My first endo visit in over 30 years!

I had my first meeting with an endocrinologist who works with insulin pump patients last month.  In the past I’ve used either my GP or a doctor that works in the endocrine area of the health field, but does not hold the title after their name (just like me, at times I’m like a CDE, but in reality, I’m just someone with 50 years of experience with T1D).  None of my past care givers understood pump technology, so as I’ve mentioned in the past, I do my own tweaking, and had been doing fine until menopause hit me last year.

The last time I’d seen an endocrinologist was way back in the 80’s … and I rarely saw them due to being busy with life, and in those days, we didn’t have all the technology today, so in some ways, at least for me, diabetes was just something in my life that today now seems to encompass my every waking moment with machines that read your blood sugars (CGM), or control the amount of insulin that goes into your body (insulin pump), along with blood glucose (BG) meters, and different types of insulin. 

It was an interesting meet up with the, originally they were coming to where I live (an hour and a half drive for them), but then a week before I was told they would have their head contained in a screen (my words – not the CDE’s words) … think of Max Headroom if you are of my age group you will know.  So, with the CDE in the meeting … we got started on figuring out my control of my diabetes, that I’ve basically been doing by myself the past 30 years.

I’d downloaded all my pump/CGM/BG meter info to Diasend that morning from home, so while the endo asked me questions, the CDE punched numbers on her screen while listening.   The endo couldn’t quite understand why I wanted a lower A1c which puzzled me, as I thought she would encourage me to attain a better number.  Explaining how many of us want to avoid complications, etc. with keeping a lower A1c didn’t interest her.

Their main concern was the hypoglycemic (hypo) reactions I have been having at night lately that they saw with the Diasend report.  Which is understandable after learning from various conferences I’ve attended over the year, hypos are harder on a diabetic body then a hyperglycemic (hyper) – e.g. going up high.  Of course, it all depends on how high you go up, but to me, anything over 15 / 270 freaks me out and the methods I use to bring even higher ones down she did not approve of.  I’m also still very lucky, I wake up to hypos, CGM or not, and generally do not over treat them which is what many diabetics do which results in that crazy roller swing.  I’ve learned over the years, depending on the BG number, to go from 5-15 grams of fast acting carbs, wait 15 minutes, retest.   Helps to offset that crazy high in the morning when you wake up.

The endo asked me to set my CGM alarm during sleep time to 15 / 270 in order to have a solid sleep (as we all know – lack of sleep can affect our blood sugars not just our sanity in our work place the next day or relationship that for me is already compromised by menopausal mood swings!).   Of course, freak out, I did request permission from CDE a week later after tying to follow endo’s instructions so I am now able to correct anything over that number, “safety first” as the CDE told me.  They just want me to be more sparse about it and only anything over 10 / 180 – which I have been doing – but this is way against the way I’ve handled my diabetes over the years by myself.  They are hoping to see what happens with my BG without correction, does it go up and stay up, or does basal bring it down.

I started to realise around that point that I had an endo that sticks to the rules and no matter what I said (e.g. I asked her if I could go on metformin, which has been shown to help T1D teenagers in attaining more level blood sugars … and that a study was being done with adult T1D’s using the drug and showing great success).  No, unless I was using over 50 units of insulin a day, she would not consider it.  I felt like I had the door slammed in my face at that point.

 My promise to follow a snack plan (carb/protein) in the evening as the endo requested in order to avoid hypos overnight – nope - that didn't last long.  Though I have now gotten into soaking almonds in water, and having about a ¼ of a cup before bed time and BG’s seem to be great overnight.  I really don’t do snacks at night time, which is something I did as a kid at home when my parents followed the CDA/ADA meal plan.

So, overall, I am realizing that it is the CDE team that is the most knowledgeable in diabetes management.  I have yet to tell them that I’ve gone ahead with upping my basal (the high wake up blood sugars during some of my major hot flash periods that last longer since I had the hysterectomy a few months ago was too much for my control level of diabetes).

It’ll be interesting to see how things go for my next visit at the end of January.  I do have a friend in Ottawa (he is on the study with Metformin) who has told me his GP who follows his diabetes is taking on new patients.  It’s something to think about, and with how I’ve always taken care of my diabetes, where I only go to see a doctor when I need a new prescription or have blood work done to see how I’m doing … I may just go back to that routine. 

Main thing for me, it’s an interesting experience to have a CDE team after all these years of my time with diabetes and even better is that they understand much of today's technology unlike my former doctors and I don't quite feel alone in working in the coal mine of my diabetes control.

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Falling through the cracks of a small town hospital

Falling through the cracks of the Cornwall Community Hospital (CCH) system … that’s the only way I can come up with an explanation of what happened with my insulin coverage last week during a 4-5 hour period when I was asked to stop my insulin pump from delivery insulin during surgery.  I put Ziggy into 0% basal rate for 4 hours – but now think I should have lied and just left him on. 

The Womb With A View

I think due to the diagnosis 2 weeks after my initial visit to ER for heavy bleeding and I was in menopause stage of life, along with the fast turnaround of 2 weeks after that for a spot on the slice and dice table this may have resulted in mistakes being made in what occurred that day with Pre-Op / miscommunication with the CDE’s / gas woman aka anesthesiologist, etc.  

Was pre-op done to close to the surgery date?

In past surgeries (e.g. mastectomy done in 2007 for diabetic mastopathy ), the Pre-Op, meeting up with endo team, was all done within 2 or more weeks of the surgery date.  In my case at CCH, pre-op was done 2 days before the surgery day  ( DH came along ).  The RN didn’t say anything about whether pump would be allowed or not, but took down that I wore an insulin pump,along with my total basal rate, average basal rate (this same information was given to the Pharmacist from the CCH the next day who said it was unusual for them to be left out of the loop for pre-op).   The RN was fully aware that I was being seen by the Diabetic Clinic within CCH and I “assumed” they would be contacted for any help (they were already aware of my upcoming surgery by an email I’d sent to them).    

Was any blood sugar testing taken during the surgery and didn’t

my CGMS alarms make them aware?

Sadly, I didn’t think of the CDE statement from an email earlier during the week when I’d asked her about wearing the insulin pump during the surgery …  

“do you have a protocol for not wearing pump during surgery”

Her response to my query, with no suggestions,  made it obviously clear to me I was on my own with handling my diabetes control in the hospital (I have since learned she expected me to respond back with my answer). 

I assumed that when the anesthesiologist (gas woman) firmly told me that she would not continue if I kept the pump on, that insulin would be at least provided in the drip.  This was told to me as I was already being strapped down to go to la la land of no pain and she meant business (she wasn’t happy with where the RN had set up the drip, but my veins are sparse and RN didn’t go to my hand which has LOTS of plump veins and has been used in the past by the blood takers).  So, basically, I had no time to say, “ let me get my overnight bag and shoot up with Lantus “.   Yes, I was in a tough position at that point, trying not to panic.  I had come prepared, but not at the last minute when the surgeon’s clock is ticking for his other scheduled patients that were behind me!!  Gulp!!

My hospital gown had the washy washy instructions to ensure no evil germs develop!

Granted this was my first major operation using an insulin pump.  Previously, I was on MDI, and with pre-op it was always determined that I do my regular long acting insulin shot and that after surgery that I took over my diabetes control.  Did my being on an insulin pump throw off the pre-op and pharmacist?  This is where both my husband and I wonder …

was any insulin drip given during the 4-5 hours I was under their care?

My darling husband (DH) had been contacted at noon time as I was being wheeled into my room after being in recovery (surgery had started between 0730 – 0800 ) and he arrived about an hour later to hear my story about the blood sugar reading of 22 mmol/l (396 mg/dl) and how the staff had determined I should be given 10 units of rapid insulin.  I vaguely remember all this happening, and again, have no time reference.  I hope I didn’t yell, but I told them it was too much.  I remember being asked what they should give me and in my state of mind was calculating 1 unit of insulin would be lower me down 3.5 mmol/l (63 mg/dl) and told them to give me 3.5 units (if I’d been more with it I should have said 5 units).  I don’t even recall them giving me the injection. 

I was having to rely on someone else to take care of my diabetic care at this point that

had wanted to inject me with 10 units of insulin

My DH at that point looked at Bowie my CGMS and it was alarming like crazy (we are wondering now if the trainee RN who was holding him during surgery noticed this).    Bowie does not like being high, and was still registering at 22 mmol/l (395 mg/dl).  At this point, having my DH by my side, I was more with it and did my own finger stick test which showed I was around 14 mmol/l (252 mg/dl).  Obviously the insulin was working (maybe they did an intramuscular injection (IM) into my arm to make the insulin work faster … which is what I do when my BG is that high – but due to no time frame of injection I’m unable to figure it out). 

With insulin coverage for a T1D it’s all about what TIME insulin is giving … 

method of injection ... site it`s injected into …

This is where even more confusion starts is that the RN that was speaking with my husband didn’t realise that my pump was functioning.  Again, either I did not explain myself properly to the gas woman / RN when turning my basal rate off for the 4 hour surgery time.

So, even now as I compose this blog, trying to put together what occurred, it seems like a dream

So, DiabetesMine ( @samanthachan at Instagram)  … I told you the true story would come  with the picture that you asked permission to use at the Diabetes Innovations Summit at Stanford in November.  Even though the trainee RN who held Bowie during surgery had been warned about what would occur if my BG’s went up or down with him alarming.  I think he was ignored OR even worse case scenario when he was finally looked at, they assumed that that was the correct blood sugar number.  That is even after I  had told her and various staff earlier and during my 2 day stay that the CGMS reading HAS TO BE verified by a blood meter.  The fingertip NEVER LIES when it comes to real time blood sugar number. 

Victorious thinking I`d be allowed to use pump during OR ... NOT

It’ll always be a mystery to me … and personally I will not return to CCH for any surgical performance if I cannot go another route (see note below).  This is after speaking to other residents where I live, they avoid it at all costs.  Though if it’s a situation where I’m not able to drive to the next closest hospital ( Winchester District Memorial Hospital has been recommended to me by many people in Cornwall ), I just hope/pray that I have someone on my side (my DH or another T1D) able to ensure that my diabetes health care does not get lost in the cracks like it did with this hospital experience.

NOTE:  The one thing I have learned out of this experience is that hospitals in Ontario have different ratings (and probably in other provinces of Canada).  A few members from the CCH Diabetic Clinic came to speak to me due to what had occurred the day before with surgery.  They had stated that CCH is a #1 hospital (I have tried to find anything pertaining to what they had told me online but have come up empty handed so this is “my version” of the “rating system”).  If my surgery had been performed at either Kingston or Ottawa, which are larger populated areas, then  insulin pumps would be more accepted and understood by the medical staff members, and perhaps allowed to remain on in the OR. 

Day after the surgery - attempting to drink a Timmy`s

Random thoughts during a heat wave from a diabetic on legal drugs

This is a long intro … the diabetes stuff comes in a afterwards …. I normally post at Diabetes1.org ... but wanted to take a break from that ... and post here for a change of pace (and bigger screen to read my words on as well ).

I’m temporarily a bachelorette; while my DH (darling husband) goes off on a last minute work trip that cut our holiday’s abit short where finally we were getting things unpacked from our move back at the end of June.   I had him take Sock Monkey (SM) with him … so at least SM can enjoy the various “ports of call” that the Challenger 650 is taking them to across the pond.  You can check out the whereabouts of SM at my Flickr account!

Sock Monkey hanging out on the wing of the Challenger 650 he's travelling in

 While I am missing my DH, especially while coping with my little black cat Mia, who underwent a large cyst from her tummy (who I just discovered now is pulling on one her 20 stitches … she made a strange cry … and I leaped out of my chair to see what she was up to).  She now will be forced to wear her Elizabeth collar for the remaining 10 days … sorry kitty kat … but I didn’t fork out almost $800 to bring save you from using 1 of your 9 lives.   Between giving her meds, and like just now, watching/listening to her (I’m a wanna be Cat Whisperer did you know that?) – things are pretty busy.  I am now realising that handling both diabetes and motherhood and everything else that entails having “kids” … I’m not sure if I could have done it.  You were right Mum to tell me to “never have children” … no wonder you started going grey before your time!! I caused it.  Waaaahhhh.

Don't I look cute in my Elizabethan collar or what?

(WARNING - the above paragraph contains A LOT of fun You Tube videos besides silly dribbles of info that is coming out of my adult company starved brain.  Please watch at home in case you are at work … I don’t want you to get the boot out the door).

Now to get onto my main reason for putting my thinking cap on and getting around to a dblogging again since life will eventually settle down in new town, pussycat, etc.  

Yesterday, on a hot and humid day (we currently have a high heat warning) … I ventured out, not by bicycle/foot as I normally do, but via stinky machine … 4 wheel car.  I’m lucky that I don’t really need a car to get around, that was one of the reasons for moving here.  Everything can be walked to / cycled / skateboarded – the benefits of living in a small town.

Now you think you’d see a lot of fit people here? Right?  Sadly, not so.  It’s kind of scary coming from Montreal where I lived it wasn’t something I saw much of.

Of course, where do I go, to escape abit of the heat and humid and duties at home?  WalMart.  The place I swear I hate to frequent if I don’t really have to since they’re forcing a lot of the local businesses to close up.  Sigh.  So, in this case, no malls to walk around in that aren’t an hour’s drive away means … I have to do my “window shopping” in a big box store.

I wonder up and down isles, looking at things to pass the time (hey I need a break from the "kitties").  Talk to a woman who moved from BC to here, and her distaste of the water we have here where we both live (I was looking at the SodaStream at the time, and asked her and her sons about it … the things a question can blossom into).  The water here is highly chlorinated / fluorinated (but I’m researching that with no answers to ascertain oui/non/maybe so).

I then proceeded to look at the various foods contained behind the freezer doors.  Remember, I do not eat prepared/mass produced food too often.  It’s a novelty for me to look at the percentages of fat/carbs/salt in these foods.  I was amazed at what I saw, and thought “OMG … no wonder some folks here are the way they are … this food is EVIL).  The one thing is, food costs here are less expensive than in Montreal … so I don’t really get it.  Even worse, I am seeing so many overweight people or folks using electric scooters, etc.  Some of it is due to the aging population here or perhaps health reasons that mean they cannot walk properly, but I see young folks using them, scary stuff.

Next it was the baking isle.  I still haven’t found the time again to bake my own bread since moving, and the cost of a nice baguette is $1.00 (we go thru’ 1 a week – we aren’t big bread eaters) and is actually a lot less than in Montreal … so factoring in my time, electricity to bake the bread, it’s sadly cheaper to buy mass produced. 

I noticed a woman, probably about my age, looking at baked goods.  Like her, I was overwhelmed by the choices.  I was looking at the carb count and just about fainting.

I said to her, “There’s too much to choose from!” (my mind whirling at Red Velvet cupcakes)

Her reply, “I know, and I’m a diabetic”.

And I said, “So am I, but I can cheat, I’m on insulin!”

From there, I found out she is on insulin.  She only takes it when she has to so she doesn’t go low.  Her doctor told her to keep her blood sugar (#BGNow) levels between 10-13 mmol/l (180-234 mg/dl) and she was used to having readings in the 30’s (540).

I tried to stay calm, as I told her about my CGMS (and the cost just made her eyes go HUGE when I told her along with my 5.1 / 92 #BGNow reading … too low for her) and also showed her Ziggy my insulin pump.  She had never heard/seen these devices.  I started to think a) how long has she been diagnosed; b) who the heck is her flipping doctor; c) I wish I could take everyone I meet into my home and help them. Sigh.

It’s really tough for many of us, when we come across folks like this.  And where this really hits me today, was reading David Edelman’s latest dblog promoting the book “Thriving With Diabetes” that he’s co-written with Dr. Paul Rosman .  If I could hand out this book to everyone I see that needs to take action with their diabetes health … I would (in my dream world I’d be a philanthropist and a CDE and a ….).  

So?  My next book I'm putting into my reference library here at home?  Need I say more!!!

Cancer or diabetes?

This blog post was originally posted back on September 19, 2009 at Diabetes1.org which owns the copyright of this blog.  Due to my inability to update some of the links that no longer work - I have had to resort to posting the blog here.   

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My friend Darlene's  daughter Jenna, was diagnosed with Stage IV Avealor Rhabdomyosarcoma cancer at the age of 15.  It is a cancerous form of tumor growth that originates in the soft tissues of the body, including the muscles, tendons, and connective tissues and is very aggressive. The most common sites for this tumor to be found include the head, neck, bladder, vagina, arms, legs, and trunk (abdomen).  Jenna had been battling this beast for the past 2 years - and her motto was "One Step at a Time".

I felt a very close connection to Jenna, as many of us did that knew her parents/family.  We were all fighting along side of her in her battle in one way or another.  I know I was ready to kick butt for her!!!  Also, since Spring time, Jenna had been using a pump to infuse morphine to deal with the pain.  I felt in some way very more connected to her, maybe because of my being on an insulin pump that keeps me alive and healthy.

Back in July I saw Jenna when she was visiting her Mum and stepdad Shawn in Rochester, NY (Jenna lives in Carleton Place, Ontario with her father Bob and his wife Jennifer).  She was in pretty good spirits - your usual spunky teenager 17 year old (she can really belt out a tune - I told her she should be on American Idol - and she looked at me like I was off my rockers with that comment ).  It was great to see her enjoying herself and it brought my hopes up for her, as I'm sure it did for others.

Sadly, a few weeks later, she started to experience alot of pain and had to go back to hospital.  During that time she fought the battle of her life and with all her might - but sadly she passed away this week - on September 16th, 2009.   All I know is that her spirit will continue on forever, she was not only beautiful, but also had great courage and remarkable strength.

I just know that if I could have traded my life as a diabetic for hers - I would not have hesitated in a nanosecond!  As I'm sure others would agree with if they thought about it.  If Jenna had been diagnosed with diabetes rather then this evil cancer - she would have been able to survive.  Yes, we have complications associated with diabetes, but we can live with them if we take care of ourselves.  

You can read more of Jenna's story from her father and stepmum's journal - at Jenna's Memorial Fund, Helping Kids with Cancer. 



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NOTE:  Jenna's Mum finally got to come on board to our Catalina 30 this past weekend - that is named Jenna's Journey.  Sadly, without her husband, as he himself had succumbed to cancer only a few years later after Jenna.  Another angel in heaven has earned their wings. 

The day I saw this boat back in the Spring of 2010, in the backyard of a house in Marblehead, MA, a butterfly flitted by and seemed to hover.  I felt a strange tingle go through me, and I started to cry for some reason (and I'm not a gal that takes easily to shedding a tear).   Jenna LOVED butterflies.  I looked up at the boat that my husband was taking a look at with the owner and it was like she was giving me signal.  That this was the boat she wanted to be on with us on our travels.  My tears were happy tears knowing she'd live on with us with her name and silhouette proudly displayed on the sides of our boat. 

My heart breaks for a T1D in a coma for past year

A few days ago – on my Facebook and Twitter pages – I made a statement about a T1D, an RN, being in a coma for almost a year.   I was in an emotional state and close to people who knew her – to really look at both sides of what actually happened.  In reality – we may never know the truth – due to lawsuit that is in progress ....

When I was around 8 and still learning the ropes of diabetes a few years after my diagnosis in the 60's, I remember a friend of mine, Karen Chin.  Her Dad had a car that had cruise control.  In my mind, I envisioned Karen and her family, on a road trip, with her Dad sitting in the driver’s seat, no hands on the wheels and simply letting the car do its thing and they’d get from A to B safe and sound.  Was it due to my watching Star Trek?   The Jetson’s?  My HIGHLY overactive imagination?  In the end, I’m not sure when, maybe when I started to grow up (me? Grow up) – I realised – there was more to “cruise control”.  A child’s imagination can be so funny at times.  Thinking about this yesterday, got me thinking about the devices we use for our diabetes control – aka the insulin pump that has been around since 1963 (a HUGE backpack version).

Early insulin pumps - a cry from what we wear today

In the past, I’ve been contacted by people who have had pump failures and written about at Diabetes1.org and in other diabetic forums on the Internet. I’ve felt privileged over the years to tell their stories – and some people who have read them – get very upset with the fact that the pump manufacturer is being pointed at as the bad guy.  From what I had heard from families – and the testing of the pump by third parties – the finger was seemed to point at the manufacturer – not the user – but in the case of what I heard this week – my mind is reeling in all the what if’s – that it’s been difficult to concentrate on work.

All I can say is – that some of us have come to the conclusion is due to mass production that society now expects – problems WILL occur – a pump will fail - in a perfect world it shouldn't happen – but it does from time to time.  I've never been able to find statistics on how often this occurs – and perhaps someone reading this knows more than I do – but still – where is the line drawn for "X out of 100" pumps – to make the users of pumps be concerned.

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I was at my first local insulin pump meeting since 2007 – in the quaint town of Cornwall, Ontario.  It was a small group, of  6 adults, but it was nice to shoot the breeze with others over some of the topics that were brought up for discussion by the ring leader John Caldwell.   Someone mentioned about a T1D woman in a coma – and sent to a rehab centre in Hamilton, Ontario.  They were wondering how she was doing and hoping she was alright. 

I didn’t think anything of it – until the next day – having breakfast at the club house (we’ve been working on our sailboat getting her ready for the season so stay there for overnighters).  As I was talking to one of the club members, doing my calculations on George Michael for my morning pig out.  I mentioned about this woman who was in a coma.  He immediately started to tell me about Amanda* who had been on an insulin pump for many years, that his wife who is an RN, had worked with her, and are close friends with her and her family.   She was diagnosed in her early 20’s.  Last June, it appears that a neighbour came by to drop off a package that contained an insulin pump that had been delivered at their house due to no response at Amanda’s house.   They then discovered later in the day, that the reason for no response to the delivery was she had slipped into a coma.

It was revealed that a call was placed to the pump manufacture by Amanda herself the day before – and this is the reason for the next day delivery of a new pump.  Perhaps her pump was having problems?   I cannot say for sure – but a new pump had arrived.   The history within Amanda’s pump had been wiped of EIGHT HOURS –with no record of anything during that time frame.   If she had stopped the basal due to having problems with blood sugars – or perhaps she bloused – and gave too much insulin – but there is no record according to what I was told in her pump history.   From one of her other pumping friends, I have heard that she did enjoy a glass of wine or two or … if she had been drinking – could she have gone low – and then passed out – then into a coma.   Whatever occurred during that time, we may never know. 

It’s all a question of theories at this point, since everything is hearsay – so saying that the pump had emptied out the full cartridge of insulin – like it has with some of the other T1D’s I’ve written about in the past – we do not know if this occurred to Amanda. 

Her family had her airlifted at some point after – at their own expense – to a state of the art health care centre in Hamilton, Ontario that deals in rehab and brain injuries.  She stayed there for abit – but with not getting any better – the family once again – air lifted her back home.  In the meantime, while dealing with this, Amanda’s only sibling, a brother died.  I mean, how devastating is that?

So, a year later, she is still in a comatose state, her eyes are open, but according to her close friends she is not there and they say she wouldn’t want to be living this way – that she would rather be dead.   That she was once a vibrant woman, full of zest for life floors me as a diabetic.   Her family has now decided to honour her wishes of DNR (Do Not Resuscitate) – as a RN herself – she probably knew how difficult this can be for family members – but watching someone who is not all there – is something I know for myself I would not want to be living that way.

As her friends said to me, seeing her in this state, and knowing her well enough that she would tell them to pull the plug, is heart breaking for them to witness (they see her a few times a week).  They’d even go to prison they were saying, if they could perform this duty.  On top of all of this, Amanda’s only other sibling was killed earlier in the year, so imagine what her parents are going through – this is what breaks my heart the most.

The other thing that has been going through my head with writing this difficult blog – that will leave many of you asking similar questions - perhaps having a closed loop system might be the answer - though I still worry that with more bells and whistles that there is more that can hiccup in the devices we wear.  If Amanda  was unable to respond to her CGMS - if she wore one that is  -  informing her pump that she was going low or high – would the pump have the ability to take over at that point – without her telling it what to do as she was unconscious –  and either shut down or give her more insulin?

Will what really happened ever be revealed about what occurred with her insulin pump, like with the other cases or it was Amanda herself at fault?  Who knows?  The one thing that I did learn is if something like this happens to any of us, with our insulin pumps perhaps going wonky, *** DO NOT GIVE IT TO THE FEDERAL GOVERNMENT TO TEST OR HAND BACK TO THE MANUFACTURER ***.  Get it tested by a third party that is impartial.  Whether this has been done with Amanda’s pump – I’m not sure – but due to the legal actions taking place right now – I’m thinking it has been.

*Name changed to protect privacy

I'm in love with the i-port - it's like a mini-me insulin pump

UPDATE -** NOVEMBER 18TH 2013 ** - I HAVE FINALLY BEEN APPROVED TO USE THE I-PORT! Why it took my insurance company so long is beyond my comprehension - but now I'm so excited - especially when I take my next holiday!!!!

Okay, okay, don't get your nose out of joint - my fellow insulin pumping peeps - that I'm saying that the i-port is a mini-me insulin pump - but in away - when you look at it "logically" without any anger from my statement - I AM the "mini-me" pump - I am the brains behind what goes into my body - via the i-port - I AM IN CONTROL - not a machine - that I've programmed with best intentions to keep my diabetes health in control.

Yes, I still have to give a separate shot for my "basal" rate with long acting insulin  - I do this twice a day - 12 hours part seems to work best for me.   The basal rate is basically what your pancreas - if it's working - squirts out all the time - in order to keep your blood sugar in a normal range when your not eating, etc.   With diabetes - your pancreas can be abit on the wonky side and either work when it feels like (e.g. Type 2) or like myself as a Type 1 - where my pancreas is dead as a door nail. 

The recommendations of the i-port website is that only ONE type of insulin being put thru' the port via either a pen needle (no shorter than 5mm) OR a syringe (29 gauge is thickest - otherwise you will possibly punction the wall of the cannula) - and I'm fine with that.  With a "real" insulin pump - which has an insulin cartridge (the i-port does NOT - you INJECT insulin via the port) - it's programmed to squirt out ""X amount" of  rapid acting insulin - for your basal rate as well as your bolus rate (aka - if you have to correct a higher than normal blood sugar (BG) or for when you are eating a meal).  If this has got you abit confused about the types of insulin - check out the link from Diabetes.co.uk that explains how injected insulins work in our bodies.

My messy diary along with box from i-port

The thing I loved about my six day experiment with the i-port (I was only given 2 samples - boo! hoo!) - is that instead of my having to do the human dart board practise on my stomach for my bolus shots 5-8 times a day - I just did my insulin injections through the port in my skin.  It really is like an infusion set that we use with an insulin pump - except it has no tubing - or connections to a little machine that goes ping.   The port is changed EVERY 3 days - which is the recommendation for most infusion sets.  Usually in the past, I've had issues with the teflon coated plastic cannula that remains in my body for that length of time.  Luckily, with the i-port I had no such issues, removing the port left barely a mark in my skin. 

The good thing about the i-port - less expensive then the alternative of an insulin pump (I can purchase the i-ports at Diabetes Express for $149.99 CAD for a box of 10).  This is bit less expensive then what I was paying for my infusion sets with my insulin pump - but the even bigger saving for me?  I'm not having to pay for a pump which ranges from $5-7K depending on where you live - along with the other supplies that go along with the pump (insulin cartridges, batteries, replacement caps, etc.). 

i-port put in place (really easy)

One thing I did find was that I didn't cringe at having to give another shot of rapid insulin for a little sinful snack or a correction shot.  It reminded me so much of the insulin pump I used to use - where a simple touch of the key pad - squirted insulin into my body via the infusion set - except with the i-port - you are the brains behind what insulin you are injecting with.

I have submitted a predetermination form thru' my husbands workplace insurance in the hopes that these ports will be covered - hopefully at 100%.  So wish me luck - since I'm really REALLY missing my little i-port right now - I felt very spoiled using the two I was sent. It's almost how I felt when I first disconnected from my pump - and went back onto multiple daily injection (MDI).  After almost a month of learning how to stay in the BG zone with MDI - I can now say - that ANYONE can do it - if they put their mind to it - and now I'm not missing my pump as I go into my 4th month of being pump free.

It stands out about 1/2" or abit less

My conclusion?  For anyone without insurance coverage - dislikes injecting to the point of not wanting to inject (not good - tisk - tisk - who hasn't done that in their life time with diabetes?) - I really think this is the route to go - to keep a diabetic from suffering the effects of poorly controlled diabetes.  

NB:  The i-port Advance has regulatory clearance in Canada, US and the European Union.  In the EU they currently have distributors in Germany, Italy and the Nordic Region and are in conversations to add some additional countries in the near future. India and Australia will be further down the road.