Saturday, November 3, 2012

#NHBPM Day 3: I'd like to know about...

This is day 3 of the Wego Health National Health Blog Post Month. Today's prompt is "I don't know about this, but I'd like to."

Every step in learning to live with type 1 diabetes has been challenging and I haven't rushed or jumped into any one step. I'm terrified of making mistakes. So when we decided to get an insulin pump and we were asked about writing up a Continuous Glucose Monitor at the same time, I said no. It would have been brain overload. I was scared of the insulin pump because I didn't know the terminology (and it sounded very technical which it is). I was scared of it because it seemed like it would be more challenging to insert (I find it easier than shots and Alex thinks it is less painful). At any rate, I wasn't ready to take on 2 devices if we could even get a CGM approved.

But now, we have been pumping for 4 months and it has been totally awesome compared to shots for all of us. We've been fortunate not to have to many bumps along the way and in fact her numbers have been way better on a pump since day one.  So now...I think I'm ready to consider a CGM and actually and feeling pressed to get something done about it because we happened to have maxed out our insurance deductible and coinsurance for the year. Why not use that to our advantage if possible and get a CGM before the calendar year ends IF in fact they will let us?

So I guess I don't know much about a CGM but I'd like to. About all I know is that it's another tool in the diabetes shed that might help us catch lows or highs before they become dangerous. I'd really like that especially at night if I am understanding how these things work. Most nights even when she goes to bed at a perfect little 120 for her, by 2 AM she is between 250-300. We have tweaked and adjusted and tweaked and adjusted her basal settings at night and it doesn't seem to like anything we try. Either we ratchet it up and I go in at 2 AM and half the time she is 60. Or we ratchet it down and she is 250-300 at 2 AM. We are only bumping it up (or down) 10% at a time. We have played with the times. We've played with the settings. Diabetes does NOT play nice at night here. That leaves Alex AND I exhausted. Could a CGM let us sleep better on the nights it actually does play nice? I really don't know. And sometimes as of late when testing during the day, we'll be totally surprised with a number in the 40s and she doesn't even realize she was so low. It isn't like it's a daily occurrence but maybe once every 2 weeks. That's scary stuff to me - that she isn't even feeling it! Again, I don't know much about this CGM and if it will help. Here is what I think I know:

  • It will help us catch upward and downward trends before a dangerous low (or out of control high).
  • It won't replace blood testing.
  • It works with a wireless monitoring device.
  • We most likely want the Dex based on feedback from other Animas pumpers (we have an Animas Ping pump).
  • The sensors can be pricey but last longer than an infusion set (is it 7 days?)
Here is what I don't know:
  • Is it painful to wear? I've heard mixed reviews about the comfort level.
  • Is it difficult to insert (compared to the infusion sets)?
  • Is it reliable?
  • Does it allow you to sleep at night and only wake for alarms? 
  • How pricey are the sensors you have to buy?
  • How much is this going to cost us out of pocket?
  • How likely will our insurance company approve it?
  • How likely is our doctor to write a prescription for it?
  • Will Alex wear it or fight me on it?
I guess I need to bite the bullet and call our endocrinologist this week if I have any hope of getting more information and getting an order placed before our insurance rolls over to the new calendar year...

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