Precision Xtra Blood Ketone Meter

It's that time of year... here come the sick days.

There are some things that you don't expect as you prepare yourself for parenthood. One of the things that I didn't imagine? Being peed on more times then I can count. I guess that I should have been ready for a little pee at the changing table or perhaps in the doctor's office. That said, I never imagined how many times I'd be hit while collecting a urine sample and I'm talking about pre-diabetes. There was a time when he was about three that I believed my son was trying to pee on my hand. And Arden, oh Arden is the biggest offender as she quite likes to break out into uproarious laughter as I'm bent over collecting a sample during her yearly well visit.

When I realized that checking ketones was a part of diabetes management my first thought was, "great, more to do and learn" but my second thought was, "well at least I don't mind getting peed on anymore".

Did you know that pee and ketone management don't have to go hand in pee covered hand.

Recently on FaceBook I had a conversation with a mother of a newly diagnosed child who was experiencing their first illness with type I diabetes. She was understandably concerned and wanting to make the next few days as stable and simple as she could. Without a moment of hesitation, I recommended that she get a Blood Ketone Meter and told her that we use the Precision Xtra from Abbott.

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This meter is fast and accurate when checking ketones, it does require a largeish drop of blood but nothing that a little extra squeezing can't provide. It's a real lifesaver during sick days and any other times that you require a ketone check. I highly recommend asking your endocrinologist to write you a script so you can try it. We actually have two, one at school and one at home. I can't specifically speak to the pricing as our insurance covered Arden's meter and test strips, but I have seen the meter online for less then twenty dollars... a small price to pay to avoid getting peed on IMO. HUGE thank you to Erin who just told me in the comments that the meter is available for FREE from Abbott when you sign up for their FreeStyle Promise Program. Who says blog comments are dead?

When you love someone who has type 1 diabetes the flu and cold season is particularly stressful!

I know that during the winter months I'm always holding my breath a little extra, hoping that Arden doesn't get a cold or worse, the flu. There is much that you can do to prevent the spread of germs but getting sick is sometimes inevitable and being prepared makes the process go much smoother. If our Precision Xtra sits in a drawer 360 days a year – it is still well worth having for the other five.

May you and your children be healthy and germ free this season!

This post was updated with new links and better writing on 1/22/15.

Remember that I am not a doctor. I am just passing on good information from my perspective. Always speak with your health care professional before making changes to a care plan. This is not a paid review. Please note that I have never used it as a blood glucose meter and can't speak to it's reliability on that front.

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Prep Pad

So there I was, surfing the Interwebs, and I saw this video...

Introducing Prep Pad from The Orange Chef Company on Vimeo.

I was intrigued, and so I set out to learn more. My advanced Googling skills quickly led me to The Orange Chef, makers of the Prep Pad. I watched a few more videos, read about the product, and decided that it may be a huge leap in how I count carbohydrates for Arden. A few phone calls later, the makers are sending me a scale so I can give it a try and write a review.

The review unit should be arriving at my house in about two weeks, then I'll put the scale through it's paces and let you know what I learn. 

Based what I've seen and the conversation that I had with Michael from The Orange Chef, I'm more than excited to see what it can do. 

This is just the tip of what Michael says the Prep Pad can do but... Imagine you make a dish at home, just enter the ingredients as you go and the scale (In conjunction with it's companion iPad app) retrieves a bevy of nutritional information about your concoction - and it saves the information so that the next time you make the dish, all you have to do is call it up, weigh your serving, and the carb count is at your finger tips. This thing may completely change how we count carbs in our home cooked meals. Fingers crossed. 

This is not a paid review. I'm not receiving a free unit... I just thought that if the Prep Pad works as advertised, it may really help a lot of people who count carbs everyday. We'll find out soon.

First Impressions: New, Smaller OmniPod

Clearly the new, smaller OmniPod is... new and smaller.

Demo Pod with Clear Shell

But is it different, better and will your BGs magically be perfect when you use it? Most importantly... is it still the OmniPod that you know and love? What follows are my unfiltered initial thoughts about the new OmniPod system. This blog is not a complete rundown of every change and feature, today I'm writing about the stuff that jumped out at me after using the new OmniPod for about a month. Arden has recently completed the first box of ten pods and I feel ready to share my thoughts on that experience. Okay, are you ready? Are you excited, nervous, wrought with fear? No need, it's pretty much the same OmniPod, just smaller, newer and with a few changes that I think are worth talking about.

Size

In my opinion, size doesn't matter as much as footprint. Insulet has said in the past that the new OmniPod is, "Approximately 1/3 smaller than the current pod". That sounds impressive, and it is, but what does it mean and are the measurements as important as the overall experience for the wearer? Let's take a look...

You can see in the images above that the new pod is smaller in dimension, though the numbers suggest not by much. That reduction, however seemingly insignificant, has created a footprint that changes the way the OmniPod interacts with even the smallest body and that is in my opinion, what is so exciting about the new pod.

Our first month with the new pods has shown me that the reduced footprint brings:

Less drag - During activity or motion, the pod doesn't pull when your body changes directions in the same way that the old pod did.

More site possibilities - Small or lean people can sometimes have trouble finding locations on themselves that don't present challenges. The new pod creates more sites for those people. One example is that Arden can now wear the pod on her lower back, a site that wasn't available to her with the first generation pod because of it's larger footprint.

Less noticeable - The reduction in overall size and height creates more opportunity for the pod to match up with your body's natural contours. The reduction in size has created a device that is one step closer to being a seamless part of the wearer. It may take years before a pump exists that the wearer can't feel, but this is definitely a positive step in that direction.

Smaller means lighter - Not 1/3 lighter but there is a noticeable difference when you hold the two in your hand.

Easier to hide under clothing - You know, cause it's smaller.

It's cuter - What, it is!

PDM (Personal Diabetes Manager)

One day last year Arden's 1st gen pod experienced an error about four minutes before her bus was about to pull up to our home and I was able to change that pod without Arden missing her bus. How could I do it so fast? Muscle memory. I was at the point where I didn't need to look at the buttons during the insertion process, I'd done it so many times over the years that it was like typing. I had no need to look at the keys or even pay complete attention to what I was doing because I'd done it so many times before.

With the new system I find myself looking down at the PDM and perhaps that's not a bad thing. There are a few new screens and some redundancies that are meant to add safety. I can see how they were needed and I don't imagine that it will take users of the previous PDM very long to learn them. New users shouldn't be bothered greatly by the differences because none of the new screens are ridiculously unneeded or difficult to maneuver. It's my understanding that some changes were deemed necessary by the FDA so, like them or not, they are here to stay. Here are two examples of new screens:

If you look at the image below you will see that the new PDM requires that you confirm who you are before beginning. If you look closely you'll see that the "Confirm" button even changes positions each time that the PDM comes online. This may not be a safety issue for most people but in households with multiple people using an OmniPod, it's a big deal. You don't want to bolus the wrong person, a problem that is increasingly more possible with the new PDM's stronger signal range. Temp basal adjustments now require an extra step but the process removes the confusion that some experienced in the past by asking you up front if you want to increase or decrease the basal rate. Bonus, you are now informed of when the temp basal will begin and end on the final temp basal screen (I like that feature).

Signal strength - So this is a feature that I think may only matter to caregivers of people who use the OmniPod. I don't imagine many adults are being bolused by another person, so signal distance probably isn't an issue for them. Having said that, the signal distance is greatly improved. In fact the distance is a vast improvement over the first generation PDM and it even works through some walls and floors (Though not as well as the DexCom G4). Take note that the PDM can still have an issue finding the pod at close range if your body is shielding the pod. Overall, the improvement is amazing... if you don't believe me you can check out this video that I recorded and see for yourself.

Nuts and Bolts and Stuff that went wrong.

We've had three pod failures during the first box and I'll admit that I was worried for a few minutes but it's been smooth sailing since then. Coincidence? Early product issues? I don't know. What I do know is that Arden has been using the OmniPod for a very long time and we've maybe had, I'm guessing, twenty that have needed to be replaced in four years. The strangest part about OmniPod errors is that they come (At least in this house) in bunches. We can go six months without one and then have three in a month. It's difficult at times not to look into things too deeply when that happens but in the end, it always seems more like a fluke to me than anything else. Plus, other pumps have their own issues that OmniPod doesn't, so I take the spectacularly good with the bad.

Here's where I love OmniPod and the recyclable nature of the pump. I bet that we've all experienced an error that sometimes requires us to send the pod back to Insulet for inspection. Those pods help the company to learn why errors are happening and when they have their answers, they are able to make adjustments to future production runs that eliminate the issue. In short, OmniPod is able to upgrade their pump without having to replace each users device and that only benefits the consumer.

So, does it suck when three out of ten pods fail, it does. Did I get pissed when that happened, I did. Did Arden complain about having to change her pod three times in five days, you better believe it. Do I have more than a reasonable expectation that this won't be the situation for every box we receive, absolutely. Am I hopeful that six months from now the issue we experienced will be eradicated, I am.

Other Stuff

Apparently filling a new pod with more than 200 units of insulin can cause an error. Be on the lookout for a communication from Insulet about that soon. In the meantime, don't fill your pods with more than 200 units.

The syringe that fills the pod has a much short needle than previously.

The cannula is blue now so you can see it easier after it has deployed.

The PDM reminds you to test after a new pod has been placed.

There's a little window on top of the new pod that turns pink when the cannula has been properly inserted.

The cannula now enters at a different angle, Arden doesn't notice the difference and insulin delivery is unchanged.

Insulet Customer support has been overwhelmed of late making it nearly impossible for customers to get their calls through. I've had trouble and I know from watching online conversations that so have most of you. The other day however, on August 31st, a CSR picked up my call on the first ring. That experience led me to wonder if Insulet was perhaps getting a handle on the problem, so I reached out to the company and asked if they would like to make a statement here on Arden's Day about the recent trouble they've had answering the phone. 

With regards to customers calling for service, we realize that we haven't lived up to our usual standards lately, and we apologize sincerely to anyone who's experienced this first hand. We can assure you that it is our foremost priority to get back to our usual high standards of service. Our customer support teams have worked around the clock to respond to all inquiries in a timely manner, and in response we've done our best to expand the teams to match the high demand. As we've ramped up, and as we're getting closer to having converted all of our OmniPod wearers, we're also experiencing better service levels. We're not quite there yet, but we're seeing good improvement. To clarify a little bit, the nature of phone calls are manifold, and the teams equipped to respond to certain types of calls are not one and the same because they require different types of expertise. Unfortunately, while a majority of calls have been related to orders, you will find that some of these calls end up with our product support teams and vice versa. Billing is an example where we don't receive a lot of calls typically.  We do acknowledge the inconvenience and disruption this has caused to some, and for that we're truly sorry. We appreciate your understanding and cooperation as we finalize the transition of all users onto the new OmniPod. - Hjalte Hojsgaard, Director of Marketing for Insulet

Final thoughts

The overall size decrease is amazing, a smaller footprint means everything to kids wearing the OmniPod insulin pump.

I wish the transition went a lot smoother than it did but I'm hopeful that many lessons were learned about product transition as well as how to navigate the world of the FDA while seeking clearance for a new device.

Arden likes the new OmniPod a lot!

I don't see any changes in Arden's BGs with the new pod. They aren't any better or any worse.

We haven't experienced any change in adhesive potency. Swimming and bathing are all status quo for Arden.

Arden wants me to tell you that the sequence of clicks that occur before insertion has changed. Those of you who prepare yourself mentally for the needle buy counting those clicks will need to adjust.

I'm already excited to see what the next generation of improvements will bring!

Update: Arden just received a new supply of OmniPods from Insulet and this note was included in the order. on 2013-09-25 15:05 by Scott Benner

Important! I am currently providing Insulet with six written pieces for their blog Suite D. Two have already run, one will post soon and three more are on the way. I was compensated for my writing. Please know this, no freelance job is more valuable to me than the integrity of Arden's Day and the information that we (You and I) use to make important decisions about the health of the people that we love. If there was something bad to say about the new pods or if I had any concerns about something Insulet related, I would say so here without hesitation. Insulet has never asked me to have thoughts that aren't my own and if they did or ever do, I would decline. I am only compensated for the writing that I do for their blog and I am not compensated in any other way. My family pays the full amount that our insurance doesn't cover when we buy Arden's Omnipods.

Life Is Short: Book Reviews

It was September of 2012 when I handed in the manuscript for my first book. Not more than an hour later, I began to wonder if readers would enjoy it. Then we sent it out into the world to find out if anyone was interested in reading and reviewing my baby. I can't tell you how nerve-wracking it was to open the first review...

"I was pulled into the book and couldn't put it down. As a pediatrician and a parent myself, I strongly recommend this book to anyone looking for a fun but poignant read-- Benner takes stay at home parenting, actually just parenting in general, to a whole new level."

"Scott's wisdom shines even more as he dives into the moments leading up to Arden's diagnosis..."

"Humorous and witty, this book will leaving you laughing in many places and touched in others."

"His unabashed “dad humor” brings a distinct charm to his writing without being mawkish or overly sentimental."

"... it was a joy to read and I would recommend it to anyone. Seriously, anyone. I can't think of a person who wouldn't enjoy reading this."

"The life lessons he shares are extremely powerful and have inspired me in ways that allow me to be a better mother, wife and person."

"Simultaneously funny, poignant, and tear-jerking..."

"I highly recommend reading Life Is Short, Laundry Is Eternal: Confessions of a Stay-at-Home Dad. Warning! Once you start, you will not be able to put it down."

"This is not only a great book about being a stay-at-home dad, but it is also a wonderful book about parenting generally.The stories and anecdotes guide you through what it is like to love and care for a child with a serious illness, and then lift parents with encouragement and hope, whatever the parenting challenges they face."

"What sets this book apart and takes it from a fun self-deprecating look at parenting to a moving story you will never forget is the chapter on his daughter Arden’s type-1 diabetes diagnosis."

Today 'Life Is Short' has twenty, five-star reader reviews on Amazon:

"I enjoyed all aspects of this book, it makes you laugh, want to cry and be happy all at the same time."

"This was a fantastic book from start to finish."

"Touching, uplifting read! - I was hooked on the first page!"

"Nothing I can remember has ever touched me more."

"It's one of the best nonfiction books I've ever read."

"Sweet, pithy and naughty - I had to finish it right away."

"The book reads quickly. I couldn't put it down and stayed up late to finish it. If this guy plans to continue writing, I look forward to his next work."

"Real, Relatable writing - Scott nails it with very real and relatable writing for everyone."

"A roller coaster ride of emotions, and opens himself and his life in a way that makes you feel you're there with him."

You can click here or go to Amazon to read these and other reviews in their entirety.

'Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad' is on sale now in paperback and all of your favorite eReader formats.

So...

Long after this crazy week has passed and we get back to talking about type I diabetes... I will always remember how supportive and loving the DOC was to me. I'm never going to be able to thank you all enough for the support that you have shown me as I brought my book to the world. Thank you for reading, and for taking the time to tell a friend. When you share a FaceBook post, retweet a link or tell someone about the book you just read, well, you are doing more than perhaps you can imagine.

I hope today, just as I did last September, that you enjoy what I wrote. If you do, please consider adding your thoughts to iTunes, Barnes & Noble, Amazon, Canadian Amazon and the rest. Reader reviews are the best and most effective way for 'Life Is Short' to find a wider audience.

My heartfelt gratitude,

Scott

The Life of a Stay-at-Home D-Dad: Scott Benner’s Story

I was interviewed recently by Laura K. from Discuss Diabetes about blogging, advocacy and being a father. Laura and I talked for over an hour and we covered some topics that I don't usually get to write about here on Arden's Day. 

In the book Scott tells the stories of what he saw as pivotal moments. “I wanted to leave people feeling uplifted, more connected with the idea of family being most important,” he said. “It comes from recognizing there’s probably nothing more important that you can do than just watch your kid at baseball practice for five minutes because it means more to him than you can understand.” 

Laura closes the interview by giving her thoughts on Life Is Short, Laundry Is Eternal. They are among the most touching words that I could imagine hearing. I hope you have a few seconds to check it out.

Speaking of my new book that arrives on April 2nd...

I've added a review section to my book page. Look for recent reviews by Manny Hernandez from TUDiabetes and Chris Snider from the Just Talking PodCast.

I'm being told that the eBook formats often become available weeks before the launch date - I'll let you know when you can download.

Those wanting a paperback take note: Amazon and Barnes & Noble have both dropped the price for LIS to $9.47. If you are planning on buying the book, this is the lowest price that I've seen yet. Pre-Orders should arrive at your home on the release date. Links to both sites, as well as Canadian and UK Amazon are here.

I'm humbled and a bit taken aback by the amount of requests that I'm receiving for autographed copies of LIS. So far we only have one signing scheduled but I'm working on getting more opportunities set up. I'm also trying to work out a way that I can provide copies directly without adding tons of shopping costs. Stay tuned and follow Life Is Short on FaceBook for updates.

Have a great weekend!

Scott

Update on 2013-03-11 23:55 by Scott Benner

The Kindle Version of 'Life Is Short' just populated on Amazon US, Canada and UK. The system is accepting pre-orders now and your Kindle version will be available for download on March 12 - that's 21 days before the paperback. No word yet about Nook and iBooks, should be soon.