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This is a conversation with my friend Ann Rosenquist Fee about the trials and tribulations of the Omnipod.
ANN:Well guess what.AMY:What? I get the feeling from the above photo whatever you are going to say is not going to be good. I’m ready. Let me hear it.ANN: Worst A1C ever. After three months on the pod I went from 6.9 to 7.6. Up until that point, 6.9 had been my worst in 18 years, which is what sent me to the pod in the first place, so I’d have tighter control. A 7.6 is not tighter control. A 7.6 is…well, see above. I’m so mad.

AMY: First off, I actually can’t believe that 6.9 was your worst ever in 18 years…wow. I consider 6.9 pretty good and in fact my last a1c was a 6.7 after 3 really careful months on the pod. And when I say careful I mean I was really paying attention and making the best use of the pod tools such as: looking at blood glucose history graphs and making adjustments. I’d never really messed with much of that fine tuning before. So it was a big disappointment to me to see that after all that hard work, I’d only gone from a 6.9 to a 6.7 because frankly, there’s no way I could do any better.

ANN: Wow. I want your 6.9.

But I know what you mean about fine-tuning to exhaustion and then not having much to show for it. That’s so hard. That said, I admit that wasn’t my case this time around. I took a little vacation from diligence because I figured the pod would do it for me. It asks me when I’m going to eat! Which is great but I guess it doesn’t take the place of an actual brain.

A few days after I saw the 7.6, I went to a park and sat in the grass for a couple hours and finally, for the first time, did the fine tuning I should have done in the first place. I set four different basal rates throughout the day based on a 60-day graph of my readings. Last week I sent the numbers to my sweetheart diabetes educator. She sent back this:

I don’t care that she gets paid to be encouraging. Right now, it helps.

But back to the times you’re awesome and then have nothing to show for it. What’s next for you? Follow my lead and take a three-month vacation from thinking?

AMY: I have to say again that your numbers are indeed awesome and I hate to admit it, but they make me jealous. I’ve been messing around with this new Glooko app, it’s an attachment that downloads your blood sugars from your meter to your iphone and allows you to enter notes etc. and email the electronic logbook to your doctor…no handwriting necessary! And, in looking at all of my numbers like this, I see a fair amount of highs, higher than yours 😦 I hate to compare, but that’s the truth.

ANN: But they’re not that awesome. The ones on the left gave me a 7.6. The ones on the right are about what I had back when I was at 6.9, which you recently beat, which is about the best I can hope for in the near future. Nothing (healthy) is going to get me lower than that for a while. I’m afraid the truth might be that my numbers were as good as possible back when I was using syringes.

If we’re not going to see fives or even low sixes from this point on, what are we doing this for? I can’t believe I’m asking you that. I should know this. I read your book.

AMY: To me, it’s not about the numbers. I’m trying hard, in my wiser years, to stress less over them. I try to look at them in a more scientific, less emotional perspective, as information instead of good and/or bad grades. This attitude doesn’t always work of course, and there are still plenty of times that I get frustrated and pissy when I see a high number, but that’s my life. What can I do?

ANN: You can draw on your pod, I guess. Hey where’s yours right now? I saw a very lovely pic of you on Facebook, and you were sleeveless. No pod in sight.

AMY: Ha! Funny you should ask…especially after your “what are we doing this for” comment! I took my pod off last week. I needed a break. I took it off after my sister’s visit. My younger sister was diagnosed with type 1 six months before me, when she was 10 and I was 14, and she has always been an old school as far as managing her diabetes. Anyway, she was here visiting with her kids and asked me about the pod (we were at my mom’s pool and wearing a bikini my pod was in plain view.) As I explained the pros and cons to her it started me thinking….what am I doing this for?

ANN: Right. Because we could just…not. Right? That’s a liberating and terrifying thought. And now I can’t stop thinking about it. I don’t mean quitting diabetes management altogether, just going back to the more comfortable technology. Relying on my own diligence and knowing it’s only going to get me so far. I can’t tell you how much I miss my syringes and my pod-less body right now.

I’m kind of afraid to ask, but how’s the break so far?

AMY: You know, up until today the break has been pretty great! A horrible stomach bug hit my family and took us down, one by one, finally hitting me on Saturday. I won’t go into details, but it wasn’t pretty, and I was nervous about managing a stomach bug without the pod (I was so sick on Saturday night I wasn’t sure I’d have the energy to get out of bed and do my nighttime shot), but I survived and my blood sugars mostly okay and its been pretty nice to take a break. I’ve enjoyed being able to pull my running shorts up as high on my waist as I like (without the pod in my way on my lower back), and being able to towel dry my entire body without having to be carefully aware of knocking the pod off my arm. I think the biggest concern for me when not wearing the pod is that I feel like I’m not taking advantage of all the tools out there for good management….does that make sense? Like I’m behind the times, living in the dark ages of diabetes care and that I’m missing something…..

ANN: As for the concern, I know, that’s the edge I’m on right now too. If the numbers don’t bear out, how great is the tool? And how much of our dilemma is really just due to good marketing? Is this really a better tool for us, or is it just good for the diabetics who aren’t very attentive on their own?

Hey how long are you thinking your break will last? Because I’ve been thinking, I’ll give the pod one more A1C and if the results aren’t dramatically better, I think I’m calling it quits for now.

AMY: I think you are right on when you talk about marketing. And I don’t like to think that I am being manipulated or influenced by marketing. I think for me too, it’s always been about joining the crowd, or about not wanting to be the only one on the other side of the fence. I don’t like to admit that, I want to believe I have more confidence than that, but it’s always been true. I like to blend in with the crowd so I can quietly observe the scene. And if I’m the only one left doing shots (not really of course), where does that leave me?

My logical mind knows I need to do what’s best for me, but doing what’s best isn’t always clear. I’m going to return to the pod today as we are headed on a family road trip from SC to Maine and I think the pod will make travel easier. We’ll be gone for nearly three weeks and when we return, maybe I will take a more extended break. Maybe we’ll be the last two pod-less women standing 🙂