The Day the Lights Went Out

Thursday morning, my blood sugar was running low and I put off getting my shower until about 11 so I didn’t drop low in the shower.  I was only in the shower for a couple minutes when all of a sudden, the lights went out.  About the same time that the lights went out, I heard what sounded like something getting knocked over.  All I could think about was the shower scene from Psycho! 

Because my balance is so bad from the neuropathy, I use a shower chair.  I sat there for a minute before I turned the water off and pulled the shower curtain back.  Everything was quiet.  My dog wasn’t growling at anything so I figured the noise was just a fluke.

I got dressed and went downstairs to call the power company.  Since it was daylight, it was hard to tell if I was the only person with power problems.  Right after I moved in here, the main breaker went and I was the only person with a problem so I know that happens.  I picked up the phone and no dial tone – I have the phone service from the cable company.  Even though the modem is powered by electricity, it has a battery backup and the phone will work for awhile if the power goes out.  I got my cell phone and called the number to report a power outage.  I no sooner hung up and the lights came back on.  The lights were on, but no cable. 

I went back upstairs to dry my hair – at least I could do that.  I wasn’t too concerned about not having cable.  I don’t watch TV during the day and I had a cell phone if I needed to make a call.  I had things I wanted to do anyway so not having internet would keep me away from the computer for the afternoon. 

I came downstairs and it was about noon so I thought I may as well get some lunch.  I took my insulin for lunch and went in the kitchen to start getting lunch ready. I reset the clock on the microwave and put some water in to make tea.  My dog didn’t want to eat breakfast that morning and I had put his bowl in the fridge.  I thought I would see if he wanted to eat so got that out.  I was sitting in the kitchen with him because my cat likes to try and steal his food – I guess dog food tastes better than cat food.  Next thing I know, the lights go out again. 

I usually cook up hamburgers and freeze them then microwave one for lunch.  I had that sitting on the counter waiting for my water to heat up.  I decided to cancel my TAG extended bolus for the protein and fat in the burger since I didn’t know how long the power would be out.  The only thing I had bloused for with the regular bolus that I couldn’t heat up was a slice of cheese.  I should be safe for the regular bolus.  I went ahead and got the part of my lunch that did not require electricity.

After I ate, I thought I would call the power company again.  This time, there was a message that the power should be back on about 2.  That wasn’t too bad.

Since there wasn’t much I could do without electricity, I thought I would sit down and read for awhile.  That proved harder than what it should be because it kept getting darker and it was getting hard to see.  I was starting to get hungry.  I wanted to wait until I could heat up my hamburger but at the same time, I don’t like eating meat too late in the day with gastroparesis.  Besides being hungry, I was getting cold.  It was about 37 degrees out and starting to get a little on the cold side inside.  It was after 2.

Then I looked at my Dexcom and saw the one bar left on the battery icon.  Crap!  I remembered I was going to plug it in when I first got up, but since my blood sugar had been running low, I decided to wait.  Lesson learned:  when your Dexcom battery needs charged, do it because you might not be able to later!  My graph did not look too bad for a messed up lunch.  Maybe I should quit eating hamburger.  I figured I would take a picture since I needed to do something for entertainment. 

Finally about 2:30, the lights came on – I had left several lights on so I would know when the power came back on.  I walked over and saw that all the lights on the modem box were now flashing so my cable was back also. 

I never did hear what caused the outage – I am guessing someone hit something that caused both cable and electricity to go out.  Although I did not have a very productive day, it did give me one more thing to write about.  Day 20 of NaBloPoMo and only 10 more to go!

Animas Ping Combo Bolus Feature

I thought I would share this here just in case anyone else was told something wrong during their training.  It is not exactly that was I told was wrong, it is just that there is an easier way to do something!

I have been playing around with using the combo bolus feature (extended bolus for you non-Animas users).  Getting interested in the TAGgers group (see my post on Total Available Glucose) has me playing with the combo bolus feature more than I had been. 

If you select “Combo Bolus” on the bolus menu of the Ping, you enter the number of units, the duration you want those units and the percent that you want extended.  When I had my training, I was told to first go to “ezCarb” on the bolus menu and enter the amount of carbs I planned to eat, and then click “show result” to find out the amount of insulin calculated for those carbs.  What I was told to do next was cancel out of the “ezCarb” section and then to go to “Combo Bolus” to enter the insulin, time and ratio that I wanted.  I thought that seemed kind of stupid to have all these automatic calculations for me on the pump and then I have to calculate on one screen and then remember the calculation to enter on another screen.

I have been trying to use TAG and have been playing with using the combo bolus.  The other day, I selected the ezCarb menu to calculate the units of insulin I needed.  I went to move the cursor down to the bottom of the screen to cancel out before going to the combo bolus.  I did not realize that the cursor landed on the line that says “Type Normal.,” and more specifically, the cursor landed on “Normal.”   I accidentally clicked on “Normal”, and that “Normal” changed to “Combo.”  When you change “Normal” to “Combo” by using the up arrow, you then go to the line above where it says “Go” and that will take you to the “Combo Bolus” menu with the recommended units of insulin for the amount of carbs you are going to eat.  You can change the units there if you want and also your time and ratios, then select go to get your combo bolus!

 

The trainer I went to was at a diabetes center near here and trained on different pumps besides Animas.  I understand they can’t necessarily know every single feature on the different pumps that they train on.  Also, the training is meant to be a start and not necessarily some in-depth training about everything on your pump.  But if you are going to touch on the Combo Bolus feature, you should at least know how it works!   I just wanted to post this just in case someone else was told the same thing as me.  And sometimes if you think there should be an easier way to do something, there might be!

Total Available Glucose (TAG)

Total Available Glucose. or TAG – I first read about TAG on TuDiabetes.  Danny on TuDiabetes started a group for TAGgers, that you can check out at the link below and read more about it there.

http://www.tudiabetes.org/group/tagers

The idea behind TAG is that besides bolusing for your carbs, you also bolus a percentage for the fat and protein that you consume and then spread that bolus out using the dual wave or extended bolus (or combo on Animas pumps) feature on your pump.  There are some people doing MDI that belong to the group so don’t think that you can’t use this system if you don’t have a pump.  Whether you use MDI or a pump, you definitely need a calculator if you want to use this system! 

I am putting this post under the gastroparesis section on my blog because although I am just now starting to use it, I really think it is going to help with some of the gastroparesis issues.  Since fat really slows down the digestion process for people with gastroparesis, it makes sense to have some insulin working to help when food finally starts to digest.  Up until this last week, I have been doing with my pump what I was doing with MDI but I can definitely see an improvement using TAG.

On the TuDiabetes TAGgers group, Danny started a thread with some sample spreadsheets.  Here is the link to that thread:

http://www.tudiabetes.org/group/tagers/forum/topics/tag-spreadsheets

Danny used 58% for protein and 10% for fat.  In that same thread, Cheri posted her spreadsheet and she uses 40% for protein and 10% for fat.  Both of them made wallet size cards to carry.  Cheri also had a food bank that she listed her favorite foods and listed the carbs, protein and fat.  Cheri is the one that mentioned TAG to me in the Animas group on TuDiabetes.   You will have to play around with what percentages work for you and you will also have to play around with what the amount of time you want to extend your bolus for.  It looks like 3 hours seems to be an average place to start – customize that to suit your needs.

Here is also a link to the thread with some meal samples that people posted:

http://www.tudiabetes.org/group/tagers/forum/topics/tag-your-meal-examples

This is what I normally eat for lunch:

	Carbs	Protein	Fat
Peanut Butter, 2 tbsp	6.0	7.0	17.0
Hamburger, 3 oz 90% lean	0.0	16.5	5.1
Cheese	2.0	4.0	5.0
Mayo	0.0	0.0	10.0
Pears	26.5	0.0	0.0
Total	34.5	27.5	37.1
		x 40%	x 10%
		11.0	3.7
Carb Bolus	34.5
TAG Bolus			14.7

 

My carb ratio for lunch is 1:12 so I would take 2.85 units of insulin up front to cover the carbs in my lunch.  There are 27.5 grams of protein, so if I multiply that by 40%, I have 11 grams that I need to cover for protein.  There are 37.1 grams of fat, so I multiply that by 10% to come up with 3.7 grams that need to be covered for fat.  I then add the 11 grams from the protein and the 3.7 grams of fat to come up with 14.7 grams that need to be covered for my extended bolus.  Since my carb ratio is 1:12 for lunch, I need an additional 1.25 units of insulin that I extend over a 3 hour period.  Again, your percents and time periods might vary.  You will have to play with what works for you!

Monday afternoon, I ended up going low and had to cancel the extended bolus before it finished.  My BS was 71 when I started and according to my Dexcom, heading south anyway. That probably was not a good day to play with trying this.  Yesterday was a better day and I hung out in the 80s and 90s all afternoon until about 5 then started going up.  I am thinking of trying Danny’s 58% and then spreading it over 4 hours instead of 3.  I would have 19.66 grams to cover instead of 14.7.  My theory in changing the percent in addition to the length of time is that I did good for almost 5 hours.   I don’t want to take less insulin during that period by extending the time and I don’t really want to take more.  If I add the extra insulin, I should extend the time so I am getting that extra insulin over a longer timeframe.

I am using it for both lunch & dinner also, but lunch is my hardest to digest meal and also has the largest amount of protein and fat so I figure I will concentrate on getting that one right first. 

TAG has made a difference in the little bit of time that I have been playing with it.  I wish I had actually tried it back when I first joined the group!

 We only have a few more days to reach 100,000 views on the Big Blue Test video.  Even if you have watched it several times, please watch it again! 

http://www.youtube.com/watch?v=nkLHgK94Z0E