Author Topic: Appointments and new meter  (Read 421 times)

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Offline Lucy

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Appointments and new meter
« on: 23 October 2018, 11:35:53 PM »

I’ve been having quite a few appointments with the hospital diabetes team since the summer so thought I’d give a little update. For a very brief summary of what’s happened so far over the last almost 10 years  :o  since I was diagnosed. First year or two i was seen at lots of GP clinics as I moved a lot, all the usual limited knowledge of diabetes, threw lots of tablets, non insulin injections at me, you name a diabetes tablet and I probably took it. Then I moved south where I’ve lived for nearly 8 years. Was referred to rubbish hospital, started me on insulin but never really got along with them. Eventually moved to good hospital. Had help with adjusting doses, lost lots of weight, everything improved, discharged back to GP... where i had a bad experience and didn’t have any input for 2 years. Weight and bgs both got worse, rereffered to good hospital where I’ve been having regular appointments since about June or July.

I’ve seen the consultant a couple of times, the dietician once, and today was the DSN. I usually struggle to communicate my points in appointments which is probably linked to being autistic, so I’ve started writing anything I want to say out on my iPad and taking it with me which is helpful. Sometimes I hand it over, sometimes I manage to explain verbally and leave it in my bag but i know it’s there if I need it.

Chat with the DSN today was useful. She emphasised the importance of taking lantus at roughly the same time every day, at least within an hour either side. I take it fairly randomly so I’ve set up a phone reminder. She also suggested a meter that calculates the doses for you, as I’m struggling to keep on top of remembering doses, calculating ratios when it’s not 1:10, knowing what changes to make for exercise, etc.

Choice given was freestyle insulinx or accu check expert. The insulinx was a bit slimmer and more pocket friendly but the expert looked better, with being able to include adjustments for exercise, stress, illness, etc. We set it up together to use 1:8 for breakfast and lunch and 1:10 for dinner, with two exercise adjustments of -25% and -50% to adjust for the meal before band and swimming respectively. The other adjustments I’m not really going to use for now. Plan is to use the meter, save me some brain power, let it gather some data, then review together in a month or so and discuss adjustments. In the meantime I need to focus on exercising, eating well and losing some weight.

Seeing the dietician in a week or two, last time we talked about making carb counting easier which I’ve been trying to put into action, but that was 3 months ago and I’ve not really lost any weight since, so this time we can hopefully discuss that more.
Type: Lucy.
Lantus and Apidra. Metformin XR, Propanolol

Offline Lucy

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Re: Appointments and new meter
« Reply #1 on: 23 October 2018, 11:37:16 PM »
Oh I have noticed that the accu chek meter seems to read lower than my contour next one, but I know doing multiple comparisons drives you mad, I just did one to check it was vaguely near!
Type: Lucy.
Lantus and Apidra. Metformin XR, Propanolol

Offline himtoo

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Re: Appointments and new meter
« Reply #2 on: 24 October 2018, 08:50:15 AM »
Wow Lucy..... you have been through the mill with your doctors ( the bad ones i mean ) --- from all my experience with GP's they just dont really have a clue

really pleased you are hooked up with a good team again..
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 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) 04/18 46 (6.4)
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 Lucy

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Re: Appointments and new meter
« Reply #3 on: 24 October 2018, 09:10:30 AM »
I just have to keep hold of them this time himtoo! At least I know how the system works better this time so if it’s suggested that I’m discharged I can explain why I’d prefer not to.
Type: Lucy.
Lantus and Apidra. Metformin XR, Propanolol

Offline Pattidevans

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Re: Appointments and new meter
« Reply #4 on: 24 October 2018, 09:28:49 AM »
I’m very pleased to hear that once again you have a decent team Lucy.  One that is going to actually help you.  THe DSN sounds like a treasure, one who will help you analyse patterns and trends and use them to your advantage instead of struggling against everything all the time.  I know how relentless it is and how sometimes you can’t see the wood for the trees and how lonely that can make you feel. 


Good idea putting everything on your iPad.  I mean I’m normally an articulate person who can advocate for myself, but the minute I’m in front of the Endo  and he starts on the route of telling me my Hba1c is too low and I’m having too many hypos I seem to become a gibbering wreck instead of getting it across that it’s not on purpose and can I please have some help.  That’s without throwing autism into the mix.  So good for you... you seem to be getting there and I admire you so much for that.


I’m sure the new meter will help immensely- it’s virtually the same as my pump handset except it doesn’t calculate doses in 0.01 units.  I had one before I had the pump and still keep it as a spare.  Keep us up to date on how it goes please.
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: Appointments and new meter
« Reply #5 on: 24 October 2018, 10:52:31 AM »
I just have to keep hold of them this time himtoo! At least I know how the system works better this time so if it’s suggested that I’m discharged I can explain why I’d prefer not to.
that is really important... knowing how the system works....i think they are forever trying to discharge peeps because they just cant cope with the numbers... so you deffo stick to your guns if they try it in the future
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 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) 04/18 46 (6.4)
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 Liam

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Re: Appointments and new meter
« Reply #6 on: 24 October 2018, 11:46:58 AM »
Glad you are back with the good ones. It really makes a huge difference when they listen and work with you.

I never used one of the meters that do all the insulin maths etc but they are a lot like pumps in some ways and if I had to come off a pump I'd want one now.

I know the feeling of planning what you want to say but then forgetting during an appointment. Having it written down really can help.

DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
3/15 56 (7.3%) 12/15 49 (6.6%)
Ramipril: 10mg Quetiapine: 550mg Metformin: 2000mg

Offline Dr DeEath

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Re: Appointments and new meter
« Reply #7 on: 24 October 2018, 01:15:13 PM »
That's good news indeed. In the past two decades I have given up on two clinics. At the first the consultant thought the answer to everything was a ultra low cholesterol level! The next one decided to centralise a number of clinics and in the process an excellent consultant had his responsibilities changed. His replacement again failed to inspire confidence. The second vascular surgeon I saw about PAD suggested I attend their clinic but it was really awkward to get to so I declined. He moved on and his replacement discharged me. Currently it is the GP's DSN. Not ideal as she has fingers in too many pies diluting her time and knowledge. Hard to know what to do?
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline GrammaBear

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Re: Appointments and new meter
« Reply #8 on: 24 October 2018, 02:47:59 PM »
I am happy for you Lucy.  Having a reliable person to help you with diabetes is an advantage.  I have never had anyone to help with the exercise adjustments so that is a big plus for you.  Hope your new meter continues to be helpful.
Type 1
Tandem Tslim pump Oct 2015
Dexcom G5 CGM Sep 2007
A1C 6.3% ~ Sep 2018

Offline Lucy

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Re: Appointments and new meter
« Reply #9 on: 24 October 2018, 10:31:20 PM »
It does make such a difference having someone you can talk to and assess patterns with. I like the meter so far, certainly takes some of the work out of calculating doses, I’m just watching it to see how it calculates doses at the moment. It added a small correction earlier as I was 7 which I wouldn’t normally correct for, but I think it’s aiming to get me to 6. Seemed to work anyway. I used “exercise 1” for band practice last night which is -25% and had no hypos and was about 7 after so that seems reasonable too.

I can’t see anywhere a cable would plug in though to download it or any mention on the website of downloading to the PC. The DSN definitely said we would download it though, does it need some special hard to obtain cable?
Type: Lucy.
Lantus and Apidra. Metformin XR, Propanolol

Offline himtoo

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Re: Appointments and new meter
« Reply #10 on: 25 October 2018, 09:05:53 AM »
hi lucy


here is the link to the accuchek website ... there is loads of info on there about getting started with uploading your results to the site..... it says you can contact their customer services to order a cable
looking at the site it seems to be an infrared cable ... not a plug in...maybe if you ring them they can explain how it exactly works

https://www.accu-chek.co.uk/help/data-management/360


hope this helps  :) :)


T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 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) 04/18 46 (6.4)
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 Pattidevans

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Re: Appointments and new meter
« Reply #11 on: 25 October 2018, 09:57:26 AM »
Hi Lucy


If you phone and ask Roche  will send you a disk with their 360degree software and an infra red dongle.  It’s a real PITA to download and the software is hard to interpret.  I gave up downloading my pump handset after about two goes and being utterly unable to make any sense of the result (unlike Abbott software which is clear and shows patterns that are easy to understand and make sense of).  However, your nurse will have a universal machine that can download your results to Diasend which will make sense of them.
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 Pattidevans

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Re: Appointments and new meter
« Reply #12 on: 25 October 2018, 10:04:08 AM »
PS, way back when Helen was my pump DSN (who was absolutely brilliant in every other way) couldn’t make sense of the 360 degree result either and she’d been trained by Roche. She used Diasend too.
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 Liam

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Re: Appointments and new meter
« Reply #13 on: 25 October 2018, 11:12:05 AM »
I think when you get the cable you can use diasend instead of the 360 software. I haven't done myself so I'm not 100% sure on that.

Interesting that it is infra red. I thought it was Bluetooth from the little I read last night. My pump uses infra red and it is slow and picky about placement.
DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
3/15 56 (7.3%) 12/15 49 (6.6%)
Ramipril: 10mg Quetiapine: 550mg Metformin: 2000mg

Offline sedge

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Re: Appointments and new meter
« Reply #14 on: 25 October 2018, 12:21:49 PM »
The Roche pumps and meters, all download via infra red.  The pump handsets and pumps communicate via Bluetooth.  As you say - they are also very picky as to placement when downloading.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4