Friday, March 18, 2011

The CGM...It's (Unfortunately) Infectious

I'm so glad it's Friday!  I look forward to the weekends so much...even though Saturday is mainly a catch-up day (laundry, housework, yard/garden stuff, etc.) since I work full-time during the week.  Then, of course, there's my other job: the 24/7 management of my diabetes.  Someone without the disease may think I'm being over dramatic, but any PWD knows I'm not...It takes A LOT of time, effort, and energy on a daily (and sometimes hourly or minute-to-minute) basis to keep your numbers under control.  It's something that I honestly think no one understands until they've walked a mile in those shoes.  I'm not complaining (well, maybe just a little bit), though, because the alternatives (complications, death) aren't so attractive.

I mentioned in my last post that my CGM has brought my attention to overnight lows that I've been unknowingly experiencing, probably since I started insulin therapy.  My CDE and I were both surprised, and were able to fix the problem almost immediately with a couple of basal rate changes.  Now I'm hoping that I'll actually have energy during the day, and be able to get out of bed at a decent time in the mornings...those nighttime lows have a tendency to drain all of your energy without you even being aware of it.  I haven't had many low alerts from my CGM since we made the basal rate changes, so I'm going to file that away as a success!

In other CGM news, I removed my first sensor on Wednesday night (I'd had it in since last Friday, so for about five days), and noticed that the site looked like it might be infected...It was red, puffy, and painful.  I took a picture of it and emailed it to my CDE (who is also an RN), and she called me back last night saying it could just be irritation from having a foreign object in my body or a staph infection...yuck.  Today it looked better, but it still hurts.  I could tell last night that the path of the sensor probe under my skin is puffy, and that's the part that is most painful.  My CDE called my endocrinologist, and he wrote a prescription for Bactraban for this and possibly for future infections (although I hope that isn't the case!). 

She also told me to only insert sensors after taking a bath and using Dial antibacterial body wash to make sure the area is 100% clean.  Medtronic specifically says not to use any sort of skin prep before inserting sensors due to possible interference with proper functioning of the sensor probe itself, so the only option for skin prep other than a good wash in the shower/tub is swabbing the area with an alcohol pad.  I've also read online that it helps to keep the sensor site dry after showers and not completely sealing off the IV tape to allow the site to "breathe".  Anyway, I figure that if I try all of these things, maybe I can prevent future Ben Franklin said, "An ounce of prevention is worth a pound of cure."  Not so helpful when it comes to Type 1 diabetes, but great advice for site management.

Other than those issues, having the CGM is (somewhat literally, apparently) infectious.  Yesterday I felt lost without it...It's so nice to be able to push a button and have more than just an educated guess of where you're at.  More than that, it helps you better tailor your treatment to how your blood sugar responds to different things.  For example, I've been consistently having after-breakfast highs.  On my CGM, I can see my BG climbing and "head it off", so to speak, before I hit that high point, either with exercise or an extra dose of insulin.  I can also see how specific foods affect my blood sugar, and bolus accordingly.  The thing about this (and every other diabetes managment tool out there) is that it's only that-a tool.  You still have to use it appropriately and understand its limitations to get the most out of it.  I wasn't sure if I would like the CGM or not after all the negative stuff I'd heard about it, but I'm only on my second sensor and I'm already sold.  And the pain factor?  Well, the first one didn't hurt at all, and the second one wasn't bad either.  I don't know if I've just lucked out, or if it really isn't as bad as some people make it out to be.

I hope you all have a wonderful weekend, and here's to hoping for a healed site by Monday!


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