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Upgrading the 640g to 670g

Discussion in 'Insulin Pump Forum' started by aphex2k, Aug 26, 2019.

  1. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Meeting went well. Sat in a cafe, got a free coffee (black, no sugar, natch). Went through my Carelink in detail. Actually showed me I'm doing OK. 88% time in Auto and 79% TIR with predicted A1C of 6.8 so that's a significant drop from my last 7.7 if it's accurate.

    Showed my night time settings are spot on, and showed me when I'm correcting a high I need to trust the system. If you try to over correct it screws the algorithm. It does learn, and to be patient. I'm trying to make less inputs and just allow the system to work.

    I said I missed my multi wave. She said people often split doses to cope with extended meals. I asked what was the difference between doing this, and entering "phantom carbs" to correct a high. Same same but different eh? Kind of stumped her I think. But at least I know I'm on the right track and had some real flat days which is good.

    Had big highs last night. Changed cannula. Hour later I'm 17. Correction with no effect and continued to rise. This went on with 4 cannula changes. Each time it went it, was uncomfortable and sore. 4 in a row! Eventually I got one in and this was 1am and my BG had risen to 25. Felt like ****, decided to bolus and go to bed. Woke up with BG 10 this morning. Sitting around 5.3 now but not eaten yet.
     
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  2. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Hi everyone!

    Weird weekend. New sensor on Sat - working fine.

    Sunday I had a low of 4 and was just about to go out, so ate a banana and wife drove. By the time we got to the beach I had 3 down arrows and the sensor said I was 2.8. BG confirmed (2.7). So I bought a caramel slice, which seemed to do very little. So I ate a cheese and ham toastie, and a coffee milkshake..... Still low? Even by the time I got home (2.5 hours later) I felt tired so had a nap. Woke up after an hour... Still under 4mmol/L!!!! By around 7pm I was back to normal range. Just odd I ate so much (and lots of sugar).

    Something must have been wrong somewhere, as this morning my sensor spat the dummy and said re calibrate in a few hours AFTER I just calibrated which is usually indicative of a sensor about to die.
     
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  3. DunePlodder

    DunePlodder Type 1 · Well-Known Member

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  4. aphex2k

    aphex2k Type 1 · Well-Known Member

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    That makes sense!

    It does seem like I get a bit of traction, then it goes. The alarms and requests to enter a BG at 3am are ridiculous. I still am not liking the slow hyper recovery and I've tried to follow advice of being patient, letting the system learn etc but there are "buts".

    I'm still having issues with calibration at times - eg last night. I had a cheeky ice cream (well, half an ice cream) and bolus'd accordingly. Clearly not enough as I shot up to 19. Although I get the pink dot for micro bolus it really wasn't coming down. At this point it asked for a calibration but at 11pm. I kind of had to do it, or risk being up late or not being in AM over night.

    Pump said 18, BG said 17.6 so I did a risky calibration which was accepted. But the calibration figure that hit the pump said 11.4 and now I've got 4u of insulin on board. So where did the 11.4 figure come from, and how can I manage hypers if my calibration just picks random figures after I've applied a correction bolus? Often high sugars (confirmed with BG) drop suddenly, which is a real pain in the 'arris after you've given yourself a correction! To me, calibration is for accuracy. EG a speed camera has to be calibrated to the speed it measures, is in line with the vehicles it's targeting. If you calibrated a speed camera at 70mph but the calibration figure was different, then this isn't calibrating is it? People could speed past and not get caught, or EVERYONE would get caught even if they weren't speeding!

    Even my wife is annoyed by the constant beeps, alarms and button clicking. This wasn't the case with the 640g. I said the "new" pump is probably going to be on the market next year.... "what's so good about this new one?"

    Another niggle is the Facebook group I use for Aussie 670g users has Medtronic staff posting messages, but they're not identified as Medtronic workers, so now any report of "yeah the pump's great, I'm in auto mode 99% of the time, the sensors work great, my TIR is 90%" are dubious comments to me.

    I still feel a bit like a beta tester for a new gadget.
     
  5. dancer

    dancer Type 1 · Well-Known Member

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    If you go low after a correction, you need to change your sensitivity factor. I had to do this on auto mode.
     
  6. aphex2k

    aphex2k Type 1 · Well-Known Member

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    We're talking the space of a few minutes between calibration and correction dose. There is no way 4u can drop me from close to 20 down to 11ish in minutes. It's definitely not sens factor. Plus, other corrections in the last 6-8 weeks have been fine.

    This is a 3 day old sensor.

    I've just had it lose signal. See pic. Tells me to move the pump closer to the transmitter. It's On the transmitter. Now it's saying there's interference but I'm at home. I disconnected the sensor and reconnected it, as the pump suggested. It's foubd it again but now I've got a 2 hour warm up and the whole calibration ********. It's 10pm. I am THIS close to getting a hammer and a would if it wasn't a rental pump!
     
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  7. Peter03

    Peter03 Type 1 · Well-Known Member

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    I am sure ever body feels for you but you are giving us real live information on how difficult it is getting the 670g to work so don't take a hammer to it, as you said earlier it is like you are a beta tester, hope things improve soon, Medtronic would not spend many millions of dollars bringing it to market if it did not work so persevere and keep letting us know how it goes hopefully things will improve soon
     
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  8. Gary61

    Gary61 Type 1 · Well-Known Member

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    O.k. aphex2k, I totally understand your frustrations but thought I'd tell you how I handle some of these problems you have experienced. Firstly the alarms, yes they do drive you mad but I've decided to switch every single one of them off except for the high and low blood sugar alarms. So now my life is a lot quieter. My pump still vibrates for some of the other alarms and I also look at my pump fairly regularly as a matter of course to be able to watch my rates of rise and falls in order to take any action I feel is necessary.
    Secondly with regards calibration issues, I calibrate three times a day which gives me some leeway on carrying out a late one before bed. My pump doesn't unexpectedly bother me about carrying out an unexpected calibration then.
    Thirdly, if you lose your signal, you should then only go to Sensor Settings then Sensor Connections and select Reconnect Sensor. That should stop it from requiring another 2hr warm up period.
    And finally, I have learnt that even though my pump shows what insulin is on board, my body sometimes has a mind of it's own and refuses to follow the way it should be working. Some days I find that my sugars will fall far quicker than normal, but I just suck it up and take on some more carbs to counteract it. And sometimes it does seem to take an age before rising and then appears to not want to stop. I then sometimes add a little more insulin in it to try and counteract the sharp rise, but I am also aware that all of my initial dosage might not have kicked in yet which could cause my b.s. to decide to fall hours later.
    Oh the joys of being a Type 1 diabetic :)
     
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  9. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Cheers Gary

    Loved the 5.30am alarm to calibrate this morning ;)

    My calibration schedule is pretty spot on. First one is not long after I wake. Fasted, no bolus on board, stable. Then I'll do another on before lunch, assuming the same (no bolus and stable) and the same before bed. I'll "enter BG" as required.

    re: the sensor issue last night. I did everything right. I noticed lost signal, I tried to reconnect, then I got the message saying "cannot find sensor signal, try moving the pump closer". It was next to the sensor and transmitter. Sat on my belly on the sofa, waiting for it to find it. When it did, it told me I was entering the 2 hour warm up.

    So I don't think I'm doing anything out of the ordinary here.

    I do look at my pump a great deal through the day. Am I rising, is the signal still there, does it want a BG etc etc

    The 670g and CGM is meant to be newer, better, more accurate, more stable? I'm finding I'm having to do a lot more work in order to achieve the same level of normality I had with the 640g. It's like an annoying little kid that says "Dad, Dad....Dad! Dad....Daddy? Daddy....DADDY!!!" all the time.

    Peter: I agree to a point - but the 670g seems to have heaps of issues and I'm not the only one. My only hope is that the new pump sorts out all of these issues, otherwise I'll be reconsidering which brand to use in the future. I do wonder if I'm waffling a bit here but glad that people are finding the thread useful, and do appreciate all the input from everyone.
     
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  10. Gary61

    Gary61 Type 1 · Well-Known Member

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    Just been to an all day conference on Type 1 diabetes and was told that the Medtronic 670g pump is the most advanced pump available in the U.K.
     
  11. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Conference sponsored by Medtronic? ;o) Most advanced just means has most features? Doesn't necessarily mean most stable or most accurate. Anyways......

    I'm feeling rough today. Monday night to Tuesday - cannula issues. Would not settle. Think I did 4 or 5 replacements in 24 hours. Woke yesterday with 20+ and had a terrible day getting back to "normal". Had spiked up around 11pm and stayed 20+ Pretty much 24 hours above 10 and only sub 10 last night. Woke with pins and needles in my hands and feet - numb and disoriented. Wasn't fun. Also at some point in the nigth my reservoir unscrewed itself so a double whammy....

    Anyway today I'm feeling like my lower back has been punched a few times but my levels are looking good. Feeling tired and achey but not enough to justify another sick day off work.
     
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    #71 aphex2k, Nov 13, 2019 at 12:44 AM
    Last edited: Nov 13, 2019
  12. DunePlodder

    DunePlodder Type 1 · Well-Known Member

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    @aphex2k Sounds like a rough time, hope you feel better soon.
    Cannula problems can happen with any pump I guess, but it sounds to me that generally the sensor is the biggest problem. If Medtronic had made the decision to go with Dexcom, especially now the G6 with no (or very few) calibrations needed , then the 680G experience would be very different.
    Would you agree?
     
  13. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Might have to consider a longer cannula. Having issues recently where it takes multiple attempts to get the cannula to be comfortable. Replaced this morning, levels were 8. Got to work. Levels 11.5. 2.9u active from my yoghurt and nuts. Alert!!! Tubing blockage....Hit 12. So removed the cannula and yay, insulin pool. I'm wondering if I should perhaps size up and go longer on the cannula (use the Sure-T). Very annoying. Just fitted a new one now at work and hopefully this one sits better. Seem to be having this issue way more often recently.

    Happy Friday y'all!!!
     
  14. Peter03

    Peter03 Type 1 · Well-Known Member

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    Sorry to hear you are having so many problems with the 670 + cgm in auto mode, it is making me think I may wait for a new system in France I think called the diabeloop which should be out in the next year or so
     
  15. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Look, it's quite different to the 640g. It takes some re-learning. It also takes a lot of effort to trust the system, and believe in it's capabilities. When it works, it's great. But keeping it working is a lot more effort than the 640 was. Many people are super happy with it. I'm about 70% happy so far.

    Maybe hold on, as the new Medtronic pump is on the market in around April (but not sure if it's a global release or a staggered country by country thing).

    Again I'm having issues with calibration. More often than not, the calibration figure on the glucometer, is not the same figure that appears on the pump after calibrating. EG pump says 9, calibration says 5.5. Send that figure to the pump and it will show 7? So how's that calibrating? What goes on when you send a blood sugar to the pump? What calculations are happening, what presumptions is the pump making?

    Oh and infusion sets: I've been using Sure T for a while now. Last 2 boxes, the tubing has been rough to touch. My last supplies seem to have gone back to the "old" tubing which is shiny / smooth and clear? Also had issues where the cannula just didn't seem to settle, taking anything from 2-5 times replacing to get the cannula seated comfortably. It could be that I'm hitting fatty build up on my belly, but I'm trying quite a wide range of area so I'm not convinced?

    Having said all this, yesterday I was 100% in auto mode and 85% TIR. The day before that 100% and 87% TIR. I do seem to be more stable in auto mode now so perhaps it's got to the point where it's understanding me.
     
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  16. Gary61

    Gary61 Type 1 · Well-Known Member

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    I'm not sure why there is such a wide margin in your two blood sugar results as I have never experienced that sort of difference. But what I do know is that if there is more than a 35% difference between the pump B.S. reading and the sample B.S. reading, then the pump cannot carry out a satisfactory result so will just give you a more random type of figure.
    As for the trouble with the cannula's, I use the Medtronic MiniMed "Mio" cannula with 6mm insert and a 60cm tubing and have never lost any other than when I've caught it on the door handle, even though I swim quite regularly. I find that using Skin Tac for adhesion on both my sensor and cannula sighting works really well for me.
     
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    #76 Gary61, Nov 20, 2019 at 8:19 AM
    Last edited: Nov 20, 2019
  17. aphex2k

    aphex2k Type 1 · Well-Known Member

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    The Mio's were worse for me, plus the stupid amount of plastic wastage... Grr! I like the Sure T as there's an extra sticky tab which means if you drop the pump or catch it, it doesn't pull at the cannula.

    I think it might have been a couple of boxes which were avoidant of QC testing... The new ones I have (back with the smooth tubing) have been pretty much insert and go, not insert, wait 60 mins, realise no insulin is going in and trying all over again.

    Yeah I'm aware not to calibrate if the figures are vastly different, but I just don't understand why a BG finger prick test, doesn't calibrate the pump to the same measurement. So you're saying if your BG is say 8, and you calibrate, the pump says 8 too? This just does not happen for me! I might do a little video one evening of a calibration just to show what happens.

    Just correcting a high as I forgot to bolus when I ate a banana when I got to work. Arrived, ate, straight into a meeting.
     
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  18. Gary61

    Gary61 Type 1 · Well-Known Member

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    There's definitely a lot to learn with this new pump that's for sure. My take on all of these hiccups with this new pump, is that it's a positive step in the right direction for Type 1 diabetes and that people who are a little unsure, should try and embrace it for the help it can offer them in obtaining better control.
     
  19. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Morning team.

    **** weekend.

    Sensor expired on Sat night and I didn't wake for the alarms. Next thing I know I'm waking up on the sofa, butt nekked and drenched in sweat. Last night I did wake up at 3am with a hypo again but had replaced everything so all good there. Just ate a bit too much as I have no self control when low (2.2) and woke up with my pump saying I'd been at 12 since around half 3. BG test on waking said I was 14.5 and the pump said I'd hit max basal limit. Still trying to get it down now but got meetings and client pickups. Love a good Monday! Oh, and due to stubbing and cutting my toe and getting some antibiotics on Sat I'm not feeling great at the moment. I have to get these meetings out the way and I might talk to my boss about leaving early. Feeling super stressed out tbh and anxious which is not like me at all.

    edit: I can't write "c r a p" it's asterisked out?
     
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    #79 aphex2k, Nov 25, 2019 at 12:29 AM
    Last edited: Nov 25, 2019
  20. aphex2k

    aphex2k Type 1 · Well-Known Member

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    OK guys sorry for the slow down in replies.

    A couple of weeks ago I had a panic attack at work. I assumed it was work related, signed off for the week. Worried about missing work, pressure on colleagues to carry my caseload etc. Anyway I felt OK and planned to go back the following Monday. But, walking to work, thinking about catching up and the week ahead, another panic attack. (I've worked in acute mental health for 15 years, dealt with serious self harm, suicide, 6'7'" psychotic Mauri's, weapons, single person home visits. No drama, that's what I do). Felt like it was work stressing me out all of a sudden so had another week signed off.

    Went back to work on Monday, albeit with 2.5mg of diazepam in me, and managed the day despite having to attend a MH tribunal about someones community treatment order. Stressful, but again, this is what I do.

    Tuesday was great. Laughing, smiling, joking etc. But got to 4pm and looked at my desk. The paperwork, notes, clinical updates, risk assessments. Meltdown. It's nearly 40c here. My boss was in meeting. The clinic co-ord was off (He's a Kiwi and the volcano / earthquake meant he was unnavailable). The next senior was out at a meeting. I walked into one of the registrars office in panic mode and said I needed some air, to go to the shops. By the time I got there my light blue shirt was dark blue with sweat. Heart was going 1 million beats and I just kept thinking "I"m ******" why me. I bought some cigarettes. Sat on a wall by work. Lit one. Put my head in my hands, then felt the burn of the cigarette on my fingers. It had burnt down and I hadn't noticed.

    I walked back into work, saw a colleague who smilingly said how are you? "****" and burst into tears.

    I've figured out that since I've been on the 670g, although my levels are great and predicted a1c has dropped from 7,7 to 6.9, the constant input this thing needs is making me so anxious. New sensors, calibration, warm up, beeping and vibrating through the night. Tuesday night 3 failed cannula inserts with unknown amounts of insulin delivered. 2am massive hypo 2.2 - obviously some insulin had got in but I don't know how much. I had a banana and went back to bed. Only to be woken by my wife with the alarms going off and another hypo. Up, cereal bar, back to bed. Then another hypo, big glass of milk.

    Woke next day, got my clothes ready for work but I knew I couldn't go in. So tired - too risky to drive. Work are super supportive.

    Went to GP who said need to see my endo. I've always self managed since being in Oz (ten years) and no chance of seeing an endo in public system this side of Christmas. So she did a referral to a private endo, except I'm chasing this but she gave me a copy and I was supposed to hand it to reception to fax (yeah, it's 2020... still faxing!). Anyway called them, no refertal obviously and no appts until at least Feb.

    Found another place locally that has private endos but I can't self refer, my GP has to change the name and address and they MIGHT be able to see me next Friday.

    I've realised that all this stress and anxiety is the pump and CGM. While it works for some, it's the constant inputs and requests for enter BG, sensors signal lost, new sensors, high levels and slow recovery. My overall picture is good, I'm just burnt out. Sleep deprived, and signed off work for another week, which obviously makes me feel guilty for adding pressure on my already busy colleagues, and the "catch up" when I get back to work.

    I have this week and next week signed off. Then I'm on 2 weeks annual leave and due back in New Year.

    I eat so healthily. Rarely eat bread bar some sourdough. I love kimchee, saurkraut etc. A friend who's a dietician said it's my gut bacteria but it's not, I don't think I could eat much healthier, nuts, seeds, greens etc. I exercise - mountain bike and thai boxing but I'm hving a break due to the heat here at the moment - 40c and it's only just started summer.

    It's the beeps and pump. It's the sleep deprivation. It's being snappy and angry at people when I'm normally the calmest most chilled.

    I have found that talking does help to some extent. My work colleagues are clin psychs, I'm not suicidal in any way. I'm not drinking to cope, and only reluctantly taking a diazepam when I feel I really need it.

    This ladies and gents is 25 years of diabetes. Burnout.

    I have considered the Dexcom G6 and using the pumo in manual mode during the day, but for some reason the G6 is not available in Aus yet and they can't tell me when. Perhaps the G5 and a Smartwatch combined with manual mode might work better. I just need to see an endo ASAP

    Sorry for the super long message. I've found it's great to listen to people's opinion here. And I hope people can relate and identify to some of these issues. As a community I know I can work through this, I'm just admitting to really being super anxious and struggling at the moment.

    I'm going to have a freezer-pop to cool down. I don't care if it's full of sugar! It's 39c now.

    PS. Panic attacks SUCK!!!!!!!!
     
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    #80 aphex2k, Dec 13, 2019 at 4:09 AM
    Last edited: Dec 13, 2019
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