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Entries by Scott Benner (615)

Thursday
Oct312013

Pound the (OmniPod) Alarm

From: System Documentation: New OmniPod PDM Model UST400

Have you ever experianced an OmniPod alarm that wouldn't stop? Have you gone online to find out how to save yourself from the incessant squeal and receive tips like: You can open the pod and take out the batteries, put it in the freezer, hit it with a hammer, or my favorite... I put it in the driveway and ran it over with my car.

While I have to admit that a few of those tips sound like a great stress reliever, you don't really have to go to all of that trouble. All you need actually, is a paper clip. The new smaller OmniPod has a manual shut-off port (Just like the first generation did) for stopping that annoying alarm! If you'll refer to the diagram above that I borrowed from page 131 of the system documentation for the new OmniPod PDM Manual (Model UST400), you'll see where the port resides.

Just follow the instructions and don't forget to give the paper clip a firm push (It has to break through a thin layer of plastic) and the alarm will be no more. Best part? You won't slip with a kitchen knife as you try to crack the shell open and cut your finger off.

Wednesday
Oct302013

Bermuda Triangle 

Last week around eleven in the morning, Arden texted from school to say that it was lunch time and she couldn't get any of her test strips to work. "I've tried five and they've all errored", her text read. 

No problem I thought, "What's your CGM say?"

"???", Arden replied.

We found that Arden could still deliver insulin with her OmniPod PDM so we bolused for lunch in the blind and I told Arden that I was leaving to bring her a backup meter. On the way to the school I spoke with OmniPod customer service (Picked up on the first ring!) and they suggested that I try a new vial of test strips. The CSR finished the conversation by saying that if the test strips weren't the issue, they would happily overnight us a new PDM.

I met Arden in the office a few moments later and we tested successfully with the new strips. The CGM sensor however, was toast, so we changed our testing strategy slightly and synched our reminder alarms. Arden went back to lunch and we managed the remaining four hours of the day the ole fashion way... with a meter.

In all of the years that Arden has had diabetes, this is the first time we've experienced a total and simultaneous loss of the ability to quantify her BG. Even though the timing couldn't have been worse, I never felt frazzled and I can only attribute that calm to having so much experience. I'm quite certain that this moment would have given me an aneurysm five years ago. 

Before I say this next bit, I want to remind you that I am not a medical professional and that the things that I share on Arden's Day are never meant as advice. There is a disclaimer at the bottom of the page if you'd like to read it. I gave Arden her lunchtime insulin in this situation without testing or the benefit of a CGM based on a number of factors. Time of day as it relates to her last bolus, we spoke about how she felt at length, based on historical data - Arden's BGs at this time of day over the week, the fact that she was going to immediately begin eating and I would be there with a new meter and strips in less than 10 minutes. I would never bolus without knowing the state of her BG in a normal situation.

We swapped Arden's DexCom G4 sensor (It had done more than its fair share... if you get my drift) when she arrived home and we were back on the path of technology based diabetes care, by dinner time. The PDM/meter has not given us a problem since, so I'm chalking this all up to an anomaly caused by faulty strips - but who knows.

Monday
Oct282013

Big Blue JDRF Walk

2013 JDRF Walk

On Sunday we participated in our eighth consecutive JDRF Walk. The walk provides something different for everyone. Community, support and hope are but a few of the good things that emanate from the gathering. I always think back to our first walk, it was just two months after Arden's diagnosis in 2006 and we were still reeling from the shock. The people that walked that day were each and every one, a stranger - but they helped me immeasurably just by being there. The stress that I felt was lightened when I saw so many living well with diabetes. Their presence made everything feel possible and the smiles on thier faces seemed to promise me that we were going to be okay. Today, eight walks later, I hope that our smiles have made someone else feel the same way.

And speaking of exercise and doing something good... When we got home from the walk each member of our family logged their information at Big Blue Test dot org.

 

from BigBlueTest.org

 

Since 2010, over 40,000 people helped themselves while helping more than 10,000 others. Most participants in the Big Blue Test experience an average blood sugar drop of 20% and by every Big Blue Test result a donation is made by the program sponsor to help others around the world with diabetes in need.The Big Blue Test is a program of the Diabetes Hands Foundation that encourages people with diabetes to test their blood sugar, exercise for 14-20 minutes, test again and share their experience on BigBlueTest.org. For every test, people with diabetes in need receive life-saving supplies through Big Blue Test grants that are awarded to humanitarian diabetes charities in the US and around the world, made possible thanks to the program sponsor. In 2013, the Big Blue Test grants will benefit two US-based initiatives (each will receive US$2,500) and an additional US$5,000 will support projects in Haiti and the Dominican Republic. This year, we’re seeking to reach 20,000 Big Blue Test entries, which will translate into a donation that will help save lives.
I want to encourage each of you to find out more about how you can support The Big Blue Test with just a few moments of effort.
 
Thursday
Oct242013

Sure, you can go to the Selena Gomez concert

If you read Arden's Day with any frequency you know that we manage Arden's Bgs with text messages while she is in school, at a friend's house and every other time that she isn't in our physical space. I've written how the process has eliminated so many issues, lowered her A1c and making us all to feel more independent are but two. I am genuinely excited to tell you that we have recently added, "Go to a concert" to that list! Now you may be thinking that there is a world of difference between managing type I from across town and being an hour away in a stadium singing along with the former Wizard of Waverly Place, but you know what - not so much. It turns out that the biggest hurdle when considering the difference between the two situations is realizing that there aren't any.

I have two main concerns when Arden isn't with me. Loss of communication and An unexpected low BG. All that remains is manageable with pre planning. Supplies, food, and juice is no issue to pack and have at the ready. A well thought out testing schedule eliminates most surprise BGs and Arden's DexCom G4 finds the ones that slip through the cracks. Of course no one can plan for a significant BG drop that defies logic, that possibility is the diabetes equivalent of having a car accident - you wear your seatbelt, drive safely and hope for the best.

I received a call asking if Arden could go to the Selena Gomez concert with one of her best friends, I didn't hesitate to say, "Yes!". One year ago the mom on the other end of the phone wouldn't have been able to finish her sentence before I said, "Thank you but no". But so much has changed in the last year. Now when a person that I trust calls and asks for Arden to accompany them for an evening, I can say yes with less trepidation and that makes me very happy for Arden.

 

Here's how I handled Arden going to the concert...

First, the mother and I had a nice lunch together the week before the event. Even though Arden goes to their house for play dates, we still manage through texts while she is there so the mom doesn't have a lot of interaction with diabetes. She understood the basics and knows how to react in an emergency but the concert was going to require me to advance her understanding of type I diabetes. 

We spoke about all emergency possibilities in very, very real terms. I explained that I needed her to understand all that could happen, even though the likelihood of it happening was extremely remote. 

I said thank you for her willingness to except the extra responsibility and went about the seemingly impossible task of preparing a person for an evening with type I without overwhelming or causing them to obsess during the event. The last thing I wanted was for the extra considerations to take away from the experience that she was going to have with her own daughter.

We spoke about supplies, testing times, CGM check ins and how to talk to the security guys in a way that makes bringing food and drinks into the venue easy. We talked about panic situations, CGM arrows and how to use glucose gel. I explained low blood glucose seizures and that I was going to discreetly slip her the glucose gel because the sight of it makes Arden anxious.

I couldn't have been prouder of Arden and her friend's mother when they pulled out of our driveway for the concert. The conversations that we had and the topics that they had to consider, just to go to a concert, were more than a nine year old and her friend's mom should be asked to think about - but they did it. When Arden got into the car with her friends she was smiling just as a little girl on her way to a concert should. Thankfully, her BG's were rather uneventful during the evening, she required two maintenance boluses during the show (Adrenaline I imagine)  and a juice box on the ride home (No more Adrenaline) but other than that, easy sailing. When she walked through the door at almost eleven, her BG was 104 (DexCom had the BG at 74). Success!

 

Never once that night did I have to speak with the adult who accompanied Arden about anything related to diabetes. Actually, at one point she sent me a text and asked, "Is there anything I need to be doing?".

The bag of supplies I sent was returned to us unopened. Arden didn't need the extra OmniPods, insulin, needles or food. In fact, she would have been just fine had I not sent any extra supplies, all she needed was the juice box that she always carries in her bag.

I want this story to illustrate that everything is possible with type I, but what I don't want is to make you feel like planning ahead isn't necessary. This trip included a number of conversations, pre planning, a well packed bag and a little luck. Actually, to show you how much luck - Arden's OmniPod experienced an error the morning after the concert and I had to go to school and change it around 8:30 am. Can you imagine if the pod would have shut down during the concert? I could, and that's why we had a plan for how to handle that situation, should it arise. We planned for every conceivable possibility and talked about each ahead of time so that if they did occur, no one would be caught off guard or be unprepared for what to do next. 

Arden popped out of bed for school the next day and put on her concert t-shirt still smiling from the evening before -- suddenly, the effort that it took to get to that moment felt like no effort at all. 

Tuesday
Oct222013

Link between Type I Diabetes and Coxsackie B Virus

I found this article particularly interesting because Arden was diagnosed with the Coxsackie virus prior to her diagnosis with type I diabetes. I was wondering how many of you also saw Coxsackie before type I?

 

The following is from The Scotsman.

A SPECIFIC virus family has been implicated in the development of Type 1 diabetes, raising the prospect of vaccinations against the disease. -

  • by JOHN VON RADOWITZ

Scientists are encouraged by data from two studies that show a clear link between the condition and group B coxsackieviruses, which are known to damage insulin-producing cells in the pancreas.

The potential breakthrough relates to type 1 diabetes which affects around 400,000 people in the UK, 29,000 of whom are children.

Researchers believe that, in time, it may be that with screening and a vaccine, they could prevent a proportion of diabetes.

Type 1 diabetes is an autoimmune disease caused by the body’s defences destroying insulin-producing beta cells. But what triggers the extreme immune reaction in the first place has been an unanswered question.

Suspicion has fallen on enteroviruses, one of the most common infective agents in humans. They include the virus responsible for the common cold, as well as those responsible for polio and viral meningitis.

The new study narrowed the diabetes culprit down to one particular enterovirus population known as group B coxsackieviruses.

 

The remainder of this article a valuable read and can be found here.