About me

I am a scientist working in a medical research institute in the DC area. After my daughter was diagnosed with type 1 diabetes 5 years ago I shifted my area of research to diabetes. I am married to the most supportive and loving man that comes from the hotel management industry and am a mom to three wonderful kids; 10 year old girl, 8 year old and 2 year old boys and a dog, a real energy booster... I am also a children's author and have one book published in Hebrew titled Tal and the Secret Treasure.

Friday, June 10, 2016

Summer pump break

After several pod failures, dislocated cannulas and pods fall off at school, at the pool and during the night at sleep overs, my daughter decided it was time to take a pump break... (Well, pump break was my interpretation, she actually said she was totally done with pumps and wanted to go back to shots). I didn't realize how thorough she had thought it through and tried to remind her how much she hated the shots and that she'll have to take one shot a day for her basal insulin and on top of that a fast acting insulin shot every time she eats carbs (which means a minimum of 4 shots a day if she lived on a tight schedule of only 3 meals a day...). Why are you trying to convince me not to do it?!" She was totally on to me. "Being on a pump is no picnic either" she reminded me and of course she was right... I had a vague memory of piles of needles, insulin pens, calculating insulin doses, battles around every single injection and then eating around those injections to avoid more. She was only five years old back then and relied completely on us. The pump gave her independence and freedom (well relatively at least) and completely took away the shot struggle that accompanied each and every meal. She could now eat whenever she wanted without having to take an injection, sleep in on the weekends without having to wake up for her basal insulin shot and most importantly do everything by herself. This last part was important for her as much as it was for us. Those 4 (and on most days 6 or 8) injections per day were replaced with one site change (cannula insertion for the pump) once in 3 days (well, in an ideal situation were the adhesive that holds the cannula in place wouldn't come off. The tedious calculations of insulin doses were done by the pump instead of my already exploding brain (once you successfully define and program all the carb ratios, insulin sensitivity factors and basals into the pump). Life have seemingly become so much more manageable and normal. But my daughter, is almost 12 now, and after living with type 1 diabetes for seven whole years, she desperately needed a change. Even if the solution is not superior to what was already in place. I asked her to give me a couple of weeks to catch up on technology, thinking the Novolog Jr. insulin pen and needles we had stored in our medicine cabinet 7 years ago were obsolete and that Lantus insulin is old news. I also explained that I would need to speak with our Endo to get prescription for pen cartridges, for long acting insulin, only to find out that Lantus is not old news and that there is a newer model to our insulin pen that has a digital dial and some memory, but that's about it. No major miracles or magic have taken place flash forward 7 years. Then I was just stalling, waiting for the right moment to make that move, to transition back to shots again, to having needles and alcohol wipes all around the house and calculating doses again. I was dreading that change, especially because it brought back the memories of my tiny 5 year old that had to deal with such a big disease. But then one day, without any warning, the pump just stopped working. My daughter called from school, I was at work, calming her down, promising we'll both be home in an hour, thinking I could fix it (like every single pump failure before). Usually a battery change or a quick reset would do the trick. But not this time, seems like everything was moving to the direction she originally wanted to go. Gradually starting to let go, I talked myself into 'we could try shots again for a while' but still called the Omnipod support line. Some resetting manipulation and error troubleshooting, nothing seemed to get the pump to work again. To their defense I have to say that the replacement pump was waiting on our door step early next morning, but at that point we were already in full swing. 12 hours are too long for someone with type 1 diabetes to go without insulin. Which meant a trip to CVS (thank god they are open 24/7) to get all the supply list we were preparing for the 'summer pump break'. So the change happened faster than planned to my daughter's satisfaction. We also found an app PredictBGL that would calculate insulin doses, insulin on board, make recommendations and even remind you to take your Lantus in time. It's actually way more sophisticated than the pump calculator and  also has a cool feature that shows your predicted blood sugar (based on all the factors that you log into it, and based on the ideal situation that your doses and ratios are perfectly set). It is not accurate of course but gives you the ball park of what you should expect and how far from it your actual blood sugar reading really is - and then based on that would raise possible scenarios and recommend what changes you could make to your ratios and/or basal insulin. It synchronizes and works on multiple devices so I can see her logs from my cell phone as well and make sure things are working and fix it or f not. I am sure there are other amazing apps out  there but this is the first one we tried and loved it. My daughter learned how to use it within seconds and within less than a day took control over the whole thing, injections, logs, doses, everything. And most importantly she's happy with the change, with not having to walk around with a pod or hooked to a pump, especially on these hot summer days. Wearing shorts, going to the pool, not having to worry about pump failures, site changes. This is a different kind of freedom.