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!

 

Happy Monday!

Usually I curse Mondays.  I mean, really, weekends should be five days, work weeks two.  AmIright?

The husband has been out-of-town on a men’s fishing trip, and it’s kind of a running joke with us that whenever he’s out-of-town, I always get overnight lows (which is kind of scary, but we won’t go there) and I don’t really miss him until the lows start kicking in.  Of course they have the past three nights every night since he’s been away.  Duh.  I’ve been over-treating and then spending the following morning chasing down elevated BGs.

Until last night.  I OWNED my overnight low.  I was 60 on my meter, 53 on my Dexcom.  Drank 6 oz of OJ, spoonful of PB and woke up to a nice steady-ish line this morning.  Definitely perked me up for a Monday!

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I also have changed my high alert from 170 to 160.  Hopefully I don’t annoy my coworkers too much with the awesome tunes the Dexcom plays.  I really wish the high alerts were in increments of 5 so I could take even smaller “baby” steps (pun intended) towards better control.  Endo appointment is on Wednesday – my first a1c since I’ve rejoined the land of pumping and started on a CGM!  I’m excited and crossing everything that I’m 7.0 or lower!!!

Friday Fives – July 19.

5 average blood sugars, according to my Dexcom:

1.  90 day average = 168

2.  60 day average = 163

3.  30 day average = 150

2.  10 day average = 144

1.  3 day average =128!!!!!

I think I’m moving in the right direction!  I am so, so happy I bit the bullet and got this tool.   It has made me understand my diabetes and my body so much better.  I am actually excited to get my A1c result next month!!

Happy Friday!

 

 

Wordless Wednesday – Perspective

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A day with my current settings of 75/170. I don’t like that yellow!

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Changing my high setting back to the default (200) makes me feel much better about my day. 🙂

 

I currently have my Dexcom settings on 75/170 but sometimes, if I go over the 170 high threshold, I change the threshold back to the default (200) to see if the day was really that bad.  Sometimes, it makes me feel much better about my sugars, which may be needed after a particularly mentally challenging Diabetes Day.  A little mental boost goes a long way.

 

(Don’t worry, I always change it back to 170.)

My CDE is my BFF.

I had an appointment with my CDE on Friday and let me just say she is quickly becoming my new BFF of my Diabetes Team.  Like, I want to make her a friendship bracelet, ’90s summer camp style.

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I was never able to master the swirly ones!
Image from the Google.

Her awesomeness does not only stem from her coming to my Endo/PA appointment last week and giving me a hug, but she has been instrumental with determining my pump rates over the past 2 months since I’ve resumed cyborg living.  I’ve emailed her reports almost weekly and we make tweeks as needed to get me where I need to be to grow a human.  She is also totally relate-able and “gets it” as a PWD.  She makes me laugh and is super supportive when I’m annoyed with myself for not being a perfect diabetic.  I know I totally sound like I have a girl crush (my girl crushes are Megan Hilty and Jessica Simpson, TYVM), but I’d say it’s safe to say I have a definite favorite on my Diabetes Team.  Don’t tell my PA or Endo.  I know I’m supposed to love them all equally, and they can believe that I do, lest I’ll be subject to more finger pricks when I’m in the office.  (Seriously, am I the only one who hates when other people prick my finger?)

So, the appointment.  My graphs look goooood.  She pulled up some of my old graphs and the change in just a couple of months is remarkable.  Definitely happy that I’m back on the pump even after having the pump-cation blues.  For the first time since starting this “get body ready for baby” journey, I feel like I can actually do this.  It’s a good feeling friends.  And it’s motivating me to keep on trying my best to get myself in the best D-shape possible before growing our future little one.

We She noticed some patterns that we are working to correct.  I tend to go higher and stay higher with meals that are more than 60 grams of carbs.  So that means that I will try to limit my meals to less than that amount of carbs.  Easy peasy, mostly.  But if I do have the weekly occasional bowl of spaghetti, I’ll bolus as usual but try a temp basal of +20-40ish%, (depending on pre-meal BG) for 60-120 miutes post meal.  Trial and error.

Another trend is that I tend to stay higher throughout the morning if I eat breakfast earlier in the day.  So we changed my I:C ratio from 1:10 to 1:9 before 9 am and 1:10 after 9am (weekends).  I would’ve never noticed this – so happy for her trained eyes to see!

I do awesome overnight.  I average 147 from 11pm – 7am.  Good-ish number.  Would like it to be a smidge lower, but the thing I am most pleased with is that my overnight lines are typically pretty steady.  No real drops or jumps.  Sweet dreams for me.  This means naptime at work, no?  I have been pretty pro-active with setting temp basals at night when I go to bed on the higher end.  And I swear, it has nothing to do with me not wanting to hear my Dexcom all night.  It has everything to do with wanting to be all I can be with the D.  Or something.

We also changed my I:C ratio for dinner from 1:9 to 1:8.  My CDE was a little reluctant to do this because sometimes after dinner my numbers are great, however, I want them to be great most, if not all, of the time.  So I figure it’s worth a shot.

The best part of the appointment however was when she said that by looking at my graphs, she thinks my A1c is/will be very close to 7 if I keep this up.  This certainly motivates me to keep fighting the good fight.  High Five!

I kinda want to take her out for a beer.

She’s got legs, she may as well use them…

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I really need to start doing some sit-ups. Yikes.

Man, two weeks in to pumping and CGM-ing and I already feel like I’m running out of real-estate.   I’ve been sticking to my belly for both, with the exception of using my upper right side of my tooshie for one pump cycle.  Since my boobs get in the way during insertion arms aren’t long enough to reach around to my left side, the upper bum area is limited to the right side.  Until I either become ambidextrous (“I’m not an ambi-inserter!” Name the movie), get really good at yoga, or lose some pounds, it seems the pump will have to be inserted on my belly, right butt cheek, or legs, which I’ve never tried.  I’ve never worn it on my arm either and for me it just doesn’t seem particularly comfortable with the tubing.

However, I decided to be a big girl and try wearing my CGM sensor on my leg.  Even though Dexcom says it should be in the belly only (because this is where they did their testing when getting FDA approval), I’ve read on the interwebs that you can really put it anywhere you feel comfortable.  I’ve heard from a lot of people who wear it on their thighs and love it.  So I’m giving it a whirl!

Insertion was a little weird as I’ve never done it before (that sounds like something a high schooler would say after prom night if you know what I’m sayin’), but other than feeling the needle a little more than I do in my tummy, it was fine.  I have it on my upper right thigh, towards the outside but not so far on the side that I will feel it when I sleep (I’m a side sleeper).  I haven’t noticed it much and it’s nice to not be rubbing against my desk at work.  I’m conscious of it when I use the bathroom as I don’t want to rip it out and be annoyed that I just wasted a sensor.  I used tons of Opsite FlexiFix per my usual and I can see that I will probably need to reinforce my tape in the next few days, simply due to pulling my pants up and down every time I use the ladies’.  There is a little bump under my pants but I think it’s one of those things that unless you know it’s there and know to look for it, you wouldn’t notice.  I’ll be attending my boxing class tonight, but I don’t anticipate it being annoying.

Dream Devices and High Fives

Diabetes Blog week, Wild Card/Day 7

Since I’m a day late with my Day 7 DBlog Week post, I figured I’d answer not only the Day 7 prompt, but would also throw in a wild card.  Double the love.dblogweek

I shall start with the wildcard:

Back by popular demand, let’s revisit this prompt from last year! Tell us what your fantasy diabetes device would be? Think of your dream blood glucose checker, delivery system for insulin or other meds, magic carb counter, etc etc etc. The sky is the limit – what would you love to see?

The obvious answer to this question is a cure.  A close second would be an artificial pancreas (hopefully soon-ish-y? Maybe in “five to ten years”????).  As you all know, I’ve newly re-cyborged myself with a Dexcom G4 and Animas Ping combo.  One of the main reasons for choosing this combo was the fact that Dexcom and Animas are BFFs and hopefully the new Vibe will be available within the next year-ish in the US.  It was just submitted to the FDA so one can cross her fingers, right?  Anyway…here is what I would LOVE as an option on the Ping…I would love it to ask how your BG is trending according to your CGM when it is calculating your bolus.  Are you trending up?  Slightly more insulin.  Rising rapidly?  Uh oh, a bit more insulin!  Falling rapidly, a lot less insulin.  It’d be nice if the Ping took the guess-work out of it!  I am not sure if this is even an option in the Vibe (I admittedly haven’t researched it a whole lot), but it sure would be nice!

Now, on to Day 7: Spread the Love!

As another Diabetes Blog Week draws to a close, let’s reflect on some of the great bloggers we’ve found this week. Give some love to three blog posts you’ve read and loved during Diabetes Blog Week, and tell us why they’re worth reading. Or share three blogs you’ve found this week that are new to you.

This is not an easy prompt!  There are so many great diabetes blogs out there that it is difficult to narrow it down to just 3 posts.  There are so many bloggers that inspire me, make me laugh, and challenge me.

A new blogger I have found is Paul at Type One Fun.  Paul is a 21 year-old college student who was recently diagnosed.  I was also diagnosed while attending college and it is very interesting to me to read about Paul’s experiences as a “newbie”.  He is doing a wonderful job adjusting to his new life with the D.  I especially enjoyed reading about his accomplishments!  Keep up the great work, Paul!

I really enjoy reading blogs from the Type 3-ers – the diabetic caregivers.  It is great to see things through their eyes, especially the parents of diabetics.  While posting about her most memorable diabetes day, Meri, a mother to four sons, three of whom are Type 1,  wrote of a special moment she shared with her husband in which she was able to accept their new lives as parents to three boys with type 1 diabetes.  Her husband reminded her that “We weren’t sent to this earth to be miserable”, very wise words and a wonderful reminder when we are feeling down or overcome by the emotional aspects of this disease.  Thank you for sharing such an intimate memory, Meri.  And for being an advocate not only for your sons but for all of us who have diabetes.

I also love the story Kelly at Diabetesaliciousness tells about her dad getting into a fight with a security guard at a Phillies game when the guard is a big ole moron when it comes to diabetes and bringing food into the old Vet.  Great memory sharing, Kelly!  And kudos to your dad for doing what so many of us want to do when we meet people who are ignorant about diabetes!

I really enjoyed participating in this year’s Diabetes Blog week.  I found some wonderful blogs to follow and loved hearing people’s experiences with diabetes.  I’m looking forward to next year!

A quick note to my (Moody) CGM Sensor

Dear Sensor,

I know, I know.  You are on day 9 of 24/7 work and you’re tired.  Believe me, I get it.  Your fatigue lead to a non-reading of “???” right at bed time last night.  When, I just happened to be running in the 300s (Damn you Cookout milkshake and your heavenly goodness).  I decided to see if perhaps you just needed a nap and would resurrect yourself as I have heard rumors of this happening.  I, being the responsible nervous diabetic (Hey, I just read a story about a 29 year old’s dead in bed death), set my alarm for 1:30 am to check my sugar.  Imagine my surprise when you not only resurrected, but you resurrected accurately!  Only off by 18, woot!  It lives!

But, sensor pal, you seem to have quite the case of the Mondays today (I do too – I am really angry that I didn’t win the powerball and am here, at the j.o.b). You, without consulting me, have decided that last night’s break wasn’t enough and you needed another nap this morning.  Seriously, how tired can you be?  Fine, nap, because, well, I’m at work and don’t have one of your pals around to replace you (mental note, throw spare sensor into my work bag).  You nap, you snore, and all of a sudden !buzz!, you are alive and ready to take on the world!

Or maybe not.  After your miraculous second resurrection, you informed me that my sugar was 274, when in reality it was 199.  That’s it; you are out of the circle of trust today, Sensor!  I will not be trusting your readings until I can replace you.

Wait just a minute.  I just checked my sugar and it’s 139, but you are telling me I’m 144.  Could it be?  Are you back and back for good?  Or are you just going to continue to drive me nuts like a pms-ing 16 year old girl going through a breakup?

What’s it going to be sensor?  Huh?

Fondly,
Your Master

Yay, team!

Diabetes Blog Week, Day 4.

We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you’ve made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small – think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.)dblogweek

Hmmmmm, good question!  I feel like I haven’t mastered anything when it comes to my diabetes care.  I mean, I have mastered the motions, testing my sugar when needed, changing my pump sites, bolusing, etc.  But I am still, 14 1/2 years in, not 100% confident to say “Yes! I kick ass at diabetes!”  My sugars are not perfect, I don’t exercise every day, I still enjoy a carb or 20, and I have days where I’m crying out of frustration that I have to live with this crap for the rest of my life.  Sometimes my blood sugar is just a real jerk for no reason (like last night for example – for about 4 hours I was cruising between 43 and 80 despite 20 oz of OJ and two not-so-small spoonfuls of peanut butter).  Is there anyone out there who really has mastered diabetes?  Who can go to their endo every three months and know that their A1c is going to be 6.0?  Who has the perfect attitude when it comes to living with this?

But, the question wasn’t if you’ve mastered diabetes.  It’s about diabetes-related accomplishments.  Recently I made some pretty darn important care decisions.  As the Hubs and I want to have a small human in the next year or two, I knew that the time had come where I need to get serious and get as close as I can to mastering diabetes.  I decided to end my months-long pump holiday and resume pump therapy with the help of a CGM.  This was something I thought about for weeks months before finally accepting that I’m going to have to become a cyborg again.

You see, in theory, I love the pump.  Don’t have to carry around syringes or pens, your meal schedule can be more varied, and it offers better management for most people than multiple daily injections.  Blah, blah, blah.

But in reality, the pump is a pain in the butt.  Site changes, being connected all the time, it’s expensive, it beeps at you, it’s bulky and gets in the way, and it makes wearing dresses a headache!  My pump-cation had been glorious!  However, knowing all of the negatives that come with wearing a pump, I decided the best thing for my health and the health of a future pregnancy would be to get back on the pump and to get a CGM.  So the research began.

I googled, I youtubed, I blog-stalked.  Wow, there are a lot of people online sharing their experiences with various pumps and CGM setups.  The doctors and manufacturer’s’ sites will only tell you so much, these blogs were so helpful in sharing real-world experiences and opinions.  I especially found blogs written by women who are in similar life stages as me to be very helpful and was so happy to find their sites (Texting my Pancreas and SixUntilMe especially).   With the help of my new blogger buddies and the fabulous interwebs, I decided on the Dexcom G4 Platinum CGM and Animas Ping pump.  In black and silver – stylin’.

Change is scary and although I had previously been on the MiniMed Paradigm pump, I was pretty nervous about going back on pump therapy.  I had a breakdown one night about the fears of the unknown and how much it sucks that I have to do this and think about these things a year before we even want to start trying for a baby.  He, however, reassured me that there are other ways to start a family and if I absolutely did not want to do this, I didn’t have to.  He also made the great point that if I hate it, I can quit.  He’s so smart.

Fast forward to today and I’m almost 2 weeks into my new cyborg life.  Have I mastered it?  Nope, not quite.  I’m still aware of the pump clipped to my pants and the CGM sensor and transmitter taped to my body.  I still feel dorky about my “diabetes tool belt”.  My sugars aren’t perfect and I definitely miss the freedom of not being attached.  But one thing I have mastered is my attitude that I’m just doing what I have to do.  And knowing that diabetes care is something that can be adjusted and modified to fit my needs at the time.  Not everyone needs to be on pump therapy.  It’s not the best course for every.single.person with a dead pancreas.  But for me, right now, it’s the best choice in regards to my goal of becoming a mother, and I’m cool with that.  Will it be my choice 5 years from now?  Who knows.  All we can really do in regards to our care is to make the best decision with the knowledge we have at the time.  I think a series of making the right decision and small accomplishments will lead me closer and closer to that whole mastering diabetes thing.  But for now, I feel like I’ve accomplished the right attitude.