Pump Infusion Site Wounds

silhouetteRight now I have the worst pump infusion site wound.  It hurts like hell.  I get them all the time.  I use the silhouette infusion sets.  I don’t remember getting these when I used the quicksets, but the quicksets always got ripped off my skin for one reason or another.  I’ve never had the silhouette do that.  Anyway, I get these massive bruises and wounds that appear AFTER I’ve removed the infusion site.  It’s like it takes a day for it to grow and develop.  Then it gets really ugly and nasty looking and extremely painful.  It takes at least a week for the pain to heal, and then at least a month for the bruise to go away, and sometimes it doesn’t go away completely.

I change sites every 3 days.  I used to wear them longer, but my CDE told me this probably happens because I’m wearing them to long, so I starting filling my reservoir with less insulin.  It happens on my stomach and my legs both.  It’s done this ever since I started using silhouettes, but I’ve just lived with it.  Since it didn’t happen with quicksets, it’s made me wonder if it happens with other types of sets like the mio or butterfly?  Does this happen with anyone else?  Am I just defective?

I don’t really want to go back to quicksets, because those were always painful to insert, and they’d spin themselves off my skin.  Quicksets are painless for me, and they NEVER come off until I tear them off, but they leave these wounds often.

Do I need to start using alcohol swabs to prep before hand?  (I know, I know.)  Do I need to put a band aid on the opening with Neosporin after every site change? Do I need to change sites every 2 days?  (That would really suck.)  Does this happen to anyone else?  Please help DOC?!

What my continuous glucose monitor has taught me . . .

Dexcom G4My continuous glucose monitor (CGM) has taught me so many things since I’ve had it.  (A little over a year.)  I’ve had both the Metronic Guardian and the Dexcom G4.  My Dexcom is definitely my preferred CGM for a boatload of reasons.  Anyway, I’ve learned a great many things having a CGM, and I’ve never really talked about that in a post, so I thought I should.  So here we go.

The main benefit of a CGM is being able to see what your blood sugar does in real time.  Why is that important?  Well, it gives you an idea of how fast or slow your blood sugar changes when you eat certain foods, or when you exercise, or when you take certain medications or supplements, and many other reasons.

For instance, since I’ve had my Dexcom, I’ve learned that when I eat cheese my blood sugar doesn’t rise immediately, but rises 2 hours later, and if I take a dual wave bolus, it helps with that rising blood sugar 2 hours later. Previously, this used to cause a roller coaster anytime I ate something with lots of cheese.  Now I know how to deal with it because I could see the blood sugar in real time.  I’ve also learned that when I exercise, my blood sugar drops ever so slowly over an 8 hour period, so my CDE helped me develop a good workout basal so I don’t drop in my sleep.  I would not have noticed this without my CGM.  Most importantly, it’s allowed me to realize that my insulin doesn’t behave the way my doctors always told me it did.  I was always told that you check your blood sugar 2 hours after eating, and if it’s high, correct.  WRONG!!!  That’s why I’ve lived on a damn roller coaster most of my life.  I’ve learned that the reason we program our pumps with a 4 hour active insulin timeframe, is because it really does keep working for 4 hours.  If I correct after 2 hours, I go low.  I have to wait a full 4 hours before issuing a correction.  Without seeing my blood sugar in real time, this would not have happened.  Things like this are why having a CGM can teach you things you might not ever notice without it.

A nice freedom I’ve discovered in having my Dexcom, is that when I’m out on the disc golf course, or at the renaissance faire (my 2 favorite summer pastimes), I no longer have to carry all of my supplies with me on the course or the at the faire.  All I need is my Dex, and a tube of glucose tabs.  As long as my needles, spare insulin, OneTouch, test strips, and poker are all nearby, I’ll be fine, but I don’t need to have them with me anymore.  That’s an unexpected freedom of having a CGM that I never thought of until the first time I went out on the course this spring.  It was totally freeing.

On a final note, there’s nothing more cool than going to my first diabetes conference/expo, and my first dinner party with type 1’s, and seeing everyone pull out their CGM’s all at once at the table.  That was totally cool!  My blood sugar was high that day, but I wasn’t alone, which made me feel like someone understood.  It was a really hard feeling to explain.  A feeling like I’m actually standing there, talking to people, that get it.

Dexcom Review: Trusting the Dexcom G4

test drive 1 - G4 Platinum receiver-transmitterThis is my 6 month Dexcom review of the G4 continuous glucose monitor (CGM).  To get straight to the point, I think every diabetic should have a Dexcom G4 CGM.  One thing that we’re told when we get any CGM device, is that we still need to check our blood sugars normally by blood draw to calibrate, and I understand that, but when I had my Medtronic Guardian, I couldn’t trust that thing at all.  It made me check my blood sugar more often because I never trusted it.  With my Dexcom, I trust it, even when I haven’t calibrated it for 24 hours!  (Don’t do that BTW!)  Most importantly, is that with my Guardian CGM, it was the worst when my blood sugar was rising or crashing, but I trust my Dexcom to be accurate even when I’m rising or falling, which is when a diabetic needs their CGM to be accurate.

A couple days ago was the first nice, sunny, warm day we’ve had here in Iowa this spring.  Actually, it was earth day too I think?  Anyway, I decided to go throw some disc golf.  (If you haven’t noticed yet, I love to play disc golf.)  Normally I wear a fanny pack on the course with me, that has all my supplies in it.  Actually I go everywhere with it.  It’s been referred to by my friends as my diabetic man purse.  So I’m prepping my disc golf bag, and I realize this is the first time I will have gone disc golfing with my Dexcom because I got it in November.  So I decide to leave the fanny pack in the car, and just throw some glucose tabs in my bag, and my Dex in my pocket.  I played a round with no problems, secure in that my Dex was accurate, and I didn’t need to check my blood sugar while playing.  What freedom!

Today I did a foolish thing.  I left for work without my diabetic man purse.  When I realized I forgot it, I was to far from home to go get it and get to work on time.  I have a job where if you’re late for work, you can get fired, so I didn’t go home because I knew my Dex was in my front pocket.  However, I hadn’t calibrated it since I went to bed the night before.  I ate and bolused for breakfast and lunch, using my Dex as my guide for my blood sugar.  I checked it throughout the day, and was floating around 150, which I was happy with.  I got home and checked my blood sugar at about 8PM.  My Dex said it was 156, and my One Touch said it was 184.  I’ll take it!!!  Remember, this is nearly 24 hours since it’s last calibration!  (#winning)  Now of course I don’t recommend leaving your diabetic supplies at home, but when you happen to forget them like I did, you can trust your Dex to keep giving you accurate results for hours and hours.  If you tried that with the Medtronic, it would turn off the sensor when you didn’t calibrate it at the first warning alarm.  (#diafail)

To conclude, if you’re currently evaluating the Dexcom G4, I recommend you just call up Dexcom, tell them you want it, let them deal with your insurance, and wait to hear from them.  I don’t think you can lose.  Ever diabetic should have one of these.  Sound off if you agree!!!  (That means please leave a comment!)

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********** Now ya know, and knowing is half the battle.  Go Joe!!! **********

<——– If you found this article helpful, please give it a LIKE and share it with others who might benefit from it.  Thanks for paying it forward!  If you’d like to connect with me, you’ll find my social networking profiles to the left.

 

Video: Benefits of Dexcom G4 Insertion vs. Medtronic Guardian

Dexcom G4 InsertionI wanted to share a video review of why I like the Dexcom G4 and it’s insertion, over the Medtronic Guardian.  The basic reason I like the Dexcom insertion over the Medtronic is because the Medtronic has such a huge freaking needle!  It HURTS.  The Dexcom needle is so tiny and thin that I don’t even feel it.  I only know 2 people that use the Guardian now days, and 1 of them hates it because it hurts so much, the other girl I know is just used to it.

Of course, there are many other reasons I like the G4 over the Guardian, the most important is the accuracy of the sensor.  Accuracy doesn’t seem to exist with the Guardian, and I count on the accuracy of the G4, even when I’m rising or falling.  There’s a lot of talk these days about the new Enlite sensor from Medtronic.  My diabetes educator says that the Enlite is still not going to be as accurate as the G4, and she’s even sticking with her G4.  She’s been type 1 diabetic most of her life, so she “get’s it”, and BTW, I have the best diabetes educator ever.  She’s awesome, and I trust everything she tells me.  :)  I wish everyone had an educator like mine.

So back to business, here is the the video for you: 

If you have any questions, please leave a comment or find me on my social networks by browsing  the links to the right of this article.

CGM Review: Dexcom G4 vs. Medtronic Guardian

CGMsThis CGM review will cover continuous glucose monitors from Dexcom and Medtronic.  The Dexcom G4, and Medtronic Guardian.  I’ve had the Medtronic Guardian since March of 2012.  I got the Dexcom G4 at the end of December and started using it last week.  First, let me just say that both have benefits and drawbacks compared to the other, however, I only trust 1 of them.  If you’ve done any reading online about CGM’s you probably already know which one I trust.

I was excited in March to be getting the Guardian.  At that time, I was only aware of the Guardian, and since it integrated directly with my pump, it was a no brainer to go with it.  I just called Medtronic and they dealt with insurance, who paid for it all.  (I have amazing insurance!)  When I received it, I was a bit terrified at the size of the needle.  So much so, that I told the Medtronic nurse I was going to send it back.  She calmed my concern over it, and got me to try it.  When I tried it, I was surprised that I barely felt it go into my skin.  After using it for a week, I called the nurse again to ask why it was so horribly inaccurate.  It was only ever close to being accurate in the mornings when I hadn’t eaten for 10 or 12 hours.  Once it told me my blood sugar as 146, but it was really 322!!!  I told her that if this is normal, it does me no good.  She said that it’s not as accurate when I’m rising or falling quickly, when my blood sugar is high, or if I calibrate it more than 3 times a day.  Well, it seems to me, that if it’s NOT accurate at those times, it’s no good to anybody?  People under good control don’t need CGM’s.  It’s the people on the blood sugar roller coaster that do, and if this CGM is admittedly inaccurate at those times, then what good is it?  Again she convinced me to stick with it.  6 months later and I’m still on the original box of sensors, with multiple  unopened boxes.

Darkness CGMThen I started to become involved in the diabetes online community, or DOC.  Everyone in the DOC raved about the Dexcom 7, with it’s comfort, accuracy, and that you can wear it for 7 days.  In the fall, I suddenly remembered that someone at Medtronic told me I have to re-order transmitters every 6 months.  Instead, I called Dexcom.  The G4 had just been released to rave reviews.  My insurance allowed it, and I got it ordered before end of year so there would be no out of pocket cost.  (Deductible was complete early in the year.)  So far, I’ve been absolutely thrilled with the Dexcom G4.  It’s accuracy is especially surprising compared to the Medtronic, especially when I’m spiking or crashing quickly, or running high.  My educator mentioned to me that it’s more accurate the more you calibrate it, so I’ve been doing that.  In just 3 days I’ve already noticed trends that I could never notice on the Medtronic because it was so horribly inaccurate.  I also like that it’s not integrated.  It allows me to set it on my desk at work, and monitor my blood sugar easily, without having to stand up and dig my pump out of my pocket.  I like that it’s brightly lit and in color so it’s easy to see in the dark, without my glasses on, when I feel low.

Over the last 2 days, I wore both sensors.  Granted, the Medtronic was past it’s 6 month mark, but it was never any good new, so who cares.  I was really just trying to prove to myself that I made a good decision this time.  At every OneTouch meter test, the Guardian failed in comparison to the G4.  Tonight, the G4 warned me of a low that I hadn’t noticed yet while the Guardian thought I was at 122.  Before the 48 hour mark, I just gave up on the Guardian and tore it off my skin.  I’m done with it.  The Dexcom G4 I have complete trust in.

Now, there are some drawbacks to the G4, but they’re minor.  What’s most important to me, and to anyone who needs a CGM, is accuracy, the the G4 is certainly impressive regarding it’s accuracy.  Below I’ve listed the benefits and drawbacks to each CGM.

Dexcom G4 Benefits:

  • Accuracy! Especially when you need it, when your blood sugar is changing quickly.  It seems the more I calibrate, the more accurate it is
  • Much thinner and more comfortable needle
  • The transmitter doesn’t have to be charged because the battery lasts 6 months
  • Not integrated into pump.  I actually like it not being integrated.
  • Color screen with red for lows, yellow for highs
  • Better range.  I can go anywhere in my apartment and not lose signal
  • It shows blood glucose as high as 400 compared to Guardian which is only 250
  • The site sticks to your skin before you plunge the needle in
  • Can move forward and backward in navigation of blood sugar history
  • Sensor lasts 7 days officially (14 unofficially), the Guardian only lasts 3 (6 unofficially)
  • Multiple alert profiles with differing sounds
  • You can adjust the rise and fall rate arrow alerts
  • When you don’t get it calibrated on time, it keeps tracking instead of stopping
  • Univeral USB charger and connection to PC to track data

Dexcom G4 Drawbacks:

  • Manual insertion of the sensor needle (no insertion catapult, it’s like taking a shot, but it was super easy and I can live with that)
  • The sensor sticks out away from your skin farther than the Guardian so it’s easier to catch on things (I’ve had no problems as of yet though)
  • You can’t go back in history and see the actual blood sugar values. You can only see the graph
  • Lots of plastic waste created each time you change a site. Every new site comes with a new insertion tool.  Really seems like a waste of materials.

Medtronic Guardian Benefits:

  • Ummmmm?  Ummmm?  Give me a minute.  I’ll think of something.
  • The guardian uses an automatic insertion catapult
  • If you use a Medtronic pump, you only have to deal with 1 supplier
  • Transmitter is smaller and doesn’t stick out as far from your skin as the G4
  • Although I don’t consider it a benefit, most people would, but it’s integrated into your pump, so you only have to carry 1 device, which you’re already used to carrying

Medtronic Guardian Drawbacks:

  • Horribly inaccurate.  Sometimes more than 200% off.  Often at least 100% off.
  • Smaller range than the G4.  If you’re in another room, chances are the signal will be lost.
  • The insertion needle is *insert colorful metaphor* HUGE . . . and leaves bloody wounds/scars
  • Integrated into pump. Which means you can’t leave it out on the desk at work, without having to stand up and dig your pump out of your pocket while you’re talking on the phone to a customer
  • Transmitter has to be charged with a battery operated charger instead of universal USB cable
  • Sensor only lasts for 3 days (6 days if you stretch it, but you’ll have a nasty wound if you do)
  • Uses proprietary bluetooth connection to PC to track data, which is horribly slow and often doesn’t work, or has driver problems, etc.
  • When you don’t get it calibrated on schedule, it TURNS OFF?!!!  

When I started this blog, it was so others could learn from my mistakes and not have to suffer them.  Please . . . learn from my mistake, buy the Dexcom G4.  And now my typical closing tag from G.I. Joe is more appropriate than ever . . . . .

 

 

********** Now ya know, and knowing is half the battle.  Go Joe!!! **********

If you found this article helpful, please give it a LIKE and share it with others who might benefit from it.  Thanks for paying it forward!  If you’d like to connect with me, you’ll find my social networking profiles to the right:  ————————>

Are You A Diabetic Cyborg?

7 of 9There are a lot of us in the diabetic online community (#doc) that refer to ourselves as “cyborg pumpers”, or “diabetic cyborgs”.  We all know what we’re referring to, but for those who don’t, I’ll try to explain.  You see, I have a Medtronic 523 insulin pump.  I also have a Medtronic Guardian continuous glucose monitor (#cgm) that communicates wirelessly to my pump.  These are attached to me 24/7.  Plus, my One Touch blood glucose meter communicates wirelessly to my pump as well.  Then finally, my pump communicates wirelessly to my computer, which sends my pump data digitally over the internet, to the servers at Medtronic for analysis.  Kinda like we’re connected to the diabetic collective.  Pretty cool eh?   Yeah, so we’re the online cyborg diabetic tribe.  We are immortal, and we are not alone.

Anyway, in an effort to lighten up my blog posts with less sciencey stuff, I thought I’d write a fun post about what famous cyborg best represents ME.  Do you wanna play too?  Good!  I’m going to post a list of questions, and ask you to comment on this post with your own answers, if you’re a diabetic cyborg like me.  So here is a list of some famous cyborgs from Hollywood.

  • Seven of 9 – Star Trek Voyager
  • Locutis of Borg – Star Trek the Next Generation
  • Darth Vader – Star Wars (From Episodes 4-6)
  • Terminator – Terminator
  • Major Kusanagi – Ghost in the Shell
  • Cable – The Marvel Universe
  • Steve Austin – The 6 Million Dollar Man
  • Jaime Sommers – The Bionic Woman
  • Robocop – The Robocop Movie Series

So this is just a short list of famous Hollywood cyborgs.  There are both male and female cyborgs listed here, so that everyone can play.  You’ll notice I did not include cyclons.  I disqualify them as cyborgs because the REAL cylons were machines, with no organic component.  I also didn’t include Daleks because they are extraterrestrial.  If you have a favorite cyborg that I didn’t list here, by all means play along.    Now for the questions.

  1. Which Hollywood cyborg best represents you?
  2. Why does he/she best represent you?
  3. What is your favorite attribute of this cyborg?
  4. If this cyborg appeared in your dream, what would you say to them?
  5. If you met the actor who portrayed this cyborg, what would you ask them?
  6. What pump, cgm, and meter do you use?

Now for my answers:

  1. Steve Austin, the bionic man, bests represents me.
  2. The Bionic Man was the first cyborg I ever knew.  Every young boy wanted to be Steve Austin in the 70’s.  To this day the intro music to the Six Million Dollar Man instills excitement, wonder, and hope.  In the 70’s this made us believe it could come true, that we really can build a man stronger, better, faster than he was before.  We’re in the next century now, and as a diabetic, I’m slowing becoming the Six Million Dollar man.  My childhood dream is coming true!
  3. My favorite attribute of Steve Austin was his bionic eyesight.
  4. If he appeared in my dream, I’d probably ask him if he ever used his eyesight to look at the stars or the moon.
  5. If I ever meet Lee Majors, I’ll ask him which of his super powers was his favorite on the show.
  6. I use the Medtronic Minimed 523 pump, the Medtronic Guardian CGM, and OneTouch Ultra glucose meter . . . and a Carelink USB Bluetooth dongle.  

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