Reverse correction (negative correction)
Using an individual’s correction factor (sensitivity factor), the reverse correction is a calculation that reduces a portion of a meal bolus dose when the patient’s blood glucose level is below their blood glucose target. This feature is an option of the PDM, which should be turned on or off according to the advice of a healthcare provider.

*  Nate is only 21-months so he does not have huge insulin needs.  His basal rates change throughout the day and the night so we love all of the different basal rates available. Here are his current settings:



* My most important tip is for site changes!  I actually got the idea from Tracy and her brave boy, Zane. We give Nate a Dum-Dum lollipop during site change and it makes the entire ordeal almost a non-issue.  Nice!


I know there are many out there that have been pumping and podding longer than we have that can offer more advice, tips and tricks but I just wanted to answer some of the questions that I received via email, comments and Facebook.

Nate has been pumping or podding since March 1st and I now cannot imagine handling his diabetes any other way.  Multiple Daily Injections (MDI) are a thing of our past.  Podding has made our lives so much easier, so much more flexible and made Nate's bg numbers so much better.  Diabetes is still here and is still difficult. We still count carbs, measure food, and check Nate's blood sugar 12 to 14 times per day.  We still get up with him 3 times per night to check his bg but the OmniPod is making everything easier.

We still keep Nate on a pretty tight schedule but if we get delayed or held up or just run late it's ok.  No more NPH to cause terrible lows when we run a few minutes behind.  No more rigid schedule in fear that we may not get Nate's meal prepared before the NPH peaks and he crashes.

To date there are 2 major things we have now done with Nate that I cannot imagine doing since his diagnosis and before he started pumping.

The 1st is our trip to Iowa.  We obviously would have gone with or without diabetes but the pod made the trip so much easier.  The day that we left, Nate was recovering from a horrific stomach bug that had kept us up most of the night due to his vomiting.  The days that followed were not easy.  He had NO appetite, would not eat, and was still suffering from a few other symptoms that I will not go into here.  Let's just say if we did get him to eat, he was losing a lot of the carbs pretty quickly.  We were stressed to the max with an all night drive on no sleep, driving non-stop in fear we would not make it to Iowa in time, then once we arrived we spent most of our days and evenings in the hospital with Jim's mom and the rest of his family.  Certainly not ideal conditions for a little one with diabetes.  The crazy good thing is that Nate was ok. We were able to set some temp basals, reduce his boluses and he did great!!  We did great!!  Hey, I'm just going to go ahead and say it - - - I rocked it!

The last time Nate had a tummy bug was just weeks after his dx and we ended up back in the hospital for 3 days.  Tummy bugs and diabetics are not a good combination but with the pod it is certainly more manageable.

The 2nd thing is not quite as big but since Nate's dx I have not wanted to spend any time at our lake house.  It is about 90 miles away from our house and about 60 miles away from civilization.  If anything were to happen there we would have a long drive back to Dallas because there in no one out there that would be able to help with Nate's diabetes.  The closest hospital is the one I went to when I had my miscarriage and there was no one that could even do a sonogram to confirm the miscarriage.  I'm going to go ahead and guess that they do not have a pediatric endocrinologist on staff and they probably don't even have anyone that would have a clue what to do with such a tiny person with Type1.

Well, we packed up our bags this weekend and headed 90 miles south and spent some time at the lake and it was great!  No shots, no worry about the rigid schedule, we didn't have to plan the drive at a certain time so that we could feed Nate at a certain time and all that blah, blah, blah that came with the NPH and the MDI.  It was awesome.  It was fun. It was relaxing.



Nate does always get his own suitcase for all D supplies everywhere we go but even that has become easier with the pod.  The funny thing about this trip is that I packed Nate's D bag with all of his supplies, Emma's bag full of clothes, Sophie's bag full of clothes and my bag with all of my clothes but I forgot to pack any clothes for Nate!!  The good news is that we had all of his D supplies but the bad news was he had to wear his sister's pretty, pretty princess nightgown for night-night!

The hard parts of D are still with us.  That will never change.  We roll with it and do the best that we can to care for him and keep his blood glucose in check but we have days were the meter says HIGH and we have days where the meter says LOW.  We have days where I cry and we have days where he cries.  We have days where we both cry.  Diabetes is not an easy disease.  It is hard on his body and it is hard on my mind.

The pod is making the management easier and his numbers better but with the pod has come more bg checks.  We check Nate's bg all day --- before meals, after meals, before and after snacks, before he goes to bed and as soon as he wakes up and anytime in between where we feel he may be high or low.  We also check him at 10:00 PM, 12:00 AM and 3:00 AM and if one of those number is low we stay up until it is up, if one of those numbers is high, we stay up until it is down.  I've had a lot of people ask me when we will be able to stop checking him at night and the simple answer is NEVER.  The risk it too great.  In the last 2 months there have been 2 young boys in the DOC (diabetes online community) that have passed away due to type 1 complications.  I cannot begin to imagine the heartbreak.  These are families that know diabetes, that do what we do and yet sometimes this silent killer takes our children even when we do everything right.  Therefor, as I pray for comfort for the families that have lost their precious children I will also continue to check my precious son throughout the day and all through the night and thank the Lord for giving me the opportunity to get up and check him even at 3:00 in the morning.



* This post was originally written to be a super positive tribute to the OmniPod but my heart is heavy tonight as I think about the families that have lost their children so my post made a slight detour.

Hello Friends,

As you know our son, Nate was diagnosed with Type 1 diabetes in September of 2009. As we approach the 6-month mark of his diagnosis we are gearing up for the annual JDRF (Juvenile Diabetes Research Foundation) Walk for a Cure. We would love to have 100 of our closest friends and family walk to support Nate in his journey with Type 1.

If you would like to walk with Nate, please email me at HoustonWeHaveAProblem@verizon.net and I will add you to our growing list. The walk is a lot of fun for the entire family. They have food, balloons, bounce houses and then there is the 5K walk that will be so much more fun if you are there.

It would be amazing if we could get 100 people to walk with Nate and raise money for finding a cure.

Please help us support Nate and find a cure for Type 1 Diabetes –

With love,

The Houston Family

Jim, Laura, Emma, Sophie and Nate

Pumping.
Well, we did it.  Nate is now officially on the OmniPod Insulin pump. Yea Nate!


He wore the the OmniPod all weekend filled with saline so that I could get comfortable bolusing for all his meals and he could get used to wearing the device.  Personally, I think we both did great!  

Yesterday we met Jessica and family downtown at CMC to get this pumping started.  Nate and Liam both tolerated their site changes and Jessica and I both passed the pump test with flying colors.  Can I just say 1 more time how awesome it is to be going through this with Jessica and Liam? AWESOME. 
Good Grief.
I decided to place Nate's pod on his bum and cover it with IV3000.  Unfortunately, the major blow out that he has after dinner required a bio-hazard suit and a site change! Good Grief!  So, lesson learned - - - Wait for bum sites until after potty training or invest in a lot more IV3000.  After the blow out I moved the pod to his arm and he is doing quite well with it there.





All in all Day 1 went pretty well (except for the bio-hazard incident).  Nate's basal rate is set at 0.15 units from 12a-12a so he experienced some highs yesterday but no ketones.  We noted the high times and will make the necessary modifications today. 

I stayed up most of the night to check his bg and watch him breathe.  He was high at midnight so I made a correction, he was in good range at 3:00 AM but was low by 6:00 AM so we definitely have some tweaking to do.  We will get there.  One day at a time.



Hope!  
I am hoping that pumping makes things better for Nate.  I am hoping that we made the right decision. I am hoping that this will help Nate live a very long life. Most of all I am hoping for a cure! 

 

• In the post The Hard Stuff she was concerned about Nate's medical information being in a public forum.  Although I did not say it, I thought to myself that if anyone wanted to steal Nate's medical problems I'm quite sure they would bring them right back!
• She was not too thrilled that I had published an email from a CDE in A Good Response but we both agreed -- my email, my property.  I decided to remove the signature line from the email for privacy.
• Dr. T also thought I should have asked permission to post pictures from our visit that included medical staff. I had not really thought about that before posting pictures of CDE, Kim teaching me how to do Nate's site insertions. 
• Since we were chatting about things that were not making us happy I decided to mention that I honestly thought it would be easier to get in to the White House and visit the president than to get an appointment with her.  The funny thing about this was that she AGREED!  She said they are hoping to expand the staff but in the meantime we would just have to wait.  

and here is the email response I got in return:

Hi Laura, 

I'm so glad you enjoyed the pump class today and 

I truly hope the pump will help Nate's blood sugars.

We want to let you know that you have not offended any 

of usin any way and we completely understand why you

have a blog.We are definitely here for you and want 

to fully collaborate as a team through Nate's diabetes

journey. You are more than welcome to keep the pictures

and email on your blog. Please continue to release your 

joys and frustrations on your blog but for confidentiality 

to not include last names.  We truly care for you, Nate

and your family and have enjoyed working with you. 

We look forward to this next journey of pumping, and 

again let us know what we can do to help. 

Your Diabetes Educators and Friends

Ok, so you can call me a dork but this email made me so happy.  This is what I have wanted all along.  I have longed for the folk's over there to know me, to know Nate and to feel like we are on the same team.  Team Super Nate!!  I am hoping that going forward we can all work together for Nate's best interest.



Will post on Monday about Pump Start Day - - - with pictures!