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24 – MiniMed 530G Edition

After I left training for my new pump, I was back on my own and back to the pumping life.  As soon as I got in the car it felt so different again having that pump in my pocket and having to buckle my seatbelt without pinching the tubing while doing so.  I haven’t had to do this in almost a year.

Once I drove home, it was approaching dinner time and I knew that I was going to be cooking chicken breasts with steamed green beans.  As I set the steamer, which takes about 25-30 minutes, the alerts started.  One set of vibrates, then another set of vibrates, and then again and again.  There were several “Low Predicted” alerts that started going off.  I loved the fact that this alert was going off because when I am cooking, I am usually sweating and concentrating on cooking the food and not paying so much attention to the quickly dropping blood sugar.  I took some time to test after a few of the alerts and the meter test confirmed that I was not just going low, but was in that low state.  Little cup of juice while I waited for dinner to finish was all I needed.

 

Later that night was #DSMA and I finally had some free time to participate for the first time in a really long time and I loved the topic of getting to know you. I always want to know more about people other than just the fact that they have diabetes, it’s not the only thing about you, so it would be nice to know more.

Several times during DSMA, I did receive a No Delivery when trying to deliver a few correction boluses.  I was in the middle of things, so I just re-tried the bolus thinking maybe it was just a hiccup.  Received the message again, so then I did a rewind and tube priming, still received the No Delivery.  Since that didn’t work, I figured that maybe it was the tubing, so I grabbed another tubing and primed that one as well, same result, No Delivery.  I kind of figured that it was a bad site, but before I just change out the site, I try to troubleshoot it with other options other than losing an infusion set.

Unfortunately, it was a bad site and when I pulled it out, there was blood.  There wasn’t a lot because I was prepared for blood to come out and put pressure on right away.  After that, it was delivering perfectly fine and my blood sugar began to come back down to normal.

In fact, it started to come down too much come morning time.  I woke up around 6 a.m. and I saw that the CGM was reading 72, and I had the threshold suspend set at 70.  That meant, that it was going to go off soon and I hadn’t really explained the really loud noise of the Threshold suspend to Amanda yet, so she was going to get freaked out.  In order to avoid this, I changed the settings to 60 instead of 70.  I then tested with a meter and the CGM read 72, and the meter was 105.  I was not very happy with that large difference in reading.  I know they will never be the same, and we are to look at the trends of the CGM and not the number, but my BG was actually rising at the time, not falling.

Once again, little OJ and we were good to go.

It was now my first day working again wearing the pump and CGM full time, so I was obsessively checking my BG (I tend to do that the day of and after an endo appt!)

There were not many alerts throughout the day.  A few highs, a few low predicted, and one that made me happy because the meter check re-assured me that the CGM was doing it’s job.

For dinner, I was really going to put the pump and infusion set site to the test with a meal at Pei Wei, which is about 200g carb in just one plate.  This was going to be close to about 2 max boluses.  I took a max bolus and then 10 minutes later did a max square bolus with 65% now and 35% 30 minutes later.  It worked….a little.  There was a high blood sugar later, but nothing the pump could have done any better.

All in all, the first day with the 530G was not bad.  It will take a while for me to work out my basal rates again, but I will get there.  Wednesday night will be a full week with the system, so I’ll be doing a weekly CareLink report as well.

Medtronic MiniMed 530G with Enlite Training Recap

As you may have read recently, I am starting a 90 day trial of the Medtronic 530G.  If you didn’t read it here, and you follow me on Twitter, I’m sure you have seen a large amount of tweets.  Tweeting is somewhat of a note taking service for me.  If I tweet it, then I can look back and remember a question I had or something that I wanted to write about.  This post is about the training session that I had with the local pump trainer for Medtronic.

MiniMed 530G Pump Training

Leading up to this trial, I had used a Medtronic pump for about 8-9 years of my 10 years with diabetes. I have been on MDI (other than a 4-6 week trial of SNAP pump) since June of 2013.  Since I have been on the pump for so long, I am very comfortable with using a pump and troubleshooting the pump.  Inserting infusion sets, filling reservoirs, changing out a battery, etc.  I can do these things in my sleep, no literally, I’ve done all of these while half asleep at 4 a.m., stopped at a red light, at sports arenas, and more.

With all of that real life experience, I tend to think, seriously, do I really need a training session?

The answer, yes.

Too many times, with anything in life, we get into the habit of doing things and they may not be the right way of doing it.  There’s the “by the label” way and then the “real life” way of doing things, and getting a refresher course on the “by the label” way is always great.  Not too mention when you have one of the most knowledgeable and passionate pump trainers around.

And I have both of those characteristics in mine.

Before showing up to the training, I read through the materials that were sent to me along with the pump and CGM.  These training materials brought back my memories from 9 years ago when I was scared to go on the pump and the talk of basal and bolus confused me. Now, it seems like second nature.  Also, the box the pump came in was awesome. It was white like a brand new Apple product, and if you know me, that’s a huge plus in my book.

The reading materials and workbooks are great.  They basically provide a bit of reading and then a few questions right after that and then on to the next lesson.

I did read the CGM training materials a bit more than the pump because I wanted to have as much knowledge as possible before entering the training, so that I could prepare for questions.  I recommend that before going to any training, or meeting or anything, do a review first and create a list of questions.  These questions may be answered naturally during the training, but some may not be.

Setting Up the Pump

Before we set the pump up there was an introduction time period where the trainer wanted to learn more about me, my diabetes and how I typically manage specific situations.  This means a lot to me because as we know, Your Diabetes May Vary, so getting to know me and my unique situation and training based on that is important.

I had already set the basal rates, patterns, bolus wizard information and set up all the alerts that I needed before I came to the training so these settings were just checked by the trainer.

After discussing the different basal patterns that can be set up (which I have a standard and Pattern A set up) it was time to get into the CGM training part.

530G CGM Enlite Sensor Training

This to me was going to be the most important part of the training.  I previously used the Medtronic Sof-Sensor about 5 years ago and I absolutely hated it.  I didn’t like anything from the pain of insertion to the inaccuracy of the sensor.  I knew of new technology used and that the insertion method was supposed to be a lot better than the older version.  Before we inserted anything, we went through the CGM workbook and went through some math examples.  Instead of just always relying on the pump to do calculations, we need to know how to do these calculations of what it means when there is one arrow pointing down, or two arrows pointing down and know what these trends mean.

medtronic-530g-enliteWe then discussed the Low / High Prediction alerts that will alert you when the sensor is predicting a low within a certain time period that you set up.  I have mine set up for 20 minutes. So this means that if the sensor trends feel that your BG will reach your selected low point within 20 minutes, it will alert you before it’s too late.  I really like this feature because I sometimes don’t react to seeing double down arrows, so the predictive alert at least gives me a heads up to test and see if I need to correct.

The next discussion was then based on the Threshold Suspend feature that may automatically shutdown your basal rates once you hit a specified low point (60 for me).  This is great for those lows in the middle of the night, because from when I heard the alert, there’s no way that I can miss it.  I will go into more details on the threshold suspend in a later post.

Next, it was time to insert infusion set and sensor.

Inserting the Enlite Sensor

I filled my reservoir and inserted the infusion set first, not much to discuss here, I’ve done this thousands of times in the past.  I will say though that “my way” of inserting the infusion set is a lot easier and comfortable for me to do then the “by the label” way, but there’s not much of a difference, it gets inserted either way.

The Enlite sensor insertion device is great.  It is not intimidating like the old Medtronic Machete on the Sof-Sensor.  There is a “double-press” rule that is used for the insertion.  Basically, once the sensor is loaded, you “punch” the button to insert the device and hold down for about 5 seconds to make sure it sticks and that you applied enough pressure.  Then you press the button again and hold it in while you pull the insertion device away and bam, it’s inserted.  Pulling out the tiny needle is easier than pulling out the Dex needle in my opinion.

medtronic-transmitter-packaging

 

The tricky part is the tape that is required to be put over the sensor before the transmitter is attached.  The training book provides great  visual aids on how the tape is supposed to look and how it’s not supposed to look so this was very helpful.  The trainer told me about an area that I’ve personally never used before that she had great feedback on.  It is at the top part of my abdomen under my chest.  She also said that her feedback has told here that the transmitter being up and down as opposed to side to side was a lot better.  I figured I would give this new spot and side to side a chance.

That was it, I was now all connected to devices and just need to hit the start sensor button on the pump. Inserting was a breeze.  Applying the tape was a little difficult the first time because of the location and staring down at it, my depth perception was a bit off.  She only had to make a slight adjustment on the tape placement.  Connecting the transmitter than was pretty easy.

After I was connected, we just went through a few troubleshooting scenarios and practical situation examples and what would I do if “this” occurred.

It was then time to leave the office and head home and get started on my first day with the 530G.

I will be writing, in detail, about the first day.  After that, I will be writing about random thoughts about the pump, how I feel about certain features (alerts, accuracy, comfort, ease of use, etc.)

Please read my disclosure.

Medtronic 530G Trial Beginning – Disclosure

Tomorrow is my training in order to start using the Medtronic 530G.  I have been reading through the training documents and it has been bringing me back almost 9 years ago when I first started on the Medtronic pump.  At that time I was very nervous and didn’t understand how an insulin pump really worked and was scared for my training.  Preparing for this training is a lot different.  I have a lot of confidence in my knowledge of the pump and feel that I could do a good job training and helping others use their pumps.

However, I want to treat this as if I’ve never used a pump before and try and learn things that maybe I’ve never utilized before.

With that being said, I must fully disclose my relationship with Medtronic.  Back in January I was invited to the Medtronic Diabetes Advocate Forum. Medtronic paid for my airfare, hotel, meals and any additional expenses during the trip. Shortly after the trip, I was given the opportunity to wear the 530G for a 90 day trial. During this time, Medtronic will provide the necessary supplies (pump, CGM, infusion sets, reservoirs, strips, sensors, etc.). In return, I will provide Medtronic with my honest opinion of the 530G system, as well as the training materials and the StartRight program. There is no monetary compensation for the trial or my review of the product.  All opinions expressed will be mine and mine only.

Please check out the disclosure page for full disclosure of the site.