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Dexcom Tips.

Dexcom and an old Trot Nixon shirt.  Almost classic.Last Thursday, my local Dexcom teaching nurse came to visit me here at dLife.  I think she's fantastic, but I'm also tremendously biased.  Little back story:

When I was first diagnosed, I was a little peanut of a kid.  My parents had no experience with diabetes or how to handle type 1 being a part of their child's life, so they looked for help within our town.  As fate would have it, one of my father's cousins (one of those once-removed cousins added to the family by marriage sorts of things) had a son with diabetes.  Jim was diagnosed when he was 18 months old, his mother, Eleanor,  was a registered dietitian and had spent time as both a diabetes professional and the mother of a kid with diabetes.  Perfect guide for my parents, right?  Right.  For years, my mother and I traveled to Joslin with Eleanor and Jim for our back-to-back endocrinologist appointments.  And when my parents would go on vacation, I would stay with Eleanor and her family because she knew how to take care of me.

So imagine my surprise when I find out that the CT/RI Dexcom teaching nurse is Eleanor!  Holy small world.  And holy long story, sorry about that.

Anyway, Eleanor came to visit me last week and brought me two spare Dexcom sensors.  We covered a lot of the technical bits about Dexcom'ing, as well as some tricks o' the trade.  My session with Eleanor helps me answer some of the reader questions I've received over the past few weeks.  Like these:

Q:  Can the sensor get wet?  I used the Dex3 and had to wear the shower patches.  They were terrible!


Yes, the Dexcom 7 sensor can be worn in the shower and the pool and any other soggy environment.  You don't need to wear those wild shower patches that eat your dermis anymore.  But here's something I didn't know:  When you are ready to put a new sensor on, you should clean the underside of the transmitter with an alcohol swab or similar.  I thought you weren't supposed to get this transmitter wet at all, but it turns out that a good swabbing can remove any soap residue, body lotion, or other random smudgy bits that may worm their way underneath.  This cleaning process helps retain the integrity of the transmitter.  

Q:  I've seen you wearing the sensor on your arm.  Aren't you supposed to wear it on your abdomen?

Ahem - according to the official Dexcom guidebook, "Choose a site on a fatty area of your abdomen (belly) to place your Sensor.  You can choose a site above or below your beltline. The best insertion areas are usually flat, 'pinchable,' and relatively free from where rubbing can occur (i.e., pant line, seatbelts)."  However, and off the record, the sensor can be worn anywhere there is a good amount of fatty tissue so you can grab the ol' interstitial fluid easily.  For me, I have a lot of placement options.  I've been wearing the sensor on my arm because that keeps it away from my waistline (I hate wearing any of these devices on my abdomen) and doesn't encounter much friction throughout the day.

Q:  You always talk about how you want your diabetes to be "seamless" and you've talked about how you hide your insulin pump so that it's not part of your wardrobe. So, my question is, how come you don't wear your sensor on your stomach or thigh?


This reader caught my recent dLife column, where I talked about some people staring at the Dexcom sensor on my arm.  This is a very good question. I wear the Dexcom sensor on my arm because it stays put there best.  The sensor is less apt to become peeled back and doesn't catch on my waistband.  It is also less likely to become loose and therefore irritating.  I don't feel comfortable wearing any diabetes devices on my stomach, and my legs are too muscular for the sensor.  Also, the sensor needs to be away from any insulin pump infusion set and from big pockets of scartissue.  So ... my arm is the best out-of-the-way location for Dex and still have it working correctly.  I'm trying to find the compromise between "external symptom" and "using available technology."  People stare sometimes, which makes me bristle a bit, but I would probably stare, too.  It's a different look for your average twenty-something.  ;)

Q:  Can you get more than seven days from one sensor?  Or are you just sticking $60 on your arm, getting a week from it, and then ripping that $60 off?  I can't imagine!

I haven't had the opportunity to restart a Dex7 sensor because the past few have melted off me before the seven day point.  On this last sensor, Eleanor applied some SkinTac on the sensor gauze and it has held steady through daily showers, daily workouts, and this blasted heat.  I have heard that you can "re-queue" a sensor by "pretending" that you've installed a new one.  I will give this a go next round.

Any other CGM-type questions?  Send 'em to kerri (at) sixuntilme (dot) com. 

EDIT:  Again, comments are being problematic.  Hopefully they're fixed now.  I need a new webhost, damnit.  Thanks for letting me know, Rachel! 

Comments

All great tips, Kerri! I've been using my Dex for about a month now, and I agree with pretty much everything you've said.

I also use my arm as my preferred site. It doesn't rub and it's out of the way.

I've done the "pretend" sensor restart before, but in general, I only get about 7-8 days out of a sensor before I start getting readings that are too wacky.

I've got a YouTube video that shows how to restart the Dexcom. Google for Dexcom reset and you'll find it.

I wish Dexcom would actually publish these tips on their website. I've posted a number on my blog, but I only recently learned about cleaning the back of the transmitter.

I've had some last 7 but my last one lasted about 12 and was working well. I had one last 3 days which never really worked and will be calling in for a replacement.

Is this a transdermal device, or is there an implanted/inserted component?

I was supposed to get a CGSM today to wear for a week, but it didn't work out. I'm sorry, but that procedure hurts like like a mother. They tried four times, and each time I tensed up enough that they couldn't maneuver it into place without hitting muscle. (I'm probably 10-12 lighter than my svelte old self, so there's not much more than an inch to pinch.)

I'm going back tomorrow and they'll try again, this time after giving me a Valium and some sort of topical that I keep thinking is "Emeril Creme," but I know that's not right. ;-]

Hi Kerri,
Thanks for the great tips! I just started on the Dexcom last week and appreciate your input. By the way, today is the start of my eighth day on the same sensor. I followed bernard's instructions http://www.youtube.com/watch?v=zswL77yDRgU and restarted the sensor today and it's working great. I hope to get another week out of it!

Hi Kerri,
Really to keep the dexcom on more then a week. If you buy a roll of opsite flexifix tape. I get the 4 inch roll. I cut a hole the big enough to go over the dexcom sensor. This miracle tape really helps to hold sites on. I have had some stay in up to 21 or more days. I know current one is over a week old.
Wendy

I love wearing the Dexcom on the arm. I am very thin and that is the only place that I get good & consistent readings. Is there anyone who can insert the Dexcom sensor on their arm without the help of another person? If so, how do you do it?

I am thinking about getting the Dex sensor but not sure yet. What kind of pump do you wear and where do you put it to conceal it?

We use a Johnson and Johnson first aid "waterproof pad"; 2 7/8 x 4 inches. It is basically a big enough bandaid to cover the entire sensor, and provides protection against the sensor's adhesive peeling off. It works pretty well, although you should monitor the bandaid to be sure it is, itself, staying on. If not, simply replace it. The bandaid we use is not one with super-strong holding power; that seems too difficult on the skin when it is time to take it off.

I inserted the Dexcom sensor on the back of my arm last night. It calibrated easily after the warm up period, but after sleeping through the night, I have the ???. I've been up for an hour and the ??? is still there. I imagine I rolled over in my sleep and put pressure on the sensor. Is this common? Do you have this problem? Thanks!

I have been using the Dexcom for about 5 months. I really do love it. I also am thin and i wear it in my stomach. The only problem is the sensor staying on. I use the iv prep pads instead of Alcohol preps. The IV Prep pads works much better to help them hold. I have managed to wear my sensor for 2.5 weeks. And the ??? that reads on the meter means that is is Calculating and sometimes it takes 5/10 minutes. My A1C was 8.8 before i started wearing the Dexcom sensor and my last visit my A1C was 6.2. My doctor and myself was very pleased. Sometimes i get wacky readings as well. But if you put in several blood suger reading in for an hour or two then the wacky readings start to become accuarte most of the time. And sometimes your blood sugar tester will give you a bad reading. So always double check you blood testing meter. I use the one touch that reads to my mini-med pump. I like the mini-med pump the best. I have been a Type 1 diabetic for 30 years now and had alot of tuff times and even went into a coma once. I am very thankful for all the new technology. 30 years ago there wasn't many doctors that was very knowledgable about diabetes. The first doctor I had told me and my parents his patients did better not being on a diet and just told me to take 2 shots a day and nothing else. You know i was in trouble from the start. But i finally ended up in a comma for 2 weeks. I am very blessed.

Hi! I'm a T1 who just found your blog, and I thought I'd share soimnhetg. We were in Belize a month ago and I went caving with my Animas pump. Found out too late that it had a hairline crack down the battery side and it filled with water. I spent the rest of the trip taking tests and shots every 3-4 hours. Nothing I could do about it from Belize in the amount of time we had left on vacation.However, when I called the company when I got back in the States, they tole me they have a loaner program for out of country vacations, so you can take an extra pump with you. Good to know, so I thought I'd spread the word.

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