A weighty decision

When I was first diagnosed with diabetes, I took one insulin injection a day: a little bit of Regular and a little bit of NPH mixed in a syringe before breakfast. That quickly shifted to twice a day: before breakfast and before dinner.

I had a glucose test kit that stayed in the school nurse’s office. In 1981 (1st grade, diagnosis), it was a urine test, in 1991 (11th-12th grade) it was a blood test. But it was there, not with me.

The only thing I carried around with me everywhere I went was a little box of Sun-Maid raisins, in case I felt low. Or maybe a roll of Life Savers, which always ended up permanently stuck to the paper wrapping (and each other) ensuring I had plenty of fiber with my low BG treatment.

At some point I switched to blood tests, first by holding the strip up to a  color chart, and later by using a big, clunky meter. I took it with me on family outings, but I don’t remember ever taking it to school. All I took was the box of stale raisins to treat lows; or maybe a roll of Life-Savers, inseparably stuck to the foil wrapping and each other.

I don’t ever remember carrying a meter with me in school. In 9th grade, I had a late lunch period and consistently went low during my biology lab period before. But I fought through it like a champ chump, traveling light.

I can’t remember if I carried a meter with me to class in college. Twelve years later after diagnosis, I was still on just two injections a day, each was a mix of Regular and NPH, taken before breakfast and dinner, with the Regular dose on a sliding scale that increased with my blood sugar. The scale matched the intervals on the old Chemstrip color chart: 180-240, add 1 unit. 240-300, add 2 units. 300-400, add 3 units, and so on.

At some point, in the late ’90s, I started carrying a meter around with me. It’s also when I went from animal-sourced insulin to Humulin, and eventually Humalog replaced Humulin R. But on two shots a day, I didn’t usually need to carry insulin. If I did, I pre-filled the syringe, stored it in a hard plastic toothbrush travel container, and stuffed it in my pocket.

This is who I was growing up. Care-free, traveling light, and happy. (And not feeling particularly wonderful).

Not until 2004 did I go to true MDI, with Lantus before bed and Humalog before every meals. Now I had to test my blood sugar and carry insulin pens for use at lunchtime. So my pockets began to fill.

Three years after that, I started pumping. I carried around a pump and a meter, plus treatments for lows and contingencies for pump malfunctions.

Then came a CGM stuck to my body. (Though I have since traded in the stale raisins and paper-covered-candy treats for the surprisingly more palatable glucose tablets).

As a sign of the times, I also carry a cellphone.

As the years went by, I could easily make small additions to my travel portfolio, but its now bursting at the seams. I can’t take any more.

It’s enough. My pockets are full and my load has become heavy. There’s a fine line between the inanimate travel-companions being a benefit and being a burden, and right now, I’m right up against that line. Another lancet could push me over the edge.

My belief (coined by JDRF) of “Less Until None” weighed heavily in the decision of the next step in my diabetes treatment.

Migrating to a bigger CGM site and a separate receiver, in one regard, is a step backward. If I could get the sensor that communicates with the pump I already have to work reliably enough, to warn me of the lows and the highs, I’d be golden.

Fortunately, I’ve been able to spend a lot of time with the Enlite sensor and its big-brother 530G pump. It’s been a little over three months that I’ve been using it, and to be honest, I still haven’t mastered it. But I’m advancing.

Despite the message you may have

gotten from some of my previous posts, I don’t feel like I’m helplessly up against a wall. I’m still learning. And the folks at Medtronic have been incredibly gracious and patient in teaching me and allowing me to learn at my own pace.

Truthfully, I fully understand that the courtesy they’ve extended to me is not the same that they would offer to others who aren’t part of their “special trial” and who aren’t going to blog about it to the world (or, if not the world, then to the 12 or so people who regularly read this blog.) And believe me when I say I’m going to make a valiant effort to have them improve their communications – and if they can’t offer help that’s helpful, I’ll put myself out there and offer to do it myself.

Lately, I’ve had some very good experiences with Enlite. I’ve also had some very not-so-good experiences. But overall, the good are becoming more frequent, and I believe that, eventually, I’ll learn to master this quirky system. I believe it really can work.

It’s a quirky system which defies intuition, and it certainly could have been designed better. That’s a post for another day. And meticulously going through the steps to get the sensor properly “implanted” (that’s a strange word, isn’t it? but it’s what they use) sure is a cumbersome pain in the ass.

But it’s not as much of a pain as carrying around a separate device: one that doesn’t show boluses on the graph, doesn’t read my meter, and doesn’t report data with all my other devices. And doesn’t do a lot of other stuff that the 530G/Enlite system does, too.

Changing a sensor is something I’ll do once a week. Fumbling with an extra receiver is something I’d do 24/7. Weighing one inconvenience against the other is pretty clear.

So, after a long and arduous process, I’ve made my decision regarding the MiniMed system.

I’m keeping it.

 

(trial disclosure)