Back in the days of working full-time, this used to be my career motto: “Always be a troubleshooter.” That was the advice I gave all the newbies I met about any job they were taking on, whether at McDonald’s or on Wall St. Words to live by… little did I know.
Since being diagnosed with diabetes, I feel like a Meister Troubleshooter. It’s not just some watchword for the workplace anymore, it’s a lifestyle. It’s what is known as diabetes management — just a fancy term for trying figure out what’s going wrong with your blood glucose control every day of your life and how to fix it.
Basal programs, temp basals, insulin-to-carb ratio, that tricky carb-counting (see yesterday’s post), infusion site rotation, wacky readings, warning arrows, high alarms, bum test strips, hidden carbs, dual wave bolus, … weigh & measure! It never stops…
When your blood sugar suddenly soars and it won’t come down, as was the case with me for four whole days last week (!), you run through every scenario: Is my pump malfunctioning somehow? (maybe this pod or that one isn’t connected right?) Or is the insulin fried? Am I even getting accurate readings on my meter? Or am I just on my way to developing a nasty cold?
If you think about it, these are the four basic points of failure:
- The insulin delivery device
- The insulin itself
- The blood glucose monitor
- The human body
The trouble is, the human body is more complex than all the other factors combined. That means no matter how well the technology works, you can always have blood sugar control issues that seem to escape logic.
Nevertheless, it sure would be nice if we knew we could rely on the technology 100%, but we’re just not there yet:
* There’s been a lot of talk about failure rates in pumps and pods. The fact is, these things do malfunction more often than any of us would like (the manufacturers included).
* Insulin is sensitive. If it’s been stored at too high temperature, or even been jarred around too much, I have learned, it becomes ineffective. But thereâs no gauge to tell us that — other than crazy-high BG readings. Yipes!
* Meters aren’t all that accurate. For traditional fingerstick meters, the FDA tolerates (in)accuracy levels of up to 20% (!), and for new CGM systems, up to 30%. That’s a huge margin of error! On top of that, these devices are prone to failure too sometimes, and/or test strips go bad at times.
Let’s be realistic: technology is immature when first introduced, and vendors have to rely on early-adopters to 1) help work the bugs out, and 2) provide the revenue to recoup past R&D costs and secure funds for future R&D. The customer — aka the patient -- literally has to pay the price, but what other options are there? At the same time, I think most of us are enormously grateful for the strides the technology has made towards better diabetes care. We’re all living freer, healthier, and longer because of it.
Still, all of this is what makes diabetes management so frustrating. Can you believe that all this was going through my mind last week as I got on the phone to troubleshoot with the Insulet reps? Yup, I was running in the 200s and even 300s, changing my pod over and over, injecting while still wearing it, having some success coming down and then soaring again. What was wrong now?!
Together we walked through every possible failure scenario, and eventually determined a cause of action – without any finger pointing or blaming. Turns out I’d been delivered a rather large shipment of “dead” Apidra. Somehow the contents of at least 3 vials had gone bad before they got to me. Luckily, my wonderful endo convinced my mail order supplier to replace them without a fuss.
But Insulet was wonderful, taking a ton of time to talk with me and follow up, and follow up again. And this is how it should be: while we cannot yet expect flawless diabetes technology, we can expect that the drug and device companies do their very best to support us in a crisis.
My experience has been that I’ve always been able to count on them when needed. But yes, I know, I’m a prominent blogger, so maybe I get pampered a bit… What about you? What has your customer service experience been when your life of troubleshooting hits a high note?