I am about to start the RT System, My first day Options

[Phetonb]

I hope you are aware that you will get a 'Weak Signal' alarm when your transmitter has been attached for 7 days. The only way to fix it is to recharge the transmitter. You will then have to do another 'start new sensor' and will have a 2 hour startup when you reconnect. I usually do not do the second start new sensor. I go ahead and disconnect/recharge/reconnect with the second sensor end.

It makes sense that you will be off most of the time, since the SG is showing what your BG was 15 minutes ago.

I am happy if I am within 15 points, although I just tested and my BG is 77, my SG = 79! (IMG:style_emoticons/default/Celebrate 2.gif)

Linda B.

I got the "Weak Signal" alarm 30 min before I left work, 2:00 pm. I put it on my charger at 3:30.

Is this the 20 min to charge, or did it go too low and I need to charge it longer?

My cal factor was still in the 6 range, so I will try and keep using this sensor.

So far this one has lasted me 8 days, and until I see my cal factor go up, I will ride it as long as I can.

[Linda B]

I got the "Weak Signal" alarm 30 min before I left work, 2:00 pm. I put it on my charger at 3:30.

Is this the 20 min to charge, or did it go too low and I need to charge it longer?

My cal factor was still in the 6 range, so I will try and keep using this sensor.

So far this one has lasted me 8 days, and until I see my cal factor go up, I will ride it as long as I can.

I only leave mine on the charger until it stops blinking. No need to keep it on longer.

This one must have lasted you 7 days, not 8, as the internal timer gives the weak signal after it's been connected for 7 x 24 hours.

Linda B.

[Phetonb]

(IMG:style_emoticons/default/cool.gif)

I only leave mine on the charger until it stops blinking. No need to keep it on longer.

This one must have lasted you 7 days, not 8, as the internal timer gives the weak signal after it's been connected for 7 x 24 hours.

Linda B.

I mis-counted. Day 0 is not 1. Began the sensor last Thursday, and got the weak signal today, Thursday at about the same time I started the sensor last week.

I read the sticky on CGMS, and realized that the short charge would get it done. I did that, and now I am waiting 15 more min to be sure my BS is stable before I enter my first BG.

I hope this one will last another 7 days. My cal factor has been steady at 6.1 to 7.2 all week. It was 6.3 this morning.

My CDE recommended I use Tegaderm instead of IV 3000. I just re-secured with Tegaderm, and wow...what a difference. I like the Tegaderm much better.

Thanks again for everyone's advice.

I can see why you would want to charge on day 6. Doing so will eliminate the gap in data I will have now. Right??

This post has been edited by gigem99: Sep 17 2009, 10:15 PM

[gigem99]

I can see why you would want to charge on day 6. Doing so will eliminate the gap in data I will have now. Right??

It will. My schedule is a little different. I change my sensor and charge the xmitter every Sunday. Sometimes I do have a gap, but it's usually just the initial 2-hour warm up it takes on the first day. I try to change it about the same time on Sunday, so I generally don't get the tell-tale weak signal.

It's interesting you are trying for 2 weeks. I have done that, but I don't right now, because it does leave some scarring. It seems to be more than twice as bad after 2 weeks than it does after 1 week.

If you are paying OOP, that's fine, but if you have decent insurance, I personally wouldn't go past a week. Just me.

Tom

[Phetonb]

It will. My schedule is a little different. I change my sensor and charge the xmitter every Sunday. Sometimes I do have a gap, but it's usually just the initial 2-hour warm up it takes on the first day. I try to change it about the same time on Sunday, so I generally don't get the tell-tale weak signal.

It's interesting you are trying for 2 weeks. I have done that, but I don't right now, because it does leave some scarring. It seems to be more than twice as bad after 2 weeks than it does after 1 week.

If you are paying OOP, that's fine, but if you have decent insurance, I personally wouldn't go past a week. Just me.

Tom

Thanks for the heads up. Unfortunately I pay 30% OOP. So I want to get all the use I can.

I typically heal well and don't scar. If I see a bad scar, or don't like the way it looks when I pull it, I will shorten my duration.

Of course, My sensor may go bad on day 9 or 10....that remains to be seen.

[Linda B]

My CDE recommended I use Tegaderm instead of IV 3000. I just re-secured with Tegaderm, and wow...what a difference. I like the Tegaderm much better.

I can see why you would want to charge on day 6. Doing so will eliminate the gap in data I will have now. Right??

Whether you recharge on day 6 or day 7 you will always have at least a 2 hour gap in the data, because the transmitter goes through a complete start up process whenever it has been disconnected.

I have not used Tegaderm, but I do use OpSite Flexifix. It comes on a roll so you can cut exactly the size you need, is stronger than IV3000, but it's just as comfortable. My insurance does not cover tape, and this is the least expensive solution I have found.

Linda B.

[Beowulf]

I've thought about using a big close pin
or something similar my arms are so skinny there is not much to grab
onto.

JohnG

Ouch!!!!! You're kidding right???

[JohnG]

Ouch!!!!! You're kidding right???

I just thought about it I haven't tried it. (Still looking for a relay big close pin LOL)
I'm not sure how anyone inserts a sensor in there arm without a third hand.
I've been using my abdomen for over a year now and don't see any need to change.

JohnG

[Phetonb]

I just thought about it I haven't tried it. (Still looking for a relay big close pin LOL)
I'm not sure how anyone inserts a sensor in there arm without a third hand.
I've been using my abdomen for over a year now and don't see any need to change.

JohnG

I wonder how I will reach around to get my upper hip / upper butt area. My CDE said once I get used to it, that is a good place. I don't know if I can reach around back there by myself though.


That clothes pin idea sounds painful even before the sensor gun fires it in. But, it may have a numbing effect too....You might be on to something. (IMG:style_emoticons/default/Laughing.gif)

[Linda B]

I wonder how I will reach around to get my upper hip / upper butt area. My CDE said once I get used to it, that is a good place. I don't know if I can reach around back there by myself though.
That clothes pin idea sounds painful even before the sensor gun fires it in. But, it may have a numbing effect too....You might be on to something. (IMG:style_emoticons/default/Laughing.gif)

There is no need to pinch when inserting a sensor. In fact, I have read that it's good to stretch the skin taut. I am confused about why Liz pinches it.

I am able to insert infusion sets and sensors into my upper hip. Once inserted I sit down and can reach better to do the taping.

I can't figure out how to pull the needle out from an arm site though. I always use two hands - one to push the sensor down and the other to pull the needle out.

Linda B.

[Arlene S.]

I'm pretty sure that I read about the ideal thigh placement for sensors here. I had tried both the outer & inner thigh without much success. Someone mentioned placing it very high up, still on the top of the thigh but just barely on the border of the outside. That area on both legs works great. The only bad thing is the marks that are left behind are worse than anywhere else. Instead of a small red pinpoint I had a darker red spot about the size of a pencil eraser, and they take a long time to fade. They're not infections or sores. The actual insertion point heals fast but the dry, red spot stays for a long time. The sites on my arms heal much faster. I always pinch up the skin when I insert there, which I don't have to do on my thighs. I know some people use the backs of their arms but they must have help with the insertion. I could never do it by myself. Even if I got the sensor in, removing the needle would be very hard and attaching the transmitter would be impossible. Then there's the tape issue...

I wouldn't try my arms. I'm always bumping into things. My thighs are out of commission for a while. I inserted a sensor in my right thigh Monday night as usual and it bled a bit; I turned it on the next day after I received my replacement pump, but by last night I was getting weird readings. I tried restarting but to no avail. I just decided to pull it and I am glad I did. I have what looks like the beginning of an infection. I've been soaking it and putting Bactroban on it. I inserted one last night in my left thigh. It bled more than usual. I didn't use ice before I inserted it. I woke up this morning and it was still bleeding. Even my transmitter was bloody. I pulled the sensor and had a gusher and a black and blue mark. I inserted a new sensor in my stomach and it seems fine. I did use ice. Also I think I'm bleeding so much because of medication I'm taking for a pinched nerve in my neck. This is the first time I've used four sensors within one week. I can't blame the sensors and even if I could I wouldn't because they expired June 11.

[Linda B]

I wouldn't try my arms. I'm always bumping into things. My thighs are out of commission for a while. This is the first time I've used four sensors within one week. I can't blame the sensors and even if I could I wouldn't because they expired June 11.

UGH! How frustrating that must be to have so much go wrong with insertions. Glad you are back in CGMS business with a sensor in your abdomen.

It's so funny how different we all are - the only place that works for me is my thighs!

Linda B.

[Arlene S.]

UGH! How frustrating that must be to have so much go wrong with insertions. Glad you are back in CGMS business with a sensor in your abdomen.

It's so funny how different we all are - the only place that works for me is my thighs!

Linda B.

My thighs have been great until this incident. I'm almost certain it's the Celebrex. I also bled when I inserted a Sure-T. I finished the Celebrex today. I definitely hit a vein where I got the gusher. I was concerned that blood got in the transmitter but it didn't; it was just on the outside. I would normally pack two sensors for a trip but I'm going to pack about 4 this time for our trip to Italy. I only expect to change the sensor once but who knows. Then again this has never happened before in more than three years.

[Hattie]

Cliff, your account in this thread is such a shot in the arm. I started CGM this summer and had some very similar experiences. I still haven't been able to make a sensor last more than the 6 days so I'm the smallest bit jealous. The sixth day for me is kind of a bust anyway, so I've just decided 5 days is it for me, and for the current sensor that's looking like four.

I was doing pretty well, thought I had the thing nearly down (although it's clear one's experience with CGM is going to keep evolving) and then I went and got sick. A cold or possibly the flu, which turned into a sinus infection, and then of all the darn horrible things I got shingles (which I knew nothing about). wham, wham, wham. It's been an ugly 3 weeks. Some of the medication I was given messed with my BG but good (don't ever let anyone tell you a cortisone nose spray won't be absorbed into your system). Through some of this sick time, the CGM helped me stay on track but keeping in my target range was like staying on a bucking horse. Sensors lasted 3 days and sometimes barely. I was doing the best I could, but I got discouraged and went off CGM for a few days, and the funny thing was how much I missed it even though I was hugely frustrated.

Doing much better now, but I wish I had been able to get the CGM to help me through this time better. It seemed like my fluctuations made it far more fussy and unreliable, yet I wanted the CGM to help me iron out the fluctuations. Rock, hard place.

Long story short, I'm back on, stuff is settling down. I'm really enjoying reading your experiences, and your optimism is renewing my energy for the CGM. Thanks.

This post has been edited by Hattie: Sep 19 2009, 04:35 AM

[Tiffany]

How do you pinch up the skin and insert the sensor? I cannot figure out
how to achieve this on my own. I've thought about using a big close pin
or something similar my arms are so skinny there is not much to grab
onto.

I sit in a chair with a high back and then rest the underside of my upper arm on the back. If you kind of roll your arm towards your body, it will push the skin up, akin to pinching. (I use to use this technique when I did MDI's too - then again I was a lot skinnier then LOL) Sitting with your knee up and resting your upper arm on your knee works in a pinch.

Linda, technically I don't think you have to pinch - I just like having my sensor on the back side of my arm, it's most comfortable, and I'm not enough of a contortionist to get back there without help LOL. Then again, I cannot for the life of me get the introducer needle out one-handed either. Heh. (IMG:style_emoticons/default/angel_not.gif)

I'm really glad that you are enjoying your new body part Cliff! (IMG:style_emoticons/default/biggrin.gif) Keep the updates coming!

[Lanihuli]

This is so cool....I am sharing with you all, my diabetic friends my first experience with CGMS.

I will post this now, and report back later what happens next.
I have never been so excited and excited about a low too....go figure. I am ready to watch it climb back up a bit. (IMG:style_emoticons/default/rolleyes.gif)
UPDATE: next reading was 76....moving back up. YEA!!!

I am so happy for you! And I'm inspired to try again tomorrow. I met with my trainer 2 weeks ago and wore the sensor for 6 days before it died. Then I waffled out thinking work was hectic and I should wait for a weekend ... which was this morning and I avoided it. My first attempt at insertion was rough. I think I was nervous and the trainer and I were both tired. Anyway, I chickened out this morning, but I just took a sensor out of the refrig (thanks, Tom) and will do it tomorrow morning, on my own.

I loved wearing the sensor. Like you, I checked the graphs a lot! So neat! So awesome! And reassuring that I knew when I was starting to climb or go low or (hurray!) flat line!

Lanihuli

[Phetonb]

Update: Sensor #1 Day 10. Haven't checked my cal factor this morning. But my sensor reading was 2 points off my morning BG.

With the data I collected over the first 5 days, I noticed that my highs were happening in a pattern. Imagine that??

I then got out my Pumping Insulin book, and read a chapter I never have read closely enough. It was about TDD and how to set you pump settings.

I had been trying to "slowly" tweak some basals, but the pattern was still there. I was thinking about changing my I:C ratios for that time period when I was looking at the number to change, this one always confuses me, so that is when I went to John Walsh. I read something about TDD and settings, and a light went of in my head.

I took my TDD and looking at the chart realized that my I:C ratios all needed some adjustments. I made those adjustments, and the next 24 hours were awesome!

My SD graph smoothed out almost immediately. I have not been in the 200's since making this change! 200's happened almost everyday!

I was somewhat shocked to see what the bolus wizard suggested for my evening meal last night. I backed off some and it was a good PP reading 2 hours later. I may bump that # so I don't have to modify it each time.

Ok, I don't know what these #'s mean on my report so I will ask you guys:

My Standard Deviation is 22
Mad % 15.5


I hope I described what I did well. With my excitement I can sometimes ramble and not make sense.

[Linda B]

I took my TDD and looking at the chart realized that my I:C ratios all needed some adjustments. I made those adjustments, and the next 24 hours were awesome!

My SD graph smoothed out almost immediately. I have not been in the 200's since making this change! 200's happened almost everyday!

I was somewhat shocked to see what the bolus wizard suggested for my evening meal last night. I backed off some and it was a good PP reading 2 hours later. I may bump that # so I don't have to modify it each time.

That is just awesome, Cliff! I am amazed that with just 5 days worth of data you were able to make such a big improvement.

Ok, I don't know what these #'s mean on my report so I will ask you guys:

My Standard Deviation is 22
Mad % 15.5

I can tell you what the numbers mean but cannot give you the mathematical details of how they are measured. I think if you do a search you will find threads about both.
Standard Deviation indicates how widely the numbers in a grouping deviate from the average. The lower the number, the closer together all the numbers that were averaged are. An SD of 22 is excellent. It means that you did not have many very low or very high numbers, that they were all close to the average.

MAD % measures how close the BG number given for a calculation was to the SG (sensor glucose) number at the time. The lower the percent the better. It tells you how accurate your sensor readings are, but it only does the comparison when you calibrate. So it can give a false impression of accuracy. Still, it's useful to know how close the numbers are when your BG is stable. I wish it would measure it every time you enter a BG whether it was with the bolus wizard or the calibration screen.

Linda B.

[Phetonb]

That is just awesome, Cliff! I am amazed that with just 5 days worth of data you were able to make such a big improvement.
I can tell you what the numbers mean but cannot give you the mathematical details of how they are measured. I think if you do a search you will find threads about both.
Standard Deviation indicates how widely the numbers in a grouping deviate from the average. The lower the number, the closer together all the numbers that were averaged are. An SD of 22 is excellent. It means that you did not have many very low or very high numbers, that they were all close to the average.

MAD % measures how close the BG number given for a calculation was to the SG (sensor glucose) number at the time. The lower the percent the better. It tells you how accurate your sensor readings are, but it only does the comparison when you calibrate. So it can give a false impression of accuracy. Still, it's useful to know how close the numbers are when your BG is stable. I wish it would measure it every time you enter a BG whether it was with the bolus wizard or the calibration screen.

Linda B.

I truly believe that I was needing to make adjustments, but did not know what adjustments needed to be made. The CGMS sure did make it clear what needed to change and when.

I am sure that my adjustments are not done yet. I am seeming to stay on the low end of my target range now. I like that I am not on the high end, but 80-90 makes me nervous when I am actively working. I would rather live in the 100-120 range.

Some more tweaks and I will get there.

Thanks for the info on those numbers.

I sure hope all my sensors behave this well. From reading here, I know not to get upset when one is not as good as this one has been.

My cal factor earlier was 8.2 and this is on Day 10.

I just hope my good fortune is not a fluke. LOL. This has been awesome!!!

[Liz]

How do you pinch up the skin and insert the sensor? I cannot figure out
how to achieve this on my own. I've thought about using a big close pin
or something similar my arms are so skinny there is not much to grab
onto.

JohnG

If I'm inserting into my left arm, I hold the loaded inserter device in my left hand. I use my right hand to pinch up the skin and then insert with the left. It's slightly awkward but not really hard. With my arms I think it would hurt way too much if I didn't pinch up the skin. I go pretty far up on the arm. You can also use a doorframe to lean against and bunch the skin up on your upper arm but I find that's even more awkward. I used to do that when inserting Silhouettes into my arms.