First Day With Dex

This post has been sitting in my Drafts for about two weeks now. Work just hasn’t let me not work recently, and by the time I come home, I’m exhausted. Blogging smogging. But it’s “wordless Wednesday” still, and this post has lots of photos. But also lots of words.

So I named the new Dexcom “Dex” for obvious reasons.

Both seem to like blood.

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See what I mean? (That’s the calibration symbol by the way.)20140213-072925.jpg

Dex arrived on the 11th in its shiny box-ness. There were really detailed pictograms and instructions, but the supplier I purchased this all from said the YouTube tutorials was where it was at.

I have to admit I felt like something was missing – the sensor inserters! I was told everything was included, except for maybe the tape to keep the adhesive down. But MedT always made me buy some other Insertion device, so I got really confused. Turns out the sensors are all inclusive and the inserters are one-time use, disposable plungers, so to speak.

So after a quick couple views of the instructions and 2 viewings of the YouTube tutorial, I decided to place my first sensor. It was a little weird, but definitely NOT painful or jarring like the old Sof Sensors were. But I wanted to let the sensor marinate overnight, thinking I’d get a quicker calibration period like the MedTs do.

Apparently Dex’s don’t work like that. You need to wait the full two hours after you start a sensor, regardless if it’s been sitting in your system for 8 hours. Hmph. It didn’t do me much good because an hour and half into my sensor start, I got this.

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Apparently this is Dex’s “Sensor Error.” If you are a MedT user, you know these generally figure themselves out eventually. This did too.

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And we’re back to normal. Time for calibration! Naturally, I just wanted to finger-stick myself all day to check the accuracy. I couldn’t help it! However, my fingers probably wished I hadn’t.

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Not identical, but mostly in range.

Of course I was having a banner blood sugar day and I wanted to test the effectiveness of the sensor, so I gave it a test.

Dex… meet Red Velvet Macaroon.20140213-073021.jpg

Actually, it wasn’t really worth the carb counting, but I’ve never had one before, so why not. It didn’t come without debate because I’d been having a no-hitter for the last few hours. Why mess with it? Oh well.20140213-073035.jpg

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I did get a matchy some time after the macaroon! So that was exciting.

It’s not without it’s downfalls and quirks, however. While 95% of my low alarms have been legit, I still have trouble with CGMs recognizing how high I am. That was among my complaints with the Sof Sensors. The give and take accuracy was never giving and taking in the correct direction. I’ve had the same problem with the Dex.
20140213-073059.jpgAlso – that disclaimer about the Dex running higher than normal after you take Tylenol? Totally legit, which is kind of a bummer if I take something for a headache or cramps right before bed. (Guess I won’t be sleeping much tonight again.)

I also never really got a personalized phone call from Dexcom, the company, after I received my Dex. I got a RoboCall, telling me that if I had any additional questions, I should call their Help Line. Alright fine… but no account manager, no customer service reach out… nothing. I mean, I figured it out on my own, but I thought it was weird from a service stand point.

I’m on my second sensor. I tried to go beyond the 7 days on my first sensor like everyone else does, but I got more “???” signs, meaning my sensor was probably in a rough spot. (My stomach is never a good place for sensors.) The sensor in my hip seems to be working just fine.

I also don’t completely trust the Dex yet. In fact, it’s too the point where I’m checking so often, my CDE doesn’t need the Dexcom trending graphs to see what my blood sugars are doing every hour. Yes – my fingers are really sore.

Carrying two devices is also a little weird, but it’s got such a kick ass range, I don’t feel like I need to carry it around all the time in my pocket. It stays on my desk at work for reference and I’ll take it with me if I leave the office for an extended period of time. I set it on a table at the dance studio during a private lesson. It stays on my nightstand while I sleep.

So far, so good.

Obligatory “The Year is Ending” Post

I used to write up a list of goals for the coming year. I did it because I hated resolutions and all their empty promises to do things better. Check-lists were much easier to maintain over “Lose 20 pounds! Quit drinking! Join a gym!”

Ugh.

However, I stopped doing check lists too because for about 3 check lists, I said I was going to paint our guest bathroom. That hasn’t happened yet. And probably won’t unless we remodel.

So what do I have to look forward in 2014?

– More family-in-law gripes about their now-expensive health care. (And me shaking my head because my 30 year old brother-in-law shouldn’t be considered their dependent.)

– A new insulin pump and CGM system – whichever brand I decide.

– No ballroom comps to speak of. I’m kinda done with the spandex costumes, which leaves room for…

– More west coast swing conventions. Looking to hit a few I missed last year due to finances and traveling to a few.

– Getting our studio’s ballroom program back on track with some pretty awesome marketing by moi!

– A new refrigerator! Which should be here tomorrow to replace our slowly dying model. First the water dispense goes, then it’s hot to touch, it makes weird noises AND the light in the fridge finally burned out.

– A new laptop! (Which showed up today!) This replaces my 7 year old model, which can’t keep a charge for more than 45 minutes, won’t recognize any USB devices larger than a wireless mouse, and sounds like it’s going to take off into space every time I edit photos.

– Maintenance of the 6.2% A1C without nightly visits to my new fridge to reach for yet ANOTHER 4 oz cup of OJ or AJ.

– Paying off my credit card from said expenses.

– Paying off our 2nd mortgage and legitimately owning 20% of our house.

– Possibly re-designing this blog a bit. Not sure. 🙂

Happy New Year!

Friday Five*: Insulin Pump Shopping

I thought this would be more exciting, but it really isn’t. I haven’t really been swayed by any of the brands out there 100%, but – after my Paradigm decided not to recognize the battery change yesterday morning, I’m thinking I need to make a decision fairly quickly. (And call for ANOTHER replacement pump… #4 in the last year.)

1) I’ve decided against upgrading to an OmniPod. While the wireless capability is pretty awesome and the customer service is spot on, the programming of the pump is not much different than my Paradigm. My docs would love for me to be able to explore a .25 unit change in my basals and the Pods can only administer a .5 unit increment, with no plans to make that an option. Their lowest carb count ratio is 1:1, which is pretty typical, but apparently other pumps can get down to .5:1, which will be super handy during that 3rd Trimester, when it should occur.

2) I really like T:Slims interface and the sleekness of it, however, their customer service has left a slightly sour taste in my mouth – and I haven’t even purchased the pump yet. I sent in my patient paper work TWICE… and still had to call someone to figure out what the heck was going on. I understand it’s the end of the year and people are probably trying to spend their deductibles. But – a little bit of “hey – thanks for your interest” would be nice. Especially if I’m going to drop $50/month on supplies.

3) I sent in my paper work to Dexcom for a G4 Platinum. I figure if I have to buy a brand new transmitter outright with the new Medtronic 530G, I might as well just get what I want. Anything I get at this point, though, will hopefully be way more accurate and less finicky than what I have now. (Though – I had to order more sensors yesterday because, well February is 2.5 months out…) I know my docs keep telling me that it’s not really the number I should be concerned with, but the direction, it’s hard justifying waking up in the 190s and stable when your CGM says you’ve been in the 130s and stable. (Or that you’ve already hit 47 when your CGM says you’re 110… that sort of thing.)

4) A reason to stick with Medtronic? Carelink. My docs know how to use it. I can just upload and send a secure message for them to evaluate – done. I believe all other pumps have SOME sort of reporting software, but I don’t know what it entails, (how much it costs), and if my docs can access it. My CDE has suddenly stopped being able to accept emails from me and her suggestions are becoming more “canned.” I figure sending her attachments is a bad idea now. It’s a bit disappointing. Anyway – if you are not using Carelink, how do you get your Dexcom or Pump or Meter results to your doctor for evaluation?

5) I still have to take a look at the Animas Ping. But – you know… the holidays and stuff.

5.5) The Asante Snap isn’t available in my area, apparently. (WTF!?)

 

On the bright side, I’ve discovered that my health insurance doesn’t have a contract solely with Medtronic, so I am free to shop around to the larger companies. But since my Insurance is “local” and “special,” the Pump companies have a few work-arounds that need to be put in place, thus probably taking longer for approvals and such. But – it’s a 20% co-pay regardless where I go. So – that’s good news. (In the grand scheme of things.)

Have a good weekend.

#WW: Champs with Diabetes

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I’ve been meaning to give Stephen over at Happy Medium props for starting up this program. In an effort to recognize the crazy D-Athletes out there that scale mountains, run marathons, or in my case, compete in dance competitions, Stephen started a Champs with Diabetes program. You can read about it here. (Because this is Wordless Wednesday and all.) I got all of this cool stuff for participating! I just owe him a photo of me with the medal on for the program’s Twitter page – which may have to wait until my next comp (this weekend) or my next show (which is the following weekend.) We’ll see. 🙂

A Slim Chance

I may have mentioned that my warranty ends on my Minimed in February, prompting me to get excited about getting the new 530G and Enlite sensor/transmitter system.

But I thought… hmm, I have the opportunity to shop around for a new brand of pump because my insurance isn’t limited to a Medtronic contract, why am I not taking it?

I know Kim over at textingmypancreas is also shopping around for a pump, so I’m following her trials and reviews a bit more closely.

Lifestyle-wise, I’ve added the T:Slim to my list of possible upgrades.

This is the T:Slim:

tslim-pump-front

It’s a touch screen insulin pump, similar to a smart phone. This would alleviate the issues I seem to have with button errors when sticking the pump in places other than a pants pocket. (See my NYE story last year…) It also has a rechargeable battery rather than being powered by an Energizer disposable, so the tree-hugger in me is semi-soothed. (Insulin pumps still produce a lot of waste, but whatever.) The infusion sets seem fairly similar, if not better, than my standard sets from Medtronic. You can enter carb counts on a keypad rather than scrolling through a sequential list. It’s flat – so more comfortable to sleep on. Color screen is easier to see in the dark or bright light – much like a smart phone. And there is an app to upload data for evaluation by a health care provider.

Sounds awesome, right? Well – you take the good with the bad. The T:Slim was introduced in 2012 by Tandem – a brand new start up trying to revolutionize pumping. Fine and dandy unless you are someone who doesn’t like to try the first version of anything. With the startup comes complaints about customer service, etc. and so forth. However, I’ve had some interesting customer service from Medtronic over the years so, that’s not a HUGE concern. (But still a valid one.) The other thing to consider is that I would need a separate device to act as my CGM. The obvious choice would be a Dexcom, which many in the DOC love to pieces and tell me it’s heaven compared to my mosquito sensors… but again, the inconvenience (and expense) of ANOTHER sensor device to tote around feels like a hassle when compared to my All-in-One, no matter how inaccurate it may be.

(Though – rumor has is that t:slim and Dexcom will be integrating eventually into one device as well… but it’s not yet.)

Anyway, I told my husband about my cursory research and that this could be the future of my pumping. Here is how the conversation went.

M: It’s fancy.
J: Yup.
M: It looks like an iPhone.
J: Yeah a little bit, huh?
M: Can it play your Snoopy game?
J: No, probably not.
M: What about Insulin vs. Carbies?
J: …Yes… actually, yes, that’s exactly it.

Think about it…

GRAAAAAAIIIINNNNNNSSSSSS!!!

GRAAAAAAIIIINNNNNNSSSSSS!!!

I think my husband is on to something.

Surviving a Holiday – T1D Style

Thus begins the season of extra stress, extra meals, and wondering how I managed to plunge through 150 units of insulin in 2 days flat.

It’s the HOLIDAYS!

And if you are celebrating Hannukhah, you get double the celebration today and tomorrow.

With all of the home-made goodness, piles of appetizers, and a litany of desserts, carb counting becomes damn near impossible a challenge. And it’s not just the variety of food that’s available with my family – it’s the amount. Seriously – Thanksgiving is an ordeal. We invite 30 people, but we cook for 50 and for whatever reason, everyone feels inclined to also bring a dessert. It really doesn’t make sense. But – I press on anyway. Usually avoiding my mom’s latest Pinterest find.

So what to do? Well, let’s start with the basics. This really cool infographic got tossed around on Twitter by Glucolift (and was created by Tandem Diabetes Care.) Give it a whirl.

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Not a bad place to start. But it’s missing the appetizers, wine, beer, cupcake turkeys, y’know… what really messes with your carb counts and makes you wonder why you suddenly have 15 active units in your system by the time dinner rolls around.

Here’s my plan – For appetizers, I try to stick to the veggie platter and dip. I’m trying this recipe instead of buying regular ol’ Ranch. Since it has avocados, I’m hoping it’ll fill me up faster so I don’t sit in front of the appetizer table and fill up before dinner actually starts. I just have to watch the carrot intake and I’m good.

For dinner? I’m actually not a huge fan of Turkey by itself. On a sandwich with cheese? Fine. Alone? Nope. But you kind of have to eat it on Thanksgiving. Then I load up the plate with salad, because salad expands and takes up a ton of room on a plate, thus leaving zero room for not so D-friendly items. (Like cheesy casseroles, mashed potatoes and whatnot.) I also don’t like Stuffing, gravy, and certain vegetables. (And definitely not the canned cranberry sauce.) See? Being a picky eater has its benefits! I just avoided a crap ton of carbs right there!

Dessert time! I’m usually too full to stick try and stuff more food down my throat. But if I have room, a sampler plate is generally the way to go. Or I share with my husband. Small tastes of everything are a lot easier to manage than trying to eat all the pie, cupcakes, cookies, candy… yes it’s ALL there!

Or I’m nursing a glass of wine for dessert. Either or. (Alcohol intake and your D may vary.)

So – there you go. A mini survival kit for your holiday experience. Have a wonderful Thanksgiving and thank YOU for following along!

Thankful for: Temp Basals

It’s Thanksgiving Week and I figured I’d throw out a few “thankful for” posts, as that seems to be a trendy thing to do this month.

Anyway – I’ve been MIA for the last few days because the hubs and I decided to go see Disneyland all decked out for Christmas. YAY! We had a very expensive enjoyable weekend to ourselves while admiring how The Mouse does itself up for the holidays.

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It does quite nicely actually.

My blood sugars were tricky, in that you are generally surrounded by not-all-that-healthy food choices but you are active for up to 8 hours per day.

1459814_10152059354311257_21927445_nThis is generally what I saw an hour to two hours after a meal. (That high trend was me skipping breakfast and getting on an airplane at 8 am.) So – a bit scary to see that slight downward trend with 5-6 active units left in your system and no typical post meal spike present. (I think I might have had one high alarm the entire trip.)

So I used the temp basal setting on my pump a lot this weekend. It didn’t always work and I still hung out in the 60s and 70s. But – it saved me from a lot of grief during some of my middle of the night alarms. (Because, exercise can effect BGs long after the day is done, y’know.)

On the flipside, I got to enjoy a Dole Whip, half a churro, and gingerbread bengiets without any spikes in the sugar. (Or insulin for that matter!)

Oh and this:

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Certainly not a Disney breakfast without one of these. YUM!

Friday Five: Parenting Edition

Today I’m reflecting on some of the trials and tribulations my parents went through  raising a T1D daughter. There are a number of D-Parent blogs out there that I peak at every once in a while. However, here’s what I remember as a child about having D-Parents in the 80s.

1) I complain a lot about my CGM waking me up every hour, on the hour with alarms. My hubs also grumbles a bit. However, my parents didn’t have the alarms of CGMs… only the alarms of their analog clocks and their best guess at patterns and research of when my NPH would send me crashing down at 2 am every night. I mastered the art of drinking juice while unconscious. It helped me later if I passed out in a grocery store, or in front of the neighbors’ kids, or on the playground. Generally, I remember waking up to the fuzzy image of my mom’s permed 80s hair with a killer headache.

2) I don’t really remember being a very picky eater. But I had my moments. Particularly, during weekends away at Family Camp. Y’know, go hang out in the woods with your family and a slew of other T1 Families. Go on hikes with nurses and heavy backpacks. Learn square dancing. Do crafts by the campfire. Yadda yadda yadda. (For those that know me in real life, YES, I went camping!) Anyway, my nemesis on these trips was the camp cafeteria. Because it wasn’t home cooked at home, nor was it a grilled cheese sandwich. And these meals were prepped by dietitians and not chefs so everything tasted like cardboard. But I needed my Regular insulin. And my parents gave me my same dose before dinner every night… then sat with me for as long as two hours after the dinner buffet opened because “I wasn’t hungry/didn’t want to eat this food/bleh.”

3) Vacations were always exciting. Particularly if we flew anywhere. (Which was often.) The amount of snacks we smuggled on to flights was insane. We still had to abide by the 2 luggage per person rule, but we kind of took that for granted… sometimes… most of the time? I remember tupperware jugs of chex mix, crackers and whatnot. On that note – hypoglycemia and flying didn’t mix well with me. Particularly if the airplane food was bad (see above story). Those kids that you often roll your eyes at for the incessant crying and whining. That was me. But I had good reason. Right?

4) Negotiating with restaurants always seemed to be a favorite past-time of my parents. My mom usually kept Ketone strips in her purse. Not for testing for Ketones on the go. But for testing sodas to make sure the restaurant gave me diet. I remember one time, my mom somehow deduced that this fast food restaurant had the lines for the diet coke and regular coke switched because my Ketone strip was coming out bright ass blue. (And it tasted funny.) So rather than asking for a refund for the soda I couldn’t drink, my parents asked that the lines be switched so the correct soda could be distributed. Mmkay.

5) My parents just made shit happen. Didn’t matter what it cost. Where they had to drive. How many doctors they had to call and fight with. My mom knew I didn’t fit the textbook definition of a T1 and probably would have thrown my sugar free jello at the nurses in the hospital if she were that type of person. Their daughter was special and they were going to put everything on hold financially to make sure I was healthy. They were the first to handle the stares, the rude questions, the inquiries, and the fanny pack full of D-supplies.

We say in the DOC that you are the only person that knows your D intimately. D-parents need to know it well too, especially with a young diagnosis. To this day, I still consult with my mom on the phone when my docs can’t give me straight answers. (My dad usually just listens to me whine… but he’s good at that.)

So this Friday, I honor D-parents. While you may not think your D-kids are remembering what you do… they are.

More Tests? But This One Is Fun #bigbluetest

I made a list of advocacy and awareness projects yesterday for Awareness month… but I forgot a BIG one that all PWDs can take part in.

It’s the Big Blue Test!

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It’s super easy.

Test your blood sugar before you exercise.

Do about 14-20 minutes of activity. Run around the block. Take a walk around the mall. Dance to a couple songs on the radio in your living room. Whatever.

Test again and record the results with Big Blue. Each test recorded will send off supplies to another PWD that doesn’t have easy access to care, both nationally and internationally.

Pretty awesome. Pretty easy.

Get moving!

Happy Blue November!

Is it really? Okay.

WDD is on the 14th, so most of the DOC is participating in some sort of Awareness prompt. I’ve been a little bit behind the times and trends as of late and didn’t really pick a project for National Diabetes Awareness Month/American Diabetes Month. (Actually, that’s not exactly accurate – I did sign up for the Postcard Project and never got contacted… which made me sad.)

So if you are looking for something to do, there are a few options.

– There is a 30 day Photo a Day challenge for diabetes, which many are taking part in. The list can be found over at sixuntilme.com. I’ve done a Project 365 before, and photo-a-days can be super fun. But I’m already behind because I was out of town last weekend, dancing up a storm as usual, and also fighting a nasty start of a cold. So – you might get a photo of the week from me.

– Christel over at theperfectd is putting together a daily “diabetes for dummies everyone else” post, detailing a characteristic, quirk, trademark, or whathaveyou of diabetes. The information is presented in small, easy to digest, sugar free posts. If you are one of my Type 3 followers (i.e. someone who is very close to me but has a functioning pancreas), I suggest marching over to her blog each day and checking it out.

– 30 Days of Facebook. You can “donate your Facebook status” to the JDRF. Or essentially, post one Diabetes related factoid to your Facebook status each day. Awareness is awareness. WTPrincessDiaries actually pre-planned her statuses, designed them into Instagrammable-awesomeness, and is posting them daily on her blog at 11:14 am all month. Super cute stuff there.

JDRF T1D for a Day Challenge. Great for my Type 3s to look into. Basically, you sign up for a day of text messages from the JDRF – not to sell you something or ask you to donate – but to put you in my shoes.

Are you participating in another project that I haven’t seen yet? Let me know. 🙂