Day Three of Podding

My third day of using the OmniPod didn't go so well. This is mainly due to my having trouble working out how the extended bolus works.

When I eat food that is high in fat, it keeps my blood sugar from rising for awhile. The extended bolus is meant to help with that by holding back some or all of the insulin bolus for however long the user specifies. My big problem has been in figuring out how long that is. On Saturday morning I ate a banana muffin with peanut butter, and when I took a bolus for it my blood sugar dropped right away and then increased significantly a couple of hours later.

On both Saturday and Sunday I ate a burger and fries for lunch. On Saturday I programmed my extend bolus for two hours, only to have a high blood sugar by the time the pod gave me the bolus. The next day, Sunday, I programmed it for an hour and a half, and again I had high blood sugar by the time of the bolus.

Because of the high blood sugar, I did something stupid. I had a high fat coffee drink at Starbucks but I gave myself the bolus right away -- at the same time the pod gave me the extended bolus from lunch. This resulted in my blood sugar crashing in the middle of Wal Mart -- not surprising, really. I temporarily suspended insulin delivery and ate some candy that I keep in my bag for emergencies.

The rest of day three was uneventful until a couple of hours before bedtime, when the pod suddenly emitted an alarm. Turns out that the insulin reservoir was low. I probably would have had enough to last the night, but I didn't want to risk either going into ketoacidosis overnight or being rudely awakened by another alarm. I decided to change my pod early.

I was nervous about doing everything on my own, since the first time I applied a pod I'd done it under the watchful eye of Nicola the pump trainer, but I had a handy "quick start" guide that was easy to follow. Changing the pod wasn't as difficult as I had feared.

Today I am going to try to find food that isn't as high in fat if I happen to be downtown at lunch time, but I am going to have to figure out that extended bolus eventually if I want to eat pizza ever again.

Day 2 as a Pod Person

My first day as a pod person had its ups and downs, or at least my blood sugar did. After my blood sugar had been high all morning, the PDM finally suggested a correction bolus to bring it down.

When I was finally down to a blood sugar in the single digits I ate a chocolate bar. The PDM then suggested a bolus for the chocolate that was a bit more than I thought I needed, but I accepted the bolus. That was a mistake, as I wound up with hypoglycemia at a blood sugar of 2.4.

However, a glass of Coke and another chocolate bar brought it back to normal. I then had to figure out how to keep it up. At first I thought I would reduce my basal rate, but I soon found the "suspend" function, and I suspended all insulin delivery for the next 90 minutes, until I had supper.

I spent most of my evening working on my new house, and I noticed my blood sugar was dropping quite quickly. Time to suspend basal insulin again. Another hour and my blood sugar had increased, so I turned on the basal once more.

I slept like the proverbial log last night, completely unaware of the pod on my arm, even when I was lying on it. The biggest change I noticed was eating without doing an injection. For more than 40 years I have done an injection at breakfast time, and this morning all I had to do was push a couple of buttons on my PDM -- fewer buttons than you would push to send a text message.

Obviously I am still getting used to setting my insulin dose on the PDM. I think my peaks and crashes on day one were due to a combination of miscalculation of carbohydrates and more activity than I was anticipating, along with the learning curve on the pump. I think I'm getting there, though, and soon I will be an expert pod person.

First Day on the Pod

Today is my first day using an OmniPod. I was very excited and found it hard to sleep last night, or maybe I couldn't sleep because my endocrinologist had instructed me to not take my Lantus long-acting insulin last night, so high blood sugar kept me awake all night. At about three in the morning I checked my blood sugar and took two units of fast-acting NovoRapid. Those were gone by the time I got up at seven and had a blood sugar of 15. I met my pump trainer, Nicola, at a local restaurant. She's very nice. She showed me how to activate my PDM (personal device manager) and program in my basal rate and my carbohydrate-to-insulin ratio, which is now 10 to 1. (My endo had originally set it at 12, but Nicola and I decided to take the middle ground between 8 to 1, which I had been using, and 12 to 1, which Dr. Miller said to use, and set it at 10 to 1.) I input all the information, filled the pod, activated it and stuck it on my left arm. When I put on the pod for the first time it felt very similar to an injection, but as I've been doing injections for 40-plus years, that's not a problem. I'm fine with going from four injections a day to one injection every three days. Unfortunately my blood sugar has been high all day. I think it's a combination of the lack of long-acting insulin in my system and probably miscalculating the carbohydrates in my breakfast. (A breakfast wrap with a side of hashbrown potatoes.) It's coming down, but very slowly. I've had to resist the temptation to just grab my insulin pen and inject a bolus to bring down my blood sugar. I skipped lunch because I had breakfast very late and because my blood sugar was so high. For supper I intend to eat something for which I know the carbohydrate count for certain so that I know how much insulin to tell the pod to give me. Maybe I can avoid getting high blood sugar again (or avoid keeping it high.)