Sunday, October 8, 2017

My trial with Fiasp

With the advent of FIASP now coming to the United States, I thought I'd finally get around to doing my much promised write up on how my trial with FIASP went earlier this year.  If you can't wade through my words here ... just go to "Dr. Google" and type in "FIASP review" and you'll get lots of hits from various bloggers around the globe - some engineeringly intense- and some - like mine - less so.  Again, remember, what I write here ... does not mean it will be the same for you.  Our bodies are all different as to how it will react.

I went against my endocrinologists wishes.  She felt that because of no medical proof/research showing that it works in an insulin pump (I'm presently on the soon to be dinosaur Animas Vibe ... sigh) that she doesn't recommend it.  I'm such a #diabadass, and off to my favourite pharmacy here in Canada, and viola, a freshly squeeze vial of our juice of life called Fiasp ... with a touch of Vitamin B3 (niacinamide) to increase the speed of absorption, along with a naturally occurring Amino Acid (L-Arginine) for stability.  These last two additions are what make Fisap work supposably much faster to absorb.  It's like they're describing a fine bottle of Chianti, maybe with some fava beans ?

My experiment involved for 2 weeks, keeping my insulin pump filled with NovoRapid purely for the basal portion of my insulin regime.  For meal times, and corrections, I injected Fiasp according to my blood sugar results.  Taking the injection a few minutes before a meal resulted in hardly any spike at all, e.g. I tested a 5 mmol/l ... 2 hours later 8 mmol/l .  I didn't eat any differently when I ate, I just did my usual thing as a semi-low carb eater (I try to stay under 150 grams of carbs a day which according to my medical team ... is not enough ... but that's the way I've always eaten).

Testing it out 20 minutes later resulted in various results, rarely did I go over my zone of 10 mmol/l after eating.  As well, it all depends on how accurate you are with figuring out carbs for that yummy dessert you decide to have later.

Correcting via injection with Fiasp went well if I had to, but I found it very rare that I went crazy high, unless, again, I didn't calculate the insulin to carb ratio (I:C).  We have to be precise in our calculations in order to stay within the range we want to be in, without sacrificing ourselves to either a low blood sugar or high blood sugar.  At times when you think about it, diabetes can be a game of chance like at a casino of rolling the dice !

Next came a 2 week session with having Fiasp in my insulin pump, so both basal and bolus were taken care of it.  Testing it out the same way, the results were no different than just using NovoRapid.  The other problem I had with the Fiasp was when removing the infusion set after 3 days, the puncture point of the Contact D set was red and irritated.  I'm thinking it maybe due to the additive, not sure.  Also, there was stinging at times with infusing insulin, but not often.

I keep on wondering if the reason it didn't work as well for me in my insulin pump was due to the insulin not being "fresh", which it is when drawn up by syringe each time.  Hard to say.

One thing before I forget, I tend to do something I've learned from the Diabetes Online Community (#DOC) that my endocrinologist and her team chastise me about. That's the intramuscular shot (IM) of rapid insulin to lower a high blood sugar (for me this is only done when in the 20 mmol/l range).  I do it in the upper muscle of my shoulder, and based on my Insulin Sensitivity Factor (ISF), I am usually in range within an hour or two.  Because the pump with Fiasp didn't do as well, I did hit a few above 20's ... and found that Fiasp via syringe worked the same.  No sudden drastic drop into no-no-land which is what I have been warned about over and over again from my medical team.

So, that's it, in a nutshell, how my little trial went.  It's worth giving it a go, if the vials aren't too expensive (here in Canada I can get a vial for $35 ... or 5-pack of penfills are $72 ... I have no insurance ... so according to my "legal drugs dealer" aka pharmacist ... I'd be paying about $10 more if I had insurance (urrrhhhh).  Both my pharmacist and myself are curious to see what Americans pay out of pocket for Fiasp - so if you do look past your co-pay - and do question why you pay such and such for a drug ... great ... let me know.


Since this experiment with Fiasp - I have found that with NovoRapid in my insulin pump ... in order to NOT have spikes ... waiting almost an hour for the insulin to start doing its "thing" ... rather than 20 minutes which is usually recommended for most of us ... gives me much better results.  Therefore, I may give Fiasp another go and try different waiting time before eating.  Also, with contemplating what insulin pump to go on due to Animas Canada pulling out of the pump business and my dislike for the company that has said they'd replace our pumps with theirs - I'm on the fence post about continuing with an insulin pump.  I was injecting for 40+ years before going onto a pump, and can if I have to, go back hopefully with Tresiba being introduced in Canada this month as another long lasting insulin (and that'll make another blog post one day in the near future).

Monday, October 2, 2017

I've Got My Eyes On You

Before I go on ... all I can say is #prayersforlasvegas ... words cannot describe my feelings of what happened in Las Vegas Sunday night. 

Last Friday night, one of my neighbours commented that my inner eyeball looked red.  It felt abit hot and itchy (I'm still not sure if I maybe had scratched it earlier, but since being told women are the worst out of the sexes to have eye irritations due to rubbing their eyes, I now am vigilant to NOT rub) .  If you think this is all poppy cock ... go check out this link to learn how dangerous it can be!

When I was washing my face later at night as I prepared for zzzzz time I saw how the blood vessels had broken in the corner of my eye.  Pretty ugly to say the least, but it was when I opened my eye up wide, I discovered what looked like a clump of cottage cheese.  Of course, I freaked out, when after washing my hands carefully, I couldn't dislodge it.  When my DH eventually heard me, he tried with a Q-tip.  No luck.  So, off to ER at Cornwall Community Hospital (CCH) we went.

Three hours later ... it was mutually decided to not remove it (the on call doctor said he could but to me that's like having a dentist do plastic surgery).  My ophthalmologist luckily was on call that weekend so he would be contacted the next day.  Main thing, they determined it was nothing serious and to use lubricating drops every hour.  I felt abit stupid going to ER, but they've told me that I did the right thing, especially being a Type 1 diabetic.  The fear of losing my our sight is always in the back of our minds, or it is for me!

So fast forward to Monday, which is today.  Took a cool stroll into downtown, and discovered that what the white clump is all to do with is the "Dropless/No Drops Long Acting Meds" that you see in the bill below when I had double cataract surgery performed at the end of July.  It will dissolve in time, and as the surgeon said, it lasts a long time.  I went this route rather than drops due to already having enough to remember about with diabetes and other meds I take.  This way, bing ... it's done ... though as he explained ... he thinks he should now maybe warn his patients about what may occur.

If you notice below, in the bill ... I went private due to feeling unsure about how I'd be treated at the CCH as a Type 1 diabetic wearing an insulin pump and CGM.  Also, any laser correction required for follow up to lens implant, is covered with this charge (this is where I'm abit puzzled, if I'd gone public, then I'd be paying for this???).  Laser has been performed once to remove cloudiness on the implanted lenses, called posterior capsule opacification (PCO) and is often more common in younger cataract patients - so that must mean I'm not an old fart <lol>.  Laser will probably be performed again to hopefully correct my other eye that surgeon had difficulty placing lens into the vitreous so it's sitting more securely (that eye had the bigger cataract .. my buggered up eye in this blog had just a itsy bitsy one starting).  Today, he also talked of removing that lens and suturing a new one in place rather than compromising my thinning vitreous.  The things I learned today when he was open and honest with both myself and my husband.

From a personal point of view, which is why I haven't written in awhile ... I wish I had never had the cataract surgery and saved the $3K for something else (wine, holiday, yadda, yadda).  I also wish I had not gone with having BOTH eyes done.  I only had a small cataract starting in the other eye (the eye that you see here in this post) ... the other one was supposedly larger.  I miss my glasses (have been wearing them since Grade 5), and during this process of recovery, miss having good vision.  My vision was never that bad even with needing extra light once in awhile due to the larger cataract, plus I only wore glasses for driving since my eyesight had been improving over the years believe it or not.  Now, both distance and close up ... are buggered up - I have my good days of seeing semi-clear ... and bad days where I frustrate myself and my husband to no end when I'm trying to read a recipe or magazine (I do not read as much or watch TV now that often - which I miss so much).  Again, I keep on telling myself it's still early days as other cataract patients (thanks Dad) have told me as well as my surgeon.
The only thing I can leave you with, if you are like myself, having doubts about going for cataract surgery along with the promise from your ophthalmologist of having perfect vision (which most times does happen ... along with not wearing glasses if you dislike wearing them).  DO YOUR RESEARCH ... this is coming from someone who researches diligently when creating a blog like this and didn't for her own health. I sadly, did not, and only saw afterwards a statement at the RNIB (see below) that if your vision is NOT helped by changing your lenses, then having cataract surgery is probably your best option.

If you need more help in understanding about cataracts, I highly recommend the Royal Institute of Blind People based in the UK ... it has amazing information ... written in easy to understand terms ... you can find a downloadable .pdf file at this website link.  If you're wondering about complications like I've just had with this surgery, check out All About Vision at this website link.

NB: the wait time for cataract surgery varies from province to province in Canada.  I was told if I'd not gone private that it would not be performed until 6 months later.  If you're Canadian and reading this, you maybe able to find a similar link like this one for Ontario wait times

Update to blog 2023-10-21  - with another link  below to a post that was written a few months later - when surgeon removed lens that they'd had problems with - and my fear of hospitals that don't understand Type 1 Diabetic patients - entitled Cranky One Eyed Cat