Monthly Archives: April 2012

Me and my pump.

April 23, 2012 – 11:26 am

The pump has been with me for a little over 2 years now. Officially, it’s a Medtonic Minimed Paradigm® Revel 723 pump. Unofficially, I have a love-hate relationship with it. Actually, you can make that a like-hate relationship. But that’s not as bad as it sounds.

When you add up the score, it’s not all that bad:

Pros
First and foremost is the convenience factor. I can go just about anywhere (not the water) with it and get insulin when I need it. A good example for me is my too infrequent day trips to New York. Instead of injecting a great deal of Lantus and hoping that my BG stays in range all day, or taking along a flexpen with something fast-acting and then looking for a quiet place alone from time to time (try finding that in Manhattan), I have what I need resting on my belt. Love that convenience.

It does help me keep my numbers in line a little better, but my numbers were pretty good for about a year before going on the pump. What the pump does is make it easier to manage my numbers. When I was first diagnosed with type 1, I was put on a twice per day Humulin 70/30 product. Same dosage every day, no matter what. That lasted for about 14-15 years. Then after having a difficult time handling lows, I was introduced to Lantus. It changed my life. For about two years. After that, I started to have additional issues with lows in the morning and highs late in the day. So the answer to that was to cut down on the Lantus and use a fast-acting insulin (Apidra) for boluses prior to eating.

By the way, this was the first time I’d heard about the word “bolus”, or even the idea of adjusting insulin dosage based on my BG and my carb intake. About 18 years into my diabetes. Until then, it was the same dosage, same time, every day, no matter what.

The next part is my fault. I found the bolus idea to be too much of a nuisance during the day (crazy, I know). Particularly because I work in a conservative environment where appearing to be out of the norm has, in the past, sometimes been seen as weakness. So I only bolused with the fast-acting insulin at night, at home, where only my family would see it. At work I still check my BG before lunch in a separate room with no windows. People at work know about my diabetes. Some of them have freaked out about it at times. Or maybe I’m still a little unsure about giving them a reminder about it every workday.

I eventually started looking into insulin pumps about 3 years ago. I decided I wanted to check it out. I loved the idea of having continuous delivery, and the fact that I could program everything in, even variances to my routine (I’m talking temp basal adjustments). I finally got hooked up with the Minimed after I started with my super Endocrinologist, who has been great.

Cons
The hardest part about wearing a pump is that you are wearing a pump. It is attached to you, 24/7/365. You can’t understate that. But let me be clear in saying that you can get used to it. And if you’re not fond of giving yourself multiple injections per day (never a problem for me), I guess one stick every few days is not so bad.

I am not a CGM (continuous glucose monitor) wearer. I tried it for a while after going on the pump, but there were two big reasons why I gave it up. First was the annoyance of having another thing attached to me all the time. The other was that I’m very concerned about real estate (??). I’m starting to read about some of my fellow pump-wearing PWDs who are finding that some sites have scar tissue after being injected many times. I’m interested in preserving potential sites as long as I can, so while a CGM might help me get real-time BG info, it’s not yet worth me destroying extra real estate. Maybe later, but not now.

In the final analysis, I am happy to have the pump. I am very happy that I have an employer that cares enough (I’m being honest here) to cover my pump, and pump supplies, and strips, and lancets, etc. It makes me sick to see people lose their benefits and think, “what if they or their family has to deal with this disease on their own?”. And I’m looking forward to the improvements that technological advances will bring to the market. Maybe the real estate issue won’t be such a big deal in the future.

And one final thought: This is just my blog… it’s very much a personal journal of my life with diabetes. Every pump and CGM decision is a personal one. You must decide for yourself. If you’re thinking about whether to take the plunge, get advice, not opinion. Get the facts, not a viewpoint. I wish you the best of luck, and the most of happiness.

By StephenS | Posted in Pumps | Tagged , , , | Comments (0)

Recipe!

April 21, 2012 – 8:40 pm

Burger
Okay, it’s not a beautiful picture, but it’s my first one, so give me a break. And I know I’m a slob with the mustard. Always have been.

The burger is not my recipe, actually… but one that I like a lot. Kind of an alternate take on the regular grilled burger; in this case, with lamb (that Maureen found on sale at the grocery today!). The recipe comes from Sam the Cooking Guy in San Diego:

http://www.thecookingguy.com/cookbook/recipe.php?id=418

This recipe works great with ground lamb, bison, or even pork, though the pork will really up the fat content. With the meal we included cole slaw and a little bit of potato salad.

Total estimated carb count: 49 grams (this counts the low carb beer in the background)
Take out the bun and the beer, and your carb count goes to just 18 grams! Or go with the cole slaw only and no bun, and you have no carbs.

Disclosure: I have received nothing from Sam the Cooking Guy or anyone else for posting this recipe. I just saw him do it once, thought it was easy, and I liked it. Carb counts are estimates only. Check with a registered dietician to find out what a healthy carb count is for you.

By StephenS | Posted in Recipes! | Tagged , | Comments (0)

DSMA Blog Carnival. Ideal Diabetes Support Group?

April 19, 2012 – 10:22 am

This blog is so new I probably shouldn’t be doing this, but I’ll give it a try anyway. The April DSMA Blog Carnival topic is:

Describe your ideal diabetes “support group”? What would you discuss?

Both of these questions are hopefully answered below.

My ideal support group… well, first of all, it would exist (more on that later). Assuming it does exist, I would want my ideal support group to have 4 qualities:

1. Inclusion. No haters in this group. I know that people don’t always look at the world in the same way, but support means accepting someone on their terms, not mine. Same for conversation. Everyone needs to feel free to be themselves.

2. A sense of humor. Diabetes is a daily struggle for all of us. Not taking ourselves too seriously allows us to focus on what is really important (and who is really important), when it really matters.

3. Flexibility. Let’s face it: things change, people change, diabetes changes all of us. Having the same agenda or focus at every get-together is the kind of rigidity that turns me off. Being flexible means keeping things new and fresh rather than old and stale. Flexibility means acceptance to change, and even embracing change that helps a group’s evolution toward a more perfect union.

4. Goals. Read: Advocacy. The primary goal of any support group should be support of group members, right? If that’s your only goal, okay. But you’re not part of my ideal support group anymore. Because there are always people who need more support than ourselves (well, almost always). My ideal group sets goals that will help make the world a better place for PWDs. That’s not reaching too far, is it? Okay, goals need to be attainable. But I would really like my group’s support to be larger than just the group.

That’s my ideal support group, and at least a basis for discussion. But I have to admit that I’m just guessing here. I’ve never attended a support group meeting since my diagnosis. In fact, in 21 years with diabetes, I think I’ve met maybe 15 other diabetics in a a live setting. And about 10 of those were at a local event for adults with type 1 a couple of months ago. I only found out about that because I had volunteered with the local JDRF chapter the week before.

To be honest, I share much of the blame. I haven’t been a particularly social creature in the past (I’m getting better, I think). Also, I was diagnosed and spent the first few years with diabetes in one city, then moved to another city where I knew virtually no one. I haven’t signed up for a lot of JDRF or ADA walks or rides. And, for various reasons, I’ve pretty much shared my D-story with people on a need-to-know basis.

I haven’t attended events, lectures, presentations, or conferences, mostly because, until recently, I didn’t even know these things existed. As it is, these things rarely happen in my part of world anyway. Wait a minute… Hey! I think I have our first discussion topic! Our first goal! Who’s with me? Let’s goooooo!!!!!

Author’s note: Looking for my first support group meeting… more to come.

This post is my April entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2012/april-dsma-blog-carnival-2/

By StephenS | Posted in DSMA Blog Carnival | Tagged , , , , | Comments (6)

A post about posts.

April 18, 2012 – 11:48 pm

I don’t know if I can handle Wordless Wednesday… I’m too much of a writer for that. Let’s see if I can just direct you to a couple of great posts I found today, with a minimal amount of explanation:

Mike Hoskins talks about lows in public. The public nature of hypoglycemia adds an extra, unwanted element. Find out how it affects Mike at The Diabetic’s Corner Booth.

And Scully got out to a local Crit race (I’m sure she knows what that means) Tuesday, and she talks about “Preparing her Diabetes”. I’m always fascinated by an athlete’s story. Read it at Canadian D-gal.

Enjoy!

By StephenS | Posted in Additional Inspiration | Tagged , , | Comments (0)

Are you listening, America?

April 17, 2012 – 11:45 pm

I like to tell people that I’m fiercely independent.  I’m not a republican or a democrat (note the non-use of capital letters).  I don’t subscribe to political ideology, and I plan to stay that way until the end.

So now the Supreme Court is considering one of the most politically charged arguments in decades:  the case for, or against, the Patient Protection and Affordable Care Act.  Or, at the very least, the case for or against the provision in the law that creates a federal mandate that requires everyone to purchase health insurance.  There are a lot of other things in the law, which can be argued forever, but if you’ve been following the news at all recently, you know that the questions are:  Is the mandate constitutional?  And if the mandate is unconstitutional, is the entire law unconstitutional?

I know that one side of the political spectrum wants the law abolished, and the other side would like to keep it.

Well, I don’t know how the court will decide.  But I do know how to add and subtract.  And I have a pretty strong sense of fairness about things.

I know that if the law is struck down, the federal deficit will go up.  Why?  If I’m not paying a premium on insurance that covers me, or me and my family, what happens when we get sick?  We go to an emergency room at a public hospital, and the government picks up the tab.  And that’s before we talk about Medicaid.  Did you know that in 2009, 5 million people lost their health insurance?  And at least 3 million of those people became eligible for Medicaid.  In 2010, another 5 million lost their coverage.  Estimates are that about 2 million of those became eligible for Medicaid.  Who pays for Medicaid?  Our state and federal governments do, thanks to our payroll deductions.  That means that if the law goes away, the people who claim to hate deficit spending and all of the supposed “freeloaders” using up entitlement money in the budget will be responsible for putting, or keeping, millions on Medicaid.  I don’t know politics, but I know that adding 5 million potential Medicaid recipients won’t close the budget gap.  Especially if at least some of those 5 million could be paying for their own insurance, if they could get coverage at a decent cost.  I read a quote somewhere recently:  the arithmetic trumps political ideology.

Then there’s the question of fairness.  I’m enrolled in what I think is a great plan through my employer.  Even with my employer-sponsored coverage, I still have a sizable out-of-pocket expense every year.  I can’t even imagine what the cost is to deal with getting coverage on your own, or paying all of the expenses of your care yourself.  Those of us with type 1 are fully aware that there’s nothing we could have done to prevent this disease from invading our bodies.  And we know that we really don’t have a choice when it comes to things like how much insulin we need (need, not want) how many test strips we need, how often we need to see a doctor.  How fair is it that because of where you live, or because of your employer’s financial distress, or because of your “risk factors” concerning a disease you can’t predict, you are denied care while I am not?

I mean, I worked hard to get where I am, and I’ve earned what I’ve received.  But couldn’t we talk about how to make things a little more fair, without breaking down into hate mongering?  We’re not going to make things perfect… but we can’t make it better unless we strive for better.  For everyone.  No exceptions.

By StephenS | Posted in Healthcare | Tagged , , , | Comments (0)
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