Part 34 of a 97-part series on "More than you needed to know about diabetes and rightfully did not ask."
In February, I had another stroke. My second, or third, I don't even know anymore. I changed my diet to not only focus on lower carb options but also lower cholesterol. The doctor couldn't really be sure whether this latest stroke was caused by clogged arteries due to glucose buildup or cholesterol, so to be safe let's change both. Other than a few scares here and there (trouble walking, which sent me to the ER to make sure I hadn't had yet ANOTHER stroke) I've been okay.
A few weeks ago I found out the next OmniPod was available. I've been using the OmniPod Dash, which is a self-contained insulin pump. No tube to snag on things, it just sticks to my leg and feeds me insulin when I need it. It can be set to give me a constant flow all day; when I eat something I tell it how many carbs I took in and it increases the amount to cover that. The OmniPod 5 talks to my Dexcom CGM, so I don't have to tell the Pod what my blood sugar is. After the usual back and forth with insurance, I received a 90-day supply of pods as well as the new controller.
Technobabble Alert!
The Pod uses a PDM - Personal Diabetes Monitor - to control it. The Dash had one, and the 5 has a different one. In addition, an iOS and Android app will let me control everything from my phone, which will be cool. As it is now, I have to carry a phone and the PDM around with me, which is annoying when I am wearing shorts. Bad enough I have two bricks flopping around my pocket, but they keep trying to pull my shorts off. Did I mention that I work in a school? Naturally, this was one of the first things I looked into. I was rather disappointed to find that the iPhone app was nowhere near ready. It made perfect sense that the Android app would be available first because the PDM has always been Android-based. How difficult is it to convert the controller to a standalone smartphone app? I follow various support forums where people talk about this stuff and there's a guy on there who claimed to be one of the testers for the iOS version. Granted, anybody could jump into an anonymous forum and claim all sorts of things, but he has been a regular there for some time and people seem to trust him. According to him, the iPhone app is at least a year out from release. I want that to be wrong but I also know what it's like when dealing with medical devices and FDA approval. It took a long time for the Freestyle phone app to be made available in the United States after being released in Europe the year before. So my bright idea was to pick up a cheap Android phone and use that as my single device, then I wouldn't have to lug two devices around with me during the day. My iPhone automatically forwards to my Apple watch so if anybody calls me both of them ring. I thought maybe AT&T could do that with an Android phone, but they can only do that with watches. So I would have two different phones with two different phone numbers. Not the end of the world; I tell my iPhone to forward to the Android phone. Plus I still have my Apple Watch, so if anybody calls me or sends me a message, I'll know about it.
Then there was the whole decision of which Android phone do I get? I don't want something so brand new that it costs me a ridiculous amount of money, especially since this is not going to be my primary phone. On the other hand, I don't want something so old that it's only going to be supported for another year or two. Android phones and iPhones have that in common - eventually, they get to a point where they are no longer supported. That is also where there is a minor difference: an iPhone will reach a point where you can install the latest operating system but it is not a good idea because the phone just slows way down. There is nothing to prevent you from doing this other than common sense and experience. Android phones on the other hand draw a hard line in the sand. Google (who created the whole Android ecosystem) decided to only support Android devices (which includes Chromebooks) for a period of about 5 years from their release. Once you hit that 5-year wall, that's it - you're done with updates. Spending the past 4 years supporting Chromebooks at a school, I've learned that that's not that big a deal. Most of the time when a new OS comes out it's to support new hardware features in more recent models. If you have an older model then nothing really has changed for you. An OS update doesn't make the device completely useless but it does mean software and hardware developers have the option to no longer support it. They may come out with new versions that require something you don't have. People constantly scream about Apple forcing people to upgrade their devices every 3 or 4 years, especially with the latest round of iPadOS updates requiring a device that runs on an M1 chip, but Google has been doing that for years. Sadly that will continue to be true. You spend $1,000 on a brand new shiny device and it's top of the line for about 12 minutes. You've barely got that device paid off when suddenly the next device with the next new fancy chipset is announced and all the development shifts towards that new thing. Unless you make $1,000 a day you're always going to be left in the dust.
After much thought and deliberation, I decided that this was for a medical device that was going to last me 5 years. I figured I might as well get something that will last so I settled upon the Samsung Galaxy S22. There was also a rather dumb personal reason for this choice: I have a Galaxy Chromebook that I absolutely love. I posted about it previously in this blog and if you read it, you know it is the coolest shade of red. I figured my Google-based devices should match in color, but the only way to get a phone in that same color red was to buy it direct from Samsung and get it carrier unlocked. So I paid $1,000 for yet another phone. It's cool but I'm not sure it would ever replace my iPhone. Of course, I'm kind of locked into Apple's little walled garden so introducing a Samsung device would require changing quite a few other things which I'm not going to do.
Two weeks ago, I received the new Pod starter kit. As with the Dash, you're supposed to go through a training program to make sure you know how this thing works. I skipped the training program last time at first because it was easy enough to figure out but then went with the training afterward to tweak the settings. (My endocrinologist is impossible to reach, otherwise, he could have done that for me.) This new Pod is a device that can make its own decisions as far as how much insulin to give me, so I decided that I need to make absolutely sure I understand this thing and put in the correct settings. I contacted the person who did my training last time and told her that I was finally set up with the new kit, and asked how I go about getting training scheduled. She sent me to the website where I registered my new device and told them I needed training. That was about a week and a half ago. Since that time I also learned that the shiny new S22 phone I just bought is not on their compatibility list yet. So now the race is on: which comes out first, the compatible Android app or the iOS app? I'm a little annoyed that I made a major purchase that ultimately does not do me any good, but it's a brand new carrier unlocked phone so if I have to turn this thing around and sell it a month from now I'm not going to be stuck with it very long. Apparently, this is a popular phone among Android users, so it's not that I made a bad purchase but I may have been a little premature. My Dash was set to expire (a Pod only lasts 3 days) so rather than put another Dash on I decided to take the plunge. It's a weekend so I'm home to monitor things. I set up the new PDM using settings copied from the old one and put on the new pod. I also had to change my Dexcom sensor early so that it would pair with the new Pod, but I can get another one of those easily. The only hitch I ran into is the new PDM could not connect with my sensor, but that was because the sensor was already connected to my iPhone. It's just a Bluetooth device so I went into the list of Bluetooth stuff and deleted it so it could pair with the PDM. From there everything worked fine. I don't know if this is a fluke but normally it takes two hours for a new sensor to start working, but it did it in about 30 minutes. I used the Samsung S22 to set it up instead of the iPhone this time, so maybe it's a difference in the app? You still have to start the sensor using a smartphone but once the sensor has started the PDM takes over. I guess if the app was ready then it would take over and I wouldn't need this new PDM but this is the price I pay for being an early adopter.
I checked the PDM before I went to bed. It said I was at about 180, but I didn't do a manual correction to see what it would do. Checked one more time before falling asleep, and it had dropped to 160. Okay, so it's working! Woke up this morning at about 8-ish and my blood sugar was 117, right where it should be. Fell back to sleep and was awakened at 11 by a low blood sugar alarm. 60 and dropping fast. Uh oh... but I wasn't sure if it was actually correct. This has happened to me before: if I change my sensor at night and then accidentally sleep on it sometimes I get false readings. Plus I didn't feel like I was that low. However, I didn't eat dinner last night and slept through breakfast, so it was entirely possible that I had dropped to 60. I got up, showered, waited a bit and it went back up to 101. Not entirely sure what's going on but I'm keeping an eye on it. I had toast for breakfast (low carb bread, so not that bad) and put in the 12 carbs for that. Between that and the auto-correction, I am waiting to see what happens. My blood sugar right now (1 pm) is 196, higher than I expected but if this new system works I should start dropping. Any minute now...