Metal or plastic?
After Friday’s emotional meltdown, I had vowed to keep myself under better control going forward. My wife had made Saturday dinner plans with friends – they were preparing a Mexican Cinco de Mayo feast, so I knew it wouldn’t be easy. But unlike so many people who halfheartedly try to quit smoking or lose weight – starting tomorrow – I wasn’t going to take the easy way out. My road to recovery started immediately. I think I did OK. Not wonderful, but all things considered – OK.
So the last thing I needed this morning was to wake up before 6 am with a blood sugar over 300 and a NO DELIVERY alarm.
By the way, Friday’s doctor visit didn’t end where Friday’s blog story ended (this is Dr. Right after all, remember?). We talked about a lot of techniques and strategies, some obvious, others not-so-obvious. I’ll discuss them in a future post. But one thing I mentioned was how I’d been having so many site problems with my Silhouettes lately. I can only speculate as to what was happening – I believe that little puddles of insulin were pooling up in the cracks of my asphalt scar tissue, and when I got fed-up and ripped out the set, it created enough of a splash that three rage boluses escaped the confines of the pothole and got absorbed all at once, leading to a massive hypo. That’s my visualization, anyway.
I don’t have a whole lot of real-estate on my body to begin with, so when a seemingly 6-inch long Silhouette needle goes in at a 20-degree angle, that takes up a lot of space and traumatizes a lot of tissue.
At nearly the same time, my medical professional and I reached the same conclusion. Sure-T.
Dear Jess, thank you, thank you, THANK YOU for your write-up on the Sure-T back in March! (and congrats on your new top-level-domain web address!). I must’ve read that ten times, and each time the Sure-T seems more and more attractive. After giving so many boluses-by-syringe because of site failures lately, I realized how nice a regular needle feels compared to the big Silhouette needle with a cannula on top.
I’ve overcome my fear of a small steel pin in place of a big Teflon tube. Besides, iron (present in steel) is natural for the body. The coating on non-stick cookware is not. I left the office with three Sure-T samples and a quick crash-course on how to use them. Easy peasy.
Back to this morning. Meter BG of 309 (CGM read 243. No trend arrows, but an uphill trace), so I run downstairs to get my emergency supplies from my jacket pocket (because what use are they if you’re out and they’re home?). Ketone results are… inconclusive.
Note to self #1: Your ketone test-strips expired more than six months ago. Get some new ones.
So I take four units by syringe, just to be sure, because I’d rather treat a low than a high. Then, not fully awake yet, I made the decision to try a Sure-T. The timing was perhaps not ideal considering the wild blood sugars I’d been having, but I’d been eager to start them and the Sils clearly have been falling out of favor with me. (This is not a knock on the Sil or its twin, the Comfort – it’s a great set that I’ve happily used for over five years – and it may be great for you, too. YDMV [Your Diabetes May Vary], and my D is varying at this very moment).
I hadn’t been through a formal training or demonstration with the Sure-T, but it seems simple enough. Like putting a thumbtack in a corkboard, only I’m the cork. I could figure it out. So I’m all set to go, and…. wait a minute… how much insulin do I use for the fixed-prime/fill cannula? I went to Google and didn’t see the answer. I watched a dopey consumer-targeted video on the Medtronic web site and didn’t see an answer. Eventually, I found this PDF on the Medtronic site.
Note to self #2: Sign up for Twitter. I probably could’ve asked the question and had an answer from someone instantly.
The answer to the fixed-prime question: you don’t. Fill the tubing until insulin drips out of the needle, then stick the whole damn thing in and remove the adhesive. Done and done.
Note to self #3: When filling the tubing, point the needle down. If it points up, the insulin drips on the set, de-adhesifying the adhesive.
First impressions are that, because of the Sure-T’s lower profile and small, straight needle, this has opened the door to so many possible parts of my body that I can use that I wouldn’t dream of using with the Silhouette. Also, because of the nature of this set, in which there’s always some amount of tubing on the body, I’ll need to be more careful when showering that I don’t rip it out. Finally, since the needle is so small, I feel it could pop out at any moment and I’ll never know. (Also, what’s with the two, rather than three, day limit on these things? Is that for real?)
I’m not sure if I’ll stick with the Sure-T or if it will solve my set problems. I’ve got a nice stash of Silhouettes on standby, but I’ll give these new ones a try. Maybe I’ll convert, maybe I won’t. But I’ve got to try something, otherwise, I’ll never know.