I mentioned that I was working to get set up with an OmniPod. I was incorrect on one detail – the OmniPod does not use insulin cartridges. You inject your insulin into the Pod, which can hold 200 units. As long as you don’t go on a Halloween candy binge, that should last a few days. Conveniently enough, that’s how long the Pod’s battery lasts.
I started the process about a year ago. I applied for a 30 day trial online, but it was rejected because my insurance would not cover it. Harvard-Pilgrim does not cover a lot of insulin hardware like pumps and CGMs if you’re Type 2, but I finally got a doctor to appeal their decision last July. The decision was reversed and they do now cover the Pods 100%, but it took all summer to make sure all parties concerned were actually talking to each other. Insulet (the OmniPod people,) DHMC Endocrinology, and Bedard Medical, who supplies my Dexcom stuff and said they would be able to supply the OmniPod stuff. Even that last part was confusing, since during a conversation with H-P I was told that Rite Aid could supply the Pods, however Rite Aid told me in May that they could not get them. Finally, after months of sending out e-mails asking W T F, I received a box of OmniPods today.
Now, about that mistake… The OmniPod does not have an insulin cartridge. I am not sure where I got that idea – possibly from when I was doing research on the InPen, which I do have as a backup. That uses 3mL cartridges, which get changed out. The InPen talks to my phone via Bluetooth to track how much insulin I am injecting. That has to be replaced once a year and costs me maybe $25 out of pocket. Worth it in case the Pod fails for some reason. Plus, every time I ended up in the hospital for low blood sugar (there have been a few times) the first question they ask is “how much insulin are you injecting?” One time, I had taken myself off insulin for two weeks because I was tired of crashing, so my answer was “none.” The guy looked like I had just replied to the question “how many balls do I have?” The InPen app keeps a record, so if anyone asks, I can show them how much I injected.
When you set up a new Pod, you inject insulin into it using the syringe provided with the Pod. Since my insulin does not come in vials, I took my Humalog “KwikPen” and just kept cranking the dosage to 60 (the max possible at once) until I injected 200 units into the Pod. (Mental note, need to change insulin prescription to vials instead of pens.) The meter that controls the Pod walks you through the setup – you pair the Pod with the meter via Bluetooth, inject 200 units into it, prep it, then stick it to your arm like a CGM sensor. Tap the button on the PDM (personal diabetes manager) and it injects the delivery needle (called a cannula – sounds dirty) into your arm. Doesn’t hurt, feels the same as putting a CGM on. The meter can now tell you how much insulin is in the Pod and what the battery level is.
For right now, the Pod’s PDM is a modified Android phone that only works to control the Pod. There is a companion app for my iPhone that is paired to the PDM so I can read the info there. Not sure what it gains me, as I can’t use the phone to control the Pod (yet) and the two have to be near enough for Bluetooth to send the data. So, I am stuck carrying two devices around for a while. There has been news about a new app coming soon called OmniPod Horizon. It will work on an iOS device and combine my Dexcom G6 and the OmniPod into one app. It was supposed to be out earlier this year, but it got held up for some reason. It’ll be nice when that comes out so I can go back to just dragging my phone around with me. I had just got used to not needing it because my Apple Watch has cellular and mostly replaced my phone, but now my phone is connected to my CGM, which the Watch cannot (yet) replace. Oh well. I’m a geek, I am used to carrying around a bag full of electronic goo-gahs. What’s one more? At least it’s small and lightweight. Don’t have to worry about it trying to drag my pants down, unlike my phone which weighs 25 pounds comparatively.
Had you asked me years ago if I wanted an insulin pump, my answer would have been a solid HELL NO. However, my diabetes educator suggested that the reason I spike high and low throughout the day is because my body does not process insulin in large amounts. I might respond better to smaller doses over a longer period. A pump would do that, but A) I did not want to deal with a device attached to a tube that can get caught on stuff, and B) my insurance wouldn’t cover it anyway. The OmniPod has no tube, so okay fine, I’ll give it a try. I know it works at least, as earlier I was reading high blood sugar so I told the Pod to give me 10 units. Instead of 10 units all at once, it gives .5 unit every second. It’s also already giving me 2 units every hour. (It ticks when it delivers insulin, so that part seems to be working.) It brought me from over 600 (that’s as high as my Dexcom will tell me, anything above that just says HI) to 155 in two hours. It’s now 122 and still going down, but the Pod has a safety feature that will stop delivery if I hit 70. Going to see what happens, and maybe bump that up to 80 so I have a cushion. There is also a manual setting on the PDM to stop delivery in case I miscalculate the number of carbs I am taking in, or (as usually happens) I enter carbs, inject to account for them, then get called away and never actually get to eat. Now I have insulin acting on nothing, and I crash.