January 29, 2009

Tattoo You

There have been a lot of news articles this week about the glucose sensing nanosensor that maybe able to be tattooed in as a kind of glow in the infrared CGM.

I was kinda shaky at first on the whole idea because I didn’t see any of the articles mentioned mice. We all know that a diabetes new story just isn’t ready for prime time unless mice are involved. Fortunately careful reading turns up the roll of mice in testing the nano thingies in a use other than glucose.

I feel better already.

(Actually it is a cool idea, I just needed a little sarcasm.)

Heroes

According to a highly respected diabetes source someone out there feel the need to disrespect my pal Kerri. Her crime? She doesn’t have perfect blood sugar and she admits it.

Hello?!
She has Type 1. We hold this truths to be self evident, Your Diabetes WILL Vary.

So for the record, Kerri is one of my heroes. She is right up there with Clint Eastwood. I think Clint, unknowingly, describes the whole idea of diabetes control in Heartbreak Ridge, “You adapt. You improvise.”

I think she does that very well. I see her at the point where diabetes is second. Living life is first. Life, liberty, and the pursuit of happiness are God given rights. Diabetes doesn’t change that. Ideally it just comes along for the ride. Yes Kerri please try to control it but not to the point that it controls you, preventing the aforementioned pursuing.

Another of my heroes, John Cleese, had this to say about laughter, “If I can get you to laugh with me, you like me better, which makes you more open to my ideas. And if I can persuade you to laugh at the particular point I make, by laughing at it you acknowledge its truth.”

Kerri lets me laugh with her about the crazy ways diabetes gets tangled up in her pursuit. That is a spectacular gift. I am very grateful for happiness that gift brings my life. I am thrilled that she exercises her liberty to shares those laughs.

Thanks Kerri, keep persuading us.

LY/MI

January 26, 2009

Pink II

I got the pink meter. :) Delaney

Happy Happy Happy face.

January 24, 2009

Two Out of Three

YDMV regulars (including a bunch of hits from J&J IP addresses) know I have been very critical of Animas’ exManager. OK in point of fact I called it “Totally Unacceptable.” There was a new version released last summer. I finally took it for a quick test drive. In this first pass I was looking for three things that I feel are criteria.

1) Does it upload pump setting changes correctly?
2) Can I make adjustments to the pump settings without connecting to the pump?
3) Does the log book show basal rates satisfactorily?

Yes
Yes
Less wrong than before.

Feel free to stop reading now if you want - the rest is minutia with a few obscure jokes


I am happy to say you can edit pump settings without maintaining a connection to the pump through the dongle. I could create pump settings and save them to a file without the pump. Yeah!

It is a big time saver to connect and save the pump settings to pre-fill a file to start. That way I was editing not starting from scratch but I could do either. That is a big and way overdue improvement.

It was by no means intuitively obvious that I could start with a file from my computer. To open a file I had to act like I was configuring with a download. Specifically I clicked START on the Configure Insulin Pump Data screen right below where I told it what type of pump and what port to scan to find our pump.

Then I clicked Open in the upper right hand part of the next screen. It asked if I was sure I wanted to open a file. After I said Yes it lets me into open a file. A bit convoluted for someone like me who would think File Open but it got me there.

The manual says you get the setup features specific to the model pump you have. Sure enough I got different screens depending on the pump I picked in the drop down up there on the Configure Insulin Pump Data screen. (I had to go back and look.)

So this begs the question is there an import / export utility to move settings if we upgrade pump models, say a 1250 to a Ping? So far I haven’t found one.

I did find an import utility under tools. When I tried to import the file I saved previously it did a strange thing, well not so strange for exManager, it crashed. It said it imported the file successfully then said it was 93% done and took a dive. Nothing a three finger salute (ctl alt del) couldn’t fix. I can replicate the crash, so genius that I am, I am guessing that isn’t what that import menu option if for.

Anyway that is beyond the scope of my three questions test drive. Lets review: So far it lets me open a file without the pump connected. I could edit basal rates in that file. Next I managed to save and up load the file with new basal rates into my DD's pump. Two down of the three down with unexpectedly good results.

On to reports. We are going on a trip in the Wayback machine with Mr. Peabody to start. (Keeping in mind you have 5th amendment rights, anyone old enough to get the Mr. Peabody reference? Was it brilliant writing or what?)

Speaking of writing (but way less brilliant than Bill Scott,) in July '06 I wrote Animas a letter in part about the ezManager Log report. I said, “The 24 hour log in ezManager is a nice report. Unfortunately the basal insulin delivery on that report is at best misleading if not downright dangerous. As I understand it basal insulin is reported in totality for periods of time. Speciffically (sic – yeah I can't spell even with spell check, but the readers of YDMV already hold these truths to be self evident.) my understanding is the basal insulin for a few hours is totaled and reported in the last of those hours. So you have no basal for a while and a ton in one period. As it is the report is nicely designed but unfortunately unusable as it is reports information dead wrong.”

The good news it doesn’t aggregate basals anymore. The bad news is it still shows nothing if the basal doesn’t change in a give time period. See there is nothing at 3, 4, 6, 8, 9, 10, 11 or 12. WTF? Still BOGUS.

Here's my last observation. No help menu. F1 doesn't do a thing. Not particularly helpful. Nor is the manual.

So the program is better but still has short comings. I guess what will be interesting is what will they do for software when they have have a CGM product in the upcoming year? I hope it is all new. I am afraid it will be another substantially equivalent incremental upgrade.

Prestodigitation

Delaney has been using WaveSense Presto meters for a week or so. As mentioned in an earlier blog entry they have the huge advantage of color. Pink to be precise.

They also have a nice big easy to read screen that is kind of back lit. Big numbers are nice. Particularly in the middle of the night when my eyes are blurry and don’t focus. OK truth be told my eyes don’t focus worth a darn any time of day without reading glasses. But the Presto’s numbers nice and big (just this side of brail) and I can see them.

The meter also seems to be happy with a lot less actual blood. It does fine with little drops that would get an “err 5” from a One Touch.

So far so good.

I said “kind of back lit” because the light is on a timer. It isn’t long enough. About ten seconds after the strip goes in the light goes off. There isn’t a menu option to adjust the delay.

At night when we test - the kids sleep through it most of the time. What I have learned is that there is an order to doing the process. First I get the meter ready with a strip. Next I hold the finger in question in one hand while poking it with the other. I set down the poker and pick up the meter with strip ready to go.

Under no circumstances do I let go of the finger. ‘Cause while the kid is asleep the reflex actions are still going strong. And what is the reflex action to having a sharp needle stuck in the finger? Why to pull away of course. If your kids are like mine it is also to lick the stuck the finger. Parents back me up here am I right?

I also have to put the poky jamoky down on the bed side table with enough care that it doesn’t get away. It wants to. It wants to be under the bed with all the other escaped Poky Jamokies. I think pokies have a better escape committee than Steve McQueen in the Great Escape.

So if I don’t hold the finger with the drop of blood it is going to go away and I have to start all over again. So I NEVER let go of the stuck finger until the test is done.

Now the Presto meter takes a few second to run a test. The say “As fast as 1-2-3®**” Where the ** in real small print says, “** In some conditions test may take as long as 12 seconds.”

At least that is what I think it says - I only have 1.75 power reading glasses on. It is some serious fine print. For all I know it could say, “In some conditions you could be back asleep in 12 seconds.” What ever it says, in real use the meter is as fast, or faster, than any other meter I have used. Of course at 3:00 am I have little sense of how long a second is anyway. It is just a second I am not sleeping.

Where was I? Oh yeah - my point here is that however long the light stays on it isn’t enough time to poke, draw blood, hold the finger so it isn’t wiped off, licked or both, put down the poky where it wont tunnel away under the bed and take all the other testing supplies with it, pick up meter, line up strip and blood, test, wait “1-2-3**” and read the results without the back light going off.

So that is my not so big (even though I wrote an epic about it) gripe - the light doesn’t stay on long enough. Considering we were using One Touch Ultra Minis where there is no back light at all it isn’t the biggest deal in the world.

Oh and a belt loop on the case would be nice. The kids don’t us them but I do. I like the batman utility belt look.

January 22, 2009

Dietitian

We had a dietitian visit at our quarterly check up last week. We hadn’t been seen by a dietitian in 5 years, since Connors diagnosis.

It was kind of funny.

Connor had a rocking A1C, 6.4 nice work on his part. ‘Laney was up a little but with adolescence coming on, up a little wasn’t bad.

Anyway the dietitian was a nice young woman who had no clue what she was in for.

“So Connor you had a really good A1C how do you count carbs?” - Dietitian

“I don’t.” - Connor

“What?!” - Dietitian

“We aren’t one of those scale families. We have one someplace but we never use it.” - Mom

“Well after 5 years you just kinda know how much stuff is.” - Connor

“You really shouldn’t guess.” - Dietitian

“6.4” Connor

We then digress into a large conversation about the relative number of carbs in different types of cereal, totally ignoring the poor earnest young dietitian. Connor is basing his numbers on his serving size that is significantly larger than Delaney’s. Then we launch into a rant about frosted Mini Wheat being way harder to bolus for than say Lucky Charms.

“Do you have a Calorie King?” – The dietitian is trying to get back in the game.

“Yeah” - “Some place.” - “It was good for going out to eat.” – “Haven’t seen it in ages” – All of us all at once.

“I have a new one I can give you.” – The dietitian is going for bribery, Nice move.

“Cool.”

It’s a week later. I have no clue where it is.

From The News Wire: Nano-tetherball Biosensor Precisely Detects Glucose

Say that five times fast.

Researchers have created a precise biosensor for detecting blood glucose and potentially many other biological molecules by using hollow structures called single-wall carbon nanotubes anchored to gold-coated "nanocubes."

http://www.sciencedaily.com/releases/2009/01/090122110652.htm


This must be really early stage stuff 'cause I didn't see any mention of curing mice. It does sound all Buck Rogers Tech Cool. Enjoy.

January 21, 2009

Pink

Delaney is changing meters. It is about her choosing to have something different. I think that is more than enough.

She is now using WaveSense Presto meters at home. They came in the mail from forms we filled out at Friends for Life. WaveSense had way fun people and very cool light up flip flop necklaces at FFL.

There is a lot of technical gibberish that I could cover to say it is a good meter choice. Who cares about that stuff? She pokes her finger and it gives a number.

The Prestos came with colored meter pouches. She chose pink. That matters. In point of fact it is a whole lot easier to figure out which meter is hers and which is her brother’s if one is in a hot pink case.

Yeah we have a bunch of One Touch Mini’s and hers are pink. But you have to open the case to figure that out. With the One Touch, the color is all inside of a black case.

So what closed the deal for WaveSense was pink kit pouches and glowing flip flops.(She signed up for pink meters but somehow we didn't get any pink ones - so WaveSense if your out there send us pink ones!) I am fine with choosing based on trinkets. That makes the meter personal.

I wonder if any of the other meter companies get the idea that these are personal items for kids? I think most meters are designed by committees that look at charts and see metrics that there are a lot of type 2 adults. So they design for the numbers.

My dad and sister are part of those numbers of T2. Delaney uses more strips in a day than they combined use in a year.

Does what meter she uses matter? - Not much.

Does her making choices matter? - Tons.

So I’ll practice what matters, making choices, on stuff that can go either way, meters. She should make choices about her care. Choosing a different meter because she thinks it looks cool is as good a place to start as any. Most importantly she needs to see my support for her choices. Practice make perfect.

Tiger practices his swing. I'll look for way to practice being supportive of her choices.

She chose the meters that look cool. I'm all for it.

Pink is smart.

January 20, 2009

Why YDMV?

I am having a little winter writers slump.

A lot of things play into it but the bottom line is I am just not feeling the muse. It happened last year at about the same time of year. Maybe there is a seasonal YDMV disorder. YDMV suffers from too much holiday activity and too little motivation to write in December and January.

Part of the problem is trying to come to terms with what I want YDMV to be and to write from that voice. I struggle with the reality that there are lots of outstanding people writing about diabetes. Does the world really need more blogs? Amy, Bernard, TuDiabetes, CWD, a couple of Scotts, Kerri and other are all great.

I want my not-so-little-anymore girl to grow up to be Kerri. Not literally, obviously, but with all the zany joie de vivre that happens around her life with type 1.

You see while I live near type 1, I don't live in it. Diabetes is and will always be a concern but some day it is moving out of the house. Everyday I try to work towards it moving out but being independently managed, if not mastered, as part of a bigger life.

It isn’t mine.

I’m a parent of kids with type 1. That, I think, is a far different thing than being type 1. I need reminding of that regularly. That is what YDMV does for me. So that is YDMV’s voice. I will try to get it back.

As a parent I hope for a cure. I don’t expect it is coming fast. I will try to stay up with the news of work towards cures because it helps to fuel that hope and I'll share some of what I see and I'll laugh at all the cured mice stories. Happy mice.

As a parent I need to guide, coach and lead. Yet none of those have any meaning without trust and space. Diabetes is just one of many things along the way I need to give space on.

I think on the mind game side of things one of the worst possible things diabetes can do is give parents one more reason not to let their kids grow up. I can’t let type 1 diabetes be an excuse for not letting the kids grow into their own zany joie de vivre.

January 5, 2009

From The News Wire: Of Mice and Men

"Of Mice and Men" is going to be this year's tag line for the ubiquitous Type 1 stories that have great sounding headlines and have something like this in the text, "This advance in mice could pave the way for routine therapy for type 1 diabetes in humans."

"Don't Hold Your Breath" was the runner up to Of Mice and Men.

Today's example headline is: "Type 1 Diabetes: Pancreatic Cell Transplants Engineered To Evade Immune Response."

Don't get me wrong I think basic research is wonderful. It just the headline hype I don't like and that is probably more about editors looking for a catchy headline than the researchers making claims.

Enjoy.

January 2, 2009

y2k plus 9

So I just got off the phone with One Touch. Gotta give'm credit not only do the minis come in colors the meters are colorful in attitude too. One of our Minis decided that the new year was a good time for an error.

Not the gold old standby err 5, not enough blood, nope err 1. I had never heard of it and the documentation for these thing was tossed out three or four moves of the diabetes supply stash ago. (We keep thinking we have a better space for it all. There is no good space for it but hey that another story.)

So I called One Touch. They wrote the phone number on the back of the meter so I could easily call. Sadly it was so small that even with two sets of reading glasses I couldn't read it. But the stash contains many many boxes with their phone number so all was not lost. After a number of who are you and are you in our database kind of things they suggested taking the battery out and resetting it.

Doh!

Why didn't I think of that? I mean I use Windows for goodness sake. Rebooting is a time honored practice around here.

Anyway it was fine after the reboot. They said it was an issue with New Years. OK. More of an issue than anything I saw at Y2K but a reboot was easy enough.

So if you Mini says err 1 try a reboot. Sorry ctl-alt-del is not an option.