Tag Archives: animas

23Apr / 2013

Bad. Worse. Worst Possible.

Animas-Ping-in-Water-1

The Purple Happy Friends could represent almost anything. The fish tank definitely represents a toilet.

Toilet.

Even if poop there already, still room for pump. It gravity law. Help! My pump fell into the toilet and I can’t get it out because there’s poop in there! (I’ll get Daddy.) Moment later Daddy walk toward Bigfoot, pump on towel held in front, tubing still connected naked Bubs, three people stand stare at each other/pump in hall wonder what next.

Answer is 1) disconnect from child 2) alcohol swipes 3) wash hands 4) reconnect. EXTRA CREDIT: change tubing/moisturize.

(Also: yay Ping! <–When Blues Clues man Ping promotional video demonstrate waterproof, kiddie pool = euphemism for shit-filled toilet.)

Doubt.

photo

For calibrations: split the difference?

Love VerioIQ because headlight. But lately trip over many mentions VerioIQ legendary unreliable/reads high. Sort of with tone of “everyone already knows that this is a cool- looking meter but that it doesn’t actually work.” Then notice in own life so often VIQ way higher than Dex which—while perfectly appropriate blood meter few hops ahead interstitial fluid meter yadda yadda yadda—just make Bigfoot doubt veracity whole operation.

Dex display blood drop icon; calibration: DEX 112/VIQ 150. Enter 150. Then Dex 137. But kind of want tell Dex you know VIQ is exaggerating, right? I mean, that’s part of your algorithm, right? Maybe it Bigfoot job downgrade VIQ#—especially when calibrating.

Very unwise read Amazon reviews VIQ (notice no link) because quickly devolve into person saying tight control not matter, can attest because experimental chemotherapy drugs injected into his (plural body part) (periodicity) for (famous diabetes problem not cancer).

For now, Bigfoot hope VerioIQ not any more unreliable than any other meter, because approx. 1,000 test strips in closet.

Death.

Over course of past 19? months, Bigfoot slowly convinced T1D = huge hassle but not so, so scary. Today Riding On Insulin fundraiser email arrive w. theme Jesse Alswager. First time heard name. Google show 7th grader obituary, “died from Type 1 diabetes.” What/how? More google, online discussion, other D-parents so sorry ask, but wonder why dead, what #, what ketones, what-what-what. Then this:

“There is nothing to really tell you other than the autopsy really proved nothing. He bolused insulin at 11:00 am on a morning that felt like nothing different. He said he wasn’t feeling great and wanted to stay home. I figured it was because he and I had stayed up late and watched Kindergarten Cop laughing the night before. When his dad came to pick him up he found him slumped over his bathroom sink at 3:30. No time for a coma. No warnings. No vomiting from ketones. NO NOTHING.”

Bigfoot never hear of this. Not only not hear of healthy-fun-adorable Jesse Alswager until today, but also not hear of child just die no reason/no DKA/no hypo. Cardiac arrhythmia like ____ in bed or other thing or what? So so so so sad. Also so curious. Jesse Alswager’s mom JDRF activist/ROI Director of Development w. blog here.

Maybe nobody mention Mystery Deaths because nothing to do except feel terrible which proven 100% ineffective against death. Also maybe because anybody D or no-D could die Mystery Death, impossible prove T1D as cause? But. Oh. Jesse.

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10Sep / 2012

Bubble Puzzle

Why are bubbles still forming in my cartridges?

It not only Bigfoot cartridge—Bigfoot Spouse cartridge same issue. Pertinent bullet point:

  • Current vial insulin room temperature 8 days before fill cartridge
  • Spend Great Deal time flick, press out bubbles, examine by bright light until really, really sure cartridge look pure water, no fizz, no speck
  • Change cartridge every other day. More if Bubs crazy high

Over the course of 45 hours, several problem areas have developed. I included this picture in full size to illustrate the enormity of the bubble issue. Is the knot relevant? There’s not usually a knot.

Promise, promise bubbles not in cartridge when insert freshie into pump. Few hypotheses:

  • Some wrong thing with how Bigfoot attach luer lock? Always feel overly casual–no click. Just tighten as much as desired? Maybe this when air happen. Maybe not tight enough
  • Could be problem of fill 200u cartridge only 100u?
  • Too much back/forth with plunger while try purge air—>could introduce air?

Bubbles! Bigfoot wish eradicate bubbles.

This happy man recommend tap tap tap while load cartridge, tap tap tap while prime tubing AND/OR fill cartridge night before, purge air bubbles next day after bubbles have chance accumulate/merge. Hmmm. Bigfoot will try. Also like this tip from UK bubble discussion board: I just make sure that the pump is always upside down when in use so any air bubbles I’m unaware of float to the opposite end of the cartridge away from the entrance to the tubing <–bravo for clever! Would be good consideration for future Ping clip designer.

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16Jun / 2012

Combo Bolus Premier

there used to be a picture of a bag of Combos here. the pretzels.
The silver Ping has a special kind of bolus just for Combos.

First time Bigfoot try combo bolus. Barely know what is, but know diabetes people often mention use combo bolus for fatty meal. As if on cue, Bubs order fatty classic: cheeseburger + fries. As if on cue too, Bigfoot bust out pump remote for BOLUS screen: NORMAL(no.) EZCARB (nope.) EZBG (nuh unh.) COMBO That one.

One nice thing about these boys is that they eat a normal amount, no matter how much is heaped on their plates. That leaves plenty of fries for the parents who ordered a miniscule goat cheese pizza and side of broccoli rabe.

Bigfoot pretty sure safe predict Bubs consume at least 45g (20 for bun? 25 for handful fry?). Bravely choose COMBO. Before plate arrive! Not need read instruction manual. Not need see actual food. Cool like that. Intuitive.

COMBO BOLUS only want these facts:

-how many units total 3

-how many units immediate 0

-how long for leak out remainder 30 minutes

This just baby step toward true combo bolus. But baby step lead to baby fist pump! 169 at bedtime.

Later watch American Ninja Warrior Kyle Cochran episode. $1.99 on iTunes if not get HD. (HD $2.99.) Northwest Regional Finals is Kyle Cochran episode.

So worth it! Same Animas Ping! Same meter, meter case. What this? Same cartridge pack wrapper! OMG! Same cartridge inside, with same blue plunger! Same cartridge cap. Same twist motion for attach—clockwise. Camera cut to shot of “Kyle’s Mom” and it Bigfoot’s same mom. For moment, very difficult find this man online. Only place is on Kyle fan site. Little bit racy but can see pump site on abs. Or here. Not racy but kind of funny little pre-competition lucky stretch moves.

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25Apr / 2012

Dongle Problongle

The scribble represents a professional opinion of the idiot gentleman's blood sugar data.

How know dongle work/not work? Bigfoot kind of worn out on Diasend software. Dongle. Hold dongle to small rectangle on Ping, wait for magic happen. No happen. Dongle OK? Dongle-Ping communicate at all? This a secret? Ping-dongle making baby?

Today need communicate many days Bubs’s #s to Coro Center. This not problem when use LogFrog app. But when begin use pump, start 8 1/2 x 11″ paper log, preferred method of Coro. This log track more detail than LogFrog. Many category data. Today attempt transmit data via breezy email message:

Hi Dream Team,
I haven’t been in touch with Bubs’s numbers since 4/11. Now I am hoping for help adjusting his night time and mid-morning basal rates. He has been waking up high. Mid morning he has often been low. My thought is to scooch up his night time basal by 0.05u/hour and to change his morning ratio from 1:10 to 1:12 or 1:15 to see if that helps. (At this point should Bigfoot Spouse and I just be making these kinds of little tweaks without checking in with you?) PLEASE DON’T BE ANNOYED THAT I’M ASKING I AM JUST SO CAUTIOUS YET AM REALLY VERY CAPABLE PLEASE LOVE ME AND THINK I’M AWESOME
 
I’m going to include all of the possibly relevant information I can think of and hope to hear back from someone tomorrow or soon. Thanks! (I am going to attend an Animas Diasend workshop in May, so I hope to soon have a better way to share this data with you. I am sorry it is so cumbersome!) PLEASE LIKE ME AND THINK I’M THE BEST PATIENT PARENT EVER AND TALK ABOUT ME AT YOUR STAFF MEETING IN GLOWING TERMS. IF POSSIBLE, ALSO SAY I’M PRETTY.

Coro call back: want Bigfoot fax 8 1/2 x 11″ papers. Lazy Bigfoot call back I do not have a fax machine read between lines: I’m too lazy to drive to Staples. Or I don’t care enough about my child’s health enough to buy a fax machine. Or Get the fuck out! A FAX machine? Do you also want me to dictate the numbers into an 8-track cassette recorder?

This tidy sample page is from Ping day 3.

Pumping one month: this awkward phase. First week, call daily with numbers. Review over phone. 2nd week, call two/three times. Review over phone. Week three…that about last time interact w/ Coro. Crap. Even if had fax, would need to rewrite each 8 1/2 x 11″ paper because so messy, also Bigfoot Spouse often omit certain info, and Bigfoot know what Spouse intends imply with blank space but it impossible non-marriage partner intuit true facts from 3AM scrawls/absences scrawls.

Perfect solution: Diasend! This graphic take Bigfoot breath away. But Diasend dongle not give any clue working. Informational videos adorable but in Swedish. Ah, here in English. Still adorable but not help Bigfoot with dongle issue. Best part in any language: features slim patient. Thank you, Sweden.

Suspicious: never ever hear any real diabetes person speak or write of Diasend success. However, Diasend web site sleek, informational video adorable, Sweden good track record machine-making (who not love 1980′s Saab) <—all bode well. In May, Bigfoot attend official Diasend lesson, fingers crossed dongle inspector on faculty.

Meanwhile, Dr. Doughnut advise pretty much same thing Bigfoot predict. That not technically true. Actually Dr. Doughnut advise lower I:C ratios throughout day and increase night time basal more than Bigfoot have cojones suggest. Gulp!

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21Apr / 2012

Pump House

The colorful tubes in the distance are slides! Really big slides.

Bubs survive Pump House! Bigfoot use Smart Liz strategy of disconnect up to one hour at time, test BG/reconnect for snack/bolus, disconnect up to one hour, repeat forever or until water park close for day.

Why this work? Bigfoot think no basal insulin kind of like hold breath. However, somehow no basal insulin OK. Energy still get to cells. But why? No one know. (That not true, only Bigfoot + maybe couple other people not know.) Bubs experience energy galore. Swim lazy river upstream. Laugh, run around, play water basketball, etc. Pause for strawberry daiquiri (Bigfoot estimate 80g carbs w/ assist from Calorie King T.G.I. Friday menu index), get pumped up, play more, more, more.

Smart Liz strategy not just work, but work better than not disconnect. Lantus times, Bubs always dip too low while swim. Disconnect pump = suspend basal insulin 100%; BG# still dip, Bubs still need uncovered carby snacks, but not so dramatic as Lantus times. And even though Animas pump waterproof, seem better disconnect for social reasons (maybe onlooker curious eye bother Bubs?), physical reasons (maybe pump get in way/feel weird while swim?), financial reasons (if lose pump, insurance not cover cost). Better for health too = BONUS.

While Bubs out of sight, Bigfoot fairly worried. Remember where meet up if feel low? What if collapse? Lifeguard stationed every ten feet. Pump House lifeguard sport reassuring Vermont look–unlike standard Rhode Island lifeguard, Vermont lifeguard no chewing gum, no hair product, attentive = ready leap in, save life. But Bubs’s medical ID bracelet obscured by Pump House admission and surf machine injury lawyer-waiver bracelet. Pretty soon realize there’s nothing I can do. Not possible stay right by side—not a 4-year-old.

Pump break at the bar w. daiquiri

Decide instead read excellent book about North Korea (David Sedaris recommend in Book Review). Very absorb. Bigfoot recommend this strategy for water park: pick meet-up place. Show child this place. Tell child stop by for BG check every five slides/loops lazy river or if feel low. Stay in place/read North Korea book. If staying-put parent have to pee, too bad. Stay in place. If really have to pee, almost peeing pants because water slide trickle noises everywhere, visit bathroom but leave all items at meet-up place: phone, wallet, pump, glucometer, brightly colored beach bag, creel–this way dying child not assume abandon forever, maybe even test own blood sugar, eat Spree, live.

It may seem Bigfoot ignore older child. That completely true! This trip Jack mostly snowboarding on slushy warm April Vermont snow, Bigfoot Spouse mostly teach snowboarding, Bubs mostly swim, Bigfoot mostly read North Korea book. All meet up at end of day watch Survivor on big hotel TV, sheets so soft/high thread count, collapse.

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06Apr / 2012

Chucklebreaths

Waiting for hot chocolate at The Sunnyside. #177.

Bubs high a lot over last 24 hour. Correction bolus. Minimal effect. Maybe infusion site bad. Change site. Correction bolus. Still high. Maybe insulin bad. Change insulin. Correction bolus. Still high. Call Dr. On Call. On Call doctor say give more insulin, call in two hours if still high, maybe pump not working. No still high: 167. 167 OK.

Wake up 207. That high, and that STUPID. Bigfoot know it OK not able explain everything. Liver, broken pancreas, growth hormone, complicated ballet variables, so forth. But still: SO STUPID. Before breakfast: 184. That almost OK. 3 hours later: 306. Call Coro Center. Receptionist chuckle warm-heartedly; catch in middle of YouTube break?

Here it comes

RECEPTIONIST: Coro Center etc.

BIGFOOT: Hello, this is Bigfoot. My son Bubs is a patient of Dr. Doughnut and he has been high a lot and I would like to talk to someone about his insulin doses

RECEPTIONIST: (catching chuckle-breath) Dr. Doughnut is on vacation until Monday

BIGFOOT: I know. I thought maybe I could talk to Julianne Moore or The Runner

RECEPTIONIST: Julianne Moore and The Runner are also on vacation until Monday! (Cracks up)

HUMORLESS BIGFOOT: Well, we called last night and the doctor on call helped us, should I call the pager?

Does this beverage cause permanent high blood sugar?

RECEPTIONIST: You’re not going to believe this—-(laughing)—-the doctor on call is also on vacation!

TOTALLY HUMORLESS BIGFOOT: That doesn’t make any sense. There must be someone on call

RECEPTIONIST: Ah yes. I see. I guess I could have one of the doctors who works with Dr. Doughnut call you back

BIGFOOT: Yes, please

Why not go straight option D) a doctor who works with Dr. Doughnut–waiting for Bigfoot give up on get help? Maybe “the doctors who work with Dr. Doughnut” is Coro Center slang for Brown University undergraduate bio lab. Just when Bigfoot about get all wound up righteous fury, blood sugar beep: #133.

If Bubs high, undoubtedly say feel fine. Act fine too–run around, play Lego, not seem tired/slow. Love read this—high blood sugar feeling from articulate adult perspective. Tell Bubs, “Cute Kerri with the blonde hair you know from the Expo you met her she was really nice? With the panda on the rocking horse and pretty like a princess but in jeans? She wrote an essay about how when she has high blood sugar it feels like there’s molasses* instead of blood in her veins.” Bubs: what’s molasses? You know, like in gingerbread. That slow, sticky stuff. Huh. Yeah. I guess so. Could I read it?

(That incorrect. Actually sticky jam + heavy cream.)

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27Mar / 2012

A1C 6.9 + 4′ 6.5″ + 71.5 lbs

Waiting for the world's coolest endocrinologist. Worried about something.

Today see Dr. Doughnut quarterly check up. While wait exam room, Bubs look so nervous. After minute or two say need ask question. Bigfoot brace self: hear story about Supreme Court health care debate day two, worry about pre-existing condition? Want know why exam table foreshortened w. stirrups? Want Bigfoot translate Spanish HPV vaccine poster? Not solamente for chicas, chicos tambien.

BUBS: Well, what I want to know is…

BFOOT: You can ask me anything

BUBS: Well, it’s (buries face in jacket)…what’s (cringes) domestic champagne?

Bigfoot do best explain France defend name “champagne” for authentic Champagne (from Champagne region? That what Bigfoot tell.) About launch into parmigiano reggiano when Dr. Doughnut enter. Polka dot glasses, black cords, clogs.

DR. DOUGHNUT: Well. So. OK! Your A1C is 6.9*. So that’s that. How’re ya doing, Bubs? Belly hurt? Sore throat? How’s that new toy?

BUBS: ?

DR. DNUT: Your pump. How’re you liking your pump?

BUBS: (Lifts shirt to show Spibelt-ed pump) It’s good

DR. D: Yeah? Good! What do you like the best about it?

BUBS: Not having to have shots any more

DD: Yeah, I thought you’d say that

Celebratory chicken legs.

Talk for while about why site hurt yesterday. Possible cannula kink. Possible too close muscle. No big deal. Just move if hurt. Bigfoot ask Dr. Doughnut backup on issue: want Bubs stop pricking finger same spot. Warty outcropping develop, but always want poke that spot. Please tell Bubs move pricker around, maintain supple fingertip.

DD: It doesn’t matter. Stop bothering him about it. Right, Bubs? Let’s tell your mom to stop bugging you about where you prick your finger (winks at Bigfoot). Bubs. I’ll tell you what: that hard spot, that’s a callous. So it’s going to get harder to get blood from that spot. But you just run that finger under hot water. That’ll open up the capillaries and make your finger nice and juicy. Nice and juicy with blood. And it’ll soften up the callous a little bit. Okay?

After appointment, visit Whole Foods zero carb snack. Upon request, pizza oven lady hack legs off rotisserie chicken ($2.99), Bubs devour. Save sinews. Dog eat later.

(* this A1C look good but is, actually, whatever/meaningless. It not as if #42 scrub away damage from #367. But make good average number if need for bizzare sort of resume/pageant.)

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24Mar / 2012

Bedtime snack

The pump

Barely remember pump lesson #2 although happen today. When lesson end, drive up/down Wickenden Street (alone) convinced sudden onset hypoglycemia require Fellini’s pizza. Try picture Fellini’s beverage display. See clearly: San Pellegrino, Orangina, Arizona Iced Tea Diet Green w/Ginseng. Beer? Not sure. Maybe very low shelf. Need see for self. But not able park; ho-hum diabetes emergency snack instead. (It mini Luna bar.)

Do remember nurse look like Julianne Moore say, “After Dr. Doughnut starts fine-tuning everything, Bubs will have different basal segments. But for now, it’s just zero point three units an hour, alllllll day long.” On paper nurse write basal dose=0.3u/hour. On data graph paper-y chart write also 0.3u/hour. Program pump together, expert watch entire time. But tonight pump say basal:

12AM 0.225

6AM 0.3

5PM 0.275

Now 11PM. Bigfoot grab self by metaphorical scrotum and reprogram basal doses: now all 0.3u. Feel very advanced. Or basal set up like that for reason unfathomable Bigfoot because so new this job? Consult spouse: do you remember doing anything with really micro-tuned numbers like 0.225 and 0.275? Nope. No remember. Only remember #0.3.

We asked our nurse if everyone tells her she looks like Julianne Moore. She seemed offended---another mystery.

Also recall this: nurse disagree Dr. Doughnut say BS#80 OK bedtime, no eat snack. No snack because need see if drift low, low, low. That why check 12AM, 3AM. Data. After collect data, expert advise adjust basal. Nurse Julianne Moore chuckle, “You didn’t hear it from me, but I’d give him a snack if he’s under 120.”

BIGFOOT: Hwhaht? Hmmm? Snack?

JULIANNE MOORE, RN, CDE: I can’t…I can tell you that Dr. Doughnut thinks he doesn’t need a snack if he’s at 80. I’d be more comfortable if he was around 140 at bedtime. But you have good judgment, you’ll know what to do

BFOOT: No, I won’t. This is all new to me. I want you to tell me what to do

JULIANNE MOORE: Dr. Doughnut wouldn’t let Bubs go on the pump if she didn’t trust your judgment

BFOOT: But my judgment is telling me to ask an expert what to do if his blood sugar is 80 at bedtime tonight, so I’m asking you

JMOORE: I’d say you should give him a snack, but Dr. Doughnut doesn’t want you to do that

BFOOT: So say…for instance…tonight. His blood sugar is 77 at bed time. Should I give him a snack or treat it as a low?

JMOORE: 77…then, well, I’d say a snack would be fine. You’ll know what to do

Lucky Bigfoot! So far not need rely judgment. 9PM #97. No snack. 12AM #105. That nice.

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22Mar / 2012

Cure marital problem…WITH BERRIES!

How kind.

Direct mail arrive, address for Bubs. All over envelope orange/green typeface Lose the bulge…WITHOUT DRUGS! and Lower high blood pressure…WITH CHOCOLATE! and Reduce your blood sugar…WITH BREAD! and other slogan target imbecile.

Direct mail opinion: Bubs=big fat fatty. Desperate big fat fatty. Dumb, desperate big fat fatty stuff face bread/chocolate await disappearance health problems. This so sad.

However, make feel little bit better insulting ads target Bigfoot Facebook, suggest Bigfoot deficiencies: inadequate eyelash (base on age?), ingrown toenail (because running?), bunion (Frye boot?), woeful circumstance due to no college degree (6-7 semester + dissertation short PhD?), insulin pump (that fair), Gevalia coffee (because pin many teapots on Pinterest?)

Tomorrow Pump Lesson #2: final lesson. Bigfoot and Bigfoot spouse ready. Humalog vial ready in fridge. Huge box infusion set, other stuff, not even know name. Many black zipper pouch free sample? Kiss saline goodbye. Goodbye, Luxura pen. Goodbye, Lantus. (Glargine so pretty name little girl/puppy.) List questions:

1. Each time we disconnect the clip for the shower or whatever–do we need to re-prime before reconnecting?

2. When we change the infusion set, do we throw away whatever insulin is left in the cartridge? And isn’t that kind of a lot? So are we supposed to not fill it up the whole way?

Other than that, ready.

The beginning of another great relationship, as illustrated by Sophie Blackall in Missed Connections.

Meanwhile, read this post. Very familiar: spouses take turns stay up wee hours, always tired, no time have fun, no energy relationship. Kinzie mom feel very bad this situation. This alarm Bigfoot. Have to ask spouse…I read this thing written by another parent of a diabetic child. It’s about marriage…I’ve been assuming we’re just mutually OK with ignoring each other…relieved. Spouse agree: yes, difficult. Yes, not have fun. Yes, tired. But not think marriage in jeopardy. Too tired leave. Also very close because shared priority: children, home, bills, learn slacklining like Flight of the Frenchies. After few years pass, maybe go have fun somewhere. Maybe Mexico.

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18Mar / 2012

Schooled

Desperate times call for reading Old Cricket marginalia.

Pump practice week require saline bolus. Saline bolus make Bubs cry: it hurts like a bee sting! Bigfoot raised by wolves; wolves train Bigfoot first course action when feel bad/sad/pain is decide bad/sad/pain imaginary; overcome problem by read book/Cricket magazine.

Faces hidden to protect these sweeties from overexposure. Pump hidden by laser gun.

However, after five bee venom bolus, Bigfoot Google “saline in pump hurts;” learn this not only real but also common. DOC recommend let saline drip into paper towel during practice week, in order not psychologically retard child pump progress/cause child hate pump.

Bigfoot not hate pump anymore. Nice pump: excellent calculator. Pump drip insulin all day, not need remember Lantus. Pump give very precise bolus. Bigfoot ashamed complain so much pump not have touch screen/moan about wish Steve Jobs Type 1 before die cancer. Bigfoot know complain/moan no good except for community service, make enlightened person feel good about self.

Lately Bigfoot provide other community service: advice repository. Bubs need exercise: check. Bubs need Omega-3 fish oil supplement: check. Dr. Weil say Bubs need cinnamon: check. Thank you these astute tips.

 

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Bigfoot say other thing

Bigfoot sure this not right placement Pinterest button

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