Discovery #1: Adventures in DexCom
Last Wednesday I was given a trial of DexCom by the Nice Folks at OHSU. Now, the insurance company pays for it for 3 days, but since the third day was a Saturday, and it's Labor Day weekend, I actually get to wear it until tomorrow. Six whole days of DexCommy good fun.
Or was it?
Ok, so last week, Amy commented that people were firmly planted in the Upstairs or Downstairs group with little room for movement. For the first couple of days I was definitely in the upstairs group.
1) It's a FREAKING CONTINOUS GLUCOSE monitor. Which is quite possibly the greatest diabetes invention since the pump. And anyone who say otherwise is either a cynic or stupid.
2) It trends nicely. Want to know if you're going up or down after a meal, Dex can tell you. This has proved exceedingly useful in the realm of Symlin and alcohol and it showed that neither is as predictable as one might assume and/or hope. In fact, part of me wants to give up Symlin entirely as I discovered that I could essentially not take insulin for two hours after taking Symlin and be just fine. And those lows with Symlin may not have had been bad carb counting, but the Symlin actually dropping me. 10 units of Symlin with dinner, no insulin, and in one hour I went from 250 to 115. Watching the blood sugar while drinking has also proved beneficial, though slightly confusing, and it's nice to see where you are headed without having to test every 15 minutes.
But after a few days, I'm starting to feel myself walking down the stairs. Here's why:
1) First and foremost, accuracy. It's the issue on everyone's mind, and while the trends were always right on, Dex didn't necessarily know where you were coming from and where you were going, just that you were, indeed, going. Some of the readings were within 10 pts, which fits with the standard variation between meters, but most of the time they were 20-30 pts. off, and sometimes as much as 50-60, especially the higher I got.
2) It's a second contraption. I know being on the pump should make me somehow adaptable to carrying around gadgets all the time, but honestly, bringing that Dex around is kind of cumbersome. The thing is not small (it's bigger and wider than a pump, but it is thinner) and the thing has the dumbest case in the world with a clip that doesn't really clip.
3) Losing signal. It didn't happen so much Wednesday, Thursday and Friday, but as soon as Saturday hit, I started receiving gaps in readings. I don't know how common this is, since no one has mentioned it before. I have also had to restart the sensor twice (in addition to the usual 3-day restart that you do get more life out of a sensor). Because of this, I'm not sure how it affects the accuracy of the Dex.
4) Information overload. Honest to God, looking at the numbers for the first day or two is really, really cool, but after awhile, I think I'm starting to get a little more freaked out. You see every single little change in blood sugar. Up and down and up and down and up and down. I don't know where half the change is coming from but boy does it like to change. And with aforementioned accuracy issues, I don't even know if the changes are actually occuring!
Edit: I forgot one more.
5) The sensor essentially stopped working in the middle of the night on Saturday. I wasn't sure what it meant so I tried to restart it and do the calibration again, but it basically was way off for all of Sunday. It still did the trends fairly good, but the numbers were ridiculously off, and there was nothing I could do because I didn't have another sensor to use.
So those have been my 5-day observations of the Dex and although the Downstairs points seem to outweigh the upstairs, I think I might be the rare breed of the Sitting on the Stairs Folk.
I like CGMs. Really, I do. It's definitely given me some useful information about how my body reacts to Symlin and to alcohol and hopefully I'll be able to figure out how to integrate this into my plan.
And perhaps some of these issues would work themselves out if I had more time to get used to the Dex. I am only on it for 5 days, which really isn't a fair assessment of a CGM.
There are major bugs to be worked out and hopefully The Next Generation of DexComs and Guardians, and the impending Navigator, will yield more promising results. It's kind of like signing up for the very first insulin pump... And if any of you have seen pictures of that monster, all I can say is: Scary!
Discovering #2: Alcohol Is Verrrry Tricksy
I'm glad that I'm finally legal and can talk about this without worrying about the legal ramifications of discussing underage drinking on a public website.
One of my very good friends, Julia, turned 21 yesterday (Happy Birthday to Julia!). And of course, we went out and drank. On Saturday and on Sunday.
Both nights fucked up my blood sugar.
Saturday, one drink dropped me two hundred points in two hours and on Sunday, two drinks brought me up 150 points in about two hours.
Now, I know that really the only way to figure this out is to do a very scientific experiment of drinking the same thing each time to see how different insulin amounts affect it. I know the kind of drink, the food I'm eating, etc. etc. all affect blood sugar.
But I was hoping the, uh, older people of the O.C. could help me out a bit by giving me some suggestions, tricks, carb counts, basal settings that might work... Anything.
The recommended (to me at least) 60% basal for 2 hrs per drink fails miserably. I'm in the 300s after an hour and I don't crash until hours later, if at all.
I tried 80% for 4 hrs on Saturday, and I ended up at 78 after 5 hrs. Since I was having twice as much to drink, I tried 70% for 7 hrs, and I woke up at 336.
There has to be a happy medium to this, and dammit, I will find it!
But suggestions are always appreciated.