Wednesday, December 28, 2005

My early Christmas present

OK, sorry it's taken a bit for me to update this, but Christmas time is somewhat crazy here. But crazy in a good way. I had my parents and four of my five siblings with their families over for dinner. This year, that was 26 people -- a small crowd, last Christmas was 34. I think we scared off my husband's tiny family this year. And no, I don't do it all myself - we all bring something (Mom made the turkey/stuffing/gravy) so my job was to clean the house, buy beverages and make mashed potatoes. Everything went really smoothly and I had a great time. It was great to see my 3 boys and 6 boy cousins all piled on the couch playing/watching Lego Star Wars on the Xbox. And the best of all was that, even with gingerbread men for breakfast, wine, brandy alexanders, potatoes, stuffing, cookies, two kinds of cheesecake, trifle, etc, etc, etc that I ate, my BG stayed between 80 and 140 80% of day, and peaked at 216 for just a short time! Of course, Monday I was back to being mostly healthy and that's when I spent like half the day out of range. Oh, well.

I know some of you have been looking for an update on the integrated continous monitor & pump setup. I can't really provide identifying info without pissing off the study people (whom I really want to stay on the good side of - I don't want to have to give this gadget up), and I don't think I'm up to the detail and elegance provided by Wil in LifeAfterDx, so I'll just highlight a few things different from Wil's experiences and include my own observations.

Basically, it works a lot like the Guardian described by Wil, with the exception that you don't need to carry a separate receiver with you. You put the sensor under the skin and tape the transmitter nearby, then the pump picks up the readings. It has 2 status pages, one a graph of the last 3 hours, one the last 24 hours. Both graphs let you scroll the cursor back to see the numbers, and have little tick marks to indicate when you've bolused. I've had the sensor remain in contact while I'm in the shower and the pump is left next to the sink, but I've also had it lose contact twice when I'm in bed with the pump on one side and the sensor on the other (it beeps and I set the pump right against the transmitter for a few minutes and then it's happy again).

Based on what I've seen from the CGMS I wore last year, the week I wore one recently and random testing when the kids/dog wake me up at night, I sleep through a low (50 or below) an average of twice a week. I think this is a big contributor to my lack of "patterns" - my body remains in a permanent state of panic, making it tough to get any set of basals that really seem to work. Two days after I got this pump, it woke me at 2am to warn I was dropping low and I tested and was 56. (the sensor thought I was 78 but I guess it's the thought that counts). It does take a while to get synched up with the fingersticks -- as synched as it's going to get. I've had one day where they stayed within 10 points and another where I got readings 35-90 points off. I also had a sensor go bad on me -- while I was on the phone to my CDE. I just told her what the alarm said and she said I'd have to put in a new sensor. Since I was at work I waited until suppertime to set up the new one, now I'd rather have my next change be a morning thing but of course I'm leery of going a night without it, since that is when it really pays off.

I guess what I'm saying is its still not perfect, but it's a heck of a lot better than whatever else is out there at the moment. I tend not to feel a low until I'm below 60, so it's real handy to just look at the pump and see whether I'm headed upward or downward, even if I still need the fingerstick to confirm what's going on. I made a lot of use of this on Christmas, double-checking to see if my guesstimates were anything close to what I needed. This was perhaps the most useful thing about it, one click on the pump and I can see that I had been climbing, but have now leveled off and started to drop. I see Wil has started to make use of this as well, in his Light Bulb Moment post. Proactive BG treatment - the wave of the future!

Monday, December 19, 2005

Name that stress

The other day my five year old said to me, "Mommy, I don't remember what you looked like before you got your pump." I ignored his older brother ("the same as she does now, only without a pump, stupid!") and said "Sometimes I don't either". Because he had just turned four when I started taking insulin; was four and a half when I got the pump. So he really doesn't remember a time when Mommy wasn't all stressed out with this disease; when I wasn't sticking my fingers ten times a day, when every third morning I wasn't busy with a site change and snapping "ask Daddy to get you breakfast". I can't say he doesn't remember a Mommy who wasn't cranky if she missed a meal, because that has pretty much always been true ; )
On the other hand, life wasn't exactly stress-free before. When my oldest son was five, I was working a ton of extra hours at work with a toddler and a baby on the way; when the middle guy was five, I was agonizing over a job change, building a new house with an old one that wouldn't sell, and so on. So I recognize that even if this is a huge new deal to me, to the kids it's just another in a long line of grownup issues. And I just have to deal with it, because that's the only real option.
His comment did bother me, but I need to look at the fact that most of the time this disease is really nothing more to me then a big pain in the butt (literally!). And sometimes, it's a source of humor. I mean, I'm getting ready for my end-of-study-control-period by wearing a CGMS again for a solid week. It would, of course, have to be the week of my company Xmas party, where my BG was way up there pretty much all day as I pigged out. Lord knows what the graph for that is going to look like ("When good diabetics go bad"). And I had a pretty amusing time trying to come up with a way to hide both a pump and a monitor beneath a slinky evening dress without looking like some kind of holiday suicide bomber. Note to self: clipping both devices to a single garter wasn't the best idea - the combined weight kept trying to pull down the garter, which was clipped to my underwear, which wasn't clipped to anything... Luckily a few timely trips to the ladies' room averted any real catastrophe.
And then there was yesterday's conversation with my husband:
me - You got a box from Amazon.
him - Don't open it; that's your Christmas present. It's something you really want.
me - I don't think they sell pancreases on amazon. Though I imagine you could try on eBay.
him - That box would be in the fridge.

Actually, my real present comes tomorrow, when I start my non-control group six months of integrated-pump-and-continuous-monitor study. Stay tuned for details...