The power of community

Manny Hernandez is Tidepool's new VP of People and Culture. He joins us after a storied history at Livongo, and Diabetes Hands Foundation.

I’ve been wearing an insulin pump for 14 years of my 18 years with diabetes. I change my infusion set (where the insulin enters the body via a plastic cannula) every three days, so that means... (14 x 365 days) divided into three days per site: I have done what I did the Friday of my first week at Tidepool approximately 1,700 times.

The steps are, as my wife would say, as second nature to me as brushing my teeth:

1. Get all my pump supplies ready.
2. Fill a new reservoir with insulin.
3. Prime the pump: That is, fill the tube with insulin until I see drops of insulin on the end.
4. Insert the site into my skin, then remove the inserter.
5. Fill the plastic cannula.
6. Resume insulin delivery.

On that Friday, I got distracted while following these steps again. I did #1, and #2, then #4, then #3… and as a result, instead of the usual 18 or so units of insulin needed to prime the pump, I primed 30 units. If you are on an insulin pump, you may already know where this is heading.

What happened next?

Since I swapped steps three and four, priming while I had the infusion set ON me meant that I accidentally gave myself 12 units. For context, for a carb heavy meal, I might bolus 10 units.

What was truly special was what happened next. I had not been a part of Tidepool for even a week. As a 100% remote organization, we use Slack to communicate throughout the day, and one of our Slack channels is aptly titled #diabetes-sucks. So I posted what had just occurred to me on it:

Within minutes, there was a FLOOD of replies (you can see the total number reached 79, as of the time of this writing). The outpouring of support was unbelievable:

• Everyone showed concern for my well-being, whether they or a loved one had diabetes or not. I felt incredibly supported.
• There were people who reassured me that they too had something similar happen to them, sharing what they did at the time.
• And there were those who asked questions in a calmed manner to help me troubleshoot. For example, given my Carb Ratio of 1:9, we concluded that about 50 grams of carbs were in order (half a package of Trader Joe’s Mac & Cheese would do the trick), to help smooth the way “down”, after chugging 15–20 grams of juice.

It “helped” that I had started the day with a high blood glucose, but from a diabetes standpoint, I ended up mostly flat effectively going back and staying in range within a few hours.

The power of community

The obvious lesson learned: No matter how much experience we might have changing infusion sites for an insulin pump, this is an activity that needs our undivided attention. We need to be PRESENT for it.

The potential for a bad hypoglycemic event was there, but things turned out well. And it was largely thanks to the power of community, which came to life through my interactions with my Tidepool team. The combination of emotional support and contextual knowledge was priceless in this situation. The determination I saw in that Slack thread: Having people who I had just met a few days before checking in on me hours later, to make sure I was doing OK; hearing from Tidepoolers who had “been there, done that”; or simply feeling accompanied in the middle of an initially scary episode… all of it was a great example of how having Pancreas in the Game comes to life at Tidepool. And for this, I am incredibly thankful to be a part of the team!

The journey ahead

As Tidepool’s new VP of People and Culture, I am looking forward to harnessing the power of community that I experienced as a foundation to grow Tidepool and its culture.

I joined Tidepool because I believe in the people here just as much as I believe in the mission. Tidepoolers came to my rescue, helping me navigate a tricky situation: THEY are what make Tidepool special. And they are what will make our goal of delivering Tidepool Loop a reality.