Friday 25 March 2011

Time for a change

My One Touch Ultra Smart blood glucose (BG) meter has been a trusted friend of mine for about 3 years now. Reliable, accurate and reasonably small it also comes with rather handy, easy to understand and user friendly software which allows me to look closer at my blood sugar level patterns and pick out places where I may be making mistakes or may need to just re-think my sometimes gung-ho approach. BG meters are usually made of pretty tough stuff and can take any amount of knocking, jolting, dropping or occasional launching at walls (it was a very bad week, OK?) without great incident. But alas, my trusty meter has started acting a little weird on me.

Us T1 diabetics have to test our blood sugar levels anything from 4 - 15 times a day depending on the day. These readings then tell us if something is wrong and what action we need to take. If our sugars are low, we need to stock up a bit and have something like fruit juice or high sugar food/drink. It they are perfect, we can do nothing and celebrate this perfect but no doubt fleeting moment. If they are high, we may need to take insulin, check our pumps are working, do some gentle exercise or curl up in the foetal position and sulk for an hour or so. I favour the latter on a fairly regular basis.

But the fact is no matter what they are telling us, these blood tests are key in managing the condition. I am a firm believer that the road to better management for everyone starts long before the insulin pump, CGMs or low carb diets. I would place good money on someone who has bad control and never tests their BGs improving them vastly by doing more blood testing alone, due to the basic fact that unless you know what your sugars are doing, you have to second guess everything. Once you are aware of what is going on, you makle little adjustments like not drinking treacle and or snorting that icing sugar (I'm kidding, just in case).

So when my trusty meter started taking a big old pause before giving me a result, I started t0 worry. I have a tendancy to do quite a few tests, including the times when I tried out CGM and rather than doing less tests (which is one of the key selling points), I effectively tripled how many tests I did, because obsessive crazy diabetic Anna (ah, OCD, I get it now) is never far from the surface. So the thought of being without my testing kit for a while is a little daunting.

But things change a lot in three years. Since 2008, we have seen a new President of the US, Omnipod landed on the UK shores, 24 finished filming (sad face) and who could forget Katie and Peter splitting up!? Who saw that coming....?

Anyway, with all the changes and advancement in technology on the diabetes front, it is fair to expect that blood glucose meters have also changed. While I love mine and it will take some time to adjust to a new one, in the last few years there have been some new editions to the blood testing arsenal over here. Two of these are:

The Bayer Contour USB:

Now this little device is quite nifty. Not only small and smart looking, it can be plugged into any USB port on a computer, where it will then upload results for the similar kind of analysis to which I referred earlier. I've heard people comment that it doesn't have the most user friendly 'interface' (mmm, neither do I depending on the day) but I have to admit, it is pretty high up on my list of maybes.

The next one is the Everymed x3.

Now this one is only used by 2 UK pumpers, and was suggested to me by my good friend Andrew at 'My Pump', who was kind enough to hook me up with an email exchange to the distributor in the UK. Although it isn't as small, it appears to be completely self contained and I believe has a drum of 6 strips held in the device meaning if you were restrained enough to only do 6, you would have a full days worth. My problem is I am more of a 56 a day kinda gal. Will that be enough for me? Not sure. But if the marketing is correct and I will always be 4.5 mmol, then who'd say no? :)

Anyway I will be having a little experiment in the next few weeks as Ultra Smart is known for being rated as 'excellent' for accuracy, so if I am to move away from my current system, I would want to know that my blood sugar readings will be in good hands (no diabetic pun joke intended).

I will definitely keep you posted about my future experiments!

Over and Out

Sunday 20 March 2011

Medtronic 2nd Annual Bloggers forum: Telepathic Bolusing and the Dia-RA

In my last post I told you that I had been lucky enough to be invited to the second annual bloggers forum created and facilitated by Medtronic, the makers of my pump. I was first invited to the event in a series of email exchanges between myself and one of the Medtronic team several months ago. Excited even at the prospect of meeting other bloggers, I jumped at the chance. I mean tea and biscuits at the Medtronic office in Watford - who would say 'no' to that?!? Well it turned out my highly anticipated tea and biscuits afternoon in Watford was in fact a weekend conference in Geneva,Switzerland, much to my surprise (and delight).

I wasn't really sure what would be in store for us or even who was going to be there, but I knew the idea was to get a group of bloggers together with some key players at Medtronic to discuss products and services, patient empowerment and of course to meet other people who like to talk so much that eventually we had to start a blog, simply so we could find another outlet for our over-active communication gene.

The weekend started on Friday with a rather well-placed hypo at the airport thanks to - I imagine - being slightly too excited about the weekend and forgetting to eat lunch. At the airport I was met by the Medtonic Product Manager for Europe, who was already deep in conversation with none other than the likes of Lesley from Input and Andrew from My Pump. It began to dawn on me that I was going to be spending my weekend with some pretty heavy-weight bloggers, after having already found out that Tim and Alison of Shoot Up or Put up and Mike of Diabetes in Spain would be going. At this point I was fairly confident that my invite was more likely to be as a result of an admin error than anything to do with how far-reaching my blog was. I mean, I can safely assume from the stats on my blog that I have at least 11 followers (who I love dearly) but in terms of reaching the far corners of the globe, I am reasonably confident that Insulin Independent isn't quite at the dizzy heights of Blogosphere fame just yet.

But nevertheless, I found myself on a flight to Switzerland, sandwiched between two smartly dressed businessmen who didn't seem nearly as excited as I was. Perhaps their plans didn't quite measure up to mine. Not many would have, I expect.

Meeting everyone for the first time was both exciting and a little daunting. I can't deny that I felt a little dwarfed by the calibre of bloggers (Adrienne and Jan and Richard to mention a few) and representatives of significant patient advocacy services who were there. But it quickly became clear that we all shared a great deal of motivation, like-mindedness, passion for diabetes advocacy and a belief in equal access to high quality diabetes treatment options for all of us living life with a duff pancreas. On top of this my nerves were calmed by the instant openness and friendly attitude of everyone in the room.

Surprisingly for me, despite being called "The 2nd annual Medtronic Bloggers Forum", there were very few people there who used a Medtronic pump and as far as I could tell only about 50% of the people there were in fact bloggers at all. But it was clear that for Medtronic, this wasn't about selling their product. This weekend was about finding out what the people behind the funding cheque were all about and how we could be used (in a good way) to improve services and expectations of their Company. Although I have no doubt that the 10 subsequent blog posts about how great a weekend it was and what a top-notch company they may have featured on the radar in their decision making process .... :)

The topic of discussion for the weekend was Left Brain,Right Brain: an idea which Tim of Shoot Up or Put Up fame (which I understand is the blog to watch out for on the world domination front, as Tim assures me) had suggested some time ago, all about how we spend very little time looking at the emotional side of living with a chronic illness. Far out for a company whose employees pay for their holidays by only worrying about the physical, don't ya think? Perhaps it was this refreshing attitude which helped make the weekend such a success.

It is difficult to say which part of the weekend I preferred the most, seeing as anything to do with diabetes tends to appeal to me. And the whole weekend, while being an opportunity to meet with Medtronic themselves and talk 'shop', was filled with entertainment and laughter. Nothing can beat a bit of general silliness like the suggesting of telepathic bolusing or starting a terrorist organisation called the DiaRA (think IRA), who could kidnap famous people and give them a pancreatectomy so as to raise the profile of Type 1 diabetes (full memo and sign up sheet to follow). I was even able to convince the group to participate in a nice and cheesey American Blogger Style group hug. Feel the love.

The whole weekend was a great opportunity to see what Medtronic are made of and watch as an active participant how the relationship between Medtronic and some of the perhaps more demanding of their clientele can develop. I certainly hope that this is something which will be continued and will allow us to put type 1 diabetes in the limelight more and more.

Wednesday 16 March 2011

Medtronic 2nd Annual Bloggers Forum

About 15 months ago I began a project - this blog. I wrote my first post the night before the highly anticipated appointment at which I was due to attach to the insulin pump for the first time. Truth be told the thought of the cannulas, tubing, chunky pumps and being completely dependent on it made me very nervous. People I have met since hooking up for the first time seem to be excited about getting one but for me, it was a last resort. After years of continued failed attempts at obtaining any kind of 'control', I had admitted defeat and decided that this was the only way I would make it to adulthood (no comments please!) with all my limbs in tact and still able to read a book. So I waved my metaphorical white hankerchief in the air and accepted my fate. Before I'd even had a chance to get my first ever cannula change wrong, I was almost prettythat while my control may get better, the pump could well have been the end of my life as I knew it.


The last year and a bit has been an enormous eye opener for me, including discovering my clapped out old body begin to repair itself thanks to improved blood sugar levels, meeting a diabetic community thriving in the face of adversity and inevitability and being lucky enough to be invited to some fantastic events, including joining (sort of) my friends Lee and Claudia on their 20km 'Diabetes Challenge' by wheelchair and bike raising money to give our shared condition the' V-sign' by completing a massive goal, diabetic aside. I never truly expected anyone to read my blog, seeing as it was effectively a slightly self-important public diary detailing me fumbling my way through cannula changes and kinked tubing. So to click on my blog today after a slightly embarassing amount of time away, to see that so far not only have I had 2675 clicks on my blog, of which I am sure 20 or so of those weren't even mine, but I am also number 2 on the google result list if you type in 'Insulin Independent'. I mean if that isn't acceptance I don't know what is!

Seriously though, the experiences I have been lucky enough to go through in the last year have been entirely humbling and have opened my world up so much more than I ever believed it could. I have met people with whom I know I will remain life-long friends, have met people young and old alike who have inspired me to work that little bit harder when it comes to blood sugar control, and have been lucky enough to do all this while staying fit and healkthy. Something us in Club-D can nevr take for granted. So when I was recently asked if I would like to take part in the Second annual Medtronic Bloggers forum, which is held in Geneva, I almost fell off my chair!

"Me? Really?" is what I asked myself for the first week or so, before it really sunk in.

Having now had a chance to read some of the blogs written by the other bloggers going, I feel fairly confident that Medtronic have in fact made some kind of massive clerical error and are a little too far down the line to correct it, but I love nothing more than to get in a room with other pancreatically defective people and talk about all things diabetes, so give me a pen and show me where to sign up!

More on this later!

Tuesday 1 March 2011

The Microsoft way of thinking

It's no secret to anyone who reads my blog (or is 'friends' with me on Facebook) that I have been having a 'blip' diabetes wise lately. No big deal, everyone has them, right?
Well for me the odd blip here and there is normal. There will always be the days of miscalculated dinners, the biscuit which had more carbs than you thought, the stressful day at the office which renders your insulin all but useless and those days when you just can't figure out what went wrong. But this latest blip of mine seems to have not only lasted longer than normal and for the life of me, I have been simply unable to fathom it. My diet hasn't changed, my weight hasn't changed, my routine hasn't changed. Nada!
So for the past two weeks I have been stumbling from one frustrating blood test to the next, becoming more baffled and more irritated with each test, exercising my right to swear at random and sometimes inopportune moments (mainly at my desk with my boss in earshot). One minute I seem to be in the major hypos, the next I am having 'highs' even the most hardened drug addict would be phased by.
I guess the most frustrating thing about this last couple of weeks is that it was all too reminiscent of a life I thought I had left behind. A life which involved nothing but fear of the blood test machine, fear of complications and fear of my own body. Deep down I suppose I always knew that it wouldn't last forever, but being grown up about it and being able to see the wood for the trees can sometimes be hard, particularly when it is my body and my health at stake.
So this weekend I decided enough was enough; it was time for some drastic action. Not only to save my own sanity, but that of my poor facebook friends and family members who no doubt have barred me from ever being allowed to comment on their wall again, following my many desperate and harassed sounding status updates. I wonder how many people can delete you in one weekend, before you get an official warning about the content of your updates.
So, I decided if it was good enough for Bill Gates it was good enough for me. I quite literally turned it all off and on again.
That is, I unplugged my pump, dusted off my insulin pens and needles (having found a stash at the back of the diabetes cupboard) and brought it back to basics : I minimised my carbs to a very basic amount so that I could make fewer mistakes when it came to boluses, I didn't do any stressful exercise, I made sure I got a perfect amount of sleep, ate healthily and tried to stop testing my bloods so fanatically.
It must have been about 3 hours before I started to miss the pump; noticing that only being able to inject full units at a time is very difficult when you are eating low carb and sometimes a meal consists of 15 grams of carbs. Do you inject one or two units? With the pump it isn't an issue. With pens, it is.
Hello and [un]welcome back injecting in public! I had forgotten all about this beast of a task for a diabetic. I had never realised what a pain this was when I had to do it, but having joined the pumping club, I had obviously adjusted to the much easier way of life that was whipping out your pump or better still, notching up a couple of units on the remote control that is all possible on the pump. But it was not so on my 'days off'. Back with a vengeance was the 'do I go to the loo or inject in front of that woman who won't quit staring' dilemma. I had forgotten what a pain that was. And I think I have a new found appreciation of the ease of just tapping a few buttons.
Another thing I was reminded of very quickly, was that on a pump, you have exact knowledge of how much insulin you have in your system in any one time. When you first programme it, you tell the pump just how long your insulin takes to wear off (based on your own experiments). So if you test your blood glucose and find a nice big fat double digit staring at you, on a pump you can check to see how much 'active insulin' you still have in your system. Sometimes I ignore what the pump tells me, because if my sugars are up near the 20s, then it is pretty obvious that I need a whole bunch more. But if you are 12 or 13mmol, you really need to know how much active insulin you still have. If you have 5 units, it would be kind of silly to inject seeing as the active insulin will still be taking effect. It wasn't long after taking the pump off that I realised how useful this function is, and how much I must rely on it! Ever noticed how much you miss the clock on your kitchen wall when you have to take it down to get more batteries for it? Well it was a lot like that.
I'm sure that had I stayed off the pump for much longer I would have found a million things to 'miss'. But the fact is, 48 hours off the pump was enough for me. I got to spend a weekend without wires, batteries and a beeping chest and I got to have a couple of nights without having to wear my pump to bed. I got to feel 'normal' for a little while.
But it was never going to last. Within a couple of days I noticed even bigger swings than before, and not having the sound knowledge that I have with the pump, I re-connected yesterday and plugged back in to the Matrix. It's much nicer in 'there'. Safer, I guess.
Today I have somehow managed sugars between 4.1 and 8.4 mmol. I'm not sure what made the difference. Perhaps it was the low carb, perhaps it was cutting myself some slack and having some time without the pump, perhaps it was the natural end to the blip.
I have no idea - and knowing type 1 diabetes as well as I do, I don't think I ever will.
But what this little exercise did teach me is that I do like my pump, even when it can't solve all of my diabetic hassles.
I missed it, I needed it and I remembered why I like it.
Perhaps when it comes down to it, that's what I needed; to be reminded of why I do this on a daily basis.
Anna (7.7 and trying not to rock the boat!)