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Posts tagged ‘CGM’

Free Shower.

(to the tune of Tom Petty and the Heartbreakers’ Free Fallin’)

He’s a good pump, does his job well
Loves priming and bolusing too.
He’s a good pump, crazy ‘bout islets
Gives insulin when those islets don’t come through.

It’s a long week being my Dex sensor
There’s adhesive workin’ while I play
And I’m a happy girl cause I don’t even miss them
I’m a happy girl on site change day

And I’m free, free showerin’
Yeah I’m free, free showerin’

All devices are sitting on my counter
Going nowhere until I put them on my bod.
And all the good pumps are taking their short leave
And all the good sensors are still in plastic sleeves

‘Cause I’m free, free showerin’
Yeah I’m free, free showerin’

Free showerin’, now I’m free showerin’
Now I’m free showerin’, now I’m free showerin’

I’m gonna dry off and refill my cartridge
I’m gonna peel back adhesive tapey rings
I’m gonna free shower but then when it’s over
I’ll reconnect with these live-saving things.

For now I’m free, free showerin’
Yeah I’m free, free showerin’

Yeah I’m free, free showerin’
Oh! Free showerin’
Now I’m free
Oh!
Free showerin’

Dexcom Rash: Updated.

Frigging rash.  The issue first presented itself back in August 2012, leaving me scratching my head and itching my sensor sites for the next four years.

At first, I tackled the problem by trying a pile of different barrier tapes, but the only one that brought about any semblance of relief was the Toughpad.  For about a year, I used a Flovent inhaler (sprayed on my skin before applying the CGM sensor), but I was cautioned against it by my first dermatologist, who cited that the skin would become thinner and compromised after prolonged use.  For the last few years, I’ve used the Toughpad exclusively, and it’s held the rash at bay.

Sort of.

It’s never ever perfect.  I’m still itchy as eff sometimes when I’m in the midst of using a sensor (like right now, with my sensor on my right thigh and the skin around the Toughpad is bright red and I want to scratch it off until my nails break but the low alarm that went off two nights ago saved my ass entirely so I’m leaving the sensor on as long as I can stand it).  The rash doesn’t seem to be concentrated underneath the Toughpad as much as before, but now I appear to be allergic to the Opsite Flexifix tape.  Add that to the fact that I get skin irritation even if I put the new sensor next to any place where a sensor has even BEEN for the last month.

A week or two ago, I went to the dermatologist to further investigate my Dexcom rash and to hopefully find different ways to scratch that itch, so to speak.

The new dermatologist circled me like a shark, only maybe a shark in search of medical journal material.  “You’re having an allergic response to the medical device adhesive?”

“Yes.  Since 2012.”

He paused.  “So just don’t use that medical device?”

“Not an option.”  (Totally not an option, especially these days, when I can’t feel my low blood sugar symptoms and I don’t take action on my high blood sugar symptoms unless the CGM is alarming.  This is why I wear a CGM.  And while I’m taking care of two little kids, this is why I will continue to wear my CGM.)

“Okay …” said the dermatologist, looking at my arm and thighs again, assessing the skin damage.  “A Flovent inhaler, too?  You mentioned using that in the past?”

“Yes, but after being warned it would thin out my skin, I stopped.”

“Good call.  Listen, I think we can try two things:  a topical steroid cream, or a non-steroid topical cream.  I would like try the non-steroid one first, because the same skin-thinning issue would happen otherwise.”  He handed me a prescription.

We scheduled a follow up appointment and I was sent on my scratchy way.  The cream, it turns out, comes with a dozen different creepy warnings that have made me very reluctant to try it while breastfeeding my son, but I did put a little bit on my rash and, within the hour, my rash was on fire and the urge to itch was all consuming.  I’m not touching this stuff again until after I’m done breastfeeding, and even then I’ll be very conservative, in case I’m allergic to this shit, too.

I’m not sure what people are doing these days to manage their adhesive irritations, but I’m reaching the end of my available skin real estate.  Any advice out there? It’s been a very long few years of wearing the CGM 24/7 and I’ve just about run out of sites that aren’t already scaly and raw.  I hear rumors about a “sensitive” adhesive being released by the Dexcom team, and about certain elements being removed from the current adhesive makeup, but until those products are shipped to my house and not sending my skin into circus mode, I’m at an itchy loss.

Rasharoni.

As this pregnancy continues on, so does the rapid rounding-out of my abdomen (today’s issue = not being able to zip my jacket without over-taxing the zipper). Feeling quite like Violet Beauregard from Charlie and the Chocolate Factory.

Pluses to this expansion are that a. the pregnancy is progressing on schedule and b. the real estate options for my pump site and Dexcom sensor are literally broadening.  Which is useful, since my adhesive rash is in full rawr mode.

In response to rashes that are taking weeks to heal properly (they aren’t oozing or anything gross, but a particularly cold day or a too-hot shower will make the area where the sensor and any tape was get madly scaly, red, and itchy), I’ve needed to really mix up where my diabetes devices are applied.  I put a sensor on my lower left-side abdomen for the first time in almost a decade and it hurt like hell going in but did not leave a residual rash when I removed it.

New skin holds up better than my favored spots, but with only seven days of wear and an aversion to abdomen sites, it’s getting tricky.  At the Friends for Life Falls Church conference in DC this past weekend, there was discussion in several groups about rash strategies, but I can’t recall everything that everyone said.  (If you have tips on dealing with skin irritation, please share them!)

I am seeing a dermatologist again this week to see if they can offer any relief/advice/assistance, so there is hope.  For now, Toughpads, DermaSarra lotion, and site rotation are my best defense.  Because hope remains an itch I refuse to scratch … especially when there are so many other bits of me that need scritch-scratching.

Second Impressions: Dexcom G5 Mobile.

Disclosure Up Front (where it should be)I have a relationship with Dexcom that includes receiving my continuous glucose supplies at no cost.  More details are outlined here on my disclosures page, but please know that the bias I’m bringing to this is pretty significant, not simply because of the working relationship with Dexcom but also the fact that this CGM has been part of my diabetes care plan since 2006, so I’m in deep for a dozen different reasons.  If you have any questions, feel free to reach out.

It’s been about a month since suiting up with the Dexcom G5 (upgrading from the previous G4 iteration) and so far, the transition has been way less jarring than I had anticipated.  Here are some second impressions:

The Parts I Like:

I was initially concerned about phone battery life, but I haven’t seen any significant change since switching to G5.  (Must be noted:  I upgraded my iPhone two weeks before starting on the G5, so any battery improvement was a big deal after switching from the iPhone 5s, which would eek down to 80% an hour after unplugging.  Also, I didn’t realize until very recently that you can double-click the home button to bring up all active apps and then close said active apps.  These two changes have improved my phone battery life exponentially.)  But having the phone as the sole data receiver has made me fastidious about bringing a back-up battery charger everywhere I go.  Which is not a new thing, but now feels like a necessary thing.

I had doubts about using the G5 on an airplane, as well, until I remembered that Bluetooth can remain active even when a phone is in airplane mode.  I’ve had a chance to test out the G5 while traveling a few times now and the phone makes a fine receiver even when it can’t make phone calls.  This was a relief.

I haven’t traveled outside of the US yet with the G5, but I’ll be headed to Vancouver for the IDF conference this afternoon, so I’ll have a few days to see how the G5 does when my cell phone has no service.  (I’m guessing Share will be out of commission unless I’m connected to wifi.  Filed under:  No shit, Sparling.)

I really dig the Dexcom Clarity application on my computer.  I know this isn’t new with the G5, but I’ve only been using Clarity since upgrading to the G5, and it’s very nice to see the data living happily on that system.  I like the A1C predictor thing, but have found it a bit fickle.  (“Your A1C looks great today!” … three days later … “Your A1C is crap.  Go directly to jail.”)  I’m still waiting to hear what my actual blood-draw A1C is, so I can’t compare the estimation to the lab work, but I’m curious to see how close those two numbers are.

Accuracy-wise, the G5 does seem to be an improvement.  The data is spot-frigging-on with my Verio Sync results.  No complaints there.

The Parts That Could Use a Shift:

I also don’t like that the alarms on the Share are exactly the same as those on the Dexcom app.  This works great for people like Chris, who follows my Dexcom data through the Share app, but for me, I am responding to my personal alarms and the alarms for the people who Share with me.  I would like the ability to change the alarm noises on my Share app so that when a low alarm goes off, I am positive it’s mine.  In the last month, I’ve treated two lows that were not mine because I responded to the alarm noise instead of checking to see which PWD was actually low.  This is a problem unique to PWD who follow other PWD on Share, but it’s making me feel daft and changing the sound would be an upgrade.

The transmitter is bigger than the G4 one.  I was not as irritated by this as I thought I would be, but when I wear the sensor on my arm, it’s very sticky-outty, and I don’t like more space being dedicated to diabetes devices.  It would be awesome to have the transmitter the size of the G4 one.  Or the size of a grain of rice.  The transmitter also claims to work for three months (instead of the six promised by the G4, which actually ended up being more like 8 months), which means I need to order new transmitters more often.  That adds one more item to the constant “to do” list of diabetes supply crap.

The G5 sensors are the same as the G4 sensors, which means the adhesive is the same as before, which means I am allergic to it.  Toughpads are still required under ever sensor, for me, and with winter almost here, my skin is starting to have its seasonal freak-out.  (The rash is not unique. There is a Facebook group with almost 500 members in it that are comparing ways to mitigate the itch.  Come on, Dexcom — find a way to update your adhesive with as much speed as you’ve done with your data transmission.)

I use an Animas Vibe insulin pump and the G5 does not transmit data to that pump.  So if my phone dies, I can’t switch over to the Vibe as my receiver.  I look forward to when the pumps integrated with Dexcom upgrade their abilities to work with G5.  Until then, it’s annoying to take one step forward with Dexcom while standing completely still with insulin pump technology.

The Parts That Remain the Same:

I never thought I’d see streaming glucose data.  I’m so grateful that I have access to this data because this is the kind of real-time safety net my parents were hopeful for back when I was diagnosed.  I’m sorry they weren’t able to take advantage of it then, but I’m glad it’s here now.

Because otherwise, what would wake me up all night long?  The cats?  That’s so 2005.

Lower Arm Real Estate.

“Rotating sites?  Hell yeah, I rotate.”

… sort of.

I’m good about rotating my pump and CGM (continuous glucose monitor) sites, but I’m decent, at best, about exploring new real estate.  Most of the time, I use my outer thigh or lower back/hips for my CGM, going back and forth between those four areas.  This sounds like proper rotating, in theory, but in practice, I am re-using and abusing the same patches of skin.

Because my skin has a persistent and scaly reaction to the sensor adhesives, it takes several weeks for parts of me to heal after they do their seven days of data due diligence.  Which means that I need to stay the eff away from my last two most recent sensor sites, or else a skin reaction blooms in a matter of hours, regardless of preventative measures.

tl;dr – My skin hates everything and I need new real estate for my diabetes devices.

I’ve seen a few of my PWD friends sporting their sensors on their arms, but until recently, I’ve never been able to keep an arm sensor stuck.  On me, the tape always comes loose and even extra adhesive goes rogue on me.  Arm sensors, up where I used to pinch up and do injections on the back of my arm, are a disaster for me.

But a few days ago, I took a crack at a lower arm sensor, placing it six inches or so above my elbow.  It’s more on the front of my arm (giving my bicep a strangely LEGO’ish look), but so far, so good.  The adhesive is staying put, the Toughpad seems fine, and no skin irritation here on day three.

Above the elbow Dexcom sensor. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Placement of sensor on arm. My arm. (Why does this caption sound so formal?! Over and out.) #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

I’ve been having trouble keeping sensors comfortably stuck in the last few weeks, so I’m hoping a true and proper site rotation helps heal what ails me.  Otherwise, I may scratch my skin into oblivion and will be forced to slather it with Brad Pitt lotion.

[Dexcom disclosures. And all my other disclosures, if you’d like some light reading.]

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