Monday, November 21, 2016


 I sat in my office today looking at the brand new Medtronic 630G insulin pump boxes and supplies spread out on my conference table. 
My patient sat their with apprehension painted on his face. He has been diabetic for the last 10 years, 9 of them wearing a pump similar to the Medtronic Revel still attached to him.
"Is it totally different? Like will I ...have to relearn everything..?". His question was more than valid. This new pump suddenly looked strikingly dissimilar to his current pancreas.
Of course it was different, even if the basic ideology was the same. And this struck fear in my patient. Change often strikes fear in a type 1 diabetic. We have daily routines and rituals that we develop and form. We choose our medications, devices and supplies and then cling to their normalcy as fixtures in our activities of diabetical daily life.

The sound of panic in voices as the call my clinic because of their formulary changes. "But I've been on Humalog for 15 years, how could they possibly expect me to use Novolog??."
Whether it be a new meter, type of test strip, a pump or new lancet device, anything new and unfamiliar causes a type 1 to have a nervous tic. We have our Rain Man routines, and when that is threatened, when we can't buy our underwear at K-Mart, we fret. 

I can tell someone via text how to change pump settings, step by step. I have worn each one long enough that each key stroke is ingrained in my diabetic brain. When my ex, Dr.  C, and I first began dating, he used Humalog, whereas I used Novolog. Our butter compartment in the fridge was suddenly like a throw down between the Crips and the Bloods. His Accu-Chek drum strips mingling with my One Touch Ultras on the floor, like a scene from Westside Story. Each one of us steadfast that OUR way and OUR products were THE best and THE way to go.

Change is scary. Especially when we are talking about a chronic disease that requires daily, almost hourly attention. Rely on your endo team, CDE, pump rep and fellow members of the DOC when faced with decisions regarding change. They are all wonderful wealths of knowledge and experience. The goods, bads and the uglies.

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