#DAM Broom Closet Bolusing

While I admired his initiative, a broken insulin pump, mid-vacation, at 7:30pm, on a weekend is not a time for amateur hour.

This past summer...during vacation...while we were eating dinner with family...

Joe's pump failed. He excused himself from the dinner table to replace the pump. He's been independently changing pump sites since he was 9. So, when I heard the 'Mom, I need help!' yelled down the stairs, I was surprised 😳.

As I entered the bedroom, Joe gave me the lowdown. He apparently tried to change his pump, but the pump had malfunctioned, gave an error message requiring a call to the company. Joe apparently looked up the pump company's number on his phone. He called the pump company where he and the representative attempted to revive the pump to no avail. 😳 I guess it was at this point the pump company rep realized Joe was a minor...🙄

'Mom, you need to call them back...they need to talk to someone over 18 to ship out a new pump.' 😑
 
🤐(*#$ #@$& $@&#)🤐

The abbreviated version of what transpired after: I called Omnipod. Pump was broken. 😑 They overnighted one to us on vacation. Which was actually two days.. because late hour on a weekend day😢. Luckily (or maybe not) I brought a 9 year old, discontinued "back-up" pump. 😟 PROBLEM...pump LED light could only be barely seen in pitch-black broom closets🤬...and piston sounded bogged down (by sand?)😵. Anyways, I decide to go the shot route for basal insulin and plug him into pump for boluses. PROBLEM...we didn't have basal insulin. Called on-call MD for Lantus order. Ran to pharmacy to get Lantus and syringes. Next two days consisted of broom closet bolusing 🤓and a shot of Lantus.
 
#omnipod #animas #makediabetesvisible #t1d #travelingw/t1d

Life Support Fad

 A fad or trend or craze is any form of collective behavior that develops within a culture, a generation or social group and which impulse is followed enthusiastically by a group of people for a finite period of time.

More on track ...

I don't think about it much.  They are a part of him; his CGM and his pump.  When I see him, I see Joe.  The devices are a seamless blur on the backs of his arms.  They help keep him safe; alive.

I remember when he was three.  I remember when the choice was made to start him on the pump.  It was a mere three months after his diagnosis; maybe not even that long.  I struggled with that decision.  Between the meals and the snacks, between the needles and the blood, and between the monitoring and the carb counting... he looked typical.  There was nothing "visible" about the disease.  There were no reminders that he had a chronic condition.  He looked like his peers. Adding technology, adding devices changed that.

Joe has never felt the need to hide his diabetes.  He wears his pump and CGM where people may see them.  Sure he gets questions. Usually, he responds to them.  Sometimes, if he is focused on something else, he may divert the conversation elsewhere. 

Last week, while we were at the track meet where Joe learned about kidney-pancreas transplants...

I was timing with a group of parents.  Joe came over to me, to my purse, for money.  As he walked away, a parent commented on the "new fad".

Timing Lady: "What is this new fad?"

Me:  "What?"

I followed her line of vision, she was watching Joe walk away from us.

Timing Lady:  "I've seen a lot of kids wearing those, what are they?  ... on the back of his arms?"

Me:  "OH."  I then saw what she saw.  "My son is a diabetic.  That is his insulin pump and a continuous glucometer."

Timing Lady:  "I thought it was some new kind of accessory the kids were wearing on their arms."

Nah,  just life support.

The "craze" of sporting some life support in his day-in-the-life.

Oh YAY! A First!

In all our years in dealing with diabetes, we haven't encountered this one yet.  I knew we were due.  I knew someday it would happen.

Yesterday...

"I cannot believe I have to use ... th..i...s."

Joe spoke about it like it was a dirty dish rag.  He was disgusted by it.  Between the process of manually entering in a BG and the fact that his arm was tethered to it with "little-boy" lengthed tubing, he felt it was archaic.  

To hear him talk about an Animas pump so negatively made me feel like I was listening to gossip about my BFF.  I let him know the Animas pump was the only pump I was comfortable placing him on when he was a 3 year old.  I let him know those little, ity-bity basals of 0.025units/hr gave me peace of mind.  I let him know I did not like him talking about our first pump in this manner.  

 

 

So ... as you may be gathering by now... Joe's Omnipod pump failed yesterday afternoon.  As in failed, I mean it had a PDM alarm, I reset it, and it went into some sort of death spiral; the screen transitioned from the happy blue/green/white "Omnipod" screen -> then to an all white poltergeist-y-like screen -> and then to an all black screen.  A phone call was made.  Customer support confirmed my hunch, the PDM was a goner; a new PDM would be over-nighted.

Joe was horrified over the re-setting procedure.  He could not believe the proper procedure was to stick a paper-clip (or equivalent) end into the little hole at the bottom of the battery compartment. 

"What kind of a re-set plan is that, just to poke something around in that hole?"

"I didn't make the pump Joe, I don't know."

"OK".  

Meanwhile... an hour before hockey practice, at dinner time, I've got a 300 and double-arrow-upping Joe, who is no longer hooked-up to insulin.  We had to get a back-up diabetes plan initiated ASAP. Good times.  At first he was dead set against the Animas pump (an old one I've held onto), but shots did not seem to be acceptable either.  

After weighing his options, he decided to pump. He would only place a site in his arm; the only place he uses the PODs, as well.  Unfortunately, the length of tubing was from when he was like a 3,4,5,6,7,8, and 9 year old.  So,  with his pump in a pant pocket..and the site in his arm.. his arm is kinda limited in maneuverability.  This was not even close to optimal in Joe's eyes, but it's only for one day, he conceded.

He's been disconnecting for any sort of physical activity, you know...so he can like ... ah ...  use his arm.  

I did end up at his school today.  The pump lost prime; he disconnected and proceeded to prime out the entire cartridge of insulin; Right.Before.Lunch.  There was a sub-nurse at his school.  He was not about to let her inject insulin and he's never done it.  So he held off on lunch for an hour and waited for me to arrive to get his pump situated.

"My day was going good until this issue."

"What makes it so bad now?"

"I guess nothing.  You're right Mom, this didn't ruin my day ... but it is annoying."

 

Very true.  It's annoying Joe.  

 

It's right now 7pm the following day.  I guess overnight doesn't really mean overnight.  We don't have a new PDM here.  We leave for Quebec City at 6am on Friday for a hockey tournament.  I sure hope the PDM makes it by then.

 

A day-in-the-life of missing our Omnipod.

 

 

The Scotch Kind

I was only in the basement for 25 minutes, working out.

I came up to this..

An old POD site, oozing blood on our kitchen counters (makes you want to come over for dinner, doesn't it?).

I look over to Joe, who is manning the POD change.

Joe..'I couldn't find medical tape, so I just used the scotch kind.'

Nice.

A day-in-the life of a 12 year old boy with diabetes.

Patient Portuguese Pancreas Princess

There may be a little spittle on your screen if ya try to say the title out loud.  Truth, I am Portuguese (half, from my father's side).  Truth, Joe's misguided T-cells forced me into performing as an exogenous pancreas.  False, I am not patient.  And I am actually a "queen" not a "princess"...well, my name means "queen" in Spanish.

Sorry for the jibber-jabber.

This morning at 6:30ish...

"Is Joe up..."  (my less~than~subtle way of knowing he is alive)

"They are both still asleep." 

"Check Joe's number, the basal increase .. he was 127." (@ the 2am check)

Yesterday morning, I had logged Joe's numbers and noticed he had a consistent climb of about 50 points from the 2am check to the 7am check.  I think he is growing.  He is constantly eating bacon (don't ask).  I tweaked his basal from 2:30am to 6am.  I had to do the every-other-hour-thingy with the Omnipod.  I was not just gonna crank him up by 0.05 units for that length of time, because 0.05 is like 1/7 of 0.35 (what is that? like a 14% increase) ... with the Ping, I would have just cranked that bad boy up by 0.025u/hr, oh well.

Last night was my night to do the night check.  Dave and I usually rotate night checks.  He does the 2am check for two nights.  I do the 2am check for two nights...and so-on and so-forth.  We have been doing this system for a good year now.  Alternating every other night did not seem to let us fall back into the "habit" of sleeping through the night.  I have thought of a three night alternating schedule, but I fear the overwhelmingness of the the thought of three nights in a row of 2am alarms is psychologically detrimental and destructive to the checker-person. 

Anyways...

When I do the night checks, I wake-up early.  I set my alarm for 2am, but many times I wake-up at like 12:03 or 12:49 or 12:55.  And.  I just check Joe then.  And.  Yes, technically this is cheating my system that I so braggity McBragger-pantsed on my blog just a couple of days ago.

Last night...

I did it again.  I woke up at midnight.  I knew that I needed to wait til 2am.  I needed to get a good glimpse of Joe's numbers at appropriate intervals surrounding the basal changes.  So, back to bed I went til the 2am alarm.

What was he at 6:30am you may or may not be asking???  128.

A horizontal Portuguese Pancreas Princess raised her arm from her bed for a zestful celebratory pump, when Dave relayed the number.

A day~in~the~life of night time basal tweakage.

Limitations...

As much as Joe likes being free of the "leash", he has, at times, verbalized the pros of the Ping and the cons of the POD.  He continues to state that he prefers the POD.  However, his frustrations with the switch to the Omnipod have not gone unnoticed by me.  In particular the adhesion issues, the POD failures, and thus subsequently the added site changes.

My Dear Joe.. He rarely complains about the diabetes aspect of his life.  I'm not sure if he thought the POD would make it more like he did not have diabetes.  Granted it looks like "less" of a big deal than the tubing-ed pumps to an outsider, but "it", the POD, doesn't really take away the day~in~the~life of managing diabetes.  I think Joe is starting to recognize that.  It is difficult to watch.

A couple of evenings ago...after dinner time...

"I don't want to do a site change now ... can't you just do it at 4am?" Tears were pooling in his medial canthi.  I could hear the emotion in his voice. (Btw this is very, very, very uncharacteristic of Joe when it comes to site changes)

The POD would be expiring at 4am.  Apparently, Joe wanted me to just pop-up and change it at 4am.  He wanted to procrastinate on the POD change.  He was as close to begging, as one could be...without actually begging.

I held firm.

I explained that waiting 'til 4am wasn't a sound plan.

He rallied a bit.  We changed the POD.  He winced with the insertion.  Tears slid down his cheeks in pain? frustration?  defeat?  I'm not sure which emotion the tears originated from.

Then Joe reached for me, for an embrace.  He was silent as we hugged.

"I think Joe...I think what you are finding out...what we are figuring out...is that there is no perfect pump for managing diabetes.  No matter what pump you use, you still have the diabetes and all that comes with it...the site changes...you still have accessories in the form of bands or pump packs...you still have to check blood sugars ... count carbs ... bolus...you still experience the highs and the lows.  The technology doesn't take away the disease.  It's still there."

Joe nodded, his head still nestled into my neck.

A day~in~the~life of recognizing the limitations of technology.  It is not a CURE.

Laundry Detergent Aisle, Pet Store, Party City?

Last evening...

As the Schnauzer Party continued...with the post dinner~leash~tangling~excrement~depositing~and streaming~and~spritzling stroll around the 'hood.



I spared you the "depositing, streaming, and spritzling"

Me to Dave:  "The instant feedback from the DOC is invaluable." (most recently in reference to pumping insulin with the Omnipod)

As many of you know, we were having adhesion issues with the PODs.  The solution to date seems to be Skin Tac (Penny)  and a Band4Life (Marla...Thanks!).  Joe's PODs were falling off in the pool with Skin Tac alone.  I believe the "Band" helps keep the edges of the dressing down and prevents water seepage into and under the dressing.



Joe's Band4Life ~ The Orange Lightning (on his arm)

 

 

Onto all the other awesome Omnipod tips.  Now, I am not a doctor nor have I trialed all of these tips, but I am gobsmacked by the nuances of PODding.  Shopping in Laundry Detergent aisles, at Pet Stores, and at Party City for POD accessories has been recommended:

*....not sure if you're doing this already but I was told, when filling PODS, to leave Pod in tray and always, when filling PODS, to keep it on the right side of the PDM, with tray touching PDM.

 

* Also, (and I made a comment on your blog) PODS need to be filled to at least the 100 mark (NO LESS) or they'll fail.

 

*Hey there! Yes, I just put a sheet of bounce in the box with the pods. I read it somewhere else and figure it can't hurt. I have heard of some wiping the pod down with the bounce sheet, but I don't do that. I have sprayed her with anti static spray prior to a bounce house, but really we had NO problem at a bounce-y house and she is a crazy girl at those places. I think our static issue happened when she went down the slide and she also happened to be wearing a sweater dress that I had not washed before. (I always wash our clothes with downy fabric softener so that helps too.) I assume Joe won't be wearing any sweater dresses. (NikDuck)

 

*Ahhh, the joys of an active, podding, 10-year-old boy! I know them well! We often wrap Jack's pod with coban or "vet wrap." We buy it at PetSmart, because it's significantly cheaper there, and it's the same stuff they sell at pharmacies. Vet wrap comes in cool colors too: red, blue, black, purple. It works really well at keeping the pod adhered. Someone else told me to try spirit gum. Apparently, costumers use it to keep costume parts in place. I bought some at Party City, but haven't tried it yet. We've tried SkinTac, but it doesn't do much for Jack. The pods still fall off. The coban/vet wrap seems to do the trick, and Jack doesn't mind wearing it at all. Hope this helps! xo ~ (Heidi)

 

*In a pinch depending on how much insulin is in the pod you can suck it back out. I've done it a few times when a pod has failed right off the bat! It's against the rules of course...but I can be done! XO loves! (I'll leave this one Anon)

 

*Hang in there Reyna. We have pod "moments" too.  FYI. Apidra is only approved for 2 days in the omnipod...your script should be for a every 2 day change. Ours do fine with 3 days.  XO (Sara)

 

*About getting them to stay on in water: we had a big problem with pods falling off in salt water (not so much in pools), despite using Skin Tac before putting them on. We tried slapping on waterproof Tagaderm, but still no luck.  What finally helped was using the Skin Tac before, and then using another Skin Tac pad to soak the pod’s adhesive bandage afterwards so that it was soaked with Skin Tac and couldn’t take up water. Added strips of waterproof Tagaderm on top, and it stayed through 3 days at the beach. ~ (Kristin)

 

A day~in~the~life of gratitude for the DOC.  Thanks guys for helping Joe and I figure this PODding business out.  I am still not sure if I like it better than the Animas Ping.  Joe does though.  I guess, in the end, that is what counts.

Glad To Do The 4am POD Change?

We are currently having a Schnauzer Party.

You see we have Oscar (salt and pepper) and Henry (the black one) and we are dog sitting Cooper (the party mix).

A couple of nights ago... on Cooper's first night at our house...

I woke.  It was 4am.  It was my night off from the blood sugar check.  Dave was standing at the foot of our bed saying something about us having a "situation"; I think he said we had a "couple of situations" actually. 

"Joe's POD is alarming that it has failed and Henry has *expelled fecal matter* (not in those words mind you) all over his crate ... *then something was mentioned about the stench ... Henry's crate housing Henry resides in our room*"

This is where I was somewhat glad and not resentful that I know more about the PODs and insertions than Dave.  Dave had not done a POD insertion yet.  He had only watched Joe and I do one. 

I volunteered for the POD change and left the soiled crate and canine to Dave.

A day~in~the~life of our nights with diabetes and dogs.

Dog Food Arm

"Here it is...you can get it in different sizes to wrap up their paws."

"Ahhh...it is for my son ... he has diabetes ... it is to secure his pump site ... cheaper than the human stuff..."

So...I was at Pet Food Warehouse a few days ago... buying Vet Wrap (thanks Heidi) to secure Joe's POD until the Skin Tac arrives (thank you Penny) and the Band4Life ships (thank you Marla).

His arm is now covered in this green polka-dotted dressing and smells like dog food.  Not exactly what I had in mind when we switched to the POD, but I am still trying to remain positive and upbeat.  Not to mention we have gone through nine PODs and a whole vial of insulin (you lose the insulin that you put into the POD with site failures/losses)  in just under two weeks.

Site failures and losses aside, we had a successful week at hockey camp.  Originally, Joe's and my plan was to have him call me with blood sugar numbers and we would handle bolusing over the phone; he keeps a phone in Woodchuck for this purpose.  A couple of days into camp, I realized that a full day without some outside help was not a safe plan.  Hockey camp consisted of  two hours of dry-land training in the morning (soccer and field games).  Lunch was consumed at 10:30 (a huge issue for us, as his ratio at that time of day is usually a 1:60 to put the brakes on his 1:10 breakfast ratio).  After the 10:30am lunch, Joe would head out on the ice for 3.5 hours of drills and scrimmaging.  Each day I packed the same lunch.  Each day Joe would have 26 grams of Gatorade carbs (2 of the G2's) for "free"... I have no idea when he drank them.  Here is how the week went down:

Monday:  First day of camp.  I went into the locker room to meet the coach.  I explained that Joe had Type 1 Diabetes.  I asked if the coach had any experience with diabetes.  He did not.  I basically stated that if Joe started acting grumpy, lethargic, became shaky, looked dazed to have him drink a juice and call me.  I stated that Joe needed to have Woodchuck with him at all times and that Joe must be able to call me at any point during the day to discuss diabetes management. 

Joe was listening to the conversation and chimed it with a "what about the glucagon?".

"I think we will just go with a simple 911 call Joe".

I then explained to the coach that if Joe were to pass out or have a seizure to just call 911 (ya know, most likely the camp protocol anyway).

Monday's numbers and care went like this:

7:11am 230 (wake-up number).  I gave Joe 10 of his 30 breakfast carbs for "free".
8:01am 286 (camp drop-off number).  I reduced Joe's basal rate by 40% for 6 hours.
9:08am 256 (not sure why Joe checked here, he did not call me with this one).
10:21am 183 (pre-lunch number).  Joe had 20 grams of his 100 grams of lunch carbs for "free" and no correction.  The first day, he received 3.5 units of insulin for lunch.
1:07 pm 70  (Joe felt low during ice time).  He drank a juice (15 grams) and I had him eat 2 glucose tabs.
2:53pm141 (camp pick-up number).  Joe's POD had failed 1.5 hours prior and had not been delivering insulin.

Tuesday:

7:17am 98 (wake-up number).  10 of 30 grams of breakfast carbs were given for "free".
8:18am 201 (drop-off number).  Basal rate was reduced by 40% for 6 hours.
9:12 am 179 (Joe checked.  No call to me... not sure what he was feeling here).
10:24am 86 (pre-lunch number).  I just started subtracting insulin dosages at lunch time based on the previous day's data.  So we went with 3 units instead of 3.5units to cover the 100 grams of lunch.
2:47 pm 54 (pick-up number)  Welp.  My plan needed revision.  Joe did not notice his low while skating, so he did not come off the ice to do a check.  He agreed that I should come to do a routine blood sugar check during his ice time for the remaining days of camp.

Wednesday:

7:19am 77 (wake-up number).  Again with the 10 of 30 grams of breakfast carbs for "free".
8:18am 144 (drop-off number).  Again with the 40% basal reduction for 6 hours.
10:28 am 65 (pre-lunch number).  Juice (15 grams of carb) chugged by Joe and then he called me.  I had him eat his lunch without waiting for 15 minutes ... I told him to bolus 2.5 units after he ate lunch (I subtracted another 0.5 units from his previous day's lunch bolus).
10:49 am 139
12:58 pm 257 (Me checking Joe while he was on the ice).  I did nothing with this number.
2:51 pm 191 (pick-up number).

Thursday:

7:28am 137 (wake-up number).  Yep.  You guessed it.  10 of 30 grams for "free" for breakfast.
8:22am 203 (drop-off number).  Basal decreased by 40% for 6 hours.
10:34am 91 (pre-lunch number).  I stuck with the 2.5 units cuz that seemed to work on Wednesday.
11:05am 73 (Joe felt like he was "dropping").  He slurped down a juice (15 grams of carb) and then called me.  I told him to eat two glucose tabs as well.
12:51pm 150 (Me checking Joe while he was on the ice).  I gave him two glucose tabs.
2:48pm 300 (pick-up number).  Oopsie.  Should not have given the two glucose tabs.  And.  Nice.  Let's just add in another POD failure at 2:30 for some added fun.

Friday:

7:22am 117 (wake-up number).  Same...10 of 30 for "free".  Basal decreased by 50% for 6 hours.
8:26am 170 (drop-off number).  Glucose tabs x 2 given.
10:38 am 88 (pre-lunch number).  I subtracted another 0.5 units from his lunch dose.  So 2 units of insulin were given to cover 100 grams of carbohydrate consumed for lunch.  Joe's usual lunch ratio is a 1:18.  Impressive.
1:02 pm 194 (Me checking Joe while he was on the ice).  I did nothing with this number.
2:52pm 90 (pick-up number)  Booyah.  Only took me all week to figure out hockey camp.  Ugh.

I believe the consistency of food in type and amount of carb grams and the predictability of activity made this week manageable.  I've said it before and I'll say it again, Diabetes loves, loves, loves routine.  Joe did ask me on the third day if he could get lunch from the snack bar.  I told him "no".  With this amount of activity I was uncomfortable with "unknowns".  He did not grouse about it much.  He understood.  This was a huge accomplishment for us... not only numbers-wise, but in flexing some independence muscle in dealing with diabetes in a complicated situation.  It was a successful week indeed.

A day-in-the-life of managing fickle D' with my son Joe, who happens to have Type 1 Diabetes.

Drowning Out The Beep

"Just crank up the radio Mom ... you know ... to drown it out."

Dear Lord the BEEPING.



The Lumineers' Stubborn Love was cranked up a few levels.  The beeping was still piercing my tympanic membranes as we headed home from Joe's first day of Tim Thomas Hockey Camp...yesterday.

The POD, according to the alarm history, had stopped delivering insulin for about an hour and a half prior.  Joe could not hear the alarm, as his elbow pads and shoulder pads and helmet all must have muffled the sound.

Once we arrived home, I placed a new POD.  It was filled with about 100 units of Apidra.  Joe then headed for his All Star baseball practice.  He came to me during practice.  He felt the adhesive pulling as he threw.  I slapped some IV 3000 over the dressing edges of the POD.  About an hour later, he lost POD #2 at the pool.  UGH.

I dropped Joe home and headed to the pharmacy.  I could not bear to put in another one of those things without a different plan.  So, at the pharmacy, I didn't find much help.  I bought some "waterproof" tape.  So Joe's current POD is in and secured with waterproof tape all around the edges.  So much for "fitting in" between the freakish beeping and his mummified arm ...this thing is requiring a lot of extra support right now.

I texted our Omnipod Rep.  She recommended Skin Tac; samples are on the way. 

Despite site issues, Joe's numbers have been steady (like 70 to 171 kind~a~steady) even with 3+ hours on the ice and dry land training.  His basal has been decreased by 40% for the 6 hours he attends camp.  Breakfast is lightly bolused for (10-15 grams of it given for "free").  20 grams of Lunch is "free".  And an extra 60 grams of carbohydrates are consumed throughout his 6 hour camp day in the form of Kashi bars and Gatorade. 

Joe calls me with each blood sugar and we discuss the bolus amount.  He has to call me from the warm room as there is no cell service in the rink locker rooms or ice-side.

A day-in-the-life of drowning out the beep and taking diabetes to yet another hockey camp.

I Offered Him Some Baby Oil

A week ...or so... ago .... while at the local pool...

I had met a POD Lady thanks to my friend's astute eye in detecting diabetes paraphernalia.  Chairs and children were immediately navigated in order to make initial contact.  I asked the said lady if her "device" was an Omnipod; she confirmed.  I shared that my son was going to try out the POD in a few short days.  That was about the extent of our first encounter.

A few days ago... again... at the local pool...

"I'm looking for the bulge...look for a bulge in her suit...I think that is POD Lady." ~ Me to Dave.

It was her, confirmed by the bulge.  I, of course, made a bee line her way.

I updated her on Joe's POD start.  She gave me a tip that she dries off her POD every 30 minutes or so, while swimming.  I listened to her diagnosis story.  She let me know that the insertion needle on the POD doesn't retract fully and can prick if the POD user bends the POD-ed area a certain way.  During her diagnosis story, I immediately identified her "trigger" to beta-cell demise; a first she stated...that someone "got it".   I asked her about a possible "over-ride" function to suspend the beeping alarm that the POD makes when it is time for a POD change.  She stated there was no such function.  I thanked her for putting up with me.  She got it.  She gets it.  Her response was "it can be a lonely way of living."

I'm sure when she spots me in the future she will experience some sort of Cop Theme Song thought-feed with the lyrics of  "POD Mom, POD Mom...whatcha gonna do?  What ya gonna do when she comes for you?" 

Onto the POD...

Joe loves it.  He loves it for the freedom.  He is currently taking a little Dexcom break to enjoy just living life with only the POD. 

I am liking it as well.  I like the built in glucometer that uses Freestyle test strips.  The blood need is so minimal compared to the One Touch.  I like seeing my son free from tubing and free from a fanny pack.  I like seeing him "fit in".  Of course he "fits in" in a social sort of way, but it is nice to see him look a little more like his peers.  I know that probably is wrong to say, but it is truthful.

What I am not liking... first off I think I have an "over-ride" issue to add to all my issues.  I don't like that I cannot just change the I:C carb ratio during a bolus.  There are times that Joe may eat breakfast a little late (his breakfast ratio runs in the range of a 1:10 to a 1:12).  His morning snack ratio is a 1:60.  With the Ping I could just alter the I:C ratio before giving the bolus and the pump would re-calculate the bolus for me.  With the POD, I have to calculate out the bolus with ... like ... using MATH.

The other issue... ADHESION...



The POD adheres remarkably well (see video), except when Joe swims.  We almost went through two PODs in one day, due to swimming.  The second site was saved by a very~still~Joe and IV 3000.  Any suggestions for adhesion and swimming?  Torbot Skin Tac?  Mastisol?  Hollister Medical Adhesive?

A day-in-the-life of being a POD mom.

Losing The "Visible" LEASH

While "Cutting The Cord" has a nice ring to it, I think perhaps they could also name it "Losing The Leash".  Joe switched from the Animas Ping to the Omnipod yesterday.

 



 

Originally ... six and a half years ago .... when I chose a pump, I was making that choice for a three year old.  I was making that choice for a three year old on very minuscule amounts of insulin.  I chose Animas because of the pump's ability to give basal insulin in 0.025u/hour increments.  I also recall there was some IOB issue with the Omnipod at that point, as in ... it.didn't.keep.track.of.it.  We have been happy with the Animas Ping: great customer service, minimal site loss, minuscule amounts of insulin delivery.  What I did not love about Animas was how Joe almost off-ed himself on accident, by inserting a full cartridge that was connected to his body into the pump with fully advanced piston, while he was at school...not the pump's fault at all...user error, but still scary.  We also had some "loss of prime" issues, which actually led to the previously mentioned almost off-ing himself issue.  Joe was trying to fix the pump issue at school and did not want to embarrass himself by disconnecting the tubing from the site, which was inserted in his butt cheek.  All-in-all though, we have been loyal Animas users.  Joe wants to try out life without a fanny pack strapped around his waist.  Joe wants to try a life without bulky plastic-y devices shoved in his pant pockets.  I understand.

So...here we are...here I was yesterday...pre-programming the Personal Diabetes Manager (PDM) for our pump start.

With the Omnipod, the basal increments are in 0.05 u/hour.  So, I currently have like 15 basal rates going (yes...head is hung down in shame).  There are two areas in Joe's day where his basal rates were at 0.075 u/hour and at 0.125u/hour.  I was not comfortable just cranking him up or down by 20 to 33% of his current rates.  I decided to do the back~and~forth basal thing for those increments in time (i.e. 9am - 0.15u/hour, 10am - 0.1u/hour, 11am 0.15u/hour).

Joe has never inserted a pump site on his own during his history with diabetes and pumps.  Yesterday, during his pump start, he did it.  He drew up the insulin.  He filled the POD.  He cleansed the site area.  He adhered the POD to his body.  He pressed the button on the PDM to "insert".  We hugged...yet another "first".

After the pump insertion, Joe went back to the lobby of the clinic.  There are computers out there.  The Rep and I continued to go over pump questions.  As  I was scrolling through the "temp basal" section of the Omnipod, I asked why it only went up to a 95% increase in basal.  I was explaining that I would crank Joe's basal up by 125% on the Animas Ping for road trips.  I wanted to show her what the temp basal program looked like on the Animas Ping...  I then realized that we had just sent Joe to the clinic lobby hooked to two pumps!  His Ping AND the POD!  Oy!!  I ran out and had Joe remove the Animas pump and his Tallygear belt.  He smiled and simply stated "Freedom".

Back to the temp basal...so I showed the Omnipod Rep the Animas pump's temp basal program.  She stated the POD could not go over a 95% increase.  I'll figure that out with bolusing or making a new basal program for travel days.

Now that Joe is "free", he is requesting a break from Dexcom.  He doesn't want to be tied down by carrying the receiver.  I have been quite liberal with Dexcom "breaks".  I told him that I preferred he wears it, but he doesn't have to wear/carry the receiver all the time.  He's been tied down to equipment for 70% of his life.  He is respectfully asking for a little break.  I get it.

A day-in-the-life of loosing the visible leash...the invisible leash remains, DIABETES.