Monday, June 14, 2010

Nate's DexCom Trial

I may or may not be in love with the DexCom Seven Plus CGM.   It is too soon to tell!

Quick Definition for my non-T1 peeps -

A continuous blood glucose monitor (CGM) determines blood glucose levels on a continuous basis (every few minutes). A typical system consists of:
  • a disposable glucose sensor placed just under the skin, which is worn for a few days until replacement
  • a transmitter which communicates to a radio receiver
  • an electronic receiver that displays blood glucose levels with nearly continuous updates, as well as monitors rising and falling trends.
Continuous blood glucose monitors measure the glucose level of interstitial fluid.
 It does NOT replace the finger pricks that Nate receives but it does help reduce them.  You cannot dose insulin from the CGM reading but you can get an idea of what his bg looks like at any given moment.  I believe the DexCom checks every 2 minutes (don't quote me on that).

On with the show . . .

 (Nate is SO ok with his pink DexCom cover - he also drinks from pink sippy cups and rides around in a pink stroller - - - he's manly like that!!!)

Nate's endo provided us with the DexCom Seven CGM to try out for a week.  We started our trial last Thursday and by Friday morning at 5:00 AM we had a sensor failure.  Boo!!  I had just started falling in love and was excited to show off our new toy when it went kaput!  Friday was Sophie's procedure so I had to try and block the big sensor failure out of my brain while I focused on getting Sophie Doodle to the hospital.

Luckily, my good friend, Kimberly a T1 and DexCom user came to our rescue Friday afternoon.  She brought over one of her sensors and did a site change on Nate for me.  Why did she do it?  Well, have you seen the needle on that thing?  Ummm - I nearly passed out just looking at it.

So, by Friday evening we were rolling again with the CGM and I am seriously thinking about running away to Mexico with the thing.  It's THAT AWESOME!

What I love about the DexCom:

* We discovered that Nate was actually going LOW (and I mean really LOW) before breakfast.  We have started bolusing Nate about 15-30 minutes before he eats to try and avoid the post-breakfast spike but what we didn't know was that Nate's insulin starts working fast!  Two mornings in a row he actually dropped down into the 50's with double arrows pointing down WHILE he was EATING!  He didn't show any signs so I NEVER would have known.  We now wait no longer than 15 minutes which gives the insulin a little time to kick in  without plummeting his bg.

* Sleep - oh beautiful sleep! I've been able to sleep more in the last 4 nights than I have in the last 4 months. I set the receiver just outside of his bed and beside his baby monitor and an alarm will go off if he drops below 100. We set it for 100 at night and 80 during the day.  It also has an alarm that goes off if he goes too high but (knock on wood) we have not heard that one yet.

* I cannot tell you how many times I have looked at his glucometer and wondered which direction his bg was going?!?!  You know that perfect number you get at bedtime but that little nagging voice in the back of your head that is wondering if it is going to stay steady, drop lower or go higher . . . well, hello little arrows on DexCom receiver - - - this little feature STOPS the NAGGING!

Why I am not sure if it is meant to be:

* Do I really need to say anything more?  I just don't know if he has enough real estate to carry this off for a long period of time.

Even when we move things around:

there just isn't that much space available!  His arm could work but I was WAY to chicken to do a site on his arm.  His pod is almost always oh his bum, back or leg so his arm could work --- I will have to think this all through.

* The other concern that I have is that I am just not sure I can do the site insertion.  OmniPod has really spoiled me with its auto-insertion.  I've gone back to my old needle phobia ways (and yes, there is a name for that - - - Trypanophobia).  I have not done one single injection since Nate started podding on 3.1.10. Not one single injection!

* Nate is a podder which means he doesn't have a pump to carry around.  He wears the pod and currently I carry the PDM.  We have struggled a little with him wanting to carry around the DexCom receiver.  I tried clipping it to his pants but he kept taking it off and throwing it at me.  I tried it in his back pocket and that was a no go.  I finally remembered  a tank top (Kangaroo Pouch) that another D mom had sent me before we had decided on a pump. I dug that out of his drawer and it has worked like a charm - - - the receiver fits in a little pocket on the back of the tank so he can't reach it.  The same momma also suggested putting it in the pocket of cargo shorts and that has worked well too.  The trouble is that the receiver is NOT waterproof and he has almost walked into the pool with it twice!!  That would have been a disaster since it's not even ours!!  YIKES!

 Thankfully, I have 3 more days and 3 more nights to ponder the DexCom situation.  In the meantime I am going to get some good sleep, enjoy no nagging bg questions and keep watching those bg trends.

PS - I already know that my son is going to want to kill me one day for constantly posting pics of his bum on my blog!!  It's ok - I'll cross that bridge when I get to it!  :)


Heidi =) said...

I find my self thinking of Nate often. My David is only about 6 months younger than Nate. Because my girls are sandwiched between my boys, David drinks from pink sipy cups and is in love with a pink ride on car that we have. It's nice to know someone else who has a boy that is manly like that :).

Meri said...

Cutest bum ever! You know with the dexcom, you can use it and lose it...use it and lose it. On and off, to tweak his numbers. Most people use it just to get the numbers back on track. So everytime Nate has a growth spurt, you can just pop one on to see what the heck is going on. And then give his bum a break while the good number waves are rolling in. :) Good luck with your decision! His butt does look REALLY crowded! (But oh so adorable!)

Penny said...

Oh he has the cutest butt ever!!! And he may not forgive you later in life, but that's what the old 'edit posts' feature is for!!!
I worry about the 'real estate' too - G's body only has so much room and she is one active child! I'm interested in how your like the CGM and how you are seeing Nate headed low and such, what good info!
Keep us posted!

Anonymous said...

We trialed for a month and at the end of the month I still was not sure. Me: "Oooookaaaaay, I guess this is good." But I was not at all convinced.

Will email you later some thoughts which may or may not help. Hopefully will :).

phonelady said...

wow I hear so many people yes and so many people no . So I dont know if I will get one anyway because they are so controversial right now . Im supposed to be approved for insurance in sept we shall see if they will cover me .LOL !!!

Heather said...

We just finished a trial last week and I LOVED it! It was very hard to give back. I also wrestled with Audrey not having a lot of "real estate" but after finishing the trial I thought It would be more beneficial in the long run. Plus we can put her DexCom sensor in her tummy and we can't use that for a pump site. (the child has no fat on her belly) Also, unlike the pump, we don't have to have a sensor in at all times. So, if we want to take a break for a week or so and let her little body "heal up" we can.

I am a little jealous of the pink cover. We are trying to find one for Audrey's Dexie. (that what we call the receiver)

Good luck with your decision!

Well, you know how I feel about Dexie! I am in love and I think you can definitely do arms! We only use arms for the Dex site and tush for pump sites. If you want to see the video of Z's first insertion, it is on my FB page. He does not mind it most of the time on his arm. :)

Love that the shirt helped give you a place for the receiver! Cargo shorts are great too! :)

Wendy said...

OMGsh. Those buns are so stinkin' cute!!!!!!!

I'll be interested in hearing your thoughts as the trial comes to an end.

I'm still not in a place to try the trial!

Keep up the great work :)

Jen said...

Laura - you are such a rock star! I wouldn't be ready to trial a CGM so soon after starting the pump. I worry about the real estate issue too with Addison but I would so love to see real time numbers that would clue me in on what is really happening in his little body. The sleep thing too sounds marvelous. Thanks for posting about your trial..looking forward to hearing about what you decide.

Lora said...

Thank you for sharing your experience. We asked about the CGM for Willie at his appt a couple of weeks ago and they really encouraged us to get it. Not sure if I want to keep track of one more thing, but the guess-work is so stressful with a little one! And he's on the Omnipod, too. Lots of stuff hanging off of those tiny bodies! Can't wait to hear your feelings about it at the end of the trial.

connie said...

Wishing you lots of luck with whatever you decide :) I don't have either of my girls on a pump or CGM yet so the real estate issue is not one that we are dealing with yet. I can see how it would be a great influence on your decision. Our little ones have such limited space for these devices.

We are just now at the place where we are considering a pump for my 4 year old, she is starting to show some real interest in it and her endo feels that it may be time to start looking into that for my two year old, I'm not so sure. She is so adventurous and kind of rough and tumble, I would be so worried she would pull off her pump :(

Good luck Laura and keep us posted!!!

Tracy1918 said...

Wow! It sounds great. The idea of sleep alone is fantastic, but knowing which way his sugar is trending??? Doesn't get any better than that!

Maybe Matthew will want a Dex one day.....

:) Tracie said...

Pinchable bootie!

I have a neighbor who just got a CGM for her son 2 months ago and she LOVES it! Mostly because she can SEE how food affects her son and what to expect with certain foods. So it helps in that aspect as well as seeing what he may be before they decide to do that extra finger poke or not.

And you can opt to only use it at certain times in life instead of daily....which will get expensive over time. That will help with those growth spurts and those weird unexplainable times of wonky numbers!

Jessi refuses to try it out even though we've explained the benefits. We've decided that at almost 10, she can have a say in her care over us right now so that we can instill choice and responsibility in her s to avoid possible rebellion later. That's why even though I want her back on her pump....she's almost into the 4th month of DMI. Sigh.

Hang in there Laura, with everything! :)

Anonymous said...

I googled dexcom, children, sensors, and cgm and came up with your blog. Call me a stalker, but our three year old got his dexcom this week (dx of pancreatic insufficiency, renal failure, hypoglycemia leading to seizures) and just had to let you know that you are not the only one going around posting butt pics on the internet. My poor FB friends who have children with a normal pancreas have seen way more than they can take I bet! Loved the rockin' pink cover (ours is boring grey)!


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Just a Mom

I am NOT a doctor, nor do I play one on this blog.

I AM a wife.
I AM the mom of 3 wonderful children.
I AM my son's pancreas.

The information provided on this blog is from our personal experiences with Type 1 diabetes. Because something works for us does not mean it will work for you.

Please consult your doctor if you have any questions or concerns about your health care options.

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