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Friday 9 October 2015

どうもありがとう, Mr. Roboto

robot
ˈrəʊbɒt/
noun
  1. 1.
    a machine capable of carrying out a complex series of actions automatically, especially one programmable by a computer.
    "half of all American robots are making cars or trucks"
    synonyms:automatonandroidmachinegolem
  2. 2.
    another term for crawler (in the computing sense)


640G - Part Two - It Thinks


"It Thinks" is the slogan that came out with the 640G. I would believe it of my little Mr. Roboto (Note: not my 640g's name...its actually still unnamed as of yet. I just can't think of anything good enough for it).

When you've had a little while to play around with the pump, its obvious the design was made with the user in mind.


Normal, every day functions are laid out on the opening screen, in easy to see positioning. It means that if you need to quickly bolus or change your basal rate, you never have to navigate away from the home screen. With my previous MiniMed, I accessed the menu fairly frequently, but now I access it only to change my set, or if I have an endo/educator appointment coming up and need to start logging my activities before a pump download.




Bolus take you to a bolus menu, where you can input your BG (if you havent used the meter that sends through your BGs automatically). If you select basal you can set up a temp basal or select from a pre-saved temp basal that you have already created. I set up some temp basals of a pre-determined strength  & time length when I first set up the pump that I could quickly swap to if needed, based on activity that I would do throughout the day. It might be easier for kids because they could be taught to swap to a pre-determined basal rate at sleepovers, etc. without actually having to set it up themselves. You could also set these up as weekday or weekend, etc. and quickly swap between them if needed.



Bolusing remains much the same, but you can now choose what types of bolus you want active. I have never actually used a square wave bolus, and haven't the foggiest what it does, so I only have dual and normal bolus types active.

Suspend delivery is now the very first item in your pump menu. Whats even more exciting is that now, when I bolus, 'stop bolus' is displayed prominently on the screen as the insulin ticks in, and is already selected. So if I need to stop my bolus (which oddly, I do often) mid-delivery, all I have to do is click the middle button and it stops. Easy peasy.

I can also bolus off the meter that goes with my pump. It does not have the wizard built into it, but my current rate is 1 unit to 10gm of carb, so I actually use it to bolus quite a lot so I don't have to grope myself in public at food time. Its much more discreet.

I am actually using the new bayer meter, because I feel like its calibrated better than the previous contour meter. It feels more accurate. It sends to your pump straight away, unless of course yu don't want it to, in which case you can hit the cancel button. Your Diabetes health team will never be any the wiser to the horrible number you just stopped from sending.

It has a strip port light at night time. It works, but not as well as my previous IQ. The light that comes out is very faint and orange, so its not the best for trying to see if you've squeezed enough blood out. Probably the only let-down of the new meter. I think they were going for a soft glow that won't wake anyone else up, but screw everyone else if I've got a reason to check my BGs in the middle of the night.

It does allow you to double-dip, which is great because I often underestimate how much blood has actually come out of my finger, and need to add more, which I can now do and not have to waste a strip in the process.

It also works as the download USB for carelink. Cheering, because I have lost all my carelink USBs now.

My 640G tells me now when I have run out of insulin. I used to always go for about 2 hours or so without insulin on my MiniMed because I would see, and promptly clear, the low reservoir warning, and then it would run out and not tell me. Now it tells me when I have zero units left so I can add more insulin straight away. Alternatively, you can set a 'set change' reminder under the reminders section of the menu so it will remind you.

The 640G was designed (in my opinion) to be more functional for its intended and actual use. It is now waterproof. Whilst I still don't intend to take it swimming, it is better in Brisbane heat. Sweat from Brisbane humidity killed my MiniMed over Christmas last year. I also think it will serve me better when I go on my honeymoon in Europe next year, because I won't have to worry so much if I land in the drink in Venice (which in all likely hood will happen) or get caught in London rain.

The clip now functions as the battery opener. The clip also slides off and on by pressing a small 'button' instead of having to lock it in place with a coin or similar.



I'm pretty excited to take my little Roboto travelling with me. There's not much more I can think of to make it the perfect companion. I've signed up to one of the cheap CGM yearly deals so I will have that helping me as well.

Now just to name it.

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Reasons Why I'm Hypo: I had breakfast half an hour later than normal.



Monday 5 October 2015

MedicALERT

For the first few months of my diabetic career I didn't have a medic alert ID. I was too embarrassed and too busy trying to work out which sharp pointy object did what to my fingers and stomach. I managed to pick up one for free about 3 months into my diagnosis from my diabetic educator. One of those rubbery band things that they usually give out with charity details on it. It was bright pink, way too large on my wrist, and simply read 'Diabetes'.

After I got my insulin pump I decided to go for an 'upgrade' and bought a whole bunch of colourful bands in bulk from an American website that had them for cheap. My intention was that I could colour co-ordinate them to what I was wearing. It worked for about a week before I just stuck the plain black band on and left it. It's been wrapped around my wrist ever since, the only exception being that I wore a translated medi-alert band in Japan, and on my wedding day.



I know why I wear one. The thought that one day, I might fall unconscious from a hypo, and need someone to know why I was unresponsive. Thankfully, that scenario has not yet eventuated, and hopefully will never eventuate.

That's not to say it sits idly by on my wrist. On Friday I found myself the unexpected and unwilling victim of a seemingly random allergic reaction. I can't eat watermelon, mango or raw tomato, but I've never had a reaction to touching them before and cook regularly with tomato (I can eat it cooked). I had just finished chopping some tomato when I felt a sting and my lips started tingling, like they do when I have accidentally eaten something I shouldn't have. A quick check in the mirror showed that my lips had definitely swollen. I didn't think much of it, because that happens every time, and after about 4 hours the swelling normally subsides.

Not this time. Less than 10 seconds after leaving the bathroom I felt incredibly weak. I had weak legs and pins and needles. I grabbed my kit wondering if I was having an unexpected low (unlikely as I had been sitting on a BGL of 12 less than an hour earlier). I never got to do the BG check. My vision blurred, I felt dizzy, sweaty, shaking, and I couldn't breathe. I managed to grab my phone and punch in for 000 (as I was home alone) but I didn't have enough breathe to tell them anything, and I knew I was seconds away from unconsciousness. Somehow I managed to get down the stairs to the apartment below me, banged on the door, and handed my neighbor the phone.

The end result being that 15 minutes later I had a paramedic kneeling in front of me and telling me I was going to hospital. I remember she looked and sounded a lot like my diabestie. I thought that was a good sign. Before they popped me into the ambulance, the second paramedic did a BGL check. I wondered how she knew, but was thankful because a BG check was far from my mind. Apparently someone had read my Medic Alert ID bracelet. My BG was 3.1, which I am 99% sure was caused by what had just happened.

It was at that point my husband arrived home, and went in search of glucose whilst they bundled me into the ambulance. I found it weird that they checked my BGL, found it low, but didn't offer any glucose and left that up to someone else to organise.

I haven't been hospitalized since my diagnosis, so this was the first time I had to deal with my diabetes in hospital. I felt like I was the only one in the room who actually understood what diabetes was and how to use the equipment involved with it. I had a paramedic BG test me, who threw away a perfectly good, unused test strip because her meter was out of battery when she put the strip in. It amazed me that she didn't have the common sense to stick the same strip into the next meter she pulled out. I can only assume she didn't know how expensive strips are.

When they requested a fourth blood sugar reading within my first hour in emergency, I insisted they let me do it myself and use my own meter & lancing device. I don't know if they were particularly happy with this, but I wasn't quite sure about the improvised torture devices that they were passing off as lancets. So I got my way and did my own Blood sugar levels.

After being ramped in emergency, I got admitted to fast track, which I quickly figured out was a holding area for people who wouldn't be admitted overnight. I was feeling a bit better by this stage, with only chills, muscle cramps & one helluva headache left. A nurse quickly filled in the area's medical staff on why I was there and my diabetic status, explaining that my allergic reaction had triggered a hypoglycaemic event and that I had had fast acting carbs but no long acting carbs and could she please get me some(it was dinnertime, after all). She was met with an incredulous look and reply of: "But that's not why she's here." To which, I'm glad, the nurse basically stamped her feet and laid it out for her plain as can be, that I needed some more carb (by now my BG was creeping back down again and had dropped 4 points in 15 or so minutes).

Everything went somewhat smoothly from there, with the exception of an intern fighting with a registrar about the cause of my allergic reaction symptoms. After reading my patient notes and seeing I had had been brought in with a low BG, the intern decided all my symptoms were caused by my low BG (nope) and wanted to send me home. My husband overheard and went to sort it out, to explain that a BG of 3.1 definitely does not cause those kind of symptoms, and that instead the allergic reaction caused my low BG. The registrar agreed with my husband and I was given some sort of medication, kept in observation for a while longer, and then cleared to go home nearing midnight.

I sank thankfully into bed that night, and slept for a solid 11 hours, waking up only once to take as much Nurofen as I could to try and get rid of the killer headache I still had. I'm not keen on that happening again anytime soon so the plan is now that my husband will chop all the tomatoes, and I will continue to wear my Medi Alert ID.