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Posts from the ‘Dexcom’ Category

Hypo Management.

“Ninety-five percent of the time, I’m fine.  The lows are ones I can treat myself, even if the number is really low.  Usually my symptoms are shakiness or like this brain fog.  When the lows are really gross, I usually cry at random.  Or I throw things.  No real in between.  But the majority of the time, I can take care of things myself, and then it’s over.  Like nothing happened.”

I tried to explain this to a friend who was asking when it’s necessary to intervene during a low blood sugar, but explaining the slide from “fine” to “holy effing low blood sugar” sounds confusing when I say it out loud.

That’s the weirdest part, for me, that whole panic-then-peace part of severe hypoglycemic events.  My lows have historically come crashing in at a breakneck speed, which is part of why using a CGM has been a pivotal change for me.  Getting a head’s up on when a low is happening, or being able to treat it even before it becomes a problem, has helped me feel safer in the face of hypo unawareness (a lack of low blood sugar symptoms) and fast-dropping numbers.

My endo suggested that I raise my low alarm on my Dexcom from 65 mg/dL to 80 mg/dL in efforts to catch lows earlier, and in the last month or so, I’ve had far fewer chaotic hypos.  Instead, I’m grabbing the lows before they even become low, snagging a 70 while it slides versus waking up in the trenches of a 40.


Low alarm at 80 has been the best suggestion in a long time. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Small little tweaks here and there make differences I couldn’t have imagined. … that, and I’m burning through my supply of glucose tabs with a little less vigor.

 

A Wicked Rash.

When I was younger, my pediatric endocrinologist told me that I shouldn’t be poking the syringes into the parts of my skin that didn’t hurt.  “If you don’t feel the pinch of the needle, that means you have scar tissue building up, which can lead to poor absorption of the insulin.”  She stayed on me about rotating injection sites, and even though I didn’t like rotating to new spots that hurt a little, she was right.  The more I rotated, the better my skin felt and fewer egg-bumps of scar tissue formed under my skin.

… shame on me for not following that same rotation protocol when it comes to Dexcom sensors.  I wear mine almost exclusively on my outer thigh because that’s where they feel the best, stay put the best, and are least apt to peel away before their time is up.  For several years, this worked fine because I rotated within the thigh site, making sure not to reuse an area in the same month.  But once the Dexcom adhesive rash started, I was screwed because the skin was taxed not just by the sensor itself, but by the residual rash.

Dexcom rash management has been better lately because of precautionary measures, but sometimes the rash flares up as a result of ten different factors (all ones that itch).  Last week, I was traveling for work and kept applying Opsite Flexifix tape to my Dexcom sensor as it was starting to peel away (and yes, I had a spare sensor on me but still didn’t want to pull the one that was working.  I’m a stubborn human.)  I covered that thing with tape.  And for two days, it was great.  But then it started to turn a little red underneath the tape (not the sensor adhesive, but the skin underneath the tape).  After another day, it went entirely bananas and turned bright red and started to swell.

“I can feel the heat of the infection through my jeans,” I said out loud to Chris.  At which point, I realized I was a frigging idiot for not pulling the sensor off.

Off it came, and what lurked beneath was gross.  (“It was the worst Dexcom rash … I ever seen!!”  Actual Large Marge quote.)  No way was I going to take a picture for evidence because it was horribly nasty and I’m irresponsible for letting the cost/convenience/reinstallation of the sensor supersede the integrity of my skin.  What was underneath the Toughpad was completely fine, but every bit of skin that had come into contact with the Opsite tape alone was raised, red, and borderline blistering.

It took a week for that site to heal, and only after I carefully applied Neosporin and bandaged to it.  Which brought me to that unfortunate realization:  I suck at rotating my Dexcom sensor sites.  And I need to be better about it, especially since the data is very important to me.

So I’m trying out a new spot in efforts to give my thighs some time to properly heal.  For the last week, I’ve had a sensor on my lower hip and it has worked much better than I thought it would.  It’s just below the belt time on my outer hip (see Gingerbread Man for placement accuracy because holidays) and despite the rub of pants, etc. it is staying put and not peeling up.  I have a little bit of Opsite tape on the lower edge and so far, so good.

I hope this sensor can run its seven day course without leaving a mark.  Because otherwise … itch, please.

LOW.

BEEP!BEEP!BEEP! from the Dexcom receiver on the bedside table.

I heard it beeping for a long time.

Woke up with sweat pouring off my forehead and running down the side of my face, pooling up in my ears and in my collarbone.  The pillow was soaked.  My hair was soaked.  An outline of me underneath me, the line drawn with the panicked sweat of hypoglycemia.

Panic.  But tempered panic, since I was so deep into the low that I was slow in recognizing anything.  My status updated slowly:  This is a low.  This is a bad, bad low.  Eat something in a hurry or you’ll probably die.

The juice box on the bedside table was hard to assemble.  Plastic sleeve around the straw, poking the straw through the foil hole … all actions I’ve done before but it took 30 seconds apiece for me to figure out how the whole thing worked.  I drank the juice as fast as I could, in just a gulp or two and then I settled back into my self-made sweat lodge.

A few minutes later – maybe two, maybe twenty – Birdy arrived fresh from a nightmare, clutching her blanket and asking to sleep in our bed because she was scared.  I don’t remember gathering her up, but I do remember putting her on the outskirts of my dampness, snuggling her up against her still-sleeping father.  I was scared, too, still arranging blankets, trying to find a cool, dry section.  I looked at the Dexcom, and it only told me I was LOW and had been LOW for a long time.

Normally, I get up and brush my teeth after a low blood sugar.  Sometimes I use the hairdryer to dry my hypo-damped hair.  This time, I couldn’t move my ankles without feeling the dizziness flooding up to my hairline.  I used the edge of my t-shirt to mop the sweat from my ears.  So gross.  But necessary.

This morning I woke up chilled to the bone, the result of falling back asleep soaked to the skin and then drying off in the cool, fall night.  The Dexcom told me I had risen up safely to 109 mg/dL, and my meter confirmed that result.  My family bounced up and was ready to start their day, and I followed behind them, nursing the hypoglycemic hangover, grateful for technology that woke me up and for portion-controlled hypo treatment, but pretty fucking pissed off that diabetes was the nightmare last night.

 

Diasend: Now With More CGM!?

Is it a glitch?  A misfiring Internet tube?  A mistake that they haven’t realized yet and now I’m that jerk for pointing it out?  WHEN DID THIS HAPPEN?!!

Dexcom data, now available for upload on Diasend.  I don’t know when this changed (last time I looked was over 18 months ago), but it’s working now.  Even here, deep in Rhode Island (can’t go too deep, actually, as it’s a very small state).

After digging through the box of diabetes-related cables that lives in my bathroom cupboard, I can easily upload my glucose meter (Verio Sync), insulin pump (Animas Ping – actually not the easiest upload because it requires dongle dexterity and I can barely say “dongle” without losing it, so being dextrous is extra difficult), and continuous glucose monitor (Dexcom G4).  All my data garbage, dumped into one source.

It’s not streamlined, but it’s closer, and I’ll frigging take it.

(For a list of supported devices, check out this link.  And if you knew Diasend worked with Dexcom for US accounts a long time ago, sorry for being late to the game.  Also, why didn’t you tell me?  I am now VERY EXCITED and the CAPS BUTTON is sort of STUCK.)

Not A Single Decent Number.

“Huh.  223 mg/dL.  Still.”

This was the mumbled mantra of our vacation to Maine.

Aside from the long drive to Bar Harbor (six hours, plus coffee stops and bathroom stops and “Hey, look at that lobster!” stops), the time we spend in Maine is usually very active.  As a family, we did the hike around Jordan Pond (about 3.5 miles), the hike up South Bubble Mountain (with a stop at Bubble Rock), and spent hours walking through downtown Bar Harbor.  The lure of blueberry ice cream was enticing, but I tried to avoid the sweets and instead downed buckets of iced coffee instead.

And yet my blood sugars were complete shit while we were traveling.

I wanted to blame my infusion set, but I changed it once while we were in Maine and my blood sugar numbers remained crap.  I wanted to blame the bottle of insulin but it was the same bottle that worked just fine at home (and it wasn’t like we microwaved it or let it bake in the car).  I wanted to blame my own actions but I was exercising, checking my blood sugar, pre-bolusing for meals, correcting highs, and sticking with reasonable carb intake.

So I blamed diabetes.

The graphs over the four days we were in Maine were gross.  When I wasn’t high (which was the majority of the time), I was erring on the side of high, teasing the edges of 160 and 180 mg/dL all day long.  Why?  No clue.  Hesitant to up my basal rate in the face of constant walking, I just watched the graph ride the mustard for a few days.  Not convenient, because blood sugars running higher means more water, more “Hey, it feels like someone put cement in my sneakers,” more teeth sweaters, more bathroom breaks.

“Mom, do you have to go potty?”

(Fun when the four year old is asking me, instead of the other way around.)

Sometimes the numbers don’t make sense, and this time, I choose to roll with it for a few days.  There are probably six dozen different things I “could have done” to take a bite out of the high blood sugar trend, but I didn’t want to the micromanagement of diabetes to eat up my brain on vacation.  Instead, I did what I was willing to do and thankfully, now that we’re back at home, my Dexcom graphed has settled back into a more forgiving pattern of Pac-Man dots.

I prefer mountains in the landscape, not in my Dexcom graph.

 

 

Whoa! Woe.

First this:

Then this:

So whoa!  Much woe.

BOLUS: Beware Of Loose, Unsupervised Snacks.

I graze.  I’m a grazer.  Visually speaking, my food choices are spread out over a gigantic field and I run through, grabbing bites here and there and never properly taking amounts or serving sizes into account.

“How many grapes did I just eat,” is a common, whispered question.  “Did I bolus for that protein bar?” is another one.  “Hey, I only had eggs and not toast – how many carbs did I bolus for, and what needs to be consumed now so I don’t hit the deck?”

I am good at going through the motions of diabetes management, but I have been slacking on minding the minutiae of late.  I don’t sit down to formal meals throughout the day (schedules are nonexistent at the moment), so keeping track of the food I’m eating has been a challenge.  Grazing makes for dodgy carb counting.

I need to mind my B.O.L.U.S:

Must Beware of Loose, Unsupervised Snacks!  When carbs are roaming around unsupervised and unbolused-for (terrible grammar, worse when spellcheck changes it to “unbloused-for”), blood sugars go high and stay there because I’m chasing my insulin-tail or I go low because I’m over-estimating.  Insulin is potent stuff, and SWAG’ing it makes for Ms and Ws on my Dexcom graph.  If I can just pay-the-fuck-attention to what I’m eating, I’ll have fewer frustrating results.  Right? RIGHT??

The more I mind what I’m eating, the more even my blood sugars will be.

Now let’s see how that theory shakes out, as I attempt it for the 10,000th time since diagnosis.

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