Perspective

This is a picture of the grand canyon from afar.



Here is a picture from the grand canyon on the ledge.




Here is picture of the grand canyon from inside.


Notice how all three photos offer differing views and alternate perspectives. Additionally, from a distance the canyon does not appear all that impressive. But as you get closer to the ledge, and ultimately inside the behemoth, you gain a new appreciation for its formidable essence. And if you've ever been there, you know pictures don't do it justice.

To me life with diabetes is just like that.

In the past I thought of tight control and healthy management as unattainable. I heard, read, and acknowledged all the possible complications, yet to me the complications were like the canyon from afar.

20 years in to diabetes, and still complication free I could feel myself getting much 'closer,' yet still was denying the enormity of my future if I did not change course, and fast.

Finally a series of life-events combined and I was standing on the ledge. One of which was a slight foot tingle, and I feared that denying the 'canyon' any longer was just not possible.

So 22 years in to diabetes I took a figurative leap of faith over the edge, and much to my surprise I did not go plummeting downward at break-neck speed.

The most amazing thing happened, actually.

For the past 7+ months it's as if I have been carried up on eagle's wings. The insulin pump has opened up a whole new world for me.

The least way I have been affected by the insulin pump is by having normal blood sugars. That's right, the normal readings are the least of my gains. My focus, my energy level, my patience level, my everything...better!

Being on the pump does not mean the years of mismanagement have not affected me adversely, or that it may not in the future.

But for the first time in my life I am now walking away from the ledge rather than toward it, and I feel GREAT in the process!

Until next time, I'll keep pumpin'....

What I regret about choosing the insulin pump over taking shots or any other diabetes management technique

(nothing)

The pump will change your life in ways you cannot imagine. The fears you or your loved ones have will evaporate. The hesitations will feel like silly excuses after you make the switch. There is no good reason to at least give it a try.

I figured I'd hate it and be back to my old regimen within weeks. After 4 hours I knew that I would never go back. 4 hours. 240 minutes.

The cost was an excuse. Turns out insurance covered almost all of it, sans about $600. Knowing what I know now, even if I had to pay FULL PRICE ($7,000+) I would.

My only regret is not making the switch earlier. But the way I see it, I just added a bunch of years - good, healthy, feeling GREAT YEARS - on my life to make up for all the lost time.

I had a virtual book of excuses in my mind of why it just wasn't for me. I could not have been more wrong. I'm just like you, just like your diabetic friend, just like your diabetic cousin. Wanting to feel better, but thinking it was as good as it could be. Thinking 20 shots a day would be better than that awful tubing, and being connected all the time. Wrong, wrong, wrong! When you're not on the pump, you can't imagine what it's like, because you don't really feel that good. Even if you're A1c is o.k., you're probably on the diabetes-rollercoaster (a 250 and a 30 = a 140 average, but so do a 120 and a 160; do you think they feel the same?)

I am committed to telling everyone, everywhere that this is the most logical, sensible, and practical way to manage diabetes.

What do I regret about choosing the pump over shots?

6 month review of the insulin pump

Greetings friends!

It's been 6 months (+ 5 days - but who's counting?!) since my life drastically changed due to the insulin pump. I've learned a lot about the medtronic paradigm system, and I wanted to share my review with you here.

The 'honeymoon' phase of feeling invincible wore off after a few weeks, but in general I cannot compare now to 6+ months ago. A few general observations:

-I sleep much better. I used to always wake up tired and lethargic, no matter how many hours of rest I got. Now I pop out of bed promptly at 5:15 AM daily whistling "It's a wonderful life!" Well, that may be a slight exaggeration, but really I wake up feeling refreshed, and that has everything to do with the blood sugar averages thanks solely to the pump.

-I'm less moody. Again, operative word: less! All kidding aside, my overall attitude, motivation, and energy level are much higher. Irritation levels have decreased [ note: that's my irritation level of how I feel, not how much I irritate others - :) ] Why do I hear a booming, "A-MEN" coming from my wife and kids??!

-I like testing my blood sugar. 20+ years of ka-ka-me-me readings makes you a little jaded towards testing. But when you see those normal readings on a consistent basis, you start to think, "hmmm, when can I test again?!"


On to the review:

1. "Low resevoir" means I should change my set soon.
I know, I know - thanks a lot Captain Obvious! But for some reason I think of insulin as liquid gold, and treat it as such. A while back I learned that there's about 10 units of insulin in the primed tubing, so even when the pump reads "0 units left" you still have around 10. Again, I should know better. I had to learn the hard way...I ran out of of insulin (bone dry) in the middle of the night, and awoke at 511 mg/dl. Yes, I said 511. Even when my average was high 511 felt horrible - but when your average is normal, 511 feels like your worst nightmare. Lesson learned.

2. De' ja' flu
I was worried about getting sick and being on the pump. I normally get the flu every few years. Well, I got the flu this year (despite the flu shot), and it was really no biggie (see a previous post). But then, I got it again. Not quite as easy the second time around, but being really sick stresses out the body, and after a day or so I recovered fine. Having the pump actually makes it easier to control the blood sugars while sick, so that's a bonus.

3. The meter & the pump talk.
So you test your blood sugar, and moments later, "voila" your reading is displayed on the pump. Magical (actually, RFID, but still impressive). They say it works up to about 8 feet or so, but the other day I had my pump off (shower) and tested my blood in the kitchen. My pump was in the bathroom - around the corner, down the hall, in the room, take a left, through 3 doors and 2 walls. Suddenly I hear the familiar 'bzzzzz bzzzzz' and I think, "whaaat now?" I look at the pump and there it is, "113." You've got to be joking me...nope, that's how cool this stuff is.

This communication makes taking your insulin easy. And who really remembers to test 2 hours after you last ate...exactly after 2 hours? The pump and meter combo make it a cinch.

4. Dress up.
Medtronic calls them 'skins,' and it's an adhesive you can put on your pump to personalize it. Being baseball season, I now sport the Milwaukee Brewers pump. Ironically, ever since the pump and the brewers got paired, the brewers have hardly lost. Who knew the team needed the paradigm insulin pump?

5. Painless.
I can't remember the last time inserting the infusion set actually hurt. Usually it's totally pain-free, as in I cannot feel it at all. Once in a blue moon it's slightly uncomfortable, but no where near the 'muscle shot' pain. And to think you only have to change it once every 4 days (I mean, 2-3 as they recommend - lol), again: awesome!

6. Care link.
It's a usb dongle that plugs in to your computer (pc only - I've logged plenty of complaints!) that reads EVERYTHING from your pump. Every setting, blood sugar reading, insulin dose, time, carbohydrate value, correction amount, basal, and bolus. As if that weren't cool enough, you can customize a variety of charts and graphs to visually see everything that's happening with your diabetes management. You can go from a daily report up to SIX MONTHS! This tool has been invaluable to me, and helps you identify trends that you might otherwise miss. I can't endorse it more highly.

7. CGMS
Fancy acronym for "continuous glucose monitoring system" which in English means a sensor that you wear that remotely sends your blood sugar to your pump every 5 minutes, 24 hours a day! (that's 288 blood sugars a day!!)

I tried the sensor twice before and we didn't get along well. So many stinking error messages, it caused more anxiety than anything. Now I know how to get around all the drama, and realize it's just the sensor and transmitter courting (who doesn't have a few minor issues while courting?!), it has nothing to do with the pump.

I gave it another try and absolutely love it. Well, mostly love it. See below for what I don't like, but I would definitely endorse it and think it's another great way to get tight control.

Here's my current screen...oh the bliss of the straight line (means blood sugars are steady)..



Notice the 'skin'? Brewer time. Also I have no clue what that is under the ACT button. My guess? Some Reese's Peanut Butter cup derivative...(I love having ratios that work!!)


What I don't like:

1. No back light on the meter.
An obvious design oversight. My one touch ultra smart has one, my one touch ultra has one, the one touch ping pump meter has one...the one touch ultra link does NOT. I've logged my frustration with Life Scan (one touch maker), but they have no plan to resolve the issue. When you test at night, or when out to dinner, or when driving at night, or at the movies....you get the point....YOU CAN'T READ THE SCREEN! So I use my cell phone as a light. Lame.

2. No back light on the pump buttons (halo lights).
Again, I don't know how this went unnoticed. Although the screen lights up beautifully, the buttons themselves do not. Having back lit buttons would ensure the proper buttons are being pressed. This would be an easy fix, and I'm going to photoshop a pic of what it could look like in the future.

3. Insulin delivery is slow.
You wouldn't think it would matter, but if you bolus (take your insulin) before a shower, you may have to wait a bit until you disconnect. If the delivery was faster (ala animas ping), you'd be ready quicker. Not a huge deal, just a minor preference issue.


4. Tubing options limited.
The tubing is what connects the pump and insulin reservoir to your body. The current options are 23" & 41." I use the 23" as I stay around the abdomen for infusion sites. But I could use a 6 or 9" as the pump and site are often just inches away from one another.

5. Care link log book
Although I sang the praises of care link above, the log book feature is useless. I called and made many suggestions for changes, none of which were incorporated. You need to be able to enter blood sugars and notes outside of the defined times, and you can't now. It's not very intuitive or user friendly, and I bypass it altogether.

6. CGMS
Yes, we're happy together now. But I have to admit, it is somewhat finicky and high-maintenance. The thought of the CGMS can be better than the reality of it at times (the CGMS is generally about 20 minutes behind your actual blood sugar). However, through proper calibration and updating, you can get the numbers to be fairly uniform. The errors and hassle therein can be a drawback, but if you simply insert the sensor and connect the transmitter WITHOUT TURNING IT ON on your pump...and leave it in for at least 2 hours before turning on (doing it before bed works best), then when you turn it on, within 15 minutes or so you calibrate and you're off and running (thanks Kevin for that great tip!)

My biggest frustration is keeping it on. The sensor uses adhesive, but the transmitter does not. I've yet to find adhesive that works well for me, and I prefer none at all (although that's risky and I've learned the hard way that the sensor can become dislodged this way rendering it useless).

7. Low blood sugar symptoms
I am much less sensitive to low b/s symptoms than before the pump, because my average is so much healthier now. I still have them, just not as pronounced. Not really something to complain about, more an observation than anything. This is where the CGMS comes in handy!


One final thought....I've noticed many diabetes suppliers and manufacturers believe we hate testing our blood sugar because it hurts. Further, many pump companies think we despise taking shots. My contention is that we don't like testing when control is difficult as more a psychological issue than a physical (pain) issue. Additionally, I never thought needles were a big deal. I mean, sheesh, they're so small and narrow you can hardly feel them at all. Again, a mind (mental) issue.

For me, being on the pump isn't great because of no shots. Before the pump I thought, "I'd rather take 10 shots/day rather than be hooked up to that pump." What you can never imagine until you experience it is how it will affect your...everything.

I'm a better husband, better father, better son, better friend, better man, better child of God, better employee.....

I'm just plain better -

Because of the pump.

So get better, and get pumpin....

"What can't you do?"

"What can't you do?" is a question I hear a lot. It's a really good question, considering most people without diabetes cannot fathom how good it is just to have normal blood sugars! If there are some trade-offs, most of us pumpers would gladly agree, it's well worth it.

But despite what you may think, the simple answer is, "nothing!" I mean, I guess technically speaking I can't go through an x-ray machine (it messes with the pumps electronics), and I need to take it off before a raging roller-coasters with steep drops and upside-down inversions; but is that really a limitation? Hardly!

This past weekend my wife & I went to our favorite resort in Michigan to enjoy some incredible skiing & snowboarding action. I've been skiing as long as I can remember, and switched to the board when I was about 16 (around when it first came out). I took a hieatus during my 20's, and now am back at it! Being on the pump and snowboarding (and skiing) is really not an issue at all. I simply adjust my basal rate (the continuous trickle of insulin) down due to the excessive exercise and go for it!

Before the pump I would allow my blood sugars to hover higher while snowboarding, knowing they would be crashing down because of the exertion. As you can imagine, it is not a reciepe for feeling great! I also noticed that when my sugar levels were high, my reaction time was a bit slower. Normally not an issue, but blazing down a mountain at break-neck speeds, you need every bit of reaction time you can muster!

So now my levels are normal and I feel better before, during, and after the weekend on the mountain. It allows me to fully enjoy each moment, and helps to create life-long memories like this:

Stay encouraged, and tell everyone you know to keep pumpin...

22 years coming....

It was a long road.

Frankly, I had all but eliminated the possibility of ever wearing an insulin pump. I was totally against the concept, and hated the thought of being 'wired up' 24 hours a day.

I was diagnosed as a type-1 diabetic on June 20, 1986. So that means for twenty-two years now I've struggled mightily with obtaining ANY thing resembling control.

I used to laugh at those One Touch commercials that always showed a perfect '120' reading. I thought, 'yeah, right...'

My family and friends had encouraged me to give it a try, but I just could not wrap my mind around being tied down with this thing 24/7. But when my son, who has Down syndrome was born, I started to think about things differently.

I began to think about the importance of good health. Further, I considered the path I had been on for over two decades and what the long-term implications were. It was (and is) scary. So one night I googled "insulin pump" and began to research the options.

In a later post, I'll compare and review each of the pumps I was considering and give my reasoning as to why I ended up with the Medtronic/Minimed 522. But for now, suffice it to say I feel I made the right choice.

So my last A1C was about 10.5, which equates to an average blood sugar of approximately 255. (to calculate your average, check this out: http://bloodsugar101.com/A1Ccalc.php)

After two weeks on the pump, my average is 146 (6.7 A1C) and headed down!! Honestly, I've never felt anything like this. The energy, focus, positivity - I simply cannot recall ever feeling anything like this.

All of my fears were unfounded. Being 'wired up' is no big deal whatsoever. And going from 6 shots a day to 1 infusion set every 3 days is a major benefit!

If you are a diabetic struggling with control, I understand where you're at. I had been told I was in the top 2%...just so 'brittle' that no matter what I tried, control may not be attainable. Listen to me, that is false information. I just want to encourage you to consider a more progressive approach to diabetes management.

In this day and age, there is no reason to suffer through the 400's only to crash in to the 30's. There is hope. If I can do it, most certainly anyone can!

Until next time, I'll be pumpin...