Pump it up!

It’s been 3 years and 2 months since I have been dealing with all the syringes, needles, lancets, insulin and testing strips  every day. During this time, I’ve gone through numerous “situations” at the dinner/lunch table. I’ve listed some of them that are relevant to this post down here:

“I’ve already taken the insulin shot according to what I thought we were eating. You guys go ahead and order the dessert”! aka “you suckers! couldn’t you have thought about the dessert in the beginning itself!”

or

“Ouch! Ouch! Ouch! shit! I can’t scream out loud in the middle of the office cafeteria! suck it up! suck it up!”

or somebody at the dinner table saying:

“Oh crap! I can’t watch this! I am just going to be rude, leave my dinner and walk out of here while you finish injecting yourself with something that saves you from dying everyday.” or something a little politer than that.

Something in the way I manage my diabetes changes today – in a good way. Now, I don’t have to deal with any of the situations listed above and I don’t even have to care about injections anymore! Instead, I am going to care about something way more sophisticated than that.

What’s different?

I finally have this brilliant piece of technology attached to my belly (trust me when I say that it is better than injections) that pumps the insulin under my skin all through the day. It’s called Omnipod. Here is how it looks:

Omnipod - Pod and the PDM

My first Omnipod - Attached to my belly.

It contains an insulin tank and a stepper motor that pumps a constant (or variable) rate of insulin (called basal insulin) to me throughout the day. And when I want to eat something, I whip out this other device called PDM from my pocket and press a few buttons. The PDM (Personal Diabetes Manager) talks to the pump over radio frequency and asks it to deliver the extra insulin (called bolus) for the food that I am about to eat. And that’s it! I put the PDM back in my pocket and start eating – no poking, no needles, no showing off your six pack (ha!) to the world.

Actually, I lied a bit there when I said “no needles”. How can a diabetic live without needles now – can he? My diabetic control still is completely in my hands which means I still need to

• Test my blood sugar by poking my fingers 4-6 times a day. [Here are the needles!]
• Count carbohydrates in whatever I am about to eat before eating it and tell my PDM to deliver insulin accordingly.
• Fly the airplane just as before – See the analogy here
• Stuff my face with whatever I can find in case my blood sugar goes low.
• And most importantly, refuse to share any food with the friends by saying – “Sorry, I already took insulin for this.” 😉

Scary Stuff!

And ofcourse, the pump is attached to me by a really strong adhesive and lasts about 3 days. So, I need to take it off every 3 days and install a new one. Now, there are a couple of problems with doing just that. First – a tiny tube (called a canulla) doesn’t just get under your skin without a needle poke. So, here come more needles. Although, the insertion process is automatic and not nearly as painful as my biggest scare about this whole setup – the pod removal. You see, being an Indian, I have been “blessed” with a very hairy belly and arm (see Russel Peters explain that to you here). I am just horrified by the thought of waxing myself twice a week! But, I’ll get to that when I get to the first pod removal day (just 2 more days to go :o).

I own my data!

Apart from getting rid of the injections, there is one more thing that my Omnipod does for me – it keeps all of the information in one place. In my old setup, I had my blood sugars in my glucometer, the amount of insulin I took in my head, and the amount of carbs I ate also in there somewhere in my head. Diabetes is different for everyone – everyone behaves differntly to different kinds of food, activities, exercises, seasons, stress, sickness, insulin. In order to manage diabetes better, you need to understand your own diabetes. In order to understand your diabetes, you need to be able to look at all the data and the graphs. This allows you to figure out what affects your blood sugar and how, so that you can make better decisions in future. This is all just a very complicated feedback loop with a lot of inputs. The problem with my old setup was that all the information was in different places and I am obviously not diligent enough to collect all of it and put it in an excel spreadsheet to visualize it. My Omnipod PDM, on the other hand, has a glucometer inside it. It also tells me how much insulin I should take if I tell it how many carbs I am eating. So, there you go – blood glucose, insulin, and carbs: all the data inside my PDM! Now, I can surely understand my diabetes better than ever before.

Shortcomings – what’s that?

Inspite of all this awesomeness, there are some shortcomings that I have noticed. But today is not the day for the shortcomings. I am too pumped up to point out any issues with it right now. I’ll post about them once I have had enough experience wearing this beautiful thing! Until then, expect some more posts about the pure awesomeness of this device!

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I am in blues today

I have those days like the Tour De Cure day when l think that diabetes may actually be a good thing. And then I have some days when everything that could go wrong goes wrong and I feel like diabetes was the worst thing that ever happened to me. Last three days definitely belonged to the latter category. Before I talk about my awful weekend, some updates: I got a call from my endocrinologist Friday evening about my test results. He told me that my HbA1c had gone down to 6.1 (yayyy!!), TSH was good at 2.3 (I think) but C-peptide was down at 0.5. What that means in plain English is that my pancreas is not producing much (or any) insulin of its own now but I am still maintaining good blood sugar levels. I knew it was going to happen one day or another, so, that was not a shocker at all. I am fully reliant on externally injected insulin now.

So, the same evening, I somehow get away from work (actually, I just ran away for one evening! couldn’t take it anymore!) and went out with friends – ate out, had cheesecake for dessert. My blood sugar after a few hours – 257. I go to sleep, wake up with 177. I inject lantus, drink just a glass of milk for breakfast and keep testing my blood sugar for next 5 hours – 158, 147. The same trend of eating less and high blood sugar continues for the rest of the day. Today, I inject the same 12 units of lantus again and eat 2 slices of bread in the morning at 1030. I dont eat a thing for 4 hours after that and my blood sugar goes up to 244 (after 4 hours!).

Now, my cause of frustration was not just my blood sugar but also the effect it was having on my weekend. It was an awesome weekend and I had decided to work through the whole of it to catch up on some stuff. But, high blood sugar and complicated programming do not go well together. I was feeling really crappy all through the weekend and couldn’t sleep well last night. Because I was feeling crappy, I couldn’t work as well as I should have, and thus was feeling even worse. So, all in all, it was a really really crappy weekend.

As far as my blood sugars are concerned, I think my lantus was the culprit. It had gone bad or something and wasn’t working at all. I took out another pen and it looks like it is working fine. It’s too early to judge but I’ll find out for sure by tomorrow. Gotta try to get some sleep now.

Inspired

As far back as I can remember, I’ve never been a performer. Never went on the stage to act in a play, to dance or to sing. I was never great at sports; still, I tried a bit but was thrown out of teams pretty quickly. Looking back, I do feel like I should have tried a bit more to do something and find my passion rather than just kill myself studying all the time but I still don’t regret any of it. On the other hand, I love performers and inspirational characters. Heck, I’ve seen ‘The Last Lecture’ a million of times! There’s so much that I need to learn from these great people, so many important lessons to live my life. Whenever I see or hear one of them, I am usually very inspired and feel great standing up and clapping for them. Just joining my hands and clapping for them to show my appreciation makes me feel really good! Ever wondered (or experienced), how it feels like if someone is clapping for you because you inspired them so much that they just want to show their appreciation? I haven’t. That’s because I am not one of those great people. I am just another software engineer who’s sitting in his balcony writing a blog for himself!

I participated in an ADA fundraising bike ride today where a number of people – some diabetics and others non-diabetics – come and bike hoping for a cure for the disease. All the diabetic riders in the event are given a special status of ‘RED Rider’ and this super-awesome Jersey that says ‘I Ride With Diabetes!’ I was wearing that jersey and was super-duper excited about it! As we lined up at the start line, the announcer asked if there were any Red Riders in the bunch. 6-7 of us raised our hands (and because I was super-duper excited, I also shouted out ‘whoooohoooo!’ at the same time!). And then to my surprise, everyone started clapping for us! The clapping went on for a couple of seconds and in those 2 seconds, I was more sure than ever that I getting diagnosed with Type 1 diabetes was really not as bad a thing as I thought it was! I wasn’t doing anything really great – I was going to bike 45 miles just like everyone else in the bunch. Ofcourse, like always, I had to make sure that I keep track of my blood sugar levels while I am doing it. But, I felt really really good standing there and watching people clap for all of us. It felt like all of them understood what it takes to live 24×7 with this disease. Now, I know that most of them were there for just a fun-filled ride on an awesome day and they probably thought that if it was for a good cause, that’s an icing on the cake. But, all of them raised funds, came to participate in the event, and clapped for all the red riders in the crowd – it’s a good enough motivation for me to keep going, thinking that all of them are standing beside us in our fight against diabetes.

There’s one line that Prof. Randy Pausch said in his last lecture that has had a huge impact on my life: “We can’t change the cards we’re dealt, just how we play the hand”. The thing that made me happy about today was that may be, by a really really remote chance, I inspired one of those people in the crowd to think about this and just play the hand that they are dealt.