When I think of managing diabetes with the holidays, my initial reaction is that it’s just like any other day – one blood sugar at a time. But when Rob asked me to write a guest post on the subject, I realized we do handle things a little bit differently.
Caleb has been pumping with Apidra® for over two years. Prior to that, he used Novolog®.
Shortly after that post, things went a little sideways and I didn’t know why. He had unrelenting highs at night. I would correct mid 200s all night long to no avail and end up with a wee hour Pod change. Then two nights later it would happen all over again, just like Groundhog Day.
I’ve brought you right to the punchline, so the problem is probably crystal clear to you. It was anything but clear to me at the time. This is why:
– Caleb had been pumping with Apidra® for about two months with no issues at all. His Pods would last the full three days and even up to eighty-hours with the 8 hour grace period.
– The “sideways” path started around the holidays. The variables were greater at this time. Timing of meals, content of meals. Schedules in general were off. BG control can easily be less than optimal in these circumstances.
– The pattern of highs every other night had not quite established itself. We were still getting some Pods through the full three days without an issue.
– Not a single person I knew who was Podding and Apidraing had this problem. All sailed smoothly through their full three days.
– Then there was the night when he actually did correct and I convinced myself that it couldn’t be the insulin clogging in the pump. Remember, I was not sleeping much during this time, so my reasoning was less than optimal.
I tested EVERYTHING. Food. Activity. Basals. Site locations. Moon phases. I called EVERYONE. Users. Insulet. Sanofi. Insulet again. Sanofi again. More users.
I thought Caleb might have to change pumps. If you know us, you know Caleb has only pumped OmniPod®. It’s been six years. We’ve never considered anything else. But Apidra® had been so effective, I was considering a pump change rather than an insulin change.
Finally, I tested the insulins. I put Caleb back on Novolog®. He went a couple of weeks and managed through day three without a problem. I put him back on Apidra® and the second day highs came right back.
It was clear. At right around the 48 hour mark, insulin seemed to have trouble getting through.
The photos in this post are of different cannulas from problematic Pods with what seems like obstructions. I had seen many a cannula before this issue that looked much the same. These other cannulas had been delivering insulin freely according to Caleb’s BGs. So even the visual evidence found in these photos didn’t convince me right away.
So we had to decide whether pump changes every two days would be worth it. I look back now remembering how difficult a decision it was, yet today it’s no big deal. It’s a slight nuisance to change Caleb’s Pod 15 times a month instead of 10. Nothing more.
And it’s worth it.
He’s using his pump of choice and my insulin of choice.
There are some benefits to more frequent site changes:
– Caleb’s sites heal MUCH more quickly. His scarring is greatly reduced. I noticed this almost instantly.
– He almost never has a kink, failure or delivery issue in any way, shape or form. This has been HUGE. When we were changing his sites every three days, that third day could be rather suspenseful. I only realized this in retrospect, now that the suspense is gone. I used to wonder more about what might be causing an unexplained high and take a gamble on whether it was just diabetes being diabetes or if there was a delivery issue. Many a time I took the wrong bet and took off a kinked or clogged Pod. Now it’s almost always diabetes just being the PITA that diabetes is, and we can correct and move on with confidence. To me, this has really had a great impact on Caleb’s overall diabetes management: increased confidence = better decisions.
Although this doesn’t seem like a prevailing issue, I know we aren’t the only ones experiencing this. If you’re having a similar challenge and haven’t quite decided what the problem is, I hope this post may help a little.
Next up: Eliminating Another Insulin Variable.
I can’t remember if I first heard about Road ID® from Harry or Gary – they both wear them. But I do remember later hearing about it being used as a medical ID for kids from Reyna – that woman is full of helpful tips!
For years, Caleb used silicone bands that were engraved with all the critical information right on the band. He had several colors and patterns and he loved them. It was always a very sad Caleb that got off the bus with a broken band in his hand when one bit the dust.
The price for those bands got to be a little too much for my liking and although Caleb still had several in inventory, I kept my eyes peeled for an appropriate replacement. Road ID® fit the bill!
Santa had the same idea. He brought both Colin and Caleb Road ID®s this past Christmas. They each have the Wrist ID Thin with several different colored bands to switch out. Colin has one because he runs and bikes by himself quite a bit. The difference between Colin’s and Caleb’s is the extra info of “Type 1 Diabetic/Peanut Allergy” on Caleb’s.
How can I not love the fact that something that Caleb needs because he has diabetes is something that non-D brother Colin needs too? Surprisingly, this was one of Caleb’s favorite Christmas presents, and Lila actually felt a little left out that Santa didn’t bring her one. (Her birthday is coming up though, and it’s on her list).
I must mention that their customer service is amazing! Santa used their measuring chart to determine what size band to get but he must have been drinking spiked coco because the one he chose was a bit too big. Getting them replaced was easy and pleasurable. They have our family’s business for life.
I just ordered another and was reminded that they contribute a portion of your purchase to an organization of your choice – I chose JDRF!
I just got a coupon promo code if you plan to place an order for $1 off! ThanksLorraine17663773
I’m very excited about tonight’s dsma live episode. Cliff Scherb will be the guest. I was lucky enough to spend a morning with Cliff last year. He is kind, generous and knowledgable. I could have spent the entire day picking his brain, but after nearly three hours, I figured I was already pushing it.
Cliff is a triathlon coach and founder of TriStar Athletes LLC. He has competed with Team Type 1 and in several Ironman events including the World Championship in Kona and is also a record holder in more than one of these events.
Since meeting with Cliff, I’ve wished everyone could have some time to hear him talk about his strategies and techniques for keeping his blood sugar in range not only on a daily basis, but also during intense training and competitions. Tonight, that wish comes true!
Please join the live conversation tonight, 9PM EST on Blog Talk Radio. If you’ve ever been frustrated by unpredictable blood sugars while exercising or training, I’m pretty sure you’ll be glad you tuned in.
Caleb had his third blood draw since being diagnosed.
He knew it was coming, but I didn’t tell him until that morning exactly when we were going. It didn’t make his day, but he pulled it together and stayed strong.
Caleb usually wants silence, no talking and no distractions. This year he asked for me to talk to him. As we were walking out of the house, I grabbed a joke book and big brother Colin’s job was to read him some funny lines.
Caleb totally rocked it!
I should take some tips from Lila – yes, she’s there too, but you wouldn’t know it because she’s doing a superb job of keeping quiet.
Here’s Caleb two years ago at his first blood draw. The bruises on his arms, which are now finally gone, jump out at me. They are the marks of alternate site testing.
I’ll never forget this phlebotomist. He was so kind and friendly. He still brings a smile to my face.
After this year’s draw, I told Caleb how proud I was of him because even though he didn’t want to, he did it without any trouble or complaining.
He told me, “Mom, I wanted to cry, but I didn’t.”