Dot-dot-dot

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Grandpa: Now, remember the plan, boy. If you run out of air, tug on the rope…
Bart: 64 times, no more, no less. Got it.
Grandpa: No no! 63 times if you’re out of air; 64 is if you found the treasure!
{later}
Grandpa: 61… 62… 63… Oh no! 63! He’s out of air! I’ve sent my only grandson to a watery gra… 64! He’s found the treasure! I’m rich!

-from The Simpsons 1996 episode “The Curse of the Flying Hellfish”

Remember that one? (I wish I could find a video to embed. Some help, please?)

Using my insulin pump is kind of like that sometimes.  As I think I’ve mentioned in the past, I keep my pump on vibrate mode. I tried the beeping-mode, but many times (like when I’m in noisy places) I can’t hear it, and other times (in quiet places) everyone can. But I can always feel the pump vibrate when clipped to my belt, so I go with that.

(Word on the street is that the next generation of alert, the can’t-be-missed design that sends an electric shock through the tubing to the infusion set, is stuck in FDA purgatory.)

But one of the problems with vibrate-mode is that it’s monotonous. Literally. While the beep-mode uses different pitch tones for different alerts, vibrate-mode does not. It requires a certain level of concentration, like interpreting Morse Code, to understand the message. Actually, it’s worse than Morse. Morse Code has two “symbols”, dots and dashes. Medtronic Code has one — just dots (or just dashes. Pick your poison).

When you add CGM alerts to the pump alerts (since they’re the same device), it’s tough to keep them all straight. Again, beep-mode is easier: three ascending tones (doremi) means the BG is rising. Three descending tones (miredo) means it’s falling. But three identical vibrating tones — three dots — could mean either. Or it could mean the reservoir is low, or that a bolus was not completed, or that  temporary basal is in effect.

A dotdotdot is actually a common occurrence, one that doesn’t freak me out that much. Sometimes I dismiss it without looking (thinking it’s a low reservoir) when I shouldn’t (it defaulted to square-wave, meaning I didn’t bolus for lunch), but it’s not catastrophic.

Beyond three, there’s trouble.

Dotdotdotdot: In Medtronic Code, four vibrates means insulin delivery has stopped. Occlusion, motor error, whatever. That fourth dot really freaks me out. I get nervous and mentally prepare for a bolus-by-syringe, a set-change, and possibly a phone call.

But sometimes it continues.

….dotdot: Six vibrates means my CGM is due for a calibration.

 
imageI can’t tell you how worrysome it is to feel that fourth vibration. I remember my last Motor Error clearly, and feeling that fourth dot sent me into a near-panic.

But when it’s followed by a fifth dot and then a sixth, the feeling of relief is immense.

Kind of like how Grandpa Simpson felt when he got the 64th tug on the rope.

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Posted on March 18, 2013, in Continuous Glucose Monitor (CGM), Diabetes, Insulin pump. Bookmark the permalink. 5 Comments.

  1. Totally!
    I’m a beeper girl myself. I tried the vibrate but because I usually keep my pump in my bra the vibrations would sometimes scare me out of my seat.
    I could sense the feeling your vibrations give you because I would get that also. I was always afraid of the four beeps. It never meant good news.

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  2. I can totally picture you stopping in the middle of whatever you’re doing to count the dots. 🙂

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  3. My God! You’d think they would have flipped that around…4 means calibrate, 6 means “oh shit!” Funny post, tho. =)

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    • I think it has to do with the chronology. The 4 meant “oh shit” long before the CGM functionality was ever folded into the device (I refuse to use the term “integrate”, for reasons I described in a post last May. To change the meaning of four, especially after it’s got the FDA’s blessing, would have likely been a big mess.

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  4. Great post. I found the vibrate function far too confusing to interpret! I started off as a loud beep kind of guy, but recently changed to the medium beep, as the loud beep can certainly be a touch obtrusive.

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