|"Wilson - surely, you must also have atypical
basal insulin needs."
I've been doing what I've been doing so long, that I sometimes forget it's not "typical".
My P.A. and I have been tweaking my basal rates for several months, and finally have things to a point where I'm not consistently running low or high anywhere; i.e. I'm at the basal rate I should be for that time of day and will mostly have in-range, predictable numbers, SWAGing notwithstanding.
It didn't occur to me that my basal insulin needs were out of the ordinary until I saw a CDE last week. Since I haven't been to an endocrinologist for two years, I haven't had access to a CDE, either. I've pretty much been winging it, and the numbers seem to suggest that it's been working well for me. It's a very detailed system, and took months to figure it out, but it works. And I'm okay with that.
The CDE, however, was not okay with that. And now I'm wondering if I should still be okay with that, too.
This CDE knows her stuff. It turns out that she was actually the one who trained me and worked with me on my first insulin pump at Dr. B's office (which she doesn't work at anymore). She's very knowledgeable, and given our track record, I'm comfortable with her. She knows what she's doing, and I mostly trust her. (I say mostly, because when it really comes down to it - I know my body best. I've been living with this for 24 years, and I know what will work for me specifically, and what won't, in most cases. I reserve Veto Power.)
Here's the deal: I have a lot of basal rate changes Monday - Friday. Twelve different rates, to be exact - which is also the maximum amount that the Ping will let me program for one pattern. I didn't think this was weird - I mean, they give you up to 12 because some people will use that many, right? I have scheduled exercise twice a day, and instead of eating a snack, I have a reduced basal rate programmed in there to accommodate that exercise.
Once the CDE and I had gone through my pump settings, and she had everything written down, she sat back. She looked at the paper she had just written all over, and said, "Wow. Um... wow. This is going to be challenging."
Her thoughts were that I was working with too many variables. That, if I could get myself down to no more than 6 rates during those weekdays, life would be easier, because adjustments could be made more easily. The "less is more" approach.
I can see where she's coming from, and part of me can agree with that. But, I also look at the side that says, "But this is working for me right now! I don't want to mess it up!"
I will hopefully be seeing my P.A. on Thursday of this week, and I'll see what her thoughts are. The CDE said she'd call my P.A. and talk through what she told me, so at least I don't have to go in and explain what she's talking about.
So... I'm wondering, from my fellow pump users - how many pre-programmed basal rates do you use on a typical day? Does anyone else go into the double digits, or is it just me?
(P.S. You may be asking why I went to the CDE in the first place - if it isn't broke, don't fix it, right? Well, maybe I'll have more of an explanation on that another day. Cliffhanger!)