Saturday, March 12, 2011

CGM Training & Other Changes

Change has always made me anxious (at best).  At worst, it makes me feel like my world is crashing down.  Six months ago, though, my world did turn upside down thanks to diabetes...And you know what?  I came out on the other side just fine.  A little shell-shocked, but fine.

I wrote last month about what I've learned since the day of my diagnosis.  It's taken six months, but my life has regained some semblance of "normal" (whatever that is!).  In the past month or so, I also feel like I've finally come into my own in regards to my diabetes.  The first month I was on the pump was largely a time of trial and error.  I had to learn in real-time what effect certain foods have on my blood sugar, and how to correct for them with insulin.  For example, pizza, ice cream, and hot dogs all require a dual-wave bolus for me...If I do it all at once, I end up with a postprandial high, but if I do some immediately and the rest over 30 minutes or so, I'm fairly reliably within my normal range two hours after the meal.  That may seem insignificant or irrelevant to PWOD (a person/people without diabetes), but as anyone dealing with this disease knows, it's huge...Normal is always wonderful when it comes to your blood sugar.

Each time I have one of these breakthroughs, I gain some more confidence in my ability to deal with diabetes.  On those rollercoaster days when you devote most of your energy to chasing highs and lows, this confidence takes a hit, so even the smallest "light bulb moments"  are more precious than diamonds to me.  After all, this is my life that we're talking about, and all I want is to live a long, fulfilling one in good health.

With this in mind, I want to come back to the concept of change...and fear.  Aside from the pump, the most amazing technology we have in managing diabetes today is the Continuous Glucose Monitor (CGM).  I've written in previous posts about the fears I had about the CGM.  After seeing the sensors in person and reading horror stories about their insertion online, I was understandably anxious about actually using them, despite the amazing asset they are to diabetes management.  However, as Rosanne Cash's quote above makes clear, you have to overcome fear in order to be successful with change.  I finally decided that the benefit I would get from using the CGM far outweighed any (hopefully) momentary pain or fear I might experience.  In short, I made the decision to "suck it up" and deal with the pain when I got to it, because the entire reason I'm making such an effort to control this disease is definitely worth it.

I tell you all of this to give you some hint as to my mindset yesterday when I went for CGM training.  Determined, (finally) not anxious (well, maybe a just a's a huge needle), and excited about the opportunity to use such amazing technology.  My mom came with me to meet my CDE at a coffee shop, and we got down to business.  It turns out I had to get the scary part over with in the beginning, because the sensor takes 5-15 minutes to wet with interstitial fluid.  I picked my spot (lower right abdomen), swabbed it with an alcohol pad, and took a deep breath (along with a couple of glucose tabs, because I didn't need to be shaking for two reasons).  My CDE showed me how to use the inserter, then handed it to me for the big moment.  She helped me place the inserter at the correct angle at my stomach, then told me to press the button.  I did (a little nervously), but nothing happened. 

My CDE checked to make sure everything was in place, then had me try again.  I didn't realize it until it was done, but as I was pressing the button the second time, I wasn't looking at the insertion site...I don't really remember where I was looking, but all I know is that it finally went off, and then it was done.  I vividly recall going, "Oh"...Not a huge "OH!", just "Oh."  I was pleasantly surprised at the virtually pain-free insertion, and the relative lack of bleeding at the site.  We had some issues with sticking the adhesive down, but the sensor magically stayed in its place, so we connected the transmitter and the rest is history.

Seven hours after inserting the sensor, my CGM was reading within 1 pt of my meter.  No, I don't have one of those nifty pictures for proof, because it was dark and we were in the car on the way home, but I promise you, it happened!  My meter was reading 126, and the CGM 127.  I wasn't so lucky through the night, though.  My alarm went off 9 times between 1:00AM and 6:00AM, when I finally silenced the alarms.  It's been better since I calibrated it upon getting up this morning and again before eating, but I've still had quite a few alarms today.  I'm going to email my CDE and see if she'll let me change the lower limit on the sensor alarms so that maybe I won't have a constant beeping at my side!  Other than that, everything is going great.  My BGs haven't topped 162 in five days, and my average is steadily coming down.  I'm hoping that by using the CGM, I'll be able to bring it down even more.


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