Because

Because the first attempt to kill off my thyroid with radioactive iodine didn’t work.

Because it was an abyssimal failure as a playroom (As in I didn’t make the mess in here, Mom! times three).

Because that honking huge bed from my in-laws needed the proper room to set it off.

Because I’ve always wanted a window seat to read in.

Because we need more than one spare bed when out of town friends and family visit.

Because my BG never seems to do as well as when I’m coating myself in sawdust, dirt, or spackle.

Because my dad didn’t mind me borrowing all his power tools for months at a time.

Because if a hyperactive thyroid is giving me all this extra energy, I may as well put it to good use.

Because if I’m spending my second week of the year shut away in a room, I might as well enjoy being there.

Because when you don’t normally do caffeine, starting the weekends with an espresso makes you really productive.

Because if I do develop superpowers this time, I’m going to need a really cool secret hideout.

Because as a guest room it was just a place to collect clutter.

Because my husband got the basement for his playroom.

Because neat wall painting always escapes me, but I can make messy look pretty darn good.

Because if I’ve got a spare bedroom, I can do what I like with it.

Because our cat looks really good curled up on a window seat. (Don’t worry, he is not allowed in while I’m radioactive).

Because I’ve been a castle freak my whole life.

Because all three boys think it’s the coolest sleepover room ever.

Because it will probably always be a work in progress, but I wanted a fun work in progress.

Because that cute boy from high school English class, to whom I’ve been married for the past nineteen years, has many great qualities but is not an actual prince. (Though I hear real princes are pretty high maintenance, anyways).

Because Number One Son and his friends really like it as a place for playing Dungeons and Dragons.

Because last time I was locked in here, I got to play around with my sewing machine for a week.

Because I’ve collected really weird souvenirs over the years and needed a place to display them.

Because my elliptical really does look like a medieval implement of torture.

Because we always have more books than shelves to hold them.

Because barring a winning lottery ticket, I’ll never afford to live in a real castle.

Because if I made the whole house look like this, people would think I’m really weird, but one room practically makes me a medieval Martha Stewart.

Because if I’m spending a week locked away in a tower, it should look like I’m locked away in a tower.

So What's Not to Like?

I said I would post more about using the new Guardian instead of my Dexcom Seven. Here it is.

I would say the “honeymoon” with this device is over. I had originally thought that by setting the low threshhold to 100, I could bypass the Guardian’s rather crappy performance on lows. So I have. And most of the time that is OK, I get a low warning that I am 100 or 95, and test and see that I am really in the 70s, so I treat if it’s dropping and forget about it. But that doesn’t always work. Today, for example, I was working and my “Low Predicted” alarm went off. It said I was 120 with one arrow down. I tested and got a 60. Quite the difference there.

Still, though, it caught it. So that’s not the most annoying thing.

The most annoying thing is when a sensor just flakes out and your readings either launch skyward or drop like a rock. Sure, my Dex has done this a handful of times in the 15 months I have had either the STS or the Seven. But I have been using the guardian a little over two weeks and it has happened 3 times.

The first time I was at work. It was the middle of the morning and I had been drifting down after breakfast when I suddenly got a predicted high warning at 170. I tested and was 125. A few minutes later Guardian said I was 190. Then 225, then 300 in the next half hour. I tested again. 122. I entered this value on the Guardian, which by now had me in 400+ range, and promptly got a CAL ERROR and a request for a new reading. Now, when Guardian thinks you have a CAL ERROR and asks for another reading, it doesn’t really mean it. If you give it that second reading you’re begging for a second cal error and a bad sensor. So instead you wait for your BG to level out if it was weird, and don’t give it a new reading for an hour or so.

So I waited. And waited. Ate lunch, went for a walk, tested two hours after lunch and was 170. OK, let’s tell Guardian. Cal Error. Bad Sensor. Since I’m in a study, I can’t just restart, I do need to change the sensor. Which is at home in the fridge. Big PITA.

The second time, I was in bed. It was not quite one in the morning, and I got a predicted low warning. I tested and was 130, right where I want to be at night. A few minutes later a high warning. Then a predicted high warning, then a bunch more high warnings and assorted beeps. I was never over 160 on the meter and pretty level. Again I tried a sync up, and got a cal error. Now it was also beeping for a “Meter BG Now” that I wasn’t going to give it. Needless to say, after that first alarm, I never fully got back to sleep. At 5:15 I finally got out of bed, flung the damn receiver into the closet and shut the door. I could still hear its muffled complaints in my 30 minutes of sleep before morning. I had to call in sick to work that day because I just couldn’t function.

At 9am I let Guardian out of his prison and let him Find Lost Sensor. He happily chugged along for the rest of the time with no problems.

Then a few days ago it happened again. Only this time Guardian thought I was low. I was 156. After an hour or so of bogus below-40 readings, that I refused to dignify by trying to sync up again, I locked Guardian in his closet and went downstairs. Several hours later he was paroled and again behaved himself.

So now I’m thinking that clunky software and carrying a goddam potato clipped to my belt might be a small price to pay for actually getting to use the darn sensor when I want to. If I’m at work when Guardian flakes out, how do I get him out of range for long enough to smack some sense into him? Ask a friend to keep an annoying beeping or vibrating device in their office for a few hours? Put him inside some kind of Faraday cage to block out the signals? Leave him in the ladies room with a “please don’t steal me” post-it note? Or just give up and go back to Dex, who flakes out every few months not every few days.

I’m done with this study in a week and a half. I find now that I’m looking forward to my old clunky but reliable Dex.

A new CGMS study

Note - I wrote this post overa week ago and hadn't gotten around to downloading the pictures to go with it...

Yes, just a few weeks after upgrading to the Dexcom Seven, I am participating in yet another CGMS study, this one using the Minimed Guardian system. Unfortunately my Dex was in a Day 11 fade-out when I got the new system, so I don’t have a good comparision, but I may try to put a new Dex 7 sensor in at the same time I put in my last sensor for the study.

In the meantime, here’s some comparison pix (please excuse the quality I’m not at my best first thing in the morning):

The sensors (side view, I know they look a bit beat up – sorry) Yes, the Minimed really is that much thicker)

With transmitters

Transmitters again

Receivers

Now, having been completely exasperated with the MM product in the first study I did, I’m going to revisit some of my original concerns.

Accuracy at BG readings under 100: I still feel the Dex is more accurate here; but I currently set my low threshhold on the Guardian to 100, meaning that it sets off the “predicted low” alarm when I’m around 85 in real life. So, it’s something I can work around.

Features – by this I mean how much can you customize the alarms. The Guardian wins hands down, having not only a “crossing threshhold” alarm, but alarms for impending highs or lows, and for rapid rise or fall rates, as well as a “snooze” feature (meaning beep again in 20 minutes if I’m still low, or 2 hours if I’m still high), and a regular alarm clock feature. Everything is configurable. Dex only allows you to set the low and high alarm threshholds.

Software – OK, I don’t actually get to use the software until the download at the end of the month, but I was able to look it over at the doctors office, and it is much better than the Seven’s reporting software.

Added bulk – I had been resigned to the Dexcom’s big bulky oval, but didn’t realize what I was missing until I have the Guardian’s reciever, which is basically a minimed pump with the pump guts taken out. Very easy to slip into a pocket, while the Dex reciever is too large to do much except clip on a belt.

So now, having lived with Dex for over a year, I’m starting to think about more than just the accuracy. I mean, I can easily work around the Guardian’s flaw by setting my “low” level to 100. But how to you work around lame software, limited configurability, and the bulky receiver? Next year when my pump goes out of warrantee it might be worth it to go for the all-in-one system. I’m tempted.

Dexcom, are you listening?

Next post - I remember what irritated me so much about MM in the first place....

Duelling Dexcoms

Copying Bernard, I'm posting a picture of my duelling Dexcoms. This shows some data from this morning, after spending all of Sunday doing yard work. The new Dexcom Seven is on top.


This shows me a couple of things:

1. They really do track quite well - at one point I got low alarms 30 seconds apart on the two recievers.


2. The new Dexcom Seven is a little more cautious about jumping up at the first few readings after drinking my juice. Actually I had just tested at 102, so both were quite reasonable. When I finally stopped treating them as alternating snooze alarms and actually looked at the screens this morning, one said 61, the other said 62, and my meter said 61. Can't get better than that!


3. Obviously, I need to quit my job and become a landscaper. I never see nice in range lines like that after a day of programming. And you don't want to know what I was eating Sunday night, but it did include bolus-free eclair, cookies, and lemon Italian ice - and my yard looks great.
   

There has been a huge gap in my posting. Life intervened - busy at work, big vacation (took the family to Edinburgh, York and London for 2 weeks), visitors and family parties. I still may be getting another shot at superpowers depending on my bloodwork mid-August. If so, maybe I'll have some time to post ; )

You would think I’d at least get superpowers

I mean, that’s how it happens in the comics. Radioactive spiders, gamma ray exposure, you name it. So there was always the hope that the pill full of radioactive iodine I swallowed for a hyperactive thyroid could have imparted some kind of special ability.

Hey, it could happen.

Just think of the possibilities here. The ability to regrow beta cells, or corral and destroy the errant T-cells that have already taken down two organs. Being able to wave your hand over a plate (I admit, I do this) and know instantly the precise carb count of everything on it (OK, so that part seldom works).

Or better yet, being able to see different paths 4 hours in the future to know the precise insulin dose you should give yourself to avoid that nasty 327 after lunch.

How about being able to keep you blood sugar level, no matter what you eat? Or turn a chocolate chip cookie into a “free food” just by looking at it? Without changing the taste or texture of course.

There were just so many things that could have happened.

I guess I just wasn’t specific enough about which organ I wanted to regrow.

Because, in the nine weeks since the radiation treatment, my thyroid output has more than doubled. In fact, if it doesn’t die off soon, we’re going to have to try it again.

This time I’ll be hoping it’s the pancreas that regenerates.

Late Night Conversations

A play in six acts

Cast of Characters –

• Val – an increasingly sleep-deprived, mother of three, type 1 diabetic
• Pump – an Animas IR1200+ insulin pump, who usually sleeps in the pocket of Val’s tee shirt
• Dex – a DexCom STS continuous blood sugar monitor, whose job it is to make sure Val’s blood sugar doesn’t go too low or too high overnight. He is set to alarm at values below 80 or over 200. He usually sleeps under Val’s pillow.
• Clock – your basic digital alarm clock, set for 5:30 am on weekdays, 7 on weekends. Lives on Val’s bookcase headboard next to a large pile of Juicy Juice 100% apple juice boxes (15 grams carbohydrate each) and a scattering of used test strips.
• Meter – a one-touch Ultra Smart blood sugar meter, whose job it is to provide real data if Dex is getting flaky. He sleeps on the headboard between Clock and the juice boxes.
• Various and sundry other characters, whose short-lived appearances should be self evident.

Act I

Thursday night – or very early Friday. We can assume that Val went to bed around 11pm, after first checking that both Meter and Dex agreed that her blood sugar was about 140.

1:30 am

Dex You’re low.

Val Hmm? [reaches under the pillow, jabs Dex, who shuts up. Goes back to sleep.]

2:15 am

Dex You’re low.

Val Hmm? [reaches under pillow, jabs Dex again. Then thinking better of it, grabs Meter off the shelf. Pops cap, inserts test strip, pricks finger without turning on the light. Then pulls Dex from under the pillow and hits a button so he lights up.]

Dex You’re low. 68, you know. [Val uses light on Dex to guide her finger to the appropriate spot on the test strip. Meter begins his countdown]

Meter 5 – 4 – 3 – 2 –

[Dex goes dark]

Meter 1!

[Val pokes Dex again, twists him so light falls on Meter]

Meter 46.

[Val stuffs Meter back on his shelf, tucks Dex under his pillow and grabs a juice box from the shelf. Pulls off straw, unwraps it, and finds the little foil dot in the dark. Sucks down juice, tosses box off side of bed. Sleeps.]

2:21 am

Dex You’re low.

Val I know that, let me sleep. [Jabs Dex and rolls over]

2:32 am

Dex You’re low. Really, really low. Like 40.

Val I know that, I just drank the juice. Leave me alone.

2:40 am

Dex You’re low. [Val hits him]

3:28 am

Dex You’re low.

Val I can’t be low.

Dex You’re low.

Val What time is it, anyway?

Clock 3:28 am. [Val grabs Meter, repeats testing procedure.]

Meter 5-4-3-2-[pause as Dex goes dark]-1. You are 54.

Dex (smugly) told you so.

Val Shit! [Stuffs Dex and Meter under pillow, grabs another juice box, then has to pull Dex from under the pillow to light up because she can’t find the spot to put in the straw.] How the hell did that happen, anyway?

Dex Last juice box brought you up to 134, then you coasted back down again. Drink your juice.

Val’s husband (sleepily) You all right?

Val Yeah. Just low. I’ve got juice.

Val’s husband You sure?

Dex We’re fine. [Val’s husband rolls over and returns to blissful sleep. Val finishes juice, tosses box to the floor, sleeps]

3:36 am

Dex You’re low.

Val Will you shut up! I just drank the frigging juice. [Jabs Dex and goes back to sleep]

5:30 am

Clock Time to get up. [Val reaches under pillow, jabs Dex]

Dex Hey!

Clock Time to get – [Val reaches up to shelf, slaps Clock]

5:39 am

Clock Time to get up. [Val groans and sits up. Turns off Clock and reaches under pillow]

Val How’d we do last night?

Dex You are 124. Nice and steady after that second juice.

Val Is that right? [tests]

Meter You are 124.

Dex See?

Act II

Friday night/Saturday morning. Scene – the same. Val was about 86 at bedtime, so she had a glass of milk and a cookie before going to bed at 11.

11:57 pm

Dex You’re high.

Val I know that, I just had a snack.

Dex But you’re high.

Val Yes. Shut up. I’ll be fine in a half hour or so. We don’t want a repeat of last night. [pokes Dex]

3:12 am

Dex You’re high.

Val I’m not low, leave me alone. [pokes Dex].

3:20 am

Dex I said you’re high. High, not low.

Val What was that? [Pulls Dex from under the pillow and hits a button].

Dex 278

Val Oh, man! [Gets Meter from his shelf]

Meter 5 – 4 – 3 – 2 [pause for light] – 1. You are 174.

Val 174’s not bad. And I drop in the morning anyway. [Pulls a wire from Meter’s case and plugs it into Meter and Dex. They converse]

Dex Maybe you aren’t that high after all.

Val Go away, Dex.

4:46 am

Dex You’re high again.

Val Wha…. [Val grabs Dex from under the pillow and hits a button]

Dex You’ve been steadily climbing for the past hour. 172 to 265. [Val hits button again] You did it twice in the last three hours. [Val hits button a third time] All night long. You’re high.

Val Are you sure? [She frowns at the nine-hour graph, blearily realizing that she is seeing The Dreaded Scallops, a pattern she has recognized before. She reaches down and finds where Dex’s transmitter is clipped to the sensor on her leg and presses on it. A click is heard.] Aha!

Dex I’m only as good as my information, you know. So what is your blood sugar? [Val pulls Meter off his shelf, puts test strip in slot, pricks finger]

Val’s cat [jumping on bed] You’re up! You’re up! Feed me. [Val pushes cat off bed. Cat jumps back up] You’re going to feed me, aren’t you? Even if you aren’t I just love you. I’ve told you that, right? And my buddy Meter. Can I have the little bottle of strips? Please? It shakes and it rolls -

Meter Get him off me! [Val picks up cat, drops him off side of bed. Now has cat fur stuck to blood drop, so has to prick a different finger.]

Meter Any day now.

Dex Don’t bother her, it’s been a rough night. [Second finger refuses to bleed, Val pricks a third]

Meter 5 – 4 – 3 – 2 – [pause] – 1. You are 143. [Val finds wire for Meter, plugs him and Dex together.]

Dex. Oh. 143. My bad. [Val returns Dex to his pillow and stuffs Meter, wire still dangling, on the shelf. Sleeps]

7 am

Clock Time to get up. [Val slaps him] What?

Act III

Saturday night – early Sunday. Scene – same. As with Wednesday, Val had a snack – a glass of milk - at bedtime because her blood sugar was 74.

2:03 am

Dex You’re high! [Val hits him]

3:16 am

Dex You’re high! [Val pulls him out from under pillow, hits a button] You’ve been high all night. Go ahead, ask Meter, he’ll back me up.

Val There is no way one glass of milk can bring me from 74 to 300. Leave me alone.

Dex But you’re high. Ask Meter, if you don’t belive me.

Meter Leave me out of this. You don’t want her getting mad. Remember what happened to Pump.

Pump What?

Dex Not you. The last Pump. Three weeks ago.

Meter Dropped on the bathroom floor. Cracked the screen straight across. It was awful.

Pump Ooooh!

Meter So watch your step.

Dex (worried) She wouldn’t do that to me, would she? I’m out of warrantee, and out-of-pocket besides. [No one answers] Oh, all right. She is high, though.

7 am

Clock Time to get up.

Val [reaching under pillow] Dex?

Dex You’re high. Like 400 plus. I can’t count that high.

Val Shit. [takes meter from shelf, tests]

Meter 5 – 4 – 3 – 2 – 1. You are 374.

Val What the hell?

Dex I tried to tell you, but you just wouldn’t listen.

Val What do I do now? [She wiggles the little button on her stomach marking Pump’s infusion set, thinking he’s disconnected. But it seems fine]

Pump Well, for starters, let’s try three and a half units of insulin. You changed the site yesterday, so it should still be good.

Val All right.

Pump And you could try listening to Dex. [Dex preens]

Act IV

Sunday. It is bedtime. Val has just tested.

Meter You are 157.

Val OK. Good. No snack tonight. Now, I have work tomorrow. You’re going to let me sleep, right, Dex?

Dex I’m just doing my job. Talk to the pancreas. And the thyroid, too, he’s hyper.

Val I mean it, I really, really need some sleep. No interruptions.

Meter (whispers) Bathroom tiles! [Dex gulps]

3:09 am (now Monday)

Pump Uh, Val? [Val reaches under pillow, slaps Dex]

Dex (sleepily) What?

Pump Val? [This time Val hits the shelf.]

Clock Ouch. Hey, what’s the big deal?

Pump Val? [She pulls pump out of his pocket and looks at him incredulously] Umm.. I just thought you should know. I’ve only got 20 units of insulin left in my reservoir, so you’re going to have to fill me by about suppertime tomorrow.

Dex Asshole.

Val What time is it anyway?

Clock 3:10. [Val puts Pump back in his pocket and looks at Dex.]

Dex You are 145. Perfect. And I’d like to point out, I didn’t wake you up. [Val puts Dex back under the pillow and sleeps]

5:30 am

Clock Time to get up. [Val hits him]

Act V

Monday night/Tuesday morning. Scene – same. Val has gone to bed at 10:15, exhausted.

11:31 pm

Dex You’re low.

Val Leave me alone. [Hits him].

12:04 am (now Tuesday)

Dex You’re low. [Val hits him again]

12:13 am

Val’s bladder I gotta go!

Dex See! I told you you were low. [Val pulls Dex from beneath the pillow, tucks him in the pocket with Meter, and heads for the bathroom]

Val’s cat You’re up! You’re up! Feed me. [Val pushes cat out of bathroom and shuts door]

Dex You’re low, you know. You really should check with Meter when you get back to bed. I think you’re 58. [Val finishes, opens bathroom door]

Val’s cat You’re back! Now you’re going to feed me. [Val pushes cat into bathroom and shuts door]

Val’s dog What’s going on up there? Are you feeding the cat? Because if he gets fed, I get fed. [Val ignores dog and goes back to bed, this time switching on the reading light]

Meter What’s up? Oh, a check. 5 – 4 – 3 – 2 – 1. You are 53.

Dex Told you. Have a juice box. [Val drinks juice, turns off light, goes back to sleep]

12:27 am

Dex You’re low! [Val hits him]

12:46 am

Dex No, I mean really low! [Val hits him again]

1:04 am

Val’s bladder I gotta go again! [Val gets up, walks to bathroom]

Val’s cat I’m saved! You’re here to feed me, right? [Val blinks at Dex]

Dex You are 55. Talk to Meter.

Val I can’t be low again, after the juice.

Dex Didn’t work. You just went lower.

Val Oh, crap. [Back in bed, Val reaches for Meter]

Meter Again? Somebody have a loose transmitter?

Dex Up yours! [Meter counts down]

Meter You are 39.

Val Shit. [Grabs another juice box]

Dex I tried to warn you, you know. If you’d just listen –

Meter Yeah, it’s the little boy who cried high. [Val ignores the bickering and sleeps]

3:29 am

Dex You’re low!

Val OK, I believe you. [Drinks another juice].

Val’s bladder You really are, you know. Or maybe it was all that juice.

Val I know, I know. [puts Dex in pocket, goes to bathroom, shuts cat in closet]

5:23 am

Dex You’re low!

Val You have got to be joking.

Dex No. 61. Honest!

Val What time is it?

Clock You have seven minutes.

Meter You are 64. Drink some juice.

Val Arrgh!

Val’s cat Um? Somebody? It’s dark in here…

Act V1

Tuesday night to early Wednesday. Scene – same. Val was 112 at bedtime and too tired to care that she should have had a snack.

5:30 am

Clock Time to get up! [Val reaches under pillow, hits Dex]

Dex Hey!

Clock No, it’s me. [Val stares at him]. It’s 5:30. You know, wake-up time?

Val Dex, how’d we do?

Dex Flat at 120, all night long.

Val You mean, we slept the whole night? It’s over?

Dex Don’t get used to it.

Quick, bring me an orange!

My in-laws took the boys overnight last night, and we decided to go out to dinner. It was a spur-of-the-moment thing; we didn’t have much in the way of leftovers and were both frazzled from the long week at work.

I wasn’t worried; I had changed my site the day before, had a ton of insulin in my pump, had my meter and juice and all in my purse. Decided, in the light of recent news, to go eat something with chili peppers in it as a sort of salute to capsaicin.

I had been running in the low 200s all afternoon despite corrections, but wasn’t too concerned. This was just my thyroid getting jealous since the pancreas was getting all the attention. I’ve noticed before I work backwards to most “typical” Type 1’s – this apparently includes being hyper- not hypo- thyroid. So when things act up, it just randomly spits out some extra hormones and keeps my around 250 for 4 or 5 hours. My 4 hours was just about up, the latest correction would work, and I’d be back to normal by the time our food arrived.

Alas, wrong again. Still 250 when we sat down. Ordered a Pilsner Urquels on tap and nibbled a bit of bread, bolused 4 units and doubled my basal for 4 hours. Dinner arrives: 300. Eat the Cajun fish and a few tablespoons of spicy risotto. Despite the menu, this is an Irish pub; my beer comes in a pint, about 4 times as much as I normally have at one sitting, and I’m pleasantly buzzed. Maybe my site’s clogged. No problem, we’ll just finish eating and head home and I’ll take care of it there. Bolus another 5 units.

I check my Dexcom. 390. Yeah, like it climbed that fast in ten minutes. Restaurant is pretty tight quarters; I’ll just nip into the ladies’ room and swap out my site with the spare from my purse. Once in the ladies’ I test again. 390. Damn! OK, lets swap out that…site…Damn again. I’d transferred the spare infusion set to my evening bag for last weekend’s Xmas party, and hadn’t put it back. OK, another 6 units, and I’ll just ask for a doggie bag for that lobster risotto.

We head home. I run upstairs to check. 372. OK, forget the stupid site, let’s just inject 5 units and then change. Rip out the old set and inspect it carefully. No kinks or bends, nothing to show why it didn’t work. Which means I may actually have like 15 units of insulin on board. Probably not though. I check Dexcom; it shows me dropping. Sharply.

Oh, shit.

“Honey, you remember how to use the glucagon, don’t you? Just in case?” We’d done a practice with an expired set last year and he’d been nervous just injecting an orange – but since then I’d made him do my site change or Symlin a few times so he’d be used to sticking me (I’m snickering here) just in case he ever had to.

I dig out the glucagon kit from the bedside table. It expired in June. But wait, I know I picked up a new one; must be downstairs. We take out both kits, set the good one aside and take the expired kit and a Clementine from the fruitbowl. Practice time again.

“All right, you need to figure out what to do. I’m not going to be telling you if you really need to use it.” He flips over the kit and begins studying the label on the bottom. “The instructions are inside.”

He opens it up, takes out the folded glucagon-for-dummies sheet and starts reading.

“Um, honey? I don’t think you need to shake the bottle until you add the liquid – it’s just a tablet in there now.”

He growls just a bit and returns to reading the sheet. Needle in the bottle, squirt and shake, draw it up into the syringe.

OK, that takes a few tries, he keeps sticking the needle too far in and sucking up air. My tipsy self is finding this incredibly humorous.

Finally, the moment of truth. He pins the orange firmly against the counter with one hand, needle in the other.

“Throw it in like a dart, don’t hang on to the plunger. Great. Now just wait ten seconds or so, you don’t want to let it dribble out if you pull out too soon…” Yeah, I know I said I wouldn’t help him. I also promise not to back seat drive.

He waits, then pulls out the syringe. The orange erupts like a mini geyser, like a garden fountain with its single perfect arc three inches into the air. Our own personal “Citrusken Pis”, taking a leak on the kitchen counter.

I lose it. We laugh so hard we can barely stand up. We can’t even look at the real kit without giggling.

“Okay, honey, if my BG keeps dropping, just dial 911 tonight, all right?”

But we don’t need to. It levels out at a great 150, stays that way most of the night.

On driving a junker

(This really is a D-related post, so be patient..)

I grew up in a family that bought only cheap used cars. So I’ve seen my share of real clunkers: the rewired toggle-switch ignition, the horn under the dash, the rusted out gas tank that could never be filled more than half full (well, it could be filled more, it would just run out until it was half full), the speedometer that always read 0 mph. When I was in grade school my dad even had a car that, if he stopped at a traffic light, he often had to open the driver’s door, duck under the side of the car, and hit something with a wrench before he could start moving again (don’t ask me what he did, I think it was something involving the clutch).

So when we were first married, our first car was a true junker given to us for free by my older brother. To be fair, he really thought we would just use it for a weekly trip to the grocery store, not 3 ½ hours of daily commuting in Boston (Callahan Tunnel or Tobin Bridge in a rusted out 1979 Chevy Monza is not for the faint of heart) and for trips back and forth between Boston and Albany at least once a month. That car lasted almost two years, helped out that every time we came home, another brother would rebuild the carburator or something to keep it running. I used to be proud of the fact that I “paid” less for my car than for subway fare; that, by God, it was ugly and clunky but had four wheels and ran (most of the time); and that when you were trying to merge on Storrow Drive you could just look over at the Alfa Romeo next to you and laugh - a car full of holes is a great intimidation factor - and they would always move out of the way.

But there was a downside to the seventiesmobile, as we affectionately called it. We had to get the AAA-plus package, the one with the 100-mile free towing (and actually used a 96.2 mile tow once when we broke down in the middle of the pike); we had to carry at least 2 gallons of water for the leaky radiator at all times; we had to drive with the heat on full blast and the windows open in the middle of July; we had to fill one tire with air every two weeks, and we had to budget a lot for repairs for the times we broke down when we weren’t near family. I could call the local tow company and say “Jim, it’s Val.” and they would ask “are you at home or at work?” not “who are you?”. We had to plan trips around how flaky the car was being, what the temperature was, and how far to the nearest rest stop. And on mornings it wouldn’t start, we had to call in to work, because none of the rental places in town would rent to someone under 25.

Finally the repairs were more than a car payment would be (and the seventiesmobile died with a boing, as the snapped alternator belt richocheted through the radiator leaving nothing but a pile of metal shavings behind). We decided to break with my family tradition and get a real car. It was a life-changing experience. Not only did we not need to run the heater in the summer, it had A/C! We no longer had to say “We’ll be there sometime between 2 and 7” or check that our supply of antifreeze and fix-a-flat was okay before we went anywhere. We could just get in the car and start it up and go.

After a week of having a “grownup” car there was no way we could ever go back. A whole layer of stress I wasn’t even aware of evaporated once I realized that I no longer had to keep track of where the nearest pullover was or how long a walk back to the emergency telephone.

Fast forward fifteen years or so to my diagnosis with Type 1. I feel I’ve got a pretty good handle on things, I’m doing okay with carb counting, and there isn’t a heck of a lot that I want to do that diabetes really gets in the way of. But, it’s like driving a junker. It’s always that background level of stress, that constant vigilance, that keeping track of stuff that nobody else needs to. I want automatic transmission, cruise control, and a stereo system. I want my grownup car.

DexCom versus The Other Guys: Twelve Thoughts

I am in a fairly unique position with regards to the new continuous glucose monitors. I partcipated in a study with an integrated pump and monitor (you know the one) where I got to use it for six months, and then went out and bought a DexCom, which I have been using for two weeks now. So I thought I’d give you the lowdown on them. Remember, this is only my opinion, your mileage may vary, etc, etc, etc.

So, here’s my notes on who beats who for various categories:

1. Size of transmitter: DexCom wins. You get a little rectangular plastic doohickey on a large white pad that’s the size of the other transmitter. Plus, DexCom has no wires, while The Other Guys (hereafter TOG) have a little 3-inch wire tether between the sensor and transmitter, which I wound up having to over with a second piece of IV-3000 so the wire didn’t catch. That brings me to the next item:

2. Sensor and water: this is a toss-up. DexCom says not to cover your sensor, except for short periods of time like a shower. I’m not going to pay $ for the big cover-up every time I shower, so I just shower with the transmitter/sensor still uncovered on my leg. Sometimes it’s a bit off for an hour or so after, other times it stays dead-on. However, when I have covered the sensor, about half the time my improvised multi-IV-3000 patch leaks, and I walk out of the shower with the sensor in a little bag of water taped to my leg, and it’s off for much longer. With TOG I never had to worry about the sensor, happy under it’s IV-3000 blanket. However, read number 4 below:

3. Accuracy in the 200-400 range: Hey, am I supposed to admit I still go this high with a continous monitor? Well, I do, and I would say both seem pretty good in this range.

4. Accuracy in the 30-100 range: DexCom wins, big time. If I look over my six months of records with TOG, it claims I’ve been below 70 maybe a handful of times. Not True. My favorite was a gardening low where I felt low even tho sensor said I was 160. Tested in at 30. I hit 30 while on vacation last week, and DexCom read 36. Much, much better. The times when the DexCom sensor is off are when it’s still drying out from one of my bad shower patch jobs. In fact, that’s when it acts like TOG – maybe theirs is affected by the humidity under that patch and they just haven’t figured it out yet?

5. Size of receiver: TOG definitely win on this. DexCom’s receiver is way too big, and awkward to stuff in your pocket. I like the size of the screen on the DexCom, but maybe in version 2.0 they could move the buttons to the top and slim it down a bit. I mean, TOG has all the same kind of stuff in there, plus a full insulin pump in almost half of the space.

6. Flexibility: TOG lets you program in a lot more choices: alarm volume, etc – DexCom pretty much lets you set the high and low alarm numbers (it also has a built-in non changeable low alarm at 45). TOG would let you specify when to re-alarm if you are still low x minutes after the first alarm. Plus, DexCom’s picture driven menu is just a pain in the butt to use. Either use that extra CPU space to do something useful, or let me have the option of a single menu with “start sensor/stop sensor/set alarms/set date”. I don’t need the cute little animated transmitter. Really.

7. Accessories: TOG wins here too. Because it’s a pump, it has the standard belt clip plus all those companies making pump cases, etc. DexCom comes with a psuedo-leather, black plastic case with an annoying cell phone clip on it. You know, the ones that stick out like a little flat-topped mushroom on the top and hook into a too-small clip that keeps falling off your pants? Plus, it clicks whenever you bump it: CLICK…CLICK…CLICK. Yuck.

8. Packaging: I have to say, I know it doesn’t matter in the long run, but my DexCom came in a plastic case, that looked like I bought it off the shelf at Target. Much nicer than the standard cardboard-box-with-label. I felt more like a consumer of geeky electronics than a medical patient.

9. Battery usage: For both, the transmitter battery is understandably sealed. TOG’s pump-and-reciever works on a AAA battery, while the DexCom needs to be recharged every 3-4 days. It would be convienient to keep the charger at work, because that’s where I sit still the longest, but then I might forget it on the weekend. The don’t recommend charging it in bed, because the range may be a bit less while it’s charging, but that’s what I have been doing anyway. Come on, guys, drop a double-A into it, please.

10. Receiver range: Seems about the same on both. Both occasionally flake out in bed. I can live with that, I suppose, but I don’t like it. Maybe Navigator will fix this.

11. Sensor insertion: Once they’re in, I never felt either sensor, though TOG's transmitter would sometimes catch on somthing and feel like a pinch. DexCom has a thinner sensor wire, but TOG has a reusable inserter that is spring-loaded. With DexCom, I can’t help feeling that part of the $35 cost is the big plastic inserter I have to throw out with every use. Plus, I really can’t bring myself to do thumb-on-the-plunger insertion with something that big – I wind up holding it in place with one hand, and slapping the plunger down a la whack-a-mole with the other.

12. Software: I’m not sure if the software I used for the study is available to those who buy TOG, nevertheless they win because DexCom doesn’t have any yet. I know, it’s in the works and I’m waiting for it, but I really miss being able to print out my single-day summaries.

Well, I’ll probably have more to say later but that’s it for now. For me #4 is the only real point. That’s what I want the thing for, the rest is just fluff. I’m sure as these products mature, they’ll move a lot closer together – especially if insurance would start paying for them, a lot more people would use them.

Ch-ch-ch-changes….

OK, this week I turned in my study pump-and-continuous-monitor, started using my new DexCom, started Symlin, went back to my old pump, had it break two days later, and am now using Lantus and a Novolog Jr pen until my replacement pump shows up on Saturday (right before the big family party at my house…) Busy, busy, busy.

I was going to jot down some of my first impresssions/pleas for improvements on the various hardware I’ve been using, but I left my notes at work, and I’m not going to be back in there until Wednesday, when I can hopefully come up with a more in-depth analysis of my pros/cons of the two continuous monitors I have used…

So instead, for today I’ll jump onto the Symlin-starters bandwagon and add my comments. Let me say that having a continuous monitor does a lot for my piece of mind, from trying the new drugs to guestimating the seldom-used back-up plan…

1. My dr’s office started me out on 2.5 units of Symlin with half my regular insulin dose. Believe it or not, for dinner this was perfect. I watched my BG on the DexCom arch gracefully up about 40 points and then back down, over the course of three hours or so. We still want to increase the Symlin, but I’ll have to cut the dinner insulin back to a quarter my regular dose.

2. Lunch seems to be better right now with about 80% of my insulin bolus plus the 2.5 units of Symlin.

3. Breakfast still sucks, even with 80% of the bolus dose. Tomorrow we try 100%, then scale it back on Sunday when I up the Symlin to 5 units.

4. I wish Symlin came in a pen – or that I could use it to fill some Novolog Jr cartridges. Symlin people – are you listening?

5. Even better, any plans to test out Symlin mixed with insulin? Maybe for people who’ve already done the ramp-up to a standard dose…

6. I haven’t experienced any nausea, or appetite issues. The theory is by starting out on a really low dose and ramping up gradually, your body will be less shocked into nausea. I hope so. Haven’t noticed any changes in my feeling full or snacking, either. Which is fine by me.

7. Symlin makes my continuous monitor graphs look more like a “typical” T1 reaction, instead of the near-vertical ups and downs. Or at least it did when I still had access to a combo bolus, which is pretty damn hard to do with a syringe (you push it veerrry slowly…) It seems to smooth stuff out overall, even at the lowest dose. We’ll see what happens when I’ve worked up to 10 units….

24 hours of being me

Thursday 10:48 am (this "day" is not starting when I wake up because I'm pretty much a zombie then). I'm sitting in front of the computer at work. My pump beeps to remind me it's been 2 hours since my last bolus. I was 277 after breakfast for no discernable reason so I took 1.6 units the pump said I didn't need [3.1 to correct, 3.9 still active]. Sensor says 192 with a single down arrow. Study meter says 145. Val 1, diabetes 0.

10:55 am. Bathroom trip. Check pump tubing from where it enters my leg back to pump, looking for air bubbles. Thought I'd seen a half-unit sized bubble last night near the pump, but now it's nowhere to be found. Maybe that explains the breakfast high, or at least part of it.

11 am Meeting. Bring meter and juice.

11:30 Discretely reach down and hit button on pump to display sensor reading. Glance down. 136. That's 60 points lower than last time I tested, where sensor was about 50 points higher than fingerstick. Even if it's still 50 points off (not likely as things should have slowed down), that would put me at 86, still ok.

11:40 Repeat push and check. 132. OK, we're fine, not moving much at all.

11:55 Meeting ends. Get lunch from cafeteria, whole wheat sandwich (26), salad (0), cookie (16?), and water. Sensor says I'm 120, UltraSmart says 98. Pump bolus estimate is 4.2 units. I usually eat an extra 15g carbs or so and still go low if I'm doing my standard 3-mile walk at lunch, but today I'm running errands. Go for 4.4 units, split half now, half over 30 minutes.

12:15 Heading out to store. Check sensor - 106. But, it hasn't caught up with my food yet. I'm fine.

12:30-1pm During errands, periodically check sensor using same technique as in meeting. 140 with 2 up arrows, 138 level 10 minutes later; 126. Hmm, maybe I should have taken less insulin. Decide I'm OK to drive back to work without testing.

1:55 - my post lunch reminder. Sensor: 114, UltraSmart: 119. Yes! Now, I should be OK for most of the afternoon.

2:15 - cup of tea with milk. No bolus.

2:30 Sensor 120. I typically (but not in the last 2 days) drop between 50-175 points on the way home. Better keep an eye on numbers, since I may have to eat at 3:30 to be able to leave at 4.

2:50 Sensor 128. Great, we're level.

3:09 Sensor 138. Still good.

3:30 I've got my "turnaround" feeling, like I'm in an elevator that's gone down unexpectedly. Sensor: 132. UltraSmart: 101. I don't want to eat too much, but I don't want to go low on the way home either. Break off two squares of my emergency dark chocolate bar, figuring 7 grams of carbs with fat should digest slowly just over the time I normally drop.

3:45 Sensor: 124. Uh, oh. Let's wait a few minutes and use meter.

3:51 Sensor: 116. Nuts! UltraSmart: 101. Still. Decide to drive home without further snacks. School ended today, and my mother in law is watching the kids, so I don't have to pick them up, making my drive less than 25 minutes instead of 90.

4-4:30 Periodic checks of sensor on the drive home show me steady around 120. Val 2, diabetes 0. Go chocolate!

5:20 Supper is ready. Sensor: 114, UltraSmart: 80. Perfect. My mother in law has made us a batch of pasta fagiole, with directions to add the pasta to the beans and sauce at the last minute. I nuke up leftover brown rice instead of pasta for me, and have sauce over that, with a small glass of red wine. Yum. My guess is 48 g carbs, I take pump's recommended 4.0 units, 50/50 split over a half hour.

5:40 Sensor alarms low, 84 with one arrow down (I set it to 100 to catch lows). Ultra smart says 90. I've just finished eating, so I should be fine. Dig up the flyer for the summer camp orientation tonight and discover it starts at 6 and serves food. So I guess we didn't really need that supper, except it was better than hot dogs. For everyone. Pile kids into car and head out. My husband drives, as he usually does when we both go out together, even before diabetes.

6:15 - 7. I have a plate of salad, two oreos, and a cup of diet pepsi at the picnic. Bolus 0.7 units for 16 grams without testing or checking the sensor.

7 pm Back in the car. Sensor says 146. We drive to supermarket with kids.

7:50 In checkout line, better look at sensor. 194, just on the slope down. Fine, no problems. Get kids ready for bed.

8:41 post-bolus alarm. Sensor : 136, StudyMeter: 141. Great!

9:12 Sensor is level at 138. I usually drop at some point before midnight. Let's try 15g dark chocolate again, no bolus. Check tubing for bubbles now because I won't remember in the morning.

11pm. Sensor still level at 140. StudyMeter: 136. Perfect. Go to sleep. Val 3, diabetes 0.

5am Friday. Alarm clock goes off, waking me from a dream that I'm low and can't find any food. Not a good sign. I'm also bathed in sweat, and we have central air: Not a good sign, either. Hit the snooze and reach for the UltraSmart. Pop the cap off in the dark and try to slide a test strip into the little notch in the meter. Can't get it in. Try using the backlight on the pump. Still can't get it in. This, too, is Not A Good Sign. Give up and flip on the bedside lamp, discovering the reason I can't get the strip in is that there's still an old one in there. Sensor says I'm 106. UltraSmart: 119. Did I bounce? Dirty finger? Stress of trying to get the frigging strip in? Or is that the real reading, and dreams of being low were just that, dreams? The cat has curled up on top of my pump. Pull the sheet up and shut off alarm clock.

5:30 am pump low alarm (cat has moved): 96. UltraSmart: 97. Get up, decide to unplug for the shower. Feed cat. Usually I wrap the pump in a ziploc freezer bag and take it in with me, but usually I'm a lot higher than 97 too. Val 4, diabetes 0. Shampoo, removing AUTS (another used test strip) that has somehow entangled in my hair.

5:50 shower over, hook pump back on and get dressed. Sensor did not lose signal when I showered, says I'm 90.

6am sensor low alarm. Turn it off but don't check.

6:15 make breakfast. Sensor: 98, StudyMeter: 121, UltraSmart: 114. We're all in sync, good. Have a Thomas' mini-bagel (24), milk(13), and cream cheese (let's try 5). Take pump's recommended 7.0 units, split 50/50 over half an hour as usual. Feed dog and kids, or at least perky, cheerful Number 3 Son, who wakes up at 6 with no alarm. Definitely not my genes there. Make decaf coffee to take with me.

6:30 ready to leave for work. Sensor: 122 with an up arrow. Fine.

7:05 am Arrive at work. I have my "turnaround" feeling. Sensor: 166, one up arrow.

8am. Bathroom, tubing check, look at sensor. 164. No arrows. Perfect. This was the same breakfast that took me to 277 yesterday, by the way.

8:10. Feeling a little sweaty. Could be the a/c. Low? After breakfast? Not likely. Check sensor: 170. It's the a/c then.

8:15 pump reminder. Sensor: 168. StudyMeter: 171. For breakfast, this is success.

8:40 Walk to cafeteria with my office mate. They do not have apple turnovers, my real weakness, so I just refill my decaf coffee and head back. Sensor: level at 170.

9:15 Sensor 134, two down arrows. Huh? I'll check with meter later..

9:30 Sensor 120. No more arrows. Probably fine, check later.

10am Sensor 102. Hmm. UltraSmart: 90. An hour and a half until lunchtime. Snack, or wait? I'll wait a bit and see what happens.

10:15 Sensor low alarm 94. So that's what happens. Don't bother with the meter, just eat a bit of lunch early. Except, didn't make a lunch today. Break into the pack of PB crackers, eat 2 (7g). Should be OK until lunch.

10:30 Sensor 90.

10:45am Sensor low alarm 78. Huh? UltraSmart 96. Crackers worked after all. I'm OK until lunch. Low successfully averted; Val 5, diabetes 0.

This was a good day. In fact, this was an extremely good day, the kind of day I only have every couple of weeks. The sensor and meters were in agreement, unlike last week, when the sensor said 160 and a finger stick said 30 (sensor never went below 85 that day). Or the night before last, when my BG wouldn't go below 350 for four hours, despite all the corrections.

This was the kind of day I hope I have more of. And that I probably will have more of, because although I hope and pray for a cure, realistically I know that when and if it comes, it will probably be for people who've just been diagnosed, who still have some beta cells left. That I may go the rest of my life like this, hoping for days when I "only" have to think about diabetes 46 times in 24 hours. Because I can deal with that, I really can.

But no little kid should have to.

Continuous Monitoring, Part 2

I have to turn in my pump-and-CGMS setup in two weeks. Which means I am back to my regular pump then. I can't go back to guessing, though. With all its problems, having the sensor still sucks less than not having it.

I have ordered a DexCom. I should be able to seamlessly jump from one to the other on the 27th.

Stay tuned for my comparison.

The Hike from Hell

Sunday of Memorial Day weekend. Wanting to do something outdoors. Decide on a hike with kids and dog, including a picnic lunch on the trailhead before we start. The kids are good hikers, completing a 6 mile hike last fall with more energy than we had. So we decide on Hadley Mountain, a nice two-hours-each-way hike with a fire tower at the top for the boys to climb, roughly 90 minutes from home.

My husband goes out for a quick shopping trip for hiking goodies and breakfast while I pack. My waking BG was 123 and was still flat around 2 hours later when he arrived with the breakfast. I ate half a cheese danish and half a glazed donut, figuring my best guestimate for the carbs minus a bit, as we’ll be exercising. We eat and get in the car.

I’m wearing my commando-dork outfit, an LL Bean fly fishing vest with every pocket stuffed: meter, extra strips, new infusion set, four juice boxes, pb crackers, gorp, spare pump battery, sunflower seeds, etc, etc. Plus a fanny pack with the digital camera, dog treats, and two water bottles, one for me and one for the dog. Number One Son (age 11) and Number Two Son (9) carry their own backpacks with water and snacks, and my husband has another with the rest of the snacks, binoculars, bug spray, sunscreen and water for him and Number Three Son (age 6). It’s surprising we even manage to get out of the house.

As we’re driving my sensor high alarm goes off. I ignore it for a bit because I just had the danish, which I know is going to shoot up there. Within 15 minutes it changes its estimate from 220 to 300. Uh-oh, better test. 358. Ugh. Well, still got over an hour before the hike. Three units should do it.

11:30 am - arrive at the trailhead, unpack the picnic, test again. 302. WTF? OK, just half a unit more. No lunch for me, just that diet ginger ale. We coat the kids and us with sunscreen and bug repellent and hit the trail. We see a bunch of tent caterpillars crawling around. The dog amuses herself by eating them and then coming to me for water.

12:15 pm – Damn, it’s hot. Wishing I brought my hat just to keep the sweat from running down my face. Hmm, sweat: let’s test, just to be safe. 47. Oh, shit. Down 3 juice boxes, suspend the pump, wait ten minutes, eat a pack of pb crackers. 12:45 – gotta be better now. 60. All right, another juice box, a handful of dried apricots. Maybe two. Put the pump back on a low temp basal. Keep going, as Numbers One and Two Sons are way ahead now.

1pm. We reach the fire tower. The kids and husband go up. I hang out with the dog, drinking water. The sensor has me at 175. Test : 111. OK, I eat a few more snacks, make the temp basal even lower, and just hang out, relaxing. The kids get a certificate from the ranger in the tower. Number Two Son (the outdoorsman) goes up and down the tower five or six times, then starts exploring the summit with his brothers. I even climb up the fire tower (trying not to focus beyond the metal ladder as I’m afraid of heights).

2pm – shortly after starting back down, I start getting stomach cramps. Well, I’ve drank four juice boxes and a bottle of water. Time to find a little girl’s tree and let some of it out.

2:30 – it didn’t help. Still got bad stomach cramps. Keep walking. Only as we get to the wet, shady section of the trail, they move in. The tent caterpillars, having lured us into a false sense of security by crawling harmlessly along the path on our way in, attack. They rappel down from the trees by the hundreds, aiming for our faces. Number Three Son wants to hold my hand, but I can’t – I’m clutching my stomach with both of them, and besides if we’re two abreast, there’s no way to avoid the dangling critters. Even the dog won’t eat them now.

The cramps increase in intensity. I almost never have stomach problems, and the last time I felt like this, it was right before getting an epidural. Why the hell did I eat all those dried apricots?

The kids look upward and flip out. Literally thousands of the caterpillars are moving in for the kill. Looks like something from an Indiana Jones movie. I fully expect to see a few hikers dangling from the trees, caught by some caterpiller Shelob. Number Two
Son takes one in the face and screams. Husband tries to calm the kids by speaking calmly, and eats one. Twice.

They’re all walking way too fast. I check my BG again, 170, so the cramps are only indirectly diabetes-related. Damned juice boxes.

Number One Son grabs Two by the shoulders and propels him forward as a human shield. Two is shreiking, One is laughing – and suddenly it’s reversed, as a kamikaze ‘pillar hits One’s open mouth and he does some impromptu break-dancing. Lord, I wonder how this will look in their autobiographies. Our kids are never leaving the house again.

3:30 – kids are ahead with the dog, trying to find the end of the trail and our caterpillar-free car. Husband is walking with me, holding my elbow as I’m bent almost double. I brush three caterpillars from my hair, find one on each shoulder of the vest like some epaulets from a goddamn caterpillar army.

The stomach cramps reach their logical conclusion and I dash for the trees, ignoring the bugs, only hoping I don’t squat in poison ivy.

We make it to the car, climb in, and pass out the cookies, ice tea, etc, we’d left in the cooler. I eat one, then reach for my meter. 245. Correct and add in that cookie. Laugh each time a caterpillar splatters on the windshield.

It’s fifteen minutes to the nearest fast-food joint. While my husband goes in for a coffee, I dash for the ladies room and stay there. Then I make it all the way home, where I lock myself in the bathroom for two hours, and don’t even attempt to eat anything until some toast about nine pm.

The next day, two of the boys broke out in a rash that looked like the start of poison ivy. Luckily it faded after a day, only a reaction to the bug spray. The kids have developed a fear of caterpillars. The dog won’t even try to get in the car anymore. And me? Tomorrow Number Two Son and I leave for a weekend camping trip at Lake George.

We’re bringing hats.

Sensor Redux

I feel that after all the rants I’ve posted about this sensor study, I ought to post an update on how I feel now. Two major things have changed. Number one was, I decided since the BG meter they wanted us to use wasn’t accurate at normal-to-low BG, that anytime I thought my BG was in the normal-to-low range, I would use my regular meter and manually enter the BG into the sensor. That has helped a lot with its accuracy. It’s still off, but now it says I’m 95 when I’m 65, not 40.

The second thing is, they’ve come out with a 2.0 transmitter and pump software. I had to go trade in what I’ve been using since Christmas, and start the new ones. This is to help with the long warm-up time, where you start a new sensor and it’s 120 points off for 12 hours. Now it does seem to reach its typical accuracy after about 3 hours.

So is it now at the point where I would use it? Yeah, I’d say so. The catch? My Animas pump is only 2 years old, so even if I wanted this, my insurance wouldn’t pay for it. On the other hand, I’ve gotten really used to being able to see the trends of what my BG is doing. The solution? The day I have to turn this in, I’m buying a DexCom. And keeping my fingers crossed my insurance will pick up at least some of the sensors. We’ve got six months of data to show how volatile my BG is, how I don’t have a hope of controlling it without continuous monitoring. So maybe they’ll pay for it. If not, well, starting in September we’ll be done with daycare, except the elementary before-school care, which is $500 less a month than we’re paying now. We’ll use that. Of course, it would be nicer if we could actually have a savings account, and we’ll have 3 kids to send to college starting in 6 years. But when you think of the possible expense of not having it…

So, for anyone who is planning on getting this integrated pump and sensor, here’s my top 5 tips/tricks/cheats. Disclaimer: I am not a doctor, blah, blah, blah, but here’s what I would do were I to keep this thing:

1. Never use a BD logic meter.

2. Be aware – this pump eats batteries.

3. When it claims to have a calibration error, don’t give it another BG value for at least an hour.

4. Unless you’re actually low when you calibrate, check the sensor isig value first. If it’s under about a 9.5, it’s not ready yet. Wait a bit.

5. If it says the sensor is bad, leave the sensor in, and tell the pump you’ve just put in a new sensor. Nine times out of ten that works and the sensor initializes happily and has no problems.

6. That same strategy also seems to work when your sensor has hit the end of its 36-hour life span. Tell the pump it’s a new one, and leave it in. The FDA says not to do it, but they aren’t paying for the damned things.

At the same time I start the DexCom, I am also going to start trying Symlin for the spikes at breakfast. We’ll see how that goes….

At what point does it become OK to blame the victim?

Last week a “friend-of-a-friend” (type 2, diet controlled) was hospitalized in diabetic coma. She’s doing OK now, still in the hospital, but my friend was asking me questions like “Is 1200 a high blood sugar?” (you bet!). The doctor said she will need to be on insulin from now on, so I was explaining about how sometimes with type 2 the beta cells burn out and just can’t produce any more. In the course of the conversation it turned out the the woman in the hospital has not been to a doctor or tested her BG in more than ten years!

Made me want to hop into a time machine, go back ten years, and slap her when it might still do some good. I didn’t want to upset my friend, but lord knows what kinds of complications Hospital Woman has set herself up for. Or what kind of success she’ll have now that she has to pay attention to her disease.

I can understand getting burned out with a tight regimen. I personally think it’s worse to have to constantly refuse food you love than to just bolus for what you’re eating. But I can’t understand someone being told you have a serious disease, and just never bothering to do anything other than decide you’ll only have cake on special occasions.

I guess I just can't help feeling a bit pissed off at Hospital Woman. If someone had told me there was something I could have done to avoid taking insulin for the rest of my life, believe me, I would have done it. She has a niece or something with Type 1. Doesn't she know how much this sucks? Doesn't she realize she just threw away what I wish I still had, a body that works on automatic?