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Patient Perspective: The Pros And Cons Of Insulin Pumps

I wrote a quick status update on Facebook, after receiving the Solo demo in the mail and then meeting with the local Animas rep for lunch to discuss pump options. My brain was buzzing with questions.

Just a quick Facebook musing that opened up the damn flood gates for me.

And the flood gates were opened.  Lots of comments, lots of perspectives, and lots of people who had great information to share.  Turns out I’m not the only one who has been thinking about this.  🙂

I’ve been a Minimed pumper for almost six years now, and have never had an issue with Minimed customer service or the pump itself.  When my pump broke two years ago, their customer service department took my call at a few minutes before midnight and a new pump was overnighted to me.  I have no problems with the color, the size, or the functionality of my Minimed 522.

But two things happened that made me think about switching.  One was the CGM upgrade, which I tried for ten weeks and still didn’t have any semblance of success and/or comfort with.  (Thankfully, the Minimed CGM works fine for some diabetics, so it’s not just me.  Appears to be personal preference.) And the second was that I haven’t seen many changes at all in the six years I’ve been pumping with Minimed (starting with a 512 and now a 522).  The CGM component was a big one, but for people who aren’t using that feature, there isn’t much going on as far as upgrades that mattered to me.

So even though Minimed has been good to me, I’m on the prowl.

With Cozmo off the market, my options are limited.  I’ve given a lot of thought to Omnipod, and while I love the idea of no tubing, I don’t like the idea of a larger device stuck to me for the duration.  I also don’t like the idea that if I lose the PDM, I’m screwed as far as dosing my insulin.  It’s important to note that I’ve never worn an Omnipod, so I’m purely speculating.  And Omnipod works great for lots of diabetics that I know, and even some cute kiddo ones.  But it’s not about the product – more about my personal preferences.

The Solo pump demo arrived in the mail yesterday and that thing appears to have both the tubeless delivery that I’d prefer and also the ability to disconnect the bulk of the pump, but it’s not a working model and with pregnancy goals on the horizon, I’d like to make a change sooner rather than later, if possible.  Still, Solo has a lot of promise and coulda been a contenda.   Could still be one, depending on their timeframe.

I’ve looked at Animas, too.  The Ping seems to be my top contender for several reasons, but the main one is the meter doubling as a remote control for the pump.  I’ve written countless times about my desires to have the pump reasonably concealed, and when my 522 is stashed in my bra at a dressy event, reaching for it to access the buttons turns me into a female, diabetic version of Mr. Bean.  I like that the Calorie King info is stored in there.  (The Dexcom/Animas integration, whenever that happens, is also a nice future-state.)  I also like the option to take a hundredth of a unit.  Precision is a nice option.  I’m not sure how I feel about the infusion sets they use (sampling some this week) or what it might be like to use their user interface, but I want to see for myself.  Thankfully, pump reps are all about hooking us up with samples so we can see if we want to make a full transition.

But then there’s the whole money thing.  And the insurance thing.  And the “closet full of supplies” thing that will be rendered sort of useless if I switch.   And the “do I want to wrangle with a new device” thing.  There’s also the “you can always go back” thing.  And the “pumping isn’t permanent” thing.  And the “if you continue to put weird phrases in quotes, people will get annoyed” thing.

There’s a lot to consider.  And I’m excited to see what options are available to me.  But there’s only so much information I can get from “official company representatives” and websites.  If you’re a pumper, what are you using and why?  If you’re thinking about going on a pump, what factors are playing into your decision?  And if you’re like me – currently pumping but thinking about changing pump providers – what would you do?

Your feedback is, without fail, among the top resources I’ll be using to make my decision.  So thanks in advance, and power to the pumpers!!

*This blog post was originally published at Six Until Me.*

A Patient Encounter With Dr. Idiot

Earlier this week, I had a bit of a medical issue.  Painful urination, high blood sugars, and the constant need to pee.  (Ladies, I know you already know what’s up.)  Urinary tract infection looming large.  I was livid, because it was the day before I was scheduled to travel for this week’s business.

I haven’t got time for the pain, so I called my primary care physician, Dr. CT.  “Hi Nurse of Dr. CT!  It’s Kerri Sparling.  Listen, I’m pretty sure I either have a kidney stone or a urinary tract infection, and I need to rule it out before I leave for a week-long business trip.”

Dr. CT was on jury duty.  Damnit.  So I had to call a local walk-in clinic, instead.

The clinic was a hole in the wall.  Part of a strip mall structure.  My confidence wasn’t high, but my blood sugars were and my whole body was screaming for attention, so I knew I had to follow through.

The receptionist was very nice.  The nurse was even nicer.  They took my blood pressure (110/74), my temperature (98.8) and a urine sample (ew). THIS is not for urine, people!

I should have known from the moment the sample cup was given to me that it wasn’t going to be a fun visit.  The very kind nurse handed me this  —>

That is not a urine sample cup.  That’s like a party cup that you use for lemonade on a hot summer day.  Not for pee.  Oh God.

And then the doctor came in.  For the sake of anonymity, we’ll call him Dr. Idiot.

“Hi.  I’m Dr. Idiot.”

“Hi, I’m Kerri.”

“Kerri, I see you are here for pain when urinating.  Are you urinating frequently?  You see, you are spilling a significant amount of urine.  I believe we may have found the source of your troubles.”

He closed his file, proud of himself.

“Dr. Idiot?  On my chart there I wrote that I have type 1 diabetes.  I know my blood sugar is elevated right now, which sucks but at least it’s not a surprise.  But that’s not why I’m here.  I actually suspect that …”

He cut me off.

“I think we need to address this first problem.  You are aware of your diabetes, you say?  How many times a month do you check your sugar?  You know, with the glucose machine and the finger pricker?”

If I wore bifocals, it’s at this point that I would have slid them down my nose and given him a hard, Sam Eagle-type stare.

“I test about 12 – 15 times a day.  But the real reason …”

“You mean a month,”  he corrected me.

“No, I mean a day.  I have type 1 diabetes.  I wear a continuous glucose sensor.  And also an insulin pump.  I’m very aware of my condition, and I’m also very aware that it’s slipping out of control today because of this other issue, the pain issue.  Can we talk about that?”

He looked at my chart again.  “So you don’t use a meter?”

“Sir, I use a meter.  And a machine that reads the glucose levels of my interstitial fluid.  This is in addition to my insulin pump.  I don’t mean to be rude but …”

Now he gave me a hard look.  “Why the interstitial fluid?  Why not the blood directly?  I mean, you could have more precise readings with the blood.”  He picked up my Dexcom from the chair next to me and pressed a few buttons to light up the screen.  (Mind you, he did not have permission to touch it, but I’m again not saying anything.)

“You mean like a pick line?  I don’t know.  I’m sorry.  Ask them?”

“Yes, but it would make much more sense and …”

I just about lost it.

“I’m sorry.  I didn’t come here to talk about that.  I want to talk about the issue I’m here for.  Which is not diabetes.  Or your ambitions to know more about CGMs.  Please can we address what I’m here for?”

“The sugar in your urine.”  With finality, he says this.

“NO.  The fact that I think I have a UTI or a kidney stone.  Please.  Help.  Me?”

I kid you not – we went ’round and ’round about this for another ten minutes.  He didn’t believe me that I was at least sort of familiar with diabetes.  His ignorance included, but wasn’t limited to, the following statements:

  • “High sugar causes frequent urination.  Maybe that’s why you are peeing often?”  (Not because I was drinking a liter of water per hour to flush my system?  Nooo, couldn’t be that.)
  • “Did you have weight loss surgery?”
  • “Grape juice also causes high blood sugar.”
  • “That thing should really be pulling blood samples.  Pointless otherwise.”  (Meaning my Dexcom.)
  • “The urinalysis won’t be back until Friday, and in the meantime you should start on a regimen of insulin immediately.”
  • And also:  “I didn’t peg you for a pink girl.”  (Are.  You.  Serious??)

The end result, after an escalating argument that involved me yelling, “Stop.  Talking about my diabetes and PLEASE focus why I’m here!” was a prescription for Macrobid that I could elect to take if my symptoms didn’t alleviate, and the instructions to call back on Friday for official lab results.

“Thank you.  Really.  Can I go now?”

He at least had the decency to look ashamed.

I’ve had some wonderful doctors over the last 30 years, and my health is better for it.  But this guy?  Complete disappointment.

*This blog post was originally published at Six Until Me.*

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