from beginning to end. removing old infusion set, drawing up insulin, filling cartridge, filling tubing of new infusion set, inserting new infusion set, priming the cannula.
• No easy way to change Cartridge on the go. If I wanted to change the OmniPod at lunch at work rather than in the morning I took a vial of insulin and a new Pod with me. That's all I needed and the actual change took about 7 minutes. My Medtronic was even simpler. I took an infusion set and a pre-filled reservoir. In order to change the T:Slim you need: A cartridge, A syringe and needle, (these are not packaged together) an infusion set, a vial of insulin. You cannot pre-fill the syringe and you cannot pre-fill the cartridge. 
• I'm using more insulin and getting less result. Since I've begun using the T:Slim I have noticed higher spikes after eating and a much slower response in blood sugars coming back down. This was so drastic at dinner and in the evening that I changed the carb ratio at dinner to 1:5 from 1:6 and increased my overnight basil rates. Even with these changes I continue to see overnight rises in blood sugar that did not occur while using the OmniPod. I'm not sure if insulin delivery, site choice, infusion set could cause this but I definitely notice a difference.  
• After being spoiled by a tubeless pump I'm finding I really dislike fighting with tubing. So many things change with the tubing and a pump that's not water proof. I move a lot when I sleep. If I clip the pump to my shorts I end up rolling over it on my back and it wakes me up. If I let the pump lay beside me I end up tangled in tubing and waking up. I slept a lot better with the tubeless pump. Showers are a pain again. I hadn't thought about the way I used to do breakfast. I'd test my blood sugar and start a bolus. I usually wait till the bolus is delivered and give a couple of extra minutes before eating. I've found my BG spikes less this way. While the bolus was delivering I'd jump in the shower. I can't do this anymore because the T:Slim is not waterproof.

So Sorry to Tandem I know they worked hard on this pump and it does some cool stuff but after a month now of using it I wish I would have fought harder for my OmniPod.

Wondering about Steak and Potato's

If you are diabetic and check this out or if you're a nutritionists I'd love to hear what you think.

I've gotten pretty good at estimating carbs when I go out to dinner and counting carbs at home. I went out to The Spaghetti Factory last night, ordered a chicken/pasta dish. I ate the chicken, sausage and some of the sauce along with a bit of the noodles. I left half the noodles on the plate and stayed away from the bread and was quite happily surprised at the way my blood sugar handled it.

Where I have been having trouble lately is Steak and Potato's. My youngest daughter learned to make twice baked potato's and she's been making them at least once a week. I looked up estimated carb counts for them and have been bolusing accordingly. The last two times we've had them though my blood sugar has skyrocketed in the late evening after I fall asleep. Again the Dexcom CGM helps because I can see the BS mainly flat until after midnight then start to rise, spiking around 2am and then staying at that level.

Is the steak fatty enough or do you think there is enough fat in the S/C and butter of the twice baked potato that I need to extend the bolus? My diabetic educator told me to do this with pizza. The fat in the cheese slows the absorption of the carbs so you extend the insulin delivery of the bolus taking half of it an hour or even two later. Otherwise all those carbs hit after your insulin is mostly gone. I'm getting better at doing this with pizza, I just didn't expect it to happen with Steak.

What do you think? Ever experienced this?

The Biggest Game Changer out there

Last Spring it was suggested that I start using the DexCom Continuous Blood Glucose Monitor. I really believe this is the biggest game-changer I've ever experienced in controlling my diabetes.

I had struggled with the idea of using a CGM (Continuous Glucose Monitor) for a long time. I had hoped that a device like this would mean that I could go without regular finger sticks and testing. This does not do that and I figured why bother with another thing attached to my side if I still have to test my blood. I didn't understand all the benefits of being able to see what your blood sugar is doing at all times.

Couple of things, There currently is no spring loaded or easy inserter for Dexcom's sensors. You have to actually push a plunger in that inserts the needle which the canula for the sensor is on. You take the needle back out leaving just a tiny and thin canula. I've never gotten really good at giving myself shots always doing it slowly and carefully rather than a quick jab so this is no fun for me. I put up with it though so that I can get all the info the sensor provides. Also the CGM is not actually testing blood sugar. As I understand it there is a formula for estimating blood sugar based on the sugars in the fluid present in the upper layers of fat cells under the skin. This estimation is why you need to do finger sticks to calibrate the unit and to be aware that the unit may be off by as much as 20 points. I've found it is within 5 points most of the time and is the furthest off when my blood sugar is at the most extreme either high or low. Each time you change the sensor site you wait two hours while the unit compiles all that time of readings setting a base. At the end of two hours the unit buzzes or beeps, depending on how you have it set, and asks for two blood sugar readings. After inputting those two blood sugar readings the Dexcom takes a glucose measurement every five minutes and creates a graph along with displaying the most recent reading. It also displays an arrow to show which way you are trending Flat, slight incline or decline, straight up or straight down, double arrows straight up or straight down. (I've never actually experienced double arrows straight down) These indications of trend have helped me more than I could ever have imagined.

You can find most of the technical information on DexCom's Website . I'd like to give you an idea how the CGM has helped me, how I use it and why I hope I never have to live without it.

When I first got the Dexcom I couldn't believe how far my blood sugar swung back and forth after meals and with exercise. For everything that we had done and all the experimenting with bolus's and basil rates it just seemed that nothing made things right. I am still amazed sometimes by what I see my body doing that doesn't make any sense.

The first place the Dexcom started helping was with low blood sugars. Over 30 years of Diabetic life have caused me to really fear Low Blood Sugars. I've had some pretty bad episodes and hypoglycemic unawareness has caused me to really not feel it until my blood sugar is close to 40. I had a tendency to feel a low blood sugar episode and eat until I felt better. This normally caused me to swing wildly the other direction where I would take insulin to fix and #1 I set it to warn me when my blood sugar hit 70. I usually feel completely normal at this time but now I know early that something needs to be fixed. I get an earlier start on stabilizing. Also the trend arrow has helped. I know how quickly the low is falling. I can react to it based on that I eat and react differently to 66 and flat than I do 66 and an arrow pointing downward. This has helped me avoid the extreme lows while reacting with confidence in a way that also avoids the spikes afterward.
Learning to use the Dexcom to treat Low Blood Sugar has also taught me exactly how much I need to eat to change my blood sugar. Imagine trying to use finger sticks to figure out how many blood sugar points a single carbohydrate affects. When I treat a low blood sugar I'm able to watch and see how high blood sugar goes before it starts leveling out. A little math and I know that a single carb raises my blood sugar 5 to 6 points.
I should mention that it is not recommended by my doctor or by Dexcom that you use the readings on the Dexcom to treat low blood sugar. They have been very helpful to me and I don't always do a finger stick but remember that it has been my experience that the biggest change for the CGM to be off is at the extreme ends of the spectrum. Also it takes a little more time for the glucose levels to change in the fat and skin than in the blood so that may be a little behind. I will check at these times and find the Dexcom off. Be aware of that. Interesting note though. Because the Dexcom asks for two blood sugars to calibrate. I have tested on both hands to do the calibration before and my left and right hands have been as many as 20 points different. Who knows how real any of the readings we are getting.
The second thing the Dexcom has helped with is overnight blood sugar. #1 that thing buzzes when my blood sugar hits 70, no more waking up with cold sweats unable to think or see and feeling like I need to eat an entire quart of ice cream. "Buzz, Buzz" it's 70, get up, eat half a granola bar, go back to sleep. It'll wake me up again if that didn't work. #2 I had a huge problem with what my doctor calls "Dawn Effect" The idea that your own liver dumps sugar into you blood stream in the morning hours to help you body wake up. I was constantly waking up with blood sugars of 240 - 260. We couldn't add too much basil overnight because of the risk of low blood sugars in the early to mid evening. Being able to look at the graphs and trends from Glucose Measurements every 5 minutes allowed my Doctor and I too see exactly where the spike started happening on a fairly regular basis. We adjusted the basil rate to take this into account and my blood sugars on most nights, (unless I have too much for dinner), hang around 120 to 100 all night long. I think this may have been the biggest factor in lowering my A1c's.
Exercise is another place the Dexcom is invaluable. I have a huge lawn, I used to never be able to mow the whole thing without my blood sugar crashing and starting the whole roller coaster. Even with reducing my basil rate it was a problem. With the Dexcom I can watch the arrow. As soon as I begin trending downward, I take a little break, have a drink and a granola bar. relax for a minute then go back to the lawn. I'm able to check the Dexcom occasionally as I finish to make sure the food I ate was enough and adjust accordingly. I don't end up ruining my whole day after crashing my blood sugar and I don't end up eating so much that I'm in the 200's for the rest of the day.
Finally the Dexcom has made me feel like I stand a chance in controlling this disease. From being able to see what is happening I'm beginning to understand how different foods affect me and when they affect me. I've been surprised at how long it takes some food to begin to change my blood sugar. I've also been amazed at how long it actually takes before you begin to see a correction bolus bring blood sugar down. All of this information has affected the way I take insulin, the way I change my basil when I exercise, what I eat and how I eat. Does it work? In January of 2014 my A1C was 8.3 in August it was 6.2
Needless to say I love the idea of CGM and I think it should be standard for every type 1 diabetic. Doctors should be prescribing it and Insurance companies should be forced to cover it as cheaply as possible for any diabetic. It would save so much money in other things.

Affordable Care Act Debacle

Very soon I'm going to write about my favorite new piece of technology available to diabetics, the Dexcom continuous blood glucose monitor. Tonight though I can't sleep because of all the insurance problems that have been caused by the U.S. Government and I just want to rant for a moment about all the "help" this mess has been.

Being Diabetic since I was nine I have always been very careful to choose my employers based on whether they have a group health insurance benefit. I have not taken jobs and left jobs because of problems with insurance. My current employer offered one of the best plans I had ever had. I say offered because that is now past tense.

With the advent of the affordable healthcare act Blue Cross Blue Shield stopped offering our plan as a Government approved policy. It had a $500 deductable and 100 percent coverage after the deductable was met. It was a wonderful plan, but for some reason was not longer available under the Affordable Healthcare Act. Among the new choices from Blue Cross Blue Shield there were none that offered 100 percent coverage after the deductable. United Healthcare offered a plan though that had a $1000 deductable and 100 percent coverage and we were told the rest of the coverage was comparable to BCBS. My company switched to United Healthcare Mid year to avoid paying penalties. Since that time it has been one hassle after another getting insulin pump and other things taken care of.

My OmniPod pump that BCBS covered was an issue for United Healthcare so I switched to a pump I don't like. Getting sensors for the Dexcom is becoming tedious each time something that was not a problem with BCBS. Now I found that the mid year switch may be costing me another $800 because of confusion.

In late may I received a authorization from BCBS for pump supplies from OmniPod. The letter stated that the date of service had to be before June 15 because insurance would run out on June 15. I was confused because the policies were supposed to switch on June 1. I called OmniPod first to see where the order came from. They told me that I was on an auto refill program and they were going to send me new supplies every three months. I told them about the insurance change and they said that it appeared BCBS had already ok'd the purchase.
I called BCBS. I explained the situation and told them I wanted to stop the order if there was going to be a problem. She said that it looked like the insurance would be in place until the 15th and I should be fine as long as the order was before then. I confirmed this with her, telling her we were switching to UHC on June 1. She told me that the 15 day hold over was standard practice to make sure switching was smooth and there was no uncovered period. I let the order go ahead.

Today I received a letter from Blue Cross Blue Shield saying that the insulin pump supplies delivered on June 10 are uncovered because the policy was not in force at that time. I'm going to call them tomorrow but don't expect much luck. I also don't expect much luck with UHC in submitting this claim because they never wanted to pay for this pump anyway. So there's a $799 bill that's not covered sitting there for me all thanks to this wonderful Government act that took away my good insurance, saddled me with inferior coverage and has generally made life more difficult.

I'm so glad they are looking out for me in Washington.

My early thoughts on the Tandem TSlim pump

On the advice of the diabetic educator at my doctors office I recently moved to Tandem's T:Slim pump. Admittedly I've only been using the T:Slim a month or so but so far I'm not a fan.

The T:Slim is small and takes up less room than the Medtronic I was using. The touch screen is nice, and I appreciate the ease of use but the amount of insulin that I loose in using the T:Slim is ridiculous.  Let me try to explain. 

Unlike other pumps I've used where you draw the insulin up and then attach the tubing and canula to the end of what you just drew the insulin into the T:slim uses a proprietary cartridge. In order to load the T:Slim you use a syringe to draw the insulin up and then fill the cartridge from the syringe. This is a multiple step process that is designed to do two things, I believe. #1 to keep the T:Slim, Slim #2 to keep air bubbles out of the tubing. If you fill the cartridge correctly there are a lot of safety features to reduce and eliminate air-bubbles. Filling the tubing though is a much longer process than the Medronic I used to use and I'm still trying to figure out where my insulin is going. As an example; last night I filled the T:Slim cartridge with 260 units of insulin. 17.5 units were used to fill the tubing another unit to prime the canula. So I should really have 240 or so units of insulin in the cartridge. After doing all this my T:Slim registered 185 usable units of insulin. Where did 55 units of insulin go? Some research says that Tandem builds a hidden portion of insulin into the pump just to make sure they are not overestimating. 55 units of insulin is almost another days insulin. This is expensive stuff.

The other problem I'm having is figuring out how much insulin I need to put into a cartridge to make it last three days. I was using 180 or so units every three days on my Optimod, Now I'm putting 250 units in and only getting 165 or 175 usable units. Since you can't add insulin to a cartridge once it's in use I've changed three cartridges now after only two days. I'm worried I'm going to run out cartridges before insurance is willing to pay for more. 

That's my main problem with the T:Slim, the way it measures and uses insulin. I haven't figured it out yet. I did begin cheating and pulling the extra "hidden" insulin out of the used cartridge when I stop using it. One that said it was empty had almost 40 units in it another upwards of 20. This is not recommended by Tandem or by my doctor but I just can't waste that much insulin. So far re-using the old insulin in a new cartridge has not hurt my blood sugar. I am being very careful not to mix the insulin from the used cartridges back into the vial that is still relatively pure. 

There is one thing the T:Slim does that I do really like and has already saved me twice. It's the bolus not finished alert. I have a bad habit of getting distracted and not finishing to the last button push a bolus at mealtime. Usually a few hours later I start feeling bad and look to my pump finding out that I didn't actually take any insulin at dinner and my blood sugar has skyrocketed. The T:Slim however will beep at you after 5 mins if you start to input a bolus and don't finish. I did it twice over the weekend and thanks to this smart little pump managed to keep my blood sugar fairly regular.

So the simple breakdown, from a person who has only used the T:Slim pump for a month now

T:Slim Advantages 

Small

Built to avoid air-bubbles (I used to be really bad about air-bubbles) 

Easy to use touch screen and controls 

Insulin given by the hundredth of a unit instead of just a tenth, 

INCOMPLETE BOLUS WARNING! (this is great)

T:Slim Disadvantage

It wastes a ridiculous amount of insulin

Takes far to long to change and load a catridge

There are too many pieces involved in changing and loading catridges. 

Again if you have any thoughts or questions please feel free to comment. 

Omni Pod pump .. My thoughts

I think I promised yesterday to give my Thoughts on the OmniPod. I loved it! I am so sorry that United Healthcare made it difficult to purchase replacement pods. I think I may have made a huge mistake switching back to a regular tubed pump in order to save the hassle of dealing with insurance.

First I have to say that United Healthcare hadn't out and out denied the Pods for the OmniPod pump but it did seem to me that they were going to require pre-authorization and doctors notes every time I ordered replacement pods. Every three months to go through all the effort put into authorizing a pump and wonder whether it would be approved. I unfortunately decided to go back to a tubed pump and am already regretting it. I will explain much of my regret when I tell you about the T-Slim pump tomorrow.

The OmniPod is a little different and has a bigger profile on you than most other pumps so you might have a problem with that. I didn't. Each OmniPod, Pod contains it's own tiny little insulin pump. This explains their expense. They are basically a 3 day one use insulin pump that attaches to your body. Each Pod is about the size of credit card and about 1/4 inch thick. I don't have one in front of me so I'm doing this from memory. This entire plastic piece is attached to your side, arm or leg, wherever your infusion site is.  As you can tell this will be a bit more noticeable than the infusion site from other pumps. The wonderful thing about the Pod is that there are no tubes attached and running to a pump. everything, the circuit board, the memory, the insulin itself is self contained. This makes the Pod water proof and you never have to take it off.

When changing a Pod you keep it close to the wireless Pod Controller. and fill the Pod with insulin. the Pod Controller wirelessly uploads all the info for the pod to the onboard memory, Basil setup, Carb ratio etc. After the Pod is filled with insulin and things are ready to go you put the Pod on your selected site for infusion and push start on the pump controller. The Pod automatically inserts the canula and begins proper basil insulin delivery. From that point until the next Pod change you only need the controller to input info for Bolus's. You can shower, bath and swim with the pod on. I wore my Pod on my side and on the back of my arms on my triceps. There is so much scar tissue on my sides from years of pump use I found that absorption was much better while on my arm.

Advantages of the Pods:

1. More variety of site placement: I can't imagine tubing running from my arm through my shirt and to a pump on my waist, but wearing a pod on my arm was easy. 
2. Waterproof: I wore my pods in the shower and even swimming. We went to the lake one weekend and I spent a few hours in the water each day. No problems. 
3. User less insulin: because you don't have to worry about filling tubing there is very little insulin waste. I was down to 175 units every three days. I'm putting over 200 units in my current pump and between the insulin lost in the tubing and the insulin it "hides in reserve" I'm getting only about 170 units of usable insulin. 
4. Never taking the pump off and not worrying about tubing kinks or air bubbles did seem to moderate my blood sugars much better. 

Disadvantages of the Pods: 

1. They are much bigger on your body than traditional infusion sites. It can feel bulky occasionally. Felt huge the first time I wore it on my arm and I worried about the weight pulling it off. As I got used to it though I would forget it was there and bump it on things like door frames as I walked through. That's a little weird. 
2. There Pod only lasts three days. There is no extending the time if there is a little extra insulin there. It will shut down and force you to change the pod. This also means that if you change your Pod at 4 oclock in the afternoon you can't wait till a more convenient 6pm to change it when you get home from work next time. It will shut down at 4 and you will need to change it. 
3. Don't forget the Pod controller: I did twice and had to go back home and get it. You cannot bolus or do anything else without that controller. The Pod will continue giving you basil insulin and follow the proper pattern for that but if you want to change anything you need the controller.
4. Controller's Glucose Monitor: OmniPod built a freeStyle Glucose monitor into the Pod Controller. Unfortunately my insurance didn't cover freestyle well and I ended up carrying a Glucose monitor too. 

I Loved the OmniPod. I wish I would have fought a little harder to keep it. Now it seems I'm stuck with Tandem's T-Slim. The Diabetic educator at my Doctors office was really high on the T-Slim. So Far I'm not so impressed. I'll tell you why in the next post. 

If you have any questions about the OmniPod please comment. I'll try to answer them. 

I finally decided to try and control it

I was diagnosed as a type 1 diabetic when I was nine years old. I guess that would have been in 1975. I never was very good at taking care of myself properly. My Dad was a doctor, My mom was a nurse so I didn't actually go to the doctor that often. You didn't need prescriptions for Insulin and syringes back then and there wasn't any way to test blood sugar at home. I followed the same regiment  two shots a day, cheating on my diet and I'm sure swinging from wild high blood sugar to extreme low blood sugar everyday. Maybe as this Blog continues I'll tell some stories of almost killing myself through the years.
In the past 12 years I've been on several different insulin pumps and still had trouble taking the disease seriously. Last year I got the talking too from my Doctor. He said, "Your problem is that you don't feel sick, but if you continue the way you're going you are headed for nothing good." I had been running with A1c's between 8.3 and 8.7. Cholesteral was high and I wasn't trying really hard. Since that talk though I've begun really working to control this disease and I've already learned a lot about how things work and don't work for me.
I thought I'd share some of my journey some of my thoughts and some of my struggles. I've now used 4 different insulin pumps. Originally the MiniMed 500 series, Then Medtronic's paradigm 700 series. I used the OmniPod for a year or so until Insurance changed and made pods hard to purchase. Now I'm using the TSlim. In the next few days/weeks I think I'll take some time and explain thoughts and review each of the newer pumps.
I'm also using the Dexcom CGM. I love this technology and will tell you all about that too, if you want to follow me or continue reading.
The only complication I've experienced so far is Diabetic Retinopothy. This was scary and I still have a few floating reminders of blood leaking into my eye. I often wonder if those are new leaks or the same old stuff. I'll tell that story too someday.
I gess that's enough for a first post. Tomorrow the OmniPod, what I thought and why I wish I could continue to use it.