[Diabetes-talk] questions from a fairly new list subscriber
Mike Freeman
k7uij at panix.com
Sat Mar 14 22:57:10 UTC 2009
Dave:
Insofar as I am aware, medical devices do not come under the rhubric of
Section 508 of the Rehab Act as Amended which mandates that the Federal
Government purchase accessible computers and software and make its web
sites accessible. Heck; even Section 508 isn't all that effective. But
it doesn't apply to medical devices. Nor does the Americans with
Disabiliteis Act because (a) the Federal government isn't covered by it
and (b) medical devices aren't a public accommodation as defined in
Title III or a telecommunications device for the deaf as defined in
Title V. Section 504 wouldn't apply, either.
I hate to voice this opinion but I suspect that any statute mandating
accessible medical devices would be *very* hard to pass although it
would be fun to see if such language could be put in any proposal for a
Technology Rights for the Blind Act as we presented it at this last
Washington Seminar. I'd bet such language would be a deal-breaker,
however.
Mike Freeman
----- Original Message -----
From: "David Anspach" <danspach at tampabay.rr.com>
To: "'Diabetes Talk for the Blind'" <diabetes-talk at nfbnet.org>
Sent: Saturday, March 14, 2009 12:12 PM
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber
Hello Chanelle and everyone,
Unfortunately, I found that you cannot even get the Paradigm Pal
software
installed without sighted assistance. To me, this is totally
unacceptable
and I will be talking to the contacts I once had with the software
development team. If memory serves me correctly, the software is
developed
using JAVA. Java alone can be made to be accessible provided the
developers
know this and include it in the Java objects they use within the
application. However, this is a big "if" as most developers still don't
understand the term "accessible" or how it applies to software as it is
developed. Hopefully, the contact info I have is still good and the 2
developers I have contacted in the past are still with Minimed. If this
software can be made accessible, then it would allow blind pumpers using
Paradigm pumps all kinds of access to the settings of their pumps. We
would
no longer have to worry about having an accessible pump because the
software
would allow us to control the pump, including setting those all
important
basal rates.
On a somewhat different note, someone at work asked me how the folks at
Minimed get away with making an inaccessible pump when they sell to the
government through the veterans administration. I told him I didn't know
and
would check into it. Does anyone know, or have a way to confirm, that
the VA
does actually purchase Minimed or any other brand of insulin pump for
those
veterans who become insulin dependent diabetics? If this is the case and
pumps are purchased, does this fall into one of those situations where
the
device being sold to the government must be accessible? This might give
us a
little more oomph if we were to find out this is indeed the case as we
might
be able to get the government involved somehow. But then again, it cold
wreck everything too <lol>.
-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Chanelle Hill
Sent: Thursday, March 05, 2009 11:02 AM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber
Hello Dave,
Thank you for explaining your process for using the bolis wizzard. I see
my
diabetes educator in a few weeks so I will talk to her about it.
For the past several years, I have been meaning to use the Paradigm Pal
Software. Now that I finally got the right cable a few weeks ago, I
should
try it. Unfortunately, the people atMinimed didn't know what I meant at
first. They sent me the meter to work with the Personal Care or whatever
it
is called where people upload their pump readings online.
I have memorized the button pushing sequence for setting a temporary
basal
rate, so if anyone needs the steps, please let me know. Of course, go
through the process with someone sighted first (smile).
I would definitely be interested in having the Paradigm Pal software
made
more accessible with Jaws. I have always wanted to learn Jaws scripting.
Maybe someday when I get around to it, I can help with the Paradigm Pal
Software (smile).
Speaking of carbs, what ways have you or anyone on this list found to be
effective for reading nutrition labels or getting access to that
information. I have sighted friends read labels for me, but it is easy
to
forget in keeping track of so many things. Since I am getting set up
with
Services for the Blind, I am hoping to get a portable scanner or
something
similar that would read barcodes. Does the K NFB reader do this? I also
know
that there are websites that give nutritional information for certain
foods,
but I have forgotten what those are.
I have been using my pump for five years, but I am feeling more hopeful
about using it more effectively since I have gotten responses to my
questions on this list.
Chanelle
-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of David Anspach
Sent: Wednesday, March 04, 2009 9:36 PM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber
Hello Chanelle,
I have successfully used the bolus wizard on the Paradigm series of
insulin
pumps. It was much easier than I expected and requires just a few things
be
set up in the pump itself first. Afterwards, it is just a matter of
pressing
the button furthest to the left followed by pressing the far right
button,
or activate, button. I haven't used this feature of my pump in quite a
while, but am planning on getting back into the habit once an insulin
pump
trainer comes out to my home and helps me adjust my basal rates. From
what I
remember, these are the steps:
1. Press the button furthest to the left. I think this tells the pump
you
are ready to begin entering information into the bolus wizard.
2. Using the arrow keys, you enter the value of your blood sugar reading
that is over your target value. For example, my target value is 100. If
I
check my blood sugar and I get a reading of 130, then I would press the
up
arrow key 30 times.
3. You then press the far right, activate, button on your pump.
4. Using the arrow keys again, you enter the value of your carbs you are
about to eat. So for example, if you are going to eat 30 grams in carbs,
you
would enter this value using the arrow keys. In my case, I chose to set
the
up arrow to enter 1 gram per arrow press as it was easier and provided
much
more control than setting it to 5 grams per press. So, I would press the
up
arrow 30 times to enter the carb value.
5. Finally, you press the activate button, I think, twice to tell the
pump
you are finished. The first press causes the pump to display the number
of
units of insulin the pump has calculated you will need based on your
blood
sugar reading and the carbs you will be eating. The second press causes
the
bolus wizard to begin administering the insulin.
As I stated above, I'm not 100% sure my steps are accurate, but, I think
they are close. So, don't try this at home <smile>. In any event, you
will
need to have someone sighted give you a hand in the initial set up of
the
bolus wizard. You will need to set your target blood sugar value, the
number
of carbs each press of the up arrow key represents and I think that's
it.
The nice thing about using the bolus wizard is that it shows your health
care provider what your blood sugars have been running and your average
carb
intake.
Someone also mentioned the software that you can purchase that allows
you to
adjust various settings on your pump, including basal rates. I believe
this
software is called something like Paradigm Pal, but I'm not totally
sure.
When I first got my pump back in 2004, I took a look at this software.
Unfortunately, it was written totally in Java and was basically
inaccessible
using a screen reader, such as JAWS. I tried working with their software
developers to get it to be more accessible, but, my efforts didn't pan
out
as I had a lot of trouble getting the Java run-time environment and
access
bridge set up correctly on my PC. Once I did, I lost their contact info
and
sort of gave up. I have a newer copy of this software around somewhere
that
I received after getting my new 722 last spring. I have been looking for
it
as I want to see if it is any better now than it was nearly 5 years ago.
Since I also work for Freedom Scientific, I may end up taking it into
our
development team and asking them to see what might be done on the JAWS
side
of things to help access the software. I think that in order to
actually
get changes made to JAWS, I will have to show project management that
there
is enough need for changes in JAWS. If you or anyone else, for that
matter
is interested, then please let me know. The more interest in the use of
this
software by blind diabetics who use Minimed pumps, then the better the
chances we will have in getting changes made. I also have a contact at
Minimed that I am going to try and use to see if I can get back in touch
with their software development team. I truly think that if we cannot
get an
accessible pump, then having software that is accessible that allows us
to
manage our pumps will be just about as good.
Sorry for the long post, but, I am very passionate about making life for
blind pumpers that much easier.
Have a great Thursday,
Dave
-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Chanelle Hill
Sent: Wednesday, March 04, 2009 12:04 PM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber
Dear Mike,
Thanks for replying to my message. I will check out the Braille Monitor.
I
subscribed to Voice of the Diabetic about a month ago and haven't
received
an issue yet. I opted to receive the publication via email.
The CD I received from Blind Inc., seems to be a few years old since
some of
the articles date back to 2004, 2001, and those reprinted from the 90's.
I would like to get connected with diabetes educators who have had
experience working with the blind.
That would be great if Prodigy made a talking pump!
Minimed pumps have software that allows one to make changes to basal
rates,
the increment for easy bolis, time and date, and other items that are
set
through the pump menus. It would be nice if one could also use the
software
to program a bolis that would be delivered as soon as the pump was
disconnected from the computer. For example, I think that the pump has
bolis
wizzard--a feature to calculate insulin needed for carbs eaten and high
blood sugars. These calculations can easily be made manually, but I
think
the pump also keeps track of active insulin.
I will figure out who I could speak to at Minimed about this or pump
accessibility. I appreciate your efforts to advocate accessibility with
the
insulin pump companies.
Chanelle
-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Mike Freeman
Sent: Tuesday, March 03, 2009 9:58 PM
To: Diabetes Talk for the Blind
Subject: Re: [Diabetes-talk] questions from a fairly new list subscriber
Chanelle:
With respect to BLIND, Inc., it's a great rehab center. I know some of
the
personnel who teach there and they're great folks and know what they're
about. If you go to http://www.nfb.org, thence to the "Publications"
link
and thence to "The Braille Monitor", you can read a review and
description
of the BLIND, Inc. program in a recent issue.
Just do a search for "Blind, INC." and you'll find it or just peruse the
tables of contents for the past few issues.
BLIND, Inc. had someone who specialized in diabetes management but don't
think there's one there now. However, there are a number of persons
there
who have diabetes and who can probably put you in touch with
blindness-savvy
CDEs. Additionally, there's a lot of practical expertise on this list.
Insofar as pump accessibility is concerned, I and several others from
the
Diabetes Action Network are working on the problem. However, the
situation
isn't much different than that which you described from an article
several
years ago. Although at first blush it would seem that it would be easy
to
make an insulin pump talk, it isn't quite as simple as one might
suppose.
One has to determine what must be spoken when and in what form (for
example,
if one is using a pump with a CGMS system, often the information is
graphically displayed, not numerically displayed and one must figure out
how
to convey this verbally). WE have had some communication with one pump
manufacturer which has showed a bit of interest. However, if truth be
told,
despite what we might think, the blind (and yes, I mean the visually
impaired also) are a pretty small segment of the market so pump
manufacturers have to be shown a good reason for making the investment
in
access technology. AS I say, we're working on it. I doubt anything is in
the
immediate offing.
AS to the Clevercheck, I've not seen one but suspect that it is like the
Prodigy Autocode or the Advocate in that it would speak a bg reading --
once
-- but that all other functions would be inaccessible. But I emphasize
that
I'm going on a hunch, not on knowledge.
We'll keep working on the pump problem, though!
Mike Freeman, President
Diabetes Action Network
National Federation of the Blind
----- Original Message -----
From: "Chanelle Hill" <chanellemh at gmail.com>
To: <diabetes-talk at nfbnet.org>
Sent: Tuesday, March 03, 2009 1:27 PM
Subject: [Diabetes-talk] questions from a fairly new list subscriber
Dear List Members,
I read an article about insulin pumps that someone from NFB wrote
several
years ago, and so I thought I would join this list to see if anyone has
had
improved accessibility with the pump and for other diabetes issues. I am
a
Type I diabetic, and I have been using the Minimed Paradigm 512 insulin
pump
and the Prodigy Voice meter. I know that NFB is heavily involved in
advocacy, but what has been done to inform insulin pump companies of the
need for more accessible pumps? Is there any way to become involved in
advocating for better accessibility? It would be wonderful to use the
new
Minimed Continuous Glucose Monitoring system, but the meter needed to
calibrate the pump doesn't talk. It seems like that could easily be
fixed
since there are already talking glucometers. I spoke with a rep from
Minimed
about upgrading my pump and asked if Minimed was working on a pump that
would be more accessible. She thought that the company was, but no one
has
gotten back to me.
It sounds like someone is having problems with the Prodigy Voice meter
on
this list? After calling and waiting a few weeks to get some more
strips, I
found out that Homecare Solutions is no longer carrying the strips for
Prodigy Voice and that they are carrying a new meter that is supposedly
like
the Prodigy called the Clever Check. Have any of you heard of this new
meter? Hopefully it has all of the audible features and more accessible
software (that's almost too much to ask :-) ).
Finally my last question. I am checking out state rehabilitation centers
in
Minnesota-one of which is Blind Inc. On the CD that SSB sent me
containing a
BLIND cyber brochure, a class for diabetes management was mentioned. Do
you
know if that is still taught? Apart from that, have any of you had
experience with the training programs at Blind Inc.?
Thanks in advance for answering my questions.
Chanelle
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