Trying a new area for the CGM Sensor

To some degree I was having some issues with the CGM (Continuous Glucose Monitoring).  One of the things that was getting frustrating was the fact that readings were all over the place.  I realize that the trends are the most important but it is hard to believe a trend when the readings are 60+ points off.  The other issue is sites for the CGM sensors as it is very limited.  I sleep on my stomach or left side so that makes it hard for the pump to be there and the transmitter for the CGM needs line of sight to work well.

I decided when I got back from vacation to call my clinical nurse from Medtronic.  We chatted about the issues I was having with consistency in the readings and the trends.  She was very helpful with some suggestions and off I went to try to get better at this diabetes management.

First thing that was discussed and with a new site have proven to myself that it does matter is that securely taping the sensor/transmitter makes a difference.  When I started using the CGM I used an entire IV3000 dressing to cover the entire site.  It was sort of effective but sweat and and water took its toll pretty quick.  the area of skin, especially under the transmitter part needed to breathe.  I then recalled reading in one of the workbooks or online that using have a strip to cover the sensor and part of the transmitter was a good way to go.  This made a tremendous difference in comfort.  I assume I got lazy with the securing of the CGM with the IV3000 as the nurse suggested to me to make sure it is secure and even use a wipe before putting on the IV3000 to make sure it bonds well and won't move.  The reasoning is that if it is a little loose and moving around it could be coming out slightly and messing up the readings.

The second part of my discussion was concern over finding other areas to use for the sensor where it would still work with transmitting to the pump.  I had used mostly my abdomen but I saw an issue that soon one side was going to be over used.  I also tried some areas on my back above the belt line but those were very ineffective and erratic.  She suggested using my upper buttock below the belt line.  I told her, "Just say butt!"  I was a little apprehensive about putting the sensor on my butt, the current look and insertion method was a little scary.   Plus I was worried about sitting, running, sleeping, etc.  The insertion part was not bad, a few yoga classes would certainly help.  I didn't get in secured very well  the first day as I had my golf league and readings were very inconsistent but I was willing to stick it out.  The next morning I secured it better and since then it has been working much better.  The readings are more accurate and the trends seem to be right on.  The only time I notice the sensor on my rear is when I am driving, but other than that it is less bothersome as it is also covered by my underwear so it gets a little bit more support.

I am very happy with this new site placement and hope that it continues to give me a better rotation.  In addition, my three year old won't be able to yank it off like she has done twice now in the last month, and her accidental sensor removal is not gentle.

IV3000 Tan Line

On our recent vacation I took extra precaution to be sure my site would not fall off in the water or running around the beach.  I used a redi-wipe and an IV3000 dressing.  Everything worked as I had hope and I only had my normal site change during vacation.

After vacation when I did my next site change I noticed something a little different, I had a nice diamond shaped tan line.  There were actually two but with the site change mid week the other was not nearly as prevalent.  In the  least it is a nice reminder of my vacation which at this point was two weeks ago.

The only thing I am not sure of is if the sunscreen helped with the UV protection of the IV3000 or if it was all on its own.

To CGM or Not on Vacation?

We recently went on a little beach vacation and I needed to make a decision as to wear the CGM or not.  The worry was that I would lose the transmitter part of the CGM in the lake or on the beach.  On the other hand I already knew I was going to be on a wacky schedule and the CGM would help in that aspect.

After debating in my head back and forth I decided to go without the CGM.  Replacement cost can be kind of high for something like that and I figured I could just test a little more often.  Overall it went very well, most of the time on the beach I was low from all the activity.  Thankfully we had plenty of yummy vacation snacks.

After dinner each night we would go walking around and get some ice cream at different ice cream places.  To some point with the pump it was so much easier as I ate what I wanted and then just bolused with the pump as necessary.  If I was still on the Insulin Pens I would have averaged about 6-7 injections a day, instead I enjoyed things such as a Downtown Dog, Chocolate Monster, Cappuccino Chocolate Chip, Blue Moon, Birthday Cake, and Chocolate Decadence (only one was not an ice cream).  The CGM would have certainly helped but overall I did very well with bolusing for all the yummy treats.

Out of fear I didn't take the CGM transmitter or sensors along which to a degree made me extra careful because I wanted to enjoy the week without having the highs and lows of diabetes.

Diabetes is Wacky

Diabetes is a wacky thing.  Some stretches I can go for days with no highs and lows then change nothing and be all over the map.  This is frustrating and mind boggling.

I had a pretty good stretch of doing very well with the pump and with blood sugars.  Then for no reason everything went crazy.  I can barely get through a night without running numbers up to 200 and then do little boluses to have some sort of control.  Then I will hear the beeping of a low and can seem to bring it up and then wham, blood sugar going up like a rocket.

I called the doctor’s office on two occasions now and on both they have lowered a basal rate in the night and raised it in the morning.  The funny part is the morning is the best part of the day (sometimes I am even a little low).  I am really confused by this.  I am giving it a few days to try and see where I end up  but so far over the weekend at night I have been high (200-275) every night.

I realize with weather changes activity levels and my body is always changing so things will be difficult.  So far though I think my concerns of the nighttime are not being communicated from the nurse to the doctor.  I have the advantage of uploading information to a website that the doctor can then look at to see what is going on, including my boluses, carbs, blood glucose and sensor glucose levels.  I asked the nurse to give him a specific report although I think the message of my issue was lost.

So I will give it a few more days and then make another attempt to convey my concerns.  It would be nice to get through a few nights in a row without a high or an alert for a high, although with the alerts it has prevented me from waking up 350-450 in the middle of the night.

Taking a Day Off

I have had the Continuous Glucose Monitor (CGM) for a little over a month. It has been very helpful with trends and helping me keep better control of my blood glucose. The alarms can get annoying but they do help. The other day the sensor I put in was hurting and just generally bugging me so I decided to take a day off.

I don't know if the site was getting sore from being bumped by my daughter, just in a bad spot, or inserted poorly. After feeling like something was poking me on the inside I decided I needed a break.  It was a little weird to not have the sensor there but it was also  somewhat nice. I did miss the predictive alerts but I didn't have to hear alarms going off in the middle of the night as I had for the past few nights. I was extra careful in my food selection and tried to make sure the carbs I counted were correct. I still wanted to do well so I would worry about the highs and lows.

I actually had a pretty good day without it. My blood sugars were good and the worst one was 174 the next morning. Plus, it was nice not to get a high alarm in the middle of the night. I have since put a new sensor back on because I am driving a lot with the kids and have other activities. During my golf league it is especially helpful since walking 1-2 miles on nine holes carrying a golf bag is pretty good exercise and can bottom out my sugar pretty quick. This way, with my Gatorade in hand, I am able to keep a fairly consistent level without having to pull the meter out all the time.

The day off was nice and will probably do it again but I don't know if I could go much longer than one day. 

Yelling at the CGM

Some days/nights I seem to get a little angry at the Continuous Glucose Monitor (CGM). I knew there would be difficult times because controlling diabetes is not a perfect science. The CGM is a great tool in staying in control but there are some frustrating moments. This leads to me yelling at my pump/CGM.

There are times that I am going about my everyday activities and I will get the predictive low alert. This is great because I can head off that low before it happens, but it sometimes will not go away. We are getting ready to have a garage sale, so I have been moving stuff into the garage and trying to get organized when the CGM gives a predicted low alert. No problem. I go get a snack and a drink and get back to work. A few minutes later, it is beeping at me again for a predicted low and I acknowledge it but keep going about my work since I just had a snack. A little bit later it is beeping at me for a low blood sugar so I go and get another snack. Thus far I have eaten one pop tart (one pop tart is about 37 grams of carbs). I figure I should be good to go but the CGM thinks otherwise. After 5 more minutes I get another predicted low alert. At this point I am getting frustrated so I start asking the CGM what it wants (unfortunately it thinks this is a bit of a game and doesn’t tell me what it wants). I check my blood sugar with my meter and indeed I am low - 68. I debate on the next action to take since I just had a pop tart. I decide to have some milk and some goldfish crackers. About 10 minutes later I get another low blood sugar alert. At this point I probably look like the guy standing on the corner yelling at traffic.  I decide to have something else to eat to get to some kind of normal level. Finally my CGM is in the 100s and in a normal range.

You may be able to guess what happens next.  In a short while I start to feel a little lethargic. I look at my pump to see the CGM reading and it is 145 with the double up arrows (meaning my glucose is rising at more than 40 points per 20 minutes or over 2 points per minute). Shortly I start to get the predicted High warnings and soon to follow high glucose warnings. Now I have to go back and think of how much I ate in grams of carbs to correct the low I was having earlier. I test and the blood glucose is already at 175 (30 points beyond the CGM). My pump tells me that I need to bolus for the elevated blood glucose. I also figure the carbs I had and add about half of them to cover that as well. I continue to get high alerts for the next half an hour or so and the crazy man yelling at the pump continues. The best part is as my glucose levels top out and start to come down I still get the alerts as it hits certain numbers on the way down.

After a frustrating couple of hours and plenty of yelling at the CGM everything finally got back to normal glucose ranges.  Through all of this I have learned one thing; the CGM listens to me as well as my kids do.

CGM Time Frame

I recently had a discussion with a friend of mine over the length of time you should wear the CGM sensor.  It is quite interesting to me and I will layout what she said and my thoughts and ask for your opinions:

My friend's doctor says to wear the CGM three days and then not for a couple of weeks.  Some of the reasoning is that you can become obsessed with it which is not a good place to be either.  The three days helps you get regulated and then to practice the same through the next two weeks, plus it can confirm how you are doing from your previous two weeks.

My thoughts are to wear the CGM all the time.  I believe it is an effective tool in helping recognize the trends of my blood sugar and help me prevent those lows and highs.  I have found that since starting the pump and using only fast acting insulin (Humalog) and discontinuing the Lantus that the high blood sugars feel much worse much sooner.  Plus when I am out and about with the kids it is nice to have that comfort of being able to see where I am at and see if I my blood sugar is trending one way or the other.

Everyone must take care of their diabetes the way that is best for them. I don't think either of us is more right than the other as there are more than two ways to make a cake.  Give your thoughts on the way you manage your diabetes with or without the CGM.

One Week on CGM

It has been 8 days since starting the CGM.  For good health and better control I don't know why you wouldn't want CGM with your pump.  In one week my Blood Glucose Readings have been better and overall I am able to keep tighter control.  I have been able to avoid some highs by seeing that my Sensor Glucose was going up rapidly and avoid some lows by seeing it drop rapidly.  Since most of the reports through the online software use a two week basis I will give an update into the change in numbers in another week when I have two weeks of CGM data to compare to two weeks without.

The great thing is I can take a quick sneak peek and see how I am doing without pulling out my meter.  If there is a potential glucose reading that needs my attention I can take care of it. If not, I don't have to poke my arm (I test on my arms as my fingers are very sensitive).  Granted it isn't always a perfect science but the trends have helped tremendously in this first week with the CGM.

My average sensor readings since May 18th have been 139, while the previous week blood glucose readings averaged approximately 150.  Since I can't breakdown a particular time frame of 8 days on the software I will give a more thorough analysis after two weeks to compare sensor glucose averages to blood glucose averages for the time frame as well.

I also think it gives piece of mind when I am sleeping as when there is a high or low predicted I can take care of it instead of waking lethargic and cotton mouthy (highs) or all sweaty, shaky and confused (lows).  Plus I hope it helps my wife sleep better and not worry as much about me.

The only issue I still have is the placement of the pump and sensor.  I move a lot in my sleep and getting them in line so the signals are reached is a little difficult at times.  When I have to move the sensor I am debating where else to put it.  I may try just around my right side towards my back area but I am unsure at this point.  That placement may help as I sleep on my left side or stomach and usually have the pump on my right hip.  It will get figured out eventually.

My question to the manufacturers is, if we can implant GPS or trackers why can't we implant some kind of more accurate glucose sensor?

Unlocked Set and Sweat

In the last two days two things have happened that have made life a little crazy.  I will start with Friday when all things were going well.

It was the first sunny day in a while and I had to get the grass cut and the kids wanted to play outside.  Not a real problem just a lot to do.  After picking up my son from school we went outside.  I worked on cutting the grass while my two kids harassed each other.  Since it was nice out I told them when I was done we would cook hamburgers on the grill and eat on the patio.  They were both hungry (I was too) and I began to prepare dinner.  While preparing dinner I checked my blood sugar and it was 142, not bad but I was a little puzzled that it was high since I just finished mowing the forest my yard had become.  Dinner was ready. I ate one and a half hamburgers and twenty tots (a total of 83 grams) plus a 0.4 correction for over 120.   I started the bolus started and shortly thereafter started eating.  It was our first meal outside in a while and it was good.  With the CGM it offers a look into the way my sugars are trending and with this big meal I was wondering how it was all working out, about an hour after my bolus I looked at my pump and my Sensor Glucose has the double up arrows (meaning my blood sugar is rising over 40+ points every 20 minutes).  The sensor glucose is 190.  I am bit concerned so I check my blood glucose with my meter and it is 221.  Now I am panicked, in an hour it raised about 80 points.

I think back to my training and inspect my pump and infusion set.  I noticed the quickset connector is not locked into place.  Now what?  I decide to call my Medtronic CGM trainer and leave a message.  It is after 6 pm on a Friday and I am not really sure who to call.  While waiting for a return call I decides that I probably didn't get any of that insulin or any basal insulin in a while so I checked my blood glucose again and it is over 330.  I did a blous for an amount a little less than the original before dinner because of the exercise.  I am not sure where my reading topped out at but slowly enough it started to come down.  I checked periodically to make sure it was coming down and to see if I needed additional insulin to make that happen.  I had another couple of small boluses and got to under 200 about 11:20 pm.  It was a very frustrating day especially since I had been doing very well.  The Medtronic rep did get back to me rather quickly and concurred that I took the right action, so I felt good about that.   All was well until Saturday.

Saturday I had some some yard work to do.  I also needed to change my site and restart my CGM.  The morning went well and I laid my daughter down for a nap and I got ready to do some work.  Everything was going quite well on this very warm Saturday as I worked in my garden.  Then I felt something pulling at my shirt.  My CGM with IV 3000 dressing was coming off, and my infusion set was coming off as well.  I was in the middle of what I wanted to get done and was sweating, I thought if I stopped and tried to do a new site it would just fall out because I was sweating and working. I decided to try to use additional IV3000 dressings to hold them in while I finished. They stayed but barely.  Plus now I wasted some dressings and had to do a new site for each.

After I cool off and stop sweating I clean up some and start a new sensor site.  First time applying one by myself and it didn't take much for me to mess up.  I got the sensor in fine and everything else went smoothly except I forgot to take the clear tape off the sensor.  I found it impossible to remove the clear tape off the sensor without removing it.  I was not very happy about it because getting the CGM was a hassle I didn't want to waste the sensors.  I started over and get the sensor in no problem and even remembered to take off the clear tape.  While I waited for the transmitter to charge I started my new site for the infusion set.  This went goes fairly well but I felt like a pin cushion since I have had four insertions in a matter of a few hours.  Live and learn.  It is still way better than injections 4-5 times a day.

As the day wore on I needed to do my 2 hour check for the sensor.  My reading was 263 and I couldn't use that as you need to have a stable reading near or int he normal range.  I took another 5 hours to get to 150 so I used that and moved on.

I did do something different from the first time of setting the sensor, I taped differently.  There was a tip in one of the learning guides for the CGM that talked about using half of a IV3000 to go over the sensor and part of the transmitter.  That has worked great so far as it allows air to pass through keeping the area dry, especially when sweating.

The Beginning of Robot Dude

My daughter used to call robots "Robot Dude".  With the CGM (Continuous Glucose Monitor) now attached to me I am feeling a little more like a robot.  The training was very good, the only issues were the husband of one trainee and the other trainee told stories.  I understand that you may want your significant other to learn this as well, but turn off the cell phone or if you answer it leave the room.  The other trainee was nice but when she started to tell a story it took a while, I am all for stories and sharing life experiences but there is a time and place and show up on time.  Part of my frustration with this was the fact that I knew from reading the materials I had to do checks with the blood sugar in two hours from the start and then again two more times that day before bed to calibrate the CGM.

I will admit when first seeing the sensor and the needle used to insert it, it is very intimidating.  They say it is painless and I believe it, I think I just hit a tender spot.  The sensor must be on the same side of the body as the pump and this caused a little thinking for me as I usually have my pump on the front of me as I keep it in a front pocket (and the clothes I wear sometimes don't have a back pocket) and when I sleep I put in on or just around my hip because I sleep on my stomach a lot.  The trainer helped me decide to put the sensor on my side a little so it can work from the front and hip.  It didn't miss a beat all night.  I did have slight bleeding where it was attached but it was minimal and stopped very quickly.  The whole process of setting the sensor was a little involved.  You have to pick it up in a certain way so you don't pull the needle out and when inserting you have to follow steps pretty well to do it right. Angles and the way you remove things when placing the sensor have to be done right.  It is still all worth all the trouble to give that added help in controlling diabetes in my opinion.

Due to the fact that I like instant gratification it was tough to wait for the first calibration time of two hours to start seeing information on my pump regarding the CGM.  Being a nerd of sorts I love things like this and it is very interesting to see the graph populate itself.  I am trying to wait another day to upload the data to look at reports.

The downside right now is getting used to having something else attached to me.  I am going to have to try different spots to find what works best and is comfortable. Right now on my side above my waist is alright but it is slightly uncomfortable which may be the tape holding the sensor and transmitter or just the area.  It is not painful, I am just always aware it is there.

This is going to be a great addition to controlling my diabetes as it will give me a good idea what is going in between Blood Glucose readings.  The thing I am looking forward to the most are the predictive alerts to help prevent the highs and lows.  In addition I think it will help figure out the best basal rates.  I realize it is a process of always fine tuning as seasons and activities change along with my body but I can't wait to see my a1C in August as my most current from a couple of weeks ago was done from 7.1 to 6.6.

The 3 Day Dilemma

With wearing the pump I have found that sometimes I have a dilemma when it comes to infusion set changes.  I was taught to change the infusion set every 3 days and if it is sometime after a full three days that is alright.  Well in the process of taking longer for site changes to not waste insulin and to not go too long to avoid an infection I have come across my dilemma, what to do when the full three days is up at 8 pm.

What do I do? I go to bed generally around 10 pm so a site change at 8 pm is not bad because I test before bed anyways.  The issue comes in it is exactly three days form the last change which probably was about 3 days and 8 hours from the previous change.  As of 8 pm last night I had 39 units of insulin left in my pump, enough for another full day.  I inquired to the Facebook group of diabetics I am a part of and received a whole range of answers.  Granted everyone is different and their bodies react differently, but being only about a month into being on the pump I needed some guidance.

The advice that I received was basically the same from most.  3 Days and no more!  Although there was agreement it is OK to occasionally go over the three days but the risk of infection and scar tissue builds up.  Some have gone over three days but never four so at least from my small sample of pumpers I have a better idea what some of them do.

I decided to go overnight without changing the site as it was too much insulin to waste and for my cost of insulin of over $500 per three months I wasn't going to throw that much away.  When I woke up and tested I was 155 so all worked out this time.  I did my breakfast bolus, ate and then changed my site.  If I stay vigilant and get my amount used a little better under control I will be able to more precisely fill the reservoir to not waste or be in that predicament too often.

All of the Facebook group suggested filling the reservoir more to the average used for three days, which I am working on but being new and with the illness I had a little over a week ago it has been tough to calculate.  When you don't want to eat due to the illness and blood sugar readings are fine it makes it tough to find a true average as I was down around 20-25 units when some regular days I have ranged from 33-40 units a day.  This reservoir fill I went to my most recent 7 day average to see how I do and have lowered my fill from 160 down to 140 units.  Hopefully this way I won't have as much unused insulin after three days.

Continuous Glucose Monitoring (CGM) Training

In a couple of days I will doing my CGM training and getting hooked up.  I am pretty excited about this.  I am a guy so therefore I have a love for technology.  It will be interesting to me to see how this all works.  The biggest interest to me are the predictive alerts so that I can head off those highs and lows.

I do think about having something else attached to me but in the grand scheme of life it is only to help me live a better healthier life.  Although my kids might start to think I am a "robot dude" (as my daughter calls robots).

The training is two hours and this one is in a group setting, so it will be interesting to see and hear other peoples thoughts and opinions.  When I did my pump training there was another person being trained at the same time, I found it very interesting to hear their questions and concerns.  The other trainee was a female so some things didn't pertain to me, like using a bra to hold the pump.  Although, from this and the Facebook group where I ask them many questions I am finding that a bra may come in very handy.  It would certainly help make changing clothes easier as I seem to not know what to do with the pump each day.  It is a crude balance and holding system that really needs some refinement.

To me the CGM with the pump seems like a necessity, even though I don't have it started yet.  It all seems so close to a better system of almost having a pancreas replacement.  At some point I believe technology will be good enough that I will be to stop testing via finger sticks (or in my case alternate site (forearm)) and just have the pump site and CGM site.  

The Shaving Decision

After some contemplation, site selection was getting difficult so I decided to shave the abdomen.  Lots of thoughts raced through my head: what if it itches, what if I look like a dork, how much to take off, what will the wife think, etc.  A lot of my decision was based on the fact that I would like to keep sites on my abdomen for now and I haven't had a lot of luck with the hairy areas.

I started with a smaller area and quickly decided that I looked ridiculous.  I was trying to achieve the best of both worlds of being practical for the site placement of my infusion sets while trying to look good at the same time.  From there I shaved off more and more up to my chest.  I wasn't sure if it was the best idea but it looked better than having some hair in areas I know I wouldn't be placing a site and maybe it would help my swimming time in a 100 meter race.

When my wife got home I asked her thoughts, she gave some advice that maybe I should do the upper part in more of a "V" shape from the bottom of my chest. So as I am continuing in this journey I am taking that advice and trying to maintain it differently.  I am still not sure what she actually thinks.

Since shaving my abdomen the site placement has been much easier, sticks far better and the removal does not hurt as much, although it is a little more difficult to remove but that is a good thing.  Even at this point I am trying the sites with out using the extra IV Hand 3000 clear film pieces around the edge of the site to be sure the pad on the infusion stays in.  Plus in that vain as I have mentioned earlier it helps me rock the look of the pump a little better, although in the summer when it is hot or I plan on being in a pool more often I will probably go back to using the extra protection.

To Shave or Not To Shave?

Saturday rolls around and I am going to be gone most of the day.  I need to a do a site change before I go.  I have my first painful "KELLY CLARKSON"  moment of removing a site.  The last placement was a little more into the dense area of hair and it hurt when it was time to remove.  After avoiding the center area (or most densely hairy area) I decide to give it a try and to see how it works out.

After first placing the site a couple of inches above my belly button all is good at first.  I have the clear sticky patches to put over the site to help make sure it stays in place and use one.  I have been using them all along as I want to be sure I don't issues while I get used to sleeping with it among other things, plus I sweat a lot when I get hot.

I go to take a shower and the problems begin.  As I get out of the shower the clear sticky patch is coming off and pulling on the site.  The hair in the area is making it hard to stick to the skin.  As I get dressed I realize this is not going to work out.  I noticed some red on the infusion set adhesive pad and figure I need to redo the site, plus it is painful.  Both kids decide they need to use the bathrooms at the same time.  So I grab an electric razor and head to the kitchen, sure would be nice to have a little privacy.

Since I am in a hurry I just shave an area that I am going to use for the next site.  I pull out the old one and now I am bleeding as I try to get the new site in the newly prepped site.  I get infusion set set up and get it on and clean up the other site that doesn't want to stop bleeding.  Finally get it taken care of and wonder if the other bolus actually made it since I had such an issue.

I test every hour after to be sure I got the insulin bolus for breakfast as I need to be ready as I have 12 young kids I am coaching at a track meet that day and want to be make sure I am in good shape to do so.  Everything checks out at every check so I am able to relax and be there for the kids. They had a great track meet by the way and turned my bad morning into a great day.

Now I have some thinking to do, do I shave as I go or just shave it all?  I am still not sure what I am going to do.  I don't think my wife will care either way as long as I am healthy and happy but I want her to have a say in the choice as well.  Plus I wonder how the brochures make the pump set look so good.  I want to be able to rock the pump out like that but I fear it make take a lot of crunches or maybe one of Tony Little's programs or devices I see on infomercials.

The Bad Site

Being new to the pump is a learning process each and every day.  I was officially on the pump one week as of Tuesday and feeling pretty good about it.  Tuesday was an odd a day.  It started out with a high after breakfast and with no correction a low mid morning.  Pre-lunch was good then the difficulty started post-lunch, 193.  

I had track practice that day and was fairly active so I tested after to see where I was at - 214.  This was frustrating so I went back and made sure I counted carbs correctly for lunch and after recounting three times I did so I did a correction.  Pre-dinner then I was 202.  In my mind I was thinking, "What the heck is going on?"  I was over my illness, still on the antibiotic but it didn't make sense to me.  Post dinner I was 186 and at least happy to be under 200.  

Before bed I tested several times while giving small corrections.  I couldn't get under 200 and was questioning changing my site.  Bedtime I was 177 so I thought things were getting back to normal although my site was bothersome, it was hurting  a little. At 3:00 am I wake for my check feeling awful, I check and I am 325. I was very confused, pissed off and not sure what to do.  Should I do a correction or site change?  I didn't do a site change because I didn't know if I would be able to get up and test an hour or so later.  A small correction (one unit) was the way I went.  Unfortunately I could not get back to sleep as when I get high I usually don't feel well and the cotton mouth I feel is the worst.  I struggled in bed for a while and eventually feel asleep.

On Wednesday morning I test and I am 355.  I freak out.  I decide before anything t change sites and do a bolus.  I pick a new site and bolus to correct my blood sugar.  After I do that I realize I should check for keytones.  Keytones come back moderate and now the panic turns into a serious panic.   I start guzzling water, checking my blood sugar every half hour and checking keytones as well.  Initially the blood sugar starts to drop (319) then goes higher than where it was (371) I listen to the pump and bolus more but fear over correcting.  Keytones are a least starting to correct to small.  I call the nurse at my doctors office as they just open.  I keep checking and wonder if my pump is having a problem as I it is taking what seems like forever to come back to reality.  Here are the times and numbers through the morning:

7:25 am 319

7:52 am 371 Keytones still Moderate

8:23 am 373 Correction Bolus

9:18 am 273 Correction Bolus, Keytones Small

9:45 am 273 Correction Bolus

10:15 am 246 Keytones down to a trace

10:49 am 171 Keytones Negative

11:50 am Pre Lunch 101

FINALLY!  Back to normal, now just waiting for the crash.  Meanwhile I put my daughter down for a nap and jump in the shower.  The phone rings, thinking it is the Doctor I get out of the shower with soapy hair and face and search for the phone - it is not the doctor but wife finding out what is going on as Tornado Sirens are going off.  I get as dried as I can scoop up my daughter and get to my basement and check the weather. Unfortunately this storm was moving fast, maybe even faster than the sirens.  Fortunately there were no tornadoes.  So I get my daughter back to bed an wait for the doctor's office to call.

Then finally call and confirm that I had a bad site.  I apparently did alright handling it, should have checked for keytones before changing the site but I was in crazy mode at that point and just wanted to get a correction right away.  We made a small basal rate change to my 10 am and bumped it up to 0.7  and my 4 am to 0.9.  

Having my confidence shaken I am back to unsure about this a bit, but it turns out bad sites happen and since that time for the next few days I did very, very, very well.  Through Saturday of that week I had one high over 200 which was totally my greedy eating fault.  and a few lows that I just had a small snack to correct.  Things are going well at least until the next site change Saturday morning.

The First Meal Without Labels

Everything was going alright and this new pump thing seemed pretty good.  Saturday was a pretty good day and my confidence was growing and life seemed to be moving along and I was sure happy to not have to use a needle since Tuesday, although my arms were getting a bit sore from all the testing but I knew it would get better.

Saturday night I made my first dive into candy as Easter was the next day and we were getting the kids Easter baskets ready.  Who can really resist a Cadbury Cream Egg or a Reese's Peanut Butter Egg.  Two of my favorite things beyond the Sweet Tart Jelly Beans.  Well I ate some candy, counted the carbs and used the bolus wizard and was feeling pretty good until the 3:00 am check.  I was 232, not surprised as a few jelly beans or a little Butterfinger egg may have slipped into my mouth on accident.  It wasn't too bad but I was a little concerned.

Easter morning I woke up at 212 and was ok but a little upset that it seemed like another step backwards.  We went to church and then over to my wife's family's house and celebrated Easter.  This would be my first meal with no labels and just my knowledge of carbs to figure out how much to bolus for what I was eating.  Before Lunch check was 169 and I was hungry.  I had some coffee cake, kielbasa, bacon, sausage, and corned beef hash.  I don't recall what I guesstimated the carbs to be but I didn't do as well as I though as I was 244 two hours after lunch.

It was time to do a site change for my pump.  I picked a new site, still avoiding the hairy parts of my abdomen as much as possible and got everything rolling pretty good for my first site change on my own not at home.  I get done and wait about an hour and test and my blood sugar is up to 261, I do a bolus and I am a little worried as I don't know if it was a bad miscalculation on the food or if I didn't pick a great site.  I check about every 45 minutes to and hour after that and the readings go 252, 215, 193 down to 176 on my pre dinner check.  I eat a little dinner even though I am not hungry and my 2 hour post dinner check is 104.  Whew, back on track!  The 3:00 am check was even good, maybe a little low at 107 but I was able to get some rest and stop worrying.

The next day, Monday (close to one week on the pump), I was to call in my blood sugars to see how I was doing and potential make some basal rates adjustments.  I called in and we made some changes to my basal rates as my mornings were still a tough one as I would always be higher than I should after breakfast and we raised my evening rate a little as well.  I started out at 0.5 Basal rate and now it goes: 12:00 am 0.5, 4:00 am 0.8, 10:00 am 0.6, 6:00 pm 0.7, then it restarts at midnight again.

From here I am pretty excited as it seems like the adjustments are getting smaller so I must be on the right path, then I have my first bad site.

The First Site Change

The next day after starting the pump on insulin I was ding pretty well.  I decided that I wasn't going to be hesitant in my meals, instead acted how I would act in any normal day.  Carb-less snacks were still happening so the basal rates could be worked on, but meals I was going to eat although be sure to count the carbs in what I was eating.  For lunch that day I decided since I had to take my kids to two doctor's appointments that we were going to have Sonic (I think I get more excited than the kids).  So after the last appointment I needed to drop off a prescription at the pharmacy for my son and barreled down the road to get our lunch.  I ordered the SuperSonic Cheesburger (58g), Large Tots (33g), and a Diet Cherry Limeade (4g and super yummy).  In total I had to bolus for 95g of carbs.  It was delicious, way too much food but well worth it and on the 2 hour post meal check I was 133.  At that moment, I was pretty hyped up as it was all going very well and I didn't have to try to figure out how to give myself 9 1/2 units by humalog pen.  The rest of the day went very well and my confidence was through the roof.  Life was good.

The next day, April 21st, I had my last training day and first site change.  The 9 am appointment started with more diet and nutrition training.  It was good as I had some questions and it was nice to review and be quizzed a little bit on the subject.  Sometimes being put on the spot is tough but in this situation it was relaxed and besides this was very important to my day-to-day life.  The second part of training was going over our basal and bolus rates, blood sugars and the site change.  I have been avoiding the more dense hairy areas of my abdomen so far but I know the time is coming for that "KELLY CLARKSON" moment.  I was nervous because I wanted to do it right, the one mistake I almost made was leaving the needle guard on the infusion set when it was time to insert it.  The nurse was watching and reminded me so it was not a problem.  Overall it went very well, a little pain with pulling off the old site sticky material but tolerable.  Putting the new set in was easier than I made it because I was nervous but it got done and was ready to go.  The nurse set up my bolus wizard and we went through some practice exercises.  This was awesome, it calculates corrections for me, it calculates food bolus amounts for me when I put in carbs, I wonder if it does windows too?  Granted the bolus wizard needs the right settings to be good and those may change for me in the future but so far so good.

With the appointment done it was time to go home and start living.  The carb ban on snacks was lifted but I was going to be cautious as I am my third day into this and want to do a good job as I am still adjusting.  Then it starts, Lunch I was high (186) pre meal and then 221 post meal, dinner I got back down to 133 pre meal and 211 post meal, I am starting to wonder what is going on.  The dreaded 3:00 am  check  I was 301. I was confused, tired and feeling lousy so I did a bolus which I was reminded later you shouldn't do in the middle of the night.  I was still awake at 4:00 am so I checked again and I was 299.  What is going on?  I did go down the next morning to 220 and was 192 post breakfast.  My ear hurt, my head felt like it was underwater so it was time to call my Primary Care Doctor to get in and see what is going on.  I called the office and they said they would call back after my Doctor's appointment but to test for keytones next time I go to the bathroom.  It turns out I had the beginning of an ear infection and my wife just had an ear infection so they gave me a prescription for antibiotics and sent me on my way.  Then pre-lunch I was 150 and post lunch I was 122 and the keytones were negative so I was feeling better.  The doctor's office called back and changed up my basal rates and the rest of my day went well beyond being sick.  Dinner pre and post I was in normal ranges, bedtimes I was 127 and 3:00 am I was 130.  Went back to sleep happy but it was difficult with being sick.  I was hopefully I would get better quick as we had Easter egg hunts and other stuff going on during the weekend.  Easter weekend was bound to make things more interesting and frustrating at the same time.

The First Day of the Rest of My Life

Tuesday, April 19th, 2011 was the first day of the rest of my life.  The pump start with insulin was a nervous time for me.  First I had to remember to not take my lantus in the morning which with two kids and being tired and starting to get a cold was a bit challenging.  We have a morning routine in our house and not being a morning person it is important to have that routine.  I actually went to the fridge where my lantus is kept and started to grab it before I remembered that I was not to do it this morning.

I succeeded in not giving myself lantus and was growing hungry. The pump start this morning I was to bring my breakfast with me so I can test and bolus (for the food and blood glucose correction if necessary).  I usually eat breakfast somewhere between 6:00 and 7:30 am when the kids get up but my appointment for the pump start/training was at 9:00 am.  Next was making sure I had my supplies for the pump start and figuring out y breakfast so I can start on the right foot and do better with counting the carbs in my meals.  It was somewhat a celebratory day as well since there would be no or little use of needles anymore so I decided I was going to have some McDonald's breakfast: a sausage mcmuffin, hash brown and a coffee.

I get to the doctor's office and can smell my food and try to wait patiently to eat.  When every morning you are set on a schedule it is hard to wait an extra couple hours to eat, but the pump is also supposed to give me freedom in when and how I eat so this was a minor inconvenience in the grand scheme of things.

Finally it was time for the appointment, I think I went through an emotional roller coaster with the ups and downs of excitement and nerves just walking down the hallway.  It was all business getting the pump setup and setting the infusion set, filling the reservoir and starting the basal rate.  After all the waiting and decision making it was on.  It didn't hurt, but it was definitely odd after 20 years of needles this little blue (very expensive) thing was providing me insulin.   So I counted up my carbs, figured my bolus amount including a small correction to get me in the normal 80-120 blood glucose range and with the press of a couple buttons my bolus for breakfast was being delivered.  Fantastic, it was time to eat.

As I ate my breakfast there was more training, mostly review of what the books with the pump taught me but also guidelines and the testing schedule: before meals, two hours after meals, bed time and 3:00 am.  All necessary to get the basal rates set correctly for me but a big pain in the butt as not being a morning person I am much less a 3:00 am person.  One important thing to remember when testing your blood glucose at 3:00 am is your glasses, when you can't see like me trying to get a good droplet of blood and get it to the test strip should be a minute to win it game.  I got it done after a couple of tries and would not have won it in a minute this time.  I stumbled back to bed and couldn't go back to sleep as the cold was getting worse.

I was nervous the first day as this was a new way of life to me,  I had to break out of my usual routine and learn to take care of myself in a different way.  One of the things that is important to help set the basal rates correctly is to have carb-free snacks the first few days unless necessary for a low blood sugar.  This was going to be difficult for me but I want to do things right so I guess it is time to stock up on some cheese.    I freaked out at lunch time as my blood glucose was up to 277, fearing the infusion set was not set right or the pump wasn't working I called the doctor's office right away.  They talked me off the ledge and assured me that this is normal for the first day as everything is an adjustment at this point.  I ate my lunch, bolused for the food and correction.  The two hour after meal check was much better so I was able to relax.  Dinner went much better with good readings before and two hours after and my confidence began to grow.  Bedtime reading was good as well, a little low so I had a small snack to be in the right range for bedtime. It was nice that there were some small cookies laying around as it is always nice to have a little treat especially when moving to a new part of life. I went to bed feeling good beyond the fact that I had a cold.

I got through the first day very well and was well on my way to the rest of my life.

The Kids and Curiosity

The kids must investigate anything that is new, especially something Daddy has hooked up to him.  I am very open with them about my diabetes.  They ask questions, more my six year old than my 2 year old, and I give them straight answers.  They often want to know why I am giving my self shots or poking my arm and making myself bleed.  I try to in the simplest terms explain diabetes and what I am doing.  It is a basic explanation that my body needs insulin and does not produce it so I have to give myself shots in to give my body insulin.  I realize this is beyond them and would answer more of their questions but that is where that usually ends.  Then they ask why I poke my ark to get blood and I tell them I have to check to make sure I am OK.  That is usually followed up with questions about how I know I am OK.  I simply tell them whether my blood glucose reading is good or bad and what the good range is and they are satisfied with that.  They are curious but giving them the straight answer on diabetes seemed to make it easier for everyone involved.

All that changed slightly the day I came home from training with the pump. Curiosity was running wild.  My two year old loves buttons and all she has wanted to do is push the buttons, at least there is a keypad lock.  She also decides that if we are laying down she must kick it a few times.  Other than that she leaves it alone.  My son on the other hand has questions, "What is that?"  "Why are you wearing that?" "What is that tube for?" I take them one at a time and explain that this is an insulin pump and that I am wearing it so I don't have to do shots anymore.  I explain the tube is what delivers the insulin and the I do that by telling the pump how much to send me.  He too wants to press the buttons but I tell him how important not pressing the buttons is and to never touch the pump.  He understands but I also know I have hung that forbidden fruit out there. It is a constant adventure because it is new to them too and I know they are at least double as curious as me.

The kids are smart and they know more than meets the eye and with everyday life I find with this it is best to be straight-forward with them.  It is a double edge sword as I know that it worries them slightly about their Dad but they also understand that I am doing all I can to be healthy for them.

There are still questions now and then, mostly the following repeated many times: Does it hurt? The answer is always "No."  How long do you have to wear that, a week?  I tell them forever and my son usually responds, "So you will live for hundreds of years?"  I sure hope so buddy.

Day One: Pump Training

Back on April 13th I had my first day of pump training, it was a long wait from when I got the pump and I was nervous and excited.  This was a big change for me so I was worried about several things:

1.  Sleeping with the pump.  I wasn't sure how that was going to go.
2.  I have a moderately hairy abdomen so I wasn't sure what to do about that (still am unsure on this one)
3.  Contemplating having something attached to me 24/7 for the rest of my life.

Although I was very excited as well because I knew in the long run I would be healthier, have better control and couldn't wait to see the freedom so many have told me about.

So it was day one of pump training and I was ready.  I had the box of stuff my insurance company sent me (pump and pump supplies).  We started training with diet and nutrition part, and it had been a long time since my last education session, at least 5 years but probably more.  Carb counting is still the way to go although I have learned it is great to have a refresher as time warps the mind a bit.  Plus I have learned there are phone apps available to help with figuring out carbs in foods.  Now I just need a new phone so I get on of those apps.  The session also gave me a good chance to talk about homemade food.  I love to cook but counting the carbs in food I make is difficult to do sometimes.  I got some helpful information in the way of breaking down the recipes to be able to count the carbs.

In the second half of day one of pump training we basically got introduced to the pump and them used Saline and started wearing the pump to get familiar with the pump.  This was a great first step because then it took some of the worry out of the change.   We learned how to set basal rates, do boluses and set the infusion set.

Now I am wearing the pump with saline and it is a little odd at first. Well it was the end of training and time to get lunch and head back home.  As I do things I had to get figure out what to do with the pump, for example wear to have it n the car as now I have a seat belt to contend with.  Then do I want to put it in my pocket, attach to my belt or to my pocket.  Little things I didn't give much thought to I know had to figure out what was best for me.  That night I had track practice, I coach an elementary team,  and decided to disconnect it for practice since it was day one and I had to do a lot of jumping in practice as was worried about it since I am just starting out.  I realize with insulin I can't just make that decision like that but I did know that I could disconnect it for short periods for some activities.  Practice went well and I reconnected it.

Now was the first night, what am I going to do with this thing.  Considering it is about the size of a pager and has a tube about 32 inches long that is attached to me I was concerned.  I sleep in boxer shorts so I didn't have a lot of options.  I sleep on my left side and belly mostly so I decided it would be best to be on my right side.  I also move quite a bit in my sleep so I was concerned about that too.  I actually did alright but was thankful for this little get used to it period.

Day two and three not much else changed, I practiced doing a little bolus with meals just to do the process.  Sleeping got a little better as well each night.  Then after the third full day it was time to take off the pump and the infusion set.  There was much concern on my part as I mentioned my moderately hairy abdomen, I couldn't but help imagine the movie "40 Year Old Virgin" when Steve Carrell's character was getting his chest waxed and when they rip off a strip he yells out "KELLY CLARKSON!"  Well it was go time.  It hurt a bit and it wasn't kind of on the side in a less dense area.  So that still leaves me with the quandary of what to do.  I am considering shaving as has been suggested but unsure of that as well.  Time will tell and I give updates as I figure it out.

After three days it wasn't so bad wearing the pump.  It was great to get to wear it with saline to get familiar with it and helped ease some of my concerns as well as give me a little more excitement for the pump start day with insulin.

CGM Request

I also applied for the Continuous Glucose Monitor (CGM) with my pump.  I believe this is an important part of managing diabetes as it has can help with avoiding the roller coaster of highs and lows.  It has predictive alerts for when your blood glucose is dropping or raising faster than a predetermined rate.  Testing with your meter is still necessary but helping to maintain better control is what I want and not have to have those low or high times when I feel awful.

The first attempt I was denied by my insurance company as they stated I didn't have enough lows.  I was upset by this because they have particular standard on approval, which basically is a certain number of lows below 50 in a set period of time.  This is ridiculous because a CGM not only helps with the low blood glucose readings but also helps with the high blood glucose readings where effects can be just as detrimental to my health.

I appealed with the advice of my reps from Medtronic and wrote an appeal letter on why I should have a CGM.  First off I stay at my home and need to be in good health to be there for my kids.  There have been instances where I am getting low and don't realize it while I doing stuff for my kids and then the confusion sets in and makes it very difficult to know something is wrong.  In addition, the paramedics had to be called once as I crashed unexpectedly in the middle of the of the night.  My doctor had also written an appeal letter to the insurance company which helped as well.  With that the insurance company approved the CGM for me which made me very happy.

I begin my training and use of the CGM in about 3 weeks from now, as I have been told it is best to get used to the pump before starting the CGM, after all it is having to have a wireless transmitter connected to a sensor that is inserted in the skin which I will have to change every 3 days. So my ratio of injections to need sticks every three days will 12-15 injections to 2 needle sticks.  I will certainly take that ratio after 20 years of varying needle sizes multiple times a day.  

Ordering and Waiting

I ordered my pump based on a time frame as I knew I would have to wait for training and I just purchased Lantus so I wanted to use that up before starting the pump as it took about $400 out of my wallet and I knew I had to pay for Humalog for the pump out of pocket as well.  My insurance company has a program for diabetics which provides all supplies for the pump and testing (except for the insulin) at no cost to me so that was a big bonus.  I ordered my pump (the color blue) and it arrived in a couple of days after processing.  I was excited as I am a technology nerd and couldn't wait to check it out.  I opened the box and did the smart thing and went to the workbooks they send first, although one was pretty basic I read them first.  In 24 hours I was done with the manuals and doing the practice exercises with the pump.  At that point I was all set, the problem was this was February and I had to wait until mid-April for pump training at the Doctor's office.  I also learned that Medtronic has a online learning section, which I proceeded to peruse.  It was very helpful and was pretty informative only issue was I have two small kids and it requires listening and watching so it was difficult for me to get very far into it.

So from that point it was a little over a month and a half of waiting to get to the training.  I had many emotions and thoughts during the time that ranged from excitement to nervousness, after all I had been doing injections for over 20 years and this was going to be a big change.  I wasn't sure how it would go or what it would be like to have something attached to me all the time but I knew it was for the better of my health and better for my family in the short and long term.  My Facebook group has been very helpful in support and giving advice as some are parents of pump users and others are pump users themselves.

I also worked on getting the CGM (Continuous Glucose Monitoring) for my pump which was a little more difficult and will tell about that process next post.

Research and Decision

After hearing from the Facebook group, I did more of my own research on the two pumps (Animas Ping and Medtronic Minimed Paradigm Revel).  I had brochures and went throughly both sites on the web to find what I considered the pluses and minuses.  They each have positives to them some of which I wish I could have combined into one pump. I will highlight a couple of features that were different as there are some features that are the same even though it is difficult to determine that from there charts on the websites as one of them compares to a different model.

Animas Ping	Minimed Revel
Bright Color Screen Remote Bolusing from Meter	Larger Reservoir Size Option CGM capability built into Pump

CGM = Continuous Glucose Monitoring

I really enjoyed the bright color screen of my Bayer Contour USB meter.  The screen actually made me more willing to test and maybe a little more excited about it.  I realize it is just a psychological thing but it helped me as it would have different colors for in and out of range blood sugars.  In addition I love technology and the fact that I could plug the meter right into the computer to download was a big plus.  

The Remote Bolusing was interesting but it wasn't a big enough item for me to want the Animas pump.  The larger reservoir size of the Minimed was something I liked because I didn't want to change sites as often, the smaller size or the Animas I might have had to change sites every two days instead of three.  Besides the better control and freedom the pump helps with I wanted less injections.  The built in CGM into the meter was a bonus on the Minimed as the Animas uses a separate module for the CGM, although they are working on integrating it.

One other factor that I got from talking to users was durability.  From talking to several folks on Facebook the Minimed appeared to more durable that the Animas pump.  Both were good in replacing a broken pump from my understanding but it appeared that the Minimed pumps did not have to replaced as often.  Granted this was a small sample but it comes from the real user experience that I was hoping would help me.

My decision came down to the CGM being integrated and the ability to have a bigger reservoir.  I have been a diabetic doing injections for 20 years and didn't want the possibility of have to do a site change every 2 days as opposed to 3.  Granted it depends on the amount of insulin used each day but I didn't want to have worry about it which was important to me.  Also I should note with the CGM you still need to test regularly but the CGM has predictive alerts and can help in those in between times, but the meter readings are used to calibrate the CGM.  Someday hopefully they will have it figured out how to remove the testing all together but until then it is still a big improvement.

The pump selected was the Medtronic Minimed Paradigm Revel 723 (which can use the regular  or larger 300 unit reservoir).

The Beginning of the Search

In the beginning I asked my Facebook group of diabetics the following:
"For the pump users. I am looking into getting a pump I know ads and disads of having one but my question is especially for those that may have a HDHP, do you know if there is a big difference in cost versus using Lantus, Humalog and pen Needles? Someone is helping me out in this and I am trying to acquire some information on this myself. After having to pay for my Lantus (in full for a 3 month supply, approx. $400) I am looking into the pump more closely. Any input on the financial aspect would be greatly appreciated."

The financial aspect was important early on because it is already expensive being a diabetic and I was worried with the pump it would only get more expensive. We are on a budget in our house and yes my health is of utmost importance but we must be able to afford whatever type of insulin therapy I was going to use.  I found that there was not much info on this as it depends more on your insurance than anything.

I started doing research online of both Animas and Medtronic and their pumps.  It was interesting the charts and comparisons they had.  I like real information though so I went back to my group to get some of their thoughts. I asked again in a slightly different way (responses will be labelled person1, person2, etc.):

ME: what pump do you have and what are your likes and dislikes? I am looking into getting a pump and wanted to get real people's thoughts. If you answered already no need to repeat unless you want to. About 3 months ago.

Person1: Love Medtronic. In over 3 years we have only had trouble once and they sent us a new one from California in less than 12 hours. Love the face that the CGM can be used with it. The doctor had me wear it for 2 days myself before they put it on my son and I was shocked that it was not painful to inject!  February 1 at 9:37pm

Person 2: Minimed! This is all we have ever used. Not much trouble and seem to be helpful. The Insulin Pump gave us our life back. I am so grateful for the company! My daughter eats so often that she would hate shots. She has had a pump since she was four! We have had it for almost 7 years!  February 1 at 9:41pm · Like

Me:  Do either of you have the newer Reveal Minimed? Maybe it is all the same as I am learning all of this, or at least that is what I thought it was called. February 1 at 9:43pm · Like

Person 2: No we both have the one right before it. I believe. I am gonna go look up the new one. The biggest reason I went with them in the first place is they seem to be slightly ahead in the technology. Wanted the new and best first!! February 1 at 9:45pm · Like

Person1: Trying to remember the name of the newer one..that doesn't sound right. My son is getting the newer one this summer but don't have it yet. February 1 at 9:46pm · Like

Me: Just looked it up it is the Paradigm Reveal February 1 at 9:49pm · Like

Person3: I really like the MiniMed pumps that my daughter had. They do seem to be ahead on the technology a bit. When she got her first one 9 yrs ago we had a rough year, but they were always good about talking to us on the phone and sending out a replacement within 24 hours if necessary. The Animas has a few cool bells that made her want it, but I don't think they are worth it. She's only had this one for about 6-7 months and had to get a new one because the screen cracked (she always wears her pump with the screen toward her body). She has been wanting an Animas for about 4 yrs. Two months after she got it she wanted to switch back to her MiniMed. :-/ February 1 at 9:53pm · Like

Person4: I have an Animas,  February 1 at 9:55pm · Like

Person4:  and 1. i like the fact that you don’t have to pull out your pump, and you can communicate, February 1 at 9:55pm · Like

Person1:  While my son was at camp they had reps from each company and I think if you could attend something like that you could get info from each rep and talk to many people that use them and find out a lot of the ups and downs of each. One of them claims to be waterproof but I know 2 people who "fried" their pumps when trying to swim with them on.  February 1 at 9:56pm · Like

Person4:  ‎2. you use energizer lithium batteries, which cost more, but you get longer lasting battery life, 3. you can wear it in water, 4. you can have a lot more insulin February 1 at 9:57pm · Like

Person4: customer service has replaced 4 of my pumps, just from breaking, never had to go back to shots! February 1 at 9:57pm · Like

Person1: You have had them break 4 times? I'm always afraid my sons will break because he is extremely active but in almost 4 years all we've had is a couple of scratches on the screen. February 1 at 9:59pm · Like

Person4:  they ship them right away! i can't think of any negatives. February 1 at 9:59pm · Like

Person5: I have a ping February 1 at 10:00pm · Like

Person3: My daughter had the MiniMed 755 which can hold a 300 units reservoir, the Animas pump reservoir only180 units. :-/ February 1 at 10:02pm · Like

Person4:  mine holds 200. February 1 at 10:02pm · Like

Me: I have been talking to reps from both somewhat, the thing I don't like about reps is their job is to sell their pump. So all the stories and suggestions you each have help more than you know. February 1 at 10:09pm · Like 

Person5: I'm glad my complaining has helped you so much. February 1 at 10:12pm · Like

Me: ‎@Person5 - there are not many opportunities to hear from current users of products that give honest opinions. Reviews I believe are skewed, but hearing complaints or praises in this scenario helps way more. February 1 at 10:18pm · Like

Person6: I have a Minimed Revel... I got it in January when my insurance let me upgrade from the Minimed Paradigm... I have only ever had a Minimed and debated switching in December. However, I was completely satisfied with my Minimed so I decided to stay with it. So, PROS: EASY to use... painfully easy at times, holds enough insulin to last 3 days-- honestly, I can't put everything down because it's basically all positives.... the only negative I can think of is that for me (a 4 year pump user) the changing of the reservoir uses baby steps that I don't need anymore (for example. the paradigm didn't ask if I saw drops of insulin after priming and the revel does) as you can see it isn't a big deal... and as to duration of boluses, I've never felt like I needed them to be shorter in duration.... and I also have the sensor- which is awesome... I'm a big numbers person so seeing trends and everything is perfect and has helped my control! If you need anything else let me know!! February 1 at 11:28pm · Like

Me:  A question about disconnecting for swimming or something tha tyou need to take it off, I know you can do this but I am curious is it just disconnecting the tube from the needle part? Or do you need to use another infusion set? I realize you can only have it disconnected for a short period but wondered how that worked. February 2 at 8:34pm · Like

Person6: I played 2 sports in high school and would disconnect for games and practices... so for 2-2.5 hours... there's the plastic part that comes out and the bandaid material part stays in with the tubing... no other infusion set is necessary.... it's kind of like an electrical plug... when not swimming it's plugged in, and you take it out when you're not, but the outlet is still there. February 2 at 8:41pm · Like

Welcome and Hello

Over the course of the next few days I am going to be posting some of my research process on selecting an insulin pump and get you up to speed on present day happenings.  I have been a diabetic for over 20 years, I was diagnosed Type 1 when I was 16.  High school was an awkward time to become a diabetic for me - I was at an all boys school in my junior year and involved in many things.  I struggled with it at times from the mental aspect and still do at times but overall I have been doing well.  My a1C's have been around 7.0 (a bit higher and a bit lower) but as I have aged I am found it harder to maintain control as the a1C's and blood glucose readings began to creep up consistently.  I stay at home and take care of my two wonderful kids so I decided I needed to do something to not only better my life for myself, but to make sure I could be the best I could for my kids so I started inquiring about insulin pumps and doing research on my own.  After being on Humulin N and R, and then Lantus and Humalog, I am now on a Minimed Paradigm Revel 723 Insulin Pump from Medtronic, started on 4/19/2011.  In the following posts over the next week I will get up to speed on why I choose this pump, how my training went and then up to present day.  When caught up I will write about my life on the pump.  Enjoy.