Monday, January 14, 2013

Dexie is cool!

This is kind of a redundant yet longer post from my last one. 

 So I finally bit the bullet and started up Alex's new Dexcom G4 continuous glucose monitor. We received it back during Christmas week. I immediately unwrapped it, looked at that BIG package the sensors come in and decided Christmas week wasn't a good time to start it up. Then, Alex and I decided to take a last minute trip to Los Angeles to do everything American Girl and, again, I decided traveling/New Years was not a good time to start it up.

Random cute picture from The Grove Los Angeles
It didn't take much to convince me that reasons x, y, and z were all good reasons it was not a good time to start it up! That sensor insertion thing looked SCARY.

This is what it looks like when you pull it out of the box.
This is what is "left" after you detach pieces from the body when leaving in the sensor.
 I'm not a nurse. I have NO medical background whatsoever. I have always HATED anything medical. It's been quite a year to conquer fears and become a diabetes nurse basically. So the longer we had it, the longer I put off putting that thing in Alex's body. I mean - if I look scared of it how the hell am I going to convince her to go through with it???

Alas, there comes a time you just have to buck up and face your fears. So, I watched the online video training...4 times. Did I mention I am totally an OCD person (at least according to my friends and family)? I then watched some YouTube videos including this one. (Thank you Wendy). Okay seriously...if that little cute kid can sit there and basically talk me through this with his mom without batting and eye, then we CAN do this!

So first I gathered up all the stuff. Then I decided it would be a perfect time for bribery and pulled out an online code to a game Alex's been begging me to get.  Alex came home from school and we talked. She was scared but I reassured it that was completely normal and that we needed to give it a try. I promised her I would talk her through it. I hugged her and reminded her how proud I am of her. I reasoned with her and explained she was scared of the pump sites too and now she prefers them over injections. It was WORTH trying. She agreed albeit it reluctantly.

I then asked her to please talk to me while we did it and tell me in words if something hurts a lot or if something doesn't feel right. I asked her to try NOT to scream and shout and pull away so we could get this done successfully. There are a few steps and if she was screaming and pulling from me it could cause us to damage the sensor.  This is something we've tried working on with her about all diabetes things - it's totally fine to cry and explain when something is hurtful. But communicate what exactly is wrong. Then we can work with that. But screaming/crying/yelling "I hate you" doesn't help any of us. She has really come a long way from last year because that rarely happens now. Sometimes she cries when a pump site hurts. We've learned certain spots hurt. We've learned certain spots "sting". We've learned she likes certain angles. She likes ways we hold her skin, etc. Talk to us. We can make it as comfortable as we can if she talks to us.

Anyway, we ordered some EMLA for this. I'm not sure if it's necessary but what could it hurt? The thing is I have no stinking idea if I used it right. I really need some education on prep stuff. Anyway, I rubbed some on the area and waited 40 minutes. When I came back it was clear looking. But then the instructions say to clean the area. Does that ruin the EMLA? No clue. I cleaned the area. I used an IV Prep wipe. Then I pulled out that big scary inserter thing and stuck it on her all the while assuring her I would push it until we counted together so calm down so I get it stuck right! She was as calm as one could expect her to be. Then it was time to remove the safety and push down on the plunger. So I did. She yelped a bit and said it hurt. I pulled the lip thing back and kept telling her that was the worst part and it shouldn't hurt anymore. I removed the big inserter thing. So far so good. Alex was back to being calm and agreeing it pinched but it wasn't awful. Then it was time to clip in the transmitter. Yeah right! That was actually the hard part to me. I put it in. I tried to pull up the latch thing. It was hard. I wasn't sure I did it right. It didn't snap in. I looked down at the picture instructions and reminded myself I needed to be firmer. I held it down with one hand and moved up the latch with the other hand. Snap! It was in. I twisted off the latch.

Now it was time to "start up" Dexie. I guess in 2 hours we would know if it worked. That 2 hours took forever and of course being Friday night, we ordered some take out food (typical Friday night for us). Alex wanted teriyaki chicken and rice...rice...always a bad choice for her blood sugar. But after being so brave...that girl was getting rice. That prompted a crazy night of highs. Didn't consider that...

However the thing works! It sometimes was within like 2 points of her number on her meter. At most it was 25 points off (either direction). And the best alarmed at about 3:30 AM for a low blood sugar and woke her up. She tested, treated her low, and came to wake me up about it. That is EXACTLY why I wanted this thing!

Needless to say that first 24 hour graph was quite scary looking. What a roller coaster ride!

So Alex has been using Dexie for about 3 days. I am in love with it. She can be in her bedroom and I can hold Dexie in the living room and it stays connected. She always tests when she goes to bed but when I go to bed an hour or so later, I test her again. With Dexie, I can determine if it's necessary to retest her when I go to bed or not. She will always test with her blood meter when she is supposed to. And the most important thing is night time alarms. I mean, perfect example would be that I tested Alex that first night around midnight and all was well. Normally if all is well, I test Alex once between midnight - 2 AM. I would NOT have caught that 3:30 AM alarm.

The other thing that excites me is Alex's readings from school and Dexie. Alex runs sky high in the mornings between about 8 AM - 11:30 AM. Then she drops like a rock and inevitably ends up in the health room in the afternoons several times. We've adjusted basals. We've done all sorts of things. Maybe Dexie can show us the patterns and we will have better insight into those adjustments? We seem to not catch her highs/lows at school until she is way high or low. I just love that this can be a new tool to better adjust Alex's insulin to avoid some of those roller coasters. Maybe? Please?

Issues Thus Far:
I don't know what it is but the adhesives don't stick to Alex's skin. I make sure it's dry. Usually withing 1-2 days the adhesive pulls away from her skin. I've been using some tape to tape the adhesive down but the tape usually comes up. And after 24 hours, the sides of the adhesive on the sensor were already coming up! I got clever yesterday and cut an opening in an IV 3000 clear patch and put that down around the sensor. I've read about Skin Tac? I'm wondering if that works better than IV Prep which seems to do nothing. But I'm utterly confused and I'll be calling the educator's office later today. I've read people who use the wipes; people who use some liquid. I've read people wipe it on the skin and other wipe it on the adhesive itself. I'm really confused about this tape stuff. Did I actually read that some people put a clear tape patch on their skin and push the infusion sites through that? It sounded like it yet other people mention putting it OVER the site.  Totally confused about the IV 3000 things which we never use because it's huge and how do you put it over the infusion sites when you need to be able to unclip? I guess cut holes in it like I did with the dexcom sensor? Not a clue. Suggestions more than welcome.

Carrying DexieI'm a little nervous about Alex carrying Dexie to school. What if she loses it? I put labels on it using a label maker that noted it being a medical device with her name and my cell phone number. It looks like an iPod so I went to school with her and talked to her teachers about it and assured them it's not an iPod. But I could see it getting stolen by someone thinking it was an iPod or something. Yikes! Also, how the heck do you "wear" this thing? Alex doesn't wear jeans a lot and doesn't have pockets. I think if she holds it, it will get misplaced. For now, I used her pump band and had her wear it and put it in one of the band pockets. She doesn't wear her pump band much - she prefers to clip her pump to her skirt/pants. This would mean she wears the band now every day. I despise the black leather case it came with - it's bulky and the clip is awful.  Not sure how this will end up...hopefully not lost!

1 comment:

  1. Hi Terri,
    Have you tried Tegaderm adhesives? They have some that are designed for IVs that have a 'notch' in them (for the IV.) Maybe the sensor could go in the notch and you could use two of them. Here's a link to one of the adhesives -

    All the best to you and Alex!