Monday, September 27, 2010

Houston...We Have a Problem

Before I went to bed last night, I had to change my pump site. I didn't have enough insulin to make it through the night, and I knew it. I don't like to change my site before bed. Too many things can go wrong. So I changed the site at around 8:30. After that, I didn't eat anything, but I did a couple of small boluses. I was chasing a high from earlier in the day. Both boluses went through, no problems. Usually, if I have a "No Delivery" message, it happens when I giving a bolus. Actually, I've never NOT had it happen then. Since my boluses had gone through, no problems, I went to sleep with the comfort that all was okay.

Fast forward to 2:30 this morning.

My pump was buzzing. I usually don't hear the beeps (I'm a hard sleeper), so it wasn't much of a surprise that the vibrations were what it took to wake me up. I looked down and low and behold, there was a "No Delivery" message. And immediately I knew it was right. My mouth felt like cotton, my head hurt, I felt like I had walked across the desert and was in desperate need of a drink...and a trip to the bathroom.

I got up, turned on the light and began to gather my items for a site change. I didn't even bother checking for ketones when I went to the bathroom. A quick blood sugar test showed my blood sugar was 387. I knew I had ketones. Didn't need that little stick to tell me.

What bothered me, first off, was that there was no kink in my cannula. I took a picture to prove it.

The second thing that bothered me...well, I probably wouldn't have noticed it if it weren't for my CGMS. I noticed, on my screen, that I'd been VERY high for a long time. Several hours. Why hadn't I heard (or felt) my CGMS telling me that?

So, then I went on to check my Alarm History. It showed that the first "No Delivery" alert came at 11:46. Another at 1:28. And the last, the one I finally heard/felt at 2:24.

Onto my Sensor Alerts. It showed a high been at 11:10 (before the first "No Delivery") and then there wasn't another until 2:12. I'm confused. Why wasn't there one in between. That's two hours between them. My CGMS is set to alert every hour. Was it the fact that the "No Delivery" was probably up on my screen? Did that "trump" the other alerts? I'm confused.

I'm even more confused (and sad) at the way this new Revel pump alerts to nighttime lows and highs. During the day, I hear my beeps. There are no problems. I LOVE the fact that it give high and low predictions and that it notifies when you are quickly falling or rising. These were the main reasons that I upgraded to the Revel from my MiniMed 722. Knowing what's happening before I hit my high and low markers can help me a lot in keeping myself in range. I know that.
But, and this is a big but that has had me contemplating switching back to the 722, the alert system is not that great for when I'm asleep. And that's a MAJOR reason that I need those alerts. I'm an adult. Until recently, I was living alone. I need those alerts. On the old 722, if you didn't turn your beep off, it would wait a minute or so and beep again. After about 5 minutes of that, it would switch to the continual beep (without a break, so that it was more like a siren), and then, if you still didn't get it, it would start to vibrate. And continue to do so until you turned it off.
That saved my life a couple of times with lows. But, with the new Revel, the vibrations don't work that way. It vibrates for about 5 seconds and then stops and doesn't do it again for a while. I'm not sure how long. Maybe around 5 minutes.
That causes a major problem for people like me who need something to pull us out of a deep sleep. The constant vibration always woke me up. I'm usually laying on my pump (sadly), which is a major part of the reason I can't hear the beeps anyway. And if that constant vibrations isn't there....well you get what I got last night. Or worse. What if it'd been a low, instead of a high? I could have gone into a seizure or anything.
Or, what if I hadn't felt that last vibration at 2:30 this morning. What would another 3.5 hours of no insulin done to me? That would have been a total of 7 hours without insulin. As it was, I went 3 hours without insulin, and who knows how long before that without adequate insulin (before the "No Delivery" was triggered).
This morning, I did check my ketones when I got up. Only "trace," thank goodness. My blood sugar was sill 217. More boluses. More water to drink. More trips to the bathroom to make.
Yet I can't help but think about how this could have gone differently (better or worse). And both bother me. So, this is my message to Medtronic:
Fix this problem!

I love MiniMed too much to just walk away from it. Besides, how would I know if anything else was better without trying it first? The point is, I love MiniMed. And I know that this is just a choice they made when designing the new Revel. But I'm telling them it was the WRONG choice. And they need to figure out a way to fix it. Because someone's life could be hanging in the balance.


Vivian said...

I agree. I miss the annoying alarm that does not give up. Daniel is a hard sleeper too. His alarms, thankfully, wake Sarah who is across the hall, but not him.
So glad you are ok. Big hugs.

Keith said...

Sorry you're having trouble w/this Cara. I too am a big fan of Minimed. My pump woke me up at 5:30 this morning, vibrating w/an 'Empty Reservoir' on the display. I would have gotten up in a few minutes anyway, but it sure is good to get those messages.

Maybe if you contact your Medtronic rep he/she might have some suggestions, or at least make sure the home office gets the message.

meanderings said...

No suggestions.
Just glad you awoke and you're ok.

HVS said...

Sorry for your rough night. I hope Medtronic gets the message & implements those options into their next pump. I rely on the vibrations of my Dexcom to wake me up,so I can understand the frustrations of something not doing that, its very necessary for some of us.(life and death necessary) Hope you feel better soon.

Lili said...

The biggest issue I noticed with the Medtronic alarms is they're pitched wrong -people over 30 can't really hear them.

I'm one of those weirdos who can still hear the mosquito ringtone the kids use. My roommate got a new 722 and turned the alarms on. He'd be upstairs, in his room, with the door shut, wearing the pump. I could hear the alarm, but he couldn't. They need to test these things.

Cara said...

Lili- you are VERY right. I have some hearing issues anyway, I think. The iPod touch has a thing that does the weird rings and the first one I can hear is the one for the 40 yr olds (Ekk!!! I'm not that old!). There are times my roommate hears me beeping before I hear me. Even in waking hours.

FatCatAnna said...

When I had the MM 522 and the CGMS - the alarms were SOOOO annoying - but like you say - they notified us that something was wrong. Like you say, voice you opinion to MM - if they don't hear from the people like us who require their products to work for them - then they'll never tweak their products perform for us.
Strange, I used to get a few NO DELIVERIES with my MM 522 - but since switching over to Animas (2020) - never had that problem since.
Keep drinking fluids / monitoring BG's / and if you have to - bolus via MDI method.