A Few Firsts

Sunday, August 06, 2006 | 10 comment(s)

This past weekend I had a handful of firsts:

  • I went to the beach
    Well...
    Obviously not a true "first" but certainly the first time in a long time. It's easily been several years since I've last spent the day at the beach. Four, maybe? Five? I don't know.

    We used to go every year with another family for a week's vacation to the beach when I was a kid and we loved it. We'd spend all day, everyday at the beach and most of that time swimming in the ocean.

    I'm not sure why, but for some reason I've all but lost my enjoyment for the beach and ocean. I attribute a portion of this to my pump and the hassle it is to spend a day on the beach with one, but then there's the crowds, the heat, the jelly-fish and seaweed, the sunburn, the shlepping of crap from car to beach, the hot sand, the gluttony and overload of the senses of boardwalks, etc., etc.

    Perhaps I'm just becoming a crotchety old man before my time, I don't know.
    close
    on Saturday for a day trip with my in-laws

  • I tried out an "unteathered
    A True First
    I'd waffled back and forth about whether or not I'd try this for a day at the beach. Then I got an email from my CDE, Gary, at the last minute with a nice, simple strategy to try out and I figured "what the heck!"

    I took 10 units of Lantus on Saturday morning, and set up an alternative basal pattern (yet another first -- and I've been pumping for 5 years!). The Lantus basically gave me 0.4u/hr of coverage which allowed me to be off my pump from 9am to 6pm. During the night, I reconnected to supplement that 0.4u/hr coverage from the Lantus with more basal insulin.

    I'd like to be able to report that it was a complete success, but I'm not sure I'd go that far. But I will say this: it was nice. I was able to disconnect for most of the day (only reconnecting twice for some beach-blanket-snack-attacks) and swim in the ocean for as long as I wanted without having to even think about needing to get back on my pump. That right there is not to be under valued, though. It really was nice not having to worry about that, so I could focus on avoiding the stray jelly fish instead.

    For the most part, my blood sugar was low and stable during the day, but the evening was another story. I can't completely tell, however, whether it was the different basal program or the pizza, beer, and the large soft-serve ice cream that botched it all up. I had a low before the pizza dinner then didn't extend my bolus for the pizza, then had another low after dinner, which lead to me ordering a large soft-serve ice cream cone with jimmies/sprinkles (depending on where you're from), which I couldn't finish.

    Rookie mistakes, I realize - I'm going to blame it on all the sun.
    close
    " regime

  • I used that little plastic dohicky
    Do these things have a name?
    I really have no idea what these things are called, and for the longest time, I didn't even know what they were.

    Like most tasks in life, I usually end up with "extra parts" when I'm finish and don't think much of it when that happens (this usually happens when assembling a new grill or some Ikea furniture, but it is something to be seriously concerned about if it happens when I'm changing the oil in my car or something important like that).

    I must say, I liked this little thing. And I found that when I forgot to put it on after my last beach-blanket-snack-attack and then went back into the ocean after that, I found re-attaching to the pump for dinner to be a bit difficult. Like the pieces just didn't fit together as nicely.

    I'm not sure whether there was salt-water to blame or not, but I'm just sayin'.
    close
    that covers one's insertion site

  • I had a strange interaction
    True Story
    So, we arrive at the beach in two cars (Meg, her parents and myself in one, and Bro & Sis in-law with three nephews in the other). The plan is that we'll get dumped at the beach, haul our stuff to a location amongst the crowds, and the cars will be parked by brother-in-law and father-in-law, respectively.

    I help get us situated on the beach and then lather myself up with sun block (though I did a less-than-perfect job and you can actually see a finger outline on my right arm: normal pale skin with coverage, burnt red skin where missed).

    I go up to the top of the beach to look out for Bro & Pa in-law as they come back from parking the cars.

    I'm standing on a bench, with my ultra-white, desk-job, hasn't seen the sun in 3 years torso serving as a beacon for the parkers to find me.

    Father-in-law shows up, we chat and I point out where we are on the beach, and I tell him that I'll wait for brother-in-law.

    I scan the crowds some more.

    I then turn back toward the beach and there's a grown man (easily in his 40s) about a foot away (clearly in my personal space) staring at me.

    I look down at him, he looks up at me and after a beat, he points and says:

    "What's that little white disk on your side for?"
    "Ummmm, it's for an insulin pump."
    "So there's a needle under there?"
    "Ummmm, yeah, a catheter, but I'm not hooked up to the rest of the pump that delivers the insulin."
    He continues to stare.
    "Do you have some familiarity with insulin pumps?" I ask to break the awkward silence.
    "No. But I am a physician."

    And with that he just turned and walked away from me. People are weird, I swear.
    close
    with a stranger re: my insertion site

  • I had my insertion site fall out
    Not really a first,
    but only the 2nd or 3rd time, maybe
    I'm not sure whether it was because of all the salt-water, or the extra twisting that was required to detach and re-attach from the site.

    I had had a stubborn low on Sunday morning (again not sure whether it was lingering Lantus cause or not) and I was pretty sure I had over treated it.

    I got home and took a nap in the afternoon and when I woke up I had a pretty high reading, so I just figured all that treatment for the low was catching up with me and I bolused to correct.

    A little while later, I went to take the dog to the park and I was feeling icky. I don't know what made me check it, but I randomly pulled up my shirt to look at the site and sure enough the catheter was hanging out and bent against the skin and there was a puddle of insulin where, I'm sure, that correction bolus landed.

    I hustled back to the house, put a new pump site in (with Novolog this time (more on that below)), checked my blood sugar (440 mg/dl), pounded water for a few hours, checked ketones (small-medium) and waited for everything to get back to normal (which took a good 4 hours and a few more corrections to do so).
    close
    on Sunday afternoon

  • And I'm trying out Novolog
    I was reading
    I'm not sure how I came across this, but I read this, which describes the action difference between Novolog and Humalog. This states that Novolog may peak slightly faster than Humalog AND that it's more stable in the heat and less likely to spoil than Humalog. Both sounded like good things, and since there have been times that I've noticed a decently long lag between my bolus and my blood sugars starting to drop, I figured why not test it out to see what happens.

    I'm pretty sure that when I was on an MDI regime I was using Novolog in my pens, so I'm guessing it shouldn't be all that different. I'm not sure whether I'll notice any differences or not. We shall see.
    close
    in my pump rather than good ol' Humalog

Hope you all had nice weekends.
I'll keep you posted on the Novolog vs. Humalog comparison/contrast...

10 Comment(s):

Blogger jill said...

Kevin,
I used Humalog for a short time before switching to Novolog. The differences that I noticed were minimal. Novolog seems to peak earlier and be a bit stronger… my correction factor changed a bit, but that’s about it. I prefer Novolog only because it works faster. Good luck!
jill

Blogger Bernard said...

Kevin

Thanks for the pointer to the article about Humalog vs. Novolog - it's very useful.

Does your pump allow you to adjust the length of time for the insulin to be considered gone? Otherwise the calculations for even a slightly faster insulin might be hard - or did you figure out a way around that?

I've an older Minimed that doesn't have the feature, but I'm going to see whether my endo can help me get a 522 and associated reader.

Bernard

Anonymous Caro said...

I found Novolog had a longer tail, and would cause late hypoglycaemia. It also didn't seem to match my IOB calculations as closely.

I found Apidra very similar to Humalog, but it tended to sting when I bolused. So I'm back to Humalog.

Interested to know how it works out for you.

And yeah... people are weird!

Blogger Shannon said...

My son uses Novolog in his pump. It holds up better with the heat than Humalog does.

And what was the interaction with the stranger all about? Do tell.

Blogger Kerri. said...

I've been thinking about switching to Novolog, but I haven't found evidence that convinces me to make that change yet. The heat factor is one thing, but I'm so insulin sensitive that I'm sure I'll experience wild lows if I make a regimen change. Hmmm...

And re: the physician, what a creep. Just because he has initials after his name doesn't mean he can corner the market on odd.

I'm glad you had a successful day at the beach!

Blogger Minnesota Nice said...

Earlier this year my HMO would no longer cover Humalog (go figure) so I had to switch to Novolog. I found no difference.

Blogger Nic said...

Your interaction with the "physician" has me howling! It reminds me of one I had with a two-year old on Sunday. "Why's your cell phone like that?" she asked, pointing to the cord. "It's medicine." "Oh. Is it in your bottom?" Kids! Physicians!

Blogger Scott K. Johnson said...

Hey Kevin,

I've been away from a PC for a few days, so I'm a bit late to the party here.

I thoroughly enjoyed this post, and more than once I was chuckling out loud. Super fun reading your super entertaining writing!

Anonymous Manus said...

Kevin,

Not an expert -- but I can say that obviously the problem here is the in-laws. If you can eliminate the in-law factor, you'll have much smoother sailing.

What sort of strange interaction did you have? I feel pretty certain that had to do with the in-laws as well.

Best,

Manus

Anonymous Tamara said...

I just switched to Novalog in my pump because I ran out of Humalog and my sister had a bottle of Novalog. I noticed that my sugar would not only take longer to lower, but that I would expeirience lows hours later. I had no idea that Novalog was any different than Humalog. All I have ever heard from Dr.'s is they are the exact same. Thanks to everyone for posting! I couldnt figure out what was going on!

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