Pros and Cons of using an Insulin Pump

I love insulin pump therapy.  I think that it is the best way of delivering insulin BUT it is not the only way AND it is not for everyone.  There, I said it. Insulin pump therapy is not for everyone. Some people really don’t like using an insulin pump and still have fabulous success in managing their diabetes care. Check out Ginger Vieira and Christel Oerum for great examples.

Whether you get your insulin through a pump or a pen or a syringe, it is important that you weigh out the pros and cons.  You must find the insulin delivery method that best suits your lifestyle.  

Here are a few of the pros and cons that we have come across when it comes to using an insulin pump.

The Pros of using an insulin pump

1.  Less Jabs

infusion sets

Infusion sets for insulin pumps only need to be changed every 2-4 days depending on the type of set used. While you may still require emergency site changes or an injection to bring down a stubborn high, you will still only use one or two injections vs multiple daily injections.

2. Flexibility with food

food

When using an insulin pump, you only use rapid-acting insulin.  This means that you don’t have to have snacks or meals at specific times.  Ideally, you don’t have to feed your insulin when using an insulin pump. You eat what you want, when you want to.

3.  Flexibility to exercise

exercise while pumping

You can adjust your background insulin to increase or decrease based on your anticipated activity level.  Some sensor augmented insulin pumps will even suspend your insulin delivery if your blood glucose levels are dropping too low or too rapidly.

4. Can be integrated with your CGM

cgm and pump

There is currently a category of insulin pumps that are “sensor augmented”.  This means that they can receive information from specific continuous glucose monitors.  This information is then used by the pump to help you make dosing and basal decisions.

5.  Micro-manage your blood sugars

An insulin pump allows you to make small corrections to your blood sugars.  The ability to dose fractions of a unit of insulin without injections gives you the flexibility of great control with greater ease. It allows you to tailor your insulin needs to your lifestyle rather than the other way around.

6.  Reduced episodes of severe hypoglycemia

Insulin pumps deliver small amounts of rapid insulin on a constant basis.  There is less variance in absorption rates and ultimately a reduced incidence of extreme hypoglycemia.

7. No peaks to chase

Again, because insulin pumps only use rapid acting insulin, there are no peaks of insulin that need to chased with food. 

8.  Built in dose calculator

You don’t have to do the math.  Your insulin pump will help you to figure out how much insulin you have left in your system and how much more insulin you will need to cover a meal or bring down a high bg level.

The Cons of using an insulin pump

1.  You are attached to something 24/7

insulin pump

Whether you are tethered to an insulin pump directly or just having to have a PDM nearby, you and your pump are attached…always.  There is no taking it off or leaving it behind unless you have gone back to at least some form of injection therapy.

2.  You can’t tell if the insulin has been delivered properly or not

Infusion sets can kink inside the body.  You can’t tell until your blood sugar levels start to spike for no apparent reason. 

3.  They cost a lot of money

RDSP

Not everyone has great insurance coverage.  Not every region offers public programs that pay for insulin pumps.  If you must pay for an insulin pump and then the supplies out of your own pocket, it can be a costly venture.

4.  Changing an infusion set takes more effort than an injection

To change an infusion set, you must prep the site, fill the tubing with insulin, inject the infusion set into the body, connect it to the tubing and fill the cannula, that is now under the skin, with insulin.

5.  Increased risk of DKA

An insulin pump uses only rapid acting insulin. This means that there is no background insulin in the body if there is a pump failure.  Without the background insulin, there is a greater risk of DKA.  A person using an insulin pump should be monitoring their blood glucose levels more closely and checking for blood ketones when readings begin to climb.

6.  Increased risk of infection

Because an infusion set stays in the skin for a period of 2-4 days, there can be an increased risk of infection to the sites.  Therefore, site rotation and proper skin prep is vital when using an insulin pump.

Make an educated choice

talk to an expert

 Choosing to inject or use an insulin pump should be a choice that you make based on your needs and comfort level.  Before you decide, spend time speaking with your diabetes team and take time to educate yourself.

If you decide to use an insulin pump, again, choose the insulin pump that is right for your lifestyle. To help you decide what is right for you, download our eBook. It has a checklist of features that will help you decide what is important to you.  It also has a list of questions that you can ask your pump reps before making your choice. 

Remember that all pumps come with some sort of guarantee. Ask your pump rep what their return policy is before you purchase.  Your insulin pump is a 4-5-year investment.  You don’t want to have buyers’ remorse.

Age should not restrict access to diabetes supplies and devices

age should not restrict access to insulin pumps. Diabetes Advocacy

Since the day that I realized that there were more options available to my son than the multiple daily injection insulin regimen we were currently on, I was adamant that all people with diabetes should have a choice in their treatment options regardless of the size of their wallets. I further believed that age should not restrict access to diabetes supplies.

People living with diabetes should be able to decide if they want to use Lantus over NPH. They should be able to choose Apirdra over regular insulin.  They should be able to see if a Continuous Glucose Monitor or an insulin pump is for them without having to sell their home.

No one chooses to have type 1 diabetes. They should be able to choose how they manage it regardless of income.

In Canada, citizens are still not always able to access the best treatment options.  They may not have private health insurance or their insurance may not cover the devices that they desire to use.  The result is that they go without or go to extreme measures to get the medical tools that they need to keep them healthy. For me, that is not acceptable.

boy with type 1 diabetes in boots

My son began using an insulin pump when he was five-years-old.  I had wanted a pump for him since the first time I heard of the flexibility that it allowed but financially it was not an option.  His father had medical insurance but insulin pumps were not covered.

It wasn’t until my family stepped in and said that they would come together to pay for the pump that we were able to get one for him.  They wanted the very best for my son and were going to make sure that it happened.

That was back in 2002. Things have changed since then. All provinces in Canada have begun to cover insulin pumps–for children.  For those over 18, assistance is not always available, however.

Compare provincial coverage options by clicking the link below.

In some provinces, adults with type 1 diabetes still have to find good insurance, high paying jobs, or go back to injections out of necessity. Other people may seriously consider moving to a province that offers better coverage just to be able to afford to optimally manage their diabetes care.

Today my son is 16.  He is heading into his final year of high school and looking at career options. The most important part of his career choice is to find one that is either very high paying or offers great benefits. What he enjoys seems to be second on our list. That is discouraging and gets my dander up.

If a person wishes to use an insulin pump to best control their diabetes care, then they should have that option.  Financial status, occupation, or age should not restrict access to diabetes supplies. 

It is sad that think that pensioners are having to go back to injections because their private health care coverage ends at retirement.  Young adults who are beginning careers and new families are having to rethink how they will move forward because of cost constraints brought on by managing their diabetes care.

This is not right.  Age should not restrict access to diabetes supplies like insulin pumps.  These devices provide just as many benefits to adults as it does to children.  Adults with type 1 diabetes who are using insulin pumps often find shift work much more manageable.  They tend to see less diabetes-related downtime because they can micro-manage their disease with greater ease. 

access to diabetes supplies. Diabetes Advocacy

The addition of Continuous Glucose Monitoring systems to their care can help them to anticipate dangerous highs or lows that could have otherwise sent them home for the day.  Increased productivity and work time for people with diabetes has a larger impact on society as well. People living with diabetes who are able to work are able to contribute to the provincial tax coffers through their employable earnings.  They are less likely to have complications or dangerous blood glucose swings that could send them to the hospital.  Our young people with diabetes are able to look at jobs in the province rather than having to move to areas with better pay and better benefits.

The rewards definitely outweigh the costs no matter where you live. It is important that governments and individuals come to realize that neither wallet-size nor age should not restrict access to diabetes supplies.

Download our chart comparing diabetes supplies coverage in Canada.

3 Tips for a Parent of Newly Diagnosed Child with Type 1 Diabetes

I was recently asked what advice I would give a parent of a newly diagnosed child with Type 1 Diabetes. It has been a number of years since I fell into that category but I can sadly remember it all like it was yesterday.  That being said, it was an easy question to answer and comes in the form of three pieces of advice.

Live your life four hours at a time

manage your new life with diabetes by taking it four hours at a time Diabetes Advocacy

First and foremost, live your life four hours at a time.  Do not worry about six hours from now. Do not worry about tomorrow.  Live life in four-hour time slots–nothing more.

Chances are high that your child is using a rapid-acting insulin. This type of insulin basically lasts for only four hours.  

Look at the readings inside the four-hour window.  Make note of the food that was eaten and the activities in that four-hour period.  

If you see a reading that is in range for that four hour period give yourself a high-five! You did fabulously!

If you see something out of range during that four hours then begin to problem solve.  What can you learn? Did you learn that your child is producing a small amount of insulin now and doesn’t need as much insulin for that food at the moment? Did you learn that not all slices of bread are the same number of carbohydrates and perhaps you made a carb counting error? Could it be that hockey practice before supper changes the amount of food and insulin your child needs?

Make note of your answers for the next time and move onto the next four hours. Four-hour chunks are simple. They are manageable. And for an overloaded parental mind, really it is more than enough to handle.

When you are a parent of a newly diagnosed child with diabetes, find a support system

parent of a newly diagnosed child with type 1 diabetes should find support Diabetes Advocacy

My second piece of advice is to find a support system and use it! Let parents, partners, friends, and people from support groups (online and in real life) help.

Share with them, unload on them, and again…use them.  Some people will “get it” more than others and that is okay but find a way to lean on even those who may not get it but are willing to learn, listen or take over for even an hour.  You deserve the break.  You cannot be the very best external pancreas that you can be without a break and finding an outlet.  It is okay to ask for help or even see a counselor. Many families with diabetes have to turn to someone along the way.  

It is okay to cry

crying is okay for parent of a newly diagnosed child with type 1 diabetes

Finally, cry in the shower.  Go ahead! Stand in that shower and let it all out. Let go of the big girl/boy pants, crumble and let that strong shell crack for just a little while.  

Allow yourself to feel the pain and frustration that comes from a diagnosis of diabetes for your child. It is okay to feel the anger and hurt.  Allow yourself to grieve while the water washes away a bit of the pain so that you can be strong again once you step back into the real world.

You’ve got this

You can do this.  There will be bumps in your new life with diabetes. There will be victories.  The landscape of your life, and that of your child, has changed forever.  This doesn’t mean that your child with diabetes will never achieve their dreams or live a long and full life.  

Being a parent a child newly diagnosed with type 1 diabetes means that your perspective will shift a little (or maybe a lot). You will find new friendships that will bring you through the worst of times and celebrate with you in the best of times.  Life will be different but it can still be amazing…just four hours at a time.

Looking for more help in organizing your new life with diabetes? Try our Diabetes Planner with pages of information, tips and places to store important diabetes-related information.

Relationships..and more

I am still running a bit behind on my Diabetes Awareness Month Photos but here we go…

Relationships

DSC_1351

 

Truly the greatest gift that diabetes has brought us is the many amazing, enduring, and incredible relationships that it has brought into our lives.   I have been blessed to meet, talk to, and interact with people from all over the world who have become family to me in every sense of the word.

Family picture

 

 

 

 

 

 

Blue…

diabetesbluecircle

Blue to me is still new. I know, the blue circle has been around for ages, why don’t I get with the program?? I have no clue.  When my son was first diagnosed, advocates displayed a grey ribbon with a drop of blood. I have that logo tattooed on my body and its the image that I have in my mind when it comes to awareness. I like the concept of a blue circle.  I like the unity that it represents.  I appreciate the hope that it brings. One day I hope that it will instantly evoke the same images and feelings that the pink and yellow ribbons currently do.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Still Finding Feathers

My nest has been empty for over a month now and it still taking a bit to get used to.

My son has been quite good at making sure he uploads his pump for me to look at his readings. He appears to be testing more than once a day so I try to offer little criticism and simply make gentle suggestions where needed.

Moving diabetes to the back of my mind after all of these years is a challenge.  I still wake up a lot during the night. I still worry but that is what Moms do. I worry about both of my children. Diabetes just gives me one more thing to be concerned about.

I really don’t miss diabetes. I don’t miss having to get up in the middle of the night. I don’t miss wondering why he had a higher or lower reading than expected. I don’t miss time spent at diabetes clinics.  I don’t miss trying to figure out a new insulin pump.

I do however miss my son. Don’t get me wrong, I miss both of my boys but I have had a bit longer to get used to my oldest being away.  My youngest and I have spent a lot of time together over his lifetime.  His best friend is my best friend’s son.  We visited together. We went on trips together, we counted carbs together.  He is now enjoying life on his own–doing stuff without Mom always there. I am sure he is loving the freedom! It’s different for me.

I still miss walking into the kitchen and seeing him sat at the table surrounded by a fridge full of food.  I miss seeing his chin up bar dangling from a door way. I miss his dry, quick whit and timing. I miss the chicken fights that we would break into as we met in the hall. 

We text every day.  We talk at least once a week. I make sure that diabetes is the last thing that we discuss. It is rarely ever the very first. I ask about his day, his school work, his friends…then I ask about readings, meters and his pump. When he tells me “I screwed up.”  I try to remind him that his job as a pancreas is both unnatural and exceptionally difficult.  As long as he knows what he did wrong and he tries to fix it next time, its something to simply learn from and move forward.

I still find test strips in the most unusual of places.  There was one in my washer even though I have not done any of his laundry in ages.  We have a fridge full of insulin “just in case”.  There is a bottle of test strips that I found hidden in a box and part of an insulin cartridge that still sits in a place of honor in my car.

My new life of a Mom of children who no longer live at home is still very busy. My boys are always in my thoughts and their ability to stand on their own shows that I have taught them independence.  They will be home at Christmas.  I will savor every moment. I will fall back into the testing routine.

Life is changing.  Change is part of life but finding those little feathers (also known as diabetes waste) in hidden places of the house no longer make me grumble at their ability to “jump” out of the trash.  They now make me smile because they remind me of my son.

empty nest Dstyle

Go Ahead and Complain

The other week I noticed nothing but customer service complaints filling my Facebook news feed. I was shocked and wondered if there was something in the wind.  It didn’t matter if someone was in a restaurant or dealing with their cell phone, they were having issues with horrific customer service. Sadly, this made me feel better when I began to have my own issues.

My son’s glucometer was having issues. It was eating batteries with astonishing speed. It had reached a point where he was no longer using it much to my dismay.  This is the meter that “talks” to his pump and gives me a true idea of his bg levels each week when we review things.

I called the customer support number and so began my run around. It appears, in a review of my situation later, that every crack that I could fall through I did! It was terribly frustrating but it also reminded me of a few things.

First is how important our pharmaceutical reps can be when we have problems.  After asking around and finding out that the service I was receiving was extremely unusual, I contacted my rep to see if she could be of any assistance.  She was horrified!  She apologized and was instantly looking for any and all help that she could get for me.  She did not stop until things were resolved.  I loved this lady before she became my son’s pump rep and now I truly love how she goes above and beyond for her customers.

Secondly was how those annoying spiels about how they are recording your conversations actually have a benefit to the customer. If you know exactly when you called and you feel that you were not treated properly, management can pull up the call and see what has happened.  In my case, I was treated fine, my issue just got lost in many transitions.  I have however received horrible service from a person on the phone with a different glucometer years ago.  The woman told me that the problem with my meter’s accuracy was related to me having dirty towels that my son was drying his hands on.  To say I was insulted was an understatement.  Later follow-up resolved that issue and the woman was re-educated.

Customer service is huge for those of us who’s lives, or children’s lives, depend on medical equipment.  Personally, I have met many people in the industry from all over North America.  They all genuinely want to help.  “Stuff” does happen.  Mistakes can be made but I have also learned that these same companies want to learn from their mistakes.  Let your reps know if you have issues.  They want to fix things for you. They want you to be healthy and satisfied with their products. That’s good for everyone.

complaints

Diabetes is a Piece of Cake

Diabetes presents many challenges.  There is the obvious one of trying desperately to match food to insulin while factoring in nutritional content, exercise (both past and anticipated), emotions, health, and more.  There is also a challenge in trying to get the outside world to understand that our fears and concerns are real.

Fourteen years ago, I knew nothing about diabetes. I had no idea how serious it was.  Today, my biggest challenge is getting people to understand that this invisible disease that appears to be a piece of cake to manage only looks that way because of the hard work that is put in behind the scenes.

The average person who walked by my son on the street would never know that he has lived with diabetes for almost 14 years.  He has no complications. He doesn’t have a cane or any limbs amputated. He looks like an average 16 year old male.

They might notice his insulin pump or his remote meter when he tested. If they did they would probably be amazed by the technology and think that it made life pretty easy. If they watched him eat in a restaurant, they would seriously wonder what all of the fuss was about. With the exception of the diet drink that he would order, the rest of his meal would be more than two average people would eat at one sitting and he would somehow find room for dessert! How can life be that much of a challenge?

What they don’t see is how hard it can be to make that technology  work to its very best. They don’t see the time that my son and I spend reviewing  data, discussing what happened when he went low–had he been exercising in the past 24 hours? What was his reading in the test before? Did he count the carbs properly? Did he factor in fat and extend the insulin delivery over time or simply give it all in one shot?

They don’t see us discussing highs–was there a site failure? Did he run out of insulin? Did he make a mistake in how many carbs were in his food? Did he over-treat the low that he had earlier? Did he miss a low and his body rebound with a high? Is he growing? and the list of questions goes on and on but only we hear them.

They don’t see the effort and thought that goes into every setting on his pump.  The details that I examine before inputting the amount of insulin he gets delivered into his body just so it can function.  They know nothing of the detailed calculations involved in deciding how much insulin he should get for each crumb of bread or bite of apple that passes his lips.

An average person does not realize that keeping my son alive and as healthy as he is has taken a lot of work and involved some serious stress at times.  Diabetes does not stop at night and neither do we.  My son is tested throughout the night and if he is high or low during that time, he must be treated.  Nights become more dangerous because unlike the day when he tends to notice fluctuation in his blood glucose levels, at night he will sleep through all but the most extreme highs.  Whether we are up for 15 minutes during the night or two hours, life goes on and the world does not notice what we had to do to keep my son alive and healthy.

The biggest irony of diabetes personally is that the harder you work, the more normal you look,  the more people think that you are exaggerating just how much work it takes.  Diabetes is an invisible disease.  With the exception of a blood test, a needle or a pump, no one “sees” the challenges that diabetes presents. They don’t see the hard work behind the scenes. They tend to think that you must be over-blowing the fears and concerns that you have.  They do not understand that the reason that you or your child looks so healthy is because of hard work not because diabetes is “no big deal”.

eat the cake

How do we change this? How do we balance getting people to understand the struggles while showing them that diabetes does not stand in the way of being who you want to be? That is yet another challenge but its a challenge that many with diabetes do daily with a strength and confidence that inspires us all. 

Psychic Connection?

The other night was night two of tossing and turning which in itself is not entirely unusual. This night was different though.  I was completely tired and ready to drop.

I had read a few pages of my book, done some relaxation exercises but sleep would not come.  After awhile anxiety began to creep in. I tossed and turned some more.  My mind began to take off on its own. There was no way to reel it back in.

I thought of my oldest son living up in Alberta.  Had he been injured at work? I would have heard if he had. I tried to shut my mind down again. I tossed and turned some more.  I thought of my youngest son. Was he testing at night? Was he in trouble? Had something happened? I again worked to calm myself down. Both boys, or someone around them, would have contacted me if there was a problem.  I was being foolish.  I was overtired. I had too much on the go. I had too much time on my hands.  There were a million reasons for me to be tossing and turning. Driving myself insane was in no way helping the situation. By 2am I finally fell asleep.

When I got up the next morning, I wondered if this had just been a reaction to so many years of interrupted sleep.  Was my body going through some sort of withdrawal? It has not slept through the night for any extended period in 20 years.  There was bound to be some issues at some point. I decided that I would try herbal tea with my book the next night.  All would be fine. My kids were still alive. No friends or family had been injured during the night. Obviously my anxiety was unwarranted. It was probably just my body being strange….and then I talked to my youngest son.

After a bit of chatter, I asked him how his readings were.  “Good except for last night. I was up all night because of a bad site.  I got it fixed though and was perfect during the day.” BINGO! There was the source of my anxiety!  He was in trouble the night before.  Well not trouble, but you know what I mean.

I have spent almost 14 years somehow waking to most diabetes related events. I would wake at unexplained times when he was low or high.  Something would bring me out of a deep sleep and make me test him.  We have no CGM.  I just somehow often “knew“.  Perhaps this knowing did not know distance?  I am not sure. Some people would say that I was crazy and this was just a coincidence.  It could be. I am not sure but I do know that I slept a little easier the next night.  Any tossing and turning  I experienced that night didn’t have a higher level of anxiety attached.  As long as my son is also waking and dealing with things…well I will probably always worry and be concerned but hopefully I will find a level of calm. If I don’t, I will text! psychic 

New Challenges

Someone asked me to continue to update my experience has a mother of a teen with diabetes who is living elsewhere.  Let me say its a bigger challenge than having him live here!

There are definitely growing pains.  As a mom, I miss having my sons around me. I actually do wake up during the night and feel lost because there is no one to test or check on. I would gladly teleport myself to some of you sleep deprived parents but unfortunately the only things that I really can do is roll over and hope he is okay where he is.

My son on the other hand seems to be loving not having Mom hover over him and what teen wouldn’t? The rules are very different for him now and he is enjoying it to the extreme I am sure.  A friend reminded me recently that even when children are away from their parents and thinking about doing a certain behavior, often Mom or Dad’s voice is still nagging in the back of their head and they may be a bit more cautious because “what if Mom/Dad found out? They would kill me!” I hope this is the case with my boys…well you know that they continue to have some common sense because its not like I would really “kill” them exactly…

Obviously with a mom who likes to be hands on and get things done and a 16 year old who is loving being away from that, there are challenges. Oh are there challenges!!  Bringing my expectations down to a reasonable level is very, very difficult and in part only done with the help of great friends.

While we do text daily I make sure that diabetes is not often the topic of conversation. We talk like, school and diabetes if he has an issue that needs to be dealt with right away. We have however agreed to sit down and chat about diabetes specifically once per week. We chose Wednesday nights.

The first week this worked perfectly.  He uploaded his pump. I looked at the data, formed my questions and was able to be calm by the time we talked. All worked out really well. The next week I had to be away on the Wednesday so we chatted Tuesday. There were a few more issues. We spoke of what to do when type situations arose. It went okay.  This week, well its been three weeks. The shine was going to wear off of things right?

Yesterday I sent him a message reminding him of our “date”.  I told him to upload his pump when he got home from school so that I wouldn’t keep him up late. Last time he had had computer issues and it took forever to even look at the data. When he got home he sent me a message telling me that the remote for his pump still didn’t work. What??? Had he called the support people? Of course not.  He was waiting for Mom to do this. Mom agreed.

I told him to call me after his supper and we would call pump support. I would keep him on one phone and call the support people on the other so that I could ask him whatever they asked me.  I ate my supper and waited…and I waited…and I waited. It turned out that heading out with a friend for the night was way more important than Mom or a pump issue.  At 11:30pm I told him to take pictures of the back of the pump and the remote, send me details and I would deal with it in the morning. We would also talk pump the next afternoon BEFORE he got busy with other things.

After a bit of troubleshooting on my part, I got his remote working again.  There is definitely an issue so I am waiting for pump support to return my call.

Balancing 16 year old freedom, Mom control and Mom letting go is definitely difficult.  This may be one of the biggest challenges I have faced in a very, very long time.  Its a good thing I have a great relationship with my hairdresser. I may need a lot of hair color to get me through!

A reminder to myself. I may need to post it on a wall somewhere.
A reminder to myself. I may need to post it on a wall somewhere.

Its Little Things

I made my first trip to Costco as an empty nester the other week. It was a bizzare experience when you factor in so many years of living with diabetes and children.

There were the normal things..the boxes of cereal that I don’t need because my boys are not here to eat it.  There was the flavored water that my youngest loved to drink that I don’t have to worry about buying until he comes to visit.  There were also the meats that were packaged into portions for two adults to eat rather than two adults and a ravenous teen or two.

Next came the diabetes things…buying items and not worrying what the carb count was.  Putting items away and not worrying about saving the nutritional information to be referred to later.

I can’t say that it felt good. It felt..well a little empty.  I have been shopping and cooking for a child for the past 20 years. I still chat with them each day.  We still FaceTime or Skype and call but not physically seeing them each day?  Not feeding them each day? Well its strange. I know my wallet will appreciate it but its a lot harder for the heart to get used to.

They will visit and old habits will quickly return. I will, and do stalk up on all of their favorite baked and bought goods for their arrival.  This is just another phase of life. It just takes a bit to get used to as well.

I still wake at night. I almost long to get up and test…almost.  Life changes. Children grow. Normally we have time to prepare.  Sometimes we don’t.  Either way we go on with our new roles and make the very best of them. I continue to be there for both of my children. I continue to teach my youngest son as much as I can about diabetes and provide him with as many supports as I can. Its strange how the little things impact you.data