Sharon Den Hartogs Website

Times are changing

Carianne (Cari) Roorda — Mon, 17 Aug 2009 11:46:15 GMT

Hello faithful readers...
I hope this update finds you all healthy and empowered to be your own diabetes self-managers...
Changes are coming up with the program. Nothing major and all for the better!
Sanford is our "Mother Ship" as far as the network Diabetes Programs go. We have decided to change up our curriculum for those newly diagnosed. A couple of months ago, we all purchased the "Type 2 Basics" curriculum from the IDC (International Diabetes Center) in Minnesota. They are pretty much the "Diabetes Education Gurus" of the world. I finally had the chance to start implementing it into the program and am very excited about it. I am thinking that I may be able to figure out where I can offer classes more often throughout the month. It will all depend on the availability of the dietician as we would teach together. So, don't be surprised if I send an informal survey your way to get an idea of what my newly diagnosed patients are looking for when it comes to classes. This basically suggests 4 classes over 6 months... it would be a change but according to the Adult Learning Theory... much easier to retain the plethora of information that we need to lead healthy lives while living with diabetes. (:

August 2009

Carianne (Cari) Roorda — Tue, 11 Aug 2009 19:04:35 GMT

Hello friends...
I am still loving my pink Medtronic Pump with the Real-time CGMS. I can say that it has saved me from several bad lows already.

I had been using the original teflon canula sets but recently started having a real problem with my sites. It seemed that for about 12 hours they were perfect, but then started getting irritated (itchy, red) and also I noticed huge swings in my blood sugars. It was like I wasn't even bolusing for my food! I decided to try an old bent-angle-needle "Polyfin QR" set that I had on hand and instantly my blood sugars stabilized- I have since been using the steel needles with way better luck and much more predictable sugars. Yesterday, after pumping for almost 10 years now...I ended up with my first "infusion site infection". I think it may have been related to dirty lake water seeping under the tegaderm dressing that I had covering my site. It was soooo painful and swollen, red and hot yesterday. TMI here, but if there is ever drainage from a site- especially if it's not clear- CALL THE DOCTOR. I called my endo as soon as I pulled the old site and he immediately started me on a 5 day course of Cipro. After just 2 doses the infection is improving- thankfully!I have seen some pretty gnarly site infections and this really freaked me out! The funny thing is that my sugars were FINE (up until the Cipro-lol) so I couldn't believe there was an infection in there...

Now on the Cipro I was having some mildly elevated blood sugars- I am trying a "Temporary Basal" of 110% my normal rate (or 10% higher) and it seems to be covering the resistance nicely. It's weird with this class of antibiotics (called Quinolones) because one may cause hypoglycemia, while another one will cause severe hyperglycemia... luckily I know how to manage that when it does happen!
Let's see...what else is new? Well, I am changing my office hours to 4 mornings (actually M-Th, 9-1) a week this year during the school year. I will, of course adjust my schedule to meet the needs of my patients when necessary.
Stay tuned for upcoming events this fall and winter!

Update

Carianne (Cari) Roorda — Fri, 08 May 2009 23:22:54 GMT

Hey all,
I just wanted to put up an update. I know I see many of my readers out and about, but for those of you that don't know I am back to wearing a Medtronic pump. I am hoping for insurance approval for an upgrade...but won't know until Monday. I am wearing the Minilink transmitter and
the new 522 pump (in PINK!)
and I love it! I miss being "untethered" but I also am liking the "lower profile" site again. Honestly the CGM makes it worth the tubing! Also I am pretty thrilled with the Carelink software and how useful it's been in checking out trends and troubleshooting. (:

Sanford aims to cure type 1?

Carianne (Cari) Roorda — Mon, 09 Jun 2008 18:30:36 GMT

OK, First of all I should make an update on my eyes- I did see a retinal specialist in Sioux Falls who said if at all, that I had "exceedingly mild" retinopathy and that he would expect this or worse since I've had type 1 for 16 + years now. YAY! What fantastic news. Also that I don't need to see him again unless I have any active bleeds pop up.

So on to the topic at hand. This weekend my family and I went up to the Sanford Imagine Festival and had a wonderful time! Rascal Flatts is one of my favorite groups, so I was more than thrilled to see them live! What great entertainers. Aly & AJ and Sheryl Crow were on as well and were wonderful!

The icing on my cake of a weekend is that Sanford announced that they will be "curing type 1" as their project- working with the JDRF to cure type 1 diabetes. They will be building a research center in Sioux Falls to accomplish this. I can't express enough the extreme joy that I feel in this announcement. Who'd have guessed that when I moved to Iowa 8 years ago, I would be within an hour and a half of a drive from where we just could possibly cure type 1 diabetes? I don't know how or when but I tell you I MUST be a part of this! I would work for free if it meant helping to find a cure. No, I am not leaving OCAHS, but I would love to add this to my plate- in several years of course, as I know it will take a while to get things going. Now I know where my education will take me, that is for sure. I am looknig into ways I can gear up for a part in the research with a Master's degree. Like I said, I don't know how or when but I do feel like I was meant to be involved somehow.

Retinopathy....

Carianne (Cari) Roorda — Sun, 13 Apr 2008 00:55:46 GMT

I officially have "mild nonproliferative diabetic retinopathy". You might remember last year that I had a small dot hemorrhage in my right eye at my dilated eye exam. This time I had 4 in the right, and 2 in the left. It really hit me hard...I know at my stage (having D for over 16 years) most people have some form of diabetic retinopathy...
but I think I have been secretly holding out the hope that I am still the invincible Cari I used to be.
Now I am humbled by the reminder that I am NOT invincible, but just as vulnerable to the complications of diabetes as anyone else. I am going to strive for the most minimal blood sugar fluctuations by being more strict about bolusing for meals ahead of time and avoiding simple sugars. The more stable my blood sugars, the less likely that I will suffer a larger hemorrhage that will rob me of my vision and being able to look into the eyes of my 2 sweet little boys...It's hard to be writing this but I do want everyone to know that I struggle too, and that is the point of this blog - so I can relate to all of you on a deeper level - yes I have the knowledge and training, but ultimately I am also a person with diabetes- and I refuse to let it take any of my quality of life- no matter how long I have it. I am going to meet with a specialist after this whole ordeal and gets some more detailed pictures of my retina so we can see just exactly what is going on in there. For those of you who don't know much about the treatment- this stage is just a wait and see and pray and take control of those A,B,Cs ( A1c, blood pressure, and cholesterol!).
Stay tuned....

Cool online newsletter

Carianne (Cari) Roorda — Wed, 26 Mar 2008 16:55:36 GMT

Today I was cleaning out the "Favorites" on my computer and came across this link:
http://www.diabetesincontrol.com/
It is a neat weekly newletter available online with some really great articles.
I have talked to many if not all of you about resistance training and muscle building as a part of your exercise routine- here is a great article on Resistance Training:
http://www.diabetesincontrol.com/results.php?storyarticle=5633
Hope you find that informative!
Now get out there and enjoy the beautiful sunshine! (:

Prediabetes info

Carianne (Cari) Roorda — Wed, 19 Mar 2008 17:18:29 GMT

First of all, I wanted to put a link up to direct those looking for "Prediabetes" information to the ADA's website. (Highlight and copy and paste into your browser's address bar)

http://www.diabetes.org/pre-diabetes.jsp

The ADA site provides great diabetes education articles and columns in addition to the info you can access under the "Resources" tab located at the top of this page.

Another thing I wanted to mention is that we will not be having a support group this month due to the weather and flu outbreaks. I hope to see you in July, which is the next time I will host the Sioux County Diabetes Support Group here in Orange City. The topic remains undecided at this time.

On to brighter things- I really hope this weather warms up so we can all get moving outside- Good for the soul- and for the blood sugars!Email me if you need some motivation to get started on an exercise or healthy eating routine so you can have a healthy summer.

That was easy!

Carianne (Cari) Roorda — Mon, 28 Jan 2008 19:40:38 GMT

In my last post I discussed trying to get set up with my new Omnipod system (www.myomnipod.com). Well, I have been "pumping" (podding?) with the Omnipod since last Thursday. Two words: Life Changing! I LOVE this new tool! It provides so much more discretion - also just the little things that had become so second nature to me- like getting wrapped up in tubing every night- are a thing of the past. Omnipod's slogan is "Making diabetes a smaller part of your life" and I really have to say that it DOES DELIVER that. I can check my blood sugar right in my PDM and it is instantly ready to be used in my bolus wizard. (In case you don't know it is the calculator built in to your pump that tells you- based on your personal pre-sets- how much insulin you need to cover your carbs while also considering your current BG and your BG goals)
If you have any questions about it, feel free to call me, or come to the next NW Iowa Insulin Pumper's support group at the Sioux Center Community Hospital on the 19th of this month and I will be available to show you exactly how it works. Have a fantastic week!

Happy New Year!

Carianne (Cari) Roorda — Tue, 08 Jan 2008 17:56:27 GMT

Is it really that time again? 2008 is here and what a perfect time to make healthy changes and goals for your Diabetes Self-Management.
My personal goal is working to get set up with the Omnipod (www.myomnipod.com) in order to further improve my blood glucose management and quality of life.
I am excited to have been with OCAHS for almost a whole year now, and feel so blessed to be doing my job and helping fellow PWD live healthy lives. I hope and pray that this new year means positive change for each of you. There are so many amazing developments coming out in Diabetes care. Not the cure I was promised "within 5 years" of diagnosis, but pretty great all the same.

Tonight's group

Carianne (Cari) Roorda — Wed, 14 Nov 2007 16:22:28 GMT

I am excited about the support group tonight! I have a lot of food prep to do beforehand (: so won't be in the office after about 2 today. I hope we have a great turnout!
I also wanted to say that on the 27th I am pleased to welcome Tim Palmer from Dexcom to the area- he will be speaking to the area educators that afternoon and then to the pump support group in Sioux Center.
Stay tuned for more information!

Beating Burnout

Carianne (Cari) Roorda — Wed, 14 Nov 2007 16:19:32 GMT

Just to let everyone know I am working on my "Beating Diabetes Burn-out" support group topic for November's Sioux County Diabetes Support group-
Anyone who has tips that work for them, please email them to me and I will be able to share with others at the group. Otherwise, come to the group in the basement of the new hospital at 7pm on November 14th and share yourself...
Hope to see you there!

Wow it's been a while!

Carianne (Cari) Roorda — Mon, 01 Oct 2007 14:17:50 GMT

I have to apologize for being a "bad blogger". I haven't updated my blog in a couple of weeks! I have no idea how the past month could be gone already.

Illness went in circles in my family all summer, and September was no better. Hopefully we will on remain healthy from here on out! I cringe at the thought of flu season. Flu shots this month already?! (By the way, be sure to get yours!)

I had a crazy month of sugars b/c of the illness. HOPEFULLY now I will see more of an even-keel blood sugar profile. I have decided (after reading mixed reviews) to give Apidra a try in my pump. Apidra is the rapid acting insulin (much like Novolog and Humalog) put out by Sanofi-Aventis- who you may or may not know also put out Lantus. Speaking of which I am still trying the Un-tethered Regimen now and again. I really like that safety net if I have a bad pump site (which is back to occuring more frequently).

On a side note: Did anybody watch the VH1 finale of Rock of Love, starring Rocker Bret Michaels? He has type 1 diabetes and the finale featured him "almost going into insulin shock" on 2 seperate occasions. Any thoughts on this, email me though the site here.

Happy October!

How do I beat burnout?

Carianne (Cari) Roorda — Wed, 12 Sep 2007 13:01:01 GMT

This morning while checking my email, one email in particular jumped out at me after thinking about my past few weeks. It was a digest from DLife, and had a little preview of the weekly featured articles. The headline that captured my attention the most was " How to Beat Burnout" (the topic I plan to cover at the November Sioux County Diabetes Support Group). I linked to the article written by "Six Until Me" blogger Kerri Morrone. You can also read it here at: http://www.dlife.com/generation_d/2007/08/bitesized_diabetes.html
In the article she opens with detailing some of the monotonous tasks that we must accomplish day to day to keep our diabetes in control and to care for ourselves. She says it well here and sums up what many of my patients are telling me on a daily basis:

"Remaining motivated is a challenge for me. Sometimes it’s the biggest challenge. My diabetes-related complications are minimal at this time in my life, so it’s hard to keep thinking “what could happen” as a way to keep myself vigilant. The threat of complications, though terrifying when I am waiting for the retinologist to peer into the depths of my dilated eyes, isn’t what makes me maintain my diabetes on an hourly basis." - Kerri Morrone

In this article she writes of the importance of short term goals (which are so important!) and how it is easier to think of your management in terms of "bite-sized" or as she puts it "whittling her diabetes management down to a manageable size".
To me that seems like a very good way to look at things. It is so easy to get overwhelmed when we think " I have to get my sugars to an average of 100, lose 25 pounds (or more), exercise, cut out some of my favorite "junk foods". So why not just think about it in as Kerri puts it- in "bite-sized bits"? What is your goal today? For me, I am focusing on fine-tuning my basal rates again as I just resumed the untethered regimen (Lantus & the pump) after I determined I am not allergic to Lantus as I thought, but instead was just having residual effects from the pneumonia I fought this summer.

Today I will be in the office most of the day, but for a lunch Webinaar in Sioux Center by the AADE called "Fact Vs. Fiction: Supplements, Herbs, and Diabetes". I will post what I learn at a later date.

Hope everyone is having a great week!

Have a fabulous weekend...

Carianne (Cari) Roorda — Sat, 01 Sep 2007 15:16:58 GMT

Here is is Saturday- September 1st already! How in the world can that be? This summer went by sooo quickly. I have an appointment in just over a week to see my endocrinologist up in Sioux Falls. Part of me wants to wait a little longer because especially with my new Dexcom 7 my sugars have been much better and I want to be able to see my improvements reflected in my a1c.

This post will be short as my toddler is working on his 2 year molars and there is rarely a whine-free moment in this house lately. Hope everyone is doing well.

Oh, I wanted to mention if you have been considering a pump- I am CLOSE to being able to train. I technically can't be certified until I train a few people (funny since I have been a pro myself for almost 8 years now!). If you have an questions about any of the pumps out there you can contact me and I will do my best to get a hold of the closest sales manager and get you info. So far I have contact with Minimed, Animas, and Cozmo.

Have a great weekend!

LOL!

Carianne (Cari) Roorda — Tue, 28 Aug 2007 15:36:00 GMT

You've seen the monitor commercials. Always a number within a few points of 100. I thought this is hilarious! I found it on the tudiabetes site as a link from Six until Me blogger Kerrie Morrone's site. Like she says we really do need to "LOL" sometimes!

Not that we exactly strive for that number but isn't it a reality of having diabetes? Especially when dealing with the eternal balancing act of carbs, activity (or stress or hormones!) and insulin. (:

Also just a quick update on my Dexcom 7- so far so good! I think it is accurate (but I've had that with the STS 3 day sensors as well) and the trends seem more predictable. Of course, this was only going by my 1st sensor. I just put the 2nd in last night and let it get completely saturated with interstitial fluid over night before I even attempted to calibrate this morning. Then I wouldn't have to upload fingersticks at 1 or 2 a.m. (: I LOVE the new software- much better than the previous version. Very cool graphs and charts. I am hoping that this sensor is just as great as the last one so I can show all of the System Educators the technology at our quarterly meeting tomorrow in Sioux Falls.

Diabetes class went pretty well yesterday (well, except that I hit 53- yeah fun!- right in the middle of class. Like I told the participants, this is real life with Diabetes on insulin. (: Gotta love that side effect of tight control. Anyway, I didn't end up using the power point after all and just had more of a discussion and looking at handouts/ diagrams to explain complications and how to avoid them. I liked it MUCH better that way and felt like it helped my patients relate more to me as someone who goes through the same feelings that they do. Like a fellow educator said, you just need to take time to find out what works best. And that is what I am doing. I did get positive feedback from the 2 attendees so that was nice.

In other news, tonight is the Sioux County Pump Support Group - we are discussing Symlin and I will go share my experiences with it. I KNOW it works for some people and I have seen it! It is something I may try again in the future but for now I am trying to use "Dex" to help me fine-tune my basal rates on my pump.

Well, life never slows down here, I have more family coming from Washington tomorrow and must get ready for them. Hope you all are doing well!

Oh, and don't forget to LOL!!

New Dexcom 7 CGMS

Carianne (Cari) Roorda — Wed, 22 Aug 2007 12:29:00 GMT

Well, after a gentle "nudge" from the Dexcom rep to push me up on the list (knowing that I have patients interested in this latest CGMS technology from Dexcom). I received my Dexcom 7 day sensor yesterday. By last night I was ready to calibrate the new receiver with the 2 fingersticks and get back to continuously monitoring my blood sugar again. I uploaded the fingerstick glucose values from my One Touch meter and waited. Nothing. I ended up needing to upload SIX values to get my receiver up and running! How annoying...But anyway, finally got it up and running and then I discovered that it was a little off...and then this morning- woke me up about 3 times before I kicked it out of the bedroom- saying I was low when I was actually 98 (it was reading in the 40s I believe). I kept re-calibrating but no luck.
This morning I went out to get it from it's "time out" spot on the kitchen bar, and the LCD screen was REALLY faint. Yet the battery is completely charged. I don't know what is going on but I am thinking the receiver is faulty. I will call Dexcom later this morning ( as we have a beginning of the year chapel this morning) and report the nature of my problems and see what they have to say.
I am looking forward to the new water-proof feature and the improved algorhythm that is supposed to be more accurate. Hmmm...I am not sure of that at the moment but it IS only day one. Stay tuned for more updates. You can read up on the Dexcom Continuous Glucose Monitoring System at www.dexcom.com.
Have a fabulous day!

This is why....

Carianne (Cari) Roorda — Fri, 17 Aug 2007 21:54:41 GMT

I just wanted to explain something. I am sure many of my colleagues might wonder why I am blogging about my everyday life for my patients to read. I want my "patients" to know that I am not just some 32-year old clicking away at a power point and sending you on your way with this new information to be all alone and figure it all out. I take a personal interest in every one of my patients. I care about each and every one of you. Why? Because I KNOW what it's like to live with this crazy little thing called "Diabetes". I don't just go from 9-5 and then forget about it because I am out of the office. Sure, part of the reason is because I am a caretaker by nature and want to help people, but most of the reason is b/c I too am up at 4 am with a low blood sugar on occasion...or balancing my insulin with ever-changing hormones or activity levels. Or trying to decide what to eat. Or trying to manage my sugars during times of stress. Or realizing that I already depleted my fast-acting carb supply in my purse, but thank goodness I take my own advice and keep something just about everywhere (car, office, bedroom) in case of emergency. (:

I talk to people who need my help, some of them listen, some of them give the illusion of listening. But all of us are on this roller coaster together. We ALL experience the peaks and valleys. The cycles of motivation and burn-out. The key is to recognizing the warning signs and precipitating factors and trying to protect ourselves from falling off of the "Good control bandwagon".
Dr. McAffee (my first endocrinologist who was a type 1 herself- only left her b/c I moved 1700 miles away!) and her wonderful staff always knew when I needed a hand holding and a scolding-lol- Probably more scolding as a rebellious teenager! But I think I really learned a lot from them. In fact the basis of my treatment is grounded in how they helped me to be my own self-manager. Nobody can do it for us, but it does help to have a hand to hold while you start out. To me it is so second nature to count carbs, adjust my insulin based on my carbs, and all of that, and I just can't imagine how anybody would NOT want to have the freedom to do that. But I do remember being a little uncertain in the beginning. The only way we gain confidence is from trying and succeeding. So that is my hope, my goal, is to help even the most "non-compliant" (wink*wink*)and you KNOW how I feel about that word- patient- to be an effective self manager in their diabetes care. Because nobody else (except maybe me) is there thinking about it in the middle of the night, it is up to us to take control of this diabetes rather than letting it control us...

Back to pumping...

Carianne (Cari) Roorda — Mon, 13 Aug 2007 13:46:12 GMT

Happy Birthday to ME! It is my 32nd birthday today. Also, I have been living with "the big D" for about 15 1/2 years now. So what am I doing for my "big day"? Well, of course I am going in to the office. (:
I didn't sleep the greatest. My CGMS kept alarming "Low BG" and then I would get up and have a snack only to have it happen again in a couple of hours. Looks like I need to tweak my basals even more. I had increased them because of being sick and the lovely resistance that comes along with that.

So yesterday I put my pump back on. For the first time in MONTHS it didn't hurt to put in! I think giving my sites that little break- albeit a short one- did make a difference. I am still doing the Lantus (aka the un-tethered regimen) as I love the freedom that comes with that. In fact I encourage anyone on a pump to try it! I love being able to disconnect for a shower and not worry about getting the pump right back on, or just connecting to bolus if I have a fitted outfit on that doesn't have a pump friendly hiding spot.

One of my friend's daughter is type 1 and on the pump. While I was at their house this past weekend, my friend was telling me how hard it has been for her to deal with the pump stuff with the busy summer, swimming, etc. Also she had taken a nap the week before and didn't realize her pump wasn't connected or was suspended, whatever it was, she didn't have any insulin delivery for a few hours and then woke up high and feeling lousy. This is why I love having the Lantus "safety net". I suppose the disadvantage is that you can't totally suspend the pump for exercise or illness where you can't eat and are low, but adjustments can be made for those circumstances. I may have more to offer in the way of practical advice once I am able to start exercising again (should be this week as I finally feel MUCH better!), but everyone is so individual. I suspect since I can set my basals at about 50% while I exercise, I will be able to do 50% of my basal dose as Lantus- right now I am closer to 90% and just had the pump to kick in for Dawn Phenomenon (DP)and a few times of the day when I need a slight increase in my basal rate.

If you are in the area and are considering a pump- CALL ME and I would love to talk to you about it! Also there are quarterly NW Iowa pump support groups hosted by Judy Hauswald ( Sioux Center's diabetes educator) where you can go and find out more about the pump and meet other pumpers. I will post the dates when I get them.

I have access to Minimed, Animas, and Cozmore pumps and will soon have even more. I am not certified YET to be a pump trainer but am working on it. I need some official pump starts before they will call me "Certified". But honestly I can't think of anything I wouldn't know how to deal with after using a pump myself for 7 1/2 years.

Well, enjoy your week...and the rest of the summer that has gone by WAY too fast!

Take care of yourself!

Carianne (Cari) Roorda — Sat, 11 Aug 2007 13:53:10 GMT

Well...If you've been to the self-management classes during the past 6 months, you've heard me preach the importance of relaxation/ stress-management and taking time out for yourself as a integral part of managing your health. I witnessed the importance of that first-hand this past month. About 3 weeks ago I had a terrible cough come on which rapidly progressed to a feeling of inability to breathe. Talk about scary! A chest xray and some blood work revealed that I had pneumonia, viral of origin. Talk about blown away! Here I am 31 (okay- so I will be 32 on Monday) and healthy, yet I am coming down with pneumonia in July! I had been extremely busy and stressed and I have no doubt that was the reason for my vulnerability to this virus. I had also (gulp) let exercise take a back seat to my busy life lately, which I know is not good, but real life happens to all of us at times, right?
In addition to all of this I am blaming my site issues (with the pump) on that as well. The only way I can explain all of this is as a great learning experience. I learn things that need to take priority in living with diabetes. I am fortunate to be able to pass that on to others. I love my job and feel so blessed to be able to share my experiences with others living with the same challenges.
I have been doing MDI (multiple daily injections) rather than the untethered regimen lately. My absorption is so much better and more predictable with the injections lately. Of course I am not having inflammation and scarring around the site of infusion as I was with the pump for the past couple of months. I think it has been an important lesson for me to go back to MDI for this short time and to remember what that is like for those on MDI after my 7 years on the pump. I also have been enjoying the Lantus and will continue to have that as my basal with the pump for bolusing. The best of both worlds...
This morning I am trying my last 3-day sensor for the Dexcom unit. I hope to upgrade to the 7-day sensor as users are reporting an incredible improvement in accuracy. Trouble is there is a big waiting list for these units (though as I am able to show others the technology and train them, shouldn't that bump me up on the list? (: ) Lately I have been less than thrilled with the Dexcom but my Mom is visiting this weekend and I really want to show her how this works (she is not living with Diabetes but loves seeing how my life can improve with new technology). So hopefully my last 3-day sensor will cooperate. She can at least get the general idea and after this sensor I hope to move right to the 7-day sensors. Aside from being much better technology they are WATER-PROOF!! YAY! Something that will be huge for me. Now rather than either dealing with the tape irritation from the shower patches, or else moisture spikes that can make the sensor say your sugars are over 400 for up to 4 hours - though they are really in range- I won't have to worry about showering, bathing, or swimming with the sensor and transmitter on.
Well, I'd better go get a move on my Saturday. Don't worry...I won't overdo it!
Have a fantastic weekend ...

Un-tethered Regimen and more...

Carianne (Cari) Roorda — Wed, 25 Jul 2007 18:55:55 GMT

Wow...It has been a while since I posted anything here. Sorry! I have been very busy with visitors from out-of-state and just recently, my sister moved here! It has been a busy time for my family but that's a good thing.
Lately I had been noticing my pump sites going bad at an increasingly fast rate. Lately I can't even get 24 hours out of them. I have tried both the teflon and steel sets ( various types of both ) with no improvement. Between that and trying Symlin (again!- after my little break)and the spikes with that, I have been really approaching burn-out. Oh, and did I mention my Dexcom CGMS has been acting up too? Sometimes it feels like insanity with all of these devices...So I talked my doctor into letting me take a little "pump holiday" to give my favorite sites a rest. My -non-pumping Diabetes regimen? Lantus- (which I was kind of looking forward to trying since that was out after I started on the pump so I never did get to try it) and of course a rapid acting insulin analog. I also remembered reading that Novolog tends to be a little better in the pumps as it is "cleaner" than Humalog, so I asked if I could try that in addition to the Lantus that way if I needed to go back to the pump I had another option.

16 hours into the pumping "vaca", I was soooo ready for my pump again!! I really missed being connected to bolus whenever without having to haul out a syringe or pen. I went online for some insight into my little break and found an article that Dr. Steve Edelman wrote describing an "Un-tethered Regimen" which you can read about here:
http://www.childrenwithdiabetes.com/clinic/untethered.htm
Basically, the pumper takes Lantus in addition to using the pump- just takes less of the basal insulin with the pump and covers that with Lantus, but still has the convenience and precision of the pump (bolusing options, increasing basals for dawn phenomenon over JUST the few hour period that is the culprit of the problem for most people). I did this for a few days and it worked AWESOME- Honestly the best BGs I have seen in a long time- they looked so "textbook" and that is so not me! I felt amazing too. More "even". Then I decided to try to introduce the Symlin again since things were going so well. That immediately pushed my baseline to 160s-170s! Yikes! (I try to keep it around 90-100 most of the time) However, I am thinking it was a bad site, because despite many futile bolusing attempts, by BG wouldn't budge. Eventually an insulin injection did bring me back down.
Anyway, I've decided to wait until I knew for sure if I am just having bad luck with sites and need to stick (pun intended!) with injections for a while before trying Symlin again-
I will say I don't think it is the material of the site but the actual continuous infusion of insulin that is irritating the tissues because I've had my i-port ( www.pattonmd.com) in for longer than the site now (both went in on Monday around noon)and still no problems. I could've just hit a lucky site too, hard to say. The i-port has a 6mm teflon cannula that looks very similar to the Minimed Quick-sets and is about the same size. It goes sub-Q (sub-cutaneous) jsut like an infusion set and has to be changed at least every 72 hours, but you can inject right into the little hub and no more than 1 stick every 3 days! The needle gauge is 27G as opposed to the 31G of the new insulin syringes, so much bigger, but less often. You can put them anywhere you would inject insulin. I heard about them on the website I host and thought they sounded like a great idea and decided it would be a good thing if I were to try them to have some practical advice for any patients who may be interested. So far I have no irritation like I did with the pump sites, so that is why I suspect the sites problems have more to do with continuous insulin infusion (albeit a tiny amount) than with reaction to the materials that the infusion sets are made of.
Well, I am running out of room but wanted to give an update on my quest for perfect control-lol- Keep checking back for updates- I suspect my pump break won't last long and I may even selectively pump for occasions where I know it will be very helpful, but for now I welcome the break with open arms!