Dec 14

Rethinking the OmniPod Long Term

By Cary diabetes, OmniPod, pumping 7 Comments »

Between myself and a friend we have lost almost an entire box of pods due to Pod failure in the past six weeks. Astronomical failure rate in a business where failure is death. I already have a list of complaints that still need to be fixed — but failure is not an option for Pods.  This morning I was pretty cranky — waking up at 6am with an empty Pod, go to fill a Pod and even before priming getting the siren of death. Angrily smashing it with a screwdriver helped.

Starting in 2011 I will likely take another pump vacation but hang on to the OmniPod for the time being too for cycling and busy work days at the office.

Insulet/OmniPod customer service is always polite, but not able to truly speak openly about the failure of the product or what they are doing to correct the situation. Maybe when a manager calls back they’ll ship me the replacement Pod as I requested and I even offered to pay the shipping on. Alas, it sounds like I will have to wait for my next shipment.

Customer Service follies: when something fails — fix it today; not when I get my next re-order since there may not be a next order.

My allegiances lie with patch-pumping; not OmniPod/Insulet. When the other players enter the market starting in 2012, we may end up with some real competition.

Update: As of Jan 2 I have lost almost an entire box of pods myself due to various pod failures (usually in the priming stage although some while wearing during the first 12 hours). It seems that OmniPod had a manufactoring issue that was disclosed at their investor conference call; but did not issue a recall since the phone-in complaints were only marginally higher (although noticable in their call center).  My wonder is what the people that toss the Pods and either use a new one or switch back to their old system.

Update 2: As of June 2011 – the last few months using a fresh box of pods has been quite sucessful.  Basically no failures.  And still, no competition to speak of as OmniPod gets closer to releasing their next gen pod (I hear talk of early 2012).

Nov 01

JDRF Ride to Cure Diabetes – AZ

By Cary diabetes 1 Comment »

Support us on our Ride to Cure Diabetes for JDRF

We will be in Tucson, AZ later in November joining up with the Tour de Tucson.

Oct 12

Meme

By Cary diabetes, lifestyle No Comments »

What type of diabetes do you have: Type 1

When were you diagnosed: 1988


What’s your current blood sugar: 155

What kind of meter do you use: OmniPod + FreeStyle Flash + basically the entire suite of OneTouch products

How many times a day do you test your blood sugar: 6-12; depends upon the day and activity

What’s a “high” number for you: 225+; I refuse to do a correction until I am over 180 due to glucometer inaccuracies.  I have trust issues if you can’t prove your worth.

What’s do you consider “low”:  < 70

What’s your favorite low blood sugar reaction treater: Fun Size candy — 10g each = about 35 BG points for me.  Tried glucose tabs when I was a kid, tasted like dirt and cost a fortune – no idea why they still make them.

Describe your dream endo: Writes perscriptions EXACTLY the way I tell them to and does not balk when I don’t show my face in the office for a year or two.

What’s your biggest diabetes achievement: I’ll let you know when I get there!

What’s your biggest diabetes-related fear: Loss of vision, organ issues.

Who’s on your support team: Wife-to-be, family, friends. Anyone willing to share creative ideas.

Do you think there will be a cure in your lifetime: Not really, but I wouldn’t turn it down.  I think a more functionally complete closed loop is a reality, potentially an implantable.  Also, smarter insulin seems much more likely.

What is a “cure” to you: Pop a pill and it’s gone.


The most annoying thing people say to you about your diabetes is: You rode a 120 miles on a bike this weekend? (Answer: Yes, yes I did.  And I only didn’t go for a run because it was getting a little dark out and wanted dinner)

What is the most common misconception about diabetes:  T1/T2 confusion.  It’s not as bad as it once was, but starting to get more confusing with LADA, gestational, and T2 becoming dependent upon insulin; so many are crossing over to my turf.

If you could say one thing to your pancreas, what would it be: You’re busted, dude.

Oct 11

Un-Tethered Regimen

By Cary diabetes 1 Comment »

A few years ago a read about Steve Edelman’s The Un-Tethered Regimen. This is something that I always thought could work – but never had the guts to try.  However, I always thought it would be a fun experiment when I went on the OmniPod for the first time.

Basically, you take a portion of your Lantus as basal and remove that portion of the basal from the pump.  Therefore, you continue pumping normally, but upon disconnecting from the pump, you will continue to have a supply of basal (Lantus).

My Lantus dose is 14u/every12 hours.  In my experience, Lantus only lasts 22-23 hours before it tappers away.  It took me a few years till I realized this by switching time of day of the injection.  However, the other added benefit of doing it every 12 hours instead of every 24 hours is you can customize your “basal”.  If I take my PM dose, but lower my AM dose by half, I have 75% basal for the next 24 hours as long as I keep my PM dose the same.

Going from Pumping to Lantus:
Sunday dinner time, 12 hours before removing the OmniPod, I take 14u Lantus, set basal on pump to 50% for 12 hours.  When I wake up in the morning, 12 hours later, remove the OmniPod and take 14u Lantus.

I like using Lantus during the week because gym excercising is more comfortable to me.  It’s much more of the sweaty uncomfortable workouts than riding or running outside.  As an added benefit, I actually eat less because I have to take a shot with every meal; not exactly easy when wearing a suit.

I have been switching from OmniPod to Lantus and back for about 3-4 weeks with very good success.  The 12 hour transition window is a very important area, but one in which can be easy once solidified with comfort in this kind of drastic change.

Oct 08

Diabetes Dream Team

By Cary diabetes 3 Comments »

I’ve been putting a lot of thought into my Diabetes Dream Team lately.  And contrary to popular opinion — it’s a one or two person job for the type of personality that I consider myself to be.  And that person is me and that second person is a rotating specialist.

I am not an elite athlete; however, I am active and intend to stay that way.

I play the role of quarterback on my team — I make the calls every day, year by year.  I have changed doctors countless times.  And over the course of the past 20+ years I’ve made some terrible choices and some really good ones (mostly by listening to doctors when I should have done it my way).  And without making bad choices, I would never have learned how to do things the right way.  No doctor would ever prescribe the current regimen that I use (in fact, it usually takes a very long time to explain it to people who have a very high level of understanding in the world of dAthletes).

Unfortunately, the limiting factor in what I do with my diabetes is the doctors and our current health care system.  I do not see nor require the help of a CDE, nutritionist, etc.  I need someone to write my prescriptions and simply walk away and let me do my job. Live.  It’s a sad reality of chronic conditions that are well maintained.  The doctors cannot get paid unless they have an appointment, and the control they have is their prescription pad.  Therefore I must go in about once a year to get new prescriptions written – -because after a while, the doctor will stop auto-renewing it if you don’t show your face.  Clock a decent A1C, chit-chat for a half hour and walk out with a pile of Rx’s for the next year.  And if I’m feeling up to it, get some blood work done (it’s been a few years, I think this January some will be done).

And as long as I can continue to runs like this 7.5 miler home on a whim, I can continue along my system.

My dream system: me, a doctor (potentially an endocrinologist) that I can just email for an Rx when I need it. Eyes checked every 1.5-2 years.  Come to think of it — I should just head back to Boston and do everything through Joslin again. And my wife to be for her support.

Aug 17

Long Distances, Sailing, Diabetes

By Cary diabetes, OmniPod, sailing No Comments »

I have the privilege of being able to do many distance races over the years (sailing, cycling, etc).  But when a race becomes a multi-day affair things get complicated quickly.  With the OmniPod, I only have a maximum of 3.5 days of life.  What’s my backup?  Well, it may surprise you, but it’s not another Pod.  It’s heading back to MDI. Rocking and rolling at sea is not easy to load up the pod and keep it flat while it initializes; however, I’ve been giving myself shots long enough to be comfortable with a tiny pen needle in pitch black (or my red-light headlamp to keep my night vision stable).  And I’ve made the mistake of moving it once during the initialization process — the Pod just kills itself.

As I’ve mentioned before about “feeding the basal” (taking more Lantus, or basal in the pump than is required to sustain a BG).  I do this so I can eat small snacks throughout the day and not need to test/bolus for everything I eat.  My PDM rarely comes out of its plastic bag, and never comes topside (it always stays down below in my bag).

This weekend we are headed for a 150 mile sailing race.  Should be a 24-30 hour event.  I’ll put a new Pod on 12-24 hours before heading out.

Diabetes Packing List

  • Waterproof bag 1: PDM w/vial of test strips & pricker
  • Waterproof bag 2 (backups): meter, test strips, pricker, lantus & novolog pen + pen needles
  • Waterproof bag 3 (Pod backup): 2x backup Pods, vial of Novolog, alcholol wipes
  • Secret Stash: 1x bottle coke, small candy, Gu

Notice that this is not a lot of stuff.  My sailing gear takes up 98% of my bag – no room for excess stuff that I will not use (but I could live for a week in survival mode with what I bring).

Aug 06

OmniPod Correction Bolus / IOB

By Cary diabetes, OmniPod 2 Comments »

A while back I wrote about how the OmniPod calculates IOB in a different way than my old pump.  The OmniPod does not take into account meal boluses for IOB — only corrections.  I gave a small correction bolus today forgetting a large meal bolus I took earlier in the day and ended up stacking my insulin until coming crashing down.  Going back through the history of the pump, it is evident that I should not have taken that bolus.  Really wishing I could modify the software on this pump occasionally.

It’s really great — until you get hung up on a small difference in the way they do something that does not jive.

Jul 19

Deltec Cozmo Cartridges (2 boxes in NYC)

By Cary diabetes No Comments »

I have almost two FULL boxes of the 300 unit cartridges for the Deltec Cozmo. If you are in the NYC area and could use them — please let me know.

Jul 12

NY Times City Room Blog: Brooklyn Cyclones 2x T1 Diabetics

By Cary diabetes, exercise, lifestyle, pumping No Comments »

I might have to go down to Coney Island to check these guys out before the baseball season comes to an end. Two type-1 diabetics playing for the Brooklyn Cyclones (minor league).  One player uses a pump, the other does not.  I really think that is great — they both are using what works well for them.

http://cityroom.blogs.nytimes.com/2010/07/10/sweat-bats-right-slides-left/

Jul 11

Beating the Heat – Safety

By Cary cycling, diabetes, exercise, Running, sailing No Comments »

Heat safety is something I am acutely aware of on a personal level.  As a diabetic athlete, it is of even greater necessity because I can use my senses to identify low and high BGs.  However, when high heat temps, and high humidity hit my BG sensitivity is thrown out the window.  This is because I am constantly thirsty, always a little tired and may or may not have a heat headache.

I found this guide made by Gatorade for the NFL (and football players in general):

Beat the Heat – Gatorade

It’s a pretty good guide and very informative using football references to make their points on heat safety.  The points are quite clear — prevent, prepare, hydrate, and plan.  I have to admit, my plan for heat stroke would obviously not to hit that point, and to be aware enough before that point to seek professional help, since I usually train alone.  But for preventing, knowing the symptoms are key.  One thing I did not realize is that it can take 10-14 days to acclimate to warmer conditions.  However, the biggest point is to hydrate regularly and properly.  Replacing electrolytes and sodium (and sometimes carbs too) seem like a no-brainer these days, but it was not too long ago when that was not as common knowledge.

Personal Story
As a kid, I once had the unfortunate experience of an ambulance ride and ER visit.  During the summer months of June, July and August from a young age, we learned how to race sailboats.  All day, every day; with a break at noon on land for lunch.  One day I passed out during lunch.  An ambulance was called, and the people around me knowing I was a Type 1 Diabetic, the EMTs instantly administered Glucose via gel under my tongue.  However, by this point I was already coming to (since I was being fed Coke from the fountain).  Upon being admitted to the ER, I learned that I was both dehydrated AND had low sodium.  A disastrous combination – with a slightly low, and at that point in the ER I was trying to lower my BG after way too much soda and Glucose gel while they got fluids into me by IV.

Learning Experience
Stay hydrated, watch the color of your urine.  And make sure you urinate regularly.  And test frequently (like I really needed to say that).

Previous Entries Next Entries
preload preload preload