Thursday, September 30, 2010

Joined another club

   Without using a stainless steel cannula it was presumed inevitable.  No time was wasted in getting to it.

   We've been chasing highs for the last 36 hours (high teens - low 20s, 320-414).  Yesterday Jonathan seemed to have a slight fever (warmer than usual forehead) at lunch but was otherwise himself and wanted to stay at school, but when he got home his temperature was normal, as well as this morning.  The working theory yesterday was a bug.  Bobbie is still fighting something off and I just got rid of a sore throat and cough myself.

   This morning I got a call from Latchkey - BG: 28 (504).  He was completely non-symptomatic and very much himself.  I had them bolus and still give him his snack and headed over to get him.

   His next set change was supposed to be tomorrow evening.  Since there was no fever today and his numbers were still high we decided it could be a site issue.... Sure enough...

   A new set is in and he's going to test hourly for the rest of the day.  The remarkable thing is he was almost completely asymptomatic.  I now have another mindset change from MDI and another lesson learned.

Monday, September 27, 2010


   Oh!  And speaking of cool......

    The watch kinda took a backseat today, at least in the "new" and "cool" arena.  I know I kinda left that little cliffhanger at the end of the previous post...  I did that on purpose, because I knew something.  I pretty much knew it when we started Jonathan on the pump but it wasn't a sure thing until the middle of last week, and even then we didn't have it in out hot little hands.

   Well, now it's here.  Fresh through the Health Canada approval process and a brief stint with the Assisted Devices Program, Jonathan is one of the first people to get Medtronic's Veo.  Built upon the same platform as the Paradigm, it does all that his current pump can... and more.

   Where to start...  There are many subtle differences, like bolus in 0.025u increments up to 1, then 0.05 after that instead of 0.1 and basil in 0.025u/hr instead of 0.05.  Reworked set change menu for less button pushing.  On-board event capture to record BG, insulin, meal, exercise and other as opposed to getting into CareLink to enter it into the log book.  IOB is now on the status screen.  And there's probably a few other little goodies in there I have yet to come across.

   One of the things that helped us pick Jonathan's Weapon of Choice was the built in CGM system.  Despite the sensors being financially prohibitive for us to use them all the time, we can and likely will used them from time to time for any number of reasons...  Here's the biggie and the top new thing for Veo - Low Glucose Suspend (LGS).  It does what it says... When BGs meet specified criteria, insulin delivery will be automatically suspended for a period of time.

   We knew Medtronic's Pathway Program was there to move him up as new technology becomes available, and because we are within our 90-day trial period, we get a full ride to new.  Even if something bigger and better comes along in the next 5 years we can still choose to upgrade with a cost dependent on where we are in the cycle.

   There are two main things I want for Jonathan when it comes to Diabetes: 1) First and foremost, a cure.  2) Until a cure, the best possible management of his diabetes.  LGS is a step, and one side of a coin in an artificial pancreas.  The dicier side is the high glucose correction / automatic bolus.  Those two things, coupled with a dual hormone delivery system (glucagon) are the basis of a self contained support system and along with the integrated cannula / sensor would be no more intrusive than the current infusion set.

   My patience is really a hypocrisy.  As much as I want to get better and better management tools, I really want a cure.  I want a cure for Jonathan, I want a cure for all the kids that have recently been diagnosed, I want a cure for everyone with some years under their belt.  I want a cure for all the people that have been waiting decades.  I want a cure for the ones that are going to be diagnosed.  I want the CDEs, and the pharma reps, and everyone making a living off of diabetes to find their living somewhere else... and I want it NOW!!  But in the mean time, I want a safe and happy and healthy Jonathan who can grow and learn and reach his potential, and then go beyond it.

   To that end, next week, after the nurses at the clinic are trained on the Veo, Jonathan will have the latest and greatest available to him.  :)