Wednesday, February 20, 2013

Musical Chairs

There's a phrase in German for when you can't pick between two people you love - "zwischen zwei Stülen" or between two chairs, meaning that you have to pick a seat if you're going to sit down.

I'm in a room of empty chairs.

I love my old, use-it-when-I'm-frustrated-with-everything-else-in-my-life, 100% dependable, out of warranty Cozmo insulin pump. They're out of business now. I have been wanting to move on. She's been there for me. When I first got my A1c into the 6s. At the end of two pregnancies when my Omnipod couldn't hold enough insulin. She's my ugly little workhorse and I love her, but being out of warranty, I'd really prefer her to be my safety school. Not my primary path.

I love my Apidra insulin. I've used it in Medtronic, Cozmo, and Omnipod with zero problems for roughly 7 years. It brings my highs down like a little speed demon and keeps me in fairly good control. I've had the best A1cs of my life on it. But it occludes in my t:slim pump. Clogs. Gels? Crystallizes? Sits there like pudding? I don't know what the hell is going on in there. I just know it has been problematic. I was wrong when I initially thought it was completely hardening in the pump (thank goodness), but I was right that I couldn't make it work for a traditional three day pump wear.

I really like the features on the Tandem t:slim pump. It is exactly what I wanted and feel we should expect from an insulin pump in so many ways. The iPhone of pumps. Feature rich, pretty, easy to work. Except for that whole little NOT PUMPING MY INSULIN thing. Kind of a bummer. A very very expensive bummer.

I could maybe learn to love Humalog curled up in her little purple chair over there. She's a bit of a finicky bitch with me. Brings my highs down when she feels like it. Bounces me around some. But she gets along with t:slim.

I keep pushing these chairs up to the table, demanding that we reach a compromise. And all the while balancing a toe on each cushion.

I don't know what to do. I tried Humalog for nearly 90 days. I don't like it as much. It's okay. It's not great. Too many highs. 400s. Last week, I spent three straight days over 250. I yanked it all, filled my Cozmo with Apidra, and spent the next three days in nearly normoglycemic control (except for those Girl Scout cookies, but that's neither here nor there). I was 90 and stable just over an hour after changing everything out.

Which makes me think I need my Apidra.

I took a deep breath and started up the t:slim again this morning...with Apidra. I'm going to try it for a month or so, using Apidra for no more than 48 hours at a time. I'm going to charge the pump between set changes so that the insulin is never exposed to the heat of a recharge.

My blood sugar two hours after a site change and breakfast is a lovely 115.

Come on t:slim. I need you guys to get along.

If not, I think I love my Apidra more than I love you. And that may put Lady Cozmo back at the table, warranty or no.


  1. I don't envy you having to make this decision. I love my Apidra too, and would hate to have to give it up. It's tough to need to choose either your favorite pump or your favorite insulin (although "favorite" doesn't seem quite like the right word - because it isn't like we're choosing ice cream flavors here!!) Hope you can find a way to make Apidra and t:slim get along!

  2. Also try getting a gel mask thingy and keeping it in the fridge to place the t:slim on if you need to charge it sooner. It's helped a lot with mine, and it's not totally cold-cold like an ice-pack.

  3. Great post, Melissa. Seems that everything in life, including diabetes, is a compromise sometimes.

    Love the picture!

  4. I think Thin Mints are both here and there and all things considered are are more glorious than your adventure in insulin.

    Look forward to the results of your 48 hour max test.

    Thanks for sharing your insight.

  5. Poor honey! The Tandem folks have no answers for you on that?

    Also, thanks for the German reference. Reminded me of my great-grammy. That's a phrase I actually heard as a child. :)

  6. I gotta ask--have you tried Novolog? I love it more than Humalog, that's for sure. I don't have a tslim, nor have I tried Apidra, but just thought I'd throw my beloved Novolog a seat there. >;)

  7. Great post. And I think of the choices and that's a good thing, right? But then again, can't we all just get along? Choices as good, and choices as compromises. Sorry.
    I've tried Apidra in G's OmniPod twice now, with disastrous results on day 3 each and every time. And I'm just not willing to compromise and change out Pod every 2 days. So we sit with Novolog, when I know we can have better.
    Sometimes choices just plain suck.

  8. "She's a bit of a finicky bitch with me." <---that made me laugh!

    I'm glad you've figured out a way to use your swish pump with your happy drug.

  9. we already have to change every 48 hours. should i try to get my hands on some apidra? i guess i will ask our endo.

    if something could be better, i'd like to sign up for that, please.