Tuesday, June 16, 2015

Omnipod: Saline Start

Last Thursday, we went to Children's Hospital to get Michael started on an Omnipod Insulin Pump. 

We researched many pumps and thought about pros and cons of each one.  We chose to go with the Omnipod since it is tubeless and since Michael is a rough and tumble two-year-old little boy.  I was nervous that tubes would get snagged or pulled on something while he played. 

In addition, for pumps that have tubes, the part of the pump where carbs and blood sugars are entered is attached to the tubes.  That means that this cell-phone sized piece of technology has to be attached somewhere on the body.  Michael would have to wear a modified fanny-pack, or clip the pump to his shorts.  Since Michael is not potty-trained yet, we didn't want something that he would have to remove before using the restroom.  Or worse, we didn't want something that might fall into the toilet! 

The "pod" of the Omnipod sticks to Michael's skin and is water-resistant.  This means that he can take a bath or swim with the pod still attached to him.  For pumps with tubes, the tubes and the pump itself must be removed from the injection site during a bath or during swimming.  The tubes then must be reattached after the bath or the swim. For my own sanity, I didn't want to have one more thing on our plates to remember to do before completing everyday tasks like bathing. 

The Omnipod offers variety in where we can place it on Michael's body.  We are able to place the pod anywhere that Michael currently gets injections-- the backs of his upper arms, the fatty parts of his thighs, and the buttocks.  Michael isn't keen on getting injections in his tummy, and it's not totally recommended that toddlers wear the Omnipod on their abdomen.  We place Michael's Continuous Glucose Monitor (CGM) (read about that insertion process here) on his upper buttocks, but we would still be able to place the pod on the opposite side of the body on the buttock-cheek.

So last Thursday we woke at our usual time (we're early risers during the week days due to our schedules at work).  My dad came over to care for Noah that day so that we wouldn't have to entertain Noah at the hospital for hours.  We're so appreciative of my dad and brother, Bryan who cared so well for Noah during our day-trip!

Aaron was able to get the day off of work to come with us.  We loaded Michael in the car and headed on our way.  We got to Children's Hospital about 45 minutes early!  I really dislike the early morning trips since we have to battle rush hour, but it worked out well this time.  I'm hoping for equal success this Thursday.

We got our choice parking spot in the parking deck and made our way down to the endocrinology clinic.  This was the first time Aaron had been there since he normally has to work during our endocrinology appointments or follow-up classes.  We were told to bring lots of toys for Michael since the class was supposed to be three hours long (8:30am-11:30am). 

We also brought snacks for Michael to eat at his normal times, as well as a sack lunch just in case class ran long. 

Michael enjoyed his morning snack of yogurt while sitting with Aaron:


Michael then spent some time playing with some d-siblings at the only toy they have in this waiting area.  The kids were nice to Michael.  They were there supporting their 13-year-old brother who was attending the insulin pump pre-start class where they describe all the different insulin pumps.  (You can read about our experience in that class here).  

The loot we brought with us included Michael's backpack (filled with diapers, clothes, emergency kit, blood-sugar meter, and insulin pens), my purse, the sack filled with Omnipod materials, and a rolling suitcase full of toys and books and magazines and coloring books and crayons. 

Later on, Michael and Aaron played a dirt-bike game on Aaron's phone.




Finally we were called back to the classroom.  It was just us and the instructor.  That was nice since it gave us some one-on-one time to ask questions.  I filled out a lot of paperwork to begin with and Michael and Aaron opened up the suitcase of toys and got busy playing and reading books.




Although the class was supposed to last three hours, it took us about an hour to get through the material and start practicing with the Omnipod's Personal Diabetes Manager (PDM). 

Aaron and Michael played in the room some, and then they went on an adventure to the gift shop which is housed in the main hospital across the street.  They got to walk across the sky-walk glass hallway that crosses over the street. 

They returned to the room so that we could put a pod on Michael.  He was so excited about getting his Omnipod!  The instructor asked us where we wanted to insert it.  I said thighs.  The instructor was nervous that Michael wouldn't have enough meat on his thighs, but he showed her!  He's got little ham hock thighs!  He got a little nervous when I had to tell him that there was going to be a clicking sound and then a pop.  I held him on my lap and we kept telling him he was a big-boy and was being so brave.  When the Omnipod clicked and then popped to insert the cannula, he didn't even flinch. 

We were able to gather up our material and head on home!

When we loaded him up into the car, I said "I like your Omnipod!"  He replied, "Ohhh, it was nothin'."  :)

We stopped at a restaurant for lunch and then picked up  Noah from my parents' house. 

The Omnipod was supposed to last from Thursday mid-morning to Sunday mid-morning, but the tiny cannula ended up coming out on Saturday night.  So we just followed directions and inserted a new pod filled with saline on Saturday night.  Tonight will mark 72 hours since that pod was inserted.  The instructors at Children's said not to put another pod on him since he'll be back at Children's hospital within 72 hours from tonight, and it would be a waste of a pod to put one on him tonight. 

"So what was this week for?" you might be asking.  Basically, this was our trial week.  We inserted the pods with saline, not insulin.  That way, we can practice using the PDM and letting it show us how much insulin it thinks Michael should get for his meals, etc.  Each time he's going to eat, we enter in his blood sugar and the number of carbs he's going to have and the Omnipod calculates how much insulin he should get.  We let the Omnipod calculate, and we also do manual calculations to check its accuracy.  Then we tell the Omnipod to give him the dosage, but it's just saline.  We still give Michael his insulin via injections this week as we practice with this new technology. 

On Thursday, we will actually fill the pod with insulin and we will not have to give anymore injections! This week was like a crash course in understanding how the Omnipod works and what it will be like when we activate it with insulin.

Aaron is not able to come this Thursday, but my mother-in-law Claudia is back in town and can come with me.  My dad and younger brother will watch Noah again since my mom is working.  I have Michael's suitcase of toys all ready to go, and we are increasingly getting excited about this new transition.

It comes with its challenges though, as is to be expected.  Since Michael wears a CGM, and since we are 10 months into life with Type 1 Diabetes, we really only check Michael's blood sugars about 4 times a day (before each meal and before bedtime).  It's not often that he warrants a blood sugar check in the night.  And he does not get sick very often to warrant increased blood-sugar checks due to illness.  However, since he will now be on an insulin pump and will be receiving insulin 24 hours a day, we are bound to see some change in his blood sugars.  We must check his blood sugar between 8 and 10 times a day for the first month while he is on the pump.  Each week we will upload information from the Omnipod onto a website, which the pump educators at the hospital can access.  They will be closely monitoring Michael's blood sugar levels as he adapts to the pump.  The increase in blood sugar checks means I'll be doing a 2:00am blood sugar check for the next month.  I definitely will appreciate prayers as we go through this transition.

Thanks for catching up with us and reading about our Saline Start.   I will share more once we activate his Omnipod with insulin this week!

Until Next Time,

Much love, Reba






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