Thought for the Day

Tuesday, February 22, 2011

Wearing the D Gear

What seems like many years ago I read about Bill King running marathons with a glucose meter strapped on his wrist. I tried a few ways to do that myself, but it seemed like more hassle than it was worth. It's really not easy to insert a strip, get a drop of blood, and touch it to the strip, all pretty much using one hand. It's more convenient to carry the meter elsewhere, like a SPIbelt, and take it out when you need it.
But at Ironman Arizona in 2009, I saw Bill Carlson with a Dexcom receiver in a plastic bag duct-taped to his forearm. That looked convenient, but painful to remove. Bill had his current blood sugar trend at the touch of a button, right there like a wrist watch.
So I've given some thought, and done some experiments, in that direction.
My first thoughts went toward sleeve-like things, cheap garments from a thrift store, cut-off tube socks or sleeves with some modification to hold the Dexcom.
I had this idea that all I really needed to do was to wrap the Dexcom in plastic wrap. Then I thought, well, just wrap it all the way around my arm. It's actually difficult to wrap my arm and the Dexcom together that way, though, and it would become a sweaty mess very quickly.
I had used stretch bandage that comes in rolls, one brand is called Co-Band, to attach some things to my bike before. It's the stuff they wrap your elbow in when you give blood. It seemed like this might work for this purpose also.
So here's something that seemed to work, the Dexcom receiver wrapped in plastic wrap with lots of plastic hanging off the ends, then the ends wrapped onto my arm using stretch bandage material.


This seems to hang on well enough while biking. I haven't tried it on a run yet. I'll probably go back to the sleeve idea, since it would save a lot of time in the swim to bike transition to have something I could just pull on, instead of wrapping my arm. I can't see fitting my wetsuit over this, even if I wanted to.

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Friday, February 18, 2011

Things I should have posted about

As a race, the Carlsbad Marathon on January 23rd went as well as I could expect. That means awful. But it was still a great experience. It was a huge Glucomotive event, and my brother Jon was also there to enjoy the festivities and support the race.
I had close to zero training, so I figured I had to be conservative. I thought 4:30 would be a remotely possible time goal, so I aimed for 10 minute miles.
I saw Gary Schmidt and Emily Iannello at the start and ran with them for a bit. I also met Ed Ettinghausen, who is going for the world record for marathons in one year.
He isn't keeping his stats up to date, but you can get an idea of what Ed's doing by looking at his stats on the Marathon Maniacs site.
Anyway, I ran OK to about 17 miles. It was clear well before that that I wasn't going to last, but at a big steep hill along the beach, at the last turnaround, I really came apart.
I slowed way down for about a mile. Realizing I was just trudging along, I started walking. Several times I tried to start running again, and it just seemed too hard. Then at about 20 miles, right before the marathon course hooked back up with the half course, I started running again and felt fine. At least fine enough to just jog through it.
I ran for a couple of miles, then came across some Glucomotive folks doing the half, Jim Collins and Ashley Ernst, who was one of the "Heroes of the Marathon", and Ashley's friend. I have to apologize for not remembering her name.
Jim was having cramp problems, so they were all helping each other along, walking and jogging as possible.
With a little over 3 miles to go, we got to the Glucomotive group of volunteers, where my brother Jon was with his girlfriend, Gina.
I asked them if they wanted to walk to the finish with me, and they did.
So I walked it off.
I had about a 20 mile run, and a lot of walking on the day. It was not a good race, but as I said, it was a great day.

In general, my new Animas Ping insulin pump is working great. I swim with it frequently. I just stick it in the side of my suit with the clip sticking out and the pump against my skin.
There are some little annoyances, but the same could be said for Medtronic pump I was using before. I wish I could take the good points from each and put them together. It all seems like common sense to me, the things I don't like, but I'm sure there are some patents that are keeping it from being as good as it could be.
For example, the Animas pump will calculate the bolus for me, then just display it. It's then up to me to enter how much I want to bolus. There's no way to just say, "Give me what you just calculated that I need, you stupid machine."
Then entering an amount to bolus is ridiculous. You can click up or down 0.05 units per button press, or you can hold down the button and it will start to roll by increasing amounts. You know how this goes. It's a similar to the Medtronic pumps. It's actually a pretty common interface, for setting digital clocks, thermostats, etc.
With Medtronic, it's easier to get used to. Animas is fricking crazy. It seems to go 0.05, 0.10, 0.15, 0.50, 1,5, 3.5, 5, 8, ... not moving at all, then moving way way too fast. And the kicker is it doesn't stop when you take your finger off the button, so if you take your finger off at 5, it will probably stop at 6.5. Entering carbs is about the same.
So you either click up one step at a time or go way over then back down too far, then over, then under, getting closer and closer to what you want to enter. It's terrible. And I can't believe they could have failed to see this in usability testing.
Maybe I'll get used to it, but if I do, it will take a while, and I will be getting used to something that's more difficult than it has to be.
Changing the reservoir is harder on the Animas, but inserting an infusion site is easier. The Animas pump times out frequently, rapidly, while changing the reservoir. And when it times out, it goes back to the Home screen, so you have to click back into the Prime/Rewind screen. Crazy and annoying.
The woman who trained me on the Animas said that I'll eventually be able to change the reservoir and an infusion site without it timing out. After changing everything out several times, I doubt it. It would take the kind of skill required of Marines who can disassemble and reassemble an M16 blindfolded in 60 seconds.
The only way I've been able to get close, and still not avoid a time out, is to put in the new site and fill up a new reservoir, having everything ready before rewinding. It's not user friendly. It's unfriendly.
Still, I'm getting comfortable with the new pump, and as I said, it's great for swimming.

The Dexcom CGM is just incredible. I know my A1c is going to be down at my next checkup. I can't help it. Being able to see what is going on with my blood sugar all the time means I am fixing problems I wasn't even aware of before.


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