« Last post by nytquill17 on Today at 02:40:17 PM »
The pod on the back started leaking about 12 hours before it was due to be changed, so I had to swap it out. First pod that didn't make it all the way to 72 hours. Other than that the back site was pretty nice, but I'm wondering if it might be not the best choice for me as a student with a backpack! I'll try another one eventually and see if I have any better luck.
Saw the CDE on Friday, she was very supportive again. Reminded me that I was probably overanalyzing/getting data overload and that's why I was feeling like things were so much "worse" than before. Felt a bit sheepish because that was one of my major worries going in (in fact one of the things that held me off getting a pump for so long) and here I was doing it anyway! Ah well! But I have tried testing a little less often (i.e. forcing myself to wait 2-3 hours between sensor scans, like I would have done if I didn't have a sensor) and I think it's helping with the anxiety. Plus just having now a few weeks under my belt and feeling a bit less like anything could go wrong at any moment - bit more confidence that I can spot problems and solve them, as with the leaking site the other day!
We also went over a few more things, mostly food related - she even mentioned bolusing for protein! I was impressed. And she had a really good trick for figuring out if the nutrition info on a package of e.g. rice or beans was for dry or cooked portions: check whether the number of carb grams is close to the total weight given for the serving size. If 70-80% or more of the serving weight is made up of carbs, that means there's very little water weight included in the serving size which means the nutrition info is for dry/uncooked. Can't believe I never thought of that, it's so logical!
We did discuss possibly tightening up my correction factor. They started me at 1u:2.5 mmol/L, and then when I had a lot of lows, put me up to 3.0. She said that according to the math (which is just 90 divided by your TDD - she said she doesn't know why 90 is the magic number but it is!) I should be closer to 1u per 2 mmol/L. That was exactly what I was using before on MDI, so it makes perfect sense to me. I agreed that my correction factor seemed too high to me - I feel like corrections at the moment just don't seem to do anything and I keep having to correct 2 and 3 times. Neither of us was comfortable making too big of a jump, so we went with 2.8 for the next little while and will probably keep dialling that in over time.
She also suspects that my carb ratio is off (currently 1:6). She thinks it will come up to 1:8 or 1:10 based on my TDD because I "don't use that much insulin in a day." I rather suspect it will go down to 1:5 or even lower. I did used to be on ratios like 1:7 for part of the day, but I find I have needed more and more insulin per carb as my weight has gone up and my lifestyle has gotten more stressful. Before going on the pump I was at 1:5 all throughout the day and sometimes even that didn't seem to quite do the trick. I think it just looks like I don't need much insulin because I eat moderate carb (vacation days aside). If I was eating the 200-300g per day that's recommended, my TDD would be much higher!
I had an A1c done on Thursday that came back as 8.1 - bit up from the one in March that was 7.8, but understandable given the roller coaster I've been on. Frankly, was expecting worse! Trigs were up again (also not surprising to me) but HDL and ratios were still pretty good. I was all geared up to firmly refuse statins (instead of just dodge the question) with my endo who I was due to see at the same time as the CDE...but she ended up having to go home sick just before my appointment time! Not that I'm pleased she was ill of course but it saved me from what probably would have been a pointless box-ticking appointment and gave me some extra time with the CDE instead which was more useful to me!
Friday evening we had a special meal that we sometimes make that is high fat and involves a lot of potatoes, and I successfully did an extended bolus for it and BGs were flat and level the whole time! I was quite pleased with myself hehe. OH is back to work on Tuesday and then I will be much stricter with my routines and food again and should start to see some real progress.
Something that still does concern me a bit is that the little holes from the infusion sites aren't healing up very quickly. I'm definitely a slower healer, more prone to scarring, as I age, but at this rate I'll need a site rotation scheme that leaves something like 2-3 weeks between repeats and I'm just not sure I have that much suitable "terrain" in the officially accepted areas - between avoiding skin folds and bendy areas, avoiding waistbands of different heights, avoiding places that I'm likely to sit/lie on or bang into, and leaving room for my Libre sensors... Eventually I will probably go "off piste" as many people do with the pods (and the sensors), but not until I'm more experienced and confident. I did ask my CDE about this, and she wrote to the Omnipod rep, but they only came back with advice about removing the adhesive. So it's another wait and see thing, I think - probably it won't be as big a problem as I'm anticipating, though.