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.

My “official” diagnosis anniversary isn’t until tomorrow, but today was the day that I first tested on my grandpa’s meter and it said “HI.” 5 years ago today is the day that started the biggest change in my life.

Since my 4 year anniversary, I have come a long way. I’ve seen 2 A1c’s below 6 (5.9 in Dec and 5.6 in April).  I found a great endo/diabetes center.  I participated in the sussy circle and got to know other diabetes bloggers. I got my butt into gear and got a Wii Fit.  I hooked up to a Dexcom, which I affectionately named Charlie.

My next A1c is in August, and I hope that I will continue my streak of sub-6 results.  I also want to meet other Type 1 diabetics; it seems like it would be so awesome.  And someday, I hope to start a family.

My new pump (Lucy 3.0) arrived yesterday and I hooked it up right away.  Luckily, I had downloaded my settings to my computer recently, so I was able to pull those up and program Lucy very easily.  Since I still had Lantus in my system, I set a 10% temp rate (the lowest it goes without being 0) and just used Lucy for meal/correction boluses.

In the comments from my previous post, Jillian said that she had a slit in the same spot as I did.  This concerns me because Lucy 3.0 does not have this slit.  As such, I don’t think it is a design element, and I’m pretty sure it makes the pump not waterproof.  I wonder if other people have the same thing, or if we just happened to crack our pumps in exactly the same place.  It does seem like a likely stress point that is easily cracked.

Another random interesting thing is that the touch bolus button on Lucy 3.0 looks very different.  The new button is much bigger and has a white circle on it (instead of being just black).  I find it interesting that they would just randomly introduce a new design element without really mentioning it anywhere.  Of course, Dexcom now has the Open Choice System, and that’s not reflected on their website at all…

Anyway, Lucy and I have been reunited and my blood sugars are once again more predictable and under control.

I should have paid more attention.

Click to see bigger.

That water you see on the screen is actually on the inside.  If you need to take a break and cry, I’ll wait.

I was very excited to finally go to a pool on the 4th of July with all my gear.  I packed my all-plastic clip for Lucy so I could wear her underwater.  I had to leave Charlie at the table, but it would only be for 1/2 hour or so.  I swam, I played, I had fun.  I got out of the pool and Lucy was VERY unhappy.

There was water all inside the screen, she said there was blockage detected, she was beeping like there was no tomorrow.  I thought I had done everything right.  What I didn’t see before I jumped in the pool was that little tiny crack above the o in Cozmo.

I disconnected and called Smiths Medical.  They’re shipping me a new pump, but since it was Friday (and a holiday), the soonest I would get my replacement is Monday.  *sigh*

Luckily, I still have Charlie to keep an eye on my blood sugar.  The data I get from her is almost more valuable than the freedom I get from the pump.  I know given the choice, some people will choose their CGMS over the pump.

I didn’t have any Lantus on me since I was out and about.  But I did have a syringe and a vial of Humalog.  GiR and I quickly ran to Walgreens before the pharmacy closed and grabbed another box of syringes (because reusing syringes hurts).  I managed doing “basal” injections every 2 hours until I got home.  Doing 1.5 units in a syringe is HARD, let me tell you.  But, with Charlie, my numbers looked great all evening.

I took my first shot of Lantus in over a year last night.  I went with a straight conversion of what I usually take as basal in Humalog.  As in, my Humalog basal comes to about 15 units, so that’s what I took of Lantus.  It might not be enough, but better to run a touch high than low.

I’ve still got some Humalog pens, so I’m using that for meals and corrections.  So far, it’s been manageable, but I miss the granularity (.35 units? not with a pen or a syringe!) and the IOB.  But, it’s only for a few days.  Then on Monday, I will get to meet Lucy 3.0.

As you might know, if you’re using a Dexcom, you can’t take Tylenol (acetaminophen).  For some reason, it produces false highs and will result in inaccurate data.  I prefer ibuprofen for my pain relief, so that was no problem.

However, what do you do about drug cocktails, such as Day-Quil, that have multiple drugs in one pill?  Most often, these include acetaminophen.  Well, here’s what I did when I was sick this weekend:

• 2 ibuprofen
• 1 phenylephrine
• 1 dextromethorphan

This is approximately equivalent to 2 Day-Quil.  Works just the same, without the off-limits Tylenol.

So, does anyone know of a good equivalent for Midol that doesn’t have acetaminophen?

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?

I’ve had Charlie for a couple weeks now, so I figure I should share some of my general thoughts and experiences.

At first, I was checking Charlie ALL THE TIME.  Needless to say, I ran through the batteries pretty quickly.  =)  I’ve gotten better about checking only when I need to.

Accuracy has been hit and miss.  Some days, it seems like everything is completely spot on.  So accurate I could bolus off the sensor values.  Other days, it seems like Charlie will consistently have me 20-30 points lower than I actually am, and no amount of calibration will get it to work.  Overall, it’s still a great way to see trends.

My alarms are set at 70 and at 160.  This has let me catch lows and highs before they become big issues.  Over the past couple weeks, I have stayed in that range about 90% of the time.  Not too shabby.  =)  Eventually, when it’s time to start thinking about having kids, I would like to lower the upper bound to 140, then again to 120.  But for now, I’m happy with staying under 160.

It’s been mildly annoying to be attached to 2 medical devices all the time.  They take up a lot of real estate on my waistband.  However, I have long abandoned hope of hiding Lucy on a daily basis, so adding another device isn’t a huge deal.  I’ve already come up with a fun answer if people ask me what they are:  “Well, this one’s a tricorder and this is my my personal web server.”  =D  Also, I like the idea of not being attached to my purse.  With Lucy on one hip and Charlie on the other, I feel like I’m ready for anything.

So, I’ve been having a problem with my dinner numbers for a loooong time now.  I brought it up at my last diabetes appointment (not with my endo, but with a diabetes educator) and she had absolutely zero clue as to what to do.  So, time to ask the blogosphere!  Here’s the deal:

• for most of the day my basal rate is at .55 units/hour
• 6:30 pm Blood sugar’s fine (90-110), bolus (1:10 I:C ratio) and eat dinner (varies).
• 7:00 pm LOW LOW LOW, usually around 65-70.  I try VERY hard not to overtreat; usually just have 1 or 2 Starburst and that’s it.
• 7:30 pm basal rate gets kicked up to .75 units/hour
• 8:30 pm Typical 2-hour after dinner test yields a moderate blood sugar (140ish) with just about the right amount of insulin on board.
• 9:30 - 10:00 pm  HIGH HIGH HIGH, easily at 170+ with practically no insulin on board.  Correct heavily and go to sleep, hoping I don’t overtreat and go low overnight.
• 10:00 basal rate goes down to .60 units/hour for overnight

So, fellow PWDs, what’s going on?  At first I thought it was a combo problem with eating a high-fat meal (i.e. need less insulin up front and more extended insulin to combat fat), but I find this pattern no matter what food I eat.

I’ve thought of decreasing my I:C ratio to maybe 1:11 or 1:12, but I still worry about going high later.  Also, I wouldn’t think that a I:C ratio problem would show up as quickly as 1/2 hour after eating.

I’ve also wondered if the resulting high is a reaction of my body because of the low.  I do try very hard not to overtreat, but maybe my body is still freaking out anyway.

I suppose I could do a combo-style bolus at dinner, but that probably means there’s an underlying basal problem.  However, my last dinner basal test with similar rates (not quite exactly the ones I’m using now, but very very close) yielded steady numbers.  I can probably try a dinner basal test again, which will be much easier with Charlie, but other than that, I’m out of ideas.  Thoughts?

I know I’ve mentioned it already, but I am hooked up to a fancy Dexcom CGMS. It’s been almost a week and I loooooove it so much. The data is just fantastic and I can’t imagine being without it ever again. Anyway, I apologize for the crappy picture (GiR is not one for taking good photos), but I would like to introduce you all to Charlie!

(Normally I have my devices more to the outside of my hips, but my pajama pants do not have a sturdy waistband, so they tend to slide towards the middle.)

As a side note, Charlie is female. She also has a slight identity crisis as part of her is on my stomach (sensor and transmitter) and part of her is on my hip (receiver).

Having Charlie around is a very interesting experience. At times, I feel like I am totally consumed by diabetes data. Am I high? Am I low? Do I have enough insulin on board? Time to check Lucy. Time to check Charlie. Time to coordinate everything with my regular meter.  It can be very overwhelming.

Then there are the times when my fears and worries are calmed by the beautiful flat line on Charlie’s screen.  I got totally excited when I successfully combo-bolused for Mexican food at a party.  I am relieved when I see consistent blood sugars overnight.  I have prevented highs.  I have prevented lows.  I can go an entire day without being out of range (70-180).

I may feel like a techno-dork who carries around tons of electronics on her belt, but I wouldn’t give up my 2 girls for anything.

I fired up my new Dexcom last night, and it seems that’s all I get: ???

The sensor insertion went fine, with only a small trouble figuring out how to get the plunger thing off.  Waiting the 2 hour startup time went fine.  Then came calibration.

Maybe it’s just because I didn’t know what I was doing, but it took 2 1/2 hours to fully calibrate the darn thing.  I know I entered at least 10 calibration values before it started showing me any data points.

I finally got a couple values, so I went to sleep.  When I woke up, I checked on the graph to see how I was doing.  Well, I have no idea really.  I got maybe 2 or 3 values an hour, with HUGE gaps in between.  What is the purpose of this thing if I doesn’t actually capture any data?

Thinking it might be that I slept on that side funny, I let it go.  I managed to get about 5 values in a row while eating breakfast, getting dressed, etc.   Then, more ???.   A couple more values while walking to work, then more ???.

Is this normal for the first day?  I was really looking forward to having a nice curve to look at, but it’s not much of a curve with only a handful of readings per hour.  I really don’t want to replace the sensor so soon, so I’m just going to wait it out for now.  Any tips or reassurance you have would be greatly appreciated.