Day 1 aka S#%@ Happens
Omnipod 5 Day 1 has officially started and it began with a Lemony Snicket's Series of Unfortunate Events of Thai fried rice, a few gallons of insulin, and a game of find the hidden pod.
I was joking with a friend that it is a universal requirement to include a disclaimer when posting graphs that starts something like "ignore the horrible numbers" or "I know, no judgment🤦". We've all been there, done that. So I'll post this graph with a very unapologetic:
S#%@ Happens and don't try this at home
We all love fried rice and what type one diabetic doesn't like a gigantic helping of fried rice at 11pm?! Queue the dramatic music and nasty rise. But that Evil Knievel ramp to jump onto the roof of Caesar's Palace definitely looked like more than fried rice.
Where Things Get Interesting
My wife, Lisa, decided to do a pod change at 2am (still dash pod) since it looked more like a failing pod than rice alone. We all know there's not much worse than a pod failure during those long rise meals. But here's where the story takes a turn to the warning to not try this at home. Stumbling in the dark to help a sleeping 17 year old change her pod is not the easiest task and the pod ended up too far around the inside of her arm where she hates it. She tells mom Don't worry, I do this all the time...pull off the adhesive opposite the cannula, gently rotate the pod around the cannula, and stick it back in place. 🧐 Maybe that explains all those pods that don't quite seem to work as well. Thankfully she had dosed a final bolus on the old pod and an immediate bolus on the new.
Not knowing the story, I told Lisa to snooze her alerts, go to bed, and I'll handle the rest of the night. I feel that I need to interject a point of reference before proceeding: Lily's total daily insulin is usually 50-55 units per day. In the 7 hours after the rice bolus, we dosed 30 units. In hindsight, the insulin obviously wasn't working even after the pod change. In the moment, while binge watching Netflix at 4 in the morning, she seemed to be coming down even though it was very slowly. We have seen crazy stubborn highs like this before and, with the pod change, it didn't seem to be that far out of the realm of possibility.
The Moral of the Story
When Lily wakes up, she was 175 mg/dL and still trending in the right direction. But she calls me in to ask a troubling question: Why is the pod in the middle of my back?. Who can guess what happens when you pull the adhesive to rotate a pod and then roll around in bed? I'll give you a hint; it rhymes with thirty-units-of-insulin-on-your-back. 👊
So what do you do with a second pod change not knowing when the pod decided to move to her back for a game of hide and seek? Since we have no idea how long she didn't have basal or how much IOB is on board, everything is going to be a SWAG for at least the next 6 hours. We might as well let go of the reins and have Omnipod 5 try to deal with it.