Wednesday, June 26, 2013

Pumping Like A....Novice.

It's Day Two, and I'm all hooked up!  I'm a cyborg now.

I went in and spent 2 and half hours with the CDE/T slim rep who when she heard I was coming, thought I was a different Heidi who was already on a pump, so instead of just training for a "pump upgrade" like she thought, she got to explain the finer points of pumping along with the finer points of the T:slim.

HAHA.  Sucks to be her.  She's super nice, though.

First of all, this is a crapload of tubing.  SO MUCH TUBING.  When the (other) Tandem rep called and asked what kind of infusion set I wanted and how much tubing, I was pretty much clueless, and I said I wanted the shorter length.

"Oh, are you kind of a short person?"

"No.  Five seven."

And she convinced me that I wanted the longer tubing and if there was extra, I could just tape it to my stomach. So I listened, because surely she knows more than a novice like me, and she was wrong, and now I have massive amounts of tubing getting in the way of everything.  The reorder will be shorter for sure.  The CDE was mildly annoyed about this - "Does SHE want things taped to her stomach?"

(This is my body now.  Super, super sexy.)

Second of all, at dinner, I bolused for the meal and then I ate some Froot Loops and then I didn't have to find another needle, and that was cool.  Also, I mostly ate the Froot Loops because of this.  One of the the reasons I wanted the pump was so I could eat more if I decided I wanted more than the initial guess finely tuned calculation of how many carbs I would eat. Breakfast cereal and I don't really get along, and I don't really remember the last time I ate some, apart from granola in Greek yogurt.

 (Hello, my little bowl of carcinogenic death circles.   I love you.)

Third of all, it is bizarre not to reach for that bottle of Levemir at night.  It's become kind of a bedtime ritual, and I can't go to sleep until I've checked my sugar and dosed the basal.  Last night, I didn't do it. This morning, I reached for the bottle first thing, only to remember that could potentially be very bad.  The tubing reminded me of this.

(It reminded me of when I got Lasik surgery.  The very last thing I did every night was take out my contact lenses, and everything being blurry became a sleep trigger for me.  Falling asleep with good vision took some getting used to - I did not realize how much I depended on this, and insomnia followed for a week or so while I adjusted.)

Fourth of all, I still went high at midnight.  Grrr.

Fifth of all, apparently my wardrobe is completely wrong for hiding this thing.  I guess everybody will just think I have a pager. I should probably buy some belts for clipping.  Also, running shorts were recommended?  To stick it in?  But doesn't that mean I will be go digging around in my pants/skirt in order to reach that bizarre bulge?  That doesn't seem creepy at all.

Sixth (and lastly), what with this and the Dexcom site, and all the rotations, I am going to seriously run out of real estate.  The gal said she had some clients who put the infusion sets on their boobs because of the side effect of fat buildup where the insulin was, but she wasn't recommending anything.  Now there's a benefit I never considered.....

So far, so good.  I think this is a good thing, even if it will take some experimenting, some adjusting, and some swearing along the way.

Tuesday, June 18, 2013

Quick! Tell Me Everything!

My new T:Slim pump comes on Friday.

So excited.

Also, freaking out.

Often, change is not my friend.  But I think this will be good.

I didn't know the answers to "How long do you want your tubing?"  and "Which infusion set did you want?" Um, you can't send me one of each?  Let me wear them all and then choose?

So, quickly!  Tell me everything I need to know about pumping.  Pros, and how to enhance them.  Cons, and how to diminish them.

I will of course meet with a T:Slim rep who will help me out.  What questions do I ask her?

Also, when you start pumping?  What do you do about the basal insulin (for me, Levemir)?  Not take it the day you start the pump?  Not take it the night before?  Take a little?

Help me.

Thursday, June 13, 2013

Went to the Endo today

Got some blood work, had a little chat, it was all good.

I was very nervous to tell him I had taken myself off the Lipitor.  There are plenty of doctors who don't like that, they call it "non compliance" and you can be dropped for it. My PCP would argue with me a lot about it.

(Just in case you were wondering, going off the meds helped a lot. Within a few days, correction doses were working again.  Insulin actually brought my blood sugar down.  Meals weren't a nightmare anymore.  It was a miracle.)

And then I remember why I love my endo so much.

He said things to the effect of "You know, I see a rise in blood glucose in some of my Type 2 patients with the statins, not yet in a Type 1, but that doesn't mean it can't happen."  "There's just a lot about drug interaction we just don't know. It really needs to be studied more"  "I'm going to bring this up in a conference I'm going to, see if others have dealt with it."  "Let's check your cholesterol and run another VAP test, and then we can revisit the statin issue if necessary".  "Have you tried red yeast rice?"

He didn't judge me.  He didn't roll his eyes.  He didn't tell me how much the benefits outweigh the risks.  He just listened and believed me, which he ALWAYS does, and this is why I LURVE HIM.

Then he looked at my chart, and then at me and said "Did you not want a pump?  Why aren't you pumping yet?"

YES.  YES I want a pump, last time I asked for one and we were going to wait to see if the T-slim and the dex talk to each other, but I'm tired of waiting, and let's do this thing.

"OK, let's check 'volatile control' and 'major swings' and see if you can't get approved.  You got approved for the CGM, so it should be OK, but I'll tell them how much you need it.  Your a1c's might not be bad enough, though.  Let's try, though."

And so I began the paperwork for the pump.  SQUEEE!!  Let's see how this goes.

A1c came back at 6.9.  This is still "under 7" but it's also "the highest I've seen since diagnosis" so I'm not really thrilled about it. I'm also not beating myself up either, it does reflect a lot of hard work, and I can't really say I'm surprised either because you know, lots of highs.

Cholesterol - with no statins, is pretty much the same as it was with the statins, and the LDL was in the 160's, which isn't stellar, but like, you know, whatever.  HDL was over 50, which is awesome, so there's that. He didn't tell me the triglycerides, which means they were good.  My triglycerides have always been good, and those seem to be the real indicators for heart disease, I think.  What do I know, though?  I could be delusional.

I'm happy to see the new results of the VAP.  Let's see if this is still fluffiness flying around in there.

Hopefully I'll be a cyborg soon.  Fingers crossed for the pump. :)