Yay, team!

Diabetes Blog Week, Day 4.

We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you’ve made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small – think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.)dblogweek

Hmmmmm, good question!  I feel like I haven’t mastered anything when it comes to my diabetes care.  I mean, I have mastered the motions, testing my sugar when needed, changing my pump sites, bolusing, etc.  But I am still, 14 1/2 years in, not 100% confident to say “Yes! I kick ass at diabetes!”  My sugars are not perfect, I don’t exercise every day, I still enjoy a carb or 20, and I have days where I’m crying out of frustration that I have to live with this crap for the rest of my life.  Sometimes my blood sugar is just a real jerk for no reason (like last night for example – for about 4 hours I was cruising between 43 and 80 despite 20 oz of OJ and two not-so-small spoonfuls of peanut butter).  Is there anyone out there who really has mastered diabetes?  Who can go to their endo every three months and know that their A1c is going to be 6.0?  Who has the perfect attitude when it comes to living with this?

But, the question wasn’t if you’ve mastered diabetes.  It’s about diabetes-related accomplishments.  Recently I made some pretty darn important care decisions.  As the Hubs and I want to have a small human in the next year or two, I knew that the time had come where I need to get serious and get as close as I can to mastering diabetes.  I decided to end my months-long pump holiday and resume pump therapy with the help of a CGM.  This was something I thought about for weeks months before finally accepting that I’m going to have to become a cyborg again.

You see, in theory, I love the pump.  Don’t have to carry around syringes or pens, your meal schedule can be more varied, and it offers better management for most people than multiple daily injections.  Blah, blah, blah.

But in reality, the pump is a pain in the butt.  Site changes, being connected all the time, it’s expensive, it beeps at you, it’s bulky and gets in the way, and it makes wearing dresses a headache!  My pump-cation had been glorious!  However, knowing all of the negatives that come with wearing a pump, I decided the best thing for my health and the health of a future pregnancy would be to get back on the pump and to get a CGM.  So the research began.

I googled, I youtubed, I blog-stalked.  Wow, there are a lot of people online sharing their experiences with various pumps and CGM setups.  The doctors and manufacturer’s’ sites will only tell you so much, these blogs were so helpful in sharing real-world experiences and opinions.  I especially found blogs written by women who are in similar life stages as me to be very helpful and was so happy to find their sites (Texting my Pancreas and SixUntilMe especially).   With the help of my new blogger buddies and the fabulous interwebs, I decided on the Dexcom G4 Platinum CGM and Animas Ping pump.  In black and silver – stylin’.

Change is scary and although I had previously been on the MiniMed Paradigm pump, I was pretty nervous about going back on pump therapy.  I had a breakdown one night about the fears of the unknown and how much it sucks that I have to do this and think about these things a year before we even want to start trying for a baby.  He, however, reassured me that there are other ways to start a family and if I absolutely did not want to do this, I didn’t have to.  He also made the great point that if I hate it, I can quit.  He’s so smart.

Fast forward to today and I’m almost 2 weeks into my new cyborg life.  Have I mastered it?  Nope, not quite.  I’m still aware of the pump clipped to my pants and the CGM sensor and transmitter taped to my body.  I still feel dorky about my “diabetes tool belt”.  My sugars aren’t perfect and I definitely miss the freedom of not being attached.  But one thing I have mastered is my attitude that I’m just doing what I have to do.  And knowing that diabetes care is something that can be adjusted and modified to fit my needs at the time.  Not everyone needs to be on pump therapy.  It’s not the best course for every.single.person with a dead pancreas.  But for me, right now, it’s the best choice in regards to my goal of becoming a mother, and I’m cool with that.  Will it be my choice 5 years from now?  Who knows.  All we can really do in regards to our care is to make the best decision with the knowledge we have at the time.  I think a series of making the right decision and small accomplishments will lead me closer and closer to that whole mastering diabetes thing.  But for now, I feel like I’ve accomplished the right attitude.

Ping!

I wanted to write this blog earlier this week, but I’ve actually (gasp!) been fairly busy at work.  What the what?!  Today is my 4th full day on the Ping.  So far, so good.  I had my appointment with my CDE on Monday afternoon and we set up my basals to be much lower than they were previously on the Paradigm.  When on the Paradigm, I seemed to go low if I didn’t eat and as someone who’s trying to shed a few lbs, this is no bueno.  Right now I’m on the following basal rates:

Midnight – 8:00 am – 1.0 Unit Per Hour
8:00 am – Midnight – 1.2 Unit Per Hour

Very complicated and complex, right?  For those non-Diabetics who may read my blog, the basal rate is the continuous stream of insulin my pump is programmed to give me.

My bolus rates are dependent on my Insulin to Carb ratios, Blood Glucose, Insulin on Board, and Insulin sensitivity factor.  Learning Time!  (I will quiz you later)

  • Insulin to Carb Ratios: Number of units of insulin I need for X number of grams of carbs I’m eating.  Mine are 1 unit per 12 grams of carbs for breakfast and lunch, and 1 unit for 10 grams of carbs for dinner.
  • Blood Glucose: Amount of Glucose (Sugar) present in my blood.  Vampires dig it.
  • Insulin on Board: The amount of insulin still present in my bloodstream based on my last bolus and current basal rate.  The pump figures this out.  It is much smarter than me.
  • Insulin Sensitivity Factor: This is the amount your blood glucose is lowered by 1 unit of insulin.  Mine is currently set to 40.

So far with these settings I think my readings are OK but there is definite room for improvement.  I’d like to be in the green as much as possible.

DailyTrends

Seeing as the spikes are generally post meal, I imagine my Insulin to Carb Ratios will change.  Especially after breakfast because coffee seems to hate me  but that is to be determined by my CDE, hopefully by the end of the day!  I’m excited to get tighter and tighter control.

Even though it’s been a while since I’ve pumped, I have noticed some things about the Ping that are different from the Minimed Paradigm:

  • There is a lot more button pushing.  You have to dial in your blood sugar as it doesn’t automatically display on the pump like it did with Minimed’s (MM) equipment.  I think this is a copyright issue with Medtronic a safety feature.  Not a huge deal but something to get used to.  I like bolusing right from my pump, but maybe I’ll have to train myself to bolus from the meter remote so I can skip the step of having to input my BG.  Those extra 10 seconds at every meal add up!  (Sarcasm)
  • Filling the Reservoir is more cumbersome.  The transfer guard that MM has is pretty slick.  Again, not a big deal just takes a few more minutes when I’m changing my site.
  • The infusion/insert seems to be smaller.  I like this.  I am using the 9mm Insert.  I was using the Silhouette with MM.  The size difference may very well be due to the fact that I’m now using a straight set rather than an angled, but so far I like it.  It makes me more eager to try different sites.
  • The all-in-one inserter has its pros and cons.  I’ve only done one site change without the watchful eye of my CDE so I am sure that it will get easier as I get used to it.  It seems a little more awkward than the MM, but at the same time I like that it’s all-in-one.  Makes travelling easier and I always would lose those inserters that MM provided.  MM does have the Mio which looks comparable to the Insert, but I have no experience in using it.
  • The display and menus are different.  This is just something that takes getting used to.
  • It’s so pretty.  Really.  The Animas Ping is just prettier than the Paradigm, in my opinion.  I love the silver.

So this is my review of the first few days.  I continue to be a work in progress.

Last day of vacation!

Whenever I go on vacation, I get what the Hubs calls the vacation blues.  I’ll get sad when we’re on like, day 2, of vacation.  “We only have 5 days left!  Wah.”  The Hubs reminds me to just relax and enjoy and I think the past few vacations we’ve gone on, I’ve been getting better at savoring the moment and not being grumpy pants that vacations don’t last forever (until we win the Powerball).

Today is my last day of my extended pump vacation.  Since my Endo’s office was able to get me in earlier than anticipated, I haven’t really had time to get the pump vacation ending blues.  But, there are definitely a few things I will miss about being un-plugged:

  1. Wearing dresses is so much easier w/out a pump.  Seriously, those leg pouches, not comfy.  Wearing the pump between your boobs, well, not so comfy either.  And it’s real attractive to go fishing for your pump in your cleavage when you’re out to dinner.  No, I’m not getting frisky with myself at the dinner table…
  2. Sexy time.  Let’s get real.  “Hold on honey, let me disconnect” isn’t exactly sexy foreplay.  It is much easier to be spontaneous when you aren’t a cyborg.
  3. Swimming, beaching, hot tubbing.  Not that I do these things often, but again, easier w/out a pump and having to disconnect.
  4. Exercising.  The bouncy-bounce-bouncy-ness of the pump while working out can get really annoying.  They need to make pump sport bras or something.
  5. I feel like diabetes isn’t as in your face when on MDI.  Granted the multiple injections every day are a reminder, but you can almost forget you have the D in between them.  The pump is connected to you 24/7, it’s visible to others, it beeps, it makes you bump into things (Am I the only one who is constantly grazing doorways?), etc.  It’s a constant reminder that you need a machine to do what your pancreas was supposed to do.  Seriously, pancreas…you had one job.  One.

However, all that being said, I’m pretty excited to go back on pump therapy.  I think I’ve made the right decision moving to the Animas Ping/Dexcom combo so I can get that elusive 7.0 (or lower) a1C.  The Ping is pretty nifty as it has a meter-remote so I can bolus right from my meter (makes wearing dresses a little easier, no boobie fishing here!).  It is water proof so swimming and such is a bit easier, although I do anticipate I will still disconnect, but this way if my Hubs wants to throw me in the pool, he can.  Exercising and sexy time…well, it is what it is.  The Hubs doesn’t make me feel any less sexy just because I have an extra step to take before getting busy.  (Thanks, honey!)  The bouncy-ness of the pump while exercising will probably always be a matter of trial and error.  I’ve found that wearing shorts/capris with compression fabric around the waist and turning the pump in towards your body helps a lot.

As far as the in your face-ness of the pump…well, I’ve been working on embracing my diabetes.  This is me.  Take it or leave it.  And, if nothing else, it’s a conversation starter.  “Why do you wear a pager?  Are you a doctor?”  “OMG, pagers are sooooooo 1996.”  “My nephew has a pump, but his is blue.”  I also like getting “the nod” from other pumpers.  We pumpers know what’s up.

And, if all else fails, there are always pump vacations to be had.  But I do imagine that once small human is created and comes into our lives, I really will be appreciative of the convenience the pump provides.  So right now, a few hours before my new cyborg life, I am feeling excited, empowered, and surprisingly not very blue.  I am going to relax and enjoy this trip!

A love letter for my Endo’s office…

I am currently on a pump-cation.  (Got hitched, sick of being a cyborg, it’s ‘spensive).  I’ve been enjoying this pump-cation for about 8 months now.  However, since the Hubs and I want to create a small human, it’s time to get back on the pump.  I’ve decided to make the switch from Minimed to Animas as I’m a new Dexcom user and Dexcom and Animas are BFFs.

BFFs

Well, my Ping (I say this in my head like “BING!!” from “Friends”.  Oh how I miss that show.) is due to arrive today!  Yay!

However, my appointment to see the Certified Diabetes Educator to train me on my new pump is not until June 28th.  That’s, like, a million years from now.

So what does any pushy patient do?  I emailed my Endo and her PA asking for my last basal rates so I could get started pumping right away as I don’t want to wait 8 weeks to resume pump therapy.  I am so excited to see what results the Dexcom/Animas Best Friends Forever-ship brings me.

But, as well all know with diabetes, nothing is ever easy.  Doc responds to my email and does not give me my basal rates and says she wants me to wait until my appointment in June.

grumpy cat

I don’t think so.  So I call and complain and some how, magically, they are able to offer me not one, but TWO options for appointments this Monday.  Imagine that?!  So my homework for the weekend is to read over the manual and get intimate with my new Ping so I am fully prepared for my appointment on monday.  I’m mostly excited, with a teeny, tiny amount of sadness that I’ll now be attached to a pump again.  But, a wanna-be Mommy’s gotta do what a wanna-be Mommy’s gotta do.  Right?

However, I do wonder if the Endo’s office had these two appointments all along and it took me being a squeaky diabetic to get in sooner.  Squeaky D gets the new Pump?  Just goes to show that it can’t hurt to ask and those of us with chronic illnesses have to be our own advocates for our healthcare.

Also, side note.  I still need to figure out what to do for a pump case for working out.  I used to have a nice case that had a clip and zipped around the pump to wear while I worked out.  It was great because it didn’t bounce around (I wear compression capris so it holds firmly when clipped towards the inside), didn’t annoy me by riding up as I imagine one of the waist pouches/spi belt things would, and the fabric zipped around the entire pump protected it from moisture (I killed 2 pumps by sweating on them.  D’oops).  Of course, my awesome case is lost and it doesn’t appear to still be offered by Minimed.  Le Sighe.  What do you use for working out?