This week, Wil responds to some device-specific questions about how we insulin pumpers and CGM-wearers navigate the summer beach scene, and well... manage to tote our D-devices around anytime of the year. Read on.
Tom, type 1 from California, writes: I have a Medtronic insulin pump and wanted to know what, if any, precautions should be taken with the pump when I am at the beach. I know I cannot get it in the water, but what about just hanging out at the beach? Should I put it in a camera bag or something to protect it from the sand and salt-water spray? Do I need to pack it in something with an ice pack to keep the heat from inactivating the insulin? I have a small camera bag that has several compartments in it. I could put the pump in one compartment and an ice pack in the adjacent compartment if that would help.
Wil@Ask D'Mine answers: I'm going to help you out even though I'm insanely jealous that you get to go to the beach and I don't. Don't worry, I'll get over it. Eventually.
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Sand first: Actually, the MedT pumps are pretty well-sealed devices. While not — as you pointed out — fully waterproof, with sealed seams and gaskets protecting all the openings, they can hold their own against the elements pretty well. Of course, that assumes your pump is in good working order. Older pumps tend to develop cracks in the casing, especially around the top of the battery compartment and near the top of the insulin reservoir chamber. But if your pump is crack-free, I think it will keep the sand out just fine, so long as you avoid Charles Atlas's sand-kicking bully.
Spray second: Spray can be pretty insidious. It's actually wetter than water, if that makes any sense. Just like dust specs can get into places the larger sand gains can't, water vapor can sneak snake-like through the smallest of openings. That said, I think for beach action you'll be fine, given the length of time you are likely to be there, the limited exposure to actual spray, and the number of days you'll likely actually be at the beach in what's left of the summer. If you were a deckhand on a small commercial fishing boat, we might need to worry more.
Temperature third: Heat is probably the greatest beach threat — after Great White Sharks, of course. Beach temps can easily exceed the approved maximum temperatures for fast-acting insulin, plus the pump itself can act like a miniature car with closed windows, getting hotter on the inside than it is on the outside. So you do need to do something about it.
Your camera bag solution would work, but I think it would be a hassle. You'd have to have the bag on your shoulder every second. It'd be worse than being a dog on a leash. If you stood up without it, you'd get than nasty infusion tube tug that every pumper has experienced at some point, or maybe even get disconnected. And if you end up having to do a site change at the beach, you can forget everything I just said about not worrying about sand inside the pump. Beach site changes are just opening the door to trouble.
Instead, although I confess I've never used one of these, I think that the reusable Pump Wallet from the Frio folks would be a better way to go. The wallet creates an anti-heat force field around your pump, while leaving the pump where it belongs: on your body. Like all Frio products, it uses those cooling crystals to keep the insulin at safe operating temps in high-heat environments. But unlike most Frio pouches, the Wallets have waterproof interiors to protect the pump's electronics. And its cooling system is powered by water, which strikes me as appropriate for a day at the beach!
(I got a kick out of the fact that the Frio website says the Wallets are $29.95, "pumps not included." I wonder how many morons called to complain about not getting an insulin pump with their order before Frio's lawyers made them add that disclaimer?)
Barb, type 3 from Idaho, writes: Hello there. Found your site by accident while trying to find a CGM case for my husband. Vince, that is my husband, has had diabetes for 49 ½ years, and bought the Dexcom monitor a few months ago. The case they sent is not designed for a rugged hard-working Idaho man who keeps losing his monitor. Are there any third-party cases that you are aware of?
Wil@Ask D'Mine answers: I agree that the Dex cases are pathetic. The company should be embarrassed to even send them out! They fall off the belt easily. The snap is problematic. They are made of low-grade materials that scuff up easily. They can only be worn horizontally. They only come in black and they hide the pretty colors of the receiver. Plus, they're ugly.
In their favor, however, the hinged design is pretty nice, for a covered case. And the belt clip, while still substandard, is heaps better than the clip that the old Dex Seven Plus cases had. I'm convinced they intentionally made that clip bad to increase sales via replacement receivers.
What I really wish Dexcom would make is a plastic holster similar to the one Medtronic makes for their pumps. Sure, the screen might get scratched up a bit, but a Dex receiver is only intended to last for one year, anyway. A rugged holster would allow you to see the screen without removing the receiver from the case, and acknowledge alarms without playing the reverse-origami game. But I'm not holding my breath for Dex to come to my rescue.
Now, given the popularity of the Dex, and the pathetic-ness of the "factory" case, you'd expect that a flock of entrepreneurs would have jumped on this bandwagon. But actually there are only a few, but I'm not convinced their offerings are really what a hard-working Idaho man needs. Myabetic has an armband case for joggers, and also a "Flip Sleeve" hard case that comes in pink and black -- but even the black looks a little "purse-ish" and is not designed to stay put during hard manual labor. Tallygear has some girly solutions, as well as a case designed to attach to a bicycle handle bar, and silicone skins. But none of those are going to help your hub.
Nutshell makes a leather Dex case that looks pretty tough, and is designed so that it can be worn at any angle on the belt by virtue of having an X-shaped belt loop on the back, but it doesn't have a window for viewing the screen; it's one of those cases you need to pull the receiver out of to read. Not ideal. Still, at least it wouldn't fall off his belt.
He needs something more like a ballistic nylon knife case with a thick, sturdy sewn belt loop. Only with a window. I'm not holding my breath we'll find that, either.
But speaking of knife cases, one possibility would be to re-purpose a case that was built for something else. This would open up the entire universe of cell phone cases, too! Thinking of hard working Western men, check out this case made by the Justin Boot people. (Further proof the Old West never dies, and can even adapt to the smartphone.) Or back to ballistic nylon, this case from timbuk2 looks like it might work pretty well. But both of those solutions still require him to take the receiver out of the stupid case to see his sensor glucose level, calibrate, or acknowledge alarms. I hate that.
As for me, I gave up on cases altogether about a year ago, and just carry the receiver in my front pants pocket. If I feel it vibrate a high alarm, I can just press the button right through the cloth to shut it up. If it's a low, if I need to calibrate, or just want to check in on my blood sugar, I can slip the receiver out of my pocket faster than I can pull it out of any of the cases that are sufficiently manly for me to stand (my current wardrobe sense won't let me wear any of those soft-edged cloth-like cases with windows).
Plus, now that I'm pumpless, and never bother to carry my cell phone with me, it's actually kind of nice having an empty waistline.
Now all my belt has to do is hold my pants up.
This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.