Diabetes: Giving Up Control To Get Control

Starting 2018 with much needed changes that I made at the end of 2017. Asking for help, giving up control to get control. 

This is me - except my hair never looks this good or this effortless. 

After my last Endo appointment in November; struggling to lower my A1C; (it's stubbornly stayed at 7.4 since July,) lower my daily insulin intake and drop weight, I decided to listen to my CDE., give up some control and let her and my Endo look at my numbers and make changes. 

And as long as I’m being honest, I was scared shitless to upload my Omnipod’s PDM to Glooko (which comes with Omnipod purchase,)and have my CDE and Endo access my info. 

Even though I have a fantastic and incredibly supportive relationship with my Diabetes Team,  old fears die hard, and I was afraid of being judged and shamed - even though my CDE & Endo have never done either. 

My diabetes team is amazing - and I know how lucky I am. 

But it’s amazing how old shame and guilt can rear it’s ugly head and cause you to NOT get the help you need. 

Showing my numbers would mean showing my flaws - which of course I have - and I know my HealthCare professionals know I have them - but now those flaws, were going to be print and available to share via Glooko. 

Also, lets talk about the the whole "control thing." 

There’s so much we can’t control on life… and our life with diabetes. 

Like you, I work hard when it comes to diabetes - and I still wasn’t getting the results I wanted. 

My a1c wouldn’t budge; I’d only lost a couple of pounds and I don’t eat huge carb filled meals very often - all incredibly frustrating. 

What I was doing wasn't working - I was taking much more insulin that someone my age and size should be taking.

I needed to give up my control in order to get the control I need and crave. 

I sucked it up, took a deep breathe and did what I was asked. 

My first round consisted of uploading/ sharing 2 weeks worth of numbers, followed by a second round of uploading and sharing 12 days worth of numbers  - and apologizing for my sucky numbers. 

4 days later, my CDE responded in the greatest of ways: 
“Kelly, please don't ever apologize for your blood sugars. You're obviously putting a lot of work into this. And these two weeks are much more stable than what we saw in the last upload. 
You aren't staying high, you work hard to bring the BG back down.”

She also told me that I was actually doing too much work  - for the results I was getting. 
Her words literally made me cry tears of joy and I posted about it on fb and twitter.

Her response motivated me to take her suggestions to heart and actually make them. 

My CDE was convinced that I was utilizing too much basal and too little bolus and wanted to closely mimic my old, "less insulin" pattern with a few changes to simplify things. 
She made drastic changes to my basal, carb ratio, and correction factors and said that if I wanted to wait until the holidays were over to make the changes, I could. 
I didn't want to wait put them into practice as soon as I received her email - 5 days before Christmas. 

The changes were immediate. 
My first 5 days (including Chinese food for Christmas dinner with my family because none of us felt like cooking,) resulted in daily insulin totals between 10 and 13 units LOWER per day, than my old settings. 

On day 6 the cold; sore throat, congestion, and cough that had been brewing in my system went all mock 5 and I caved. Setting elevated temp basal rates. 

Here’s the kicker: Even with higher temp basal for sick days, I was still taking between 6 and 10 units less on those sick days than I would have been with my old settings. 

And I’ve lost 1.5 pounds. 

MIND OFFICIALLY BLOWN.

Things I've Learned/Been Reminded Of

This experiencereinforced that I don’t know everything, can be too proud for my own good,  

and that I’m not great with change, even when it brings good things. 
I'm glad I moved out of my own way, shared my numbers with my team and took their advice. 

I need to upload my next round of numbers at the end of the week and will embrace what ever tweaks are required. 

Bottom line: Change can be hard  - even when it’s good. 
Admitting; asking, and taking help isn't easy. 
IN 2018 I’m embracing change and those who help me make the changes needed to become what and who I want to be in my life…. and my life with diabetes~ 

My Omnipod Experience - Part 2

Yesterday I wrote about part 1 of switching things up and starting the Omnipod. 

Today I share part two of my experience, where I discuss the stuff I love about podding - and the stuff that takes some getting used to. 

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The Stuff I Love

Swimming in the ocean with my Pod - I LOVE IT.

Not having to disconnect, and more importantly - not worrying about the contortion issues re: access to my pump site to reconnect after swimming - which for some reason, was always trickier for me, is freeing in all dimensions. 

The same goes for showering without disconnecting and sleeping naked if I so choose. 

Also: YAY!!

Wearing dresses and not having to wear bikes shorts or pump garters - makes things so much easier. 

I still have to deal with Spanx on occasion, but at least I don't have to worry about dealing with infusion site issues!

Access/Utilizing Arm/Leg Sites Is A Game Changer 

I could never navigate arm sites with my tubed pump and the thought of getting tangled in tubing freaked me out.

Every time I tried a thigh site with my previous pump, they had a limited shelf life and normally only worked for 24 to 40 hours before crapping out. 

Thighs = high access area and the tubing was continually being pulled, yanked, etc. 

With Omnipod, I’m able to wear arm and thigh sites for three days and that makes my life with diabetes easier. 

Scar tissue was a huge issue with me on my previous pump and is the primary reason I chose the Omnipod. I was changing out my site every 30 hours - that’s no longer the case and I’m thrilled. 

Good To The Last Drop

Most of the time I’ve been able to use all the insulin in my pod - that wasn’t always the case with my old pump reservoirs - which normally would be less efficient when the reservoir went below 30 units.

Cool Techno:

When you activate your new pod on your person, the PDM tells you the exact date and time it’s supposed to expire, based on your personal pump settings and insulin amount.

My pods run low on insulin between 3 and 4 hours earlier. 

That’s not on Omnipod issue, that’s a Kelly issue - yours truly needs to do some MAJOR basal rate testing, which I  didn’t want to consider let alone  attempt until I was wearing new diabetes tech. 

Basal Testing is now on the horizon. 

Loud Alarms

 The first time my 15 unit Low Reservoir went off, my PDM was in another room and I thought it was my smoke detector.

The PDM & Pod do their priming dance BEFORE you put it on your body.

Cool Software 

I can download the Omnipod PDM to Glooko, making it easy for my CDE to access all my PDM info: Carbs; blood sugars, basals, carb ratios, etc. 

This should allow for easier tweaks and I'm looking forward to giving it a try.

Blood Sugars

4 out of the first 8 days, my daily 24 hour insulin intake was 10 to 12 units lower than my old “low side” of normal. 

That still seams to be the case 36 days in - sans elevated bg's due to a couple "dead sites," and the summer cold that's been the bain of my existence for the past week.

Facing Fears 

I have officially conquered arm, thigh, calf and love handle infusion sites. 

day 18 (and for the first time, ever,) I attempted a back /love handle site, it required some major twisting on my end, but mission accomplished!

BONUS: Great numbers with that never before used real estate space.

I tried an inner side calf site - it was easy but I had absorbtion issues. 

I’m going to try the back of calf to see if works better. 

Still have not tried back or front belly sites. 

I’ve decided that before I give my abdomen areas a complete break, I want to see how that area works with the omnipod verses my old pump - I haven’t done it yet - but I will. 

Issues /Learning Curves

The only insulin pump delivery system that’s 100% perfect is a fully functioning pancreas. 

I don’t have that - same goes for many reading this post. 

Andit makes sense that changing pumps = dealing with some issues and learning curves 

as I learn to navigate wearing/using the Omnipod insulin delivery system.

Bad Pod/Bad Pod sites 

Dealing with Pod failures and insulin reimbursement issues. 

Unexpected Pod Change Out On Day 2 of Wearing My First Pod  

I wasn’t thrilled, but shit happens - how many times did I rip my old pump's tubing out by walking by a door knob or getting caught on my car's emergency break? .

Answer: ALOT.  

Anyway, everything was working great with my first official pod (left arm,) the first 27 hours. 

Then I started noticing blood sugar spikes that wouldn’t come down, no matter how much I corrected. Something was up and the top of my pod looked uneven. 

I called Insulet's Customer Service and the Rep and I spent almost an hour on the phone. 

I told him my issue, answered a series of questions, emailed the Rep pics of the pod on my arm so Insulet could study the issue and send out a replacement pod.  

The Rep also talked me through my Pod change - it was only my second time and I was a little nervous - but it was easy and he was patient. 

CS Rep and I discussed the insulin reimbursement program - 7 cents per unit (OK, it’s something,) with an insulin receipt and 5 cents per unit without.

I emailed a photo of my insulin receipt from my pharmacy and via my phone to Receipts@insulet.com. 

Insulin Reimbursement takes up to 6 weeks to be approved and payment received. 

  

There’s two different procedures - one for dealing with a bad pod and or bad pod site, another dealing with insulin reimbursement issues - that can get confusing if you're new to  podding. 

I’ve learned to take notes and jot down the the case numbers for both, along with the date and the name of the CS I spoke with. 

Follow up

I’d like the follow up fort the insulin reimbursement (it takes 6 weeks,) to be better. 

I’d like an email to be sent saying they received my email and receipt photo and are working on my case.

Sidebar: My second pod (on my right arm,) stayed put for 3 days through daily showers and body surfing in the Atlantic, no problem.

ALWAYS follow up

7 days post my first pod site failure, I called Customer Service to check on the status of my insulin reimbursement and found out the wrong report had been filed.

The new CSR rectified the situation, immediately - and yes, I followed up to make sure.

Day 24 - Pod Failure Alarm

PDM called a Pod Failure while said pod was in Prime Mode and not yet attached to my bod. 

FTR, I liked and very much appreciate that the PDM recognized an issue with the Pod BEFORE it was officially up and running on my person. 

I called CS, they asked me some questions and then told me they’d FedEx me a new Pod. Filed both a failed pod report and insulin reimbursement report. 

This time, the phone call took less than 10 minutes and I received my replacement pod 

3 days later. I returned the failed pod to them in the package and shipping label Omnipod included with my replacement pod. 

All in all, I'm learning and going with the curve~

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Embracing Something Different 

Change is difficult - even when it's good. 

Diabetes or not, we get used to doing things a certain way and I love that going with the Omnipod is helping me knock down my walls when it comes to embracing change in life... and life with diabetes.

 I wore a different brand's insulin pump for 15 years, I knew the idiosycricies of that pump brand like the back of my hand - I was losing real estate because of scar tissue and I needed to switch things up - so I did. 

So far, I’m glad that I made the change - and I 'll keep sharing my podding experiences with you guys - The good, the bad, and the diabetesalicious of it all. 

And if you have any questions - ASK! 

My Omnipod Experience - Part One

Learning and discovering new things every damn day and glad that Insulet gives us 45 days to figure it out. 

There’s a learning curve when it comes to wearing the Omnipod, but so far it's been good - except for a few hiccups along the way.

I’ve taken copious amounts of notes - so many notes that I had to divide them up into two posts!

Part one is below and I hope you enjoy!

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So this happened!

Day 1: Omnipod training with my CDE went well and I'm officially untethered!
Wearing pod on my right arm. It's weird not being tethered to my electronic pancreas ,but in a really great way!

Also, discovered that I walk freakishly close to the edge of door frames.

Seriously, why have I not realized this about myself before?  
Another also, since noticing this Kellyism, I have become better at not slamming into door frames.  

Day Day 2: Experienced absorption issues 27 hours into wearing with perfect numbers up until then. I was the wearing the pod on my arm - the one I kept banging into door frames. 

Called CS and replaced pod. More on that in part 2.

Day 5: I swam in the Atlantic ocean with my pod for the very first time - it was fantastic!

Also, it stayed securely on my person - muddy legs and all. 
Also: AWESOME. 

Actual aerial footage of my and my pod about to
go in for a dip in the Atlantic~

Day 8: I left my PDM/case on the table in a restaurant that I had just exited. 

I immediately noticed after checking my hand bag (to make sure I had my PDM,) and ran back in to retrieve it - and all the while silently praying to the Diabetes Gods that it was still there. It was and I was grateful - it has not happened since. 

Day 9: Wearing the pod on my left arm - it's working well, but I'm aware of my pump whenever I twist to exit my vehicle. 

Day 17: Getting the hang of podding and no longer waking up and reaching to check if my pump is attached to the waistband of my Pajamas. 

Same goes for reaching to disconnect every time I walk towards the bathroom to shower.

Day 35: OK, every once in a while I Still grab my waist band to disconnect before taking a shower - old habits die hard.

Maybe it’s just me

For the first few days, I kept confusing my PDM with my iPhone and whenever I was trying to take a picture of my PDM screen. 

I’d stare at the screen for a few seconds, all confused as to why I couldn’t take a screen shot. 

Unlike an iPhone you can’t take a picture of the PDM screen with said PDM and no matter how hard you try and attempt to press Home button and the nonexistent Silent switch. 

No matter how hard one tries, you cannot take a
screenshot with your PDM.

But you can customize your PDM~

Day 33 and since I'm being balls out honest, sometimes I still grab my iPhone when I mean to grab my PDM and then wonder "why" and out loud when I press the "Home" button and start to bitch out load because I can’t scroll down.

Then I realize why and I feel like an idiot. 

Spacial Issues

I still have them, but instead of doorknobs and edges issue with pump tubing, arm pods and door frames have become my new jam - literally.  

like I mentioned earlier in the post, for the first few days of podding, I banged my pod arm into my kitchen and bedroom door frames more often than I’d like to admit. 

Now, I'm specially more aware of my surroundings - at least when I'm wearing the pod on my arm. 

Black on Black pump skin 

PDM came with a black Skin. Black PDM + Black Case/ Black Skin means the potential for misplacing is an issue because diabetes or not, I am extremely nearsighted - there's a reason I avoid handbags with black lining and my wallet is not black for a reason - I can't freaking find anything in a blackened handbag - especially a black wallet.

Also, I've put aqua blue K-tape on my black remote control for the same reasons.

My Fix

I have a collection of several brightly colored and insulated, 3 and 3/4 inch X 7 inch, makeup bags. I use one of these bags daily and rotate whenever the mood strikes. 

Currently the one I'm using has owls all over it  - and people stop me every damn day because it's so cute.

 I always put the PDM (and my canister of teststrips/lancets because the PDM also acts as a meter,) back in whatever bag I’m using, ASAP and without fail.

It's now become a full fledged habit - and it didn't take 30 days!

When I go out, I put the PDM, spare pod, test strips,and insulin in said makeup bag, and place in my handbag/work bag. 

Sidebar: Lipstick, eye-drops, my driver’s license and a credit card also fit in the bag along with all of the above mentioned - VERY IMPORTANT.

Also, recently started using bright green skin for the PDM because it brings out my eyes  - but I still bag it~

Owl bag because functional and very cute!

Tune in tomorrow for Part 2, where I break down and get to the nitty gritty re: what I love about podding, as well as the learning curve when it comes to being a Podder~ 

Diabetes, Pointing Fingers And Switching Hands~

 I check my blood sugar a lot  - a hell of a lot. 

And for some reason even though I’m left handed, I prefer to use my left pointer finger when I check - which doesn’t make sense, and I'm totally aware of that. 

Today I looked down at my keyboard and took a good look at my dominant hand against the silver and black of my laptop. 

My left pointer finger looks like a dirty, Jackson Pollack wannabes
attempt at body art gone wrong.

My little hand (did I mention I have freakishly small hands?) was riddled with so many lancet marks and covered with calluses, that the tips of my fingers actually looked dirty, even though they were scrubbed clean. 

And my left pointer finger looked like a dirty, Jackson Pollack wannabes attempt at body art gone wrong. 

And right at that moment I knew that I had to stop checking my blood sugar on left pointer and middle fingers. 

And so that's what I'm going to do.

It's funny (and little weird for those sans D,) that people with diabetes develop certain habits when it comes to our diabetes. 

Things like developing favorite sides for infusion sites and preferring certain fingers or hands when we check our glucose. 
Part habit, part comfort, part, superstition? 
Who the hell knows?  

Having to change things can be strange, no matter whether it's changing insulin pumps, switching insulin brands, or using different fingers to test our glucose.

But eventually, we do because we have to. 

And so I am~  

Sidebar: Does anyone know a good left handed guitar teacher because I've already got the calluses down pat!