Skip to content

Archive for

Livongo Health: First Impressions of Their Meter.

Disclosure:  Manny Hernandez, SVP of Member Experience at Livongo Health, reached out to me a few weeks ago about test driving the Livongo meter.  Manny is my good friend, and diabetes is not my friend, so anything that helps a friend and also helps me take a bite out of diabetes is a welcomed opportunity.  For the purposes of this post, please know that the Livongo meter starter kit was sent to me at not cost, as were the test strips.  I offered to write about my experiences.  I’m not being paid for any of this.  All perspectives are mine.

For the last few weeks, I’ve been trying out the Livongo Health glucose meter.  These are my first impressions.  For another take, check out this post from the College Diabetes Network.  Time to purge thoughts:

The glucose meter is solid, and familiar enough to not be confusing.  The meter itself is big, but nice.  It’s much bigger than the Verio Sync that I’ve been using for the last two years, and I have a fear of dropping it on the floor and having it smash into a thousand pieces (as is my life trend).  The meter also did not fit into the bag I have been using for my One Touch meter, so I had to find a bigger bag.  The test strips are also much bigger (almost comically so).  But size, for me, doesn’t matter too much since my meter exists on my kitchen counter or in my purse, never in my pocket.  The color screen is very cool.  The touch screen is even cooler, and was appropriately responsive to commands from my digits.  Nicely done.

On the whole, checking my glucose was easy, especially since I’ve used lots of different meters in my years with diabetes.  The meter lets you know when the strip is ready for blood, and while you’re waiting for the countdown to the result, the meter gives you a little health fact.  “Did you know that laughing is a great way to reduce stress (make you feel better)?”  I would have loved to have been a fly on the wall for the meetings where they came up with dozens of these gems.  I enjoyed every, single one of them, even the repeats.  They gave a dose of personality and humanity to a task that is oftentimes less-than-enjoyable.

Syncing my results to the cloud wasn’t always seamless.  More often than not, my meter would claim that the connection to cellular signal {EDIT – I originally thought this was a wifi signal, but Manny let me know it’s a cellular connection.}  was too weak, and promised to send the result after my next check.  This didn’t bother me too much, but I with there was a manual way to send my results, instead of having to wait until the next check.  Hopefully that comes with the next iteration.

On the meter, the Snapshot Summary is very useful for me.  That’s why I like the Verio so much, because it uploads to my phone, giving me at-a-glance access to what my numbers have been like for the last two weeks.  The Livongo meter hits that same sweet spot.  The Logbook screen is basic and if this was my primary meter, it would be a good screen to track.  Same for the Patterns & Stats screen.  This screen was particularly helpful because it tracked my averages for specific times of day, and then gave me a percentage in-goal range on the same screen, for 14 days, 30 days, and 90 days worth of data.  Again, it’s hard to get a full feel for how functional these screens would be in my life because I’ve only been using the meter for about two weeks.  But a meter that logbooks automatically (automagically?) is an asset for someone like me who loathes to logbook.

The Activity option on the meter confused me, to be honest.  I wear a FitBit and I enjoy those competitions, but it’s easy to wear the FitBit on my wrist while I’m moving around.  Trotting around with my glucose meter on my hip is not going to happen.  Ever.  If this setting expanded to include activity trackers outside of the Livongo brand, that would be awesome.  Otherwise, this setting becomes akin to the one on the Apple watch (for me, anyway):  I already have a fitness tracker.  I don’t want to use four of them.  Communicate with the one I already use, or maybe allow for manual input?

The online portal is comprehensive.  I like logging into the online portal and seeing the weather for my location.  It was a touch creepy at first (I am predictably creeped out by how much the Internet knows about my location), but then it became a nice thing.  Like, “Hey.  Good morning, Kerri.  It’s 54 degrees out in your sunny corner of Rhode Island.  Put on a coat before walking to the bus stop, kitten.”  Only it didn’t call me kitten.  Though I’m sure that can be programmed in.

Two notes:  In updating my personal health profile on the Livongo portal, I entered my diagnosis date (9/11/1986) and realized that the year option only went back to 1979.  Is that because it was taking my birthday into account?  If so, clever.  Less-than-clever is the field about my last A1C.  I was able to note when my last A1C was taken, and also what the value was.  But I did not have the option NOT to enter a value.  I didn’t like this.  When it comes to health information stored on an external website, I prefer the option to share or not share.  Forcing the A1C value felt … forced.

The online portal allows me to add folks to access my data, in as much real-time as possible.  I can add people (Chris, my mom, my best friend) to be alerted to my blood sugars when they are out of range.  If I had a child with diabetes, this would be a terrific option because it would help me stay on track with what’s going on when my kid is out of my arm’s reach.  But as an adult with diabetes, I don’t need to alert my family and friends if I check and am low or high.  I realize this flies in the face of my decision to share CGM data, but there’s a difference for me:  my CGM data will stream to the cloud and alert my family in the moments when I might not be awake or aware enough to check my blood sugar.  A low in the middle of the night is not always confirmed with a glucose check.  Most of the time, I wake up knowing I’m in trouble, and I treat without checking first.  The important thing is bringing up the low; I don’t need to know the exact number.

The portal also allows a health team to be created (or at least documented), letting me add my doctor to receive updates from my meter in a comprehensive way.  Again, this isn’t something I have any plans to take advantage of, but for people who need and/or want to be in more constant contact with their medical team, this is a terrific option.  (I don’t think my doctor wants to hear from me all the time, but when I was pregnant, I know she would have loved receiving my logs every two weeks, instead of me faxing them to her office.)  Through the portal, you can also access a Livongo health coach (from their team of CDEs) who will walk you through different issues at a pace set by you.  I haven’t tried this feature out yet, but if you have and can offer some feedback, I’d love to hear it.

The meter results are what matter most to me, though.  Size, color, bells, whistles, etc don’t matter when it comes to accuracy.  I have an inherent mistrust of all data (I think it stems from the lack of trust I have for my stupid pancreas), so I check and double check new devices until I feel comfortable with them.  To that end, I’ve used my Verio meter every time I’ve used my Livongo meter, and have checked both of those results against my CGM data.  (Excessive?  Yep.  But the meter came as part of a trial experience, so it wasn’t an out of pocket cost.)  Overall, the Livongo meter ran lower than the Verio meter.  Not enough to cause an uproar, but enough that I noticed every time.  My Verio meter was closer to my Dexcom on the whole, but I also use the Verio to calibrate my Dexcom, so there’s a data bias in play.  But everything was in line, well enough, to make me feel comfortable making insulin decisions off the Livongo results.

Did I trust the results?  Yes.  Well enough, at least, to be honest.  It’s hard for me not to defer to the tech that shows me as higher because when shown lower results, my brain immediately thinks, “Yes, but what if I’m actually the higher number?  That should be corrected.  I don’t want to be lulled into a false sense of security.”  I plan to use the Livongo meter to calibrate my next Dexcom sensor, to see if that shows a noticeable trend difference.  I’ve talked about new tech here on SUM often, and the running theme seems to be that I balk at change.  “New” and “different” are always initially met with a “get off my lawn” response, because I don’t like adjusting to anything new.  (Case-in-point:  The clip on the Animas pump made me crazy at first, because the top of it was just ever-so-slightly different from the Minimed one.  It took me at least two weeks to adjust to how that felt.  But then I got used to it.  Same with the new G5 transmitter, which is slightly thicker than the G4 transmitter, and it currently feeling like a doorknob attached to my thigh.  I’m sure I’ll adjust to that newness, too, but it takes me some time.  Also, you’re welcome to stay on my lawn.  I don’t mind.  It will just take a few days for me to get used to you being there.)

Looking at the cost.  There is an early access program being offered by the Livongo team right now (but rapidly drawing to a close, so if you want to sign up, I’d recommend doing that today.  Manny advised that the offer is “winding down as we speak.”).  For more details, you can click on this link or on the image below.  I’m not sure about insurance coverage for this meter and it’s associated services, but I do know that the early access program offers a deal with subscription.  From the website:  “The In Touch blood glucose monitoring system and all supplies, including unlimited strips and lancets — even shipping costs — are covered as part of your subscription.  Your participation as an early access member costs only $25 per month (guaranteed for 2 years).”  It’s the “unlimited” promise, as it pertains to the test strips, that peaks my interest for sure.  Strips are the priciest part of testing my blood sugar, so “unlimited” is a nice and welcomed bonus.

I’ll check back in a few weeks with second impressions of the Livongo meter.  If there’s anything specific you’d like to know more about, please ask!  Thanks to Manny, and the team at Livongo, for letting me give this meter a go.

 

 

Bury the Gift.

I hate the “gifts” of diabetes.  It makes me a little twitchy when anyone asks me to think about all the good that has come as a result of my diabetes diagnosis.  The urge to reach across the table and poke them in the nose and remind them, “Disease is not a PLUS,” is hard to squish.  Diabetes doesn’t give gifts and I don’t like giving it credit for any of my perceived strengths, as far as I’m concerned.

I was reminded of this when Birdy and I were reading a book over breakfast the other day.  It was about cats (contain your shock) and discussed how cats may bring you “gifts” to impress you.  The book kindly suggested that you appreciate the gift and then politely bury it.

“Bury the gift” is how I deal with the things diabetes has brought into my life that are an asset.  I appreciate the perspective and lessons I’ve learned after twenty-nine years with type 1 diabetes, but I’d still like to take all of those “gifts” and politely bury them in the backyard. 

However, I have to grudgingly admit that the influence of diabetes on my life hasn’t been all garbage, so I’ve dug up some of the gifts in order to work my way out of this patch of wet paint.

Breakfast reading. #burythegift

A photo posted by Kerri Sparling (@sixuntilme) on

One gift? I’ve learned to see things in numbers.  For better or for worse, a plate of food is not a plate of food but instead a math problem.  I can calculate how many carbs are in a set meal and mash that up with how much insulin is on board, the amount of exercise I have done (or will do), and take any cortisol-inducing stressors into account when deciding how much insulin to dose.  This is not a magical power but a talent that many PWD have in their arsenal.  It’s hard-earned, the ability to rake your eyes over something for the briefest moment and determine the amount of dangerously-potent drug you need to administer.  Hogwarts doesn’t teach this shit.

It’s helped me learn to forgive.  In order to succeed in a body that doesn’t make insulin anymore, I had to learn to forgive that shortcoming.  I had to teach myself to let go of some of the anger and find things I was still okay liking.  This was a very hard learning curve and I still struggle with it on days when diabetes makes me filled with rage.  But my body is still mine, and still  successful in so many other ways.  I forgive my pancreas, mostly, for being a crumb.

Diabetes has helped me learn to be patient.  Waiting in line at the post office, at the airport, in the grocery store … it’s all smooth when I compare it to the endless vacuum of minutes while I’m sweating and swaying and waiting for food to bring my blood sugar back up into livable range.  I am able to be more patient because I’ve learned to wait.  (This mindset works 80% of the time but has limits, like when I ask Birdzone to put her frigging shoes on seventeen times in efforts to not miss the school bus. Just. Put. Your. Shoes. ON.)

It’s showed me that some shit is terribly funny.  Even when it seems like it shouldn’t be.  Diabetes isn’t funny (except that it totally has to be when emotions are intense and the tension can’t be broken with anything other than some gallows humor).  Some of the hardest laughs I have ever had have been through tears of frustration.  Laughing at this nonsense keeps me centered.

And life with diabetes has taught me perspective, a perspective that I would gladly do without but since I don’t have a choice to give diabetes back, I’ll take the perspective it offers and try to remain grateful for it.  Some people are frustrated by the statement, “But it could be worse.”  That doesn’t frustrate me.  I believe it could be worse, and I’m grateful that it’s not.  I’m thankful that I live in circumstances that allow for a butter compartment stashed with insulin and a job that pays for medical necessities.  Diabetes has shown me what one malfunctioning order can do to my system, which prompts me to take good care of my body, broken bits and all.  I’ve had close to three decades with diabetes, and I’m unsure about what opportunities the future might hold.  But I’m not waiting for a cure.  There’s life after diagnosis, and I can’t put everything on hold until “there’s a cure.”

There’s still a life.

And there’s still a mental garden filled with “gifts” that I can draw from when I need to.

(Is it okay to end on a macabre mental image about dead mice that my cat has brought to us, comparing those critters to the things that diabetes has taught me?  I say yes, and will blame Halloween.)

 

As a Kite.

Woke up to this little gremlin number on my meter:

Gross, gross start to the day. #DOCtober #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

I pulled my site and immediately blood streamed out, leaving a trail down the side of my hip and actually running onto the bathroom floor (which is DISGUSTING and makes me feel like queen of the macabre).  The site was sore and tender and 12 hours past the “three day” mark, which may explain why it went gross on me.

Regardless of the “why,” the day started with an insistent need to pee and then drink a ton of water from the faucet.  And then change my pump out.  And then rage bolus.  And then start the day determined to have this be the One Thing that Sucks today instead of letting it set the stage for a crappy Tuesday.

If I Knew Then: Traveling with Diabetes.

I wish I had known, years ago, that blaming diabetes for my lack of travel experiences was a stupid excuse.  Sure, I didn’t backpack around Europe after college for a dozen different reasons, with the need to work a structured job immediately after school was done so that I could have medical insurance to cover all my diabetes shit, but I could have figured it out.  I let the fear win on that one, allowing fear of flying and fear of debt and fear of trying something new keep me grounded.

I wish I had known that fear is good.  It’s good to be scared.  It’s good to step outside of my teeny little bubble of Rhode Island and explore the world.  It’s good to be scared of flying and still do it in pursuit of adventure and experience.  It’s good to see something outside of my own zip code, which is why I find myself on the move as often as possible.

I wish I had known that I had options when it came to traveling with diabetes.  It’s perfectly acceptable for me to put my insulin pump in my purse when I go through security.  It’s okay for me to wear it as I pass through the metal detector.  I can opt out of conventional screening and ask for a pat down.  I can also decide to buck the whole system and go back to injections while I travel.  The choice is MINE.  And it took me along time to realize my rights as a traveling PWD.

Same with decisions made while traveling!  I wish I had known that diabetes doesn’t always have to dictate.  Traveling for a formal event and the diabetes hardware simply doesn’t fit the way you want?  Ditch it.  And I also need to recognize that wearing my devices while traveling might afford some excellent advocacy opportunities.  It’s not all bad.

I wish I had known the importance of packing smart.  I will bring enough socks and underwear to last me the duration of my travels, but I’ll pack enough diabetes supplies to cover any circumstance.  It seems like too much, but I bring pump supplies and insulin pens in case I want to go back to injections (or if my pump fails).  I always have glucose tabs and snacks.  My shoulder might ache from the weight of my carry-on, but I’m prepared for just about anything, diabetes-wise.

I wish I had known that my blood sugar would respond to my flight anxiety, and I needed to find ways to manage that anxiety in a healthy way.  I should have brought yarn on the plane with me years ago.  It does wonders for my mindset and now I have better blood sugars and a collection of wonky scarves to give away to flight attendants at the close of my flight.

I wish I had known to stick a slip or two of medical tape into my wallet when on the road.  You never know when you, or a loved PWD friend, might need a little sticky assistance.

I wish I had known how powerful sharing my CGM data would be when it came to traveling.  I am on the road quite a bit for work and flying solo, quite literally, with my support team at home.  Allowing Chris (and other loved ones) to see my data while I’m sleeping alone in hotel rooms can make all the difference in a night that’s good or tremendously bad.  (Sometimes you just have to have the sharing conversation to get that ball rolling.)

And I wish I had known that all the planning and careful thought can still result in bullshit moments, like the time my bag was accidentally run over while in Paris.  But again, going back to that fear thing, traveling is not about waiting for the bullshit moments to happen.  It’s about best planning practices to avoid them, but being able to roll on gracefully when aforementioned shit happens.

Because there’s a whole world to be seen.  And diabetes is not going to be what keeps me from seeing it.

These Boots Were Made For Talking.

At the airport two weeks ago, I was coming home from Washington and my flight to Rhode Island was delayed.  The wait in the cramped US Airways terminal was long and oddly warm for October, giving people a certain irritated twitch.  I was still dressed from my meeting, with a dress and tights and boots and not enough real estate in the dress itself to hide my insulin pump so eff the bullshit, I clipped my pump to the top of my boots.  (Like this.)  It felt comfortable and somewhat discreet.  A nice change of pace.

The other people on my flight and I kept close to the gate, watching the delay extend and hearing sighs from fellow travelers.  There was a thick tension to the air, one that even the smell from the Dunkin Donuts kiosk couldn’t cut through.

And then suddenly a fight broke out between these two random ladies, one of whom was heavily pregnant.  There was excitement and a scuffle and lots of “Oh no you did NOT” and the response of “But I DID.”  Security showed up around the same time as our plane, which added to the chaos.

“This was unexpected,” the man next to me said, shaking his head.

“Almost makes the plane delay tolerable,” I agreed.

He looked at me and then his eyes traveled to the top of my boot.

“Is that an insulin pump?” he asked, with a look on his face that indicated he knew exactly what it was.

And as I said, “Yes,” I realized that I meet people touched by diabetes everywhere.  In coffee shops, at Disney World, on planes, going through TSA, and now, watching a pregnant lady and another lady try to punch one another in the face while waiting for my delayed plane.  People with diabetes are everywhere, and I am lucky to find a lot of them.

… that, and it probably helps catalyze conversation, keeping my medical device clipped to my shoe.

“My daughter has type 1 diabetes,” he said.  “She was diagnosed when she was nine.  She’s 18 now and at college.  Volleyball player,” he added proudly.

“No kidding?  I’ve had it for 29 years, diagnosed when I was seven.”

“Yeah?  Wow, 29 years.”  He looked impressed, as if I had mentioned an ability to build functional spaceships out of pasta noodles instead of an inability to produce my own insulin.  “And you’re okay?”

I shrugged, thinking about the difficult last few months.  But I was okay.  I’d be okay.

“I’m not picking fights with pregnant people at the airport, so I’d say I’m pretty okay.”

He looked at me with those hourglass eyes that parents of children with diabetes often have, visibly fast-forwarding his own daughter’s life another two decades, wondering what her life would be like when she had lived with diabetes for almost thirty years.

“That’s a plus,” he said.

And all at once, I wanted to give him a run-down of my life, telling him everything that I had still done and would still do, despite or because of diabetes.  I wanted to show him pictures of my daughter.  I wanted tell him about how Chris takes care of me without smothering me.  I wanted to tell him how my mom and I are immeasurably close through diabetes.  I wanted to tell him it would be okay and his kid would be okay.

And then I wanted him to tell me I would be okay, and that the people I love who have diabetes would also be okay.

The gate attendants called for people to start boarding our flight.  We shook hands and did the “Nice to meet you; good luck with everything” send off.

But there was a moment that hung between us, one of understanding and connection that only people who really understand this life can share.  He knew my life and I knew his, to a certain extent, yet we’d walk away from the conversation without sharing our names.  Which, strangeness aside, was really comforting.

Follow

Get every new post delivered to your Inbox

Join other followers