What is that thing on my arm?

Like Kerri, I wear my Dexcom sensor on my arm.  I have found this to be the most out of the way area that’s still comfortable.  Most of the time, it’s hidden by dress shirts or T-shirts.  However, yesterday, I happened to wear a little cap-sleeved top that displayed Charlie to the world.

Needless to say, I got asked about “that thing on [my] arm.”  I took the opportunity to explain what it was.  My usual speech goes something like this:

It’s a sensor for my continuous glucose monitoring system.  It checks my blood sugar every 5 minutes and I can see the results on this graph. (At which point, I click on the receiver and show the graph)

This seems sufficient for most people, but I do get some interesting follow-up questions/comments.  One woman said “oh, I’m so sorry”.  She quickly asked about something else, so I didn’t get to respond, but there’s no reason to be sorry.  I may have diabetes, but it’s very well managed.

Another woman asked if I had it “really bad” because I have this sensor.  I find this to be the most common response.  I politely explained “Not really.  It’s just that I plan on getting pregnant in the near future and this will help me stay under control much easier.”  This is also a sufficient response most of the time, but this particular woman made an interesting comment.  “Yeah, when you get pregnant, you can get that other kind of diabetes.  Gestational diabetes.”  I know I should have corrected her, but I was too busy laughing to myself.  While technically, I would have diabetes while I was pregnant, it’s still Type 1.  It doesn’t transform itself into gestational.  I did comment, though, that my aunt had gestational diabetes and she managed to have 3 kids, so I think I’ll be okay.

I do not go to great lengths to hide my diabetes (Lucy and Charlie are always on my hips, my sensor is often clearly visible, I test my blood sugar when/where I need to, etc), but it’s not something I ever flaunt or actively bring up in conversation.  I usually wait until someone asks, then I give a clear and simple answer.  Hopefully I’ve helped some people understand a little more about diabetes and the technologies available.

Playing with the super bolus

Now that I’ve got Charlie, I’ve been feeling more confident about trying new tricks in managing my diabetes.  Specifically, I have been using the super bolus.  Actually, to be more accurate, I have been using what GiR and I like to call a super correct.

From what we can guess, it’s EXACTLY like a super bolus, but it’s just used to correct a very high blood sugar.  Just like a “correction bolus” is just a meal bolus without the meal, a “super correct” is just a “super bolus” without the meal.

I have found that if my blood sugar is above 200, a “2 hour super correct” does the trick.  I take 2 hours of basal ahead of time as a bolus, then reduce my basal to 0 for those 2 hours.  If I’m hovering in the 160-ish range, a “1 hour super correct” is fine.

HOWEVER!  I will guarantee you right now that I am not doing this correctly.  According to Bernard, the basal portion of the super bolus should be taken via the “fill cannula” method so as to not mess up IOB calculations.  I do not do this.

My #1 biggest fear about using the fill cannula method is the fact that my Cozmo defaults to the last amount used.  For example, if I use the fill cannula to deliver 1.2 units of basal, then the next time I go to fill my cannula, 1.2 will be auto-filled.  Now, when I switch out my infusion set, I do this VERY FAST.  I have got this down to a science, people.  So, imagine with me the horror of accidentally delivering 1.2 units instead of .2.  This spells serious trouble.

I know for a fact that delivering the basal portion directly via the correction mechanism really messes with my Delivery Summary.  So according to my pump, I have occasionally taken a LOT of correction, when in fact some of that has been basal.  Of course, my diabetes control should take into a large number of factors and not just my Delivery Summary, but that’s a discussion for another time.

So what do I do?  Right now I am doing my own vague mental calculations of IOB, but that’s not very effective.  I suppose I could learn to slow down and pay more attention to filling my cannula, but that will be a hard habit to break.  Any tips/suggestions?

Final thoughts on the Keynote

I’m pretty much done trying out the Keynote for now, so here are my final thoughts.

Bad

• The test strips seems “wobbly” when I put it into the meter.  Like it’s not as secure or something.
• The backlight is either on or off, no quick button to toggle it.
• No light down the strip.  I got really spoiled on this when using the Freestyle products (Flash and Lite).
• Numbers tend toward the center, which could result in missed lows.
• Still need to code the meter.
• You MUST get all the blood on in one go.  This is the deal breaker, sorry.

Good

• Considerably less extreme values, which prevents over-treating lows and highs
• Excellent form factor (small, light, grippy sides)

So, as you can see, I’m not all that happy with the Keynote for regular use.  However, once I get my Dexcom (still waiting to hear from the insurance!), I plan on using the Keynote for calibration.  Thanks to Agamatrix for letting me try this out!

Meme time

Once you’ve been tagged, you write a post with 10 weird, random facts, habits or goals about yourself. At the end, choose 6 new victims to be tagged, list their names, and why you tagged them. Don’t forget to leave them a comment saying (’You’re It!’) and to go read your blog. (I am totally skipping the tagging part because it is entirely unnecessary).

1. I would love to learn to play the cello.  Yo-Yo Ma is my hero.
2. I would like to visit Poland.  My mom’s entire side of the family is Polish, so it will always have a soft spot in my heart.
3. I cannot STAND peppermint, in any forms.  I also do not like most other flavors of mint.  This makes it very hard to find a toothpaste that I can tolerate.  I also cannot kiss GiR after he’s had a mind.  Nasty….
4. I have eaten the exact same breakfast nearly every day for at least a year.  It’s very predictable.  One frozen waffle (blueberry is preferred) with a little butter and sugar-free syrup.  16-18g carbs, depending on the brand of waffle.
5. I save all the cans of soda I drink at work (one in the morning and one at lunch) so that I can recycle them.  I don’t have many decorations in my cube, but my soda can wall is definitely the most prominent.  Currently I have nearly 80 cans stacked up (10 cans wide, 4 cans deep, 2 cans tall) ready to recycle.
6. GiR and I have pretty much picked out the names that we would give our kids when/if we have them.  We probably spend way too much time talking about it.  =)
7. I have always dreamed of opening my own bakery/pastry shop.  It would specialize in foods for people with dietary restrictions:  sugar-free, low-carb, no aspartame, no MSG, lactose-free, no fried potatoes, no food dyes, gluten-free, no coconut, no nuts, etc.  Tasty food should be available to all people, no matter their “restrictions.”
8. I always spell the past tense of the word “cancel” as “cancelled.”  My spell checkers consistently tell me that it is incorrect and it should be “canceled.”  I’m sorry, but “canceled” just doesn’t look right.  “Cancelled” is an acceptable spelling anyway, so I’m going to continue to spell it that way.
9. For the most part, I refuse to talk in “IM speak.”  I use full spelling, mostly correct grammar, and very few abbreviations.  bc srsly, do u get wut I’m sayin?
10. I would love to live in a city that has reasonable temperatures.  I don’t like snow and I don’t like heat.  Just something in the middle would be nice.  And not too much rain or gray skies.  As far as I know, a place like this doesn’t exist, but hey, I can dream, right?

Waiting game

I had an endo-follow-up appointment yesterday with the Nurse Practitioner yesterday, and it was rather anti-climactic. The NP didn’t really offer any suggestions for some of the dinner number troubles I’ve been having, and I don’t think she did a very good job of “following up” on the stuff that got talked about at my endo appt. It seemed like such a waste for me to take a 1/2 day off work and drive all the way up to the Diabetes Center, to talk about…. nothing really.

HOWEVER, I did get a date set up for my Dexcom training. It won’t be until next Friday (the 23rd), which seems like soooo far away. According to my Dexcom rep, I should be getting my kit either today or tomorrow, so I’ll have a week of tortuous waiting. I am halfway tempted to try it out ahead of time, but I don’t really feel like messing up a $60 sensor.

There is (potential) good news about insurance coverage though. Dexcom says that they have an in-network supplier for the sensors, so they’re going to try to get it covered. If they do, the sensors will end up being fairly reasonably priced, which will be totally sweet.

GiR’s guide to blood sugar

After seeing the wide range of values I could get from the same blood drop when comparing the Keynote to my Flash, GiR and I decided that it would just be easier to make up numbers based on how I feel instead of actually testing.

Question 1: How do I feel?

1. Loopy
2. Fine
3. I want to kill something

If 1, blood sugar is low. Eat something.
If 2, blood sugar is normal.
If 3, blood sugar is high. Then ask Question 2: What do I want to kill?

1. Myself
2. My friends and family
3. The entire world
4. The entire universe

If 1, blood sugar is 150.
If 2, blood sugar is 200.
If 3, blood sugar is 250.
If 4, blood sugar is 300.

=D

What’s really frustrating about the comparisons between meters is that I now see that I can’t really trust any of my numbers at all. If, with the same blood drop, I get numbers that are 20+ points different, then what’s the point of being so accurate at all? My pump can calculate very, very precise doses of insulin. But! They are based on this vague result of a blood sugar test. Sometimes it feels like I could just pull a number out of a hat (or take GiR’s questionnaire) and it would be close enough.

Testing out the Keynote

Yesterday, I received my “assessment package” from Agamatrix to try out the Keynote.  I switched around my pouches so that I could carry both the Keynote and my Flash around to compare the values.

First test before dinner:  Flash = 72, Keynote = 92

To me, this is a fairly dangerous situation.  72 would be a low that I would need to treat, but a 92 is normal and doesn’t need to be treated.

Further tests throughout the evening and this morning have shown that the Keynote pulls up numbers that are “closer to center”, as GiR put it.  This makes sense considering the Keynote’s claim that is has a lower margin of error.  As such, it would be reasonable to say that my Flash would produce more extreme values, while the Keynote would produce more consistent values.

HOWEVER!  There is one small bug/feature that makes the Keynote not worth switching to:  You have to get the full amount of blood on the strip at one time.  If it starts sucking your blood and you don’t get enough the first time, you just wasted a strip.  I HATE THIS SOOOO MUCH!  This is why I love my Flash.  If you don’t get enough blood, it’s okay.  You have a small window of time to finish filling the test strip.

I will continue using the Keynote for awhile because half a day is hardly enough to fuss about just yet.  GiR suggested that maybe I use the Keynote to calibrate my Dexcom, since the Keynote is more likely to be accurate.  We’ll see.

Recovering

Well, turns out my high blood sugars were most likely due to happy happy female issues…  So, things are mostly under control again.  I also raised my basal rates a touch.  I know at my last endo appointment, I had been having a lot of lows, so we wanted to back off the basals a bit.  However, now I am finding that I have waaaay too many highs or semi-highs (i.e. 130 isn’t bad, but it’s not a good fasting number).  Constantly battling highs was wearing on my nerves, so I bumped the rates back up.  They’re not as high as they were before the endo appointment, so hopefully I won’t have as many lows.

This past weekend was crazy busy.  So many parties and get-togethers and SWAGing for homemade tasty food.  This whole month will be equally crazy, so I’m trying to figure out what things I can do to keep myself from getting too stressed out.  In theory, I’d like to stop beating myself up over my blood sugar, but I’m not sure that’ll ever happen.  My diabetes is just too important right now.

Next week is my follow-up appointment at the diabetes center.  I’m planning on requesting a Dexcom.  I think it will ease some of my stress about trends so I know whether to fend off a low or a high.  I’ve already got a name picked out, but I will save that reveal until I actually have it it my hands.  Wish me luck!

Scale spoon

As both a diabetic and a chef, this scale spoon intrigues me.  It seems like a fairly logical gadget.  I am often weighing out small amounts of ingredients like salt, spices, vanilla, etc.  I typically do this on my regular scale with small bowls, but I wonder if this spoon would work better.  Of course, the types of things that I would weigh in those small amounts, would have a negligible effect on the total carb count anyway, so I’m not sure the extra precision would be worth the $37.  What do any other diabetic chefs think?

CGMS questions

I talked to my husband last night and he seems okay with the idea of pursuing a CGMS.  I just don’t know where to start.

For those who have gotten insurance coverage, what does that mean exactly?  Do they cover 20% of the costs?  50%  90%  What?  Does the part that goes through the insurance go towards the deductible?  Even if they decide not to pay for it, is it possible to have it still go towards the deductible?  Example:  at one point in my diabetes life, I found that I could buy biohazard containers through the insurance.  They didn’t actual pay for any of it, but it went towards paying off the deductible.  I hope that made sense.

My endo recommended either Dexcom or Abbott’s Navigator.  I looked at the Navigator, but man, the transmitter is HUGE.  No thanks.  Also, does the Dexcom allow manual blood sugar entry yet?  My endo said yes, but I couldn’t verify that on their website.

I’m pretty sure I will have a hard time convincing my insurance to pay for it.  I have some hypoglycemia, but no unawareness and no need for hospital visits.  I am looking to get pregnant, but not for another couple years.  Any other ideas for reasons?

Oh man, this is a scary new place.  But, I want CGMS so bad…