Thursday, 25 October 2012

Adam's School Report

Student: Adam Pump

Year ending: October 2012

Dear Parent of Adam,

It’s come to pass that Adam Pump has nearly completed a full year of education so it is time for Adam to receive his annual school report.  Please read through and add any comments at the end.

Adam is very strong at mathematics using his advanced algorithmic skills to calculate bolus amounts and adjustments based on the magic formulas of carbohydrate and correction ratios. Despite this Adam sometimes struggles with his binary view of whether his owner (AKA Dave) has perfect or non-perfect BG levels. To improve in this area Adam could sometimes use his judgement to decide whether the same correction ratios should be used at all times. For example if Dave posts a BG of 2.8mmol/L* (50mg/dL) and then records 15g of carbs; suggesting a small dose of insulin using the Bolus Wizard isn’t always the cleverest idea.  *Dave, please note your performance here also needs improvement as Adam prefers to operate within 'non-waffy' BG levels.

Adam needs a little improvement in this area. He’s trying to articulate what he’s thinking but using a very restricted menu style approach that hides away much useful information. Adam also needs to consider maybe using different forms of communication for different situations.  Due to the constant beeping involved in any Dave interaction, Dave chose to replace Adam’s audio output with vibrations. This is great but it would be useful if Adam could use different methods at different times of day and for different alerts. For example if Adam has completed delivering a square wave a small vibration is appropriate. However if there is an occlusion / blockage at 3am Dave would appreciate a loud alarm with Inspector Gadget stylee arm to shake him until he wakes up. Or even just some repetitive beeps.

Adam has had an excellent school year with only a couple of moments that required detention.  Most sets have lasted three days with little comfort issues suggesting they could go longer if just left where they were. Adam did however have one instance of pure rebellion. Without any warning he threw his tubing at a nearby moving pram handle and leapt from his wearer’s pocket after detaching from the skin completely. After this Adam has been much better behaved and hasn’t suggested a repeat performance. I think we all achieved understanding of what was acceptable on that day.

Adam is strong with modern history memorising recent dosage and blood tests. He could try harder in applying his history knowledge to the current situations and how that might assist his wearer. For example Adam knows that Dave went low for three Saturday mornings running at around the same time of day. Using so far unseen initiative Adam could suggest to Dave, maybe by email, text or vibrate that he needs to tweak his basals the following week.

Adam likes to get active and this should be praised. Dave also likes a run now and again and thanks to a fantastic Spibelt they work together well to get out and about. The use of Temporary Basal Rates (TBRs) when exercising is a huge plus over the old regime of injecting and setting the basal insulin amount once or twice a day. This was proven fantastically last May with the assistance of Adam’s cousin Colin the CGM to enable Dave to do a full day of exercise with very little drama along the way. Well done Adam.

Headteacher’s comments:
Due to a late connection Adam only joined is in November 2011. Dave had survived the previous 30-odd years with MDS (multiple daily stabs) and often looked at the technically advanced facilities of pumps such as Adam with high suspicion of ‘always being connected’. Despite this delay in being accepted Adam has worked hard to give the control needed to enable his wearer to live as normal a life as possible. Dave does understand the drawbacks of Adam needing to be working all the time without fail but Dave understands that the benefits proven faar outweigh any connections nuisances.

Overall Mark:
B +

Parent’s comments:
Life isn’t perfect and a few hiccups along the way including the continued struggle with pasta and pizza mean that Adam isn’t going to make everything perfect. But, and this is a big but, the ability to bolus and eat on the move along with the priceless TBRs means I am very happy with Adam’s permanent attachment to my body. I am hoping the next year shows continued improved BG control and Adam maintains his high levels of reliability.