Author Topic: Omnipod is GO!  (Read 671 times)

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Offline Pattidevans

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Re: Omnipod is GO!
« Reply #30 on: 10 June 2018, 07:20:15 AM »
I know that on a pump there are so many factors that are in play and it’s sometimes hard to know exactly which one is the one to blame.  As you get more experienced with it you will have a better idea where to start deciding which it is.  To start with, when you were having all those lows you most likely had Toujeo still working, it is, after all, a very long acting insulin.  I started from a split dose of Levemir which had far less effective life.


When I started my DSN put me on what I thought was a basal that was far too low.  In fact I’m on less now!  She also put me on 1:15 ratio... and that WAS far too low.  It’s all a leap of faith to start with, but you WILL get there.


I remember that fir weeks after he started the pump Liam was running high and he was afraid to up his basal because he was staying level between meals.  When he did up his basal it worked!  It happened to me later on when I needed a tweak. 


It’s a pity your clinic is closed over the weekend.  At least my DSN was at the end of a phone 24/7when I first started on a pump.  Keep strong, you will get through this and start feeling better!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline himtoo

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Re: Omnipod is GO!
« Reply #31 on: 10 June 2018, 08:41:57 AM »
my first weekend with the pump was pretty stressful for me as i had no ability to contact my DSN..............and the chat we had on pump start day was not very reassuring either , as she explained to me that if I did go DKA there would be NOBODY in the medical world that could help me via the pump. she said the paramedics would just take it off my body , and nobody in hospital would understand it either , so i was on my own.....

fortunately the scenario never happened.....

hopefully some more update today Nyt ??
i keep fingers and toes crossed you are having a decent set of numbers.
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline nytquill17

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Re: Omnipod is GO!
« Reply #32 on: 10 June 2018, 02:48:29 PM »
Well, better numbers yesterday evening and overnight, but I have no clue why or what's going on generally  :o  But I'll take it!

So yesterday after the pen correction had run its course, we went out to do groceries. Now, I know that a Patti and Sedge often experience lows in the grocery store, but honestly I never have seen ANY difference to my levels and usually the short (20 min) walk that we do to get there has no effect either. But yesterday it took me from 9ish down to 5.3 by the time we got back, and then I was into the low 4s again another hour or so after that. So I had 2 dextabs (8g) which put me back up to 7 or so by the time supper came around.

Where I'd had pizza and Swiss Chalet the two previous nights and seen massive, intractable highs afterwards, yesterday I had 30g at supper, bolused for that and...was heading towards a low 3-4 hours later. I had gotten some mango in for dessert so I thought rather than have YET MORE dextabs (ugh) I would just have a small mango with no additional bolus and see what that does. I ended up at 11-12 by bedtime but then came down on my own to a nice steady, very flat, 7 all night long (and still going so far this morning).

So yesterday afternoon and today have been more like what I was used to seeing all the rest of the week. I don't know why the two days before were so different. It makes me a bit angry, honestly - I did everything I was supposed to! I carb counted, I gave accurate (massive!) boluses. I could understand it still going high afterwards, but not THAT high, not for that long, and certainly not stubbornly refusing to come down in spite of my giving, overall, half again as much insulin as I had originally bolused over the course of the next 6 hours.

It probably is the basal, as well. But then there are moments like yesterday where, between meals/after very mild exercise (more like just moving around doing my daily tasks!) and overnight, basal brought me down all on its own. Makes me scared to either move or eat. Maybe if I just sit here...  :rolleyes:


P.S. oh yes, and yesterday evening all of a sudden pod site got VERY itchy. Pulled up my shirt to look at it - blood! Not massive amounts, but could see some blood on the adhesive and around the cannula (through the little viewing window thingy). But BGs were nice and steady and responding as expected, no pain or signs of infection, and since I was due to change the pod anyway in 12 hours or so I figured I'll just ride out the 12 hours unless something went wrong. So far, it hasn't - but still super itchy. REALLY looking forward to taking this one off in a few hours so I can scratch (gently!)
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Pattidevans

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Re: Omnipod is GO!
« Reply #33 on: 10 June 2018, 03:03:01 PM »
To be honest, there is no way on God’s earth I could cope with 120g of Pizza and not see what you saw.  Not being judgemental at all, but the pump isn’t magic.  My own numbers at the moment are none too good, but it’s because I am not eating as usual.  Baked beans on white toast for breakfast this morning and I was above 12 before I ate.  I knew why... and why it’s probably 15 years since I have had them!  A walk down to the harbour and back (about 2km up and down hills and in this heat)only got me to 8 and I had to do a correction.

Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline nytquill17

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Re: Omnipod is GO!
« Reply #34 on: 10 June 2018, 03:20:57 PM »
Oh, no I know you're not judging. I certainly don't expect the pump to be able to handle things like that seamlessly - I was expecting to go high after. Choices and consequences, right? But I honestly didn't expect the pump to handle it that much *worse* than on MDI. Ordinarily I would not have gone as high and more importantly it would have responded to corrections within an hour or two, not twelve! (that was the really scary part). I'm sure it's because all my settings aren't fully adjusted yet and I don't yet have the full bag of tricks, whereas I was an old hand with MDI.

The thing is now I'm stuck between - if I eat a lot it goes up and doesn't come down. If I eat a normal amount it goes down and doesn't want to come up. Every meal is a problem :P
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline nytquill17

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Re: Omnipod is GO!
« Reply #35 on: 10 June 2018, 06:29:27 PM »
Pod is changed now! Ahhhh so nice to scratch underneath haha.

Cannula was definitely bent when it came out. But BGs were okay from last night to today so I don't think it was affecting delivery. But that's probably what caused the sudden bleeding last night. New site doing fine so far as well! Nice flat line on the Libre since about 1 a.m. last night, sticking between 7-8. Of course, I haven't eaten anything or gone anywhere so that helps with the flatness :P
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline himtoo

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Re: Omnipod is GO!
« Reply #36 on: 11 June 2018, 10:33:45 AM »
I'm sure it's because all my settings aren't fully adjusted yet and I don't yet have the full bag of tricks, whereas I was an old hand with MDI.

The thing is now I'm stuck between - if I eat a lot it goes up and doesn't come down. If I eat a normal amount it goes down and doesn't want to come up. Every meal is a problem :P

i think you are sort of answering your own statement if you put the second sentence first and the first one second.....................being an old hand at MDI is what you are used to,  so much as i was too.
  this change to a pump will definitely take time........ so try and be kind to yourself as you adjust......rooting for ya bigstyle here   :) :)
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline everydayupsanddowns

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Re: Omnipod is GO!
« Reply #37 on: 12 June 2018, 02:45:15 PM »
Sorry, not been able to give this thread the attention it deserves, but sorry to hear that you are having a bit of a runaround in your early days with a pump.

Having said that... I don't know anyone who doesn't - and Sedge famously remembers wanting to log the darned thing out of the window SEVERAL times along with that lost, alone and unloved 'newly diagnosed' feeling where you can't really tell what is causing what or whether this... that... or the other 'feels right' because it's all a bit new and strange.

FWIW, regarding your recent bent cannula pod and the resulting BG weirdness, in my first year on Medtronic's standard quicksets I had all sorts of bother with bent cannulas, and while the pressure never *quite* built up to trigger the sensor for a No Delivery alarm, I can confidently say that a slightly bnt cannula caused significant BG upheaval for me more than once - which then resolved fairly promptly when I changed infusion site. In my first year on a pump I frequently saw high BGs that I'd *never* seen on MDI. :eek:

You are doing all the right things, and your methodical approach will pay off and have you rocking and rolling in no time. It took me a year before I felt I had made some real progress, so you have plenty of time yet :rofl:
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

Offline nytquill17

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Re: Omnipod is GO!
« Reply #38 on: 12 June 2018, 07:49:49 PM »
Thanks for the words of encouragement, Mike. I can't say enough what a godsend it has been having you all here to help me not panic and understand that everything I'm feeling so far is normal and not either failure on my part or a divine sign that I should quit!

Thankfully the bent cannula did nothing more to me than a little blood at the site which ended up being REALLY SUPER ITCHY. It happened just before bed, BGs were fine and stable all night. 2 days after the fact and the "bent" site has healed up quicker than the site before it.

Just back from my 1-week-post-pump-start followup appointment. We went over the basics of temp basals and extended boluses, talked over recent observations and fine tuned a couple basal rates, and talked about things like exercise and big meals (helpful, since I have a birthday coming up!) Overall consensus is that I'm already doing really well, getting lots of flat lines already overnight and during the middle of the day. I asked about basal testing and they said that since I don't eat for much of the day anyway (personal preference) and I have the Libre data, it's like I'm basal testing all the time to begin with, so no need - maybe eventually for the evening part of the day when I do normally have a meal, but there's enough still to work on elsewhere that it's not a pressing issue.

Had a brief but nice chat about the psychological side of things and that feeling of "this would NEVER have happened to me on MDI" and the like. They all reassured me also that it was normal and that actually it's going really well for me compared to a lot of other patients that they see, and they have no doubt I will pick up what I need quickly from here.

Going forward, I've moved off of daily check-ins and towards "every few days." Of course I can always contact them if I need help in the meantime! Next appointment is a week from Friday, when I was due to see the endo anyway so they will just pile on a pump check-in then. I still have to re-learn basically everything that was intuitive before until it becomes intuitive again, now with new patterns and tools. Considering my previous intuition was built up over 20+ years, I feel like a year to really get the swing of things sounds about right! Although also like a long time...but that's trial and error for you!

I just keep thinking...I'm grateful for all of you, and for my clinic team, and my Libre, and my insurance, and my personal inclinations to be able to and motivated to understand all this sciencey mathy stuff. Without any one of those pieces I feel like this whole thing would just be a complete wash. I am really very lucky to be able to pull this off!
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline himtoo

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Re: Omnipod is GO!
« Reply #39 on: 13 June 2018, 10:32:06 PM »
you are not giving yourself all the credit you are due Nyt... you have battled through 20 years previously to get to this point and give yourself a while longer and you will conquer this too 
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline nytquill17

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Re: Omnipod is GO!
« Reply #40 on: 13 June 2018, 10:57:07 PM »
Thanks Paul :) I dunno if battled is so much the word. It's similar to that thing I do in water, I dunno if you can properly call it swimming, but I manage not to drown!
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline nytquill17

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Re: Omnipod is GO!
« Reply #41 on: 14 June 2018, 03:31:45 AM »
My first more or less successful extended bolus! This was for a curry/butter chicken combo with rice and 2 samosas. Not too shabby! I still need a lot of practice though to master it all. Guess I will just have to eat a lot of "difficult" foods, you know, to gain experience ;)


I did have pizza again last night (OH is having a stressful time at work and convenience is kind of taking a priority to nutrition at the moment) and that didn't go quite as well as the curry did but definitely better than the last time having pizza! I was a bit gunshy to try the full 8-hour extension even though we discussed at my appointment the fact that there is actual research (1 study) showing that pizza does have measurable effects for around 8 hours for most people. Next time I think I will try it though, I'm starting to get some confidence.


Confidence has been shaky for lots of reasons, primarily just not knowing how to anticipate things, because of course they don't work the same way. It has been really weird getting used to the idea that a flat BG just after a meal doesn't automatically mean "low on the horizon" that I need to preemptively treat. Or not knowing, say if I have 0.7u IOB or 1.2u or 2.8, what kinds of effects can I expect to see before that runs out - should I try to correct because it won't realistically do much more, or wait it out a few more hours and see where I end up? And so on. Once I start feeling like I know when I need to react and when I don't, and what's likely to happen based on all the information I have at hand, I think I will be pretty much my old self again.


I have another week of pigging out ahead of me because OH is taking some much-needed time off and it will be my birthday weekend as well, so plenty of chances to try things out. And then I really HAVE to stop!  :bev_alert:
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Pattidevans

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Re: Omnipod is GO!
« Reply #42 on: 14 June 2018, 08:17:25 AM »
Nyt


Considering what you ate, and being new to this, that line is not at all bad.  Thinking back to when I started on the pump, I really tried to stick to lower carb meals and I did OK, but it was months before I dared a Pizza and I still have trouble with rice.  I don’t use extended blouses all that much, cos I don’t seem to need them so much (except for Pizza and Pasta which I don’t often eat). Then again, being retired I have plenty of time to cook.


Talking of rice... I spike straight up, so not sure that any kind of fancy bolus, other than a super bolus would work. I know we are all different and given that butter chicken would likely slow the absorption then you giving an extended bolus would be the obvious answer and it clearly worked, so well done.


I promise you that in a year’s time you will be sailing with all this, I’d actually cut that time frame down to 3 months knowing you. 


I’ve been struggling with FBGs being 10 plus and I know I should probably increase my overnight basals, but without a Libre I don’t know if it’s restaurant food or insufficient basal.  You are so lucky to have the Libre full time 😀 and I am so glad you do!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline nytquill17

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Re: Omnipod is GO!
« Reply #43 on: 14 June 2018, 12:29:23 PM »
I completely intended to be good and only eat low-carb, easy to measure meals in the first weeks after getting the pump. But then there was OH's difficult workload, and yesterday I was with a friend who really wanted to try out a new restaurant on campus, and as I'd never had proper Indian food I jumped at the opportunity to try it with someone along to tell me what to pick, haha!

I only ate the rice that had bits of sauce on it from the chicken, and I ate it last. That often helps, for me anyway. I find that anytime I eat a large meal, the profile of the meal is generally slower, and I also need proportionately more insulin than I "should" according to my ratios. On MDI I would often come back and "top up" after I finished the meal without any danger of going low anytime soon! I figure those are the circumstances where it's appropriate to try out an extended bolus and see if it helps.

On the other hand, although I know that I've been indulging entirely too much, it's nice to feel I do have the option to say yes to these things when they come up, unlike how it used to be 20 and more years ago where you really had to eat exactly what was in your meal plan, no more, no less. And desserts had to be anticipated a day in advance! And there was no food info widely available on the Internet, so if it wasn't in the big Canadian Diabetes Association binder they sent you home with, it didn't exist! Or you had to find the next best thing and guess.

How far we've come, eh?
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Lucy

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Re: Omnipod is GO!
« Reply #44 on: 14 June 2018, 01:36:08 PM »
Read through this with interest, all I have to say it that it sounds like you’re doing fantastically. Although your confidence might not feel that strong it sounds like you’re trying a lot of the different features etc and getting good results!
Type: Lucy.
Lantus and Apidra. Metformin XR, Propanolol