My impression has always been that OpenAPS started with mostly adult t1d users. (And mostly adult t1d users who have some sort of coding experience, too.) However, as word has spread, the system is seeing more and more parents using OpenAPS with their t1d kids. So…there didn’t seem to be a whole lot of discussions I could find about remotely operating the OpenAPS system as a parent. What tools could prove useful? How would I set them up?
I’m super happy to say that several people have stepped up and helped me understand some of those tools, and write-ups have been added to the OpenAPS docs so that these are more readily available to parents. I guess the purpose of this post is that having the tools available is one thing…but concrete examples of how to use the tools is sometimes super helpful.
The first line of remote monitoring of OpenAPS is through a Nightscout site. In fact, I cannot imagine Loop without a Nightscout site, either (although technically you don’t HAVE to have one for Loop). Nightscout sites allow you to see so much of what your rig is doing.
The little blue lines are wonderful easy visuals for what is going on for your temp basals. Like the example above shows, you can see temp basal “buildings” growing above whatever the normally scheduled basal rate for that time of day is (indicated by a dashed blue line on the blue basal area). Visually, I can see in an instant that her OpenAPS loop is giving her a high temp basal rate in response to her rising blood sugar.
The next really helpful tool is simply clicking on, or hovering over, the OpenAPS pill. The pill contains information not just about what is being done, but even some insight about WHY those decisions are being made. For example, in this screenshot, the OpenAPS pill shows that based on her rate of BG increase, the loop would like to provide a temp basal rate of 4.75 units/hour to help control the rise back to target. You can see that it is predicting a BG of 150 mg/dl and that my target is 90 mg/dl. And, even more, you can see that it is respecting my max temp basal setting of 2.4 units/hour. You can also see, if you have autotune and/or autosens enabled, what ISF is being used in the calculations.
If the pump is suspended, you will also see a grey dot on the BG line with a hover over message that the pump was suspended. The OpenAPS pill will display an “x” for the pill’s status and text to let you know it is not enacting temp basals while it is suspended. SO helpful for teenagers who finish their morning showers and forget to resume or reattach their sites.
If you have multiple rigs, as I do, you can see the status of the various rigs in the OpenAPS pill too. I have an “edison3” that stays at home in her room, so it is “waiting” for her to come home. The “edison1” rig is at school with her.
Also nice to see information about the pump’s reservoir and battery. I have alerts set through Nightscout to let me know when her pump battery gets close to low, as well as the reservoir.
The battery icon (75% in this picture) is the rig’s battery level, so I can also keep an eye about when/if the rig needs charging.
Temp BG Targets
Setting temp BG targets to help adjust to changing situations like exercise or upcoming meal times is super easy using the care portal in Nightscout. The site also will provide a grey line showing the range and duration of the temp BG target. You can cancel the temp target and the line will end at the time the temp target was cancelled. It leaves the grey bar on the graph so that you can scroll back in time to see if your actions might need modifying later. For example, we are currently using temp targets to get our daughter to her after school track team workouts without carrying extra IOB. We set a temp target at lunch time, 3 hours ahead of the start of her workout for 120-140 mg/dl. As her lunch bolus wears off, the temp target helps keep loop from giving too much extra insulin between lunch and track workout. We keep the temp target going all the way through her 2.5 hours of track workout.
So while all the Nightscout stuff is fantastic, it does not really help you figure out WHY your rig might not be looping while your kid is away at school or a friend’s house. Most of the time, the troubleshooting for OpenAPS rig is as simple as a power button restart. But, if you are setting up a new rig, or getting connected on new networks…or wondering about anything in your loop’s functions…Papertrail provides an INVALUABLE insight to the rig without needing to be near the rig. Directions on setting up Papertrail for OpenAPS are here.
As you can see, both my rigs (edison1 and edison3 are uploading to Papertrail). The blue words indicate where the information is coming from (in other words, what action in the rig is logging the activity). Pump loops, nightscout loops, CRON loops, etc. are all in there.
Super helpful is to set-up filters for activities that you may be interested in seeing more often. Such as pump tuning. If you come from Loop, and are familiar with the “tuning” as part of trouble shooting…sometimes you may not have been entirely sure whether the retuning was really affecting things or if it was the cause of the original problem anyways. Well, OpenAPS has a similar tuning called mmtune. If the loop detects that the pump is not establishing communications well, it will retune it’s radio automatically after failed tries and periodically during the day. The working frequency is 916. A failed tune will look like “916, 0, -99”. The “-99” means a very weak signal. Typically, if you are getting tuning results in the “-90s”, you are unlikely to keep a good loop going. In the “-80s”, you may have sporadic problems. Anything in the “-70s” or better, you should have pretty stable pump-to-rig communications.
Below is a filter for “edison1 916” which effectively shows her rig’s tuning results for the last several days.
Some interesting things that you can learn about your kid’s habits and the rig’s behaviors by watching your papertrail. My kid took a shower at about 6:55am today…she leaves her pump in the bathroom, fairly removed from her rig in the bedroom. You can see the distance has caused pump comms to deteriorate to a “916, 1, -98” tune result. When she finally gets dressed and puts her stuff all back together, around 7:25am, the pump tune picks up a nice “916, 5, -79″…and that was with the rig stuff in her purse, stuffed in her backpack. Pretty good. She arrives at school and the next pump comms failure is at about 11:39am with “916, 0, -99” just as she is finishing a PE change before lunch. The loop picks back up and retunes by 11:43pm with “916, 5, -75”.
Why is all this info so important? It means that I am not interrupting my kid at school nearly as much when the loop temporarily might stop. I can see if it is likely a temporary stop based on her school patterns (PE changes for example where she may leave rig or pump somewhere separated for awhile). I can also provide better troubleshooting advice. If I see that the pump comms are poor…I would text “hey, can you move rig to better place?” vs. asking her to totally reboot the rig (which might not solve the problem if the rig is far away anyways). I also know that a poor pump comms on the system are really handled quite well because I’ve been able to see how often the rig already does it’s own retuning efforts. I am VERY supportive of keeping texts to my teen in school as short and sweet as possible.
Another extremely helpful Papertrail use is to watch how the rig is utilizing or moving between BT and wifi networks. The screenshot below is a filter for “edison1 network.log -CRON” so that I can see just the internet connections the rig has used.For Anna’s morning, you can’t see it, but she got in the car at 7:35am to go to school and left our home wifi. Her rig got onto her cell phone via BT connection by 7:43am. She arrived at school and the rig got on the school’s wifi network at 7:54am. How can you see all this…well the wifi networks have their name listed (like “Paso Schools”). The cell phone BT connections for iPhones have local IP addresses that always start with 172.20.10.xx. Papertrail has been so useful for figuring out if the rig is actually online while she is remotely moving around. Especially useful for little kids who might not be the most helpful troubleshooters when you are trying to decide what network the rig is on. So, if I see her loop is failing (yet has good pump communications), the next thing I do is usually to see if there might be a problem with wifi connections.
Papertrail is also super useful if you ever need to get on Facebook or Gitter to get troubleshooting help. Being able to see these logs is key to know where to start in looking for a problem.
Sadly, there is no iPhone app for Papertrail, but you can easily setup a bookmark of each of the filters you use frequently and add the to your home screen. I have one for pump loops filter and one for edison1 network logs, as I have described above.
So, there’s some tips about WHY you should take the effort to setup good remote logging/viewing of your rig. Nightscout and Papertrail make things pretty easy as a parent using OpenAPS.