“The Hook” brings you back

It’s been 6-1/2 years since I’ve been pumping insulin, and I’m up to on my fifth Medtronic pump. This is my third since the start of the year. I know there are other pumps out there, and I probably owe it to myself to look into one of them (especially if Epsilon lets me down!). I’m sure there are better CGM’s out there, too.

But there’s something that keeps me loyal to Medtronic. Something that I don’t know if I can ever give up. I call it “The hook”

Because the hook brings you back
I ain’t tellin’ you no lie
The hook brings you back
On that you can rely

I’m a stats guy. A numbers guy. For years, I worked for a well-known mobile telephone service provider where I spent years building, optimizing, and troubleshooting the wireless network. How did I do that? By analyzing numbers. Dropped calls, attempted calls, successful calls, quality of calls. Lots of sets of numbers reflecting customer experiences in lots of places: Bayside, Bay Ridge, Bayonne, Torrresdale, Tacony, Trenton. Daytime, nighttime, springtime, football Sunday. Oh, and the technical: frequencies, antennas, timers, settings, parameters. Each scenario comes with a different set of circumstances and different behaviors, and each comes with a different set of numbers.  And it’s my job to make sense of it all, to find the problem areas, and make them better.

It makes my head spin. That’s why I always made it a mission to organize these numbers. Rows and columns can give the details, but they can’t give the picture. The best picture is… well… a picture!

What does this have to do with diabetes and Medtronic? I’m getting to it.

From the time I was diagnosed in 1981 until I met my current endo in 2010, I’ve been instructed to keep an honest log book. Early on, it was easy: glucose reading (urine or blood) 4 times a day, units of insulin taken (regular and NPH) and the site on my body once or twice a day.  But I was no good at it then, and when MDI and carb-counting came along, it was that much harder to keep a log. Not only is it hard to keep a log, but it’s hard to interpret a log! So I didn’t do it.

Enter CareLink Pro. It’s the “Physician’s Only” version of the CareLink tool that Medtronic pumpers get to use at home. And all doctors don’t even know about it! My endo-before-this-one would have me laboriously navigate through the screens of my pump and recite all of my settings: basal, bolus, sensitivity, etc. He didn’t have CareLink Pro. But Dr. Right? The first time I saw him, he asked for my pump, and what he brought back amazed me. The second time (I was using a CGM by then), I was completely blown away.

Logging, who the hell needs manual logging when you’ve got THIS:

(Click all images to enlarge)

For illustrative purposes only. Please don’t judge me.

Downloaded from my pump and printed out by CareLink Pro.  All my blood sugars, my carbs, my boluses, and my ridiculously unbalanced basal/bolus ratio. No effort required on my part… well, other than LIVING through those days, which requires enough effort in itself!

And as for the CGM, here’s two weeks of data overlaid on top of each other. It helps to spot trends as well as anomalies (like the one my doc circled). There’s even a nice heavy dotted line to show the average.

But wait… there’s more!  If I want to look at just one day, I can see my sensor readings, my fingerstick readings, my insulin taken (basal and bolus combined), and my carbs eaten (assuming I’ve put them honestly into the Bolus Wizard).

I was clearly going through a rough patch here.  And I suspect that 338 after lunch was because I still had food-residue on my fingers, and that the 237 was perhaps more accurate.  It also looks like I missed a dinner bolus (10 carb dinner? I don’t THINK SO!) and didn’t realize until all my little corrections did nothing to help.  But, for the most part, putting carbs where they are, it eliminates the need for tagging BG’s with “before meal” or “after meal” (something I never did anyway).

And, finally, my endo always validates whether the A1C that comes back from the lab is “reasonable” or not by comparing it to this:

All of this data is in that little black box at my hip, and I never have to put pen to paper to write anything down.  Ever. How could I even THINK of giving that up? When the thought crosses my mind, CareLink Pro AKA “The Hook” brings me back.

There is something amiss
I am being insincere
In fact I don’t mean any of this
Still my confession draws you near

But I can’t help but wonder. Is there a better way; an easier way? Would I be willing to lose these quarterly reports in order to jump into an ocean or swimming pool without worry? If I do a 3am test/Ping  correction and no one’s there to report it, did it really make a difference? Do I want a more accurate, more comfortable CGM if it means more d-crap to haul and less comprehensive reports? I’d be lying if I said it doesn’t cross my mind, but then I’d be letting myself down. I’d be taking away the tools my endo needs to do his job, letting him down as well.

So desperately I sing to thee
Of love
Sure but also rage and hate and pain and fear of self
And I can’t keep these feelings on the shelf
I’ve tried well no in fact I lied
Could be financial suicide but I’ve got too much pride inside

Painful CGM insertions! The “Meter BG Now” bully! The Dual-Wave bolus default (if it’s what I used last)! MOTOR ERRORS! Those g-damn freakin’ MOTOR ERRORS!  Sometimes I’ve had enough.  I look at the shiny new Platinum Dexcom and I drool (I’ve already named my Dex, and I haven’t even ordered one!).  I know that if I switch it’s gonna cost me. I’ve always been afraid of commitment and usually find myself content with the status quo.

I’ll do as I’ll decide and let it ride until I’ve died
And only then shall I abide this tide

Newark Airport used to be my favorite because it was the one that I was the most familiar with. I figured we would be together for life. But after I finally flew in and out of enough others, the dysfunctional airport that ranks worst in delays and highest in fares slipped out of my top spot.  I’m just stubborn like that. Resistant to change. It takes a lot to change my mind. A LOT.

In a marriage, that’s a noble ambition, to stick with it for life. It’s certainly my plan for the future, anyway. But should I ride out the Medtronic system ’til one of us dies? Maybe someday I’ll find something better. Unbreakable loyalty shouldn’t apply to inanimate objects, even life-saving ones. Should they?

I often wonder if there’s a better pump, a better CGM. Even a better way to effortlessly record and present my d-data. But CareLink Pro, I just can’t let you go…

All lyrics, as well as the title of this post, written and performed by John Popper, PWD T2, from the Blues Traveler song “Hook“.