Back on track. But to where?
I received the new pump, as expected last night. What a relief it was to hook it up... As I said in yesterdays post my replacement pump is a Paradigm 511. This is one version lower than my regular pump (I use the Paradigm 512.)
The 512 is much better.
For example, the 511 doesn't have a
bolus wizard. It's interesting how a simple feature such as a bolus wizard can improve my quality of life. By calculating (instead of me guessing) boluses for each meal, it impoves my control. And improved control means improved quality of life.
These kind of shortcomings can be expected when new insulin pumps are launched. The 511 was after all a leap forward from the 508. And Medtronic improved it by launching the Paradigm 512 "shortly" after. Then they launched the 515 giving even further improvements and better usability.
But I live in the wrong country. The Paradigm 515 is not available in Western Europe!
Why? I have called Medtronic about this and apparently it has to do with the regulatory offices. Just like the US has the
FDA , so does Europe have its own agencies. In France it is called
AFSSAPS.
So what do these offices do? One thing they do is to create barriers to innovate products. Everything has to be approved in the name of safety. This takes time, and costs money for the companies involved. For users (like me) it means getting access to products later. The development of new features is slowed down.
Their justification is to protect the users from hazards, and thereby save life. However, the software gets thorougly tested by the company that make it. Any faults would be damn expensive for a medical company. Word spreads quickly, leading to reduced sales. In addition, willing and ambitious lawyers are plentyfull around negligence cases.
It is seldom mentioned how many tragedies could have been
avoided had the FDAs and the AFSSARS' of the world
disappeared. How many lives could have been saved? Launching products to the market 5-10 years before (new insulin pumps, but also new cancer drugs, vaccines etc) can save lives. In addition it would mean lower costs for introducing new treatments, and it would open up the market for smaller companies. More competition would be the result. more choices and lower prices for the end consumer.
But is this limited to only Europe and the US? No! In Australia, for example, they are now using the Minimed 508. This is the dinosaur of insulin pumps! Poor bastards. But atleast they get to practice their math at each meal...
I feel naked...
My insulin pump went into “stasis” today. After changing the reservoir it refused to recognize the new one. No matter what I did, it continued priming until the whole reservoir was used. So now I am now not wearing one. I feel stripped.
So how does the support in France work, you may ask (if you don’t you should probably stop reading now)?
First, I called the Medtronic Service line (I have a Paradigm 512): After 10 minutes of getting switched from one person to another, all while listening to elevator music, I got the privilege to leave a message on the phone of someone in their gastro-intestinal products department. Don’t ask my why.
Not expecting much help from Medtronic, I called LVL, the company that sends me new supplies every month. These guys are usually great. After only 5 minutes on the phone, listening to an ABBA disco remake, I got connected to a live(!) person. Yes, they would deliver a replacement pump at my apartment. They would leave within five minutes and arrive at my door within an hour. Great!
But here I am, 3 hours later. Still stripped. So, what went wrong, you may ask? The service guy arrived one hour later, as promised. But the pump they brought was “functionally challenged” (it kept giving E512 and E17 error messages). They probably grabbed the wrong product in the hurry to reach me.
So he asked me if I have a pen to cover your insulin needs until we deliver a new one tomorrow morning? I answer “No”. A white lie…Yes, I have NPH insulin and syringes but no, I don’t have an actual insulin pen to deliver it with. A yes answer would mean 15 hours of being alone. No insulin pump. So here I am waiting for their next delivery guy bringing a Paradigm 511 replacement pump. It should arrive within the hour...
Find 7 errors in the following picture:
Answer: That's right, I measured 7 lows (values below 70mg/dl) within a 24 hour timespan this weekend. This must be a new record?! I could feel all the lows and they were all easily treated, but they kept coming back. Like the IRS.
So why did I do wrong? Here's some theories...
1) For starters I did 2 1/2 hours of exhausting sports on Sunday the 15th, right before the spike of 261mg/dl (mesured afterwards). I practice Brazilian Jiu Jitsu, and during training I disconnect my pump (to avoid that it gets ripped out.) This explains the first peak in BG value. Then what happened was that I bolused to conver the lost basal insulin, and lunch. Agressively (OK, I felt hungry after practice!) This explains the first two lows...
2) Then what happened, or rather did not happen, was that I did not reduce my basal insulin the rest of the day.
3) Finally, who knows if the lows were even more numerous, or lower. Maybe I could have had a record 8 lows!? Seriously though, some of these lows could probably have been avoided if I had a Continous Glucose Monitoring system. For example, check out this graph (from
LifeAfterDx): Nice and smooth no undetected values and discrete jumps there... Also he would have had an alarm if he had a low:
1) Are there anyone out there with more lows in a 24 hour timeperiod than my 7? Write to me:)
2) Do you have any suggestions about how to reduce the number of lows after a hard workout? I am thinking about either setting a special basal profile, or reducing my basal temporarily with 20% next time, but would be interested in other's experiences / practices.
Two roads...
The following question was palced on the
Diabetes Talkfest blogsite a while back:
If you were given the chance to go back to before you were diagnosed and had two roads to take, one was the road that leads you up to the point you are at now with all that has come with diabetes and the other will lead you to a life without diabetes, which road would you take and why?I was surprised to see so many commenters selecting the diabetes road.
My choice is
to live a life without diabetes. No doubt.
If your choice is not, I have one question for you: Would you select to have your children or other family members live with diabetes? Really, if it has given you so much, why not share it with someone else? Personally, I would prefer to have my thumb cut of (ouch!) instead of my daughter getting diabetes.
So, why do some people not want to get rid of a disease? Most answers revolve around God, diabetes forcing one to eat right and excercise, gaining self awareness and friends.
Off course, it has given me friends and more self insight also. But so could entering any other activity (flying, bowling, salsa, ...) or getting any other disease (AIDS, syphilis, cancer, drug addiction...) I wish my daughter the healthy and voluntary road, and hope they find a cure for diabetes. Soon.
