Tag Archives: insulin pump

Don’t try this at home.

Mostly (at least in my mind), the day revolved around this:

DSC00478

Sunday was our annual holiday open house at the homestead, with nearly 40 guests, a kitchen helper, and a piano player all crammed into our little house. With all of this bolus-worthy goodness in front of me, I decided before the start that I would set a temporary basal rate to help me manage the BG’sus out of my glucose.

Sometimes, I know just enough to be dangerous.

I’ve set temp basals dozens of times in the last couple of years. They always worked out well too. Set for just the right amount of insulin, just the right amount of time. Mostly for workouts, where I set the rate for an hour or an hour and a half at 0.575 units per hour. That’s a little less than half my average basal. Once in a great while, I’ll set one that’s higher than my normal basal rate because I know I’ll be eating a bit more than usual over an extended period of time. This was one of those times.

The problem is, when you’re hosting your own party, you don’t get much of a chance to graze at the buffet. And that’s where my trouble started.

Instead of eating my way through the afternoon and being helped along by my over-basalness, I was greeting people, taking coats, taking out trash, refilling drinks, but not eating. A couple of hours in, I realized I had made a mistake.

I realized I was going a bit low (spoiler alert: nothing to worry about in the long run), and I had to cancel the temporary basal rate then get something to eat. Only… all of my temporary basals had worked great before, and I never had to cancel one early. So I didn’t know how! Never even had thought about it before.

Fortunately, I found it rather quickly, right next to the option to set the temp basal. Crisis averted.

Don’t try this at home, folks. Read up on your pump settings before you start to freelance.
 
 
 

The Best of Intentions.

The Great Spousal Unit and I went to a play last weekend. It was fun, a light-hearted look at three aging World War I veterans who hatch a plan to escape from the retirement home they’re living in circa 1960.

I knew the insulin in my reservoir was getting lower, and when I checked at about 8:00 that morning, I saw that there were just over 30 units left. I thought I could probably make it through the day with that much and change my site that evening. But… remembering the “Please turn off all of your cell phones and other electronic devices” speech that’s given before every live performance, I decided to do the site change before the 2:30 showtime so I (and the rest of the audience) wouldn’t hear that Low Reservoir beep during the show. Smart thinking to plan ahead, right?

So we get to the theater, an intimate, 200 seat venue that produces great plays all year long. We’re in our seats, the show begins, and… during a quiet moment in the first act (it’s always a quiet moment)… beep BEEP beep!

Low Battery Alarm.

To make it worse, it was the first time in 2 1/2 years that I had let my battery run down enough to cause an alarm. Not that anyone in the audience really cared about that in that moment.

Fortunately, the performances in the play more than made up for my lack-of-planning faux pas. I heard this phrase once, and it seems appropriate here: “Someday, we’ll look back on all this, have a good laugh, and plow our car into a tree.”
 
 
 

Pump Exploration, Part 1.

I’ve been interested in writing about my pump and its many features for some time. But to be honest, I haven’t been able to find the time lately, since my real job and worries about Hurricane Sandy have been taking up most of it.

I tried going through the pump manual/owner’s guide for a few days in my off hours to get some ideas, but that eventually made me sleepy. Sorry Medtronic… it’s not you, it’s me.

So since I wanted to write something, but I don’t have a lot of time to go in depth yet, instead of breaking down some unique feature of my Minimed Paradigm® Revel™ insulin pump, I’m going to invoke the Same Time, Next Year rule.

This rule is named after The Great Spousal Unit’s favorite movie: Same Time, Next Year starring the great Ellen Burstyn and Alan Alda. In the movie (and the earlier play of the same name), there’s a scene where the characters decide that they’ll each tell one good story and one bad story about their spouses, thereby insuring that they don’t look either too good or too bad to the other. So that’s what I’m going to do here. It’s my blog, I make up the rules.

The good story: Gotta admit, I like the freedom. I held off on pump therapy for a long time because I didn’t want to be tethered to a device for the rest of my life. But as time has gone on (2½ years), I’ve figured out that I can do pretty much anything (except swim) with my pump.

I also like the freedom that comes with being able to adjust my basal rates on the fly. With MDI (multiple daily injections), what I inject is what I get insulin-wise. So I found myself in situations from time to time where I would inject a certain basal amount of Lantus for the day, then have some kind of strenuous exercise that I hadn’t planned on, which could make my BG go dangerously low. With pump therapy, if something like that happens, I have the ability to adjust my basal rate on a temporary basis as a result of the impromptu exercise. I count on that a lot, and it works.

The bad story: I’m not a big fan of the circles. These are the different icons that tell you if your pump is in alert status or in alarm status. Also known as Special Mode and Attention Mode.

Alert icon (Special Mode):

Alarm icon (Attention Mode):

Basically, if your pump is in Special Mode, you’ll still be getting insulin. If your pump is in Attention Mode, insulin delivery has stopped completely. If your reservoir is low, you’ll get a message, then the blank circle icon on your screen that says you’re in Special Mode. Great, but after you clear the low reservoir message, it’s easy to forget that the icon is there.

If your reservoir goes completely empty, or your battery dies, or you have a motor error, you’ll receive an error message and then the Black Circle of Non-Delivery.

Obviously, the big difference here is that the alert icon can be rather innocuous. You’ll get this for a temp basal event. Not a big deal, right? I mean, you should already know if you’re using a temp basal right now.

On the other hand, the alarm icon means that you’d better do something pretty quick. Immediately, if not sooner. While I’m not a fan of ridiculously recurring alarms, I would be totally okay with the pump beeping a bit louder than usual in this case. A loud beep, instead of the quiet one I get, that I can’t hear when I’m out walking on a city street. In this instance, a black circle doesn’t really mean anything to me because I can’t see it on my pump unless I’m looking at the pump for another reason.

Hopefully, the good story here is a good one, and the bad story isn’t too bad. Overall, I’m glad I made the choice to start using an insulin pump. And I hope to get more in depth with it as the months and years go by, and as I get more time. If I do, I’ll pass along a few more pump stories. Maybe before it’s time for a new one.
 
 
 

Pumpin’ ain’t easy.

My apologies if some other blogger has already used this blog title. I can’t imagine someone hasn’t thought of it by now. So if you have, let me know and I’ll give you all the credit.

It’s been a little over 2 years since I started on pump therapy. And since a commenter asked me recently about it, I thought I would write down a few thoughts while they are fresh in my mind. This isn’t so much a product review. It’s just my thoughts on living the life of a pumper. I want to stress that it’s important to work with a medical professional to find what works best for you.

Officially, I’m using the Medtronic Minimed Paradigm Revel insulin pump. I’ll start off by saying I haven’t really had any problems with it. I wanted this pump for some time before I finally got it. I’d like to tell you that my choice was well thought out, and that I had gone through a few test runs of a few different models before making a decision. But I didn’t. Really, I went with the Med-T for two reasons. I had read the most about Medtronic, and the only other type 1 that I knew (actually– the only type 1 I know other than online) has a Medtronic pump. I did not do my due diligence, and I wish I had.

That said, I’m pretty happy with my choice so far. It’s not flashy, but it does exactly what I need it to do. And it’s been extremely reliable. I’ve beaten it up some. There’s a sizable scratch across the display. I got that going a little too close to the metal part of a door frame. While wearing this pump I’ve worked in the yard and around the house. Worked out at the gym. Stood on the train platform when it’s 10 degrees and 105.

I like that it’s powered by a normal AAA battery (simple things, right?). I like that I can upload data from the pump and share it with my endo. Even when the information isn’t always great. Making changes isn’t always intuitive, but I can usually figure out what to do. And Medtronic’s documentation is pretty thorough and mostly understandable, so if I can’t figure something out right away, I can always look up the answer.

Now, let’s talk infusion sets. I’m using the Quick-set infusion set with the 9mm cannula and the 23 inch tubing. I need the long tubing because it needs to go down and around the dress shirts that I wear to work. Here’s another area where I didn’t do a lot of research. I honestly don’t know if people generally like these sets or not. I like them okay. With one caveat: I wish the tape holding the set in was stronger. Mostly, it seems to be susceptible to big changes in temperature, either warm or cold. And it gets a little weaker when it gets wet. So if I’m swimming one day, then running in the 90 degree heat the next day, by the third day, I can feel the set trying to work its way out. I don’t think the set is bad; it’s pretty comfortable once you get used to it. Again, I just wish I had tried out a few more sets just so I could gauge the differences. Maybe I’m using the perfect set for me. I just don’t know if it is or isn’t.

Wanna talk continuous glucose monitors? I have one, but I don’t wear it often. I wear it about 2 to 3 weeks in between visits to my endocrinologist, so she can get an idea of how my BGs are trending throughout the day. Other thoughts about using the CGM will have to take up space in another post.

One additional complaint: well, not a complaint as much as an observation. This is one expensive piece of medical apparatus. I don’t really see the cost in the software or the look of the device. It must all be in the durability factor, which, right now, is pretty good. I can live with that. But I wonder if a drop in the price might get a few more people access to this kind of therapy. For some, it could be a life changer.

Speaking of cost: as much as I can tell, once you swallow the cost of the device (my insurance picked up a sizable portion of the bill), the ongoing cost is roughly the same as when I was on multiple daily injections.

The real advantage for me is in convenience. I can go nearly everywhere with it. And I love how a pump gives me the ability to adjust my basals or boluses on the fly, based on where my glucose is at that moment. That’s a huge thing for me.

So all in all, I’m glad I went to pump therapy. I’m happy with my decision to go with Minimed. If you’re thinking about going to the pump, and you have any questions, feel free to ask. Whomever you talk to, remember to ask a lot of questions! Make your choices in care from a well-informed point of view. Remember: pumpin’ ain’t easy (had to get that in there one more time). But it might be the next great step in your walk with diabetes. Good luck!
 
 
 

Low Tech.

When your infusion set is on its 5th day, and you really want to keep it from working its way out before you squeeze the last few drops of d-fuel from your reservoir, you’ll do just about anything to keep it in.
 
 

 
 
I’m kind of embarrassed to show this photo, actually. But not enough to change out my set a day early.
 
 
 

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