mySentry Trial: Wearing the Sensor

Last post in this series: mySentry Trial: Starting Up

I wore the pump for about a week before starting on a sensor.  That time was used to become familiar with the basics of delivering insulin with a pump that was brand new to me.  My sensor training went great, and without any trouble I was up and running.

I own a Dexcom SEVEN+ system (a different brand of CGM) and decided that I wanted to wear both devices to get a feel for how they compare.  I didn’t do any scientific comparisons, I didn’t keep any detailed records, nothing fancy.  Just anecdotal observations.

Medtronic and Dexcom CGM Transmitter

The transmitter from each system

The first low I had while wearing both systems just about rocked my socks off.  Lows are often unsettling, especially when right in the middle of something, and on top of that I had both devices buzzing and beeping at me.  It was completely overwhelming, and I questioned whether I’d continue to wear them both.

But I did continue, and I discovered something very interesting.  When one system was off (not matching up to actual blood sugar numbers), they were both off.  So maybe perceived inaccuracies between brands of CGM technology actually come right back to something weird happening in the wearer’s interstitial fluid rather than either of the devices being wrong.  That was a real eye-opener for me.

MedT Sensor Introducer needle and device

Huge needle

Inserting the Medtronic CGM sensor was surprisingly painless for me.   During the course of twenty-plus sensors, there wasn’t a single one that hurt.  This surprised me because the needle (and the sensor, for that matter) are pretty big.

Actually, the needle is huge.

In this picture, you see the sensor and needle loaded into the Sen-serter, a spring-loaded sensor insertion device.  For the record, I am a fan of spring-loaded insertion devices.  I like that they help me with a quick insertion, something I’ve always had trouble with doing manually.

Again, I want to say that, even though the needle is the largest I’ve seen/used, not a single insertion hurt.  Not even a little bit.  I had one that bled like crazy, but even that was pain-free.

The process after insertion was slightly confusing though.  There is a 5-minute “wetting” period after insertion.  What that means is that you have to wait for at least 5-minutes before plugging in the transmitter.   Once plugged in, the clamshell is supposed to show a green light (that part is kind of cool. It seems the light is buried way inside, but still shows through the clamshell skin).

There was a couple of times where I didn’t get the green light, and I wasn’t sure why.  I would disconnect the transmitter and try again, and then it seemed to work fine.

Calibration is also a bit harder (the system is less forgiving of blood sugar on the move).  Jeff talks a lot about calibrating in his CGM post (a wealth of tips and knowledge), and something that Wil talks often about too.  The post I’ve linked to for Wil is quite old, and many things have changed since, but still offers a lot of wisdom around calibration.

CGM Integration

The CGM integration into the Medtronic pump felt very sophisticated compared to what I was used to with the Dexcom system.  I could dig deeper into the historical data, I could see the amount of time left on the sensor, and I could see when the next calibration was due.

Queued data rocks.  If the clamshell transmitter loses connection to the pump, it can store up to 40-minutes of CGM information.  Once the communication is re-established, it back-fills all of that information into the pump.  This was great for when I was taking a shower, or just after basketball when my pump is in my locker and I’m cleaning up.  I had very few gaps in my CGM graphs.

Another thing I really enjoyed was the ability to silence alerts for a set period of time.  I used this when I knew my CGM wasn’t tracking very well and didn’t want to be pestered by any of the alerts.  I could tell it to be quiet for whatever period of time I wanted, and it left me completely alone.

Wearing the System

Physically wearing the system proved to be more troublesome.  Especially during basketball.  I made a little video to explain.

I’ve never used more extra tape and crazy solutions to keep a CGM sensor in place.  Ooh, wait.  That’s a lie. I once used toupee glue to keep my Navigator sensors on.  That probably deserves its own post…

These sensors are approved for three days, which feels really, really short.  That being said, there are times where my Dexcom sensor itches so bad by day 5 or 6 that I’m ready for it to be gone.

And yes, I know that people restart their sensors.  Officially I did no such thing.  Unofficially?  I couldn’t keep the damn things on long enough to do it.  One or two basketball sessions and they were toast (clamshell flop).

Another thing I had trouble with is the holes they left in me.  I don’t know if it’s due to the size of the sensor, or the clamshell flopping, or something else, but these things seemed to leave much bigger (and more irritated) holes in my stomach.  In fact, the holes took longer to heal than the three days each sensor is approved for use.   I know my stomach is no masterpiece, but it looked like it had been shot with a shotgun by the time I had used a couple months worth of sensors.

Last Two Small Irritations

I once got a CGM alert on the last screen of programming a meal bolus.  After confirming the CGM alert, I had to start the whole bolus programming sequence over again.  I know it’s not a big deal, but it bothered me enough to make a note of it.

In that same vein, when I got a CGM alert at night I would turn on the back-light to see what it was.  After acknowledging the alert, the back-light turns off.  I’d have to turn the backlight back on to program my correction bolus, or set a temporary rate, or whatever action needed doing.  Again, a very small thing in the big picture, but it bothered me.

Last Two Large Concerns

The CGM alarms on the pump are way too quiet.  Dangerously quiet.  Can’t hear them at night quiet.  This was one big concern that I heard from many readers.   I didn’t hook up the MySentry device for a few days after starting the CGM, and many (most?) of the pump alarms without MySentry watching over them went unnoticed.

The last concern I have is all about the weak signal.

Weak signal, weak signal, weak signal, weak signal.  All the time, weak signal.

With the transmitter on one side of my body, and the pump on the other side, weak signal.  Talk about feeling fat.  Holy crap.  Feeling fat AND having a device beep at you all day to remind you of how fat you are. I’m not a fan.

I have never had to adjust my life to a diabetes device more than when I was wearing this system.

In my years of pumping I have found a “sweet spot” on my belt for my insulin pump.  It’s become a part of my movements to keep that sweet spot out of harms way.  When I get in the car and put my seatbelt on, the sweet spot is safe.  When I am navigating tight spaces, I’m subconsciously aware of that sweet spot and keep it out of the way.

I had to change where I put my pump to accommodate the weak transmission of information between the transmitter and pump.  It caused major disruption for me.  Remember how I broke the belt clip in the last post?  I wasn’t wearing my pump in the sweet spot because the transmitter couldn’t talk to it.

I should not have to adjust my lifestyle to accommodate a diabetes device.

When I play basketball there is one place where I feel my pump is safe.  I wear it in a pouch on an elastic band that goes around my waist, and I position it specifically where I do because it is comfortable and safe. I got so many weak signal alarms during basketball that I had to use the “silence” feature I mentioned above.  Sometimes the pump would be less than 18-inches away from the transmitter and still couldn’t communicate.

It made me feel so fat.  Like I needed a satellite orbiting my stomach in order to relay information back and forth.

Final Thoughts & More to Come

I still have a lot more left to say on my trial.  This post is, by far, the most critical and complaint-filled section of my review as a whole.

It sounds like I hated the system.  Which I didn’t.  There were certain aspects of the system that gave me a lot of trouble, but overall, I still liked the system.  Stick with me, and I’ll cover those in detail in the next post or two.

Next post in this series: mySentry Trial: The mySentry Unit

Disclosure

I received all of the pump supplies, components, and training from Medtronic, free of charge.  I was not asked to write or say anything about my experience, I was not given any limits around anything I did write or say.  I did not receive any compensation other than the opportunity to try their products.

Sloppy Evenings, Low Blood Sugars, Guilt, and Fear

This has been an active week for me. It feels good. My body feels good.

Four days of basketball, with one seriously kick ass weight session afterward. Four days of tossing a football around with my son and shooting baskets with my daughter. One short bike ride back home after taking my old pickup truck to the repair shop.

As far as exercise, I’m doing it. And it feels good.

But I get sloppy in the evenings. High carb foods combined with estimated carb counts and ballpark boluses PLUS a lot of exercise and activity equals an evening full of lows that leave me feeling fat, guilty, foolish, frustrated, helpless, stupid, and scared.

The first low blood sugar I treat with glucose tabs. But because I’ve been so sloppy with my insulin dose, they are not enough to do the trick. So I have food.

But then I worry about having over-treated, and I’m sure I’ll be sky high later. So I toss a little more insulin into the mix. You know, to balance it all out.

My blood sugar never crawls above 96 mg/dl (5.3 mmol/L), but because I’ve got all of that insulin working, it’s not long before I’m low again. I’m full, and the last thing I want to do is eat more. But I’m low (again) too, so I eat. Glucose tabs, wait, regular soda, wait. Doritos then ice cream. That should do it. That is enough to fix all of the low blood sugars of the DOC combined!

As I come to my senses, I start thinking about the doritos and ice cream. Slow food. Fatty food. So I program some insulin to be slowly delivered over the next 4-5 hours to help curb the rebound high that is sure to happen. My CGM is all confused, reading just enough lower than my blood sugar to trigger the unchangeable 55 mg/dl (3.0 mmol/L) alert over and over again. Not wanting to be pestered by false low BG alerts as I try to fall asleep, I turn it off.

But I can’t sleep. I start thinking about my daughter lying next to me, and those that we’ve lost overnight, and start praying that tonight is not my night. That I wouldn’t want her to be the one to find me, cold and grey and gone.

What the fuck. Am I losing it? Something not right. Something nagging at me. God told me to check my blood sugar.

No rebound high. More low. Ironically, it is 55 mg/dl (3.0 mmol/L). Right where my CGM had me pegged before I shut if off.

I’m still full. I’m sleepy, but with a weird adrenaline edge to it. I’m jittery and exhausted.

I’ve packed in a fourth dinner and really don’t care how high my blood sugar will be when I wake up. My stomach is bloated enough to push doors open before I walk through them. I feel miserable.

My activity level and sloppy insulin dosing led to a world of trouble tonight, and I know better. There is a lot of guilt and frustration I’m dealing with, because I know better. But I need to let it go. It is not my fault. My pancreas is broken, and our very best attempt is still not as good as the real thing.

I need to try and remember that my activity level does not grant me a free pass to eat less responsibly. In fact, with diabetes, it probably requires MORE attention and precision, more thought and planning for the rest of the day and night.

If I would have simply done a better job of counting carbs for dinner, this spiral of crap would have been much less crappy.

Even though I’ve had all of this trouble tonight, I have every intention of exercising again tomorrow. I’m also going to try my best to be smarter about my actions after exercising. That’s where it all comes together. Even if I can’t get it perfect, it will surely be closer than I got tonight.

Ninjabetic Weekend – Saturday – The Afterparty

I’m revisiting the tail end of my time in Los Angeles celebrating with George for his 20 year diabetes diagnosis anniversary.   There’s just a few more stories (and pictures) to share before I can close the book on that adventure.

After the celebration everyone parted ways for a little siesta.  We met up a bit later for dinner for more visiting and lots of laughing.

Picture of Melissa, Chris, Sara, Lee Ann and Scott at the restaurant.

I started double-fisting Diet Coke’s early in the evening.  Didn’t take too many Diet Cokes before I dropped my Dexcom into a pile of ketchup and the bartender had to cut me off.

Picture of my Dexcom in a pile of ketchup and me laughing

It took a bit of work to clean it up, but in the end it was probably better in the ketchup than in my sodapop.  Do you think ketchup voids my warranty?