Posts Tagged ‘insulin pump’

New Pump, Take 2

I still have the box that my new pump was delivered in.  That’s because I really haven’t had it for very long, and I haven’t unpacked all the swag that it came with yet.  (I live in a bit of chaos this days – don’t judge.)  The box says it was delivered on Wednesday, August 22nd.  That’s less than a month ago.

So I wasn’t really expecting this last night:

This morning, after dealing with Medtronic (right or wrong, I put it off until morning) I looked back at Scott’s post on Motor Errors from a few months ago.  It made me think that maybe I shouldn’t have been so surprised when this message came up last night.

The woman I spoke with from Medtronic technical support explained to me that a sudden increase in pressure on the piston can cause a Motor Error to display, and often this is just the result of an occlusion or otherwise bad set.  In that respect, it’s similar to the No Delivery error, but is a result of sudden pressure rather than a gradual buildup.  She said that this was most often the reason for the error message, and not an actual problem with the pump itself.  Interestingly, the explanation Scott was given at the time of his Motor Error was slightly different.  I don’t know which is the correct explanation.

Either way, the rep had me run a diagnostic test (the old air-filled-reservoir-with-tubing test).  My pump failed said test.

So I’m getting a new pump tonight.  Or, rather, a new new pump.

Since I bought my first pump in 2007 (this pump is only my second purchased pump), including loaners while malfunctioning pumps were being replaced, the pump arriving via courier tonight will be #8.

This.  Is.  Crazy.

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This Sh** Just Got Scary

Something very scary happened to me the other night.  I was woken up by my baby to discover that my bloodsugar was 1.8 mmol/l (32 mg/dl)!

Oh, you thought that was the scary part?  Not so.  Just wait…

Lately I’ve been very tired, due to an unusually restless baby sleeping in a bed about two feet away from me and waking me multiple times every night.  (She was such a good night sleeper, but not lately.  I digress…)  So I’ve been wearing earplugs to sleep.  They let me hear her when she really needs me and tune her out when she doesn’t.  I’ve also been using my short stints of good sleep to sleep extremely soundly.

One drawback to the earplugs and the sound sleep is that I haven’t been noticing my CGM alarms.  My pump is set to vibrate for alarms, and I have it on the waistband of my pajamas up against my belly so I’ll feel it.  (NOT between my boobs!!)  Normally the vibration wakes me.  But lately, between my exhaustion and my earplugs, my husband has been waking me quite often to tell me I’m sleeping through my CGM alarm.

This hasn’t been ideal because it’s meant that my pump has tried to wake me with vibration, then with an alarm, then resorted to waking my husband, who then wakes me.  It gives my bloodsugar time to drop further before I notice a problem – and the CGM already has the (approximately) 15 min. delay, so timeliness leaves something to be desired.  In the past, I actually used to wake up to nypos quite easily, but this has changed with the aforementioned exhaustion.  All in all, timely bloodsugar-related wake-ups are sketchy at best these days.

So when my baby girl woke me up, I realized I was pretty darn low.  My CGM said 2.3 mmol/l  (41 mg/dl), and must have been alarming – which is probably what woke the baby. I wobbled, bleary-eyed, into the bathroom to test and could barely stand up.  When the 1.8 appeared on my meter, I cursed, inhaled seven dextrose tabs (3g carb each) summoned all my energy and dragged myself back to bed .  In a case of bad timing, the baby wanted to eat at this very moment (she’s breastfed).  So I lay in bed and fed her (thank goodness for the side-lying breastfeeding position!), while my husband kept a watchful eye on us.

By the time she was finished, my BG was going up at a reasonable pace (quite quickly, actually), but I tacked on a few crackers with peanut butter for good measure. (Am I the only one who craves peanut butter when I’m low?) It was another 10g of carbs at most.  I was pretty impressed with myself for managing a wicked nypo like that with only 30g of carbs, since I’m just as prone to face-feeding during a nypo as the next PWD.

By breakfast time, I was in the 8s (that’s about 150 mg/dl), which was too high, but really not too bad considering what had happened overnight.  I had my breakfast of high fibre oatmeal/flax/etc. and proceeded to feel hungover.  By mid-morning, though, I was a whopping 17.8 mmol/l (320 mg/dl) – WAY higher than I usually see.

It was at that point (or, rather, after my BG came down to a more reasonable level) that I decided to start logging again to figure out what the hell needed to change in my diabetes management to keep this from ever happening again.

I sat down at my spreadsheet template (because I’m a geek).

I entered in my bloodsugar readings from my meter memory.

I started to enter in my boluses from my pump’s bolus history.

That’s when I saw this:

What the…..??

Something important to know at this point is that I was 8.7 mmol/l (157 mg/dl) when I took this correction bolus during the night.

Something else important to know at this point is that my regular correction for an 8.7 mmol/l should have been about 1 unit.  I would only ever take 7.4 units of insulin at night if I were eating a second supper of about 40g-50g of carbs.

Something else important to know is that I don’t remember taking this bolus.  I do remember fiddling around with my pump – trying to take a smaller bolus or calibrate my sensor or something – but the details are fuzzy.  Thankfully I do have a recollection of doing something or I’d be likely to blame my new pump and would be very afraid to continue wearing it.  But I’m quite sure this was human error.  My error.

Yikes.

I’ve never, in all my 30 years of having diabetes, done something like that before.

Presumably my liver kicked in to bring my bloodsugar up, because I don’t know how 30g of carbs, plus a bowl of oatmeal (with breakfast bolus), would have brought my bloodsugar up to 17.8 otherwise.  So it’s good to know that something was working – since I couldn’t feel the low, feel the vibrating pump, hear the alarming pump, or even think clearly enough to bolus properly.

This mistake has me very freaked out.  Lows like that are so dangerous, and I can only imagine the speed at which I must have been dropping after that whopper of a bolus.  I don’t want to think about what could have happened if the baby didn’t wake me.  Do I owe my life to her already…?

The question is, how do I keep from repeating this mistake?  My pump’s Max Bolus had been set to 12 units, and since this mistake it has been changed to 6 units.  If I ever want a bigger bolus than that, I’ll do it in two parts.  Also, I no longer wear earplugs to sleep.  I’d rather have a restless sleep than continue to sleep through my CGM alarm.  And I’ll be wearing a CGM 24/7 for the foreseeable future – at least until I’m less exhausted and easier to wake.  (Funny how even an unusual breath from my baby can wake me, yet a beeping pump won’t.)

Beyond that, I’m not sure what to do.  Will I do it again…?  I’m crossing my fingers that this was both the first and last time, because that was just way too scary.

Wordless Wednesday: Rough Night

Unexplained highs…3 set changes…default to syringe…then low. Whee!

Making a Pump Purchase – And the Winner is….

…The Medtronic Paradigm VEO!

(See here for the back-story.)

Ultimately, after hearing stories from both sides (i.e. Medtronic users and Animas users), I realized three things:

  1. No model of pump is free from issues.  Maybe my issues have been a bit extreme, but  any device that is expected to function 24/7 and is subjected to as many bumps, drops and general-life-related incidents is going to malfunction from time to time.  The fact that it’s a life-saving device means those malfunctions are a bigger deal, but they’re still going to happen.  It sucks, but it’s true.
  2. Customer service is an important factor to consider when making a pump-purchase decision.  The purchase itself isn’t likely the last you’ll be dealing with the pump company – especially given the possibility of the above-noted malfunctions.
  3. I need CGMS capabilities far more than I need to be able to swim tethered.  Also, in light of the fact that I’m currently breastfeeding, exhausted and caring for two small children (who I can’t yet rely on for a 911 call if needed), I’m not really in a position to wait for Dexcom to come to Canada.  I need CGMS now.

So that’s that.  Order’s in, and I should have my new pump this week.  I’m kind of excited!  🙂

My Boobs Are Costing Me $7000 (a.k.a. Time for a New Insulin Pump)

Opening Note:  If the title of this post seems like a shameless grab for attention, that’s because it is.  I’m really interested in some opinions/feedback from other pumpers on this post. However, being largely absent from the blogosphere since having Baby B (I’m spending lots of time with the kids instead of at the keyboard, and also dealing with some wicked carpal tunnel) makes me feel the need to put a little extra effort into getting this post noticed.  So if you’re here  just to read about boobs, you’ll likely be disappointed.  If you’re here as a pumper – please read on and leave a comment!

Back in April, I had a baby.  You may already know this.  You may also already know that I had a c-section.  Normally I wear my pump (a Medtronic Paradigm) clipped to the waist of my pants/shorts/skirt/pyjamas, but after my c-section I found it a bit uncomfortable to wear it near my belly while sleeping, so I decided to keep it between my boobs at night.

It’s probably also no surprise to anyone that boobs tend to expand significantly when you’re breastfeeding a baby.  So that pump was in there nice and snug.  What may be news to some, though, is that hormones take a while to settle down after having a baby, and these wacky hormones can cause night sweats.  I don’t mean seems-a bit-warm-in-here sweating.  No, I mean doing-cardio-outside-in-summer sweating.

Does anyone see yet where this story is headed?

It is important to note that Medtronic pumps are not advertised as being waterproof.  I was quite well versed in the dangers of exposing a Medtronic Pump to water after I accidentally took my pump swimming with me last year.  But I’ve always sort of assumed that they would be somewhat water resistant.  And definitely sweat resistant.  I mean, athletes wear them, right?

I realized my error when, a few weeks after Baby B was born, I woke up drenched in post-partum, hormone-induced sweat, tested to find my bloodsugar was high, and hauled my pump out from between “The Girls” to bolus.    To be clear, my pump had not been immersed in liquid.  It was not sitting in a pool of sweat.  It was damp and it was hot, but it wasn’t dripping.  It had not been swimming this time.

So it was a bit surprising to me when the buttons didn’t work as they should.  It took a couple of tries to get a button-push to register.  It was even more surprising when I saw “Button Error” come up on the screen.  (An error I’m sadly familiar with – I’ll get to that in a bit.)

The rest of the story involves me borrowing a pump from a local contact who had a spare while I attempted to dry out my pump in a bowl of uncooked rice (didn’t work), waiting until Monday to call Minimed (because it was the weekend and we Canadians get bumped to Medtronic’s U.S. call centre on the weekends), and realizing I was going to need to purchase a new pump since mine was off warranty as of  last fall.  Once I did get on the phone with the Canadian Minimed folks, I was told that I could use a loaner pump from them for 3 months while I made my purchase decision, so that was couriered out to me quickly and I’ve been using it ever since.  (To Minimed’s credit, when they found out that I had just recently had a baby, they were willing to extend the decision-making time for me.)

So now I’m trying to finalize this ReallyBig purchase decision.  It’s ReallyTough because (a) my pump is such a huge part of my life and I absolutely have to be happy with its quality, its features, and the service I get for it; and (b) I have no coverage for the pump, so this money is coming out of my pocket.  Yuck.

In all honesty, I’m quite happy with the features of the Medtronic pumps.  The one available to me in Canada is the Paradigm VEO, and I quite like the looks of it.  I’m sure it would suit my life quite well, with the exception of the waterproof issue. (You can check out the VEO here.)  I’m also very happy with the service I’ve received from Minimed.  I’ve had a few frustrating conversations with them when ordering CGM sensors (one time a box of four came with only two sensors in it), but they were excellent when replacing my warrantied pump when it joined me in the pool, and the local rep is absolutely fantastic!  So for features and service, I really can’t complain.

Unfortunately, what I can complain about is quality.  Here’s why:

#1 – June 2010: My pump had ghoulies.  It developed a Button Error, brought on by seemingly nothing, and started counting up units without being asked to.

#2 – August 2011: I proved that my pump is definitely not waterproof.  Another Button Error.  This one was totally my fault.  But I can’t help be somewhat disappointed that Animas can make a waterproof pump but Medtronic can’t.  Maybe this is more about features than quality…

#3 – April 2012: I drowned my pump between my boobs.

#4 – April 2012: A borrowed pump given to me by one of my pump contacts had an “A33” error and won’t even start for me.  I don’t know what that means beyond the fact that I couldn’t make it work.  To be fair, this was a used pump, and not a certified refurbished one directly from Minimed.  But it didn’t make me feel any better about Medtronic quality.

#5 – April 2012: The first loaner pump sent to me by Minimed (which was a certified refurbished one) had a loose rubber sealing ring in the reservoir compartment, which fell out as soon as I tried to insert a reservoir.  It was obviously loose when I received the pump.  How it slipped by Quality Control at Minimed is a mystery to me.  Thankfully the second loaner pump they sent me has been working just fine.

Since this most recent experience, I’ve heard from a lot of other folks who have had problems with their Medtronic pumps as well.  If you go to the above link to my post about pump ghoulies, you’ll see that two reader comments are about similar problems – and one even mentions the between-the-boobs location as being a possible cause!  I’m hearing from more and more people who have had to have their pumps replaced on warranty like I did.  As long as the pump is still on warranty and the replacement time is quick, it’s not really a big deal, I guess – usually just 24 hours or less on MDI (although I’d never go anywhere remote without a loaner!)  The problem comes when that warranty runs out.  And that’s where I’m at now.

I’ve debated switching to Animas.  With two young kids, and a bad case of “Mommy brain”, I’d love to have a waterproof pump that I can swim with and that I don’t have to remember to take off every time I go in the pool…or run through the sprinkler…or walk in the rain….or sweat :S

The problem is, I don’t want to give up my CGMS, and Dexcom isn’t available in Canada.  If I want the CGMS, I have to go Minimed.

Granted, my CGMS and I have had a rocky relationship, but I’ve finally gotten the kinks worked out and am kind of liking it!  Plus, my local rep tells me that there are new sensors coming soon that are supposed to be much more accurate and much more comfortable.  While I’m breastfeeding and tired, my BGs are wackier and I’m less likely to pick up sudden lows on my own, so I feel so much more secure with a sensor – especially at night.  The long and short of it is that my levels are better when I wear a sensor, and with 30 years of diabetes coupled with proliferative retinopathy I feel like this should trump any desire I have to swim while tethered.

But it’s a $7000 decision that significantly affects my day-to-day life.  How can I feel comfortable putting this kind of money toward a product with this kind of track record?

I don’t have the answer…

Just Like Mommy

This week my 2 year old daughter was playing with one of the baby monitors and managed to clip it to the waistband of her jeans.

Proudly, she came up to where my husband and I were sitting and annouced,

“I have a pump like Mommy’s!”

🙂

I’m happy it was all pretend.

Thirty

December 30th, 2011 was the 30th anniversary of my diabetes diagnosis.

Thirty years is a long time.

On December 30th, 1981, I was 3 years old.  As you can imagine, a lot has happened since then – with diabetes care in general, but also in my own life with diabetes.  Here’s just a taste:

  • Blood glucose meters got a LOT smaller – and a lot faster.  I’m pretty sure my first meter took a full 2 minutes to give me a reading and was the size of about 6 of my current meters laid side-to-side.
  • I went from one shot of mixed insulin per day to multiple daily injections with both short (Toronto/Regular) and long (NPH, Lente, Ultralente) acting insulins to pumping with much faster-acting insulins (NovoRapid, Apidra).
  • I started using a technology that I once could only have dreamed of – a Continuous Glucose Monitoring System (CGMS).  I continue to dream of a day when this technology will function with more accuracy and consistency.
  • I stopped being afraid of blood tests, then stopped being afraid of injections, then stopped being afraid of infusion site insertions – but I’m still afraid of CGMS insertions.
  • I’ve developed callouses on my fingertips, and scar tissue in various parts of my body thanks to thousands upon thousands of needles piercing my skin.
  • I went from eating limited carbs that were measured precisely for me, to eating whatever I wanted using the “balancing act” method with multiple daily injections and the pump, back to limiting carbs that are precisely measured by me.  Funny how this one’s come full circle.
  • The girl who was embarrassed every day at 10:15 a.m. when her watch alarm went off and her grade 3 class tried to pretend not to notice her pull out her morning snack became the girl who writes on a public blog about her experiences with diabetes and who has trouble shutting up about it when asked a question.
  • I’ve struggled with the social aspects of diabetes: kids who taunted me with candy I couldn’t eat, how to handle Halloween and birthday parties, testing in public, learning to manage the effects of alcohol, etc.
  • I’ve been hospitalized with DKA – once.
  • I’ve never lost consciousness or been unable to be in control of myself due to diabetes.
  • I’ve struggled with anxiety.  A lot.
  • I’ve worked So Damn Hard to figure out how to make this disease my bitch instead of the other way around.  I’m close, but it’s a never-ending challenge.
  • I’ve logged hundreds (or more) of days of bloodsugar readings, insulin doses, and carb amounts.  I’ve searched for trends until my eyes hurt.  I’ve developed a serious dislike of this process.
  • I got married – to a man who wants to help me succeed at this.  I also learned that my success, my diabetes care, and ultimately my quality (and length) of life extend beyond myself to the people who love me.
  • I’ve brought my A1C down to levels I never would have believed I could.
  • My belief that diabetes complications would never happen to me has been shattered, thanks to retinopathy.
  • In spite of working So Damn Hard, I’ve still experienced blame from others, including medical professionals, for not getting it right.  I’ve also had my retinopathy blamed on my past of “too much cheating” by people who obviously don’t know what they’re talking about.
  •  I’ve met some great people, both in person (Hi Mimi! Hi Krista!) and online (Hi Mike! Hi Aaron!) who I wouln’t have met if not for diabetes.  (Please don’t be offended if I omitted your name – there are just too many of you!)
  • I’ve had a child – a perfect little girl who has no lasting effects of being created in the womb of an imperfect woman with diabetes.
  • I’ve learned to deal with retinal haemorrhages – and the ongoing possibility of more.  I no longer lift anything very heavy, put my head lower than my heart during yoga, or blow up balloons.
  • I’ve started to think a lot more about the genetics behind diabetes, and to hope I never have to learn how to manage diabetes in a child.
  • I’ve made the somewhat terrifying decision (with my husband and my doctors) to have another child and am over halfway through my second (and last) pregnancy.
  • I’ve spent 30 years working my ass off and doing the best that I could (can) with what I had (have) and knew (know).

Thirty years is a long time.

I’m tired.

Here’s hoping that the next 30 years include some pretty amazing leaps in technology, in knowledge and in the strength of all of us to apply both.

And maybe even a cure….?