Arm Site Review

I’ve been wanting to try using the backs of my arms for a CGM site for quite some time now.  My High Risk OB told me that once I get pregnant (I’m not yet!) I shouldn’t wear my sensor on my thighs for some reason or other.  I forget what the reason was as it was an information-overload type of appointment, but anyway, I remembered she said that!  So when I got a mild rash from my last site, I decided it’d be time to give my thighs a break and try the back of my arms.  Sadly, I don’t have Cameron Diaz guns, so there is a lot of fleshy area to choose from.

I wanted to have my husband insert it (hehe, see what I did there?) but he seemed a little apprehensive, so I took matters into my own hands.  (You could go so dirty with that last sentence, but I’m going to assume that the kind readers of my blog will be keeping their minds out of the gutter.)  So, using a mirror, I put a sensor in the back of my left arm.  It wasn’t easy, but it was do-able.  I’ve been wearing this sensor for almost 2 weeks and had my husband reinforce it with some OpSite FlexiFix for me a few days in.  So far, it’s been sticking like a champ.  Probably better than it sticks to my thighs.

A few things I don’t like about the arm site – I seem to meet so many more door frames.  I swear, I’m constantly bumping it. Visibly, it is definitely more noticeable than thigh sites.  Also, I’ve noticed that overnight it doesn’t seem as accurate.  Maybe because I am a side sleeper and my sensor doesn’t have clear access to my receiver?  Regardless, I’ve woken up a few times with it pretty far off.  This morning I tested at 168 and my Dexcom said 102.  On Thanksgiving morning, it said I was 144 and I was 222.  I haven’t yanked it due to this inaccuracy just yet, as it only seems to happen over night.

Also, it’s really nice to not have to remember to be careful of my sensor every time I go to the bathroom.  I think the arm is definitely the way to go as far as out-of-way-ness, (as long as I miss those door frames!), but accuracy-wise, my thighs seem to work a little bit better.  But, it is great to know that my arms may be a good Dexcom spot for a future pregnancy!

 

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Blue and organization!

Slacking on my Diabetes Month Photo-a-Day posts!

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I may not always wear blue on Fridays (I really try though!) but I always make sure I sport my “Cure Type 1 Diabetes” bracelet! Thanks JDRF!

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My pump supplies cubbie. Don’t worry, I just placed an order today!

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My test strips/extra Rxs/Random D stuff drawer. Anyone want to have a BG testing party?

Sadly, I don’t have a fun spot for my Dexcom supplies.  They just stay in their box in the bottom of my closet.  I feel I need a cute (blue) basket for them!

“That is so cool.”

In a meeting the other day, a coworker noticed my CGM receiver (which I still rock in the Dexcom provided 1990s business-person themed leather snappy case thing).

“What is that?  A MP3 player?”

“Oh, it’s my continuous glucose monitor.  It tells me what my blood sugar is.  See?  Right now I’m 98 and steady.”  (I wanted him to high-five me for my awesome reading, but alas, he did not.)

“But….how?”

“See this lump on my leg?  It’s a sensor that’s reading my blood sugar level.”

“So, does it alert you if you go out of range?  Is that what those lines are?”

(Dude. He must be brilliant.)

“Yup!  It beeps and vibrates and acts like a jerk if I go too high or too low.”

“That.is.so.cool.”

And to think, a couple of months ago I was all sorts of nervous about starting a new job and explaining diabetes and stuff.  Now I’m clearly the coolest kid on the block!

 

Five for Josh

Last Sunday I participated in the Durham Bull City Race Fest in honor of my nephew, Josh, who passed away in June.  My sister, Josh’s Mommy, organized a team of over 80 people to participate in this event – from the one mile fun run to the half marathon!  She is amazing and has raised over $6000 for SIDS research!  It was a great weekend, full of love.

I decided to participate in the 5 mile distance.  Myself and a few others on “Team Josh” were going to walk and I admit, I trained for this event for about 10 minutes.  I think I’ve gone running (shuffling) maaaaybe 3 times since we’ve moved here a year and a half ago?  Boxing is my favorite exercise, but I’ve been a complete bum in that department as well.  Oooops.

Of course since I didn’t train, diabetes decided to be a butthead.  I woke up around 200 and had a bagel for breakfast.  I bolused about 70% of what I’d bolus normally.  I wanted to come down a smidge but I still wanted to stay around 170-200 because I knew this was going to be physically challenging and personally, I like to run a tad high when I exercise to prevent drastic drops.

Before the race started I looked at my CGM and saw the dreaded double down arrows.  20131024-073622.jpg

Oy.  I ate two glucose tabs and figured I’d hopefully level out.  I’d be very pleased if I stayed around 160 for the whole 5 miles.

Of course, diabetes rarely plays nice when you want it to.  Throughout the whole race I had at least a southeast arrow.  I was popping glucose tabs every 2 miles or so (along with texting my husband such ladylike things as “My BG is being an asshole”, I am the epitome of class, friends), took Gatorade when it was offered, set my pump to only give me 10% of my insulin, and still finished the race at 78.  I suppose this could be considered a victory because I never really dropped, was just slowly going down.  However, it caused me to panic and I couldn’t really enjoy myself and take in the race.

BUT, I did it, there wasn’t a catastrophe, and it was nice to be a part of Team Josh.  I think about him often and miss him so much.

However, the next time I decide to do 5 miles, I’ll do one of two things: I will either actually train for it so I can remember how my BG reacts and can properly prepare, or I will eat a giant cupcake right before the race.

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I made these delicious chocolate cupcakes with peanut butter icing for the Team Josh potluck. Don’t judge my awesome icing skills.

Artificial Pancreas? Say what now?!

***Note, I’m not a tech guru.  I panic when I have to update my iPhone and can’t find my apps on the correct screen.  My husband manages the DVR because I don’t understand why we can’t record 200 shows at once and having to pick only two overwhelms me.  And, as always, I’m not a doctor so this isn’t medical advice and all that stuff.***

In case you haven’t heard the news, Medtronic has developed an artificial pancreas.  AND, even better, the FDA has approved it!  HUZZAH!  So this means that I can slap on a pump and CGM sensor, leave it there, and not have to think about diabetes for a few days until it’s time to change my site?  Right?  Like, that’s it?!?!  The days of finger pricks, bolusing, temp basaling are over?  Freakin’ awesome, man.

Scrreeeeeeech.  Wait a hot second.  According to this article by The Wall Street Journal, “the U.S. Food and Drug Administration has approved a pump designed to automatically stop insulin delivery in diabetes patients when blood-sugar levels are too low, the first “artificial pancreas” to be approved in the U.S.”.  Heh?  I mean, that’s cool and all, but is that an artificial pancreas?

“Medtronic’s MiniMed 530G, which includes a sensor, sends out an alert if (blood sugar) levels are too low, and if the individual is sleeping, unconscious or unable to react, the pump will shut off for two hours.”  Oooook.  But what does it do if my blood sugar is creeping up?  Does it automatically bolus insulin or set a temp basal?  What about if I eat a bowl of pasta?  Will it sense my blood sugar rising and do what needs to be done to keep me in that 100-130 zone?

To me, this sounds like a pump with a shut-off feature.  Definitely an added security measure that I am sure many people will be happy to have for themselves, their spouses, their children.  Hell, I dropped to 40 the other night and didn’t hear my CGM beeping at me.  (Thank you to the husband for waking me up so I could treat and clip coupons!)  A shutoff feature would’ve been great in this situation!

Another thing that concerns me is that according to the interwebs and other rumor mills, the Medtronic CGM isn’t quite as accurate as the Dexcom.  I wonder how many false shutoffs occur?  And if they do and your body is getting zero insulin for two hours while you’re blissfully unaware in dreamland…well, that’s not really a good thing.

Also, I don’t know about anyone else, but when I have those pesky middle-of-the-night lows, I’m not quite fully awake.  I stumble to the kitchen, pretend I’m only consuming 15g carbs, wait (half-asleep) for 15 minutes, test again, and stumble back to bed.  I can guarantee that I’d forget to turn my pump back on and would not be getting insulin to cover all those carbs (Because we all know, it’s more than 15g) I just consumed.  Of course from the sound of it, this device is geared more towards when the wearer is incapable of treating their low, but still.  I’m forgetful.

So while I think that this new device is a step in the right direction towards the artificial pancreas, I think it’s more of a baby step than the giant leap it’s being made out to be.  Artificial, to me, means I don’t have to think about it.  I want a device that I just wear on my hip and it does all the work for me – it knows when I’m exercising and to give me less insulin, when I’m stressed to give me more insulin, or when I’m indulging in a plate of nachos and may need an extended bolus.  Sure, I’ll change out my insulin/glucagon and change the site every few days, check my sugar for calibration purposes, but, other than that, I want something that is mindless.  To me, artificial pancreas does not = pump with a shutoff feature.

The beauty of choice.

I recently read a post on the diabetes sub-Reddit from someone claiming that their doctor said MDI was the best way to manage diabetes.  This lead to a fury of posts from people claiming “No, no, no, the pump is the best” or “I agree with you!  MDI is the way to go!”.  This got me thinking…

There is no BEST course of action for managing diabetes.  What may work for me (currently cyborging with a pump and CGM) may not work for you.  Heck, what works for me right now hasn’t worked for me in the past (remember that time I took almost a year-long pump vacation?  Yeah.) and may not work for me in the future (sometimes been a cyborg gets old).

The great thing is that we have options.  We, as PWD, have the beauty of choice (of course within the realm of our finances, insurance plans, etc.).  I may be going to a wedding or on a vacation and a pump may not work with my vacation plans or my outfit (cue my inner Cher from Clueless “Ummm, a pump doesn’t really go with this outfit, Daddy”). So, I can rock MDI for a bit.  I may get sick of the constant information about my blood sugar, so out comes the CGM.  I may be planning a pregnancy so I may want the tightest control possible right now and for me, that comes in the form of a CGM and a pager/camera.  In a world surrounded by blood sugar testing, carb counting, and insulin dosing, it’s nice to have just a little bit of freedom.

It’s important to remember that what works for you may not work for someone else.  And it’s hard to not say “Hey, have you tried what I’m doing?  Because it rocks.”  I know I’m guilty of this and I hope that when I suggest things to people who may be struggling with their management or are looking to shake things up, they know I’m not judging them for their choices in diabetes care.  I’m just offering friendly tips about what is currently working/not working for me and different things they can try.  Because change is good.  And choice is great.