LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Thursday, April 05, 2012

Alpine Outpost

Dateline: 2350 hours (that’s 11:50 p.m.) yesterday

’Twas minutes before midnight, when all through the house,
Not a creature was stirring, not even a mouse.

When what, to my despair, did mySentry declare?
But, yes, once again. A motor error.

Today, let’s talk about the Outpost’s new home. Hmmmmm… where to start? Well, to begin with, the MiniLink—the seashell CGM transmitter—frankly is a limp-dicked, sorry-assed excuse for a transmitter. I say that because it really can’t do the one thing that’s required of transmitters; which is to transmit.

Well, that’s not quite accurate. It does transmit. Just not very far. Officially it will transmit six feet. Hah! Maybe on the international space station it will. But you know what? I actually have to wear my pump on the same side of my body that my CGM sensor is on. If I have a sensor in my right leg and clip the pump to my left hip (being left handed, this would be most natural for me) I’ll lose signal. At night, I need to be sure the pump stays down under the covers around my knees. If the pump were between our pillows, where the Dex used to live, it will lose signal.

Oh, as a side note, don’t be adding that little factoid to your list of who’s better and who’s worse: I wore my Dex sensors on my arms, so the signal origin was closer to the headboard. For all I know, if I’d worn Dex sensors on my legs, I might have had the same problem.

Anyway, back to the story. In fact, I’ve got a great lack-of-transmission strength tale for you. I had this patient who was having the worst time with her Revel and CGM—it was always losing signal. We’d been doing leg sets for her, and she’d decided that perhaps there was too much scar tissue from all the shot she took as a kid, because she kept getting “lost sensor” errors. We switched to her arms and everything was suddenly fine. I chalked it up to one of those weird things… until last week.

Now that I’m wearing Med-T CGMs again, I’m keenly aware of the limited signal range, and how easily the signals get blocked. As my patient pulled her Revel out of her bra I snapped my fingers and said, Now I know why the leg sets wouldn’t work for you!

“OK, why?” she asked.

Your boobs are too damn big,* I told her.

She laughed, “No one ever complained before.”

But that was the problem. The combo of skin, tissue, and extra clothing kept leg-set sensor signals from reaching her pump, nestled between her breasts. By moving the sensor sites to her arms, we closed the distance, and the system was working just fine.

*Important clinical note: I feel that as an educator you need, as much as humanly possible, to talk the same language as your patients. This means avoiding Doc-speak, Med-speak, and Anatomy-speak. But it’s equally important not to insult your patient. I pay a great deal of attention to how various patients refer to their own body parts. Then I speak to them in their own language. I felt comfortable telling this girl her boobs were too big because I’d heard her refer to her breasts as “boobs” several times before. On another patient I might have said “tits,” “bust,” “jugs,” “melons,” or the Spanish “chichis.” For an older woman, or one I didn’t know so well, I probably would have fallen back on safe ground and said, “I just realized the problem is that you’re too well-endowed.”

Anyway, out of my office and back into my bedroom (which I know sounds bad following a conversation about women’s breasts), I had solved the problem of seashell to pump communication by keeping them snuggled closely together, but I had a new problem: I live a mile above sea level.

And that means, at night, even in April, it gets damn cold.

Oh, and the second problem is that I have almost no body fat to keep me warm at a night, and as we’ve already covered ad nauseam, I have no bed warmer to keep me company most nights. My solution? One sheet. One comforter. One fluffy polyfil blanket. Not nearly as much fun as boobs that are too damn big, but every bit as effective at choking off CGM sensor signals.

My choice seemed to be to freeze my ass off at night, or not get any Sentry alarms. (No signal to the Outpost means no signal to the Sentry which means no signal to Wil which means the funeral home will have a better month than they thought they would have.

Now I sleep in a bed. Which means I’m off the floor, I dunno… a couple of feet? And the Outpost plugs into the wall, I dunno… four inches off the floor? It’s lower and it’s not line-of-site. And so I began to wonder….

What if?

What if the Outpost were higher? Isn’t that what we all do when we’re broken down on the highway and can’t get cell signal to call Triple-A for help? Stand on the roofs of our cars?

So power drill in hand, I was out to solve the signal problem once and for all. (For those of you who don’t know, mixing me and power tools is historically a recipe for disaster.) But not to worry, this time I just put a couple of screws in the wall to hang a powerstrip from. I debated just how high to climb the wall, so to speak. In the end, tempting as it was to mount the Outpost all the way towards the ceiling for greater around-the-house coverage, intelligence ruled the day, and I recalled that even in the international space station, our best-hope range was six feet. Going too high into the heavens would just make matters worse. In the end I choose:

High enough for line of site. Low enough to keep within six feet of my thigh buried under sheet, comforter, and blanket.

And you know what? It works. It works great. I’ve put an end to nocturnal “lost signal” alarms. It works well enough to get all the data from the pump… including the damn Motor Errors.

Dateline: 1238 hours (that’s 12:38 a.m.) today:
Motor Error.



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