A “yay”: Summer is here!!! Hooray for warm weather, beach trips, and backyard BBQs! (Not to mention VACCINES!)
A “nay”: My pods and my CGM sensors are about to bare themselves for the world to see and we are NOT READY for it.
My confidence in my appearance is rarely, if ever, high. But I like to fake it ’til I make it and act like I’m rocking my summer wardrobe instead of stressing about how my legs or arms look in the staples of the season that are designed to show more skin.
Usually, I have a lot more success in feeling good about how my medical devices appear on my body. Whether they’re hidden under my clothes or out for the world to see, I typically don’t care because these gadgets are keeping me alive!!! And that’s a lot more important than any negative body image connotations they may create.
But something about this year feels different to me. I am so not looking forward to the extra stares that my diabetes technology attracts. I’m not sure if it has to do with being sheltered in the last year and a half because of the pandemic, but whatever the cause may be, this is something I’m grappling with as the temps creep up and the temptation to hit the beach grows stronger.
I know I’m not the only one dealing with this. In fact, I was in Maine for a couple of days with my parents and I was wearing my pod on my leg, whereas my mom had hers on her arm. And we had multiple people approach us about our pods! They weren’t necessarily rude in their approaches – curiosity drove them to speak with us and that’s innocent enough – but it’s still weird to know that people are looking closely enough at our bodies to see our devices and feel comfortable enough to ask us about them. Plus, I felt extra self-conscious about it because in typical Molly fashion, I had a sunburn all around my pod thigh site…when applying sunscreen, I almost always miss the area directly around my pods because I’m afraid of the sunscreen making my adhesive weaker or interfering with the pod’s functionality. So not only did I have this big chunk of plastic sitting on my leg, it was also red all around the site, drawing even more attention to it. It was a relief when I was able to put shorts on over my swimsuit and cover up both the burn and the pod.
So while I’m not loving how wary I’ve felt lately about baring my diabetes devices, I’m also coming to terms that it’s just a sort of phase that I’m going through right now. And that’s okay. I’m also trying to remind myself that I don’t have to feel obligated to go into detailed explanations when people ask me about my pod or CGM. It’s a natural tendency that I have to use it as a teaching moment and be a good diabetes advocate, but sometimes I just don’t have the energy for it. I’m keeping my fingers crossed that as the summer season goes on, my comfortability with my diabetes devices increases and I worry less about the looks they tend to draw.
I was a mile into my regular morning walk when the beeps started.
The beeps were coming from my Dexcom app on my phone and they were alerting me to a low blood sugar. Rather than correcting the low, though, or even opening up the app to dismiss the alarm, I just kept walking.
Outwalk the low blood sugar, Molly.
I really couldn’t understand why my blood sugar was low in the first place considering that I had no food in my system or insulin on board (other than my standard basal rate). Fasting workouts tend to virtually guarantee stable blood sugars for me, which is wonderful because otherwise exercise tends to make me crash. But what was different about this morning? I was utterly befuddled. My Dexcom alarm chimed a second time.
Outwalk the low blood sugar, Molly.
Even more confusing was my complete and utter determination to not treat the low blood sugar until I got home. I had glucose tablets on me, so it’s not like it was a matter of lacking a treatment. Rather, I think I was more focused on maintaining my fasted state for as long as possible, since I almost always do an exercise circuit (weight lifting, cardio training, HIIT intervals, etc.) when I return home from my morning walks. My low alarm rang a third time, just as loudly as it had before.
Outwalk the low blood sugar. You’re only 15 minutes from home.
I was deaf to my Dexcom’s persistent alarms for the next 15 minutes as I somewhat floundered down the road home, letting my impatient puppy tug me along. It’s almost like she knew that I was low and was trying to hurry me home, and I was 100% okay with that because my brain was starting to get fuzzy.
Outwalk the low blood sugar…
At long last, nearly half an hour after my first low alarm sounded, I was crossing the threshold of my front door and fishing my phone from my bag. I tapped through my notifications and cleared the low alert, noting that I was 66 mg/dL and definitely needed to eat something before continuing on with my morning routine. I sighed, set my sight on the kitchen (where a low blood sugar food stash awaited me), and resigned myself to the fact that I couldn’t outwalk the low blood sugar this time.
This blog post was originally published on Hugging the Cactus on May 13, 2020. I’m sharing it again today because I think it’s super important to weigh the answers to these questions before deciding to try new diabetes technology. This is coming from someone who waited 17 years before she tried her first insulin pump, and even though it has had an enormously positive influence on my life and sometimes I wish I’d tried it sooner, I’m ultimately glad that I waited that long! Read on for more details…
So you want to try your first continuous glucose monitor. Or maybe you’re ready to leave behind multiple daily injections and switch to insulin pump therapy. Whichever diabetes device you’re looking to start using, there are some questions you’ll probably want to have answers to before decide that now’s the time to introduce new diabetes technology into your daily routine.
The following is a compilation of the questions that I thought long and hard about (literally for years) and that I wish I’d thought long and hard about before I made the transition to the OmniPod insulin pump.
1.Am I ready for it? It took me 17 years before I decided that I was ready to try an insulin pump. 17 freakin’ years!!! I spent most of that time being too afraid of introducing such a drastic change to a routine I’d had down pat for such a long period of my life. There are times when I wish I’d gone onto my insulin pump sooner, but ultimately, I’m glad that I wasn’t swayed by my family or doctors to go on it before I truly felt ready. By the time I started using my OmniPod, I had the maturity, responsibility, and emotional intelligence that I felt that I needed for an insulin pump.
2. Will I be able to afford it? Obviously, this isn’t a question that I wondered about when I was younger, but it’s one of the first things that comes to mind as an adult on her own health care plan. We all know that diabetes supplies are expensive, and it seems that the more technologically advanced something is, the more money that has to be forked over in order to obtain it. This isn’t right or fair, but it’s a simple truth and an important one to think about before choosing one pump or continuous glucose monitor over another.
3.Why do I want to start using it? I wanted to start using my OmniPod because my mom experienced great success when she started using it. And I decided to get a Dexcom CGM because I fell in love with the technology after undergoing a trial period with my endocrinologist. In both situations, I felt very much in control of my decision to start using these devices and I didn’t really listen to anyone else’s opinions. But I am very aware of the fact that social media and real-life friendships with other people with diabetes can often sway people in different directions. After all, if I saw a post on Instagram from a dia-influencer who was singing the praises of a Tandem T:slim pump, then I might seriously start thinking about switching to it (this has actually happened to me). But the bottom line is to think about the why – will this device enhance quality of life for me? Will diabetes be easier to manage with it? Will it help me achieve my A1c and/or blood sugar goals? Do I need to add something new to my routine because I’m feeling burnt out by doing things the same way all the time? Knowing why I wanted to use an OmniPod or a Dexcom CGM made me feel that much better during the whole process of learning how to use them – I felt like I had clear goals that would help me navigate the integration of these new technologies into my daily routine.
4. Will I be comfortable wearing it 24/7? This is a big one! Pods, pumps, and CGMs are very visible, and it can be jarring to go from being “naked” to having bumps and lumps underneath clothes that can get caught on doorknobs, chairs, and the like. Personally, the benefits of my OmniPod and Dexcom outweigh something like this which is a bit superficial, but that doesn’t mean it’s not something to think about. But it’s also worth thinking about comfort and what is least painful when it comes to insulin delivery, so that’s why this is an important question to ask.
5.Do I know anyone else using it who can provide feedback from a patient’s perspective? I’ve talked about this before, but I’m not sure when, if ever, I would have seriously considered using the OmniPod if my mother hadn’t tried it first. The fact that we both have diabetes has probably made us a little closer and strengthened our bond, so if there’s anyone’s opinion that I’m going to trust when it comes to something like this, then it’s hers. I can actually remember her first few weeks on the OmniPod – in which she learned a lot of valuable lessons – and how pleased she was with it once a few months with it elapsed. She taught me the ins and outs of the OmniPod when I started to use it, and I’d argue that her advice was more helpful than that of my diabetes educator. So I’d advocate gathering opinions from family and friends (if either is applicable) or the diabetes online community before going on a new diabetes device, in addition to the research component below…
6.Have I done enough research on it? …Like any smart shopper, it’s crucial to really consider all options and research them thoroughly, especially when it comes to the top contender. I definitely did not complete sufficient research before going onto the OmniPod or Dexcom; rather, I trusted that they were just right for me. If I were to switch to something else tomorrow, though, you can bet that’d I’d spend a lot of time scouring the web for every last bit of information on the device so I could make the most informed decision possible.
New diabetes technology can be both scary and exciting. But more than anything else, it can really make life with diabetes much more carefree, and I’m glad that in this day and age there are so many options available to people with diabetes that continue to be technologically impressive
I’ve had four CGM sensors fall off in the last six weeks or so.
Four! And they’ve all been in different locations, too – both the left and the right sides of my thighs and my stomach. I’ve worn overlay patches – at times multiple – to help keep them on, and I’ve still dealt with adhesive that just doesn’t want to lay flat against my skin.
What gives? I can’t recall a time in which I’ve had worse luck with my CGM sensors staying stuck.
Normally, I’d blame it on weather, but it hasn’t exactly been warm here in New England yet. Temps have mainly stayed in the 50s and 60s, so it’s not like I can pinpoint the problem on heat.
The only silver lining in this scenario is that Dexcom does have a nice replacement program. They make it really easy to submit a patient support request online that goes straight to Dexcom support for processing. Filling this form out takes me no more than five minutes and by doing so, I’ve received a replacement sensor for each one that’s fallen off in the last month and a half. And while I was starting to worry that I was submitting too many requests, Dexcom hasn’t further inquired me on the matter yet, so I feel a little better knowing that I can count on them to give me replacements for sensors that won’t stay stuck.
Until the adhesive improves, though, it looks like I’m stuck wearing at least two or more overlay patches on my sensors to ensure their 10-day lifespans.
I guess they just don’t make ’em like they used to…
This post was originally published on Hugging the Cactus on September 27, 2019. I’m sharing it again today because I still find the concept of “sensor soaking” to be fascinating, though I haven’t been brave enough to try it yet. Not sure what sensor soaking is? Read on to find out…
I saw an Instagram story a few weeks back that intrigued me.
In it, a friend of mine was talking about how she “soaks” her CGM sensors. Instantly, I was confused: What the heck did she mean by that? Soaks them in what, hot water or some other liquid?
Within seconds, her definition of “soaking” became much clearer. “Soaking” a CGM sensor means inserting a fresh sensor hours before you intend to activate it. Rather than giving your sensor just two hours to warm-up, you’re giving it 4-6 hours so it can supposedly provide much more accurate readings immediately after the warm-up period has ended.
I was interested in this practice because I’ve definitely experienced sensors that were off for several hours post-insertion/warm-up. Sometimes, it even takes a full day for a sensor to start reporting accurate numbers, and I wouldn’t exactly call that efficient.
While I haven’t had the guts to actually try sensor soaking yet – I’d like to sometime in the near future – I’ve been doing some research on it so I’m fully prepared to try it whenever I’d like. Here are some questions I had about the process, and the answers I’ve found to them:
Q: Doesn’t this mean that you’re wearing two sensors at once? A: Yes. But it’s only for a short window of time, until the old sensor expires and it’s time to activate the new one; in other words, for the full soaking period.
Q: How long should I let a new sensor soak? A: According to what I’ve found online, it seems that 4 to 6 hours is the sweet spot for soaking. It’s basically doubling or tripling the built-in warm-up period that all sensors must go through, so I can see how this might contribute to improving immediate accuracy.
Q: How do I protect the new sensor if it doesn’t have a transmitter snapped in it for several hours? A: The reason why I haven’t tried soaking yet is because I was worried about wearing a sensor that didn’t have a transmitter snapped in it. But I found some photos online of people who wore transmitter-less sensors with stretchy, self-adhesive wrap tape to protect the nook in which transmitters rest for the soaking period. It’s smart to protect that space, because in theory, it could be vulnerable to catching on clothing or other surfaces. Plus, tape like that is really easy to remove without damaging the sensor in the process.
Q: What changes about the sensor activation process when it’s finally time to start the new soaked sensor? A: My research leads me to believe that nothing really changes at the end of the soaking period/when it’s time to activate the soaked sensor. All that will be needed is the sensor code so it can be properly activated within the receiver/Dexcom app. So the most important thing you can do at the very start of the soaking period is hold onto your sensor code/store it somewhere safe so you’ll be able to enter it at the end.
Q: So…why would anyone bother trying this again? A: My understanding is that it all relates back to making sure a fresh sensor is as accurate as possible once it’s activated. I can’t tell you how many times I’ve put on a new sensor, only to discover a few hours after it has warmed up that it’s off by 40 or 50 points – and that just doesn’t cut it. So I don’t think there’s any harm in me giving sensor soaking a shot one of these days. I just have to remember to do it, and have the patience to wear three devices at once (my pod, the soon-to-expire sensor, and the new soaking sensor).
Have you tried soaking? If so, please drop a comment and let me know your thoughts on it – and be sure to tell me if I missed any key steps in my research!
I don’t usually regret trying new sites for my Dexcom and OmniPod.
But recently, I discovered the one area that I wish I hadn’t tried…and that is my forearm.
For a couple years now, I’ve seen forearm Dexcom sites all across social media. People lauded the location for how comfortable it is and the accurate readings it produces, so I figured, why not give it a shot? (LOL diabetes humor.)
Plus, I wanted to give my stomach and the backs of my arms a break. I put both pods and sensors in those locations and while I like them a lot, I’m wary of scar tissue building up.
So with little fanfare, I tried putting my Dexcom on my left forearm (my non-dominant arm). And I knew immediately after hitting the orange button to insert the sensor that it was a bad choice because it STUNG. It stung something fierce! I remember wincing the moment it pierced my skin, and fortunately, the pain did go away…but resurged with a vengeance about half the time I made any arm motions. It didn’t matter if I was flexing it up or down or twisting it to reach for something – any movement could trigger varying degrees of pain. Nothing incredibly intolerable, but enough to make this site uncomfortable.
And this pain didn’t altogether disappear one day: I still felt stings 24 hours after I put the sensor on. Maybe I hit precisely the wrong spot (I noticed a very small amount of blood discoloring the white adhesive of the sensor), but I asked the diabetes online community and it seems that the general consensus is that this location sucks. The half-dozen or so people who messaged me said that either the pain was too much and they took the sensor off early, or they toughed it out for a full 10 days and never used the site again.
What’s more is that this site wasn’t as out-of-the-way as I wanted it to be. I roll up my sleeves dozens of times each day for different tasks, and each time I went to roll up my left sleeve, I had to go about it gingerly so I didn’t risk bumping into the site and prompting ripples of pain. This was straight-up annoying because my diabetes devices don’t usually inhibit my movements so much.
The one plus-side of trying the new site, and the only thing that motivated me to keep it on for the full 10 days, is that it was just as accurate as any other Dexcom site I’ve tried. My readings matched up pretty closely with how I felt and with what my blood sugar meter reported, so that was a saving grace. And I have to admit that even though I was worried that sleep would be impossible with the sensor in such a tender spot, it really didn’t interfere with my slumbers, which was a relief.
All in all, though, the accuracy wasn’t enough to convince me to want to keep forearm sites in my regular rotation. I’ll stick with abdomen and upper arm sites for now, with the occasional thigh site to further prevent scar tissue.
Something that all people with diabetes that I know – myself included – struggle with from time to time is the adhesive that keeps our diabetes devices stuck to our bodies.
Real talk? Both the adhesives for my pods and my Dexcom sensors can be lackluster. About half the time, the adhesives that secure them to my body begin to peel around the edges when I’m only partway through the wear time of both devices. And another (much smaller, though far more infuriating) part of the time, the adhesives lose their stickiness entirely, causing the device to fall off my body.
When the adhesive is the reason why a sensor or a pod doesn’t last the full 10 and 7 days, respectively, it’s practically like experiencing a slap in the face because at least a technology error or failure feels more out of my control…the adhesive, though, feels like something that should never be a real issue, and I can’t help but blame myself for not making a pod or sensor more secure when the glue completely fades.
On the bright side, my experience with less-than-sticky pods and sensors forced me to think of ways to get them to last their full lifecycles on my body. Here’s how I make them last as long as possible:
Protective barrier wipes: I use these wipes each time I do a pod change. When my new pod is priming, I wipe whichever site I’m about to place it on with a protective barrier wipe. (I use an alcohol wipe earlier on in my pod change process.) These seem to help with adhesion without adding a ton of stickiness like regular SkinTac wipes tend to do. They literally do what they say they’ll do, which is make a protective barrier for a piece of medical equipment to stick to easily.
Dry my skin: This seems incredibly obvious, but I make sure that new pod and sensor sites are as dry as possible before I apply a device. This is much more of a problem for me in the summertime when weather causes me to sweat more, but I’ve been able to navigate that by wiping my skin with a clean towel and making sure air is circulating well in the room in which I’m applying the pod or sensor so any excess moisture evaporates off my skin.
Specially designed stickers: Both Dexcom and OmniPod produce stickers that customers can request for free. I get them mailed straight to me and I find that they are most useful when a pod or a sensor is hanging precariously off my body. The stickers are shaped exactly to fit around both, so I never have to worry about missing a spot, and they’ve definitely helped me save more than one pod and sensor in the past. I don’t like wearing them unless I have to, though, because sometimes the extra adhesive seems to make the underlying adhesive weaker (not sure how that’s possible, but I’ve always had more luck waiting to add a sticker on top of a loose pod/sensor that’s in its last couple days of wear than adding the sticker on top in the beginning).
The “circle and press” technique: Most people probably already do this, but I actively have to remind myself that when I apply a new pod or sensor, I need to take my finger and circle it around the adhesive firmly three times in order to make sure it’s pressing up against my skin as securely as possible. This method also sort of irons out any wrinkles that might have appeared when the pod or sensor was initially stuck on, so it’s a simple yet effective thing to do…which is absolutely something we could all use more of when it comes to handling diabetes.
I can’t be the only one who feels that it takes five-ever (which is even longer than FORever) for high blood sugar to come back down to normal levels.
I don’t use any super-fast-acting insulin (such as Afrezza or Fiasp), so typically, I have to wait about an hour for my good ole Humalog to kick in. And an hour can feel agonizingly long when it comes to diabetes.
Fortunately, I’ve used different tips and tricks over the years to help make that hour fly by:
Blast some music and dance around in place. You might feel dorky when doing this, but I honestly swear by it – not only is it fun, but it can also help my blood sugar come down faster because yes, dancing around is still exercise!
Sip water over the course of the hour. I challenge myself to drink at least one full water bottle (I’m talking my 25 ounce reusable water bottle, here) in this hour of time. It’s my opportunity to rehydrate myself, and it’s also a good way to flush out the system when trying to bring a high blood sugar back down.
Watch episodes of “comfort” television. I know that I can watch exactly one episode of The Boys, two episodes of Sex and the City, or three episodes of Community (yes my taste in TV is eclectic) and allow myself to get totally immersed in the shows as opposed to stressing about my blood sugar. I call these shows “comfort” TV because I’ve seen all the episodes before, but I enjoy them still and I know how much of them I need to watch in order to stay distracted.
Read a magazine or a few book chapters. I’m kind of a hoarder and I save old magazines that I’ve purchased at airports over the years…but my magazine stash comes in handy when I need an hour of time to go by faster because I can pretty much read one cover to cover (depending on how big it is, of course) while I wait for my blood sugar to come down. Or I can turn to my book collection, select a piece of “comfort” literature (like the comfort TV described above), and get lost in the words for awhile.
Get into an arts and crafts project (or anything that requires focus). For me, this is knitting. Depending on the knitting project, it can take anywhere from a day to weeks to complete something. So if I need to wait for a high to come back down, I can focus on making knitting progress as opposed to what my blood sugar’s doing for an hour – and honestly, I sometimes get so into my work that I don’t stop for a few hours. Time goes by quickly when knitting!
Make it impossible to keep checking the CGM app. Sure, I could torture myself by checking my app literally every 5 minutes for updates, but that’s one guaranteed way to drive myself crazy for a full hour (or longer, because there’s a 15-minute delay with my CGM). So I force myself not to check it by putting my phone in a different room, silencing it, or turning it off altogether. Removing the temptation to check my blood sugar is majorly helpful when waiting for it to drop down because I’m not constantly stressing over how long it’s taking for the insulin to start working.
It might seem kind of ridiculous that I rely on these strategies to make time go by faster when I have a high blood sugar, but they work – and feel a heck of a lot better to do than anxiously staring at my CGM for a full hour!
I may have had diabetes for more than three-quarters of my life, but that doesn’t mean that I don’t make silly mistakes with it from time to time.
But I must admit, I still surprise myself on the occasions that I make a slip-up that’s incredibly stupid…and incredibly avoidable.
For example, one morning my Dexcom started alarming, and I thought that I knew exactly why it was sounding off: It sounded like the signature triple buzz of a high alert, so I did what anyone else would do when it’s very early in the morning and not quite time to wake up yet…I ignored it and fell back asleep.
But true to typical Dexcom alarm nature, my sleep was interrupted again by continued buzzing. Rather than pick up my phone to dismiss the alarm, though, I decided to bolus for a couple of units without ever verifying that I was, indeed, high.
Yikes. Can you say rookie mistake?
Fortunately for me, I really did have to get up and start my day within a couple of hours of taking that bolus. Thank goodness I did, because when I got up, I immediately glanced at my Dexcom and was taken aback to see that my blood sugar had not ticked up past my high threshold in the last several hours…it had actually lost reception completely.
Ahh…so that’s what it was trying to tell me. Oops.
Furthermore, my blood sugar was inching below my low threshold – the two units I’d carelessly taken had kicked in, and all I could feel in that moment was relief that I hadn’t taken more insulin.
This story could’ve had a very different ending. I’m still kind of in disbelief that I didn’t just roll over to check my Dexcom and confirm the reason why it was alarming in the first place. I mean, that’s what I do any other time it goes off, regardless of the time of day. I suppose that I was just overly confident in what kind of alarm it was. Coupled with the fact that I was barely awake when this all went down, then it really isn’t all that crazy that this happened…but it doesn’t make me feel any less dumb.
Lesson learned. When it comes to Dexcom alarms, always check them, and never make assumptions.
I’ve decided to take a break from continuous glucose monitoring. This means that for an undefined period of time – maybe 3-4 days, a week, or a few weeks – I’m not going to wear my Dexcom G6 CGM.
Initially, I wanted to give myself a break because I was just burnt out from wearing it all the time and feeling so dependent on it. But as I started thinking about more, I realized that there were some other really great reasons for me to take a break from my CGM:
1 – I wanted to wear one less device. It can be tough to wear two medical devices 24/7. Sometimes I get super self-conscious of them. Other times they just aren’t comfortable to wear, such as when I roll over one the wrong way when I’m sleeping at night. So it’s nice to feel a little more free with one less device stuck to my body at all times.
2 – I was sick of the constant data feed. All those alarms going off whenever I cross my high or low threshold are straight up annoying!!! I know I could just turn them off on my CGM receivers, but the point of them (for me) is to try to maintain as tight of a control on my numbers as possible. But now that I’m intentionally not wearing my CGM, I’m realizing how much I appreciate the reprieve from all that buzzing and beeping.
3 – I have some new blood glucose meters to try. The only way that I can really put my new meters to the *test* (lol) is to use them – and goodness knows that I have very little desire to do manual finger stick checks when I’m wearing my CGM.
4 – I’d like to hold myself more accountable. I rely on my Dexcom heavily at all times. I look to it before I start exercising, before I eat something, before I do anything, really. I bolus using the data it provides and trust it implicitly. But I’ve recognized that by developing this habit, I’ve become lazy. I don’t measure out food as much because I figure that if I bolus too much or too little for it, I can just watch what my Dexcom tells me and treat from there. It’s kinda sloppy, in my humble opinion, so I’m trying to put more of the trust back in myself for my diabetes monitoring.
5 – I’m trying to reacquaint myself with my body’s cues. Before CGM technology, I was really good at recognizing high and low blood sugar symptoms…but then I started using a CGM and found myself reacting to highs and lows (e.g., treating them prematurely), even if I didn’t feel those high/low symptoms. So I want to retrain myself so I can make sure I never lose that ability, because I think it’s important to know exactly how my body alerts me to various blood sugars, rather than depending solely on a piece of technology to do it for me.