San Antonio and the Death of Dex

I spent a long weekend, out of my usual routine and either walking far more than usual or sitting still far more than usual, without Dexcom (a continuous glucose monitor).  And I was just fine.

You see, last Wednesday night (or early Thursday morning!), Dexcom vibrated to wake me and tell me I was low.  I felt OK, but tested... and I was 90.  Perfectly fine.  So I calibrated Dex and laid my head back down to sleep... only to be startled awake by an incredibly shrill BEEEEEEEEEP!!!!

I've seen other D bloggers complain that Dexcom is too quiet and won't wake them up at night.  Yeah, I don't have that problem.

I grabbed it and saw that Dex was initializing, and then that it had recovered a session.  Okayyy...  I put Dex back on the nightstand and settled back in, trying to relax...

BEEEEEEEEEP!!!!


Initializing and recovering again!
 
I went through this two more times before I turned Dex off and got out of bed, wide awake.  3:30 am.  Great.  No way I could get back to sleep, as wired as I now was.
 
I called the Dexcom service line as soon as business hours arose and they confirmed that, yeah, something pretty bad had gone wrong with the receiver, and they wanted to just replace it to be safe.  They offered to overnight it, but I asked them to wait and send it so it would arrive Monday, since I was leaving town early the next morning.  (They were, by the way, extremely awesome and offered to just overnight it to where I was going.  I didn't really feel secure about sending it to a hotel when I surely wouldn't get there until well after delivery.)
 
Friday morning, after stopping for the #7 breakfast at Cafe Antigua (this particular meal is both incredibly delicious and miraculously easy for me to bolus correctly!!!), Chad and I made the long Trek down to San Antonio for my grandmother's memorial service.  As a straight shot, it's about an 8 hour drive.  It's much longer when you're pregnant and need to make frequent stops to use the restroom and stretch your legs.  The drive wasn't bad though (especially since Chad was awesome and happily drove the whole way!), and we met up with my family on The Riverwalk when we arrived.
 
I had few blood sugar issues.  I went low twice over the weekend, but neither time was bad at all.  I probably went a little higher than I might have with Dexcom once, but it wasn't really out of my typical range, either.  Basically, I just tested more often... A lot more often.  And it was fine.  But still, there's so much that Dexcom gives me.  For example, I ate most of a sugar free fried pie and felt like maybe I'd given myself too much insulin for it.  We Dexcom, I could have just kept glancing to make sure my blood sugar wasn't dropping.  Without it, I tested like 45 minutes after eating to make sure I was going in the right direction at the right rate (I was), but I still felt kind of paranoid until the two-hour test.  And with Dexcom, I didn't feel the need to test my blood sugar before sleeping.  I just glanced to make sure it was in the right range and fell asleep with confidence that it would wake me if I went too low or too high.  Without it, I tested before sleep (a good thing too, as I was a little low at that test on Saturday night) and still worried as I fell asleep... In fact, I let myself run a tiny bit higher during some of the weekend than I normally would while pregnant and with the safety net of a CGM.
 
Things have been fine, but I'll be really happy to see that Dexcom box this afternoon!

WTF, BG?

WTF? I haven't eaten in like four and a half hours! Where is this coming from?!

 

(It has to be fat from dinner, but it normally doesn't sneak up suddenly like this. )

A conversation with Dexcom, with a sensor on its last legs:

Me: 152.
Dexcom: 208?
Me: No.  152.
Dexcom: 255?!?!
Me: No!  152!
Dexcom: OMG!  OMG!  283!!!!!!!  OMG!!!!!!!!!!!!!!!!!!!!!
Me: No, I said...
Dexcom: ???  (Translation, "OMG, I'm so freaking confused my circuits just almost exploded!")
Me: Sigh... OK, I think 8 days was this sensor's lifespan...  *stop sensor*

Back on Track

It feels good to be back on track.

 And that highest peak wasn't actually as high as it looks, according to Ping.

My weekly average, according to Ping, is also back to 125 (it was creeping up into the 130s, which isn't so bad except that I'm trying reallllly heard to keep things closer to 120 while trying to conceive).

But I'm not going to get cocky about it.  Things are good, but they'll only stay that way if I keep a close eye on my BGs, count the carbs in those game night snacks, and watch for troublesome foods and habits.

Oh yeah, and watch the pizza.  Two plus slices of delivery pizza, with the crust dipped in garlic butter, is not beneficial to my BG numbers no matter what combination bolus I've tried!  But half an Amy's pizza, without additional fat like garlic butter, seems to be an acceptable indulgence.  (One slice of delivery pizza, with no garlic butter, also seems to be reasonably acceptable with a combo bolus... but it's sooooo hard to stick to one slice!!!)

In Which I Say BACK To Dexcom, "???"

I've had my (non-trial) Dexcom since Thursday evening. The first sensor was crap, apparently. The trial one from the previous week had gone so well (after the first night, which was crazy), but this one seemed to give me numbers not even remotely related to the ones my meter showed me (Dexom 44, meter 126?! Dexcom 250, meter 160?! ), and it gave me ??? errors a couple times, plus a long and inexplicable out-of-range error... so after another insanely inaccurate reading followed immediately by ???, I finally ripped it off and started a new one Sunday afternoon.

I also wasn't especially pleased with the new sensor the first day and started wondering if it could be the transmitter or receiver... until that evening, when everything started going smoothly. And now, it's damn near perfect, staying well within the acceptable variations (20 points off on the low side, 20% off on the high side). Even over the first night (which gave me trouble on the trial sensor), it didn't throw me any usual numbers, and my fasting numbers matched pretty closely.

Ahhh, CGM bliss. I'm hoping Dexcom will replace that crazy sensor (I tried contacting them, but you know, it's Labor Day weekend). In any case, I'm once again so glad to have this tool. It's just too useful... when it works.

Dexcom, Weddings, and Alcohol

I absolutely love this thing.

It's a Dexcom reciever. Part of a Continuous Glucose Monitoring System. The sensor and transmitter are pretty small, and currently attached to my abdomen. Every 5 minutes, the Dexcom gives me my glucose levels.

These are not yet accurate enough to totally replace traditional glucose meters. Before you ever give yourself insulin based on your current BG, you have to stick your finger. But the number on the screen isn't what's so awesome about this device. What's so awesome is that you can see where your blood glucose is going!

Three examples of when I loved this thing this week:

Wednesday: I was driving to an appointment when Dexcom buzzed to tell me my BG was dropping fast. I knew (and it showed) that my numbers weren't high enough to stand such a quick drop for long, so I chowed down on some glucose tabs. 5 minutes later, I could feel that my BG was getting low... but very shortly after that, the glucose tabs kicked in and I felt better, and Dexcom showed my BG starting to slowly rise to safer levels.

Friday: At my birthday party, I decided to have some wine. I rarely do this for fear of what it'd do to my blood glucose levels, but I had Dexcom to tell me about any sudden drops... which I did not have. Dexcom gave me a view of my BG trends all evening, and I kept it where it would wake me if I went low during the night. I didn't have to stress.

Saturday (last night): I went to my cousin's wedding with an already elevated blood glucose due to eating fast food for lunch. At the reception, I gave myself insulin and made myself wait until Dexcom showed my BG starting to lower before beginning to eat my dinner (thus avoiding an even worse spike). This meant that, when it came time for cake, I didn't feel horrible about eating sugar. Again, I took my insulin a few minutes before eating the cake and saw that my numbers were starting to come down slightly before I ever put the first bite in my mouth. In fact, after that cake, I finally saw my numbers begin to return to a healthy range. Then, about three and a half hours after the cake, Dexcom buzzed me and showed a sharp drop in BG. What?! I tested to confirm and yes, I'd had a sharp drop. Aided by Dexcom (and the occasional finger stick to confirm whenever I was shocked to not see a rise in BG), I started consuming carbs. A small cookie... nothing. Another cookie... nothing. A 10-carb box of apple-carrot juice... A slight drop?! Glucose tabs... a slight rise, so wait and see.... no change? Finger-stick shows a BG of 88, which is too low for bedtime with such a downward trend and the knowledge that I'd had alcohol two nights in a row! I ate a 16-carb South Beach bar and sleepily watched Dexcom's numbers rise to almost 100 (with a slightly-upward trend arrow) before nestling it next to me and going to sleep. Dexcom shows I reached the 190 range in the night (which, I've discovered, means I was probably closer to 170 or 180), but the glucose meter showed me a 112 (Dexcom showed 130) when I got up late in the morning. I'd rather not go that high, but I think two evenings of alcohol threw my system through a loop, and it was necessary.

I've found the Dexcom numbers off by 20 points pretty often, but it's been an invaluable tool already. This was just a "trial" week, required by my insurance before they'll actually cover Dexcom, and I'm now more convinced than ever that I want one. It's helped me learn more about the timing of my insulin (I'm now trying to take it 15 minutes before I eat, when I can, to avoid spikes) and has helped me live a slightly more normal life (normal for me!) without worrying that I'd have a middle-of-the-night emergency. (I also learned that something last night didn't work for me. Was it two nights of wine in a row? Or did I guess horribly wrong about the carb content of cake? Or did even that small amount of dancing bring my BG down? I'll now have a much more watchful eye on all of those elements until I figure out what the problem was.)

Dexcom, you rock.

The Other Side of 30

So today is my 31st birthday, and last night was a celebratory game night with close friends (which wound up feeling more like a party than I expected, which was cool!). I opted against the rather large parties we tend to have partly because I still occasionally feel frustrated when faced with some food and drink situations, but also partly just because I wanted a smaller get-together.

Food and drink awesomeness:

1. I made low carb peanut butter balls, which took a little modifying (1 oz of chocolate was not enough!) and recalculating but turned out great and made 35 small balls at 1.3 carbs each (mmmm!).
2. Two desserts arrived with me in mind! Jenn brought cupcakes (with sugar-free penutbutter cups in them, FTW!) and told me upfront how many carbs were in them, and Jess (quite a famous chef in our group!) brought a low carb plumb tart with an almond crust. Yum!
3. I had three glasses of red wine and, while I let myself run slightly on the higher side for the evening, I wasn't afraid of dropping too low since I have a trial Dexcom unit this week (what great timing!).
4. No one brought anything super hard to "count," and I didn't feel pressured to eat out of courtesy.

Rock!

Other awesomeness:

1. GAMES! We played Ultimate Werewolf and Quelf, both of which make for goofiness and fun!
2. Friends! I felt really loved.
3. Fun and thoughtful gifts! One of the things Jenn and Bonnie gave me was a set of Russian nesting dolls that double as measuring cups!!! As Bonnie is also type 1, they probably knew how handy it is for me to have plenty of measuring cups around (and these are so cute!!!). Liz and Matt also gave me some cool vintage fabric with the thought that I could use it for making purses or meter cases to carry all my stuff, and Melissa and Jade gave me a copy of Quelf!
4. A really awesome husband! It was Chad that arranged all of this, and it turned out to be perfect. He's so sweet. :)

It was an awesome birthday celebration. I have to admit that, a couple months ago, I worried my birthday would be depressing. But surrounding myself with just my closest friends and not facing down a giant, sugary cake (and happening to have a Dexcom to help make drinking safer!) worked out beautifully. I felt normal, and yet not pressured to be normal.

Chad has commented a couple times that, after this diagnosis and some other less than pleasant issues this past year, we should be glad to say goodbye to 30. I think I agree with that, but I also think I've come out the other side of 30 in better shape than I went in. I suspect I went into it with this disease already in development, and now I've finished it with it under pretty good control and... overall happiness.

This was not the most pleasant year for me, but I think I'm better off for having gone through it.

Dexcom on Its Way!

So not only am I getting an insulin pump, but I found out today that I've been approved for the Dexcom continuous glucose monitor (CGM)!

I was skeptical my insurance would approve it, because it's still so common for people to get turned down, but I'm betting the pregnancy planning is what won them over... though Mom pointed out that my situation is an unusual one, even if it's not uncommon, so they may have been prone to approving it for someone with a brand new case of Type 1 at the age of 30. She also thinks insurance companies are catching on to the fact that good treatment now is usually less expensive than complications down the road.

Caremark and BCBC of Oklahoma, your recent moves to benefit my health and treatment plan are starting to shake my whole insurance-companies-are-evil stance!

While the pump is very exciting, I'm even more excited about some of the benefits of the Dexcom. First of all, it'll warn me about lows and highs, sometimes even before I think to test for them. And I find that, while I feel most lows before they get bad, I haven't really tuned into the symptoms of highs yet. I don't pee like crazy, my thirst isn't unusual enough to tip me off, and I don't feel that "off," which I attribute to having recently spent so much time with even higher BGs as an undiagnosed diabetic. Highs just feel like more of the same to me. But now, Dexcom will buzz me when things are climbing too fast.

And, in tandem with the temporary basal options the pump gives me, I think this technology will let me exercise and be otherwise physically active without worrying as much about lows anymore. If I take a sudden nose dive, Dexcom will most likely tell me.

Badass.