The Big Chill

Ironically, the low-point of my CGM graph makes it look like a big smile *

I am guilty of a scary borderline-serious low this evening.

I say borderline-serious because I was still fully aware of what was happening around me, and because I never reached that confusing haze, also known as Telltale Sign Number One.

I say borderline-serious because my CGM was, at one point, showing a 54 mg/dl with double-down arrows.

I say scary because I felt fine – I had no idea I was so low (and going lower, with a full unit of insulin on-board from an earlier high correction). I would not have known if not for my CGM alert, and even then, I thought it was a false reading until my meter confirmed it.

Then the sweat caused my shirt to stick to my back, and my hand to constantly wipe my oversized (thanks, receding hairline) forehead. Then I really believed it.

Though I’ve been doing a really good job of keeping by blood sugars on the lower-but-normal side in the eight weeks or so leading up to Thanksgiving (I’m targeting a monumental A1c improvement), I’ve pretty much fallen off the wagon since Thanksgiving, so much to the point that I’m feeling lows when they aren’t really low, which has led me to trust my feelings more.

Sometimes, trusting one’s feelings is a good thing. When it comes to hypoglycemia awareness, it is not

DENIED!

It’s been quite awhile since I made the decision to keep the 530G/Enlite (pump/CGM) system. If you followed me through the process earlier in the year, you know it was not an easy decision. Not by a long shot.

But I gave it every benefit of the doubt during my trial, and the Medtronic team tried really hard to get me to like it.  And you know what? It worked. Over the past several months, I’ve really grown to like the system and have been very comfortable with my decision.

The sensor works well for me, and I understand how to make it well. The pump is comfortable and familiar, and talks to all of my other devices. The CGM is not as lumpy as its biggest competitor, and when I get out of the pool or ocean and back in range of the receiver-pump, it backfills the last 40 minutes of readings so i know what’s going on. The ISIGs give me a window into the CGM’s workings and lets me know if my sensor is performing well even if it’s got a bad calibration. The proprietary non-Luer connector makes the reservoir easier to fill than with the more common method. The pump’s raised blister-like buttons make it easy to operate without looking at it (don’t try this at home). And the clear/white case gives it a cool and modern look that I had never before anticipated – nor cared about. And CareLink!

Try to take it away and replace it with another pump or CGM, and you’ll be in for a fight.

And now, after all of the angst and turmoil of my trial, they’re telling me I can’t keep it.

They is my insurance company — an insurance company that has treated me fairly since I first got on one of their policies 17 years ago. I’ve changed employers, plans, and coverages, but always were fortunate to have the same company administering them. They, through my current (wife’s) employer-sponsored plan, have been really good at providing coverage to keep me healthy rather than simply keep me alive until the next open-enrollment period.

Target

This new guideline first crossed my eyes in the form of  a **BREAKING NEWS** post on Facebook.

It was posted by the very organization that made the news. (Does anyone else find that just a little bit self-serving and disingenuous?)

But after getting over my disgust over the misrepresentation of (what should have been) a press-release as a groundbreaking, developing situation, my thoughts shifted from the presentation to the message.

And my reaction to the lowering of an A1C target to 7.5% (from something that, I could only guess was something more than that) was a hearty, passionate…

Trashed

My “current” vial of insulin gets stored, wrapped in a paper towel, stuffed in a Ziploc snack-sized bag, and tucked in my emergency/all-purpose pencil-case diabetes travel bag.

That way, it’s always with me, my emergency-supply stays current and unexpired, and it doesn’t shatter if the bag gets smacked around a bit (as it’s prone to do.)

On Saturday morning, I did a combo infusion set/sensor change. With all the trash this process generated (incidentally, Enlite and Mio are the #1 and #2 offenders, respectively, when it comes to destroying the planet), I must have swept my one-quarter-full vial of Novolog in the wastebucket along with all of the other stuff..

I just realized this on Sunday night. That vial is probably sitting out in the can by the curb, nestled comfortably between some eggshells, dryer lint,  and dirty diapers. And unfortunately, that’s where it will stay.

Hopefully, my insurance company will understand.

Awkwardly avoiding awkwardness

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My office building is home to probably nine or ten different companies. The cafe on the first floor serves all of them. I had just started my dual-wave bolus and placed the order for my lunch when I felt the unexpected and repeated vibration coming from my hip.

Bvvt. Bvvt. Bvvt. Bvvt…. (I’m not sure how many times, but it was a lot. Also, is that how you spell the sounds of a vibrating insulin pump?)

When I checked the pump to see what was up, it  turned out to be a Motor Error. It was the first one in a year, I think — I certainly haven’t been plagued with them as I was at an earlier time. Having been through these in the past, I didn’t panic. But I did have a bunch of thoughts go through my mind.

• Did I bump it or go near any strong magnetic fields lately? (No.)
• Do I have time to run to the restroom and restart the pump before my food is ready? (No).
• Could I possibly remember all the variables I just so meticulously calculated into my dual-wave bolus, and then factor in what’s been delivered already, so that I can do it again? (No.)
• Are the insulin gods conspiring against me in retaliation for filling a medical device with an alcoholic beverage this weekend? (Possibly.)

My thought-process was then interrupted by a voice coming from my right, asking a person behind the counter if he could see the package of whole-wheat wraps. He wanted to check the carb-counts.