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July 17th 2008 @ 11:26 pm by Michelle Kowalski
Categories: Type 1 Insulin & Pumps Highs & Lows Emotions Real Life
Tags: low blood sugar
Views: 1101

I've gotten into the habit lately of bolusing for a meal more toward the middle or the end instead of before. It depends on a number of factors, including what and when I ate last, what I'm getting ready to eat, and what my pre-meal blood sugar is. This mid-meal bolus stems from several instances when I've either gone low or started to go low before I even finish eating. It's pretty unnerving to feel a low so close to a meal.

 

Like today, for example. I tested at 130 not long before we headed downstairs to eat lunch. Since there are few tables for the amount of people who typically choose to eat lunch in the lobby, I went ahead of the microwave-users to secure a place for the five of us.

 

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This is a breakdown of my first use of the Dexcom CGM. It's had its ups and downs, as you'll see. It's been peace of mind and obsession all in one. Mostly, it's been eye opening to what my diabetes is really like these days.

 

Day 1: I was really excited to start the first sensor. I went through all the setup process. I waited for the receiver to charge, downloaded the software, and prepped my skin for the sensor. The sensor comes with its very own insertion device. The insertion is nothing like the Minimed CGM that I used before. You see the needle in the device, just like you see the needle with the Minimed. However, this isn't a fast, hard insertion. It's up to your own fingers to stick the needle in. Surprisingly, past the initial sting of the needle, it really doesn't hurt at all. Much less than the Minimed for sure.

 

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There's a Band Aid on my tummy. A small, flexible-fabric Band Aid.

 

Underneath is neosporin, which is covering up my last pump site. I've never used neosporin -- or a Band Aid -- after pulling a site.

 

That site had been itchy for about a day. I knew it was (over)due for a change, but I had so little insulin in my pump that I didn't want to do two "site changes" back to back.

 

I primed my pump this morning and was preparing to quick-sert the set when I glanced at my soon-to-be-old site. It looked like my skin had been sucked up into the set. I usually leave the old set in for several hours, but this one I quickly ripped out.

 

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I am seriously considering an upgrade.  I guess you could call it a life upgrade, in some ways. 

 

I've been reading up on the Minimed Revel pump and CGM system.  Though the upgrade is pricey, I'm thinking that come the new year and a renewal on my Flexible Spending for medical benefits, I might just be able to swing the $1,300 or so in 2012.  Of course, it'll mean forgoing other items that I might want in favor of putting money into my FSA account to cover the cost of the new devices.  But I'm thinking it might just be worth it.

 

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Right now, I'm a complete bundle of nerves. Last night, I suddenly decided that today I would go off the pump. I know that I've been talking about it, but I assumed that I'd get it all straightened out and be back into "normalcy" before April 1st came around.

 

But you'd be surprised to find that poor control is actually NOT the reason why I'm going off the pump. In the past two weeks, I've had some highs and far fewer lows (which is just amazing). My averages are still in the 150 range though, which is what I'd settle for to get down to the 130 range (slowly, without lows).

 

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CGM Update

 I’m taking a break from the CGM.  I wore it consistently for three full weeks and gathered a ton of data to share with my doc when I see him.  But I really did need a few days off.  Wouldn’t it figure that my second day in, I’d have a very scary and inexplicable bloodsugar of 23 mg/dl, followed by a rebound high of 400 mg/dl the following morning? 

 

I’m going to go back at it starting tomorrow for another two weeks.  I’ll be seeing the doctor the following week, and I want to have at least a month worth of data look over with him.

 

Some notes about the system:

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When Olivia was first diagnosed, I was told to check her four times a day. That didn't seem very often, but for the first 6 months or so, that's what I did. She was not quite 3 at diagnosis, so she was still going to bed quite early; probably around 7 p.m.. She'd get up at 7 or 8 in the morning. That was 12 hours without a blood sugar check. The thought of doing that now makes my skin crawl.
I started doing overnight checks for two reasons: She'd come to me in the middle of the night, complaining of not feeling well. She was invariably low. Or, when she'd wake up in the morning and would have wet her bed. I knew that she'd been high during the night. I decided to start doing a blood sugar check around midnight. I'd correct if she was over 200 or below 80. Her morning numbers improved immediately. (READ MORE)

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I talked to Olivia again about going off the pump and she's adamant about wanting to do it.  We were changing her site because, once again, the site she'd had in got infected. She only keeps a site in for 2 days, but they often seem to get red and irritated. We use antiseptic wipes before inserting them - I don't know if she's just sensitive or if we're doing something wrong or what, but she's sick of it. I don't blame her; after looking at her stomach and arms, she's got a lot of ugly, raised white  bumps, especially on her belly. We rotate sites all the time and go pretty far out on to her sides, but the scars just don't seem to go away.

 

I don't know if there's anything that can be used to get rid of the scars or if she's stuck with them forever.  I just know they really bother her. 

 

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Three days, or until the insulin is all used up - that is how long an OmniPod is to be worn for. Before pumping, I was unsure if the scheduled three day replacement interval was going to be a nuisance. I even pondered the idea of trying to sneak in an extra day on the pods- so long as there was enough insulin stowed away in them. Well, that notion, along with a little of my patience, consistently scurries away when I near the end of a pod cycle, and the three day itch sets in. (READ MORE)

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Diabetes is a very physical disease. It loves to leave behind marks to show it was there. The strange "tells," "war wounds," and "evidence" that this disease is wreaking havoc on my body both internally and externally.

 

The easiest sign of diabetes is the calluses on my fingertips. They've been my biggest complaint with this disease (physically at least) since I can remember. I hate the way they mar my fingers with their tiny spots and uneven edges. It never can be skin against skin, smooth and simple. When I run my hands over anything, I feel the tips of my fingers drop their tiny hints of this disease.

 

As if my fingertips weren't beaten enough, my body has all the signs of needles and insertions. I have bruises galore. Plus the tiny red spots from infusion sites and syringes. And every three months, there's the bruise of getting blood drawn on the crease of my arm.

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