Me & my speech.

Posts tagged ‘symptoms’

WHOOPS DISEASE- 7b6. Problems with Diabetes & ABNORMAL Sugars in Life

For insulin dependent diabetics the problems during WHOOPS DISEASE include abnormal sugar results & body actions that impact uses of insulin & diet actions.

As well as sugar issues that have abnormal results based on normal actions.

The normal life of waking and sleeping, eating and drinking, washing and more are all part of what an individual prepares and organizes into insulin uses with diabetes. For more than 40 years I’ve lived with the disease and for over 25 years have had the insulin pumps, and for over 15 years have functioned with sugar variation patterns on my insulin pumps. BUT additional weird issues and sugar situations with the Whoops Disease make it a lot harder to live normally.

Bathing/Showering

Previous to Whoops Disease there were NO sugar change issues with taking a bath. Yes I had to take care that my sugars were at correct levels with bathing, but nothing else. BUT over the last 10 years I’ve had variations of sugar changes with bathing & even showering AT TIMES. It’s likely because this disease is water related that the sugar variations happen with bathing and showering.

The body processes water as well as more, which means that when sugars are portioned into the body that variations in water amounts, like with Whoops can also shift sugar amounts because of the type of the disease and how water processing influences everything else. With bathing I’ve had sugar drops, so much so that in 3 cases I disconnected my insulin pump, for a 4 hour period while in the bath and only plugged it back in 3 hours later. That’s not normal at all.

And there’s the times where I take a shower for 20 minutes OR so starting with normal sugar levels, insulin disconnected, and get out of the shower with my sugar dropping low. This could be assigned to eating before showering, but this is not the case. So take care if you’re insulin dependent, bathing, showering, swimming, and other water activities with Whoops could cause dangers that are unexpected.

Waking

This is a more recent issue, having continued since about June and it’s getting worse all the time. It started doing this like every once every 3 days, but it graduated to once every 2 days, and now it’s doing it every day. I wake up, check my sugar normally, and go about the day. BUT if I consume milk, nutrition drinks with protein, or even eat protein my sugar goes up at least 80 beyond the amount of any carb in milk AND these issues last up to 3 hours beyond waking.

Today was an example:

  • A sugar check 3 hours before waking had my sugar at 116, it was fine and nothing was eaten until I woke.
  • After waking
    • First I had my initial mug of tea with about 1/3 of a cup of whole milk, which is normally equal to 5 carbs, but with it heated it’s generally a carb value of 2.5.
    • Then I had my 2nd mug of tea prepared the same way as the first mug.
    • While drinking the tea I had some venison sausage.
  • I just checked my sugar, the results were 205, that’s 5.40 units of insulin worth of a high.
    • I know it’s not the basal, the basal changes were tried previously with the post waking times and I had issues with lows on the next days because the basals were correct enough.
    • The milk carb total consumed was only an active 5 carbs. That equals 1 unit of correction insulin that could have been needed.
  • This means that 5.4 given minus the 1 means my sugar went up over 90 points with nothing but protein and dairy in my system to raise the sugars.
    • And for the next 2 to 3 hours any protein OR dairy I get will keep my sugar high.

This issues happens right after waking for the 2 to 3 hour time period…AS WELL AS when I’m doing stuff.

Sleeping & Activity

Normally with diabetes the basal, base, insulin rates are set higher for sleeping than for being awake. There are issues with that if you have a sit down at the computer job, because you’re not relaxed, but your body isn’t exercising, so it’s like watching a film OR television, your sugar basal levels are generally as high OR even higher than they are with sleeping.

BUT normally doing stuff helps your body utilize more carbs and allows your sugar levels to be lower.

BUT NOT WITH WHOOPS at these later stages!

For any activity my sugar levels are higher than normal, it’s odd because instead of lowering my basal temporarily, I have to raise it temporarily to keep my sugars level. I didn’t do that today, while it wasn’t a lot of activity, my sugar didn’t go down instead it went up tremendously, as shared above.

Last night I spent 3 hours preparing food and my sugar levels went up during the process of making. So instead of exercise and activity reducing insulin needs, it actually causes a rise in insulin needed for those time frames. This amount will vary by individuals. AND as is discussed in other articles about water weight and diabetes issues in 10 posts by me there are sensor use issues that make utilizing the continuous glucose monitoring (CGM) mostly useless with Whoops Disease. Which means you need to manually be keeping check of the sugars, the results, the insulin, uses and lots more. And I fail with this repeatedly.

Eating

Please note that types of food as well as type of food making processes vary the values of the food as well as the use measures for people. Parts of this is discussed in the 7a. post under the Hemorrhoid Issues heading because of discussing fiber foods & food values with processes.

PROTEINS causing need for insulin at least in the first 2 to 3 waking hours.

VEGETABLES like corn, maybe also lima beans, and other carb veggies not having the insulin need that they used to.

  • cooked potatoes=1.25 amount of carb now
  • cooked corn=0.5 amount of carb now
  • cooked black beans= 0.75 amount of carb now
  • cooked chili beans= 0.75 amount of carb now
  • cooked garbanzo beans= 1.25 amount of carb now
  • raw carrots= 0.25 amount of carb now
  • summer squash= 0 amount of carb and still is for me
  • zucchini= 0 amount of carb and still is for me
  • leaf greens= 0 carb, but always are no carb
  • peas= ?
  • winter squash= ?
  • lima beans= ?
  • Others= ?

Generally the starchiness in vegetables is less when they are not cooked while the fiber contents can be higher, the nutrition is also varied. So for raw squash, tomatoes, turnips, rutabagas, parsnips, garlic, corn, green type beans, and others I don’t take any insulin anyway…BUT the oddity of not taking insulin with carrots is weird.

FRUITS also have had varied insulin issues for me. There are always variations based on the ripeness/starchiness of the fruits as well as the sizes. This means that all fresh fruits always have insulin variations, BUT generally the canned fruits are ‘the same’ in accord with the carbs listed on the cans. But I’ve noted some variations with these also, but I do not take as many fruits as I do vegetables.

For the listings here I’m adding the info from the newer Calorie King book, which is not the newest, in my home PLUS I”m doing the math to show the size aspects with the fruits I normally get, because the insulin uses are based on me consuming those.

  • Avocados– Hass variety (Mexican)- Half cup, 2.5 oz= 6 carbs, BUT I need to take 1.5 times the amount, 9 carbs worth, because of the high protein content in this fruit.
  • Bananas
    • Green– 7″, 5oz. so 10 carbs normally, but with Whoops only 5 carbs are needed.
    • Good Yellow– 7″, 5oz. so 15 carbs normally, but with Whoops only 7 or 8 carbs are needed.
    • Brownish Yellow– 7″, 5oz. so 20 carbs normally, but with Whoops only 10 carbs are needed.
  • Apples
    • These vary but for 2 to 4 ounces I take 0 insulin, for a larger one I only take up to 8 carbs, depending on how sweet they are.
  • Grapes
    • cut insulin by 50%
  • Blueberries
    • cut insulin by 75%
  • Watermelon
    • cut insulin by 25%
  • Cherries
    • cut insulin by 75%
  • Strawberries
    • cut insulin by 50%
  • Others
    • Like the info above demonstrates the darker the color of the fruit the more cutting with Whoops Disease. BUT also, like with the bananas the less ripe the fruit is the more cutting that should be done normally.

So the fruit variations in carbs can cause low sugars with Whoops, but beyond Whoops the normal uses of insulin should return if an individual remains an insulin dependent diabetic.

Basal Changes

Normally in life there are basal patterns that can be mostly predicted based on lifestyles and patterns of daily living during those days of styles. BUT with Whoops my lifestyle has been consistent for most times of the year. The only variation was last spring, summer, and fall with the gardening.

Normal Basal Insulin Versus Whoops Insulin Basal Variations

BUT this means that in comparison there are issues in life because of the abnormality and amount of insulin changes that are so abnormal with Whoops. So let’s compare this last year for Rhapsodie and the normal variations in Basal for her with the Whoops Disease Basal Issues:

Normal Basal Pattern with Life Type

Were going to start with the spring gardening pattern, to the summer gardening pattern, the fall gardening pattern, the winter holiday pattern, then the later winter previous to spring patterns that are normal.

  • Work Basals
    • Early work day, to evening day work pattern
      • Basals are set with working times being lower than sleeping times, varying body functions, activities, and eating.
    • Late day start to mid morning work pattern
      • Basals are set with working times being lower than sleeping times, varying body functions, activities, and eating.
    • Early morning to mid night extra long work pattern
      • Basals are set with working times being lower than sleeping times, varying body functions, activities, and eating.
    • [Without gardening the work patterns also have the ‘weekend’ days/ non work days to calculate depending on the work schedules and their time frames. BUT  not with gardening…that work continues for months with variations because of work and growth cycles and works with the growth cycles. This pattern ends with a couple months of winter break, but with greenhouse work starting in February/March… it means the winter break from November into January is only a short time.]
  • Mid menstrual, ovulation, cycle, 24 hours of basals going up 15%.
  • Premenstrual into menstrual cycle pattern, up to 3 days with basals graduating
    • up 0.5 the 3rd day before,
    • 1.0 the 2nd day before,
    • 1.5 the day before, and
  • Menstrual cycle, 5 days total,
    • staying high through the period, then
  • Post menstrual
    • 1.0 basal drop for 24 hours the day after.
  • Normal
    • Sugar cycles back to normal patterns.

These pattern amounts allow a person on an insulin pump who has the normal cycles to setup up patterns with variations that are more normal and consistent for life. BUT that’s not the same with Whoops.

Whoops Disease Basal Pattern Issues with Life Types

Whoops disease basal patterns are so inconsistent, I barely get 2 days of the same basals, then I have to adjust things for many days, then get 1 or 2 days of no adjusting and then am back to rearranging my basals all over again. There have been so many patterns that I only at times have made records… copies are shared in multiple posts:

The information on the spreadsheet clips, shared on those posts was begun with a basal sheet setup that I have varied things for at least 182 days between 1 and 12 times a day this is ridiculous. At times because of using the Paradigm to allow me better control of my insulin without the innaccurate submariners fiddling with my basals and boluses on the 670g, I have just kept the pump in a single state and have made adjustments repeatedly. So using Excel have setup a listing that allows me to vary the ups and downs on page, then I can have that record as well as a copy that’s not erased for change uses.

This means that for 2020 I only have listings of variations for

  • 2020- March 4 days of Morning & Evening changes- that’s 8 sets with the 4 days of listed complete changes in basal list records.
  • 2020- April
    • 1 day of Morning & Evening changes- that’s 2 sets with the 1 day doing double records,
    • only 16 other days of multiple sets of changes recorded in basal list records
    • total of 17 days of recorded changes during April
  • 2020- May
    • total of 19 days of recorded changes during May
  • 2020- June
    • total of 1 day of recorded changes during June
      • Gardening and sleeping was most of my summer life.
  • 2020- July
    • total of 3 days of recorded changes during July
  • 2020- August
    • total of 0 days of recorded changes during August…too busy in real life to make recordings updates, but the variations were continuing…May is just an example of my life over the last years.
  • 2020- September
    • total of 2 days of recorded changes during September.

Instead of making up a brand new record now, I only do so when I have an issue with losing the records in the pump OR think of making an update from the Paradigm. While I was able to load the 670g I was doing the info records at least once a month, so I could copy the numbers onto the basal of that pump for the official records. BUT I’ve not been able to download the new setup from Minimed, and still can’t.

To Be Finished Soon!

And my poor little sensor with my 670g insulin pump is having trouble keeping up with my sugars which earlier tonight reading low, BUT my sugar tested 98% lower than the sensor readings with a count of 51 when the blood test is at 39. This means doing an all around basal lowerings all over again…yeehah more fun.  Because of body issues as well as Whoops there are many occasions where spending time on the computer adding info is too much for me to do, sorry…this also means there will be no improvement in my blogging style pertaining to frequency. But I’ll continue trying to share useful info for some of us.

Other Connecting Posts

Please beware they are grouped based on a style of topics.

Diabetic’s and Treatments

[Sorry posts still need dividing & completing for better online reading.]

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

 

1). Pump Diabetics- Ischemia Treatment Options & Painkiller Works with PUMP & CGM

Sorry everyone

Plans are to divide this info into multiple posts that are linked to the diabetic info posts and the Whoops disease posts in some areas. This lack of division means this incomplete paper of info is also still HUUUUUUGE, so that means it’s more difficult at present to locate the insulin & sugar variation issues and actions planned with insulin pumps and sugar processes to allow treatments of Ischemia as well as acetaminophen AND other drugs to be better with the care of diabetics on insulin systems like Rhapsodie is.

This also means at the present time if you’re reading this info you may find copying it and pasting it to a document allows you to copy and utilize Rhapsodie’s info, but please also know I have no medical education that’s not self learned and self taught. In addition I have not tried these actions, other than living with insulin pumps for over 25 years. So please operate with caution when considering using these action ideas and when communicating with patients about the actions and options.

Updates and fixes may take some time for this information and these posts to be better for you. I’m sorry…BUT here it is more of Rhapsodie’s Words-

Lower & Higher sugar levels for medical uses

This document section was originally part of the Ischemia or ischaemia Treatment options document, but since there are so many additional options and actions utilizing sugar level variations we’re adding this information here. For example one of the sets of info below is about diabetics suffering low sugar comas, and how ischemia damages and sugar treatment variations can improve their health with reduced risk for the patients. Parts of this information are from the discussed common treatments which can be varied with actions that impact blood coagulation including low sugar actions AND therapeutic hypothermia which is a part of the treatment info included within the Natural Infection & Pain & Inflammation Fighting document. Plus there are additional details about ischemia and treatments for reperfusion injuries with sugar treatments in the Ischemia or ischaemia Treatment options document.

 

The reason for this document is because insulin dependent diabetics with good basal patterns for their body uses, can generally keep their sugar levels consistent. This means if they have insulin levels below the normal and keep these maintained over a period of time by ‘changing’ the goal target ranges with their insulin levels, they can keep their sugars at the reduced ranges for fighting coagulations because of the blood thinning like are needed for recovery from ischemia injuries that include strokes and comas. The levels for each diabetic with the low sugar ‘changes’ impacting the body vary as do the higher sugar levels and how those impact the body as found from Rhapsodie’s experiences.

General Reduced sugar levels

The value of sugar levels at a slightly reduced rate still has thinner blood, because the red blood cells aren’t as full of sugar or other nutrients, thus they have a more difficult time at transporting white blood cells and other normal blood flow things. These blood flows are still fluid, and often more watery which means with some cases of Ischemia there could still be some blood flowing, but it’s not as heavy nutritionally. The value for reducing ischemia is that the blood flows are wimpier, which means that if a patient is treated for an injury with normal or higher sugars during surgery, but blood sugar levels are reduced for post-surgery recovery, there can be a reduced hit on the cells with the nutrition, white blood cells, and other cell foods.

 

  • For Rhapsodie if her sugar gets below 60 she gets slightly drunken,
    • if her sugar goes below 50 she may get somewhat sweaty and jitter a bit,
    • if her sugar gets down to around 40 or less there are more dramatic episodic problems, like epileptic attacks, and
    • like others if her sugar reduces to below 05 she can go into a coma.

Common Higher sugar Levels

Red blood cells are released by the liver for sugar assistance and body uses. While an individual with sugar levels at normal stages are getting normal releases, there are thicker and fatter blood cells which actually have reduced blood flow. When low sugars are being fought more red blood cells are released to assist in keeping the body fed by the liver, feeding the body more. When high sugars are existing less red blood cells and care elements are released, so there is less nutrition for the body through the liver, but the cells are getting hit with a lot more at one time.

 

  • For Rhapsodie if her sugar goes up to 140 she feels slightly heavy,
    • if her sugar goes between 140 and 180 the heaviness body feeling increase, plus she gets grumpier because of slight physical discomfort that grows.
    • AND if her sugar goes up to numbers between 180 and 240 she gets hot and uncomfortable as well as feeling heavy.
    • Plus if Rhapsodie’s sugar goes over 240 her hot feet, super heavy body, needing to pee a lot and more are just additional indications of higher sugar.

 

The blood restriction in the body can become more normal to people that live with it constantly, but with normal sugars around 100 these higher levels feel wrong. In addition with sugar testing there are thicker blood flows, which means the higher sugar levels are the harder it is to get blood from the body for the sugar checking. This is the exact opposite with lower sugar levels, this is part of the reason Rhapsodie believes this will be a value with reperfusion injury treatments for preventing ischemia.

Treating Ischemia & Reperfusion Injuries with Sugar Variations, Rhapsodie’s Ideas

 

For surgical treatments if Rhapsodie has prepped these sugar levels to rates which doctors can find useful with the surgical actions there can be assistance in reducing thrombosis and ischemia. This means having knowledge and preparations done with tests as well as time allowances for sugar changes for the resulting body value needs. Without OR even with the drugging influences that change her sugars, she could have thinner blood without the anticoagulation drugs that cause other issues on top of drug uses that could be avoided. Plus with the treatments corresponding to blood sugar levels and uses of the insulin pump there can be variations impacting results from these treatment actions and how those result for the patient.

 

How to utilize insulin and goal targets with sugar treatments are below, but first because of low sugar coma’s discussing how to avoid brain issues, stroke problems, with treatments is being discussed because it’s an area of treatment that can really impact many diabetics.

 

LOW BLOOD SUGAR COMA’S, BETTER TREATMENTS

When Rhapsodie suffers low sugars she fights to get treatment, the results of the low sugar make her movements more and more spaghetti flingish, epileptic. The reasons are that the blood feeding bones, brain, blood vessels, joints, and tissues are all reduced, so that muscle coordination and action controls are hindered. With the information about ischemia which is caused because ‘of blood starved body zones’ it can be that with low blood sugar levels that cause comas that dramatic sugar changes will actually increase brain injury to those patients. While an incremental shift could allow healthier reactions with slower sugar rising.

 

For example doing things over an 1 to 6 hour period to raise sugar levels, which should allow the starving brain zones to regain activity with less chances for ischemia, especially if they were done incrementally gradually.]

  • Reperfusion injury plays a major part in the biochemistry of hypoxic brain injury in stroke.
    • Similar failure processes are involved in brain failure following reversal of cardiac arrest;[3] control of these processes is the subject of ongoing research.

[It can be that sugar level changes can be a reason that diabetics in comas, from low sugar who are treated immediately to raise their sugars can suffer brain injury.

  • Instead of a slow and steady rise of sugars their bodies are hit with sugar all at once, and the enhanced blood changes could be causing ischemic injury to the brain. More in the Natural Infection & Pain & Inflammation Fighting document under the B3- Reperfusion Injury in Other Health Issues
  • For example if a person goes into a coma and they have sugar levels of 3, then their sugar levels are 300% lower than 90. This means that the blood flow is 300% thinner and less nutritious than normal. Now with these actions we’re thinking that there are extra insulin & activity aspects also influencing sugar levels, so sugar checking is a part of this recovery process as well as treatment against the ‘insulin activities and activities’ that are continuing.
    • So if raising sugar is done with an instant glucose shot, the person may get hit with a lot of ‘blood fluids and food’ which can cause ischemia in the brain.
    • If the treatment begins with some glucose, taking care of the activity issues and other insulin use issues this will not change the coma treatment processes other than keeping the patient from having sugars go lower.
  • BUT if the individual is given a sleep drug, to induce slower blood processing as well as reducing possible ‘epileptic style’ movements. Then with treatments that are given over hours of time glucose in a higher protein content it could be that recovery is much better as well as much healthier.
This would mean that the percentage of change would also gradually increase over time.

If the treatment begins with some glucose given for taking care of the adrenalin running activity issues and other active insulin issues this will not change the coma treatment processes other than keeping the patient from having sugars go lower. This is easier to know about with the insulin pump, more is mentioned above under the Sugar Value Adjustments heading, but activities are not always determinable without others OR even ‘video’ action evidence, so this is likely to be guessed on without that info being able to be available. These amounts for correction should be added before the raising work is started, this is done to reduce sugar dropping from happening any more.

  • If a diabetic comatic’s sugar is at 3 doubling that would mean it would be shifted to 6, this amount would be a glucose of a proportional level based on the individuals carb ratios if those are accurate. [More above.]
  • Doubling 6 would shift sugars to 12,
  • Doubling 12 would shift sugars to 24,
  • Doubling 24 would shift sugars to 48,
  • Doubling 48 would shift sugars to 96.
  • With the sleep drug, the patient wouldn’t awaken while that drug was working, but the sugar tests can still be done. With the slower body processes the sugar impacts are likely to be noted as being slower than normal. The impact would be what it should be, but if we give this process time I’d make sure that the process was slower at the beginning, speeding up towards the end to reduce injury to the brain and other body zones. Just like weight changing, it’s much healthier to have gradual processes that extend over time, graduate into normalities.
How to use sugar changes against coma more slowly?

The slower return of the brain to normal blood flows with normal sugar levels slowly being gotten should reduce ischemia damages for diabetics that suffer low blood sugar comas. If the treatment begins with some glucose given for taking care of the adrenalin running activity issues and other active insulin issues this will not change the coma treatment processes other than keeping the patient from having sugars go lower. This is easier to know about with the insulin pump, more is mentioned above under the Sugar Value Adjustments heading, but activities are not always determinable without others OR even ‘video’ action evidence, so this is likely to be guessed on without that info being able to be available. These amounts for correction should be added before the raising work is started, this is done to reduce sugar dropping from happening any more.

 

Since there are 5 levels of change here, with process times of changes varied by body uses and sizes it means that a change will still take time, depending on how much change is being worked on. This means that with the lower levels of change, smaller numbers, things will shift faster, but it’s better for the health of the body that body portions and areas are given time to get used to the adjustments to assist in keeping ischemia injuries and brain stroke issues minimized.  So if we add 20 minutes to 30 minutes for each level for this whole process after the ‘active insulin & adrenalin’ care is done, it will mean between 1 to 1.5 hours for recovery to normal.

 

For uses of the generic levels, mentioned above, with 10 carbohydrates= 1 unit of insulin= 40 change in sugar levels math can assist in determining how to vary the sugar levels. Please remember these insulin evaluations above are only samples each individual has different numbers in use, so different calculations are needed with the same patterns of uses.

 

  • If a diabetic comatic’s sugar is at 3 doubling that would mean it would be shifted to 6, since in this generic level example 10 carbohydrates= 40 change, this means 1 carbohydrate= a sugar change of 4 we could just determine to add 1 carbohydrate because 4 is so close to 3… this would mean the proportional shifts would also vary for the amount of carbs.
    • If we were set on doing just 3 because of doubling, then we would use ¾ of 1 carb in this generic level example.
      • The impact would be what it should be, but if we give this process time I’d make sure that the process was slower at the beginning, speeding up towards the end to reduce injury to the brain.
      • So I would make sure that 10 to 20 minutes were a normal time taken before a sugar check in the right hand is done, then after the ‘goal target’ is either reached OR surpassed I would start the next glucose treatment.
    • Doubling a sugar of 6 would shift sugars to 12, the carbohydrate amount is 2 times more than from 3 to 6.
      • With that change of 3 being ¾ of 1 gram of carbohydrate.
      • So ¾ + ¾ = 6/4 or 1 2/4 or 5 carbohydrates.
        • And like the sugar rates, the carb rates would continue to double for raising sugars.
      • Doubling 12 would shift sugars to 24,
        • So 1.5 + 1.5 carbohydrates= 3
          • And like the sugar rates, the carb rates would continue to double for raising sugars.
        • Doubling 24 would shift sugars to 48,
          • So 3 + 3 = 6
            • And like the sugar rates, the carb rates would continue to double for raising sugars.
          • Doubling 48 would shift sugars to 96.
            • 10 carbohydrates= 40 change, this means 1 carbohydrate= a sugar change of 4.
              • Thus 48 divided by 4 equals 12 carbs.
            • Again, done differently mathematically, 6 +6 carbohydrates= 12.
              • And like the sugar rates, the carb rates would continue to double for raising sugars.

 

Over this whole generic levels process, the individual receiving carbs gets a total of the correction rates needed against previous activities and insulin in use, plus 22.25 carbs which have a value of 89. The value of these limited raises is that the brain isn’t hit with lots of sugar with no food value, that brain damage is reduced because the blood getting to the brain with more and more ‘value’ is gradual, and the results at the end are at a good normal sugar rate. Rhapsodie has had those carb shots and sugar hit her body dramatically after a low, for her the results are high sugar with all the high sugar blood pressure problems also. When the brain with a low sugar coma is suffering reperfusion injuries like with stroke victims, the high flow of sugar increasing blood pressure is also likely to increase lack of recovery as well as more dangerous problems with ischemia injury to the brain.

 

NON-coma low sugar recovery

With low sugars while an individual is still awake, there are also issues that can impact brain health, but since the brain is awake the individual injury aspects are likely to be a lot lower than they can be with a person suffering a coma. The sped up recovery process is not the best thing, but in some cases, like with epileptic body actions it’s much better to get the sugar into the person to reduce injury. BUT if a person hasn’t reached a shaky level it’s often better to use a higher protein slower processing carbohydrate, like milk OR a nutrition drink higher in protein which will stick with the person with the same digestive processes of a simple sugar and less low sugar follow up possibilities’.]

 

Insulin & Sugar level Variations for repercussion treatments & avoiding ischemia injuries

This information is not tested yet, so Rhapsodie hopes these will be utilized for her to assist in avoiding excess medications and side effects from those with her injury treatments. The numbers added here are pertinent for others as well, but the numbers can be varied with different equipment also. For Rhapsodie these uses may not need the higher sugars. Tests for blood coagulation and more with sugar variables can impact the plans for surgical treatments and recoveries also. Different individuals may have various level valuations because of life styles, normal sugar levels, other in use drugs and side effects, and blood valuations with individual’s health which shift the blood values for people. I’m not sure if these impacts can work with non-insulin dependent diabetics, but they may in some ways using the insulin as the medication.

Glucose Levels and Insulin Uses

Insulin pump diabetics have machines which hold the glucose and correction rates of insulin for them. The endocrinologists and modern diabetic doctors also have math formulas for figuring out the general values of sugar uses for ‘unknown’ patients. BUT over time patients with insulin uses and their bodies have shifted insulin uses and results with glucose levels.

Generic setups

These setups utilize the basal rates generally being used plus body weight levels, BUT it’s probable that generic setups are used to assist in determining correct insulin use values. Rhapsodie began insulin pump uses years ago with:

  • 10 carbohydrates= 1 unit of insulin= 40 change in sugar levels.

 

  • This would mean that the percentage of change would also gradually increase carb amounts over time like for treatment of diabetic comas more above. Please remember these insulin evaluations above are only samples each individual has different numbers in use, so different calculations are needed with the same patterns of uses.

Lower sugar levels repercussion treatment & ischemia reduction action ideas

As the general reduced sugar info above discusses some more about lower sugar, with Rhapsodie, plus there are various results with sugar levels that may be utilized with surgical situations like are discussed above and below.

  • Lower sugar levels like between 55 and 70 can also help keep the blood thinner without body reactions that could make surgery more difficult, AND extreme Serrapeptase Enzyme uses could also possibly help, along with ginger as an anti-inflammatory.
    • Diabetics with low sugar suffer thinner blood, this impacts bruising as well as injury potentials.
  • The thinner blood has less coagulation value, it flows faster but it’s not as thick.
  • This causes the individual with lower sugars to feel cold more easily also.
Possible treatments with low sugar against ischemia-
  • When the blood flow return to the ‘starved’ areas hits the body…lower sugar can be continued for days if the process is planned using modified for lower sugar insulin pump goal target levels. More below.
  • With some options including decrease in body temperature a value for ischemia treatments, it could be that the lower blood sugar isn’t really a value until closer to the end of the surgical treatments. For treaters it can be useful that normal room temperatures make the patient still feel cool, because they aren’t having normal nutrition blood levels.
  • More below discussing how to do this with uses of the insulin levels and insulin pumps like the Paradigm.

Higher sugar levels

As the common higher sugar info above discusses some more about higher sugar situations with Rhapsodie and others, plus there are various results with sugar levels that may be utilized with surgical situations like are discussed above and below. This may not be of use with surgeries, it will make the process of shifting to lower blood sugar levels more difficult and longer, but also more extreme, which may be a value.

  • Higher sugar levels like between 180 and 220 are uncomfortable for Rhapsodie.
    • Plus because these thicken her blood with the sugars, she normally works to reduce her sugars as fast as possible.
    • The coagulation values are unknown because the ‘blood health’ isn’t as good as it should be with extra carb and less other blood action values, these sugars increase blood pressure levels, damage from ischemia is found with patients running high sugars constantly because of blood vessel body damage from the sugar fat cells with limited nutrition for body health. With the thicker blood an individual has discomfort because the blood cells throughout the body aren’t processing as they should be, but this could assist surgical treatments before ischemia issues are reached.
Pre & During Surgical Treatments having higher sugar levels

For surgical treatments that can cause repercussion injuries, it can be useful to perform the surgeries with higher sugars, then within 2 to 3 hours before finishing the surgeries, having the sugar levels drop to the lower sugar ranges mentioned above, so that through surgical closures of body areas where blood flow is restricted the blood types are varied to the lower sugar blood levels with less coagulation and other blood enzymes hitting the ‘starved’ from ischemia zones.  Reasons for this as a value are because:

  • Rhapsodie feels hotter in the same environment that she would be comfortable normally OR cold with low sugars. Her heart, organs, and body doesn’t feel as cool as quickly because her blood is sugar fat not normal.
    • This could mean with working to do therapeutic hypothermia the higher sugars can also reduce body movements, like shivers because of the higher sugars.
  • This means the air could be at normal OR even cooler temperature and the patient doesn’t get as chilled, but the surgeons will suffer the cold more.
  • BUT since this can also mean ischemia issues switching to the lower levels should be planned as part of the surgical insulin processes with the time frames of insulin impact added to the result plans.
    • It could be that aspects of the thicker blood also include alternate coagulation and flow factors that could impact surgical situations, because the sugar isn’t the same as normal food for the body, but the sugar may also cause faster processing of blood which can make it harder to deal with ischemia issues if sugars aren’t lowered with reperfusion situations.

Sugar Value Adjustments

With insulin pumps like with a Paradigm Insulin Pump are possible because the pump doesn’t have automatic actions that will make uses with different sugar levels problems. Rhapsodie’s 670g is a problem because if her sugar reaches 65 it’s often beeping and screaming with alarm noises saying her sugar is at 55 or lower. Because CGM is still of use in reading the blood sugar levels it’s useful to have that system in use, but not for controlling sugar levels through these processes.

Reduced Ischemia with Lower Sugar Levels for extended time periods

The value for surgical treatment with an individual like Rhapsodie is that with the insulin pump sensor in use, the insulin levels keeping the blood sugar at a lower level, the blood will be thinner and less coagulation will be happening through this time period. Levels of lower sugar continued for days can assist in keeping this value in use; gradual sugar level rises can assist with body re-composition. BUT in order to do so well a pump that doesn’t yell about low sugars is necessary, PLUS it’s good to setup the insulin pump processes for the lower OR even the higher sugar levels as goal target ranges.

Discussions below are based on insulin pumps as controls for insulin deliveries, but doctors that don’t have patients with the insulin pumps may also utilize in hospital pumps to learn patient insulin rates and adjustments, like with temporary uses for days to weeks before the surgeries. Then they can use those calculations with IV insulin setups and more, OR if the patient tests the pump and finds uses determines to get one those ‘test values’ can lead to the new setups they get in use. The sugar change factors are able to be done with better insulin control, so the individuals taking long term insulin and shots are less likely to have patterns of body uses with insulin that can assist the raising and lowering of sugars to reduce ischemia risks.

Insulin Pumps & Insulin Use Paradigm Insulin Pump Goal target Range Setup Variations

These values in the Paradigm insulin pump are located in the Bolus Wizard Setup, this is the same with the 670g, but there are additional setups with the sensor. The lowest level sugars can be at with the 670g is 50 then the low sugar warning system is fully activated and unable to be turned off. Even if an individual, having anything like up to 20% different can set this off. This means that levels at 60 can do that, so for lower sugars with surgeries use of different insulin pump systems can be much better, but any pump will work for higher sugar levels. BUT these varied goal targets should be setup and used as medically necessary for the results that are best for the patient.

 

The notes above are how to reduce ischemia problems by utilizing different sugar levels with insulin delivery systems. The insulin pumps in use aren’t the only systems that can be used, but this will also require knowledge of the system processes as well as having ‘sugar sensor’ setups that can assist the surgical teams to vary insulin ranges for sugar variations. BUT the great value of an insulin pump with an individual that has their body variable insulin uses ordered, there can be shifts of goal target ranges while not having to modify the system in other ways for uses.

 

  • In some cases like with acetaminophen in use, the sensor of the 670g reads higher sugars than are actually with the body.
    • This means that with the sensor in use and the 670g connected for insulin delivery OR even just being used for the sensor values, there could be goal target range variations to reduce the problems with low sugars that are the actual results not the drugging results of the body sugars.
    • Because the sensor results are never trusted for use as glucose readings with insulin deliveries the Paradigm doesn’t have sensor issues.
    • More about the 670g with sensor and insulin uses below.
Goal target range variations & reasons general INFO

When utilizing the lower sugar ranges individuals that have better insulin use values more consistently, like Rhapsodie, can be better for longer times because they have knowledge of how their insulin base, basal, rates are at different times through the month. With goal target ranges on an insulin pump the processes can allow food as well as drink like normal while still keeping sugar levels within the lower levels at least with non-high carb foods which act like helium hot air balloons rising fast and also dropping fast when poked. The goal target range values are easier to utilize if the patient has more consistently horizontal sugar levels most of the time. This means the various goal targets won’t have to shift the insulin setups, just the goal targets for uses of the normal sugar levels. BUT other stuff like drugs, medicines, food types, and more have different delivery aspects that charts can demonstrate, so CGM’s are nice to keep in use.

 

The Minimed 670g is only one of the insulin pumps that also have CGM systems. These values in the 670g insulin pump are located both within the Bolus Wizard Setup plus with the sensor within the sensor goal target setups. The lowest level sugars can be at with the 670g is what the sensor says is 50 then the low sugar warning system is fully activated and unable to be turned off.  Please return to the 670g for additional info about pump uses and setups including uses of the sensor even if the insulin delivery is being done with the Paradigm.

1.    Altering sugar values with uses of some CGM options BUT no Automode

The use of the sensor with the system provides value to 670g users without AUTOMODE being active and this can correspond in some ways with other systems. The sensor readouts do allow users to be more accurate as well as more consistent with their basal setups and evaluations of physical actions and food intakes as long as they learn how to use the information accurately. This with a system uses both the basal and bolus factors but there are still variables depending on users and their bodies plus what they are consuming &/OR doing. The graph watching and basal changes became better for Rhapsodie as soon as she returned to using the Paradigm for insulin deliveries.

 

The ‘illegal’ remote controllers with the 670g were adjusting insulin rates, changing basal levels, stopping bolus deliveries, and adding insulin amounts based on their stupid thinking that Rhapsodie was a generic user. SHE HATED THOSE ACTIONS AND WILL NEVER USE THE 670g WITHOUT ABUSER FEARS. Her sugar goal targets were never as high as the automode AND her body wasn’t working correctly with automode so it wasn’t used for more than unsuccessful trials. BUT remote users were ignorantly playing on their computer systems; cell phones fiddling with her, so they are likely fiddling with others also…

 

This is illegal AND not part of the diabetic care where the diabetic is to work with their doctor. The doctors have remained ignorant of these invasive actions and Minimed continues to deny the ability to have that happen with the 670g, they are WRONG! This means that whoever is doing this is not approved by anyone for these actions, and they are likely paid for other work which they are failures at because they are so busy fiddling with other people’s health.

  1. Insulin Amount Setups

Generally medical professionals assist individuals in prepping their systems with insulin uses, over time with systems and setups the insulin levels shift and vary. Experienced diabetics often learn and do things that work for them more often than their doctors realize. The AUTOMODE 670g records should have these levels listed, but if the system doesn’t do that the diabetic who goes off automode can have a lot of problems because of insulin variations auto setup by the insulin pump without sharing that info with users. There are basal, base insulin amounts that are not influenced by food, but are influenced by activities and actions, more below. Then there are the bolus insulin levels which are correction factors influenced by sugar levels, goal target ranges, insulin use times, and amounts of food carbohydrates put into the pump, more is below. The way the insulin is used depends on the delivery system consistency and accuracy of delivery amounts with times and users.

  1. Insulin Insertion Setups

Rhapsodie’s body has varied a lot with age AND with Whoops Disease. Insulin delivery with the insulin pump acts on the body like IV deliveries building more scar tissue around insertion zones, but because of the fattier locations there are less issues with blood vessel damage than there was with shots in locations like legs and arms. The less frequency of the insulin insertions is both a value and a hassle, that’s why it’s best that only 2 to 3 days is allowed for an insertion. The insertion locations also vary the insulin uses, this is dependent on an individual’s body as well as their body composition.

 

Through Whoops Disease with 93.3% of Rhapsodie’s body as water, it means that there looks like a larger fat area BUT there is a lot less fat so the inserts are not within a higher level of body tissue. This has meant that deliveries act a lot faster than normal, so body sugars change fast also. The fatter a person is the slower the insulin will work for them, the more muscles &/OR water a body has the faster the body utilizes the insulin, but water is faster than muscle. Rhapsodie has found that the water build ups above her belly button have caused alternate insulin use amounts than below her belly button. These variations have also influenced the type of insertion sets for use.

  1. Sensor Uses

There are different styles of sensors some insert straight, some insert at angles, some work with cell phones & tablets, some work with insulin pumps, some work with combinations of devices. There are also various sensor lengths as well as body composition variables that impact the uses and the users. In addition there are different sensor locations that shift the results with the body locations depending on the body portions and person’s bodies.

2.    Sensor Accuracy Variations with Normal & Alternate Goal target Ranges

Because the sensor accuracy is worse the further from the goal target ranges an individual is there are more problems having the 670g setup with goal targets in normal ranges because the differences grow from distance away from the goal targets.  Here’s one of the math reason for better understandings, additional measures are shared below with different goal targets calculated:

 

  1. Normal goal target range 96 to 104
    • Sugar at 75 but sensor at 52 the variation is actually=
      • (75/96) – (52/96) = 0.78 – 0.54= 0.24 (24%) difference while the difference between 75 and 52 only equals 23.
        • BUT for the exact same percentage of difference above the goal target ranges, there are much greater amounts.
      • So sugar levels on sensor at 243 with numbers at sensor as 193 are=
        • (104/243)- (104/193) = 0.427 – 0.538 = 0.111 (11.1%) difference while the difference between 243 and 193 equals 50.

 

This can mean that with lower goal target ranges and higher goal target ranges the percentage of variation differences with the sensors will be varied. BUT with the amounts lower than goal targets the percentages will still be greater than the differences with amounts above because the range of percentages are greater within smaller amounts than they are from larger amounts above goal target ranges.

 

  1. Surgical Setup Goal target Range Differences and variables

Goal target range variables for surgical and recoveries of diabetics can impact the setups as well as the sensor percentages found with the goal target differences. Above the normal goal target range of 96 to 104 was utilized, but with smaller OR larger goal target ranges the percentages of difference will also have various placements and impacts. For the 670g the sensor variations are generally found being further away from the center goal target instead of being closer to the goal target ranges. More info pertaining to goal range variations, which aren’t necessarily like the surgical amount levels are shared below within the A. Interstitial higher sugar modifications heading. Plus additional measures are shared above with the normal goal target ranges calculated:

Higher goal target range 180 -200

  • Sugar at 75 but sensor at 52 the variation is actually=
    • (75/190) – (52/190) = 0.394 – 0.273= 0.121 (12.1%) difference while the difference between 75 and 52 still only equals 23.
      • BUT for the exact same percentage of difference above the goal target ranges, there are much greater amounts.
    • So sugar levels on sensor at 243 with numbers at sensor as 193 are=
      • (200/243)- (200/193) = 0.823 – 1.036 = 0.213 (21.3%) difference while the difference between 243 and 193 still equals 50.

 

More info pertaining to goal range variations, which aren’t necessarily like the surgical amount levels are shared below within the A. Interstitial higher sugar modifications heading.

Lower goal target range 65 -70

Because the 670g alarm system will go off with the sensor at 50 because there are no ways to change that level, it means that lower goal target ranges of 65 to 70 which may not be low enough are about the maximum lows for the system to be able to function correctly without lots of alarm hassles while still allowing space for accuracy tests if the sensor readings are lower BUT wrong. For the 670g the sensor variations are generally found being further away from the center goal target instead of being closer to the goal target ranges.

  • Sugar at 75 but sensor at 52 the variation is actually=
    • (75/65) – (52/65) = 1.15 – 0.8= 0.35 (35%) difference while the difference between 75 and 52 still only equals 23.
      • BUT for the exact same percentage of difference above the goal target ranges, there are much greater amounts.
    • So sugar levels on sensor at 243 with numbers at sensor as 193 are=
      • (70/243)- (70/193) = 0.288 – 0.3626 = 0.0746 (7.46%) difference while the difference between 243 and 193 still equals 50.

 

  1. Surgical Setups Using 670g Sensor

For surgical setups like we discussed above with the Paradigm Pump in use there are aspects that will also impact the results like with different drug impacts, but with insulin deliveries connected also like with the 670g there will have to be fiddling to get the accurate results with uses.

 

  • In some cases like with acetaminophen in use, the sensor of the 670g reads higher sugars than are actually with the body.
    • This means that with the sensor in use and the 670g connected for insulin delivery OR even just being used for the sensor values, there could be goal target range variations to reduce the problems with low sugars that are the actual results not the drugging results of the body sugars.
    • With the AUTOMODE on the 670g turned on the 120 goal target range is sought by the pump utilizing the sensor, BUT we are not adding AUTOMODE actions because our goal target variations can’t work with that function at present times.
      • This means that automode should not be used because goal targets will need to be different to keep the pump from inaccurately reading things and delivering insulin OR treating sugar results inaccurately. For instance if an individual has acetaminophen in use which with the interstitial fluids raises sugar that the body really doesn’t have then the insulin pump will give insulin while the sugar levels are not that high really. This means the only way the system will work is if the automode goal target ranges are able to be varied.
    • AND with inaccurate 120 goal target ranges when a person needs lower sugars to resist ischemia AUTOMODE can’t assist in this process.
      • Eventually the company may eventually change the goal target ranges which will make the system better for more users like those having various medications, like acetaminophen that require various goal target ranges for better health results. OR even situations like low sugar recoveries from comas OR ischemia where various sugar levels are necessary for good recovery.
3.    670g Graph with only Sensor in use, NOT Automode

The full display graph images are available with the Automode on, but the squiggly graph box needs to be pressed to show the graph without the over numbers that reduce graph values. The up & down arrow actions lead you through the graph options, which are set with 3, 6, and 9 hours. The Automode visuals are shifted also, because the auto goal target ranges are colored across the graphs. The first 3 hour image below shows the normal screen on display with the 670g while sensor is in use. The image to the right shows the expanded graph. The vertical sections display the spaces of time between hours, the blue circle tells when insulin was delivered, this can also be found with history. The red outlined tear drop point shows the accurate sugar results with glucose tests. Carb values are shared at the bottom with a small yellow rectangle containing a fork plus another tool.

 

These images display the graphs larger than the pump shows:

  1. 3 HOUR GRAPHS

Normal display screen                                    Extra Info Display screen

 

 

These graphs indicate that Rhapsodie took insulin around 6:20am, with the full displays using the right & left arrows can take users to the historical info attached to those markings, this can also be located using the history menu of the pump.

 

  1. 6 HOUR GRAPH

 

This image shows that sugar levels were going up around 3:20 to 3:30, which means without food being consumed these were basal inaccuracies. The insulin after 6 didn’t really influence the results until almost 7am, and there are some variables in how that was happening. At 9:15 the results were at goal target ranges because basals were made more accurate and the insulin brought the inaccurate sugar levels down.

 

  1. 9 HOUR GRAPH

 

This is the maximum graph time the 670 g has available. The tear drop points show that the sensor results are always inaccurately low. The levels of insulin uses and changes should be based on accurate sugar results not the sensor. Some systems say no sugar checker is needed, but they may not work with individuals like Rhapsodie with extra fluid under the skin influencing the sugar results. These display one of the reasons Rhapsodie will not use Automode, that’s in addition to the inaccurate automode goal targets for her health.

4.    General Graph Uses

The graph value allows individuals to see the approximate ways that insulin levels are altering body sugar results, plus the graph lets plans and work with the insulin variations to be modified more accurately for actions and results desired. For Rhapsodie the only 670g values have been the graph with the sensor, BUT the sensor uses with the beeps and inaccurate measures are so annoying she has been tempted to sewer drop it repeatedly.

 

For insulin variations and changes graph levels assist users to determine how accurate their basal rates are and how accurate their bolus intakes have been based on the food they’ve had. By observing the graph lines and knowing insulin uses, a 3 hour insulin begins processing in about 15 to 30 minutes after insertion, this means that when a line pattern goes up or down on a pump with no bolus insulin in use, a variation in a basal about ½ hour before the resulting change is indicated by the graph. Types of changes vary depending on what insulin levels are and what additional bolus insulins are in use.

 

  1. Graph Line Results that Display with the 670g

These results are based on the 670g pump graph and Carelink reports, but some CGM systems have graph systems designed with line indications, pattern indications, and other patterns being shared which have various meanings that in some cases can be opposites of the notes below.

  1. GRAPH LINES GRADUATING UP,

These show the sugar levels as sensed rising.

 

  • GRAPH LINES GRADUATING UP, show both the raising of sugars as well as the results based on
    • Just basals
      • The steeper, redder, up arrow shown here demonstrates faster changes, which also means more insulin for accurate basal results is needed.
        • Which means raising the basal levels maybe 2 insulin increments through those time frames.
      • The shallower ups may be normal, but if they continue for times they are showing the amount of time that the insulin variations need to be made for.
        • Which means raising the basal levels like only 1 insulin increments through those time frames.
      • Activity variations-
        • If the basals are setup for an individual that is normally active at the times when they are now not being active there can be results showing ups.
        • If it’s just temporary activity variation it may be useful to setup temporary basal, but
        • if the variations are consistent alternate basal patterns can be prepared and utilized.
      • Bolus uses
        • If the insulin is still active for a food OR a drink the up arrows & down arrows are expected because of the food values and how the body is using those.
        • If the insulin has finished for the food, the compensation to correct sugars towards goal target ranges will demonstrate either:
          • Not enough insulin used, OR
          • Food carbohydrate estimates being wrong.
  1. GRAPH LINES Going Down

These show the sugar levels going down.

  • GRAPH LINES Going Down, show both the lowering of sugars as well as the results based on
    • Activities
      • If the basals are setup for an individual that is normally less active at the times when they are now more active there can be results showing downs.
        • If it’s just temporary activity variation it may be useful to setup temporary basal before the activity, BUT if that’s been missed doing correction actions to raise sugars are likely necessary, but
      • if the variations are regularly consistent alternate basal patterns can be prepared and utilized.
    • Bolus uses
      • If the insulin is still active for a food OR a drink the up arrows & down arrows are expected because of the food values and how the body is using those.
      • If the insulin has finished for the food, the compensation to correct sugars towards goal target ranges will demonstrate either:
        • Not enough insulin used, OR
        • Food carbohydrate estimates being wrong.
      • Just basals
        • The steeper, green, down arrow shown here demonstrates faster sugar changes, which MAY means less insulin for accurate basal results is needed.
          • Which can mean lowering the basal levels 1 or maybe 2 insulin increments through those time frames.
        • The shallower downs may be normal, but if they continue for times they are showing the amount of time that the insulin variations need to be made if no other insulin OR activity actions are happening that could have caused the variations.

 

  1. HORIZONTAL GRAPH LINES

These show the sugar levels remaining consistent. There are generally slight variations in the horizontal lines, but those are still considered level because the results aren’t varying much more than a range of 5 to 10 points.

  • HORIZONTAL GRAPH LINES demonstrate accurate basals, without bolus variations.
    • These mean that the basal levels are accurate during the times those are showing horizontally.
    • These are the goal targets with the insulin in use, but those goal targets are almost only found in sleeping times after insulin levels are accurately adjusted.
      • The patterns and how much valuation is determined are based on the amount of time with the variations AND the normal range goal targets and reasons for the variations. This is more a sleep pattern than a waking time pattern, often there are greater extremes even with accurate basals when individuals are also eating, drinking, and being active.

 

 

 

5.    Variations of Sugar Changes demonstrated with images of Graph Results

Rhapsodie is familiar with these patterns using the 670 G graph system which also shows a chart with lines along defined sugar levels and times above the lines to show when things are happening. It’s likely that other CGM systems will have similar information BUT placements, styles, and uses are probably different.

REGULAR GRAPH RESULTS WITH LIFE SHOWING PATTERN IMAGE EXAMPLES

  • NORMAL FOOD USE PATTERNS with the graphs the insulin uses through food consumption allow users to note what patterns of food consumption and insulin interactions are.
  1. Correct 3 hour Insulin Levels with Food
    • With correct insulin levels for food it’s generally found that the insulin works slower than the food is digested. The pattern of utilization on the graph is of a graduated curve.
      • Insulin uses are shown with the red line above, the food with the blue. The insulin pump shows the insulin uses but at the end of use times you are back to goal target ranges if the insulin was correctly setup for the food.
  1. Heavy food with Light amounts of 3 hour insulin
    • With too much food and not enough insulin the graph results and food results don’t return to the goal target range. This is a pattern of that

 

 

Notice that the levels aren’t equal at the end of the process, because there wasn’t enough insulin utilized.

  • The food is shown with the purple line, the insulin with the red line.
  1. Light food with too much 3 hour insulin
    • With too much insulin and not enough food sugar results are lower after the insulin finishes than the goal target ranges. In some cases light food is food that doesn’t have a value as stated because it has limited body use, which means that it’s digested way faster than the insulin time frame is.
      • Corn syrup, white flour, sugars, sweets, and many other non-protein high sugar products have light food values with insulin uses lasting longer and being more powerful.
        • For Yoohoos which Rhapsodie uses to correct low sugars, there is no protein, this means a 20 carb box only has a 10 carb use value.
      • The food is shown blue and the insulin in reddish.

Notice that the levels aren’t equal at the end of the process, because there wasn’t enough insulin utilized.

  1. Higher sugar foods with correct 3 hour insulin
    • With higher sugar foods, white flour items like pasta and white bread, donuts, cakes, juices, simple no nut candies, and more the higher sugars result from limited protein which adds time to food processing and keeps the sugar levels less but active for longer times. But accurate insulin uses for those the insulin will follow the food a lot more than with normal foods, which means that if the insulin amounts were not accurate there could be drops because the insulin works a lot longer than the food remains active sharing carbs with the body.

The food levels shown in pink go way higher on the sugar level chart, but they drop off in a short time while the insulin, shown in blue continues for some time. So if the insulin is correct the levels end in the accurate goal target ranges, if the levels are inaccurate the ending sugars can be higher OR lower.

  1. Higher fiber foods with correct 3 hour insulin
    • Higher fiber foods digest slower than normal foods with the same carb content. Food like oatmeal is one of these.

The food levels in pink, the insulin levels are in blue. The sugar levels with these levels can cause lower sugars followed by higher sugars because the insulin is more active before the food is. Then when the carb reaches high activity sugar results are higher than they should be, but the insulin is still active. Things end well if no corrections are taken with insulin OR foods.

  1. Foods with square wave OR dual wave 3 hour insulin accurately taken for extended times of use
    • Square wave insulin is delivered as a bolus but for an extended time frame. The value of square wave bolus is that higher protein and fat foods can take a longer getting digested, this means the insulin if taken immediately can cause sugar drops, but later with corrections taken to fix lows, there are highs because the higher fat OR protein foods are still being digested.

 

 

 

 

 

The food levels in pink, the insulin levels are in blue. The extended time frames assist in keeping the peaking levels of the food digestion more consistent with the insulin delivery. With pizza a dual wave bolus is used. This allows portioning of the insulin between immediate delivery and longer term delivery. For normal pizza a 6.5 to 8 hour square wave bolus is generally used with 50% of the full carbohydrate amount.

  1. HIGH Sugar Corrections by 3 hour insulin graphed
  • When an individual is not using the 670g Automode the only way that goal target ranges are met is by delivering insulin if sugars are high, Automode works to do this based on goal targets, but only after all food insulin is finished. This system doesn’t do any corrections until there is no food insulin active…which means high sugars are common. Depending on how high the sugars are and how the high sugars arose the patterns of dropping vary.
    • An inaccurate and low basal that needs to be raised.

The high sugar levels in green, the additional insulin levels are in blue.

 

 

 

 

  • An inaccurate insulin amount with more food than insulin was delivered for.

The food levels in pink, the insulin levels are in blue.

 

 

 

  1. LOW Sugar Corrections by 3 hour insulin graphed
  • When an individual is not using the Automode, the only way automode shifts lower sugars is by suspending insulin, it was programmed dumbly so doesn’t activate or alter temporary basal actions which could work like doing so manually.
  • The non Automode ways that higher goal target ranges are met are by lowering basal insulin temporarily, if an insulin pump is in use, OR by consuming carbs to correct the low sugar levels. Depending on how low values are and the active insulin in system plus the life situations either of these options may work better.
    • Sugar consumed after brushing teeth OR while sleeping will mean additional teeth cleansing to cut teeth rot from low sugar treatments with consumptions.
      • Since Rhapsodie uses cider vinegar & honey to fight acid reflux anything consumed when being awakened to treat low sugar requires also fighting the acid reflux then brushing her teeth to keep them healthy.
    • While sleeping when low sugars are noted Rhapsodie often uses a lower temporary basal rate that in hours raises her sugar.
      • Since she is inactive these actions aren’t dangerous. BUT Rhapsodie doesn’t do this when she is active to correct her sugars, but she will do the temporary basal before activity to keep her sugars at good levels.
    • Diabetics that have lower sugar that consume treatments have various options with various results:
      • With meals, the protein & fatty foods should be eaten before the sugary treatment is taken, because the heavy protein & fatty food blocks sugar digestion if those are taken first. So depending on sugar levels and needs various actions can be taken:
        • Eating the meal foods, not taking the full insulin amount, the insulin pump automatically calculates this, and waiting for normal food digestion to process the carbs. This depends on how low sugars are AND what is being consumed because lower sugars under 50 shouldn’t be stalled with slower recovery when a person is physically active OR has insulin already in use with no food fighting it;
        • Eating the food for the meal then taking in the sugar treatment of wimpier food value, like sugar water OR Yoohoo’s.
        • Eating the meal foods, not taking the full insulin amount normally, the insulin pump automatically calculates this, instead take the insulin as a square rate, like for 30 minutes to allow a more enjoyable meal with food results having a faster utilization than the insulin .

The choices depends on

  • how low sugars are AND
  • what is being consumed because lower sugars under 50 shouldn’t be stalled with slower recovery when a person is physically active OR has insulin already in use with no food fighting it;
  • how much time it will take to consume the food,
  • the types of food being consumed and their correction values.
    • Some foods like many of Rhapsodie’s healthy homemade meals with vegetables, limited starch, and higher protein & fat contents digest slower with less carb values being found for the body to use.
      • With normal times different products have various calorie, carb, and protein factors which influence how they work and how fast they work.
    • Sugar utilization factors are also values to consider,
      • With lower sugars under 50 sucking on a straw makes it easier to get the fluids especially with jitters & shaking. In addition the straw use allows the carbs to hit the back roof mouth which also processes some of those sugars straight to the brain and the blood.
      • Candy bars, sugar tablets, other chew ables take time to chew plus often also require drinking to rinse them away OR to make space for more which could be needed. AND sugar levels rise slower than they do with fluids that are more simple sugars.
    • Sugar Drinks of Value

With lower sugars under 50 sucking on a straw makes it easier to get the fluids especially with jitters & shaking. In addition the straw use allows the carbs to hit the back roof mouth which also processes some of those sugars straight to the brain and the blood.

  • Corn syrup & water OR Yoohoo’s made with corn syrup:
    • Are working in 5 to 10 minutes, but don’t stick with the users, so more protein is necessary to keep the carb active. The value of the Yoohoo’s is that they come with a straw and a sealed container. This provides multiple values:
      • The straw;
      • The sealed container while needing to be poked to be used also means that if an individual is shaky or unable to maintain normal body control there is less chance for making a mess.
        • PLUS these containers can be carried in bags and packages for accessibility outside of normal home & office situations where refrigerators are easily accessible.
        • AND being sealed these containers can be placed in multiple access locations for use needs and times.
      • Vanilla Nutrition Plus:
        • Is working in 10 to 20 minutes, comes at 50 carbs in a 8 ounce container and also contains 8 grams of protein, which means one mouth full can be 10 carbs. But without normal physical control this is still not a great sugar treatment when having a straw can be so much better, but these containers can utilize a straw.
      • Milk:
        • Is working in 10 to 20 minutes, it has protein and depending on the grade has various calorie levels if it’s not skim milk. But without normal physical control this is still not a great sugar treatment because pouring into a container is a need and can be harder when having a straw can be so much better. For protein amounts
          • Whole Milk has 8gms per cup & 150 calories;
          • 2% Milk has 6gms per cup & 130 calories;
          • 1% Milk has 4 gms per cup & 110 calories;
          • Skim Milk has 2gms per cup & 90 calories.

[NOT DONE] POSSIBLE RESULT IMAGES WITH MEDICAL SHIFTS CHANGING SUGAR VALUES

Because some of these aspects will vary based on goal target ranges while others will shift because of treatment plans that may mean having modified OR modifying goal target ranges Rhapsodie has work to add those notes as well as a goal aspect to the images for reference to the levels being reached for.

  1. Interstitial higher sugar medications

These medications like acetaminophen do not really change body sugars, but they vary the skin waters to seem higher in sugar which also cause sensors in use to read sugars as being higher than they really are. Likely partially in response to the drug which has impacts on the body, “Acetaminophen is considered the pain and fever reliever of choice for most patients receiving oral anticoagulant therapy like warfarin.”  (https://www.rxlist.com/consumer_acetaminophen_tylenol/drugs-condition.htm ) The higher sugar levels of the skin raise internal body temperatures that can assist the body in sweating out poisons and infections that cause fevers.  This means that with the sensor in use and the 670g connected for insulin delivery OR even just being used for the sensor values, there could be goal target range variations to reduce the problems with low sugars that are the actual results not the drugging results of the body sugars.

 

Modified Goal Chart Example

For example with the acetaminophen raising the sensor evaluations, but the real body sugars being lower, the 670g in AUTO MODE with the insulin connected could kill a person. Let’s say that the acetaminophen causes rise in sugar levels of the sensor readings by 20%, this means that taking the normal goal ranges and modifying those at a 20% higher range will keep more low sugars from happening. In addition with insulin corrections use of the pump that has the inaccurate sugar goals will mean that the insulin rates for corrections will need to be increased by 20%.

 

 

133

 

Possible Drug change Goal Range 20% higher than normal,

are rounded to 115 – 125 by multiplying the normal ranges

into 0.20 (or 20%) and adding those results to the normal levels.  

104

Rhapsodie’s Normal goal target range 96 to 104                                                              

 

85

Sensor result levels with the higher goal ranges are shown in blue, accurate sugar test sugar levels shown in brown. With correction actions accurately taken shown with purple.

Raised goal target Ranges modifying insulin uses with Real results for the lower goal target ranges

So having the goal target ranges higher than normal will mean that the sugar target goals & test actions will also need to be modified for accurate insulin uses. BUT for corrections it’s always better to use the median instead of any of the boundaries of goals to make more accurate corrections.

  • Higher Sugar Test Results
    • With the goal ranges of 115 to 125 a sugar test result of 133 will mean only a correction for 13, BUT using the normal ranges of 96 to 104 mean, 96 + 104= 200/2= 100 will cause a correction to be needed of 33.
      • The insulin use values are kept the same, but the change amounts are shifted, so more math is necessary for periods of time with reaching towards normal while the pump delivery system is set for higher results.
        • This means that the accurate insulin use results need to be calculated also, so if 10 carbohydrates= 1 unit of insulin= 40 change in sugar less than a unit of insulin is necessary. Since 1= .25 +.25 + .25 + .25 this calculation means 30 equals 3/4ths of one unit. This is a change of .75 of a unit of insulin for the pump to give the user to keep sugar values close normal ranges. This means an additional .50 amount, should be added onto the pump, for more accurate goal range sugar values.
      • Please remember these insulin evaluations above are only samples each individual has different numbers in use, so different calculations are needed with the same patterns of uses.
        • Let’s redo the amounts above using one insulin pattern from Rhapsodie’s pump on 7-1-20.
Start Time End Time Grams of Carbs Amount of Insulin Sugar Changes
0:00 3:30 5.1 =     1   = 23
3:30 4:30 5.1 =     1   = 23
4:30 9:00 5.0 =     1   = 22
9:00 10:00 5.0 =     1   = 23
10:00 10:30 4.9 =     1   = 23
10:30 16:00 4.9 =     1   = 22
16:00 16:30 4.9 =     1   = 21
16:30 21:00 4.9 =     1   = 23
21:00 21:30 5.0 =     1   = 23
21:30 22:30 5.0 =     1   = 22
22:30 23:00 5.1 =     1   = 22
23:00 0:00 5.1 =     1   = 23
  • With the goal ranges of 115 to 125 a sugar test result of 133 will mean only a correction for 13, BUT using the normal ranges of 96 to 104 mean, 96 + 104= 200/2= 100 will cause a correction to be needed of 33.
    • With a change of 33 by 23 per unit of insulin, 33/23 = 1.26 meaning there will need to be 1.43 (1.45) units of insulin for the correction to correct the sugar results. With that amount subtracting what the machine will do based on the goal ranges, the amount of 13/23 is .56 which is rounded to .55 will provide correct insulin rate changes.
      • Accurate change 1.45 units,
      • Inaccurate change 0.55 units,
      • Amount of extra insulin for correction 0.90.
    • Normal Test Results
      • With the modified higher goal ranges, for the sensor, of 115 to 125, averaged to 120, a sugar test result of 104 with normal ranges of 96 to 104, averaged to 100, will mean NO CORRECTION really NEEDED. But the higher goals will cause less insulin to be used if these normal ranges are associated with food intakes.
        • This means that the accurate insulin use results need to be calculated also, so if 10 carbohydrates= 1 unit of insulin= 40 change in sugar less than a unit if insulin is necessary, but since 1= .25 +.25 + .25 + .25 this means that the difference of 104 to 120 will cause that 16 point change. With a 16 change = 16/40= 0.40. This will mean reducing the units of insulin, by 0.40 if any carbs are to be consumed with insulin being given in compensation.
          • If this isn’t done, it is likely to mean higher sugars resulting closer to the inaccurate higher goal ranges, which will also need work to shift those results back to normal.
        • Please remember these insulin evaluations above are only samples each individual has different numbers in use, so different calculations are needed with the same patterns of uses.
          • Let’s redo the amounts above using one insulin pattern from Rhapsodie’s pump on 7-1-20.
Start Time End Time Grams of Carbs Amount of Insulin Sugar Changes
0:00 3:30 5.1 =     1   = 23
3:30 4:30 5.1 =     1   = 23
4:30 9:00 5.0 =     1   = 22
9:00 10:00 5.0 =     1   = 23
10:00 10:30 4.9 =     1   = 23
10:30 16:00 4.9 =     1   = 22
16:00 16:30 4.9 =     1   = 21
16:30 21:00 4.9 =     1   = 23
21:00 21:30 5.0 =     1   = 23
21:30 22:30 5.0 =     1   = 22
22:30 23:00 5.1 =     1   = 22
23:00 0:00 5.1 =     1   = 23
  • With the modified higher goal ranges, for the sensor, of 115 to 125, averaged to 120, a sugar test result of 104 with normal ranges of 96 to 104, averaged to 100, will mean NO CORRECTION really NEEDED. But the higher goals will cause less insulin to be used if these normal ranges are associated with food intakes.
    • With a 16 change = 16/23= 0.695 (0.70) units of insulin taken away from any additional insulin prescribed by the pump. This will mean that maintaining normal goal results with the pump set at higher results will be able to be done by reducing the units of insulin, by 0.70 if any carbs are to be consumed.
    • Otherwise the levels are perfectly fine, within normal ranges, at present so no other corrections are necessary.
  • Low Test Results [Not Done]
    • With the modified higher goal ranges, for the sensor, of 115 to 125 the average goal is 120. Meaning that with a sugar test result of 85 the raised for needed change higher goal ranges area calculated change amount of 35 will be set by the pump, with that amount being subtracted from any compensation delivery. BUT with the normal goal range average being 100 there’s only a correction for 15 needed.
      • So needed corrections amounts are for a change of 15 with the sugar levels.
      • This means that with the insulin pump doing a correction of 35 there’s a variation of 20 which isn’t needed. This means with 10 carbohydrates= 1 unit of insulin= 40 change that a change for 20 divided by the full amount of change provides the amount of insulin that shouldn’t be taken. And with using that amount to figure out the carbohydrates there can be compensation taken that will raise levels to the correct amount without overdoing it.
        • These amounts can be tested by doing the other math shared previously (120/85= approximately 1.41) – (100/85=1.17)= 0.24 (or 24%) of normal use units that shouldn’t be given. This results as 23 change values x 0.24= 5.52 change values that shouldn’t be given, done another way this is 5.51 carbs x 0.24
      • So with the real correction a value of 20, 20/40= 0.5 which equals ½ a unit of insulin if there wasn’t a compensation done.
      • This means that only 5 carbs are needed because that the amount of the results previously calculated define what food/carb compensation is needed to raise sugars to the accurate levels, not the high levels.
    • Please remember these insulin evaluations above are only samples each individual has different numbers in use, so different calculations are needed with the same patterns of uses.
      • Let’s redo the amounts above using one insulin pattern from Rhapsodie’s pump on 7-1-20.
Start Time End Time Grams of Carbs Amount of Insulin Sugar Changes
0:00 3:30 5.1 =     1   = 23
3:30 4:30 5.1 =     1   = 23
4:30 9:00 5.0 =     1   = 22
9:00 10:00 5.0 =     1   = 23
10:00 10:30 4.9 =     1   = 23
10:30 16:00 4.9 =     1   = 22
16:00 16:30 4.9 =     1   = 21
16:30 21:00 4.9 =     1   = 23
21:00 21:30 5.0 =     1   = 23
21:30 22:30 5.0 =     1   = 22
22:30 23:00 5.1 =     1   = 22
23:00 0:00 5.1 =     1   = 23
  • With the modified higher goal ranges, for the sensor, of 115 to 125, averaged at 120 with a sugar test result of 85 will mean that with higher goal ranges a correction of 35 will be set by the pump. BUT with the normal goal range being averaged at 100 there’s only a correction for 15 needed.
    • The correction of 35-15 is a difference of 20. With 1 unit of insulin being equal to a change of 23 it means that almost one whole unit is unnecessary for the corrections to result in more normal sugar results.
      • So 23/30= .7667 averaged at .75 of a unit of insulin can be subtracted from the machine calculated delivery amount for accurate sugar changes.
    • If no extra carbs are to be ingested, the correction factor of the amount of 15 is needed to raise sugars to the normal goal target ranges. This means that with 15/23= 0.65 of the correction carb is needed. With 5.1 carbs per unit of insulin this is 5.1 carbs x 0.65 percentage of unit change, which equals 3.315 carbs to raise sugar levels from 85 into 100.

 

  1. Retained sugar values in intermediate stages
  2. Lower goal target ranges
  3. Lower sugar issues
To vary sugar goal target ranges on the PARADIGM INSULIN PUMP separate from CGM:

These are the function aspects for all Paradigm insulin pumps, but there are also additional actions if there is a connected sensor use with the Paradigm pump, but I’m describing the use of the 670g below which also has sensor connections.

A1- For All Goal target Ranges with the Paradigm
  • Click ACT;
  • Choose Bolus and press ACT again;
    • The menu can be moved through using the up and down arrows to the right of the ACT
  • Arrow down to Bolus Setup and press ACT again;
  • Choose Bolus WIZARD Setup and press ACT again;
  • Choose Edit Settings and press ACT again;
  • Arrow down to BG Target and press ACT again;
    • Set the goal target ranges for the times, [more continued following this section of illustrations put into italics.]

A1a- High Sugar into Low Sugar Surgical Goal target Range Example

  • Like for surgical procedures let’s say Rhapsodie is being brought in for surgery initially at 9am, so
    • for at 8am the insulin pump is shifted to a goal target range of 180 to 190.
    • Rhapsodie is given corn syrup water to raise her sugar levels before surgery,
  • At 9am the drugs are given her, which could include acetaminophen which with the sensor of the 670g OR a Paradigm could read higher than her sugars really are, so real sugar tests are needed.
    • Let’s say the real test results at 11am are that her sugar is at 240, so that amount is added into the pump to make sugar adjustments to get her into the goal target ranges by:
      • Clicking ACT;
      • Choose Bolus and press ACT again;
      • Choose Bolus WIZARD and press ACT again;
        • Use the UP & Down arrows to enter the sugar if that’s not already in the pump, then press ACT again;
      • Do not enter Food leave it blank, and press ACT again;
      • The pump will provide the insulin delivery estimate details based on the values already in it for Rhapsodie’s body,
      • Press ACT again
      • Choose Normal Delivery,
      • And press ACT 2 more times to deliver the insulin.
    • The reason insulin is used instead of a temporary basal is because there is a definite goal target in mind and using the bolus operation will assist the pump in going towards that goal target.

A1b- Into accurately planned goal target range setup

With this preset the only care to get the sugars into the ‘altered’ lower ranges would be to provide insulin as described above, while the new goal target ranges are in place. BUT this process takes up to 3 hours, so there should also be process shift over time plans in the action plans for the patient assistance as well as surgical shifts with the processes. The value of the lower sugars is that the body tissues which are ‘stiffened’ with higher sugars should actually soften and be easier to close and seal with sugars through the 150 to 80 sugar ranges. BUT like is normal this will take time based on the insulin the drugs being used and  lots more.

  • Now let’s say that the surgical time plan was originally prepared for 8 hours, which means that by 5pm Rhapsodie would be out of surgery. In preparations varied goal target rates could have been set, that include medium into lower rates as goal targets starting at 3pm. So this was done previously because of following the instructions shared above:
    • Click ACT;
    • Choose Bolus and press ACT again;
      • The menu can be moved through using the up and down arrows to the right of the ACT
    • Arrow down to Bolus Setup and press ACT again;
    • Choose Bolus WIZARD Setup and press ACT again;
    • Choose Edit Settings and press ACT again;
    • Arrow down to BG Target and press ACT again;
    • Set the goal target ranges for the times, [this wasn’t above]
      • This starts at 0:00 (Midnight)
        • Click ACT on the first screen, the lower edge of that goal target range is flashing now and you can change that number with the up and down arrow;
        • follow this by clicking ACT again to the higher goal target edge number and using the arrows to make that go up and down.
        • Click ACT again and you are taken to the next time screen if there is one setup.
      • This starts at the time that is flashing from the previous ACT clicking;
        • The time can be kept OR can be changed with the up & down arrows; then
        • The actions of the range goal target amounts can be set like shared above.
      • The starts at midnight processes are repeated through the whole system until the full 24 hours is assigned goal target ranges.
        • So with our setup above with surgical processes for Rhapsodie:
          • 8am- goal target range 180 to 200;
            • This means getting the sugar up to these levels also before surgery.
          • 2 to 4pm goal target range 145 to 80;
            • The lowering will utilize insulin, it generally takes about ½ and hour to 1 hour for results to start being noticed with the sugar levels, so previous levels are maintained for a time.
            • The amount of gluing/suturing to be done and the body sugar levels will shift how easy these process are versus normal processes.
            • Once the goal targets are set lower the insulin correction rates will work towards those after insulin bolus deliveries are given with the Paradigm.
              • If there is a bolus being used to lower sugar from a high to a lower goal target range a 30 minute to 2 hour Square Wave Bolus can extend full insulin delivery from 3 hours to 3.5 to 5 hours, this can allow more procedure time especially if events are complicated.
              • The temporary basal rates, more below, can allow you more OR less use times with alternate insulin without you needing to take carbs for corrections OR take insulin for corrections. For example if Rhapsodie’s already been given a bolus to get sugars lower, it’s been 2 hours since delivery and the sugar levels are great right now for gluing suturing, it can be useful to note how much insulin is still in use. Go to the bolus screen fake in delivery and see what amount of insulin is remaining as still active. With the basal amounts for an hour and an hour of delivery left it means that if the normal basal is 1.35 and there’s a bolus of 1.20 left then a reduction of the temporary basal to 0.5 for 1 hour starting about ½ hour after the change. This should maintain the present levels of sugar, but these can also mean that more correction of 1.2 is needed in an hour, to keep sugars dropping beyond that time without having sugars shoot up again.
            • For surgical sessions where there are suturing processes being extended it could be that a normal goal target range temporarily utilized is better in the schedules and insulin goal target setups for those processes, but so can uses of the Square Wave Bolus.
          • 4 to 6 pm goal target range 60 to 70
            • More insulin is needed to reach these ranges. AND this can be started during OR even within the gluing/suturing processes.
            • Care is needed to make sure that the sugars don’t go too low from too much insulin being given without the variation time frames already being prepared for. Insulin acts in a bulby way, it is most active towards the center and is less active early and later, but it’s still active.
          • 6pm to next day 6pm goal target range 60 to 70
            • The reason’s this is being maintained for 1 to 2 days is to reduce the ischemia impacts from the surgical procedures. It’s not normal to have sugars at these levels.
            • Because the insulin was previously setup for the surgical day(s) these processes will require going into the pump and rearranging all the goal target ranges to maintain these rates for an extended period of time.
            • These processes with goal target ranges are often the least varied with the insulin pump, but with different medications and sugar impacts it can be a value to set the systems up with varied goal targets at times to assist in keeping the patient healthy while things are happening.
              • For example with the acetaminophen raising the sensor evaluations, but the real body sugars being lower, the 670g in AUTO MODE could kill a person. So having the goal target ranges higher than normal will mean that the sugar target goals & test actions will also need to be modified for accurate insulin uses, but the pump’s auto actions won’t be endangering the life of the person wearing the insulin pump.

A1c- If surgical schedules are varying

Varied surgical schedules will shift the insulin goal target range time frames, there are a couple of options with this situation, but it’s dependent on the patient and the surgical procedures that include uses of insulin at time periods with the modified goal target ranges already in place.

  • If the 3pm goal target range is changed to 65 to 75 it means that any insulin corrections should be avoided until approximately 2 to 2.25 hours before the end of the surgical sutures are anticipated to be done. This can mean that sugars can go higher, BUT it also could mean that sugars could drop because of other factors in life.
    • This case may mean varying the goal target ranges to other times to reduce the accidental change problems while still keeping sugar levels in goal target areas for most of the surgical procedures will involve following the instructions above under the goal target range time settings changes, heading A1b.
      • Going into the pump and shifting the goal target times for the results of the lower sugars of 65 to 75 about 2 to 2.25 hours before suturing is to be completed.

 

This should mean that when the suturing is finished the lower goal targets are reached, which will also mean that ischemia issues are likely to be reduced tremendously without additional drugs that can cause more issues with treatments and recoveries.

 

A1d- With Goal target Ranges how do you Raise Sugars Accurately?

Now as described above with the sugar at 240 the goal target is what the insulin use is working to attain. For food and sugar raising this is almost the same, but there’s a slight variation to the correction process with the insulin pump as described at A1a above:

  • Let’s say the real test results at 4pm are that her sugar is at 80, but Rhapsodie was given lowering insulin only 1 hour before, meaning there is still 2 hours 2/3rds of the insulin left to act. So a glucose correction is needed for the suturing and to reduce low sugars for a time. So these adjustments are done by:
    • Clicking ACT;
    • Choose Bolus and press ACT again;
    • Choose Bolus WIZARD and press ACT again;
      • Use the UP & Down arrows to enter the sugar if that’s not already in the pump, then press ACT again;
    • NOW ENTER the glucose amount as normal with protein based carbs OR as reduced by 50% with simple sugar carbs as Food and press ACT again;
      • For normal sugar corrections like milk OR nutrition plus drinks the carbs amounts with a protein base will last through the insulin uses. The food with goal target factors will give the correct amounts of insulin with the pump setup with the goal targets,
        • For surgical sessions where there are suturing processes being extended it could be that a normal goal target range is better in the schedules and insulin goal target setups for those processes.
      • This means that if 20 carbs are being given, of simple sugars, which get multiplied by 50% OR divided by 0.5 there are only 10 carbs given for the results being worked for.
        • For any corn syrup and sugar waters used Rhapsodie always cuts their correction factors by 50% because they don’t last more than 30 minutes.
      • The pump will provide the insulin delivery estimate details based on the values already in it for Rhapsodie’s body, and the carbohydrate values added within the Food setting.
    • Press ACT again
    • Choose Normal Delivery OR even Square Wave Bolus which will deliver the insulin during the amount of delivery time chosen.
      • This correction will only impact any incoming insulin, the previous insulin delivery is already being utilized. BUT if there is a bolus being used to lower sugar from a high to a lower goal target range a 30 minute to 2 hour Square Wave Bolus can extend full insulin delivery from 3 hours to 3.5 to 5 hours.
    • The ACT click demonstrates the amount of insulin planned into delivery as well as what type of delivery it is.
    • Press ACT for a final time to start the delivery.

 

A2- This is not the only medical variation action that can be taken with the Paradigm insulin pump there are many other options also, like:

[Not done] Regular Basal Changes with the Paradigm Insulin Pump

Basal changes are often just based on previously found body patterns with insulin rates for types of activities and actions, but these changes with medications, so shifting the basals can be vital for assistance with health care. For health care providers the activity valuations will impact which change pattern rates are best to be altered. BUT use of the temporary basals can assist in assigning change levels for diabetics by sharing the ‘percentage’ of change needed once those are found to be accurate or inaccurate after 3 hours of trials.

 

Regular

[Not Done] Regular Bolus Changes with the Paradigm Insulin Pump

Bolus changes generally follow multiple sets of basal changes, the reason is that the body is utilizing less insulin for the same work, which also means that the amount of food & high sugar compensation to reach the goal target levels change.

Temporary basal rates

Before using suspend when sugars are low and teeth are brushed for the sleep times use of the Temporary basal actions are preferred by Rhapsodie for raising her sugar by reducing the insulin while she continues to sleep. This means calculating the rates of need for the changes against the basal amounts, but it also means waiting 3 hours for sugars to get up to the ‘accurate’ levels, so this function doesn’t work well with the 670g connected to the sensor.

  • Temporary basal rates; which shift delivery amounts through the use hours, but they aren’t as consistent as established action patterns with goal targets.
    • BUT in some cases these may be needed like when drugs increase body sugar levels and the amount of insulin for basals start graduating up or down with the drug uses.
      • If levels on a graph graduate up then more basal is needed, that’s if no food is part of these factors and the insertion areas are working accurately.
      • If the levels on a graph are dropping than less basal is needed, that’s if no bolus insulin is part of these factors and the insertion areas are working accurately.
    • The Temporary basal actions with the Paradigm let you enter the amount of insulin for the amount of time which means you can set it at 0% for anything over ½ an hour with only 1 beep per hour.
      • This is done by:
        • Click ACT;
        • Arrow down to Basal and press ACT again;
        • Choose Set/Edit Temp Basal and press ACT again;
        • Arrow up OR down to Set Duration and press ACT again;
          • The menu can be moved through using the up and down arrows to the right of the ACT
        • Set Temp Basal % opens, use the arrows to set the percentage of change from the present basals, and press ACT again;
        • The process starts until you turn it off, alter it to later, OR it ends.

 

The temporary basal rates can allow you to see the amount of insulin variation for the types of activities you’re doing, in addition it can provide you use times with alternate insulin without you needing to take carbs for corrections OR take insulin for corrections.

 

There is more info added under the Suspend function because Rhapsodie has found that the temporary basal actions & others are preferable to use of suspend in most cases.

Square Wave Bolus & Dual Wave Bolus

  • Square Wave Bolus & Dual Wave Bolus rates shift delivery amounts over time by what and whens.
    • SO if there is a bolus being used to lower sugar from a high to a lower goal target range a 30 minute to 2 hour Square Wave Bolus can extend full insulin delivery from 3 hours to 3.5 to 5 hours.
    • If pizza is being eaten a Dual Wave Bolus allows a portion of the insulin to be given normally and a portion to be extended over the time set like the square wave. For Rhapsodie 6.5 hours with 50% immediate and 50% long term is what she has used for years with normal pizza, but with a thin crust pizza, burritos, hamburgers on buns, or other higher fat and cheap white flour carbs these levels are shifted.

Suspend function

There is also the Suspend function, which stops insulin delivery totally, but it’s not the best function when there are other options that work better in most cases.

  • Like there is the unplug option, which allows others to disconnect the insulin delivery from the body. When an individual is able to fix this as sugars raise it means that there aren’t the suspend beeps AND there is a physical sign that the insulin is disconnected. But uses of better functions like the Temporary basal offers additional values at times:
    • Before using suspend when sugars are low and teeth are brushed for the sleep times use of the Temporary basal actions are preferred by Rhapsodie for raising her sugar by reducing the insulin while she continues to sleep. This means calculating the rates of need for the changes against the basal amounts, but it also means waiting 3 hours for sugars to get up to the ‘accurate’ levels, so this function doesn’t work well with the 670g connected to the sensor.

In addition there is the unplug option, which allows others to disconnect the insulin delivery from the body. When an individual is able to fix this as sugars raise it means that there aren’t the suspend beeps AND there is a physical sign that the insulin is disconnected.

[NOT DONE] Insulin Variations USING CGM Pump Goal target Range Setup (Continuous Glucose Monitoring)

Systems that use blood glucose tests as rates for accuracy with uses of the insulin pumps and systems are considered a value in CGM (Continuous Glucose Monitoring), so users aren’t insulin dependent still find these systems of value. The general values for diabetics with insulin variations OR non-insulin dependent diabetics can be found using the senor and the sytems of the pump for monitoring and varing sugar results. There is more about these systems shared above, BUT because many systems like the 670g require sugar tests for system accuracy it means that pricking is common still.

 

With the 670g there are as many OR even more sugar pricks with the sensor being used then there are without it being used, partially because of the system regulating when the sensor rates are showing lows, but also because the system inaccuracies often cause multiple checks because the sensor is so wrong so often. This causes multiplied uses to make sure insulin corrections and food consumption insulin uses are accurately arranged. In addition with calibration factors the machine has specified calibration patterns which at times don’t accept the calibration when the machine isn’t ready for it with new setups. In addition if sugars are checked the system doesn’t accept calibration without the buttons being pushed to make it calibrate.

 

There are alternate options that can assist with the glucose checking more information is included in the NO- Finger Prick Glucose Meters Types document, of highest count, which has some information Rhapsodie has researched. The value of no pricking goes beyond less pricks, but the CGM systems utilize pricks to place sensors under the skin so they aren’t prick free that’s why the document title isn’t titled Prick Free Sugar Meters. But some glucose monitors don’t use any pricking to find sugar levels CNOGA, Gluco-wise, and Glucotrack brands are some of those options Rhapsodie has researched beyond their names, other options are within that paper which is still incomplete.

 

Because Rhapsodie’s only CGM experience is utilizing the 670g her info below is based on that system and uses in many ways these uses can be paralleled &/OR modified with different CGM systems.  The reasons for Goal target range variations are discussed above for this information as well as for that info. Reference to this info assists readers into returning here if they use the link above or scan or click down to this section.

 

Goal target Range Variations Using the 670g Sensor CGM System

The reasons for Goal target range variations are discussed above for this information as well as for that info. Reference to this info assists readers into returning here if they use the link above or scan or click down to this section. 

 

The Minimed 670g is only one of the insulin pumps that also have CGM systems. These values in the 670g insulin pump are located both within the Bolus Wizard Setup plus with the sensor within the sensor goal target setups. The lowest level sugars can be at with the 670g is what the sensor says is 50 then the low sugar warning system is fully activated and unable to be turned off.

C. Using 670g without AUTOMODE

Please reference this insulin use info above under the Paradigm info, but return here for the 670g variations along with sensor info.

 

C1- Reasons Rhapsodie Avoids the 670g for insulin delivery

There are multiple reasons that Rhapsodie hasn’t used AUTOMODE and will not use it.

  1. Automode with the 670g is presently designed to have a goal target target of 120, that’s too high for Rhapsodie. Her goal target range is 96 to 104.
  2. Rhapsodie having the Whoops Disease has a higher than normal body water content level, this means the 670g system has many problems with her that aren’t normal.
    • The interstitial body fluids are higher in water content so sugar results are always lower than blood sugar results.
    • Plus the fluids block signal sharing, so Rhapsodie sleeping the sensor connected always has the pump disconnecting during sleep, so this system hasn’t been a value for sleep uses.
    • Rhapsodie’s sensor values are always extremely WRONG unless they are exactly within the goal target ranges she has defined. They are more than ordinarily wrong because of the excess fluid under her skin which the sensor gets values from.
  3. There are remote controllers that have, illegally, modified and shifted Rhapsodie’s 670g pump setups multiple times, they don’t do that with AUTOMODE in use, but they have ruined Rhapsodie’s desire to trust the pump for uses at all.
  4. The insulin deliveries with the 670g aren’t accurately consistent.
    • The early deliveries just after setup with a new reservoir are often too low for 20 to 40 ml of insulin.
    • The later use of reservoir, the last 20 units before the low level warnings and after the low level warnings deliver insulin slower than it should be.
      • All insulin pump values are based on deliveries that are exactly consistent based on the levels defined for uses.
  1. The 670g reservoir always, at least outside of hospital temperatures, gets air in it which also causes insulin delivery issues with less insulin than needed when air is being given instead of insulin.
    • Rhapsodie has her insulin pumps, both the Paradigm and the 670g, worn upside down so that tapping the air to the back end of the reservoir means it doesn’t get delivered to Rhapsodie.

 

With the insulin delivery rates shifting through a reservoir of insulin, with the sensor readings always extreme away from the goal targets, with her body acting too fast for the pump sensor to be accurate, and with the remote controllers fiddling with the rates and amounts she sets on the pump she’d never recommend it to other users. BUT many people have this piece of crap for insulin delivery.

C1a- 670g Automode

The 670g automode uses computer processes based on goal targets to deliver the assigned by computer insulin levels for sugar results based on goal targets of the system and user patterns. BUT it doesn’t shift bolus rates or levels. The method options for this process uses a process where a computer program OR process reads the sensor sugar levels and varies insulin rates for sugar goal targets. This system is a dependent system, which means if a user goes off the system, like for eating pizza with a dual wave bolus used, the rates the automode had been using aren’t put into processes for the user, they have to go back to previously established basal patterns and insulin use levels with foods and adjustments. Users find it easier because it’s more like a real pancreas, but it does make them dumber about the insulin pump and their health. No graph is shared with automode, calibration is still a requirement, the goal target ranges are preset by the system and are unable to be modified by the users.

 

Other CGM systems have different manufacturers and processing systems, but there are similar actions and results with uses of the body if the body uses are accurately being done. Other CGM’s, not the 670g, are as useful OR even better with sensor uses and body actions because they use computers, cell phones, and other blue tooth devices to get the info from the sensor. In addition they also are likely to be varied with insulin uses depending on the type of insulin delivery system and individuals using the insulin. The other devices, that aren’t the 670g, should also allow that the sharing will be able to set up info on larger screens for easier observation in multiple use surgical spaces.

C1b- Sensor Uses with the 670g and Rhapsodie

The additional issues with it could correspond to how her body is working, like how any sensor signal blocking happens with the sensor more than 12 inches from the pump. For uses with the basal setups in surgery it could work great with the higher sugar level goal targets, but it’s likely to be crappy with the lower sugar level goal targets. The lowest level sugars can be at with the 670g is 50 then the low sugar warning system is fully activated and unable to be turned off. Even if an individual, having anything like up to 20% different can set this off.

 

This means that levels at 60 can do that, so for lower sugars with surgeries use of different insulin pump systems can be much better, but any pump will work for higher sugar levels. The pump doesn’t recognize how the temporary basals are helping a person, because of the slow insulin & body responses, it takes over 3 hours with a temporary basal set at 55% delivery to get sugar levels back to normal. It takes about 1.25 hours with 0% insulin to get sugars back to normal, then sugars go high. The reason is the pump has goal target ranges preset, inaccurately at 120, but it also has no recognition of temp. basals impacts. Which means for treatments it’s a crappy machine to use with the sensor on, unless it’s set off the body, with sensor attached, and it’s removed from the signal zone when it gets to the low warning zone of whatever was set. Rhapsodie’s is normally set at 65 to 60.

 

Everything reddened below hasn’t been modified for accuracy of information with the 670g insulin pump.

G. To vary sugar goal target ranges on the 670g INSULIN PUMP:

The 670g pump has both

  • the sensor goal target ranges as well as
  • the Bolus Wizard insulin changes.

The changes of insulin with the 670 differ in multiple ways beyond the extra button presses and fiddling that are requirements making the pump harder to use than the Paradigm.

A1- For All Goal target Ranges with the 670g

  • Click ACT;
  • Choose Bolus and press ACT again;
    • The menu can be moved through using the up and down arrows to the right of the ACT
  • Arrow down to Bolus Setup and press ACT again;
  • Choose Bolus WIZARD Setup and press ACT again;
  • Choose Edit Settings and press ACT again;
  • Arrow down to BG Target and press ACT again;
    • Set the goal target ranges for the times, [more continued following this section of illustrations put into italics.]

A1a- High Sugar into Low Sugar Surgical Goal target Range Example

  • Like for surgical procedures let’s say Rhapsodie is being brought in for surgery initially at 9am, so
    • for at 8am the insulin pump is shifted to a goal target range of 180 to 190.
    • Rhapsodie is given corn syrup water to raise her sugar levels before surgery,
  • At 9am the drugs are given her, which could include acetaminophen which with the sensor of the 670g OR a Paradigm could read higher than her sugars really are, so real sugar tests are needed.
    • Let’s say the real test results at 11am are that her sugar is at 240, so that amount is added into the pump to make sugar adjustments to get her into the goal target ranges by:
      • Clicking ACT;
      • Choose Bolus and press ACT again;
      • Choose Bolus WIZARD and press ACT again;
        • Use the UP & Down arrows to enter the sugar if that’s not already in the pump, then press ACT again;
      • Do not enter Food leave it blank, and press ACT again;
      • The pump will provide the insulin delivery estimate details based on the values already in it for Rhapsodie’s body,
      • Press ACT again
      • Choose Normal Delivery,
      • And press ACT 2 more times to deliver the insulin.
    • The reason insulin is used instead of a temporary basal is because there is a definite goal target in mind and using the bolus operation will assist the pump in going towards that goal target.

A1b- Into accurately planned goal target range setup

With this preset the only care to get the sugars into the ‘altered’ lower ranges would be to provide insulin as described above, while the new goal target ranges are in place. BUT this process takes up to 3 hours, so there should also be process shift over time plans in the action plans for the patient assistance as well as surgical shifts with the processes. The value of the lower sugars is that the body tissues which are ‘stiffened’ with higher sugars should actually soften and be easier to close and seal with sugars through the 150 to 80 sugar ranges. BUT like is normal this will take time based on the insulin the drugs being used and  lots more.

  • Now let’s say that the surgical time plan was originally prepared for 8 hours, which means that by 5pm Rhapsodie would be out of surgery. In preparations varied goal target rates could have been set, that include medium into lower rates as goal targets starting at 3pm. So this was done previously because of following the instructions shared above:
    • Click ACT;
    • Choose Bolus and press ACT again;
      • The menu can be moved through using the up and down arrows to the right of the ACT
    • Arrow down to Bolus Setup and press ACT again;
    • Choose Bolus WIZARD Setup and press ACT again;
    • Choose Edit Settings and press ACT again;
    • Arrow down to BG Target and press ACT again;
    • Set the goal target ranges for the times, [this wasn’t above]
      • This starts at 0:00 (Midnight)
        • Click ACT on the first screen, the lower edge of that goal target range is flashing now and you can change that number with the up and down arrow;
        • follow this by clicking ACT again to the higher goal target edge number and using the arrows to make that go up and down.
        • Click ACT again and you are taken to the next time screen if there is one setup.
      • This starts at the time that is flashing from the previous ACT clicking;
        • The time can be kept OR can be changed with the up & down arrows; then
        • The actions of the range goal target amounts can be set like shared above.
      • The starts at midnight processes are repeated through the whole system until the full 24 hours is assigned goal target ranges.
        • So with our setup above with surgical processes for Rhapsodie:
          • 8am- goal target range 180 to 200;
            • This means getting the sugar up to these levels also before surgery.
          • 2 to 4pm goal target range 145 to 80;
            • The lowering will utilize insulin, it generally takes about ½ and hour to 1 hour for results to start being noticed with the sugar levels, so previous levels are maintained for a time.
            • The amount of gluing/suturing to be done and the body sugar levels will shift how easy these process are versus normal processes.
            • Once the goal targets are set lower the insulin correction rates will work towards those after insulin bolus deliveries are given with the Paradigm.
              • If there is a bolus being used to lower sugar from a high to a lower goal target range a 30 minute to 2 hour Square Wave Bolus can extend full insulin delivery from 3 hours to 3.5 to 5 hours, this can allow more procedure time especially if events are complicated.
              • The temporary basal rates, more below, can allow you more OR less use times with alternate insulin without you needing to take carbs for corrections OR take insulin for corrections. For example if Rhapsodie’s already been given a bolus to get sugars lower, it’s been 2 hours since delivery and the sugar levels are great right now for gluing suturing, it can be useful to note how much insulin is still in use. Go to the bolus screen fake in delivery and see what amount of insulin is remaining as still active. With the basal amounts for an hour and an hour of delivery left it means that if the normal basal is 1.35 and there’s a bolus of 1.20 left then a reduction of the temporary basal to 0.5 for 1 hour starting about ½ hour after the change. This should maintain the present levels of sugar, but these can also mean that more correction of 1.2 is needed in an hour, to keep sugars dropping beyond that time without having sugars shoot up again.
            • For surgical sessions where there are suturing processes being extended it could be that a normal goal target range temporarily utilized is better in the schedules and insulin goal target setups for those processes, but so can uses of the Square Wave Bolus.
          • 4 to 6 pm goal target range 60 to 70
            • More insulin is needed to reach these ranges. AND this can be started during OR even within the gluing/suturing processes.
            • Care is needed to make sure that the sugars don’t go too low from too much insulin being given without the variation time frames already being prepared for. Insulin acts in a bulby way, it is most active towards the center and is less active early and later, but it’s still active.
          • 6pm to next day 6pm goal target range 60 to 70
            • The reason’s this is being maintained for 1 to 2 days is to reduce the ischemia impacts from the surgical procedures. It’s not normal to have sugars at these levels.
            • Because the insulin was previously setup for the surgical day(s) these processes will require going into the pump and rearranging all the goal target ranges to maintain these rates for an extended period of time.
            • These processes with goal target ranges are often the least varied with the insulin pump, but with different medications and sugar impacts it can be a value to set the systems up with varied goal targets at times to assist in keeping the patient healthy while things are happening.
              • For example with the acetaminophen raising the sensor evaluations, but the real body sugars being lower, the 670g in AUTO MODE could kill a person. So having the goal target ranges higher than normal will mean that the sugar tests will also need to be modified for accurate insulin uses, but the pump’s auto actions won’t be endangering the life of the person wearing the insulin pump.

A1c- If surgical schedules are varying

Varied surgical schedules will shift the insulin goal target range time frames, there are a couple of options with this situation, but it’s dependent on the patient and the surgical procedures that include uses of insulin at time periods with the modified goal target ranges already in place.

  • If the 3pm goal target range is changed to 65 to 75 it means that any insulin corrections should be avoided until approximately 2 to 2.25 hours before the end of the surgical sutures are anticipated to be done. This can mean that sugars can go higher, BUT it also could mean that sugars could drop because of other factors in life.
    • This case may mean varying the goal target ranges to other times to reduce the accidental change problems while still keeping sugar levels in goal target areas for most of the surgical procedures will involve following the instructions above under the goal target range time settings changes, heading A1b.
      • Going into the pump and shifting the goal target times for the results of the lower sugars of 65 to 75 about 2 to 2.25 hours before suturing is to be completed.

 

This should mean that when the suturing is finished the lower goal targets are reached, which will also mean that ischemia issues are likely to be reduced tremendously without additional drugs that can cause more issues with treatments and recoveries.

 

A1d- With Goal target Ranges how do you Raise Sugars Accurately?

Now as described above with the sugar at 240 the goal target is what the insulin use is working to attain. For food and sugar raising this is almost the same, but there’s a slight variation to the correction process with the insulin pump as described at A1a above:

  • Let’s say the real test results at 4pm are that her sugar is at 80, but Rhapsodie was given lowering insulin only 1 hour before, meaning there is still 2 hours 2/3rds of the insulin left to act. So a glucose correction is needed for the suturing and to reduce low sugars for a time. So these adjustments are done by:
    • Clicking ACT;
    • Choose Bolus and press ACT again;
    • Choose Bolus WIZARD and press ACT again;
      • Use the UP & Down arrows to enter the sugar if that’s not already in the pump, then press ACT again;
    • NOW ENTER the glucose amount as normal with protein based carbs OR as reduced by 50% with simple sugar carbs as Food and press ACT again;
      • For normal sugar corrections like milk OR nutrition plus drinks the carbs amounts with a protein base will last through the insulin uses. The food with goal target factors will give the correct amounts of insulin with the pump setup with the goal targets,
        • For surgical sessions where there are suturing processes being extended it could be that a normal goal target range is better in the schedules and insulin goal target setups for those processes.
      • This means that if 20 carbs are being given, of simple sugars, which get multiplied by 50% OR divided by 0.5 there are only 10 carbs given for the results being worked for.
        • For any corn syrup and sugar waters used Rhapsodie always cuts their correction factors by 50% because they don’t last more than 30 minutes.
      • The pump will provide the insulin delivery estimate details based on the values already in it for Rhapsodie’s body, and the carbohydrate values added within the Food setting.
    • Press ACT again
    • Choose Normal Delivery OR even Square Wave Bolus which will deliver the insulin during the amount of delivery time chosen.
      • This correction will only impact any incoming insulin, the previous insulin delivery is already being utilized. BUT if there is a bolus being used to lower sugar from a high to a lower goal target range a 30 minute to 2 hour Square Wave Bolus can extend full insulin delivery from 3 hours to 3.5 to 5 hours.
    • The ACT click demonstrates the amount of insulin planned into delivery as well as what type of delivery it is.
    • Press ACT for a final time to start the delivery.

 

A1e- This is not the only action that can be taken with the insulin pump there are many other options also, like:

  • Temporary basal rates; which shift delivery amounts through the use hours, but they aren’t as consistent as established action patterns with goal targets.
    • BUT in some cases these may be needed like when drugs increase body sugar levels and the amount of insulin for basals start graduating up or down with the drug uses.
      • If levels on a graph graduate up then more basal is needed, that’s if no food is part of these factors and the insertion areas are working accurately.
      • If the levels on a graph are dropping than less basal is needed, that’s if no bolus insulin is part of these factors and the insertion areas are working accurately.
    • Square Wave Bolus & Dual Wave Bolus rates shift delivery amounts over time by what and whens.
      • SO if there is a bolus being used to lower sugar from a high to a lower goal target range a 30 minute to 2 hour Square Wave Bolus can extend full insulin delivery from 3 hours to 3.5 to 5 hours.
      • If pizza is being eaten a Dual Wave Bolus allows a portion of the insulin to be given normally and a portion to be extended over the time set like the square wave. For Rhapsodie 6.5 hours with 50% immediate and 50% long term is what she has used for years with normal pizza, but with a thin crust pizza, burritos, hamburgers on buns, or other higher fat and cheap white flour carbs these levels are shifted.
    • There is also the Suspend function, which stops insulin delivery totally.
      • The Temporary basal actions are preferred by Rhapsodie, because suspension is a temporary measure, beeps every 5 minutes while the pump is in suspend are annoying and reduce battery life very fast. The Temporary basal actions with the Paradigm let you enter the amount of insulin for the amount of time which means you can set it at 0% for anything over ½ an hour with only 1 beep per hour. This is done by:
        • Click ACT;
        • Arrow down to Basal and press ACT again;
        • Choose Set/Edit Temp Basal and press ACT again;
        • Arrow up OR down to Set Duration and press ACT again;
          • The menu can be moved through using the up and down arrows to the right of the ACT
        • Set Temp Basal % opens, use the arrows to set the percentage of change from the present basals, and press ACT again;
        • The process starts until you turn it off, alter it to later, OR it ends.

 

The temporary basal rates can allow you to see the amount of insulin variation for the types of activities you’re doing, in addition it can provide you use times with alternate insulin without you needing to take carbs for corrections OR take insulin for corrections.

 

 

NOT DONE- To vary sugar goal target ranges on the 670g Insulin Pump:

This is varied depending on how the 670g is working with the individual as well as how the processes on the machine are functioning. For Rhapsodie this has never been an accurate system. With the insulin delivery rates shifting through a reservoir of insulin, with the sensor readings always extreme away from the goal targets, with her body acting too fast for the pump sensor to be accurate, and with the remote controllers fiddling with the rates and amounts she sets on the pump she’d never recommend it to other users. BUT many people have this piece of crap for insulin delivery.

 

For Rhapsodie the only 670g values have been the graph with the sensor, BUT the sensor uses with the beeps and inaccurate measures are so annoying she has been tempted to sewer drop it repeatedly. The additional issues with it could correspond to how her body is working, like how any sensor signal blocking happens with the sensor more than 12 inches from the pump. For uses with the basal setups in surgery it could work great with the higher sugar level goal targets, but it’s likely to be crappy with the lower sugar level goal targets. The lowest level sugars can be at with the 670g is 50 then the low sugar warning system is fully activated and unable to be turned off. Even if an individual, having anything like up to 20% different can set this off.

 

This means that levels at 60 can do that, so for lower sugars with surgeries use of different insulin pump systems can be much better, but any pump will work for higher sugar levels. The pump doesn’t recognize how the temporary basals are helping a person, because of the slow insulin & body responses, it takes over 3 hours with a temporary basal set at 55% delivery to get sugar levels back to normal. It takes about 1.25 hours with 0% insulin to get sugars back to normal, then sugars go high. The reason is the pump has goal target ranges preset, inaccurately at 120, but it also has no recognition of temp. basals impacts. Which means for treatments it’s a crappy machine to use with the sensor on, unless it’s set off the body, with sensor attached, and it’s removed from the signal zone when it gets to the low warning zone of whatever was set. Rhapsodie’s is normally set at 65 to 60.

 

BUT it does have the one value of the graph, which allows the sensor results to be monitored. BUT other CGM’s are as useful OR even better with that function because they use other devices also, like the 14 day device which allows cell phones, and other blue tooth devices to get the info from the sensor. The other devices should also allow that the sharing will be able to set up info on larger screens for easier observation in multiple use surgical spaces.

 

A2- This is not the only medical variation action that can be taken with the insulin pump there are many other options also, like:

[Not done] Regular Basal Changes with the Paradigm Insulin Pump

Basal changes are often just based on previously found body patterns with insulin rates for types of activities and actions, but these changes with medications, so shifting the basals can be vital for assistance with health care. For health care providers the activity valuations will impact which change pattern rates are best to be altered. BUT use of the temporary basals can assist in assigning change levels for diabetics by sharing the ‘percentage’ of change needed once those are found to be accurate or inaccurate after 3 hours of trials.

 

Regular

[Not Done] Regular Bolus Changes with the Paradigm Insulin Pump

Bolus changes generally follow multiple sets of basal changes, the reason is that the body is utilizing less insulin for the same work, which also means that the amount of food & high sugar compensation to reach the goal target levels change.

Temporary basal rates

Before using suspend when sugars are low and teeth are brushed for the sleep times use of the Temporary basal actions are preferred by Rhapsodie for raising her sugar by reducing the insulin while she continues to sleep. This means calculating the rates of need for the changes against the basal amounts, but it also means waiting 3 hours for sugars to get up to the ‘accurate’ levels, so this function doesn’t work well with the 670g connected to the sensor.

  • Temporary basal rates; which shift delivery amounts through the use hours, but they aren’t as consistent as established action patterns with goal targets.
    • BUT in some cases these may be needed like when drugs increase body sugar levels and the amount of insulin for basals start graduating up or down with the drug uses.
      • If levels on a graph graduate up then more basal is needed, that’s if no food is part of these factors and the insertion areas are working accurately.
      • If the levels on a graph are dropping than less basal is needed, that’s if no bolus insulin is part of these factors and the insertion areas are working accurately.
    • The Temporary basal actions with the Paradigm let you enter the amount of insulin for the amount of time which means you can set it at 0% for anything over ½ an hour with only 1 beep per hour.
      • This is done by:
        • Click ACT;
        • Arrow down to Basal and press ACT again;
        • Choose Set/Edit Temp Basal and press ACT again;
        • Arrow up OR down to Set Duration and press ACT again;
          • The menu can be moved through using the up and down arrows to the right of the ACT
        • Set Temp Basal % opens, use the arrows to set the percentage of change from the present basals, and press ACT again;
        • The process starts until you turn it off, alter it to later, OR it ends.

 

The temporary basal rates can allow you to see the amount of insulin variation for the types of activities you’re doing, in addition it can provide you use times with alternate insulin without you needing to take carbs for corrections OR take insulin for corrections.

 

There is more info added under the Suspend function because Rhapsodie has found that the temporary basal actions & others are preferable to use of suspend in most cases.

Square Wave Bolus & Dual Wave Bolus

  • Square Wave Bolus & Dual Wave Bolus rates shift delivery amounts over time by what and whens.
    • SO if there is a bolus being used to lower sugar from a high to a lower goal target range a 30 minute to 2 hour Square Wave Bolus can extend full insulin delivery from 3 hours to 3.5 to 5 hours.
    • If pizza is being eaten a Dual Wave Bolus allows a portion of the insulin to be given normally and a portion to be extended over the time set like the square wave. For Rhapsodie 6.5 hours with 50% immediate and 50% long term is what she has used for years with normal pizza, but with a thin crust pizza, burritos, hamburgers on buns, or other higher fat and cheap white flour carbs these levels are shifted.

Suspend function

There is also the Suspend function, which stops insulin delivery totally, but it’s not the best function when there are other options that work better in most cases.

  • Like there is the unplug option, which allows others to disconnect the insulin delivery from the body. When an individual is able to fix this as sugars raise it means that there aren’t the suspend beeps AND there is a physical sign that the insulin is disconnected. But uses of better functions like the Temporary basal offers additional values at times:
    • Before using suspend when sugars are low and teeth are brushed for the sleep times use of the Temporary basal actions are preferred by Rhapsodie for raising her sugar by reducing the insulin while she continues to sleep. This means calculating the rates of need for the changes against the basal amounts, but it also means waiting 3 hours for sugars to get up to the ‘accurate’ levels, so this function doesn’t work well with the 670g connected to the sensor.

In addition there is the unplug option, which allows others to disconnect the insulin delivery from the body. When an individual is able to fix this as sugars raise it means that there aren’t the suspend beeps AND there is a physical sign that the insulin is disconnected.

Other Connecting Posts

Please beware they are grouped based on a style of topics.

Diabetic’s and Treatments

[Sorry posts still need dividing & completing for better online reading.]

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

 

WHOOPS DISEASE-7c2. A Possible Cure for Type 1 Diabetes BUT Pain Issues & Possible Treatments

SORRY not done yet…I’ve reordered the previous post, BUT it’s still too huge, which means it MAY be split more, AND I’ve not added the images with the active link to the CDC info or the other image again…sorry.

My treatments have gone way more natural because of multitudes of reasons as well as many useful options available for me AND for you.

Pain Care & Diabetes Care

When looking at issues with diabetes there are always aspects about sugar to consider with treatment options and actions. For instance I got steroid and gabapentin prescriptions’ AND both those drugging’s caused raised sugars OR even lowered sugars. Having to raise and lower my insulin amounts because of the medication was a huge issue, AND in some cases these issues can vary reality depending on the type of drug AS WELL AS the type of application AND where sugar readings are gotten from with the body and measuring system.

Medicine sugar Changes

Please be aware before reading this info, that I have had issues with acetaminophen raising the interstitial sugar levels approximately 0.15 to 0.55 more per basal amount, that’s from about a 10 to 30 percent rise in insulin amounts. This is for both my basal/base insulin rates AND my bolus/bonus food & sugar correction insulin rates, depending on how much acetaminophen I get. My blood sugar tests versus the sensor aren’t near the same amounts at all. BUT I’m using a more modern sugar checker and I’ve not had any issues with the insulin when I calculate the changes by the time of taking the med and how long it works for me.

NOT DONE-Possible Delivery System Variation Options

This requires that I calculate blood glucose and sugar amounts accurately instead of utilizing the sensor readings OR the pump in automode normally. But for healthcare this action can be shifted depending on the need people have for sugar altering drugs. The variations of insulin delivery systems can use similar math, but it’s dependent on the system and how the insulin versus rates are calculated.

Some links provide multiple pump options, but make sure to read the info, you’ll note that water resistance, basal & bolus use options, amounts of insulin possible, types of insertion devices and setups vary.

·       Minimed Pumps- Paradigm with sensor adaptations, 630g, with Enlite,& 670’s- Info from Rhapsodie’s use of these pumps
  • BOLUS INSULIN
    • Carb Ratios (Insulin for Carbs)= Grams divided by carb ratio of insulin units (Grams/units)
    • Corrections= (sugar levels- target goal range) mg’s to reach goal sugar amounts divided by delivery Levels of insulin. (mg/dL)
      • In cases where there is already active insulin the initial correction rate is figured then the amount of active insulin is subtracted from the correction dL.
      • Where sugars are low the same formula works in the negative for the mg, and a minus in the correction dL so that extra insulin isn’t delivered
      • AND at times the pump will show that more insulin is in use than the body needs, because of sugar levels, generally I will consume an amount to meet this level, but at times I take more, so I add the whole carb amount to the pump. The pump subtracts the correction carbs as well as the working insulin, so the correct rates are delivered.
    • BASAL INSULIN
      • Sensitivity [Corrections with Tandem pumps]= mg’s to reach goal sugar amounts divided by delivery Levels of insulin. (mg/dL)
·       Tandem t:slim, t:slimG4, t:slim X2, t:flex and (PDF guide from Tandem Link)

The math for this process is the same as the Minimed pumps, but the readouts show the calculations differently when on some screens. [Visuals show a smaller delivery setup than the Minimed pump, but multiple devices are needed for pump uses. The pump alone can’t do the work, like it can with the Minimed. No sensor OR other device is needed for that pump to function. BUT a connected Blue tooth device is needed for the Tandem control, at least that’s how it seems.]

  • BOLUS INSULIN
    • Carb Ratio (Insulin for Carbs)= Grams divided by carb ratio of insulin units (Grams/units)
      • “The carb ratio is the amount of carbohydrate in grams that 1 unit of insulin will cover. For example, a carb ratio of 1 to 10 (also written 1:10) indicates that 1 unit of insulin is needed for every 10 grams of carbohydrate.”
    • Corrections [Sensitivity with Minimed pumps]= (sugar levels- target goal range) mg’s to reach goal sugar amounts divided by delivery Levels of insulin. (mg/dL)
  • BASAL INSULIN
    • Unit(s) of insulin divided by a whole hour (U/H) which is supposed to deliver consistently and incrementally through the hour.
·       Omnipod & Omnipod Dash Insulin Pumps

“Its unique design consists of just two parts; a lightweight, tubeless, waterproof7, wearable Pod controlled by a smartphone-like touch-screen Bluetooth® enabled controller, minimizing the number of components to carry… Tubeless and Waterproof7 Pod design with 200-unit insulin reservoir [Minimed pumps have up to 300 units in a reservoir with no air.]… Automatic cannula insertion at the push of a button [a real pain in avoiding pain issues and areas.]

… Integrated Bolus Calculator, Presets & CalorieKing® that does the thinking and math for you. BUT the delivery needs to be off for any delivery adjustments to be added to the system, which alter the program calculations, which means it can be better to do the delivery rates on computer OR paper, then put the numbers in the system…AND records of places like Calorie King are NOT accurate when it comes to vegetables AND at times fruit…variations in activity alter insulin rates and needs also. The pod is LARGER than most Minimed insertion setups.]

 

Dose wirelessly* without having to wake or interrupt your child [or mate or patient] at school, while playing or sleeping…[This is also great for health care with individuals who are injured OR sick needing insulin care from caregivers.]  Small, tubeless and waterproof7 design [this is great, the 670g isn’t water proof, the sensor only works for up to 30 minutes under water.] The Omnipod DISPLAY™ mobile app helps you stay informed remotely, … The Omnipod VIEW™ mobile app enables nurses and caregivers to monitor up to 12 Omnipod users, keeping them informed at all times.

Both Omnipod & Omnipod Dash
  • BOLUS INSULIN
    • Carb Ratios (Insulin for Carbs)= Grams divided by carb ratio of insulin units (Grams/units)
    • Corrections= (sugar levels- target goal range) mg’s to reach goal sugar amounts divided by delivery Levels of insulin. (mg/dL)
      • “The calculator uses your current blood glucose, carbs entered, and your insulin on board (IOB) to determine a suggested bolus dose.”
      • [In cases where there is already active insulin the initial correction rate is figured then the amount of active insulin (IOB) is subtracted from the correction dL.]
      • Where sugars are low the same formula works in the negative for the mg, and a minus in the correction dL so that extra insulin isn’t delivered
      • AND at times the pump will show that more insulin is in use than the body needs, because of sugar levels, generally I will consume an amount to meet this level, but at times I take more, so I add the whole carb amount to the pump. The pump subtracts the correction carbs as well as the working insulin (IOB), so the correct rates are delivered.]
    • BASAL INSULIN
      • Basal= units per hour based on the ability to adjust for 24 hours[, like the Minimed pumps. BUT the delivery needs to be off for any delivery adjustments to be added to the system, which alter the program calculations, which means it can be better to do the delivery rates on computer OR paper, then put the numbers in the system.]
Additions with Omnipod Dash
  • Extended Basal [Called Square Basal with Minimed pumps]
  • Temporary Basal
  • Up to 6 Basals, which you can self name [Minimed pumps have these, but the non-Bluetooth devices only have letters and specified basal titles, but 8 different basal options.]
  • Food Look up option based on the Calorie King info
  • Can create a custom foods menu for regularly used food option items, maybe also for homemade food creations.
  • Temp Basal Presets [called Preset basals in Minimed 670g]
  • Bolus Preset options- You can add food types for a click quick of what is normal OR common OR even unique for you.

 

·       Valeritas V-Go

“…If regular adjustments or modifications to the basal rate of insulin are required in a 24-hour period, or if the amount of insulin used at meals requires adjustments of less than 2-Unit increments, [this is abnormal with the Minimed pumps increments as small as 0.05 can be taken] use of the V-Go Wearable Insulin Delivery Device may result in hypoglycemia…”

  • This insulin pump isn’t a programmed computerized device, it is a manually programmed device, which means it doesn’t suffer computer OR programming issues. It is more like a fan where you set the speed of air flow, adjust it for possible moves, and let it mechanically function versus a computer controlled temperature control system which can be programmed for temperature, times, and additional options.] It also is limited use wise:
    • Wear each V-Go for one (1) 24-hour period
      • [Basal rates are set before insertion, they do not shift OR vary like the body does.]
      • [“To begin use, the V-Go is filled with insulin using their EZ Fill device. Valeritas recommends that you apply the V-Go within 24 hours of filling the reservoir with Humalog. If filling with Novolog, you have up to 5 days if refrigerated OR 3 days if left at room temperature.” (https://www.diabetesnet.com/animas-vibe/ ) Which means travelers & busy people & parents & caregivers can prep 3 sets of the V-Go for daily uses at any time that the future, of up to 3 days with no fridge OR 5 with fridge when the, process of filling will be a hassle OR an issue.]
      • Push the Bolus Ready Button followed by the Bolus Delivery Button to provide
        • bolus doses at meals as prescribed by your healthcare professional.
          • [The insulin delivery doesn’t allow extension OR different bolus deliveries, because it works like a needle that doesn’t come off for 24 hours. Which means there is a limited insulin control & adjustment use with the device.]
        • At the end of the 24-hour period, retract the needle by sliding AND then
        • pushing the Needle Release Button AND remove the V-Go from your body
          • Discard the device after use (V-Go is 100% disposable)
        • Repeat these steps for each 24-hour period using a new V-Go
      • IMPORTANT: Each V-Go has a total of 36 Units of insulin available for on-demand bolus dosing per 24-hour period [only].
        • The 36 Units of insulin can only be delivered in 2-Unit increments (1 click = 2 Units). [This could be too little insulin in many cases, while the limit to, Rhapsodie’s, my pump is set for a single total maximum of 20 units there’s been times where at a Super bowl party I’ve had 35 units total with no sugar drinks. For me one slice of pizza with 70 carbs has been about 14 units of insulin…BUT other people have varied rates.]
          • You can only click the Bolus Delivery Button 18 times in every 24-hour period. After 18 clicks, the Bolus Ready Button will lock.(p. 24 instructions)
·       Lifescan Animas Vibe Insulin Pump
  • 15th January 2019- co.uk
  • “…Amongst its key features are its direct integration with the Dexcom G4 Platinum CGM, its on board food database, to help with carb counting, and its proven to be waterproof for extended periods of time…But manual pump button uses needed for bolusing [when sensor isn’t used]…The Animas Vibe is therefore a strong choice for water lovers, children and other people that have experienced, or are wary of, water damage to their pump…BUT it only holds up to 4 different basals at one time. Otherwise it seems to be as great as the Minimed devices, it’s even better being water proof for up to 24 hours with depths up to 12 feet…” (https://www.diabetes.co.uk/diabetic-products/pumps/lifescan-animas-vibe-insulin-pump.html ) & https://www.diabetesnet.com/animas-vibe/   “Dexcom G4® PLATINUM Sensor and Transmitter [work] with pump” (https://www.manualslib.com/manual/1430396/Animas-Vibe.html )
  • NOT DONE
  • BOLUS INSULIN
    • Carb Ratios (Insulin for Carbs)= Grams divided by carb ratio of insulin units (Grams/units)
    • Corrections= (sugar levels- target goal range) mg’s to reach goal sugar amounts divided by delivery Levels of insulin. (mg/dL)
      • In cases where there is already active insulin the initial correction rate is figured then the amount of active insulin is subtracted from the correction dL.
      • Where sugars are low the same formula works in the negative for the mg, and a minus in the correction dL so that extra insulin isn’t delivered
      • AND at times the pump will show that more insulin is in use than the body needs, because of sugar levels, generally I will consume an amount to meet this level, but at times I take more, so I add the whole carb amount to the pump. The pump subtracts the correction carbs as well as the working insulin, so the correct rates are delivered.
    • BASAL INSULIN
      • Sensitivity [Corrections with Tandem pumps]= mg’s to reach goal sugar amounts divided by delivery Levels of insulin. (mg/dL)

Adjusting Pump Uses for Better Medical Care

 

I’ve written a partial setup of information about use of the pump with insulin adjustments, drugs, and surgical situations also. So I’m adding a link to that first set of posts…please remember this info isn’t finished, but I’ve tried to make it as useful as possibly could be needed already when it comes to insulin issues.

 

For example acetaminophen raises interstitial fluid, under the skin, sugar levels, BUT not blood sugar levels.

  • Health Grades- How Pain Relievers Can Affect Blood Sugar Levels
    • 8/7/2020 “…You may take a low dose of aspirin or a nonsteroidal anti-inflammatory drug (NSAID) like
      • ibuprofen or naproxen [sodium/ ibuprofen] to relieve the occasional headache or muscle pain. A regular dose is unlikely to affect your blood sugar levels, but a higher-than-usual dose MAY LOWER your blood sugar level
      • salsalate. Research has shown that this drug can also LOWER blood glucose levels
      • Duloxetine medication can also RAISE your blood sugar levels
      • opioid painkiller … tramadol may be more likely to cause your blood sugar levels TO DROP DANGEROUSLY LOW, causing hypoglycemia
    • Endocrinology Advisor- Acetaminophen Interference With Blood Glucose Readings: What Clinicians Need to Know
      • 6-12-2017 “…The study investigators found that peak concentrations of acetaminophen were higher when measured by CGM when administered intravenously vs enterally or rectally (33.9±2.2 mg/dL, 27.6±2.0 mg/dL, and 15.0±4.1 mg/dL, respectively). The results suggested that, after acetaminophen is administered, clinicians should wait between 2.4 and 3.7 hours, depending on type of administration (2.4 for rectal, 3.7 for enteral, and 3.3 for intravenous) to avoid treating falsely elevated blood glucose levels…”
    • + Treatment- Acetaminophen Can Affect Meter and CGM Readings
      • 9-22-2015 “…There’s been evidence as far back as 2009 that acetaminophen can cause inaccurate blood sugar readings with meters. Now, a more recent study suggests that the common pain reliever also might interfere with continuous glucose monitor (CGM) readings, as well…In July 2009, The Journal of Diabetes Science and Technology published a paper discussing sources of meter errors in measurement of blood glucose levels, including patient use of acetaminophen… Researchers in the 2009 study documented how acetaminophen use seemed to cause errors in blood glucose readings with meters… The researchers did say older meters were more prone to these erroneous readings than newer meters, but that such fluctuations can be possible with all meters they researched.

 

Now, a similar inaccuracy has been documented in connection with CGM use. In 2015, clinical investigators published a paper in Diabetes Care describing meter and monitor variations for a group of acetaminophen-using patients who tested both with meters and CGMs. The study, led by Dr. David M. Maahs of the University of Colorado Barbara Davis Center for Childhood Diabetes, was a stress test to predict the reliability of investigational closed-loop artificial pancreas systems relying on CGMs. Study participants took 1,000 milligrams of acetaminophen at breakfast and tested their levels at seven intervals within eight hours using Dexcom G4 monitors and a variety of blood drop test strip meters. Researchers saw the same elevated glucose reading phenomenon as had been found with [older] meters. In some cases CGM variances were recorded of up to 100 mg/dl over [up to date/ more accurate] meter testing.

 

Blood drop test strip meters read the electrical current generated by the reaction of blood glucose to a glucose oxidase enzyme impregnated in the test strip. CGM sensors read the electrical current generated by the reaction of blood glucose and glucose oxidase loaded in the sensor tip cannula assembly. It’s believed that one’s own body chemistry can affect the range of inaccuracy exhibited in CGM results, as many CGM users report no elevated blood glucose readings after taking acetaminophen. Also, some CGM users who regularly take acetaminophen have reported that they need to replace their sensor tips more frequently than manufacturer recommendations.

 

It’s important to identify if this phenomenon is happening regularly in your diabetes self-care, as erroneous readings can lead to dosing more insulin than needed.

If at all possible using other treatments may be a lot better, like Natural Pain Treatments which can be effective for you in ways like they are for me.

Pain Care Methods

Because of the diabetes and Whoops Disease under skin bone clasping, the injuries remain, but do not show outside the skin in most instances. The stress fractures of the left calf and left arm have grown because of additional splicing of splintered bones. While the damage to the right calf has allowed the micro bone portion to go into the bone core instead of floating away from the bone. AND the right arm fractures have been contained, so only Rhapsodie notes their shifting when using her arm.

Common Opioid Prescription Avoidance & Reasons to NOT Take These

The lies in Rhapsodie’s medical files have doctors avoiding giving her correct medical assessments and they prefer to prescribe narcotics, addictive drugs, instead of reading the tests accurately which were falsely reported multiple times as being ‘nothing found’. They keep trying to treat the ‘pain’ without trying to treat the reasons for the pain, this is bad treatment. It’s amazing that the majority of treatment options are ‘prescription painkillers’ with many doctors very ignorant of natural treatments without side effects issues.

I’m not famous, I don’t play sports, and I don’t have a job since years with these issues mean I’m barely able to do 20 hours of work a week without walking, driving, getting dressed, or wearing shoes. I haven’t been out in a car since December 2020, to visit the doctor, because car travel hurts too much. My only car traveling has been for necessities, my husband does the shopping, I only go out when I have to like to the doctors OR dentist. Mostly issues because of the untreated and uncared for bone injuries, not the Whoops Disease.

CDC Chart- Deaths from prescribed opioids in 2018 were about 242% higher than 1999. With numbers of about 400,000/around 165,000 people that’s a huge increase. While it’s 2021 now, many doctors are still prescribing stupidly.

According to the CDC- Appropriate prescribing of opioids is essential to protecting the health and safety of Medicare beneficiaries. [1] in [3] Medicare Part D beneficiaries received a prescription opioid in 2016.  “You are age 65 or older. You have a qualifying disability for which you have been receiving Social Security Disability Insurance (SSDI) for more than 24 months. You have been…” (https://www.silverscript.com/learn/medicare-part-d-eligibility)

This is a huge issue because it means that people who are in a state requiring good medical care, retirees, those with disabilities, and often with limited incomes because of not working OR not having great income are often getting prescribed without proper treatment in other ways being done if their cases are similar to mine with treatment. I’ve avoided addiction by taking the effort to research options as well as avoid ‘prescribed pain medicines’ when not needed.

Natural Pain Treatments

The struggle to find natural pain treatments is that these are often ‘unknown’ by doctors. AND they are often untrusted by doctors also. For me these treatments have worked in various ways depending on the treatment, but there are additional values to some of these treatments that I’m loving:

  • Kava Kava– is also a treatment that assists in recovery from narcotics because it reduces issues that drugging causes. AND can assist in helping people recover from issues with uses of narcotics. There are the additional benefits of how it can help fight stress as well as assist people to sleep better. AND it’s been found helpful against tension headaches. It’s been said to cause liver damage, that lie is because of ‘bad’ forms not the natural root forms and accurate amounts of kavalactones being used.

In addition today I took my second capsule of a standardized root dose of 30% kavalactones of the 250mg pill. This means with the FDA suggesting doses of up to 290 kavalactones maximum daily, that 250x.30=75mg kavalactones per capsule. So I can take up to 3 with no issues, even though if this is really from the root there should be no limit to the amount I can ingest healthily.

Plus NO new sugar issues at all, in fact taken in conjunction with the Wild Lettuce & Natto-Serra I’ve noted that my sugar levels are way more consistent and a lot less shifting is happening.

Reasons I’m trying this include the ability to assess another product that may be less tiring with uses. The possibilities of surgical treatments with chemical drugs and the need for recovery as well as pain killing without becoming addicted to the drugs OR being able to avoid addiction as much as possible.

BUT as it’s not been tried I don’t know what sugar issues could be had.

  • Turmeric Curcumin– Is a treatment I do not use most of the time because of it causing diarrhea and tiredness when used alone.  BUT it’s a great treatment to use along with prescription pain killers because of cutting nausea, tiredness, and a need to barf with post surgery drugging. It’s great because of allowing better ability to think with those drugs being used.
    • I found this with the use of prescribed codeine and acetaminophen, which I never finished a bottle of that. AND I plan on using this with surgery because of doctors trying to get me being drugged to sign forms and agree to treatments my thinking brain could disagree with.

Because it causes issues with diarrhea after being taken 3 days in a row it will lower my sugar about the 3rd day and beyond taking it consistently.

  • Natto- Serra– Which is a combination of Nattokinase, the fermented soybean done thousands of years in Japan, AND Serrapeptase…and is free from vitamin K. Serrapeptase (SP) and nattokinase (NK) are proteolytic enzymes belonging to serine proteases. (https://pubmed.ncbi.nlm.nih.gov/23821590/ ) There are many ‘it’s not proven to work comments online, BUT it’s often the case with natural treatments.

I know that I’ve found value in using the combination. Since about 2010 I’ve had a pained throat, which feels ripped and torn. It is often swollen also, BUT with the use of the Natto-Serra the pain goes away. I use a single dose of Doctor’s Best Natto-Serra each night before going to sleep. Through the next 24 hours I don’t have a sore throat. While I may be a little more tired than just the use of Wild Lettuce, the blood pressure values have also been great, even though I fart more than normal at times, but that can be from other ‘treatments’ also. The product is a combination of 2 natural ingredients:

Along with taking the Wild Lettuce use of this has had me raise my insulin 0.05 per hour with the basal rates.

The cost of the chamomile tea was less than $3 AND the ginger was even cheaper, and the next doctor’s visit had the result of no pneumonia OR bronchitis issues found. I’ve never had doctoral treatment for either of those issues since the use of ginger & chamomile tea which is a daily use. I’ve noted with the lack of ginger how much tighter and more swollen my limbs and throat are. So with a product that’s available in many ways I love it’s anti-inflammatory values.

    • Ginger can be consumed naturally grated, chopped, cooked, dried, blended, or even partially cooked and sugared, the dry spice also works as an anti-inflammatory without any side effects other than taste bud fiddling for a few moments.
      • I chop up the roots and use them in my Nutribullet with vinegar. Then the excess is stored in the fridge. Only one teaspoon is needed daily of this mix.
      • The powdered doesn’t seem to be as effective as the dried candied ginger, AND neither of these is effective as the blended with vinegar which has stupendous values almost immediately.
        • The powdered can be consumed in coffee, on toast like with cinnamon & sugar, and it can also be added to other stuff.
        • The candied ginger has various values depending on how it was processed.
          • I tried cutting and drying the root and sugaring it, but it wasn’t as consumable, because it was burning spicy.
          • It’s possible that parboiling it, then sugaring and drying it will work.
    • The ginger eases the movement of these with less inflammation, less white blood cell coagulation.
    • Ginger is loaded with antioxidants, compounds that prevent stress and damage to your body’s DNA. They may help your body fight off chronic diseases like high blood pressure, heart disease, and diseases of the lungs, plus promote healthy aging…Got menstrual cramps? Ginger powder may help. In studies, women who took 1,500 milligrams of ginger powder once a day for 3 days during their cycle felt less pain than women who didn’t…
      • [Rhapsodie has noticed this as a value over the years of use, but the Wild Lettuce didn’t help as much, BUT the Natto-Sera has almost eliminated all issues. It’s sometimes that there’s nothing noted and things happen causing noticeable issues before care is taken. ]
    • A daily dose of ginger may help you battle your “bad” or LDL cholesterol levels. In a recent study, taking 5 grams of ginger a day for 3 months lowered people’s LDL cholesterol an average of 30 points.
      • [This is not the case with me through Whoops Disease, in fact I’m not sure, but it may be that cholesterol levels are even higher with use of ginger through Whoops.]
    • Ginger Info Links with no other info
  • Wild (Opium) Lettuce/ Wild Lettuce
    • This product is generally only sold up to 500mg maximum, I’ve found slight issues only using 1,500mg daily. For me the use of this before bed has been great, depending on my needs I’ve used both the quick release capsules AND the normal release capsules. BUT the quick release doesn’t last as long, only about 6 to 8 hours versus the normal release which lasts about 24 hours for a single dose. The quick release is felt in about 20 minutes or so, the normal release takes about an hour to be felt.
      • Tiredness, which is less than prescription Gabapentin
      • Softer poop, BUT is a lot less of an issue than diarrhea which the Turmeric Curcumin causes.
    • I’ve been using this product almost daily now for over a year. The side effects above are a lot less than other drugs and the results have been pretty good. BUT at times I started adding the Arnica to reduce tiredness with uses.
  • Arnica [Montana]
    • This product is one of my more recent trials. It’s been in use for hundreds if not thousands of years. Originally I purchased the rub on, and found that it actually helped me be less tired while active, so I got the tablets also. This is also a possible blood thinner, but the value for me with uses of the tablets is that I don’t get tired using the doses.

These aren’t supposed to be used for any extended time, but no pain treatment is supposed to extend indefinitely because of issues with body resistance to the treatment growing and the treatment effectiveness decreasing, plus other side effects issues. AND the side effects are almost not mentioned at all with this product. Which means if I find that uses are continued, I may do what they recommend with the Kava Kava, links above, take it for up to 60 OR 90 days and then ‘stop’ for a week or 2, before resuming uses again.

With this product in tablet form the doses are stronger with lower numbers and weaker with higher numbers. It’s because the dose numbers are the portions of the amounts. Like 90/3=30 results in more than 90/9=10.

I’ve only mentioned some of my other natural use things like the cider vinegar and the chamomile tea. BUT I’ve found that if I can locate a natural treatment as a substitute for a manmade one AND if I can take the time to get info to avoid issues and problems from misuse of the natural products, that I can be healthier, happier, and in less pain without worries and stress that the drugs cause.

Research for Natural Treatments

There are many different types of natural treatments, and some places that may not seem to be resources can be great for getting information. This includes from veterinarians as well as herbalists, and other natural medicine users and people. In some cases veterinarians are as bad as doctors for pushing drugging, but in other cases the natural medical treatment options can work just as well for people as they do for animals, more below.

For individuals that don’t want to be drugged to death, time and effort is needed to research and look under some search terms can help for the research:

Some veterinarian advice that has been useful for my healthcare because the options were able to be done and the results were good I’m sharing them here.

  • Bruising Issues
    • Deep bruises often cause pain problems for weeks. The application of a hot water cloth and a cold water cloth alternating between a 2 minute, for the hot, and 30 seconds for the cold repeatedly cut the bruising.
      •  I’d had a baseball size bruise on my hip which was gained 3 days earlier. I used the hot and cold pack, until the color of the bruising was reduced to a light scratched pinkish color. The pain was reduced also, probably from cutting the swelling as well as the coagulation of white blood cells through that area were reduced allowing better blood flow and less inflammation. I do not have any bruise issues now, not like in some cases where the bruises are allowed to remain and the swelling causes damage to tissues and areas.
  • Ear Puss Issues
    • Now the vet didn’t do any treatment for puss, but with my kitties the ear cleaning was mentioned. Taking a tissue and folding it then rolling it into a tight insert allows it to go into ears and absorb fluids and puss without damaging anything.
  • Wound Infection Issues
    • I had a cat that had a long rip on a limb. That got pussy & swollen, and I took him to the vet. They showed me an effective method of removing the puss and infection issues, with a hurt kitty that still has claws.
      • Using a similar method as above, this method uses only hot water on a cloth, hot like as hot as can touch the hand OR skin with the application. This is done with replacing the cloth until the infection bursts out of the skin. Use of the cloth allows absorption of that infection material, and it also allows the deeper infection material to surface to a more ‘vulnerable’ infection filling area near the air. That method with my cat meant 3 days of this process 2 times a day, but the cleansed wound didn’t get any medication OR anything else and healed fine.
        • I would also use unpasteurized cider vinegar for the wound care, more below.
  • Cider Vinegar Health Values
    • Cider vinegar was heard of from my grandma, but she pointed me to the info by D.C. Jarvis, a veterinarian who eventually became a physician. My dentist had a concern when he heard I was using that information, because he had witnessed people drinking the cider vinegar and honey ruining their teeth. The unpasteurized vinegar is more acidic and less healthy to use for health benefits.

BUT there is also the use and care issues, I drink my vinegar & honey in my chamomile tea with use of my ginger right before brushing my teeth before bed. The value of vinegar is huge if you use it accurately consistently. For me with the use of honey I’ve not had acid reflux issues even with eating right before drinking my tea mixed with vinegar & honey then going to bed. In addition my father found that the aches of his feet diminished using this mixture:

Research & Figure Out What is Good for You

For all of these you could stupidly just say, oh I’ll try that, but if you don’t take the time to do to research about the possible interactions and side effects it could be that you end up buying stuff that doesn’t work for you OR you may have side effects that cause issues when you were unaware of the possibility for those. In cases where the side effect possibilities for you cause the product to be undesired it can mean saving money OR even preparing for possible side effects without getting struck with them.

For example the Natto-Serra is a blood thinning agent, so it can be that use of blood pressure medications with that treatment could have other issues. In fact there’s a warning in the research that an individual shouldn’t use Natto-Serra with taking aspirin. I’ve had 2 doses of aspirin with the Natto-Serra and have had bruises both times that resulted.

Other Whoops Disease Issues

Through the Whoops posts I’ve mentioned and accented some issues with the disease. BUT there are also the issues of other diseases that are diagnosed as problems, BUT may only be OR added to OR taken away because of Whoops Disease.

Other Connecting Posts

Diabetic’s and Treatments

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

WHOOPS DISEASE 7a2- About How SOME Symptoms Mimic Other Diseases & Issues

There are many different possibilities for issues with Whoops disease that can be misdiagnosed as well as assumed inaccurately because of the general ignorance about Whoops. As these posts have shown there are many cases that with self-care the issues can be reduced OR even eliminated enough to not require any medical attention. BUT doctors who don’t know about Whoops it can be that they misdiagnose and have patient treated inaccurately for issues that really either don’t exist OR exist only on a temporary basis.

Some of these issues & diseases can be diagnosed because of Whoops:

Care is needed in some of these cases because treatments that allow Whoops to get worse could cause additional Whoops healthcare problems and health conditions that cause problems.

Asthma-

  • The trouble with the Whoops is that the microscopic organisms in the lungs make it harder to breathe. The inhalers that open up the lungs allow these organisms more play ground to make it even more difficult to breathe with less chance of breathing easier every single time an inhaler is used.
    • One of my doctors prescribed inhalers for me, because nothing was improving after months on the devices she prescribed another ‘medical’ inhaler. It was burning my throat. A visit to the ER had that doctor taking me off all inhalers accept the albuterol. I have only used that once since, because a visit to a lung specialist with an expensive test on a huge machine resulted in “You have no asthma”. So because of the chamomile tea, ginger, black licorice root at times, and licorice tea helping me, I’ve not even tried to use an inhaler at other times even though my breathing is really hard in the moist spring, summer, and fall air.

Bronchitis/Pneumonia-

  • The lung issues from the organisms also mean that lung infection possibilities are greater, so more care with health is a necessity. These organisms aren’t going to be killed by antibiotics, your healthy bacteria will be killed and you’ll suffer more issues.

Eczema-

  • Dryer skin is almost a guarantee with this disease, the less moisture you consume, the dryer your body is, the less baths you take, the more likely you’ll suffer symptoms more like Eczema.

Acid Reflux-

  • You MAY suffer this even if you never have previously, my mom and I both have this issue now since Whoops.

Diabetes-

  • You MAY suffer this even if you never have previously, there is a need to treat this with the Whoops, BUT it could be immediately OR within a few hours after treatment that the diabetes gained from Whoops goes away.

Sleep Apnea-

  • This seems to be worse for males & it also seems to be horrid for those that don’t take, at least 15 minute, baths once a week.

Narcolepsy-

  • “The signs and symptoms of narcolepsy may worsen for the first few years and then continue for life. They include: 1. Excessive daytime sleepiness. People with narcolepsy fall asleep without warning, anywhere, anytime…” (https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497 ) BUT I’ve found with Whoops though I’m extremely tired so much of the time, I only nod off when I let myself. Like in the bath OR leaning a backrest. My fractures are also reasons for lack of energy.

High Cholesterol-

  • I’ve had my cholesterol up at around 138-142LDL, which is an issue…BUT since I’ve been starving myself, my body is working to protect my organs. I think the cholesterol is likely protecting my organs from being choked to death by the masses of water in the body. AND for Whoops Disease treatment with the electric shock hitting the organs, the bioelectrical impedance with the extra LDL cholesterol fat around the center of my body may actually assist the organs in being more protected against the electrical shock then if those organs were just surrounded by water like my skin layer and rest of the body is.

This also means those body areas are likely to assist in better recovery because of the electrical charge ‘dissipating’ versus spreading with water. The recovery should be a bit faster, because my body isn’t overloaded with electric hitting my core, like it would be if my cholesterol was in normal ranges. Some more about this is added in the blog post about body composition tests.

High Blood Pressure-

  • If you already have high blood pressure that’s likely to be an issue after treatment again if it’s not with the disease. BUT every single individual in my Whoops Diseased family has had an issue with high blood pressure, BUT every single one of us has no issue now. So with Whoops Disease this was only temporary as an issue for all of us.

Hyperthyroid-

  • My mom and I have been diagnosed with thyroid issues. I’ve been getting the pills for over 10 years now, but the white ones of any brand eat my throat, so I always need the pink ones. AND they make me super sleepy all the time. Dosage wise the amounts are really small, less for my mom than for me, and the amounts once reaching 125mg was too much for me, 112mg has been better, but not more has ever been needed. That’s after going almost a year with none, which is abnormal, because doctors say, “amounts go up regularly” and doctors predict, “you’ll need this for the rest of your life.” If this was because of the Whoops it’s unlikely that it will be needed for life and it’s unlikely that the rates will ever go up through the disease.

Shakes that are NOT Parkinson’s Disease

Assumed as Parkinson’s by Whoops Ignorant People- [No pictures are in these pages yet, they are prepared and they are placed in the document this information was copied from, but they still need to be added to the media files and these pages…sorry.]

BUT it’s Not Likely to be Parkinson’s even though some similarity with tremors, for the majority of Whoops people. The shakes aren’t that dramatic OR even noticeable when hands aren’t empty, and they have no impact on holding things, not like with real issues.

  • This shaking only happens when nothing is being held or touched by that hand. So writing, drawing, sewing, cleaning, eating, and typing is not bothered by the soft shakes.  For some people they may think you have Parkinson’s Disease because of this shaking- the article 10 Signs of Parkinson’s Disease, from June 12, 2019 with very descriptive images also tells us a list of Parkinson Disease signs which ‘non-Rhapsodie people could assume she has, because they don’t live in her body.”
  • “…The loss of these neurons causes essential neurotransmitter levels to decrease, particularly the production of the neurotransmitter dopamine [it’s likely blood tests can show dopamine levels, but it’s possible that like sugar levels the normal amount needs to be correct for the individual’s height, weight, bone mass, and life style]. This, in turn, leads to abnormal brain activity that affects one’s control of muscle movement. Older individuals are the most common group diagnosed with Parkinson’s.
  • If you’re an individual like me some of your relatives may even assume that your symptoms are other diseases. AND in some cases the options you have for showing that it’s something else like Whoops Disease are really limited, especially when doctors don’t even know about issues and aspects of care for a disease like Whoops which is man made. In addition family & doctors may hear of OR believe that you are suffering diseases, BUT taking the time to research the disease can help you assess the accuracy of what is being diagnosed. AND because you live in your body 24 hours a day ever since you were born, you’re more likely able to better know your body in many aspects than assumers who aren’t you.

Parkinson’s Disease Versus Whoops Disease

My father was concerned that I was suffering Parkinson’s Disease, but my research & the evidence I’ve prepared show that’s not the case. Parkinson’s has some other issues that are, at times, similar to the issues with Whoops Disease, BUT the disease aren’t the same. I’ve listed a set of Parkinson’s symptoms below with my comments and at time images about my issues added.

1. [Resting] Tremors-

[With Parkinsons]…usually, this begins with the trembling or shaking of one finger. Sometimes the hand or foot on one side of the body experiences tremors or, in rare cases, the face or jaw. The tremors usually begin when the affected body part is relaxed, which is why they are called “resting tremors.” Not all tremors are symptomatic of Parkinson’s, however.

[This is why looking at more than one sign is vital for trying to determine any issues being suffered. I’ve had only some slight tremors in my right hand, and also everyone I’ve heard of suffering this disease has this issue after they get into the last third of the disease. Plus recently my trembling has been mostly after being too tired, when I go to bed I start trembling. My hands had ‘the shakes’ for about 6 months, so you may only have issues for a time also.]

2. Muscle Rigidity

“However, those with Parkinson’s experience stiff muscle tone. This means the muscles of an affected body part do not relax completely even at rest…[I am suffering injuries, but my muscles are remaining flexible, can be rubbed, and work without rigidness when not being overworked. They relax fully when I sleep as long as I don’t move and hurt myself awake, in fact I relax so much that my arm goes asleep and numbs, which means I have to awaken it because it feels dead, that’s not a rigid muscle, that’s a blood flow pressure issue.

  • Muscle rigidity can be felt with rubbing and soothing of body parts, it sort of feels like how muscles do after extreme exertion OR how feet sometimes feel after getting out of high heeled shoes. You know how when you feel a hard muscle because it’s been overused OR suffer stiff feet from bad shoes OR moves.]

3. Slowed Movement

With Parkinson’s– “Also known as bradykinesia, slowness of movement [with] Parkinson’s disease … causes people to perform ordinary activities, such as walking, moving, or changing clothes, more slowly than normal…” [Imagine trying to walk or move with air pressure casts on areas of your body. It’s harder to move and thus people perform slower to allow them to complete their actions with moving. AND this is generally for all movements, not just specific types of movements.

  • For me I move slowly because certain lifting of items, moving of items, walking moves, standing moves cause fresh pains to shoot out. Putting spoons back in the silverware drawer one day had me screaming out in pain because of an unexpected shooting pain, 3 days ago changing the bedding caused my left lower leg to shoot out pains at me 3 times because of the movement… which I’ve avoided since. But other actions like cooking take a lot of effort and energy, plus because of limited activity muscles aren’t as supportive as they used to be in protecting my bones from moving issues.

This has grown worse over time because my injuries have remained uncared for, and the only prescribed drug that really reduces my pain is an antibiotic. This means I am cautious because the pain is not good nor do I think the doctors will ever treat the problems because they haven’t as yet.

  • I had a painkiller, a steroid drug; and only took 2 doses of the 7 because of the Penicillin in the drug which I’m allergic to causing rashes & itchiness. That drug relieved me of pain for almost 7 days, and cautiously I did enjoyed activities like walking up to the pond once, cleaning the house, doing dishes, cooking dinner, but after that ‘pain killer’ dissolved out of my system I had 2 months unable to move normally OR do almost anything because of further injuring my body additionally while the drug was in my system…now I take other natural treatments. Other issues with doctors are also blogged about if you’re interested.
4. Change in Posture

https://facty.com/conditions/parkinsons/10-signs-of-parkinsons/4/

Postural instability is common among people with Parkinson’s and usually appears in the LATER stages of the disease…may be unable to maintain balance in general … Turning, pivoting, and standing upright also become difficult.” [This makes sense because with the muscles ‘going rigid’ the other parts of the body working under and around the muscles have less use AND less repair advancement. It’s sort of the like body is atrophying while the individual is not resting on a bed OR dead.

Rhapsodie’s posture is still very good, her movement hindrances are because of the pain from ripping bones AND the rheumatoid arthritis resulting from the lack of bone care over the years. Her balance is still good, but she works really hard in moving to not hurt, so others could think she has posture issues.]

5. Weakened Facial and Throat Muscles

https://facty.com/conditions/parkinsons/10-signs-of-parkinsons/5/

  • “…The face tends to have a fixed, vacant expression called the “Parkinson’s mask.” Loss of facial muscle movement restricts facial expressions, including smiling, frowning, and laughing.
    • [The image on the website reminds me of individual’s I’ve seen with Downs Syndrome.
    • Rhapsodie has no facial problems other than the blinking of her eye, which isn’t happening anymore. She doesn’t smile as often being a companion with the T.V. & her reading/ writing most days without any discussions with other people.]
  • Similarly, weakened throat muscles cause the individual’s speech to become low-toned, unclear, and sometimes slurred.
    • [Rhapsodie’s indistinct speech happens because of limited interaction with other people, which has meant lazy talking styles.
    • Her sore throat is strong, just sore all the time.
      • Muscles in use get sorer than muscles that aren’t being used.
      • Unused muscles get itchy feeling because they need movement to keep the bloodflow to be feeling good. That’s why individuals wearing casts have itchiness, the skin issues are only a part of that factor, then there are the issues with limited blood flow in areas of the muscles that are familiar with those actions.]
    • Choking, coughing, and drooling may develop at advanced stages.
      • [Rhapsodie has had coughing with the sneezing & sleep drooling because of the masses of water in her body. The coughing began early in the disease, the sneezing within the first 2 years; the drooling was a situation of the previous 2 years, with NOTHING of the drooling now. Additionally she knows this is not Parkinson’s because
        • Coughs leave a dried glittery white mass on any darker materials. It’s such a mess that it looks like glittering shimmer makeup but coughed OR sneezed onto nearby stuff.
        • The sneezes cause the same issues; these are the disease remains that die as they dry. BUT look like glitter glaze used on nails and come from the wet releases.
      • Dry lungs really reduce this hassle, the more moist the air is the more coughs & sneezes that are released. The WHOOPS DISEASE nano microorganisms are waterborne, meaning they need water to live and reproduce. Have a super dry house, with less than 20% humidity 3/4ths of the year mean Rhapsodie continues to fight them choking her to death.]

6. Freezing Gait

https://facty.com/conditions/parkinsons/10-signs-of-parkinsons/6/

“…People with Parkinson’s sometimes hesitate to move forward and report feeling as if their feet are glued to the ground…” [This sounds like something with the muscle atrophying is swelling OR causing nerves in those areas to not feel enough to move. It sounds like they are not feeling ‘some’ of their foot areas as much. With individuals laying in beds, they say that they should be turned to keep them from having body parts atrophy, harden, and weaken areas of skin, bones, muscles and more.]

7. Small[er] Handwriting & Other test possibilities for fine motor skills

Images of Rhapsodie’s writing & artwork over time have been collected as the evidence that she does NOT have Parkinson’s, they are not added yet to this blog.  

If you take your car to the mechanic for an overall check with mention of noises & wiggles of the front end in driving and they change the oil and check the tire air pressure, but then your tie rod collapses, OR your brakes fail to work, OR the noise and the shaking also continues so that you go to other mechanics that read the report of the previous mechanics time and again. So they don’t do the work to fix the struts OR rotors OR brake pads and you eventually end up selling that car you’re unlikely to ever want to return to those mechanics for vehicle service. Plus if they were paid by you for service to your car it’s likely they can also be sued for lack of care that they were supposed to do. That could be multiplied if the mechanics lack of care caused further injury & problems for you and your family.

https://facty.com/conditions/parkinsons/10-signs-of-parkinsons/7/

“An early indicator of Parkinson’s is a change in the size of a person’s handwriting [AND other aspects of hand work and how it is & has been done over time.]  Often, a marked decrease in the letter sizes and spaces between the words becomes noticeable…” [but more can be found if there is a way to learn beyond just using handwriting. Plus there’s a need to make sure to get the ‘past’ in a recordable style that is of use in determining the situation if the ‘patient’ doesn’t tell the doctor and if the doctor doesn’t listen to the patient.]

Some Test Options Including & Beyond Handwriting Alone

Options for testing are added here because Rhapsodie’s handwriting sizes have shifted for many years, so that’s no evidence against Parkinson’s. The fine skill control for doing work, like with the pen, can be tested in other ways also.

  • Change in the Size of Handwriting
    • Handwriting often shifts and changes sizes. Over time people develop a style of writing, like Rhapsodie has based on where she’s writing and how much paper she has available for what she’s trying to write.
    • So I’m assuming because of the muscle atrophy, the amount of muscle, tendon, and skin flexibility with these actions ‘rusts’ which means to write requires smaller, slower, and more controlled writing work efforts.
  • Paper Folding
    • Origami– “…[A]nimals and flowers of Japanese origami…”- If a person has never done this it can be a harder test for them if no directions are shown with the folding, but if there were numbers, letters, colors, or designs and a sheet of directions to create the shapes the folding shouldn’t be a huge hassle. The skill of a new person will not be as fast or as great as a more experienced origami worker, but it could demonstrate issues with muscles in hand uses also.
    • Folding fans– if a person has never done this it is an easily perceived action, and there are generally the simple back and forth fold that drives the style for these fans;
    • Folding paper airplanes– if a person has never done this it is an easily demonstrated activity;
    • Zhezhi. “…Traditional Chinese paper folding concentrates mainly on objects like boats or hats rather than the animals and flowers of Japanese origami…”
    • Paper flowers, could be made easily with a couple sheets of paper with a tack OR a swivel paper snap going through.
  • Button sewing on;
    • if a person has never done this it is an easily taught action;
  • Snowflake Cutting– This skill uses hands and scissors to get done, the folding of the paper, the holding & cutting of the paper, and the opening of the paper snowflake designs are all hand muscle skills.
    • This work doesn’t need a lot of experience to be done, but if the individual trying the work is being tested for Parkinson’s disease it can demonstrate how hand uses are ‘stiff’ and how use of materials & tools is impacted by the hands.
  • Makeup application can be a sign also-
    • Like having the individual with the possible Parkinson’s disease apply nail polish to their self AND also possibly onto others.
    • Other make up application processes can shift depending on the skill levels of the applier and the result desires for the test information.
  • Hair work can also be a good test- this depends on whose hair and the type of hair they have also. The longer hair which needs braiding is going to be more difficult for a person with hand troubles.
  • Seam repair;
    • if a person has never done this it can be a harder test for them;
  • Knitting– individuals hold the knitting needles with both hands, so if a person has never done this it’s not a good test for them;
  • Crocheting– individuals don’t need a crochet hook for a simple loop, but the hook allows them to feed and grab the material with one hand doing the needle work and the other holding the weaving strands generally. The weaving is easier with the hook than the fingers for many strand materials and sizes.
  • Cross Stitch– this is following a pattern on material for weaving in and out,
    • Plastic grid sheets, can allow cross stitch tests using yarn and a blunter yarn needle.
    • Canvas backings, the canvas sizes vary, but the holes are way smaller than with the plastic grid sheets. This work is generally done with embroidery floss or similar threads, which come 6 OR 8 strands combined.
      • The strands need to be separated to be worked so that’s more muscle testing also.
    • Macramé uses larger strands, plant holders are often created using macramé weaving; since the strands are more ropey in texture they are rougher for the hands, but they are easier to grip also.
    • Weaving– I’ve never done real weaving, my only experience is weaving potholders with the device that allows square potholders to be woven with use of weaving.
    • Drawing; unlike coloring in the lines is less defined, so it’s easier for those that are losing skill to rearrange creations to seem normal even when they have had problems making them. Thar are the options of doing this with
      • Pencils;
      • Leads;
      • Chalks;
      • Pens;
      • And other drawing tools.
    • Coloring like in
      • Paint by number books with a water paint brush with a finer tip can also demonstrate how that skill compares to use of a pen in writing.
      • Children’s coloring books with crayons OR colored pencil; can show how an individual can do repetitive motions without too much physical stress. Comparing older work that was done can assist in determining the uses of the tools and actions with the coloring.
      • Adult coloring books with markers, ink pens, colored pencils, chalks, watercolor pens/ markers, and maybe also crayons;
      • Painting a large portion of painting skill comes in melding colors and layers of types of paint correctly to create the images that are formed. So while it’s a possible skill test it’s not necessarily the best ‘test’, but individuals may share work hassles with painting that impact the results of their work tremendously.
        • Like with coloring, painting uses broader strokes in some aspects of the work while smaller ones in other aspects of the work.
      • Maze games like those done in children’s coloring, games, and skill books, and on the backs of cereal boxes can show the hand control of an individual follow the pattern. BUT t
        • his should be watched, if the individual is slow and seems to be having a hard time they could be having muscle trouble if they aren’t so drugged that the test is invalid anyway.
      • Skill queries if individuals used to be able to
        • Hold a camera for great photos
          • If they can’t hold the camera, when they love using it, it means there’s a problem stopping them from doing what they like.
        • Hold a phone and can’t grip it any more
          • New flat phones, without cases, are really difficult to grip without extra holding tools, older phones were easier to hold but weren’t as comfortable to use over super long periods.
        • Keyboarding
          • If an individual has been a typist, accountant, secretary, writer, or more it’s likely that muscle problems would also minimize their ability to use the keyboard.
        • Craft Jewelry
          • This is a tight and generally tiny task that means fine muscle control.
        • Cook or Chef
          • It’s possible with some modern tools to avoid use of a knife if you’re having trouble in the kitchen, but use of hands, arms, feet in conjunction are common needs acted on with cooking.
        • Do bead work OR strand work
          • This doesn’t need to be an expensive test, buttons OR beads can be gotten in bunches. Popcorn strands like for Christmas with dried cranberries added can demonstrate the action abilities of hands and arms for a smaller cost.
        • Do other crafts
      • Dot-to-dot pictures like those done in children’s coloring, games, and skill books, can allow the past skills to be compared to the present skills and how the users functioning is getting worse OR not.
        • The line work is often as difficult as writing, but it can be harder because of the span of spaces, but it can be easier if the dot to dot image lines are almost all the same in the shape of the image.
      • Other hand use tests could be used, but I’m not sure what they are other then the ones previously mentioned above.

Historical Information References

One of the best options for having past records is handwriting, because over years of time people write repeatedly, at least before the keyboard has become the tool of the writer. The printing of modern students doesn’t have the versatility, speed, and usefulness that handwriting has had for millennia.  So what can we use for doctors to view as handwriting evidence OR other types of evidence AND where may we locate these? We can work to collect different sets of evidence:

By Age with types included &/OR by types with ages distinct

A time line of writing OR other samples of the same &/OR different styles can assist doctors to see the ‘problems’ better if they exist at all. If signs are being shown over time, then the sooner the ‘signs’ are showing & put into record then the sooner they can be visible as evidence for quicker treatment to be approached, hopefully with less cost in life problems, lack of care results, and doctor & tests & nurses visit costs and cares. The record of signs should assist the doctor to help more also.

 

  • Ages 0 to 9.99 writing, coloring, dot to dots, drawing, maze games, hangman games, and more.
    • Childhood writing styles are likely to be bigger and wider than the more advanced writing styles grown with practice over time. The styles developed with writing over time can be ‘determined’ by the children during these ages if they want, and if there aren’t injuries that hinder that style processing. BUT other people may find that they need to try and write consistently regularly, because they have a harder time with it than others.
      • These earliest records may OR may not be used depend on the value of the early writing & action records. The record of these early records may OR may not assist the doctor to help more also.
    • Ages 9.99 to 14 through 16 or 17 writing, coloring, dot to dots, drawing, maze games, hangman games, and more.
      • In the early teen years the writing styles in development start becoming finer and more refined. They may find that they need to try and write consistently regularly, because they have a harder time with it than others.
        • Either because of lack of practice OR because of how they naturally write OR because they have suffered injuries that have caused the muscles, tendons, joints, and more to shift the writing style that’s a normality for them.
      • If signs are being shown over time, then the sooner the ‘signs’ are showing the sooner treatment can be approached. The record of signs should assist the doctor to help more also.
    • Ages 14 up to early 20’s &/or 30’s writing, coloring, dot to dots, drawing, maze games, hangman games, and more.
      • In modern times the writing practice during these times of life is tremendously reduced because of computers, cell phones, and other ‘electronic devices.’ There is still a need to practice writing, because it’s a way to ‘be yourself’ and to connect in life to your past.
        • Reviewing my writing since about 4 has shown me this.
      • If signs are being shown over time, then the sooner the ‘signs’ are showing the sooner treatment can be approached. The record of signs should assist the doctor to help more also.
    • Ages 20 &/or 30 up to 40 &/or 50 writing, coloring, dot to dots, drawing, maze games, hangman games, and more.
      • If individuals are suffering diseases, like Parkinson’s the results over time will alter.
        • “An early indicator of Parkinson’s is a change in the size of a person’s handwriting [AND other aspects of hand work and how it is & has been done over time.] Often, a marked decrease in the letter sizes and spaces between the words becomes noticeable…”
          • This is harder to discern with less samples to compare.
          • If signs are being shown over time, then the sooner the ‘signs’ are showing the sooner treatment can be approached. The record of signs should assist the doctor to help more also.
        • If signs are being shown over time, then the sooner the ‘signs’ are showing the sooner treatment can be approached. The record of signs should assist the doctor to help more also.
      • Ages 40 &/or 50 up to 60 writing, coloring, dot to dots, drawing, maze games, hangman games, and more.
        • If signs are being shown over time, then the sooner the ‘signs’ are showing the sooner treatment can be approached. The record of signs should assist the doctor to help more also.
      • Ages 60 up to 70 writing, coloring, dot to dots, drawing, maze games, hangman games, and more.
        • If signs are being shown over time, then the sooner the ‘signs’ are showing the sooner treatment can be approached. The record of signs should assist the doctor to help more also.
      • Ages 70 up to …? writing, coloring, dot to dots, drawing, maze games, hangman games, and more.
        • If signs are being shown over time, then the sooner the ‘signs’ are showing the sooner treatment can be approached. The record of signs should assist the doctor to help more also.

Rhapsodie’s handwriting, coloring, maze work, and drawing over time with images

[Not done, images are being captured of Rhapsodie’s writing, art, and some other work done over time to compare with the most modern work. BUT that’s taking time which hasn’t been used yet today. Rhapsodie’s writing varies in sizes & styles, at least in some degrees, based on the size of her information and the size of the paper sections OR amounts she has to use. This was much rougher when she was learning to write, but in 6th grade Rhapsodie’s writing was good enough to take notes of a deaf student in that glass after his translator learned to interpret the loops. He could read them right off the paper OR her computer/ tablet/ USB screen.

Trouble Sleeping

https://facty.com/conditions/parkinsons/10-signs-of-parkinsons/8/

Tossing and turning even while deeply asleep can be a sign of Parkinson’s. Some individuals may even fall out of bed during the night. This symptom interrupts sleep patterns and decreases sleep quality, which can exacerbate other symptoms. Half of all people with Parkinson’s disease have muscles that do not completely relax during sleep. This increases the risk of leg cramps and abnormal leg movements at night. Some people even “act out” their dreams by moving their limbs. It is also common for people with Parkinson’s to experience excessive sleepiness during the day [because of not sleeping well at sleep times.

  • BUT Rhapsodie sleeps fine, just super heavy, as well as too much for a normal healthy person at present because of uncared for injuries. Exasperated injuries cause further need for rest to recover and allow more healing for Rhapsodie. BUT her body is so damaged this is very minimal now and it causes more sleep needs.]

9. Constipation [& Leaking Bladder]

Straining to move the bowels can be a sign of Parkinson’s and is also one of the most overlooked symptoms. Parkinson’s affects the nervous system that controls the movement of muscles, so it is logical that it should also affect the bowels and bladder.

  • The bowel can lose its sensitivity and become inefficient, slowing down the digestive process and the movement of waste, leading to constipation.
    • Care is needed to make sure an individual is consuming proper amounts of fiber, so that normal bowel problems are reduced from this assessment. Individuals with other muscle problems will have more knowledge of what is happening, in some ways, than observers who assume they understand without listening to the person suffering something like WHOOPS Disease.
  • The urinary tract actions are controlled by muscles. So leaking bladder is another sign of the muscle weakness that is Parkinson’s disease.
    • Individuals with leaking bladder are more common, but very few of them have Parkinson’s Disease.
10. Excessive Sweating

Parkinson’s disease severely affects the central nervous system. As the disease progresses, changes in the skin can develop. Many individuals with the disease experience excessive sweating or hyperhidrosis for no apparent reason. For women, this symptom can feel similar to hot flashes during menopause. In addition, medications used to treat Parkinson’s disease can cause excessive sweating.

  • Rhapsodie has had some sweating she associates with Menopausal symptoms, but nothing more than that.
  • For the lack of muscle uses the body often finds fat builds up, this can cause excess sweating also, but it does not indicate Parkinson’s Disease most of the time.

[Finding Parkinsons & Treating

The signs above are used by individuals to share with the doctors their Parkinson’s symptoms, but as you read Rhapsodie’s added information you can see how individuals not living with the problems can ‘believe’ Parkinson’s or other problems because of what they think they are seeing. That’s a problem with doctors not treating patients based on what the patients are telling them about things and situations.]

1. Studies and lab tests

Parkinson’s disease is a neurological disease created by the build-up of the protein called alpha-synuclein. The disease creates problems with motor function and movement, rigid muscles and severe hand tremors. Roughly 60,000 Americans are diagnosed with the disease every year, and it affects up to 10 million people worldwide…

2. Previously mentioned actions & possible tests

The drawing, writing, coloring in the lines, doing dot to dot, can be indicators of issues with Parkinson’s. Part of the test involves actions and how familiar they are normally AND different they are with Parkinson’s for individuals. Family members & close friends may note issues, while strangers/doctors may assume issues where there aren’t any. The writing style issues, the dot to dot issues, and more can be ‘faked’ with individuals practicing not to be diagnosed. BUT it’s really hard to take years of evidence and dismiss it no matter what the evidence shows.

In fact it may be useful, especially with older & more experienced adults to ask them to update an older work ‘like’ one that’s not recent and see how they do it. I am not a copying person, I hate redoing stuff, but if a doctor took one of my crocheted yarn doubles from the past and handed me the yarn and crochet hook now, it would take some time to get the stitch style again, but I could repeat it if the pattern was remembered enough to do so.

There are simple sewing, stitching, boot lacing, shoe lacing, drawing, actions that are like riding a bicycle able to be done in other ages, but modified ways also. In addition there are actions like mixing pancake batter by hand/fork/whisk and more that aren’t too expensive trials to do. There’s also that finger string game, I think I remember how to set up the starting pattern still, and only string of a type not too hard OR soft is needed. I just used my double crochet line with the kitty toy at the end to do this setup like I remember.

Other Connecting Posts

Diabetic’s and Treatments

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

WHOOPS DISEASE- 7b5b.- BMI Ignorance Versus Accurate Body Composition Treatments

Doctors who ignorantly use BMI ratings, body mass index ratings, based on weight without taking into account muscle, organs, water, bone density & size, ASSume that it’s fat gain. “BMI has many limitations and is a poor tracking tool for weight change because there’s no way to identify if changes in your weight are in fat or muscle. Predicting health or mortality using a single number such as BMI oversimplifies health risks and ignores important factors that contribute to positive health.”  (https://inbodyusa.com/general/what-is-body-composition/)

Not only do doctors ignorantly using BMI with people having WHOOPS DISEASE try to make you stop eating enough to stay alive, I’m barely getting 1,600 calories a day on average over the last year, and that amount is up from previous years which had been down to under 1000 calories a day. They inaccurately start adding to your medical files ‘overweight/fat/and more’ without taking the time to ask for body composition tests OR taking the time to do the test manually, or even doing the work to read your lists of food consumption, the lists of calorie counts, or more that you do to keep yourself alive.

Body composition tests do not have to be expensive, and doctors who took the time to ‘buy’ a cheap tool, learn to use it, and found ‘abnormal results’ with the body composition tests could get more accurate tests AND could be more accurate with their records. Since, “[b]ody composition is a method of breaking down the body into its core components: fat, protein, minerals, and body water. It describes your weight more accurately and provides a better glimpse into your overall health than traditional methods. Body composition analysis can accurately show changes in fat mass, muscle mass, and body fat percentage. ” (https://inbodyusa.com/general/what-is-body-composition/)

There are various tools that can be used for body composition measures. The methods should be based on the measurement system that can be done manually, like with fat measuring tools like calipers. I haven’t added the tape measure methods because with an abnormal water composition measure the tape measure calculations will be wrong.

Goal Body Fat Percentage [GBF%]

The measures of the tools are based on finding out how close or far from the desired Goal Body Fat Percentages, [GBF%], a person is. These rates are generally more activity altered BUT ratings can be based on more than age. Here are some links to some different sites with GBF%’s shared:

These were pulled from the linked site above, these are age related Body Fat Percentage ratings, but modified for more accuracy and better readability by me for sharing with you:

The body fat ‘ideals’ are of use in the body composition calculations. AND while some machines will do the work for you other systems and processes could need double checking so using these manual calculation options can be of great help with many machines. The start of the calculations below utilizes the skin caliper measures, but other systems can give you measures. The second part of the calculation uses the body fat ideas and factors like age to work from.

Body Composition Calculations

As you can see with the body composition tools the measurements may result with some tools in a total that can be used. BUT with other tools additional calculations are needed, like with the body calipers. First take the time to get the correct material for measuring. The skin caliper method use the layer of fat under the skin and pinches for a measure. To do this accurately practice sliding your skin around over the under layers, you’ll note that you are also gathering fat. This is the layer that gets pinched, not anything else, OR your measures are inaccurate. The location of the pinches are listed in the calculations below. The locations impact the gathering, BUT also does the amount of actual body fat that you have. The skinnier OR fatter you are, the less OR more fat that you have, the more difficult it will be to pinch an amount accurately without causing damage OR hurt to other areas.

Below are some of the bits of info pulled from the Determination of Body Composition PDF authored by uml.edu/campusrecreation/staff:

Determination of body composition from skinfold measurements is based on the fact that a
large proportion of total body fat is stored directly underneath the skin…Reasonably accurate prediction of % body fat from skinfolds therefore requires that the equation
used for a given person to have been developed using a similar subject population…In an attempt to remedy this problem, Jackson and Pollock and Jackson, Pollock, and Ward
have provided generalized equations that have been validated for various age groups and both athletic and non-athletic populations.

Skin Caliper Uses for Body Composition Measures

[First take the time to get the correct material for measuring. The skin caliper method use the layer of fat under the skin and pinches for a measure. To do this accurately practice sliding your skin around over the under layers, you’ll note that you are also gathering fat. This is the layer that gets pinched, not anything else, OR your measures are inaccurate. The location of the pinches are listed in the calculations below. The locations impact the gathering, BUT also does the amount of actual body fat that you have. The skinnier OR fatter you are, the less OR more fat that you have, the more difficult it will be to pinch an amount accurately without causing damage OR hurt to other areas.]

Where

  • x=sum of triceps, chest, and subscapular skinfolds (in mm) for men, and
    • the sum of triceps, suprailium, and abdominal skinfolds for women, and
  • y =age in years.
  • These equations are:
    • Men: D [Determination of body composition fat amounts]
      • =1.1125025-0.0013125(x) + 0.0000055(x2) – 0.000244(y)
    • Women: D [Determination of body composition fat amounts]
      • =1.089733-0.0009245(x) + 0.0000025(x2) – 0.0000979(y)

…Goal Body Fat Percentage and Target Weight
The following method can be used to determine goal body fat percentage (GBF%) and target weight (TW).
1. Multiply total body weight (TBW) by the body fat percentage (BF%) to determine fat weight (FW).

  • Step 1: TBW x BF%-FW
  1. Subtract FW from TBW
  • Step 2: TBW – FW=LBM [or FFM]
  1. The remaining weight is the fat free mass (FFM [or LBM])
    4. Determine an appropriate and reasonable GBF% [Goal Body Fat Percentage]
    5. Divide the LBM by the (1-GBF% [Goal Body Fat Percentage])
  • Step 3: LBM/(1-GBF%) = TW
  1. The answer will be the TBW at the predetermined GBF% [Goal Body Fat Percentage]
    7. Subtract the TW from the TBW to determine the amount of weight loss (WL) [OR Weight Gain (WG) required to achieve GBF%
  • Step 4: TBW – TW = WL

[Steps compiled]

  • Step 1: TBW x BF%-FW
  • Step 2: TBW – FW=LBM
  • Step 3: LBM/(1-GBF%) = TW
  • Step 4: TBW – TW = WL

Body Composition Measurement Tool Options

Some tools are cheap enough, they may not be as accurate as other tests, but they are way better than the BMI lies added to medical records. General tools search links:

There are various aspects of tools and values for users. So considering your needs, uses, and more can impact the better tools for you. In addition there are the issues with learning how to use the tools properly for the measures. Because a tool, like a scale that takes the body fat percentage, doesn’t mean it does the work in sharing the correct values with us and in some cases, since most the tools are setup for weight loss, there can be issues if a person has too little fat on their body.

Specific tools:

I’ve been to multiple sites looking for information including Walmart.com, Amazon.com, and others. One of the aspects I really appreciate is others comments/ratings on the items they have used. Their comments and more can really help me with my assessments. BUT the info often found requires time, so variations of needs and uses will impact each persons evaluations.

      • Display the correct resulting 6 seconds…After inputting your personal data, a measurement can be started by simply holding the grip electrodes and pressing the start button.
        • [Being handheld means that some individuals will have an easier time grasping it than standing. BUT because grips vary it can also mean various results will be gained at times with uses.]
      • Since the analyzer is built with a [9] person profile memory, each member of your family or team can track the success of their individual exercise routines
    • $14.49, No ratings at Walmart.com so far– This tool requires use on the 3 to 7 correct locations of the body, which vary for males and females, links about this above. AND as many people that can fit this can use it without messing up other ratings, each calculation setup is for each test by each individual. [This tool is different than other electronic calipers having a wider pinch mechanism which means less pain and damage for people.]
      • The calculations above describe more how to use this, but care is needed, because the pinch should only be the skin fat and skin, not the other body portions that are under layers in those zones where the pinching is being done.
    • $12.99- 5 Star rating from 1 person- Body Fat Caliper Handheld BMI Body Fat Measurement Device 
      • Made of ABS plastic material, more gentle to clip the skinfold than metal caliper…Electronic digital caliper, working buttons are illustrated with corresponding characters. Caliper can be used for measuring 0-50mm ranges of body fat accurately. Accurate, dependable and with good repeatability. 3 Volt battery not included.
  • Stand on, holds up to 400lbs- Beurer Body Fat Scale, BF221
    • $28.27- 4.5 out of 5 stars with 15 ratings at Walmart.com & 4.5 out of 5 stars with 232 ratings at amazon.com BODY ANALYZER: The Beurer BF221 gives you a full body analysis. The scale measures body weight, body fat, body water, muscle %, and bone muscle; 1 scale – 10 people. This smart scale has memory spaces for 10 people and automatically recognizes each user. Up to 400lb users… the scale features a large platform and extra-large illuminated LCD display…Place your scale on a hard and level surface. Place bare feet on the stainless steel electrodes/conductors on the sides of the scale. Within seconds, the conductors then send a safe and very low electrical current through the lower half of your body. This full analysis measures and determines your percentage of body fat, water weight and muscle mass.
      • Gatorboy- 2-22-20 comment– The setup was quick and easy. Note that the quick start guide shows how to set up user data in slightly wrong order, but the main manual is accurate…There is no app with this scale since it does not support Bluetooth.
        • [This is great for people that don’t want to fiddle with an additional device while using the scale. BUT this can be an issue if your doctors demand copies of the info that they will trust. While they may accept your personal records OFTEN they only believe digital info they think can’t be modified or changed.]
      • jim f- 2-21-16 comment– Every time you want to get I for other than your weight, you have to hit a button and wait about 10 seconds for the scale to prep.
      • Amazon customer- 2-26-20 comment– I really like this scale and bought it specifically to measure the amount of water weight I am carrying.
      • Amazon customer- 2-26-20 comment– The scale has great features, however, batteries need to be replaced every two-three weeks. [It uses-  3 x AAA batteries, which means that battery changes can be costly unless an individual removes the batteries when the scale isn’t in use. This will mean more battery in and out hassles, and it could also mean having to reprogram the device repeatedly.]
      • alvaro herrara, 1-8-2018– The muscle percentage calculation is one of my favorite features on this scale. It’s nice to see what my weight measures at, but it’s even better to see where that number is derived from in terms of, is it increasing because I’m lifting more? Or is it increasing because of my diet? It’s really helping me stay on track of my overall health and diet/food consumption. I’m not sure why it has taken me so long to make this purchase.
    • $49.99- 4 out of 5 stars at Omron.com & 4.4 out of 5 stars with 6,366 ratings at Amazon.com, $70– Body Composition Monitor and Scale measures 7 fitness indicators including
      • body fat percentage,
        • If you’re losing weight, tracking your body fat percentage lets you know you’re trimming the fat as opposed to losing other kinds of weight [which are healthy to maintain AND keep].
      • body mass index (BMI),
        • This indicator is calculated from your height and weight and [uses a charted measure for estimating the overall body fat by doctors, but a scale with the multiple measures like this can be way more accurate]. The higher the BMI, the greater the chance for possible health risks.
      • skeletal muscle,
      • resting metabolism,
        • Regardless of activity level, a minimum level of caloric intake is required to sustain your body’s everyday functions. Knowing your resting metabolism helps you plan your diet according to your weight loss or maintenance needs. [Care is needed with this also, because an amount of weight to lose OR gain should be planned and worked for with incrementally working towards goal amounts, so the body doesn’t shock itself and so you can mentally get into the groove of weight changing into a consistent way of living healthily.]
      • visceral fat,
      • body age and
        • This indicator is calculated using your weight, body fat percentage and skeletal muscle percentage. The resulting number reflects your body age in relation to your calendar age. You want to keep it lower [than calendar age] if possible.
      • body weight.
        • It may be an obvious fitness indicator, but body weight alone doesn’t tell you everything. Measuring your weight in conjunction with other readings gives you a clearer picture of what’s going on with your body.
    • This OMRON body composition monitor can be used by adults up to 330 pounds and 6.5 feet tall. It stores up to 180 days of data to track your progression over nearly 6 months and features a [4] person memory profile for the whole family to use… Accurately measures body fat percentage using proven bioelectrical impedance method…
        • Bioelectrical impedance analysis (BIA) is a commonly used method for estimating body composition, in particular body fat and muscle mass. In BIA, a weak electric current flows through the body and the voltage is measured in order to calculate impedance (resistance) of the body. Most body water is stored in muscle. Therefore, if a person is more muscular there is a high chance that the person will also have more body water, which leads to lower impedance.. BIA[1] actually determines the electrical impedance, or opposition to the flow of an electric current through body tissues which can then be used to estimate total body water (TBW), which can be used to estimate fat-free body mass and, by difference with body weight, body fat

Although the instruments are straightforward to use, careful attention to the method of use (as described by the manufacturer) should be given.[citation needed]

…Dehydration is a recognized factor affecting BIA measurements as it causes an increase in the body’s electrical resistance, so has been measured to cause a 5 kg underestimation of fat-free mass i.e. an overestimation of body fat.[4] [The reason is that with less water in the body the electrical resistance of tissues and body portions is higher than normal, which is estimated as body fat.

This also means that with higher body water amounts there is less electrical resistance, so this means that the body fat measures will be lower. Since it’s so abnormal to have a higher water mass amount that’s a reason for Whoops Disease that this is a good measurement when it gives body water amounts. BUT there can be machine problems because the devices aren’t able to read higher body water mass in some cases.]

Body fat measurements are lower when measurements are taken shortly after consumption of a meal, causing a variation between highest and lowest readings of body fat percentage taken throughout the day of up to 4.2% of body fat.[5]

Moderate exercise before BIA measurements lead to an overestimation of fat-free mass and an underestimation of body fat percentage due to reduced impedance.[6] For example, moderate intensity exercise for 90–120 minutes before BIA measurements causes nearly a 12 kg overestimation of fat-free mass, i.e. body fat is significantly underestimated.[7] Therefore, it is recommended not to perform BIA for several hours after moderate or high intensity exercise.[8]

BIA is considered reasonably accurate for measuring groups [of results], …for tracking body composition in an individual over a period of time, but is not considered sufficiently precise for recording of single measurements of individuals.[9][10]

…Two-electrode foot-to-foot measurement is less accurate than 4-electrode (feet, hands) and eight-electrode measurement. Results for some four- and eight-electrode instruments tested found poor limits of agreement and in some cases systematic bias in estimation of visceral fat percentage, but good accuracy in the prediction of resting energy expenditure (REE) when compared with more accurate whole-body magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DEXA).[12]

The use of multiple frequencies in specific BIA devices that utilize eight electrodes has been found to have a 94% correlation method with DEXA when measuring body fat percentage. The correlation with DEXA is as high as 99% when measuring Lean Mass, if strict guidelines are adhered to.[13][14]

        • Bioelectrical impedance analysis (or BIA) is a simple and non-invasive test measuring how low-voltage electric currents circulate through the body with the help of electrodes… By measuring the voltage drop between source and receiver electrodes, BIA determines the resistance level of these tissues to the passage of the current.

A four-electrode configuration for BIA between the right arm and right leg. Called “impedance,” this

resistance (Z)

Resistance measured in fatty tissues. In fatty tissue, the resistance (or impedance, or “Z”) is high, and measured current flow (V) is low…

[Z] corresponds to the ratio of the voltage (V) measured between 2 points in contacts with the tissue,…

Resistance measured in fat-free tissues. In muscles or water, there is less opposition to the current flow, so the measured current (V) is higher and impedance is low…

on the

intensity (I) of the frequency to the current applied to this tissue.

The impedance calculation is then Z=V/I

    • [With the devices like Omron it is]…Recommended to take the measurement in the morning before exercise, eat, drink or take a shower…Omron’s Full Body Sensing takes measurements from both hands and feet [4 points] creating a more accurate reading by reducing the influence of water movement throughout your body…For optimum accuracy, use your body composition monitor [either] right after you wake up and at least 2 hours after each meal [or food intake. For more accurate measures.] Avoid taking measurements after exercising, drinking a large amount of water, or bathing. These may significantly alter your body composition readings. [Normal actions and activities shouldn’t bother the system readings, but odd OR abnormal actions can.…Plus] 4 AA batteries required …For more accurate BIA measurements the device used needs to use DSM-BIA technology
    • Omron device Comments at Amazon.com
      • Robert Mauro, 4-22-16– HOW TO USE:
        – Do not take out handle
        – Press the power button and release
        – Do not touch the machine until it is calibrated
        – Hit the profile number you want (1-4)
        – Remove handle and hold appropriately
        – Step on scale
        – Wait until all measurements complete
      • Adam, 9-9-15– The scale actually does factor in the weight of the handle according to where the handle is when you turn on the scale. For instance if the handle is clipped in when you turn it on it will read zero. In the same way if you would unclip and hang on to the handle, then turn it on, and place the handle back down on top of the scale, it will now read 1 pound. This is why the readings will be different if you weigh yourself first holding the handle then weigh yourself again just stepping on the scale it will show you a difference of 1 lb.
      • W.tom- 7-25-18…when my partner took the batteries out without replacing them for two weeks, all my history was deleted…
      • Don D.- 7-1-20…The battery life is good, power switch turns on quickly (located at front, beneath the edge, and the display is easy to read…
      • Keith- 3-20-14…I would very highly recommend this scale because it will let you see the day to day progress you are making. Physically, it is very difficult/impossible to see small changes day to day, but having this show the daily changes is very motivating that progress is being made even if you don’t see it…and I agree that there are many factors that go into your overall ‘health age’, so the value doesn’t really represent your health age, but it does represent your physical composition age…
      • Mike Ransom- 1-7-17… I measure the body fat percentage about once a we[e]k. I take that measurement before I take a shower and before eating or drinking anything as getting wet even after drying can change the results along with food in your stomach. I don’t know how accurate the body fat percentage is since I have not[h]ing to compare it to but I use it to more or less track a trend in rise or fall in the percentage. It is easy to use. I am able to turn it on with my foot with a switch on the front of it.
      • Ron- 6-25-19- Same measuremernt as the $6000 one at my Dr’s office.
      • Amazon Customer- 9-24-18– …The history feature for up to 4 sets is really complete and accurate. The indicators are everything you need to assess yourself in nutritional terms. I compared results with professional testings and they match by 95% I would say…
      • Randy M- 7-11-18…If you buy this, don’t skip over the instructions. To get all the measurements, you need to be barefoot, press power on, after it shows CAL and 0.00, press the desired person button 1-4. First time it will prompt for age, sex, and height. If you want to use the GUEST FEATURE (doesn’t save), wait for the CAL and 0.00 and press the top middle button…
      • Jamie W- 5-30-20– Definitely read the instructions and it measures 1/4 inches that gives more accuracy for measurements…
      • Mark Twain- 9-12-18– …when weighing yourself, turn the unit on, [if you] pick up the hand-held piece, but hold it so that the attached rope is slack. Otherwise, if you pull up on it while weighing, you will weigh lighter. Once the weight displays and blinks, you can hold it out in front of you to test the body fat, etc
      • Eliot Gable- 3-13-13– I bought this scale over a year ago…1) The scale provides accurate body weight results, as verified by my multiple visits to the doctor’s office…This scale had the exact same weight readings as each of the scales I stepped on in the various doctor’s offices,…2) The body fat percent and muscle percent measurements seem to be affected a lot by water and muscle glycogen content.
  • [The more water weight you have, the higher your muscle percent reading will be and the lower your body fat percent reading will be.
  • If you go on a diet and do lots of [exercising] it drains your muscle glycogen a little more each day and your fat percent reading increases with each day until you have used up all [excess] muscle glycogen. It took me about 8 lbs of weight loss (1 week at 10 miles per day and 1,000 calorie diet each day) before the readings leveled out. Once glycogen was depleted, the fat percentage stopped increasing. [It seems that the muscle glycogen, ‘food’, is read as fat until the muscle glycogen is not too high.]

In fact, based on my calorie deficit for the day and the difference between subsequent days of readings, the the fat percentage difference converted to lbs of fat lost exactly matched my calorie deficit for the prior day. Prior to hitting glycogen depletion, the readings were more sporadic and it would appear that I was gaining and losing as much as 2 – 4 lbs of fat between days. My wife also had a water submersion test done to determine body fat percent, which is the most accurate way to determine it. That test put her at 34% body fat while th[is] scale read 37.4%. That’s a difference of about 5 lbs of fat for her weight.

3) The scale takes measurements fairly quickly. 4) The original batteries are still working, but I only weigh myself once a day. 5) The body age number seems a bit wacky. I am 32, but it says my body age is 71. I have lost about 35 lbs so far, and my body age has dropped from 75 to 71. I still have another 60 lbs to lose to hit my ideal weight (15% body fat). However, I have lost 1/3 of the weight I needed to lose and the body age has only changed by 4 years. So, that means when I hit my ideal weight, it will probably still be saying I am 63. I walked 1400 miles last year. [This shows that the scale is measuring more than just the present ‘amounts’. A damaged, body composition aged body, will not repair as fast as you may exercise into better health rates. A person who stops smoking has to take years to have better health results from the damage done.]

6) The visceral fat reading has dropped from 15 to 14. I seem to be stuck at 14. 15 is the highest reading. Even after my initial 8 months on my weight loss program eating a very clean diet, and losing 30 lbs, it still only went from 15 to 14 and has stayed there. I am not too sure it is working correctly.  7) Overall, the scale is awesome, and it is way more accurate than I expected it to be with weight and body fat readings. However, I would like the ability to import the data into my computer for tracking. I currently manually enter it into a Google Docs spreadsheet for tracking and graphing progress.

      • Kristen- 8-17-12– I bought this after visiting a fitness resort and learning the importance of NOT using the number on the scale, but rather using measurements such as body fat percentage… I did have to follow the instructions to get it properly set up, as I wanted to use the recording system for myself to track my progress, but I think the instructions were easy to follow. This scale is VERY sensitive, though, so if you’re going to invest in it, just be sure to give it the care it needs, which is not difficult.

Other types of tools exist, the values and uses vary depending on how the tools work and what they are measuring. As we’ve shared above there are various ways that the measurements can be found, but at times the ability to get the individual numbers can be the best for individuals because they can do the calculations without needing to rely on the machine OR even as tests for the machine result accuracy with the calculated readings.

Other Connecting Posts

Please beware they are grouped based on a style of topics.

Diabetic’s and Treatments

[Sorry posts still need dividing & completing for better online reading.]

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

 

WHOOPS DISEASE- 9. Me & My Pets Updates

My really handsome kitty is dead now, I think, he disappeared and is presumed dead. My newer kitties are:

  • one presumed dead, and
  • the other one biting me.

My parents cat has also been biting at me. So I must assume that it’s a WHOOPS DISEASE thing, which means that these normally nice and affectionate animals think I’m tasty. Likely because I’m close to dying OR my skin is so deliciously ‘cat food’ tasty that biting me is an attractive kitty option. Take care if you have a dog, they may OR may not be as attracted to you as my cats are to me. They also MAY BE more careful with their master/mistress…BUT they may not be…I don’t know you & I don’t know your animals.

My cat biting at me haven’t broken the skin with the biting, they have barely bruised me, but the biting actions are so abnormal for them that I’m afraid that I’m just getting closer to dying all the time. AND this could be happening with you and your pets also. BUT please don’t react harshly with your critters, it’s just you having Whoops Disease, and if the doctors ever treat us the pets will still be ours to care for.

For me if I pet my cat for a while after it’s bit me, and then get close to its mouth, it’s so happy I’ve been nice that it doesn’t even try to bite me until the next time I accidentally put my hand in it’s face when I haven’t been affectionate towards it recently &/OR it’s hungry enough not to care how affectionate I’ve been.

Other Connecting Posts

Please beware they are grouped based on a style of topics.

Diabetic’s and Treatments

[Sorry posts still need dividing & completing for better online reading.]

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

 

WHOOPS DISEASE-8. Dryness Issues & Self Treatment Actions

These issues grow as time goes on and the ‘microscopic organisms multiply’. In addition the amount of effort that’s gone into personal health maintenance including:

  • drinking enough,
  • modifying and adjusting humidity better,
  • bathing,
  • using lotions,
  • moisturizing eye care,
  • moisturizing hair care, and
  • more

will have huge impact on the dryness issues being lived through.

I live in an atmosphere that’s really dry a long portion of the year, in my home the humidity level from about October through April is under 20%. That’s a great level for reducing mold and bug issues, but it’s a really dry atmosphere. This has meant that living in a dryer environment has meant taking the time to figure out ways to make the air easier to breathe and less dry.

Treatments against Dryness

As we mentioned above the dry air causes additional issues with a body that’s suffering dryness. Treatments can be practical, but they may not be cheap, this is depending spaces and needs by users with spaces. In additional person dryness care varies with our actions through the disease.

Reduce Dry Air in the Environment

Because of the super low humidity in the home I suffer dry air breathing issues if I don’t have a water source humidifying the air in my areas. While this means I’m adding more water which will increase the Whoops organisms growth potentials, I have a really hard time with my throat feeling like a scrub brush is being used on it every time I breathe. The humidity in the house with a humidifier next to me, a pan of water near the stove, a dish of water out, and a tub of water in the kitchen sink is still less than 20%.

In house plants

While the plants don’t humidify the air a lot, they allow watering AND do release moisture with their air cycling works. In addition the natural plant air is likely more reduced in issues that help Whoops Disease, because the fresh air varies the possible issues that could come from not being clean & fresh.

Humidifier(s)

These come in various types and sizes. Larger sizes and smaller sizes often have replacement filters, cleaning methods, and more. BUT the prices for the devices vary, the locations for possible uses vary, the amount of water with uses varies, the care for them varies, and the water potentials with them vary. Here are some links to search locations for humidifiers:

Larger ones

Smaller ones

Boiling pots of water

This method is generally better with a larger pan, because the boiling even simmering will dry out water from the pan pretty fast. This will humidify the air some, it’s more than nothing.

  • If you boil out 2 gallons of water, 8 quarts, it means that you have that amount of moisture put into the air.

Other pots/buckets/pans/tubs with water

These can be placed in locations that work for you. In some cases like with floor, or wall heating vents, or even heater stands it could be adding water pots OR tubs near those areas can allow more moisture to be added from evaporation.

Wet towels OR cloths

While you may not have a large space it can be that if there are available hangers & hooks OR even rods, wetted towels OR cloths can be hung to add moisture into the air where those are placed.

  • Care is needed because the hanging wetted thing may cause damage if the location OR items near the location are bothered by the wetted instrument.

Fan around water dish with a cloth

I don’t run a humidifier in my bedroom, but with sleeping in the dry atmosphere I need the moisture to keep my throat from hurting as much. So instead of fiddling to bring a humidifier into the bedroom I’ve made another option that works great AND is a lot quieter.

  • The fan over the dampened cloth that has one side in a dish of water and the other side on a raised platform which allows the fan to blow over the cloth and spread moisture. The issues can be drips that cause damage to furniture, but a plastic layer under this setup can assist in reducing that issue. The dish, fan, cloth are able to be of any preferred style, the tray shown is upside down to lift the wetted cloth closer to the fan.

The humidifying options help the breathing a lot, BUT so does the work to drink a lot each day. Days with drinking less than a gallon a day result in dryer and itchier skin, dryer eyes, and harder breathing, so making sure to drink enough is a huge value for reducing dryness issues.

Personal Dryness Treatments For

My personal treatments for the body are mostly successful, and they aren’t too expensive in most cases either. These treatments aren’t needed too much because of the fluids ingested daily. But just recently I had a couple of days of burning dry skin. After showering and drying taking the time to rub my skin resulted in flaking that’s normally seen after a sunburn.

Dry body

Treatment for the dry body begins with taking in enough moisture regularly. In addition the lotions OR creams that are used should enhance moisture with the skin. It’s amazing but recently I found a great dry skin treatment.

Aloe gel with some added liquid colloidal silver & glycerin:This was purchased by me during the summer when it was available, then I used some of my colloidal silver concentrate AND glycerin to help this be a better moisturizing solution. After the flaking skin, I used this on my limbs and shoulders. It’s been 2 days since that now, and my skin is still not flaking after that treatment neither is it burning like it was previous to the treatment.

 

 

 

 

 

 

 

 

 

Dry Underarms & Belly Button

The dry flakiness at my belly button and underarms is gone with the use of Bag Balm after every single shower OR bath.

Dry scalp

I haven’t found a way to stop my scalp from flaking with tons of dandruff right after a hair wash, it’s possible I can try my allow solution in my hair care post conditioning also. The dry scalp and flaky itching is reduced for me because I wash my hair only when absolutely needed. It assists in helping me to avoid itchy scalp.

Dry mouth/throat

For my dry mouth and throat drinking lots of tea with added milk really helps. The milk alone helps also, but it’s gone to fast and it’s super expensive, so adding milk to the tea really helps. My Traumeel may increase saliva flow, which can possibly also assist in reducing my dry mouth issues. Two aspects that really helps on top of drinking large amounts with milk is that I brush my tongue when cleaning my teeth, AND I do not drink sugar fluids.

The sugary fluids cause ‘mouth’ food processing at enhanced rates and this also drys my mouth a lot.

Dry lips

I’ve made a lip balm mix using vitamin E balm, glycerin, a bit of tea tree oil & iodine which act as a disinfectant and taste bad which keeps me from licking my lips. In addition I at times add a bit of bag balm, vaseline, and some cocoa butter balm. This solution has shifted and varied a lot over time, some of the ingredients originally gotten aren’t available any more at a price I want to spend. The addition of the glycerin assists in keeping the balm as a moisturizing agent while it’s on my lips instead of a drying agent.

Dry face

At times my face is drying abnormally, but the addition of the glycerin to my face cream has reduced the dryness issues a lot. In addition I make sure to add the lotion right after rinsing and patting dry my skin. BUT I’m still tremendously wrinkled.

Dry ears

My ears are dry outside AND super moist inside. This means various treatments.

Inside ears

Inside my ears the moisture and masses of skin cause a needed scraping cleaning issue daily. At times recently I’ve also had a whitish puss like remains. That can be what adds to the dry flaky remains that are scraped out daily.

 

 

 

 

 

 

 

The ears are generally dug into with my fingers before I remember to pull out my tools. The tools are safer for my ears and can be disinfected. The amount of mass shown on the towel is what my fingers had as well as what the scrapers helped me get in this use.

Outside ears

My outside ears between my inner ear hollow and outer rim get really dry, I use the Bag Balm on that also each time I wash my hair OR take a shower, but at times I need to add more because of the flakiness issues.

Dry eyes

As discussed previously I use the equate brand multi purpose solution, which allows thorough moisturizing infrequently versus other solutions that require frequent applications.

Dry hands

While the skin on my hands is also dry drinking enough generally keeps them moist enough. I don’t add additional lotion most of the time until I moisturize my feet before going to sleep. BUT I’ve found that in some cases the addition of the Bag Balm to dry areas, like under my arms OR at my belly button leaves enough excess I can add it to my hands.

While my hands are swollen, dry, and more I’m avoiding a lot of issues because of drinking enough. BUT in addition to that when I get a hangnail, OR another hand wound taking the time to add a bit of superglue allows the healing with less damage. The Gorilla brand superglue, I’ve not tried the gel, lasts up to 6 OR 8 hours with use on my hands, it lasts about 24 to 30 hours in use elsewhere for injuries both larger AND smaller.

Dry feet

I’ve mixed a variation of lotions and cream, my base is the Udderly Smooth which is unscented and allows the addition of the ‘oilier/ heavier’ moisturizing materials like the face creams, vitamin E oil, and non oily aloe juice and glycerin to feel right for uses on my feet nightly right before bed.

With all of these treatments there has been a bunch of experimenting and trials until I find ‘it’ working correctly. The Gold Bond Ultimate- Diabetics’ Dry Skin Relief– lotion is really good, but I like more moisturizing at less cost, so my fiddling is done enough to supply me with useful solutions that work right while not being as costly at one time.

Dryness issues are likely to increase more as time goes on, they have already, it may also be that with Whoops Treatment the issues will continue OR stretch for some time also.

Other Connecting Posts

Diabetic’s and Treatments

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

WHOOPS DISEASE- 11. Life Beyond Whoops Disease Medical Treatments

We haven’t gotten to this stage of Whoops Disease yet, but it can be that you guys might need additional follow up information beyond the treatment issues previously mentioned. The medical treatment posts are likely to run in a series similar to the diabetic aspect posts. We may add some videos, but I’ll try to avoid as many as possible, because internet in the boonies costs a lot of money. Unless you have signal then you are paying for service all the time.

Other Connecting Posts

Diabetic’s and Treatments

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

WHOOPS DISEASE-7c1. A Possible Cure for Type 1 Diabetes fighting False Whoops Disease Issues

Because of all the medical variables with Whoops Disease, it’s really easy for doctors to assume other problems and issues. AND if you’re not keeping an accurate record for yourself, it means that you like me could be suffering believing the doctors know what they are talking about. BUT after you start making your own records, don’t expect the doctors to believe you, they will base their estimations on their assumptions and previous records.

So keep your Own Records to Assist you In Protecting Your Health

There are many aspects to this work. Including:

  • Medicine Records,
  • Natural treatment records,
  • Fluid consumption records,
  • Pee records,
  • Calorie records, with other variables as desired OR needed,
  • Personal Mood/Feeling Records
  • Temperature & Fever Issues
  • Yelling & Screaming Issues

Medicine Record Variations from Normal

Rhapsodie from 2013 into 2014 didn’t take the Thyroid medication. After taking it again in 2015 the prescription from before was kept EXACTLY the same, there were no medicine changes and Rhapsodie is taking the EXACT same amount now. This is a sign of the Whoops Disease, with the exact prescription maximized by non-users previous to problem of 1.25 for females not taking depression medications. Also for females previously taking thyroid medications the amounts only go up OR down to 2.5 not anymore OR any less. After treatment this should normalize, but I’m not sure at what speed.

Fluid intake Records & Pee Records

The great intake of water to keep up the needs of the body, for Rhapsodie a proven 1.25 to 1.5 gallons of fluid daily, reduce the size of the stomach’s intake of food, this when fluid intake is good to keep the body moisture levels accurate, so no inaccuracies in blood tests BUT the results have similar aspects to some starvation issues Rhapsodie lived. This also means that others need to keep track of their eating and amounts of that with Whoops Disease. While drinking fluids like water often add a fullness to a stomach, with Whoops Disease they are filling and nothing else seems to be wanted.

Pee amounts aren’t done all the time, just using an empty gallon jug a couple of times has proven I’m peeing only about ½ of what I’m drinking. BUT fluids go out in other ways also. But this also varies with types of fluids, types of activities and durations, types of environments, types of moods/events/and other impact actions and stresses for the body, and variations in aspects of environment like humidity. When I have a sweating low with my sugar I can lose enough water to soak my mattress, or at least my sheets.

Calorie Intake Records

I’ve suffered from not consuming enough, and the calorie intake measured from 2013 to 2015 went up from around 900 calories a day to almost 1,250…those years of starvation previous to my calorie measures were super bad. During the timeframe of my starvation broken bones happened, which has meant that the doctors should have found the injuries, but being stress fractures, inaccurate X-ray reading, Whoops Disease water beneath the skin, inaccurate BMI weight assessments instead of accurate body composition measures, and bad communication additional problems have grown. This includes issues from limited abilities to exercise, needs for pain fighters and avoiding the narcotics doctors ignorantly keep prescribing. The starvation notes by Rhapsodie are kept in her MEDICAL folders.

Keeping a record of calorie intake isn’t hard to do, BUT I also try to make sure to have balanced diet as a norm. This has meant preparing all my hot drinks with whole milk, so I get enough calories of protein and fat daily while still getting all the fluids Whoops causes me to want. The daily list helps me to continue to consume at least 3 servings of fruits and veggies daily, even though they take a lot of stomach space, digestion time, and leave me to full to consume many other calories. BUT they are full of fiber if veggies and are way healthier than other foods.

The calorie papers I have kept get put into my 2012- 2021 Food Calories of Rhapsodie Excel spreadsheet which is prepared to take the daily counts and average those by amounts per week, month, 4 months, and year as daily amounts. So when I tell you that my recent average per day is up to 1611 calories per day, the number is from the 4 month daily average. This means it’s a running calorie average, not a day of amount OR a week of  average OR a month of amounts. For 2020 my daily average of calories came to 1570 calories per day. This is in no way a way to be fat, and while I’m not starving anymore, the fractured bones are still suffering the times of starvation.

For others this means taking care to make sure to keep accurate food consumption records in order to avoid starvation and issues that can result from that.

Symptom & Treatment Records

I’ve tried to add the symptoms and treatments used by me here in this blog, but I’m sure that more is happening with other people because more has happened with my mom, my dad, and my husband. This means various life actions as well as ages and sexes can shift the symptoms in various ways. Types of treatment through this blog are mostly natural, BUT I’ve also been having the issues with the broken bones. My treatments have gone way more natural because of multitudes of reasons as well as many useful options available for me AND for you…

Personal Mood/Feeling Records

Our health issues and our times in life impact our feelings and moods. So does the weather, our comfort, and the aspects of life that bother us and help us feel better. Understanding ourselves and our tolerance for problems and issues as well as our willingness to care for others and ways to do so through issues is a big help for all of us. In addition with Whoops Disease patterns could be located that can assist health care people AND our families to understand more about what we may be having issues with when. Some of this is impacted by sugar levels, temperature & fever issues, fluid intake aspects, bathing aspects, sleep aspects, and also medicines we may be taking OR on.

  • For me, Rhapsodie, high sugar makes me feel stretched out of my skin, all my limbs feel slightly, only slightly tight. Also I desire food and drink way more than when my sugar is normal or low, at least with Whoops.
  • Temperature & Fever Issues, like every 3 to 6 days, now, I have a temperature cycle from high to chill…This has been going on for the last three years, BUT it’s getting more and more frequent. When my temp is high I’m super thirsty, and I’m also less patient with others around me. In addition the higher temperatures seem to go away when I sleep AND reappear only when I’m awake.
  • Fluid is necessary with Whoops, tremendous amounts of it, if my sugar is higher I try to drink only clear fluids, but the milky tea is the only thing that soothes my throat when it hurts without additional medications.
  • I’m so much more calm and relaxed if I can get a good soak, 4-8 hours once a week. That hasn’t happened for months because of hot water issues, so I’m also not sleeping as well which also adds to harsher and less patient moods. Which sometimes end up in frustration and meanness towards the air around me.
  • For me, I generally sleep when I’m tired enough not to stay awake if I’m in the middle of something. BUT if I’m not involved in something, I may sleep and go back to sleep, because sleep is super important.
    • My tiredness is huge with the injuries, the first day after fracturing my right calf I conked out for 13 hours straight. That week I missed a day of classes, and did no homework that weekend for the first time since college began…for months I suffered lots of sleeping and very little energy. I didn’t work a single day that year of classes, not like the previous years and I had a lot fewer than the previous years also. I was just too tired all of the time. I struggled to get projects & papers done repeatedly and it was my senior year in college. It would have helped if I’d realized the injury then, I never remembered the cracking break sound till the summer of 2014 after the fracture in the fall of 2013, which remains undiagnosed to this day.
  • Medicines & more we take can alter moods tremendously.
    • Gabapentin was a pain killer I stopped taking after 4 days…it made me tired, moody, mean, grumpy, and super gassy.
    • Kava Kava, is a mood calmer.
    • Humalog insulin also calmed my mood versus the beef & pork insulin taken previously.
    • Fluoride is also a mood calmer.
  • Mood boosters
    • Sunshine, good old fun days in the sun with the vitamin D can really pick up a person, only 15 minutes a day is needed for enough D to be enough for the whole day.
    • Adrenalin, which comes from exercise, also improves moods, adds ‘pepp’ to the step, and helps people feel ‘a bit sunnier’.

Temperature & Fever Issues

With higher temperatures my skin and body, mostly face, throat, and neck feel like 10 times hotter and more stretched than with high sugar. The oddity about the Whoops fevers is that they seem to work their way up. Starting in the thighs through the head, and finally ending nearer the top of the head with a headache days OR hours later depending on the time frame of the pattern. Unlike being sick fevers that run from the toes to the head, the Whoops fevers seem more upper body for me.

Normal temperature feelings are like abnormal for me now, but I’ve had a couple of days this last year when I’m just feeling ‘good’, and with checking my temperature I’m at 97.7 OR 97.8, right almost at my normal temperatures of 97.6 to 97.7 which have been normal since about 5 years of age. I run a lower than normal average, so does my dad, grandma, aunts, and maybe also my uncle…it seems to be a family trait.

Yelling & Screaming Issues

My ‘days of yells’ upsets are mostly Fridays and Saturdays every 2 weeks, my husbands are every Saturday and Sunday every 3 weeks. While spread a bit they are still issues for all of us because we are usually yelling toward each other unless we recognize the pattern and yell to the air as much as possible.

Keeping our own records can really help us help ourselves and others we spend time with if we also note that we have Whoops disease. What I’ve found with all these issues is that my patterns are weirdly ‘ordered’.

Other Connecting Posts

Diabetic’s and Treatments

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

WHOOPS DISEASE- 10. Life Through Whoops Disease Medical Treatments

I’m adding another apology because I do not have the clinical name for Whoops Disease yet, it’s changed so much over the years name and most of them I’ve dealt with treat me for the ‘effects’ of the disease not for the disease.  Because since I’ve learned about it, so only the ‘professionals’ with the treatment have the clinical Whoops Disease, as named by Rhapsodie is easy to remember AND because many of us get it whoopsily it makes sense for us. But the clinical treatment impacts the body and systems also, this is what I’ve heard of, but more can be added after treatment shows the effects.

Please take care, no correct treatment leads to death because the parasites (microscopic organisms) overwhelm air systems and take away any ability to breathe. The wake up chokes that happen twice are only a couple of the effects with this action by the nano organisms. Asthma symptoms, with no asthma, is another effect. Having hard times fighting colds, getting bronchitis & pneumonia are other issues from this disease while it’s working. Additionally your HIV blood tests may show HIV that’s not AIDS, but it’s an immune virus impacted by the wastes of the organisms filling your body and weakening your ability to live.

Post Treatment Things

I am not treated, this is just what I have heard that there are repetition cycles beginning right after treatment. These patterns of repetition are heaviest closest to the treatment, the cycles are the same except for the new thing(s) every 3 days, I think. Additional effects may be nice OR not, but I’m not sure what the other treatment values are for sufferers of Whoops Disease.

Water Release

With Whoops Disease being a water borne microscopic organism, as described in many of the previous posts, the water is a necessity for that organism to survive. For individuals living with that disease water in take increases a lot more than normal, as is described with life in many of the previous posts also, links below. This means after disease treatment there will be a great release of water that the organism’s have stored for expansion in the body. In nature water is where it lives at warmer OR like ‘human body temperature’ or thereabouts (or around). That’s why with the human body, the water intake has increased so that the organisms have a supply to use while the body still functions ‘normally’ enough.

This should mean that after treatment the water release comes out of the human body in any way that we expel water. This means with the skin through sweat secretions, the urinary tract, from around the eyes with the tear ducts, and possibly the mouth. I’m assuming that the skin water release is in the initial 24 hours the most, while the urinary tract because of processing through the system it could vary and extend a lot longer.

With the extensive amount of water expelling through the body, it’s likely that the bathroom is going to be the best friend of anyone during the early day. BUT that’s not normal even if a person falls asleep in the bath tub. If you have nature space, like outside, it could be that summer warmth will allow you to be outdoors letting go of water, that’s not going to harm the environment. But anyone in the hospital, because of other injuries that were hidden with the water in the body refracting light from image machines hiding images of the reality of injuries under the skin.

This means the water run off of the body, will likely need a flow off bed (table) prepared. Something like is used in surgery that allows the released body fluids to flow away from the body on the operating table.  Slosh there are materials that allow garments to remain sweat free, so I’m sure there could be ‘fabric’ on beds/ mattresses/ tables that allow the water to flow away from the body of the patient on bed. This is only outside the body, what happens with the body.

What happens with the body?

With the water flowing out of the body, I’m assuming that the pores of the skin will allow the releases but will expand with the water outflow. While the urinary systems will work normally BUT at a higher potential, so it may be modified water expelling systems can be prepared. Like with underwear fitted with a water flow bag, like an old hot water bottle that allows the screw thread top to be connected to a hose to a bucket OR something else. BUT what about the pores, they are expelling massive amounts ABNORMALLY.

If the pores are expelling massive amounts abnormally, then they are expanded abnormally for extended lengths of time. So a rubbing OR vibrating rubbing could allow them to shrink back to normal a lot faster. Using a lubricating solution, like pregnancy rub OR sexual lubricant, can assist the friction from the rubbing to be reduced for the skin areas and the rubbing hands OR tools OR both. If the machinery tools are prepared so they can work like a vibrating mattress, pad, or other it means that they can possibly be rubbing tools that are used for other functions also.

These are just my ideas, they may OR may not be good, they are just ideas because of my thinking without having lived this section of the disease, treatment, yet. BUT I have also heard of the repetition cycles of things, that will impact life at the same time that water flows are happening.

Repetition Patterns

This is part of the proof that this disease is nano, not normal. There are repetition cycles, of movements & speech, that go from the first day of treatment to 7, 10, 13, or even 20 days. The first day is the most with the heaviest amounts of repetition. I’m not sure if this is repetition of the day before, OR from months before. I’m not sure what it comes from, but I think it comes from hearing a pattern of sound while the memories of what is spoken OR done OR read are captured for the repetition cycles. Each individual will repeat based on what they have done.

The heaviest sharing with the repetitions is the first day/days after treatment. The cycling pattern reduces away from treatment.  For everyone away from the repeater, things will not be as loud as they are for the speaker. It may be that in some ways, like with eating OR chewing gum OR sucking on something there won’t be as much vocal repetition hassle, but I’m not sure at present, time will tell after treatments begin.

I’m not sure of the patterns OR the time cycles with that. The reduction in repetitions and the actions with those can be prepared for. The patterns will bother everyone over time, BUT THE PERSONS WITH THE REPETITIONS WILL HAVE THINGS THE WORST. It’s possible that treatments done while the individual was sleeping will be easier for doctors, BUT it could be that there will be no moves OR speaking if the ‘patient’ OR ‘released patient’ is sleeping I’m not sure yet.

This means preparing for the repetitions. (I’ve made my own copy of an Excel Spreadsheet and this bit is only ‘some’ of it, so that it can be filled in.

But you may want to create your own form, with a series, please note that doctors can use pages with the same pattern easier than different patterns. So preparing pages for uses will vary with treatment, and the fewer changes can mean less pertinent pages, but easier to use. Plus with movements & VIDEO RECORDS it can be that some repetition pattern problems can be less stressful for individuals & carers and this can possibly also assist recoveries to be less of a problem.

  •  The record of when, what is done, and what is said made the first day will assist the other repetition day records to be prepared to be crossed out as time goes on and things STOP repeating.
    • With a spreadsheet form prepared with Time & Moves & Speech by volume & span of cycle can allow carer’s and individual’s living with the events to prepare to live through the events. AND with the new ‘event’ OR ‘words’ that are likely once OR ???… I’m not sure to be added onto the cycle pages also.

I prepared a 24 hour, 15 minute segmented, multiple day form in Excel which is detailed with a lot more information for filling. Some of the info is likely a waste of space, but other info may be needed also. So far the spreadsheet is just prepare, it’s not filled in because no treatment has been received, but here’s a simplified clip of that which is prepared in my Whoops files likely under treatment:

      • This can be placed into print form OR left on computer, using the video records will allow the time records to be captured and stored correctly on the pages/ computer.
        • For individuals kept in the hospital through the treatment, it can be good that the repetition records are:
          • Kept in the doctors pages,
          • Placed in the Nurses records,
          • Added outside the door for other ‘carer’s to reference’, that is if the patient agrees to that,
          • Placed inside the room for the patient’s family and others as an easier reference,
          • Then there is the connection surface, pad, computer, page, or whatever is used, like a clipboard OR a computer that can be a go between for all the other records pages/ systems.
      • Using video records will allow the verbal and physical actions to be ‘seen & heard’, plus time captured for the cycle pattern records. BUT please remember all the video is viewer capture of the actions, which means anyone seeing this who is living with it is getting the capture perspective.
        • If you have a sports camera on your glasses/ chest/ hat/ head rim/ or arm things will be seen as you do them from the location of the camera, but if you have an exterior camera looking at you that will see things from that angle, which may mean multiple  exterior captures UNLESS one can be placed umbrella like over you where you go with what you do.
    • The physical and verbal repetition patterns in record  can help everyone treated, their families, the doctors/ healthcare givers, and it should mean that the repeater hassles can be minimized also.
      • For instance if you’re treated with ‘going to the bathroom’ as part of the repetition, how was your body held, what future actions in repetition can you pass over OR will you do exactly the same again. So what treatment repetition patterns do you plan?
        • Like for guys that use the urinal, could you have a waist wrap that ‘hides your repetition actions’ OR for a woman that squats on a low toilet is there a … OR maybe you just determine to try and use the bathroom with the repetition, so the hassles aren’t a ‘bother’.
    • It’s likely that the verbal exclamations and actions can be more annoying, especially if you’re having repetitions while at work OR if you’re being treated by doctors.
      • For any getting treated and walking out, it could be that at ‘home’ for the weekend OR  a long weekend’ could be best for recording & making pattern action guides for things that get less and less over the 7 to 10 days of repetition.
      • For in hospital people, having an ‘on the door record’; ‘in the room record’, and ‘in between record’ that allows the other records to be kept accurate is good. It can also be great if the doctors & nurses have a copy of the repetition cycle records.
    • Your plans and actions will impact everything,
      • So making sure to have a record of the repetitions will enable you to work through and with things. For instance if you drive to work, maybe before treatment you get someone(s) you can prepare travel plans with, so you don’t have driving issues in repetition actions that could cause accidents.
        • Maybe you have meetings planned, so you prepare the meeting times with the repetition schedules in mind, maybe even coffee breaks, that allow you to ‘go repeat’ in the bathroom or however is better with you for live around the repetition with the meeting situation.
      • Doctors may be learning this disease, but I’m sure they may be able to provide a ‘doctor’s note(s)’ about the repetitions, so bosses won’t be able to fire you for disease treatment actions that you don’t have control over during treatment repetition days.
  • Family & Work mates & job people might be able to work with you also, your boss can hopefully have plans to work with you through  these times. Just like they will need to with treatment beyond and times with aspects of this disease.

Some issues that can happen may be extreme amounts of bathroom uses, there are the repetition cycle patterns, and there are also other issues like ‘abnormally speaking out’ because of the repetition of speech . As we discuss in this article above the work to prepare and setup ways to measure what is happening both before treatment and through treatment can really impact the results of what happens and how things are planned after treatment.

In addition there’s the possibility with treatment at the correct time that any person with Type 1 diabetes could have that go away. I’m not sure about how this impacts people that have gotten diabetes with Whoops AND I’m not sure how ‘fast’ things will shift.

We haven’t gotten to this stage of Whoops Disease yet, but it can be that you all might need additional follow up information beyond the treatment preparations above. Plans are to extend these posts following the title above with letter codes.  We may add some videos, but I’ll try to avoid as many as possible, because internet in the boonies costs a lot of money. Unless you have signal then you are paying for service all the time. AND video takes a massive amount of internet signal space.

Other Connecting Posts

Diabetic’s and Treatments

Whoops Disease Info

Additional Connecting Information

Rhapsodie has written about these issues for multiple reasons:

1) To have a shared written record, that’s useful. 2) To provide info to others to assist them in planning to deal with the horrid medical system of the U.S. 3) To hopefully impact doctors & health carers to do more work than just using reports which may be false.

Pain ASSessment Inaccuracies & Health Issues

Rhapsodie’s Visual PAIN Diary- From September 2013 into April 2017

 Rhapsodie’s ideas to improve Medical ASSESSMENTS by doctors

PAIN Variables

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