Choosing An Insulin Pump.

It's that magical time of every-four-years-or-so where we insulin pump folks are allowed to select which small hunk of plastic, metal and science will help us manage our diabetes for the next few years. My Animas warranty runs out at the end of December, which means that our insurance plan is probably, possibly willing to cover some yet-to-be-learned percentage of the cost of a new insulin pump (assuming the paperwork gets processed before the end of the year).

The freedom! The choices! The intense pressure to choose wisely!

I've been pretty happy with my Animas Ping over the past few years. (I mean, I drew it into my blog header - I must be fond of it, right?) I've had very few technical issues with it, Animas' customer service has always been a pleasure to work with, the pump is waterproof, and frankly, I'm just used to it. It's familiar and comfortable. And who knows, maybe the Vibe will be granted the a-okay from FDA soon, and I'd be able to upgrade for (what I hope would be) a small fee. The Ping feels... safe.

But what about new hotness?

There's Medtronic's low glucose suspend pump and CGM combo, the 530g with Enlite. There's Omnipod (I've never worn one!), and there's that snazzy touchscreen (ooooh, shiny) pump from Tandem, the t:slim.There's also Accu-check's Combo pump and Asante's Snap. (Aw, snap!)

Six choices! SIX!

How will I decide? Which features are most important, this go-round? (I think all of these pumps are "good", and which one you choose really just depends on what features are important to you and fit the way you live/play. I don't think there's a "bad pump", just maybe a bad fit for an individual.) I think I can eliminate the Omnipod, because I appreciate tubed pumps (as I can move it around to accomadate different outfits during the time that infusion set is in).

Okay, how about Medtronic? The LGS pump could be nice during nighttime low excursions. But... it's not integrated with the Dexcom CGM I love so much, so getting the full benefit out of that system would require me to abandon my Dexcom.

Ah, now the t:slim! I trialed this pump for a couple of days during FFL 2012, and I liked what I could test of it. Touchscreen = cool. Bigger reservoir = cool. More intuitive functionality = cool. But it's a whole new company and device, and it feels like it would be a pretty big transition for me. Am I ready for that?

Then there's the Asante Snap. I don't know much about it, or the company that makes it, but I know that Scott liked it, and I totally trust him, so maybe that's good enough for me. Besides, it looks super easy (a snap, ha ha haaaaaaa) to use.

And the Combo pump from Accu-chek: again, haven't seen it in person, but I know someone that's worn it and liked it. I'm just not sure it's for me.

Which circles me back to Animas. While the features of my pump wouldn't change, I'd at least be able to order a different color.... but I'd be sticking with the same technology I've had for the past four years.

I've got some things to ponder.

Update: I tried to sign up for the Snap's four-week trial, and was told (by way of automated reply) that this pump is not yet available in my area.

Update to the update: Even though our insurance plan tells me that they will cover any pump except Tandem's and Asante's, there may be ways to work through this. I'll update when I know something!

Update, v3.0: You can find the rest of this story here, here, and here.

Diabetes Won't Stop Me.

Whether you're a kid or an adult, type 1 or type 2, diagnosed recently or decades ago, MDI or insulin pump, diet and exercise or insulin therapy... I think one of the things we can all come together around is the idea that diabetes doesn't have to stop us from living the lives we want to live.

You can call it resilience... hope... optimism... stubbornness... whatever it is, it's a part of us that fights against the idea that living with a chronic disease limits us. And it can be comforting - even inspiring - to see others are "just like us" succeed and struggle and face the same things we do.

"Me too!" is a powerful emotion, no?

It's with that mindset that I'm announcing this: You Can Do This Project and Jerry the Bear are partnering to launch a new video campaign called "Diabetes Won't Stop Me". And we want you to join in!

The idea came about after watching the video below:



... and realizing how inspiring it would be to see dozens - hundreds! - of short videos from all sorts of people in the diabetes community, just like this! We want you to share why "Diabetes Won't Stop Me".

So here's what we're asking:

• Make a short (less than 30 seconds!) video telling and showing us about your biggest dreams and goals - or if you've already accomplished some, share what you did!

• Starting on November 14th (yep, World Diabetes Day!), upload your video to somewhere like YouTube, Vimeo, Instagram or Vine. 

• Here's the important part - be sure to tag your video post with #DWontStopMe, so we can find it! You can also use the submit form on the You Can Do This site, if that's your jam. Every video (or photo, if you're video-shy) we find will be featured on youcandothisproject.com, as well as Jerry the Bear's Facebook page.

I can't wait to see what you share!

Letting The Dust Settle.

I once heard someone note that when you have a baby, "your life just kind of explodes". I'd like to add to that thought and remark that when you have a baby AND you have diabetes, your life just kind of explodes but then all of those fragments proceed to land on their self-destruct buttons. Life post-baby seems to resemble some sort of Michael Bay-directed cinematic adventure (with the addition of an adorable infant).

The total takeover of mind, energy and heart that a child brings has been... intense. But after a few months, I'm feeling that we're adjusting okay to this new version of normal. Our mornings look a little different, and not just because we're up waaaay earlier now - there exists a whole new set of activities that run in tandem with ours in order to get another human ready for the day. But I'm finding that I don't even mind all that, because that first grin of the morning - the one where the dimple in her right cheek surfaces; where her eyes widen, then light up with recognition when we lock stares; where she kicks her legs jubilantly and, with clenched fists, swings her chubby arms around - sets the tone for everything else. No matter what else may happen throughout the day, this daily treat remains the highlight. The joy in that moment fills up my heart, and I continue to be astounded at how this perfect little person could have been made by me.

Sorry, I'm baby gushing. I do that now.

While I may be adjusting to the shift in schedules and priorities, my relationship with my health has become more tumultuous. Diabetes is running alongside me like the child, arms flailing with panic, whose school bus drove right by them but never slowed down: "Hey! HEY!!! Stop the bus! You forgot me!!" I see you, diabetes - I just don't have the time to come to a complete stop for you. Don't throw yourself in front of me, okay? And no angry calls from your parents.

Where I once might have seen patterns and predictability, I now just see a jumbled mess... but maybe it's not as bad as I think it is, because I'm comparing it to the super-intensive routine I had during pregnancy. I saw my endocrinologist a few weeks back and after studying my CGM and insulin pump downloads for a bit, the corners of her mouth began to turn up.

"You know...." she paused, shuffling papers twice, and then three times, looking back to double (and triple) check herself, still smirking. "I'm actually really happy with where you're at." The tone of her voice indicated that even she couldn't believe she was saying that.

Pause. "I'm sorry... you're what?"

Laughter. "I mean, with most new moms, the baby comes and diabetes goes out the window. But I can see that you're still testing. And you're bolusing! I mean you're not entering carbs most of the time, but you're remembering to take insulin... at all. I can be happy with that if you are."

Well, that was true. And when we checked my A1C, she and I were both pleasantly surprised when I clocked in at 6.5.

"If you're okay with it, I really don't think we should make any changes yet. Let's let the dust settle a bit more before we start changing things - you already have enough to adjust to right now."

I'm okay with it.

I think.

Wordless Wednesday: The Tradition Continues.

(Okay; it's not Wordless: the "tradition" revolves around the onesie Rabbit is wearing,
which originated with Gina Capone and her handsome little man. She sent it to me,
and now I'll send it to another DOC mom for her little one.)

Speaking of You Can Do This Project: I'm going to have a pretty exciting collaboration to share with you later this month, but in the meantime, did you know we're going to be at TCOYD Omaha this Saturday?

Pregnancy And Type 1 Diabetes.

One of the most excerrifying (that's being excited and terrified at the same time, if you're unfamiliar) times of my life was being pregnant with my daughter. As a woman who has lived with type 1 diabetes since the dawn of time she was six years old, I'm familiar with the notion that pregnancies with pre-existing diabetes are complicated. Even when you're managing your diabetes perfectly well thankyouverymuch, pregnancy puts us in the "high risk" category and everyone freaks the heck out.

While it's true that balancing pregnancy and pre-existing T1D is a major challenge, what I wish someone would have told me way back when is that not only is it possible for someone like me to create a brand new human being who is totally healthy - there are perks to being pregnant and diabetic!

In that spirit, I'd like to balance out all of the "aaaaaah everything will go wrong!" with a little of what will go right.

In Search.

"So how are you feeling?"

There are many ways I might answer that question, and most times I never quite know which version I'm being asked. Are you asking how I'm feeling after having major abdominal surgery? Are you asking if I'm getting enough sleep? Perhaps you're trying to, as lightly and vaguely as possible, ask if I'm experiencing some baby blues. You may be wondering if I'm finding ways to juggle both motherhood and diabetes management, or if I'm finding ways for Old Kim and Mommy Kim to co-exist*.

Ahhh, there it is. Balance.

It's something I'm working on finding again, with more success in some areas than others.

*Much better now; lately yes, as Rabbit is sleeping 5-7 hours at a time during the night (yay!); nothing of note yet; most days have me thinking WTAF** while looking at my CGM trends, especially overnights; the new sewing box is an indication that I might just be.

**The "a" stands for "actual".

Discoveries.

With a month of momhood under my belt now, I'm noticing a few things:

• If you're going to snuggle a baby against you, probably go ahead and get your insulin pump out of your bra (who wants to snuggle against hard plastic/metal - no one).
• If you're going to take it one step further and snuggle that baby with the use of a wrap, definitely get that insulin pump out of your bra because now you can't bolus without beeps and/or buzzes letting loose right next to their teeny, tiny, sleeping self.
• Trying to figure out where my basal rates (or really, anything) should be at post-pregnancy is really hard. My body is still healing and readjusting to the baby being outside so simply going back to pre-pregnancy settings on my pump doesn't quite cut it. My CGM graphs are resembling [insert name of well-known roller coaster here]. 

• How does anyone get anything done when there is a baby around? I'm lucky if I get to shower before 3:00 pm now, much less appear (clean, dressed, and coherent) at work on time. I have around 6 weeks left in my maternity leave and I have no idea how to go back to real life, or how to get into pants that don't stretch, or what "well-rested" feels like.
• It's really, really hard to have to momentarily ignore my daughter's cries because I have to handle a low blood sugar. There's no way for me to communicate to her yet that while I know she needs me and more than anything I want to pick her up and take care of her, for her safety it's not a good idea right then. It upsets me every time it happens.
• Also really hard? Dealing with a very fussy baby with a blood sugar of 376 at four in the morning without letting myself get cranky about it.
• And lastly, I'm digging this tote from Tallygear (disclosure: I received this tote for free and while I am not required to write about or mention it, I like it, so I am), as a convenient way to carry my CGM, phone, a tube of GlucoLift and some lipbalm while taking a stroll with the Rabbit. The viewing window in the front of the pouch means I don't need to dig it out each time I want to see my CGM screen - super thoughtful! Getting out into the world - and the fresh air and sunshine - for a little bit each day helps to curb the cabin fever 'round here.