The Biggest Diabetes Mistake I Made on My Trip to California

A couple weeks ago, I shared about my fears over flying again for the first time since before the pandemic.

Fast-forward to now and I’m happy to report that basically none of those fears came to fruition over the course of my trip…

…but of course I did experience one snafu that was definitely avoidable.

All smiles in scenic California in this pic, but I definitely wasn’t grinning like this when I made my mistake.

The biggest diabetes mistake I made on my trip to California was neglecting to charge my OmniPod DASH PDM as often as it (apparently) needs to be charged.

I’m not going to make excuses for myself because I should’ve planned better, but I will say that I’ve only been on this system for about six weeks or so now…and I’m still getting used to some of the PDM’s quirks. In particular, I have yet to figure out exactly how often I need to charge my PDM. It runs on a lithium ion battery, which is the same thing that most cell phones use. So one might make the assumption that I’d need to charge the PDM daily, but that’s definitely excessive – I’d guess that I only use about 20% of the PDM’s battery each day, but of course that depends on how frequently I need to bolus or play around with my basal rates. However, using that rationale, I’ve been charging the PDM every 3-4 days, or whenever I notice the battery falling to a 20% or less charge.

My logic failed me, though, when I falsely assumed that my PDM’s battery would last a day trip into San Francisco when it had a 40% charge.

I still have no idea what happened – all throughout my day walking the hilly streets of San Fran, I was careful to turn off my PDM screen whenever I wasn’t actively looking at it, and I was only turning it on to bolus slightly more than usual (I was basically snacking my way through the city the whole afternoon).

I consider myself pretty lucky, though, because I made the discovery that my PDM battery was dead towards the end of our day, right when we were headed on the subway back to our Airbnb: If there was a time for this to happen, it’s definitely better at the end of the day’s activities rather than at the beginning or somewhere totally inconvenient.

At least, this was what I tried to futilely tell myself in an attempt to feel better about my negligence.

Instead of feeling better, I was beating myself up over making what felt like a rookie mistake. I should’ve charged the PDM because, after all, there was no way that I was about to go into a brand new city for the first time with my phone battery at 40%, so why on earth did I think it was okay to do that with my PDM? Moreover, how the heck did this happen in the first place – does the battery really just drain super quickly and/or easily?

I knew there was no point in trying to figure out why it happened at that point in time – it was more important for me to charge the PDM as soon as possible so that my partner and I could experience In-N’-Out for the first time on our way back to the Airbnb as we had planned.

So, because he is brilliant and calm in “emergency” situations (unlike me), he came up with a plan: I’d head over to In-N’-Out, order our food, and wait for him in our rental car while he ran up the street to a nearby CVS to see if they sold any USB cables (you know, the types of charging cables that everyone has because most electronics are charged with those). And his strategy worked out beautifully. Soon after I had our bag of In-N’-Out in hand, he arrived at the car with the charging cable and I was able to plug my PDM into it so I could bolus for dinner right then and there instead of having to delay it. (We could’ve just waited until we were back at our Airbnb, but then I would’ve either had to eat a cold burger [blech] or eaten it fresh and run the risk of my blood sugar jumping up without the necessary insulin in my system. Obviously, we went with the more appealing option.)

All things considered, if that was the biggest diabetes mistake I made in California, then I’d say I did pretty good – more to come soon on my strategies for maintaining decent blood sugars while on vacation.

As for now, I’ll leave you with this – In-N’-Out is kinda overrated.

First Impressions: The OmniPod DASH

At long last, the day has come…the day for me to share my first impressions of the OmniPod DASH!

Full disclosure: I’ve only been using the system for 3 days as of this writing. But I thought it was important to capture my beginning thoughts on how it works because they’re bound to change over time as I gain more experience and familiarity with the system.

So without further ado, here’s a bullet point list (‘cuz who doesn’t love a good list) that hits the highs and lows – yes, pun intended – of the DASH so far:

  • It was shockingly easy and fast to set up. I was worried about inputting all my settings from my old OmniPod into the DASH system and assumed that I would need a block of time to do so. This is why I decided to do my set up on a free and clear Sunday afternoon with minimal distractions around me. Turns out, though, that I didn’t need so much time set aside – it took me exactly 10 minutes to get all my settings straightened away. In fact, it probably would’ve taken closer to 8 minutes if I hadn’t agonized over choosing my background photo for my lock screen! The PDM made the entire setup process extremely intuitive and easy to navigate, much to my relief.
  • The PDM is incredibly high-tech…and, at times, suffers from that. I’ve spent a lot of time marveling over the clean, sleek design of both the touchscreen and the PDM itself. It’s almost identical to my iPhone, which I think is both a pro and a con because I can see myself confusing one for the other in the future (though it’d be extremely obvious which was which once I unlocked the device). The touchscreen and menus are thoughtfully designed, but my big beef with them is twofold: 1) Some menus are totally buried – it took me an embarrassingly long time to figure out how to set a temp basal and 2) Anyone who ever claims to suffer from “fat fingers” or struggles to hit the right buttons 100% of the time on a smartphone might find navigation on the PDM to be a challenge. The good news is that it’s really easy to go back if you’ve mistakenly navigated to a menu that you didn’t need and to correct any accidentally hit buttons, but I could definitely see some users taking issue with the operation of the touchscreen as a whole – even though I personally haven’t found it bothersome.
Shout-out to the Insulet/OmniPod website for providing a much better image of the DASH PDM and pod than I ever could!
  • The pod change process has a new addition to it. DASH users have the option to record the site of their new pods, a feature that I think is pretty neat! I’ve always been pretty good about rotating sites, but having a record of exactly where I’ve placed my pods over time is bound to be helpful so I don’t ever use one particular site too much.
  • Speaking of the pod change process…I almost activated a pod when it wasn’t even on my body yet. I’m used to the pod change process consisting of multiple pages on my PDM that outlines everything step-by-step. The DASH system aims to consolidate things a bit and features more than one step on a page. This was all fine and dandy up until I hit the last step of the process – I touched the button to activate the pod, thinking that I was navigating to the last page in the setup process! This was mostly user error because I should’ve read the screen more carefully, but luckily, I had to hit a “confirm” button in order to actually activate the pod (so there’s basically 2 buttons that have to be hit to activate a pod, not one).
  • So far, I’m unsure how I feel about the rechargeable battery feature. I thought this would be a huge improvement over the old OmniPod, which took 2 AAA batteries, but now I’m having some doubts. Those AAA batteries easily lasted 6 weeks – maybe even longer. Now I’m going to have to recharge the DASH PDM at least once or twice a week, depending on how often I’m actively using it. This is going to be a slight pain, but according to what I’ve read, the PDM is still useable when it’s charging, so that makes it more tolerable. But I’m also thinking from the perspective of someone who is away from home at least a few nights a month – this is going to be just ANOTHER charger that I have to remember to pack every time I go away, which is a bit of a bummer.
  • The system sounds are SO MUCH BETTER!!! OMG, I think the days of OmniPod beeeeeeeeeeeeeeeeeeeeeeeeps are in the past! I haven’t noticed any of those lingering, ear-shattering beeps yet; instead, they seem to have been replaced with a pleasant chiming sound. I’m sure that over time, I’ll grow to hate that sound, too, but for now I’m just loving that I’m not being pestered with pod reminders by those grating beeps!

Like any diabetes device, I knew there would be some faults with the DASH system. But generally speaking, those faults are extremely minor and I’m still thrilled that I’m on this new system…and extremely curious as to how my thoughts and feelings about it will change over time. I’ll be sure to post about my new discoveries and experiences with it in the future!

Why I Went with an OmniPod Insulin Pump

This post was originally published on Hugging the Cactus on February 28, 2020. I’m sharing it again today because while my affection for the pump is still very much intact, I still wish at times that I had explored other options. But that doesn’t deter my excitement about switching to the DASH soon! Read on to learn about the one major factor that made me decide to go with an OmniPod over all the other insulin pumps out there.

Choosing an insulin pump therapy can be stressful and overwhelming, especially if you’ve never pumped before.

Factors like tubed vs. tubeless, whether or not your insurance will cover a given pump, ease of use, reservoir capacity, and many others all play into the big pump decision…

Weird to think that soon, I will no longer be using this exact same OmniPod system!

…if you’re like most (logical) people.

But if you’re me, then you count on pretty much one thing when making the choice: familiarity. I solely relied on the fact that someone I knew and trusted used the OmniPod and had a positive experience with it, and that person is my mother. On top of that, I waited a solid 2-3 years after she started to use it before it was my turn, because I wasn’t willing to even think about trying it until I could feel fairly confident that I would even like it myself.

Luckily, I’ve been on it for just over five years now without any major issues. While I do love it more than I ever liked multiple daily injections, I do wish I had thought it over some more before just going with it…especially now that there are other insulin pumps out there with some amazing features. I know that the manufacturer of the OmniPod, Insulet, has some great upgrades in the works, but it can be hard to wait for them.

If I could go back in time, I’d definitely do more research before semi-idly deciding that the OmniPod is right for me. Of course, I could make the switch to a new insulin pump in the future…but if and when I do decide to try something else down the road, I know I’ll make much more of an effort to really learn everything I can about my options before committing to a new piece of diabetes technology.

A Diabetes Waiting Game

I am smack-dab-in-the-middle of a very long, very annoying diabetes waiting game.

I’ve waited for my Dexcom sensors and transmitter refill for two months now.

I’ve waited to transition to the OmniPod DASH system for a few weeks now.

I’m very glad, and fortunate, that this waiting game does not apply to the most crucial of my diabetes supplies, which is of course my insulin.

But I’m still tired of waiting.

I don’t mind it as much for the OmniPod DASH; after all, I’d rather use up my remaining pods before diving right into full-time use of the new system.

But the Dexcom sensors and transmitter? That wait has been borderline ridiculous.

I may have to wait to use my new DASH pods, but at least I have ’em here when I’m ready to put them in action.

To sum it up, the wait is due to a series of miscommunications between me, my doctor’s office, my health insurance provider, and my DME (durable medical equipment) provider. And it sucks, because just like anyone else who has diabetes, works full-time, manages a household, and has a social life, I’m doing everything I can to address the matter when I have the time and mental bandwidth to do so, but still blame myself for not getting my prescriptions sooner.

It sucks that I feel failed by the healthcare system.

And again, I find myself feeling grateful that this is my first time experiencing anything like this in 23ish years of life with diabetes. But what’s opened my eyes is that this is a reality for some people with diabetes all the time. That doesn’t just suck – it’s unacceptable.

When will we stop having obstacles block the paths to getting essential, life-saving medications and equipment?

Do You Know How Long OmniPods Last?

This post was originally published on Hugging the Cactus on June 3, 2020. I’m sharing it again today because I have seriously benefited from learning the “true” length of time that a single OmniPod lasts on my body. Read on to learn more…

When people notice my OmniPod insulin pump, the first question that I’m asked isΒ “what IS that?”

After I explain that it’s my insulin pump, and it’s called a pod, the second question I’m asked is some variation of “how long does it last?”

The canned answer that I provide is something about having to change it every three days, because that’s how the OmniPod is advertised.

But I’ve used this pump for years now and never bothered to really test this three-day limit. I’ve known for a long time that my pod works a handful of hours after the expiration alarm starts chiming, but I wasn’t sure about exactly how many hours I had before a pod expired for good.

So, the other day, I decided to find out.

Have you ever made your pod last longer than 80 hours? If so…are you a wizard???

My pod expired at 10:22 A.M. Since I prefer to change my pods in the evening, I figured it was the perfect time for this little experiment, assuming that the pod really would last me for the majority of the day.

And, well, it did! At 10:22 on the dot, the pod beeped at me to notify me that it was expired. And in the six hours after that, it would alarm every hour (on the 22nd minute) to remind me, time and time again, that it was expired. In the seventh hour – beginning at 5:22 P.M. – my PDM started chirping at me on and off every 15 minutes or so. First it was because I was running out of insulin, but then it was to really get the point across that my pod was expired!

I was determined to use every last drop of insulin in the pod, though, so I bolused for my dinner around 5:45 and I was pleased to discover that I got my full dose of insulin without any issues. As I was cleaning up after dinner, that’s when the signature OmniPod BEEEEEEEEEEEEEEEEEP went off as one blaring, unceasing alarm. I checked the time: 6:22 P.M.

So there was my answer. An OmniPod can last precisely 80 hours after you initially activate it for the first time (or in other words, 8 hours after you receive the first expiration message)…as long as it still has insulin in it. It’s definitely something good to know for sure now, because in the future, it might come in handy and help me avoid wasting precious insulin.

Swimsuit Season is Here and My Diabetes Gadgets and I are Not Ready

A “yay”: Summer is here!!! Hooray for warm weather, beach trips, and backyard BBQs! (Not to mention VACCINES!)

A “nay”: My pods and my CGM sensors are about to bare themselves for the world to see and we are NOT READY for it.

My confidence in my appearance is rarely, if ever, high. But I like to fake it ’til I make it and act like I’m rocking my summer wardrobe instead of stressing about how my legs or arms look in the staples of the season that are designed to show more skin.

Usually, I have a lot more success in feeling good about how my medical devices appear on my body. Whether they’re hidden under my clothes or out for the world to see, I typically don’t care because these gadgets are keeping me alive!!! And that’s a lot more important than any negative body image connotations they may create.

A picture from a time during which I was very okay with PDA (public displays of my arms).

But something about this year feels different to me. I am so not looking forward to the extra stares that my diabetes technology attracts. I’m not sure if it has to do with being sheltered in the last year and a half because of the pandemic, but whatever the cause may be, this is something I’m grappling with as the temps creep up and the temptation to hit the beach grows stronger.

I know I’m not the only one dealing with this. In fact, I was in Maine for a couple of days with my parents and I was wearing my pod on my leg, whereas my mom had hers on her arm. And we had multiple people approach us about our pods! They weren’t necessarily rude in their approaches – curiosity drove them to speak with us and that’s innocent enough – but it’s still weird to know that people are looking closely enough at our bodies to see our devices and feel comfortable enough to ask us about them. Plus, I felt extra self-conscious about it because in typical Molly fashion, I had a sunburn all around my pod thigh site…when applying sunscreen, I almost always miss the area directly around my pods because I’m afraid of the sunscreen making my adhesive weaker or interfering with the pod’s functionality. So not only did I have this big chunk of plastic sitting on my leg, it was also red all around the site, drawing even more attention to it. It was a relief when I was able to put shorts on over my swimsuit and cover up both the burn and the pod.

So while I’m not loving how wary I’ve felt lately about baring my diabetes devices, I’m also coming to terms that it’s just a sort of phase that I’m going through right now. And that’s okay. I’m also trying to remind myself that I don’t have to feel obligated to go into detailed explanations when people ask me about my pod or CGM. It’s a natural tendency that I have to use it as a teaching moment and be a good diabetes advocate, but sometimes I just don’t have the energy for it. I’m keeping my fingers crossed that as the summer season goes on, my comfortability with my diabetes devices increases and I worry less about the looks they tend to draw.

How a Normal Pod Change Turned Into a Bloodbath

WARNING: If you are at all squeamish when it comes to blood…then this blog post is NOT for you! I will not be posting any graphic photos or anything, but I’ll be telling a bloody tale that might make the faint of stomach a bit queasy. Read on if you have no fear…

There’s nothing quite like waking up and doing a routine pod change…only to have blood literally pour out of your body the moment you tear your old pod from its site.

Okay, so using the word “bloodbath” in the title might be a gross exaggeration (LOL at my pun because yep it was GROSS), but I digress…blood really did stream in a rivulet down my arm. It sounds wild, but it’s true!

This happened to me a couple of weeks ago. I don’t often change my pod first thing in the morning, but every now and then, I’ll time it so that my pod is set to expire (like, really expire – pods expire for good 8 hours after receiving the initial “pod expired” message on the PDM) as soon as my wake-up alarm goes off. My only goal in prolonging the pod like that is to use up as much insulin as possible that’s left in the reservoir…naturally, I don’t like the idea of tossing a pod when it’s still got 50+ units of insulin left in it.

So I literally woke up on this particular morning at 6 A.M. to my pod screaming because I’d hit the 8-hour mark. I rolled out of bed and stumbled over to my mirror so I could have a better view of the pod, which was sitting on the back of my arm, and proceeded to rip the pod off. That’s when I saw blood – not just a tiny drop, but a full-on stream running down my arm!

The ‘betes can get bloody from time to time.

I was surprised, but still had my wits about me to the extent that I was able to run into my bathroom and grab some tissues so I could start wiping up the blood and apply pressure at the site. I barely made it in time – the blood was coming out so fast that drops were falling on the floor and my sink was getting dotted with red. I wasn’t really freaked out, per se, because I knew that if I just pressed hard enough with a tissue, then I’d be able to staunch the wound. And sure enough, within 5 minutes or so, I’d successfully done just that. I peeked under the last tissue I’d used and noticed a purplish mark at the old pod’s site, which indicated to me that I must’ve hit some sort of vein when I had put that pod on. Definitely not intentional, but something I hope to avoid going forward.

And undoubtedly…definitely not my favorite way to start the day!

Dodging DKA: What Happened and What I Learned From It

In 23ish years of life with type 1 diabetes, I’ve never really experienced DKA…and I feel wildly fortunate to have avoided it.

But the other day, I came extremely close to it, and it’s something I won’t soon forget.

Here’s what happened: It was the wee hours of a Sunday morning. I woke up because I had to use the bathroom. My pod was on my thigh. I was due to change it that Sunday evening. I noticed that the pod’s adhesive folded up in the exact wrong way (it was crinkled up by the cannula), causing the cannula to bend and dislodge itself from my body…

…except I didn’t make that super-important observation until around 11 A.M., after several hours of tossing and turning in bed, unable to sleep because I was battling both a headache and stomachache.

What’s more is that around 10 A.M., I noticed that my CGM had been reporting a high blood sugar since about 5 A.M., and I simply hadn’t heard it alarming. When I saw that I was high, I took a bolus, but I didn’t bother checking on my pod because to my knowledge at that point, there was nothing wrong with it. Fast-forward to one hour later to when I did discover the dislodged cannula and I was feeling downright terrible: My stomachache turned into full-blown nausea, my head was pounding, my throat was drier than the Sahara, I couldn’t unfold myself out of the fetal position, AND I was feeling incredibly stupid for 1) missing my CGM’s blood sugar alerts and 2) not checking my pod to make sure it was secure to my body.

What bothered me more during this whole ordeal: my headache, my stomachache, or my anger at myself for letting this happen? (If you guessed the latter, then you’d be right.)

Fortunately, I did have a back-up pod and insulin with me, so I went about activating the new pod as quickly as possible. I felt a fleeting sense of relief when it was on me, but that relief turned into panic when I felt a swooping sensation in my stomach that indicated I was about to be sick. I ran to the bathroom and retched once, grateful that nothing actually came up, then sank down on the floor in shame, wondering how I could let myself get to this point of obvious borderline DKA.

The next few hours passed in a blur as I crumbled back into bed. I drank as much water as I could stomach, gave myself bolus after bolus, increased my basal rate, and tried to settle into a comfy position. I was extremely lucky that I wasn’t alone during this whole ordeal: My significant other was very concerned and doing everything he possibly could to help me. I was and am still so grateful for his care and attention. I didn’t admit it to him, but I was a little freaked out by the whole experience, but I took consolation over the fact that it didn’t come down to him having to bring me to the hospital.

By 4 o’clock that afternoon, my blood sugar was finally below 180 again and I was able to eat a little food, though I wasn’t overly hungry. I spent the remainder of the day beating myself up for letting this happen, but I guess that if I learned anything from it, it’s that I need to remember to 1) keep the volume turned up on my CGM so I can hear the alarms going off overnight, 2) check my pod immediately after hearing a high alarm so I can rule out any obvious pod issues, and 3) bring a syringe with me wherever I go so I can inject myself with insulin/get it in my system faster than a pod would be able to.

The experience also taught me a couple of other things…DKA is very real, very dangerous, and should be taken very seriously. The fact that I just barely dodged it is a jarring reminder that I should never underestimate it. On a much lighter note, though, I also proved to myself that I’m able to take control of a situation like that the moment I become aware of what’s going on. Thank goodness I was at least prepared enough that I had an extra pod and insulin on hand. I hope there isn’t a next time, but if there is, I know exactly what to do in order to take care of it as quickly as possible, thanks to this icky experience.

The Forgotten Bolus

My friends and family have always complimented me for having a good memory.

What can I say? I have a knack for remembering names and faces. I’m slightly better than decent at keeping track of birthdays. And I’ve kept journals of some sort for most of my life, so I’m usually able to recall the date on which a certain event took place (or I can at least look it up fairly quickly).

But my memory can fail me sometimes, and it did just that the other day when I forgot to bolus for dinner.

I don’t think I’ve ever forgotten a mealtime bolus in more than 23 years of life with diabetes. I suppose there’s a first time for everything…

To give myself a little credit, I truly thought that I had bolused. I remembered picking up my PDM and entering my blood sugar and carbohydrate information, but I never actually hit the very important “enter” button that would start delivering my insulin.

Imagine my surprise, then, when I saw my blood sugar rapidly rising – I’m talking double “up” arrows here – approximately 20 minutes after I finished my dinner.

And at first, I decided to ignore it! I thought that my insulin just needed a little more time to kick in, so I waited. And waited. And waited. But when I saw that I was rising above 250 mg/dL, I figured I should increase my temp basal…perhaps my body just needed a bit more insulin than I anticipated.

That’s when I picked up my PDM and saw that I had zero units of insulin on board. Extreme confusion turned into extreme panic as I asked my mom if I could check her PDM – what if I had picked hers up instead when I bolused for dinner and mistakenly gave her the insulin that was intended for me?!

Thankfully, that wasn’t the case, and I slowly began to piece together that I simply forgot to hit the bolus delivery button.

Whoops.

Almost one full hour after finishing my meal, I was finally delivering my mealtime bolus and silently fuming over my high blood sugar that ended up lasting several hours. It was a completely avoidable situation that shouldn’t have happened, but at least one good thing came out of it: I don’t think I’ll be forgetting to bolus any time soon.

Hello, Highs: Pooled Insulin Under my Pod Leads to Elevated BG

Have you ever tried troubleshooting a problem so much that you start to feel insane, and then like magic, the solution to it becomes clear and you wonder why you hadn’t tried it earlier?

This was the case with me and the mysterious high blood sugars that plagued me for two and a half days.

Based on this image, can you tell what was causing my blood sugar to be stubbornly high?

Once I started noticing a pattern of high blood sugars that got worse every time I ate food, I started doing everything else except changing my pod. I tried taking insulin for double the amount of carbs that I was actually eating, I ran a 95% temp basal increase for 8 out of 24 hours in the day, I cut carbs altogether and ate only 0 carb foods, I skipped meals altogether, and I even tried marching around the house for 15-minute intervals to try to get my insulin pumping through my system faster.

And nothing worked. I was able to get my blood sugar no lower than 180, but for most of that 60-hour window of time, I spent a good chunk of it in the mid-to-upper 200s.

Finally, on the day that my pod was due for a change, I decided that it must be the culprit behind my high blood sugars. When I removed the old pod, I knew immediately that something was wrong because the smell of insulin was so strong; plus, there was a large, damp spot on the pod’s adhesive, indicating that perhaps my insulin was pooling under my pod instead of entering my body.

It took 5-6 hours after I removed the leaky pod, but I finally did start to come back down to my normal levels, and was totally back on track the next day. It was a frustrating experience to endure, but a stark reminder of something that I’ve known in the back of my mind for years: that when I’m in doubt, I should change my pod.