The Ca-Chunk Factor: MiniMed 530G with Enlite

The Enlite® serter, the device patients use to insert the Enlite® sensor beneath the skin, was designed with patient comfort in mind. With a simple insertion process, it inserts the sensor at a 90-degree angle using a completely hidden needle.  Courtesy Medtronic, Inc.
The Enlite® serter, the device patients use to insert the Enlite® sensor beneath the skin, was designed with patient comfort in mind. With a simple insertion process, it inserts the sensor at a 90-degree angle using a completely hidden needle.
Courtesy Medtronic, Inc.

Control. It’s a concept that people with diabetes wrestle with… control over what we eat, our blood sugars, our lives in general. When you’ve done everything in your power to keep this disease in check, and yet, you see a high (or low) blood sugar on the meter, it’s frustrating.

So, I take control whenever I can in my diabetes, which includes needle insertion. I’m not a huge fan of “auto-insertion” and never have been. From my very first injection in 1983, I would slowly insert the needle into my selected spot. If I was halfway in and it began to hurt or I felt a twinge, it wasn’t uncommon for me to pull the needle out and start in another spot. Quirky? Guilty as charged. There are times that I am jealous of those who jam a needle in and quickly inject and move on, but I prefer having control over at least, inserting the needle. I use a Silhouette insertion set for my insulin pump because I can insert it manually…under my control.

The Medtronic Enlite® Sensor uses a insertion device that doesn’t allow for the rate of needle insertion. (The Dexcom G4 sensor insertion device uses a plunger, so yes, I totally take my time pushing that plunger down.) I didn’t have a positive experience with the Sof-Serter sensor insertion and truth? Freaking out about putting in the Enlite®  on Friday was actually raising my blood sugar. I was… scared. What if it hurt just like the Sof-Serter? What if the needle hit a spot that was tender and it bled? What if it came time to put that inserter onto my skin and I chickened out.

The Ca-Chunk Factor

Then there’s the Ca-Chunk Factor. That sound that the inserter makes when the mechanics release and the spring load snaps and something happens. If you’ve had diabetes for a while, you’ll remember the “Ca-Chunk” sound with the Autolet lancet device (a.k.a The Guillotine). I dread that sound. Sends shivers up my spine. I sweat a little in anticipation.

I had my training session with the Medtronic trainer on Friday and after the polite introductions, I spilled my guts. “I’m scared about the insertion pain and the accuracy and the Ca-Chunk Factor, but right now, it’s the insertion pain. I’ve been told that it hurts much less than the Sof-Serter, but I have nightmares about those insertions, so…”

Lisa, the trainer, was incredibly cool about it all. (I think I may not have been the first to express these fears.) We talked about the difference in needle gauge sizes (the Enlite®  introducer needle is significantly smaller) and how many individuals had expressed surprise at how comfortable the sensor felt after insertion. She asked me to explain the Ca-Chunk Factor. She offered to have me practice using the inserter, but I took a deep breath and said: “Let’s just do this.”

Here’s how the insertion of my first Enlite® Sensor went for me.

Lisa: “You don’t need to pinch skin at all. Just place the inserter directly onto the skin and don’t press the inserter hard. Most people find it comfortable to stand up when they do the insertion.”

I nervously stand, whipping my shirt up and searching my abdomen for a spot that would have the least potential for an “OWW!”.

Me: “OK. Wait! Where should I have the green button?” (The green button is what you press and release to insert the Enlite Sensor.) I turn the inserter around on my abdomen, trying to find a comfortable way to hold it and the button and begin to feel that sweat beading on my forehead.)

Lisa: “When you’re ready, press the green button.”

Deep breath. Moment of truth. I push the green button.

I think to myself: ‘Wow. She was right! That didn’t hurt at all! Jeez, I have no idea why I was freaking out about this.’

Lisa: “Now, release the button.”

Me: “No problem.”

As I released the button, I heard…

“Ca-Chunk.”

I had been fooled by the Medtronic Enlite®  Sensor serter. It drives the needle in upon the release of the button, not the push. And because I was lulled into the concept that I had already done the hard part, it came as a surprise. What was more of a surprise was that it didn’t hurt when it really went in.

My first fear – squashed. Annihilated. (Next week when it’s time to put a new sensor in? I’ll have to trick myself, but I know it won’t be as painful as I thought it would be.)

After the insertion process was complete (There are more steps, including a complicated process of taping the sensor down onto your skin…), I told Lisa that I had been duped by the inserter. Happily duped.

Right now, a few days into this, if you asked me where the sensor was on my abdomen right now, I’d have to think hard. No pain. No twinges. (I’ll talk about the accuracy in another post.)

Control. I could give up a little for this…

 

Guinea Pig: MiniMed 530G Insulin Pump with Enlite

OLYMPUS DIGITAL CAMERAIn second grade, Mr. Harris introduced us to our class pet: a black, tan, and white guinea pig named Zipper. He (she?) squeaked quietly in a large cage filled with shavings in the back of the room while we learned about math and good citizenship. I got to bring him home for one of our breaks and loved on that little guinea pig while our cat shot daggers from her eyes. She was jealous.

Hi. Please call me Zipper for the next 90 days.

The MiniMed 530G with Enlite will become my insulin pump/sensor system, along with all that it entails over the next three months, thanks to a trial offered to me by Medtronic.

Here are the details of the trial, as I’m all into disclosure:

Medtronic is loaning me the entire system for the 90 day trial, including the 530G pump, CGM transmitter, Bayer Contour Next Link meter and test strips, Enlite sensors, reservoirs, and infusion sets. After the trial is complete, I will return all unused supplies as well as the pump, transmitter, and Bayer blood glucose meter.

I will be providing feedback to Medtronic through a survey and a one hour phone call after the trial is over. I will go through the entire set up as if I am a new pump user, including meeting with a Medtronic trainer and using their protocols and help desk. I will be changing my infusion sets every three days and my Enlite sensor every six days.

They won’t be putting words into my mouth (which is great, because it’s already full of my own) and I will share my honest opinion, my ups and downs, and what I think about the system. They know I’m not one to dance around the real issues, so you’ll get what you always get from me: unabashed and never whitewashed realism.

I’ve worn a Medtronic MiniMed pump for years and I’ve been happy with it. As I have said before, when I first started on a pump, there were only two companies in the game. As I was moving to Europe, I chose the “not Minimed” company, but when I returned to the U.S., Minimed had jumped so far ahead in technology, it was a no-brainer.

Time marches on and the market has expanded, not just with insulin pumps but with CGMs, and this is where my trepidation comes in. I had tried the Sof-Serter and abandoned it due to pain and accuracy issues. When I attended the Medtronic Advocacy Summit in January, I spoke with several Medtronic employees who assured me that the new CGM is less painful to insert and more accurate than before.  We. Shall. See.

Why I’m Trying The MiniMed 530G with Enlite

I’m curious. (Isn’t that enough?)

I love my Dexcom CGM. I love its accuracy, it’s ability to eek past the recommended seven day readings, and the fact that my husband can take it from me and still watch my numbers as I snuggle in the other room with The Kid. (And yes, he has brought me a juice box when I didn’t realize I was going low.) I love my MiniMed Revel 723. My fingers know the buttons in the dark. It’s been a part of me for so long. There are other insulin pumps out there and I’ve petted some of them, wondering if I would like them just as much if not more than what I currently have.

But this Threshold Suspend thing that will stop insulin delivery if it goes below a decided upon BG level? Totally looking forward to that if it does what it’s supposed to do. My overnight lows, even with the Dexcom, are still pretty rough. I’m sleeping through my alarms until I get to the 55 mg/dl or below “prisoners are escaping” blare. By then, I’m wobbly, cranky, and I eat until I stop panicking. Total barrel full of fun the next day. As the Threshold Suspend is unique to the Medtronic Minimed 530G, it’s a big deal for me. Will it be worth giving up my Dexcom? Would it be better for me than the upcoming but not yet released Animas Vibe? Can I get over the non-open standard nature of Medtronic data?  We. Shall. See.

We. Shall. See.

I keep saying: “We. Shall. See.” because you’re basically taking me home for 90 days. You get to watch me run around like Zipper and observe this experiment in ThePerfectD.com habitat. Fun photos! Great stories! An expletive or two! (O.K., I hope not…) Reality.

I would like a water bottle on the side of my cage, please. Maybe filled with caffeine? Can you do that for me?

My name is Zipper and I’ll be wearing the MiniMed 530G with Enlite for the next 90 days.

Squeak.