Cute, Unusual and Very Functional Insulin Pump Cases in Australia

Announcing the availability of cute, functional insulin pump cases in Australia!

I’m just a small start-up with these cases and have almost no advertising budget. How will I let people know that these are available? I’m hoping you can help! Please link to this post and let as many people as possible know – particularly in Australia.

These cases are not only cute, but protect the pump, which has to last at least 4 years! As a Type 1 with an Animas 2020 insulin pump, I know how important that is! They come with a matching belt and can also be worn with the clip that comes with the pump. I’m hoping that kids will love these and be proud to wear their pumps and show off the cases.

The cases are available at www.estore.zansuri.com. They are designed mostly for kids, but teens and adults can wear them too! Please don’t hesitate to contact me if you have any questions.

— Insulin Pump Cases

Insulin Pump Cases - Flyer

— Insulin Pump Case – Dalmation Puppy

Insulin Pump Case - Dalmation Puppy

Infusion Site Annoyances

Oh my, another long story!

I had a gusher last week. That’s an infusion site that bleeds like crazy after you take it off. No problem – just another thing we have to deal with. I was left with a lovely, perfect-circle bruise that is slowly fading. After that one, the next infusion site became a warning about the warmer weather headed our way in Australia. It itched like crazy! Even using a barrier wipe.

When I pulled off the infusion set for that one, there was a lovely crimson oval, exactly the shape of my Inset II.

I was sure it wasn’t infected, just an allergic reaction, which took several days to fade, and hasn’t quite completely gone.

The site after that had a bleed, but the insulin line was clean and working, so I left it another 24 hours. I think I know how that happened on the second day.

Some kind of drama with 3 infusion sites in a row.

We had a dust storm on the east coast of Australia a couple of weeks ago. Since then, despite thoroughly steam cleaning anything I usually touch, I’m itchy.

I’m talking frustratingly, infuriatingly, exasperatingly, aggravatingly itchy.

My skin is a little flushed in places – more so on my face than elsewhere, but I don’t have a definite rash confined to a specific area. Just itchy spots here and there,  on my scalp, face and upper torso. Add to that the mosquitoes who can find me under bug repellent, and it’s a recipe for a prolonged scratch-fest. It’s driving me so nuts, that I think it’s probably raising my blood sugar at times. Stress always does.

Double doses of non-drowsy antihistamines (as advised by “Dr Steve”, as I’ve aptly named my pharmacist), haven’t helped.

Today, I added that horrid stuff, Phenergan. Yes, the stuff that puts you into a stupor faster than a bottle of vodka. Haven’t taken any yet but plan to before bed, so I don’t spend yet another night scratching.

I’m sure that all this contributed to the infusion site allergy.

So, it was site change day today. In nearly 5 months on a pump, I can still see the rather large bruise from the side I was injecting Levemir before. No amount of Arnica, massaged in thoroughly, is shifting it. That area is not yet ready for any infusion sites.

The old Novorapid (Novolog) injecting side, is ok as far as I know, but I haven’t been using either side of my belly for infusion sites (only above my belly button).  The only time I did, on the old Levemir side, I got a  pump occlusion, so in 4 months, I never tried again.

After this week of gushers, allergy spots, and my abdomen peppered with little red site-dots that I can still see weeks later, I thought I’d dangerously venture on down to the old bolus side for an infusion set site.

The pattern is that my blood glucose goes up with a site changes. It happens to many pumpers and it’s not a problem that I or anyone else I’ve read about have been able to solve easily.

I also had to go out today not long after my planned site change. Unless I got an occlusion alarm on the pump, how would I know whether the site worked or whether it was just going to be a usual site-change high?

I bit the bullet, and while I was at it, gave a small correction, which I’d needed. These days I also fill the 9mm cannula a tad more than is recommended.

My husband and I then went out, ran some errands, did some shopping, and went for a very short walk along the beachfront to listen to the sunset drumming. Always a treat.

I tested just before the walk. Yup, I was high – higher than when I changed the site. I gave another correction.

About half an hour later, we decided to go have some sushi. I tend to pick the good bits out of some and not eat much of the rice. That way, I end up with about half a cup of rice. Not too much to bolus for with the protein, and the extra sugar in the sushi rice, I think.

So I test again as we sit down. I’m higher still at 9.5 mmol/l (174 mg/dl).

So I’m going to throw some food at it as well. Not a good idea, I know, but we were in town, it was nearly dinner time, and I was starving after only a couple of eggs for breakfast. So was my husband. I also hadn’t got around to buying some meat or fish for dinner. We’d have done that on the way home so it didn’t have to sit too long in a warm car. The sushi was calling.

It was only 2-ish hours after the site change and it usually takes around 3-4 hours for my sites to get going. But I was also worried about the location of the site. Was it working or was this my usual site-change high? By then I was a little higher than usual, so I was suspicious.

We ate in the yummiest of the three sushi places in town. It was also 3 boluses later. I need to get home. Just couldn’t forego that sushi though.

And I’m going higher. By the middle of dinner, I’m 13.9 mmol/l (250 mg/dl), and not about to do a site change in the middle of a Japanese restaurant, with clients and acquaintances around me.

Nah, this is definitely a bad site. I never go that high in the first couple of hours. I need to get home. We finish dinner and  make a move.

There are buskers playing in town on Friday nights – really good ones, amplified most strangely by car batteries. I heard an incredible voice singing a Stevie Nicks song. We go look but can’t stay for all of the song.

A friend owns a store across the road. We always say hello. We can’t because it means a 15 minute chat, at least.

We can’t walk back up to the beach and watch the moon over the bay. We can’t stop off at the supermarket and buy some meat & fish for the weekend.

The stupid D takes priority.

As it was, I wasn’t panicking or rushing, but knew the primary target was home to get the site sorted.

We drove the 7k (4.3 miles) back to our house, bring in the shopping, say hi to and feed the cat and dog, and I get ready for another site change.

I test. What the? I’m 7.2 mmol/l (127 mg/dl). I test again to be sure. Pretty much the same. I often don’t trust my meter because it lies, and I never know which test is the lie, but that’s another story.

Dropped that fast? I guess so!

Seems as if the site was finally starting to work and the last bolus plus a bit of the others were finally starting to kick in.

Why on earth does the site take so long to get going? What happened to all those corrections? Well I know now. They didn’t just disappear into the ether as they usually do. It’s just after midnight, some 8 hours later, and I’m 3.8 mmol/l (68.4 mg/dl). Go figure!

Looks like I have another viable area of site-skin.

PS: Woke up itchy again but had the BEST scratchless sleep with 20 mg of phenergan!

Exercise Times Two

Harry, in a funny post at 25 Units to Go wrote about his lawn mowing and how it must be a “cure” for diabetes.

Exercise makes the blood glucose of most people with diabetes go low.

I always go high during exercise or physical activity, then low 4-6 hours later, for several hours. I was an exercise-hypo virgin… until today.

Today I did 2 lots of increased activity – major cleaning in the morning and gardening in the afternoon. First time ever I had a hypo during activity – the afternoon one. I was so excited! What a sight! Raking leaves, eating carbs and no bolus!

I’d suspected the opposite would happen, but couldn’t be sure, I didn’t raise my bolus like I usually would for increased activity. I thought the second lot of exercise would still raise my blood glucose, but maybe not as much as usual. Totally wrong about that. When I checked, I was 3.3 mmol/L. And I’m pretty much hypo-unaware, so didn’t feel a thing except my eyes went strange – my only occasional hint these days that I’m going hypo.

So, I get a delayed “cure”, I guess – hours later! And with two lots of more-than-usual activity in a day, I can say (only on those days) that I go low during exercise. Gosh I almost feel normal!

Only other “cure” that I know of  is red wine with dinner. Very rare, but when I partake, the only problem is that I get tipsy on half a glass, so I can never drink enough for a really effective “cure” for the next few hours.  Pity!

What’s the answer? Exercise more and drink more red wine?

Wrong Diagnosis? No one knows!

It’s Newly Diagnosed Week at Diabetes Daily. Welcome to the crazy world of D. Other bloggers are giving some sage advice. I’m just thinking history.

I’m trying hard to remember. What I remember and how it really was, I’m sure are two different things. Such is my recall about details I’ve barely thought about all these years. I don’t remember specific dates, just the year.

It was 31 years ago, in 1978, that I went to the doctor with some strange symptoms – unquenchable thirst, head-dropping tiredness, constantly and urgently full bladder. I was bundled off to see an endocrinologist. At that stage, my family doctor hadn’t run any tests or told me what he suspected. I suspected enough for both of us but was hoping it was some strange virus.

The endo was a lovely old professor at one of our local hospitals in Sydney. How kind and caring he was! I can’t recall exactly how it went or what tests were run, but I know he told me I had “mature age onset diabetes” and how unusual it was at 25. He couldn’t explain why. I was a little overweight,  having gained a few pounds in the preceding 2 years, but I was by no means obese.

The day wasn’t memorable, my age was.

Why did I get this ‘mature age’ thing at 25? No one knows.

It scared me silly. I’m not sure I was that compliant about anything in my life until that diagnosis.

I was taught to count calories, to weigh everything and was given a diet that seemed to limit carbs. No sugar or sweet drinks. No sweet anything. No potatoes, rice, pasta, limit the fruit and so on. Really, it was a great lower-carb diet, but it was never called that. And I stuck to it. Those tiny portions, just enough for a two-year-old. In 3 months I lost so much weight that I ended up skinny! I don’t think I’ve tasted a soda with sugar since and I never again was that skinny. It made the diabetes go away.

I stayed somewhat careful of my diet for a while – a few years. I even worked in a chocolate factory for 2 years and never touched a crumb! I have no idea how I did that – I’m a certified chocoholic!

Miraculously the diabetes was kept under control – no medication, no insulin, just diet. In those days, there were no blood glucose meters, so the odd test with a urine stick was all I had, plus a fasting blood test from time to time. I was told I didn’t have diabetes. Carry on as normal. Eventually, I got lax with diet and mostly ate whatever I wanted. Rice, potatoes and everything carb was back on the menu. Why the diabetes didn’t return during that time, I’ll never know. It might have, but my testing and doctor follow up was pretty much non-existent, and so were symptoms.

I knew diabetes could rear its ugly head again anytime. When I fell pregnant 10 years later, I wondered when it would hit. I was a very normal weight and at around 18 weeks, having gained very little weight, I was loaned a meter, put on insulin and told that after pregnancy it would disappear again. Most women get it in the third trimester. Why did I get gestational diabetes at 18 weeks? No one knows.

I came out of hospital 2 lbs below my pre-pregnancy weight, with an unexpectedly small baby. My BGL control had been pretty awful. I was very insulin sensitive and I remember having many hypos with only a half to two units of insulin and also having what today would be considered unacceptably high BGLs at times. Why didn’t I have a large baby? No one knows.

My syringes thrown in the bin, I was off the insulin and supposedly ok. Unfortunately, at that time I was diagnosed with lupus, an autoimmune disease. Getting my head around that pretty much put everything else in the background.

Over the next year or two, I had a couple of fasting blood glucose tests. Results always came back ok, or just a little higher that normal. Nothing to worry about, I was told, but as time went on, I didn’t agree. I felt something was wrong on top of everything else that was wrong. In hindsight, could fasting too long before a blood test – 14-16 hours – have given me ok BGL results? No one knows.

I was feeling like I had high BGLs after meals, by which time I was already watching carbs a bit. Eventually I bought a blood glucose meter and tested for a few weeks. On showing the doctor my graphs, he panicked… er… packed me off to an endo. I was angry. It had been way more than a year after my daughter was born and I’d probably been spiking all over the place!

So started the next battle with Type 2 and tablets. They did work, but they all caused horrible side-effects, so most of the time I didn’t take as much as I was supposed to. At that time, I also didn’t care. It was all too hard. The doctor kept giving me new tablets, and I kept having problems with them including hypos and GI problems that the doctor said was IBS. It wasn’t. Inexplicably, I’d gained some weight and couldn’t lose it no matter what I tried. Why? No one knows.

— Confused

BMI around 26 and gaining, my clothing 2 sizes bigger, my BGLs going higher and I was angry.

In 2006 I finally went on insulin, after 2 years of urging by a new endo. I had been needle phobic and I wouldn’t hear of it. I finally relented after HbA1Cs that were truly shameful. I was starting to care again. Diabetes burnout was over.

By then I was in my 50s with nearly 30 years of an on and off diabetes history. I was clearly Type 2, the medications were horrid, and I switched to insulin. Needle phobia gone. I had pens this time. Too easy. From that day, I wanted an insulin pump, but no way to get subsidised supplies in Australia as a Type 2, only as a Type 1.

In January 2009, after asking for a year and being told, “Impossible! You’re definitely a Type 2!”, I was finally sent for some antibody tests. I’d nagged a lot! I wanted to know for sure that I was not eligible for subsidised pump supplies. To everyone’s surprise, including mine, I had highly positive GAD antibodies on 2 tests, 3 months apart and c-peptide almost zero (0.1).

I had LADA – Latent Autoimmune Diabetes of Adulthood.

So that was my second diabetes diagnosis, and in many ways a somewhat more welcome one than the first one because this time, something positive would come of it eventually – an insulin pump. While I don’t remember the date of my original diagnosis, I certainly remember my insulin pump start date earlier this year. Finally something to celebrate!

On the other hand, that diagnosis brought up a bunch of nagging questions.

Is LADA what I’ve had all along? No one knows. Did I first have Type 2 then LADA? No one knows. When did I get LADA? No one knows. Did I get LADA the same time as Lupus? No one knows. Did I have a short or long LADA honeymoon? No one knows. If I’ve always had LADA, then why did it virtually go away for the first 10 years? No one knows.

Does anyone know anything?

Note to self: Stop looking for answers! No one knows!

Reflections on Fasting with Diabetes on Yom Kippur

[This is my first guest blog post for diabetesdaily.com, the post can be found here and is reproduced below.]

Reflections on Fasting with Diabetes on Yom Kippur

Don’t get me wrong, I’m not a stick-in-the mud, but on some forums lately, I’ve seen some downright awful, inappropriate and uneducated advice. Perhaps it was advice given with the best of intentions, it nevertheless prompts me to write about the subject. Some of the info here is going to be obvious to most people, but maybe for some, not necessarily. I’m going to write about medical advice given and taken on the Internet. And finally, some advice about fasting on Yom Kippur.

Internet Advice: Beware!
We all know that we have ever-multiplying resources on the Internet – easy-to-find, immediate information for people who would otherwise not have access to it without the Internet. This includes the giving and taking of certain problem-solving medical advice – from small problems to life-saving ones. We learn, we explore, we take some advice, we dismiss some.

No doubt there’s a lot of rubbish out there to be waded through with an open but somewhat cautious and critical mind. That goes without saying. You come across it on the Internet during almost every possible information gathering mission.

I’ve watched and participated on the Internet since its beginning, in all different areas. This amazing, interesting and often engaging medium with websites, forums, blogs and so much more, in the area of health particularly, has often made me wonder how many have been helped! Too many for me to fathom. Despite all that, I’d like to talk about when that medical advice can be downright dangerous! While the dangers may seem obvious, sometimes being reminded to stop and think, especially for newcomers, can’t be all that bad, can it?

As it says in my blog disclaimer: Any personal information sent to me, will be kept strictly confidential. Please do not ask for medical advice. Only your medical team can see a full picture of your health. I don’t mean to offend, but I can’t, shouldn’t and won’t.

This, in my opinion, is part of responsible blogging and equally applies to participating in forums. The giving and taking of medical advice comes with a fine line that some people cross and don’t know they’re doing it.

I participate in blogs and forums as a patient. If someone has a problem I can identify with or know about, if I’m confident, I suggest reasons or solutions they may not have thought about. It’s entirely their choice what to do with the info. But I can’t always assume they’ll make the right decision, for them, and I hope I’ve communicated it properly too, but maybe I haven’t.

What We Don’t Know Can Hurt Them
I would almost never say, “you should”, and add some medical advice that I’m very enthusiastic about because it worked for me, or insist they take advice that a doctor should be giving. At least I’m aware that I shouldn’t, and I try not to. Unfortunately, I see this kind of advice all the time. While I assume everyone knows how to weed out the good from the bad, a small group of people still insist on giving advice in the most inappropriate way, often unknowingly.

If it sounds like I’m some kind of authority, I’m not, and don’t mean to lecture. I’m just giving a heads-up to those who haven’t thought about it in a while. It’s a subject that comes up often amongst my group of friends.

For example: diet advice. There’s lots of evidence out there that lowering carbs makes it easier to manage diabetes, especially if you’re having a problem. It works – both scientific and anecdotal evidence – so I don’t have much hesitation in suggesting it. No big deal, right? It’s just food. Yet, even diet changes sometimes need to be run past a doctor. Do I know that recommending what is usually a higher protein diet may be harmful for someone with kidney disease? Of course! Even recommending something so simple as eating different foods, comes with a lot of conditions and responsibilities. Many of us deal with much more serious and potentially hazardous advice.

If someone asks me what to change their insulin basals or boluses to, or what medication to take, I run for the hills. That kind of advice is definitely unqualified, inappropriate, and could be dangerous for the person adopting it. I can only hope that I responsibly relate what I’ve done and what has worked for me, and even then, it’s sometimes not appropriate to say anything at all.

Doctors giving advice on the Internet often have no real picture of the person’s full medical condition! Yes, of course, it depends on what kind of advice, but most doctors know what advice they can give and what they can’t, and will say so (unless maybe their egos get in the way). This is the line that patients sometimes unknowingly cross – the one that the doctors wouldn’t.

I’m neither saying that information given by patients isn’t knowledgeable (it very often is), nor that it’s right or wrong, but there are inherent dangers in giving certain medical advice to someone you don’t know. And there are also dangers in taking advice from others who don’t know you or your medical situation.

The onus is always on me, you, anyone to manage information responsibly – given or taken. That includes knowing when to adopt advice, and knowing when it needs to be checked with a medical team. That line will be different for everyone. It’s easy to cross that line in both giving and taking advice.

Unless I’m confident about the writer and about my ability to state the problem with all the background, and then correctly interpret information in the reply, I try to proceed with caution. Doesn’t always happen – enthusiasm often gets in the way.

Yom Kippur: Fasting With Diabetes
So that brings me to the issue of fasting on Yom Kippur, the Jewish day of atonement. It’s an arduous sunset to sunset fast with no food or water. In 2009, it starts this Sunday evening.

I thought about doing a blog post on fasting for Yom Kippur with diabetes, but hastily changed my mind. Then I thought about why not. Hence this post.

Any recommendations for altering medications during a fast, would be so individual that it would take a volume or two for a doctor or diabetes educator to give the kind of advice that would cover all people with all diabetes situations!

I thought about relating my own experience of Yom Kippur fasting and what I did with medications, but I doubt that would be helpful for anyone because everyone’s situation is different. How someone will react to something I’d do, could be different and maybe detrimental.

In no way would I want to give any medical advice on a fasting issue. I’m neither qualified, nor would I want to cause any harm. Too many scenarios as well. Here we go: Type 2s on diet only, Type 2’s on medication – both insulin promoting and insulin sensitivity enhancing – separately or both, Type 2s on insulin basals only, Type 2s on full insulin regime, Type 1s & 2s on injections, Type 1s & 2s on insulin pumps; Type 1s & 2s on a fixed insulin regime… and so on. I’m sure I’ve left out quite a few more scenarios. I think it’s minefield that few people should be stepping into as far as advice goes. I hope you agree.

Here’s some more interesting information about fasting on Yom Kippur that I am in no way promoting, endorsing or otherwise. Let that be the responsibility of the writer.

In the case of fasting on Yom Kippur, despite my warnings above, I would like to give you some “you should” advice!

If you want to fast, and your medical situation or treatment has changed since the last time you fasted, you should go to your Rabbi and your medical team. They should be the only ones deciding if you can fast or not, and if you can, how to do it.

Photo by Trodel (http://www.flickr.com/photos/trodel/ / CC BY-SA 2.0)