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Posts tagged ‘blood glucose’

Looking Back: How Often Should I Change My Lancet? (A “Grost.)

source: Type 1 Diabetes Memes

I’m on the road today, visiting with the Patient Revolution team, so I’m looking back at a post from the past.  But it’s not just any post … it’s a grost.  (A gross post.)  How often do you change your lancet?  I will admit that I don’t do it as often as I should, but I’ve been really trying to do it more regularly.  In efforts to keep my fingertips from hating me.

  *   *  *

(Taking a cue from Glu today because when this post rolled through my feed, I was like, “Hmmm.  A lot now, but before?  NEVER!!”)

Every single time there’s a new meme about changing the lancet in a finger pricker device (nope, that is not the technical term), I laugh because they are all true in that “whoops” sort of way.

Upstairs in the bathroom closet, I have boxes and boxes of lancets for all kinds of different poker devices (again, not the technical term).  All different sizes and shapes and gauges … years and years worth of lancets for half a dozen different devices.  (Except The Guillotine.  That thing was retired decades ago, thank goodness.)  And the reason I have so many lancets stashed?  I went years without regularly changing my lancet.

Gross.  I know.  And I’ve seen that photo of what a needle looks like before use, after one use, and after six uses and yes, it grosses me right the hell out.  But for a long, long time, I changed my lancet once a month.  Maybe once a week, depending.  And I only changed it if it didn’t procure a good blood droplet or if it went into my fingertip and got “stuck.”  (You know what I mean … when you press the button and the lancet deploys, only it lodges itself into your fingertip and has a weird suction feeling when it pulls out?  Horribly horrible.)  Lancet swapping-out was a shameful non-priority for a long time.

Two things made me start changing my lancet regularly:

ONE.  A friend told me about how she’d heard a story about a person with diabetes whose fingertips were downright gangrenous because they didn’t change their lancet.  “Ew, really?”  “Really.”  And even though I stand firmly on the “hope vs. fear” motivation concept, this story about mostly-dead fingertips made me want to throw up.  Then I started searching the Internet for information on needle reuse and the photos made me want to apologize profusely to all my digits.  I had no idea how nasty and serrated the needle edges became after just one use.  I thought about all the times I had injected syringes through my jeans in high school.  I thought about how a box of lancets could last me two years.  I thought about how gross I was.  Gross, gross, groooooosssssss.

TWO.  And then I explored lancing device options.  I had heard really good things about the Accu-Chek Multiclix (mostly from Sara, because she frigging loves hers), and the device was snazzy because it comes with a drum of lancets that automagically swap out, but the size of the thing was too big for the case I kept my meter in.  Switching to the One Touch Delica was the winner, for me, because the lancet gauge is so thin that I’m forced to change it regularly because otherwise, I don’t bleed.  (It becomes that dance of pull back the device, press the button, nothing happens, repeat 10x, change lancet and curse.)  Like it or not, I have to change my lancet regularly or the device becomes useless.

Now I change my lancet once a day.  Every day.  And every time I kill a box of lancets, I feel accomplished because in the last four years, I’ve gone through at least two dozen boxes.

In the 20+ years prior?  Probably the same number of lancet boxes.

It’s Just a Blood Sugar Check.

Checking my blood sugar takes less than 30 seconds.  Truly – upcapping the bottle of test strips, inserting the strip, pricking my finger tip, squeezing blood onto the absorption pad on the test strip, waiting the five second countdown of my meter to see the result up on the screen, and then taking the strip out and turning off the meter.

Thirty seconds.

Great.  No big deal.  Easy-peasy, and other rhyming phrases.

Let’s add in the responsive elements.  First, I anticipate the result.

Have you ever had go force yourself to check your blood sugar because you don’t want to see the result?  You know you’re high, so you want to avoid confirming it because seeing that number adds to the emotional failure quotient.  Have you ever forgone checking your blood sugar because you know you’re low, choosing fast-acting glucose sources over the 30 second confirmation routine?  The process of checking blood sugar isn’t just the installation of strip, pricking of finger.  There’s oftentimes an emotional hurdle that needs to be leapt over first, forcing me to attempt to view data as data instead of data as self-worth.

Then I perform the glucose check.

Then I respond mentally.  What is that number?  Do I have insulin on board?  Have I exercised in the last hour or two?  Am I planning on exercising?  Do I need to correct the number, either with food or insulin or exercise, to bring it into range?  Am I okay to leave it alone?

Normal questions like, “Am I hungry?” come to mind oddly late in this hierarchy.

But before the mental response, I respond emotionally.  A blood glucose result of any kind stirs up emotions, even when I try to immediately squash them.  There’s pride built into a 100 mg/dL.  Anxiety built into a 50 mg/dL.  Guilt baked right the fuck into a 300 mg/dL.  This is what keeps me from viewing my data as simply “data,” because every number represents something I’ve done or didn’t do … and I need to remind myself more that the thing I’m honestly not doing is making insulin.  The rest is a basket of beady variables that spill out unpredictably.

Checking my blood sugar is important because it gives me a view of where I’m at and helps me set the pace for where I’m going.  But it’s never “just a blood sugar check.”  It’s more than that.  There’s so much mental and emotional real estate dedicated to a 30 second process.

 

How Often?

“How often do you think about diabetes on an average day?”

“Not sure,” I said, checking my blood glucose twice so I could calibrate my continuous glucose monitor, mentally calculating the lunch insulin bolus I needed to take cover my food without making me low for my run later this afternoon. Looking at the five strips left in the bottle, I realized I needed to refill my kit. And to also reorder supplies.

“Probably a lot.”

First Impressions: One Touch Verio Sync.

[Disclosures up front:  I currently have a contract with Animas and I have received the Verio Sync meter for review prior to the full US launch. I was not asked to write this review.  Opinions shared, for better or for worse, are mine.  Typos, too.]

“Mawm!  Are there cookies in there?” my daughter asked, after the package containing the Verio Sync meter was delivered.  (Not sure why, as we’ve yet to receive cookies in the mail.)

“No, it’s a new meter.  To check my blood sugar,” I replied.

“Oh.  To make sure it isn’t whoa?”

I’ve been using the Verio IQ for over a year now, and I have a good relationship with that meter.  (It still buys me flowers, and I scratch its back before bed.)  I’m adjusting to not using the Ping remote to bolus (though I miss that feature) and I don’t often use the tagging feature, but I like that it’s available, if I want to use it.  Basically, I want my meter to give me accurate results and to fit into my insurance coverage.  Those are my two big needs.  If it’s cool to look at and does fancy things, even better, but those first two needs make or break my relationship with a meter.

Testing out the Verio Sync wasn’t a big switch, but there are differences between the Sync and the IQ.  The Sync, at its core, is the same meter but it syncs up with my iPhone via the One Touch Reveal app, sucking all the results over and logging them automagically.

Comparing the Sync to the IQ is apples to apples, for me, because I was already happily using the IQ.  That said, I like these apples.  Personal pros and cons?  Got ’em.

PROS of the VERIO SYNC:

  • It looks and feels like the meter I was using (Verio IQ).  The results are consistent with my Verio IQ, and with my Dexcom results.  It fits into the meter bag I use.  It uses the same strips as the IQ.
  • The syncing mechanism is easy, and seamless, in that the Bluetooth capability on my iPhone needs to be active, and the Sync needs to be paired with my phone.  The set-up process took a matter of seconds.
  • The interface of the application is very visual, and downright pretty.  Like with the Dexom G4 system, adding in color-coding as a reference point is terrific because it gives me a quick look at how my blood sugars are doing.  Lots of green means I’m in-range often, while blue and red signify lows and highs, respectfully.  The bar graph of in-range/out-of-range is also calculated by percentages, which gives a more finely tuned look into my numbers.
  • Logging specifics like insulin dose (kind, units), activity levels (type, duration, exertion level), and being able to fine-tune the timing of my day through the logbook set-up make for personalized diabetes management.  My doctor will love this data, and I’d do well to look at it more closely.  (But how long will it be before I burn out on inputting all that data, and return to my basic meter needs of “be accurate, be covered?”)
  • Also, every data point has the option for notes, which makes a HUGE difference for me in terms of actually making the data useful.  I can say that I was 240 mg/dL before 60 minutes of moderate exercise, but being able to add that I took a correction bolus before exercising puts a post-exercise low into context more precisely than me looking at the results a few days later, forgetting I had corrected, and thinking that the moderate exercise dropped my blood sugar more than it did, in reality.  Data is most useful in context, and open-field note options are long overdue in this kind of diabetes software.  And not just in the blood sugar result data points, but ALL data points.

  • One thing I always look at on my meter(s) are the averages, and the Sync gives averages in an overall sense, but also offers blood sugar averages by time-of-day (and looking at mine, I see that that lunchtime results could use some love, as could before bed.)

CONS of the VERIO SYNC:

  • Even though the device was paired and the Bluetooth was on, it didn’t sync automagically for the first few blood sugar checks.  I’m not sure why.  Now, a week later, it syncs fine.
  • Leaving the Bluetooth active on my phone sucks the battery life away.  Not optimal, especially while traveling.
  • Entering the logbook times of day was awkward.  Sliding the little white dots around to indicate the time took longer than it should have because my fingers are stupid.
  • The Sync has a white-text-on-black-screen feel on the meter itself.  This is the biggest con, for me, because the colorful screen of the Verio IQ is easier on the eyes on all levels.  Why go backwards?
  • Rechargeable meters seem to be the wave of the future, but needing to charge my meter makes me a little anxious.  I’m already worried I don’t have all the appropriate cables, etc. while I’m traveling, and now I need to make sure I have my meter charger, too.
  • I have absolutely no idea if I’m able to export the logbook to something I can print/send to my doctor.  Having it on my phone is great, but unless I can export the data to something shareable (even a Word doc), it’s only useful to me.  (Exporting the logbooks might be an option, but at the time of writing this, I haven’t figured it out yet.)
    EDIT:  I heard from the PR outreach person for Lifescan and they updated me re: the ability to export.  From her email:  “One of the comments we noticed had to do with exporting the log book to something you can print/send to your doctor. We wanted to let you know that by sending just what is on your screen, the system allows you to control what part of the logbook you’re sharing. You can use the 14-Day Results screen to email a table with all 14 days of results – just tap on the range bar on the 14-Day Glucose Report to get to the 14-Day Results Screen. When you share this screen as an email it is converted into a table.”  I tried this out by going to the 14 Day Results page and then pressing my finger against the screen and holding to bring up a “Help/Share” menu.  By clicking “Share,” I was given the option to “Email, Text, or Cancel.”  Clicking email exported the 14 Day Results page into an email – EASY.
  • If I don’t use the app, and I only use the meter, the Sync is inferior to the Verio IQ in look and feel.
  • Which brings me to the last con:  if the usual techno-joy burnout sets in and the meter becomes simply a meter (and not a clever way to easily create a logbook), it’s not as nice to use at the Verio IQ.  Accuracy seems to be the same as the IQ, but the MS-DOS look of the Sync screen isn’t nearly as nice as the updated, clean look of the Verio IQ.

If there was a way to mash up the visual appeal of the Verio IQ meter and have that be the one that automagically syncs with an iPhone app, this meter would hit all the marks for me.  For now, I’ll bounce between the Sync and the IQ as preference and phone battery allow.

Off to see if I can mail order cookies for Cyber Monday.

Strip Safely: Taking to Twitter.

(Note that the banner looks like a test strip.  Clever, eh?)

Wednesdays are usually a diabetes-heavy night on Twitter, since it’s the night that the #DSMA conversation takes place (at 9 pm EST – check out the #DSMA webpage for info, and for tips on joining the conversation, click through to this post on Diabetes and Twitter).  Lots of #diabetes and #DOC hashtags happening on Wednesday nights.

So let’s add one more to tonight’s agenda?  YES.

The Strip Safely website offers the following details on what’s at stake, and how you can get involved:

“Please Tweet Congressional leadership and your elected officials, letting them know how important it is for their aides to attend the Diabetes Technology Meeting: ‘Verifying the Performance of Blood Glucose Monitors Following FDA Clearance.’

Click the ‘Tweet about Meeting’ link next to a Member’s name to send a tweet asking them to send a staff aide to the September 9 Diabetes Technology Society Meeting. Not sure who your Representative is in the House? Use this link: http://www.house.gov/representatives/find/

All U.S. citizens, regardless of state, should tweet the Senate and House Leaderships.

Then, please, get creative and send additional positive messages to help the diabetes community build friends in Congress. (Include the hash tag #StripSafely.) Feel free to use this link to our letter for your tweets: http://www.stripsafely.com/?page_id=618

Diabetes isn’t partisan about whose life it impacts. We shouldn’t be partisan in seeking support for safe tools to say healthy.”

If you’re living in the United States, tonight is a night to raise awareness, and a ruckus, about how test strip accuracy, and reliability, matter to all people with diabetes.  Send your Tweets out between 8 – 9 pm EST, before #dsma.  Our elected officials need to know what matters to us, and taking to social media is one way to show them how many of us want – need – to be heard.

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