Comments (3)

By shannon, December 24, 2009 8:46 am

I had no idea that when I wrote that first poem,

That you’d kick and scream and disrupt my whole home.

If I’d known I’d have taken greater care,

To ensure that your response wasn’t too much to bear.

But, I didn’t expect your reaction to it all,

Keeping me up for two nights with your HIGH alarm call.

Yes, I know that deep down, I deserve all the blame,

But I’ll continue to throw it on you just the same.

I know it’s not fair and it’s definitely not right,

But never before had you put up such a fight.

Since we met, you’ve been there through thick and through thin,

You’ve saved my life and brought peace from within.

I know I had to bump you from your spot on my arm,

For the Pod because there, he can do me no harm.

Besides, you stick so well in your new home on my butt,

Where you’re safe from the edges and doors that slam shut.

So, this rhyme’s for you, Dex, you don’t have to cry,

Now shut the fuck up!  Kthanksbye.

Comments (2)

By shannon, December 23, 2009 9:59 am

It has not been a good week for sleep, and I’m exhausted.  

I’m the type of person who NEEDS at least eight hours of sleep per night.  If I get less, I do not function at the level that I should.  I get headaches, I’m cranky, and I spend the day in a fog.  

I know that everyone is different; Brian needs much less sleep to function, while others need more.  But eight hours is my minimum.

I can’t remember the last time I got eight hours of sleep.  Between getting up for work at 5:30 everyday (I’m so not a morning person) and rarely getting to sleep before 10:00pm, I’m averaging between six and seven hours per night.  This does not a happy Shannon make.

Which brings me to my current state of luggage-ness.  I’ve been eating like crap.  I know it, and I know I shouldn’t, but with so much going on (i.e., preparing for Christmas at our house, which includes painting our kitchen and other assorted home repair projects), we haven’t had a chance to hit the grocery store in a while.  With no food in the house, we either go out to eat or order in EVERY NIGHT.  Weight Watchers is a fond, but distant memory at this point.  I’ll get back to it, but not until this craziness is over.

For the past two nights, we’ve eaten very high carb, very high fat meals.  I’ve done my best to SWAG bolus, but I’ve been way off.  Each night, I’ve gone to bed high, but with a correction bolus pumping away.  Each night, every hour, Dex has alerted me to his unhappiness with my BG. Every.  Single.  Hour. 

I know, I know, I could have changed the alarm settings.  But, normally I *like* the settings I use, and I didn’t want to mess with them.  Besides, the point is to correct the high or low BG, not ignore it.  That’s why I got the DexCom in the first place.

So, back to the story.  Monday night was awful.  I think I got a total of four hours of sleep.  I rage bolused all night, but my stubborn high BG wouldn’t budge. Finally, when I got into the office, I was at a nice 110 mg/dl.  Dead tired, but good BG. 

I have no idea how I made it through an entire workday – probably because there’s absolutely no work this week and I could zone out at will.  I got home before 5:00pm determined to get a good night’s sleep:  eight hours minimum! 

After having the usual “what do you want for dinner” conversation with Brian, we decided a quick trip to Chili’s would be best.  It was early enough that we’d be able to beat the rush.  I bolused, we ate, we came home, I tested, I corrected, and went to bed.  

Dex was unhappy again.  I was high all night.  But, Oliver (my Omnipod) was also displeased.  It seems that I was nearing the expiration of my pod, and it was necessary to inform me of that fact in the middle of the night.  Another sleepless(ish) night.  Unfortunately, I can’t be luggage today – there’s too much to do.  So, I’m drinking coffee like there’s no tomorrow and hoping I can make it through without killing anymore (or getting fired). 

D-technology, I love you because you make it easier to control the beast.  But, I hate you right now because I’m so, so tired.  Have you seen the size of my to-do list?  C’mon man!

Comments (2)

By shannon, December 11, 2009 11:21 am

Yesterday felt like the longest day ever while I was at work.  I tired to get into the office super early so that I’d be able to leave early. Why?  Because my new Omnipod would be waiting for me when I got home.  But the bad drivers of Baltimore were conspiring against me.  I ended up getting to work 30 minutes later than I’d intended.

Once I arrived, I spent far too many minutes checking and rechecking the FedEx tracking page.  Finally, at 12:28, the package was delivered, and from that moment on, I was completely useless at work (not that I’d been all that productive anyway).  I just wanted to go home to my new present.

Does it make me a complete geek to be that excited about an insulin pump?  Do I care?  Nope.  Not even a little.  I wear the geek title with pride.  The other badge I wear, although not with any pride, is impatience.  I’m a type A personality (as if you hadn’t already figured that out for yourself).  I’m extremely high strung, and I want what I want when I want it.

Finally, at 3:30 pm, I hopped in my Tahoe and started home.  First, I had to stop at the pharmacy to pick up my new Freestyle Test Strips to use with the Omnipod PDM.  Since I’m well known at my local Walgreens, it was a quick in/out process.  Once again, I was back in the Tahoe heading home.

As I pulled into our driveway, I saw it.  Like a big, beautifully wrapped Christmas gift, there sat the plain brown cardboard box that held the next phase of my diabetes life.  I hurried out of the Tahoe, grabbed my 30 lb (well, probably not 30, but it’s damned heavy) bag that I have to carry because I must cart tons of diabetes supplies around, and bent over to pick up the box.

It was a lot heavier than I expected.  I remember all of my Minimed supply shipments being really light.  For some reason, the extra weight of the box pleased me.  Almost like the whole system had more . . . I don’t know? Substance?

Once upstairs, I ripped the box open, and the heavens sang.  It was beautiful (I should have taken a photo, but I suck).  My starter kit and five (5!) boxes of pods were carefully packed.  Also in the box:  a white silicone “skin” for the PDM, a Freestyle Flash meter (I guess to use as a backup), and a USB cable for uploading data to a PC (note my only disappointment – no Mac compatibility).

I immediately went to work setting up the PDM according to the instructions and the online tutorial I had watched earlier (while pretending to work).  I entered all of the typical date/time/etc. stuff, basal rates (I have seven!), my I:C ratio, and my correction factor.  After all the settings were done, the PDM asked it I wanted to activate a new Pod.  Why, yes.  I did!

I filled a new Pod with Novolog according to the instructions (the PDM walked me through each step of new Pod activation), removed the needle cap and adhesive backing, and stuck it on my arm.  I pinched the skin, pressed the magic Start button on the PDM, and felt a tiny prick as the needle inserted the cannula.

That’s all it took.  I looked through the little window on the pod, confirmed that the cannula was inserted properly and that there was no blood, and I was done.

I removed the Minimed infusion set, pulled the battery, and placed it in the small box that the Omnipod PDM came in.  I felt a moment of sadness – this pump has been with me through most of the recent big events in my life.  But, when I lost faith in Minimed, my pump had to go.

As I was completely wrapped up in my new device, cooking dinner was out of the question.  We decided to order a pizza, which meant . . . The Pizza Bolus.  It was the first test of my new Omnipod, and the extended bolus worked perfectly.  I was in love.

I tested my BG before bed, calibrated Dex, and crashed.  I slept great!  I woke up once to use the bathroom, and for the first time in years, I didn’t have to search for my pump before sliding out of bed (I often dropped it during that process).  I didn’t have to clip it to my pajama bottoms when I got up this morning, and I didn’t have to disconnect anything before taking my shower.  And my loofah didn’t get stuck on anything!  It was a beautiful moment, and I almost cried.

When I got to work this morning, I download the CoPilot and Extension software to my new Netbook (more on that later), connected my PDM, and uploaded my pump settings and data (so far).  It was painless, and I’m impressed with the software (I just wish I could use it for my DexCom, too).

So, after 18 hours, I’m a very happy Pod person!

Comments (5)

By shannon, November 19, 2009 2:06 pm

Dear Insulin Pump/Glucose Meter/CGM Manufacturers,

First, let me tell you how much I love your products.  I’m a big geek, who actually gets excited at the prospect of new diabetes technology.  When I get a new meter, it’s like my birthday.  CGM arrival day is like Christmas.  And, well, new pump day?  That only happens once every four years, so I can’t even compare it to any other day.  I don’t know what it is about new tech gadgets that gets me so excited.  It’s just all so shiny and new and wonderful.

Until I look at the minimum requirements for using your software.  Why-oh-why won’t any of you support Mac OS? Imagine my disappointment when, after carefully unboxing my new Accu-Check Compact Plus meter, I found that in order to use the software, I had to use Windows.  Windows!?!  

What is it?  Did Apple beat you up in grade school?  Did they steal your college girlfriend?  Did they get you fired?  Seriously.  What is it?

Because, when/if one of you guys ever steps up and makes Mac-friendly software, I’ll be first in line to give it a try.  Hell, I’ll even beta test it for you!  Just.  Make.  Something.

kthanksbye,

Shannon

Comments (4)

By shannon, November 18, 2009 1:27 pm

Which is better?

Next year, I’m going to get a new insulin pump.  I’ve used a Minimed 722 pump for three years, and while I like it, I don’t *love* it.  I admit to some pump envy.

At this point, I’m torn between the Omnipod and the Animas One Touch Ping.  I really like both of these guys for similar reasons.  

I LOVE the idea of remote bolusing.  Now, before you tell me about Minimed’s remote control for the 722, let me say that I have it and don’t like it.  I’m not a math person, so if I have to calculate a bolus, without the luxury of a “wizard,” I’m not happy.  So, score one for the Omnipod and one for the Ping. 

Next, I’m tired of tubing.  I’m constantly getting it wrapped around a doorknob or caught in my dog’s feet (he’s a bit of a lap dog).  I feel limited to certain pump sites because of the tubing issue.  Point for the Omnipod.

I’m somewhat intimidated by the size of the Pod.  I don’t want it to be visible under my clothes.  This is especially true because I’ve gotten used to using my arms and legs as pump sites.  My abdomen is so scarred that absorption is pathetic there.  I keep my DexCom sensors on my arms, and they’re already pretty visible, so what will adding a Pod to the mix do?  Point for the Ping.

So, I’m back to square one.  Which is the better pump and why?

Comments (4)

By shannon, November 15, 2009 11:29 am

My 24-hour DexCom graph.

It’s been a rough few days.  On Friday, when I was running high for most of the day, I started wondering WTF is going on with my diabetes.  I can’t blame it on SWAG bolusing because I’ve been really good about measuring my food.  The only explanation is stress.  I’ve been pretty stressed lately with lots of family issues.

At dinner on Friday night, I carefully calculated my carbs and dialed up a bolus.  DexCom showed me spiking slightly after we got home, but nothing alarming.  By bed time, I was at 97 mg/dl and steady.

That was the last time I felt normal.  Around 12:30 am, I woke up.  I knew something wasn’t right, but I didn’t move.  I just laid there for I don’t know how long.  Then, the three wailing beeps of the DexCom permeated the haze.  I was low.  I knew I had to get up and test, but I just didn’t want to.  Brian didn’t wake up, and since I couldn’t talk, I couldn’t wake him up.

Somehow, I managed to reach over to the mini-fridge on my nightstand and grab a juice box.  I struggled with getting the straw out of the plastic and into the little hole, but eventually, I managed to drink the entire box.  That’s when I noticed the sweat.  I hate sweating; it’s the main reason I loathe exercising. The amount of sweat pouring off my body was equivalent to what I’d expect during a hard, long workout.   My brain knew that I had to test, but my body was not listening.  I glanced at the DexCom and saw a 41 mg/dl.  Hands shaking, I fumbled with my meter, wasted at least two test strips, and pricked every finger on my left hand.  Finally, I got a reading:  37 mg/dl.

That didn’t make sense to me – I felt a lot worse than 37!  What was happening?

As the sweating continued and the shaking increased, I took another look at the DexCom.  It simply read:  LOW.  The little graph was at the very bottom line.  I waited for 10 more minutes before testing again.  The result:  LOW.  No number, just LOW.  I think this was actually a good thing because it managed to “wake me up.”  I grabbed another juice box and sucked it down (the next time someone teases me for keeping a mini-fridge next to my bed, I’m going to pull out this blog post).

After another 10 minutes, I started feeling a little more steady.  Not great, but I could think a little more clearly.  That’s when I noticed the hunger.  I was hungrier than I’d ever been.  I stumbled into the kitchen, grabbed the bag of Sun Chips, plopped (there is no better word for what I did) down on the couch, and I ate.  I devoured the contents of that bag.  Nothing has ever tasted as good as those Sun Chips.  I didn’t care about the carbs; I didn’t care about Weight Watchers; I didn’t care about crumbs.  If someone had tried to take them away, I probably would have growled.  Seriously, it was animalistic.  I didn’t care.

I then went to work on my little Weight Watchers mini cakes.  I ate two of those, followed by a large milk chaser.  It was awesome.  Feeling much better (no more sweating or shaking), I crawled back into bed and crashed.

Two hours later, I was awakened by the two wailing beeps of the DexCom.  And so began the next high-to-low-to-high cycle.

Last night, as Brian and I were falling asleep, he says, “Oh, so it’s two beeps for high and three for low, right?”  Welcome to the roller-coaster, babe.

Comments (3)

By shannon, November 13, 2009 9:03 am

Let me set this one up for you guys.  I work (as a consultant) for a big, well-known corporation.  My client is a large government agency.  Whenever I have a meeting with <client>, I must pass through metal detectors, and my bag must go through an x-ray machine (similar to what you deal with at the airport).

The Scene:  The main lobby for Agency.

The Players:  Me, Security Guard #1, Security Guard #2, Co-workers, Metal Detector

Already running late for a meeting, I rush over to security and hope that *this* time will be different.  I put my cell phone, keys, and DexCom in my bag and place it on the belt.  Having already transferring my pump from its usual resting place in my bra, it’s now clipped to the pocket of my pants.   It’s always worse if I have an audience when removing it from my bra, so I’ve learned to move it ahead of time. 

My co-workers are all proceeding normally through the metal detector.  It’s now my turn.

Metal Detector:  BEEEEEEP!!!!

Security Guard #1:  Referring to the insulin pump clipped to my pants, “You’re gonna have to put that cell phone through the x-ray.”

Me:  Big sigh.  I already know where this is going because it happens EVERY TIME I go to Agency.  “It’s not a cell phone, it’s an insulin pump.”

SG#1:  “Whatever it is, you need to take it off, put it in a bin to go through x-ray, and pass through again.”

Me:  Thinking about the fact that the infusion set is currently on my right thigh, “Where would you like me to change?”

SG#1:  “Huh?”

Me:  “See, this is an insulin pump.  I have diabetes, which means that my pancreas doesn’t produce enough insulin for me to survive.  I have to use this device to pump insulin into my body.  It’s currently attached by a catheter to my leg.  If you want me to remove it, I’m going to have to take off my pants.”

SG#1 to Security Guard #2:  “Hey Joe, you ever heard of a insolent pump?”

Me:  “Insulin Pump.”

SG#2:  “Nope.  Better call <supervisor>.”

Me to Co-workers:  “Stop laughing and go tell <client> that I’m going to be late!”

SG#2:  “What’s that thing on your arm?  That has to come off, too.”  

Me:  Oh, shit.  He’s going to give me a hard time about my DexCom sensor?  “This is a sensor to read my blood sugar.  I can’t take it off, and if I hadn’t removed my jacket to pass through the metal detector, you would never have seen it!”

SG#1:  On the phone with supervisor. “Don’t get upset, ma’am.  We’re just doing our job.  This is all to keep you safe.”

Me:  “Look, I have a meeting with <client> in three minutes, and I still have to walk all the way across the building.  Either use your little wand thingy on me to make sure I’m not carrying a concealed weapon, or get your supervisor down here to address the situation in person.”

SG#1 to SG2:  Hangs up phone.  “<Supervisor> says to Wand her, and if she’s cool, let her go.”  To me, he says, “<Supervisor> also said that next time, you gotta bring papers from your doctor for them things.”  He waves his hand in disgust at me, almost as if I’ve got some contagious disease.

Me:  Just wanting to go.  The crown that has gathered is really starting to irk me. “Yep, sure.  Will do.”

The Wand confirms that I’m not packing heat.  I grab bag and proceed to meeting, chuckling at the fact that neither guard said a word about the syringes in my bag.  Security at its finest.

Comments (0)

By shannon, November 3, 2009 9:33 am

Recently, there was a discussion on tudiabetes.com about driving while diabetic.  Evidently, some countries restrict diabetic drivers, especially those who use insulin.  While the title of the thread was a bit controversial, the spirit of the article was one that promoted personal responsibility.  

Some people use their diabetes as an “excuse” for a crash or other traffic offense.  This, frankly, pisses me off.  It’s this kind of irresponsibility that promotes the many misconceptions about diabetes.  It is casual comments like these that cause lawmakers to think that they must “protect” other drivers from the dangerous diabetics.  This is what leads to driving restrictions being imposed on diabetics.  It shouldn’t happen.

However, I have to wonder how many diabetics really take all necessary precautions before getting behind the wheel. Driving is something that I take very seriously for two reasons:

1. I’m married to a racecar driver.
2. I was involved in a pretty serious car accident almost two years ago.

My husband is an amazing driver.  Sometimes, it’s like he knows what his car is thinking.  He’s taught me (and many others) more about performance driving than I ever thought existed.  He’s helping me overcome my fears (from the aforementioned crash), and I’m so proud of all that he’s accomplished.

The crash I was involved in was, without a doubt, the worst thing that has ever happened to me.  But, the first thought I had after coming out of the post-crash daze was “where is my blood sugar – am I low?”  I wasn’t, but that’s only because I’m very proactive when it comes to driving and diabetes.

Before I start my car, I have a little mental checklist that I follow:  I take the juicebox out of my purse, check the DexCom, and, if I’m not confident of its accuracy, I test.  If I’m low (or dropping quickly), I drink the juicebox.  I never drive if I don’t have fast-acting glucose on hand.  EVER.  I’ve gone low when driving, and let me tell you, it’s a scary thing.  I’ve had to pull over on a busy interstate and chug juice (or eat glucose tabs) just to keep from passing out.  It sucks and I hate it.  But, it would suck a lot more if I wasn’t so prepared.   

It’s part of being a diabetic.  It’s my responsibility and I take it very seriously.

Comments (3)

By shannon, October 23, 2009 10:16 am

CGM Wars: Get Ready to Rumble.

For over a year, I used Minimed’s Continuous Glucose Monitoring System.  It was a logical choice since half of its technology was already built into my pump.  For over a year, I dealt with highs and lows much better than I’d ever done before.  My A1c dropped to 6.8 – the lowest it had ever been.  I didn’t go low as often, and when I did, I knew it was coming.  Sometimes.  See, I thought the wide variations between the CGM and my meter were normal.  I knew it wasn’t 100% accurate, so I accepted the false highs and, far more often, false lows as part of CGM life.  I dealt with the painful, bloody insertions as “a small price to pay” for better overall health.  But, as time went on, I began to trust it less and less.  It was just wrong a lot.  The constant calibration errors and “Meter BG Now” demands were seriously cramping my style.  

All that changed a little over a month ago when I switched to the DexCom CGM.  Right away, I was impressed.  Not only did this company fight for me to get insurance coverage, they rectified a rocky beginning by going far above and beyone.  These folks know customer service.

When I received the box, I tore into it like it was Christmas morning.  I impatiently waited for the receiver to charge, inserted my first sensor (totally painless and NO blood), and I was off.  This thing lasts for (at least) seven days, and the readings are consistently accurate.  My current sensor has been chugging away for 12 days (restarting a sensor after the initial seven days is super easy), and until I start getting funky readings, I’m sticking with it.  (Note:  DexCom does not condone this behavior.  They say to wear the sensors for seven days.  PERIOD.  What they don’t know won’t hurt ‘em.)  

Unlike the Minimed sensors, I don’t have to use any kind of surgical tape to keep my DexCom sensors stuck.  Their adhesive is very similar to what is used for my pump’s infusion sets, which is (thankfully) non-irritative to my sensitive skin.  I used a little Skin Tac to help it stick better, and I’m good for the entire seven days.  For wearing the sensor longer than seven days, I will use some waterproof bandage tape, but that’s it.  You don’t have to cover the entire sensor with tape so that it stays down.  

So, there it is.  My independent assessment of the Minimed vs. DexCom CGM.  For a year, I believed that all CGMs were the same, with the same pros and cons.  They’re just not.  I’m glad I took a chance and found the one that works best for me.

Comments (0)

By shannon, September 24, 2009 10:41 am

For almost 10 years, I’ve been told different things about my diabetes. I was diagnosed as a type 2, despite my young age, “normal” BMI, very high A1c, and no family history of type 2.

I was put on oral meds (metformin), which did nothing except make me incredibly sick. I vomited almost everyday while taking it, and my blood sugar remained high. This pattern continued for six months, with a few ER trips for DKA-type episodes in between. I changed doctors twice, but neither thought to test me for type 1. In fact, one even said that such testing would be stupid because if I was a type 1 and not taking insulin, I would be dead within a few days.

Like a good little patient, I believed them. I went to the required CDE classes, learning all about how my poor eating habits and lack of exercise caused my diabetes. I was the youngest and smallest person in the group.

After one year of taking metformin and losing 40 pounds (yes, 40!), I made an appointment with a new endo practice. I was immediately placed on insulin, which was an entirely new experience for a reformed needle-phobe. My doctor told me that I probably had type 1.5, but she did no testing to confirm. Since my treatment would be insulin, it didn’t really matter what type I had (or so I thought).

After many years of MDIs, I decided to make the transition to insulin pump therapy. My endo at that time was a proponent of Minimed, so I went with their Paradigm 722pump. Eventually, I decided to ditch my doctor (she treated me like a child – threatening to withhold pump supply prescriptions if I changed any pump settings myself), and I found a new endo.

I began seeing Dr. S. about a year and a half ago. Our relationship started off well. He was more interested in my opinions and feedback than any doctor I’d ever met. He encouraged me to adjust my basals and worked with me to get a Minimed CGM.

When the subject of my “type” came up, I told him that I had never received a definitive answer. He ordered a c-peptide test, which came back low. Despite this, he decided to classify me as a type 2. I know why he did this. In the years since I began taking insulin, my weight has crept up to its now “obese” BMI. There are some underlying reasons for the most recent weight gain, but they’re not really relevant to this issue.

Flash forward to last month. After using the Minimed CGM for 18 months, I decided that I’d had enough of painful insertions, bleeding, and sensor errors. I called DexCom, requested and completed the materials to get approval, and waited for my new system. I couldn’t have imagined what happened next.

When Dr. S. sent the Letter of Medical Necessity, he classified me as a type 2 diabetic. He did this in spite of the evidence to suggest otherwise (lack of insulin resistance, low c-peptide, etc.). He also told the DexCom folks that I expressed concern over the cost of supplies as a type 2. While we did have a hypothetical discussion about the need to know what type I am so that insurance would cover my supplies, it wasn’t with the understanding that I was a type 2. His statement insinuated that I was trying to pass myself off as a type 1 so that I could get “stuff.”

Naturally, as a type 2, insurance is reluctant to pay for high-ticket items like pumps and CGMs for me. I immediately sent an email to Dr. S. to find out why he’d told DexCom such a thing. His response was that he “really doesn’t think I’m a type 2.” He ordered antibody testing to be sure, but he felt confident that his diagnosis (type 2) was correct.

I received the following email from Dr. S. last week:

” . . . labs showed a positive GAD antibody. In addition, with a fasting glucose of 146, the c-peptide was low . . . This is consistent with Latent Autoimmune Diabetes of the Adult, a form of Type 1 DM. I was not sure before, but it is clear now that you are a Type 1 diabetic.”

To say I feel vindicated is such an understatement. I feel like I had to fight for this diagnosis for one reason: my weight. Doctors really need to step out of the box when diagnosing patients.