Tuesday, July 25, 2017

The 670G is coming! The 670G is coming!

Confessions of a Complicated Diabetic updated 6/21/2017

The exercise specific routines I've tried out can be found here:  Exercise log Updated 4/27/2017
The technical details of my transition to the 670G can be found here:  Change Log Updated 6/3/2017
Prior to the 670G my diabetic life proceeded as follows:

Monday: BG’s are all over the place in the evening but fine in the morning. Must remember to tweak basal rates for after 2 pm. Exercising in the am results in a severe low during exercise.  Must wait to shower because I cannot tell if it’s workout sweat or diabetes sweat.  I have correction bolused and dosed for everything I’ve eaten and I’m not coming down, WTF!

Tuesday:  After a suspend on low at 4 am my bg’s are super high.  Why can’t my life be easy….Exercising with a temp basal rate 30 minutes before and eating a piece of bread?  Went less low during this workout.  Why can’t I just run… why do I have to add 3 tasks prior to trying to get in shape?  This is not fair.  Ok fine.  I ate just enough so I should be in range.  Afternoon and evening rates are all over the place after eating a salad.

Wednesday: BG’s were good this morning. So this is what success feels like. Victory.  2 pm rolls around after eating a salad and my bg’s are rising.  I correction bolus and It plateaus.  Maybe it will be good today.   After multiple corrections, I’m in decent range.  Maxing out at 230 which is great for me.  Wow, a great day of diabetes, I’ve finally gotten it down.  Maybe there is hope for me to keep my appendages and eyesight after all.  I sure as heck work hard enough for it.

Thursday: Did everything identical to yesterday including meals and have a completely different result.  My bg’s are rollercoastering like I’m eating brownies every 4 hours.  COME ON. GIVE ME A BREAK.  If I exercise my blood sugar levels will come down to range quicker.  I exercise and they come down.  Yay, all is not lost today.  I don’t have to feel like a total failure as a diabetic today.  I’ll make a healthy super low carb dinner in hopes to keep it stable.  Good meal, BG’s rising again.  All hope is lost.  I’ll write today off as a day that cannot be salvaged.

Friday: A lot of stress at work so my BG’s are rollercoastering regardless of how I try to manage it.  I should have picked a different profession.  I spend so much time managing my diabetes, it adds so much stress to my life. 

Saturday:  I need a break.  I will perform everything I should but not stress over the minutia of trying to be in perfect control.  32 years of ever changing diabetes with no true trends is wearing me out. I need a break, did I say that already?

Sunday: Ok, time to get back in the mindset of the war on Diabetes.  Battle on MF. Performed a lot of yard work, I am so grateful for suspend on low and temporary basal rates.  I would not be able to perform this work without it.

Monday: New week, new hope for better management.  Do my routine with same erratic results and not many similarities.  I’ve standardized my breakfast, exercise, and lunch and daily results differ so much.  I’m discouraged from how much work it takes and how little improvement there is.  Must revisit basal rates in the afternoon, evening, because like always, I will be higher than I should be.  I hate you diabetes, I hate you so much.

Tuesday: The beeping is driving me crazy! I have it set super aggressive in an attempt to better control my philandering diabetes.  If only I didn’t like carbs… I don’t eat a whole lot but I do want some.  I refuse to let diabetes minimize the enjoyment of my life.  It may suck the life out of me, but I’m going to keep trying and keep living.

Wednesday: Why can’t my day to day results be normalized in relation to the reaction of my diabetes towards my standardized schedule.  I hate you so much. The incessant beeping is driving me nuts, but it's the only way I can be in the best control possible for me.  My settings are super aggressive and it's so much work. I work full time, then I have a second full time job, diabetes.  I need a break.  I'm exhausted.

WHY WON'T MY DIABETES COOPERATE AND FUNCTION LIKE IT IS SUPPOSED TO!!! For 32 years I’ve been hearing how there will be a cure in 5 years.  That they’re on the brink of major advancements in treatment.  I have become so skeptical about such statements and don’t believe them anymore. When people tell me big thing A is about to happen, I laugh and say I'll believe it when I see it.  When people say, there is a huge breakthrough someplace in a cure, I simply laugh because I'll believe it when it's REAL.

670G in Manual Mode

Ok. I'll breeze over this part because people want to hear about Auto Mode.  Bottom line, I spent a week in Manual Mode so the pump could learn my trends or calculate average micro bolus rates to keep me in range.  You cannot turn on Auto Mode without the pump having your historical data.  I utilized the Suspend Before Low function numerous times and had fewer lows.  I slept better at night because Suspend Before Low does not beep when it's activated and easily prevents lows for me because it was properly configured to suit my needs.  After 8 days in Manual Mode, I was so eager to start Auto Mode.  If I had a tail it would be wagging furiously with eager anticipation.

670G in Auto Mode

So this is what’s it’s like to be almost normal!  I never thought this day would come.

Day 1 in Auto Mode
The future is looking brighter than ever before. I’ve never had such a high percentage in range! HOLY COW THIS IS AMAZING!!  I was told that the time in range would be relatively low at the beginning because my pump will adapt. As time goes on the in time range will increase.  I’m so excited that I’m getting exhausted. I look at my pump every 5-10 minutes. I tried one method of pre-exercise management and didn’t get low or high afterwards! THIS IS AMAZING.  I’m so happy that I’ve baked cupcakes to celebrate (and put the pump through it’s paces).  If there were a shining armour SKin-it, it’s warranted, I’d buy that. (The key for this screen is below if you're wondering what all the icons are)

Day 2 in Auto Mode:  I have a nearly flat line! I’ve NEVER had that ever.  EVER!!!!!! I’m crying from joy. My percentage time in range is climbing as the hours go by and the pump learns about me.  Even though it doesn’t respond to long walks on the beach or Pina Coladas, I still love it.  I tried a different pre exercise routing which requires less time in advance and had FANTASTIC results.  Exercise is now not nearly as much a burden.  It’s funny, my stress has vanished.  The elephant in the room is now outside the window looking in wondering why it can’t sit on me anymore.  Take that elephant! Medtronic’s got my back!  I even went to far as to have Nutella and peanut butter.  I maxed out at 210 which is phenominal since I likely should have dosed earlier than I did for it.  It’s insane.  This should be on TV everywhere.  This is a game changer.  I don’t have to worry about managing diabetes much anymore, only about keeping the pump in Auto Mode.  Has anyone had a Tamagotchi?  SAME THING. Time to take a breath. I am half heartedly considering getting a tattoo of the Auto Mode shield on my arm, it’s that kind of love.

Day 5 in Auto Mode
Whaaaaaaaaaaaaaaat! 71% in range! That's amazing and it just keeps climbing!  The highest "In range" percent I've ever had was 64%. I am so excited to be on this.  Less than a week on it and there are already dramatic improvements in my overall control as well as time in range. I was told that the first few weeks would be a little higher than expected while the pump learns my levels and adjusts its deliveries to suit my needs.  I must have a super smart one for it to have learned so quickly ;)

I am BLOWN away by this technology.  This is a game changer for me. No more mood swings based on sudden drastic highs or lows, no lows. Super easy to manage and the response time is quicker.  The sensor is SO ACCURATE it amazes me.  In the past, I’d had some fluctuations, but this sensor is dead on.  I don’t know what to do with my diabetes self now.  I’ve spent so much time managing and stressing about diabetes and control and it’s gone now.  My brittle diabetes has been impossible to control over the years, it’s been such a burden.  It's like the relief when a war is over.

Why is this device not being featured all over the news?!?!?!?!

Day 6 in Auto Mode:  My numbers were off yesterday and slightly off on Friday between SG and BG.  The numerous BG required and Calibrate now prompts were getting to be like the old times on the 630G.  The pump/sensor finalize realized something was wrong and prompted me to change it.  Like normal, I dutifully called Medtronic's Support Line and went through troubleshooting with them.  They're sending me a new sensor and I'll be returning the old one so they can figure out what happened.  To be completely fair, I did insert the Guardian 3 Sensor with the old inserter, so it might be my fault.


Day 7 in Auto Mode
I was 100% in range today even post meals.  I don't ever recall that being possible no matter how hard I worked for it.  I'm at my highest "in range" EVER after being on this pump in Auto Mode fully for 6 days (the first day I was only in Auto Mode for half the day at best) and it will only increase.  I've never in 32 years of diabetes had a perfect day. The afternoon in range increase was due to a slight modification in my carb ratio.  My active insulin time was also  greatly reduced due to being told there was greater success when doing so.  (I love the exercise icons on the charts).  There is a drastic improvement in my results in only 6 days.  Imagine what years on this will accomplish.  The fear of losing eyesight or needing to amputate an appendage is fading slowly but noticeably.  The realization that there is hope for me is so beautiful it makes me cry.  I know this seems dramatic, but I've been struggling to get in only decent control for decades, and it's been a full-time job that has sucked my soul dry on numerous occasions.  Think of all the possibilities now.

Now if they could only make it waterproof down to 100 feet for multiple hours, I'd take up scuba diving. :-D

Day 8 in Auto Mode
Another perfect diabetic day. My in time range keeps climbing.  If my results keep performing like this my A1c will from from 7.9 to 6.9.  I've never been excited to get an A1c, but alas, it isn't time yet. I spiked a little at the end due to some grapes that wandered across my lap.....Not the pumps fault, 100% mine. They were good though :)

Day 9 in Auto Mode: Well, I am still blown away by how quickly this has changed my life.  I knew it would, I just didn't think it would be after 1 day.  My blood sugars are better than ever and the pump is fine tuning the micro boluses to get me in better control.  I ran the 670G reports in Carelink and was blown out of the water for their estimated A1C.  My diabetes has always been exceedingly hard to control, as stated above to some degree.  I never anticipated being under 7.0 even when in the tightest life control possible when eliminating any change and a lot of fun.  With Auto Mode I am getting stability in my bg's in addition to reliability and accuracy with the new sensor.  Words simply cannot describe how great it is.  It's a feeling deep down inside of relief and hope.

Day 10 in Auto Mode
WHAAAAAAAAAT!?! Mind blown, head explodes.....My in range time seems to be climbing 1-2% a day.  I wonder when it will plateau.  Likely around the 2 week time frame that they said it takes for the pump, whom I've named Henry, to learn my levels.  I am very excited about the future and eager to get my next A1c done in 2 months (I can't believe I'm saying that)

Day 11 in Auto Mode
My percent in range keeps climbing despite my best efforts to be a bad diabetic.  I was horrible this weekend and ate a lot of stuff I shouldn't have.  But the number keeps climbing.  I think I'm at the point where it will climb 1% every other day until it plateaus.  I'm super happy with my current time in range and look forward to hitting that plateau to see what it is.

Day 13 in Auto Mode
My time dealing with the sickness of diabetes is over.  Now, I am simply dealing with a manageable and semi-predictable disease.  I had issues with a sensor after inserting a new sensor prior to showering.  It got wet and it seems that is what did the sensor in.  It never functioned from the initial calibration to 6 hours after it should have been working.  I will not shower while the transmitter is not connected again to reduce the time of warm-up for Auto Mode.  Lesson learned and percent is once again rising! Yay technology!

Day 17 in Auto Mode
I dared to try pizza today at 7 pm.  My hopes were that it wouldn't go too high and the spike would be minimal.  But this happened.  I HAVE TAMED YOU PIZZA!  YOU WILL NOT BAFFLE ME AGAIN! (or rather Medtronic has....)  I will no longer feel guilty eating pizza while being a diabetic.  The health portion, perhaps.

Day...who cares! Diabetic life is Good now!
I'm in Mexico on vacation and was looking forward to 3 things: 1. The long overdue vacation, 2. Seeing how the pump did in water as I'd been avoiding it up until recently, and 3. Seeing how it would adjust to my sensitivity change based on weather.  I always get far more sensitive to insulin in warm weather. 

My bg's were higher than normal for 1.5 days before leveling out again.  I figured it would take 1-2 days for it to adjust to my sensitivity changes.  

As for the water...well.  I went in a pool and noticed that the CGM stopped communicating with the pump after 2-5 minutes. My pump was on the lower back of my bathing suit.  Obviously not near the sensor.  I moved it very close to the transmitter and it reconnected.  I changed the location to the leg trim of the bathing suit and it still disconnected after a longer time.  I posted on Facebook and a swimmer replied that she'd had luck with keeping the 670G within 3 inches of the transmitter.  It didn't get disconnected when it was that close.  Game on!  I grabbed my ez comfy sleeping belt and added it to my stylish bathing suit.  It worked! I was in for 20 minutes and didn't get disconnected once!  The pump kept updating from the sensor data as well as having the blue shield the entire time.  And believe me, I was looking every 3rd minute. The EZ comfy sleeping belt is now an EZ comfy swimming belt.  Water park, here I come!

My routine is Mexico is as follows:

After a very long vacation in Mexico, I've come to the obvious conclusion that pina coladas and the betes are not friends.  :)

When arriving in Mexico I did not change my time on the pump which I probably should have.  The reason I did not was to prevent any confusion, brain fart I know.  I have known since I started CGM'ing that my insulin sensitivity is affected by temperature.  In the summer months, I am far more sensitive to insulin than I am in the winter months in the North East.  I was very curious to see how long it would take for the 670G to realize the difference and adjust accordingly.  It took a day and a half before I was back in golden mode.

Having the active insulin time at 2.15 hours wasn't working well for me.  I've lowered it down to 2.0 hrs for active time.  I'm going to try this setting for 1-2 weeks.  I think that my most successful results were when I was at 2.5 hours active insulin time.  We'll see in a week or two if I need to switch back to that.

On a side note, I am SO grateful for my Medtronic trainer.  Lindsay has been fantastic over the whole process and made the change to the 670G so easy.  I am SO GRATEFUL for her availability and patience while I learned to let the pump do it's thing while I backed off from the management.

I am happy to say, the 670G has made another aspect of my life so much easier!  I'm an avid motorcyclist and riding while Diabetic could easily be life threatening.  Prior to the 670G, I would test every gas stop or 2 hours depending upon which came first.  I would keep my blood sugar levels significantly higher because it's difficult to hear or feel the pump's alerts while riding.  I never wanted to chance going somewhat low with the general inability to feel it.  It was a lot of extra work and a lot of extra eating which I dealt with because I love riding.  After taking my first short motorcycle trip on the 670G, a mere 270 miles, I am so relieved and ecstatic about how the 670G handled my BG's throughout the trip.  I did not go low, I did not go high, I did not eat (insert a Seussism), I was completely fine. IT WAS FANTASTIC! One less stress to worry about while enjoying a wonderful, yet somewhat dangerous activity.  It was smooth sailing with almost a straight line (on the pump, certainly not on the road).    Thank you Medtronic!!!

It just keeps getting better, even in relation to itself.

I got my A1c done, for the first time in 32 years of diabetes, my A1c is below 7!!!!!!! I cried.  It was spot on to what Carelink said it would be at 6.8%.  I am so happy!  I have tried SO HARD my whole life to get an A1c under 7 including giving up activities and food which I love and never come close.  The 670G has made it all possible!

I got my A1c before I started and I was at 7.9%.  After 3.5 months on the 670G I've dropped 1.1% which is ridiculous!  I am so happy and hopeful for the future.  Now they just need to get cracking on the faster acting insulin.  As for stress, I'm living nearly carefree.  So few beeps, so few swings.  Only 2 lows under extreme circumstances and hardly what I would consider low before starting on it. 

I 💓 Medtronic 670G

Conclusion...so far
This system has changed my life in many ways.  My A1c is the best it's ever been, I feel better, sleep better, my stress level is 10% of what it used to be, I'm no longer worried about highs or lows  and my personal relationships have improved due to the lack of Hangry(high angry)/Langry(Low angry) which I used to experience.  I simply cannot say enough good things about this system.  The CGM is accurate, I would trust it to do everything automatically if the system was capable, including cover for highs.  I have forgotten what all the beeps sounded like, and believe me, I used to hear them OFTEN.  I am proud to wear this device and fortunate to have it.

Flat SG liiiiiines can come truuuuuue
It can happen to yooooooou
When you're on a 67000000 GGGGGGGGGGGGGGGG

SG Chart Key